scholarly journals Association of education with dietary intake among young adults in the bi-ethnic Coronary Artery Risk Development in Young Adults (CARDIA) cohort

2003 ◽  
Vol 6 (7) ◽  
pp. 689-695 ◽  
Author(s):  
SL Archer ◽  
JE Hilner ◽  
AR Dyer ◽  
KJ Greenlund ◽  
LA Colangelo ◽  
...  

AbstractObjective:To examine associations of changes in dietary intake with education in young black and white men and women.Design:The Coronary Artery Risk Development in Young Adults (CARDIA) study, a multi-centre population-based prospective study. Dietary intake data at baseline and year 7 were obtained from an extensive nutritionist-administered diet history questionnaire with 700 items developed for CARDIA.Setting:Participants were recruited in 1985–1986 from four sites: Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; and Oakland, California.Subjects:Participants were from a general community sample of 703 black men (BM), 1006 black women (BW), 963 white men (WM) and 1054 white women (WW) who were aged 18–30 years at baseline. Analyses here include data for baseline (1985–1986) and year 7 (1992–1993).Results:Most changes in dietary intake were observed among those with high education (≥ 12 years) at both examinations. There was a significant decrease in intake of energy from saturated fat and cholesterol and a significant increase in energy from starch for each race-gender group (P < 0.001). Regardless of education, taste was considered an important influence on food choice.Conclusion:The inverse relationship of education with changes in saturated fat and cholesterol intakes suggests that national public health campaigns may have a greater impact among those with more education.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3188-3188
Author(s):  
David Green ◽  
Nancy Foiles ◽  
Cheeling Chan ◽  
Pamela J. Schreiner ◽  
David Jacobs ◽  
...  

Abstract Elevated levels of hemostatic factors are observed in patients with atherosclerosis, but whether they promote plaque formation or are a consequence of the disease is uncertain. To examine this issue, we used data from a large biracial cohort of young adults (Coronary Artery Risk Development in Young Adults [CARDIA]) followed up for 13 years, to examine the relationships of hemostatic factors - fibrinogen, factors VII and VIII, and von Willebrand factor (vWF) - with coronary artery calcium (CAC) and carotid intimal-medial thickness (IMT). Complete data were available on 1382 participants, whose mean age was 32 years at enrollment. The age, race, and gender-adjusted prevalence of CAC for increasing quartiles of fibrinogen levels was: 14.0%, 15.0%, 19.6%, and 28.4% (p <0.001 for trend). After further adjustment for BMI, smoking, systolic BP, and total cholesterol, the prevalence of CAC for increasing quartiles of fibrinogen was 15.5%, 16.0%, 19.0%, and 26.4% (p <0.001 for trend). Similar trends were observed for IMT (age, race, and gender-adjusted, p<0.001; multivariable adjusted, p=0.022). When race and gender subgroups were further analyzed, the prevalence of CAC was associated with fibrinogen levels in women and white men after age adjustment, and in women on multivariable analysis. IMT scores adjusted for age were associated with elevated fibrinogen levels in all except black men, and in black women after multivariable adjustment (p=0.003). While the prevalence of CAC was not associated with increasing quartiles of FVII, FVIII, or vWF, IMT scores were associated with elevated FVII on multivariable analysis in white women (p=0.006) and with vWF antigen in white men on age-adjusted (p=0.004) and multivariable analysis (p=0.013). There were no significant associations of hemostatic factors with either the prevalence of CAC or IMT in black men. Participants were categorized as to whether they had 0, 1, or more than 1 hemostatic factors in the highest quartile. After adjustment for age, race, and gender, hemostatic group classification was associated linearly with the prevalence of CAC (p<0.001 for trend) and IMT score (p=0.01 for trend). In conclusion, the main finding from this study is that elevated levels of fibrinogen in persons aged 25 to 37 are associated with the later appearance of subclinical markers of cardiovascular disease. These associations were observed in whites and black women, but not black men. We suggest that atherosclerosis became established during the 13 year observation period, and that increased fibrinogen may have been a contributing factor or a marker for disease development.


Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Paul Muntner ◽  
John N Booth ◽  
Stephen J Thomas ◽  
Luqin Deng ◽  
Joseph E Schwartz ◽  
...  

