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Importance: Variation in DNA methylation at specific loci estimates biological age, which is associated with morbidity, mortality, and social experiences. Aging estimates known as epigenetic clocks, including the Dunedin Pace of Aging Calculated From the Epigenome (DunedinPACE), were trained on data predominately from individuals of European ancestry; however, limited research has explored DunedinPACE in underrepresented populations experiencing health disparities. Objective: To investigate associations of neighborhood and individual sociobehavioral factors with biological aging in a racially and ethnically diverse population. Design, Setting, and Participants: This cohort study, part of the Multiethnic Cohort study conducted from May 1993 to September 1996 to examine racial and ethnic disparities in chronic diseases, integrated biospecimen and self-reported data collected between April 2004 and November 2005 from healthy Hawaii residents aged 45 to 76 years. These participants self-identified as of Japanese American, Native Hawaiian, or White racial and ethnic background. Data were analyzed from January 2022 to May 2024. Main Outcomes and Measures: DNA methylation data were generated from monocytes enriched from cryopreserved lymphocytes and used to derive DunedinPACE scores from November 2017 to June 2021. Neighborhood social economic status (NSES) was estimated from 1990 US Census Bureau data to include factors such as educational level, occupation, and income. Individual-level factors analyzed included educational level, body mass index (BMI), physical activity (PA), and diet quality measured by the Healthy Eating Index (HEI). Linear regression analysis of DunedinPACE scores was used to examine their associations with NSES and sociobehavioral variables. Results: A total of 376 participants were included (113 [30.1%] Japanese American, 144 [38.3%] Native Hawaiian, and 119 [31.6%] White; 189 [50.3%] were female). Mean (SE) age was 57.81 (0.38) years. Overall, mean (SE) DunedinPACE scores were significantly higher among females than among males (1.28 [0.01] vs 1.25 [0.01]; P = .005); correlated negatively with NSES (R = -0.09; P = .08), HEI (R = -0.11; P = .03), and educational attainment (R = -0.15; P = .003) and positively with BMI (R = 0.31; P < .001); and varied by race and ethnicity. Native Hawaiian participants exhibited a higher mean (SE) DunedinPACE score (1.31 [0.01]) compared with Japanese American (1.25 [0.01]; P < .001) or White (1.22 [0.01]; P < .001) participants. Controlling for age, sex, HEI, BMI, and NSES, linear regression analyses revealed a negative association between educational level and DunedinPACE score among Japanese American (ß, -0.005 [95% CI, -0.013 to 0.002]; P = .03) and Native Hawaiian (ß, -0.003 [95% CI, -0.011 to 0.005]; P = .08) participants, yet this association was positive among White participants (ß, 0.007; 95% CI, -0.001 to 0.015; P = .09). Moderate to vigorous PA was associated with lower DunedinPACE scores only among Native Hawaiian participants (ß, -0.006; 95% CI, -0.011 to -0.001; P = .005), independent of NSES. Conclusions and Relevance: In this study of a racially and ethnically diverse sample of 376 adults, low NSES was associated with a higher rate of biological aging measured by DunedinPACE score, yet individual-level factors such as educational level and physical activity affected this association, which varied by race and ethnicity. These findings support sociobehavioral interventions in addressing health inequities.
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Metilação de DNA , Estilo de Vida , Classe Social , Humanos , Masculino , Feminino , Metilação de DNA/genética , Pessoa de Meia-Idade , Idoso , Havaí , Estilo de Vida/etnologia , Envelhecimento/genética , Estudos de Coortes , Epigenômica , População Branca/estatística & dados numéricos , População Branca/genética , Asiático/genética , Asiático/estatística & dados numéricos , Etnicidade/estatística & dados numéricos , Etnicidade/genética , Havaiano Nativo ou Outro Ilhéu do Pacífico/genética , Havaiano Nativo ou Outro Ilhéu do Pacífico/estatística & dados numéricosRESUMO
OBJECTIVES: Diabetes is a non-communicable disease where the patient's glucose level in the blood is too high. Diabetes is prevalent among ethnic minority groups in the United Kingdom (UK). Type 2 diabetes is a major cause of premature mortality in England. Unfortunately, the lifestyle of these minority groups has become a barrier to diabetes healthcare treatment. The timely intervention of programmes targeting risk factors associated with diabetes may reduce the prevalence of diabetes among these ethnic minority groups. This review critically explores and identifies barriers that hinder specific African-Caribbean groups from accessing diabetes healthcare and how nurses can promote lifestyle changes in patients with prediabetes from African-Caribbean backgrounds. DESIGN: An extended literature review (ELR). The process consisted of a search of key databases and other nursing and public health journal articles with the keywords defined in this extended review (prediabetes, diabetes, lifestyle of Afro-Caribbean). Thematic analysis is then applied from a socio-cultural theoretical lens to interpret the selected articles for the review. RESULTS: Three main barriers were identified: (a) the strong adherence to traditional diets, (b) a wrong perception about diet management and (c) 'Western medication' as a key barrier that hinders effective diabetes management in ethnic minorities, including the African-Caribbean in the UK. CONCLUSION: To address these barriers, it is important for policymakers to prioritise well-tailored interventions for African-Caribbean groups as well as support healthcare providers with the requisite capacity to provide care.
