Abstract P303: High Birth Weight Modifies Estimated Effects of Physical Activity on Cardiometabolic Health in Females

Background: Birth weight and physical activity are independently associated with cardiometabolic health outcomes. Low or high birth weight are indicators of adverse prenatal development, which may alter physiological response to physical activity later in life. However, few studies have explored the potential interaction between birth weight and physical activity as determinants of cardiometabolic health. Objective: We evaluated the hypothesis that high or low birth weight modifies the association of early life physical activity with cardiovascular disease or diabetes later in life. Methods: We analyzed data from the National Longitudinal Study of Adolescent and Adult Health (Add Health), a nationally representative cohort of US adolescents followed into adulthood ( n =20,745) with four data collection waves between 1994 and 2008. Outcomes were assessed in early adulthood: (1) predicted 30-year cardiovascular disease (CVD) risk, computed by a validated algorithm based on objective measures, and (2) prevalent pre-diabetes and diabetes. Using gender-stratified multivariable regression on multiply imputed data, we modeled (1) log-transformed 30-year CVD risk (linear regression) and (2) prevalent pre-diabetes and diabetes (PDM/DM; ordinal regression) each as a function of birth weight (low, normal, high; LBW, NBW, HBW) and self-reported moderate-to-vigorous physical activity frequency (MVPA) in adolescence and young adulthood, adjusting for age, smoking, and sociodemographic factors. Results: A greater proportion of women born at LBW had diabetes than NBW and HBW women (10.8% versus 5.9% and 5.4%, respectively). In adjusted analyses, MVPA in adolescence (MVPA1) and early adulthood (MVPA3) were not significantly associated with predicted CVD risk and prevalent pre-diabetes diabetes in men or women overall. However, greater MVPA1 was associated with lower predicted 30-year CVD risk in HBW females (estimated effect coefficient -0.02 [95% CI: -0.03, -0.005, p =0.02], p =0.05 for HBWхMVPA1 interaction), and the HBWхMVPA1 interaction on PDM/DM approached significance in females ( p =0.12). In females and males of LBW or NBW, MVPA1 was not significantly associated with predicted 30-year CVD risk or PDM/DM and LBWхMVPA1 interactions were not significant. Conclusions: Greater adolescent physical activity was most strongly associated with lower 30-year CVD risk in young women born at HBW. A similar association with prevalent DM/PDM approached significance, with greater adolescent physical activity most strongly associated in HBW women. Females born at HBW may be especially sensitive to the effects of physical activity on reducing risk of cardiometabolic disease later in life, with important implications for disease prevention and health policy.

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High birth weight modifies association between adolescent physical activity and cardiometabolic health in women and not men

Preventive Medicine ◽

10.1016/j.ypmed.2017.12.015 ◽

2018 ◽

Vol 108 ◽

pp. 29-35 ◽

Cited By ~ 6

Author(s):

Thomas L. Jeanne ◽

Elizabeth R. Hooker ◽

Thuan Nguyen ◽

Lynne C. Messer ◽

Rebecca M. Sacks ◽

...

Keyword(s):

Physical Activity ◽

Birth Weight ◽

Cardiometabolic Health ◽

High Birth Weight ◽

Adolescent Physical Activity

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Urbanization and market integration have strong, nonlinear effects on cardiometabolic health in the Turkana

Science Advances ◽

10.1126/sciadv.abb1430 ◽

2020 ◽

Vol 6 (43) ◽

pp. eabb1430

Author(s):

Amanda J. Lea ◽

Dino Martins ◽

Joseph Kamau ◽

Michael Gurven ◽

Julien F. Ayroles

Keyword(s):

