Alcohol Consumption in Young Adults and Incident Hypertension: 20-Year Follow-up From the Coronary Artery Risk Development in Young Adults Study

ABSTRACT Background Epidemiological evidence has demonstrated a positive association between artificially sweetened beverage (ASB) and sugar-sweetened beverage (SSB) consumption and type 2 diabetes (T2D) risk. However, research informing this topic in young adults is limited. Objective This study examined the association between ASB, SSB, and total sweetened beverage (TSB; combined ASB and SSB) consumption and T2D risk in young adults. Methods A prospective analysis of 4719 Black and White men and women aged 18–30 y at baseline was conducted from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Each participant's beverage intake was assessed using the CARDIA Diet History at baseline and at study Years 7 and 20. Multivariable Cox proportional hazards regression models were used to examine cumulative average ASB, SSB, and TSB intakes and risk of T2D. Results During the 30-y follow-up period, 680 participants developed T2D. ASB consumption was associated with a 12% greater risk of T2D per serving/day (HR 1.12, 95% CI 1.04–1.20) in a model adjusted for lifestyle factors, diet quality, and dieting behavior. Further adjustments for baseline BMI (HR 1.07, 95% CI 0.99–1.14) and weight change during follow-up (HR 1.04, 95% CI 0.97–1.12) attenuated the association. SSB and TSB consumption as continuous variables per 1 serving/day of intake were associated with 6% and 5% increased risks of T2D, respectively (HRSSB 1.06, 95% CI 1.01–1.10; HRTSB 1.05, 95% CI 1.01–1.09), in the model accounting for lifestyle factors, dieting behavior, baseline BMI, and weight change. Results were consistent when the exposures were modeled in categories of consumption and quintiles. Conclusions In young adults, long-term ASB, SSB, and TSB consumption were associated with increased risks of T2D. However, the estimates for ASB were attenuated when accounting for weight changes.

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Can Cognitive Bias Modification Simultaneously Target Two Behaviors? Approach Bias Retraining for Alcohol and Condom Use

Clinical Psychological Science ◽

10.1177/2167702619834570 ◽

2019 ◽

Vol 7 (5) ◽

pp. 1078-1093 ◽

Cited By ~ 5

Author(s):

Austin M. Hahn ◽

Raluca M. Simons ◽

Jeffrey S. Simons ◽

Reinout W. Wiers ◽

Logan E. Welker

Keyword(s):

Young Adults ◽

High Risk ◽

Alcohol Consumption ◽

Cognitive Bias ◽

Cognitive Bias Modification ◽

Training Condition ◽

Positive Attitudes ◽

And Behavior ◽

Bias Modification

This study tested the effectiveness of a cognitive bias modification (CBM) intervention to simultaneously reduce approach biases toward alcohol and increase approach biases toward condoms among high-risk young adults. Participants ( N = 102) were randomly assigned to either a training condition or a sham-training condition. Participants in the training condition were trained to make avoidance movements away from alcohol stimuli and approach movements toward condom stimuli over four training sessions. Approach biases and behavior were assessed at pretest, posttest, and 3-month follow-up. Approach biases changed for both stimulus categories in accordance with training condition. Condom behavior and attitudes also changed as a function of training condition such that participants in the training condition reported fewer instances of condom nonuse and more positive attitudes toward condoms at a 3-month follow-up. Participants in both conditions had significant reductions in alcohol consumption following the intervention and did not differ by training condition.

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Abstract 13676: Association of Plant-centered Diet Intake With Cardiovascular Disease and All-cause Mortality: Findings From the Coronary Artery Risk Development in Young Adults Study

Circulation ◽

10.1161/circ.142.suppl_3.13676 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Yuni Choi ◽

Nicole Larson ◽

Lyn M Steffen ◽

Pamela J SCHREINER ◽

Daniel D Gallaher ◽

...

Keyword(s):

