Long-Term Associations Between Disaster Experiences and Cardiometabolic Risk: A Natural Experiment From the 2011 Great East Japan Earthquake and Tsunami

Abstract We investigated the association between disaster experience and the cardiometabolic risk of survivors 2.5 years after disaster onset, adjusting for health information predating the disaster, using natural experiment data stemming from the 2011 Great East Japan Earthquake and Tsunami. We used data from a cohort of adults aged 65 years or older in Iwanuma City, Japan, located 80 km (128 miles) west of the earthquake epicenter. The baseline survey was completed 7 months before the disaster, and the follow-up survey was performed among survivors approximately 2.5 years after the disaster. The survey data were linked to medical records with information on objectively measured cardiometabolic risk factors (n = 1,195). The exposure of interest was traumatic disaster experiences (i.e., housing damage and loss of loved ones). Fixed-effects regression showed that complete housing destruction was significantly associated with a 0.81-unit greater change in body mass index (weight (kg)/height (m)2; 95% confidence interval (CI): 0.24, 1.38), a 4.26-cm greater change in waist circumference (95% CI: 1.12, 7.41), and a 4.77-mg/dL lower change in high-density lipoprotein cholesterol level (95% CI: −7.96, −1.58) as compared with no housing damage. We also observed a significant association between major housing damage and decreased systolic blood pressure. Continued health checkups and supports for victims who lost homes should be considered to maintain their cardiometabolic health.

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Increased risk of dementia in the aftermath of the 2011 Great East Japan Earthquake and Tsunami

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.1607793113 ◽

2016 ◽

Vol 113 (45) ◽

pp. E6911-E6918 ◽

Cited By ~ 30

Author(s):

Hiroyuki Hikichi ◽

Jun Aida ◽

Katsunori Kondo ◽

Toru Tsuboya ◽

Yusuke Matsuyama ◽

...

Keyword(s):

Cognitive Decline ◽

Fixed Effects ◽

Community Dwelling ◽

Great East Japan Earthquake ◽

Instrumental Variable Analysis ◽

Increased Risk ◽

Housing Damage ◽

Fixed Effects Regression ◽

The Impact

No previous study has been able to examine the association by taking account of risk factors for dementia before and after the disaster. We prospectively examined whether experiences of a disaster were associated with cognitive decline in the aftermath of the 2011 Great East Japan Earthquake and Tsunami. The baseline for our natural experiment was established in a survey of older community-dwelling adults who lived 80 km west of the epicenter 7 mo before the earthquake and tsunami. Approximately 2.5 y after the disaster, the follow-up survey gathered information about personal experiences of disaster as well as incidence of dementia from 3,594 survivors (82.1% follow-up rate). Our primary outcome was dementia diagnosis ascertained by in-home assessment during the follow-up period. Among our analytic sample (n = 3,566), 38.0% reported losing relatives or friends in the disaster, and 58.9% reported property damage. Fixed-effects regression indicated that major housing damage and home destroyed were associated with cognitive decline: regression coefficient for levels of dementia symptoms = 0.12, 95% confidence interval (CI): 0.01 to 0.23 and coefficient = 0.29, 95% CI: 0.17 to 0.40, respectively. The effect size of destroyed home is comparable to the impact of incident stroke (coefficient = 0.24, 95% CI: 0.11 to 0.36). The association between housing damage and cognitive decline remained statistically significant in the instrumental variable analysis. Housing damage appears to be an important risk factor for cognitive decline among older survivors in natural disasters.

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The Effect of Replacing Carbohydrate-based Breakfast Foods with Eggs on Cardiometabolic Risk Factors in Adults at Risk for Type 2 Diabetes (P08-045-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz044.p08-045-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Kevin Maki ◽

Orsolya Palacios ◽

Mary Buggia ◽

Mary Dicklin ◽

Marjorie Bell ◽

...

