Aims
To quantify the extent to which ethnic differences in muscular strength might account for the substantially higher prevalence of diabetes in black and South‐Asian compared with white European ...adults.
Methods
This cross‐sectional study used baseline data from the UK Biobank study on 418 656 white European, black and South‐Asian participants, aged 40–69 years, who had complete data on diabetes status and hand‐grip strength. Associations between hand‐grip strength and diabetes were assessed using logistic regression and were adjusted for potential confounding factors.
Results
Lower grip strength was associated with higher prevalence of diabetes, independent of confounding factors, across all ethnicities in both men and women. Diabetes prevalence was approximately three‐ to fourfold higher in South‐Asian and two‐ to threefold higher in black participants compared with white European participants across all levels of grip strength, but grip strength in South‐Asian men and women was ~ 5–6 kg lower than in the other ethnic groups. Thus, the attributable risk for diabetes associated with low grip strength was substantially higher in South‐Asian participants (3.9 and 4.2 cases per 100 men and women, respectively) than in white participants (2.0 and 0.6 cases per 100 men and women, respectively). Attributable risk associated with low grip strength was also high in black men (4.3 cases) but not in black women (0.4 cases).
Conclusions
Low strength is associated with a disproportionately large number of diabetes cases in South‐Asian men and women and in black men. Trials are needed to determine whether interventions to improve strength in these groups could help reduce ethnic inequalities in diabetes prevalence.
What's new?
In participants in the UK Biobank study, grip strength was significantly associated with odds of diabetes, independent of major confounding factors in all ethnic groups.
Grip strength was lower (by ˜ 5–6 kg) in South‐Asian men and women compared with black and white European men and women.
Lower grip strength combined with higher diabetes prevalence resulted in the attributable risk for diabetes associated with low grip strength being substantially higher in South‐Asian people (3.9 and 4.2 cases per 100 men and women) than in white people (2.0 and 0.6 cases). Attributable risk was also high in black men (4.3 cases) but not in black women (0.4 cases).
•Carbohydrate intake was negatively associated with grip strength in all particpants.•Oily fish, retinol and magnesium intake were positively associated with grip strength in all particpants.•In ...women only positive associations were observed between red meat, fruit and vegetables, vitamin E, iron, vitamin B12, folate and vitamin C and hand grip strength.•In men only negative associations were seen between bread and processed meat and grip strength.•Many aspects of diet are associated with muscle strength in older people and randomised controlled trials are needed to confirm causality of these observations.
The aim of the current study was to investigate the association between diet and handgrip strength. The current study included 68,002 participants (age 63.8 ± 2.7 years, 50.3% women, 49.7% men) from UK Biobank. Diet and nutritional data (carotene, retinol, potassium, vitamin C, foliate, vitamin B12, vitamin B6, iron, vitamin E, calcium, magnesium, carbohydrates, protein, polyunsaturated fat, fat, starch and saturated fat) were collected and handgrip strength measured. Associations were compared, stratified by sex, using regression analyses, after adjustment for age, sex, month of assessment, ethnicity, deprivation index, height, comorbidities and total energy intake. The current data revealed negative associations between carbohydrate intake and handgrip strength as well as positive associations between oily fish, retinol and magnesium intake and grip strength in both sexes. In women, positive associations were observed between intake of red meat, fruit and vegetables, vitamin E, iron, vitamin B12, folate and vitamin C and hand grip strength. In men only negative associations were seen between bread and processed meat with grip strength. We have shown associations of several nutrients and food items with muscle strength and appropriately designed trials are needed to investigate whether these nutrients/food items may be beneficial in the maintenance of muscle during ageing.
