Impacts of mid- to later childhood body build, social circumstance and blood pressure on early-adult arterial stiffness in different ethnic groups

OBJECTIVE: Arterial stiffness, measured as aortic pulse wave velocity [PWV], is a powerful prognostic indicator for cardiovascular events, displacing blood pressure (BP). Little is known of its determinants. We tested how factors measured twice previously in childhood in the MRC ‘DASH’ study, particularly body mass (BMI) components and BP, affected PWV in young adults. DESIGN AND METHODS: Of 6643 London children, aged 11-13y, from 51 schools in samples of about 1000 in 6 ethnic groups, 4785 (72% of the cohort), were seen again at 14-16y. In 2013, 666 (97% of invited) took part in a young-adult pilot (21-23y). With psychosocial, anthropometric and BP measures, PWV was recorded via an upper arm cuff on the calibrated Arteriograph device. RESULTS: PWV reproducibility was excellent, with mean differences across 3 x 6-8 cardiac cycles each of -0.06, 0.03 and 0.06 m/sec. Unadjusted PWVs in Caribbean-origin and White UK young men were similar (mean+SD 7.9+0.3 vs 7.6 +0.4 m/sec) and lower in other groups at similar SBPs (120mmHg), BMIs (24.6kg/m2) and waists (84.3cm). In full regression models, while Caribbean (higher BMIs and waists), African and Indian young women had lower PWV (by 0.5-0.8, 95%CI 0.1-1.1,m/sec) than did white UK women (6.9+0.2), values were still increased by age, BP, a powerful impact from waist/height, with a racism effect (+0.4m/sec) in women. Childhood effects of waist/hip were also detectable. CONCLUSION: Even by young adulthood, increased waist/height ratios, BP and psychosocial variables such as perceived racism were independent determinants of arterial stiffness, likely to increase with age.

Racism triggers smoking in British ethnic minority adolescents: evidence from the determinants of young adult social wellbeing and health (DASH) longitudinal study

OBJECTIVE: Racism may have a negative impact on the health behaviours in adolescence, however there were few longitudinal studies. We examined the impact of perceived racism on smoking in an ethnically diverse sample of adolescents in the UK, and potential modifying factors. DESIGN AND METHODS: In 2002/03, 6643 11-13 year olds in London, ~80% ethnic minorities, participated in the baseline survey. In 2005/06 4,782 were followed-up. In 2012-14 665 took part in a pilot follow-up aged 21-23y, including 42 qualitative interviews. Measures of socio- economic and psychosocial factors and health were collected. RESULTS: Ethnic minority adolescents were more likely to report racism compared with White British, but smoking was generally lower. Reported racism in adolescence was associated with having ever smoked (e.g. males Odds Ratio 2.20, 95% CI 1.59-3.02), and with smoking initiation (males 4.09, 2.45-6.83). Smoking initiation was greatest among Black Caribbeans. Attendance to a place of worship, being a Muslim and a good parent-child relationship were independent protective factors. Qualitative interviews supported evidence for reported racism as well as protective factors including increasing ethnic diversity, a sense of identity and belonging, supportive parenting, high aspirations, and religious faith. CONCLUSIONS: This is the first UK study to show the negative impact of racism on smoking in adolescence, regardless of ethnic origin. Religious involvement and parenting may provide social support and reinforce cultural and religious values which may prevent the uptake of harmful health behaviours such as smoking. This has implications for health promotion among young people of all ethnicities.

Decline in, and lack of difference between, average birth weights among African and Portuguese babies in Portugal.

BACKGROUND: In preliminary data in Portugal, we found that African babies of migrant mothers were heavier than White Portuguese babies born in Lisbon. We investigate whether this pattern is replicated in the national data, and in addition the trends in birth weight in these groups. DESIGN AND SETTING: Births registered between 1995 and 2002 classified by reported nationality of mothers. PARTICIPANTS: 849,595 Portuguese births ('Portuguese' nationality, predominantly of European descent) and 22,463 African births ('Angola', 'Cape Verde', or 'Guinea Bissau, Republic of Guinea or Equatorial Guinea' nationality, predominantly of African origin). RESULTS: Among Portuguese births, there was a decline in births to teenaged mothers and an increase to mothers aged >or=35 years, with >9 years of education or in a non-manual class, but among African births there was an increase in births to teenaged mothers and a decline to mothers from advantaged socioeconomic backgrounds. Using the Wilcox-Russell method, overall mean birth weights of term Portuguese (3,303, SD 424 g) and African (3297, SD 441 g) babies were not different but the percentage of small preterm births was higher among African (4.7%) than among Portuguese (2.9%) births. Between 1995 and 2002, mean birth weight of term Portuguese babies declined by 58 g (3,334-3,276 g) and of African babies by 57 g (3,341-3,284 g). The left shift of the birth weight distributions was independent of maternal age, parity, and social factors among Portuguese babies, but among African babies the decrease appeared to be associated with socioeconomic advantage. CONCLUSION: There has been a downward trend in birth weights in Portugal among both Portuguese and African term births, but average birth weights of the two groups were similar.