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The Puerto Rico (PR) Young Adults' Stress, Contextual, Behavioral & Cardiometabolic Risk Study (PR-OUTLOOK) is investigating overall and component-specific cardiovascular health (CVH) and cardiovascular disease (CVD) risk factors in a sample of young (age 18-29) Puerto Rican adults in PR (target n=3,000) and examining relationships between individual-, family/social- and neighborhood-level stress and resilience factors and CVH and CVD risk factors. The study is conducting standardized measurements of CVH and CVD risk factors and demographic, behavioral, psychosocial, neighborhood, and contextual variables and establishing a biorepository of blood, saliva, urine, stool, and hair samples. The assessment methods are aligned with other National Heart, Lung, and Blood Institute funded studies: the Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic Disease Trends (PROSPECT) of adults 30-75 years, the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), the Boston Puerto Rican Health Study (BPRHS), and the Coronary Artery Risk Development in Young Adults (CARDIA). PR-OUTLOOK data and its biorepository will facilitate future longitudinal studies of the temporality of associations between stress and resilient factors and CVH and CVD risk factors among young Puerto Ricans, with remarkable potential for advancing the scientific understanding of these conditions in a high-risk but understudied young population.
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BACKGROUND: Multiple dietary patterns have been recommended by the 2015-2020 Dietary Guidelines for Americans for the prevention of cardiovascular disease (CVD). The adherence to these patterns and its relation with risk of CVD remain unclear in the US Hispanic/Latino population. OBJECTIVES: We aimed to evaluate 3 healthy eating patterns measured by 3 dietary pattern scores [the Alternate Mediterranean diet (aMED), the Healthy Eating Index (HEI)-2015, and the healthful Plant-based Diet Index (hPDI)] across different Hispanic/Latino backgrounds and generations. We further examined the associations of these dietary scores with incident CVD in US Hispanics/Latinos. METHODS: We included 10,293 adult participants of US Hispanics/Latinos of 6 backgrounds (Mexican, Puerto Rican, Cuban, Dominican, Central American, and South American), free of CVD or cancer at baseline, in the Hispanic Community Health Study/Study of Latinos. Dietary pattern scores were derived at the baseline visit using two 24-h dietary recalls. The primary outcome was major incident CVD (n = 232), comprised of coronary heart disease and stroke, during an average 6-y follow-up. RESULTS: Mean levels of all 3 dietary scores were significantly different across the 6 Hispanic/Latino background groups (all P < 0.001), with the highest (i.e., healthiest) in those of Mexican background and lowest in those of Puerto Rican background. Compared with non-mainland-US-born Hispanics/Latinos, mainland-US-born Hispanics/Latinos had significantly lower dietary scores (P < 0.001). Differences in dietary scores between mainland-US-born and non-mainland-US-born Hispanics/Latinos were majorly driven by differences in dietary intakes of healthy plant-based foods. After adjusting for multiple covariates, significantly lower risk ratios (95% CI) of CVD were observed for 1-SD increments of the dietary scores, with 0.74 (0.60, 0.91) for aMED, 0.80 (0.63, 1.00) for HEI-2015, and 0.74 (0.60, 0.93) for hPDI. CONCLUSIONS: Although adherence to healthy eating patterns varied by Hispanic/Latino backgrounds and generations, greater adherence to these eating patterns was associated with lower risk of CVD across diverse US Hispanics/Latinos.
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Doenças Cardiovasculares , Adulto , Doenças Cardiovasculares/prevenção & controle , Hispânico ou Latino , Humanos , Prevalência , Saúde Pública , Porto Rico , Fatores de Risco , Estados Unidos/epidemiologiaRESUMO
Acculturation and depression are linked to poor sleep quality and sleep problems that may explain ongoing health disparities for Hispanics/Latinos. We examined the associations of acculturation, depression, and sleep duration among the Mexican American population. We used a multinomial logistic regression model on cross-sectional data from the 2005-2018 National Health and Nutrition Examination Survey on 4,700 Mexican American adults aged ≥18 years old. The outcome of sleep duration was operationalized as short (≤6 h), optimal (7-8 h), and long (≥9 h). Acculturation was constructed using years living in the U.S. and language(s) spoken at home (majority Spanish, English and Spanish equally, majority English). Depression severity was assessed using the 9-item Patient Health Questionnaire. Covariates included gender, age, marital status, income, and U.S. citizenship. Speaking majority English (Adjusted Odds Ratio (AOR) = 1.23; 95% Confidence Interval (CI) = 1.00-1.52) and mild (AOR = 1.63; 95%CI = 1.32-2.01), moderate (AOR = 1.94; 95%CI = 1.43-2.63), and moderately severe/severe (AOR = 2.58; 95%CI = 1.72-3.88) levels of depression were significantly associated with short sleep duration. Living in the U.S. for ≥10 years (AOR = 1.61; 95%CI = 1.17-2.23) and moderately severe/severe depression (AOR = 2.30; 95%CI = 1.34-3.93) were significantly associated with long sleep duration. Our results provide additional evidence of a link between acculturation, depression, and short and long sleep duration among the Mexican American population. Understanding the sleep health of this population is important for informing future public health interventions and research. Additional investigation into the relationship between acculturation/depression and other sleep health measures among this population is warranted.