Cardiovascular Disease ◽

Urban Areas ◽

Market Integration ◽

Nonlinear Effects ◽

Cardiometabolic Health ◽

Adult Health ◽

Way Of Life ◽

Cvd Risk ◽

Subsistence Level ◽

Refined Carbohydrates

The “mismatch” between evolved human physiology and Western lifestyles is thought to explain the current epidemic of cardiovascular disease (CVD) in industrialized societies. However, this hypothesis has been difficult to test because few populations concurrently span ancestral and modern lifestyles. To address this gap, we collected interview and biomarker data from individuals of Turkana ancestry who practice subsistence-level, nomadic pastoralism (the ancestral way of life for this group), as well as individuals who no longer practice pastoralism and live in urban areas. We found that Turkana who move to cities exhibit poor cardiometabolic health, partially because of a shift toward “Western diets” high in refined carbohydrates. We also show that being born in an urban area independently predicts adult health, such that life-long city dwellers will experience the greatest CVD risk. By focusing on a substantial lifestyle gradient, our work thus informs the timing, magnitude, and evolutionary causes of CVD.

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Abstract 047: Sedentary Behavior Increases Risk for Cardiovascular Disease in Older Women: The Objective Physical Activity and Cardiovascular Health (OPACH) Study

Circulation ◽

10.1161/circ.137.suppl_1.047 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

John Bellettiere ◽

Michael J LaMonte ◽

Eileen Rillamas-Sun ◽

Jacqueline Kerr ◽

Kelly R Evenson ◽

...

Keyword(s):

Physical Activity ◽

Cardiovascular Disease ◽

Sedentary Behavior ◽

Older Women ◽

Cardiovascular Health ◽

Sedentary Time ◽

Vigorous Physical Activity ◽

Cvd Risk ◽

Bout Duration ◽

Increased Risk

Background: Evidence on sedentary behavior and cardiovascular disease (CVD) is largely based on self-reported sedentary time. Furthermore, how sedentary time is accumulated (in longer vs. shorter bouts) may be related to CVD risk but has not been tested. Methods: Women (n=5638, mean age=79±7) with no history of myocardial infarction or stroke wore accelerometers for 4-7 days and were followed for up to 4 years for incident CVD. Hazard ratios (HR) and 95% confidence intervals (CIs) for CVD and coronary heart disease (CHD) events were estimated across quartiles of sedentary time and mean sedentary bout duration using Cox proportional hazard models adjusting for covariates. Separate models evaluated associations after adding moderate-to-vigorous physical activity (MVPA) and possible mediators: body mass index, diabetes, hypertension, systolic blood pressure, fasting glucose, HDL-cholesterol, and triglycerides. We then tested whether mean bout duration was associated with increased risk for CVD and CHD among women with above median sedentary time (≥10hr/day). Results: Covariate-adjusted HRs for CVD and CHD increased across quartiles of both sedentary time and mean bout duration (Table). All CHD associations remained significant but attenuated after adjustment for possible mediators. After adjustment for MVPA, highest vs. lowest quartile HRs (CI) for CHD were 1.6 (0.7-3.4; p-trend = .08) for sedentary time and 1.8 (0.9-3.5; p-trend = .047) for mean bout duration. Among women with high sedentary time, the HRs (CI) comparing the 75 th vs. 25 th percentile of mean bout duration were 1.05 (0.95-1.15) for CVD and 1.16 (1.01-1.34) for CHD. Conclusions: Both sedentary time and mean bout duration showed independent, dose-response associations with increased risk of CVD and CHD events in older women. Among women with high sedentary time, longer mean bout duration was associated with higher CHD risk. Taken together, this provides evidence that both total sedentary time and the way it is accumulated are predictive of incident CHD.

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Changes in exercise frequency and cardiovascular outcomes in older adults

European Heart Journal ◽

10.1093/eurheartj/ehz768 ◽

2019 ◽

Vol 41 (15) ◽

pp. 1490-1499 ◽

Cited By ~ 5

Author(s):

Kyuwoong Kim ◽

Seulggie Choi ◽

Seo Eun Hwang ◽

Joung Sik Son ◽

Jong-Koo Lee ◽

...

