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Objectives:We investigated the prospective associations between meat consumption and CVD and whether these relationships differ by dietary quality among African American (AA) adults.Design:Baseline diet was assessed with a regionally specific FFQ. Unprocessed red meat included beef and pork (120 g/serving); processed meat included sausage, luncheon meats and cured meat products (50 g/serving). Incident total CVD, CHD, stroke and heart failure were assessed annually over 9·8 years of follow-up. We characterised dietary quality using a modified Healthy Eating Index-2010 score (m-HEI), excluding meat contributions.Setting:Jackson, MS, USA.Participants:AA adults (n 3242, aged 55 y, 66 % female).Results:Mean total, unprocessed red and processed meat intakes were 5·7 ± 3·5, 2·3 ± 1·8 and 3·3 ± 2·7 servings/week, respectively. Mostly, null associations were observed between meat categories and CVD or subtypes. However, greater intake of unprocessed red meat (three servings/week) was associated with significantly elevated risk of stroke (hazard ratio = 1·43 (CI: 1·07,1·90)). With the exception of a more positive association between unprocessed meat consumption and stroke among individuals in m-HEI Tertile 2, the strength of associations between meat consumption categories and CVD outcomes did not differ by m-HEI tertile. In formal tests, m-HEI did not significantly modify meat–CVD associations.Conclusions:In this cohort of AA adults, total and processed meat were not associated with CVD outcomes, with the exception that unprocessed red meat was related to greater stroke risk. Dietary quality did not modfiy these associations. Research is needed in similar cohorts with longer follow-up and greater meat consumption to replicate these findings.

Context Sudden cardiac deaths (SCDs) have accounted for nearly half of the line-of-duty deaths among US firefighters over the past 10 years. In 2018, 33% of all SCDs occurred after the end of a fire service call. Researchers have suggested that an imbalance in autonomic nervous system (ANS) regulation of heart rate postcall may interfere with recovery in firefighters. Objective To use heart-rate recovery (HRR) and heart-rate variability (HRV), 2 noninvasive markers of ANS function, to examine the ANS recovery profiles of firefighters. Design Cross-sectional study. Setting Firehouse and research laboratory. Patients or Other Participants Thirty-seven male career active-duty firefighters (age = 39 ± 9 years, height = 178.8 ± 5.4 cm, mass = 87.9 ± 11.2 kg). Main Outcome Measure(s) Percentage of maximal HR (%MHR) and HRV (natural log of the square root of the mean sum of the squared differences [lnRMSSD]) were collected after both submaximal and maximal exercise protocols during a 10-minute seated recovery. The HRR profiles were examined by calculating the asymptote, amplitude, and decay parameters of the monoexponential HRR curve for each participant. Results Differences in HRR parameters after 10 minutes of seated recovery were identified after submaximal versus maximal exercise (P < .001). In addition, although ANS was more suppressed after maximal exercise, HRV indicated incomplete recovery, and regardless of the test, recovery %MHR and lnRMSSD values did not return to pretest %MHR and lnRMSSD values. Conclusions Our results suggest that the ANS contributions to recovery in active-duty firefighters are exercise-intensity specific, and this is likely an important factor when establishing best-practice recovery guidelines.

Background. Sugar-sweetened beverage (SSB) consumption is highly associated with obesity, but the metabolic mechanism underlying this correlation is not understood. Objective. Our objective was to examine metabolomic links between SSB intake and obesity to understand metabolic mechanisms. Design. We examined the association of plasma metabolomic profiles with SSB intake and obesity risk in 781 participants, aged 45–75 y, in the Boston Puerto Rican Health Study (BPRHS) using generalized linear models, controlling for potential confounding factors. Based on identified metabolites, we conducted pathway enrichment analysis to identify potential metabolic pathways that link SSB intake and obesity risk. Variants in genes encoding enzymes known to function in identified metabolic pathways were examined for their interactions with SSB intake on obesity. Results. SSB intake was correlated with BMI (β = 0.607, P=0.045). Among 526 measured metabolites, 86 showed a significant correlation with SSB intake and 148 with BMI (P≤0.05); 28 were correlated with both SSB intake and BMI (P≤0.05). Pathway enrichment analysis identified the phosphatidylcholine and lysophospholipid pathways as linking SSB intake to obesity, after correction for multiple testing. Furthermore, 8 of 10 genes functioning in these two pathways showed strong interaction with SSB intake on BMI. Our results further identified participants who may exhibit an increased risk of obesity when consuming SSB. Conclusions. We identified two key metabolic pathways that link SSB intake to obesity, revealing the potential of phosphatidylcholine and lysophospholipid to modulate how SSB intake can increase obesity risk. The interaction between genetic variants related to these pathways and SSB intake on obesity further supports the mechanism.

Osteoporosis is a bone disease classified by deterioration of bone microarchitecture and decreased bone strength, thereby increasing subsequent risk of fracture. In the United States, approximately 54 million adults aged 50 years and older have osteoporosis or are at risk due to low bone mass. Osteoporosis has long been viewed as a chronic health condition affecting primarily non-Hispanic white (NHW) women; however, emerging evidence indicates racial and ethnic disparities in bone outcomes and osteoporosis management. The primary objective of this review is to describe disparities in bone mineral density (BMD), prevalence of osteoporosis and fracture, as well as in screening and treatment of osteoporosis among non-Hispanic black (NHB), Hispanic, and Asian adults compared with NHW adults living on the US mainland. The following areas were reviewed: BMD, osteoporosis prevalence, fracture prevalence and incidence, postfracture outcomes, DXA screening, and osteoporosis treatments. Although there are limited studies on bone and fracture outcomes within Asian and Hispanic populations, findings suggest that there are differences in bone outcomes across NHW, NHB, Asian, and Hispanic populations. Further, NHB, Asian, and Hispanic populations may experience suboptimal osteoporosis management and postfracture care, although additional population-based studies are needed. There is also evidence that variation in BMD and osteoporosis exists within major racial and ethnic groups, highlighting the need for research in individual groups by origin or background. Although there is a clear need to prioritize future quantitative and qualitative research in these populations, initial strategies for addressing bone health disparities are discussed. © 2021 American Society for Bone and Mineral Research (ASBMR).

Introduction Obesity is a precursor of type 2 diabetes (T2D). Objectives Our aim was to identify metabolic signatures of T2D and dietary factors unique to obesity. Methods We examined a subsample of the Boston Puerto Rican Health Study (BPRHS) population with a high prevalence of obesity and T2D at baseline (n = 806) and participants (without T2D at baseline) at 5-year follow-up (n = 412). We determined differences in metabolite profiles between T2D and non-T2D participants of the whole sample and according to abdominal obesity status. Enrichment analysis was performed to identify metabolic pathways that were over-represented by metabolites that differed between T2D and non-T2D participants. T2D-associated metabolites unique to obesity were examined for correlation with dietary food groups to understand metabolic links between dietary intake and T2D risk. False Discovery Rate method was used to correct for multiple testing. Results Of 526 targeted metabolites, 179 differed between T2D and non-T2D in the whole sample, 64 in non-obese participants and 120 unique to participants with abdominal obesity. Twenty-four of 120 metabolites were replicated and were associated with T2D incidence at 5-year follow-up. Enrichment analysis pointed to three metabolic pathways that were overrepresented in obesity-associated T2D: phosphatidylethanolamine (PE), long-chain fatty acids, and glutamate metabolism. Elevated intakes of three food groups, energy-dense takeout food, dairy intake and sugar-sweetened beverages, associated with 13 metabolites represented by the three pathways. Conclusion Metabolic signatures of lipid and glutamate metabolism link obesity to T2D, in parallel with increased intake of dairy and sugar-sweetened beverages, thereby providing insight into the relationship between dietary habits and T2D risk.

