Life's Essential 8 and Incident Hypertension Among US Hispanic/Latino Adults: Results From the Hispanic Community Health Study/Study of Latinos.

BACKGROUND: Life's Essential 8 (LE8) is a new metric to define cardiovascular health. We aimed to describe LE8 among Hispanics/Latinos and its association with incident hypertension. METHODS AND RESULTS: The HCHS/SOL (Hispanic Community Health Study/Study of Latinos) is a study of Hispanic/Latino adults aged 18 to 74 years from 4 US communities. At visit 1 (2008-2011), information on behavioral and clinical factors (diet, smoking status, physical activity, sleep duration, body mass index, blood pressure, cholesterol, fasting glucose, and medication use) were measured and used to estimate an LE8 score (range, 0-100) for 14 772 participants. Hypertension was defined as systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥80 mm Hg, or self-reported use of antihypertensive medications. Among the 5667 participants free from hypertension at visit 1, we used Poisson regression models to determine the multivariable adjusted association between LE8 and incident hypertension in 2014 to 2017. All analyses accounted for the complex survey design of the study. Mean population age was 41 years, and 21.6% (SE, 0.7) had high cardiovascular health (LE8 ≥80). Mean LE8 score (68.2; SE, 0.3) varied by Hispanic/Latino background (P<0.05), ranging from 72.6 (SE, 0.3) among Mexican Americans to 62.2 (SE, 0.4) among Puerto Ricans. Each 10-unit decrement in LE8 score was associated with a 22% increased risk of hypertension over ≈6 years (incident density ratio, 1.22 [95% CI, 1.16-1.29]). CONCLUSIONS: Only 1 in 5 Hispanic/Latino adults had high cardiovascular health, and LE8 varied substantially across Hispanic/Latino background groups. Improvements in other components of cardiovascular health may result in a lower risk of developing hypertension.

Change in Neighborhood Socioeconomic Status and Adherence to the Cancer Prevention Lifestyle Guidelines in Hispanic/Latino Adults: Results from the HCHS/SOL Study.

Neighborhood conditions are dynamic; the association of changing neighborhood socioeconomic factors with cancer preventive behaviors remains unclear. We examined associations of neighborhood socioeconomic deprivation, gentrification, and change in income inequality with adherence to the American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention in The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). The HCHS/SOL enrolled 16,415 adults, ages 18­74 years, at baseline (2008­2011), from communities in the Bronx, NY, Chicago, IL, Miami, FL, and San Diego, CA. Geocoded baseline addresses were linked to the 2000 decennial Census and 5-year American Community Survey (2005­2009 and 2012­2016) tracts to operationalize neighborhood deprivation index (NDI), gentrification, and income inequality. Complex survey multinominal logistic regression models estimated the relative risk ratio (RRR) with overall guideline adherence level (low, moderate, high) and by components­diet, physical activity, body mass index (BMI), and alcohol intake. Overall, 14%, 60%, and 26% of the population had low, moderate, and high ACS guideline adherence, respectively. NDI was negatively associated with risk of high (vs. low) guideline adherence [RRR = 0.87, 95% confidence interval (CI) = 0.78­0.98], although attenuated after controlling for individual socioeconomic status (SES; RRR = 0.89, 95% CI = 0.80­1.00), and associated with lower adherence to BMI recommendations (low vs. moderate RRR = 0.90, 95% CI = 0.84­0.97; high RRR = 0.86, 95% CI = 0.77­0.97). Gentrification was associated with higher likelihood of meeting the dietary recommendations (low vs. moderate RRR = 1.04, 95% CI = 1.01­1.07), but not with overall adherence or individual components. Change in income inequality was not associated with outcomes. Neighborhood deprivation may be negatively associated with ACS guideline adherence among Hispanic/Latino adults. SIGNIFICANCE: This study provides new evidence on the link between neighborhood gentrification, changing income inequality and adoption and maintenance of cancer preventive behaviors in an understudied population in cancer research. We observed that while neighborhood deprivation may deter from healthy lifestyle behaviors, positive changes in neighborhood SES via the process of gentrification, may not influence lifestyle guideline adherence among Hispanic/Latino adults.

Prevalence of electronic cigarette use and its determinants in us persons of Hispanic/Latino background: The Hispanic community health study / study of Latinos (HCHS/SOL).

