Background The HealthNuts study previously reported interim prevalence data showing the highest prevalence of challenge-confirmed food allergy in infants internationally. However, population-derived ...prevalence data on challenge-confirmed food allergy and other allergic diseases in preschool-aged children remain sparse. Objective This study aimed to report the updated prevalence of food allergy at age 1 year from the whole cohort, and to report the prevalence of food allergy, asthma, eczema, and allergic rhinitis at age 4 years. Methods HealthNuts is a population-based cohort study with baseline recruitment of 5276 one-year-old children who underwent skin prick test (SPT) to 4 food allergens and those with detectable SPT results had formal food challenges. At age 4 years, parents completed a questionnaire (81.3% completed) and those who previously attended the HealthNuts clinic at age 1 year or reported symptoms of a new food allergy were invited for an assessment that included SPT and oral food challenges. Data on asthma, eczema, and allergic rhinitis were captured by validated International Study of Asthma and Allergies in Childhood questionnaires. Results The prevalence of challenge-confirmed food allergy at age 1 and 4 years was 11.0% and 3.8%, respectively. At age 4 years, peanut allergy prevalence was 1.9% (95% CI, 1.6% to 2.3%), egg allergy was 1.2% (95% CI, 0.9% to 1.6%), and sesame allergy was 0.4% (95% CI, 0.3% to 0.6%). Late-onset peanut allergy at age 4 years was rare (0.2%). The prevalence of current asthma was 10.8% (95% CI, 9.7% to 12.1%), current eczema was 16.0% (95% CI, 14.7% to 17.4%), and current allergic rhinitis was 8.3% (95% CI, 7.2% to 9.4%). Forty percent to 50% of this population-based cohort experienced symptoms of an allergic disease in the first 4 years of their life. Conclusions Although the prevalence of food allergy decreased between age 1 year and age 4 years in this population-based cohort, the prevalence of any allergic disease among 4-year-old children in Melbourne, Australia, is remarkably high.
Background Epidemiological evidence has shown that pediatric food allergy is more prevalent in regions further from the equator, suggesting that vitamin D insufficiency may play a role in this ...disease. Objective To investigate the role of vitamin D status in infantile food allergy. Methods A population sample of 5276 one-year-old infants underwent skin prick testing to peanut, egg, sesame, and cow’s milk or shrimp. All those with a detectable wheal and a random sample of participants with negative skin prick test results attended a hospital-based food challenge clinic. Blood samples were available for 577 infants (344 with challenge-proven food allergy, 74 sensitized but tolerant to food challenge, 159 negative on skin prick test and food challenge). Serum 25-hydroxyvitamin D levels were measured by using liquid chromatography tandem mass spectrometry. Associations between serum 25-hydroxyvitamin D and food allergy were examined by using multiple logistic regression, adjusting for potential risk and confounding factors. Results Infants of Australian-born parents, but not of parents born overseas, with vitamin D insufficiency (≤50 nmol/L) were more likely to be peanut (adjusted odds ratio aOR, 11.51; 95% CI, 2.01-65.79; P = .006) and/or egg (aOR, 3.79; 95% CI, 1.19-12.08; P = .025) allergic than were those with adequate vitamin D levels independent of eczema status. Among those with Australian-born parents, infants with vitamin D insufficiency were more likely to have multiple food allergies (≥2) rather than a single food allergy (aOR, 10.48; 95% CI, 1.60-68.61 vs aOR, 1.82; 95% CI, 0.38-8.77, respectively). Conclusions These results provide the first direct evidence that vitamin D sufficiency may be an important protective factor for food allergy in the first year of life.
Objectives To examine the modifiable factors that alter the trajectory of blood pressure (BP) from childhood to adulthood. Study design This study investigated the BP of 798 participants (53% female) ...from the Childhood Determinants of Adult Health Study who had BP measured when aged 9, 12, or 15 years, and at follow-up 20 years later. BP was classified as normal or elevated (prehypertensive or hypertensive) in childhood and adulthood. BP trajectory groups (persistently normal, resolution, incident elevated, persistently elevated) were established according to these classifications. Potentially modifiable factors measured at both examinations included body mass index, fruit and vegetable intake, physical activity, cardiorespiratory fitness, alcohol consumption, smoking, and socioeconomic status. Results Spearman correlation coefficients for BP tracking from childhood to adulthood were 0.31 ( P < .001) for systolic BP and 0.16 ( P < .001) for diastolic BP. Children with elevated BP had a 35% increased risk of elevated BP in adulthood compared with those with normal BP (relative risk 1.35, 95% CI 1.18-1.55, P < .001). Relative to those with persistently elevated BP, participants in the resolution group significantly decreased their body mass index z-score, decreased their alcohol consumption z-score, and increased their vegetable consumption z-score between childhood and adulthood. The proportion of participants with upwardly mobile socioeconomic status was significantly higher in the resolution group (41.2%) compared with the persistently elevated group (27.5%). Conclusions Resolution of elevated BP in the transition from childhood to adulthood appeared to be partially determined by modifiable factors associated with a healthy lifestyle.
