Search

Objectives. To examine whether workplace interventions to increase workplace flexibility and supervisor support and decrease work–family conflict can reduce cardiometabolic risk. Methods. We randomly assigned employees from information technology (n = 555) and long-term care (n = 973) industries in the United States to the Work, Family and Health Network intervention or usual practice (we collected the data 2009–2013). We calculated a validated cardiometabolic risk score (CRS) based on resting blood pressure, HbA1c (glycated hemoglobin), HDL (high-density lipoprotein) and total cholesterol, height and weight (body mass index), and tobacco consumption. We compared changes in baseline CRS to 12-month follow-up. Results. There was no significant main effect on CRS associated with the intervention in either industry. However, significant interaction effects revealed that the intervention improved CRS at the 12-month follow-up among intervention participants in both industries with a higher baseline CRS. Age also moderated intervention effects: older employees had significantly larger reductions in CRS at 12 months than did younger employees. Conclusions. The intervention benefited employee health by reducing CRS equivalent to 5 to 10 years of age-related changes for those with a higher baseline CRS and for older employees. Trial Registration. ClinicalTrials.gov Identifier: NCT02050204. (Am J Public Health. 2023;113(12):1322–1331. https://doi.org/10.2105/AJPH.2023.307413) [ABSTRACT FROM AUTHOR]

Background: Epstein-Barr virus (EBV) is a common herpesvirus linked to infectious mononucleosis and multiple cancers. There are no national estimates of EBV seroprevalence in the United States. Our objective was to estimate the overall prevalence and sociodemographic predictors of EBV among U.S. children and adolescents aged 6–19. Methods: We calculated prevalence estimates and prevalence ratios for EBV seroprevalence using data from the 2003–2010 U.S. National Health and Nutrition Examination Survey (NHANES) for children aged 6–19 (n = 8417). Poisson regression was used to calculate multivariable-adjusted prevalence ratios across subgroup categories (sex, race/ethnicity, parental education, household income, household size, foreign-born, BMI, and household smoking). Findings: Overall EBV seroprevalence was 66.5% (95% CI 64.3%–68.7%.). Seroprevalence increased with age, ranging from 54.1% (95% CI 50.2%–57.9%) for 6–8 year olds to 82.9% (95% CI 80.0%–85.9%) for 18–19 year olds. Females had slightly higher seroprevalence (68.9%, 95% CI 66.3%–71.6%) compared to males (64.2%, 95% CI 61.7%–66.8%). Seroprevalence was substantially higher for Mexican-Americans (85.4%, 95% CI 83.1%–87.8%) and Non-Hispanic Blacks (83.1%, 95% CI 81.1%–85.1%) than Non-Hispanic Whites (56.9%, 95% CI 54.1%–59.8%). Large differences were also seen by family income, with children in the lowest income quartile having 81.0% (95% CI 77.6%–84.5%) seroprevalence compared to 53.9% (95% CI 50.5%–57.3%) in the highest income quartile, with similar results for parental education level. These results were not explained by household size, BMI, or parental smoking. Among those who were seropositive, EBV antibody titers were significantly higher for females, Non-Hispanic Blacks and Mexican-Americans, with no association found for socioeconomic factors. Conclusions: In the first nationally representative U.S. estimates, we found substantial socioeconomic and race/ethnic differences in the seroprevalence of EBV across all ages for U.S. children and adolescents. These estimates can help researchers and clinicians identify groups most at risk, inform research on EBV-cancer etiology, and motivate potential vaccine development. [ABSTRACT FROM AUTHOR]

Abstract: Health-related behaviors in adolescence establish trajectories of risk for obesity and chronic degenerative diseases, and they represent an important pathway through which socio-economic environments shape patterns of morbidity and mortality. Most behaviors that promote health involve making choices that may not pay off until the future, but the factors that predict an individual’s investment in future health are not known. In this paper we consider whether expectations for the future in two domains relevant to adolescents in the U.S.—perceived chances of living to middle age and perceived chances of attending college—are associated with an individual’s engagement in behaviors that protect health in the long run. We focus on adolescence as an important life stage during which habits formed may shape trajectories of disease risk later in life. We use data from a large, nationally representative sample of American youth (the US National Longitudinal Study of Adolescent Health) to predict levels of physical activity, fast food consumption, and cigarette smoking in young adulthood in relation to perceived life chances in adolescence, controlling for baseline health behaviors and a wide range of potentially confounding factors. We found that adolescents who rated their chances of attending college more highly exercised more frequently and smoked fewer cigarettes in young adulthood. Adolescents with higher expectations of living to age 35 smoked fewer cigarettes as young adults. Parental education was a significant predictor of perceived life chances, as well as health behaviors, but for each outcome the effects of perceived life chances were independent of, and often stronger than, parental education. Perceived life chances in adolescence may therefore play an important role in establishing individual trajectories of health, and in contributing to social gradients in population health. [Copyright &y& Elsevier]

