Lifestyle Behavioral Factors and Integrative Successful Aging Among Puerto Ricans Living in the Mainland United States.

BACKGROUND: Few studies have assessed multidimensional models for predicting successful aging that incorporate both physical and cognitive-psychosocial elements among minority populations. This study aimed to establish a comprehensive lifestyle behavioral factors (cLBF) score and an integrative successful aging (ISA) score and explore their associations among older Puerto Rican adults. METHODS: Data were assessed from 889 adults (45-75 years) participating in the longitudinal (baseline and 2-year follow-up) Boston Puerto Rican Health Study. Higher cLBF score (range 0-10) indicates healthier behaviors (nonsmoking, lack of sedentarism, physical activity, high diet quality, and adequate sleep). The physical domain score of ISA included 8 components (functional impairment, hypertension, diabetes, cancer, cardiovascular disease, respiratory disease, arthritis, osteoporosis) and ranged 0-11. The cognitive-psychosocial domain of ISA included 5 components (cognitive impairment, depressive symptoms, social support, perceived stress, and self-rated health) and ranged 0-10. The sum of both domains comprised the ISA score, ranging 0-21. Higher scores of ISA and its domains indicate more successful aging. RESULTS: At 2 years, the mean ± SD of cLBF score was 4.9 ± 1.8, and ISA was 10.1 ± 3.3. In multivariable-adjusted models, cLBF score was significantly and positively associated with 2-year change in overall ISA (ß [95% CI]: 0.15 [0.07, 0.24] points), in physical domain (0.09 [0.04, 0.13] points), and in cognitive-psychosocial domain (0.08 [0.02, 0.14] points). CONCLUSIONS: Maintaining healthier lifestyle behaviors may contribute to successful aging through both physical and cognitive-psychosocial domains. The results support using a multidimensional definition of successful aging in Puerto Ricans and evaluating it in other populations.

The Mediterranean Diet and 2-Year Change in Cognitive Function by Status of Type 2 Diabetes and Glycemic Control.

OBJECTIVE: To determine associations of a Mediterranean diet score (MeDS) with 2-year change in cognitive function by type 2 diabetes and glycemic control status and contrast it against other diet quality scores. RESEARCH DESIGN AND METHODS: We used data from the longitudinal Boston Puerto Rican Health Study (n = 913; 42.6% with type 2 diabetes at 2 years). Glycemic control at baseline was categorized as uncontrolled (hemoglobin A1c ≥7% [53 mmol/mol]) versus controlled. Two-year change in glycemic control was defined as stable/improved versus poor/declined. We defined MeDS, Healthy Eating Index, Alternate Healthy Eating Index, and Dietary Approaches to Stop Hypertension scores. Adjusted mixed linear models assessed 2-year change in global cognitive function z score, executive and memory function, and nine individual cognitive tests. RESULTS: Higher MeDS, but no other diet quality score, was associated with higher 2-year change in global cognitive function in adults with type 2 diabetes (ß ± SE = 0.027 ± 0.011; P = 0.016) but not in those without (P = 0.80). Similar results were noted for Mini-Mental State Examination, word recognition, digit span, and clock drawing tests. Results remained consistent for individuals under glycemic control at baseline (0.062 ± 0.020; P = 0.004) and stable/improved over 2 years (0.053 ± 0.019; P = 0.007), but not for individuals with uncontrolled or poor/declined glycemic control. All diet quality scores were associated with higher 2-year memory function in adults without type 2 diabetes. CONCLUSIONS: Both adhering to a Mediterranean diet and effectively managing type 2 diabetes may support optimal cognitive function. Healthy diets, in general, can help improve memory function among adults without type 2 diabetes.

Lifestyle Cardiovascular Risk Score, Genetic Risk Score, and Myocardial Infarction in Hispanic/Latino Adults Living in Costa Rica.

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.

A Healthy Lifestyle Score Is Associated with Cardiometabolic and Neuroendocrine Risk Factors among Puerto Rican Adults.