Risk variants of fat mass and obesity‐associated (FTO) gene have been associated with increased obesity. However, the evidence for associations between FTO genotype and macronutrient intake has not ...been reviewed systematically. Our aim was to evaluate the potential associations between FTO genotype and intakes of total energy, fat, carbohydrate and protein. We undertook a systematic literature search in OVID MEDLINE, Scopus, EMBASE and Cochrane of associations between macronutrient intake and FTO genotype in adults. Beta coefficients and confidence intervals (CIs) were used for per allele comparisons. Random‐effect models assessed the pooled effect sizes. We identified 56 eligible studies reporting on 213,173 adults. For each copy of the FTO risk allele, individuals reported 6.46 kcal day⁻¹ (95% CI: 10.76, 2.16) lower total energy intake (P = 0.003). Total fat (P = 0.028) and protein (P = 0.006), but not carbohydrate intakes, were higher in those carrying the FTO risk allele. After adjustment for body weight, total energy intakes remained significantly lower in individuals with the FTO risk genotype (P = 0.028). The FTO risk allele is associated with a lower reported total energy intake and with altered patterns of macronutrient intake. Although significant, these differences are small and further research is needed to determine whether the associations are independent of dietary misreporting.
Policy makers are being encouraged to specifically target sugar intake in order to combat obesity. We examined the extent to which sugar, relative to other macronutrients, was associated with ...adiposity.
We used baseline data from UK Biobank to examine the associations between energy intake (total and individual macronutrients) and adiposity body mass index (BMI), percentage body fat and waist circumference. Linear regression models were conducted univariately and adjusted for age, sex, ethnicity and physical activity.
Among 132 479 participants, 66.3% of men and 51.8% of women were overweight/obese. There was a weak correlation (r = 0.24) between energy from sugar and fat; 13% of those in the highest quintile for sugar were in the lowest for fat, and vice versa. Compared with normal BMI, obese participants had 11.5% higher total energy intake and 14.6%, 13.8%, 9.5% and 4.7% higher intake from fat, protein, starch and sugar, respectively. Hence, the proportion of energy derived from fat was higher (34.3% vs 33.4%, P < 0.001) but from sugar was lower (22.0% vs 23.4%, P < 0.001). BMI was more strongly associated with total energy coefficient 2.47, 95% confidence interval (CI) 2.36-2.55 and energy from fat (coefficient 1.96, 95% CI 1.91-2.06) than sugar (coefficient 0.48, 95% CI 0.41-0.55). The latter became negative after adjustment for total energy.
Fat is the largest contributor to overall energy. The proportion of energy from fat in the diet, but not sugar, is higher among overweight/obese individuals. Focusing public health messages on sugar may mislead on the need to reduce fat and overall energy consumption.
Type 2 diabetes has been associated with high dementia risk. However, the links to different dementia subtypes is unclear. We examined to what extent type 2 diabetes is associated with dementia ...subtypes and whether such associations differed by glycemic control.
We used data from the Swedish National Diabetes Register and included 378,299 patients with type 2 diabetes and 1,886,022 control subjects matched for age, sex, and county randomly selected from the Swedish Total Population Register. The outcomes were incidence of Alzheimer disease, vascular dementia, and nonvascular dementia. The association of type 2 diabetes with dementia was stratified by baseline glycated hemoglobin (HbA1c) in patients with type 2 diabetes only. Cox regression was used to study the excess risk of outcomes.
Over the follow-up (median 6.8 years), dementia developed in 11,508 (3.0%) patients with type 2 diabetes and 52,244 (2.7%) control subjects. The strongest association was observed for vascular dementia, with patients with type 2 diabetes compared with control subjects having a hazard ratio HR of 1.34 (95% CI 1.28, 1.41). The association of type 2 diabetes with nonvascular dementia was more modest (HR 1.10 95% CI 1.07, 1.13). However, risk for Alzheimer disease was lower in patients with type 2 diabetes than in control subjects (HR 0.94 95% CI 0.90, 0.99). When the analyses were stratified by circulating concentrations of HbA1c, a dose-response association was observed.
The association of type 2 diabetes with dementia differs by subtypes of dementia. The strongest detrimental association is observed for vascular dementia. Moreover, patients with type 2 diabetes with poor glycemic control have an increased risk of developing vascular and nonvascular dementia.