The Health and Retirement Study (HRS) is an important national resource for policy makers and investigators across a wide range of disciplines, and it is critical that the study collects the best information possible on the health status of its participants within the constraints of the survey design, and without compromising the integrity of the sample. Potential directions for the collection and analysis of biomarker data in future waves of HRS are discussed, with a primary focus on blood-based biomarkers. Advantages and disadvantages of various methods for collecting blood in the home are considered, with particular attention given to the strengths and weaknesses of dried blood spot (DBS) sampling. DBS sampling has been widely applied in recent biosocial surveys due to the low cost and burden associated with sample collection, but these benefits need to be weighed against challenges associated with quantification in the laboratory. Attention is also given to additional biomarkers that may be of relevance to HRS, and that would expand the survey's current focus on obesity and metabolic syndrome. Measures of inflammation, pathogen exposure, reproductive function, stress, and epigenetic modifications are suggested as potentially productive future directions for the study. In addition, the analysis concludes with the following recommendations for HRS: Continue to collect DBS samples, but consider alternatives; implement enhanced procedures for quality control; calibrate DBS results against plasma values, and invest in methods development. [ABSTRACT FROM AUTHOR]

The article presents a study on the effect of breastfeeding on childhood obesity in the U.S. The study evaluated the relation between body mass index (BMI) and infant feeding using linear-, logistic-, and sibling fixed-effects regression models. Results show that breast feeding during infancy may help against obesity and these results could provide additional support for implementation of policies made to support breastfeeding mothers, according to the authors.

Cardiovascular disease (CVD) is a leading cause of death in the Philippines, although few studies here have examined the lipid profiles underlying disease risk. The isolated low high density lipoprotein cholesterol/HDL-c) phenotype has been implicated as a CVD risk factor, the prevalence of which exhibits significant variation across populations. To assess population variation in individual lipid components and their associations with diet and anthropometric characteristics, we compare lipid profiles in a population of adult Filipino women (n=1877) to US women participating in the National Health and Nutrition Examination Survey (NHANES, n=477). We conducted multiple regression models to assess the relationship between lipid components, body mass index, and dietary variables in the two populations. We measured the prevalence of lipid phenotypes, and logistic regression models determined the predictors of the isolated low HDL-c phenotype. High density lipoprotein cholesterol was lower in the Philippines (40.8±0.2 mg/dL) than in NHANES (60.7±0.7 mg/dL). The prevalence of the isolated low HDL-c phenotype was 28.8%, compared to 2.10% in NHANES. High prevalence among Filipinos was relatively invariant across all levels of BMI, hut was strongly inversely related to BMI in NHANES and exhibited only at the BMI>25 kg/m2 threshold. Diet did not consistently predict the low-HDL phenotype in Filipinos. Filipino women exhibit a high prevalence of the isolated low HDL-c phenotype, which is largely decoupled from anthropometric factors. The relationship of CVD to population variation in dyslipidemia and body composition needs further study, particularly in populations where the burden of cardiovascular and metabolic disease is rapidly increasing. [ABSTRACT FROM AUTHOR]

Objectives. We explored how income and skin color interact to influence the blood pressure of African American adults enrolled in the longitudinal Coronary Artery Risk Development in Young Adults (CARDIA) Study. Methods. Data were derived from 1893 African American CARDIA year-15 participants who had undergone skin reflectance assessments at year 7. We adjusted for age, gender, body mass index, smoking status, and use of antihypertensive medication to examine whether year-15 self-reported family incomes, in interaction with skin reflectance, predicted blood pressure levels. Results. Mean systolic and diastolic blood pressure levels were 117.1 (±16.07) and 76.9 (±12.5) mm Hg, respectively. After adjustment, the interaction between skin reflectance and income was significantly associated with systolic blood pressure (P<.01). Among lighter-skinned African Americans, systolic pressure decreased as income increased (b = -1.15, P<.001); among those with darker skin, systolic blood pressure increased with increasing income (b = 0.10, P = .75). Conclusions. The protective gradient of income on systolic blood pressure seen among African Americans with lighter skin is not observed to the same degree among those with darker skin. Psychosocial Stressors, including racial discrimination, may play a role in this relationship. (Am J Public Health. 2007;97: 2253-2259.doi:10.2105/AJPH.2006.088799) [ABSTRACT FROM AUTHOR]

