Publications by authors named "Katherine L Tucker"

382 Publications

The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet is associated with physical function and grip strength in older men and women.

Am J Clin Nutr 2021 Oct 12. Epub 2021 Oct 12.

Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA.

Background: Diet quality may be protective of physical function and muscle strength during aging.

Objectives: We aimed to investigate associations of the Mediterranean-Dietary Approaches to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) diet with physical function and grip strength.

Methods: Data were obtained from men and women in the Baltimore Longitudinal Study of Aging (mean ± SD age: 68 ± 14 y at first diet visit; n = 1358). Diet was assessed by FFQ. MIND diet score was calculated from 15 food groups, with a higher score indicating better diet quality; tertile categories of averaged MIND score across visits were used. Physical function was assessed using the Short Physical Performance Battery (SPPB), with a score < 10 indicative of impaired function, and the Health, Aging and Body Composition Physical Performance Battery (HABCPPB). The highest value of grip strength over 3 trials was used. Multivariable logistic and linear mixed-effects models were examined with repeated measurements of physical function and grip strength, respectively.

Results: MIND score was inversely associated with physical function impairment (per 1-point increment: OR: 0.81; 95% CI: 0.71, 0.93; P < 0.01), and with each SPPB component, over a median 6 y of follow-up. Participants in the highest compared with the lowest tertile of MIND diet score had 57% lower odds of functional impairment (OR: 0.43; 95% CI: 0.25, 0.73; P < 0.01), and slower decline by the HABCPPB. Men and women in the highest compared with the lowest tertiles of MIND score had 1.86-kg (95% CI: 0.33, 3.40 kg; P < 0.05) and 1.24-kg (95% CI: 0.04, 2.45 kg; P < 0.05) greater grip strength, respectively.

Conclusions: Adherence to the MIND dietary pattern was associated with lower odds of physical function impairment and decline, and with better muscle strength, indicating that the MIND dietary pattern may be protective of physical functional health in older adults.
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http://dx.doi.org/10.1093/ajcn/nqab310DOI Listing
October 2021

Examination of the allostatic load construct and its longitudinal association with health outcomes in the Boston Puerto Rican Health Study.

Psychosom Med 2021 Sep 24. Epub 2021 Sep 24.

Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. School of Exercise and Nutritional Sciences, San Diego State University, San Diego, California. Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA. Department of Biomedical and Nutritional Sciences, Humanities, and Social Sciences, University of Massachusetts, Lowell, Massachusetts.

Objective: Despite evidence on allostatic load (AL) as a model explaining associations between stress and disease, there is no consensus on its operationalization. This study aimed to contrast various AL constructs and their longitudinal associations with disease and disability.

Methods: Baseline and 5-year follow-up data from 738 adults participating in the Boston Puerto Rican Health Study were used. Five AL scores were created by summing presence of 21 dysregulated multi-system physiological parameters using: (1) z-scores, (2) population-based quartile cutoffs, (3) clinical-based cutoffs, (4) ten pre-selected clinical-based cutoffs (AL-reduced); and (5) twelve clinical-based cutoffs selected a posteriori based on association with disease (AL-select). Adjusted logistic regression models examined associations between each AL score at baseline and 5-year incident type 2 diabetes (T2D), cardiovascular disease (CVD), activities (or instrumental activities) of daily living (ADL; IADL) for physical impairment, and cognitive impairment.

Results: AL-quartile was associated with greater odds of T2D (OR = 1.20; 95%CI = 1.07-1.35) and CVD (OR = 1.14; 95%CI = 1.06-1.22). AL-reduced was associated with higher odds of IADL (OR = 1.21; 95%CI = 1.07-1.37) and AL-clinical with CVD (OR = 1.14; 95%CI = 1.07-1.21), IADL (OR = 1.11; 95%CI = 1.04-1.19), and ADL (OR = 1.15; 95%CI = 1.04-1.26). AL-select showed associations with T2D (OR = 1.35; 95%CI = 1.14-1.61), CVD (OR = 1.21; 95%CI = 1.11-1.32), IADL (OR = 1.15; 95%CI = 1.04-1.26), and ADL, (OR = 1.24; 95%CI = 1.08-1.41). No associations were found with AL-zscore.

Conclusion: AL scores computed with clinical-based cutoffs performed robustly in our sample of mainland Puerto Ricans, whereas z-scores did not predict disease and disability. AL-select was the most consistent predictor, supporting its use as a disease-predicting model. Future assessment of AL-select in other populations may help operationalize AL.
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http://dx.doi.org/10.1097/PSY.0000000000001013DOI Listing
September 2021

Metabolite patterns link diet, obesity, and type 2 diabetes in a Hispanic population.

Metabolomics 2021 Sep 22;17(10):88. Epub 2021 Sep 22.

USDA Agricultural Research Service, Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA.

Introduction: Obesity is a precursor of type 2 diabetes (T2D).

Objectives: Our aim was to identify metabolic signatures of T2D and dietary factors unique to obesity.

Methods: We examined a subsample of the Boston Puerto Rican Health Study (BPRHS) population with a high prevalence of obesity and T2D at baseline (n = 806) and participants (without T2D at baseline) at 5-year follow-up (n = 412). We determined differences in metabolite profiles between T2D and non-T2D participants of the whole sample and according to abdominal obesity status. Enrichment analysis was performed to identify metabolic pathways that were over-represented by metabolites that differed between T2D and non-T2D participants. T2D-associated metabolites unique to obesity were examined for correlation with dietary food groups to understand metabolic links between dietary intake and T2D risk. False Discovery Rate method was used to correct for multiple testing.

Results: Of 526 targeted metabolites, 179 differed between T2D and non-T2D in the whole sample, 64 in non-obese participants and 120 unique to participants with abdominal obesity. Twenty-four of 120 metabolites were replicated and were associated with T2D incidence at 5-year follow-up. Enrichment analysis pointed to three metabolic pathways that were overrepresented in obesity-associated T2D: phosphatidylethanolamine (PE), long-chain fatty acids, and glutamate metabolism. Elevated intakes of three food groups, energy-dense takeout food, dairy intake and sugar-sweetened beverages, associated with 13 metabolites represented by the three pathways.

Conclusion: Metabolic signatures of lipid and glutamate metabolism link obesity to T2D, in parallel with increased intake of dairy and sugar-sweetened beverages, thereby providing insight into the relationship between dietary habits and T2D risk.
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http://dx.doi.org/10.1007/s11306-021-01835-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8458177PMC
September 2021

MIND Diet and Cognitive Function over Eight Years in Puerto Rican Older Adults.

J Gerontol A Biol Sci Med Sci 2021 Sep 22. Epub 2021 Sep 22.

Department of Public Health, University of Massachusetts Lowell.

Background: Healthy diets have been associated with better cognitive function. Socio-economic factors including education, poverty and job complexity may modify the relationship between diet and cognition.