Our objective was to quantify the cross-sectional associations between dietary fatty acid (DFA) patterns and cognitive function among Hispanic/Latino adults. This study included data from 8942 participants of the Hispanic Community Health Study/Study of Latinos, a population-based cohort study (weighted age 56·2 years and proportion female 55·2 %). The National Cancer Institute method was used to estimate dietary intake from two 24-h recalls. We derived DFA patterns using principal component analysis with twenty-six fatty acid and total plant and animal MUFA input variables. Global cognitive function was calculated as the average z-score of four neurocognitive tests. Survey linear regression models included multiple potential confounders such as age, sex, education, depressive symptoms, physical activity, energy intake and CVD. DFA patterns were characterised by the consumption of long-chain SFA, animal-based MUFA and trans-fatty acids (factor 1); short to medium-chain SFA (factor 2); very-long-chain n-3 PUFA (factor 3); very-long-chain SFA and plant-based MUFA and PUFA (factor 4). Factor 2 was associated with greater scores for global cognitive function (β = 0·037 (sd 0·012)) and the Digit Symbol Substitution (DSS) (β = 0·56 (sd 0·17)), Brief Spanish English Verbal Learning-Sum (B-SEVLT) (β = 0·23 (sd 0·11)) and B-SEVLT-Recall (β = 0·11 (sd 0·05)) tests (P < 0·05 for all). Factors 1 (β = 0·04 (sd 0·01)) and 4 (β = 0·70 (sd 0·18)) were associated with the DSS test (P < 0·05 for all). The consumption of short to medium-chain SFA may be associated with higher cognitive function among US-residing Hispanic/Latino adults. Prospective studies are necessary to confirm these findings.

OBJECTIVES: There is evidence to suggest that higher serum concentration of carotenoids is protective of osteoporosis, although studies have shown inconsistent findings. The majority of studies on serum carotenoids and bone have been conducted in predominantly non-Hispanic white populations. This study examined the relationship between serum total carotenoids and bone mineral density (BMD) and odds of osteoporosis among Puerto Rican older adults. METHODS: Data are from the Boston Puerto Rican Osteoporosis Study, a prospective cohort of Puerto Rican adults aged 47 to 79 y (n = 907). Serum total carotene (ug/dL) concentration was measured by fasting blood sample at baseline and 2-year follow-up. A cumulative average of the two measures was calculated. BMD (g/cm2) at the hip and lumbar spine sites were measured using dual x-ray absorptiometry. Multivariable analysis of covariance models tested associations between serum total carotenoids and BMD outcomes and multivariable logistic regression models examined associations with odds of osteoporosis. Models were adjusted for age, height, estrogenic (male, non-menopausal or taking hormone replacements, no estrogen) status, BMI, alcohol use, smoking status, calcium intake, and serum vitamin D and triglycerides. RESULTS: Participants were primarily female (72.1%), mean age: 59 years ± 7.4 and mean serum carotenoids: 93 ug/dL ± 34.2. Serum total carotenoids were not associated with BMD at the trochanter (β = 0.16 ± 0.13), femoral neck (β = 0.09 ± 0.13), total hip (β = −0.46 ± 0.18), or lumbar spine (β = 0.11 ± 0.14) (P = 0.16–0.50). Further, there was no association between serum carotenoids and odds of osteoporosis after adjusting for potential confounding (OR = 1.00, 95%CI: 0.99, 1.01). CONCLUSIONS: These findings suggest that dietary factors other than total carotenoids may be more important for bone health among Puerto Rican adults. Further research is needed to confirm these results. Investigation of individual dietary carotenoids may provide additional insight into the associations with bone in this population. FUNDING SOURCES: NIH (P01 AG023394, P50 HL105185, R01 AG027087). SEN is supported by K01 AR067894.

BACKGROUND: Dairy foods have been shown to improve bone mineral density (BMD) in non-Hispanic whites. Puerto Rican adults have a higher prevalence of osteoporosis and vitamin D deficiency than non-Hispanic whites. However, there is little understanding of lifestyle influences on bone in this population. OBJECTIVE: The aim of this study was to examine associations of dairy intakes with BMD among adults from the Boston Puerto Rican Osteoporosis Study with and without adequate serum vitamin D status. METHODS: A total of 904 participants in this cross-sectional analysis provided dietary intakes with a culturally tailored food-frequency questionnaire. Dairy food groups were calculated [total dairy, modified dairy (without cream or dairy desserts), fluid dairy (milk + yogurt), cheese, yogurt, and cream and desserts]. BMD (grams per centimeter squared) was measured using dual-energy X-ray absorptiometry. Vitamin D status was defined as sufficient (serum 25-hydroxyvitamin D [25(OH)D] ≥20 ng/mL) or insufficient (

BACKGROUND: Vitamin D deficiency has been associated with health problems globally, but there is limited information on vitamin D status and associated risk factors among adults in underserved populations. OBJECTIVE: This study aimed to identify risk factors for vitamin D deficiency/insufficiency among Puerto Rican adults from the Boston Puerto Rican Health Study (BPRHS). METHODS: A total of 822 adults (45–75 y, at baseline) were included in these analyses. Deficiency was defined as serum 25-hydroxyvitamin D [25(OH)D]

Background Puerto Rican adults have higher odds of peripheral artery disease (PAD) compared with Mexican Americans. Limited studies have examined relationships between clinical risk assessment scores and ABI measures in this population. Methods Using 2004–2015 data from the Boston Puerto Rican Health Study (BPRHS) (n = 370–583), cross-sectional, 5-y change, and patterns of change in Framingham Risk Score (FRS) and allostatic load (AL) with ankle brachial index (ABI) at 5-y follow-up were assessed among Puerto Rican adults (45–75 y). FRS and AL were calculated at baseline, 2-y and 5-y follow-up. Multivariable linear regression models were used to examine cross-sectional and 5-y changes in FRS and AL with ABI at 5-y. Latent growth mixture modeling identified trajectories of FRS and AL over 5-y, and multivariable linear regression models were used to test associations between trajectory groups at 5-y. Results Greater FRS at 5-y and increases in FRS from baseline were associated with lower ABI at 5-y (β = -0.149, P = 0.010; β = -0.171, P = 0.038, respectively). AL was not associated with ABI in cross-sectional or change analyses. Participants in low-ascending (vs. no change) FRS trajectory, and participants in moderate-ascending (vs. low-ascending) AL trajectory, had lower 5-y ABI (β = -0.025, P = 0.044; β = -0.016, P = 0.023, respectively). Conclusions FRS was a better overall predictor of ABI, compared with AL. Puerto Rican adults, an understudied population with higher FRS over 5 years, may benefit from intensive risk factor modification to reduce risk of PAD. Additional research examining relationships between FRS and AL and development of PAD is warranted.

