Current Zinc Intake and Risk of Diabetes and Coronary Artery Disease and Factors Associated with Insulin Resistance in Rural and Urban Populations of North India

Objective: To determine the association between current zinc intake and prevalence of coronary artery disease (CAD) and diabetes as well as factors associated with insulin resistance.

Design, Subjects and Methods: In this cross sectional survey, 3575 subjects, aged 25 to 64 years, including 1769 rural (894 men, 875 women) and 1806 urban (904 men, 902 women) subjects were studied. The survey methods included questionnaires for 7-day food intake record, physical examination, and electrocardiography using World Health Organization criteria.

Results: The prevalence of CAD, diabetes and glucose intolerance was significantly higher among subjects consuming lower intakes of dietary zinc. There was a higher prevalence of hypertension, hypertriglyceridemia and low high-density lipoprotein cholesterol levels which showed significant upward trend with lower zinc intakes. Serum lipoprotein (a) and 2-hour plasma insulin levels also were associated with low zinc intake. Multivariate logistic regression analysis after adjustment for age showed that zinc intake and CAD were inversely associated. Serum zinc (odds ratio:men 0.77, women 0.57), serum triglycerides (men 0.86, women 0.81), blood pressure (0.83 men, women 0.76), diabetes mellitus (men 0.90, women 0.85), central obesity (men 0.88, women 0.87), glucose intolerance (men 0.66, women 0.57) and low high-density lipoprotein cholesterol (men 0.72, women 0.70) were significant risk factors for CAD (explained by tertiles of zinc status) in urban subjects. These associations were not observed in rural subjects.

Conclusion: Lower consumption of dietary zinc and low serum zinc levels were associated with an increased prevalence of CAD and diabetes and several of their associated risk factors including hypertension, hypertriglyceridemia and other factors suggestive of mild insulin resistance in urban subjects.     

Associations Between Acculturation and Weight,Diet Quality,and Physical Activity Among Latina Breast Cancer Survivors: The ¡Mi Vida Saludable! Study

BackgroundAmong Latinos, greater acculturation to the United States (US) is associated with risk of obesity and obesity-related comorbidities. Less is known about the associations between acculturation and obesity-related modifiable risk factors, such as diet quality and physical activity (PA) among Latina breast cancer survivors.ObjectiveThe aim of this study was to explore associations between acculturation and weight status, diet quality, and PA among Latina breast cancer survivors.DesignThis is a cross-sectional secondary analysis of baseline data on demographic and clinical characteristics, acculturation, anthropometric measures, diet quality, and PA collected from Latina breast cancer survivors enrolled in the ¡Mi Vida Saludable! (My Healthy Life) behavioral diet and PA intervention trial.Participants/settingParticipants were Latina women (n = 167) residing in New York City, with a medical history of stage 0 to III breast cancer, no evidence of recurrent or metastatic disease, and at least 90 days post cancer treatment who participated in the ¡Mi Vida Saludable! randomized controlled trial between July 2016 and October 2018.Main outcome measuresAcculturation status was measured by the Short Acculturation Scale for Hispanics score, language preference, place of birth, and duration of US residence. Weight, height, and waist and hip circumferences were measured at an in-person clinic visit. Diet information was collected via 3 telephone-based 24-hour dietary recalls and PA information was collected via staff administered 7-day recalls.Statistical analyses performedLinear regression models examined associations between acculturation and weight status, diet quality, and PA.ResultsBased on the Short Acculturation Scale for Hispanics acculturation score, more acculturated compared with less acculturated Latinas were younger in age, more educated, and had higher annual household incomes (all, P < .05). Compared with Spanish-speaking Latinas, English-speaking Latinas had larger waist circumference (103 vs 96.1 cm; P = .01) and poorer-quality diets (Healthy Eating Index 2015 scores, 57.3 vs 71.5; P < .001). Greater levels of acculturation were also associated with higher levels of leisure walking at a moderate-to-vigorous intensity (265.8 vs 179.0 min/wk; P =.04).ConclusionsGreater levels of acculturation were associated with higher central obesity and poorer-quality diets. Future lifestyle modification trials tailored to the unique role of acculturation on adopting behavior change recommendations is a promising next step in this line of research.     