Keyword(s):

Physical Activity ◽

Cardiovascular Disease ◽

Older Adults ◽

Vigorous Physical Activity ◽

Previous History ◽

Cvd Risk ◽

Exercise Frequency ◽

History Of ◽

Reduced Risk ◽

Physically Inactive

Abstract Aims Little is known about the association of changes in moderate to vigorous physical activity (MVPA) level with cardiovascular disease (CVD), especially in older adults whose ability to engage in frequent MVPA naturally wanes as they age. We aimed to examine the association of changes in MVPA and CVD in older adults. Methods and results In a nationwide cohort study of older adults aged 60 years or older, we identified more than 1.1 million subjects without previous history of CVD at baseline who underwent two consecutive national health screening from 2009 to 2012. We prospectively assessed the risk of CVD occurred between 2013 and 2016 according to changes in frequency of MVPA by initial MVPA status. Compared to those who were continuously physically inactive, those who increased their frequency of MVPA from physically inactive to 1–2 times per week [0.7/1000 person-years (PY) decrease in incidence rate (IR); adjusted hazard ratio (aHR) 0.95; 95% confidence interval (CI) 0.92–0.99], 3–4 times per week (1.5/1000 PY decrease in IR; aHR 0.89; 95% CI 0.84–0.94), ≥5 times per week (0.4/1000 PY decrease in IR; aHR 0.91; 95% CI 0.85–0.97) had a significantly reduced risk for total CVD (P for trend <0.001). Older adults who became physically inactive from engaging in more than 1–2 times of MVPA per week had a higher CVD risk compared to those who maintained their frequency of MVPA. Conclusion Among older adults, engaging in higher frequency of MVPA or maintaining MVPA level was associated with reduced risk of CVD.

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Abstract 13: Economic Impact of Moderate-vigorous Physical Activity Among Those with and without Established Cardiovascular Disease: 2012 Medical Expenditure Panel Survey

Circulation ◽

10.1161/circ.133.suppl_1.13 ◽

2016 ◽

Vol 133 (suppl_1) ◽

Author(s):

Javier Valero-Elizondo ◽

Joseph A Salami ◽

Chukwuemeka U Osondu ◽

Adnan Younus ◽

Alejandro Arrieta ◽

...

Keyword(s):

Physical Activity ◽

Cardiovascular Disease ◽

Medical Expenditure Panel Survey ◽

Vigorous Physical Activity ◽

Medical Expenditure ◽

Panel Survey ◽

Cvd Risk ◽

Vigorous Exercise ◽

Physically Active ◽

Artery Disease

Background: Physical activity (PA) is an established factor for favorable cardiovascular disease (CVD) outcomes and quality of life. However, to date little is available on PA’s independent impact on healthcare cost. In this study, we aimed to estimate this effect on medical expenditure from a nationally representative cohort with and without CVD. Methods: The 2012 Medical Expenditure Panel Survey data was analyzed. Our study population was limited to non-institutionalized adults ≥ 40 years of age. Variables of interest were CVD (coronary artery disease, stroke, heart failure, dysrhythmias or peripheral artery disease), modifiable risk factors (MRF; hypertension, diabetes mellitus, hypercholesterolemia, smoking, and/or obesity), and PA (dichotomous variable: defined as moderate-vigorous exercise of ≥ 30 minutes, 5 times/week). Two-part econometric models were utilized to study cost data; a generalized linear model with gamma distribution and link log was used to assess expenditures per capita, taking into consideration the survey’s complex design. Results: Our final study sample consisted of 15,651 surveyed individuals (mean age: 58.5 ± 12 years, 46% male). Overall, 46% engaged in at least moderate exercise, translating to 21 million physically active adults in the U.S. Of those with CVD, 34% reported PA, vs. 47% without CVD. In those without CVD, a higher prevalence of PA was noted with lower MRF burden (≥ 3: 35%, 2: 44%, 0-1: 53%). Generally, participants reporting moderate-vigorous PA incurred significantly lower healthcare costs, seen both in those with and without CVD. Among those without CVD, those engaged in moderate-vigorous PA with 0-1 & ≥ 3 MRF had $1,038 & $1,785 less healthcare expenditure, respectively, than their less physically active counterparts. Conclusion: In addition to tremendously improving CVD risk, moderate-vigorous PA is also associated with significantly less healthcare spending. Our findings further reinforce the importance of physical activity in health promotion and CVD prevention.

