Increased Adiposity Appraised with CUN-BAE Is Highly Predictive of Incident Hypertension. The SUN Project

Overweight and obesity are growing worldwide and strongly associated with hypertension. The Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) index is proposed as an optimal indicator of body fatness. We aimed to investigate the association of body fat as captured by the CUN-BAE index with incident hypertension in a Mediterranean population. We assessed 15,950 participants of the SUN (Seguimiento Universidad de Navarra) prospective cohort (63.7% women) initially free of hypertension. Participants completed follow-up questionnaires biennially. A validated 136-item food-frequency questionnaire was administered at baseline. We used Cox models adjusted for multiple confounders. Among 12.3 years of median follow-up (interquartile range: 8.3, 15.0 years), 2160 participants reported having received a diagnosis of hypertension. We observed a strong direct association between progressively higher the CUN-BAE index at baseline and incident hypertension during follow-up in multivariable-adjusted models for men and women, even after further adjustment for BMI ≥ 30 kg/m2, showing a significant association also in non-obese participants. For each 2-unit increase in the CUN-BAE index, hypertension risk increased by 27% and 29% in men and women, respectively. The results remained significant when considering longitudinal repeated measures of changes in body fat assessed with the CUN-BAE index among the different biennial follow-up questionnaires. Our results emphasize the importance of reducing and maintaining a low body fat to prevent hypertension.

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Low Dietary Magnesium and Overweight/Obesity in a Mediterranean Population: A Detrimental Synergy for the Development of Hypertension. The SUN Project

Nutrients ◽

10.3390/nu13010125 ◽

2020 ◽

Vol 13 (1) ◽

pp. 125

Author(s):

Ligia J. Dominguez ◽

Alfredo Gea ◽

Liz Ruiz-Estigarribia ◽

Carmen Sayón-Orea ◽

Ujue Fresán ◽

...

Keyword(s):

Mediterranean Population ◽

Inverse Association ◽

The Sun ◽

Cox Models ◽

Incident Hypertension ◽

Magnesium Intake ◽

Dietary Magnesium ◽

Incident Cases ◽

Sun Project

Hypertension is the strongest independent modifiable risk factor for cardiovascular disease. We aimed to investigate the association of magnesium intake with incident hypertension in a Mediterranean population, and the potential modification of this association by body mass index (BMI). We assessed 14,057 participants of the SUN (Seguimiento Universidad de Navarra) prospective cohort (67.0% women) initially free of hypertension. At baseline, a validated 136-item food frequency questionnaire was administered. We used Cox models adjusted for multiple socio-demographic, anthropometric, and lifestyle factors, and prevalent conditions present at baseline. Among a mean 9.6 years of follow-up we observed 1406 incident cases of medically diagnosed hypertension. An inverse association in multivariable-adjusted models was observed for progressively higher magnesium intake up to 500 mg/d vs. intake < 200 mg/d, which was greater among those with a BMI > 27 kg/m2. Lean participants with magnesium intake < 200 mg/d vs. >200 mg/d also had a higher risk of incident hypertension. Adherence to the Mediterranean diet did not modify these associations. In conclusion, dietary magnesium intake < 200 mg/d was independently associated with a higher risk of developing hypertension in a Mediterranean cohort, stronger for overweight/obese participants. Our results emphasize the importance of encouraging the consumption of magnesium-rich foods (vegetables, nuts, whole cereals, legumes) in order to prevent hypertension.

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Hypothesis-oriented food patterns and incidence of hypertension: 6-year follow-up of the SUN (Seguimiento Universidad de Navarra) prospective cohort

Public Health Nutrition ◽

10.1017/s1368980009991066 ◽

2009 ◽

Vol 13 (3) ◽

pp. 338-349 ◽

Cited By ~ 31

Author(s):

Estefanía Toledo ◽

Francisco de A Carmona-Torre ◽

Alvaro Alonso ◽

Blanca Puchau ◽

María A Zulet ◽

...