Methods: We used adjusted linear mixed models to examine the association between long-term adherence to the Mediterranean-Dietary Approaches to Stop Hypertension - Intervention for Neurodegenerative Delay (MIND) diet and cognitive function over 8 years of follow-up in Puerto Rican adults residing in the Boston, MA area (aged 45 to 75 years at baseline). We also examined whether the MIND diet - cognition association was confounded or modified by socioeconomic measures.

Results: In both cross-sectional and longitudinal analyses the highest, vs lowest, MIND quintile was associated with better cognition function (ß = 0.093; 95% CI: 0.035, 0.152; P trend = 0.0019), but not with cognitive trajectory over 8 years. Education <=8 th grade (ß = -0.339; 95% CI: 0.394, -0.286; P < 0.0001) and income-to-poverty ratio <120% (ß = -0.049; 95% CI: -0.092, -0.007; P = 0.024) were significantly associated with lower cognitive function, while higher job complexity (ß = 0.008; 95% CI: 0.006, 0.011; P < 0.0001) was associated with better cognition function. These variables acted confounders, but not effect modifiers of the MIND-diet - cognitive function relationship.

Conclusion: Adherence to the MIND diet was associated with better cognitive function at baseline and over 8 years of follow-up, however MIND diet was not associated with 8-year cognitive trajectory. More studies are needed to better understand whether the MIND diet is protective against long-term cognitive decline.
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http://dx.doi.org/10.1093/gerona/glab261DOI Listing
September 2021

Prospective Study of Plant-Based Dietary Patterns and Diabetes in Puerto Rican Adults.

J Nutr 2021 Sep 13. Epub 2021 Sep 13.

Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA.

Background: Vegetarian-type dietary patterns have been associated with reducing the risk of developing diabetes and may function as an effective strategy for diabetes management.

Objectives: We aimed to examine the associations between adherence to plant-based diet indices and the risk of developing diabetes in the Boston Puerto Rican Health Study.

Methods: Puerto Rican adults (n = 646), aged 45-75 y and free of diabetes at baseline, were included. Dietary intake was assessed via a validated FFQ. Three plant-based dietary indices were calculated: an overall plant-based diet index (PDI), a healthful plant-based diet index (hPDI), and an unhealthful plant-based diet index (uPDI). Incident diabetes was defined as fasting plasma glucose ≥ 126 mg/dL (7.0 mmol/L), glycated hemoglobin ≥ 6.5% (48 mmol/mol), or use of hypoglycemic agents during follow-up. Cox proportional hazards were used to evaluate associations between the dietary patterns and incidence of diabetes, adjusting for potential confounders, such as age, sex, socioeconomic status, lifestyle factors, obesity, total energy intake, depressive symptomatology, and plasma concentrations of lipids.

Results: During a mean of 4.2 y of follow-up, we identified 134 diabetes cases. After adjustment for covariates, higher hPDI was associated with lower risk of developing diabetes (adjusted HR for the highest compared with the lowest tertile: 0.54; 95% CI: 0.31, 0.94; P-trend = 0.03). In contrast, the PDI and uPDI were not significantly associated with the risk of diabetes (P-trend > 0.3 for both).

Conclusions: The healthful plant-based dietary index, but not the total plant-based dietary index, was inversely associated with diabetes risk. These findings suggest that the quality of plant-based diets must be considered when recommending plant-based diets for the prevention of diabetes.This trial was registered at clinicaltrials.gov as NCT01231958.
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http://dx.doi.org/10.1093/jn/nxab301DOI Listing
September 2021

Sufficient Plasma Vitamin C Is Related to Greater Bone Mineral Density among Postmenopausal Women from the Boston Puerto Rican Health Study.

J Nutr 2021 Sep 11. Epub 2021 Sep 11.

Department of Biomedical and Nutritional Sciences, Center for Population Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, USA.

Background: Vitamin C may benefit bone as an antioxidant.

Objectives: This cross-sectional study evaluated associations between dietary, supplemental, and plasma vitamin C with bone mineral density (BMD) among Puerto Rican adults.

Methods: Diet was assessed by food-frequency questionnaire (n = 902); plasma vitamin C, measured in fasting blood (n = 809), was categorized as sufficient (≥50 μmol/L), insufficient (20-49 μmol/L), or low (<20 μmol/L). Associations between vitamin C and BMD (measured by DXA) were tested, with false discovery rate correction for multiple comparisons, and interactions by smoking, sex, and estrogen status. Least-squares mean BMDs were compared across tertiles of diet and plasma vitamin C.

Results: Participants' mean age was 59 ± 7 y (range: 46-78 y), 72% were women, mean dietary vitamin C was 95 ± 62 mg/d, and plasma vitamin C ranged from 1.7 to 125 μmol/L. No associations were observed between dietary vitamin C and BMD (P-value range: 0.48-0.96). BMD did not differ by vitamin C supplement use (P-value range: 0.07-0.29). Total femur BMD was higher (P = 0.04) among plasma vitamin C-sufficient participants (mean: 1.06; 95% CI: 1.035, 1.076 g/cm2) compared with low plasma vitamin C participants (1.026; 0.999, 1.052 g/cm2) in adjusted models. Findings at the trochanter were similar (P = 0.04). Postmenopausal women without estrogen therapy, with sufficient plasma vitamin C, showed greater total femur BMD (1.004 ± 0.014 g/cm2) compared to those with low plasma vitamin C (0.955 ± 0.017 g/cm2; P = 0.001). Similar findings were observed at the trochanter (P < 0.001). No significant associations were observed among premenopausal women or those with estrogen therapy or men. Interactions with smoking status were not significant.

Conclusions: Dietary vitamin C was not associated with BMD. Low plasma vitamin C, compared with sufficiency, was associated with lower hip BMD, particularly among postmenopausal women without estrogen therapy. Future research is needed to determine whether vitamin C status is associated with change in BMD or reduction in fracture risk.
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http://dx.doi.org/10.1093/jn/nxab291DOI Listing
September 2021

Lower dietary intake of magnesium is associated with more callous-unemotional traits in children.

Nutr Neurosci 2021 Sep 3:1-10. Epub 2021 Sep 3.

School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.

Background: Although researchers increasingly recognize the role of nutrition in mental health, little research has examined specific micronutrient intake in relation to antisocial behavior and callous-unemotional (CU) traits in children. Vitamin B and magnesium are involved in neurochemical processes implicated in modulating antisocial behavior and CU traits. The current study examined dietary intakes of magnesium and vitamin B in relation to antisocial behavior and CU traits.

Method: We enrolled 11-12 year old children ( = 446, mean age = 11.9 years) participating in the Healthy Brains and Behavior Study. Magnesium and vitamin B dietary intake were assessed with three 24-hour dietary recall interviews in children. CU traits and antisocial behavior were assessed by caregiver-reported questionnaires. We controlled for age, sex, race, total energy intake, body mass index, social adversity, ADHD or learning disability diagnosis, and internalizing behavior in all regression analyses.

