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Background

Limited research has evaluated the relationship between dietary behavior and mortality among those with mobility limitations.

Objective

To examine the association between dietary behavior and mortality in a national sample of American adults with mobility limitations.

Methods

Data from the 2003–2006 National Health and Nutrition Examination Survey were utilized. Participants were followed through 2011. Based on self-report, analyzed participants included those with mobility limitations (N = 1369). Dietary behavior was assessed from the alternate healthy eating index (AHEI).

Results

For the sample, 108,010 person-months occurred with an all-cause mortality rate of 2.07 per 1000 person-months. Dietary behavior was associated with reduced all-cause mortality risk when expressed both as a continuous variable and binary variable (i.e., meeting dietary guidelines). With regard to the latter, and after adjustments, those meeting dietary guidelines (vs. not) had a 40% reduced hazard of all-cause death (HR = 0.60; 95% CI: 0.38–0.97; P = 0.03).

Conclusion

Among adults with mobility limitations, and thus, who unable to engage in sufficient physical activity, dietary behavior may have survival benefits.  相似文献   
2.

Objective

To evaluate the potential independent and combined associations of cognitive and mobility limitations on risk of all-cause mortality in a representative sample of the US older adult population who, at baseline, were free of cardiovascular and cerebrovascular disease.

Patients and Methods

Data from the 1999 to 2002 National Health and Nutrition Examination Survey were used to identify 1852 adults (age, 60-85 years) with and without mobility and/or cognitive limitations. Hazard ratios (HRs) for mortality risk were calculated for 4 mutually exclusive groups: no limitation (group 1 as reference), mobility limitation only (group 2), cognitive limitation only (group 3), both cognitive and mobility limitations (group 4).

Results

Compared with group 1, the adjusted HRs (95% CI) for groups 2, 3, and 4 were 1.72 (1.24-2.38), 2.00 (1.37-2.91), and 2.18 (1.57-3.02), respectively. The mortality risk when comparing group 4 (HR, 2.18) with group 3 (HR, 2.00), however, was not statistically significant (P=.65). Similarly, the mortality risk when comparing group 4 (HR, 2.18) with group 2 (HR, 1.72) was not statistically significant (P=.16).

Conclusion

Although the highest mortality risk occurred in those with both limitations (group 4), this point estimate was not statistically significantly different when compared with those with cognitive or mobility limitations alone.  相似文献   
3.
Objectives: The purpose of this study was to 1) evaluate whether physical activity has a protective effect on incident diabetes among African Americans across combinations of body mass index (BMI) and waist circumference (WC), 2) evaluate the effect of changes on BMI and WC on incident diabetes, and 3) evaluate the effect of ‘normal range’ glycated hemoglobin (A1C) on incident diabetes.

Methods: Data from the prospective Jackson Heart Study were evaluated, with baseline data assessed between 2001 and 2004 and follow-up data occurring between 2009 and 2013. Physical activity was assessed via a validated questionnaire, with measured BMI, WC and A1C assessed via standard procedures.

Results: The sample included 2,450 adults who did not have evidence of diabetes at the baseline assessment, with 286 incident diabetes cases occurring at the follow-up assessment. Physical activity did not have a protective effect against incident diabetes across different BMI and WC combinations. Notably, BMI change from baseline to follow-up was associated with incident diabetes (HR = 1.08; 95% CI: 1.03–1.13). Further, higher levels of A1C within the ‘normal-range’ was associated with incident diabetes (HR = 7.51, 95% CI = 2.66–21.25).

Conclusion: Increases in BMI over time and higher A1C within the normal range were associated with incident diabetes. Serial monitoring of BMI, as well as A1C, even among those with a ‘normal’ A1C, may be warranted by clinicians. Future work evaluating this novel three-way model (physical activity, BMI and WC) should consider utilizing an objective measure of physical activity.  相似文献   

4.
5.
Objective: To evaluate the association of habitual physical activity engagement on changes in cognitive function among Puerto Rican adults.