A Comparison of Different Measures of Acculturation with Cardiovascular Risk Factors in Latinos with Hypertension

The effect of acculturation with cardiovascular disease (CVD) risk factors is poorly understood. We assessed the association of three acculturation measures (English language, US country of birth and a combination of the two) with CVD risk factors and co-morbid medical and behavioral conditions in a registry of 6,793 Latinos with hypertension. Greater acculturation was associated with higher adherence to medication (P < 0.05) and a higher prevalence of behavioral conditions (P < 0.01) but not with differences in prevalence of CVD risk factors, greater levels of CVD risk factor control or outcomes. Our study demonstrates that our proxies for acculturation were associated with behavioral risk factors, but not with the level of control of biomedical CVD risk factors. While more work is needed to develop proxies that can predict risk factor control and CVD outcomes, our simple measures can facilitate regular assessment of the cultural component of behavioral risk.     

The Association between Parity and Inflammation among Mexican-American Women of Reproductive Age Varies by Acculturation Level: Results of the National Health and Nutrition Examination Survey (1999–2006)

IntroductionParity and acculturation are linked with cardiometabolic risk. Their joint association with cardiometabolic health among Mexican-American women is less established, even though immigrant Mexican-American women have the highest fertility rate in the United States. We examined the modifying role of acculturation on the association of parity with a cardiometabolic risk biomarker, C-reactive protein (CRP).MethodsParticipants (n = 1,002) were women of Mexican background, ages 16 to 39 years, in the National Health and Nutrition Examination Survey (NHANES) from 1999 through 2006. The association between parity and elevated CRP was examined using logistic regression adjusted for age, household food security, access to health care, hemoglobin A1c, total cholesterol, high-density lipoprotein cholesterol, waist circumference, physical activity, acculturation, and a product term of parity and acculturation. Acculturation was measured on a 6-point score based on nativity status and duration of residence in the United States (0, Mexico born, U.S. resident <10 years; 1, Mexico born, U.S. resident 10–19 years; 2-Mexico born, U.S. resident ≥20 years; and 3, U.S. born), and language used at home (0, Spanish; 1, bilingual; 2, English). Scores of 0 or 1, 2 or 3, and 4 or 5 represented low, moderate, and high acculturation, respectively.ResultsThe association of parity with elevated CRP varied by acculturation level (p_interaction = 0.10). Parity was associated with elevated CRP among women with low (adjusted odds ratio [OR], 2.26; 95% CI, 1.07–4.80) and moderate acculturation (adjusted OR, 2.79; 95% CI, 1.16–6.73), compared with nulliparous women.ConclusionsHigher odds of elevated CRP associated with parity in immigrant Mexican-American women of reproductive age indicate the need for greater use of maternal/women's health care services for cardiometabolic risk screening and interventions.     

Association of glycemic load with cardiovascular disease risk factors: The Women's Health Initiative Observational Study

ObjectiveAssociations between dietary glycemic load (GL) and cardiovascular disease risk factors, including plasma lipoprotein/lipid levels, blood pressure, and glucose metabolism factors, in the Women's Health Initiative Observational Study were examined.MethodsA random sample of 878 Observational Study participants (postmenopausal women 50–79 y of age) with baseline blood measurements (647 white, 104 black, 127 Hispanic) was included. Dietary GL was estimated from baseline food-frequency questionnaires, which assessed dietary intake over the previous 3 mo. At the baseline visit, participants completed demographic and health habit questionnaires, fasting blood samples were collected, anthropometric measurements were completed, and blood pressure was assessed.ResultsIn all participants combined, GL was inversely associated with high-density lipoprotein cholesterol (P for trend = 0.004) and positively associated with log₁₀-transformed triacylglycerols (P = 0.008). Although there were no statistically significant interactions of race/ethnicity with associations between GL and cardiovascular disease risk factors, stratified results were suggestive, showing that GL was positively associated with total cholesterol (P = 0.018) and low-density lipoprotein cholesterol (P = 0.038) in Hispanics. In white subjects, there was a trend of reduced high-density lipoprotein cholesterol with higher GL (P = 0.003), whereas GL was positively associated with log₁₀-transformed triacylglycerols (P = 0.015). Associations between GL and high-density lipoprotein cholesterol and between GL and triacylglycerols also differed by body mass index, although the interactions were not statistically significant.ConclusionAmong these generally healthy postmenopausal women, GL was associated with high-density lipoprotein cholesterol and triacylglycerols. Suggestive effects of race/ethnicity and body mass index on these associations need to be confirmed in larger studies.     

