Aim
We investigated the cross‐sectional association between diet quality and severe periodontitis in a sample of diverse Hispanics from the Hispanic Community Health Study/Study of Latinos.
Materials ...and methods
A total of 13,920 Hispanic/Latinos aged 18–74 years of different heritages underwent a full‐mouth oral examination and completed two 24‐hr dietary recalls during 2008–2011. Severe periodontitis was defined as having ≥30% tooth sites with clinical attachment loss ≥5 mm. Diet quality was assessed using the Alternative Healthy Eating Index (AHEI‐2010). We evaluated the association of diet quality with severe periodontitis adjusting for age, sex, nativity status, income, education, last dental visit, current insurance, cigarette smoking, diabetes, and energy intake.
Results
Relative to those at the lowest quartile of diet quality, individuals at the highest quartile had significantly lower odds of severe periodontitis (adjusted OR = 0.57, 95% CI: 0.39–0.82), with evidence of a dose–response relationship across AHEI quartiles. Among AHEI‐2010 components, higher consumption of whole grains and fruits, and lower consumption of red/processed meats were associated with lower odds of severe periodontitis.
Conclusion
Better‐quality diet was associated with lower prevalence of severe periodontitis although the causal pathways need to be clarified in future work.
Abstract Background Data on the association between dietary patterns and age-related cognitive decline are inconsistent. Objective To determine whether dietary patterns assessed by the alternate ...Mediterranean diet score (aMED), the Healthy Eating Index-2010 (HEI-2010), the Alternate Healthy Eating Index 2010 (AHEI-2010), or the Dietary Approach to Stop Hypertension (DASH) diet score are associated with cognitive decline in older women, and to examine whether dietary patterns modify the risk for cognitive decline in women with hypertension. Design Prospective, longitudinal cohort study. Food frequency questionnaires were used to derive dietary patterns at baseline. Hypertension was defined as self-report of current drug therapy for hypertension or clinic measurement of systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg. Participants and setting Postmenopausal women (N=6,425) aged 65 to 79 years who participated in the Women’s Health Initiative Memory Study and were cognitively intact at baseline. Main outcome measures Cognitive decline was defined as cases of mild cognitive impairment (MCI) or probable dementia (PD). Cases were identified through rigorous screening and expert adjudication. Statistical analyses performed Cox proportional hazards models with multivariable adjustment were used to estimate the relative risk for developing MCI or PD. Results During a median follow-up of 9.11 years, we documented 499 cases of MCI and 390 of PD. In multivariable analyses we did not detect any statistically significant relationships across quintiles of aMED, HEI-2010, DASH, and AHEI-2010 scores and MCI or PD ( P values for trend=0.30, 0.44, 0.23, and 0.45). In women with hypertension, we found no significant association between dietary patterns and cognitive decline ( P values for trend=0.19, 0.08, 0.07, and 0.60). Conclusions Dietary patterns characterized by the aMED, HEI-2010, AHEI-2010, or DASH dietary score were not associated with cognitive decline in older women. Adherence to a healthy dietary pattern did not modify the risk for cognitive decline in women with hypertension.
Recently developed accelerometer devices have been used in large epidemiological studies for continuous and objective monitoring of physical activities. Typically, physical movements are summarized ...as minutes in light, moderate, and vigorous physical activities in each wearing day. Because of preponderance of zeros, zero‐inflated distributions have been used for modeling the daily moderate or higher levels of physical activity. Yet, these models do not fully account for variations in daily physical activity and cannot be extended to model weekly physical activity explicitly, while the weekly physical activity is considered as an indicator for a subject's average level of physical activity. To overcome these limitations, we propose to use a zero‐inflated Poisson mixture distribution that can model daily and weekly physical activity in same family of mixture distributions. Under this method, the likelihood of an inactive day and the amount of exercise in an active day are simultaneously modeled by a joint random effects model to incorporate heterogeneity across participants. If needed, the method has the flexibility to include an additional random effect to address extra variations in daily physical activity. Maximum likelihood estimation can be obtained through Gaussian quadrature technique, which is implemented conveniently in an R package GLMMadaptive. Method performances are examined using simulation studies. The method is applied to data from the Hispanic Community Health Study/Study of Latinos to examine the relationship between physical activity and BMI groups and within a participant the difference in physical activity between weekends and weekdays.
