Associations between diet and cardiometabolic risk among Yup'ik Alaska Native people using food frequency questionnaire dietary patterns.

BACKGROUND AND AIMS: In previous analyses, we identified three dietary patterns from food frequency questionnaire data among a sample of Yup'ik Alaska Native people living in Southwest Alaska: a "subsistence foods" dietary pattern and two market-based dietary patterns "processed foods" and "fruits and vegetables". In this analysis, we aimed to characterize the association between the dietary patterns and cardiometabolic (CM) risk factors (lipids, blood pressure, glucose, adiposity). METHODS AND RESULTS: We used multilevel linear regression to estimate the mean of each CM risk factor, comparing participants in the 4th to the 1st quartile of each dietary pattern (n = 637). Models were adjusted for age, sex, past smoking, current smoking, and physical activity. Mean log triglyceride levels were significantly higher among participants in the 4th compared to the 1st quartile of the processed foods dietary pattern (ß = 0.11). Mean HbA1c percent was significantly lower (ß = -0.08) and mean diastolic blood pressure (DBP) mm Hg was significantly higher (ß = 2.87) among participants in the 4th compared to the 1st quartile of the fruits and vegetables dietary pattern. Finally, mean log triglyceride levels and mean DBP mm Hg were significantly lower among participants in the 4th compared to the 1st quartile of the subsistence foods dietary pattern (ß = -0.10 and ß = -3.99 respectively). CONCLUSIONS: We found increased CM risk, as reflected by increased triglycerides, associated with eating a greater frequency of processed foods, and reduced CM risk, as reflected by lower triglycerides and DBP, associated with eating a greater frequency of subsistence foods.

Which measure of adolescent psychiatric disorder--diagnosis, number of symptoms, or adaptive functioning--best predicts adverse young adult outcomes?

OBJECTIVE: To test the ability of psychiatric diagnosis, symptom count, and adaptive functioning in adolescence to predict failure to complete secondary school and criminal involvement in young adulthood. DESIGN: Community-based cohort study. SETTING: Two counties in upstate New York, USA. PARTICIPANTS: 181 adolescents interviewed in 1983 and 1985-86 who were randomly selected in 1975 from a probability area sampling of representative families with 1-10 year old children. MAIN RESULTS: Compared with adolescents without psychiatric disorders, adolescents with depressive, anxiety, disruptive, and substance abuse disorders were 2.86-9.21 times more likely to fail to complete secondary school. Compared with adolescents without disruptive disorders, adolescents with disruptive disorders were 4.04 (1.96-8.32) times more likely to get in trouble with police during young adulthood. The positive predictive value of each measure of adolescent psychiatric disorder for school non-completion was higher in the lowest SES stratum and for young adult criminal involvement was higher for boys. Combining knowledge of symptom counts, age, gender, and social class in a logistic regression model yielded 89% sensitivity and 87% specificity for predicting future school non-completion at the p >or= 0.13 cut off. The optimal cut off value in a model incorporating knowledge of disruptive symptoms and demographic characteristics yielded 75% sensitivity and 76% specificity for predicting future criminal involvement. CONCLUSIONS: Screening children and adolescents for psychiatric disorders can identify those at high risk of adverse young adult outcomes. Future school and community adjustment can be predicted as easily and accurately on the basis of a simple count of psychiatric symptoms as by applying more complex diagnostic algorithms. Screening youth for psychiatric symptoms in neighbourhood, school, or primary care settings is a logical first step for early intervention to promote increased school completion and decreased criminal activity in young adulthood.