Publications by authors named "Lara R Dugas"

68 Publications

Transcriptome prediction performance across machine learning models and diverse ancestries.

HGG Adv 2021 Apr 5;2(2). Epub 2021 Jan 5.

Program in Bioinformatics, Loyola University Chicago, Chicago, IL, USA.

Transcriptome prediction methods such as PrediXcan and FUSION have become popular in complex trait mapping. Most transcriptome prediction models have been trained in European populations using methods that make parametric linear assumptions like the elastic net (EN). To potentially further optimize imputation performance of gene expression across global populations, we built transcriptome prediction models using both linear and non-linear machine learning (ML) algorithms and evaluated their performance in comparison to EN. We trained models using genotype and blood monocyte transcriptome data from the Multi-Ethnic Study of Atherosclerosis (MESA) comprising individuals of African, Hispanic, and European ancestries and tested them using genotype and whole-blood transcriptome data from the Modeling the Epidemiology Transition Study (METS) comprising individuals of African ancestries. We show that the prediction performance is highest when the training and the testing population share similar ancestries regardless of the prediction algorithm used. While EN generally outperformed random forest (RF), support vector regression (SVR), and K nearest neighbor (KNN), we found that RF outperformed EN for some genes, particularly between disparate ancestries, suggesting potential robustness and reduced variability of RF imputation performance across global populations. When applied to a high-density lipoprotein (HDL) phenotype, we show including RF prediction models in PrediXcan revealed potential gene associations missed by EN models. Therefore, by integrating other ML modeling into PrediXcan and diversifying our training populations to include more global ancestries, we may uncover new genes associated with complex traits.
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http://dx.doi.org/10.1016/j.xhgg.2020.100019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087249PMC
April 2021

Evolution of water conservation in humans.

Curr Biol 2021 Apr 5;31(8):1804-1810.e5. Epub 2021 Mar 5.

Lester E. Fisher Center for the Study and Conservation of Apes, Lincoln Park Zoo. Chicago, IL 60614, USA.

To sustain life, humans and other terrestrial animals must maintain a tight balance of water gain and water loss each day. However, the evolution of human water balance physiology is poorly understood due to the absence of comparative measures from other hominoids. While humans drink daily to maintain water balance, rainforest-living great apes typically obtain adequate water from their food and can go days or weeks without drinking. Here, we compare isotope-depletion measures of water turnover (L/d) in zoo- and rainforest-sanctuary-housed apes (chimpanzees, bonobos, gorillas, and orangutans) with 5 diverse human populations, including a hunter-gatherer community in a semi-arid savannah. Across the entire sample, water turnover was strongly related to total energy expenditure (TEE, kcal/d), physical activity, climate (ambient temperature and humidity), and fat free mass. In analyses controlling for those factors, water turnover was 30% to 50% lower in humans than in other apes despite humans' greater sweating capacity. Water turnover in zoo and sanctuary apes was similar to estimated turnover in wild populations, as was the ratio of water intake to dietary energy intake (∼2.8 mL/kcal). However, zoo and sanctuary apes ingested a greater ratio of water to dry matter of food, which might contribute to digestive problems in captivity. Compared to apes, humans appear to target a lower ratio of water/energy intake (∼1.5 mL/kcal). Water stress due to changes in climate, diet, and behavior apparently led to previously unknown water conservation adaptations in hominin physiology.
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http://dx.doi.org/10.1016/j.cub.2021.02.045DOI Listing
April 2021

A standard calculation methodology for human doubly labeled water studies.

Cell Rep Med 2021 Feb 16;2(2):100203. Epub 2021 Feb 16.

Maastricht University, Maastricht, the Netherlands.

The doubly labeled water (DLW) method measures total energy expenditure (TEE) in free-living subjects. Several equations are used to convert isotopic data into TEE. Using the International Atomic Energy Agency (IAEA) DLW database (5,756 measurements of adults and children), we show considerable variability is introduced by different equations. The estimated rCO is sensitive to the dilution space ratio (DSR) of the two isotopes. Based on performance in validation studies, we propose a new equation based on a new estimate of the mean DSR. The DSR is lower at low body masses (<10 kg). Using data for 1,021 babies and infants, we show that the DSR varies non-linearly with body mass between 0 and 10 kg. Using this relationship to predict DSR from weight provides an equation for rCO over this size range that agrees well with indirect calorimetry (average difference 0.64%; SD = 12.2%). We propose adoption of these equations in future studies.
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http://dx.doi.org/10.1016/j.xcrm.2021.100203DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7897799PMC
February 2021

Family-based lifestyle interventions: What makes them successful? A systematic literature review.

Prev Med Rep 2021 Mar 31;21:101299. Epub 2020 Dec 31.

Parkinson School of Health Sciences and Public Health, Loyola University Chicago, United States.

Nearly one in five young people in the United States has obesity, putting one-fifth of America's children at higher risk of having chronic health conditions and of having obesity into adulthood. Family-based lifestyle interventions (FBLI) have been proposed as effective mechanisms to improve the health through health education and the adoption of healthier behaviors. The aim of this review is to identify and summarize effective intervention activities and lessons learned that organizations can adopt when planning health promotion interventions for families, and to assess the effect of family-based lifestyle interventions on BMI z-score. A systematic review on lifestyle health-promotion interventions for families was conducted following PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses) statements. Inclusion criteria were: duration ≥12 weeks and inclusion of family members. Summary data about the assessment tools, intervention strategies, and outcomes in parents and children were extracted and compared for all studies. A meta-analysis of BMI z-score change was conducted. Thirty-four articles were included in this review. Frequent strategies used were delivering education and training on healthy habits and well-being (94%), engaging community in the planning and implementation phases (80.6%) and providing reminders and feedback (47.2%). BMI z-score mean differences were reported in 40 cohorts and included in a meta-analysis, with no statistically significant differences between groups. The findings of this systematic review and meta-analysis indicate that components of a successful family lifestyle intervention program include duration between six to twelve months and delivery in a community setting. Other key factors include constructing a multidisciplinary team, using a mentor/role model approach, and reinforcing messaging with technology.
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http://dx.doi.org/10.1016/j.pmedr.2020.101299DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7816001PMC
March 2021

Childhood Daily Energy Expenditure Does Not Decrease with Market Integration and Is Not Related to Adiposity in Amazonia.

J Nutr 2021 03;151(3):695-704

Department of Evolutionary Anthropology, Duke University, Durham, NC, USA.

Background: Childhood overweight and obesity (OW/OB) is increasingly centered in low- and middle-income countries (LMICs) as rural populations experience market integration and lifeway change. Most explanatory studies have relied on imprecise estimates of children's energy expenditure, restricting understanding of the relative effects of changes in diet and energy expenditure on the development of OW/OB in transitioning contexts.