Results: Children with lower magnesium intake had higher levels of CU traits, controlling for covariates (β= -0.18,  = -0.0066,  = 0.0027,  < 0.05). Vitamin B intake was not significantly associated with CU traits (β= 0.061,  = 0.19,  = 0.20,  > 0.05). Neither magnesium (β= 0.014,  = 0.0020,  = 0.0093,  > 0.05) nor vitamin B (β= 0.025,  = 0.33,  = 0.70,  > 0.05) were significantly associated with antisocial behavior.

Conclusions: Findings suggest that low dietary intake of magnesium may play a role in the etiology of CU traits but not general antisocial behavior. More studies are needed to determine if magnesium supplementation or diets higher in magnesium could improve CU traits in children.
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http://dx.doi.org/10.1080/1028415X.2021.1963064DOI Listing
September 2021

Associations between dietary fatty acid patterns and cognitive function in the Hispanic Community Health Study/Study of Latinos.

Br J Nutr 2021 Aug 26:1-35. Epub 2021 Aug 26.

Department of Agriculture Nutrition and Food Systems, University of New Hampshire.

Our objective was to quantify the cross-sectional associations between dietary fatty acid (DFA) patterns and cognitive function among Hispanic/Latino adults. This study included data from 8,942 participants of the Hispanic Community Health Study/Study of Latinos, a population-based cohort study (weighted age 56.2 y and proportion female 55.2%). The NCI (National Cancer Institute) method was used to estimate dietary intake from two 24-hr recalls. We derived DFA patterns using principal components analysis with 26 fatty acid and total plant and animal monounsaturated fatty acid (MUFA) input variables. Global cognitive function was calculated as the average z-score of 4 neurocognitive tests. Survey linear regression models included multiple potential confounders such as age, sex, education, depressive symptoms, physical activity, energy intake, and cardiovascular disease. DFA patterns were characterized by consumption of long-chain saturated fatty acids (SFA), animal-based MUFA, and trans fatty acids (Factor 1); short to medium-chain SFA (Factor 2); very-long-chain omega-3 polyunsaturated fatty acids (PUFA) (Factor 3); very-long-chain SFA and plant-based MUFA and PUFA (Factor 4). Factor 2 was associated with greater scores for global cognitive function (β=0.037 ± 0.012) and the Digit Symbol Substitution (DSS) (β=0.56±0.17), Brief Spanish English Verbal Learning-Sum (B-SEVLT) (β=0.23 ± 0.11), and B-SEVLT-Recall (β=0.11 ± 0.05) tests (P<0.05 for all). Factors 1 (β=0.04 ± 0.01) and 4 (β=0.70 ± 0.18) were associated with the DSS test (P<0.05 for all). Consumption of short to medium-chain SFA may be associated with higher cognitive function among U.S.-residing Hispanic/Latino adults. Prospective studies are necessary to confirm these findings.
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http://dx.doi.org/10.1017/S0007114521003275DOI Listing
August 2021

Associations of network-derived metabolite clusters with prevalent type 2 diabetes among adults of Puerto Rican descent.

BMJ Open Diabetes Res Care 2021 08;9(1)

Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Introduction: We investigated whether network analysis revealed clusters of coregulated metabolites associated with prevalent type 2 diabetes (T2D) among Puerto Rican adults.

Research Design And Methods: We used liquid chromatography-mass spectrometry to measure fasting plasma metabolites (>600) among participants aged 40-75 years in the Boston Puerto Rican Health Study (BPRHS; discovery) and San Juan Overweight Adult Longitudinal Study (SOALS; replication), with (n=357; n=77) and without (n=322; n=934) T2D, respectively. Among BPRHS participants, we used unsupervised partial correlation network-based methods to identify and calculate metabolite cluster scores. Logistic regression was used to assess cross-sectional associations between metabolite clusters and prevalent T2D at the baseline blood draw in the BPRHS, and significant associations were replicated in SOALS. Inverse-variance weighted random-effect meta-analysis was used to combine cohort-specific estimates.

Results: Six metabolite clusters were significantly associated with prevalent T2D in the BPRHS and replicated in SOALS (false discovery rate (FDR) <0.05). In a meta-analysis of the two cohorts, the OR and 95% CI (per 1 SD increase in cluster score) for prevalent T2D were as follows for clusters characterized primarily by glucose transport (0.21 (0.16 to 0.30); FDR <0.0001), sphingolipids (0.40 (0.29 to 0.53); FDR <0.0001), acyl cholines (0.35 (0.22 to 0.56); FDR <0.0001), sugar metabolism (2.28 (1.68 to 3.09); FDR <0.0001), branched-chain and aromatic amino acids (2.22 (1.60 to 3.08); FDR <0.0001), and fatty acid biosynthesis (1.54 (1.29 to 1.85); FDR <0.0001). Three additional clusters characterized by amino acid metabolism, cell membrane components, and aromatic amino acid metabolism displayed significant associations with prevalent T2D in the BPRHS, but these associations were not replicated in SOALS.

Conclusions: Among Puerto Rican adults, we identified several known and novel metabolite clusters that associated with prevalent T2D.
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http://dx.doi.org/10.1136/bmjdrc-2021-002298DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8378385PMC
August 2021

Dietary Patterns in Latinx Groups.

J Nutr 2021 Sep;151(9):2505-2506

Department of Biomedical and Nutritional Sciences and Center for Population Health, University of Massachusetts Lowell, Lowell, MA, USA.

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http://dx.doi.org/10.1093/jn/nxab225DOI Listing
September 2021

Skin Tone, Discrimination, and Allostatic Load in Middle-Aged and Older Puerto Ricans.

Psychosom Med 2021 Sep;83(7):805-812

From the Department of Community Health (Cuevas, Chan, Carvalho, Flores) Tufts University, Medford; Boston College William F. Connell School of Nursing (Abuelezam), Chestnut Hill, Massachusetts; Graduate School of Social Work (Wang), University of Denver, Denver, Colorado; Department of Nutrition (Mattei), Harvard T.H. Chan School of Public Health, Boston; and Department of Biomedical and Nutritional Sciences (Tucker) and College of Fine Arts, Humanities and Social Sciences (Falcon), University of Massachusetts Lowell, Massachusetts.

Objective: A growing body of research suggests that skin tone may be a health risk indicator for Hispanics. Black and darker-skinned Hispanics have worse mental and physical outcomes than White and lighter-skinned Hispanics. Discrimination exposure has been implicated as a risk factor that may explain the association between skin tone and health. However, there is scant research examining the interrelationship between skin tone, discrimination, and health, particularly among Puerto Ricans. We examine the interrelationships between two measures of skin tone, two measures of discrimination, and allostatic load (AL) among Puerto Rican adults.