Chronic inflammation is a potentially important mechanism through which social inequalities may contribute to health inequalities over the life course. Excess body fat contributes to chronic inflammation, and younger adults in the US have come of age during a pronounced secular increase in body mass index (BMI). We aim to document levels of chronic inflammation in a nationally representative sample of 33-to-44 year-old adults in the US, and to describe associations with BMI, race/ethnicity, and education. High sensitivity C-reactive protein (CRP) was measured in Wave V (2016–18) of the National Longitudinal Study of Adolescent to Adult Health, with complete data available for 4349 participants. Sex-stratified weighted regression models were implemented to investigate CRP in association with education, race/ethnicity, and BMI. Geometric mean CRP was 1.9 mg/L, and 35.4% of the sample had CRP >3 mg/L. Females had significantly higher CRP than males. Body mass index was a strong positive predictor of CRP, and education level was negatively associated with CRP. Associations between education and CRP were substantially attenuated after adjusting for BMI. High risk CRP increased linearly with BMI even among the obese: 87.0 percent of females and 74.1 percent of males with class 3 obesity (BMI ≥40) were predicted to have high risk CRP > 3 mg/L. The obesity epidemic is producing an epidemic of chronic inflammation in early mid-adulthood in the US. Strong associations between BMI and chronic inflammation portend high risk for future disease—and inequitable distribution of disease—as the cohort ages. • Levels of chronic inflammation are high among young and middle-age US adults. • Body mass predicts chronic inflammation and largely explains differences by education. • The obesity epidemic is producing an epidemic of chronic inflammation in the US. • High levels of chronic inflammation portend increased risk for future disease. [ABSTRACT FROM AUTHOR]

The United States is characterized by persistent and widening social inequities in a wide range of adult health outcomes. A life course approach challenges us to consider if, and how, these inequities trace back to early life conditions, and chronic inflammation represents a potentially important mechanism through which early environments may have lasting effects on health in adulthood. Low birth weight (LBW) and shorter durations of breastfeeding both predict increased inflammation in adulthood, which is associated with increased risk for cardiovascular disease, metabolic syndrome, and all-cause mortality. Using data from a large representative sample of young adults in the US (National Longitudinal Study of Adolescent to Adult Health (Add Health)), we document the socioeconomic status (SES) gradient in chronic inflammation, as indicated by concentrations of C-reactive protein (CRP). Using a nested set of structural equation models and marginal standardization techniques, we investigate the extent to which this gradient is explained by patterns of LBW and breastfeeding in infancy. Findings reveal a particularly important role for breastfeeding duration: Based on model predictive margins, increasing breastfeeding duration to three or more months corresponds to a flattening of the SES gradient by 80%, and 83% when LBW is eliminated. This study expands current understandings of the consequential role of developmental environments for population health and for addressing health inequities in future generations. • Lower socioeconomic status is associated with higher chronic inflammation. • Breastfed individuals have lower levels of chronic inflammation in young adulthood. • Breastfeeding accounts for 80 percent of the socioeconomic gradient in inflammation. • Body mass partly mediates the association between breastfeeding and inflammation. [ABSTRACT FROM AUTHOR]

Highlights: [•] We model the relationship between color and educational attainment within sex and race. [•] We use the percent of light reflected off skin as a continuous measure of skin color. [•] Lightness is associated with higher attainment in US-born Black men and women. [•] Lightness is associated with higher attainment for White women, but not for White men. [•] Discrimination by skin color may be less specific to race than previously thought. [Copyright &y& Elsevier]

Background: Adolescent violence victimisation is associated with a spectrum of adult social and behavioural health outcomes, including adverse mental health symptoms. However, underlying social stress mechanisms linking adolescent victimisation to adult cardiometabolic health remains poorly understood., Aim: The current study aims to reveal how adolescent and adult interpersonal violence exposures each get "under the skin" to affect adult metabolic syndrome, including direct victimisation and, additionally, witnessing violence., Subjects and Methods: We use a nationally representative longitudinal cohort, the National Longitudinal Study of Adolescent to Adult Health, and leverage a quasi-experimental approach, propensity score matching regression analysis ( n  = 14,267)., Results: We find that adolescent violence exposure carries an enduring effect on young adult metabolic syndrome risk factor incidence and high-risk status, which is independent of young adult violence. Violence effects do not vary by sex or racial identity., Conclusion: In sum, adolescent exposure to direct interpersonal violence significantly affects young adult cardiometabolic health in ways suggesting adolescence is a sensitive period for the onset of harmful cardiometabolic effects in early adulthood. Findings warrant future study of underlying pathways and how these effects shape social inequities in cardiometabolic health among U.S. adults broadly.