Objectives: This study used gold-standard measurements of children's energy expenditure to investigate the changes that underlie OW/OB and the nutrition/epidemiologic transition.

Methods: Cross-sectional data were collected from "rural" (n = 43) Shuar forager-horticulturalist children and their "peri-urban" (n = 34) Shuar counterparts (age 4-12 y) in Amazonian Ecuador. Doubly labeled water measurements of total energy expenditure (TEE; kcal/d), respirometry measurements of resting energy expenditure (REE; kcal/d), and measures of diet, physical activity, immune activity, and market integration were analyzed primarily using regression models.

Results: Peri-urban children had higher body fat percentage (+8.1%, P < 0.001), greater consumption of market-acquired foods (multiple P < 0.001), lower concentrations of immune activity biomarkers (multiple P < 0.05), and lower REE (-108 kcal/d, P = 0.002) than rural children. Despite these differences, peri-urban children's TEE was indistinguishable from that of rural children (P = 0.499). Moreover, although sample-wide IgG concentrations and household incomes predicted REE (both P < 0.05), no examined household, immune activity, or physical activity measures were related to children's overall TEE (all P > 0.09). Diet and energy expenditure associations with adiposity demonstrate that only reported consumption of market-acquired "protein" and "carbohydrate" foods predicted children's body fat levels (multiple P < 0.05).

Conclusions: Despite underlying patterns in REE, Shuar children's TEE is not reliably related to market integration and-unlike dietary measures-does not predict adiposity. These findings suggest a leading role of changing dietary intake in transitions to OW/OB in LMICs.
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http://dx.doi.org/10.1093/jn/nxaa361DOI Listing
March 2021

Predictors of HbA1c among Adipocytokine Biomarkers in African-American Men with Varied Glucose Tolerance.

Biomedicines 2020 Nov 20;8(11). Epub 2020 Nov 20.

Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL 60153, USA.

This study explored adipocytokine associations with acute and chronic hyperglycemia in African-American men (AAM). Fourteen adipocytokines were measured from men with normal glucose tolerance (NGT) or type 2 diabetes (T2D, drug-naïve MF(-) or using metformin MF(+)). Acute and chronic hyperglycemia were evaluated by 120 min oral glucose tolerance test (OGTT) and glycohemoglobin A1c (HbA1c). AAM with T2D ( = 21) compared to NGT ( = 20) were older, had higher BMI and slightly higher glucose and insulin. In the fasted state, TNF-α, IL-6, PAI-1, IL-13, adiponectin, adipsin, and lipocalin were lower in T2D vs. NGT. At 120 min post-glucose load, TNF-α, IL-6, IL-13, IL-8, PAI-1, adiponectin, adipsin, lipocalin, and resistin were lower in T2D vs. NGT. There were no statistical differences for GM-CSF, IL-7, IL-10, IP-10, and MCP-1. Regression analysis showed that fasting IL-8, TNF-α, adiponectin, lipocalin, resistin, adipsin, and PAI-1 were associated with HbA1c. After adjusting for age, BMI, glucose tolerance, and metformin use, only adipsin remained significantly associated with HbA1c ( = 0.021). The model including adipsin, TNF-α, age, BMI, and group designation (i.e., NGT, MF(-), MF(+)) explained 86% of HbA1c variability. The data suggested that adipsin could be associated with HbA1c in AAM with varied glucose tolerance.
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http://dx.doi.org/10.3390/biomedicines8110520DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7699586PMC
November 2020

Fecal transplantation and butyrate improve neuropathic pain, modify immune cell profile, and gene expression in the PNS of obese mice.

Proc Natl Acad Sci U S A 2020 10 5;117(42):26482-26493. Epub 2020 Oct 5.

Department of Cell and Molecular Physiology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153;

Obesity affects over 2 billion people worldwide and is accompanied by peripheral neuropathy (PN) and an associated poorer quality of life. Despite high prevalence, the molecular mechanisms underlying the painful manifestations of PN are poorly understood, and therapies are restricted to use of painkillers or other drugs that do not address the underlying disease. Studies have demonstrated that the gut microbiome is linked to metabolic health and its alteration is associated with many diseases, including obesity. Pathologic changes to the gut microbiome have recently been linked to somatosensory pain, but any relationships between gut microbiome and PN in obesity have yet to be explored. Our data show that mice fed a Western diet developed indices of PN that were attenuated by concurrent fecal microbiome transplantation (FMT). In addition, we observed changes in expression of genes involved in lipid metabolism and calcium handling in cells of the peripheral nerve system (PNS). FMT also induced changes in the immune cell populations of the PNS. There was a correlation between an increase in the circulating short-chain fatty acid butyrate and pain improvement following FMT. Additionally, butyrate modulated gene expression and immune cells in the PNS. Circulating butyrate was also negatively correlated with distal pain in 29 participants with varied body mass index. Our data suggest that the metabolite butyrate, secreted by the gut microbiome, underlies some of the effects of FMT. Targeting the gut microbiome, butyrate, and its consequences may represent novel viable approaches to prevent or relieve obesity-associated neuropathies.
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http://dx.doi.org/10.1073/pnas.2006065117DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7584890PMC
October 2020

Socioeconomic Status and Determinants of Pediatric Antibiotic Use.

Clin Pediatr (Phila) 2021 01 4;60(1):32-41. Epub 2020 Aug 4.

Loyola University Medical Center, Maywood, IL, USA.

. Evidence suggests that early-life antibiotic use can alter gut microbiome, predisposing children to obesity. The obesity epidemic has a disproportionate effect on individuals from lower socioeconomic status (SES). Thus, this study aims to explore the link between SES and antibiotic use. . We performed a retrospective cohort study of all babies born at and receiving 2 or more outpatient visits at a large, suburban health system in Illinois (United States) between 2007 and 2017. We collected data on zip code as a proxy for SES and antibiotic use in the first year of life. We also obtained comorbid diagnosis codes, race/ethnicity, gender, and number of inpatient, outpatient, and emergency department visits. . A total of 7224 patients met our study criteria. Children from low-poverty areas received a lifetime average of 4.28 prescriptions, while those from high-poverty neighborhoods received an average of 3.31 prescriptions. This was statistically significant in our unadjusted analysis but not after adjusting for covariates. Children from high-poverty areas were significantly more likely to receive more antibiotics at 48 hours, 1 week, and 1 month of life in our unadjusted analysis, but not after adjusting for covariates. In our unadjusted and adjusted analyses, children from high-poverty areas were significantly more likely to have received antibiotics at 1 week of life. . The relationship between SES and antibiotic use warrants further investigation to help elucidate possible causes of the disproportionate impact obesity has in low-income communities.
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http://dx.doi.org/10.1177/0009922820941629DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7983842PMC
January 2021

Newborn feeding recommendations and practices increase the risk of development of overweight and obesity.