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BACKGROUND: Previous diet findings in Hispanics/Latinos rarely reflect differences in commonly consumed and culturally relevant foods across heritage groups and by years lived in the United States. OBJECTIVES: We aimed to identify and compare a posteriori heritage-specific dietary patterns (DPs) and evaluate their associations with "healthfulness" [using the Alternative Healthy Eating Index-2010 (AHEI-2010)] and years living in the United States. METHODS: We used baseline data from a population-based cohort of 14,099 Hispanics/Latinos aged 18-74 y in the Hispanic Community Health Study/Study of Latinos. We performed principal factor analysis using two 24-h recalls to derive DPs, separately, in each heritage group (Cuban, Dominican, Mexican, Puerto Rican, Central American, and South American), and identified overarching DPs based on high-loading foods shared by ≥2 groups. We used multivariable linear regression to test associations of DPs with AHEI-2010 and years living in the United States. RESULTS: We identified 5 overarching DPs (Burgers, Fries, & Soft Drinks; White Rice, Beans, & Red Meats; Fish; Egg & Cheese; and Alcohol). All Burgers, Fries, & Soft Drinks DPs were inversely associated with AHEI-2010, whereas all Fish DPs (except Dominican) were positively associated with this index (all P-trend < 0.001). White Rice, Beans, & Red Meats DPs showed inverse associations in Cuban and Central American groups and positive associations in Mexican-origin individuals (all P-trend < 0.001). Fewer years living in the United States was associated with higher scores for White Rice, Beans, & Red Meats DPs in Cuban and Mexican heritage groups and lower scores on Burgers, Fries, & Soft Drinks DPs in Cuban, Mexican, and Puerto Rican groups (all P-trend < 0.01). CONCLUSIONS: Our findings show substantial variation in DPs across Hispanics/Latinos and adherence to DPs by time in the United States, which could inform dietary interventions targeting this diverse US population. This trial was registered at clinicaltrials.gov as NCT02060344.
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Hispânico ou Latino , Saúde Pública , Dieta , Dieta Saudável , Humanos , Prevalência , Porto Rico , Fatores de Risco , Estados UnidosRESUMO
OBJECTIVE: To compare diet quality and its association with excess body weight (EBW: overweight/obesity), central adiposity (CA) and CVD risk factors (CVDR) among adolescents from Brazil and USA. DESIGN: Data from two cross-sectional surveys: Health Survey of São Paulo (ISA-Nutrition) and Hispanic Community Health Study/Study of Latino Youth (SOL-Youth). Dietary intake was assessed from 24-h recalls, and diet quality using the Alternate Healthy Eating Index-2010 (AHEI) developed in the USA and the Revised Brazilian Healthy Eating Index (BHEI-R). CVDR was defined as ≥3 of: obesity, elevated blood pressure, dyslipidaemia, high plasma glucose and insulin resistance. Adjusted OR for EBW, CA and CVDR by diet quality were tested using logistic regression. SETTING: São Paulo, Brazil; and Chicago, IL; Miami, FL; Bronx, NY; San Diego, CA. PARTICIPANTS: Adolescents (12-16 years) living in São Paulo (n 189) and USA (n 787). RESULTS: ISA-Nutrition individuals with EBW (v. without) had marginally lower (unhealthier) scores for whole grains using BHEI-R and sugary beverages using AHEI. SOL-Youth individuals with EBW had lower scores of nuts/legumes using AHEI, and Na using BHEI-R, but higher scores of whole grains and dairy using BHEI-R. In ISA-Nutrition, BHEI-R was inversely associated with EBW (OR = 0·87; 95 % CI 0·80, 0·95) and CVDR (OR = 0·89; 95 % CI 0·80, 0·98). In SOL-Youth, AHEI was inversely associated with EBW (OR = 0·93; 95 % CI 0·87, 0·99). CONCLUSIONS: Dietary improvements should be made by adolescents in both USA and Brazil. Healthier diet quality as measured with the country-specific index was associated with lower odds of EBW in Brazilian and USA-Hispanic/Latino adolescents, and with lower CVDR in Brazilian adolescents.