This paper examines how body size changes over the early life course to predict high sensitivity C-reactive protein in a U.S. based sample. Using three waves of the National Longitudinal Study of Adolescent Health (Add Health), we test the chronic disease epidemiological models of fetal origins, sensitive periods, and chains of risk from birth into adulthood. Few studies link birth weight and changes in obesity status over adolescence and early adulthood to adult obesity and inflammation. Consistent with fetal origins and sensitive periods hypotheses, body size and obesity status at each developmental period, along with increasing body size between periods, are highly correlated with adult CRP. However, the predictive power of earlier life course periods is mediated by body size and body size change at later periods in a pattern consistent with the chains of risk model. Adult increases in obesity had effect sizes of nearly 0.3 sd, and effect sizes from overweight to the largest obesity categories were between 0.3 and 1 sd. There was also evidence that risk can be offset by weight loss, which suggests that interventions can reduce inflammation and cardiovascular risk, that females are more sensitive to body size changes, and that body size trajectories over the early life course account for African American- and Hispanic-white disparities in adult inflammation., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Stress and immune function may be important mediators of the strong association between social factors and health over the life course, but previous studies have lacked the data to fully explore these links in a population-based sample. This study utilizes data from Waves I-IV of the U.S. National Longitudinal Study of Adolescent Health (Add Health) to test the associations of race/ethnicity and socioeconomic status (SES) with levels of perceived stress and exposure to stressful life events (SLE) among 11,050 adult respondents aged 24-32 in 2008-2009. We further tested whether race/ethnicity and SES were associated with Epstein-Barr Virus (EBV) specific IgG antibodies, an indirect marker of cell-mediated immune function. Finally, we tested whether measures of stress were associated with EBV IgG and whether there was evidence that they explain any associations between race/ethnicity, SES and EBV IgG. We found strong associations between lower SES and higher levels of perceived stress (OR 2.07, 95% CI 1.73-2.48 for < high school vs. college or above) and a high level of stressful life events (OR 7.47, 95% CI 5.59-9.98 for < high school vs. college or above). Blacks had higher odds of a high level of stressful life events compared to whites (OR 2.00, 95% CI 1.63-2.47), but not higher perceived stress (OR 1.11, 95% CI 0.96-1.28). Blacks also had significantly higher EBV levels compared to whites (β = 0.136, p < 0.01), but lower SES was not associated with higher EBV IgG. We found no evidence that stressful life events or perceived stress were associated with EBV IgG in this sample, and thus did not account for racial differences in EBV IgG. These results suggest consistent race/ethnic and SES differences in stressful life events, and confirm race/ethnic differences in markers of immune function that may have health implications across the life course., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Background and Objective: Rates of paternal depression range from 5% to 10% with a growing body of literature describing the harm to fathers, children, and families. Changes in depression symptoms over the life course, and the role of social factors, are not well known. This study examines associations with changes in depression symptoms during the transition to fatherhood for young fathers and whether this association differed by key social factors., Methods: We combined all 4 waves of the National Longitudinal Study of Adolescent Health to support a 23-year longitudinal analysis of 10 623 men and then created a "fatherhood-year" data set, regressing age-adjusted standardized depressive symptoms scores on fatherhood status (nonresidence/residence), fatherhood-years, and covariates to determine associations between Center for Epidemiologic Studies Depression Scale scores and fatherhood life course intervals., Results: Depressive symptom scores reported at the entry into fatherhood are higher for nonresident fathers than nonfathers, which in turn are higher than those of resident fathers. Resident fathers have a significant decrease in scores during late adolescence (β = -0.035, P = .023), but a significant increase in scores during early fatherhood (β = 0.023, P = .041). From entrance into fatherhood to the end of early fatherhood (+5 years), the depressive symptoms score for resident fathers increases on average by 68%., Conclusions: In our longitudinal, population-based study, resident fathers show increasing depressive symptom scores during children's key attachment years of 0-5. Identifying at-risk fathers based on social factors and designing effective interventions may ultimately improve health outcomes for the entire family., (Copyright © 2014 by the American Academy of Pediatrics.)

