Red meat consumption, incident CVD and the influence of dietary quality in the Jackson Heart Study.

OBJECTIVES: We investigated the prospective associations between meat consumption and CVD and whether these relationships differ by dietary quality among African American (AA) adults. DESIGN: Baseline diet was assessed with a regionally specific FFQ. Unprocessed red meat included beef and pork (120 g/serving); processed meat included sausage, luncheon meats and cured meat products (50 g/serving). Incident total CVD, CHD, stroke and heart failure were assessed annually over 9·8 years of follow-up. We characterised dietary quality using a modified Healthy Eating Index-2010 score (m-HEI), excluding meat contributions. SETTING: Jackson, MS, USA. PARTICIPANTS: AA adults (n 3242, aged 55 y, 66 % female). RESULTS: Mean total, unprocessed red and processed meat intakes were 5·7 ± 3·5, 2·3 ± 1·8 and 3·3 ± 2·7 servings/week, respectively. Mostly, null associations were observed between meat categories and CVD or subtypes. However, greater intake of unprocessed red meat (three servings/week) was associated with significantly elevated risk of stroke (hazard ratio = 1·43 (CI: 1·07,1·90)). With the exception of a more positive association between unprocessed meat consumption and stroke among individuals in m-HEI Tertile 2, the strength of associations between meat consumption categories and CVD outcomes did not differ by m-HEI tertile. In formal tests, m-HEI did not significantly modify meat-CVD associations. CONCLUSIONS: In this cohort of AA adults, total and processed meat were not associated with CVD outcomes, with the exception that unprocessed red meat was related to greater stroke risk. Dietary quality did not modfiy these associations. Research is needed in similar cohorts with longer follow-up and greater meat consumption to replicate these findings.

Protein Intake and Long-term Change in Glomerular Filtration Rate in the Jackson Heart Study.

OBJECTIVE: Dietary protein intake could have deleterious renal effects in populations at risk for chronic kidney disease. Here, we examined whether higher protein intake (≥80th percentile of energy from protein) is associated with decline in kidney function and whether this decline varies by diabetes status. DESIGN: Observational cohort study. SUBJECTS AND SETTINGS: Participants were African-Americans (n = 5,301), who enrolled in the Jackson Heart Study between 2000 and 2004. METHODS: Dietary intake was assessed using a validated food-frequency questionnaire at baseline, and serum creatinine was measured at baseline (visit 1) and 8 years later (visit 3). Estimated glomerular filtration rates (eGFRs) at baseline and follow-up were computed using the chronic kidney disease epidemiology collaboration equation. MAIN OUTCOME MEASURE: The change in eGFR was computed by subtracting eGFR at visit 1 from that at visit 3. RESULTS: Of 3,165 participants with complete data, 64% were women, 57% had hypertension, and 19% had diabetes. The median (25th, 75th percentile) percent energy intake from protein was 14.3 (12.4, 16.4), comparable to that reported for the general US population (15% of energy). During a median (25th, 75th percentile) follow-up of 8.0 (7.4, 8.3) years, eGFR declined by 10.5% from a mean (SD) of 97.4 (17.5) to 86.9 (21.3) mL/min/1.73 m2. In the fully adjusted model, consumption of protein as percent of energy intake in lowest and highest quintiles was associated with decline in eGFR among diabetic subjects. The analysis of variance with a robust variance estimator was used to determine whether long-term change in eGFR significantly varies by protein intake. CONCLUSIONS: Our results show that, among African-Americans with diabetes, higher protein intake as a percent of total energy intake is positively associated with greater decline in eGFR in analyses that accounted for risk factors for kidney disease.

Pedometer determined physical activity tracks in African American adults: the Jackson Heart Study.