Association between serum cholesterol levels and Alzheimer’s disease in China: a case-control study

To examine the association between blood cholesterol concentrations and Alzheimer’s disease (AD) in the Chinese elderly. A case-control study was implemented between November 2011 and November 2017. Elderly patients aged ≥?55?years with (n?=?117) and without AD (control participants; n?=?117) were recruited from the Neurology Central Hospital of Tianjin, China. The associations between AD and blood parameters were assessed using multiple binary logistic regression analyses adjusted for multiple covariates. Higher serum total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels and lower serum high-density lipoprotein cholesterol (HDL-C) levels associated with AD risk in the models adjusted for (1) age, sex and education; and (2) further adjusted for body mass index, smoking status, stroke, hypertension, type 2 diabetes mellitus and heart disease. Increased serum TC and LDL-C levels and lower HDL-C levels were independently associated with the risk of AD.     

The relationship of education and acculturation with vigorous intensity leisure time physical activity by gender in Latinos

Objectives: Latinos have poorer health outcomes among certain conditions (e.g. diabetes, obesity, mental health) compared to non-Latino Whites in the U.S., in part due to difference in the amount of physical activity, which are heavily influenced by sociocultural factors such as educational attainment and acculturation. Vigorous-intensity leisure time physical activity (VLTPA) may provide health benefits with a shorter amount of time than moderate-to-light physical activity. However, VLTPA has been significantly understudied compared to LTPA in general. The purpose of this study is to examine the associations between educational attainment, acculturation, and VLTPA by gender among Latino adults in the U.S.

Design: Nationally representative samples of Latino adults aged 25 years and older (n?=?4393) from the 2010 National Health Interview Survey were analyzed. VLTPA was measured as the number of hours per week of VLTPA consisting of heavy sweating or large increases in breathing and heart rate. Acculturation was measured as the degree to which the English language versus the Spanish language was spoken most often. The zero-inflated Poisson regression model was constructed using the full information maximum likelihood estimation and controlling for a series of sociodemographic characteristics and relevant health behaviors.

Results: Educational attainment was positively associated with VLTPA among Latino adults [exp(b)?=?1.09, p?b)?=?1.10, p?Conclusions: Education had a positive association and acculturation had negative association with the hours/week of VLTPA among Latinos. Also, the association between education and VLTPA was significantly stronger among women than men. These findings inform culturally and socially sensitive approaches to improve the health of Latinos, in hopes to address health disparities by race/ethnicity the U.S.     

Acculturation and healthy lifestyle among Latinos with diabetes

PURPOSE Latinos have a high prevalence of diabetes and disproportionately experience diabetic complications. We sought to examine the association of acculturation on healthy lifestyle habits among the Latino population in the United States with diabetes.METHODS We studied Latino adults (aged ≥20 years) with previously diagnosed diabetes in the 1999–2004 National Health and Nutrition Examination Survey (unweighted N = 467; weighted N = 1,957,778). Healthy lifestyle habits were those consistent with recommendations of the American Diabetes Association (ADA) regarding exercise, smoking, obesity, and diet. Acculturation was measured with the Short Acculturation Scale, a validated 5-item scale assessing use of the Spanish language. Logistic regression analyses of acculturation and healthy behaviors were computed controlling for access to care, demographics, and disease characteristics.RESULTS In bivariate analyses, compared with their less-acculturated counterparts, individuals who were more-acculturated to any extent were less likely to have a higher fiber intake (9.4% vs 35.4%, P = .001) and lower saturated fat intake (17.2% vs 46.5%, P = .03). More-acculturated individuals were more likely to report leisure time exercise (59.2% vs 19.3%, P <.001), whereas the proportion of individuals who smoked did not differ. In logistic regression analyses using the 1994 ADA dietary guidelines, more-acculturated individuals were less likely than their less-acculturated counterparts to meet dietary criteria for saturated fat consumption (odds ratio, 0.13; 95% confidence interval [CI], 0.04–0.41). When using the stricter 2006 ADA dietary guidelines, more-acculturated individuals were less likely to have recommended consumption of both saturated fat (odds ratio, 0.06; 95% CI, 0.02–0.20) and fiber (odds ratio, 0.19; 95% CI, 0.08–0.48). Acculturation did not significantly influence exercise and smoking status in logistic regression analyses.CONCLUSIONS These results suggest that acculturation among diabetic Latinos to the general US culture is associated with adoption of some less desirable dietary habits.     