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The Associations Between Cardiovascular Risk Factors, Physical Activity, and Arterial Stiffness in Youth

Journal of Physical Activity and Health ◽

10.1123/jpah.10.2.198 ◽

2013 ◽

Vol 10 (2) ◽

pp. 198-204 ◽

Cited By ~ 11

Author(s):

Darolyn J. Walker ◽

Andrea MacIntosh ◽

Anita Kozyrskyj ◽

Allan Becker ◽

Jon McGavock

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Cardiovascular Disease ◽

Body Mass Index ◽

Risk Factor ◽

Arterial Stiffness ◽

Cardiometabolic Risk ◽

Vigorous Physical Activity ◽

Cardiometabolic Risk Factor ◽

Cvd Risk

Background:The primary aim of this population-based study was to determine if arterial stiffness is associated with cardiovascular disease (CVD) risk factor clustering and physical activity in youth 12−14 years old. We hypothesized that arterial stiffness would be positively associated with CVD risk factor clustering and negatively associated with physical activity in a dose-response manner in this cohort of youth.Methods:This was a cross sectional study of 485 youth recruited from the 1995 Manitoba birth cohort. The primary outcome, arterial stiffness, was assessed noninvasively using conventional pulse wave analysis and velocity. The primary exposure variables included 1) a measure of cardiometabolic risk, defined as a composite of novel and traditional risk factors for cardiovascular disease and type 2 diabetes and 2) self-reported physical activity.Results:Neither cardiometabolic risk factor clustering, nor physical activity were associated with either measure of arterial stiffness in this cohort of youth 12−14 years. Cardiometabolic risk decreased with increasing levels of vigorous physical activity, (P < .05) and increased with increasing body mass index.Conclusions:Cardiometabolic risk factor clustering and physical activity are not associated with arterial stiffness in youth 12−14 years of age. Increased vigorous physical activity is associated with reduced cardiometabolic risk in youth independent of body mass index.

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Birth weight, cardiometabolic risk factors and effect modification of physical activity in children and adolescents: pooled data from 12 international studies

International Journal of Obesity ◽

10.1038/s41366-020-0612-9 ◽

2020 ◽

Vol 44 (10) ◽

pp. 2052-2063

Author(s):

Guro Pauck Bernhardsen ◽

◽

Trine Stensrud ◽

Bjørge Herman Hansen ◽

Jostein Steene-Johannesen ◽

...

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Birth Weight ◽

Waist Circumference ◽

Low Birth Weight ◽

Children And Adolescents ◽

Cardiometabolic Risk ◽

Cardiometabolic Risk Factors ◽

Cardiometabolic Health ◽

High Birth Weight

Abstract Objectives Low and high birth weight is associated with higher levels of cardiometabolic risk factors and adiposity in children and adolescents, and increases the risk of cardiovascular diseases, obesity, and early mortality later in life. Moderate-to-vigorous physical activity (MVPA) is associated with lower cardiometabolic risk factors and may mitigate the detrimental consequences of high or low birth weight. Thus, we examined whether MVPA modified the associations between birth weight and cardiometabolic risk factors in children and adolescents. Methods We used pooled individual data from 12 cohort- or cross-sectional studies including 9,100 children and adolescents. Birth weight was measured at birth or maternally reported retrospectively. Device-measured physical activity (PA) and cardiometabolic risk factors were measured in childhood or adolescence. We tested for associations between birth weight, MVPA, and cardiometabolic risk factors using multilevel linear regression, including study as a random factor. We tested for interaction between birth weight and MVPA by introducing the interaction term in the models (birth weight x MVPA). Results Most of the associations between birth weight (kg) and cardiometabolic risk factors were not modified by MVPA (min/day), except between birth weight and waist circumference (cm) in children (p = 0.005) and HDL-cholesterol (mmol/l) in adolescents (p = 0.040). Sensitivity analyses suggested that some of the associations were modified by VPA, i.e., the associations between birth weight and diastolic blood pressure (mmHg) in children (p = 0.009) and LDL- cholesterol (mmol/l) (p = 0.009) and triglycerides (mmol/l) in adolescents (p = 0.028). Conclusion MVPA appears not to consistently modify the associations between low birth weight and cardiometabolic risk. In contrast, MVPA may mitigate the association between higher birth weight and higher waist circumference in children. MVPA is consistently associated with a lower cardiometabolic risk across the birth weight spectrum. Optimal prenatal growth and subsequent PA are both important in relation to cardiometabolic health in children and adolescents.

