In this study, childhood cardiovascular risk factors including BMI, systolic blood pressure, lipid levels, and smoking were correlated with cardiovascular events in adulthood after a mean follow-up ...of 35 years. Childhood risk factors and the change in risk score between childhood and adulthood were associated with midlife cardiovascular events.
The long-term effects of skipping breakfast on cardiometabolic health are not well understood.
The objective was to examine longitudinal associations of breakfast skipping in childhood and adulthood ...with cardiometabolic risk factors in adulthood.
In 1985, a national sample of 9-15-y-old Australian children reported whether they usually ate breakfast before school. During follow-up in 2004-2006, 2184 participants (26-36 y of age) completed a meal-frequency chart for the previous day. Skipping breakfast was defined as not eating between 0600 and 0900. Participants were classified into 4 groups: skipped breakfast in neither childhood nor adulthood (n = 1359), skipped breakfast only in childhood (n = 224), skipped breakfast only in adulthood (n = 515), and skipped breakfast in both childhood and adulthood (n = 86). Diet quality was assessed, waist circumference was measured, and blood samples were taken after a 12-h fast (n = 1730). Differences in mean waist circumference and blood glucose, insulin, and lipid concentrations were calculated by linear regression.
After adjustment for age, sex, and sociodemographic and lifestyle factors, participants who skipped breakfast in both childhood and adulthood had a larger waist circumference (mean difference: 4.63 cm; 95% CI: 1.72, 7.53 cm) and higher fasting insulin (mean difference: 2.02 mU/L; 95% CI: 0.75, 3.29 mU/L), total cholesterol (mean difference: 0.40 mmol/L; 95% CI: 0.13, 0.68 mmol/L), and LDL cholesterol (mean difference: 0.40 mmol/L; 95% CI: 0.16, 0.64 mmol/L) concentrations than did those who ate breakfast at both time points. Additional adjustments for diet quality and waist circumference attenuated the associations with cardiometabolic variables, but the differences remained significant.
Skipping breakfast over a long period may have detrimental effects on cardiometabolic health. Promoting the benefits of eating breakfast could be a simple and important public health message.
Few studies have investigated factors that influence physical activity behavior during the transition from adolescence to adulthood. This study explores the associations of sociodemographic, ...behavioral, sociocultural, attitudinal and physical factors measured in childhood and adolescence with physical activity behavior during the transition from adolescence to adulthood.
Childhood and adolescent data (at ages 7-15 years) were collected as part of the 1985 Australian Health and Fitness Survey and subdivided into sociodemographics (socioeconomic status, parental education), behavioral (smoking, alcohol, sports diversity, outside school sports), sociocultural (active father, active mother, any older siblings, any younger siblings, language spoken at home), attitudinal (sports/recreational competency, self-rated health, enjoyment physical education/physical activity, not enjoying school sports) and physical (BMI, time taken to run 1.6 km, long jump) factors. Physical activity between the ages 15 and 29 years was reported retrospectively using the Historical Leisure Activity Questionnaire at follow-up in 2004-2006 by 2,048 participants in the Childhood Determinants of Adult Health Study (CDAH). Australia's physical activity recommendations for children and adults were used to categorize participants as persistently active, variably active or persistently inactive during the transition from adolescence to adulthood.
For females, perceived sports competency in childhood and adolescence was significantly associated with being persistently active (RR=1.88, 95% CI=1.39, 2.55). Smoking (RR=0.31 CI=0.12, 0.82) and having younger siblings (RR=0.69 CI=0.52, 0.93) were inversely associated with being persistently active after taking physical and attitudinal factors into account. For males, playing sport outside school (RR=1.47 CI=1.05, 2.08), having active fathers (RR=1.25 CI=1.01, 1.54) and not enjoying school sport (RR=4.07 CI=2.31, 7.17) were associated with being persistently active into adulthood. Time taken to complete the 1.6 km run was inversely associated with being persistently active into adulthood (RR=0.85 CI=0.78, 0.93) after adjusting for recreational competency.
Perceived sports competency (females) and cardiorespiratory fitness, playing sport outside school and having active fathers (males) in childhood and adolescence were positively associated with being persistently active during the transition from adolescence to adulthood.
Background
Although low child and adult grip strength is associated with adverse cardiometabolic health, how grip strength across the life course associates with type 2 diabetes is unknown. This ...study identified the relative contribution of grip strength measured at specific life stages (childhood, young adulthood, mid-adulthood) with prediabetes or type 2 diabetes in mid-adulthood.