Summary
Using a cross‐sectional probability sample with actigraphy data and two 24‐h dietary recalls, we quantified the association between sleep duration, continuity, variability and timing with the ...Alternative Healthy Eating Index‐2010 diet quality score and its components in 2140 Hispanic Community Health Study/Study of Latinos participants. The Alternative Healthy Eating Index diet quality‐2010 score ranges from 0 to 110, with higher scores indicating greater adherence to the dietary guidelines and lower risk from major chronic disease. None of the sleep measures was associated with total caloric intake as assessed using dietary recalls. However, both an increase in sleep duration and sleep efficiency were associated with healthier diet quality. Each standard deviation increase in sleep duration (1.05 h) and sleep efficiency (4.99%) was associated with a 0.30 point increase and 0.28 point increase, respectively, in the total Alternative Healthy Eating Index‐2010 score. The component of Alternative Healthy Eating Index‐2010 most strongly associated with longer sleep duration was increased nuts and legumes intake. The components of Alternative Healthy Eating Index‐2010 most strongly associated with higher sleep efficiency were increased whole fruit intake and decreased sodium intake. Both longer sleep duration and higher sleep efficiency were significantly associated with better diet quality among US Hispanic/Latino adults. The dietary components most strongly associated with sleep duration and sleep efficiency differed, suggesting potentially independent mechanisms by which each aspect of sleep impacts dietary choices. Longitudinal research is needed to understand the directionality of these identified relationships and the generalizability of these data across other ethnic groups.
Arsenic exposure has been linked to poor pulmonary function, and inefficient arsenic metabolizers may be at increased risk. Dietary rice has recently been identified as a possible substantial route ...of exposure to arsenic, and it remains unknown whether it can provide a sufficient level of exposure to affect pulmonary function in inefficient metabolizers. Within 12,609 participants of HCHS/SOL, asthma diagnoses and spirometry-based measures of pulmonary function were assessed, and rice consumption was inferred from grain intake via a food frequency questionnaire. After stratifying by smoking history, the relationship between arsenic metabolism efficiency percentages of inorganic arsenic (%iAs), monomethylarsenate (%MMA), and dimethylarsinate (%DMA) species in urine and the measures of pulmonary function were estimated in a two-sample Mendelian randomization approach (genotype information from an Illumina HumanOmni2.5-8v1-1 array), focusing on participants with high inferred rice consumption. Among never-smoking high inferred consumers of rice (n = 1395), inefficient metabolism was associated with past asthma diagnosis and forced vital capacity below the lower limit of normal (LLN) (OR 1.40, p = 0.0212 and OR 1.42, p = 0.0072, respectively, for each percentage-point increase in %iAs; OR 1.26, p = 0.0240 and OR 1.24, p = 0.0193 for %MMA; OR 0.87, p = 0.0209 and OR 0.87, p = 0.0123 for the marker of efficient metabolism, %DMA). Among ever-smoking high inferred consumers of rice (n = 1127), inefficient metabolism was associated with peak expiratory flow below LLN (OR 1.54, p = 0.0108/percentage-point increase in %iAs, OR 1.37, p = 0.0097 for %MMA, and OR 0.83, p = 0.0093 for %DMA). Less efficient arsenic metabolism was associated with indicators of pulmonary dysfunction among those with high inferred rice consumption, suggesting that reductions in dietary arsenic could improve respiratory health.
Objective: Levels of estrogen, androgen, and prolactin have been related to risk of postmenopausal breast cancer. However, the determinants of these hormone concentrations are not established. The ...purpose of this study was to examine correlates of endogenous sex hormones.
Research Methods and Procedures: Associations among adiposity, physical activity, and diet and concentrations of estradiol, free estradiol, estrone, testosterone, free testosterone, sex hormone‐binding globulin (SHBG), androstenedione, dehydroepiandrosterone, dehydroepiandrosterone sulfate, and prolactin were evaluated in 267 postmenopausal women randomly selected from the Women's Health Initiative Dietary Modification Trial.