Methods: Using cross-sectional data from wave 3 of the Boston Puerto Rican Health Study (n = 882), we examined the indirect association (IA) of skin tone on physiological dysregulated systems, also known as AL, through major discrimination and everyday discrimination. We tested these associations using two distinct measures of skin tone: interviewer-ascribed skin tone and spectrophotometer-measured skin tone.

Results: Interviewer-ascribed skin tone was indirectly associated with AL through major discrimination (IA = 0.03, 95% confidence interval = 0.004 to 0.06). However, there was no evidence of an IA of interviewer-ascribed skin tone on AL through everyday discrimination (IA = -0.01, 95% confidence interval = -0.03 to 0.01). In addition, there was no evidence that spectrophotometer-measured skin tone was indirectly associated with AL through major discrimination or everyday discrimination.

Conclusions: The sociocultural significance of skin tone may affect how Puerto Ricans are perceived and treated by others, which can, in turn, have physiological health consequences. Future research is needed to replicate these findings and examine the interrelationship between skin tone, discrimination, and other health outcomes.
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http://dx.doi.org/10.1097/PSY.0000000000000969DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8419137PMC
September 2021

A guide for authors and readers of the American Society for Nutrition Journals on the proper use of P values and strategies that promote transparency and improve research reproducibility.

Am J Clin Nutr 2021 10;114(4):1280-1285

Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA.

Two questions regarding the scientific literature have become grist for public discussion: 1) what place should P values have in reporting the results of studies? 2) How should the perceived difficulty in replicating the results reported in published studies be addressed? We consider these questions to be 2 sides of the same coin; failing to address them can lead to an incomplete or incorrect message being sent to the reader. If P values (which are derived from the estimate of the effect size and a measure of the precision of the estimate of the effect) are used improperly, for example reporting only significant findings, or reporting P values without account for multiple comparisons, or failing to indicate the number of tests performed, the scientific record can be biased. Moreover, if there is a lack of transparency in the conduct of a study and reporting of study results, it will not be possible to repeat a study in a manner that allows inferences from the original study to be reproduced or to design and conduct a different experiment whose aim is to confirm the original study's findings. The goal of this article is to discuss how P values can be used in a manner that is consistent with the scientific method, and to increase transparency and reproducibility in the conduct and analysis of nutrition research.
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http://dx.doi.org/10.1093/ajcn/nqab223DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8488872PMC
October 2021

Association between egg consumption and arterial stiffness: a longitudinal study.

Nutr J 2021 07 13;20(1):67. Epub 2021 Jul 13.

Department of Nutritional Sciences, The Pennsylvania State University, 109 Chandlee Lab, University Park, State College, PA, 16802, USA.

Background: Inconsistent associations between egg consumption and cardiovascular disease (CVD) risk have been observed in previous studies. This study aims to longitudinally investigate the association between egg consumption and altered risk of arterial stiffness, a major pre-clinical pathogenic change of CVD, which was assessed by brachial-ankle pulse wave velocity (baPWV).

Methods: A total of 7315 Chinese participants from the Kailuan Study, free of CVD and cancer were included in this study. Egg consumption was assessed by a semi-quantitative validated food frequency questionnaire in 2014. baPWV was repeatedly measured at baseline and during follow-up (mean follow-up: 3.41 years). General linear regression was used to calculate means of baPWV change rate across different egg consumption groups, adjusting for age, sex, baseline baPWV, healthy eating index, total energy, social-economic status, blood pressure, obesity, smoking, lipid profiles, and fasting glucose concentrations.

Results: Compared to the annual baPWV change rate in participants with 0-1.9 eggs/wk. (adjusted mean: 35.9 ± 11.2 cm/s/y), those consuming 3-3.9 eggs/wk. (adjusted mean: 0.2 ± 11.4 cm/s/y) had the lowest increase in baPWV during follow-up (P-difference = 0.002). Individuals with low (0-1.9 eggs/wk) vs. high (5+ eggs /wk) egg intake showed similar changes in baPWV.

Conclusions: In this large-scale longitudinal analysis, we did not find a significant difference in arterial stiffness, as assessed by baPWV level, between low and high egg consumption groups. However, moderate egg consumption (3-3.9 eggs/wk) appeared to have beneficial effects on arterial stiffness.
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http://dx.doi.org/10.1186/s12937-021-00720-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8278728PMC
July 2021

Association of physical activity on memory interference: Boston Puerto Rican Health Study.

Health Promot Perspect 2021 19;11(2):256-260. Epub 2021 May 19.

Center for Population Health, Biomedical & Nutritional Sciences, University of Massachusetts Lowell, Lowell, Ma, USA.

: The objective of this study was to evaluate the association between habitual physical activity engagement on memory interference. The present analysis used cross-sectional data from the Boston Puerto Rican Health Study (n=1,241; mean age= 57.2; 72.1% female). : Physical activity was evaluated via self-report. Memory interference was evaluated using a word-list paradigm. The memory task included learning a list of 16 words (List A; 5 trials), followed by a distractor list (List B), and then an immediate recall of List A. Proactive interference occurs when preceding stimuli (e.g., Trial 1 and Trial 5 of List A) interferes with performance on a subsequent stimuli (List B). Retroactive interference occurs when subsequent stimuli (List B) interferes with the recall of previously encoded stimuli (Trial 5). : For proactive interference, there was no association between physical activity and the difference between performance on List B and Trial 1 of List A (β=0.00001; =0.96). Similarly, for retroactive interference, there was no association between physical activity and the difference between the short delay recall and Trial 5 of List A (β=0.0002; P=0.50). : The present study did not observe an association between habitual physical activity on attenuating memory interference.
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http://dx.doi.org/10.34172/hpp.2021.31DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233684PMC
May 2021

Short-Term Postpartum Blood Pressure Self-Management and Long-Term Blood Pressure Control: A Randomized Controlled Trial.

Hypertension 2021 Aug 28;78(2):469-479. Epub 2021 Jun 28.

Radcliffe Department of Medicine Division of Cardiovascular Medicine, Cardiovascular Clinical Research Facility (J.K., H.B., Y.K., A.M., K.S., A.J.L., P.L.), University of Oxford, United Kingdom.

[Figure: see text].
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http://dx.doi.org/10.1161/HYPERTENSIONAHA.120.17101DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8260340PMC
August 2021

Specific Dietary Protein Sources Are Associated with Cardiometabolic Risk Factors in the Boston Puerto Rican Health Study.

J Acad Nutr Diet 2021 Jun 15. Epub 2021 Jun 15.

Background: Puerto Rican adults residing in the US mainland experience a high prevalence of metabolic syndrome (MetS). A diet containing healthy protein-rich sources may help control risk factors for MetS.