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População Negra , Diabetes Mellitus Tipo 2 , Estilo de Vida , Estado Pré-Diabético , Humanos , Estado Pré-Diabético/etnologia , Reino Unido/epidemiologia , Diabetes Mellitus Tipo 2/etnologia , Região do Caribe/etnologia , População Negra/estatística & dados numéricos , Estilo de Vida/etnologia , Promoção da Saúde , Dieta , Acessibilidade aos Serviços de SaúdeRESUMO
Multiple sclerosis (MS) is a neuro-inflammatory and neurodegenerative disease that is most prevalent in Northern Europe. Although it is known that inherited risk for MS is located within or in close proximity to immune-related genes, it is unknown when, where and how this genetic risk originated1. Here, by using a large ancient genome dataset from the Mesolithic period to the Bronze Age2, along with new Medieval and post-Medieval genomes, we show that the genetic risk for MS rose among pastoralists from the Pontic steppe and was brought into Europe by the Yamnaya-related migration approximately 5,000 years ago. We further show that these MS-associated immunogenetic variants underwent positive selection both within the steppe population and later in Europe, probably driven by pathogenic challenges coinciding with changes in diet, lifestyle and population density. This study highlights the critical importance of the Neolithic period and Bronze Age as determinants of modern immune responses and their subsequent effect on the risk of developing MS in a changing environment.
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Predisposição Genética para Doença , Genoma Humano , Pradaria , Esclerose Múltipla , Humanos , Conjuntos de Dados como Assunto , Dieta/etnologia , Dieta/história , Europa (Continente)/etnologia , Predisposição Genética para Doença/história , Genética Médica , História do Século XV , História Antiga , História Medieval , Migração Humana/história , Estilo de Vida/etnologia , Estilo de Vida/história , Esclerose Múltipla/genética , Esclerose Múltipla/história , Esclerose Múltipla/imunologia , Doenças Neurodegenerativas/genética , Doenças Neurodegenerativas/história , Doenças Neurodegenerativas/imunologia , Densidade DemográficaRESUMO
Limited attention has been given to the role of cultural orientation towards different ethnic groups in multi-ethnic settings without a dominant host culture. We evaluated whether acculturation levels, reflecting cultural orientation towards other ethnic groups, were associated with obesity and related lifestyle behaviors in a cosmopolitan Asian population. We conducted the current study based on data from the Singapore Multi-Ethnic Cohort (N = 10,622) consisting of ethnic Chinese, Malays, and Indians aged 21 to 75 years. Multivariable linear and logistic regression analyses were used to examine associations between the acculturation level (z-score), obesity, and related lifestyle behaviors, including dietary habits and physical activity. A higher acculturation level was directly associated with a higher prevalence of obesity among Chinese, whereas an inverse association was found for ethnic Indians, and no significant association in Malays. In ethnic Malays, greater acculturation was significantly associated with higher dietary quality and less sedentary time. Furthermore, a high acculturation level was significantly associated with higher sugar-sweetened beverage consumption and more leisure-time PA in all ethnic groups. Our findings suggest that greater cultural orientation towards other ethnic groups was associated with convergence in obesity levels. More research is required to understand how acculturation affects obesity-related lifestyle factors in multi-ethnic settings.
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Aculturação , Asiático , Estilo de Vida , Obesidade , Humanos , Asiático/etnologia , Etnicidade , Estilo de Vida/etnologia , Obesidade/epidemiologia , Obesidade/etnologia , Obesidade/etiologia , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Singapura/epidemiologiaAssuntos
Doenças Cardiovasculares , Estilo de Vida , Comportamento de Redução do Risco , População do Sul da Ásia , Humanos , Povo Asiático , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Estilo de Vida/etnologia , Fatores de Risco , Estados Unidos/epidemiologiaRESUMO
ABSTRACT Objective To evaluate the consumption of free sugars and associated factors in the diet of university students entering full-time courses at a public university in Mato Grosso. Methods Cross-sectional study with students aged 16 to 26 years in the first semester of 2016, 2017, and 2018. Average sugar consumption was estimated using a 24-hour diet recall, evaluating the percentage of free sugars in total energy intake and the prevalence of consumption greater than 10.0% of total energy intake, according to socioeconomic and lifestyle variables, stratified by sex, and the foods that most contributed to its consumption. Results A total of 1,063 students were evaluated, the percentage of free sugars in the students' diet was on average 14.3% among men and 15.4% among women, with the prevalence of consumption above 10.0% also being higher among women (72.6 vs. 66.6%). There was a direct relationship between the participation of free sugars in the highest tertiles of energy intake, and the main food groups sources of sugar were desserts, juices, soft drinks, and coffee. There was a significant association between courses outside the health sciences, tobacco use, and unsatisfactory meal consumption profile with higher consumption of free sugars among women. Among men, sugar consumption was higher among those who were not overweight compared to those who were overweight. Conclusion The consumption of free sugars is high among university students, being associated with higher energy consumption, especially for sweetened beverages.