Acculturation and Cardiovascular Behaviors Among Latinos in California by Country/Region of Origin

Despite generally lower socioeconomic status and worse access to healthcare, Latinos have better overall health outcomes and longer life expectancy than non-Latino Whites. This "Latino Health Paradox" has been partially attributed to healthier cardiovascular (CV) behaviors among Latinos. However, as Latinos become more acculturated, differences in some CV behaviors disappear. This study aimed to explore how associations between acculturation and CV behaviors among Latinos vary by country of origin. Combined weighted data from the 2005 and 2007 California Health Interview Survey (CHIS) were used to investigate associations between acculturation level and CV behaviors among Latinos by country of origin. Among all Latinos, increased acculturation was associated with more smoking, increased leisure-time physical activity, and greater consumption of fast foods, but no change in fruit/vegetable and less soda intake. These trends varied, however, by Latino sub-groups from different countries of origin. Country of origin appears to impact associations between acculturation and CV behaviors among Latinos in complex ways.     

NEWS

Background: Psychosocial factors such as depressive symptoms should be considered when assessing cardiovascular (CV) risk. Depressive symptoms are suggested to be associated with poor perception of one’s health, i.e. self-rated health (SRH). Thus, assessing SRH could be a practical tool in CV risk prediction. However, SRH may also emphasize physical, mental or social aspects.

Objectives: To assess the relationship of SRH and depressive symptoms, classic CV risk factors and perceived physical health among persons at risk for type 2 diabetes (T2D) and cardiovascular disease (CVD).

Methods: In this cross-sectional study in a primary care population, 2555 persons (mean age 58?±?7, 56% women) at risk for T2D or CVD were evaluated. Generalized linear statistical models were used to evaluate the association of depressive symptoms (Beck’s Depression Inventory score ≥10), CV risk factors, and perception of SRH and physical health (assessed by Short Form Health Survey).

Results: Poor or fair health was reported by 40% of the participants. They had more unhealthy lifestyle habits and CV risk factors than subjects rating their health as at least good. Among those with poor or fair SRH, the prevalence of depressive symptoms was 36% and associated with perception of physical health.

Conclusion: Poor SRH is associated with depressive symptoms and impaired perceived physical health. Assessing SRH might be useful for detecting possible depressive symptoms in patients in CV risk management and diabetes care.     

Association between iq’mik smokeless tobacco use and cardiometabolic risk profile among Yup’ik Alaska Native people

Objective: The traditional lifestyle of Yup’ik Alaska Native people, including a diet abundant in marine-based foods and physical activity, may be cardio-protective. However, iq’mik, a traditional form of smokeless tobacco used by >50% of Yup’ik adults, could increase cardiometabolic (CM) risk. Our objective was to characterize the associations between iq’mik use and biomarkers of CM status (low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], triglycerides [TG], systolic blood pressure [SBP] and diastolic blood pressure [DBP], glycated hemoglobin [HbA1c], fasting blood glucose [FBG], waist circumference [WC], and body mass index [BMI]).

Design: We assessed these associations using data from a cross-sectional sample of Yup’ik adults (n?=?874). Current iq’mik use, demographic, and lifestyle data were collected through interviews. Fasting blood samples were collected to measure LDL-C, HDL-C, TG, HbA1c, and FBG. SBP, DBP, WC, and BMI were obtained by physical examination. We characterized the association between current iq’mik use and continuous biomarkers of CM status using multiple approaches, including adjustment for measures of Yup’ik lifestyle and a propensity score.

Results: Based on either adjustment method, current iq’mik use was significantly and positively associated with at least 5% higher HDL-C, and significantly associated but in an inverse direction with multiple biomarkers of CM status including 7% lower TG, 0.05% lower HbA1c, 2% lower FBG, 4% lower WC, and 4% lower BMI. Observed associations for LDL-C, SBP, and DBP varied by adjustment method.

Conclusions: This inverse association between iq’mik use and cardiometabolic risk status has not been previously reported. Additional research is needed to replicate these findings and explore physiological mechanisms and/or confounding factors.     

