Dietary habits mediate the relationship between socio-economic status and CVD factors among healthy adults: the ATTICA study

AbstractBackgroundThe aims of the present work were to investigate whether dietary habits are associated with socio-economic status (SES), and if they modify the relationship between SES and CVD risk factors, in a sample of men and women free from known CVD.MethodsThis population-based study was carried out in the province of Attica, where Athens is a major metropolis. During 2001–2002, information from 1528 men (18–87 years old) and 1514 women (18–89 years old) was collected (75 % participation rate). Among several sociodemographic, clinical and biological factors, adherence to the Mediterranean diet was assessed by a special diet score (Mediterranean Diet Score, MDS) that incorporated the inherent characteristics of this traditional diet. CVD risk factors were examined across the participants’ educational level and annual income that defined their SES.ResultsLow SES groups exhibited higher prevalence of CVD risk factors, such as obesity, hypertension, diabetes mellitus and hypercholesterolaemia (allP< 0·001). Low SES groups also showed less adherence to the Mediterranean diet than high SES groups (MDS: 23·6 (sd8·1)v. 25·6 (sd5·6),P< 0·001). Higher SES index was associated with lower likelihood of having hypercholesterolaemia (OR = 0·91; 95 % CI 0·83, 1·00) and diabetes (OR = 0·83; 95 % CI 0·72, 0·95), after adjusting for various potential confounders. However, the previously mentioned inverse relationship observed between SES and prevalence of CVD risk factors was mainly explained by the dietary habits of the participants.ConclusionsLow SES groups showed less adherence to the Mediterranean diet compared with high SES groups. This finding may, in part, explain the higher CVD risk factors profile observed among low SES participants.

Download Full-text

Lessons from Studies in Middle-Aged and Older Adults Living in Mediterranean Islands: The Role of Dietary Habits and Nutrition Services

Cardiology Research and Practice ◽

10.4061/2011/901651 ◽

2011 ◽

Vol 2011 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Stefanos Tyrovolas ◽

Evangelos Polychronopoulos

Keyword(s):

Risk Factors ◽

Mediterranean Diet ◽

Mediterranean Basin ◽

Dietary Habits ◽

The Elderly ◽

Cvd Risk Factors ◽

Mediterranean Islands ◽

Cvd Risk ◽

The Mediterranean ◽

The Mediterranean Basin

Background. Islands in the Mediterranean basin share particular habits and traditions and greater life expectancy than other European regions. In this paper, particular interest has been given to the effect of the Mediterranean diet, as well as nutritional services on CVD risk, on Mediterranean islands.Methods. Published results from observational studies were retrieved from electronic databases (Pubmed and Scopus) and summarized.Results. Prevalence of CVD risk factors is increased. Adherence to the Mediterranean diet was moderate, even among the elderly participants. Furthermore, the presence of a dietician was associated with higher adherence to the Mediterranean dietary pattern and consequently lowers CVD risk.Conclusion. Adherence to the Mediterranean diet is reduced, while the prevalence of CVD risk factors is increasing at alarming rates. Public health nutrition policy has the opportunity to improve the health and quality of life of people living in isolated insular areas of the Mediterranean basin.

Download Full-text

Neighborhood Environment Associates with Trimethylamine-N-Oxide (TMAO) as a Cardiovascular Risk Marker

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084296 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4296

Author(s):

Nicole Farmer ◽

Cristhian A. Gutierrez-Huerta ◽

Briana S. Turner ◽

Valerie M. Mitchell ◽

Billy S. Collins ◽

...