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Fatores de Risco Cardiometabólico , Dieta , Adolescente , Brasil/epidemiologia , Estudos Transversais , Humanos , Obesidade/epidemiologia , Estados Unidos/epidemiologiaRESUMO
INTRODUCTION: Apolipoprotein E (APOE) alleles are associated with cognitive decline, mild cognitive impairment (MCI), and Alzheimer's disease in Whites, but have weaker and inconsistent effects reported in Latinos. We hypothesized that this heterogeneity is due to ancestry-specific genetic effects. METHODS: We investigated the associations of the APOE alleles with significant cognitive decline and MCI in 4183 Latinos, stratified by six Latino backgrounds, and explored whether the proportion of continental genetic ancestry (European, African, and Amerindian) modifies these associations. RESULTS: APOE ε4 was associated with an increased risk of significant cognitive decline (odds ratio [OR] = 1.15, P-value = 0.03), with the strongest association in Cubans (OR = 1.46, P-value = 0.007). APOE-ε2 was associated with decreased risk of MCI (OR = 0.37, P-value = 0.04) in Puerto Ricans. Amerindian genetic ancestry was found to protect from the risk conferred by APOE ε4 on significant cognitive decline. DISCUSSION: Results suggest that APOE alleles' effects on cognitive outcomes differ across six Latino backgrounds and are modified by continental genetic ancestry.
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Alelos , Doença de Alzheimer , Apolipoproteína E4/genética , Cognição , Disfunção Cognitiva , Hispânico ou Latino/genética , Idoso , Envelhecimento/genética , Doença de Alzheimer/etnologia , Doença de Alzheimer/genética , Região do Caribe/etnologia , Disfunção Cognitiva/etnologia , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Estudos Prospectivos , América do Sul/etnologia , Estados UnidosRESUMO
BACKGROUND: Compared to non-Hispanic white individuals, assistive technology (AT) utilization is lower among Hispanic individuals.1-7 In the US, Spanish is the 2nd most frequently spoken language. Greater than one-fifth of Spanish-speaking households are limited English proficiencty (LEP) households (i.e., all individuals over age 14 in the household speak English less than "very well").8 Availability of AT materials in Spanish is one factor influencing knowledge about and utilization of AT among Spanish-speakers. OBJECTIVE: To examine the availability of Spanish-language AT information on state AT program websites and to assess the relationship between availability and state demographic and linguistic characteristics. METHODS: In 2018, we evaluated 56 state and territory AT program websites for the availability of AT information in Spanish. We calculated 4 measures (US Hispanic population in the state/territory; Hispanic individuals as a proportion of state population; overall Spanish-speaking households, and Spanish-speaking, limited English proficient households) from the 2016 American Community Survey and created ranked lists for each measure. Point biserial (rpb) correlations were calculated to test associations between each measure and availability of AT information in Spanish on each program's website. RESULTS: Sixteen program websites (15 states, 1 territory) provided access to Spanish-language AT information. None of the 4 measures were strongly associated with this outcome (rpb ranged from 0.30 to 0.42). For any of the 4 measures, no more than half of states in the top 10 ranks offered online access to AT information in Spanish. CONCLUSIONS: Improving the online availability of AT information in Spanish is necessary to increase equity in AT utilization among Spanish-speaking people with disabilities.