Keyword(s):

A Priori ◽

Healthy Food ◽

University Graduates ◽

Inverse Association ◽

The Sun ◽

Period Range ◽

Cox Models ◽

Incident Hypertension ◽

Food Patterns

AbstractObjectiveTo study the association between adherence to several a priori-defined healthy food patterns and the risk of hypertension.DesignProspective, multipurpose, dynamic cohort study (recruitment permanently open). We followed up 10 800 men and women (all of them university graduates), who were initially free of hypertension, for a variable period (range 2–6 years, median 4·6 years). During follow-up, 640 participants reported a new medical diagnosis of hypertension. Baseline diet was assessed using a validated 136-item FFQ. Validated information about non-dietary potential confounders was also gathered. We calculated adherence to fifteen different hypothesis-oriented food patterns and assessed the association between each of them and incident hypertension using multivariable Cox models.SettingThe SUN (Seguimiento Universidad de Navarra – University of Navarra Follow-up) Project, Spain.SubjectsParticipants recruited to the SUN cohort before October 2005 were eligible for inclusion; after excluding those with self-reported hypertension or CVD at baseline, or with extreme total energy intake, data of 10 800 were analysed.ResultsHigher adherence to the DASH (Dietary Approaches to Stop Hypertension) diet (range of the score: 0 to 5) was significantly associated with a lower risk for developing hypertension (P for trend = 0·02). The other food patterns showed no significant association with incident hypertension.ConclusionsOur results support a long-term protection of the DASH diet against the incidence of hypertension, but we found no evidence of a similar inverse association with hypertension for any other a priori-defined healthy food pattern.

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Serum Thyroid Peroxidase Antibody Level and Incident Hypertension in Iranian Men: A Suggestion for the Role of Thyroid Autoimmunity

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530320666200624163035 ◽

2020 ◽

Vol 20 (10) ◽

pp. 1711-1718

Author(s):

Maryam Tohidi ◽

Aidin Baghbani-Oskouei ◽

Atieh Amouzegar ◽

Ladan Mehran ◽

Fereidoun Azizi ◽

...

Keyword(s):

Total Population ◽

Thyroid Autoimmunity ◽

Elevated Serum ◽

Thyroid Peroxidase ◽

Incident Hypertension ◽

Natural Logarithm ◽

Hazard Ratios ◽

Thyroid Peroxidase Antibody ◽

Unit Increase

Background: Dysfunction of the thyroid gland has profound effects on the cardiovascular system. Objective: We aimed to explore the relation of serum thyroid peroxidase antibody (TPO-Ab), as a marker of thyroid autoimmunity with incident hypertension among a euthyroid population. Methods: A total of 3681 participants (1647 men) entered the study. Multivariate Cox proportional hazard models were conducted to estimate the association between TPO-Ab and incident hypertension. Results: The mean age (standard deviation) of the participants was 37.5 (12.8) years. During a median follow-up of 12.2 years, 511 men and 519 women developed hypertension. The multivariable hazard ratios (HRs) and related 95% confidence intervals (CIs) of 1-unit increase in natural logarithm (ln) of TPO-Ab for incident hypertension were 1.09 (1.00-1.19), 1.03 (0.97-1.10), and 1.05 (1.00-1.11) for men, women, and total population, respectively. Moreover, considering the TPO-Ab status as a categorical variable (i.e. TPO-Ab positive or TPO-Ab negative), the multivariate-adjusted HRs (95% CIs) of TPO-Ab positivity for incident hypertension, were 1.33 (0.95-1.85), 1.12 (0.86-1.45) and 1.19 (0.97- 1.46) for men, women, and total population, respectively. Conclusion: Elevated serum TPO-Ab level can contribute to the development of hypertension among euthyroid men during a long follow-up; suggesting a role for thyroid autoimmunity.

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Later Meal and Sleep Timing Predicts Higher Percent Body Fat

Nutrients ◽

10.3390/nu13010073 ◽

2020 ◽

Vol 13 (1) ◽

pp. 73

Author(s):

Elizabeth A. Thomas ◽

Adnin Zaman ◽

Marc-Andre Cornier ◽

Victoria A. Catenacci ◽

Emma J. Tussey ◽

...