Abstract Background Partnering and parenting are important life-stage transitions that often occur during young adulthood. Little is known about how these transitions affect two dietary behaviors ...linked to increased cardiometabolic disease risk: skipping breakfast and takeaway-food consumption. Objective Our aim was to examine whether partnering and parenting transitions during a 5-year period were associated with change in diet quality, skipping breakfast, and takeaway-food consumption. Design We conducted a cohort study. Questionnaires were completed at baseline (2004 to 2006) and follow-up (2009 to 2011). Marital status and number of children were self-reported. Participants/setting Australian participants (n=1,402 39% men) aged 26 to 36 years were included. Main outcomes measures Diet quality was assessed using a Dietary Guideline Index. Breakfast skipping (not eating before 9 am the previous day) and frequent takeaway-food consumption (≥2 times/week) were reported. Statistical analysis Linear regression (mean differences in Dietary Guideline Index) and log binomial regression (relative risks for skipping breakfast and frequent takeaway-food consumption) were adjusted for age, education, follow-up duration, day of the week (skipping breakfast only), the other transition, and baseline behavior. Results During the 5-year follow-up, 101 men and 93 women became married/living as married, and 149 men and 155 women had their first child. Diet quality improved among all groups and was similar at follow-up between those who experienced the transitions and those who did not. Compared to having no children, having a first child was associated with a lower risk of skipping breakfast for men (relative risk 0.65; 95% CI 0.42 to 1.01) and women (relative risk 0.47; 95% CI 0.31 to 0.72). Men who became partnered also had a lower risk of skipping breakfast than those who remained single (relative risk 0.64; 95% CI 0.42 to 0.98). The transitions were not significantly associated with takeaway-food consumption. Conclusions Life-stage transitions were not associated with better diet quality. Participants who became partnered or parents were more likely to eat breakfast at follow-up than those who remained single or had no children.
Background Pedometers are increasingly being used to assess population levels of physical activity and as motivational tools for individuals to increase their physical activity. To maximize their ...utility, a framework for classifying pedometer-determined activity into meaningful health-related categories is needed. Purpose This study investigated whether a pedometer step index proposed by Tudor-Locke and Bassett can effectively group younger and older adults according to cardiometabolic health status. Methods Analyses (conducted in 2008) used cross-sectional data from the Childhood Determinants of Adult Health study (1793 adults aged 26–36 years; collected 2004–2006) and from the Tasmanian Older Adult Cohort study (1014 adults aged 50–80 years; collected 2002–2006). Participants wore a pedometer for 7 days and the prevalence of cardiometabolic health indicators, including the metabolic syndrome, elevated Pathobiological Determinants of Atherosclerosis in Youth risk scores, and elevated Framingham risk scores, was examined across the following step categories: sedentary (<5000); low-active (5000–7499); somewhat active (7500–9999); active (10,000–12,499); and high-active (≥12,500). Results With the exception of younger men, individuals achieving ≥5000 steps had a substantially lower prevalence of adverse cardiometabolic health indicators than those obtaining fewer steps. Differences in the prevalence of adverse indicators were generally modest across higher steps-per-day categories. However, younger men and women in the high-active category had a substantially lower prevalence of some adverse health indicators. Conclusions In general, the proposed index for classifying pedometer activity effectively distinguishes cardiometabolic health risk. Pedometers may be a useful tool for objectively identifying inactive individuals at greatest risk for poor cardiometabolic health.
Physical Activity and Depression in Young Adults McKercher, Charlotte M., BA; Schmidt, Michael D., PhD; Sanderson, Kristy A., PhD ...
American journal of preventive medicine,
02/2009, Letnik:
36, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Background Epidemiologic research suggests that physical activity is associated with decreased prevalence of depression. However, the relationship between physical activity accumulated in various ...domains and depression remains unclear. Further, previous population-based studies have predominantly utilized self-reported measures of physical activity and depression symptom subscales. Associations between physical activity in various domains (leisure, work, active commuting, yard/household) and depression were examined using both subjective and objective measures of physical activity and a diagnostic measure of depression. Methods Analyses (conducted in 2007) included data from 1995 young adults participating in a national study (2004–2006). Physical activity was measured by self-report (International Physical Activity Questionnaire) and objectively as pedometer steps/day. Depression (DSM-IV 12-month diagnosis of major depression or dysthymic disorder) was assessed using the Composite International Diagnostic Interview. Results For women, moderate levels of ambulatory activity (≥7500 steps/day) were associated with ∼50% lower prevalence of depression compared with being sedentary (<5000 steps/day) ( p trend=0.005). Relatively low durations of leisure physical activity (≥1.25 hours/week) were associated with ∼45% lower prevalence compared with the sedentary group (0 hours/week) ( p trend=0.003). In contrast, high durations of work physical activity (≥10 hours/week) were associated with an approximate twofold higher prevalence of depression compared with being sedentary (0 hours/week) ( p trend=0.005). No significant associations were observed for steps/day in men or for other types of self-reported activity including total physical activity in both men and women. Conclusions These findings indicate that the context in which physical activity is assessed and the measurement methods utilized are important considerations when investigating associations between physical activity and depression.