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Informática Aplicada à Saúde dos Consumidores/métodos , Bases de Dados Factuais , Pessoas com Deficiência/educação , Hispânico ou Latino/educação , Tecnologia Assistiva , Traduções , População Branca/educação , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hispânico ou Latino/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Porto Rico , Estados Unidos , População Branca/estatística & dados numéricosRESUMO
Background: Sparse data exist to describe national population-level trends in short sleep duration among Latinos. Because short sleep duration is associated with several health conditions that are common in Latinos, such as obesity, diabetes, and hypertension, understanding sleep trends among this population may be key to reducing their disease burden. This study aimed to document Latino subgroup differences in self-reported sleep duration by nativity and country of origin relative to Whites. Design and Setting: Pooled cross-sectional analysis of self-reported data from the National Health and Interview Survey (NHIS), 2004-2017. Participants: 303,244 respondents, aged 18 to 84 years, who self-identified as non-Latino US-born White, US-born Mexican, foreign-born Mexican, US-born Puerto Rican, island-born Puerto Rican, US-born Cuban, foreign-born Cuban, US-born Dominican, foreign-born Dominican, US-born Central/South American, foreign-born Central/South American, US-born "other" Latino, and foreign-born "other" Latino. Methods: Multinomial logistic regression models were used to predict sleep duration controlling for demographics, acculturation, socioeconomic, and health-related factors. Results: We found that all Latino subgroups (except US-born Cubans) were more likely to report poor sleep duration relative to non-Latino Whites, net of demographic, acculturation, socioeconomic, and health-related characteristics. However, the magnitude of disadvantage varies by Latino subgroup. We also found that poor sleep duration is concentrated among certain age groups for the various Latino subpopulations. Conclusions: Given that Latinos in the United States are at higher risk for obesity, diabetes, and hypertension, understanding the patterns of sleep among this population can help identify strategies to improve sleep habits in order to reduce disease burden.
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Aculturação , Hispânico ou Latino/estatística & dados numéricos , Transtornos do Sono-Vigília/etiologia , Sono , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Diabetes Mellitus/etnologia , Feminino , Humanos , Hipertensão/etnologia , Modelos Logísticos , Masculino , México , Pessoa de Meia-Idade , Obesidade/etiologia , Porto Rico , Inquéritos e Questionários , Estados Unidos , Adulto JovemRESUMO
INTRODUCTION: We estimated the prevalence and correlates of mild cognitive impairment (MCI) among middle-aged and older diverse Hispanics/Latinos. METHODS: Middle-aged and older diverse Hispanics/Latinos enrolled (n = 6377; 50-86 years) in this multisite prospective cohort study were evaluated for MCI using the National Institute on Aging-Alzheimer's Association diagnostic criteria. RESULTS: The overall MCI prevalence was 9.8%, which varied between Hispanic/Latino groups. Older age, high cardiovascular disease (CVD) risk, and elevated depressive symptoms were significant correlates of MCI prevalence. Apolipoprotein E4 (APOE) and APOE2 were not significantly associated with MCI. DISCUSSION: MCI prevalence varied among Hispanic/Latino backgrounds, but not as widely as reported in the previous studies. CVD risk and depressive symptoms were associated with increased MCI, whereas APOE4 was not, suggesting alternative etiologies for MCI among diverse Hispanics/Latinos. Our findings suggest that mitigating CVD risk factors may offer important pathways to understanding and reducing MCI and possibly dementia among diverse Hispanics/Latinos.
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Envelhecimento , Disfunção Cognitiva/epidemiologia , Depressão/psicologia , Hispânico ou Latino/estatística & dados numéricos , Apolipoproteína E4/genética , Doenças Cardiovasculares/etiologia , Disfunção Cognitiva/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Porto Rico/etnologia , Fatores de Risco , Fatores Sexuais , Estados UnidosRESUMO
INTRODUCTION: Tobacco smoking and binge or excess drinking are unhealthy behaviors that frequently co-occur. Studies of Hispanics/Latinos have mostly been of Mexican Americans although there are substantial differences in smoking and drinking by heritage background. Associated with co-use by 5 subpopulations. METHODS: Cross-sectional data of 16,412 Hispanics/Latinos from Miami, the Bronx, Chicago and San Diego collected between 2008 and 2011 as part of the HCHS/SOL were analyzed. Smoking and alcohol consumption and demographic data were measured by self-report. Prevalence of smoking and alcohol consumption and co-use were reported. Logistic regression models examined the odds of co-use of smoking and binge or excess alcohol use by Hispanic/Latino background group. RESULTS: Men of Cuban (10.3%), Puerto Rican (8.9%), and Mexican (8.9%) background had the highest prevalence of co-use of smoking and binge drinking compared to men of Central American (6.1%) and Dominican (6.6%) background. Women of Dominican (16.4%) and Puerto Rican (19.7%) background had the highest prevalence of binge drinking compared to women of Central American (10%) and Cuban (8%) background and Puerto Rican (34.1%) and Cuban (21.8%) women were the most likely to report current smoking compared to women of Central American (8.3%) and Mexican (10.4%) background. Acculturation was not associated with co-use among men and women. Elevated depressive symptoms were positively associated with smoking and binge drinking among men, ORâ¯=â¯1.5 [1.2-2.0], and women, ORâ¯=â¯1.5 [1.1-2.2]. Puerto Rican women had increased odds of co-use of smoking and binge or excess drinking compared to Mexican American women, ORâ¯=â¯3.2 [1.5-6.6]. CONCLUSIONS: Puerto Rican and Dominican Latinas and Central American and South American men have a higher prevalence of co-use.