Methods: Longitudinal data (2-year follow-up) from the Boston Puerto Rican Health Study were analyzed (n = 862; mean age = 56.5 year). A daily energy expenditure score was calculated using the number of hours over a 24-h period engaged in various activities, including sleeping, light activity, and moderate-to-vigorous exercise. Energy expenditure estimates were weighted based on the rate of oxygen consumption associated with each activity. Seven cognitive function outcomes were evaluated, including an assessment of general cognitive function, episodic memory, attention and working memory, cognitive flexibility, response inhibition, processing speed, and visuo-spatial organization. From these, overall executive function and memory capacity were derived using principal components analysis.

Results: Physical activity was not associated with changes in overall executive function. However, compared to those with low baseline physical activity, those with moderate physical activity had 48% reduced odds of having ≥1 standard deviation decline in memory function (OR = 0.52; 95% CI: 0.32, 0.84; p = 0.008) in 2 years.

Conclusion: Among Puerto Rican adults, physical activity may help attenuate memory decline.  相似文献   

6.
Objective: The predictive validity of the Pooled Cohort risk (PCR) equations for residual-specific mortality (deaths not resulting from the 9 leading causes of death) among a national sample of U.S. adults has not previously been evaluated, which was the purpose of this study.

Methods: Data from the 1999–2010 National Health and Nutrition Examination Survey were used, with participants followed up through 31 December 2011 to ascertain mortality status. The analyzed sample included 11,171 cardiovascular disease-free adults (40–79 years of age). The 10-year risk of a first atherosclerotic cardiovascular disease (ASCVD) event was determined from the PCR equations.

Results: For the entire sample, 849,202 person-months occurred with an incidence rate of 0.29 (95% CI: 0.25–0.33) residual-specific deaths per 1,000 person-months. The unweighted median follow-up duration was 72 months. For all analyses, ASCVD risk score (via the PCR equations) was significantly associated with residual-specific mortality. In a fully adjusted model including moderate-to-vigorous physical activity (MVPA), obesity, age (yrs; continuous measure), gender (male/female) and race-ethnicity (Mexican American, non-Hispanic white, non-Hispanic black and other) as covariates, those with an ASCVD ≥ 20 (vs. < 20) had a 91% increased hazard of residual-specific death during the follow-up period (HR = 1.91; 95% CI: 1.10–3.31). Expressed as probability, there was a 66% chance that those with ASCVD ≥ 20 (vs. < 20) would have a residual specific-death during the follow-up period.

Conclusion: The 10-year predicted risk of a first ASCVD event via the PCR equations was directly associated with residual-specific mortality among those free of cardiovascular disease (CVD) at baseline, providing evidence of predictive validity of the PCR equations among this national sample of U.S. adults.  相似文献   

7.
Objective: Limited research has evaluated the individual and combined associations of physical activity (PA), cardiorespiratory fitness (CRF) and muscle strengthening activities (MSA) on generalized anxiety, panic and depressive symptoms. We evaluated this topic in a representative sample of young (20–39 years) adults, with considerations by sex.

Methods: Data from the 1999–2004 National Health and Nutrition Examination Survey (N = 2088) were used. Generalized anxiety, panic and depressive symptoms were assessed via self-report as well as using the Generalized Anxiety Disorder, Panic Disorder, and Depressive Disorders modules of the automated version of the World Health Organization Composite International Diagnostic Interview (CIDI-Auto 2.1). PA and MSA were assessed via validated self-report questionnaires and CRF was determined via a submaximal treadmill-based test. An index variable was created summing the number (range = 0–3) of these parameters for each participant. For example, those meeting PA guidelines, MSA guidelines and having moderate-to-high CRF were classified as having an index score of 3.

Results: MSA was not independently associated with generalized anxiety, panic and depressive symptoms, but those with higher levels of PA and CRF had a reduced odds of these symptoms (ranging from 40 to 46% reduced odds). Compared to those with an index score of 0, those with an index score of 1, 2, and 3, respectively, had a 39%, 54% and 71% reduced odds of having generalized anxiety, panic and depressive symptoms. Results were consistent across both sexes.

Conclusion: PA and CRF, but not MSA, were independently associated with generalized anxiety, panic and depressive symptoms. There was evidence of an additive association between PA, CRF, and MSA on these symptoms.  相似文献   

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