Risk factors for nocturnal hypertension are more common among blacks compared with whites. We hypothesized nocturnal hypertension and nocturnal non-dipping BP are more common among blacks compared with whites. We analyzed data for 781 participants of the population-based Coronary Artery Risk Development in Young Adults (CARDIA) study who completed ambulatory blood pressure (BP) monitoring (ABPM) in 2015-2016. Awake and sleep periods were defined using actigraphy and self-report. Nocturnal hypertension was defined as mean sleep systolic BP (SBP)/diastolic BP (DBP) ≥ 120/70 mm Hg. Non-dipping SBP and DBP, separately, were defined as a decline in mean sleep BP, relative to mean awake BP < 10%. The mean age of participants was 54.7 years, 21.1% were white women, 38.5% were black women, 16.8% were white men and 23.6% were black men. The prevalence of nocturnal hypertension was 18.2% and 44.5% among white and black women, respectively, and 35.9% and 59.8% among white and black men, respectively. After multivariable adjustment, the prevalence of nocturnal hypertension was higher among black women, white men and black men, each compared with white women (Table). The prevalence of non-dipping SBP was 21.2% and 40.9% among white and black women, respectively, and 19.8% and 37.5% among white and black men, respectively. After multivariable adjustment, non-dipping SBP was more common among black women and black men compared with white women. There were no statistically significant differences in non-dipping DBP across race-gender after multivariable adjustment. Nocturnal hypertension and non-dipping SBP are more common among blacks compared with whites even after adjustment for mean BP.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ruth Misha ◽  
Laura A Colangelo ◽  
Lucia Petito ◽  
Cora E Lewis ◽  
Pamela Schreiner ◽  
...  

Introduction: Cardiovascular disease (CVD) is the leading cause of death in women and early onset of menopause before the age of 40 years has been identified as a risk enhancer for future CVD events. Quantifying the magnitude of risk for premature CVD among women with early menopause may inform and guide the intensity of sex-specific preventive strategies. Methods: We included all women in the Coronary Artery Risk Development in Young Adults (CARDIA) study who attended a follow-up exam after the age of 40 years, had available data on menopausal status, and had not experienced premature CVD before 40 years. We performed multivariable Cox proportional hazards regression to examine the relationship between early onset of menopause defined as <40 years and incident CVD (coronary heart disease, peripheral arterial disease, stroke, and heart failure) prior to the age of 65 years. We performed Cox proportional hazards models and adjusted for risk factors levels at baseline: age, race, age at menarche, years of education, smoking status, body mass index, diabetes, hypertension, and total cholesterol: high-density lipoprotein ratio. Results: Among 2136 women with mean age of 43.0 (SD 3.0), 9.1% reported premature menopause before the age of 40 years (4.5% in white and 13.9% in black women). Over a median follow-up of 14.0 (IQR 11.5, 16.9) years, 81 premature CVD events occurred. Incidence rate (95% CI) of CVD was 6.46 (2.43, 17.22) and 1.41 (0.92, 2.17) per 1,000 per person-years for white women with and without early onset menopause, respectively; 4.94 (2.66, 9.16) and 3.92 (2.94, 5.24) per 1,000 person-years for black women with and without early onset menopause (FIGURE). Conclusions: In a population-based sample, white women with early onset of menopause had a 3-fold higher rate of premature CVD events, independent of perimenopausal risk factor levels. Interventions to intensify CVD prevention in at-risk women are needed following early onset of menopause.


2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Esme Fuller-Thomson ◽  
Rachel S. Chisholm ◽  
Sarah Brennenstuhl

This observational epidemiological study investigates sex/gender and racial differences in prevalence of COPD among never-smokers. Data were derived from the 2012 Center for Disease Control’s Behavioral Risk Factor Surveillance System. The sample consisted of 129,535 non-Hispanic whites and blacks 50 years of age and older who had never smoked. Descriptive and multivariable analyses were conducted, with the latter using a series of logistic regression models predicting COPD status by sex/gender and race, adjusting for age, height, socioeconomic position (SEP), number of household members, marital status, and health insurance coverage. Black women have the highest prevalence of COPD (7.0%), followed by white women (5.2%), white men (2.9%), and black men (2.4%). Women have significantly higher odds of COPD than men. When adjusting for SEP, black and white women have comparably higher odds of COPD than white men (black women OR = 1.66; 99% CI = 1.46, 1.88; white women OR = 1.49; 99% CI = 1.37, 1.63), while black men have significantly lower odds (OR = 0.62; 99% CI = 0.49, 0.79). This research provides evidence that racial inequalities in COPD (or lack thereof) may be related to SEP.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Sarah M Camhi ◽  
Peter T Katzmarzyk ◽  
Stephanie Broyles ◽  
Timothy S Church ◽  
Arlene L Hankinson ◽  
...  

