Reported organic food consumption and metabolic syndrome in older adults: cross-sectional and longitudinal analyses.

PURPOSE: Examine cross-sectional and longitudinal relationships between organic food consumption, metabolic syndrome (MetS), and its components among older adults. METHODS: Respondents of the 2012 Health and Retirement Study (HRS), and Health Care and Nutrition Study (HCNS) were included in this study. Organic food consumption was measured with a crude binary question asking about past-year consumption (yes/no). Cross-sectional analyses were conducted with 6,633 participants (mean (SE) age, 65.5 (0.3) years). Longitudinal analyses were conducted with a subset of 1,637 respondents who participated in the HRS Venous Blood Study (mean (SE) age, 63.8 (0.4) years). Hemoglobin A1C and high-density lipoprotein cholesterol were assessed using dried blood spots at baseline. Glucose, high-density lipoprotein cholesterol, and triglycerides were assessed using fasting blood samples collected 4 years after baseline. Waist circumference and blood pressure were measured at baseline and follow-up. Logistic and linear regressions were used to assess the associations between organic food consumption, MetS, and its components. RESULTS: Any organic food consumption over the previous year was reported among 47.4% of cross-sectional and 51.3% of longitudinal participants. Unadjusted models showed inverse cross-sectional associations between organic food consumption and waist circumference, blood pressure, and hemoglobin A1C, and positive longitudinal association with high-density lipoprotein cholesterol. No significant associations were detected in the fully adjusted models. CONCLUSIONS: No association was observed between organic food consumption and MetS among older adults after adjusting for confounders. Future studies with a precise definition, quantitative assessment of the consumption, and duration of organic food consumption, together with pesticides biomarkers, are warranted.

Organic food consumption is associated with inflammatory biomarkers among older adults.

OBJECTIVE: The association between organic food consumption and biomarkers of inflammation, C-reactive protein (CRP) and cystatin C (CysC) was explored in this cross-sectional analysis of older adults. DESIGN: Dietary data and organic food consumption was collected in 2013 from a FFQ. Alternative Mediterranean diet score (A-MedDiet) was calculated as a measure of healthy eating. Biomarkers CRP and CysC were collected in serum or plasma in 2016. We used linear regression models to assess the associations between organic food consumption and CRP and CysC. SETTING: This cross-sectional analysis uses data from the nationally representative, longitudinal panel study of Americans over 50, the Health and Retirement Study. PARTICIPANTS: The mean age of the analytic sample (n 3815) was 64·3 (se 0·3) years with 54·4 % being female. RESULTS: Log CRP and log CysC were inversely associated with consuming organic food after adjusting for potential confounders (CRP: ß = -0·096, 95 % CI 0·159, -0·033; CysC: ß = -0·033, 95 % CI -0·051, -0·015). Log CRP maintained statistical significance (ß = -0·080; 95 % CI -0·144, -0·016) after additional adjustments for the A-MedDiet, while log CysC lost statistical significance (ß = -0·019; 95 % CI -0·039, 0·000). The association between organic food consumption and log CRP was driven primarily by milk, fruit, vegetables and cereals, while log CysC was primarily driven by milk, eggs and meat after adjustments for A-MedDiet. CONCLUSIONS: These findings support the hypothesis that organic food consumption is inversely associated with biomarkers of inflammation CRP and CysC, although residual confounding by healthy eating and socioeconomic status cannot be ruled out.

Sleep disturbance as a moderator of the association between physical activity and later pain onset among American adults aged 50 and over: evidence from the Health and Retirement Study.