Keyword(s):

Risk Factors ◽

African American ◽

Dietary Intake ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Neighborhood Deprivation ◽

Microbial Metabolite ◽

African American Adults ◽

Tnf Α ◽

The Relationship

Background: Neighborhoods and the microbiome are linked to cardiovascular disease (CVD), yet investigations to identify microbiome-related factors at neighborhood levels have not been widely investigated. We sought to explore relationships between neighborhood deprivation index (NDI) and the microbial metabolite, trimethylamine-N-oxide. We hypothesized that inflammatory markers and dietary intake would be mediators of the relationship. Methods: African-American adults at risk for CVD living in the Washington, DC area were recruited to participate in a cross-sectional community-based study. US census-based neighborhood deprivation index (NDI) measures (at the census-tract level) were determined. Serum samples were analyzed for CVD risk factors, cytokines, and the microbial metabolite, trimethylamine-N-oxide (TMAO). Self-reported dietary intake based on food groups was collected. Results: Study participants (n = 60) were predominantly female (93.3%), with a mean (SD) age of 60.83 (+/−10.52) years. Mean (SD) NDI was −1.54 (2.94), and mean (SD) TMAO level was 4.99 (9.65) µmol/L. Adjusting for CVD risk factors and BMI, NDI was positively associated with TMAO (β = 0.31, p = 0.02). Using mediation analysis, the relationship between NDI and TMAO was significantly mediated by TNF-α (60.15%) and interleukin)-1 β (IL; 49.96%). When controlling for clustering within neighborhoods, the NDI-TMAO association was no longer significant (β = 5.11, p = 0.11). However, the association between NDI and IL-1 β (β = 0.04, p = 0.004) and TNF-α (β = 0.17, p = 0.003) remained. Neither NDI nor TMAO was significantly associated with daily dietary intake. Conclusion and Relevance: Among a small sample of African-American adults at risk for CVD, there was a significant positive relationship with NDI and TMAO mediated by inflammation. These hypothesis-generating results are initial and need to be confirmed in larger studies.

Download Full-text

Relationship between Depressive Symptoms and Cardiovascular Disease Risk Factors in African American Individuals

Depression Research and Treatment ◽

10.1155/2011/836542 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Ali A. Weinstein ◽

Preetha Abraham ◽

Guoqing Diao ◽

Stacey A. Zeno ◽

Patricia A. Deuster

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

African American ◽

Depressive Symptoms ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Regression Analyses ◽

Cvd Risk Factors ◽

Cvd Risk ◽

The Relationship

Objective. To examine the relationship between depressive symptoms and cardiovascular disease (CVD) risk factors in a group of African American individuals.Design. A nonrandom sample of 253 (age 43.7 ± 11.6 years; 37% male) African American individuals was recruited by advertisements. Data were obtained by validated questionnaires, anthropometric, blood pressure, and blood sample measurements.Results. Regression analyses were performed to assess the relationship between depressive symptoms and CVD risk factors controlling for socioeconomic status indicators. These analyses demonstrated that those with higher levels of depressive symptoms had larger waist-to-hip ratios, higher percent body fat, higher triglycerides, and were more likely to be smokers.Conclusions. It has been well documented that higher levels of depressive symptoms are associated with higher CVD risk. However, this evidence is derived primarily from samples of predominantly Caucasian individuals. The present investigation demonstrates that depressive symptoms are related to CVD risk factors in African American individuals.

Download Full-text

Relationship of urinary liver-type fatty acid-binding protein with cardiovascular risk factors in the Japanese population without chronic kidney disease: Sasayama study

BMC Nephrology ◽

10.1186/s12882-021-02398-8 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Yoshimi Kubota ◽

Aya Higashiyama ◽

Mikio Marumo ◽

Masami Konishi ◽

Yoshiko Yamashita ◽

...

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Fatty Acid ◽

Fatty Acid Binding Protein ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Fatty Acid Binding ◽