Objective: This study aimed to evaluate 2-year longitudinal associations between intake of various protein-rich foods and changes in the six MetS components.

Design: This is a secondary analysis of a longitudinal cohort study using data from the baseline (2004-2007) and 2-year follow-up visits (2006-2011) in the Boston Puerto Rican Health Study.

Participants/setting: Participants were self-identified Puerto Ricans, aged 45 to 75 years, residing in Boston, Massachusetts, or the surrounding area (n = 1,126).

Main Outcome Measures: MetS components were fasting glucose, high-density lipoprotein (HDL) cholesterol, triglycerides, systolic and diastolic blood pressures, and waist circumference.

Statistical Analysis: Baseline intake of foods reported in a semiquantitative food frequency questionnaire were expressed as servings/day, and protein-rich foods were categorized as unprocessed white meat, unprocessed red meat, processed meat, milk and yogurt, cheese, fish and seafood, beans, nuts, and eggs. Associations between each continuous protein food group and continuous 2-year change in MetS components were assessed using linear mixed models adjusted for socioeconomic and behavioral factors, and other dietary sources.

Results: The top contributors to total protein intake were unprocessed red meat (13.3%) and unprocessed poultry (13.0%), and the lowest were eggs (2.92%) and nuts (0.91%). Higher intake of processed meats was associated with an increase in waist circumference over 2 years (β = 1.28; standard error [SE] = 0.63), whereas higher intake of fish and seafood was associated with a decrease in waist circumference (β = -3.47; SE = 1.39). Intake of unprocessed poultry was associated with a decrease in triglycerides (β = -24.5; SE = 9.13). No other significant associations were observed between protein sources and 2-year changes in MetS components.

Conclusions: Consuming less processed meat and more fish and seafood and unprocessed poultry was associated with decreases in waist circumference and triglycerides among US mainland Puerto Ricans. Other dietary protein sources were not related to cardiometabolic health.
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http://dx.doi.org/10.1016/j.jand.2021.05.020DOI Listing
June 2021

"You Probably Won't Notice Any Symptoms": Blood Pressure in Pregnancy-Discourses of Contested Expertise in an Era of Self-Care and Responsibilization.

Qual Health Res 2021 07 11;31(9):1632-1644. Epub 2021 Jun 11.

University of Aberdeen, Aberdeen, United Kingdom.

Pregnancy is not a disease or illness, but requires clinical surveillance as life-threatening complications can develop. Preeclampsia, one such potentially serious complication, puts both mother and baby at risk. Self-monitoring blood pressure in the general population is well established, and its potential in pregnancy is currently being explored. In the context of self-monitoring, the information and guidance given to women regarding hypertension, and the literature they themselves seek out during pregnancy, are vital to perceptions of disease risk and subsequent responses to, and management of, any symptoms. Drawing on online, offline, official, and unofficial sources of information, discourses are examined to provide analysis of how self-responsibilization is reflected in contemporary information, advice, and guidance drawn from multiple sources. A paradox emerges between the paternalistic and lay discourses that seek to challenge and regain control. Findings are discussed in the context of Foucault's governmentality and medical power.
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http://dx.doi.org/10.1177/10497323211003067DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8438769PMC
July 2021

Application of a Lifestyle-Based Score to Predict Cardiovascular Risk in African Americans: The Jackson Heart Study.

J Clin Med 2021 May 22;10(11). Epub 2021 May 22.

Division of Endocrinology, Diabetes and Metabolism, The Ohio State University Wexner Medical Center, 579 McCampbell Hall, 1581 Dodd Drive, Columbus, OH 43210, USA.

Cardiovascular disease (CVD) primordial prevention tools applicable to diverse populations are scarce. Our aim was to assess the performance of a lifestyle-based tool to estimate CVD risk in an African American population. The Jackson Heart Study is a prospective cohort including 5306 African American participants in Jackson, Mississippi (2000-2004), with a mean follow up of 12 years. The Healthy Heart Score is a lifestyle-based CVD risk prediction model based on nine components: body mass index (BMI), physical activity, smoking, and a 5-component diet score. Gender-specific beta coefficients from its derivation cohorts were used to assess the performance of the Healthy Heart Score. Model discrimination was assessed using Harrell's C-Index for survival data and time dependent Area Under the Curve. Model calibration was evaluated through calibration plots. A total of 189 CVD events occurred. The Healthy Heart Score showed high-moderate discrimination for CVD events (C-statistic 0.75 [95% CI, 0.71-0.78]) but with little improvement over the age-only model. Both the age-only and Healthy Heart Score models had better performance in participants without diabetes at baseline and showed good calibration. In African Americans, the Healthy Heart Score does not improve prediction of mid-life CVD events beyond what is obtained by age alone.
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http://dx.doi.org/10.3390/jcm10112252DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8196953PMC
May 2021

Associations between diet quality scores and central obesity among adults in Puerto Rico.

J Hum Nutr Diet 2021 May 14. Epub 2021 May 14.

Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Background: Adults in Puerto Rico experience an excessive burden of central obesity. It remains unknown which dietary components are more strongly associated with central obesity in this high-risk group. We aimed to evaluate the relationship of the Mediterranean diet (MeDS) and Alternate Healthy Eating Index 2010 (AHEI) with central obesity in the Puerto Rico Assessment of Diet, Lifestyle and Diseases (PRADLAD) cross-sectional study.

Methods: Data from PRADLAD participants (ages 30-75 years) were used (n = 166). Dietary intake was assessed by food frequency questionnaire. The MeDS [nine components; range: 0 (lowest) to 9 (highest observance of a Mediterranean-like diet)] and AHEI [11 components; range: 0 (lowest) to 110 (highest diet quality)] were defined. Daily intake of foods and beverages within each MeDS component was ranked by contribution to total energy intake. Multivariable logistic regression was used to evaluate associations between MeDS and AHEI with central obesity (waist circumference > 102 cm males, > 88 cm females).

Results: Mean ± SD MeDS was 4.46 ± 1.77 and AHEI was 60.2 ± 11.1. Traditional foods representative of the MeDS included potatoes, root vegetables, fruit juice, avocados, bread, oatmeal, beans, chicken, seafood, low-fat milk, cheese, eggs and beer. Adjusted odds ratios and 95% confidence intervals of central obesity were 0.78 (0.63-0.97) per unit increment of MeDS and 0.61 (0.42-0.90) per 10-unit increment of AHEI.

Conclusions: Higher adherence to MeDS or AHEI was associated with lower central obesity in adults in Puerto Rico. Consuming traditional foods reflecting these dietary patterns (i.e., Mediterranean-like) may reduce central obesity in high-risk populations.
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http://dx.doi.org/10.1111/jhn.12873DOI Listing
May 2021

Risk Factors Associated with Vitamin D Status among Older Puerto Rican Adults.

J Nutr 2021 04;151(4):999-1007

Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA.