Depressive symptoms in Hispanic and non-Hispanic White rural elderly: the San Luis Valley Health and Aging Study

Literature on depression in rural and Hispanic elderly adults is sparse. This report describes the prevalence of depressive symptoms in 1,151 community-dwelling, Hispanic and non-Hispanic White participants in the San Luis Valley Health and Aging Study, conducted in rural Colorado during 1993-1995. The prevalence and odds ratios of high depressive symptoms, defined as a Center for Epidemiologic Studies Depression Scale score of > or = 16, were calculated. The crude prevalence of high depressive symptoms was 11.4% (95% confidence interval: 9.6, 13.6). Female gender, chronic diseases, dissatisfaction with social support, living alone, and lower income and education were associated with depressive symptoms. There were no ethnic differences in the men. The age-adjusted odds ratio of depressive symptoms in Hispanic women compared with that of non-Hispanic White women was 2.11 (95% confidence interval: 1.32, 3.38). After adjustment for multiple sociodemographic and health risk factors, the odds ratio in Hispanic women was 2.12 (95% confidence interval: 1.19, 3.80). Higher depressive symptoms in Hispanic women varied by acculturation level. The odds ratio in the high acculturation stratum was 1.56 (95% confidence interval: 0.75, 3.27) and in the low acculturation stratum was 2.51 (95% confidence interval: 1.11, 5.70). A lower acculturation level may increase the risk for depression in older Hispanic women.     

National report on the association of serum vitamin D with cardiometabolic risk factors in the pediatric population of the Middle East and North Africa (MENA): The CASPIAN-III Study

ObjectivesAs the first, to our knowledge, nationwide study in the Middle East and North Africa (MENA), this study aimed to investigate the association of serum 25 hydroxy vitamin D [25(OH)D] levels with cardiometabolic risk factors in a nationally representative sample of the pediatric population in Iran. The second objective was to provide the prevalence of hypovitaminosis D and the percentiles of serum 25(OH)D in the study population.MethodsThis national population-based study was conducted among 1100 Iranian students living in 27 provinces in Iran. The association of 25(OH)D with each cardiometabolic risk factor was determined after adjustment for age, gender, body mass index, and waist circumference.ResultsParticipants consisted of 1095 students (52% boys) with a mean age of 14.74 ± 2.61 y. The median 25(OH)D level corresponded to a vitamin D insufficiency level: 12.70 ng/mL in boys and 13.20 ng/mL in girls. Overall, 40% of participants were vitamin D deficient, and 39% had vitamin D insufficiency. There were no significant differences in these findings between boys and girls. Adjusted regression analysis revealed a significant weak inverse association of 25(OH)D with systolic blood pressure, diastolic blood pressure, total cholesterol, and low-density lipoprotein cholesterol. This association was significantly positive with high-density lipoprotein cholesterol, but not with fasting plasma glucose and metabolic syndrome.ConclusionWe found a considerably high prevalence of hypovitaminosis D in the pediatric population of a sunny region. Our findings also revealed an association of hypovitaminosis D with many cardiometabolic risk factors from childhood; these associations were independent of obesity indexes. It is of special concern that the highly prevalent disorders of low 25(OH)D and low high-density lipoprotein cholesterol in children and adolescents of the MENA region had significant association. The clinical importance of our findings needs to be confirmed in longitudinal studies.     

Cardiovascular risk factors in young,overweight, and obese European adults and associations with physical activity and omega-3 index

Excess body fat is associated with increased cardiovascular disease (CVD) risk. The hypothesis of the study was that physical activity and omega-3 index, a marker of past long chain n-3 polyunsaturated fatty acids consumption, counteract the negative associations between fatness and CVD risk factors in young overweight and obese adults. A total of 324 subjects (20-40 years, body mass index [BMI], 27.5-32.5 kg/m², from Iceland, Spain, and Ireland) were investigated cross-sectionally. Dietary intake, anthropometric measurements, blood pressure, CVD risk factors, and fatty acids in erythrocyte membrane were analyzed. Information on physical activity was collected. Linear models were constructed to find out the associations of BMI, physical activity (quartiles), and omega-3 index with CVD risk factors. The most frequently increased risk factors were blood lipids (41.4%) and blood pressure (32.1%); fewer participants experienced disturbed glucose metabolism (11.8%). Body mass index was significantly associated with increased CVD risk factors (P = .001-.029), with the exception of total cholesterol, low-density lipoprotein, and high-density lipoprotein. The highest physical activity quartile had a lower fat mass (P = .005, at a given BMI), leptin (P = .008, in male participants only), and interleukin 6 (P = .021) but higher high-density lipoprotein (P = .020) than other quartiles; however, an approximate dose-response relationship could only be observed for leptin. The omega-3 index was not associated with lower low-density lipoprotein (P = .056), but docosahexaenoic acid in erythrocyte membrane was associated to it (P = .016). It is concluded that physical activity and docosahexaenoic acid diminish some of the negative health effects associated with overweight and obesity; however, body fatness remains the most important variable associated with increased CVD risk factors in young overweight and obese adults.     