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Feelings of safety during daytime walking: associations with mental health, physical activity and cardiometabolic health in high vacancy, low-income neighborhoods in Detroit, Michigan

International Journal of Health Geographics ◽

10.1186/s12942-021-00271-3 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Amber L. Pearson ◽

Kimberly A. Clevenger ◽

Teresa H. Horton ◽

Joseph C. Gardiner ◽

Ventra Asana ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Low Income ◽

Spatial Data ◽

Vigorous Physical Activity ◽

Future Research ◽

Cardiometabolic Health ◽

Multilevel Regression ◽

Critical Pathway ◽

Perceived Safety

Abstract Introduction Individuals living in low-income neighborhoods have disproportionately high rates of obesity, Type-2 diabetes, and cardiometabolic conditions. Perceived safety in one’s neighborhood may influence stress and physical activity, with cascading effects on cardiometabolic health. Methods In this study, we examined relationships among feelings of safety while walking during the day and mental health [perceived stress (PSS), depression score], moderate-to-vigorous physical activity (PA), Body Mass Index (BMI), and hemoglobin A1C (A1C) in low-income, high-vacancy neighborhoods in Detroit, Michigan. We recruited 69 adults who wore accelerometers for one week and completed a survey on demographics, mental health, and neighborhood perceptions. Anthropometrics were collected and A1C was measured using A1CNow test strips. We compiled spatial data on vacant buildings and lots across the city. We fitted conventional and multilevel regression models to predict each outcome, using perceived safety during daytime walking as the independent variable of interest and individual or both individual and neighborhood-level covariates (e.g., number of vacant lots). Last, we examined trends in neighborhood features according to perceived safety. Results In this predominantly African American sample (91%), 47% felt unsafe during daytime walking. Feelings of perceived safety significantly predicted PSS (β = − 2.34, p = 0.017), depression scores (β = − 4.22, p = 0.006), and BMI (β = − 2.87, p = 0.01), after full adjustment. For PA, we detected a significant association for sex only. For A1C we detected significant associations with blighted lots near the home. Those feeling unsafe lived in neighborhoods with higher park area and number of blighted lots. Conclusion Future research is needed to assess a critical pathway through which neighborhood features, including vacant or poor-quality green spaces, may affect obesity—via stress reduction and concomitant effects on cardiometabolic health.

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Reducing cardiovascular disease risk among families with familial hypercholesterolaemia by improving diet and physical activity: a randomised controlled feasibility trial

BMJ Open ◽

10.1136/bmjopen-2020-044200 ◽

2020 ◽

Vol 10 (12) ◽

pp. e044200

Author(s):

Fiona Jane Kinnear ◽

Fiona E Lithander ◽

Aidan Searle ◽

Graham Bayly ◽

Christina Wei ◽

...

Keyword(s):