OBJECTIVES: To assess the relationship between sugar-sweetened beverages (SSBs) and bone mineral density (BMD) in Puerto Rican adults living in Boston. METHODS: Data were from the Boston Puerto Rican Health Study and the Boston Puerto Rican Osteoporosis Study. SAS (version 9.4) was used to conduct general linear model analyses assessing bone mineral density as an outcome in relation to all other relevant covariates. Dietary data including sugar-sweetened beverage (SSB) intake was assessed by an FFQ that was validated for this population. We defined SSB as any sweetened drinks, including soft drinks, fruit drinks and nectars, apple juice and 100% juice blends, sweetened tea, energy drinks, coffee drinks, and Malta. Bone mineral density was determined by dual-energy x-ray absorptiometry (DXA) scan. RESULTS: The mean intake of SSB was 10.7 ± 11 ounces per day, while mean total energy was 1876 ± 843 kcal per day. A majority of the population (62.3%) were post-menopausal women. At the femoral neck, 39.7% had osteopenia and 4.4% had osteoporosis; and at the spine (L2-L4), 30.4% had osteopenia and 8% had osteoporosis. BMD of the femoral neck was significantly associated with SSB intake, and remained significantly associated across all models after adjusting for age, estrogenic status (men, pre-menopausal women or post-menopausal and using estrogen, and post-menopausal women without estrogen), population admixture, BMI, height, total energy, season of bone measurement, alcohol use, smoking status, education, physical activity score, dietary calcium, calcium supplement use, and 25(OH)D (serum) (β ± SE = −0.001 ± 0.001, P = 0.03). Other bone sites did not reach significance. CONCLUSIONS: Intake of SSBs was significantly related to lower femoral neck BMD, and although not significant, was consistently negatively associated with other bone sites. Reduction in SSB intake may decrease risk of osteoporosis in this population. FUNDING SOURCES: NIH.

OBJECTIVES: Red and processed meat consumption is adversely related to cardiometabolic risk, but the impact of overall dietary quality on this association has not been systematically investigated. We examined the influence of dietary quality on associations of meat intake with biomarkers of cardiometabolic risk. METHODS: Data are from the Jackson Heart Study, a cohort of African Americans (baseline age 55 y, 66% female, 20% diabetes, 9% CVD). We analyzed those with biomarker data available at Visit 1 (2000–04) and at Visit 2 (2005–09) or 3 (2009–13). Diet was assessed by food frequency questionnaire (Visit 1). Total observations used were: Visit 1 (n = 3725), Visit 2 (n = 2736), and Visit 3 (n = 3319). Unprocessed red meat included beef and pork, and processed meat included sausage, lunch, and cured meats. Diet quality was measured by a modified Healthy Eating Index 2010 score (m-HEI) that excluded meat contributions. Modified HEI stratified and unstratified analyses were conducted using linear mixed modeling. Fasting HbA1c and CRP values were log transformed. RESULTS: Meat consumption was not associated with HbA1c in m-HEI stratified or unstratified analyses. A 1 oz/1000 kcal/wk increase in unprocessed red and total meat was associated with a 1.3% ± 0.5% (P = 0.02) and 1.1% ± 0.3% (P = 0.005) higher CRP in unstratified analyses, respectively. Unprocessed red meat was positively associated with CRP in m-HEI tertiles 1 (2.0% ± 0.8%, P = 0.01) and 3 (2.2% ± 0.8%, P = 0.008). Total meat was associated with CRP in m-HEI tertile 1 (2.0% ± 0.6%, P = 0.001) and trended in tertile 3 (1.1% ± 0.6%, P = 0.09); processed meat also approached significance in m-HEI tertile 1 (2.1% ± 1.2%, P = 0.08). There was evidence that m-HEI modified the associations between processed meat and CRP (P-interaction = 0.04), but not for other associations. Excluding those with diabetes or CVD did not alter these results. CONCLUSIONS: Our results do not support that meat intake is associated with HbA1c, or that overall dietary quality modifies these associations. Unprocessed red and total meat intakes were associated with greater CRP in unstratified and subsets of stratified analyses. Associations of processed meat with CRP appeared stronger among those with the poorest diet quality. These data suggest that reduction in red meat intake could benefit inflammation among African American adults. FUNDING SOURCES: The Beef Checkoff.

OBJECTIVES: To characterize nutrient intakes and identify key food sources among Bhutanese refugee adults eligible for SNAP (Supplemental Nutrition Assistance Program) benefits. METHODS: We recruited a convenience sample of Bhutanese refugee adults (n = 54, mean age = 47 y, 83% female) residing in New Hampshire. Diet was estimated from foods recorded using three 24-hr recalls. Selected nutrients included vitamins C, D, E, and K, thiamin, riboflavin, niacin, B6, folate, B12, pantothenic acid, calcium, magnesium, sodium, and saturated fat. Participants were categorized based on meeting the Recommended Dietary Allowance (RDA) or Adequate Intake (AI) of selected nutrients. For sodium and saturated fat, meeting recommendations was defined as consuming

OBJECTIVES: Dietary calcium and magnesium have been shown to be beneficial for bone health primarily in non-Hispanic white populations. There are no studies of calcium and magnesium intake among Hispanics of Caribbean origin. A calcium to magnesium ratio (Ca: Mg) may be important due to their competitive nature during absorption. This study examined associations between dietary calcium and magnesium and osteoporosis, accounting for calcium to magnesium ratio among Puerto Rican adults METHODS: Data from the Boston Puerto Rican Osteoporosis Study were used. Puerto Ricans aged 47–79 y with complete data on bone and diet were included (n = 955). Bone measures were assessed using dual-energy X-ray absorptiometry. A food frequency questionnaire adapted for this population was used. Dietary calcium and magnesium were energy adjusted using the residual method. Tertiles of Ca : Mg were calculate. Multivariable logistic regressions modeled associations between calcium, magnesium and tertiles of Ca : Mg. Model 1 included Ca : Mg tertiles and dietary magnesium; Model 2 Ca : Mg tertiles and dietary calcium; Model 3 Ca : Mg tertiles and dietary calcium and magnesium. All models were adjusted for age, estrogenic status (male, non-menopausal or taking estrogen, postmenopausal not taking estrogen), height, BMI, calcium (0, 0–300 mg, ≥300 mg) and magnesium (0, 0–100 mg) supplement use, serum vitamin D, alcohol use, smoking status, and bone medication use. RESULTS: Mean age was 59.9 y ± 7.6 and 71.3% were female. In model 1, the highest tertile of Ca : Mg was associated with higher likelihood (OR: 1.3; 95%CI: 0.77, 2.4) and the middle tertile with lower likelihood (OR: 0.51; 95%CI: 0.26,0.99) of osteoporosis compared with the lowest Ca: Mg tertile. Dietary magnesium was also associated with lower odds of osteoporosis (OR: 0.99; 95%CI: 0.98, 0.99). In model 2, dietary calcium (OR: 0.99, 95%CI: 0.99, 1.0) was associated with lower of odds osteoporosis, but Ca: Mg was not. In model 3, dietary calcium and magnesium and tertiles of Ca : Mg were not associated with osteoporosis. CONCLUSIONS: Dietary calcium and magnesium are important nutrients for bone health in Puerto Rican older adults. The Ca : Mg ratio appears optimal within a range of 2.6–3.1 suggesting that a balance of these two nutrients is most important. FUNDING SOURCES: National Institutes of Health P01 AG023394, P50 HL105185, R01 AG027087 K01 AR067894