RESUMO Objetivo Avaliar o consumo de açúcar livre e os fatores associados na alimentação de universitários ingressantes em cursos de período integral em uma universidade pública de Mato Grosso. Métodos Estudo transversal com estudantes de 16 a 26 anos de idade no primeiro semestre de 2016, 2017 e 2018 (n=1.063). O consumo médio de açúcar foi estimado por meio de recordatório de 24 horas, sendo avaliada a participação do açúcar livre na ingestão energética total e a prevalência de participação do consumo superior a 10,0% da ingestão energética, segundo variáveis socioeconômicas, de estilo de vida e fatores dietéticos, , estratificadas por sexo. Resultados A participação do açúcar livre na dieta foi, em média, de 14,3% entre os homens e 15,4% entre as mulheres, sendo a prevalência de consumo acima de 10,0% também maior entre as mulheres (72,6 vs. 66,6%). Foi maior a participação do açúcar livre nos tercis mais elevados de ingestão energética, sendo verificado que os principais grupos de alimentos fontes foram sobremesas, sucos, refrigerantes e café. Entre as mulheres, verificou-se maior consumo de açúcar livre entre aquelas que faziam uso de tabaco e que apresentavam perfil de consumo de refeições insatisfatório. Por outro lado, menor consumo de açúcar livre foi observado entre as estudantes da área da saúde. Entre os homens, o consumo de açúcar livre foi maior entre aqueles sem excesso de peso, comparados aos com excesso. Conclusão O consumo de açúcar livre foi elevado entre estudantes universitários, sendo maior entre os estudantes com maior consumo energético. Verificou-se que as bebidas adoçadas estiveram entre as principais fontes.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Universidades , Ingestão de Alimentos/etnologia , Fatores Socioeconômicos , Estudos Transversais , Açúcares , Bebidas Adoçadas com Açúcar , Estilo de Vida/etnologiaRESUMO
PURPOSE: This study aimed to determine the effect of reproductive, hormonal, lifestyle and nutritional factors on breast cancer development among Tanzanian black women. METHODOLOGY: We undertook a case-control study age-matched to ±5years in 2018 at Muhimbili National Hospital. The study recruited 105 BC patients and 190 controls giving it 80% power to detect an odds ratio of ≥2 at the alpha error of <5% for exposure with a prevalence of 30% in the control group with 95% confidence. Controls were recruited from in patients being treated for non-cancer related conditions. Information regarding hormonal, reproductive, nutritional and lifestyle risk for breast cancer and demography was collected by interviews using a predefined data set. Conditional multinomial logistic regression used to determine the adjusted odds ratio for variables that had significant p-value in the binomial logistic regression model with 5% allowed error at 95% confidence interval. RESULTS: The study recruited 105 cases and 190 controls. Only old age at menopause had a significant risk, a 2.6 fold increase. Adolescent obesity, family history of breast cancer, cigarette smoking and alcohol intake had increased odds for breast cancer but failed to reach significant levels. The rural residency had 61% reduced odds for developing breast cancer though it failed to reach significant levels. CONCLUSION: Older age at menopause is a significant risk factor for the development of breast cancer among Tanzanian women. This study has shed light on the potential role of modifiable risk factors for breast cancer which need to be studied further for appropriate preventive strategies in similar settings.