BACKGROUND: This study investigated the number of pedometer assessment occasions required to establish habitual physical activity in African American adults. METHODS: African American adults (mean age 59.9 ± 0.60 years; 59 % female) enrolled in the Diet and Physical Activity Substudy of the Jackson Heart Study wore Yamax pedometers during 3-day monitoring periods, assessed on two to three distinct occasions, each separated by approximately one month. The stability of pedometer measured PA was described as differences in mean steps/day across time, as intraclass correlation coefficients (ICC) by sex, age, and body mass index (BMI) category, and as percent of participants changing steps/day quartiles across time. RESULTS: Valid data were obtained for 270 participants on either two or three different assessment occasions. Mean steps/day were not significantly different across assessment occasions (p values > 0.456). The overall ICCs for steps/day assessed on either two or three occasions were 0.57 and 0.76, respectively. In addition, 85 % (two assessment occasions) and 76 % (three assessment occasions) of all participants remained in the same steps/day quartile or changed one quartile over time. CONCLUSION: The current study shows that an overall mean steps/day estimate based on a 3-day monitoring period did not differ significantly over 4 - 6 months. The findings were robust to differences in sex, age, and BMI categories. A single 3-day monitoring period is sufficient to capture habitual physical activity in African American adults.

Comparison and predicted equation of energy expenditure during walking or running among Caucasians, African Americans and Asians.

Knowledge of measured energy expenditure (EE) during walking and running is important for exercise prescription. Further, research on the EE comparison and EE predicted equation during walking or running among different ethnicities is limited. The purpose of the current study was to compare EE to walk or run 1 mile in Caucasian, African American and Asian adults and to develop a regression equation to predict EE to walk or run 1 mile. Two hundred and twenty-four participants were included (71 Caucasians, 68 African Americans and 85 Asians) with 3 groups (normal weight walking, overweight walking and running). EE was measured via indirect calorimetry. Analysis of variance was used to compare EE across groups. Multiple regression analysis was employed for EE prediction, and the prediction equation was cross-validated. A significant EE difference was found between walking and running among three ethnicities. The prediction equation was: EE â€‹= â€‹0.978 Body Weight - 4.571 Gender (male=1; female=2) â€‹+ â€‹3.524 Ethnicities (Caucasians=1, African Americans=2, Asians=3) â€‹+ â€‹32.447 (standard error of estimate=12.5 â€‹kcal·mile-1). The equation was valid through cross-validation, so it is recommended to apply for calculating EE during walking or running 1 mile among Caucasians, African Americans and Asians.

Prediction and Cross-validation of an Energy Expenditure Equation in Walking or Running in Asian Adults.

The prevalence of obesity is increasing across the world. Knowledge of the actual energy expenditure (EE) of walking and running can lead to a more precise exercise prescription which may contribute to obesity reduction or avoidance. Limited research has focused on EE prediction during walking or running in Asian adults. So, the aims of this study included developing an EE prediction equation and cross-validating the equation for Asian adults. METHODS: A total of 85 Asians participated to test EE through indirect calorimetry. Linear regression analysis was employed for EE prediction, and a dependent t-test and Chow statistical test were used to cross-validate the equation. RESULTS: Predicting EE during walking or running, corrected for one mile, yielded the following equation: EE = 0.933 * (Body Weight) - 4.127 * Gender (M = 1, F = 2) + 44.256 (standard error of estimate, SEE = 12.1 kcal·mile-1). A dependent t-test revealed no significant difference between measured EE (101.4 ± 4.3 kcal) and predicted EE (100.0 ± 2.8 kcal) (p = 0.546). Also, the coefficients for body weight and gender between the development prediction equation and the predicted equation in the cross-validation group were not significantly different (p = 0.365). CONCLUSION: The cross-validation results supported the validity of our predicted equation in Asians. In a practical field setting, exercise professionals could apply this equation for assessing EE during walking or running, corrected for one mile, in normal weight (body fat percentage ≤ 22 for males, ≤ 35 for females) and overweight (body fat percentage > 22 for males, > 35 for females) Asian adults.

Physical activity and obesity in African Americans: the Jackson Heart Study.

OBJECTIVES: To better understand how obesity and low levels of physical activity (PA) contribute to racial health disparities, we examined the association of PA domains (work, home life, and leisure) with indicators of socioeconomic status and markers of obesity in African Americans. METHODS: These cross sectional analyses of interview and clinical measures from the baseline visit of the Jackson Heart Study of cardiovascular disease (CVD) in African Americans of the Jackson, Mississippi metropolitan statistical area included 3,174 women and 1,830 men aged 21-95 years. The main measures were active living, sport, work, home life, and total PA scores; participation in regular moderate or vigorous intensity leisure physical activity (MVLPA); demographics, body mass index (BMI), waist circumference (WC) and CVD risk factors. RESULTS: The sample was 63% female, 81% high school or college graduates, with 51% aged 45-64 years, and mostly overweight (32%) or obese (53%). Women were less active than men in all domains except home life. Total PA was inversely associated with WC in women and men. The overweight (BMI 25-29.9) group was most active in all domains except work; active living and sport PA and prevalence of MVLPA then declined in a dose response association with increasing BMI. Work PA was associated with the lowest BMI but otherwise with indicators of less favorable socioeconomic status and health. CONCLUSIONS: Observed differences in PA in African Americans by domain and association with obesity biomarkers suggest areas for future study and intervention to reduce health disparities.