Methods
Between 1985 and 2019, 263 participants had their grip strength measured using an isometric dynamometer in childhood (9–15 years), young adulthood (28–36 years) and mid-adulthood (38–49 years). In mid-adulthood, a fasting blood sample was collected and tested for glucose and glycated haemoglobin (HbA1c). Participants were categorized as having prediabetes or type 2 diabetes if fasting glucose levels were ≥ 5.6 mmol or if HbA1c levels were ≥ 5.7% (≥ 39 mmol/mol). A Bayesian relevant life course exposure model examined the association between lifelong grip strength and prediabetes or type 2 diabetes.
Results
Grip strength at each time point was equally associated with prediabetes or type 2 diabetes in mid-adulthood (childhood: 37%, young adulthood: 36%, mid-adulthood: 28%). A one standard deviation increase in cumulative grip strength was associated with 34% reduced odds of prediabetes or type 2 diabetes in mid-adulthood (OR 0.66, 95% credible interval 0.40, 0.98).
Conclusions
Greater grip strength across the life course could protect against the development of prediabetes and type 2 diabetes. Strategies aimed at increasing muscular strength in childhood and maintaining behaviours to improve strength into adulthood could improve future cardiometabolic health.
Video abstract
9We8fDWFvcvmu4LvwGw9g4
The Association Between Grip Strength Measured in Childhood, Young- and Mid-adulthood and Prediabetes or Type 2 Diabetes in Mid-adulthood
Objective.
To determine the relationship between return on investment (ROI) and quality of study methodology in workplace health promotion programs.
Data Source.
Data were obtained through a ...systematic literature search of National Health Service Economic Evaluation Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE), Health Technology Database (HTA), Cost Effectiveness Analysis (CEA) Registry, EconLit, PubMed, Embase, Wiley, and Scopus.
Study Inclusion and Exclusion Criteria.
Included were articles written in English or German reporting cost(s) and benefit(s) and single or multicomponent health promotion programs on working adults. Return-to-work and workplace injury prevention studies were excluded.
Data Extraction.
Methodological quality was graded using British Medical Journal Economic Evaluation Working Party checklist. Economic outcomes were presented as ROI.
Data Synthesis.
ROI was calculated as ROI = (benefits − costs of program)/costs of program. Results were weighted by study size and combined using meta-analysis techniques. Sensitivity analysis was performed using two additional methodological quality checklists. The influences of quality score and important study characteristics on ROI were explored.
Results.
Fifty-one studies (61 intervention arms) published between 1984 and 2012 included 261,901 participants and 122,242 controls from nine industry types across 12 countries. Methodological quality scores were highly correlated between checklists (r = .84–.93). Methodological quality improved over time. Overall weighted ROI mean ± standard deviation (confidence interval) was 1.38 ± 1.97 (1.38–1.39), which indicated a 138% return on investment. When accounting for methodological quality, an inverse relationship to ROI was found. High-quality studies (n= 18) had a smaller mean ROI, 0.26 ± 1.74 (.23–.30), compared to moderate (n= 16) 0.90 ± 1.25 (.90–.91) and low-quality (n= 27) 2.32 ± 2.14 (2.30–2.33) studies. Randomized control trials (RCTs) (n= 12) exhibited negative ROI, −0.22 ± 2.41(–.27 to –.16). Financial returns become increasingly positive across quasi-experimental nonexperimental, and modeled studies: 1.12 ± 2.16 (1.11–1.14), 1.61 ± 0.91 (1.56–1.65), and 2.05 ± 0.88 (2.04–2.06), respectively.
Conclusion.
Overall, mean weighted ROI in workplace health promotion demonstrated a positive ROI. Higher methodological quality studies provided evidence of smaller financial returns. Methodological quality and study design are important determinants.
To review the most recent population-based estimates of keratinocyte cancer incidence in Australia, to describe the trends over time and to calculate lifetime risk of developing these skin cancers.
...We conducted a literature search of PubMed/MEDLINE from 2001 to August 2021 to identify relevant literature. We defined eligible articles as those reporting population-based studies of adults and excluded studies that reported only on high-risk or paediatric populations, or on incidence of precursor or related lesions. We summarised identified studies qualitatively. We calculated lifetime risk of developing keratinocyte cancer using the methods of Cancer Research UK, adjusting for multiple primaries and the competing risk of death.