Objective: To determine the prevalence and determinants of electronic nicotine delivery systems (ENDS) use among Hispanic/Latino adults from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods: Cross-sectional data collected between the years 2015-2017 were analyzed to assess ENDS use (ever (current: use ≤ past 30 days; former: use > past 30 days) and never) among 11,623 adults (mean age 47 years±0.3 years; 52% women). Weighted prevalence estimates were reported, and age-adjusted logistic regression models were used to examine associations between sociodemographic and clinical exposures with ENDS use. Results: The prevalence of current and former ENDS use was 2.0% and 10.4%, respectively. Having ever used ENDS was associated with prevalent coronary artery disease. Current ENDS use was higher in males and associated with higher education, English language preference, and Puerto Rican background compared with nonsmokers and cigarette-only smokers (all p<0.05). Conclusions: Hispanic/Latino individuals who are young adults, male, US-born, and have high acculturation were more likely to report current ENDS use. These findings could inform preventive and regulatory interventions targeted to Hispanics/Latinos.

Acculturation level and change in cigarette consumption behaviors among diverse Hispanics/Latinos: the Hispanic Community Health Study/Study of Latinos.

PURPOSE: To study associations between language acculturation level and changes in cigarette consumption among the diverse and growing U.S.-based Hispanic/Latino population and inform culturally tailored smoking prevention and cessation strategies. METHODS: In the Hispanic Community Health Survey/Study of Latinos cohort, we used cigarette consumption behaviors at baseline (2008-2011) and follow-up (2014-2017) and a modified Short Acculturation Scale for Hispanics (SASH) language subscale to measure associations of language acculturation (unidimensional) with changes in cigarette consumption and quitting rates. Weighted multivariable linear and logistic regressions were stratified by daily (n = 1397) and nondaily (n = 633) smoking, and either sex, educational attainment, or migration status. RESULTS: Smokers at baseline (n = 2030) on average were aged 42 years old (SE = 0.5) with a mean SASH-language score of 2.3 (SE = 0.1; range = 1-5), indicating more Spanish language use. Among male daily smokers, we observed increases in smoked cigarettes-per-day (CPD) with unit increases in SASH-language score (1.08, 95% CI: 0.24-1.92). Associations with acculturation trended toward greater increases in CPD and lower odds of quitting as educational attainment increased. CONCLUSIONS: Language acculturation level is an important determinant for increased smoking behaviors, particularly among men. Our findings are significant in informing smoking reduction programs for the Hispanic/Latino population.

Reproductive period duration and cognitive function in postmenopausal Latina women in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

OBJECTIVES: A shorter reproductive period, a marker of estrogen exposure, has been related to cognitive impairment among older (>65 years) non-Hispanic White women. We explored whether reproductive period duration, age at menarche, and age at menopause are related to cognitive function among postmenopausal Hispanic/Latina women. METHODS: This cross-sectional analysis used baseline (Visit 1: 2008-2011) data from 3630 postmenopausal women in the Hispanic Community Health Study/Study of Latinos. Reproductive period duration, age at menarche, and age at menopause were assessed by self-report. Cognitive function variables included global cognition, verbal learning, memory, verbal fluency, and processing speed. Associations between each reproductive event and cognitive function were examined using multivariable linear and logistic regression analyses accounting for the complex survey design of the study and adjusting for socio-demographics, parity, and cardiovascular risk factors. We assessed whether associations differed by type of menopause (natural versus surgical) and hormone therapy use. RESULTS: The study population was on average aged 59 years, with a mean reproductive period duration of 35 years. Older age at menopause and a longer reproductive period were related to higher verbal learning (ß = 0.04, SE = 0.02; p < 0.05) and processing speed (ß = 0.16, SE = 0.04; p < 0.001); associations were more pronounced for women with natural menopause. Older age at menarche was associated with lower scores on the digit symbol substitution test (ß = -0.62, SE = 0.15; p < 0.0001). There were no associations with global cognition. CONCLUSION: Among postmenopausal Hispanic/Latinas, a longer reproductive period was related to more favorable cognitive measures of verbal learning and processing speed. Our findings support the hypothesis that greater lifetime exposure to estrogens may be associated with higher cognitive performance.

Perceived neighborhood factors, health behaviors, and related outcomes in the Hispanic Community Health Study/Study of Latinos.