BACKGROUND: High phosphorus (P) exposure may have negative effects on kidney function. Nutrient databases provide total P, but bioavailability varies by source. OBJECTIVES: We aimed to assess natural, added, and bioavailable P intake, and to relate these to estimated glomerular filtration rate (eGFR) in the Jackson Heart Study (JHS). METHODS: A total of 3962 African-American participants of the JHS, aged 21–84 y, with urine albumin:creatinine ratio < 30 mg/g, and eGFR ≥ 60 mL · min(−1) · 1.73 m(−2), and without self-reported kidney disease, were included. Diet was assessed by FFQ. We assigned P in foods as naturally occurring or added, and weighted intake by P bioavailability, based on published literature. Relations between P variables and eGFR were assessed using multivariable regression. RESULTS: Mean ± SE intakes were 1178 ± 6.7 mg and 1168 ± 5.0 mg for total P, 296 ± 2.8 mg and 291 ± 2.1 mg for bioavailable added P, and 444 ± 2.9 mg and 443 ± 2.2 mg for bioavailable natural P, in participants with eGFR = 60–89 and ≥90 mL · min(−1) · 1.73 m(−2), respectively. Major sources of total P included fish, milk, beef, eggs, cheese, and poultry; and of added P, fish, beef, processed meat, soft drinks, and poultry. After adjustment for confounders, P intakes, including total (β ± SE: −0.32 ± 0.15; P = 0.03), added (β ± SE: −0.73 ± 0.27; P = 0.01), bioavailable total (β ± SE: −0.62 ± 0.23; P = 0.01), and bioavailable added (β ± SE: −0.77 ± 0.29; P = 0.01), were significantly associated with lower eGFR. However, neither total nor bioavailable P from natural sources were associated with eGFR. CONCLUSIONS: Added, but not natural, P was negatively associated with kidney function, raising concern about P additives in the food supply. Further studies are needed to improve estimation of dietary P exposure and to clarify the role of added P as a risk factor for kidney disease.

The impact of nutrition on the metabolic profile of osteoporosis is incompletely characterized. The objective of this cross-sectional study was to detangle the association of fruit and vegetable (FV) intakes with osteoporosis prevalence. Dietary, anthropometric and blood plasma metabolite data were examined from the Boston Puerto Rican Osteoporosis Study, a cohort of 600 individuals (age 46-79yr). High FV intake was protective against osteoporosis prevalence. Associations of 525 plasma metabolites were assessed with fruit and vegetable intake, and separately with osteoporosis status. Several biological processes affiliated with the FV-associating metabolites, including caffeine metabolism, carnitines and fatty acids, and glycerophospholipids. For osteoporosis-associated metabolites, important processes were steroid hormone biosynthesis in women, and branched-chain amino acid metabolism in men. In all instances, the metabolite patterns differed greatly between sexes, arguing for a stratified nutrition approach in recommending FV intakes to improve bone health. Factors derived from principal components analysis of the FV intakes were correlated with the osteoporosis-associated metabolites, with high intake of dark leafy greens and berries/melons appearing protective in both sexes. These data warrant investigation into whether increasing intakes of dark leafy greens, berries and melons causally affect bone turnover and BMD among adults at risk for osteoporosis via sex-specific metabolic pathways, and how gene-diet interactions alter these sex-specific metabolomic-osteoporosis links.

Background Caribbean Latino adults have disproportionately high prevalence of chronic disease; however, underlying mechanisms are unknown. Unique gut microbiome profiles and relation to dietary quality may underlie health disparities. Objectives To examine the dietary quality of an underrepresented group of Caribbean Latino older adults with high prevalence of chronic disease; characterize gut microbiome profiles in this cohort; determine associations between dietary quality, gut microbiome composition, and short-chain fatty acid (SCFA) production; examine associations of clinical factors (body mass index, type 2 diabetes [T2D] status, and laxative use) with gut microbiome composition. Design The study design was cross-sectional. Participants/setting Recruitment and interviews occurred at the Senior Center in Lawrence, MA, from September 2016-September 2017. A total of 20 adults aged ≥50 years, self-identified of Caribbean Latino origin, without use of antibiotics in 6 months or intestinal surgery were included in the study. Exposure and outcome measures Diet was assessed by two, 24-hour recalls and dietary quality was calculated using the Healthy Eating Index 2015 and the Mediterranean Diet Score. The gut microbiome was assessed by 16S rRNA sequencing and fecal SCFA content. Anthropometrics (ie, weight and height) were measured by a trained interviewer, and self-reported laxative use, and other self-report health outcomes (ie, T2D status) were assessed by questionnaire. Statistical analyses Faith Phylogenetic Diversity (alpha diversity) and unique fraction metric, or UniFrac (beta diversity) and nonphylogenetic metrics, including Shannon diversity index (alpha diversity) were calculated. Spearman correlations and group comparisons using Kruskal-Wallis test between alpha diversity indexes and nutrient intakes were calculated. Patterns in the microbiome were estimated using a partitioning around medoids with estimation of number of clusters, with optimum average silhouette width. Log odds were calculated to compare predefined nutrients and diet score components between microbiome clusters using multivariable logistic regression, controlling for age and sex. Pearson correlation was used to relate SCFA fecal content to individual nutrients and diet indexes. Final models were additionally adjusted for laxative use. Differences in lifestyle factors by gut microbiome cluster were tested by Fisher's exact test. Results Generally, there was poor alignment of participant's diets to either the Mediterranean Diet score or Healthy Eating Index 2015. Range in the Healthy Eating Index 2015 was 36 to 90, where only 5% (n=1) of the sample showed high adherence to the Dietary Guidelines for Americans. Mediterranean Diet scores suggested low conformance with a Mediterranean eating pattern (score range=2 to 8, where 45% scored ≤3 [poor adherence]). The gut microbiome separated into two clusters by difference in a single bacterial taxon: Prevotella copri (P copri) (permutational multivariate analysis of variance [PERMANOVA] R2=0.576, ADONIS function P=0.001). Significantly lower P copri abundance was observed in cluster 1 compared with cluster 2 (Mann-Whitney P Conclusions Two unique microbiome profiles, identified by abundance of P copri, were identified among Caribbean Latino adults. Microbiome profiles and SCFA content were associated with diet, T2D, and lifestyle. Further research is needed to determine the role of P copri and SCFA production in the risk for chronic disease and associated lifestyle predictors.