Results: In multiple regression analyses on log‐transformed hormones, BMI was positively associated with estrone (β = 0.031, p < 0.001), estradiol (β = 0.048, p < 0.001), free estradiol (β = 0.062, p < 0.001), free testosterone (β = 0.017, p = 0.02), and prolactin (β = 0.012, p = 0.02) and negatively associated with SHBG (β = −0.02, p = 0.001). Total physical activity (metabolic equivalent tasks per week) was negatively associated with concentrations of estrone, estradiol, and androstenedione (β = −0.006, −0.007, and −0.005, respectively, all p ≤ 0.05). Using a composite variable of BMI and physical activity dichotomized by median values, women with high BMI/low physical activity had a mean estrone concentration of 28.8 pg/mL, compared with 24.1, 19.9, and 18.4 pg/mL for women with high BMI/high physical activity, low BMI/low physical activity, and low BMI/high physical activity, respectively (p trend < 0.001). Similar trends were observed for estradiol and free estradiol and, in inverse, for SHBG.
Discussion: These associations may, in part, explain the positive associations between overweight/obesity and a sedentary lifestyle on breast cancer risk.
Relatively few APOE ε4+ carriers survive to old age (age 80+) without cognitive impairment (CI); thus, little is known about distinguishing characteristics of resilient APOE ε4+ carriers. Herein, we ...describe the sociodemographic characteristics of a large sample of resilient APOE ε4+ women from the Women's Health Initiative Memory Study (WHIMS) and compare them to noncarriers and APOE ε4+ women who developed CI before age 80.
Women were recruited for clinical trials evaluating postmenopausal hormone therapy and incidence of dementia. During posttrial follow-up, cognitive status was adjudicated annually. Among 5716 women, we compared groups by APOE ε4 status using logistic regression, covarying for treatment, demographics, lifestyle, cardiovascular and physical function, well-being, and self-rated general health.
Among 557 APOE ε4+ women, those who survived to age 80+ without CI had higher baseline self-rated general health (odds ratio OR: 1.02; 95% confidence interval CI, 1.01-1.04) and cognitive scores (OR: 1.18; 95% CI, 1.12-1.25) than those who did not reach age 80 without CI. Baseline high total cholesterol and low-density lipoprotein (LDL) levels were similar across APOE ε4+ groups but were higher compared with APOE ε4- women. Among women who survived to 80+ without CI, more APOE ε4+ women had a history of high total cholesterol (P = .003) and LDL cholesterol (OR: 1.01; 95% CI, 1.00-1.01). There were no differences in hypertension, diabetes, or other vascular risk factors in APOE ε4+ women compared with noncarriers.
Results highlight the importance of baseline cognitive function and general health for late-life cognition among ε4+ women.
Availability of accelerometer data has made it possible to objectively and continuously monitor sedentary behavior. Various summaries of the extensive accelerometer data have been used to understand ...the relationship between sedentary behavior and health. However, the widely used summary measures on sedentary bouts, average bout length or its derivatives, fail to reveal patterns of accumulated sedentary behavior over time. Studies have suggested that prolonged uninterrupted sedentary behavior can be an important metric that is related to health states. Yet existing measures to capture the prolonged sedentary patterns either rely on parametric assumptions on the underlying distribution of sedentary bout length or have to categorize sedentary bout length into somewhat arbitrary categories. Gini index was also used; however, it only measures the variability in bout lengths but not the actual length. To overcome these limitations, we proposed a non-parametric weighted survival function to characterize uninterrupted sedentary behavior over time in a continuous fashion and used the area under the survival curve as a new summary measure to quantify sedentary behavior. We showed that this measure is a weighted average of bout length and contains the information on both the mean and variability of bout lengths. We demonstrated in the simulation studies that the proposed measure could better identify prolonged uninterrupted sedentary behavior and predict health outcomes. We applied this new measure and existing sedentary measures to data from the Hispanic Community Health Study/Study of Latinos to examine the association between sedentary behavior and overweight/obesity.
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