Background Food insecurity is a global leading public health challenge that affects not only developing countries but also developed countries, including the United States. About 50 million Americans ...are food insecure. In this study we examined the associations of the adult food insecurity with all-cause and cardiovascular disease mortality in a nationally representative sample of US adults. Methods and Results We included 27 188 US adults (age ≥40 years of age) who participated in the US National Health and Nutrition Examination Survey from 1999 to 2014. Food insecurity status was assessed using the Food Security Survey Module developed by the US Department of Agriculture. Mortality from all causes and cardovascular disease was ascertained through data linkage to the National Death Index through December 31, 2015. We used multivariable Cox proportional hazards regression with sampling weights to estimate hazard ratios (HRs) and 95% CIs of all-cause and cardiovascular disease mortality, according to food security status. During 205 389 person-years of the period, 5039 deaths occurred, including 1084 cardiovascular disease deaths. After adjustment for age, sex, race/ethnicity, education, income, and dietary and lifestyle factors, participants with very low food security had higher risk of all-cause and cardiovascular disease mortality, with multivariable-adjusted HRs of 1.32 (95% CI, 1.07-1.62), and 1.53 (95% CI, 1.04-2.26), respectively, compared with those with high food security. Conclusions Food insecurity is significantly associated with increased risk of excess death from cardiovascular disease and all causes in US adults.
Few studies have investigated the potential combined effects of multiple PCB congeners on diabetes. To address this gap, we used data from 1244 adults in the National Health and Nutrition Examination ...Survey (NHANES) 2003-2004. We used (1) classification trees to identify serum PCB congeners and their thresholds associated with diabetes; and (2) logistic regression to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of diabetes with combined PCB congeners. Of the 40 PCB congeners examined, PCB 126 has the strongest association with diabetes. The adjusted OR of diabetes comparing PCB 126 > 0.025 to ≤ 0.025 ng/g was 2.14 (95% CI 1.30-3.53). In the subpopulation with PCB 126 > 0.025 ng/g, a lower PCB 101 concentration was associated with an increased risk of diabetes (comparing PCB 101 < 0.72 to ≥ 0.72 ng/g, OR 3.3, 95% CI 1.27-8.55). In the subpopulation with PCB 126 > 0.025 & PCB 101 < 0.72 ng/g, a higher PCB 49 concentration was associated with an increased risk of diabetes (comparing PCB 49 > 0.65 to ≤ 0.65 ng/g, OR 2.79, 95% CI 1.06-7.35). This nationally representative study provided new insights into the combined associations of PCBs with diabetes.
Recent animal and small clinical studies have suggested depression is related to altered lipid and amino acid profiles. However, this has not been examined in a population-based sample, particularly ...in women. We identified multiple metabolites associated with depression as potential candidates from prior studies. Cross-sectional data from three independent samples of postmenopausal women were analyzed, including women from the Women's Health Initiative-Observational Study (WHI-OS, n = 926), the WHI-Hormone Trials (WHI-HT; n = 1,325), and the Nurses' Health Study II Mind-Body Study (NHSII-MBS; n = 218). Positive depression status was defined as having any of the following: elevated depressive symptoms, antidepressant use, or depression history. Plasma metabolites were measured using liquid chromatography-tandem mass spectrometry (21 phosphatidylcholines (PCs), 7 lysophosphatidylethanolamines, 5 ceramides, 3 branched chain amino acids, and 9 neurotransmitters). Associations between depression status and metabolites were evaluated using multivariable linear regression; results were pooled by random-effects meta-analysis with multiple testing adjustment using the false discovery rate (FDR). Prevalence rates of positive depression status were 24.4% (WHI-OS), 25.7% (WHI-HT), and 44.7% (NHSII-MBS). After multivariable adjustment, positive depression status was associated with higher levels of glutamate and PC 36 : 1/38 : 3, and lower levels of tryptophan and GABA-to-glutamate and GABA-to-glutamine ratio (FDR-p < 0.05). Positive associations with LPE 18 : 0/18 : 1 and inverse associations with valine and serotonin were also observed, although these associations did not survive FDR adjustment. Associations of positive depression status with several candidate metabolites including PC 36 : 1/38 : 3 and amino acids involved in neurotransmission suggest potential depression-related metabolic alterations in postmenopausal women, with possible implications for later chronic disease.