Total antioxidant performance is associated with diet and serum antioxidants in participants of the diet and physical activity substudy of the Jackson Heart Study.

Total antioxidant performance (TAP) measures antioxidant capacities in both hydrophilic and lipophilic compartments of serum and interactions known to exist between them. Our objective was to assess TAP levels in a subset of Jackson Heart Study (JHS) participants and to examine associations with dietary and total (diet + supplement) intakes of alpha-tocopherol, gamma-tocopherol (diet only), beta-carotene, vitamin C, fruit, vegetables, and nuts, and serum concentrations of alpha-tocopherol, gamma-tocopherol, and beta-carotene. We conducted a cross-sectional analysis of 420 (mean age 61 y; 254 women) African American men and women participating in the Diet and Physical Activity Sub-Study of the JHS in Jackson, Mississippi. In multivariate-adjusted models, we observed positive associations between total alpha-tocopherol, total and dietary beta-carotene, and total vitamin C intakes and TAP levels (P-trend < 0.05). Positive associations were also observed for vegetable, fruit, and total fruit and vegetable intakes (P-trend < 0.05). For serum antioxidant nutrients, alpha-tocopherol but not beta-carotene was associated with serum TAP levels. There were inverse associations for serum gamma-tocopherol and TAP levels. Associations for alpha-tocopherol were seen at intake levels much higher than the current Recommended Dietary Allowance. It may, therefore, be prudent to focus on increasing consumption of fruit, vegetables, nuts, and seeds to increase total antioxidant capacity.

Patterns of Beverages Consumed and Risk of Incident Kidney Disease.

BACKGROUND AND OBJECTIVES: Selected beverages, such as sugar-sweetened beverages, have been reported to influence kidney disease risk, although previous studies have been inconsistent. Further research is necessary to comprehensively evaluate all types of beverages in association with CKD risk to better inform dietary guidelines. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a prospective analysis in the Jackson Heart Study, a cohort of black men and women in Jackson, Mississippi. Beverage intake was assessed using a food frequency questionnaire administered at baseline (2000-2004). Incident CKD was defined as onset of eGFR<60 ml/min per 1.73 m2 and ≥30% eGFR decline at follow-up (2009-13) relative to baseline among those with baseline eGFR ≥60 ml/min per 1.73 m2. Logistic regression was used to estimate the association between the consumption of each individual beverage, beverage patterns, and incident CKD. Beverage patterns were empirically derived using principal components analysis, in which components were created on the basis of the linear combinations of beverages consumed. RESULTS: Among 3003 participants, 185 (6%) developed incident CKD over a median follow-up of 8 years. At baseline, mean age was 54 (SD 12) years, 64% were women, and mean eGFR was 98 (SD 18) ml/min per 1.73 m2. After adjusting for total energy intake, age, sex, education, body mass index, smoking, physical activity, hypertension, diabetes, HDL cholesterol, LDL cholesterol, history of cardiovascular disease, and baseline eGFR, a principal components analysis-derived beverage pattern consisting of higher consumption of soda, sweetened fruit drinks, and water was associated with significantly greater odds of incident CKD (odds ratio tertile 3 versus 1 =1.61; 95% confidence interval, 1.07 to 2.41). CONCLUSIONS: Higher consumption of sugar-sweetened beverages was associated with an elevated risk of subsequent CKD in this community-based cohort of black Americans.

Dietary Phosphorus and Ambulatory Blood Pressure in African Americans: The Jackson Heart Study.