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Neoplasias da Mama/epidemiologia , Hormônios/sangue , Estilo de Vida , Estado Nutricional/fisiologia , Reprodução/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , População Negra/estatística & dados numéricos , Neoplasias da Mama/etnologia , Neoplasias da Mama/etiologia , Estudos de Casos e Controles , Feminino , Hormônios/fisiologia , Humanos , Estilo de Vida/etnologia , Menopausa/fisiologia , Pessoa de Meia-Idade , Paridade/fisiologia , Obesidade Infantil/complicações , Obesidade Infantil/epidemiologia , Gravidez , Fatores de Risco , Fatores Socioeconômicos , Tanzânia/epidemiologia , Adulto JovemRESUMO
To examine the prevalence and co-occurrence of lifestyle risk factors for non-communicable diseases (NCDs) according to sociodemographic characteristics in Chilean residents. A cross-sectional study based on data from 5995 adults from the Chilean National Health Survey. The lifestyle risk factors included were physical inactivity, tobacco consumption, alcohol consumption, low fruits and vegetable consumption, and overweight/obesity. The most frequent risk factor was overweight/obesity (75.6%), followed by alcohol consumption (74.8%), low fruits and vegetable consumption (51.7%), physical inactivity (36.3%), and tobacco consumption (27.9%). Only 1.0% of the participants did not present any risk factor, while 9.6%, 30.4%, 34.0%, 20.3%, and 4.7% accumulated one, two, three, four, and five risk factors. Men (OR 1.56; 95% CI 1.18; 2.04), people who have secondary education (OR 1.59; 95% CI 1.20; 2.10), and those with lower household income (OR 1.39; 95% CI 1.09; 1.59) had higher odds of three or more risk factors. Associations were inverse for older adults (OR 0.57; 95% CI 0.41; 0.79) and rural geographic areas (OR 0.77; 95% CI 0.67; 0.89). The prevalence of risk factors for NCDs is fairly high in Chilean residents. Interventions may need to target these co-occurrences rather than emphasizing individual risk factors for NCDs. Interventions could further consider these co-occurrences as a potential target for population stratification.
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Estilo de Vida/etnologia , Doenças não Transmissíveis/epidemiologia , Fatores Sociodemográficos , Adulto , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Chile/epidemiologia , Estudos Transversais , Dieta/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças não Transmissíveis/etnologia , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Prevalência , Fatores de Risco , Comportamento Sedentário/etnologia , Uso de Tabaco/efeitos adversosRESUMO
Non-communicable diseases (NCDs) are increasingly becoming the global cause of premature death encompassing cardiovascular diseases (CVDs), cancer, respiratory diseases and diabetes mellitus. However, cardiometabolic risk factors in the general population, especially among the high-risk groups have rarely been assessed in Ethiopia. The study aimed to assess the prevalence of metabolic syndrome, its components and associated factors among staff in the Ethiopian Public Health Institute (EPHI). An institutional-based cross-section study was conducted from March to June 2018 among EPHI staff members. A total of 450 study participants were involved in the study, and the World Health Organization NCD STEPS survey instrument version 3.1 was used for the assessment. The biochemical parameters were analyzed by using COBAS 6000 analyzer. Statistical package for the social science (SPSS) version 20 was used for data analysis. Both bivariate and multivariate logistic regression analyses were used to identify associated risk factors. p value < 0.05 was considered for statistical significance. The overall prevalence of metabolic syndrome was 27.6% and 16.7% according to IDF and NCEP criteria respectively, with males having greater prevalence than females (35.8% vs 19.4%). Central obesity, low high-density lipoprotein (HDL) and hypertension had a prevalence of 80.2%, 41.3%, and 23.6%, respectively. In multivariate analysis increasing age and having a higher body mass index (25-29.9) were significantly associated with metabolic syndromes. The magnitude of metabolic syndrome was relatively high among public employees. Preventive intervention measures should be designed on the modification of lifestyle, nutrition and physical activities, and early screening for early identification of cardiometabolic risks factors should be practised to reduce the risk of developing cardiovascular diseases.
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Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etiologia , Adulto , Glicemia , Índice de Massa Corporal , Doenças Cardiovasculares/complicações , Diabetes Mellitus/fisiopatologia , Etiópia/epidemiologia , Exercício Físico/tendências , Feminino , Humanos , Hipertensão/fisiopatologia , Estilo de Vida/etnologia , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade Abdominal/complicações , Estresse Ocupacional/fisiopatologia , Prevalência , Saúde Pública , Administração em Saúde Pública , Fatores de Risco , Seguridade SocialAssuntos
Asiático , Doenças Cardiovasculares/etnologia , Disparidades nos Níveis de Saúde , Estilo de Vida/etnologia , Doenças Cardiovasculares/diagnóstico , Doença da Artéria Coronariana/etnologia , Bases de Dados Factuais , Diabetes Mellitus/etnologia , Feminino , Fatores de Risco de Doenças Cardíacas , Insuficiência Cardíaca/etnologia , Humanos , Hiperlipidemias/etnologia , Hipertensão/etnologia , Masculino , Inquéritos Nutricionais , Fatores Raciais , Medição de Risco , Estados Unidos/epidemiologiaRESUMO
OBJECTIVE: To compare racial differences in male fertility history and treatment. DESIGN: Retrospective review of prospectively collected data. SETTING: North American reproductive urology centers. PATIENT(S): Males undergoing urologist fertility evaluation. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Demographic and reproductive Andrology Research Consortium data. RESULT(S): The racial breakdown of 6,462 men was: 51% White, 20% Asian/Indo-Canadian/Indo-American, 6% Black, 1% Indian/Native, <1% Native Hawaiian/Other Pacific Islander, and 21% "Other". White males sought evaluation sooner (3.5 ± 4.7 vs. 3.8 ± 4.2 years), had older partners (33.3 ± 4.9 vs. 32.9 ± 5.2 years), and more had undergone vasectomy (8.4% vs. 2.9%) vs. all other races. Black males were older (38.0 ± 8.1 vs. 36.5 ± 7.4 years), sought fertility evaluation later (4.8 ± 5.1 vs. 3.6 ± 4.4 years), fewer had undergone vasectomy (3.3% vs. 5.9%), and fewer had partners who underwent intrauterine insemination (8.2% vs. 12.6%) compared with all other races. Asian/Indo-Canadian/Indo-American patients were younger (36.1 ± 7.2 vs. 36.7 ± 7.6 years), fewer had undergone vasectomy (1.2% vs. 6.9%), and more had partners who underwent intrauterine insemination (14.2% vs. 11.9%). Indian/Native males sought evaluation later (5.1 ± 6.8 vs. 3.6 ± 4.4 years) and more had undergone vasectomy (13.4% vs. 5.7%). CONCLUSION(S): Racial differences exist for males undergoing fertility evaluation by a reproductive urologist. Better understanding of these differences in history in conjunction with societal and biologic factors can guide personalized care, as well as help to better understand and address disparities in access to fertility evaluation and treatment.