Abstract
Bisphenol A (BPA) has been recognized as an endocrine disrupting chemical and identified as an obesogen. Although once ubiquitous, human exposure to BPA has been declining owing to its ...substitution with other bisphenols. Two structurally similar substitutes, bisphenol S (BPS) and bisphenol F (BPF), have raised similar concerns, although fewer studies have been conducted on these newer derivatives. We used data from the US National Health and Nutrition Examination Surveys from 2013 to 2016 to evaluate associations between BPA, BPS, and BPF and body mass outcomes among children and adolescents aged 6 to 19 years. Concentrations of BPA, BPS, and BPF were measured in spot urine samples using HPLC with tandem mass spectrometry. General obesity was defined as ≥95th percentile of the age- and sex-standardized body mass index (BMI) z-scores according to the 2000 US norms. Abdominal obesity was defined as a waist circumference/height ratio of ≥0.5. BPA, BPS, and BPF were detected in 97.5%, 87.8%, and 55.2% of urine samples, respectively. Log-transformed urinary BPS concentrations were associated with an increased prevalence of general obesity (OR, 1.16; 95% CI, 1.02 to 1.32) and abdominal obesity (OR, 1.13; 95% CI, 1.02 to 1.27). BPF detection (vs not detected) was associated with an increased prevalence of abdominal obesity (OR, 1.29; 95% CI, 1.01 to 1.64) and continuous BMI z-score (β = 0.10; 95% CI, 0.01 to 0.20). BPA and total bisphenols were not statistically significantly associated with general obesity, abdominal obesity, or any body mass outcome. These results suggest that BPA substitute chemicals are correlated with obesity in contemporary children.
Bisphenol F (BPF) and bisphenol S (BPS) are increasingly used in consumer products as substitutes for bisphenol A (BPA), a widespread environmental endocrine disruptor and putative obesogen. However, ...studies on the effects of BPF and BPS on obesity in human beings are scarce. We examined the associations of BPA, BPF, and BPS exposure with obesity in US adults.
We included participants aged 20 years or older, who had available data on concentrations of BPA, BPF, and BPS (n=1709), from a cross-sectional study, the National Health and Nutrition Examination Survey 2013–14. Participants who were pregnant or had cancer were excluded from the analysis. Urinary BPA, BPF, and BPS concentrations were measured using on-line solid phase extraction coupled to high performance liquid chromatography and tandem mass spectrometry. We used body-mass index to define general obesity and waist circumference to define abdominal obesity. We used logistic regression with sample weights to estimate the odds ratios (ORs) for obesity.
1521 participants were included in the analysis. Higher BPA, BPF, and BPS concentrations were observed in adults who were obese than adults who were not obese; median concentration 1·5 ng/mL (IQR 0·7–2·8) versus 1·1 ng/mL (0·5–2·3) for BPA, 0·4 ng/mL (0·1–1·3) versus 0·3 ng/mL (0·1–0·9) for BPF, and 0·4 ng/mL (0·2–1·0) versus 0·3 ng/mL (0·1–0·8) for BPS. After adjustment for demographic, socioeconomic, and lifestyle factors, and urinary creatinine concentrations, BPA, but not BPF or BPS, was significantly associated with obesity. The OR for general obesity was 1·78 (95% CI 1·10–2·89; p=0·04 for trend) comparing the highest with lowest quartile of BPA, 1·02 (0·70–1·47; p=0·81 for trend) for BPF, and 1·22 (0·81–1·83; p=0·30 for trend) for BPS. The corresponding OR for abdominal obesity was 1·55 (1·04–2·32; p=0·02 for trend) for BPA, 1·05 (0·68–1·63; p=0·99 for trend) for BPF, and 1·16 (0·72–1·88; p=0·54 for trend) for BPS.
Whereas there were significant associations of BPA exposure with general and abdominal obesity, concentrations of BPF or BPS were not significantly associated with obesity in US adults at current exposure levels. Continued biomonitoring of these bisphenols and further investigation into their health effects on human beings are warranted.
National Institutes of Health.