BACKGROUND: Higher dietary phosphorus is associated with left ventricular hypertrophy and mortality, which are blood pressure (BP)-related outcomes. For this reason, we hypothesized that dietary phosphorus may be associated with adverse clinic and ambulatory BP patterns. METHODS: Our study included 973 African American adults enrolled in the Jackson Heart Study (2000-2004) with 24-hour ambulatory BP monitoring (ABPM) data at baseline. We quantified dietary phosphorus from a validated Food Frequency Questionnaire as follows: (i) absolute daily intake, (ii) ratio of phosphorus-to-protein intake, (iii) phosphorus density, and (iv) energy-adjusted phosphorus intake. Using multivariable linear regression, we determined associations between dietary phosphorus intake and systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure in clinic and over daytime, nighttime, and 24-hour periods from ABPM. Extent of nocturnal BP dipping was also assessed. Using logistic regression, we modeled relationships between dietary phosphorus intake and clinically relevant qualitative BP phenotypes, such as masked, sustained, or white-coat hypertension and normotension. RESULTS: There were no statistically significant associations between phosphorus intake and SBP or pulse pressure in adjusted models. Most metrics of higher phosphorus intake were associated with lower daytime, nighttime, and clinic DBP. Higher phosphorus intake was not associated with clinic or ABPM-defined hypertension overall, but most metrics of higher phosphorus intake were associated with lower odds of sustained hypertension compared to sustained normotension, white-coat hypertension, and masked hypertension. There were no associations between dietary phosphorus and nocturnal BP dipping. CONCLUSIONS: These data do not support a role for higher phosphorus intake and higher BP in African Americans.

Serum carotenoid and tocopherol concentrations vary by dietary pattern among African Americans.

BACKGROUND: Intakes and biochemical concentrations of carotenoids and tocopherols have been associated with chronic diseases. OBJECTIVE: To describe dietary patterns in Jackson Heart Study participants and to determine if biochemical measurements of antioxidants differ across these. DESIGN: Cross-sectional analysis of data for 373 African-American men and women (age 35 to 80 years), participating in the Diet and Physical Activity Substudy of the Jackson Heart Study. METHODS: Dietary intake was assessed with a region specific food frequency questionnaire. Patterns were defined by cluster analysis of food groups, as percent of energy intake. RESULTS: Four dietary patterns were identified: fast food, Southern, prudent, and juice. Individuals in the fast-food pattern (n=153) had significantly lower serum concentrations of lutein plus zeaxanthin and beta-cryptoxanthin; those in the Southern cluster (n=99) had significantly lower serum alpha-carotene; and those in the prudent (n=63) and juice (n=58) clusters had significantly higher serum alpha-carotene and beta-cryptoxanthin (P<0.05) relative to those in at least one other cluster (all P<0.05). The juice cluster also had higher serum alpha-tocopherol concentrations relative to the fast-food cluster. CONCLUSIONS: Diets high in fast foods, snacks, soft drinks, and meat were associated with relatively low concentrations of carotenoids and alpha-tocopherol. This pattern contained the largest number of participants, and could contribute to the extensive health disparities seen in this region.

Physical activity, body mass index and waist circumference change, and normal-range glycated hemoglobin on incident diabetes: Jackson Heart Study.

OBJECTIVES: The purpose of this study was to 1) evaluate whether physical activity has a protective effect on incident diabetes among African Americans across combinations of body mass index (BMI) and waist circumference (WC), 2) evaluate the effect of changes on BMI and WC on incident diabetes, and 3) evaluate the effect of 'normal range' glycated hemoglobin (A1C) on incident diabetes. METHODS: Data from the prospective Jackson Heart Study were evaluated, with baseline data assessed between 2001 and 2004 and follow-up data occurring between 2009 and 2013. Physical activity was assessed via a validated questionnaire, with measured BMI, WC and A1C assessed via standard procedures. RESULTS: The sample included 2,450 adults who did not have evidence of diabetes at the baseline assessment, with 286 incident diabetes cases occurring at the follow-up assessment. Physical activity did not have a protective effect against incident diabetes across different BMI and WC combinations. Notably, BMI change from baseline to follow-up was associated with incident diabetes (HR = 1.08; 95% CI: 1.03-1.13). Further, higher levels of A1C within the 'normal-range' was associated with incident diabetes (HR = 7.51, 95% CI = 2.66-21.25). CONCLUSION: Increases in BMI over time and higher A1C within the normal range were associated with incident diabetes. Serial monitoring of BMI, as well as A1C, even among those with a 'normal' A1C, may be warranted by clinicians. Future work evaluating this novel three-way model (physical activity, BMI and WC) should consider utilizing an objective measure of physical activity.