BMC Pediatr 2020 03 4;20(1):104. Epub 2020 Mar 4.

Department of Public Health, Loyola University Chicago Medical Center, Chicago, Illinois, USA.

Background: The prevalence of obesity among infants less than 2 years of age has increased by more than 60% over the last three decades. Obese infants and toddlers are at an increased risk for staying overweight into adolescence and adulthood. Metabolic programming has been demonstrated in animal models whereby early life feeding habits result in life-long changes in hormone balance and metabolism. Our study explores if newborn over-nutrition on the first day of life (DOL1) is associated with risk for future overweight and obesity in childhood.

Methods: Retrospective chart data was collected for full term formula-fed infants born between January 2008 and December 2012 who continued care at the same institution. Data included the volume of formula (ml) consumed on DOL1 as well, as subsequent yearly BMI measures from well child checkups (WCC). Overfeeding was categorized as any feed greater than or equal to 30 ml on any of the first seven feeds while controlling for birth weight.

Results: The final data set included 1106 infants (547 male; 559 female). 1023 of the 1106 newborns (93%) were overfed at least once during DOL1, while 789 of 1106 (71%) were overfed 3 or more times during their first 7 feeds. After adjusting for birth weight, infants who were overfed 5 of the first 7 feeds were 5 times as likely to be overweight or obese at their 4th year well child check-up (p < 0.05) compared to children not overfed. Infants who were overfed on all 7 of their first 7 feeds were 7 times more likely to be overweight or obese at their 4th year WCC (p = 0.017).

Conclusions: Infants overfed on DOL1 were significantly more likely to be overweight or obese at their 4th year WCC, compared to infants not overfed on their first day of life. Newborn families may benefit from counseling regarding age-appropriate volumes of formula during this critical time period. Future studies will aim to look at effect of implementation of smaller feeding bottle size on reducing overfeeding practices and future risk of overweight and obesity.
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http://dx.doi.org/10.1186/s12887-020-1982-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7055094PMC
March 2020

Constraint and trade-offs regulate energy expenditure during childhood.

Sci Adv 2019 12 18;5(12):eaax1065. Epub 2019 Dec 18.

Department of Evolutionary Anthropology, Duke University, 130 Science Drive, Durham, NC 27708, USA.

Children's metabolic energy expenditure is central to evolutionary and epidemiological frameworks for understanding variation in human phenotype and health. Nonetheless, the impact of a physically active lifestyle and heavy burden of infectious disease on child metabolism remains unclear. Using energetic, activity, and biomarker measures, we show that Shuar forager-horticulturalist children of Amazonian Ecuador are ~25% more physically active and, in association with immune activity, have ~20% greater resting energy expenditure than children from industrial populations. Despite these differences, Shuar children's total daily energy expenditure, measured using doubly labeled water, is indistinguishable from industrialized counterparts. Trade-offs in energy allocation between competing physiological tasks, within a constrained energy budget, appear to shape childhood phenotypic variation (e.g., patterns of growth). These trade-offs may contribute to the lifetime obesity and metabolic health disparities that emerge during rapid economic development.
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http://dx.doi.org/10.1126/sciadv.aax1065DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6989306PMC
December 2019

Predictors of Obesity among Gut Microbiota Biomarkers in African American Men with and without Diabetes.

Microorganisms 2019 Sep 5;7(9). Epub 2019 Sep 5.

Department of Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL 60153, USA.

Gut microbiota and their biomarkers may be associated with obesity. This study evaluated associations of body mass index (BMI) with circulating microbiota biomarkers in African American men (AAM) ( = 75). The main outcomes included fecal microbial community structure (16S rRNA), gut permeability biomarkers (ELISA), and short-chain fatty acids (SCFAs, metabolome analysis). These outcomes were compared between obese and non-obese men, after adjusting for age. The results showed that lipopolysaccharide-binding protein (LBP), the ratio of LBP to CD14 (LBP/CD14), and SCFAs (propionic, butyric, isovaleric) were higher in obese ( = 41, age 58 years, BMI 36 kg/m) versus non-obese ( = 34, age 55 years, BMI 26 kg/m) men. BMI correlated positively with LBP, LBP/CD14 ( < 0.05 for both) and SCFAs (propionic, butyric, isovaleric, < 0.01 for all). In the regression analysis, LBP, LBP/CD14, propionic and butyric acids were independent determinants of BMI. The study showed for the first time that selected microbiota biomarkers (LBP, LBP/CD14, propionic and butyric acids) together with several other relevant risks explained 39%-47% of BMI variability, emphasizing that factors other than microbiota-related biomarkers could be important. Further research is needed to provide clinical and mechanistic insight into microbiota biomarkers and their utility for diagnostic and therapeutic purposes.
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http://dx.doi.org/10.3390/microorganisms7090320DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780321PMC
September 2019

The human microbiota is associated with cardiometabolic risk across the epidemiologic transition.

PLoS One 2019 24;14(7):e0215262. Epub 2019 Jul 24.

Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, United States of America.

Oral and fecal microbial biomarkers have previously been associated with cardiometabolic (CM) risk, however, no comprehensive attempt has been made to explore this association in minority populations or across different geographic regions. We characterized gut- and oral-associated microbiota and CM risk in 655 participants of African-origin, aged 25-45, from Ghana, South Africa, Jamaica, and the United States (US). CM risk was classified using the CM risk cut-points for elevated waist circumference, elevated blood pressure and elevated fasted blood glucose, low high-density lipoprotein (HDL), and elevated triglycerides. Gut-associated bacterial alpha diversity negatively correlated with elevated blood pressure and elevated fasted blood glucose. Similarly, gut bacterial beta diversity was also significantly differentiated by waist circumference, blood pressure, triglyceridemia and HDL-cholesterolemia. Notably, differences in inter- and intra-personal gut microbial diversity were geographic-region specific. Participants meeting the cut-points for 3 out of the 5 CM risk factors were significantly more enriched with Lachnospiraceae, and were significantly depleted of Clostridiaceae, Peptostreptococcaceae, and Prevotella. The predicted relative proportions of the genes involved in the pathways for lipopolysaccharides (LPS) and butyrate synthesis were also significantly differentiated by the CM risk phenotype, whereby genes involved in the butyrate synthesis via lysine, glutarate and 4-aminobutyrate/succinate pathways and LPS synthesis pathway were enriched in participants with greater CM risk. Furthermore, inter-individual oral microbiota diversity was also significantly associated with the CM risk factors, and oral-associated Streptococcus, Prevotella, and Veillonella were enriched in participants with 3 out of the 5 CM risk factors. We demonstrate that in a diverse cohort of African-origin adults, CM risk is significantly associated with reduced microbial diversity, and the enrichment of specific bacterial taxa and predicted functional traits in both gut and oral environments. As well as providing new insights into the associations between the gut and oral microbiota and CM risk, this study also highlights the potential for novel therapeutic discoveries which target the oral and gut microbiota in CM risk.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0215262PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6656343PMC
February 2020

Early antibiotic exposure and development of asthma and allergic rhinitis in childhood.