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Fertilidade , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/etnologia , Infertilidade Masculina/etnologia , Infertilidade Masculina/terapia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Técnicas de Reprodução Assistida/tendências , Adulto , Índice de Massa Corporal , Estudos Transversais , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/fisiopatologia , Estilo de Vida/etnologia , Masculino , Idade Materna , América do Norte/epidemiologia , Idade Paterna , Fatores Raciais , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , VasectomiaRESUMO
BACKGROUND: Stroke risk can be quantified using risk factors whose effect sizes vary by geography and race. No stroke risk assessment tool exists to estimate aggregate stroke risk for indigenous African. OBJECTIVES: To develop Afrocentric risk-scoring models for stroke occurrence. MATERIALS AND METHODS: We evaluated 3533 radiologically confirmed West African stroke cases paired 1:1 with age-, and sex-matched stroke-free controls in the SIREN study. The 7,066 subjects were randomly split into a training and testing set at the ratio of 85:15. Conditional logistic regression models were constructed by including 17 putative factors linked to stroke occurrence using the training set. Significant risk factors were assigned constant and standardized statistical weights based on regression coefficients (ß) to develop an additive risk scoring system on a scale of 0-100%. Using the testing set, Receiver Operating Characteristics (ROC) curves were constructed to obtain a total score to serve as cut-off to discriminate between cases and controls. We calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) at this cut-off. RESULTS: For stroke occurrence, we identified 15 traditional vascular factors. Cohen's kappa for validity was maximal at a total risk score of 56% using both statistical weighting approaches to risk quantification and in both datasets. The risk score had a predictive accuracy of 76% (95%CI: 74-79%), sensitivity of 80.3%, specificity of 63.0%, PPV of 68.5% and NPV of 76.2% in the test dataset. For ischemic strokes, 12 risk factors had predictive accuracy of 78% (95%CI: 74-81%). For hemorrhagic strokes, 7 factors had a predictive accuracy of 79% (95%CI: 73-84%). CONCLUSIONS: The SIREN models quantify aggregate stroke risk in indigenous West Africans with good accuracy. Prospective studies are needed to validate this instrument for stroke prevention.
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População Negra , Técnicas de Apoio para a Decisão , Acidente Vascular Cerebral Hemorrágico/etnologia , AVC Isquêmico/etnologia , Fatores Etários , Estudos de Casos e Controles , Comorbidade , Feminino , Gana/epidemiologia , Acidente Vascular Cerebral Hemorrágico/diagnóstico por imagem , Humanos , AVC Isquêmico/diagnóstico por imagem , Estilo de Vida/etnologia , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Valor Preditivo dos Testes , Fatores Raciais , Reprodutibilidade dos Testes , Medição de Risco , Fatores de Risco , Determinantes Sociais da Saúde , Fatores SocioeconômicosRESUMO
Background The Asian population is the fastest-growing immigrant population in the United States. Prior studies have examined the Asian immigrant population as a homogenous group. We hypothesized that there will be heterogeneity in cardiovascular disease risk factors among Asian immigrant subgroups (Indian subcontinent, Southeast Asia, Asia) compared with the non-Hispanic White population. Methods and Results A cross-sectional analysis of the 2010 to 2018 National Health Interview Survey was conducted among 508 941 adults who were born in Asian regions or were non-Hispanic White and born in the United States. Generalized linear models with Poisson distribution were fitted to compare the prevalence of self-reported hypertension, overweight/obesity, diabetes mellitus, high cholesterol, physical inactivity, and current smoking among Asian immigrants compared with White adults, adjusting for known confounders. We included 33 973 Asian immigrants from Southeast Asia (45%), Asia (29%), the Indian subcontinent (26%), and 474 968 White adults. Compared with non-Hispanic White adults, Indian subcontinent immigrants had the highest prevalence of overweight/obesity (prevalence ratio, 1.22; 95% CI, 1.19-1.25); Southeast Asian immigrants had the highest prevalence of high cholesterol (prevalence ratio, 1.16; 95% CI, 1.10-1.23); Indian subcontinent (prevalence ratio, 1.69; 95% CI, 1.49-1.93) and Southeast Asian (prevalence ratio, 1.38; 95% CI, 1.26-1.52) immigrants had a higher prevalence of diabetes. All Asian immigrant subgroups were more likely to be physically inactive and less likely to smoke than White adults. Conclusions We observed significant heterogeneity in cardiovascular disease risk factors among Asian immigrants and a varied prevalence of risk factors compared with non-Hispanic White adults. Providers caring for Asian immigrants should provide tailored and culturally informed care to improve the cardiovascular health of this diverse group.