Geographic Disparity in Funding for School Nutrition Environments: Evidence from Mississippi Schools.

BACKGROUND: Despite the federal initiatives on equitable provision of school nutrition programs, geographic disparity in childhood obesity persists. It may be partly because built-in school nutrition environments rely on each school's efficient use of existing operational funds or its ability to obtain expanded financial support. This study explores how funding acquisition by schools is determined by local community characteristics and how it relates to healthy school meal offerings. METHODS: Information about food preparation technology and funding in 811 schools in Mississippi was obtained by in-depth phone interviews of district child nutrition directors and school foodservice managers, which was matched to socioeconomic indicators of schools and communities. Probit models were estimated. RESULTS: About 56% of schools in the sample received some funds toward combination oven/steamers in the last few years. Small schools, schools in non-metro counties, and those in low-income minority areas were significantly less likely to be funded. Obtainment of funds was associated with a 45 percentage-point reduction in the probability of serving fried foods. CONCLUSIONS: Funds obtained by schools for advanced food preparation technology contributes to creation of healthier nutrition environments for children. However, fund availability is associated with community characteristics, possibly contributing to geographic disparity of child health.

Association of kidney stones with atherosclerotic cardiovascular disease among adults in the United States: Considerations by race-ethnicity.

BACKGROUND: There is a paucity of research examining the relationship between kidney stones and risk of cardiovascular disease while considering individuals of different race-ethnicities. PURPOSE: The purpose of this study was to examine the association between history of kidney stones and increased odds of atherosclerotic cardiovascular disease (via the Pooled Cohort Equations) across race-ethnicity groups. METHODS: 5571 participants aged 40-79 from the 2007-2012 cycles of the NHANES were used for this study. A history of kidney stones was collected from survey data. Predicted odds of having a 10-year atherosclerotic cardiovascular disease (ASCVD) event was assessed from the Pooled Cohort Equations. RESULTS: After adjustments, having kidney stones was not associated with an increase odds of having an ASCVD event within the next 10-years (OR 1.03; 95% CI: 0.58-1.82, P=0.91). However, among non-Hispanic blacks, those with kidney stones had a 2.24 increased odds (OR 2.24; 95% CI: 1.08-4.66; P=0.03) of having an ASCVD event within the next 10-years when compared to non-Hispanic blacks with no history of a kidney stone. CONCLUSION: Kidney stones were associated with 10-year risk of a future ASCVD event among non-Hispanic blacks.

Physical activity assessment methods in the Jackson Heart Study.

OBJECTIVES: Physical activity measures used in exam 1 of the Jackson Heart Study (JHS), including the diet and physical activity substudy (DPASS), are described. DESIGN: The JHS physical activity (PAC) survey instrument was administered by interview. Accelerometer data, pedometer step counts, and additional questionnaire data were collected from volunteer subsamples of the cohort, including the DPASS. OUTCOME MEASURES: The PAC assessed four different domains of physical activity (active living, work, home and garden, and sport and exercise indexes). The 24-hour accelerometer and pedometer monitoring provided objective measures for validation of cohort survey responses. The DPASS past week activity (PWA) questionnaire assessed time spent in moderate and vigorous activity during the previous seven days. Pedometer step counts for three days before three DPASS visits provided additional data for the DPASS. RESULTS: 5296 respondents completed the PAC, 423 completed 24-hour accelerometer monitoring, and 499 completed the DPASS measures; 85 completed both 24-hour monitoring and DPASS measures. Initial analyses of leisure and sports activity items showed similar distributions for men and women and for the cohort and DPASS participants, in a bimodal distribution, with similar proportions reporting infrequent and frequent activity. The physical activity measures from the JHS can provide unique information about the association between physical activity, other risk factors, and cardiovascular disease in African Americans.

Dietary assessment in African Americans: methods used in the Jackson Heart Study.