OBJECTIVES: To examine risk factors for bone mineral density (BMD) and osteoporosis at the femoral neck (FN) and lumbar spine (LS) in a cross-sectional study among Puerto Rican adults, 47- 77 y. METHODS: The Boston Puerto Rican Osteoporosis Study (BPROS) is an ancillary study to the Boston Puerto Rican Health Study, a cohort of 1504 Puerto Rican adults from the Greater Boston area. A total of 973 participants participated in the BPROS, where data on sociodemographics, health and health behaviors, and medication use were collected through questionnaire, and anthropometrics measured. Dietary intake and supplement use were assessed using a food frequency questionnaire. Fasting blood samples were collected for biochemical analysis. BMD (g/cm(2)) at the FN and LS (L2-L4) was measured using dual-energy X-ray absorptiometry. Linear regression models estimated associations between risk factors and FN and LS BMD and logistic regression for osteoporosis (T-score ≤ −2.5 g/cm(2)) at the FN and/or LS. A total of 680 participants had complete data on risk factors and bone measures. RESULTS: Average age of participants was 59.9 y ± 7.6 y and 71.3% were women. The prevalence of osteoporosis was 10.6%. Age was inversely associated with FN BMD (Table 1). BMI and height were positively associated with BMD. Neither calcium intake from food sources nor plasma 25-OH vitamin D were associated with BMD (P > 0.36). Bone medication and calcium supplement use were inversely associated with BMD, likely due to reverse causation. Magnesium intake from supplements was positively associated with LS and FN BMD (β = 0.07, P = 0.006 and β = 0.05, P = 0.008). Moderate alcohol consumption was associated with lower odds of osteoporosis, compared to no intake (OR: 0.40, P = 0.02; Table 2). Current smoking (vs. never smokers) was associated with increased odds of osteoporosis (OR: 2.5, P = 0.02). Magnesium from supplements was associated with lower odds of osteoporosis (OR: 0.41, P = 0.04). CONCLUSIONS: In contrast to expectation, dietary calcium and plasma 25-OH vitamin D were not associated with bone. Interestingly, magnesium intake from supplements was associated with higher BMD and lower odds of osteoporosis. This requires further investigation, as this may serve as a feasible intervention to improve BMD and decrease risk of osteoporosis in this high-risk population. FUNDING SOURCES: NIH/NIAMS K01 AR067894, NIH P50 HL105185, P01 AG023394, and R01 AG027087. SUPPORTING TABLES, IMAGES AND/OR GRAPHS

SUMMARY: Few studies have examined knowledge and perceptions of osteoporosis among Caribbean Latino adults. Confusion regarding the term osteoporosis was noted. Doctors were viewed as trusted sources of health information, although descriptions of a paradoxical relationship emerged. This study can be used to inform culturally tailored interventions for osteoporosis prevention. PURPOSE: The overall goal of this study was to assess knowledge, attitudes, and beliefs of bone health and osteoporosis among Caribbean Latino adults aged ≥ 50 years. METHODS: This triangulated mixed methods study included completion of a quantitative questionnaire and participation in one of four focus groups to obtain information on (1) general health, (2) knowledge about bone health and osteoporosis, (3) sources of information about bone health, and (4) prevention knowledge and personal responsibility. Quantitative data were analyzed using SAS, and qualitative data were analyzed using descriptive and structural coding by two independent research members. RESULTS: The majority of participants were female (73%), Dominican (84%), and low income (82% < $20,000) with a mean age of 68.4 (± 8.5) years. Most participants had heard of osteoporosis (90%); however, the majority were not able to accurately describe this chronic condition. Health care providers were viewed as most trusted sources of health information, despite feelings of being rushed during their visits, with limited communication about preventative care. Most participants felt that nutrition and exercise were important for overall health. CONCLUSIONS: Caribbean Hispanic adults in this study reported knowledge of osteoporosis and nutritional factors associated with prevention of this chronic condition. However, qualitatively, there was confusion between osteoporosis and other bone and joint conditions. Culturally specific interventions to promote prevention of osteoporosis are urgently needed for this underserved, high-risk population.

Background The impact of nutrition on the metabolic profile of osteoporosis (OS) is unknown. Objective Identify biochemical factors driving the association of fruit and vegetable (FV) intakes with OS prevalence using an untargeted metabolomics approach. Design Cross-sectional dietary, anthropometric and plasma metabolite data were examined from the Boston Puerto Rican Osteoporosis Study, n = 600 (46–79 yr). Methods Bone mineral density was assessed by DXA. OS was defined by clinical standards. A culturally adapted FFQ assessed usual dietary intake. Principal components analysis (PCA) of 42 FV items created 6 factors. Metabolomic profiles derived from plasma samples were assessed on a commercial platform. Differences in levels of 525 plasma metabolites between disease groups (OS vs no-OS) were compared using logistic regression; and associations with FV intakes by multivariable linear regression, adjusted for covariates. Metabolites significantly associated with OS status or with total FV intake were analyzed for enrichment in various biological pathways using Mbrole 2.0, MetaboAnalyst, and Reactome, using FDR correction of P-values. Correlation coefficients were calculated as Spearman's rho rank correlations, followed by hierarchical clustering of the resulting correlation coefficients using PCA FV factors and sex-specific sets of OS-associated metabolites. Results High FV intake was inversely related to OS prevalence (Odds Ratio = 0.73; 95% CI = 0.57, 0.94; P = 0.01). Several biological processes affiliated with the FV-associating metabolites, including caffeine metabolism, carnitines and fatty acids, and glycerophospholipids. Important processes identified with OS-associated metabolites were steroid hormone biosynthesis in women and branched-chain amino acid metabolism in men. Factors derived from PCA were correlated with the OS-associated metabolites, with high intake of dark leafy greens and berries/melons appearing protective in both sexes. Conclusions These data warrant investigation into whether increasing intakes of dark leafy greens, berries and melons causally affect bone turnover and BMD among middle-aged and older adults at risk for osteoporosis via sex-specific metabolic pathways, and how gene-diet interactions alter these sex-specific metabolomic-osteoporosis links. ClinicalTrials.gov Identifier: NCT01231958 .

Firefighters have a sustained risk for experiencing a sudden cardiac event after completing a fire call. Heart rate recovery (HRR) can be utilized to characterize autonomic nervous system (ANS) recovery and has been linked to cardiac events. Research suggests that body composition influences post-exercise HRR responses in non-firefighter populations. The purpose of this study was to examine the influence of body mass index (BMI), waist circumference (WC), and percent body fat (BF) on the HRR response of firefighter recruits. BMI (kg&middot, m&minus, 2), WC (cm), and BF (%) data from 57 firefighter recruits were collected. HRR (b&middot, min&minus, 1) data were collected at completion (HR0), as well as 15 (HR15), 30 (HR30), 45 (HR45), 60 (HR60), 120 (HR120), and 180 (HR180) seconds following a submaximal step test, and commonly utilized clinical HRR indices were calculated (&Delta, HRR30, &Delta, HRR60, &Delta, HRR120, and &Delta, HRR180). After controlling for sex, linear mixed regression models did not identify significant interactions between body composition (ps &gt, 0.05) and HRR response across time. However, significant (ps &lt, 0.05) indirect semi-partial correlations were identified between BF and &Delta, HRR30 (rsp = &minus, 0.31) and &Delta, HRR60 (rsp = &minus, 0.27), respectively. Reducing overall BF (vs. BMI or WC) should be prioritized to improve the post-exercise ANS recovery of firefighter recruits.

Sudden cardiac death (SCD) is the leading type of line-of-duty death among firefighters. An inability to restore parasympathetic nervous system (PSNS) control after activity is associated with SCD. Post-exercise heart rate recovery (HRR) provides unique insight into reactivation of the PSNS. Thus, the purpose of this study was to examine longitudinal changes in HRR responses of 25 male firefighter recruits. HR data were collected after submaximal exercise at week 1 (W1), week 6 (W6), and week 15 (W15) of their training at an academy. Percent maximal heart rate (%MHR) measures were computed at each HRR time point (%MHR0, %MHR15, %MHR30, %MHR45, %MHR60, %MHR120, %MHR180) and absolute HRR values were calculated at 30 s (&Delta, HRR30), 60 s (&Delta, HRR60), 120 s (&Delta, HRR120), and 180 s (&Delta, HRR180). After controlling for age and percent body fat, there was no statistically significant interaction between Week &times, HRR (p = 0.730), and there were no changes in &Delta, HRR30, &Delta, HRR60, and &Delta, HRR120, and &Delta, HRR180 indices across time. However, %MHR at W6 and W15 was significantly lower than %MHR at W1 at every HRR time point (ps &lt, 0.001). Therefore, although the firefighter recruit training academy elicited positive training adaptations, changes in PSNS reactivation after submaximal activity were not identified.