Hispanic/Latino populations may experience significant neighborhood disadvantage, but limited research has explored whether these factors affect their health behaviors. Associations between perceived neighborhood factors at Visit 1 and health behaviors and related outcomes at Visit 2 in the Hispanic Community Health Study/Study of Latinos were evaluated. Multivariable logistic regression assessed cross-sectional and longitudinal relationships between perceived neighborhood social cohesion (NSC, 5 items), and neighborhood problems (NP, 7 items), with cancer screening, current smoking, excessive/binge drinking, hypertension, obesity, physical activity, and poor diet by gender and birthplace. NSC and NP scores were converted into quartiles. Mean age of participants was 42.5 years and 62.1% were women. Perceived NP, but not perceived NSC, differed by gender (p < 0.001). In unstratified models, no significant associations were observed between perceived NSC and any health behavior, whereas greater perceived NP was associated with less adherence to colon cancer screening (moderate level: aOR = 0.68, 95% CI = 0.51, 090) and more physical activity (very high level: aOR = 1.34, 95% CI = 1.06, 1.69) compared to low perceived NP. Women with moderate perceived NP, versus low NP, had a lower odds of colon cancer screening at Visit 1 (aOR = 0.62, 95% CI = 0.43, 0.91) and higher odds of mammogram adherence at Visit 2 (aOR = 2.86, 95% CI = 1.44, 5.68). Men with high perceived NP had a higher odds of excessive or binge drinking at Visit 2 (aOR = 1.99, 95% CI = 1.19, 3.31). We conclude that perceived NP were significantly related to health behaviors among HCHS/SOL individuals. Perceptions of neighborhood environment may be considered modifiable factors of structural neighborhood environment interventions.

Body image and disordered eating behaviors in Hispanic/Latino Youth: Findings from the Hispanic Community Health Study/Study of Latino Youth.

BACKGROUND: Prevalence of certain disordered eating behaviors is higher among Hispanic youth compared to non-Hispanics. Understanding the role of body image and social attitudes towards weight in disordered eating may inform treatment in Hispanic youth. METHODS: We analyzed data from the Hispanic Community Health Study/Study of Latino Youth (SOL Youth). Our sample included 1,463 children aged 8-16 years from four sites (Bronx, Chicago, Miami, San Diego) assessed in 2011-2014. Body image discrepancy score was calculated as the difference between perceived ideal body image and actual body image using two numbered visual graphs: adolescent (n = 728) or child (n = 735), each with slightly different scales. Questionnaires measured influences from social attitudes toward weight and disordered eating behaviors. Three disordered eating behaviors (dieting, overeating, and compensatory behaviors) were analyzed as the dependent variable. Logistic regression models adjusted for age, sex, acculturative stress, and field center to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI). RESULTS: Mean body image discrepancy score was -0.79 for adolescents (SE = 0.08) and -0.50 for children (SE = 0.05), with a negative score signifying a perceived actual body image larger than their ideal. Body image discrepancy was strongly associated with dieting (dieting ≥5 times/year aOR = 0.64, 95% CI 0.53, 0.77) and compensatory behaviors (aOR = 0.65, 95% CI 0.50, 0.85) among adolescents, and was strongly associated with overeating among children (aOR = 0.74, 95% CI 0.61, 0.91). Significant associations were not observed with social attitudes towards weight. CONCLUSIONS: Associations observed with body image discrepancy and disordered eating behaviors can inform interventions in Hispanic/Latino youth, which should consider acculturative stress.

Sex-Specific Prevalence, Demographic Characteristics, and Risk Factors of Tinnitus in the Hispanic Community Health Study/Study of Latinos.