Background: Vitamin D deficiency has been associated with health problems globally, but there is limited information on vitamin D status and associated risk factors among adults in underserved populations.

Objective: This study aimed to identify risk factors for vitamin D deficiency/insufficiency among Puerto Rican adults from the Boston Puerto Rican Health Study (BPRHS).

Methods: A total of 822 adults (45-75 y, at baseline) were included in these analyses. Deficiency was defined as serum 25-hydroxyvitamin D [25(OH)D] <30 and insufficiency as 30 to <50 nmol/L. Dietary intake was assessed with a validated FFQ. Associations between risk factors, including dietary vitamin D, supplement use, ancestry, skin pigmentation, months in the past year spent in a southern climate, and serum 25(OH)D were assessed with multivariable general linear models.

Results: Approximately 13% of participants were deficient in 25(OH)D and another 43% insufficient. Skin pigment was associated with 25(OH)D using 3 measures, greater African ancestry (β ± SE) (-7.74 ± 2.91, P = 0.01); interviewer assessed dark or medium, compared with white, skin tone, (-5.09 ± 2.19, P = 0.02 and -5.89 ± 1.58, P < 0.001, respectively); and melanin index of the upper inner right arm, assessed using a spectrophotometer (-2.04 ± 0.84, P = 0.02). After adjusting for ancestry, factors associated with lower serum 25(OH)D included smoking (-4.49 ± 1.58, P = 0.01); BMI (-0.21 ± 0.10, P = 0.04); and spring compared with autumn blood draw (-4.66 ± 1.68, P = 0.004). Factors associated with higher serum 25(OH)D included female sex compared with male (4.03 ± 1.58, P = 0.01); dietary vitamin D intake μg/d (0.71 ± 0.25, P < 0.004); vitamin D supplement use (4.50 ± 1.87, P = 0.02); income to poverty ratio (0.01 ± 0.01, P = 0.06), and months in a southern climate during the past year (0.96 ± 0.56, P = 0.09).

Conclusions: Vitamin D deficiency/insufficiency was prevalent in this Puerto Rican population living in the northeastern USA. Several factors were associated with this, which may assist in identifying those at risk. Interventions are needed to improve serum 25(OH)D concentration, particularly among those with limited exposure to sunlight.
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http://dx.doi.org/10.1093/jn/nxaa426DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030721PMC
April 2021

Metabolomic Markers of Southern Dietary Patterns in the Jackson Heart Study.

Mol Nutr Food Res 2021 04 11;65(8):e2000796. Epub 2021 Mar 11.

Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.

Scope: New biomarkers are needed that are representative of dietary intake.

Methods And Results: We assess metabolites associated with Southern dietary patterns in 1401 Jackson Heart Study participants. Three dietary patterns are empirically derived using principal component analysis: meat and fast food, fish and vegetables, and starchy foods. We randomly select two subsets of the study population: two-third sample for discovery (n = 934) and one-third sample for replication (n = 467). Among the 327 metabolites analyzed, 14 are significantly associated with the meat and fast food dietary pattern, four are significantly associated with the fish and vegetables dietary pattern, and none are associated with the starchy foods dietary pattern in the discovery sample. In the replication sample, nine remain associated with the meat and fast food dietary pattern [indole-3-propanoic acid, C24:0 lysophosphatidylcholine (LPC), N-methyl proline, proline betaine, C34:2 phosphatidylethanolamine (PE) plasmalogen, C36:5 PE plasmalogen, C38:5 PE plasmalogen, cotinine, hydroxyproline] and three remain associated with the fish and vegetables dietary pattern [1,7-dimethyluric acid, C22:6 lysophosphatidylethanolamine, docosahexaenoic acid (DHA)].

Conclusion: Twelve metabolites are discovered and replicated in association with dietary patterns detected in a Southern U.S. African-American population, which could be useful as biomarkers of Southern dietary patterns.
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http://dx.doi.org/10.1002/mnfr.202000796DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8192080PMC
April 2021

The Impact of a Randomized Controlled Trial of a Lifestyle Intervention on Sleep Among Latina Postpartum Women.

Ann Behav Med 2021 Aug;55(9):892-903

Department of Biostatistics and Epidemiology, University of Massachusetts, Amherst, MA, USA.

Background: Poor sleep is associated with adverse outcomes among postpartum women. Exercise may improve sleep, but this has not been well examined in the postpartum period.

Purpose: To examine the impact of a culturally modified, individually tailored lifestyle intervention on sleep outcomes among postpartum Latina women.

Methods: Estudio PARTO was a randomized controlled trial aimed at reducing Type 2 diabetes among Latina women with abnormal glucose tolerance in pregnancy. Participants were randomized to a lifestyle (i.e., diet and exercise; n = 70) or a health and wellness control intervention (n = 78) in late pregnancy (baseline). The Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality (PSQI score), onset latency (minutes per night), duration (hours per night), efficiency (percentage of the time in bed asleep), and daytime dysfunction at baseline, 6 weeks, 6 months, and 12 months postpartum.

Results: Mean PSQI score (6.56 ± 3.87), sleep duration (6.84 ± 1.75 hr/night), and sleep efficiency (79.70% ± 18.10%) did not differ between the arms at baseline. Mixed-effects models indicated a greater decrease of 1.29 in PSQI score (i.e., improved sleep quality) in the lifestyle versus health and wellness arm (95% confidence interval [CI] = -2.50 to -0.08, p = .04) over follow-up. There was the suggestion of a smaller decrease in sleep duration (mean = 0.48 hr/night, 95% CI = -0.10 to 1.06, p = .10) in the lifestyle versus health and wellness arm. There were no statistically significant differences in other sleep outcomes between arms.

Conclusions: Findings suggest that lifestyle interventions improve sleep quality but not sleep duration, sleep onset latency, sleep efficiency, or daytime dysfunction in postpartum Latina women and, therefore, may hold promise for improving subsequent mental and physical health in this population.

Clinical Trials Registration: NCT01679210.
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http://dx.doi.org/10.1093/abm/kaaa118DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8382142PMC
August 2021

Patterns of change in cardiovascular risk assessments and ankle brachial index among Puerto Rican adults.

PLoS One 2021 20;16(1):e0245236. Epub 2021 Jan 20.

Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, Massachusetts, United States of America.

Background: Puerto Rican adults have higher odds of peripheral artery disease (PAD) compared with Mexican Americans. Limited studies have examined relationships between clinical risk assessment scores and ABI measures in this population.

Methods: Using 2004-2015 data from the Boston Puerto Rican Health Study (BPRHS) (n = 370-583), cross-sectional, 5-y change, and patterns of change in Framingham Risk Score (FRS) and allostatic load (AL) with ankle brachial index (ABI) at 5-y follow-up were assessed among Puerto Rican adults (45-75 y). FRS and AL were calculated at baseline, 2-y and 5-y follow-up. Multivariable linear regression models were used to examine cross-sectional and 5-y changes in FRS and AL with ABI at 5-y. Latent growth mixture modeling identified trajectories of FRS and AL over 5-y, and multivariable linear regression models were used to test associations between trajectory groups at 5-y.