Background Current cholesterol guidelines have recommended very low low‐density lipoprotein cholesterol (LDL‐C) treatment targets for people at high risk of cardiovascular disease (CVD). However, ...recent observational studies indicated that very low LDL‐C levels may be associated with increased mortality and other adverse outcomes. The association between LDL‐C levels and long‐term risk of overall and cardiovascular mortality among the U.S. general population remains to be determined. Methods and Results This prospective cohort study included a nationally representative sample of 14 035 adults aged 18 years or older, who participated in the National Health and Nutrition Examination Survey III 1988–1994. LDL‐C levels were divided into 6 categories: <70, 70–99.9, 100–129.9, 130–159.9, 160–189.9 and ≥190 mg/dL. Deaths and underlying causes of deaths were ascertained by linkage to death records through December 31, 2015. Weighted Cox proportional hazards regression models were used to estimate the hazard ratios (HR) of mortality outcomes and its 95% CIs. During 304 025 person‐years of follow up (median follow‐up 23.2 years), 4458 deaths occurred including 1243 deaths from CVD. At baseline, mean age was 41.5 years and 51.9% were women. Very low and very high levels of LDL‐C were associated with increased mortality. After adjustment for age, sex, race and ethnicity, education, socioeconomic status, lifestyle factors, C‐reactive protein, body mass index, and other cardiovascular risk factors, individuals with LDL‐C<70 mg/dL, compared to those with LDL‐C 100–129.9 mg/dL, had HRs of 1.45 (95% CI, 1.10–1.93) for all‐cause mortality, 1.60 (95% CI, 1.01–2.54) for CVD mortality, and 4.04 (95% CI, 1.83–8.89) for stroke‐specific mortality, but no increased risk of coronary heart disease mortality. Compared with those with LDL‐C 100–129.9 mg/dL, individuals with LDL‐C≥190 mg/dL had HRs of 1.49 (95% CI, 1.09–2.02) for CVD mortality, and 1.63 (95% CI, 1.12–2.39) for coronary heart disease mortality, but no increased risk of stroke mortality. Conclusions Both very low and very high LDL‐C levels were associated with increased risks of CVD mortality. Very low LDL‐C levels was also associated with the high risks of all‐cause and stroke mortality. Further investigation is needed to elucidate the optimal range of LDL‐C levels for CVD health in the general population.
Bisphenol F (BPF) and bisphenol S (BPS) are increasingly used as substitutes for bisphenol A (BPA), an environmental obesogen. However, health effects of BPF and BPS remain unclear. In this study, we ...evaluated the associations of BPA, BPF, and BPS with obesity in children and adolescents.
We used data from the U.S. National Health and Nutrition Examination Survey 2013 to 2014, a nationally representative study. We included 745 participants aged 6 to 17 years old. General obesity was defined based on the 2000 Centers for Disease Control and Prevention body mass index-for-age growth charts for the United States. Abdominal obesity was defined as waist-to-height ratio ≥0.5.
After adjustment for demographic, socioeconomic and lifestyle factors, and urinary creatinine levels, the odds ratio of general obesity comparing the highest with lowest quartile of urinary bisphenol levels was 1.74 (95% confidence interval CI, 0.92 to 3.31) for BPA, 1.54 (95% CI, 1.02 to 2.32) for BPF, and 1.36 (95% CI, 0.53 to 3.51) for BPS. Moreover, the associations were stronger in boys than in girls for BPA and BPF. Similar results were observed for abdominal obesity.
This study for the first time showed that exposure to BPF, a commonly used substitute for BPA, was positively associated with higher risk of obesity in children and adolescents. The association of BPA and BPF with general and abdominal obesity was primarily observed in boys, suggesting a possible sex difference. Further investigations on the underlying mechanisms are needed.