Keyword(s):

Type 2 Diabetes ◽

At Risk ◽

Risk Factor ◽

Insulin Sensitivity ◽

Cardiometabolic Risk ◽

Dietary Intervention ◽

Density Lipoprotein ◽

Cardiometabolic Health ◽

Cardiometabolic Risk Factor

Abstract Objectives To assess the effect of breakfast egg intake, vs. energy-matched carbohydrate (CHO)-based foods, on insulin sensitivity and markers of cardiometabolic health in adults at-risk for type 2 diabetes. Methods Overweight or obese adults with prediabetes and/or metabolic syndrome were included in this randomized crossover study consisting of two 4-wk dietary intervention periods, separated by a ≥4 wk washout. During each intervention, subjects consumed study products containing either 2 eggs/d for 6 d/wk (12 eggs/wk) or energy-matched CHO-based foods for breakfast. Percent changes from baseline were assessed for insulin sensitivity; CHO metabolism; lipid metabolism, including lipoprotein lipids, subfactions and particle sizes; high-sensitivity C-reactive protein (hs-CRP); and blood pressures (BP). Results Overall, 30 subjects (11 male; 19 female) with mean age of 53.5 ± 1.9 y and body mass index (BMI) of 31.9 ± 0.7 kg/m2 provided evaluable data. Median low-density lipoprotein cholesterol (LDL-C) decreased by 6.0% from a baseline of 119 mg/dL after 4-wk intake of the CHO breakfast foods, which was larger than the 2.9% reduction during the egg condition (P = 0.023 between diets). Mean systolic blood pressure was reduced significantly more during the egg condition vs. the CHO condition (2.7% vs. 0.0%, respectively, P = 0.018) from a baseline value of 127 mmHg. None of the other cardiometabolic risk factor parameters showed significant differences in response between diet conditions. Conclusions Intake of 12 eggs/wk for breakfast, vs. energy matched CHO-based foods, did not adversely affect the cardiometabolic risk factor profile in men and women at risk for diabetes. Funding Sources American Egg Board/Egg Nutrition Center, Park Ridge, IL Supporting Tables, Images and/or Graphs

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Plant-Based Dietary Patterns and Cardiometabolic Risk: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

Current Developments in Nutrition ◽

10.1093/cdn/nzab038_028 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 416-416

Author(s):

Sarah Jarvis ◽

Maria Tinajero ◽

Tauseef Khan ◽

Anthony Hanley ◽

David Jenkins ◽

...

Keyword(s):

Cohort Studies ◽

Dose Response ◽

Prospective Cohort ◽

Fixed Effects ◽

Cardiometabolic Risk ◽

Risk Of Bias ◽

Cardiometabolic Health ◽

Inverse Association ◽

Prospective Cohort Studies ◽

Meta Analyses

Abstract Objectives Plant-based diets defined by limited animal food consumption have been extensively associated with cardiometabolic health benefits in Western nations. Diet indices are increasingly used to distinguish the protective characteristics of a plant-based diet at different levels of adherence. We aimed to synthesize evidence on the association between adherence to plant-based diet indices and cardiometabolic risk. A plant-based diet index (PDI) is hypothesized to be inversely associated with type 2 diabetes (T2D) and cardiovascular disease (CVD) with a stronger association with the healthful index (hPDI) that emphasizes higher quality plant-based foods. Methods We systematically searched MEDLINE, EMBASE and CINAHL databases through January 2021. Prospective cohort studies assessing the association of plant-based diet indices with T2D and CVD in adults were included and appraised for risk of bias and quality (NutriGrade). We followed the PRISMA-P, Cochrane and MOOSE guidelines. Random and fixed-effects meta-analyses were conducted to pool risk ratios (RR) of extreme quantiles. Dose-response meta-analyses were conducted after harmonizing all diet index scores. I2-values of 30–60%, 50–90%, and 75–100% denoted moderate, substantial, and considerable heterogeneity respectively. Results We included a total of 10 studies from 5927 retrievals. Across 6 studies there were 22 135 cases of T2D over 4 817 308 person-years. Across 7 studies there were 15 077 cases of CVD over 6 117 016 person-years. The PDI was associated with a lower risk of T2D (RR = 0.82, 95% CI [0.75, 0.91], I2 = 55.4%), and CVD (RR = 0.88, 95% CI [0.8, 0.96], I2 = 16.2%). The hPDI had a stronger inverse association with T2D (RR = 0.73, 95% CI [0.68, 0.77], I2 = 84.3%) and CVD (RR = 0.8, 95% CI [0.77, 0.88], I2 = 55.9%). All dose-response relationships were linear (except hPDI with CVD). All studies had acceptable risk of bias and the quality of evidence was moderate. Conclusions Adherence to a plant-based diet was inversely associated with T2D and CVD with a stronger association for a healthful plant-based diet pattern. Since highest quantiles of the index still included moderate meat consumption, linear dose-responses emphasized potential benefits on risk of T2D and CVD with any incremental progression towards a plant-based diet. Funding Sources Nora Martin Fellowship, Ontario Graduate Scholarship.