BMC Pediatr 2019 07 5;19(1):225. Epub 2019 Jul 5.

Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL, 60153, USA.

Background: The prevalence of pediatric allergic diseases has increased rapidly in the United States over the past few decades. Recent studies suggest an association between the increase in allergic disease and early disturbances to the gut microbiome. The gut microbiome is a set of intestinal microorganisms that begins to form during birth and is highly susceptible to disturbance during the first year of life. Early antibiotic exposure may negatively impact the gut microbiota by altering the bacterial composition and causing dysbiosis, thus increasing the risk for developing childhood allergic disease.

Methods: We performed a retrospective chart review of data in Loyola University Medical Center's (LUMC) Epic system from 2007 to 2016. We defined antibiotic exposure as orders in both the outpatient and inpatient settings. Inclusion criteria were being born at LUMC with at least two follow up visits. Asthma and allergic rhinitis diagnoses were obtained using ICD 9 and ICD 10 codes. We controlled for multiple confounding factors. Using Stata, bivariate logistic regression was performed between antibiotics from 0 to 12 months of life and development of disease. This analysis was repeated for total lifetime antibiotics. We defined statistically significant as p < .05.

Results: The administration of antibiotics within the first 12 months of life was significantly associated with lifetime asthma (OR 2.66; C. I 1.11-6.40) but not allergic rhinitis. There was a significant association between lifetime antibiotics and asthma (OR 3.54; C. I 1.99-6.30) and allergic rhinitis (OR 2.43; C. I 1.43-4.11).

Conclusion: Antibiotic administration in the first year of life and throughout lifetime is significantly associated with developing asthma and allergic rhinitis. These results provide support for a conservative approach regarding antibiotic use in early childhood.
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http://dx.doi.org/10.1186/s12887-019-1594-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6612173PMC
July 2019

Extreme events reveal an alimentary limit on sustained maximal human energy expenditure.

Sci Adv 2019 06 5;5(6):eaaw0341. Epub 2019 Jun 5.

Department of Anthropology, Hunter College, New York, NY 10065, USA.

The limits on maximum sustained energy expenditure are unclear but are of interest because they constrain reproduction, thermoregulation, and physical activity. Here, we show that sustained expenditure in humans, measured as maximum sustained metabolic scope (SusMS), is a function of event duration. We compiled measurements of total energy expenditure (TEE) and basal metabolic rate (BMR) from human endurance events and added new data from adults running ~250 km/week for 20 weeks in a transcontinental race. For events lasting 0.5 to 250+ days, SusMS decreases curvilinearly with event duration, plateauing below 3× BMR. This relationship differs from that of shorter events (e.g., marathons). Incorporating data from overfeeding studies, we find evidence for an alimentary energy supply limit in humans of ~2.5× BMR; greater expenditure requires drawing down the body's energy stores. Transcontinental race data suggest that humans can partially reduce TEE during long events to extend endurance.
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http://dx.doi.org/10.1126/sciadv.aaw0341DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6551185PMC
June 2019

Sustained high levels of physical activity lead to improved performance among "Race Across the USA" athletes.

Am J Phys Anthropol 2019 04 29;168(4):789-794. Epub 2019 Jan 29.

Anthropology, Hunter College, New York, New York.

Objective: To investigate physiological and performance adaptations associated with extremely high daily sustained physical activity levels, we followed six runners participating in the 2015 Race Across the USA. Participants completed over 42.2 km a day for 140 days, covering nearly 5,000 km. This analysis examines the improvement in running speed and potential adaptation in mean submaximal heart rate (SHR) throughout the race.

Methods: Data were collected during three 1-week long periods corresponding to the race beginning, middle, and end and included heart rates (HRs), body mass, running distances and speeds. HR data were collected using ActiTrainer HR monitors. Running speeds and distances were also recorded throughout the entire race.

Results: Athletes ran significantly faster as the race progressed (p < .001), reducing their mean marathon time by over 63 min. Observed mean SHR during the middle of the race was significantly lower than at the beginning (p = .003); however, there was no significant difference between mean SHR at the middle and end of the race (p = .998).

Conclusion: These results indicate an early training effect in SHR during the first half of the race, which suggests that other physiological and biomechanical mechanisms were responsible for the continued improvement in running speed and adaptation to the high levels of sustained physical activity.
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http://dx.doi.org/10.1002/ajpa.23781DOI Listing
April 2019

Oxytocin alterations and neurocognitive domains in patients with hypopituitarism.

Pituitary 2019 Apr;22(2):105-112

Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Illinois at Chicago, 1819 West Polk Street, Chicago, IL, 60612, USA.

Purpose: Oxytocin is a hypothalamus derived, posterior pituitary stored nonapeptide which has gained recent interest as an important neuropsychiatric and metabolic hormone beyond its classic role in lactation and parturition. Hypopituitarism is a heterogenous disorder of derangement in one or more anterior or posterior pituitary hormones. Diagnosis of deficiency and hormone replacement exists to address all relevant axes except for oxytocin. Our study aims to define derangements in oxytocin in a unique population of patients with hypopituitarism and correlate levels with measures of emotional health and quality of life.

Methods: A cross-sectional, single day study was completed to measure plasma oxytocin levels in a diverse population of patients with hypopituitarism compared to controls. Subjects also completed depression, quality of life and stress-related questionnaires, and emotion recognition tasks.

Results: Thirty-eight subjects completed the study, 18 with hypopituitarism (9 with diabetes insipidus) and 20 controls. After controlling for differences in age, weight and gender, plasma oxytocin levels were highest in subjects with diabetes insipidus compared to control [mean, IQR: 44.3 pg/ml (29.8-78.2) vs. 20.6 (17-31.3), p = 0.032]. Amongst hypopituitary subjects, those with duration of disease greater than 1 year had higher oxytocin levels. No significant differences were observed for psychosocial measures including emotion recognition tasks.

Conclusions: Plasma oxytocin levels were found higher in patients with hypopituitarism compared to controls and highest in those with diabetes insipidus. Longer duration of hypopituitarism was also associated with higher plasma levels of oxytocin. Further study is needed to better define oxytocin deficiency and investigate response to treatment.
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http://dx.doi.org/10.1007/s11102-019-00936-0DOI Listing
April 2019

Gut microbial features can predict host phenotype response to protein deficiency.

Physiol Rep 2018 Dec;6(23):e13932

Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, University of Illinois at Chicago, Chicago, IL.