PURPOSE: The aim of this study was to determine the prevalence of any and chronic tinnitus among female and male individuals from varied Hispanic/Latino backgrounds and to estimate associations between risk factors for chronic tinnitus. METHOD: Our analysis used cross-sectional baseline data collected from 2008 to 2011 from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Prevalence estimates and multivariable logistic regression were conducted using survey methodology. Participants included 15,768 adults (8,229 women and 7,539 men) aged 18-76 years. The primary outcome of interest was chronic tinnitus, defined as self-reported tinnitus lasting ≥ 5 min at a time and at least once per week. We hypothesized that after adjusting for covariates, the risk factors of depressed and anxious symptoms, smoking history, hypertension, and noise exposure history would be associated with higher odds of chronic tinnitus. RESULTS: Unstratified prevalence for any tinnitus was 32.9%, and for chronic tinnitus, it was 12.1%. Sex-stratified results demonstrated that 2,995 female individuals (36.4%) and 2,187 male individuals (29.0%) reported any tinnitus, and of these, 1,043 female individuals (12.7%) and 870 male individuals (11.5%) reported chronic tinnitus. In the fully adjusted model, depressed and anxious symptoms as well as recreational noise exposure were associated with higher odds of chronic tinnitus in female individuals (odds ratios [ORs] = 1.06, confidence interval [CI; 1.04, 1.07]; 1.02, CI [1.01, 1.04]; and 1.40, CI [1.20, 1.62]) and in male individuals (ORs = 1.06, CI [1.03, 1.08]; 1.05, CI [1.02, 1.08]; and 1.30, CI [1.05, 1.65]). Current smoking was a risk factor for chronic tinnitus in male individuals (OR = 1.53, CI [1.16, 2.02]). CONCLUSIONS: Prevalence of any and chronic tinnitus in the HCHS/SOL baseline cohort is higher than that reported in previous studies, particularly among female individuals. Understanding risk factors associated with tinnitus is important for the development of culturally and linguistically appropriate public health programs that consider sex differences and promote lifestyle modifications known to lower the odds of experiencing tinnitus.

Association of Accelerometer-Measured Physical Activity and Cardiovascular Health in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

INTRODUCTION: Evidence regarding the associations between accelerometer-measured moderate-vigorous physical activity (MVPA) and cardiovascular health (CVH) indicators among Hispanic/Latino adults are unavailable. METHODS: Examined cross-sectional data from 12,008 Hispanic/Latino adults aged 18-74 years participating in the Hispanic Community Health Study/Study of Latinos. Accelerometer-measured MVPA was assessed categorically and dichotomously per 2008 PA guidelines. Adverse and ideal CVH indicators were determined by standard cut-points for blood glucose, total cholesterol, blood pressure, body mass index (BMI), and smoking. A composite of low CV risk, defined as achieving all ideal CVH indicators, was included. Adjusted Poisson regression models and complex survey design methods were used for all analyses. RESULTS: Compared to high MVPA, lower MVPA categories were associated with higher prevalence of all adverse CVH indicators, except hypertension, and with lower prevalence of low CV risk and ideal blood glucose, blood pressure, and BMI. Similarly, non-adherence to PA guidelines was associated with a higher prevalence of diabetes (16%), hypercholesterolemia (9%), obesity (28%), and smoking (9%); and lower prevalence of low CV risk (24%), ideal blood glucose (6%), ideal blood pressure (6%), and ideal BMI (22%). CONCLUSION: Overall, high accelerometer-measured MVPA and meeting PA guidelines were associated with favorable CVH in Hispanic/Latino adults.

Associations of Helicobacter pylori and hepatitis A seropositivity with asthma in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL): addressing the hygiene hypothesis.

BACKGROUND: The hygiene hypothesis posits that microbial exposure reduces risk of asthma and other respiratory-related diseases. Helicobacter pylori and hepatitis A virus (HAV) are common fecal-oral infections. Our study aimed to examine associations of seropositivity to these agents with asthma in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). METHODS: A total of 12,471 HCHS/SOL participants with baseline data on self-reported physician-diagnosed asthma, and antibodies anti-H. pylori and anti-HAV were included in this cross-sectional analysis. Multivariable logistic regression models were used to estimate the odds ratios and 95% confidence intervals for the overall associations of seropositivity to each agent with asthma. Analyses were also stratified by Hispanic/Latino background. Effect modification by smoking status and nativity were tested. An analysis restricted to individuals with spirometry-defined chronic obstructive pulmonary disease (COPD) was also considered. RESULTS: The weighted overall prevalence of asthma was 16.6%. The weighted seroprevalence of H. pylori was 56.6% and of HAV was 76.6%, and they significantly differed by Hispanic/Latino background. After accounting for age, sex, education and other key confounders, we found no associations between H. pylori or HAV seropositivity with asthma (with and without COPD), either for all individuals combined or for any of the six specific backgrounds. There were no significant interactions by smoking and nativity. CONCLUSION: Our findings did not provide support for the role of H. pylori or HAV, as evidence of the hygiene hypothesis in asthma among the large and diverse Hispanic/Latino populations of the HCHS/SOL. Trial registration NCT02060344.

Allostatic load, unhealthy behaviors, and depressive symptoms in the Hispanic Community Health Study/Study of Latinos.