OBJECTIVES: Emerging evidence suggests that overall dietary quality is important for the prevention of disability, which maybe be due to protective effects on cardiovascular risk factors. Few studies have investigated adherence to a DASH diet and disability and muscle strength prospectively, particularly among Puerto Rican adults. This study examined the relationship between a DASH dietary index and incidence of disability and change in muscle strength over 5 years of follow up. METHODS: Data are from the Boston Puerto Rican Health Study, a prospective cohort of Puerto Rican adults aged 45 to 75 y (n = 1408). The DASH dietary quality index (DASH) was derived from averaged dietary data assessed by validated food frequency questionnaire at baseline and 2-y follow up. Self-reported disability included activities of daily living (ADL) and instrumental ADL assessed at baseline, 2-y and 5-y follow up. Hand grip measures were obtained using a hand dynamometer at baseline, 2-y and 5-y follow up. Cox Proportional Hazards models were adjusted for sex, age, cardiovascular disease, smoking status, educational attainment, alcohol consumption, physical activity, hypertension, diabetes, cholesterol concentration, C-reactive protein and body mass index. Multivariable linear regression was used to model changes in handgrip. Interactions by sex, age and diabetes status were examined. RESULTS: The prevalence of ADL and IADL disability at baseline was 70.8% and 48.6%. Mean change in handgrip from baseline to 5 y was −2.19 kg. Interactions by age, sex and diabetes status were not significant. Participants with higher adherence to the DASH diet had lower incidence of impaired ADL (HR = 0.95, 95% CI: 0.92, 0.99) and IADL disability (HR = 0.96, 95% CI: 0.93, 0.98). The relationship between the DASH dietary index and change in handgrip measures from baseline to 5-y follow up approached significance (β = 0.14 ± 0.08, P = 0.07). CONCLUSIONS: These findings suggest that higher adherence to a DASH diet may reduce risk of disability and mitigate muscle strength loss among Puerto Rican adults. This may be an important intervention strategy for prevention of disability in this population. FUNDING SOURCES: National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases.

BACKGROUND: The role of acculturation in dietary behaviors among Hispanics/Latinos in the United States remains unclear. Discrepancies may be explained by variations in acculturation constructs or ethnicity-specific dynamics. OBJECTIVE: We aimed to compare relations between 3 different acculturation constructs with dietary quality and patterns among Puerto Ricans in the mainland United States. METHODS: We analyzed cross-sectional data with 1194–1380 Puerto Ricans, aged 45–75 y. Acculturation was measured with the use of a language-based scale (0–100; higher score denotes more English use), a psychological-based scale (0–50; higher score denotes stronger US orientation), and years living in the mainland United States. Diet quality scores (higher scores denote healthier diet) were defined with the use of the Alternate Healthy Eating Index-2010 (AHEI) and the Mediterranean Diet Score (MeDS). Three dietary patterns were previously derived with the use of principal components analysis. Adjusted multivariable regression models tested the association of each acculturation construct with diet quality score or pattern. Interaction terms were included for income or education status. RESULTS: Psychological-based acculturation, but not the other constructs, was positively associated with AHEI (β ± SE: 0.013 ± 0.004; P = 0.002) and MeDS (0.009 ± 0.005; P = 0.041). Income, but not education, moderated this association (P = 0.03), with higher diet quality observed with higher income (>$25,000) and stronger US orientation. All constructs were inversely associated with a traditional dietary pattern, with the language-based scale being stronger (z score β ± SE: −0.160 ± 0.032; P

Historically, osteoporosis has not been considered a public health priority for the Hispanic population. However, recent data indicate that Mexican Americans are at increased risk for this chronic condition. Although it is well established that there is heterogeneity in social, lifestyle, and health-related factors among Hispanic subgroups, there are currently few studies on bone health among Hispanic subgroups other than Mexican Americans. The current study aimed to determine the prevalence of osteoporosis and low bone mass (LBM) among 953 Puerto Rican adults, aged 47 to 79 years and living on the US mainland, using data from one of the largest cohorts on bone health in this population: The Boston Puerto Rican Osteoporosis Study (BPROS). Participants completed an interview to assess demographic and lifestyle characteristics and bone mineral density measures. To facilitate comparisons with national data, we calculated age-adjusted estimates for osteoporosis and LBM for Mexican American, non-Hispanic white, and non-Hispanic black adults, aged ≥50 years, from the National Health and Nutrition Examination Survey (NHANES). The overall prevalence of osteoporosis and LBM were 10.5% and 43.3% for participants in the BPROS, respectively. For men, the highest prevalence of osteoporosis was among those aged 50 to 59 years (11%) and lowest for men ≥70 years (3.7%). The age-adjusted prevalence of osteoporosis for Puerto Rican men was 8.6%, compared with 2.3% for non-Hispanic white, and 3.9% for Mexican American men. There were no statistically significant differences between age-adjusted estimates for Puerto Rican women (10.7%), non-Hispanic white women (10.1%), or Mexican American women (16%). There is a need to understand specific factors contributing to osteoporosis in Puerto Rican adults, particularly younger men. This will provide important information to guide the development of culturally and linguistically tailored interventions to improve bone health in this understudied and high-risk population. © 2017 American Society for Bone and Mineral Research.

ObjectiveTo determine the prospective relationship between changes in sugar-sweetened beverage (SSB) intake and central adiposity in older children.DesignDietary intakes of children were obtained by 3 d food records at ages 10 and 13 years. Waist circumference (WC) and weight and height to determine BMI were measured at 10 and 13 years and total body fat mass (TBFM) at 13 years by dual-energy X-ray absorptiometry. Analyses were conducted using multivariable linear regression. Reporting errors were measured and participants were categorized as under-, plausible and over-reporters of dietary intakes.SettingCommunity-based British cohort of children participating in the Avon Longitudinal Study of Parents and Children.ResultsAmong 2455 older children, increased SSB consumption from ages 10 to 13 years was associated with higher WC (standardized β=0·020, P=0·19), BMI (β=0·028, P=0·03) and TBFM (β=0·017, P=0·20) at 13 years. Effects were strengthened among plausible dietary reporters (n 1059): WC (β=0·097, Pβ=0·074, Pβ=0·065, P=0·003). The association between change in SSB and WC was weakened, but remained statistically significant after accounting for BMI (β=0·042, P=0·02) and TBFM (β=0·048, P=0·01).ConclusionsHigher consumption of SSB from ages 10 to 13 years was associated with a larger WC at age 13 years independent of differences in total adiposity. Accounting for dietary reporting errors strengthened associations. Our findings further support recommendations to limit intakes of SSB to reduce excess weight gain in children and suggest that SSB have an additional deleterious effect on central adiposity.