We identified six eligible studies. In the absence of compulsory notifications of keratinocyte cancer to state and territory cancer registries in Australia, all estimates of national incidence rates of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) have limitations. The most recent population-based estimates of people annually affected for the period 2011-2014 (BCC: 770/100 000 person years; SCC: 271/100 000 person years) represent the lower end of the possible range of incidence rates nationally. Because many people are affected by multiple lesions, the lesion-based incidence estimates are more than double the person-based rates (BCC: 1565/100 000 person years; SCC: 580/100 000 person years). Analyses of temporal trends in treatment rates (excisions, cryotherapy/curettage) show increases over time, most marked for people aged 55 years or older. We estimate that 69% of Australians will have at least one excision for histologically confirmed keratinocyte cancer in their lifetime (60% to age 79 years).
The available evidence on national incidence rates is out of date and of moderate quality, but indicates very high rates of keratinocyte cancer in Australia. We recommend that population-based cancer registries work towards statutory notification and routine reporting of keratinocyte cancer in Australia.
Low muscular strength is a risk factor for current and future adverse health outcomes. However, whether levels of muscular strength persist, or track, and if there are distinct muscular strength ...trajectories across the life course is unclear. This study aimed to explore muscular strength trajectories between childhood and mid-adulthood.
Prospective longitudinal study.
Childhood Determinants of Adult Health Study participants had their muscular strength (right and left handgrip, shoulder extension and flexion, and leg strength measured by hand-held, shoulder and leg-back dynamometers, and a combined strength score) assessed in childhood, young adulthood and mid-adulthood. The tracking of muscular strength was quantified between childhood and mid-adulthood (n=385) and young- and mid-adulthood (n=822). Muscular strength trajectory patterns were identified for participants who had their muscular strength assessed at least twice across the life course (n=1280).
Levels of muscular strength were persistent between childhood and mid-adulthood and between young- and mid-adulthood, with the highest tracking correlations observed for the combined strength score (childhood to mid-adulthood: r=0.47, p<0.001; young- to mid-adulthood: r=0.72, p<0.001). Three trajectories of combined muscular strength were identified across the life course; participants maintained average, above average, or below average levels of combined muscular strength.
Weak children are likely to become weak adults in midlife unless strategies aimed at increasing muscular strength levels are introduced. Whether interventions aimed at increasing muscular strength could be implemented in childhood to help establish favourable muscular strength trajectories across the life course and in turn, better future health, warrant further attention.
The effect of supplementing unscreened adults with vitamin D
on mortality is unclear. We aimed to determine whether monthly doses of vitamin D
influenced mortality in older Australians.
We did a ...randomised, double-blind, placebo-controlled trial of oral vitamin D
supplementation (60 000 IU per month) in Australians 60 years or older who were recruited across the country via the Commonwealth electoral roll. Participants were randomly assigned (1:1), using automated computer-generated permuted block randomisation, to receive one oral gel capsule of either 60 000 IU vitamin D
or placebo once a month for 5 years. Participants, staff, and investigators were blinded to study group allocation. The primary endpoint was all-cause mortality assessed in all participants who were randomly assigned. We also analysed mortality from cancer, cardiovascular disease, and other causes. Hazard ratios (HRs) and 95% CIs were generated using flexible parametric survival models. This trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12613000743763.
Between Feb 14, 2014, and June 17, 2015, we randomly assigned 21 315 participants, including 10 662 to the vitamin D group and 10 653 to the placebo group. In 4441 blood samples collected from randomly sampled participants (N=3943) during follow-up, mean serum 25-hydroxy-vitamin D concentrations were 77 (SD 25) in the placebo group and 115 (SD 30) nmol/L in the vitamin D group. Following 5 years of intervention (median follow-up 5·7 years IQR 5·4-6·7), 1100 deaths were recorded (placebo 538 5·1%; vitamin D 562 5·3%). 10 661 participants in the vitamin D group and 10 649 participants in the placebo group were included in the primary analysis. Five participants (one in the vitamin D group and four in the placebo group) were not included as they requested to be withdrawn and their data to be destroyed. The HR of vitamin D
effect on all-cause mortality was 1.04 95% CI 0·93 to 1·18; p=0·47)and the HR of vitamin D
effect on cardiovascular disease mortality was 0·96 (95% CI 0·72 to 1·28; p=0·77). The HR for cancer mortality was 1·15 (95% CI 0·96 to 1·39; p=0·13) and for mortality from other causes it was 0·83 (95% CI 0·65 to 1·07; p=0·15). The odds ratio for the per-protocol analysis was OR 1·18 (95% CI 1·00 to 1·40; p=0·06). In exploratory analyses excluding the first 2 years of follow-up, those randomly assigned to receive vitamin D had a numerically higher hazard of cancer mortality than those in the placebo group (HR 1·24 95% CI 1·01-1·54; p=0·05).