Purpose: To determine whether baseline metabolic risk in young adults is associated with physical activity (PA) trajectories over 20 years. Methods: The sample included young adults from the Coronary Artery Risk Development in Young Adults (CARDIA) study, baseline ages 18–30 years (n= 4161). PA was determined from self-reported questionnaire at baseline and at years 2,5,7,10,15 and 20 of follow-up. Baseline metabolic risk was calculated using age-adjusted principal components analysis (elevated=top 10% of first factor), within sex-by-race groups, from mean arterial pressure (1/3(SBP-DBP)+DBP), glucose, waist circumference, triglycerides, and high-density lipoprotein cholesterol. Repeated measures general linear modeling was used to generate PA trajectories over 20 years, separately in black men, white men, black women and white women, adjusting for age and smoking status. Time by metabolic risk interaction terms did not contribute significantly to any model for any sex-by-race group and were therefore not included in final models. Results: In black men, white men, and white women, PA (in exercise units) at baseline was significantly lower among those with elevated metabolic risk (elevated risk vs. normal risk: black men 473.0 ± 27.0 vs. 572.0 ± 22.7; white men: 498.0 ±20.6 vs. 568.7 ± 17.3; white women: 402.4 ± 17.0 vs. 481.1 ± 14.3), and these differences persisted over 20 years (black men: −98.9 ± 16.4, white men: −70.8 ± 12.5 , white women: −78.7 ± 10.2; all p<0.0001). There were no significant differences in PA by metabolic risk in black women (307.2 ± 15.5 vs. 317.4 ± 13.1, difference: −10.1 ± 9.3, p =0.27). Conclusion: Elevated metabolic risk is associated with lower levels of PA in early adulthood, and these differences persist over 20 years. Despite these lower levels at baseline, the PA trajectory declines at similar rates for those with and without elevated metabolic risk. Young adults with elevated metabolic risk are important to identify early, in order to prevent PA level gap which remains over 20 years between those with and without elevated metabolic risk.


Stroke ◽  
2021 ◽  
Author(s):  
Elizabeth M. Aradine ◽  
Kathleen A. Ryan ◽  
Carolyn A. Cronin ◽  
Marcella A. Wozniak ◽  
John W. Cole ◽  
...  

Background and Purpose: Although the US Black population has a higher incidence of stroke compared with the US White population, few studies have addressed Black-White differences in the contribution of vascular risk factors to the population burden of ischemic stroke in young adults. Methods: A population-based case-control study of early-onset ischemic stroke, ages 15 to 49 years, was conducted in the Baltimore-Washington DC region between 1992 and 2007. Risk factor data was obtained by in-person interview in both cases and controls. The prevalence, odds ratio, and population-attributable risk percent (PAR%) of smoking, diabetes, and hypertension was determined among Black patients and White patients, stratified by sex. Results: The study included 1044 cases and 1099 controls. Of the cases, 47% were Black patients, 54% were men, and the mean (±SD) age was 41.0 (±6.8) years. For smoking, the population-attributable risk percent were White men 19.7%, White women 32.5%, Black men 10.1%, and Black women 23.8%. For diabetes, the population-attributable risk percent were White men 10.5%, White women 7.4%, Black men 17.2%, and Black women 13.4%. For hypertension, the population-attributable risk percent were White men 17.2%, White women 19.3%, Black men 45.8%, and Black women 26.4%. Conclusions: Modifiable vascular risk factors account for a large proportion of ischemic stroke in young adults. Cigarette smoking was the strongest contributor to stroke among White patients while hypertension was the strongest contributor to stroke among Black patients. These results support early primary prevention efforts focused on smoking cessation and hypertension detection and treatment.