Background: Multiple diet quality scores have been used to evaluate adherence to specific dietary recommendations or to consumption of healthful foods and nutrients. It remains unknown which score can more strongly predict longitudinal changes in cardiometabolic risk factors.Objective: We aimed to determine associations of 5 diet quality scores [AHA diet score (AHA-DS), Dietary Approaches to Stop Hypertension (DASH), Healthy Eating Index (HEI)-2005, Mediterranean diet score (MeDS), and Alternative Healthy Eating Index (AHEI)] with 2-y changes in cardiometabolic risk factors in adults 45-75 y old.Methods: Data from the Boston Puerto Rican Health Study were analyzed (n = 1194). Diet quality scores were calculated from a baseline-validated food-frequency questionnaire. Multivariable-adjusted, repeated-subjects, mixed-effects models, adjusted for baseline measures, estimated associations between each z score and 14 individual cardiometabolic factors measured at 2 y.Results: MeDS was significantly associated with lower 2-y waist circumference (β coefficient ± SE: -0.52 ± 0.26, P = 0.048); body mass index (BMI; -0.23 ± 0.08, P = 0.005); log-insulin (-0.06 ± 0.02, P = 0.005); log-homeostasis model assessment of insulin resistance (HOMA-IR; -0.05 ± 0.02, P = 0.030), and log-C-reactive protein (-0.13 ± 0.03, P = 0.0002). Similar but weaker associations were observed for the AHEI with BMI, insulin, and HOMA-IR. The AHA-DS was inversely associated with BMI (-0.17 ± 0.08, P = 0.033). Neither the HEI-2005 nor DASH was significantly associated with any variable. Traditional Puerto Rican foods consumed by individuals with high MeDSs included vegetables and meats in homemade soups, orange juice, oatmeal, beans and legumes, fish, whole milk, corn oil, and beer.Conclusions: The MeDS comprises food components and scores associated with a favorable cardiometabolic profile over 2 y in Puerto Rican adults. An overall healthy diet may be particularly beneficial for maintaining a lower BMI. These results can help identify suitable measures of diet quality in epidemiologic studies and craft meaningful nutritional messages and dietary recommendations for the intended population. This study was registered at clinicaltrials.gov as NCT01231958.

There is scarce information regarding the dietary intake of adults living in Puerto Rico (PR). We aimed to assess intake of nutrients and foods, adherence to recommended intake of nutrients and diet quality, and sociodemographic and lifestyle factors correlated with diet quality among adults in the San Juan metropolitan area of PR. Data were obtained from participants of the cross-sectional convenience-sample Puerto Rico Assessment of Diet, Lifestyle, and Diseases (n = 248, ages 30&ndash, 75 years). Diet quality was defined using the Alternate Healthy Eating Index 2010 (AHEI, range 0&ndash, 110 indicating lower&ndash, higher quality). Linear regression models were used to relate AHEI to sociodemographic and lifestyle factors. Most participants met the Estimated Average Requirement (EAR) for iron, folate, and vitamins B12 and B6, 61% met the EAR for magnesium and 56% for calcium. Only 4% met the EAR for vitamin D, and 7% met the adequate intake for potassium. The main contributors to total energy intake were sugary beverages (11.8%), sweets/desserts (10.2%), dairy (8.5%), mixed dishes (7.6%), starches (6.3%), fast foods (5.5%), and rice (4.9%). The mean (SD) AHEI score was 59.8 (11.0). The lowest AHEI components for which recommended servings were met were red/processed meats, fruit, sodium, sugary beverages, and polyunsaturated fats, and the highest were nuts/legumes, omega-3 fats, and whole grains. Significantly higher AHEI scores were noted for older adults, other ethnicities (vs. Puerto Rican), being single, having some college or higher education, and never/formerly smoking. Adults living in PR report healthy and unhealthy dietary intakes, providing an opportunity to improve diet at the population level.

OBJECTIVES: Sweetened beverage (SB) consumption is highly associated with obesity, but the mechanism underlying this correlation is not understood. Our objective was to examine metabolomic links between SB intake and obesity to understand metabolic mechanisms. METHODS: We examined the association of plasma metabolomic profiles with SB intake and obesity risk in 782 participants, aged 45–75y, in the Boston Puerto Rican Health Study (BPRHS) using linear regression models, controlling for potential confounding factors. Based on identified metabolites, we conducted pathway enrichment analysis to identify potential metabolic pathways that link SB intake and obesity risk. Genetic variants in identified metabolic pathways were examined for their interaction with SB intake on metabolites of interest and obesity. Interactions between SB and genotypes on obesity were evaluated for replication in the Framingham Heart Study (FHS). RESULTS: In BPRHS, SB intake was highly correlated with BMI (β = 0.455, P

The interaction between a functional apolipoprotein A2 gene (APOA2) variant and saturated fatty acids (SFAs) for the outcome of body mass index (BMI) is among the most widely replicated gene-nutrient interactions. Whether this interaction can be extrapolated to food-based sources of SFAs, specifically dairy foods, is unexplored. Cross-sectional analyses were performed in 2 U.S. population–based samples. We evaluated interactions between dairy foods and APOA2 −265T > C (rs5082) for BMI in the Boston Puerto Rican Health Study (n = 955) and tested for replication in the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN) study (n = 1116). Dairy products were evaluated as total dairy, higher-fat dairy (>1%), and low-fat dairy (≤1%) in servings per day, dichotomized into high and low based on each population median and also as continuous variables. We identified a statistically significant interaction between the APOA2 −265T > C variant and higher-fat dairy food intake in the Boston Puerto Ricans (P-interaction = 0.028) and replicated this relation in the GOLDN study (P-interaction = 0.001). In both groups, individuals with the previously demonstrated SFA-sensitive genotype (CC) who consumed a greater amount of higher-fat dairy foods had greater BMI (P = 0.013 in Boston Puerto Ricans; P = 0.0007 in GOLDN women) compared with those consuming less of the higher-fat dairy foods. The results expand the understanding of the metabolic influence of dairy products, an important food group for which variable relations to body weight may be in part genetically based. Moreover, these findings suggest that other strongly demonstrated gene-nutrient relations might be investigated through appropriate food-based, translatable avenues and may be relevant to dietary management of obesity.

Population admixture plays a role in the risk of chronic conditions that are related to body composition; however, our understanding of these associations in Puerto Ricans, a population characterized by multiple ancestries, is limited. This study investigated the relationship between genetic admixture and body composition in 652 Puerto Ricans from the Boston Puerto Rican Osteoporosis Study. Genetic ancestry was estimated from 100 ancestry-informative markers. Body composition measures were obtained from dual-energy X-ray absorptiometry. Multivariable linear regression analyses examined associations between bone mineral density (BMD) of the hip and lumbar spine and percent fat mass and lean mass with genetic admixture. In Puerto Ricans living on the US mainland, European ancestry was associated with lower BMD at the trochanter (P = 0.039) and femoral neck (P = 0.01), and Native American ancestry was associated with lower BMD of the trochanter (P = 0.04). African ancestry was associated with a higher BMD at the trochanter (P = 0.004) and femoral neck (P = 0.001). Ancestry was not associated with percent fat mass or lean mass or waist circumference. Our findings are consistent with existing research demonstrating inverse associations between European and Native American ancestries and BMD and positive relationships between African ancestry and BMD. This work contributes to our understanding of the high prevalence of chronic disease experienced by this population and has implications for other ethnic minority groups, particularly those with multiple ancestries. Future research should consider interactions between ancestry and environmental factors, as this may provide individualized approaches for disease prevention.