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Povo Asiático , Doenças Cardiovasculares/etnologia , Emigrantes e Imigrantes , Disparidades nos Níveis de Saúde , Estilo de Vida/etnologia , População Branca , Adulto , Doenças Cardiovasculares/diagnóstico , Comorbidade , Estudos Transversais , Diabetes Mellitus/etnologia , Dislipidemias/etnologia , Exercício Físico , Feminino , Inquéritos Epidemiológicos , Fatores de Risco de Doenças Cardíacas , Humanos , Hipertensão/etnologia , Masculino , Pessoa de Meia-Idade , Obesidade/etnologia , Prevalência , Medição de Risco , Comportamento Sedentário/etnologia , Fumar/efeitos adversos , Fumar/etnologia , Fatores de Tempo , Estados Unidos/epidemiologiaRESUMO
BACKGROUND AND AIMS: Obesity is associated with an increasing prevalence of cardiovascular diseases in Africa, but some obese individuals maintain cardiometabolic health. The aims were to track metabolically healthy overweight or obesity (MHO) over 10 years in African adults and to identify factors associated with a transition to metabolically unhealthy overweight or obesity (MUO). METHODS AND RESULTS: The participants were the South African cohort of the international Prospective Urban and Rural Epidemiological study. From the baseline data of 1937 adults, 649 women and 274 men were followed for 10 years. The combined overweight and obesity prevalence of men (19.2%-23.8%, p = .02) and women (58%-64.7%, p < .001), and the prevalence of the metabolic syndrome in all participants (25.4%-40.2%, p < .001) increased significantly. More than a quarter (26.2%) of the women and 10.9% of men were MHO at baseline, 11.4% of women and 5.1% of men maintained MHO over 10 years, while similar proportions (12.3% of women, 4.7% of men) transitioned to MUO. Female sex, age, and total fat intake were positively associated with a transition to MUO over 10 years, while physical activity was negatively associated with the transition. HIV positive participants were more likely to be MHO at follow-up than their HIV negative counterparts. CONCLUSIONS: One in two black adults with BMI ≥25 kg/m2 maintained MHO over 10 years, while a similar proportion transitioned into MUO. Interventions should focus on lower fat intakes and higher physical activity to prevent the transition to MUO.
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Adiposidade/etnologia , População Negra , Estilo de Vida/etnologia , Síndrome Metabólica/etnologia , Obesidade Metabolicamente Benigna/etnologia , Adulto , Idoso , Fatores de Risco Cardiometabólico , Gorduras na Dieta/efeitos adversos , Progressão da Doença , Exercício Físico , Feminino , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Obesidade Metabolicamente Benigna/diagnóstico , Obesidade Metabolicamente Benigna/fisiopatologia , Prevalência , Prognóstico , Estudos Prospectivos , Medição de Risco , Saúde da População Rural , Comportamento Sedentário/etnologia , África do Sul/epidemiologia , Fatores de Tempo , Saúde da População UrbanaRESUMO
BACKGROUND: Anthropometric and hormone-related factors are established endometrial cancer risk factors; however, little is known about the impact of these factors on endometrial cancer risk in non-White women. METHODS: Among 110,712 women participating in the Multiethnic Cohort (MEC) Study, 1150 incident invasive endometrial cancers were diagnosed. Hazard ratios (HRs) and 95% confidence intervals (CIs) for associations with endometrial cancer risk for race/ethnicity and for risk factors across racial/ethnic groups were calculated. RESULTS: Having a higher body mass index (BMI) at baseline or age 21 years was strongly associated with increased risk (pint race/ethnicity ≥ 0.36). Parity (vs nulliparity) was inversely associated with risk in all the groups except African Americans (pint 0.006). Current use of postmenopausal hormones at baseline (PMH-E; vs never use) was associated with increased risk in Whites and Japanese Americans (pint 0.002). Relative to Whites, endometrial cancer risk was lower in Japanese Americans and Latinas and non-significantly higher in Native Hawaiians. Risk in African Americans did not differ from that in Whites. CONCLUSIONS: Racial/ethnic differences in endometrial cancer risk were not fully explained by anthropometric or hormone-related risk factors. Further studies are needed to identify reasons for the observed racial/ethnic differences in endometrial cancer risk.