Results: Greater FRS at 5-y and increases in FRS from baseline were associated with lower ABI at 5-y (β = -0.149, P = 0.010; β = -0.171, P = 0.038, respectively). AL was not associated with ABI in cross-sectional or change analyses. Participants in low-ascending (vs. no change) FRS trajectory, and participants in moderate-ascending (vs. low-ascending) AL trajectory, had lower 5-y ABI (β = -0.025, P = 0.044; β = -0.016, P = 0.023, respectively).

Conclusions: FRS was a better overall predictor of ABI, compared with AL. Puerto Rican adults, an understudied population with higher FRS over 5 years, may benefit from intensive risk factor modification to reduce risk of PAD. Additional research examining relationships between FRS and AL and development of PAD is warranted.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0245236PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817056PMC
May 2021

Depressive symptoms and allostatic load have a bidirectional association among Puerto Rican older adults.

Psychol Med 2021 Jan 14:1-13. Epub 2021 Jan 14.

Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Background: Depression is strongly associated with chronic disease; yet, the direction of this relationship is poorly understood. Allostatic load (AL) provides a framework for elucidating depression-disease pathways. We aimed to investigate bidirectional, longitudinal associations of baseline depressive symptoms or AL with 5-year AL or depressive symptoms, respectively.

Methods: Data were from baseline, 2-year, and 5-year visits of 620 adults (45-75 years) enrolled in the Boston Puerto Rican Health Study. The Center for Epidemiology Studies Depression (CES-D) scale (0-60) captured depressive symptoms, which were categorized at baseline as low (<8), subthreshold (8-15), or depression-likely (⩾16) symptoms. AL was calculated from 11 parameters of biological functioning, representing five physiological systems. Baseline AL scores were categorized by the number of dysregulated parameters: low (0-2), moderate (3-5), or high (⩾6) AL. Multivariable, multilevel random intercept and slope linear regression models were used to examine associations between 3-category baseline CES-D score and 5-year continuous AL score, and between baseline 3-category AL and 5-year continuous CES-D score.

Results: Baseline subthreshold depressive symptoms [(mean (95% CI)): 4.8 (4.5-5.2)], but not depression-likely symptoms [4.5 (4.2-4.9)], was significantly associated with higher 5-year AL scores, compared to low depressive symptoms [4.3 (3.9-4.7)]. Baseline high AL [19.4 (17.6-21.2)], but not low AL [18.5 (16.5-20.6)], was significantly associated with higher 5-year CES-D score, compared to baseline moderate AL [16.9 (15.3-18.5)].

Conclusions: Depressive symptoms and AL had a bi-directional relationship over time, indicating a nuanced pathway linking depression with chronic diseases among a minority population.
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http://dx.doi.org/10.1017/S0033291720005139DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8277900PMC
January 2021

Current prevalence of self-monitoring of blood pressure during pregnancy: the BUMP Survey.

J Hypertens 2021 05;39(5):994-1001

Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.

Objective: To understand the current prevalence of, and attitudes to, self-monitoring of blood pressure (BP) during pregnancy.

Methods: Five thousand, five hundred and fifty-five pregnant women from antenatal clinics in 16 hospitals in England were invited to complete a survey.

Main Outcome Measures: The primary outcome was the proportion of women currently BP self-monitoring. Secondary outcomes included self-monitoring schedules and women's interactions with clinicians regarding self-monitoring. Population characteristics including risk factors for preeclampsia, ethnicity and deprivation level were considered.

Results: Completed surveys were received and analysed from 5181 pregnant women (93% response rate). Comparison to hospital demographic data suggests that respondents were representative of the UK population. Nine hundred and eighty-three of 5181 (19%) women were currently self-monitoring their BP, constituting 189 of 389 (49%) hypertensive women and 794 of 4792 (17%) normotensive women. However, only 482 of 983 (49%) reported ever sharing this information with antenatal care teams. Of those who self-monitored, 68% (668/983) were able to provide a previous BP reading, compared with 1% (67/5181) of those who did not self-monitor.

Conclusion: Many women are now choosing to self-monitor their BP during pregnancy and clinicians should enquire about this proactively and consider providing better information on BP monitoring. Those who self-monitor appear to have better knowledge about their blood pressure. If these findings were replicated nationwide, around 125 000 pregnant women would be currently self-monitoring BP in the UK, yet only half of these women may communicate their readings to their antenatal care teams, suggesting a missed opportunity for enhanced care. Current trials will make the place of self-monitoring in pregnancy clearer.
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http://dx.doi.org/10.1097/HJH.0000000000002734DOI Listing
May 2021

High fructose corn syrup, excess-free-fructose, and risk of coronary heart disease among African Americans- the Jackson Heart Study.

BMC Nutr 2020 Dec 8;6(1):70. Epub 2020 Dec 8.

Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA.

Background: Researchers have sought to explain the black-white coronary heart disease (CHD) mortality disparity that increased from near parity to ~ 30% between 1980 and 2010. Contributing factors include cardiovascular disease prevention and treatment disparities attributable to disparities in insurance coverage. Recent research suggests that dietary/environmental factors may be contributors to the disparity. Unabsorbed/luminal fructose alters gut bacterial load, composition and diversity. There is evidence that such microbiome disruptions promote hypertension and atherosclerosis. The heart-gut axis may, in part, explain the black-white CHD disparity, as fructose malabsorption prevalence is higher among African Americans. Between 1980 and 2010, consumption of excess-free-fructose-the fructose type that triggers malabsorption-exceeded dosages associated with fructose malabsorption (~ 5 g-10 g), as extrapolated from food availability data before subjective, retroactively-applied loss adjustments. This occurred due to an industrial preference shift from sucrose to high-fructose-corn-syrup (HFCS) that began ~ 1980. During this period, HFCS became the main sweetener in US soda. Importantly, there has been more fructose in HFCS than thought, as the fructose-to-glucose ratio in popular sodas (1.9-to-1 and 1.5-to-1) has exceeded generally-recognized-as-safe levels (1.2-to-1). Most natural foods contain a ~ 1-to-1 ratio. In one recent study, ≥5 times/wk. consumers of HFCS sweetened soda/fruit drinks/and apple juice-high excess-free-fructose beverages-were more likely to have CHD, than seldom/never consumers.

Methods: Jackson-Heart-Study data of African Americans was used to test the hypothesis that regular relative to low/infrequent intake of HFCS sweetened soda/fruit drinks increases CHD risk, but not orange juice-a low excess-free-fructose juice. Cox proportional hazards models were used to calculate hazard ratios using prospective data of 3407-3621 participants, aged 21-93 y (mean 55 y).