Malnutrition remains a major health problem in low- and middle-income countries. During low protein intake, <0.67 g/kg/day, there is a loss of nitrogen (N ) balance, due to the unavailability of amino acid for metabolism and unbalanced protein catabolism results. However, there are individuals, who consume the same low protein intake, and preserve N balance for unknown reasons. A novel factor, the gut microbiota, may account for these N balance differences. To investigate this, we correlated gut microbial profiles with the growth of four murine strains (C57Bl6/J, CD-1, FVB, and NIH-Swiss) on protein deficient (PD) diet. Results show that a PD diet exerts a strain-dependent impact on growth and N balance as determined through analysis of urinary urea, ammonia and creatinine excretion. Bacterial alpha diversity was significantly (P < 0.05, FDR) lower across all strains on a PD diet compared to normal chow (NC). Multi-group analyses of the composition of microbiomes (ANCOM) revealed significantly differential microbial signatures between the four strains independent of diet. However, mice on a PD diet demonstrated differential enrichment of bacterial genera including, Allobaculum (C57Bl6/J), Parabacteroides (CD-1), Turicibacter (FVB), and Mucispirillum (NIH-Swiss) relative to NC. For instance, selective comparison of the CD-1 (gained weight) and C57Bl6/J (did not gain weight) strains on PD diet also demonstrated significant pathway enrichment of dihydroorodate dehydrogenase, rRNA methyltransferases, and RNA splicing ligase in the CD-1 strains compared to C57Bl6/J strains; which might account in their ability to retain growth despite a protein deficient diet. Taken together, these results suggest a potential relationship between the specific gut microbiota, N balance and animal response to malnutrition.
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http://dx.doi.org/10.14814/phy2.13932DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6280014PMC
December 2018

Decreased microbial co-occurrence network stability and SCFA receptor level correlates with obesity in African-origin women.

Sci Rep 2018 11 20;8(1):17135. Epub 2018 Nov 20.

Division of Endocrinology, Diabetes, and Metabolism, University of Illinois at Chicago, Chicago, IL, USA.

We compared the gut microbial populations in 100 women, from rural Ghana and urban US [50% lean (BMI < 25 kg/m) and 50% obese (BMI ≥ 30 kg/m)] to examine the ecological co-occurrence network topology of the gut microbiota as well as the relationship of short chain fatty acids (SCFAs) with obesity. Ghanaians consumed significantly more dietary fiber, had greater microbial alpha-diversity, different beta-diversity, and had a greater concentration of total fecal SCFAs (p-value < 0.002). Lean Ghanaians had significantly greater network density, connectivity and stability than either obese Ghanaians, or lean and obese US participants (false discovery rate (FDR) corrected p-value ≤ 0.01). Bacteroides uniformis was significantly more abundant in lean women, irrespective of country (FDR corrected p < 0.001), while lean Ghanaians had a significantly greater proportion of Ruminococcus callidus, Prevotella copri, and Escherichia coli, and smaller proportions of Lachnospiraceae, Bacteroides and Parabacteroides. Lean Ghanaians had a significantly greater abundance of predicted microbial genes that catalyzed the production of butyric acid via the fermentation of pyruvate or branched amino-acids, while obese Ghanaians and US women (irrespective of BMI) had a significantly greater abundance of predicted microbial genes that encoded for enzymes associated with the fermentation of amino-acids such as alanine, aspartate, lysine and glutamate. Similar to lean Ghanaian women, mice humanized with stool from the lean Ghanaian participant had a significantly lower abundance of family Lachnospiraceae and genus Bacteroides and Parabacteroides, and were resistant to obesity following 6-weeks of high fat feeding (p-value < 0.01). Obesity-resistant mice also showed increased intestinal transcriptional expression of the free fatty acid (Ffa) receptor Ffa2, in spite of similar fecal SCFAs concentrations. We demonstrate that the association between obesity resistance and increased predicted ecological connectivity and stability of the lean Ghanaian microbiota, as well as increased local SCFA receptor level, provides evidence of the importance of robust gut ecologic network in obesity.
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http://dx.doi.org/10.1038/s41598-018-35230-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6244201PMC
November 2018

Benefits and challenges of serial sports training risk assessment and counselling in kids: the T.R.A.C.K. randomised intervention study.

Br J Sports Med 2019 Feb 17;53(4):243-249. Epub 2018 Nov 17.

School of Medicine, Department of Orthopedics and Family Medicine, Emory University, Atlanta, Georgia, USA.

Background: Published training recommendations exist for youth athletes aimed at reducing injury risk. No studies have assessed the impact of counselling interventions using training recommendations on risk of injury in young athletes.

Objectives: To determine if online training counselling regarding safe sport participation can reduce injury risk in youth athletes and to assess recommendation compliance, including barriers to compliance.

Methods: A multicentre randomised intervention trial was performed at two Midwestern academic institutions with expertise in treating young athletes. Enrolled subjects ages 8-17 completed a baseline risk assessment survey and were randomised to a control or intervention group. Both groups completed exposure surveys every 3 months for 1 year. The intervention group also received online training counselling on safe sport participation every 3 months. Training characteristics including training volume, degree of specialisation and adherence to recommendations were captured. Differences in self-reported injury between groups, compliance to recommendations and barriers to compliance were evaluated.

Results: At baseline, n=357 subjects were enrolled (n=172 control and n=185 intervention). Controls were nearly twice as likely to be injured during the intervention period after controlling for age, sex, baseline injury and level of specialisation. No improvement in recommendation compliance was detected among intervention subjects. Primary barriers to compliance were no prior knowledge of recommendations, personal choice and following coaches' recommendations.

Conclusions: In this convenience sample of youth athletes, electronic training counselling surrounding safe sports participation was not determined to affect injury risk. Lack of knowledge and adherence to appropriate training recommendations is evident and barriers to compliance exist.
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http://dx.doi.org/10.1136/bjsports-2018-099863DOI Listing
February 2019

More evening preference is positively associated with systemic inflammation in prediabetes and type 2 diabetes patients.

Sci Rep 2018 10 26;8(1):15882. Epub 2018 Oct 26.

Division of Endocrinology and Metabolism, Mahidol University, 270 Rama VI Rd, Ratchathewi, Bangkok, 10400, Thailand.