Acid Binding Protein ◽

Proximal Tubular ◽

The Relationship

Abstract Background Urinary liver-type fatty acid-binding protein (L-FABP) is a well-known marker of proximal tubular impairment. We evaluated the relationship between cardiovascular disease (CVD) risk factors and levels of L-FABP in a cross-sectional community-based study. Participants with normoalbuminuria and normal estimated glomerular filtration rate (eGFR), that is, non-chronic kidney disease (non-CKD), were enrolled in this study. To the best of our knowledge, this is the first study to focus on the association between CVD risk factors and a proximal tubular marker in the Japanese general population with normoalbuminuria and normal eGFR. Methods The present study is part of the Sasayama study. The participants included 1000 community residents (447 men and 553 women) aged 40–64 years without a history of CVD or renal dysfunction. Out of these participants 375 men and 477 women, defined as non-CKD, were included for further analysis. In each sex, the highest quintile group was considered to have high-normal L-FABP levels. A multiple logistic regression model was used to evaluate the relationship between risk factors for CVD and high-normal L-FABP levels in the non-CKD participants. We performed a similar analysis using the high-normal urinary albumin to creatinine ratio (UACR) as a dependent variable instead of L-FABP. Results Among the non-CKD participants, in the highest quintile group (Q5, top 20%), L-FABP was ≥2.17 μg/gCre in men and ≥ 2.83 μg/gCre in women. In women, the multivariate odds ratio was 3.62 (1.45–9.00) for high-normal L-FABP in the presence of diabetes mellitus (DM) compared with that in the group without DM. However, the relationship between DM and the UACR level was not significant. In men, DM was significantly associated with high-normal UACR. However, the relationship with L-FABP levels was not significant. Conclusions The presence of DM was more strongly related to high-normal L-FABP levels than to high-normal UACR in women even at the stage of normoalbuminuria and normal eGFR. Our results were also consistent with the findings of a previous study where women were more prone to nonalbuminuric renal impairment compared to men, although further studies are required to confirm the results.

Download Full-text

Abstract P400: The Association Between Cross-sex Hormone Therapy and Cardiovascular Disease Risk Factors Among Male-to-female Transgender Persons in Chiang Mai, Thailand

Circulation ◽

10.1161/circ.141.suppl_1.p400 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Rebecca L Molinsky ◽

Kanokwan Kulprachakarn ◽

Sakaewan Ounjaijean ◽

Ryan Demmer ◽

Kittipan Rerkasem

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Risk Factor ◽

Hormone Therapy ◽

Sex Hormone ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Transgender Persons ◽

The Relationship ◽

Male To Female

Background: Cross-sex hormone therapy (CSHT) is prescribed to transition secondary sexual characteristics among individuals undergoing male-to-female (MtF) transitions (age range 18-41, mean age=24). Limited data exist to inform the cardiovascular disease (CVD) risk factor profile associated with CSHT. We investigated the relationship between CSHT and cardiovascular risk factors in MtF transgender persons and hypothesize that CSHT will be associated with adverse CVD risk factor profiles. Methods: A cross-sectional study was conducted from October 1 st , 2018 to November 30 th , 2018 in 100 MtF transgender people not receiving CSHT vs. 100 receiving CSHT. CSHT use was defined by self-report use of up to 23 medications. Serum testosterone and 17-beta estradiol were assessed to validate CSHT use. Systolic and diastolic blood pressure was measured. Lipid profiles, fasting plasma glucose (FPG), C-reactive protein, cardiac troponin I and pro b-type natriuretic peptide (proBNP) were assessed from fasting blood. Non-invasive arterial examinations included: carotid intima-media thickness (CIMT), ankle-brachial index (ABI), cardio-ankle vascular index (CAVI), and pulse wave velocity (PWV). Multivariable linear regression models, regressed CVD risk factors on CSHT status. Among the subgroup of CSHT users, we assessed the relationship between duration of use and CVD risk factors. Multivariable models included age, gender, education, income, drinking, smoking, exercise, and BMI. Results: Participant mean age was 24±0.38 years and did not differ by CSHT use. Mean±SE values of testosterone were in the CSHT vs. control group were 4.8±0.3 vs. 5.8±0.3 ng/ml, p=0.06 and 17-beta estradiol levels were 45.6±14.9 vs. 34.7±14.8, p=0.7). CIMT was modestly lower among CSHT vs. controls (0.35±0.01 vs. 0.38±0.01, p=0.09). The average duration of CSHT use was 6.65±0.522 years. Among CSHT users, for every 1-year increase in duration of CSHT use total cholesterol decreased by -2.360 ± 1.096, p=0.0341 mg/dL, LDL-cholesterol decreased by -3.076 ± 1.182, p=0.0109 mg/dL, ABI decreased by -0.006 ± 0.002, p=0.0087 while FPG increased by 2.558 ± 0.899 mg/dL, p=0.0055. Conclusion: Among MtF transgender persons, using CSHT was not associated with increased CVD risk factors levels.