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Impact of the occupational environment of a submerged submarine on cardiometabolic health of Royal Navy submariners

Occupational and Environmental Medicine ◽

10.1136/oemed-2019-106292 ◽

2020 ◽

Vol 77 (6) ◽

pp. 368-373

Author(s):

Frances Gunner ◽

Michael Lindsay ◽

Pieter Brown ◽

Anneliese Shaw ◽

Trish Davey ◽

...

Keyword(s):

Body Weight ◽

Serum Lipids ◽

Cardiometabolic Risk ◽

Prolonged Exposure ◽

Activity Patterns ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Cardiometabolic Health ◽

Royal Navy

ObjectiveTo determine the effect of prolonged exposure to a submarine environment on biomarkers of cardiometabolic risk in Royal Navy (RN) submariners.MethodsSerum lipids (cholesterol (C), triglyceride (TG), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), non-HDL-C), glucose, insulin and anthropometrics were compared within three RN submarine crews before and after submerged patrols of 12 or 6 weeks, and with a crew that remained ashore (SUB-HOME). Dietary intake and activity patterns were self-reported during each patrol. Differences were assessed in crew characteristics using one-way analysis of variance and in serum lipids using paired t-tests.ResultsPostpatrol, the mean body weight of submerged crews decreased (−1.4±4.2 kg, p=0.0001), but increased in SUB-HOME (1.9±1.8 kg, p=0.0001). Modest improvements in serum lipids (mean individual change (mmol/L); C=−0.3±0.7, p=0.0001; TG=−0.3±0.7, p=0.0001; HDL-C=−0.1±0.3, p=0.0001; non-HDL-C=−0.2±0.6, p=0.012), glucose (−0.2±0.5, p=0.0001) and insulin (−1.5±4.6 mU/L, p=0.001) were observed in submerged crews. Changes in serum lipids were positively associated with changes in body weight within crews combined. Energy intake was maintained during submerged patrols but was lower compared with non-submerged (11 139±2792 vs. 9617±2466 kJ, p=0.001; 11 062±2775 vs. 9632±2682 kJ, p=0.003).ConclusionsThe environment of a submerged submarine produced no adverse effects on serum biomarkers of cardiometabolic risk in crew. Conversely, modest improvements in these biomarkers were associated with a decrease in body weight.

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The Clustering of Low Diet Quality, Low Physical Fitness, and Unhealthy Sleep Pattern and Its Association with Changes in Cardiometabolic Risk Factors in Children

Nutrients ◽

10.3390/nu12020591 ◽

2020 ◽

Vol 12 (2) ◽

pp. 591

Author(s):

Xianwen Shang ◽

Yanping Li ◽

Haiquan Xu ◽

Qian Zhang ◽

Ailing Liu ◽

...