Administering vitamin D
monthly to unscreened older people did not reduce all-cause mortality. Point estimates and exploratory analyses excluding the early follow-up period were consistent with an increased risk of death from cancer. Pending further evidence, the precautionary principle would suggest that this dosing regimen might not be appropriate in people who are vitamin D-replete.
The D-Health Trial is funded by National Health and Medical Research Council.
To evaluate whether childhood obesity is associated with infertility in women's reproductive-aged life.
Prospective longitudinal study.
Not applicable.
None.
A total of 1,544 girls, aged 7–15 years ...in 1985, and who completed questionnaires at follow-up in 2004-2006 and/or 2009-2011.
Infertility was defined as having difficulty conceiving (had tried for ≥12 months to become pregnant without succeeding) or having seen a doctor because of trouble becoming pregnant.
At ages from 7–11 years, girls at both the lower and upper end of the body mass index (BMI) z score had increased risk of infertility. Compared with normal weight girls, those with obesity at ages 7–11 years were more likely in adulthood to report infertility (adjusted relative risk aRR = 2.94, 95% confidence interval CI 1.48–5.84), difficulty conceiving (aRR = 3.89, 95% CI 1.95–7.77), or having seen a doctor because of trouble becoming pregnant (aRR = 3.65, 95% CI 1.90–7.02) after adjusting for childhood age, follow-up length, highest parental education, and marital status.
Childhood obesity before 12 years of age appears to increase the risk of female infertility in later life.
Asociación de obesidad infantil con infertilidad femenina en la edad adulta: Un estudio de 25 años de seguimiento
Evaluar si la obesidad infantil se asocia a infertilidad en mujeres en edad reproductiva.
Estudio prospectivo longitudinal.
No aplica.
Ninguna.
Un total de 1544 niñas, con edades entre 7-15 años en 1985, y que completaron cuestionarios en seguimientos en 2004-2006 y/o 2009-2011.
La infertilidad fue definida como tener dificultad para concebir (haber intentado conseguir embarazo durante ≥ 12 meses sin éxito), o haber visitado al médico por problemas para conseguir embarazo).
A las edades de 7-11 años, las niñas en los límites inferior y superior del índice de masa corporal (IMC) tuvieron un riesgo incrementado de infertilidad. Comparadas con las niñas con peso corporal normal, aquellas con obesidad a las edades de 7-11 años fueron más propensas a reportar infertilidad en la edad adulta (riesgo relativo ajustado aRR = 2,94, 95% intervalo de confianza IC 1,48-5,84), dificultad para concebir (aRR = 3,89, 95% IC 1,95-7,77), o haber visitado a un médico por problemas para conseguir embarazo (aRR = 3,65, 95% IC 1,90-7,02) después de ajustar para edad infantil, duración del seguimiento, mayor educación de los padres y estado civil.
La obesidad infantil antes de los 12 años parece aumentar el riesgo de infertilidad femenina en la vida posterior.
Abstract Objectives Low muscular fitness levels have previously been reported as an independent risk factor for chronic disease outcomes. Muscular fitness tracking, the ability to maintain levels ...measured at one point in time to another point in time, was assessed from youth to adulthood to provide insight into whether early identification of low muscular fitness in youth is possible. Design Prospective longitudinal study. Methods Study including 623 participants who had muscular fitness measures in 1985 (aged 9, 12 or 15 years) and again 20 years later in young adulthood. Measures of muscular fitness were strength (right and left grip, leg, shoulder extension and flexion measured by dynamometer, and a combined strength score) and power (standing long jump distance). Results Strength and power were relatively stable between youth and adulthood; the strongest tracking correlations were observed for the combined strength score (r = 0.47, p ≤ 0.001), right grip strength (r = 0.43, p ≤ 0.001) and standing long jump (r = 0.43, p ≤ 0.001). Youth in the lowest third of muscular fitness had an increased risk of remaining in the lowest third of muscular fitness in adulthood (strength: relative risk (RR) = 4.70, 95% confidence interval (CI) (3.19, 6.92); power: RR = 4.06 (2.79, 5.90)). Conclusions Youth with low muscular fitness are at increased risk of maintaining a low muscular fitness level into adulthood. These findings warrant investigation into the long term effects of early interventions that focus on improving low muscular fitness levels in youth which could potentially improve adult muscular fitness and reduce future chronic disease outcomes.
PDF