Currently it is not known whether morningness-eveningness preference in non-night shift working population is associated with systemic inflammation. This study investigated the relationship between morningness-eveningness and systemic inflammation, as measured by high-sensitivity C-reactive protein (hs-CRP) in 163 non-night shift working patients with abnormal glucose tolerance (86 type 2 diabetes and 77 prediabetes). Morningness-eveningness was assessed by Composite Scale of Morningness, and participants were screened for Obstructive sleep apnea (OSA). Sleep duration, efficiency, and variability were obtained using actigraphy, and depressive symptoms and dietary patterns were also captured. Participants' mean age was 54.7 ± 10.4 years and median hs-CRP was 1.39 (interquartile range 0.82, 3.33) mg/L. More evening preference was significantly associated with higher natural log transformed (ln) hs-CRP (B = -0.051, p = 0.001). Diabetes status, glycemic control, OSA severity, sleep duration, caloric consumption and timing were not related to hs-CRP. After adjusting for age, sex, body mass index, depressive symptoms, sleep efficiency, sleep variability, percentage of daily caloric intake from protein, and statin use, more evening preference was independently associated with higher ln hs-CRP (B = -0.032, p = 0.014). In summary, in non-night shift working patients with abnormal glucose tolerance, more evening preference was independently associated with higher systemic inflammation. This finding underscore the importance of circadian regulation on cardiovascular health.
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http://dx.doi.org/10.1038/s41598-018-34045-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6203737PMC
October 2018

Gut microbiota, short chain fatty acids, and obesity across the epidemiologic transition: the METS-Microbiome study protocol.

BMC Public Health 2018 08 6;18(1):978. Epub 2018 Aug 6.

Division of Endocrinology, Diabetes, and Metabolism, University of Illinois at Chicago, Chicago, IL, USA.

Background: While some of the variance observed in adiposity and weight change within populations can be accounted for by traditional risk factors, a new factor, the gut microbiota, has recently been associated with obesity. However, the causal mechanisms through which the gut microbiota and its metabolites, short chain fatty acids (SCFAs) influence obesity are unknown, as are the individual obesogenic effects of the individual SCFAs (butyrate, acetate and propionate). This study, METS-Microbiome, proposes to examine the influence of novel risk factors, the gut microbiota and SCFAs, on obesity, adiposity and weight change in an international established cohort spanning the epidemiologic transition.

Methods: The parent study; Modeling the Epidemiologic Transition Study (METS) is a well-established and ongoing prospective cohort study designed to assess the association between body composition, physical activity, and relative weight, weight gain and cardiometabolic disease risk in five diverse population-based samples in 2500 people of African descent. The cohort has been prospectively followed since 2009. Annual measures of obesity risk factors, including body composition, objectively measured physical activity and dietary intake, components which vary across the spectrum of social and economic development. In our new study; METS-Microbiome, in addition to continuing yearly measures of obesity risk, we will also measure gut microbiota and stool SCFAs in all contactable participants, and follow participants for a further 3 years, thus providing one of the largest gut microbiota population-based studies to date.

Discussion: This new study capitalizes upon an existing, extensively well described cohort of adults of African-origin, with significant variability as a result of the widespread geographic distributions, and therefore variation in the environmental covariate exposures. The METS-Microbiome study will substantially advance the understanding of the role gut microbiota and SCFAs play in the development of obesity and provide novel obesity therapeutic targets targeting SCFAs producing features of the gut microbiota.

Trial Registration: Registered NCT03378765 Date first posted: December 20, 2017.
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http://dx.doi.org/10.1186/s12889-018-5879-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6090745PMC
August 2018

Socioeconomic Factors for Sports Specialization and Injury in Youth Athletes.

Sports Health 2018 Jul-Aug;10(4):303-310. Epub 2018 May 31.

Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois.

Background: The effect of socioeconomic status (SES) on rates of sports specialization and injury among youth athletes has not been described previously.

Hypothesis: Young athletes from lower socioeconomic status will have lower rates of sports specialization and subsequently lower risk of overuse injuries.

Study Design: Cohort study.

Level Of Evidence: Level 3.

Methods: Injured athletes aged 7 to 18 years were recruited from 2 hospital-based sports medicine clinics and compared with uninjured athletes presenting for sports physicals at primary care clinics between 2010 and 2013. Participants completed surveys on training patterns. Electronic medical records provided injury details as well as patient zip code, race, and health insurance type. SES was estimated from zip codes. The sample was divided into SES tertiles. Analysis of variance and multivariate regression were used for continuous variables, and multivariate logistic regression analyses were conducted to explore relationships between risk factors and injury.

Results: Of 1190 athletes surveyed, 1139 (96%) had satisfactory SES data. Compared with low-SES athletes, high-SES athletes reported more hours per week spent playing organized sports (11.2 ± 6.0 vs 10.0 ± 6.5; P = 0.02), trained more months per year in their main sport (9.7 ± 3.1 vs 7.6 ± 3.7; P < 0.01), were more often highly specialized (38.9% vs 16.6%; P < 0.01), and had increased participation in individual sports (64.8% vs 40.0%; P < 0.01). The proportion of athletes with a greater than 2:1 ratio of weekly hours in organized sports to free play increased with SES. Accounting for age and weekly organized sports hours, the odds of reporting a serious overuse injury increased with SES (odds ratio, 1.5; P < 0.01).

Conclusion: High-SES athletes reported more serious overuse injuries than low-SES athletes, potentially due to higher rates of sports specialization, more hours per week playing organized sports, higher ratio of weekly hours in organized sports to free play, and greater participation in individual sports.

Clinical Relevance: As SES increases, young athletes report higher degrees of sports specialization, greater participation in individual sports, and more serious overuse injuries.
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http://dx.doi.org/10.1177/1941738118778510DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6044126PMC
July 2018

The Association of Dietary Fiber Intake with Cardiometabolic Risk in Four Countries across the Epidemiologic Transition.

Nutrients 2018 May 16;10(5). Epub 2018 May 16.

Public Health Sciences, Stritch School of Medicine, Maywood, IL 60153, USA.

The greatest burden of cardiovascular disease is now carried by developing countries with cardiometabolic conditions such as metabolic syndrome, obesity and inflammation believed to be the driving force behind this epidemic. Dietary fiber is known to have protective effects against obesity, type 2 diabetes, cardiovascular disease and the metabolic syndrome. Considering the emerging prevalence of these cardiometabolic disease states across the epidemiologic transition, the objective of this study is to explore these associations of dietary fiber with cardiometabolic risk factors in four countries across the epidemiologic transition. We examined population-based samples of men and women, aged 25⁻45 of African origin from Ghana, Jamaica, the Seychelles and the USA. Ghanaians had the lowest prevalence of obesity (10%), while Jamaicans had the lowest prevalence of metabolic syndrome (5%) across all the sites. Participants from the US presented with the highest prevalence of obesity (52%), and metabolic syndrome (22%). Overall, the Ghanaians consumed the highest dietary fiber (24.9 ± 9.7 g), followed by Jamaica (16.0 ± 8.3 g), the Seychelles (13.6 ± 7.2 g) and the lowest in the USA (14.2 ± 7.1 g). Consequently, 43% of Ghanaians met the fiber dietary guidelines (14 g/1000 kcal/day), 9% of Jamaicans, 6% of Seychellois, and only 3% of US adults. Across all sites, cardiometabolic risk (metabolic syndrome, inflammation and obesity) was inversely associated with dietary fiber intake, such that the prevalence of metabolic syndrome was 13% for those in the lowest quartile of fiber intake, compared to 9% those in the highest quartile of fiber intake. Notably, twice as many of participants (38%) in the lowest quartile were obese compared to those in the highest quartile of fiber intake (18%). These findings further support the need to incorporate strategies and policies to promote increased dietary fiber intake as one component for the prevention of cardiometabolic risk in all countries spanning the epidemiologic transition.
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http://dx.doi.org/10.3390/nu10050628DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986507PMC
May 2018

Determining the Accuracy and Reliability of Indirect Calorimeters Utilizing the Methanol Combustion Technique.