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Blood Pressure ◽

Diet Quality ◽

Cardiometabolic Risk ◽

Fasting Glucose ◽

Density Lipoprotein ◽

Sleep Pattern ◽

Cardiometabolic Health ◽

Z Scores

The clustering of diet quality, physical activity, and sleep and its association with cardiometabolic risk (CMR) factors remains to be explored. We included 5315 children aged 6–13 years in the analysis. CMR score (CMRS) was computed by summing Z-scores of waist circumference, an average of systolic and diastolic blood pressure, fasting glucose, high-density lipoprotein cholesterol (multiplying by −1), and triglycerides. Low diet quality and low cardiorespiratory fitness (CRF) were more likely to be seen in a pair, but low diet quality was less likely to be clustered with unhealthy sleep patterns. Low diet quality, low CRF, and unhealthy sleep pattern was associated with a 0.63, 0.53, and 0.25 standard deviation (SD) higher increase in CMRS, respectively. Compared to children with no unhealthy factor (−0.79 SD), those with ≥1 unhealthy factor had a higher increase (−0.20 to 0.59 SD) in CMRS. A low diet quality-unhealthy sleep pattern resulted in the highest increase in CMRS, blood pressure, and triglycerides. A low diet quality–low CRF-unhealthy sleep pattern resulted in the highest increase in fatness and fasting glucose. Unhealthy factor cluster patterns are complex; however, their positive associations with changes in CMR factors are consistently significant in children. Some specific patterns are more harmful than others for cardiometabolic health.

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Maternal prenatal anxiety and depression and trajectories of cardiometabolic risk factors across childhood and adolescence: a prospective cohort study

10.1101/2021.01.17.21249963 ◽

2021 ◽

Author(s):

Karen Matvienko-Sikar ◽

Kate N O’ Neill ◽

Abigail Fraser ◽

Catherine Hayes ◽

Laura D Howe ◽

...

Keyword(s):

Risk Factors ◽

High Density Lipoprotein ◽

Fat Mass ◽

High Density Lipoprotein Cholesterol ◽

Cardiometabolic Risk ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Anxiety And Depression ◽

Cardiometabolic Health ◽

Prenatal Anxiety

AbstractBackgroundQuantifying long-term offspring cardiometabolic health risks associated with maternal prenatal anxiety and depression can guide cardiometabolic risk prevention. This study examines associations between maternal prenatal anxiety and depression, and offspring cardiometabolic risk from birth to 18 years.MethodsParticipants were 526-8,606 mother-offspring pairs from the Avon Longitudinal Study of Parents and Children (ALSPAC). Exposures were anxiety (Crown-Crisp Inventory score) and depression (Edinburgh Postnatal Depression Scale score) measured at 18 and 32 weeks gestation. Outcomes were trajectories of offspring body mass index; fat mass; lean mass; pulse rate; glucose, diastolic and systolic blood pressure; triglycerides, high-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol, and insulin from birth/early childhood to 18 years. Exposures were analysed categorically using clinically relevant, cut-offs and continuously to examine associations across the distribution of prenatal anxiety and depression.ResultsWe found no strong evidence of associations between maternal anxiety and depression, and offspring trajectories of any cardiometabolic risk factors, except for small, inconsistent associations with fat mass trajectories that attenuated upon confounder adjustment. For instance, in unadjusted analyses, anxiety at both 18 and 32 weeks was associated with a 1.8% (95% Confidence Interval (CI), 0.29,3.33) higher mean BMI, which spanned the null (difference (95% CI): 0.7% (−0.76,2.13) after adjustment for confounders.ConclusionsThis is the first examination of maternal prenatal anxiety and depression and trajectories of offspring cardiometabolic risk. Our findings suggest that prevention of maternal prenatal anxiety and depression may have limited impact on offspring cardiometabolic health across the first two decades of life.

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Resistance training and HIIT improve cardiometabolic health in high risk older adults

International Journal of Sports Medicine ◽

10.1055/a-1560-6183 ◽

2021 ◽

Author(s):

Kelly Ann McLeod ◽

Matthew D. Jones ◽

Jeanette M Thom ◽

Belinda J. Parmenter

Keyword(s):

Older Adults ◽

Resistance Training ◽

Cardiometabolic Risk ◽

Meta Analysis ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Interval Training ◽