BACKGROUND: The Environmental Affordances Model (EAM) proposes that the effects of chronic stress on depression are moderated by unhealthy behaviors and race/ethnicity. The unique social structures and contexts of Hispanics/Latinos in the U.S. may influence such relationships. This study evaluated whether unhealthy behaviors weakened the relationship between allostatic load, a measure of chronic stress, and future elevated depressive symptoms among Hispanic Community Health Study/Study of Latinos participants. METHODS: Longitudinal data (2008-2011 and 2014-2017) from 11,623 participants were analyzed. The exposure was allostatic load, an index of twelve established biomarkers categorized using clinically relevant cut points, at Visit 1. Elevated depressive symptoms were operationalized as a score of ≥10 (out of 30) on the CES-D 10 at Visit 2. An index of unhealthy behaviors, with one point each for cigarette smoking, excessive/binge drinking, sedentary behavior, and poor diet quality at Visit 1, was examined as an effect modifier. Multivariable logistic regression, in the overall sample and among Mexicans specifically and adjusted for demographic characteristics and elevated depressive symptoms at Visit 1, was used to model allostatic load, unhealthy behavior index (range: 0-4), and their interaction in relation to elevated depressive symptoms at Visit 2. RESULTS: Overall, greater allostatic load was associated with higher odds of elevated depressive symptoms after at least 6 years (aOR = 1.06, 95% CI = 1.01, 1.10). Overall, individuals with greater allostatic load and an unhealthy behavior index = 1, compared to those with an unhealthy behavior index = 0, had lower odds of elevated depressive symptoms at follow-up (aß = -0.065, 95% CI = -0.12, -0.007). CONCLUSIONS: The relationship between chronic stress and depression was partially moderated among Hispanics/Latinos who engaged in unhealthy behavior, which may have reduced their risk of elevated depressive symptoms given more chronic stress.

Association of Subjective Social Status With Life's Simple 7s Cardiovascular Health Index Among Hispanic/Latino People: Results From the HCHS/SOL.

Background Evidence suggests that subjective (perceived) social status (SSS) may predict health outcomes more strongly than objective social status, but little is known about the relationship between SSS and cardiovascular health (CVH). This study focuses on this relationship among diverse Hispanic/Latino adults because while poor CVH profiles are prevalent in this population, immigration complicates attempts to measure their social status. Methods and Results We analyzed baseline HCHS/SOL (Hispanic Community Health Study/Study of Latinos) data on 15 374 Hispanic/Latino adults aged 18 to 74 years in 2008 to 2011. SSS was assessed using the McArthur Scale, a 10-rung "social ladder." CVH was based on levels of 7 metrics defined by the American Heart Association. Linear and logistic regressions were used to examine cross-sectional associations of SSS with CVH (overall and single metrics) after adjusting for objective social status, demographic, and health factors. Less than half of the population (46%) had Ideal scores in ≥4 metrics of CVH. In multivariable-adjusted models, an increase in SSS was associated with a higher overall CVH score (ß=0.04; 95% CI, 0.01-0.06) and greater likelihood of Ideal levels of body mass index, physical activity, and fasting blood glucose levels. Nativity and time in the United States modified the association between SSS and Ideal smoking. Conclusions Subjective measures of social status can enhance an understanding of CVH among Hispanic/Latino people. Future studies should explore the stability of SSS over time in comparison with objective social status and the mechanisms through which SSS may influence CVH.

The Role of Family Health History in Predicting Midlife Chronic Disease Outcomes.