Nutr Clin Pract 2018 Apr;33(2):206-216

Department of Foods and Nutrition, University of Georgia, Athens, Georgia, USA.

Background: Several indirect calorimetry (IC) instruments are commercially available, but comparative validity and reliability data are lacking. Existing data are limited by inconsistencies in protocols, subject characteristics, or single-instrument validation comparisons. The aim of this study was to compare accuracy and reliability of metabolic carts using methanol combustion as the cross-laboratory criterion.

Methods: Eight 20-minute methanol burn trials were completed on 12 metabolic carts. Respiratory exchange ratio (RER) and percent O and CO recovery were calculated.

Results: For accuracy, 1 Omnical, Cosmed Quark CPET (Cosmed), and both Parvos (Parvo Medics trueOne 2400) measured all 3 variables within 2% of the true value; both DeltaTracs and the Vmax Encore System (Vmax) showed similar accuracy in measuring 1 or 2, but not all, variables. For reliability, 8 instruments were shown to be reliable, with the 2 Omnicals ranking best (coefficient of variation [CV] < 1.26%). Both Cosmeds, Parvos, DeltaTracs, 1 Jaeger Oxycon Pro (Oxycon), Max-II Metabolic Systems (Max-II), and Vmax were reliable for at least 1 variable (CV ≤ 3%). For multiple regression, humidity and amount of combusted methanol were significant predictors of RER (R = 0.33, P < .001). Temperature and amount of burned methanol were significant predictors of O recovery (R = 0.18, P < .001); only humidity was a predictor for CO recovery (R = 0.15, P < .001).

Conclusions: Omnical, Parvo, Cosmed, and DeltaTrac had greater accuracy and reliability. The small number of instruments tested and expected differences in gas calibration variability limits the generalizability of conclusions. Finally, humidity and temperature could be modified in the laboratory to optimize IC conditions.
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http://dx.doi.org/10.1002/ncp.10070DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6457648PMC
April 2018

Independent association of resting energy expenditure with blood pressure: confirmation in populations of the African diaspora.

BMC Cardiovasc Disord 2018 01 10;18(1). Epub 2018 Jan 10.

Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA.

Background: Obesity is a major risk factor for hypertension, however, the physiologic mechanisms linking increased adiposity to elevations in blood pressure are not well described. An increase in resting energy expenditure (REE) is an obligatory consequence of obesity. Previous survey research has demonstrated that REE is an independent predictor of blood pressure, and eliminates the co-linear association of body mass index. This observation has received little attention and there have been no attempts to provide a causal explanation.

Methods: At baseline in an international comparative study on obesity, 289 participants aged 25-44 were recruited from communities in the US, the Seychelles, Ghana and South Africa and had REE measured with indirect calorimetry. All participants were thought to be free of major illness.

Results: In multivariate regression models, both systolic and diastolic blood pressure were positively associated with REE (p < 0.01), while body mass index and fat mass were negatively correlated with systolic blood pressure (p < 0.01, and p < 0.05 respectively), but not diastolic blood pressure.

Conclusions: These data confirm previous reports and suggest that a common physiologic abnormality links REE and blood pressure. Elevated catecholamines, a putative metabolic characteristic of obesity, is a possible candidate to explain this association. The direct role of excess adipose tissue is open to question.
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http://dx.doi.org/10.1186/s12872-017-0737-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5763572PMC
January 2018

Oxytocin is lower in African American men with diabetes and associates with psycho-social and metabolic health factors.

PLoS One 2018 4;13(1):e0190301. Epub 2018 Jan 4.

Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America.

Objective: Recently, it has been suggested that oxytocin (OT) has a role in metabolism and neuropsychiatry health and disease, and therefore, it may represent a potential therapeutic target. The current study aimed to investigate relationships between OT and glycemic status along with psycho-social and behavioral factors.

Design And Methods: A total of 92 obese or overweight, African American, male subjects were enrolled in the study. Biometric and biochemical data were collected including oral glucose tolerance testing and urinary OT (measured by ELISA). Subjects also completed questionnaires on social and lifestyle factors.

Results: OT levels were found to be significantly lower in subjects with type 2 diabetes mellitus (T2DM) compared to normal glucose tolerance (p<0.05). When stratified by OT tertiles, subjects with higher OT had lower weight, body mass index (BMI) and hemoglobin A1c, but higher eGFR which remained significant after BMI adjustment. The highest OT tertile also had more smokers and more users of psychiatric medications. A stepwise ordered logistic regression supported these findings and could account for 21% of the variation in OT categories (pseudoR2 = 0.21).

Conclusions: In this unique population, OT was found lower in subjects with diabetes but higher with better renal function, cigarette smoking and use of psychiatric medications. Future studies are needed to confirm these findings and examine the potential therapeutic role of OT.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0190301PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5754076PMC
February 2018

Cardiovascular risk status of Afro-origin populations across the spectrum of economic development: findings from the Modeling the Epidemiologic Transition Study.

BMC Public Health 2017 05 12;17(1):438. Epub 2017 May 12.

Public Health Sciences, Stritch School of Medicine, Maywood, IL, USA.

Background: Cardiovascular risk factors are increasing in most developing countries. To date, however, very little standardized data has been collected on the primary risk factors across the spectrum of economic development. Data are particularly sparse from Africa.

Methods: In the Modeling the Epidemiologic Transition Study (METS) we examined population-based samples of men and women, ages 25-45 of African ancestry in metropolitan Chicago, Kingston, Jamaica, rural Ghana, Cape Town, South Africa, and the Seychelles. Key measures of cardiovascular disease risk are described.