OBJECTIVES: The dietary assessment methods used in the Jackson Heart Study (JHS) with the entire cohort and a subset of the cohort who participated in a diet and physical activity substudy (DPASS) are reported. These methods were employed to validate culturally explicit data collection instruments developed by Delta Nutrition Intervention Research Initiative (NIRI) for assessing dietary intake in an all African-American cohort. DESIGN: A validation/calibration design was employed. A short food frequency questionnaire (FFQ) was used with all JHS participants (N=5302). A long FFQ and four 24-hour diet recalls were used for the subset of DPASS participants (n=449). OUTCOME MEASURES: Completion rates and preliminary macronutrient intakes are reported for the cohort and DPASS methods. RESULTS: Participants (5302) in the JHS full cohort completed the short FFQ. Of these, 572 were enrolled in the DPASS. A total of 506 participants completed four 24-hour dietary recalls, and 499 completed all six measures, including the long FFQ. Validation of dietary instruments in African Americans will help assure that valid conclusions can be drawn regarding the effects of diet on cardiovascular disease in this population.

Associations of whole-grain, refined-grain, and fruit and vegetable consumption with risks of all-cause mortality and incident coronary artery disease and ischemic stroke: the Atherosclerosis Risk in Communities (ARIC) Study.

BACKGROUND: Recent epidemiologic study results showed that subjects who had high intakes of whole-grain foods had lower risks of death and heart disease than did subjects who had low intakes. However, the findings were inconsistent for fruit and vegetable intake. OBJECTIVE: The relations of whole-grain, refined-grain, and fruit and vegetable intakes with the risk of total mortality and the incidence of coronary artery disease (CAD) and ischemic stroke were studied in the Atherosclerosis Risk in Communities (ARIC) cohort (baseline: age 45-64 y, n = 15,792). DESIGN: Proportional hazards regression analyses were used to assess the relations of whole-grain, refined-grain, and fruit and vegetable intakes with the risk of death and the incidence of CAD and ischemic stroke, with adjustment for age, sex, ethnicity, energy intake, and cardiovascular disease risk factors. Dietary intakes were assessed by using a food-frequency questionnaire. RESULTS: Over an 11-y follow-up period, whole-grain intake was inversely associated with total mortality and incident CAD. The relative hazards of death for quintiles 2-5 of fruit and vegetable intake were 1.08 (95% CI: 0.88, 1.33), 0.94 (0.75, 1.17), 0.87 (0.68, 1.10), and 0.78 (0.61, 1.01), respectively; P for trend = 0.02. An inverse association between fruit and vegetable intake and CAD was observed among African Americans but not among whites (P for interaction = 0.01). The risk of ischemic stroke was not significantly related to whole-grain, refined-grain, or fruit and vegetable consumption. CONCLUSION: These observational findings suggest a beneficial effect of whole-grain and fruit and vegetable consumption on the risks of total mortality and incident CAD but not on the risk of ischemic stroke.

Obesity, physical inactivity, and risk for cardiovascular disease.

Despite considerable progress in understanding disease mechanisms and risk factors, improved treatments, and public education efforts, cardiovascular disease (CVD) remains the leading cause of death in the United States. Obesity and physical inactivity, 2 important lifestyle-related risk factors for CVD, are prevalent in the southeastern United States and are becoming more prevalent in all racial groups and areas of the country. In reviewing these risk factors, we explored topics including prevalence and trends in population data; associated psychosocial and environmental factors; and some of the mechanisms through which these risk factors are thought to contribute to CVD. We identified significant, but as yet poorly understood, racial disparities in prevalence of obesity, low levels of physical activity, and correlates of these risk factors and examined important differences in the complex relationship between obesity, diabetes, and cardiovascular disease risk between African American and European American women. The Jackson Heart Study will provide important and unique information relevant to many unanswered questions about obesity, physical inactivity, and obesity in African Americans.

Dietary patterns, abdominal visceral adipose tissue, and cardiometabolic risk factors in African Americans: the Jackson heart study.