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Consumo de Bebidas Alcoólicas/etnologia , Consumo Excessivo de Bebidas Alcoólicas/etnologia , Fumar Cigarros/etnologia , Hispânico ou Latino/estatística & dados numéricos , Aculturação , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo Excessivo de Bebidas Alcoólicas/epidemiologia , Região do Caribe/etnologia , América Central/etnologia , Fumar Cigarros/epidemiologia , Cuba/etnologia , Depressão/epidemiologia , Depressão/etnologia , República Dominicana/etnologia , Feminino , Humanos , Masculino , Americanos Mexicanos/estatística & dados numéricos , Pessoa de Meia-Idade , Porto Rico/etnologia , Fatores Sexuais , América do Sul/etnologia , Estados Unidos/epidemiologia , Adulto JovemRESUMO
Racial/ethnic minorities, rural populations, and those with low socioeconomic status income are underrepresented in research in the United States (U.S.). Assessing preferences for recruitment, participation, and the role of beliefs about biomedical research in specific and unique underserved communities represents a potentially critical step in reducing barriers to biomedical research participation. We developed a culturally informed survey to measure factors related to participation, knowledge, expectations, and barriers to biomedical research participation among Latinos living in a U.S. border community. We employed a multidisciplinary team approach to a sequential, three-phase qualitative study that included interviews ( n = 35), focus groups ( n =24), and "think-aloud" cognitive interviews ( n = 5). Our study demonstrates the value of applying multiple qualitative approaches to inform a culturally relevant quantitative survey incorporating words and constructs relevant to the population of interest. The study contributes to qualitative method research paradigms by developing a research protocol that integrates the expertise and perspectives of researchers and community members from multiple disciplines and institutions.
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Pesquisa Biomédica/organização & administração , Competência Cultural , Seleção de Pacientes , Sujeitos da Pesquisa/psicologia , Inquéritos e Questionários/normas , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Entrevistas como Assunto , México , Pesquisa Qualitativa , Projetos de Pesquisa , Fatores Socioeconômicos , Confiança , Estados UnidosRESUMO
Objectives:To examine the association between diabetes and cognitive function within U.S. Hispanics/Latinos of Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American background. Method: This cross-sectional study included 9,609 men and women (mean age = 56.5 years), who are members of the Hispanic Community Health Study/Study of Latinos. We classified participants as having diabetes, prediabetes, or normal glucose regulation. Participants underwent a neurocognitive battery consisting of tests of verbal fluency, delayed recall, and processing speed. Analyses were stratified by Hispanic/Latino subgroup. Results: From fully adjusted linear regression models, compared with having normal glucose regulation, having diabetes was associated with worse processing speed among Cubans (ß = -1.99; 95% CI [confidence interval] = [-3.80, -0.19]) and Mexicans (ß = -2.26; 95% CI = [-4.02, -0.51]). Compared with having normal glucose regulation, having prediabetes or diabetes was associated with worse delayed recall only among Mexicans (prediabetes: ß = -0.34; 95% CI = [-0.63, -0.05] and diabetes: ß = -0.41; 95% CI = [-0.79, -0.04]). No associations with verbal fluency. Discussion: The relationship between diabetes and cognitive function varied across Hispanic/Latino subgroup.