Heterogeneity in periodontitis prevalence in the Hispanic Community Health Study/Study of Latinos

PurposeThe aim of the study was to examine acculturation and established risk factors in explaining variation in periodontitis prevalence among Hispanic/Latino subgroups.MethodsParticipants were 12,730 dentate adults aged 18–74 years recruited into the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) from four U.S. field centers between 2008 and 2011. A standardized periodontal assessment measured probing pocket depth and gingival recession at six sites per tooth for up to 28 teeth. Periodontitis was defined according to the Centers for Disease Control and Prevention and American Academy of Periodontology case classifications developed for population surveillance. Covariates included acculturation indicators and established periodontitis risk factors. Survey estimation procedures took account of the complex sampling design. Adjusted multivariate binomial regression estimated prevalence ratios and 95% confidence limits (CLs).ResultsUnadjusted prevalence of moderate and severe periodontitis was 38.5% and ranged from 24.7% among Dominicans to 52.1% among Cubans. Adjusted prevalence ratios for subgroups relative to Dominicans were as follows: (1) 1.34 (95% CL, 1.13–1.58) among South Americans; (2) 1.37 (95% CL, 1.17–1.61) among Puerto Ricans; (3) 1.43 (95% CL, 1.25–1.64) among Mexicans; (4) 1.53 (95% CL, 1.32–1.76) among Cubans; and (5) 1.55 (95% CL, 1.35–1.78) among Central Americans.ConclusionsHeterogeneity in prevalence of moderate/severe periodontitis among Hispanic/Latino subpopulations was not explained by acculturation or periodontitis risk factors.     

Intuitive Eating and Biomarkers Related to Cardiovascular Disease in Older Adults

ObjectiveExamine whether exercise and diet motivation are associated with 4 biomarkers related to cardiovascular disease.DesignCross-sectional analysis. Data collection involved questionnaires, blood draws, body composition assessments, and accelerometry.SettingSmall, midwestern college town.ParticipantsCommunity older adults (≥ 58 years of age; n = 79) recruited through convenience sampling; the sample was representative of the population of interest for some demographic characteristics (eg, age and sex) but not representative of other characteristics (eg, level of activity).Variables MeasuredIndependent variables comprised self-reported intrinsic exercise motivation (Behavioral Regulation for Exercise Questionnaire-3) and intuitive eating (Intuitive Eating Scale-2). Dependent variables included inflammatory proteins (C-reactive protein and interleukin-6) and lipid levels (low-density lipoprotein/high-density lipoprotein and triglycerides) quantified from blood samples. Covariates included age, body mass index, sex, and objective physical activity measured by accelerometers worn for 7 days.AnalysisMultiple linear regression was used to assess the association between diet and exercise motivation and biomarker outcomes; we analyzed 4 regression models (1 for each biomarker). Significance level P < 0.05.ResultsGreater intuitive eating was associated with a lower low-density lipoprotein/high-density lipoprotein ratio (β = ?0.45, P = 0.001) and lower triglycerides (β = ?0.37, P = 0.003). Intrinsic exercise motivation was not associated with the biomarkers.Conclusions and ImplicationsIntuitive eating may be a key determinant of certain biomarkers and could be a viable target for interventions to help decrease the risk of cardiovascular disease among older adults.     

Nutrition Label Use and Its Association With Dietary Quality Among Latinos: The Roles of Poverty and Acculturation

Objective

To investigate how acculturation and poverty are independently and jointly associated with the use of the Nutrition Facts panel (nutrition label) and to examine the extent to which nutrition label use moderates the association of poverty and acculturation on dietary quality among Latinos.