Assuntos
Pesos e Medidas Corporais/estatística & dados numéricos , Neoplasias do Endométrio/etnologia , Neoplasias do Endométrio/etiologia , Hormônios Gonadais/sangue , Adulto , Idoso , Índice de Massa Corporal , Estudos de Coortes , Neoplasias do Endométrio/sangue , Etnicidade/estatística & dados numéricos , Feminino , Humanos , Estilo de Vida/etnologia , Pessoa de Meia-Idade , Grupos Raciais/estatística & dados numéricos , História Reprodutiva , Fatores de Risco , Estados Unidos/epidemiologia , Adulto JovemRESUMO
Epidemiological studies of obesity, Type-2 diabetes (T2D), cardiovascular diseases and several common cancers have revealed an increased risk in Native Hawaiians compared to European- or Asian-Americans living in the Hawaiian islands. However, there remains a gap in our understanding of the genetic factors that affect the health of Native Hawaiians. To fill this gap, we studied the genetic risk factors at both the chromosomal and sub-chromosomal scales using genome-wide SNP array data on ~4,000 Native Hawaiians from the Multiethnic Cohort. We estimated the genomic proportion of Native Hawaiian ancestry ("global ancestry," which we presumed to be Polynesian in origin), as well as this ancestral component along each chromosome ("local ancestry") and tested their respective association with binary and quantitative cardiometabolic traits. After attempting to adjust for non-genetic covariates evaluated through questionnaires, we found that per 10% increase in global Polynesian genetic ancestry, there is a respective 8.6%, and 11.0% increase in the odds of being diabetic (P = 1.65×10-4) and having heart failure (P = 2.18×10-4), as well as a 0.059 s.d. increase in BMI (P = 1.04×10-10). When testing the association of local Polynesian ancestry with risk of disease or biomarkers, we identified a chr6 region associated with T2D. This association was driven by an uniquely prevalent variant in Polynesian ancestry individuals. However, we could not replicate this finding in an independent Polynesian cohort from Samoa due to the small sample size of the replication cohort. In conclusion, we showed that Polynesian ancestry, which likely capture both genetic and lifestyle risk factors, is associated with an increased risk of obesity, Type-2 diabetes, and heart failure, and that larger cohorts of Polynesian ancestry individuals will be needed to replicate the putative association on chr6 with T2D.
Assuntos
Diabetes Mellitus Tipo 2/genética , Predisposição Genética para Doença , Insuficiência Cardíaca/genética , Obesidade/genética , Asiático/genética , Asiático/estatística & dados numéricos , Índice de Massa Corporal , Estudos de Coortes , Feminino , Estudo de Associação Genômica Ampla , Havaí , Humanos , Estilo de Vida/etnologia , Masculino , Herança Multifatorial , Havaiano Nativo ou Outro Ilhéu do Pacífico/genética , Havaiano Nativo ou Outro Ilhéu do Pacífico/estatística & dados numéricos , Análise de Sequência com Séries de Oligonucleotídeos , Fenótipo , Polimorfismo de Nucleotídeo Único , Fatores de Risco , Samoa , População Branca/genética , População Branca/estatística & dados numéricosRESUMO
Japanese Americans include Japanese individuals migrating from Japan to the United States (first-generation Japanese Americans [JA-1]) and their offspring (second- or later-generation Japanese Americans [JA-2]). Although Japanese Americans share their genetic predisposition with the Japanese, their lifestyles have been westernized rapidly and extensively. We conducted a medical survey for atherosclerosis among Japanese Americans living in Hawaii and Los Angeles and native Japanese living in Hiroshima for 50 years since 1970 (the Hawaii-Los Angeles-Hiroshima Study) and obtained the following results:(1) In the 1990s, a westernized lifestyle induced hyperlipidemia among Japanese Americans, and based on the evaluation of the carotid artery intima-media wall thickness (IMT), atherosclerosis was apparently more advanced in Japanese Americans than in native Japanese. In addition, the advancement of atherosclerosis corresponded to the degree of westernization of lifestyles in JA-1 and JA-2.(2) In the 2010s, the serum total cholesterol and low-density lipoprotein cholesterol levels in native Japanese were significantly higher than those in Japanese Americans, and the difference in the progression of carotid artery IMT was smaller between native Japanese and Japanese Americans.(3) Maintaining a healthy Japanese lifestyle since childhood may suppress future worsening of risk factors for atherosclerosis (such as obesity and diabetes mellitus) and contribute to atherosclerosis prevention in the Japanese.