OBJECTIVE: To examine the relative association of abdominal visceral adipose tissue (VAT) with cardiometabolic risk factors between African and European Americans. DESIGN AND METHODS: We conducted a cross-sectional study of 2035 African Americans from Jackson Heart Study (JHS) and 3170 European Americans from Framingham Heart Study (FHS) who underwent computed tomography assessment of VAT and subcutaneous adipose tissue (SAT). The FHS participants were weighted to match the age distribution of the JHS participants and the metabolic risk factors were examined by study groups in relation to VAT. RESULTS: JHS participants had higher rates of obesity, hypertension, diabetes and metabolic syndrome than FHS participants (all p = 0.001). The associations were weaker in JHS women for VAT with blood pressure, triglycerides, HDL-C, and total cholesterol (pinteraction = 0.03 to 0.001) than FHS women. In contrast, JHS men had stronger associations for VAT with high triglycerides, low HDL, and metabolic syndrome (all pinteraction = 0.001) compared to FHS men. Similar associations and gender patterns existed for SAT with most metabolic risk factors. CONCLUSIONS: The relative association between VAT and cardiometabolic risk factors is weaker in JHS women compared to FHS women, whereas stronger association with triglycerides and HDL were observed in JHS men.

Validity and calibration of food frequency questionnaires used with African-American adults in the Jackson Heart Study.

OBJECTIVE: To examine the relative validity of two food frequency questionnaires (FFQs) developed for use in investigating diet and disease relationships within the adult African-American population in the southern United States. DESIGN: Cross-sectional analyses of dietary nutrient intake data, comparing four 24-hour dietary recalls with an FFQ developed by the Lower Mississippi Delta Nutrition Intervention Research Initiative, and its shorter version adapted for use in the Jackson Heart Study. SUBJECTS: A representative subset of participants (n=499, aged 35 to 81 years) from the baseline Jackson Heart Study cohort (N=5,302) was selected for this study. Data collection took place between winter 2000 and spring 2004. STATISTICAL ANALYSES: Pearson's correlation coefficients (energy adjusted and de-attenuated) for 26 nutrients estimates from each of the FFQs, comparing them with the mean of four 24-hour dietary recalls. The ability of the FFQs to rank individuals based on nutrient intakes was compared to that of the mean of four 24-hour dietary recalls and attenuation coefficients were also calculated. RESULTS: Median nutrient intake estimates tended to be higher on the long and lower on the short FFQ compared to the median for the mean of four 24-hour dietary recalls. Energy adjusted and deattenuated correlations of FFQ intake estimates with recalls ranged from 0.20 for sodium to 0.70 for carbohydrate for the short FFQ and from 0.23 for polyunsaturated fat to 0.75 for dietary fiber and magnesium for the long. Attenuation coefficients for men on average were 0.42 for the short and 0.49 for the long FFQ. For women, these were 0.31 for the short and 0.42 for the long FFQ. CONCLUSIONS: Both FFQs appear to be reasonably valid for assessment of dietary intake of adult African Americans in the South. The Lower Mississippi Delta Nutrition Intervention Research Initiative FFQ exhibited higher intake estimates and stronger correlations with recalls than the Jackson Heart Study FFQ for most nutrients analyzed, more so for women than men.

Carotenoid intakes, assessed by food-frequency questionnaires (FFQs), are associated with serum carotenoid concentrations in the Jackson Heart Study: validation of the Jackson Heart Study Delta NIRI Adult FFQs.

OBJECTIVES: Intake and status of carotenoids have been associated with chronic disease. The objectives of this study were to examine the association between carotenoid intakes as measured by two regional food-frequency questionnaires (FFQs) and their corresponding measures in serum, and to report on dietary food sources of carotenoids in Jackson Heart Study (JHS) participants. DESIGN: Cross-sectional analysis of data for 402 African American men and women participating in the Diet and Physical Activity Sub-Study (DPASS) of the JHS. RESULTS: Mean serum carotenoid concentrations and intakes in this population were comparable to those reported for the general US population. After adjustment for covariates, correlations between serum and dietary measures of each carotenoid, for the average of the recalls (deattenuated), the short FFQ and the long FFQ, respectively, were: 035 and 0-carotene; 026 and 0-carotene; 017 and 0-carotene; 034 and 0-cryptoxanthin; 015 and 037, 014 for lycopene. Major dietary sources of -carotene and lutein plus zeaxanthin, mustard, turnip and collard greens; of beta-cryptoxanthin, orange juice; and of lycopene, tomato juice. CONCLUSIONS: On average, carotenoid intakes and serum concentrations are not lower in this southern African American population than the general US population. The two regional FFQs developed for a southern US population and used as dietary assessment tools in the JHS appear to provide reasonably valid information for most of these carotenoids.