Mean Difference ◽

Cardiometabolic Health ◽

High Intensity Interval

Progressive resistance training (PRT) and high-intensity interval training (HIIT) improve cardiometabolic health in older adults. Whether combination PRT+HIIT (COMB) provides similar or additional benefit is less clear. This systematic review with meta-analysis of controlled trials examined effects of PRT, HIIT and COMB compared to non-exercise control in older adults with high cardiometabolic risk. Databases were searched until January 2021, with study quality assessed using the PEDro scale. Risk factor data was extracted and analysed using RevMan V.5.3. We analysed 422 participants from nine studies (7 PRT, n=149, 1 HIIT, n=10, 1 COMB, n=60; control n=203; mean age 68.1±1.4 years). Compared to control, exercise improved body mass index (mean difference (MD) -0.33 [-0.47, -0.20], p≤0.0001), body fat % (standardised mean difference (SMD) -0.71 [-1.34, -0.08], p=0.03), aerobic capacity (SMD 0.41 [0.05, 0.78], p=0.03), low-density lipoprotein (SMD -0.27 [-0.52, -0.01], p=0.04), and blood glucose (SMD -0.31 [-0.58, -0.05], p=0.02). Therefore, PRT, HIIT and COMB can improve cardiometabolic health in older adults with cardiometabolic risk. Further research is warranted, particularly in HIIT and COMB, to identify the optimal exercise prescription, if any, for improving older adults cardiometabolic health.

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Cardiometabolic health in adolescence and its association with educational outcomes

Journal of Epidemiology & Community Health ◽

10.1136/jech-2019-212256 ◽

2019 ◽

Vol 73 (12) ◽

pp. 1071-1077 ◽

Cited By ~ 1

Author(s):

Paulina Correa-Burrows ◽

Estela Blanco ◽

Sheila Gahagan ◽

Raquel Burrows

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Educational Outcomes ◽

Cardiometabolic Risk ◽

International Diabetes Federation ◽

Density Lipoprotein ◽

Cardiometabolic Risk Factors ◽

Cardiometabolic Health ◽

Model Assessment ◽

Grade Point

AimTo explore the association of selected cardiometabolic biomarkers and metabolic syndrome (MetS) with educational outcomes in adolescents from Chile.MethodsOf 678 participants, 632 (52% males) met criteria for the study. At 16 years, waist circumference (WC), systolic blood pressure, triglycerides (TG), high-density lipoprotein and glucose were measured. A continuous cardiometabolic risk score (zMetS) using indicators of obesity, lipids, glucose and blood pressure was computed, with lower values denoting a healthier cardiometabolic proﬁle. MetS was diagnosed with the International Diabetes Federation/American Heart Association/National Heart, Lung, and Blood Institute joint criteria. Data on high school (HS) graduation, grade point average (GPA), college examination rates and college test scores were collected. Data were analysed controlling for sociodemographic, lifestyle and educational confounders.ResultzMetS, WC, TG and homeostatic model assessment of insulin resistance at 16 years were negatively and significantly associated with the odds of completing HS and taking college exams. Notably, for a one-unit increase in zMetS, we found 52% (OR: 0.48, 95% CI 0.227 to 0.98) and 39% (OR: 0.61, 95% CI 0.28 to 0.93) reduction in the odds of HS completion and taking college exams, respectively. The odds of HS completion and taking college exams in participants with MetS were 37% (95% CI 0.14 to 0.98) and 33% (95% CI 0.15 to 0.79) that of participants with no cardiometabolic risk factors. Compared with adolescents with no risk factors, those with MetS had lower GPA (515 vs 461 points; p=0.002; Cohen’s d=0.55). Adolescents having the MetS had significantly lower odds of passing the mathematics exam for college compared with peers with no cardiometabolic risk factors (OR: 0.49; 95% CI 0.16 to 0.95).ConclusionIn Chilean adolescents, cardiometabolic health was associated with educational outcomes.

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Handgrip Strength and Current Smoking Are Associated with Cardiometabolic Risk in Korean Adolescents: A Population-Based Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17145021 ◽

2020 ◽

Vol 17 (14) ◽

pp. 5021

Author(s):

Sae Yun Kim ◽

Jung Soo Lee ◽

Yeo Hyung Kim

Keyword(s):