Download Full-text

Association between birth weight and childhood cardiovascular disease risk factors in West Virginia

Journal of Developmental Origins of Health and Disease ◽

10.1017/s204017441900045x ◽

2019 ◽

Vol 11 (1) ◽

pp. 86-95

Author(s):

Amna Umer ◽

Candice Hamilton ◽

Lesley Cottrell ◽

Peter Giacobbi ◽

Kim Innes ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cardiovascular Disease ◽

Birth Weight ◽

West Virginia ◽

Disease Risk ◽

Density Lipoprotein ◽

Cvd Risk Factors ◽

Cvd Risk ◽

The Relationship

AbstractThe reported associations between birth weight and childhood cardiovascular disease (CVD) risk factors have been inconsistent. In this study, we investigated the relationship between birth weight and CVD risk factors at 11 years of age. This study used longitudinally linked data from three cross-sectional datasets (N = 22,136) in West Virginia; analysis was restricted to children born full-term (N = 19,583). The outcome variables included resting blood pressure [systolic blood pressure (SBP), diastolic blood pressure (DBP)] and lipid profile [total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, non-HDL, and triglycerides (TG)]. Multiple regression analyses were performed, adjusting for child’s body mass index (BMI), sociodemographics, and lifestyle characteristics. Unadjusted analyses showed a statistically significant association between birth weight and SBP, DBP, HDL, and TG. When adjusted for the child’s BMI, the association between birth weight and HDL [b = 0.14 (95% CI: 0.11, 0.18) mg/dl per 1000 g increase] and between birth weight and TG [b = –0.007 (–0.008, –0.005) mg/dl per 1000 g increase] remained statistically significant. In the fully adjusted model, low birth weight was associated with higher LDL, non-HDL, and TGs, and lower HDL levels. The child’s current BMI at 11 years of age partially (for HDL, non-HDL, and TG) and fully mediated (for SBP and DBP) the relationship between birth weight and select CVD risk factors. While effects were modest, these risk factors may persist and amplify with age, leading to potentially unfavorable consequences in later adulthood.

Download Full-text

Dietary phytochemical index associated with cardiovascular risk factor in patients with type 1 diabetes mellitus

10.21203/rs.3.rs-239129/v1 ◽

2021 ◽

Author(s):

Saeideh Delshad Aghdam ◽

Fereydoun Siassi ◽

Ensieh Nasli Esfahani ◽

Mostafa Qorbani ◽

Asadollah Rajab ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Cross Sectional Study ◽

Lipoprotein Cholesterol ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Cross Sectional ◽

The Relationship

Abstract Background Dietary phytochemical index (DPI) is useful and inexpensive method to identify the role of phytochemicals on cardiovascular disease (CVD) risk factors. This study aimed to assess the relationship between DPI and CVD risk factors in patients with type1 diabetes mellitus (T1DM). Methods A total of 261 participants aged 18–35 years with T1DM were enrolled in this cross-sectional study to assess the relationship between DPI and CVD risk factors. Anthropometric measurements, blood lipids, glucose, and antioxidant level were measured. Food intakes were determined using a food frequency questionnaire to calculate DPI. Logistic regression was used. Results The mean age of participants was 25 years. After adjustment for potential confounders, participants in the highest tertile of DPI had 88% lower chance of hyperglycemia (P for trend = 0.020), 81% lower chance of low high-density lipoprotein cholesterol (HDL-C) (P for trend = 0.030) and 98% lower chance of high low-density lipoprotein cholesterol to HDL-C ratio (P for tend = 0.040). There were no relationships between DPI and other CVD risk factors. Conclusions Although higher intake of phytochemical-rich foods had a beneficial effect on some risk factors of CVD, more studies more studies are warranted to corroborate the present findings.