Keyword(s):

Body Fat ◽

Overweight And Obesity ◽

Percent Body Fat ◽

P Value ◽

Activity Monitors ◽

Food Records ◽

Sleep Timing ◽

Meal Timing ◽

Increased Risk ◽

Unit Increase

Accumulating evidence suggests that later timing of energy intake (EI) is associated with increased risk of obesity. In this study, 83 individuals with overweight and obesity underwent assessment of a 7-day period of data collection, including measures of body weight and body composition (DXA) and 24-h measures of EI (photographic food records), sleep (actigraphy), and physical activity (PA, activity monitors) for 7 days. Relationships between body mass index (BMI) and percent body fat (DXA) with meal timing, sleep, and PA were examined. For every 1 h later start of eating, there was a 1.25 (95% CI: 0.60, 1.91) unit increase in percent body fat (False Discovery Rate (FDR) adjusted p value = 0.010). For every 1 h later midpoint of the eating window, there was a 1.35 (95% CI: 0.51, 2.19) unit increase in percent body fat (FDR p value = 0.029). For every 1 h increase in the end of the sleep period, there was a 1.64 (95% CI: 0.56, 2.72) unit increase in percent body fat (FDR p value = 0.044). Later meal and sleep timing were also associated with lower PA levels. In summary, later timing of EI and sleep are associated with higher body fat and lower levels of PA in people with overweight and obesity.

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A prospective study of eating away-from-home meals and weight gain in a Mediterranean population: the SUN (Seguimiento Universidad de Navarra) cohort

Public Health Nutrition ◽

10.1017/s1368980009992783 ◽

2009 ◽

Vol 13 (9) ◽

pp. 1356-1363 ◽

Cited By ~ 59

Author(s):

Maira Bes-Rastrollo ◽

Francisco Javier Basterra-Gortari ◽

Almudena Sánchez-Villegas ◽

Amelia Marti ◽

José Alfredo Martínez ◽

...

Keyword(s):

Weight Gain ◽

Dietary Habits ◽

Mediterranean Area ◽

Mediterranean Population ◽

University Graduates ◽

The Sun ◽

Adjusted Risk ◽

Mediterranean Countries ◽

Eating Out

AbstractObjectiveThe traditional Mediterranean food pattern is more easily preserved when meals are eaten at home; however, as a result of recent socio-economic changes, away-from-home meal consumption has increased rapidly in Mediterranean countries. Little research has been conducted so far to investigate the long-term health effects of these changes in the Mediterranean area.DesignIn a prospective Spanish dynamic cohort of 9182 university graduates (the SUN Study; Seguimiento Universidad de Navarra, University of Navarra Follow-up) with a mean age of 37 years, followed up for an average of 4·4 years, we assessed the association between the frequency of eating out of home and weight gain or incident overweight/obesity. Dietary habits were assessed with an FFQ previously validated in Spain.ResultsDuring follow-up, eating-out consumers (two times or more per week) had higher average adjusted weight gain (+129 g/year, P < 0·001) and higher adjusted risk of gaining 2 kg or more per year (OR = 1·36; 95 % CI 1·13, 1·63) than non-eating-out consumers. Among participants with baseline BMI < 25 kg/m2, we observed 855 new cases of overweight/obesity. Eating away-from-home meals was significantly associated with a higher risk of becoming overweight/obese (hazard ratio = 1·33; 95 % CI 1·13, 1·57).ConclusionsA higher frequency of meals eaten out of home may play a role in the current obesity epidemic observed in some Mediterranean countries.

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Smoking habits and incidence of cardiovascular diseases in men and women: findings of a 12 year follow up among an urban Eastern-Mediterranean population

BMC Public Health ◽

10.1186/s12889-019-7390-0 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 4

Author(s):

Parisa Amiri ◽

Kamyar Mohammadzadeh-Naziri ◽

Behnood Abbasi ◽

Leila Cheraghi ◽

Sara Jalali-Farahani ◽

...

Keyword(s):

Cardiovascular Diseases ◽

Eastern Mediterranean ◽

Smoking Habits ◽

Mediterranean Population ◽

Men And Women

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Abstract P496: The Development of Anthropometric Measures Over Time and Predictors for Overweight and Obesity

Circulation ◽

10.1161/circ.141.suppl_1.p496 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Hawazen Atalla ◽

Bledar Daka ◽

Ulf Lindblad ◽

Margareta I Hellgren

Keyword(s):