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Cognição , Diabetes Mellitus/etnologia , Diabetes Mellitus/psicologia , Hispânico ou Latino/psicologia , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , México/etnologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , América do Sul/etnologia , Estados Unidos , Índias Ocidentais/etnologiaRESUMO
OBJECTIVE: To identify barriers that prevent healthy eating practices in Puerto Rican early adolescents (EAs). DESIGN: Qualitative data collected via focus groups. A total of 7 focus groups were conducted: 5 with EAs and 2 with parents and caregivers (PCs). SETTING: Urban and rural Puerto Rico. PARTICIPANTS: Early adolescents aged 12-14years (nâ¯=â¯52) and PCs (nâ¯=â¯17). PHENOMENON OF INTEREST: Factors that prevent healthy eating behavior in EAs in Puerto Rico. ANALYSIS: Verbatim transcripts from focus group interviews were coded for concept frequency, extension, and content analysis. RESULTS: The 3 main factors that influenced participants' eating habits, according to EAs' and PCs' answers, were stores that sold less healthful foods on or near school and the community, parental influence in the development of unhealthy eating habits, and the low cost of unhealthy foods. CONCLUSIONS AND IMPLICATIONS: When EAs chose what to eat, primary food choices were based on taste preferences, physical access, economic cost, and influence of PCs, whereas health effects had little consideration. Nutrition education programs have to meet taste preferences and provide eating options that are affordable, accessible, and easy to prepare to achieve healthy food practices among EAs.
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Comportamento do Adolescente/psicologia , Comportamento Alimentar/psicologia , Preferências Alimentares/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Pais/psicologia , Adolescente , Criança , Feminino , Grupos Focais , Humanos , Entrevistas como Assunto , Masculino , Porto Rico , Pesquisa Qualitativa , População Rural , População UrbanaRESUMO
OBJECTIVE(S): Cross-sectional and longitudinal studies have yielded inconsistent findings on the associations of social support networks with cardiovascular health in Hispanic/Latino adults with diabetes. We examined the cross-sectional associations of structural social support and traditional cardiovascular disease (CVD) risk factors in a diverse sample of Hispanic/Latino adults with diabetes. RESEARCH DESIGN AND METHODS: This analysis included 2994 adult participants ages 18-74 with diabetes from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL - 2008-2011). Select items from the Social Network Inventory (SNI) were used to assess indices of structural social support, i.e. network size (number of children, parents, and in-laws) and frequency of familial contact. Standardized methods were used to measure abdominal obesity, BMI, hypertension, hypercholesterolemia, and smoking status. Multivariate regression was used to examine associations of structural support with individual CVD risk factors with demographics, acculturation, physical health, and psychological ill-being (depressive symptoms and anxiety) included as covariates. RESULTS: There were no significant cross-sectional associations of structural support indices with abdominal obesity, hypertension, hypercholesterolemia, or smoking status. There was a marginally significant (OR: 1.05; 95%CI 0.99-1.11) trend toward higher odds of obesity in participants reporting a larger family unit (including children, parents, and in-laws) and those with closer ties with extended family relatives (OR: 1.04; 95%CI 0.99-1.09). CONCLUSIONS: Structural social support was marginally associated with higher odds of obesity in Hispanic/Latino adults with diabetes. Alternate forms of social support (e.g. healthcare professionals, friends, peers) should be further explored as potential markers of cardiac risk in Hispanics/Latinos with diabetes.
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Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus , Hispânico ou Latino/estatística & dados numéricos , Apoio Social , Aculturação , Adolescente , Adulto , Idoso , Doenças Cardiovasculares/etnologia , Estudos Transversais , Feminino , Humanos , Masculino , México/etnologia , Pessoa de Meia-Idade , Obesidade , Fatores de Risco , Estados Unidos/epidemiologiaRESUMO
Uric acid (UA) is the end product of the metabolic breakdown of purine nucleotides. Recent studies have measured UA in saliva in relation to obesity and chronic disease risk. Given the increasing prevalence of metabolic syndrome among Latino youth, we examined gender and age differences in salivary uric acid (sUA) and weight in a sample of Mexican-origin children (n = 65, 2 months to 18 years, 49% female) and adults (n = 46, 19-58 years, 72% female). We measured weight, height, waist, and hip circumference and collected saliva samples (later assayed for sUA). Structural equation models estimated the relationship between age, developmental stage, and weight outcomes in relation to sUA levels between genders, while controlling for race. Results demonstrate that increased sUA levels were related to higher BMI percentiles in females of all ages (ß = 0.43, p < .001). There were significant differences in sUA levels between developmental stages for girls, with female toddlers having the highest sUA levels (ß = .28, p = .02). In an interaction between BMI z-score and gender between youth and adults, BMI has a larger effect on increasing sUA levels among younger girls (ß = 0.27, p < .03) and adult women (ß = 0.33, p = .02). Levels of sUA may be gender-specific in relation to BMI and developmental stage.