Chronic inflammation is a potentially important physiological mechanism linking early life environments and health in adulthood. Elevated concentrations of C-reactive protein (CRP)--a key biomarker of inflammation--predict increased cardiovascular and metabolic disease risk in adulthood, but the developmental factors that shape the regulation of inflammation are not known. We investigated birth weight and breastfeeding duration in infancy as predictors of CRP in young adulthood in a large representative cohort study (n = 6951). Birth weight was significantly associated with CRP in young adulthood, with a negative association for birth weights 2.8 kg and higher. Compared with individuals not breastfed, CRP concentrations were 20.1%, 26.7%, 29.6% and 29.8% lower among individuals breastfed for less than three months, three to six months, 6-12 months and greater than 12 months, respectively. In sibling comparison models, higher birth weight was associated with lower CRP for birth weights above 2.5 kg, and breastfeeding greater than or equal to three months was significantly associated with lower CRP. Efforts to promote breastfeeding and improve birth outcomes may have clinically relevant effects on reducing chronic inflammation and lowering risk for cardiovascular and metabolic diseases in adulthood.

Household financial debt in America has risen dramatically in recent years. While there is evidence that debt is associated with adverse psychological health, its relationship with other health outcomes is relatively unknown. We investigate the associations of multiple indices of financial debt with psychological and general health outcomes among 8400 young adult respondents from the National Longitudinal Study of Adolescent Health (Add Health). Our findings show that reporting high financial debt relative to available assets is associated with higher perceived stress and depression, worse self-reported general health, and higher diastolic blood pressure. These associations remain significant when controlling for prior socioeconomic status, psychological and physical health, and other demographic factors. The results suggest that debt is an important socioeconomic determinant of health that should be explored further in social epidemiology research., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Purpose: To examine the associations between adverse interpersonal relationship histories experienced during adolescence and health in young adulthood in a large, nationally representative sample., Methods: Using data from Waves I, II, and III of the National Longitudinal Study of Adolescent Health, multiple adverse relationship experiences were examined, including high loneliness, low perceived parental support, frequent transitions in romantic relationships (relationship instability), exposure to intimate partner violence, and loss by death of important relationship figures. These histories are assessed, both individually and in a relationship risk index, as predictors of self-reported general health and depressive symptoms at Wave III (ages, 18-27), controlling for baseline (Wave I) health and for demographic and health behavior covariates., Results: Net of baseline health and covariates, each type of relationship risk (experienced between Wave I and Wave III) was related to either depression or general health at Wave III, with the strongest effects seen for exposure to intimate partner violence. In addition, a cumulative relationship risk index examining the extent to which youth experienced high levels of multiple relationship risk factors revealed that each additional adverse relationship experience increased the odds of reporting worse mental and general health at Wave III, with increases occurring in an additive manner., Conclusion: Multiple types of adverse relationship experiences predicted increases in poorer general health and depressive symptoms from adolescence to early adulthood. Consistent with a cumulative risk hypothesis, the more types of adverse relationship a youth experienced, the worse were their young adult health outcomes., (Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Measurement and distribution of systolic and diastolic blood pressure and related health risk factors in the National Longitudinal Study of Adolescent Health (Add Health) were compared with data from the National Health and Nutrition Examination Survey (NHANES) 2007-2008. Sociodemographic patterns of blood pressure, prevalence of hypertension, and measurement characteristics in Add Health were also examined. Prevalence of hypertension (20.88%) in Add Health was significantly higher than that in NHANES (4.60%). This difference was only partially explained by body mass index and waist circumference and could reflect different measurement techniques, sample composition differences, or masked hypertension.

Background: Inflammation may be an important mediator of the association between nutrition and cardiovascular diseases, but most studies have been conducted in Western populations with high rates of overweight and obesity and low levels of infectious disease., Objectives: This study sought to investigate the predictors of C-reactive protein (CRP) in young adults living in the Philippines and to examine patterns of association with adiposity compared with young adults in the United States., Design: Maximum likelihood logistic regression models were used to predict elevated high-sensitivity CRP (>3 mg/L) in relation to anthropometric measures of adiposity, symptoms of infectious disease, and proxy measures of pathogen exposure in men and women from the Philippines (n = 1648; age: 20-22 y). Comparative data were drawn from a nationally representative sample in the United States (National Health and Nutrition Examination Survey; n = 616; age: 19-24 y)., Results: Median concentrations of CRP were substantially lower in the Philippines (0.2 mg/L) than in the United States (0.9 mg/L), and the likelihood of elevated CRP was lower in the Philippines than in the United States at the same level of waist circumference or skinfold thickness. In the Philippines, infectious symptoms and pathogen exposure predicted elevated CRP, independent of adiposity., Conclusions: Adiposity and infectious exposures are associated with elevated CRP in the Philippines; other populations undergoing comparable lifestyle and dietary changes associated with increasing rates of overweight and obesity are likely experiencing similar double burdens of inflammatory stimuli. Low concentrations of CRP in this Philippine sample raise the question of whether CRP cutoffs based on European or European-American reference populations are appropriate for predicting disease risk in populations undergoing the nutrition transition.