1992 ◽  
Vol 26 (10) ◽  
pp. 1292-1295 ◽  
Author(s):  
Sandra L. Melnick ◽  
J. Michael Sprafka ◽  
David L. Laitinen ◽  
Roberd M. Bostick ◽  
John M. Flack ◽  
...  

OBJECTIVE: To assess racial differences in the use of antibiotics, including penicillins, erythromycins, tetracyclines, sulfas, and cephalosporins. DESIGN: Population-based surveys, conducted from 1985 to 1987. SETTING: The seven-county metropolitan area of Minneapolis-St. Paul, MN. PARTICIPANTS: 3127 whites (response rate 68 percent) and 1047 blacks (response rate 65 percent), aged 35–74 years. RESULTS: White women (26 percent of 1625) were more likely to report having taken an antibiotic in the past year than were white men (18 percent of 1502), black women (18 percent of 590), or black men (15 percent of 457). Reported antibiotic usage decreased with increasing age. Black men were more likely than white men to report the use of tetracyclines or sulfas; otherwise, white men reported higher usage prevalences. White women reported higher usage prevalences of all drug classes than black women. CONCLUSIONS: Significant independent predictors of antibiotic use were younger age, white race, and female gender. Potential explanations for these differences include differences in patient access, physician-prescribing behaviors, or both.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Jingjing Li ◽  
Sunil K Agarwal ◽  
Alvaro Alonso ◽  
Saul Blecker ◽  
Alanna M Chamberlain ◽  
...  

Objective: To investigate the association between low forced expiratory volume in 1 second (FEV 1 ) and incident atrial fibrillation (AF) in a population-based cohort. Background: Impaired FEV 1 , a complex measure indicating genetic, developmental, obstructive and restrictive airway disease, musculoskeletal function, and motivation, has been inconsistently associated with an increased risk of cardiovascular disease mortality. Also, extant reports do not provide separate estimates for African Americans, who surprisingly have lower AF incidence than Caucasians. Methods: We examined 15,282 middle-aged African Americans (26%) and Caucasians, men (45%) and women from four U.S. communities enrolled in the Atherosclerosis Risk in Communities (ARIC) cohort study. Lung volumes by standardized spirometry and information on covariates were collected on these participants at the baseline visit (1987-1989). Prevalent AF cases were excluded by 12-lead ECG at baseline. Incident AF was defined as the first event identified from the following: ICD codes for AF from hospital discharge records or death certificates, or ECGs performed during three triennial follow-up visits. Results: Over an average follow-up of 17.5 years, a total of 1,733 (11%) participants developed new-onset AF. The rate of incident AF increased monotonically and inversely by tertiles of FEV 1 in each of the 4 gender-race strata. The unadjusted average incidence rates of AF per 100 person years of follow up by tertiles of FEV 1 (from lowest to highest tertile) were 13.6, 8.3, and 5.7 for white men; 8.7, 4.5, and 3.4 for white women; 8.2, 5.5, and 3.8 for black men; 6.9, 4.1, and 2.4 for black women. After multivariable adjustment for traditional cardiovascular disease risk factors and height, hazard ratios (95% CI) of AF comparing the lowest with the highest tertile of FEV 1 were 1.44 (1.16,1.78) among white men, 1.45 (1.12, 1.87) among white women, 1.81 (1.09, 3.02) among black men, and 1.84(1.20, 2.82) among black women. The trend estimate for per 1 Standard-Deviation lower FEV 1 for the corresponding race and gender groups were 1.21 (1.12, 1.32), 1.38 (1.25, 1.54), 1.45 (1.18, 1.76), and 1.35 (1.12, 1.63), respectively. The above associations were observed across all smoking status categories (current, former, and never). The association between low lung function and incidence of AF was similarly unchanged after exclusion of participants with heart failure (n = 689) or CHD (n = 558) at baseline. The hazard of AF was about 50% higher among those with FEV1/FVC ratio below 0.7. Conclusions: In this large population-based cohort study with a long term follow-up, reduced FEV 1 is strongly associated with a higher AF risk, independent of race, gender, smoking, and several other CVD risk factors. These findings suggest the need for research on mechanisms underlying the observed association to seek broader opportunities for prevention of AF.


Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Sarah M Camhi ◽  
Aviva Must ◽  
Philimon N Gona ◽  
Arlene Hankinson ◽  
Andrew Odegaard ◽  
...  

Background: Obesity is heterogeneous condition with phenotypic variation. Metabolically healthy obese (MHO) may represent an unstable phenotype which changes over time. MHO duration, or the length of time in MHO, is not well characterized. The purpose is to quantify MHO duration over 25 years and explore possible race/sex differences. Methods: Young adults (baseline ages 18-30 yrs) from CARDIA were included if they were non-obese at baseline, developed obesity (BMI ≥30kg/m 2 ) at any follow-up exam (yrs 7, 10, 15, 20 and 25), and had complete data for metabolic status, age, race and sex (n=702). MHO was defined as obese (BMI ≥30 kg/m 2 ) and having either 0 or 1 risk factor of the following: ≥SBP/DBP 130/85 mmHg; glucose ≥100 mg/dL; triglycerides (≥150 mg/dL); and HDL-C (men <40, women <50 mg/dL). Obese individuals with ≥2 risk factors were classified as metabolically unhealthy obese (MUO). MHO duration (yrs) and obesity duration (yrs) were estimated for subsequent time-points; and a duration sum was calculated for the follow-up period. For two time-points in which a person remained MHO and obese, a duration for that period was assigned. If they transitioned to MUO or non-obese, then the midpoint of the time period was estimated as MHO duration (yrs). MHO duration was also expressed as the percentage (%) of the total obesity duration. Multivariable adjusted ANCOVA was used to compare MHO duration (%) between race and sex groups (black men, white men, black women and white women), adjusting for baseline age, baseline BMI status (normal weight or overweight). Results: The eligible CARDIA sample was 55% black, 71% women and had a mean (± SD) baseline age of 25.0 ± 3.7 yrs. Duration of obesity was 12.3 ± 6.8 yrs, MHO duration (yrs) was 6.2 ± 5.4 yrs (range: 0 years to 19 yrs), and MHO duration (%) was 51.9 ± 34.8%. After adjusting for age and baseline BMI, MHO duration (%, mean ± SE) was significantly higher in women compared to men within race (black women n=292: 56.3 ± 2.0% vs. black men n=91: 43.3 ± 3.6%, p=0.001; white women n=206: 56.1 ± 2.4% vs. white men n=113: 39.7 ± 3.2%, p <0.0001). No significant differences were found between race groups within gender (black men vs. white men or black women vs. white women). Conclusion: MHO status is a transient phenotype accounting for only approximately half of obesity duration. Women have longer MHO duration compared to men, but differences by race were not apparent. Future research is needed to explore possible modifiable predictors and/or determinants of longer MHO duration in order to maintain a healthy cardiometabolic phenotype, even in the presence of obesity.


Crisis ◽  
2014 ◽  
Vol 35 (4) ◽  
pp. 268-272
Author(s):  
Sean Cross ◽  
Dinesh Bhugra ◽  
Paul I. Dargan ◽  
David M. Wood ◽  
Shaun L. Greene ◽  
...  

Background: Self-poisoning (overdose) is the commonest form of self-harm cases presenting to acute secondary care services in the UK, where there has been limited investigation of self-harm in black and minority ethnic communities. London has the UK’s most ethnically diverse areas but presents challenges in resident-based data collection due to the large number of hospitals. Aims: To investigate the rates and characteristics of self-poisoning presentations in two central London boroughs. Method: All incident cases of self-poisoning presentations of residents of Lambeth and Southwark were identified over a 12-month period through comprehensive acute and mental health trust data collection systems at multiple hospitals. Analysis was done using STATA 12.1. Results: A rate of 121.4/100,000 was recorded across a population of more than half a million residents. Women exceeded men in all measured ethnic groups. Black women presented 1.5 times more than white women. Gender ratios within ethnicities were marked. Among those aged younger than 24 years, black women were almost 7 times more likely to present than black men were. Conclusion: Self-poisoning is the commonest form of self-harm presentation to UK hospitals but population-based rates are rare. These results have implications for formulating and managing risk in clinical services for both minority ethnic women and men.


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