OBJECTIVE: To examine whether sleep disturbance modifies the association between physical activity and incident pain. DESIGN: Prospective population-based study. SETTING: Health and Retirement Study. PARTICIPANTS: American adults aged ≥50 years who reported no troublesome pain in 2014 were re-assessed for pain in 2016. Of 9828 eligible baseline respondents, 8036 (82%) had complete follow-up data for adjusted analyses (weighted analysis population N=42 407 222). EXPOSURES: Physical activity was assessed via interview with questions about time spent in moderate and vigorous physical activity. Sleep disturbance, assessed using a modified form of the Jenkins Sleep Scale, was examined as a potential moderator. MAIN OUTCOME MEASURE: Troublesome pain. RESULTS: In weighted analyses, 37.9% of the 2014 baseline pain-free sample participated in moderate or vigorous physical activity once a week or less, with an overall mean Physical Activity Index Score of 9.0 (SE=0.12). 18.6% went on to report troublesome pain in 2016. Each one-point higher on the Physical Activity Index Score was associated with a reduced odds ratio (OR) of incident pain for those who endorsed sleep disturbance never/rarely (OR=0.97, 95% CI 0.94 to 0.99), but not for those who endorsed sleep disturbance sometimes (OR=0.99, 95% CI 0.97 to 1.01) or most of the time (OR=1.01, 95% CI 0.99 to 1.03). The analysis of possible interaction demonstrated that frequency of sleep disturbance moderated the physical activity and incident pain association (Wald test: p=0.02). CONCLUSIONS: The beneficial association of physical activity on reduced likelihood of later pain was only observed in persons who endorsed low levels of sleep disturbance.

Specialty-Based Variability in Diagnosing and Managing Heart Failure With Preserved Ejection Fraction.

OBJECTIVE: To quantify differences in the diagnosis and treatment of heart failure with preserved ejection fraction (HFpEF) between cardiologists and noncardiologists, who often diagnose and manage HFpEF. METHODS: Cardiologists and noncardiologists (internal medicine, medicine/pediatrics, family medicine, geriatrics) were anonymously surveyed between January 16, 2018, and March 2, 2018, regarding practices related to diagnosing and managing HFpEF at the University of Michigan and Weill Cornell Medical Center. Response data were compared using χ2 analysis. RESULTS: Of 1010 physicians surveyed, 211 completed a significant portion of the survey: 32 cardiologists and 179 noncardiologists. Most noncardiologists were unaware of HFpEF diagnostic guidelines and commonly used left ventricular diastolic dysfunction and natriuretic peptides to diagnose HFpEF. Noncardiologists (32.3%, n=52) were less likely than cardiologists (64.5%, n= 20) to prescribe an aldosterone antagonist for HFpEF (P=.001). Both groups reported similar use of ß-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and exercise programs. Noncardiologists were more likely to refer patients with HFrEF to cardiology (63.1%, n=111) compared with patients with HFpEF (33.5%, n=59; P<.001). Noncardiologists were more likely to discuss prognosis and goals of care with patients with HFrEF (84.4%, n=151) than with patients with HFpEF (65.9%, n=118; P<.001). CONCLUSION: Cardiologists and noncardiologists vary significantly in their HFpEF diagnosis and treatment practices. As diagnostic criteria continue to be evaluated for HFpEF, dissemination of these guidelines to noncardiologists, with an emphasis on the morbidity and mortality associated with HFpEF, is imperative.

Sleep, Diet, and Cardiometabolic Health Investigations: a Systematic Review of Analytic Strategies.

PURPOSE OF REVIEW: Poor sleep is a risk factor for cardiometabolic morbidity. The relationship of sleep and cardiometabolic health could be confounded, mediated, or modified by diet, yet the incorporation of diet in sleep-cardiometabolic health studies is inconsistent. This rapid systematic literature review evaluates the conceptualization of diet as a confounder, mediator, or effect modifier within sleep-cardiometabolic health investigations, and the statistical approaches utilized. RECENT FINDINGS: Of 4692 studies identified, 60 were retained (28 adult, 32 pediatric). Most studies included diet patterns, quality, or energy intake as confounders, while a few examined these dietary variables as mediators or effect modifiers. There was some evidence, mostly in pediatric studies, that inclusion of diet altered sleep-cardiometabolic health associations. Diet plays a diverse role within sleep-cardiometabolic health associations. Investigators should carefully consider the conceptualization of diet variables in these relationships and utilize contemporary statistical approaches when applicable.