The prevalence of sleep disturbance is high and increasing. The study investigated whether active, former and passive smoking were associated with sleep disturbance.
This cross-sectional study used ...data from the UK Biobank: a cohort study of 502 655 participants, of whom 498 208 provided self-reported data on smoking and sleep characteristics. Multivariable multinomial and logistic regression models were used to examine the associations between smoking and sleep disturbance.
Long-sleep duration (>9 h) was more common among current smokers odds ratio (OR): 1.47; 95% confidence interval (CI): 1.17-1.85; probability value (P) = 0.001 than never smokers, especially heavy (>20/day) smokers (OR: 2.85; 95% CI: 1.66-4.89; P < 0.001). Former heavy (>20/day) smokers were also more likely to report short (<6 h) sleep duration (OR: 1.41; 95% CI: 1.25-1.60; P < 0.001), long-sleep duration (OR: 1.99; 95% CI: 1.47-2.71; P < 0.001) and sleeplessness (OR: 1.47; 95% CI: 1.38-1.57; P < 0.001) than never smokers. Among never smokers, those who lived with more than one smoker had higher odds of long-sleep duration than those not cohabitating with a smoker (OR: 2.71; 95% CI: 1.26-5.82; P = 0.011).
Active and passive exposure to high levels of tobacco smoke are associated with sleep disturbance. Existing global tobacco control interventions need to be enforced.
Adequate dietary protein intake is important for the maintenance of bone health; however, data in this area is ambiguous with some suggestion that high protein intake can have deleterious effects on ...bone health. The aim of the current study was to explore the associations of protein intake with bone mineral density (BMD).
We used baseline data from the UK Biobank (participants aged 40–69 years) to examine the association of protein intake with BMD (measured by ultrasound). These associations were examined, in women (n = 39,066) and men (n = 31,149), after adjustment for socio-demographic and lifestyle confounders and co-morbidities.
Protein intake was positively and linearly associated with BMD in women (β-coefficient 0.010 95% CI 0.005; 0.015, p < 0.0001) and men (β-coefficient 0.008 95% CI 0.000; 0.015, p = 0.044); per 1.0 g/kg/day increment in protein intake, independently of socio-demographics, dietary factors and physical activity.
The current data have demonstrated that higher protein intakes are positively associated with BMD in both men and women. This indicates that higher protein intakes may be beneficial for both men and women.
•A higher dietary protein intake was associated with a higher bone mineral density.•These associations were adjustment for socio-demographic and lifestyle confounders and co-morbidities•A sex by age interaction was observed, but stratified analysis found little difference in associations between age groups.
We examined whether seasonal variations in depressive symptoms occurred independently of demographic and lifestyle factors, and were related to change in day length and/or outdoor temperature.
In a ...cross-sectional analysis of >150,000 participants of the UK Biobank cohort, we used the cosinor method to assess evidence of seasonality of a total depressive symptoms score and of low mood, anhedonia, tenseness and tiredness scores in women and men. Associations of depressive symptoms with day length and mean outdoor temperature were then examined.
Seasonality of total depressive symptom scores, anhedonia and tiredness scores was observed in women but not men, with peaks in winter. In women, increased day length was associated with reduced reporting of low mood and anhedonia, but with increased reporting of tiredness, independent of demographic and lifestyle factors. Associations with day length were not independent of the average outdoor temperature preceding assessment.
This was a cross-sectional investigation – longitudinal studies of within-subject seasonal variation in mood are necessary. Outcome measures relied on self-report and measured only a subset of depressive symptoms.
This large, population-based study provides evidence of seasonal variation in depressive symptoms in women. Shorter days were associated with increased feelings of low mood and anhedonia in women. Clinicians should be aware of these population-level sex differences in seasonal mood variations in order to aid recognition and treatment of depression and subclinical depressive symptoms.