INTRODUCTION: The generational relevance for determining disease risk for the leading causes of morbidity and mortality for U.S. adults is a source of debate. METHODS: Data on 12,300 adults (Add Health Study Members) participating in Wave V (2016-2018) of the National Longitudinal Study of Adolescent to Adult Health (also known as Add Health) were merged with data from respondents' parents (n=2,013) participating in the Add Health Parent Study (2015-2017). Analyses beginning in January 2020 examined the concordance in lifetime occurrence of chronic conditions across 4 generations, including cardiovascular disease, diabetes, hypertension, hyperlipidemia, obesity, cancer, and depression and examined the associations between individual disease history and ones' family health history for the same condition. RESULTS: Mean ages were 37.4 years for Add Health Study Members and 62.9 years for Add Health Parent Study mothers. The histories of mothers from the Add Health Parent Study on hyperlipidemia (AOR=1.61, 95% CI=1.04, 2.48), obesity (AOR=1.77, 95% CI=1.27, 2.48), and depression (AOR=1.87, 95% CI=1.19, 2.95) were significantly associated with increased odds of Add Health Study Member report of these conditions. Maternal great grandparent hyperlipidemia history was significantly associated with the Add Health Study Member hyperlipidemia (AOR=2.81, 95% CI=1.51, 5.21). Histories of diabetes in maternal grandfather (AOR=2.41, 95% CI=1.24, 4.69) and maternal great grandparent (AOR=3.05, 95% CI=1.45, 6.43) were significantly associated with Add Health Study Member diabetes. Each additional point in the Add Health Parent Study mothers' cardiometabolic risk factor index was associated with an 11% increase (incidence rate ratio=1.11, 95% CI=1.04, 1.19) in the expected count of cardiometabolic risk conditions for the Add Health Study Members. CONCLUSIONS: Multigenerational health histories have value for quantifying the probability of diabetes, obesity, depression, and hyperlipidemia in early mid-adulthood. Family health history knowledge is relevant for health promotion and disease prevention strategies.

Current Smoking Raises Risk of Incident Hypertension: Hispanic Community Health Study-Study of Latinos.

BACKGROUND: Hypertension has been implicated as a smoking-related risk factor for cardiovascular disease but the dose-response relationship is incompletely described. Hispanics, who often have relatively light smoking exposures, have been understudied in this regard. METHODS: We used data from a 6-year follow-up study of US Hispanic adults aged 18-76 to address the dose-response linking cigarette use with incident hypertension, which was defined by measured blood pressure above 140/90 mm Hg or initiation of antihypertensive medications. Adjustment was performed for potential confounders and mediators, including urinary albumin-to-creatinine ratio which worsened over time among smokers. RESULTS: Current smoking was associated with incident hypertension, with a threshold effect above 5 cumulative pack-years of smoking (vs. never smokers, hazard ratio for hypertension [95% confidence interval] of 0.95 [0.67, 1.35] for 0-5 pack-years, 1.47 [1.05, 2.06] for 5-10 pack-years, 1.40 [1.00, 1.96] for 10-20 pack-years, and 1.34 [1.09, 1.66] for ≥20 pack-years, P = 0.037). In contrast to current smokers, former smokers did not appear to have increased risk of hypertension, even at the highest cumulative pack-years of past exposure. CONCLUSIONS: The results confirm that smoking constitutes a hypertension risk factor in Hispanic adults. A relatively modest cumulative dose of smoking, above 5 pack-years of exposure, raises risk of hypertension by over 30%. The increased hypertension risk was confined to current smokers, and did not increase further with higher pack-year levels. The lack of a smoking-hypertension association in former smokers underscores the value of smoking cessation.

Comparing Methods from the National Cancer Institute vs Multiple Source Method for Estimating Usual Intake of Nutrients in the Hispanic Community Health Study/Study of Latino Youth.

BACKGROUND: The Multiple Source Method (MSM) and the National Cancer Institute (NCI) method estimate usual dietary intake from short-term dietary assessment instruments, such as 24-hour recalls. Their performance varies according to sample size and nutrients distribution. A comparison of these methods among a multiethnic youth population, for which nutrient composition and dietary variability may differ from adults, is a gap in the literature. OBJECTIVE: To compare the performance of the NCI method relative to MSM in estimating usual dietary intakes in Hispanic/Latino adolescents. DESIGN: Data derived from the cross-sectional population-based Hispanic Community Health Study/Study of Latino Youth, an ancillary study of offspring of participants in the adult Hispanic Community Health Study/Study of Latino Youth cohort. Dietary data were obtained by two 24-hour recalls. PARTICIPANTS/SETTING: One thousand four hundred fifty-three Hispanic/Latino youth (aged 8 to 16 years) living in four urban US communities (Bronx, NY; Chicago, IL; Miami, FL; and San Diego, CA) during 2012 through 2014. MAIN OUTCOME MEASURES: The NCI method and the MSM were applied to estimate usual intake of total energy, macronutrients, minerals and vitamins, added sugar, and caffeine. STATISTICAL ANALYSES: Mean, standard deviation, minimum and maximum values, coefficient of variation, variance ratio, and differences between NCI and MSM methods and the 2-day mean were estimated in several percentiles of the distribution, as well as concordance correlation coefficients and Bland-Altman plot analysis. RESULTS: The distributions of all nutrients studied were very similar between NCI and MSM. The correlation between NCI and MSM was >0.80 for all nutrients (P<0.001), except dietary cholesterol, vitamin C, and n-3 fatty acids. In individual estimations, NCI method predicted higher estimates and lower variance than the MSM. The lowest level of agreement was observed in the values at the tails of the distribution, and for nutrients with high variance ratio. CONCLUSIONS: Overall, both MSM and NCI method provided acceptable estimates of the usual intake distribution using 24-hour recall, and they better represented the usual intake compared with 2-day mean, correcting for intraindividual variability.