Physical Activity ◽

Body Weight ◽

Venous Blood ◽

Overweight And Obesity ◽

Weight Increase ◽

Predicted Body Weight ◽

Anthropometric Measures ◽

Men And Women ◽

Low Level

Background: Today, more people die because of obesity and it′s comorbidities than due to malnutrition and actions to prevent the development of overweight and obesity is urgently needed. Different measurements, such as body mass index and waist circumference (WC) may develop differently with age and play different roles in the development of cardiovascular and metabolic disease. Objective: The purpose of this study was to examine the development of anthropometric measures in men and women and to identify possible biochemical predictors for at least five percent weight increase over ten years, considering the modifying effect of physical activity. Methods: In the Vara Skövde Cohort, a longitudinal, prospective study, 1327 randomly selected individuals (35-75 years) participated in two examinations, 2002-2005 and 2012-2014. All participants (657 men, 670 women) were carefully examined with body weight and height, WC and fasting venous blood samples. Validated questionnaires about socioeconomic factors and lifestyle were completed. Physical activity was reported on a 4-graded scale and dichotomized into a high and low level of physical activity. Data are analyzed with T-Test and logistic regression and adjusted for age, sex, weight at baseline, smoking, education, physical activity, plasma glucose and triglycerides. Results: Mean age at baseline was 48.8 years. Mean body weight increased till the age of 55 years, 2.4 kg (SD 6.0, P &#8804 0.0001), and decreased significantly thereafter, -1.1 kg (SD 6.3, P= 0.001) without any difference between men and women. Contrary, WC increased continuously over the years in all age-groups, 4 cm (SD 7.4, P &#8804 0.001). Further, no normal weight person became obese at follow- up. Individuals who maintained or increased their level of physical activity to high had a significantly lower risk for weight increase as compared to those who remained or decreased their level of physical activity to a low level (OR 0.7, CI 0.7 - 0.9, P= 0.008). Serum concentration of LDL (low density lipoprotein) was inversely associated with 5% weight increase after ten years (OR 0.7, CI 0.6-0.7, P &#8804 0.001). We did not find that education level, psychological stress or sleep quality at baseline predicted body weight change. Conclusion: While body weight peaked at the age of 55 years, abdominal obesity increased continuously during the follow-up time. Maintained physical activity seems to limit this increase and emphasizes the importance of a high level of physical activity over the years. The risk of a low concentration of LDL for weight gain needs to be further examined.

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Long-term incidence of cardiovascular outcomes in the middle-aged and elderly with different patterns of physical activity: Tehran lipid and glucose study

BMC Public Health ◽

10.1186/s12889-020-09747-6 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Parisa Naseri ◽

Parisa Amiri ◽

Hasti Masihay-Akbar ◽

Sara Jalali-Farahani ◽

Davood Khalili ◽

...

Keyword(s):

Physical Activity ◽

Eastern Mediterranean ◽

Age Groups ◽

Developed Countries ◽

Cardiovascular Outcomes ◽

Guideline Recommendation ◽

Mediterranean Population ◽

Middle Aged ◽

Men And Women

Abstract Background Following the global upward trend of cardiovascular diseases (CVD/CHD), much attention has been paid to lifestyle behaviors such as physical activity (PA). However, most of previous studies were conducted in developed countries and with just one measurement of physical activity. The aim of the current study is to assess the effect of changes in the PA on the incidence of CVD/CHD in middle-aged and older men and women in an Eastern-Mediterranean population, over a decade follow-up. Methods This study has been conducted within the framework of the Tehran Lipid and Glucose Study (TLGS) including 4073 (57% women) participants without CVD/CHD at baseline. The participants were followed up for an average period of 12 years. The Iranian version of Modified Activity Questionnaire (MAQ) was used to measure PA at baseline and at the closest follow-up to the outcome. Subsequently, participants were categorized as “compliers”, “non-compliers”, “adopters” and “relapsers”, based on their adherence to the PA guideline recommendations. All analysis has been conducted in two separate age groups including middle-aged and elderly in both men and women. The effect of PA patterns on incidence of CVD/CHD was investigated using Cox proportional hazard model. Variables including marital status, job status, education, smoking, and family history of CVD/CHD were adjusted in the models. Results Adherence to guideline recommendation increased from 63.5 to 66.6% between the two measurements. At the second measurement of PA, the percentages of compliers, non-compliers, adopters and relapsers were 48.4, 18.3, 18.2, and 15.1%, respectively. In fully adjusted models, HRs of CVD and CHD for men aged 40–60 years in the complier group were 0.58 (95% CI: 0.38–0.87, P = 0.008) and 0.58 (95% CI: 0.38–0.89, P = 0.01), respectively. HRs of CVD and CHD for men aged 40–60 years in adopter group were 0.61 (95% CI: 0.38–0.96, P = 0.03) and 0.60 (95% CI: 0.37–0.97, P = 0.04) respectively. The corresponding values were not significant in women. Conclusions Adhering to established PA recommendations have a protective effect on the incidence of CVD/CHD among middle-aged men; findings which need to be considered in reducing cardiovascular outcomes in this population.