Background Dietary recommendations regarding protein intake have been focused on the amount of protein. However, such recommendations without considering specific protein sources may be simplistic ...and insufficient. Methods and Results We included 102 521 postmenopausal women enrolled in the Women's Health Initiative between 1993 and 1998, and followed them through February 2017. During 1 876 205 person-years of follow-up, 25 976 deaths occurred. Comparing the highest with the lowest quintile, plant protein intake was inversely associated with all-cause mortality (hazard ratio HR, 0.91 0.86, 0.96), cardiovascular disease mortality (HR, 0.88 0.79, 0.97), and dementia mortality (HR, 0.79 0.67, 0.94). Among major protein sources, comparing the highest with the lowest quintile of consumption, processed red meat (HR, 1.06 1.01, 1.10) or eggs (HR, 1.14 1.10, 1.19) was associated with higher risk of all-cause mortality. Unprocessed red meat (HR, 1.12 1.02, 1.23), eggs (HR, 1.24 1.14, 1.34), or dairy products (HR, 1.11 1.02, 1.22) was associated with higher risk of cardiovascular disease mortality. Egg consumption was associated with higher risk of cancer mortality (HR, 1.10 1.02, 1.19). Processed red meat consumption was associated with higher risk of dementia mortality (HR, 1.20 1.05, 1.32), while consumption of poultry (HR, 0.85 0.75, 0.97) or eggs (HR, 0.86 0.75, 0.98) was associated with lower risk of dementia mortality. In substitution analysis, substituting of animal protein with plant protein was associated with a lower risk of all-cause mortality, cardiovascular disease mortality, and dementia mortality, and substitution of total red meat, eggs, or dairy products with nuts was associated with a lower risk of all-cause mortality. Conclusions Different dietary protein sources have varying associations with all-cause mortality, cardiovascular disease mortality, and dementia mortality. Our findings support the need for consideration of protein sources in future dietary guidelines.
As the most important ecological barrier in eastern China, the three northeast provinces have extraordinary ecological significance. Their geographical location and climatic conditions make the ...distribution pattern of vegetation unique. Among them, climate change and human activities are the main factors affecting the richness and complexity of vegetation, climate change dominates the overall pattern of vegetation distribution, and regional human intervention locally changes the growth state of vegetation. Therefore, based on NDVI data of vegetation, meteorological data and socio-economic data, statistical methods such as Sen’s slope estimator, Mann-Kendall trend test, center of gravity transfer model, Hurst index and coefficient of variation were adopted to analyze the spatio-temporal changes and future trends in vegetation coverage; The use of Geographic detector to understand the relationship between NDVI to climate change and human activities. The results suggested that: 1) The three northeast provinces of China experienced an overall increasing NDVI at a rate of 0.016%/year from 2001 to 2020. The NDVI shows intensive heterogeneity in space, exhibiting a landscape of high in the East, low in the west, high in the north and low in the south; 2) The results of geographic detectors show that the temporal and spatial distribution pattern of vegetation NDVI is mainly determined by ≥ 10°C accumulated temperature, ≥ 0°C accumulated temperature, annual average temperature and land use type. The interaction between factors presents a bi-variable enhancement and nonlinear enhancement, and human activity factors enhance the contribution of climate factors. 3) Future changes in NDVI indicated that the vegetation coverage showed a trend of “overall improvement and regional degradation” from 2001 to 2020, and showed reverse persistence. The degraded area of vegetation will be more than the improved area. The research results will help the three northeast provinces cope with global climate change, enrich the research on the vegetation in the three northeastern provinces, and provide a scientific basis for formulating appropriate regional ecological protection policies.
Several studies have suggested that vitamin B12 deficiency is more common in obese individuals. We evaluated the cross-sectional associations of serum vitamin B12 concentrations with obesity in a ...nationally representative sample of adults in the United States.
We included 9,075 participants aged ≥20 years in the National Health and Nutrition Examination Survey 2011-2014. Serum vitamin B12 concentrations were measured by electrochemiluminescence immunoassay. Obesity was defined as BMI ≥30 kg/m
. We used logistic regression with sample weights to estimate the odds ratios (ORs) and 95% confidence intervals (CIs).
Serum vitamin B12 concentrations were lower among obese adults compared with non-obese adults. After adjustment for age, gender, race/ethnicity, socioeconomic status, dietary and lifestyle factors, use of medications that could affect the serum vitamin B12 levels, dietary supplement use and fasting time, the multivariable-adjusted ORs (95% CIs) of obesity were 1.00 (reference), 0.95 (0.79, 1.14), 0.86 (0.74, 0.99), and 0.71 (0.60, 0.84) (
for trend <0.001) for increasing quartiles of serum vitamin B12 concentrations.
In a large nationally representative sample of U.S. adults, higher serum vitamin B12 levels were inversely associated with obesity. Further investigation is needed to understand the underlying mechanisms.
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