•Evidence of seasonality of depressive symptoms was identified in women but not men.•In women, anhedonia, low mood and tiredness scores peaked in winter.•Shorter day length was associated with higher low mood and anhedonia scores.•Findings have important implications for the recognition and treatment of depression.
Objective
The objective of this study was to investigate the allelic frequency of the fat mass and obesity‐associated (FTO) gene (rs9939609) and its influences on obesity and metabolic risk ...biomarkers in a cohort of normal weight and obese Chilean children determining its ethnicity.
Methods
A total of 136 normal weight children and 238 obese children (between 6 and 11 yr old) from an urban setting were recruited for this case–control study. The children were classified as normal weight body mass index (BMI) ≥ 5th and < 85th percentiles or obese (BMI >95th percentile), according to the international age‐ and gender‐specific percentiles defined by the Center for Disease Control and Prevention. The analysis of serum markers was carried out using commercial kits. The FTO polymorphism was determined through a high‐resolution melting enabled real time polymerase chain reaction. Ethnicity was determined by analyzing mitochondrial DNA by the restriction fragment length polymorphism method.
Results
As much as 85% of the cohort was Amerindian. The minor A allele of rs9939609 was associated with obesity (odds ratio (OR): 1.422 95% confidence interval (CI) 1.068–1.868 p = 0.015), calculated using an additive model. In sex‐stratified analysis we found that the risk variant (A) of rs9939609 was associated with a higher homeostasis model of assessment for insulin (HOMA‐IR) in prepubertal obese girls. In male carriers of the A allele, HOMA‐IR showed no further deterioration than that already associated with obesity.
Conclusions
In summary, we confirm the association of the FTO gene single‐nucleotide polymorphism rs9939609 with obesity in Chilean Amerindian children. Furthermore we show an association between the risk allele (A) and insulin resistance‐related markers in prepubertal obese girls.
Disruption of sleep and circadian rhythmicity is a core feature of mood disorders and might be associated with increased susceptibility to such disorders. Previous studies in this area have used ...subjective reports of activity and sleep patterns, but the availability of accelerometer-based data from UK Biobank participants permits the derivation and analysis of new, objectively ascertained circadian rhythmicity parameters. We examined associations between objectively assessed circadian rhythmicity and mental health and wellbeing phenotypes, including lifetime history of mood disorder.
UK residents aged 37-73 years were recruited into the UK Biobank general population cohort from 2006 to 2010. We used data from a subset of participants whose activity levels were recorded by wearing a wrist-worn accelerometer for 7 days. From these data, we derived a circadian relative amplitude variable, which is a measure of the extent to which circadian rhythmicity of rest-activity cycles is disrupted. In the same sample, we examined cross-sectional associations between low relative amplitude and mood disorder, wellbeing, and cognitive variables using a series of regression models. Our final model adjusted for age and season at the time that accelerometry started, sex, ethnic origin, Townsend deprivation score, smoking status, alcohol intake, educational attainment, overall mean acceleration recorded by accelerometry, body-mass index, and a binary measure of childhood trauma.
We included 91 105 participants with accelerometery data collected between 2013 and 2015 in our analyses. A one-quintile reduction in relative amplitude was associated with increased risk of lifetime major depressive disorder (odds ratio OR 1·06, 95% CI 1·04-1·08) and lifetime bipolar disorder (1·11, 1·03-1·20), as well as with greater mood instability (1·02, 1·01-1·04), higher neuroticism scores (incident rate ratio 1·01, 1·01-1·02), more subjective loneliness (OR 1·09, 1·07-1·11), lower happiness (0·91, 0·90-0·93), lower health satisfaction (0·90, 0·89-0·91), and slower reaction times (linear regression coefficient 1·75, 1·05-2·45). These associations were independent of demographic, lifestyle, education, and overall activity confounders.
Circadian disruption is reliably associated with various adverse mental health and wellbeing outcomes, including major depressive disorder and bipolar disorder. Lower relative amplitude might be linked to increased susceptibility to mood disorders.
Lister Institute of Preventive Medicine.
PDF