Download Full-text

User Engagement With Smartphone Apps and Cardiovascular Disease Risk Factor Outcomes: Systematic Review (Preprint)

10.2196/preprints.18834 ◽

2020 ◽

Author(s):

Erin M Spaulding ◽

Francoise A Marvel ◽

Rebecca J Piasecki ◽

Seth S Martin ◽

Jerilyn K Allen

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Cardiovascular Disease ◽

Risk Factor ◽

Health Behavior Change ◽

User Engagement ◽

Smartphone Apps ◽

Cvd Risk Factors ◽

Cvd Risk ◽

The Relationship

BACKGROUND The use of mobile health (mHealth) interventions, including smartphone apps, for the prevention of cardiovascular disease (CVD) has demonstrated mixed results for obesity, hypercholesterolemia, diabetes, and hypertension management. A major factor attributing to the variation in mHealth study results may be mHealth user engagement. OBJECTIVE This systematic review aims to determine if user engagement with smartphone apps for the prevention and management of CVD is associated with improved CVD health behavior change and risk factor outcomes. METHODS We conducted a comprehensive search of PubMed, CINAHL, and Embase databases from 2007 to 2020. Studies were eligible if they assessed whether user engagement with a smartphone app used by an individual to manage his or her CVD risk factors was associated with the CVD health behavior change or risk factor outcomes. For eligible studies, data were extracted on study and sample characteristics, intervention description, app user engagement measures, and the relationship between app user engagement and the CVD risk factor outcomes. App user engagement was operationalized as general usage (eg, number of log-ins or usage days per week) or self-monitoring within the app (eg, total number of entries made in the app). The quality of the studies was assessed. RESULTS Of the 24 included studies, 17 used a randomized controlled trial design, 4 used a retrospective analysis, and 3 used a single-arm pre- and posttest design. Sample sizes ranged from 55 to 324,649 adults, with 19 studies recruiting participants from a community setting. Most of the studies assessed weight loss interventions, with 6 addressing additional CVD risk factors, including diabetes, sleep, stress, and alcohol consumption. Most of the studies that assessed the relationship between user engagement and reduction in weight (9/13, 69%), BMI (3/4, 75%), body fat percentage (1/2, 50%), waist circumference (2/3, 67%), and hemoglobin A<sub>1c</sub> (3/5, 60%) found statistically significant results, indicating that greater app user engagement was associated with better outcomes. Of 5 studies, 3 (60%) found a statistically significant relationship between higher user engagement and an increase in objectively measured physical activity. The studies assessing the relationship between user engagement and dietary and diabetes self-care behaviors, blood pressure, and lipid panel components did not find statistically significant results. CONCLUSIONS Increased app user engagement for prevention and management of CVD may be associated with improved weight and BMI; however, only a few studies assessed other outcomes, limiting the evidence beyond this. Additional studies are needed to assess user engagement with smartphone apps targeting other important CVD risk factors, including dietary behaviors, hypercholesterolemia, diabetes, and hypertension. Further research is needed to assess mHealth user engagement in both inpatient and outpatient settings to determine the effect of integrating mHealth interventions into the existing clinical workflow and on CVD outcomes.

Download Full-text

Abstract 13525: The Association Between Multiparity and Adipokine Levels: The Multi-Ethnic Study of Atherosclerosis (MESA)

Circulation ◽

10.1161/circ.142.suppl_3.13525 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Carla P Rodriguez ◽

Oluseye Ogunmoroti ◽

Renato Quispe ◽

Olatokunbo I Osibogun ◽

Chiadi E Ndumele ◽

...

Keyword(s):

Risk Factors ◽

Covariate Adjustment ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Live Births ◽