BACKGROUND: Although individual healthy lifestyle behaviors may reduce cardiovascular disease risk, few studies have analyzed the combined effect of multiple lifestyle components as one all-inclusive measure on such outcomes, much less in minority populations. OBJECTIVE: We aimed to develop a Healthy Lifestyle Score (HLS) that included several lifestyle recommendations and to test its association with metabolic syndrome (MetS) and allostatic load (AL) and their cardiometabolic and neuroendocrine factors in Puerto Ricans. METHODS: In a cross-sectional study in 787 Puerto Ricans living in Boston (aged 45-75 y), we developed an HLS that ranged from 0 to 190 (higher score indicative of healthier lifestyle) and included 5 components (diet, physical activity and sedentary behaviors, smoking, social support and network, and sleep). Multivariable-adjusted models were used to test associations between the HLS and biomarkers of dysregulation and odds of MetS and high AL (≥4 out of 10 components). RESULTS: The HLS showed adequate internal consistency (ρ = 0.31-0.69) and was inversely associated with urinary cortisol (ß ± SE = -0.22 ± 0.11; P = 0.042), epinephrine (-0.20 ± 0.09; P = 0.017), and norepinephrine (-0.26 ± 0.11; P = 0.016); waist circumference (-0.014 ± 0.004; P = 0.003); and serum insulin (-0.30 ± 0.13; P = 0.028) and positively associated with plasma HDL cholesterol (0.007 ± 0.003; P = 0.021) after adjustment for potential confounders. For each 20-unit increase in HLS, participants had 19% (95% CI: 2%, 33%) and 25% (11%, 36%) lower odds of MetS or AL, respectively. Healthier scores for social support and network and smoking components were associated with lower odds of high AL (P < 0.005). No significant associations were observed for other individual lifestyle components. CONCLUSIONS: Following an overall healthy lifestyle that comprises a combination of multiple behaviors may provide stronger protection against MetS and AL in Puerto Rican adults than individual components. The HLS may be a useful tool for examining health-related outcomes. This trial was registered at clinicaltrials.gov as NCT01231958.

[Impact of apolipoprotein A5 on cardiovascular risk. Genetic and environmental modulation]. / Impacto de la apolipoproteína A5 en el riesgo cardiovascular. Modulaciones genéticas y ambientales.

Triglyceride concentrations are an independent risk factor for coronary heart disease. Apolipoprotein A5 gene (APOAS) has an important role determining triglyceride metabolism and it is a potential cardiovascular risk. However the mechanisms for these actions are not well-known. Despite the different allelic frequency of its major polymorphisms in different populations, multiple studies have shown consistent associations between these variants and fasting triglycerides. Variations in the APOA5 gene have also been associated with postprandial triglycerides, as well as with different sizes of lipoproteins and other markers. Moreover, some of the APOA5 gene variants have been associated with ischemic heart disease, stroke, and carotid intima media thickness, although the references on this issue are scanty and contradictory. This may be due to the presence of gene-environment interactions that have been poorly studied until now. Among the few studies that have examined the influence of environmental factors on possible genetic variations, the most important are those that contemplate possible gene-diet interactions. However, the evidence is still scarce and more research is required in the field of nutrigenomics. To understand the impact of this gene on cardiovascular disease, we review the genetic functionality and variability of APOA5, its associations with intermediate and final phenotypes and gene-environment interactions detected.

Impacto de la apolipoproteína A5 en el riesgo cardiovascular: Modulaciones genéticas y ambientales / Impact of apolipoprotein A5 on cardiovascular risk: Genetic and environmental modulation

Triglyceride concentrations are an independent risk factor for coronary heart disease. Apolipoprotein A5 gene (APOA5) has an important role determining triglyceride metabolism and it is a potential cardiovascular risk. However the mechanisms for these actions are not well-known. Despite the different allelic frequency of its major polymorphisms in different populations, multiple studies have shown consistent associations between these variants and fasting triglycerides. Variations in the APOA5 gene have also been associated with postprandial triglycerides, as well as with different sizes of lipoproteins and other markers. Moreover, some of the APOA5 gene variants have been associated with ischemic heart disease, stroke, and carotid intima media thickness, although the references on this issue are scanty and contradictory. This may be due to the presence of gene-environment interactions that have been poorly studied until now. Among the few studies that have examined the infuence of environmental factors on possible genetic variations, the most important are those that contemplate possible gene-diet interactions. However, the evidence is still scarce and more research is required in the feld of nutrigenomics. To understand the impact of this gene on cardiovascular disease, we review the genetic functionality and variability of APOA5, its associations with intermediate and fnal phenotypes and gene-environment interactions detected.