Cardiovascular Disease ◽

Young Adults ◽

Coronary Artery ◽

Diet Quality ◽

Lower Risk ◽

Multivariable Analysis ◽

Parental History ◽

Plant Foods ◽

All Cause Mortality

Introduction: There is growing data regarding the potential for plant-centered diets to reduce risk for cardiovascular disease (CVD) and mortality. However, additional investigation is needed to strengthen and address inconsistencies in the existing evidence base. We examined the association between cumulative consumption of a plant-centered diet and a shift toward a more plant-centered diet and onset of CVD and all-cause mortality. Hypothesis: Nutritionally-rich plant-centered diets will be related to decreased risk of CVD and mortality. Methods: We included 4,926 black and white men and women from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort, ages 18-30 years and free of CVD at baseline (1985-1986, exam year [Y0]) and followed until 2018. Diet was assessed through an interviewer-administered diet history at Y0, Y7, and Y20. A Priori Diet Quality Score (APDQS) was used to assess plant-centered diet quality, and high index scores were characterized by higher consumption of nutritionally-rich plant foods with limited consumption of meats and less healthful plant foods. Proportional hazards regression estimated the association of time-varying APDQS, which were cumulatively averaged over follow-up and 13-year change in APDQS (Y7-Y20) with CVD and all-cause mortality. The model was adjusted for sociodemographic factors, energy intake, parental history of CVD, smoking, and physical activity. Results: We documented 289 new CVD cases and 445 all-cause deaths during the median 32-years of follow up. In multivariable analysis, the highest quintile of cumulative APDQS was associated with a 52% lower risk of CVD (hazard ratio [HR]: 0.48, 95% CI: 0.28-0.81) compared with the lowest quintile of cumulative APDQS. Increased APDQS over 13 years was related to a 62% lower subsequent 12-year risk of CVD (95% CI: 0.18-0.78) when comparing extreme quintiles. The association for all-cause mortality was only apparent among high educational groups. Conclusions: Following a plant-centered, high-quality diet staring from young adulthood was associated with a lower risk of developing CVD and death by middle age. Our findings support the concept that a plant-centered diet may help prevent early CVD and death.

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Abstract 16731: Early Onset of Menopause and Premature Cardiovascular Disease: The Coronary Artery Risk Development in Young Adults Study

Circulation ◽

10.1161/circ.142.suppl_3.16731 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Ruth Misha ◽

Laura A Colangelo ◽

Lucia Petito ◽

Cora E Lewis ◽

Pamela Schreiner ◽

...

Keyword(s):

Cardiovascular Disease ◽

Young Adults ◽

Coronary Artery ◽

Black Women ◽

Early Onset ◽

White Women ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Age At Menarche

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.

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Long-term change in alcohol-consumption status and variations in fibrinogen levels: the coronary artery risk development in young adults (CARDIA) study

BMJ Open ◽

10.1136/bmjopen-2013-002944 ◽

2013 ◽

Vol 3 (7) ◽

pp. e002944 ◽

Cited By ~ 2

Author(s):

Tochi M Okwuosa ◽

Oana Klein ◽

Cheeling Chan ◽

Pamela Schreiner ◽

Kiang Liu ◽

...

Keyword(s):

Young Adults ◽

Coronary Artery ◽

Alcohol Consumption ◽

Term Change

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Life Course Change Towards a Plant-Centered Diet and Incidence of Type 2 Diabetes: The Coronary Artery Risk Development in Young Adults (CARDIA) Study (OR33-03-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz039.or33-03-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Yuni Choi ◽

David Jacobs ◽

Kristin Hirahatake ◽

Nicole Larson ◽

Andrew Odegaard ◽

...

Keyword(s):

Type 2 Diabetes ◽

Young Adults ◽

Coronary Artery ◽

Diet Quality ◽

Proportional Hazards ◽

Dietary Quality ◽

Food Groups ◽

Incident Type

Abstract Objectives There has been limited study of long-term change towards a plant-centered diet in relation to incident type 2 diabetes (T2DM). We examined this question in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort. Methods Analyses included 2717 participants in CARDIA, a US multicenter, community-based prospective cohort study, currently with 30 years of follow-up. Participants were free of diabetes through year 20, with follow-up for incident T2DM through year 30. Dietary intake at years 0 and 20 was assessed by interviewer-administered diet history; overall dietary quality was assessed using a hypothesis-driven index based on 46 food groups, the A Priori Diet Quality Score (APDQS). The APDQS has possible scores 0 to 132 and increasing score is largely led by consumption of nutritionally rich plant foods–fruits and vegetables and plant-derived fats (e.g., seeds, nut, vegetable oils) and proteins (e.g., avocado, legume, soy). Change in diet quality (year 20 – year 0) and its quintiles were calculated. Diagnosis of T2DM was based on self-reported use of antidiabetic medication treatment or lab tests (fasting glucose, 2-hour glucose, or glycated hemoglobin). In proportional hazards regression, covariates included sociodemographics, baseline APDQS, and time-varying energy intake, smoking, and physical activity. Results Mean baseline age was 25.0 ± 3.6y, 43% were black, and 58% were women. During 10 years of follow-up after year 20, 206 cases of incident T2DM occurred. Mean year 0 APDQS was 64 ± 13 points and mean 20-year changes in APDQS was 7 ± 11. In multivariable-adjusted analysis, we found that the greatest increase in dietary quality over 20 years (median APDQS increased by 22 points) was associated with a 60% decrease in risk of T2DM as compared to a small decrease in diet quality (median APDQS decreased by 8 points); HRQ5 vs. Q1: 0.40; 95% CI:0.24–0.67). For every 10-point increase in APDQS over 20 years, there was a 23% decrease in risk of T2DM (95% CI: 0.67–0.88, P-trend = 0.0009). The pattern of findings persisted within below median and within above median year 0 APDQS. Conclusions Our finding suggests that young adults would benefit from improving diet quality by shifting toward a more plant-centered diet over time for the prevention of T2DM. Funding Sources This research was funded by an NHLBI contract and the University of Minnesota Healthy Food, Healthy Lives Institute. Supporting Tables, Images and/or Graphs

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