Grand Multiparity ◽

Adjustment Model ◽

Multiparous Women ◽

History Of ◽

The Relationship

Background: Multiparity is a risk factor for cardiovascular disease (CVD). However, the mechanism of this relationship is unknown. Adipokines may predispose multiparous women to certain cardiometabolic complications that can increase their risk of future CVD. Methods: We studied 975 female MESA participants (ages 45-84 yrs and initially free of CVD) who had complete data on parity assessed at baseline and adipokine levels measured at either Exam 2 or 3. Parity was categorized as nulliparity (reference), 1-2, 3-4 and ≥5 live births. Multivariable linear regression was used to evaluate the association of parity categories with log-transformed levels of leptin, resistin, and adiponectin. Results: The women (38% white, 23% black, 13% Chinese, and 26% Hispanic) had mean age at MESA visit 2/3 of 63±9 yrs. Median adipokine levels by parity group are shown in the Table . Compared to nulliparity, a history of 3-4 live births was associated with higher leptin levels, even after full covariate adjustment including body mass index (BMI) and CVD risk factors (model 4). Grand multiparity (≥5 births) was associated with greater leptin after adjustment for demographic and lifestyle factors (models 1 & 2), but these associations were no longer significant after BMI adjustment (model 3). Grand multiparity was also associated with lower adiponectin levels in demographic/lifestyle-adjusted models but not after adjustment for BMI. In contrast, grand multiparity remained associated with higher resistin levels after full covariate adjustment (model 4). Conclusions: In a multiethnic U.S. cohort of women, multiparity is associated with adipokine levels, specifically with higher leptin and resistin levels. Further studies are needed to determine whether adipokines mediate the relationship between multiparity and CVD.

Download Full-text

Abstract MP38: The Program SI! Intervention for Enhancing a Healthy Lifestyle among Children aged 3 to 5: A Cluster Randomized Trial

Circulation ◽

10.1161/circ.129.suppl_1.mp38 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

JOSE L PENALVO ◽

MERCEDES SOTOS-PRIETO ◽

GLORIA SANTOS-BENEIT ◽

STUART POCOCK ◽

JULIANA REDONDO ◽

...

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Human Body ◽

Fixed Effects ◽

Dietary Habits ◽

Lifestyle Behaviors ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Healthy Behaviors ◽

Cluster Randomized

The development of CVD risk factors carries a behavioral component that may be corrected at an early age, when behaviors are first formed, by effective health promotion initiatives. School-based interventions are an effective way to promote healthy behaviors, specially when they also reach out to the children’s most proximal environment: their families, teachers and the school itself. Within this framework, the first phase of the long-term Program SI! intervention targets children from 3 to 5 years of age aiming to establish appropriate lifestyle behaviors early in life. The intervention entails a comprehensive approach including four lifestyle-related components: correct dietary habits, promotion of physical activity, understanding how the human body and heart work, and emotion’s management. To evaluate the efficacy of the Program SI! to instill healthy behaviors in children aged 3-5, a cluster-randomized controlled trial in public schools in the city of Madrid (Spain) was initiated in 2011. A total 24 schools were selected on the basis of socio-demographic characteristics. These included 2062 children (3-5 years), 1949 families, and 125 teachers at baseline. Schools were randomized (1:1) to follow their usual school curriculum or to engage in the intervention. The primary outcome of this report is the 2-years differential change from baseline in scores for knowledge, attitudes and habits (KAH) in the four components of the intervention between intervention and control. Children were interviewed by trained psychologists and scored on overall and component-specific KAH questionnaires. The Test for Emotional Comprehension (TEC) was used to assess children’s ability to recognize emotions. Mixed linear models accounting for the cluster-randomized design were used to test for intervention effects. Fixed effects in each model were the corresponding baseline score, the class year, and the treatment group. Schools were handled as random effects. After 2 years, the Program SI! intervention increased children’s overall KAH score (5.6, 95%CI, 4.1-7.1, p<0.001) corresponding to an additional 7% improvement in the intervened children. KAH assessing improved Physical activity contributed the most (3.39, 95%CI, 2.35-4.43, p<0.001) to the difference between groups, followed by KAH relating Dietary habits (1.78, 95%CI, 0.94-2.62, p<0.001). A weak, non-significant improvement in KAH score for Human body (0.37, 95%CI, -0.14-0.89) was also found. Regarding emotion’s management, this component also increased after the intervention (0.50, 95%CI, 0.02-0.97, p<0.040), with greater improvements in older children (5 years old). The Program SI! is demonstrated as an effective and feasible strategy for improving lifestyle behaviors among very young children that may eventually impact in lower rates of development of CVD risk factors.

Download Full-text