Like Parent, Like Child: Intergenerational Patterns of Cardiovascular Risk Factors at Midlife.

PURPOSE: We aimed to assess the prevalence of four cardiovascular risk factors (obesity, diabetes, excessive alcohol intake, and cigarette smoking) for parents and their adult children at the same approximate midlife age. We also evaluated associations of parents' cardiovascular risk factors, childhood health exposures, and social contexts (i.e., family, school, and neighborhood) during adolescence with adult children's cardiovascular health at midlife. METHODS: We used data from respondents at Wave V of the National Longitudinal Study of Adolescent to Adult Health who had corresponding parent (mostly mothers) data from Wave I. The final sample included 10,466 adult children with a mean age of 37.8 years. Descriptive statistics and logistic regression models were estimated, accounting for the National Longitudinal Study of Adolescent to Adult Health sampling design. RESULTS: At similar ages (i.e., 35-45 years) to their parents, adult children had higher rates of excessive drinking and obesity than their parents, lower rates of diabetes, and similar rates of smoking. Adult children's health largely converged and correlated with their parents' health at similar ages. Cardiovascular risks for adult children were also significantly associated with their childhood health exposures and social contexts during adolescence. Some associations varied with respect to the health status of parents at Wave I. CONCLUSIONS: The cardiovascular risk of parents at midlife is strongly associated with the cardiovascular risk of their adult children at midlife. The status of parents' health during adolescence can also modify the significance and magnitude of associations between childhood health exposures or adolescent social contexts and adult children's cardiovascular risk factors.

Physical activity, stress, and cardiovascular disease risk: HCHS/SOL Sociocultural Ancillary Study.

We assess whether the cross-sectional associations between moderate-vigorous physical activity (MVPA) and CVD risk factors are modified by various stress types. Complete baseline data from 4,000 participants, ages 18-74 years, of the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study (HCHS/SOL SCAS) were analyzed using complex survey design methods. Accelerometer-measured MVPA was assessed continuously (average minutes per day). CVD risk factors assessed were diabetes, hypercholesterolemia, hypertension, and obesity. Stress was assessed using the Chronic Burden Scale for chronic stress, Traumatic Stress Schedule for traumatic stress, and the Perceived Stress Scale for perceived stress. Poisson regression models estimated prevalence ratios of CVD risk factors. The interaction was evaluated by cross-product terms with p <0.10. There was a significant interaction between chronic stress and MVPA among those with prevalent diabetes (pinteraction = 0.09). Among those reporting low chronic stress, higher MVPA was associated with a low prevalence of diabetes, however among those reporting high chronic stress, the prevalence of diabetes remained high even with higher MVPA. We did not observe interactions between chronic stress and MVPA for the remaining CVD risk factors, or interactions between traumatic stress or perceived stress and MVPA. This study provides initial evidence on the role of chronic stress on the association between MVPA and diabetes for Hispanic/Latino adults. Mostly, however, chronic stress, traumatic stress, and perceived stress did not modify the associations between MVPA and CVD risk factors for Hispanic/Latino adults.

A longitudinal analysis of nondaily smokers: the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

PURPOSE: Nondaily smoking is increasing in the United States and common among Hispanic/Latino smokers. We characterized factors related to longitudinal smoking transitions in Hispanic/Latino nondaily smokers. METHODS: The Hispanic Community Health Study/Study of Latinos is a population-based cohort study of Hispanics/Latinos aged 18-74 years. Multinomial logistic regression assessed the baseline factors (2008-2011) associated with follow-up smoking status (2014-2017) in nondaily smokers (n = 573), accounting for complex survey design. RESULTS: After ∼6 years, 41% of nondaily smokers became former smokers, 22% became daily smokers, and 37% remained nondaily smokers. Factors related to follow-up smoking status were number of days smoked in the previous month, household smokers, education, income, and insurance. Those smoking 16 or more of the last 30 days had increased risk of becoming a daily smoker [vs. < 4 days; relative risk ratio (RRR) = 5.65, 95% confidence interval (95% CI) = 1.96-16.33]. Greater education was inversely associated with transitioning to daily smoking [>high school vs.