Results: African Americans who consumed HFCS sweetend soda 5-6x/wk. or any combination of HFCS sweetened soda and/or fruit drinks ≥3 times/day had ~ 2 (HR 2.08, 95% CI 1.03-4.20, P = 0.041) and 2.5-3 times higher CHD risk (HR 2.98, 95% CI 1.15-7.76; P = 0.025), respectively, than never/seldom consumers, independent of confounders. There were no associations with diet-soda or 100% orange-juice, which has a similar glycemic profile as HFCS sweetened soda, but contains a ~ 1:1 fructose-to-glucose ratio.

Conclusion: The ubiquitous presence of HFCS in the food supply may pre-dispose African Americans to increased CHD risk.
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http://dx.doi.org/10.1186/s40795-020-00396-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7722296PMC
December 2020

Diet-derived fruit and vegetable metabolites show sex-specific inverse relationships to osteoporosis status.

Bone 2021 03 2;144:115780. Epub 2020 Dec 2.

USDA Agricultural Research Service, Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, Boston, MA 02111, USA.

Background: The impact of nutrition on the metabolic profile of osteoporosis (OS) is unknown.

Objective: Identify biochemical factors driving the association of fruit and vegetable (FV) intakes with OS prevalence using an untargeted metabolomics approach.

Design: Cross-sectional dietary, anthropometric and plasma metabolite data were examined from the Boston Puerto Rican Osteoporosis Study, n = 600 (46-79 yr).

Methods: Bone mineral density was assessed by DXA. OS was defined by clinical standards. A culturally adapted FFQ assessed usual dietary intake. Principal components analysis (PCA) of 42 FV items created 6 factors. Metabolomic profiles derived from plasma samples were assessed on a commercial platform. Differences in levels of 525 plasma metabolites between disease groups (OS vs no-OS) were compared using logistic regression; and associations with FV intakes by multivariable linear regression, adjusted for covariates. Metabolites significantly associated with OS status or with total FV intake were analyzed for enrichment in various biological pathways using Mbrole 2.0, MetaboAnalyst, and Reactome, using FDR correction of P-values. Correlation coefficients were calculated as Spearman's rho rank correlations, followed by hierarchical clustering of the resulting correlation coefficients using PCA FV factors and sex-specific sets of OS-associated metabolites.

Results: High FV intake was inversely related to OS prevalence (Odds Ratio = 0.73; 95% CI = 0.57, 0.94; P = 0.01). Several biological processes affiliated with the FV-associating metabolites, including caffeine metabolism, carnitines and fatty acids, and glycerophospholipids. Important processes identified with OS-associated metabolites were steroid hormone biosynthesis in women and branched-chain amino acid metabolism in men. Factors derived from PCA were correlated with the OS-associated metabolites, with high intake of dark leafy greens and berries/melons appearing protective in both sexes.

Conclusions: These data warrant investigation into whether increasing intakes of dark leafy greens, berries and melons causally affect bone turnover and BMD among middle-aged and older adults at risk for osteoporosis via sex-specific metabolic pathways, and how gene-diet interactions alter these sex-specific metabolomic-osteoporosis links. ClinicalTrials.gov Identifier: NCT01231958.
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http://dx.doi.org/10.1016/j.bone.2020.115780DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7856195PMC
March 2021

Exploring the potential for introducing home monitoring of blood pressure during pregnancy into maternity care: current views and experiences of staff-a qualitative study.

BMJ Open 2020 12 1;10(12):e037874. Epub 2020 Dec 1.

Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.

Objective: One in 20 women are affected by pre-eclampsia, a major cause of maternal and perinatal morbidity, death and premature birth worldwide. Diagnosis is made from monitoring blood pressure (BP) and urine and symptoms at antenatal visits after 20 weeks of pregnancy. There are no randomised data from contemporary trials to guide the efficacy of self-monitoring of BP (SMBP) in pregnancy. We explored the perspectives of maternity staff to understand the context and health system challenges to introducing and implementing SMBP in maternity care, ahead of undertaking a trial.

Design: Exploratory study using a qualitative approach.

Setting: Eight hospitals, English National Health Service.

Participants: Obstetricians, community and hospital midwives, pharmacists, trainee doctors (n=147).

Methods: Semi-structured interviews with site research team members and clinicians, interviews and focus group discussions. Rapid content and thematic analysis undertaken.

Results: The main themes to emerge around SMBP include (1) different BP changes in pregnancy, (2) reliability and accuracy of BP monitoring, (3) anticipated impact of SMBP on women, (4) anticipated impact of SMBP on the antenatal care system, (5) caution, uncertainty and evidence, (6) concerns over action/inaction and patient safety.

Conclusions: The potential impact of SMBP on maternity services is profound although nuanced. While introducing SMBP does not reduce the responsibility clinicians have for women's health, it may enhance the responsibilities and agency of pregnant women, and introduces a new set of relationships into maternity care. This is a new space for reconfiguration of roles, mutual expectations and the relationships between and responsibilities of healthcare providers and women.

Trial Registration Number: NCT03334149.
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http://dx.doi.org/10.1136/bmjopen-2020-037874DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7709507PMC
December 2020

If we offer, will they come: Perceptions of yoga among Hispanics.

Complement Ther Med 2021 Jan 20;56:102622. Epub 2020 Nov 20.

Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, MA, USA.

Objective: Yoga is underutilized by the Hispanics. This study examined perceptions of benefits and barriers to yoga among Hispanic adults, to provide information that may increase their participation in this practice.

Setting: Participants were recruited from a Community Center serving low-income Hispanics.

Design: Self-administered cross-sectional questionnaires assessing benefits and barriers to yoga were conducted in Spanish and English. Fisher's exact test was used to examine perceptions of yoga by gender, age, and prior experience.

Results: Participants (ages 18-85, 65 % women, n = 121) reported several benefits to yoga. Hispanic women, individuals 65 y or older, and those with prior experience, perceived more benefits. Barriers to yoga also differed by demographics. Men reported that time and the perception that they would have to do unrealistic pretzel-like poses as deterrents to yoga practice; younger individuals perceived yoga to be boring, and those with no experience perceived lack of flexibility and feeling like an outsider in class, as barriers to yoga. The most common barrier, across subgroups, was the cost associated with yoga practice. The majority of participants reported being willing to attend yoga classes if offered at a low cost.

Conclusion: Perceived barriers related to yoga reflect a lack of knowledge about yoga and what it entails and the cost of classes. Despite these barriers, Hispanic adults from a low-income population said they would be willing to attend yoga classes if offered at a low cost. Understanding and addressing these barriers can help researchers and health practitioners improve diversity in yoga classes and research.
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http://dx.doi.org/10.1016/j.ctim.2020.102622DOI Listing
January 2021
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