Physical Activity ◽

Cardiovascular Disease ◽

Familial Hypercholesterolaemia ◽

Disease Risk ◽

Pilot Trial ◽

Feasibility Trial ◽

Cvd Risk ◽

Sedentary Behaviours ◽

Diet And Physical Activity ◽

Randomised Controlled

ObjectiveFamilial hypercholesterolaemia (FH) elevates low-density lipoprotein cholesterol (LDL-C) and increases cardiovascular disease (CVD) risk. This study aimed to provide evidence for the feasibility of conducting a randomised controlled trial to evaluate the efficacy of an intervention designed to improve diet and physical activity in families with FH.DesignA parallel, randomised, waitlist-controlled, feasibility pilot trial.SettingThree outpatient lipid clinics in the UK.ParticipantsFamilies that comprised children (aged 10–18 years) and their parent with genetically diagnosed FH.InterventionFamilies were randomised to either 12-week usual care or intervention. The behavioural change intervention aimed to improve dietary, physical activity and sedentary behaviours. It was delivered to families by dietitians initially via a single face-to-face session and then by four telephone or email follow-up sessions.Outcome measuresFeasibility was assessed via measures related to recruitment, retention and intervention fidelity. Postintervention qualitative interviews were conducted to explore intervention acceptability. Behavioural (dietary intake, physical activity and sedentary time) and clinical (blood pressure, body composition and blood lipids) outcomes were collected at baseline and endpoint assessments to evaluate the intervention’s potential benefit.ResultsTwenty-one families (38% of those approached) were recruited which comprised 22 children and 17 adults with FH, and 97% of families completed the study. The intervention was implemented with high fidelity and the qualitative data revealed it was well accepted. Between-group differences at the endpoint assessment were indicative of the intervention’s potential for improving diet in children and adults. Evidence for potential benefits on physical activity and sedentary behaviours was less apparent. However, the intervention was associated with improvements in several CVD risk factors including LDL-C, with a within-group mean decrease of 8% (children) and 10% (adults).ConclusionsThe study’s recruitment, retention, acceptability and potential efficacy support the development of a definitive trial, subject to identified refinements.Trial registration numberISRCTN24880714.

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Association of daily composition of physical activity and sedentary behaviour with incidence of cardiovascular disease in older adults

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-021-01157-0 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Manasa S. Yerramalla ◽

Duncan E. McGregor ◽

Vincent T. van Hees ◽

Aurore Fayosse ◽

Aline Dugravot ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Sedentary Behaviour ◽

Cox Regression ◽

Vigorous Physical Activity ◽

Movement Behaviour ◽

Cvd Risk ◽

Daily Movement ◽

Intensity Physical Activity ◽

Current Duration

Abstract Background Moderate-to-vigorous physical activity (MVPA) is proposed as key for cardiovascular diseases (CVD) prevention. At older ages, the role of sedentary behaviour (SB) and light intensity physical activity (LIPA) remains unclear. Evidence so far is based on studies examining movement behaviours as independent entities ignoring their co-dependency. This study examines the association between daily composition of objectively-assessed movement behaviours (MVPA, LIPA, SB) and incident CVD in older adults. Methods Whitehall II accelerometer sub-study participants free of CVD at baseline (N = 3319, 26.7% women, mean age = 68.9 years in 2012–2013) wore a wrist-accelerometer from which times in SB, LIPA, and MVPA during waking period were extracted over 7 days. Compositional Cox regression was used to estimate the hazard ratio (HR) for incident CVD for daily compositions of movement behaviours characterized by 10 (20 or 30) minutes greater duration in one movement behaviour accompanied by decrease in another behaviour, while keeping the third behaviour constant, compared to reference composition. Analyses were adjusted for sociodemographic, lifestyle, cardiometabolic risk factors and multimorbidity index. Results Of the 3319 participants, 299 had an incident CVD over a mean (SD) follow-up of 6.2 (1.3) years. Compared to daily movement behaviour composition with MVPA at recommended 21 min per day (150 min/week), composition with additional 10 min of MVPA and 10 min less SB was associated with smaller risk reduction – 8% (HR, 0.92; 95% CI, 0.87–0.99) – than the 14% increase in risk associated with a composition of similarly reduced time in MVPA and more time in SB (HR, 1.14; 95% CI, 1.02–1.27). For a given MVPA duration, the CVD risk did not differ as a function of LIPA and SB durations. Conclusions Among older adults, an increase in MVPA duration at the expense of time in either SB or LIPA was found associated with lower incidence of CVD. This study lends support to public health guidelines encouraging increase in MVPA or at least maintain MVPA at current duration.

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