Assuntos
Asiático/estatística & dados numéricos , Aterosclerose/etnologia , Dieta Ocidental/etnologia , Exercício Físico , Comportamentos Relacionados com a Saúde/etnologia , Estilo de Vida/etnologia , Adulto , Idoso , Asiático/psicologia , Espessura Intima-Media Carotídea , Feminino , Havaí , Humanos , Japão/etnologia , Los Angeles , Masculino , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
AIM: To update data previously published on the health profile of the refugees resettling in New Zealand, and to draw attention to the change in health profile over time, with a decline of infectious disease/deficiencies, and a rise of non-communicable diseases, a worldwide phenomenon. METHOD: Comparative data was extracted from (1) written annual reports prepared by medical officers at the Mangere Refugee Resettlement Centre (1978-1991), (2) a Microsoft ACCESS patient management system between 1995 and 1999 and (3) a MEDTECH patient management system between 2010 and 2014. RESULTS: Over the period 1979-2014, the rate of infectious diseases has declined markedly in resettling refugees, and the rate of non-communicable diseases has increased. For example, the incidence of tuberculosis has decreased from 4% to 0.2%, gut parasites from more than 40% to, in some intakes, 15% and iron deficiency from 22% to 10%, while the diabetes rate has gone from 0.1% to 2.7%. CONCLUSION: While management of unfamiliar infectious diseases and deficiencies (especially vitamin D) still remains an important part of the management of refugee health, their management usually involves limited time and expense, and their burden is much less than before. However, refugees now resettling in New Zealand and the rest of the world often present with familiar non-communicable diseases that require long-term management.
Assuntos
Nível de Saúde , Estilo de Vida/etnologia , Atenção Primária à Saúde/estatística & dados numéricos , Refugiados/estatística & dados numéricos , Adolescente , Adulto , África Subsaariana/etnologia , Idoso , Idoso de 80 Anos ou mais , Sudeste Asiático/etnologia , Butão/etnologia , Índice de Massa Corporal , Criança , Pré-Escolar , Colômbia/etnologia , Comportamento Contraceptivo/etnologia , Comportamento Contraceptivo/tendências , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/etnologia , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Infecções por HIV/etnologia , Infecções por Helicobacter/etnologia , Helicobacter pylori , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/etnologia , Lactente , Recém-Nascido , Enteropatias Parasitárias/etnologia , Iraque/etnologia , Masculino , Saúde Mental/etnologia , Pessoa de Meia-Idade , Nova Zelândia/epidemiologia , Prevalência , Infecções Sexualmente Transmissíveis/etnologia , Uso de Tabaco/etnologia , Tuberculose Pulmonar/etnologia , Deficiência de Vitamina D/etnologia , Adulto JovemRESUMO
BACKGROUND: Comparisons of traditional hunter-gatherers and pre-agricultural communities in Africa with urban and suburban Western North American and European cohorts have clearly shown that diet, lifestyle and environment are associated with gut microbiome composition. Yet, little is known about the gut microbiome composition of most communities in the very diverse African continent. South Africa comprises a richly diverse ethnolinguistic population that is experiencing an ongoing epidemiological transition and concurrent spike in the prevalence of obesity, largely attributed to a shift towards more Westernized diets and increasingly inactive lifestyle practices. To characterize the microbiome of African adults living in more mainstream lifestyle settings and investigate associations between the microbiome and obesity, we conducted a pilot study, designed collaboratively with community leaders, in two South African cohorts representative of urban and transitioning rural populations. As the rate of overweight and obesity is particularly high in women, we collected single time-point stool samples from 170 HIV-negative women (51 at Soweto; 119 at Bushbuckridge), performed 16S rRNA gene sequencing on these samples and compared the data to concurrently collected anthropometric data. RESULTS: We found the overall gut microbiome of our cohorts to be reflective of their ongoing epidemiological transition. Specifically, we find that geographical location was more important for sample clustering than lean/obese status and observed a relatively higher abundance of the Melainabacteria, Vampirovibrio, a predatory bacterium, in Bushbuckridge. Also, Prevotella, despite its generally high prevalence in the cohorts, showed an association with obesity. In comparisons with benchmarked datasets representative of non-Western populations, relatively higher abundance values were observed in our dataset for Barnesiella (log2fold change (FC) = 4.5), Alistipes (log2FC = 3.9), Bacteroides (log2FC = 4.2), Parabacteroides (log2FC = 3.1) and Treponema (log2FC = 1.6), with the exception of Prevotella (log2FC = - 4.7). CONCLUSIONS: Altogether, this work identifies putative microbial features associated with host health in a historically understudied community undergoing an epidemiological transition. Furthermore, we note the crucial role of community engagement to the success of a study in an African setting, the importance of more population-specific studies to inform targeted interventions as well as present a basic foundation for future research.