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Stunted children gain less lean body mass and more fat mass than their non-stunted counterparts: a prospective study

British Journal Of Nutrition ◽

10.1079/bjn20041274 ◽

2004 ◽

Vol 92 (5) ◽

pp. 819-825 ◽

Cited By ~ 78

Author(s):

P. A. Martins ◽

D. J. Hoffman ◽

M. T. B. Fernandes ◽

C. R. Nascimento ◽

S. B. Roberts ◽

...

Keyword(s):

Body Composition ◽

Body Fat ◽

Fat Mass ◽

Lean Mass ◽

Overweight And Obesity ◽

Significant Difference ◽

Normal Stature ◽

Baseline Values ◽

A Prospective Study

The aim of the present study was to analyse the changes in body composition of stunted children during a follow-up period and to test the hypothesis of a tendency to accumulate body fat as a consequence of undernutrition early in life. We selected fifty boys and girls aged 11 to 15, who were residents of slums in São Paulo, Brazil. Twenty were stunted (S) and thirty had normal stature (NS). The children's nutritional status and body composition were assessed through anthropometry and dual-energy X-ray absorptiometry, at the beginning of the present study and after 3 years, and changes in lean mass (LM and LM%) and fat mass (FM and FM%) were calculated. Stunted boys accumulated more body fat (FM%: S=1·62%, NS=−3·40%;P=0·003) and gained less lean mass (LM%: S=−1·46, NS=3·21%;P=0·004). Stunted girls gained less lean mass (S=7·87 kg, NS=11·96 kg;P=0·032) and had significantly higher values of FM% at follow-up when compared with their baseline values (P=0·008), whereas non-stunted girls had a non-significant difference in FM% over time (P=0·386). These findings are important to understand the factors involved in the increased prevalence of overweight and obesity among poor populations, which appear to be associated with hunger during infancy and/or childhood.

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Changes of Aerobic Capacity, Fat Ratio and Flexibility in Older TCC Practitioners: A Five-Year Follow-Up

The American Journal of Chinese Medicine ◽

10.1142/s0192415x08006442 ◽

2008 ◽

Vol 36 (06) ◽

pp. 1041-1050 ◽

Cited By ~ 13

Author(s):

Ching Lan ◽

Ssu-Yuan Chen ◽

Jin-Shin Lai

Keyword(s):

Body Fat ◽

Aerobic Capacity ◽

Tai Chi ◽

Exercise Program ◽

Community Dwelling ◽

Control Group ◽

Older Individuals ◽

Men And Women ◽

Age Related

The objective of this study was to evaluate the 5-year changes of aerobic capacity, fat ratio and flexibility in older Tai Chi Chuan (TCC) practitioners and sedentary controls. Sixty-nine community-dwelling elderly individuals (mean age: 68.6 ± 6.3 years) completed this study. The TCC group (18 M; 17 F) had been practicing TCC regularly for 6.3 ± 3.7 years at baseline and continued training in the study interval. The control group (16 M; 18 F) did not participate in any regular exercise program. A graded bicycle exercise testing was conducted at the baseline and at 5-year to evaluate the age-related decline in aerobic capacity. Triceps and subscapular skinfolds, and thoracolumbar flexibility were also measured. At baseline, the TCC group displayed higher peak oxygen uptake [Formula: see text] and thoraolumbar flexibility, and lower fat ratio than the control group. At the 5-year follow-up, the TCC group displayed a smaller decrease in [Formula: see text] than the sedentary group. The annual decrease of [Formula: see text] in TCC men and women was 0.32 and 0.22 ml · kg-1 · min-1, respectively. In the control group, the annual decrease of [Formula: see text] was 0.50 and 0.36 ml · kg-1 · min-1 in men and women, respectively. The TCC group also showed a smaller increase of body fat ratio, and a less decrease of flexibility than the control group. In conclusion, long-term practice of TCC attenuates the age-related decline of aerobic capacity, and it also reduces the increase of body fat ratio in older individuals. TCC may be prescribed as a conditioning exercise for the elderly to maintain their health fitness.

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