Cardiometabolic Risk ◽

Handgrip Strength ◽

Risk Index ◽

Density Lipoprotein ◽

Population Based ◽

Cardiometabolic Health ◽

Inverse Association ◽

Current Smoking ◽

Z Scores ◽

Independent Association

This study aimed to identify the independent association of handgrip strength and current smoking with cardiometabolic risk in adolescents. Data of 1806 adolescents (12–18 years) from the Korea National Health and Nutrition Examination Surveys were analyzed by complex samples logistic regression analyses. Handgrip strength was normalized by body weight into relative handgrip strength. A cardiometabolic risk index score was calculated from the z-scores of the following components: waist circumference, triglycerides, high-density lipoprotein cholesterol, glucose, and blood pressure. Relative handgrip strength showed an inverse association with high cardiometabolic risk, with an adjusted odds ratio of 8.5 (95% confidence interval [CI], 3.7–19.3) for boys and 5.7 (95% CI, 2.9–11.2) for girls on comparing the lowest and the highest age-and sex-specific quartiles of relative handgrip strength. The adjusted odds ratios for high cardiometabolic risk on comparing the second quartile and the highest quartile of relative handgrip strength were 3.9 (95% CI, 1.7–8.9) in boys and 2.6 (95% CI, 1.3–5.3) in girls. Current smoking was independently associated with high cardiometabolic risk in boys aged 15–18 years. These findings suggest the need to increase muscle strength in adolescents and reduce smoking in older boys to promote cardiometabolic health.

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Constraints of Weight Loss as a Marker of Bariatric Surgery Success: An Exploratory Study

Frontiers in Physiology ◽

10.3389/fphys.2021.640191 ◽

2021 ◽

Vol 12 ◽

Author(s):

Saulo Gil ◽

Karla Goessler ◽

Wagner S. Dantas ◽

Igor Hisashi Murai ◽

Carlos Alberto Abujabra Merege-Filho ◽

...

Keyword(s):

Blood Pressure ◽

Bariatric Surgery ◽

Weight Loss ◽

Exploratory Study ◽

Cardiometabolic Risk ◽

Fasting Glucose ◽

Density Lipoprotein ◽

Cardiometabolic Health ◽

Model Assessment ◽

Pressure Index

PurposeThe aim of this exploratory study was to investigate whether the degree of weight loss properly reflects improvements in cardiometabolic health among patients who underwent Roux-en-Y gastric bypass.MethodsIn this ancillary analysis from a clinical trial, patients were clustered into tertiles according to the magnitude of the percentage weight loss (1st tertile: “higher weight loss”: −37.1 ± 5.8%; 2nd tertile: “moderate weight loss”: −29.7 ± 1.4%; 3rd tertile: “lower weight loss”: −24.2 ± 2.3%). Delta changes (9 months after surgery-baseline) in clustered cardiometabolic risk (i.e., blood pressure index, fasting glucose, high-density lipoprotein [HDL] and triglycerides [TG]), glycated hemoglobin (HbA1c), homeostasis model assessment (HOMA-IR), and C-reactive protein (CRP) were calculated.ResultsA total of 42 patients who had complete bodyweight data (age = 40 ± 8 year; BMI = 47.8 ± 7.1 kg/m2) were included. Surgery led to substantial weight loss (−37.9 ± 11.3 kg, P < 0,001), and clinically significant improvements in blood pressure index (−17.7 ± 8.2 mmHg, P < 0.001), fasting glucose (−36.6 ± 52.5 mg/dL, P < 0.001), HDL (9.4 ± 7.1 mg/dL, P < 0.001), TG (−35.8 ± 44.1 mg/dL P < 0,001), HbA1c (−1.2 ± 1.6%, P < 0.001), HOMA-IR (−4.7 ± 3.9 mg/dL, P < 0.001) and CRP (−8.5 ± 6.7 μg/mL P < 0.001). Comparisons across tertiles revealed no differences for cardiometabolic risk score, fasting glucose, HbAc1, HOMA-IR, blood pressure index, CRP, HDL, and TG (P > 0.05 for all). Individual variable analysis confirmed cardiometabolic improvements across the spectrum on weight-loss. There were no associations between weight loss and any dependent variable.ConclusionWeight loss following bariatric surgery does not correlate with improvements in cardiovascular risk factors. These findings suggest that weight loss alone may be insufficient to assess the cardiometabolic success of bariatric surgery, and the search for alternate proxies that better predict surgery success are needed.

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