Do healthy behaviors decline with greater acculturation? Implications for the Latino mortality paradox

Relative to non-Latino whites, Latinos in the United States have a lower socioeconomic status (SES) profile, but a lower all-cause mortality rate. Because lower SES is associated with poorer overall health, a great deal of controversy surrounds the Latino mortality paradox. We employed a secondary data analysis of the 1991 National Health Interview Survey to test the health behavior and acculturation hypotheses, which have been proposed to explain this paradox. These hypotheses posit that: (1) Latinos have more favorable health behaviors and risk factor profiles than non-Latino whites, and (2) Health behaviors and risk factors become more unfavorable with greater acculturation. Specific health behaviors and risk factors studied were: smoking, alcohol use, leisure-time exercise activity, and body mass index (BMI). Consistent with the health behaviors hypothesis, Latinos relative to non-Latino whites were less likely to smoke and drink alcohol, controlling for sociodemographic factors. Latinos, however, were less likely to engage in any exercise activity, and were more likely to have a high BMI compared with non-Latino whites, after controlling for age and SES. Results provided partial support for the acculturation hypothesis. After adjusting for age and SES, higher acculturation was associated with three unhealthy behaviors (a greater likelihood of high alcohol intake, current smoking, a high BMI), but improvement in a fourth (greater likelihood of recent exercise). Gender-specific analyses indicated that the observed differences between Latinos and non-Latino whites, as well as the effects of acculturation on health behaviors, varied across men and women. Results suggest that the health behaviors and acculturation hypotheses may help to at least partially explain the Latino mortality paradox. The mechanisms accounting for the relationship between acculturation and risky behaviors have yet to be identified.     

Immigration,Acculturation and Chronic Back and Neck Problems Among Latino-Americans

Higher acculturation is associated with increased obesity and depression among Latino-Americans, but not much is known about how acculturation is related to their prevalence of back and neck problems. This study examines whether acculturation is associated with the 12-month prevalence of self-reported chronic back or neck problems among US-born and immigrant Latinos. We performed multivariable logistic regression analysis of data from 2,553 noninstitutionalized Latino adults from the 2002–2003 National Latino and Asian American Survey (NLAAS). After adjusting for demographic, physical and mental health indicators, English proficiency, nativity and higher generational status were all significantly positively associated with the report of chronic back or neck problems. Among immigrants, the proportion of lifetime in the US was not significantly associated. Our findings suggest that the report of chronic back or neck problems is higher among more acculturated Latino-Americans independent of health status, obesity, and the presence of depression.     

Effects of Phytosterol Supplementation on Serum Levels of Lipid Profiles,Liver Enzymes,Inflammatory Markers,Adiponectin, and Leptin in Patients Affected by Nonalcoholic Fatty Liver Disease: A Double-Blind,Placebo-Controlled,Randomized Clinical Trial

ABSTRACT

Objective: Considering the high prevalence of nonalcoholic fatty liver disease and based on the evidence about the role of dietary cholesterol in liver inflammation, and also with regard to the effect of phytosterols on the metabolism of cholesterol, we aimed at exploring the therapeutic potential of phytosterol supplementation against nonalcoholic fatty liver disease.

Method: Thirty-eight patients with nonalcoholic fatty liver disease were randomly divided into two groups: The phytosterol group (n = 19) received a 1.6-g phytosterol supplement daily and the control group (n = 19) received 1.6 g starch daily as placebo for an 8-week period. Blood samples of all patients were taken at baseline (week 0) and at the end of the study (week 8) for measurement of lipid profiles, liver enzymes, inflammatory markers, adiponectin, and leptin.

Results: Phytosterol supplementation significantly improved the levels of low-density lipoprotein cholesterol, aspartate aminotransferase, alanine aminotransferase, and tumor necrosis factor alpha compared to the placebo group. On the other hand, there were no significant differences between the two groups in total cholesterol, triglycerides, high-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol, ratios of low-density lipoprotein cholesterol/high-density lipoprotein cholesterol and total cholesterol/high-density lipoprotein cholesterol, gamma-glutamyl transferase, interleukin 6, high-sensitivity C-reactive protein, adiponectin, and leptin.

Conclusions: The present study suggested that daily consumption of 1.6 g phytosterols efficiently lowers low-density lipoprotein cholesterol, aspartate aminotransferase, alanine aminotransferase, and tumor necrosis factor alpha in patients with nonalcoholic fatty liver disease.