Purpose To compare the ability of alternative measures of physical activity and fitness to quantify associations with health outcomes. Methods Associations between a range of subjective and objective ...physical activity and fitness measures and cardiometabolic risk factors were examined using data from 1,631 Australians aged 26–36 years. Anthropometry, fitness, blood pressure, and fasting blood glucose, insulin, and lipids were measured at study clinics. Participants completed the International Physical Activity Questionnaire (IPAQ) and 7-day pedometer diaries; they also reported sedentary behavior (sitting, television viewing). Results In men and women, associations were strongest for fitness, with those in the highest (vs. lowest) fitness quarter having a 75% to 80% lower prevalence of two or more primary risk factors (waist circumference, high-density lipoprotein cholesterol, and insulin resistance). In men, a 60% to 70% reduced prevalence of two or more risk factors was observed across extreme quarters of IPAQ leisure, IPAQ vigorous, sitting duration, and pedometer measures. Similar reductions in prevalence were observed only across extreme quarters of pedometer activity and television viewing in women. Conclusions Associations between alternative measures and cardiometabolic risk were relatively independent, suggesting that a range of physical activity and fitness measures may be needed to most accurately quantify associations between physical activity and health.
Socioeconomic disadvantage throughout the life course is associated with increased risk of cardiometabolic diseases, but traditional risk factors do not fully account for the social gradient. We ...investigated the interactions between low socioeconomic status (SES) and infection in childhood and adverse cardiometabolic parameters in adulthood.
Participants from the Cardiovascular Risk in Young Finns Study, a cohort well phenotyped for childhood and adulthood cardiometabolic risk factors and socioeconomic parameters, were linked to lifetime hospitalization data from birth onward available from the Finnish National Hospital Registry. In those with complete data, we investigated relationships between infection-related hospitalization in childhood, SES, and childhood and adult cardiometabolic parameters.
The study cohort consisted of 1015 participants (age range 3-18 years at baseline and 30-45 years at follow-up). In adults who were raised in below-median income families, childhood infection-related hospitalizations (at age 0-5 years) were significantly associated with higher adult BMI (β ± SE comparing those with 0 vs ≥1 hospitalizations 2.4 ± 0.8 kg/m(2), P = .008), waist circumference (7.4 ± 2.3 cm, P = .004), and reduced brachial flow-mediated dilatation (-2.7 ± 0.9%, P = .002). No equivalent associations were observed in participants from higher-SES families.
Infection was associated with worse cardiovascular risk factor profiles only in those from lower-SES families. Childhood infection may contribute to social gradients observed in adult cardiometabolic disease risk factors. These findings suggest reducing childhood infections, especially in socioeconomic disadvantaged children, may reduce the cardiometabolic disease burden in adults.
Objectives This study was designed to determine which of the National Cholesterol Education Program or National Health and Nutrition Examination Survey low- and high-density lipoprotein cholesterol ...classifications of dyslipidemia status in adolescents is most effective at predicting high common carotid artery intima-media thickness (IMT) in adulthood. Background Two classifications of pediatric dyslipidemia status have been proposed. No study has assessed which of these is most effective for predicting adolescents who will develop preclinical atherosclerosis in adulthood. Methods Three population-based, prospective cohort studies collected lipoprotein measurements on 1,711 adolescents age 12 to 18 years who were remeasured as young adults age 29 to 39 years. Lipoproteins in adolescence were classified according to National Cholesterol Education Program and National Health and Nutrition Examination Survey cut points, and high IMT in adulthood was defined as those at or above the age-, sex-, race-, and cohort-specific 90th percentile of IMT. Results Independent of the classification employed, adolescents with dyslipidemia were at significantly increased risk of having high IMT in adulthood (relative risks from 1.6 to 2.5). Differences in predictive capacity between both classifications were minimal. Overweight or obese adolescents with dyslipidemia had increased carotid IMT (males: 0.11 mm; females: 0.08 mm) in adulthood compared with those who did not have both risk factors. Adolescent dyslipidemia status was more strongly associated with high IMT in adulthood than change in dyslipidemia status. Conclusions Pediatric dyslipidemia classifications perform equally in the prediction of adolescents who are at increased risk of high IMT in young adulthood. Our data suggest that dyslipidemia screening could be limited to overweight or obese adolescents.
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