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Índice de Massa Corporal , Desenvolvimento Humano/fisiologia , Americanos Mexicanos/estatística & dados numéricos , Ácido Úrico/metabolismo , Adolescente , Adulto , Fatores Etários , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Saliva/química , Fatores Sexuais , Adulto JovemRESUMO
BACKGROUND: A lifestyle cardiovascular risk score (LCRS) and a genetic risk score (GRS) have been independently associated with myocardial infarction (MI) in Hispanics/Latinos. Interaction or joint association between these scores has not been examined. Thus, our aim was to assess interactive and joint associations between LCRS and GRS, and each individual lifestyle risk factor, on likelihood of MI. METHODS AND RESULTS: Data included 1534 Costa Rican adults with nonfatal acute MI and 1534 matched controls. The LCRS used estimated coefficients as weights for each factor: unhealthy diet, physical inactivity, smoking, elevated waist:hip ratio, low/high alcohol intake, low socioeconomic status. The GRS included 14 MI-associated risk alleles. Conditional logistic regressions were used to calculate adjusted odds ratios. The odds ratios for MI were 2.72 (2.33, 3.17) per LCRS unit and 1.13 (95% CI 1.06, 1.21) per GRS unit. A significant joint association for highest GRS tertile and highest LCRS tertile and odds of MI was detected (odds ratio=5.43 [3.71, 7.94]; P<1.00×10-7), compared to both lowest tertiles. The odds ratios were 1.74 (1.22, 2.49) under optimal lifestyle and unfavorable genetic profile, and 5.02 (3.46, 7.29) under unhealthy lifestyle but advantageous genetic profile. Significant joint associations were observed for the highest GRS tertile and the highest of each lifestyle component risk category. The interaction term was nonsignificant (P=0.33). CONCLUSIONS: Lifestyle risk factors and genetics are jointly associated with higher odds of MI among Hispanics/Latinos. Individual and combined lifestyle risk factors showed stronger associations. Efforts to improve lifestyle behaviors could help prevent MI regardless of genetic susceptibility.
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Consumo de Bebidas Alcoólicas/epidemiologia , Dieta , Infarto do Miocárdio/epidemiologia , Comportamento Sedentário , Fumar/epidemiologia , Classe Social , Idoso , Doenças Cardiovasculares/epidemiologia , Estudos de Casos e Controles , Costa Rica/epidemiologia , Feminino , Predisposição Genética para Doença , Humanos , Estilo de Vida , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/genética , Razão de Chances , Polimorfismo de Nucleotídeo Único , Relação Cintura-QuadrilRESUMO
Individuals with favorable levels of all readily measured major CVD risk factors (low CV risk) during middle age incur lower cardiovascular morbidity and mortality, lower all-cause mortality, and lower Medicare costs at older ages compared to adults with one or more unfavorable CVD risk factors. Studies on predictors of low CV risk in Hispanics/Latinos have focused solely on Mexican-Americans. The objective of this study was to use data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL; enrolled 2008 to 2011) to assess relationships of nativity and length of residence in the US, a commonly used proxy for acculturation, with low CV risk (not currently smoking; no diabetes; untreated total cholesterol <200mg/dL; untreated blood pressure<120/<80; body mass index <25kg/m(2); and no major ECG abnormalities) in 15,047 Central American, South American, Cuban, Dominican, Mexican, Puerto Rican men and women, and Hispanic/Latino men and women identifying as other or >1 heritage. We also tested whether associations varied by Hispanic/Latino background. Women living in the US<10years were 1.96 (95% confidence interval: 1.37, 2.80) times more likely to be low CV risk than US-born women after adjusting for sociodemographic characteristics, diet, physical activity, and self-reported experiences of ethnic discrimination. Findings varied in men by Hispanic/Latino background, but length of residence was largely unrelated to low CV risk. These findings highlight the role acculturative processes play in shaping cardiovascular health in Hispanics/Latinos.