Accelerometer-assessed physical activity and incident diabetes in a population covering the adult life span: the Hispanic Community Health Study/Study of Latinos.

BACKGROUND: The association between accelerometer-assessed physical activity and risk of diabetes remains unclear, especially among US Hispanic/Latino adults who have lower levels of physical activity and a higher diabetes burden compared with other racial/ethnical populations in the country. OBJECTIVES: To examine the association between accelerometer-assessed physical activity and incident diabetes in a US Hispanic/Latino population. METHODS: We included 7280 participants of the Hispanic Community Health Study/Study of Latinos who aged 18-74 y and free of diabetes at baseline. Data on moderate-to-vigorous physical activity (MVPA) were collected using a 7-d accelerometer measurement. Incident diabetes was assessed after a mean ± SD of 6.0 ± 0.8 y using standard procedures including blood tests. RRs and 95% CIs of diabetes associated with MVPA were estimated using survey Poisson regressions. The associations of MVPA with 6-y changes in adiposity measures were also examined. RESULTS: A total of 871 incident cases of diabetes were identified. MVPA was inversely and nonlinearly associated with risk of diabetes (P-nonlinearity = 0.006), with benefits accruing rapidly at the lower end of MVPA range (<30 min/d) and leveling off thereafter. The association differed by population age (P-interaction = 0.006). Higher MVPA was associated with lower risk of diabetes among individuals older than 50 y (RRQ4 versus Q1 = 0.50; 95% CI: 0.35, 0.73; P-trend < 0.001) but not among younger individuals (RRQ4 versus Q1 = 0.98; 95% CI: 0.66, 1.47; P-trend = 0.92). An inverse association between MVPA and 6-y gain in waist circumference was also limited to the older group (P-interaction with age < 0.001). CONCLUSIONS: Among US Hispanic/Latino adults, baseline accelerometer-derived MVPA was inversely associated with incident diabetes only among individuals aged 50 y and older. Further studies are needed to confirm our findings and to clarify potential mechanisms underlying the possible age differences in the MVPA-diabetes association. This study was registered at clinicaltrials.gov as NCT02060344.

Occupational Exposures and Cardiac Structure and Function: ECHO-SOL (Echocardiographic Study of Latinos).

Background Our objective was to determine associations of occupational exposures with cardiac structure and function in Hispanic/Latino adults. Methods and Results Employed participants were included (n=782; 52% women, mean age 52.9 years). Occupational exposures to burning wood, vehicle exhaust, solvents, pesticides, and metals at the current and longest-held job were assessed by questionnaire. Survey multivariable linear regression analyses were used to model the relationship of each self-reported exposure with echocardiographic measures of cardiac structure and function. Exposure to burning wood at the current job was associated with decreased left ventricular (LV) ejection fraction (-3.1%; standard error [SE], 1.0 [P=0.002]). When the analysis was restricted to exposure at the longest-held job, occupational exposure to burning wood was associated with increased LV diastolic volume (6.7 mL; SE, 1.6 [P<0.0001]), decreased LV ejection fraction (-2.7%; SE, 0.6 [P<0.0001]), worse LV global longitudinal strain (1.0%; SE, 0.3 [P=0.0009]), and decreased right ventricular fractional area change (-0.02; SE, 0.004 [P<0.001]). Exposure to pesticides was associated with worse average global longitudinal strain (0.8%; SE, 0.2 [P<0.0001]). Exposure to metals was associated with worse global longitudinal strain in the 2-chamber view (1.0%; SE, 0.5 [P=0.04]), increased stroke volume (3.6 mL; SE, 1.6 [P=0.03]), and increased LV mass indexed to BSA (9.2 g/m2; SE, 3.8 [P=0.01]) or height (4.4 g/m2.7; SE, 1.9 [P=0.02]). Conclusions Occupational exposures to burning wood, vehicle exhaust, pesticides, and metals were associated with abnormal parameters of LV and right ventricular systolic function. Reducing exposures to toxic chemicals and particulates in the workplace is a potential opportunity to prevent cardiovascular disease in populations at risk.