Results: The risk factor profile varied widely in both total summary estimates of cardiovascular risk and in the magnitude of component factors. Hypertension ranged from 7% in women from Ghana to 35% in US men. Total cholesterol was well under 200 mg/dl for all groups, with a mean of 155 mg/dl among men in Ghana, South Africa and Jamaica. Among women total cholesterol values varied relatively little by country, following between 160 and 178 mg/dl for all 5 groups. Levels of HDL-C were virtually identical in men and women from all study sites. Obesity ranged from 64% among women in the US to 2% among Ghanaian men, with a roughly corresponding trend in diabetes. Based on the Framingham risk score a clear trend toward higher total risk in association with socioeconomic development was observed among men, while among women there was considerable overlap, with the US participants having only a modestly higher risk score.

Conclusions: These data provide a comprehensive estimate of cardiovascular risk across a range of countries at differing stages of social and economic development and demonstrate the heterogeneity in the character and degree of emerging cardiovascular risk. Severe hypercholesterolemia, as characteristic in the US and much of Western Europe at the onset of the coronary epidemic, is unlikely to be a feature of the cardiovascular risk profile in these countries in the foreseeable future, suggesting that stroke may remain the dominant cardiovascular event.
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http://dx.doi.org/10.1186/s12889-017-4318-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5429531PMC
May 2017

Improving Urban Minority Girls' Health Via Community Summer Programming.

J Racial Ethn Health Disparities 2017 Dec 31;4(6):1237-1245. Epub 2017 Mar 31.

Public Health Sciences, Loyola University Chicago, Stritch School of Medicine, Maywood, IL, USA.

Summertime has emerged as a high-risk period for weight gain among low-income minority youth who often experience a lack of resources when not attending school. Structured programming may be an effective means of reducing risk for obesity by improving obesogenic behaviors among these youth. The current multi-method study examined sedentary time, physical activity, and dietary intake among low-income urban minority girls in two contexts: an unstructured summertime setting and in the context of a structured 4-week community-based summer day camp program promoting physical activity. Data were analyzed using paired-sample t tests and repeated-measure analyses of variance with significance at the p < .05 level. Results evidenced no significant differences in total calories and fat consumed between the unstructured and structured settings. Participants exhibited significant increases in fruit consumption and physical activity and significant decreases in sedentary time of over 2 h/day and dairy consumption when engaged in structured summer programming. All improvements were independent of weight status and age, and African-American participants evidenced greater changes in physical activity during programming. The study concludes that structured, community-based summertime programming may be associated with fewer obesogenic behaviors in low-income urban youth and may be a powerful tool to address disparities in weight gain and obesity among high-risk samples.
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http://dx.doi.org/10.1007/s40615-016-0333-xDOI Listing
December 2017

Specialization patterns across various youth sports and relationship to injury risk.

Phys Sportsmed 2017 09 10;45(3):344-352. Epub 2017 Apr 10.

a Division of Pediatric Orthopaedic Surgery & Sports Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago , Chicago , IL , USA.

Objectives: Current trends among young athletes towards earlier specialization age and year-round training on multiple teams has raised concern for increased injury risk. Our previous analyses showed higher risk for injury in highly specialized young athletes. The goal of this research was to determine whether sports specialization and injury patterns vary by sports type.

Methods: In this clinical case-control study, injured athletes (aged 7-18 years) were recruited from sports medicine clinics and compared to similarly aged uninjured athletes recruited from primary care clinics. Participants completed a survey reporting age, gender, sport type, specialization patterns, and details regarding sports-related injuries in the previous 6 months. Clinical diagnoses were collected from patients' medical records. Injuries were classified as acute, overuse, or serious overuse.

Results: Of 1,190 athletes enrolled, 26% (313) were single-sport specialized (reported participation in one sport and trained >8 months/year). Sports with the highest proportion of single-sport specialized athletes were tennis (46.7%), gymnastics (30.1%), and dance (26.3%). Single-sport specialized athletes in individual sports started specializing at a younger age (11.2 ± 2.4 vs. 12.0 ± 2.7, p = 0.05) and reported higher training volumes (11.8 vs. 10.3 h/week, p = 0.04) than those in team sports. Sports with the youngest specialization age were gymnastics (8.9 ± 1.7), dance (10.8 ± 3.0), and soccer (10.9 ± 2.4). Single-sport specialized athletes in individual sports accounted for a higher proportion of overuse injuries (44.3% vs 32.2%, OR = 1.67, p = 0.037) and serious overuse injuries (23.4% vs 11.6%, OR = 2.38, p = 0.011), but a lower proportion of acute injuries (28.8% vs 13.8%, OR = 0.37, p = 0.001) compared to single-sport specialized athletes involved in team sports.

Conclusions: Athletes in individual sports may be more likely to specialize in a single sport than team sport athletes. Single-sport specialized athletes in individual sports also reported higher training volumes and greater rates of overuse injuries than single-sport specialized athletes in team sports.
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http://dx.doi.org/10.1080/00913847.2017.1313077DOI Listing
September 2017

Accelerometer-measured physical activity is not associated with two-year weight change in African-origin adults from five diverse populations.

PeerJ 2017 19;5:e2902. Epub 2017 Jan 19.

Public Health Sciences, Stritch School of Medicine, Loyola University Chicago , Maywood , IL , United States.

Background: Increasing population-levels of physical activity (PA) is a controversial strategy for managing the obesity epidemic, given the conflicting evidence for weight loss from PA alone . We measured PA and weight change in a three-year prospective cohort study in young adults from five countries (Ghana, South Africa, Jamaica, Seychelles and USA).

Methods: A total of 1,944 men and women had baseline data, and at least 1 follow-up examination including measures of anthropometry (weight/BMI), and objective PA (accelerometer, 7-day) following the three-year study period. PA was explored as 1-minute bouts of moderate and vigorous PA (MVPA) as well as daily sedentary time.

Results: At baseline; Ghanaian and South African men had the lowest body weights (63.4 ± 9.5, 64.9 ± 11.8 kg, respectively) and men and women from the USA the highest (93.6 ± 25.9, 91.7 ± 23.4 kg, respectively). Prevalence of normal weight ranged from 85% in Ghanaian men to 29% in USA men and 52% in Ghanaian women to 15% in USA women. Over the two-year follow-up period, USA men and Jamaican women experienced the smallest yearly weight change rate (0.1 ± 3.3 kg/yr; -0.03 ± 3.0 kg/yr, respectively), compared to South African men and Ghanaian women greatest yearly change (0.6.0 ± 3.0 kg/yr; 1.22 ± 2.6 kg/yr, respectively). Mean yearly weight gain tended to be larger among normal weight participants at baseline than overweight/obese at baseline. Neither baseline MVPA nor sedentary time were associated with weight gain. Using multiple linear regression, only baseline weight, age and gender were significantly associated with weight gain.

Discussion: From our study it is not evident that higher volumes of PA alone are protective against future weight gain, and by deduction our data suggest that other environmental factors such as the food environment may have a more critical role.
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http://dx.doi.org/10.7717/peerj.2902DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5251933PMC
January 2017
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