Objectives. To quantify the characteristics of community health workers (CHWs) involved in community intervention research and, in particular, to characterize their job titles, roles, and responsibilities; recruitment and compensation; and training and supervision. Methods. We developed and administered a structured questionnaire consisting of 25 closed- and open-ended questions to staff on National Institutes of Health–funded Centers for Population Health and Health Disparities projects between March and April 2014. We report frequency distributions for CHW roles, sought-after skills, education requirements, benefits and incentives offered, and supervision and training activities. Results. A total of 54 individuals worked as CHWs across the 18 research projects and held a diverse range of job titles. The CHWs commonly collaborated on research project implementation, provided education and support to study participants, and collected data. Training was offered across projects to bolster CHW capacity to assist in intervention and research activities. Conclusions. Our experience suggests national benefit in supporting greater efforts to recruit, retain, and support the work of CHWs in community-engagement research.

Epidemiologic studies report conflicting results for the relationship between milk intake and adiposity in children. We examined prospective and cross-sectional associations between milk intake and percent body fat among 2245 children from the Avon Longitudinal Study of Parents and Children. Cross-sectional analyses were performed at age 13 y between total, full-fat, and reduced-fat milk intake assessed using 3-d dietary records and body fat from DXA. Prospective analyses were conducted between milk intakes at age 10 y and body fat at 11 and 13 y. Models were adjusted for age, sex, height, physical activity, pubertal status, maternal BMI, maternal education, and intakes of total fat, sugar-sweetened beverages, 100% fruit juice, and ready-to-eat cereals; baseline BMI was added to prospective models. Subset analyses were performed for those with plausible dietary intakes. Mean milk consumption at 10 and 13 y was (mean 6 SD) 0.90 6 0.73 and 0.85 6 0.78 servings/d [1 serving = 8 oz of milk (244 g of plain and 250 g flavored milk)], respectively. Cross-sectional results indicated an inverse association between full-fat milk intake and body fat [b = 20.47 (95% CI = 20.76, 20.19); P = 0.001]. Milk intake at age 10 y was inversely associated with body fat at 11 y [b = 20.16 g/d (95%CI = 20.28, 20.04); P = 0.01], but not among those with plausible dietary intakes, suggesting that this association was influenced by dietary measurement errors. Milk intake was not associated with body fat at age 13 y after adjustment. Although our prospective results corroborate other findings of a null associations between milk intake and adiposity, our inconsistent findings across analyses suggest further investigation is needed to clarify the relation, and accounting for dietary reporting errors is an important consideration. J. Nutr. 141: 2035‐2041, 2011.

Stroke mortality rates and prevalence of several chronic diseases are higher in Southern populations and blacks in the US. This study examined the relationships of race (black, white) and region (Stroke Belt, Stroke Buckle, other) with selected nutrient intakes among black and white American men (n = 9229). The Block 98 FFQ assessed dietary intakes and multivariable linear regression analysis was used to examine whether race and region were associated with intakes of fiber, saturated fat, trans fat, sodium, potassium, magnesium, calcium, and cholesterol. Race and region were significant predictors of most nutrient intakes. Black men consumed 1.00% lower energy from saturated fat compared with white men [multivariable-adjusted β: 1.00% (95% CI = −0.88, −1.13)]. A significant interaction between race and region was detected for trans fat (P < 0.0001), where intake was significantly lower among black men compared with white men only in the Stroke Belt [multivariable-adjusted β: −0.21 (95% CI = −0.11, −0.31)]. Among black men, intakes of sodium, potassium, magnesium, and calcium were lower, whereas cholesterol was higher, compared with white men (P < 0.05 for all). Comparing regions, men in the Stroke Buckle had the lowest intakes of fiber, potassium, magnesium, and calcium compared with those in the Stroke Belt and other regions; men in both the Stroke Buckle and Stroke Belt had higher intakes of cholesterol compared with those in other regions (P < 0.005 for all). Given these observed differences in dietary intakes, more research is needed to understand if and how they play a role in the health disparities and chronic disease risks observed among racial groups and regions in the US.

The prevalence of metabolic syndrome was approximately 50% for Puerto Rican elders living in Massachusetts. Diet is known to be associated with metabolic syndrome. Little information exists regarding the dietary intakes of Puerto Ricans. We aimed to characterize the dietary patterns of 1167 Puerto Ricans (45-75 y) using principal components analysis and to further examine associations with metabolic syndrome. Factor solutions were examined for robustness using a random split sample. Adjusted means for metabolic syndrome components were calculated for factor quintiles. Logistic regression models examined associations between factors, metabolic syndrome, and its components. Analyses were also performed excluding subjects with diabetes. "Meat and French fries," "traditional," and "sweets" patterns emerged as most meaningful. A meat and French fries pattern was associated with higher blood pressure (systolic P-trend = 0.03 and diastolic < 0.001) and waist circumference (P-trend = 0.04). The traditional pattern was associated with lower HDL concentrations (P-trend = 0.007) and a higher likelihood of metabolic syndrome [odds ratio (OR): 1.7, 95% CI: 1.04, 2.7]). The sweets pattern was associated with lower HDL concentrations (P-trend < 0.001) and higher waist circumference (P-trend < 0.05). After excluding individuals with diabetes, the sweets pattern was no longer associated with fasting serum glucose and was associated with metabolic syndrome (OR: 1.8, 95% CI: 1.03, 3.3). Dietary patterns were significantly associated with metabolic syndrome and its components. More research is needed to make appropriate nutritional recommendations for this high-risk population.

Background Little is known about the interplay between n-3 fatty acids and genetic variants for diabetes-related traits at the genome-wide level. The present study aimed to examine variance contributions of genotype by environment (GxE) interactions for different erythrocyte n-3 fatty acids and genetic variants for diabetes-related traits at the genome-wide level in a non-Hispanic white population living in the U.S.A. (n = 820). A tool for Genome-wide Complex Trait Analysis (GCTA) was used to estimate the genome-wide GxE variance contribution of four diabetes-related traits: HOMA-Insulin Resistance (HOMA-IR), fasting plasma insulin, glucose and adiponectin. A GxE genome-wide association study (GWAS) was conducted to further elucidate the GCTA results. Replication was conducted in the participants of the Boston Puerto Rican Health Study (BPRHS) without diabetes (n = 716). Results In GOLDN, docosapentaenoic acid (DPA) contributed the most significant GxE variance to the total phenotypic variance of both HOMA-IR (26.5%, P-nominal = 0.034) and fasting insulin (24.3%, P-nominal = 0.042). The ratio of arachidonic acid to eicosapentaenoic acid + docosahexaenoic acid contributed the most significant GxE variance to the total variance of fasting glucose (27.0%, P-nominal = 0.023). GxE variance of the arachidonic acid/eicosapentaenoic acid ratio showed a marginally significant contribution to the adiponectin variance (16.0%, P-nominal = 0.058). None of the GCTA results were significant after Bonferroni correction (P

Children on the autism spectrum have numerous metabolic abnormalities that are often not well controlled and can lead to early chronic disease. Children with ASD often consume very limited diets th...

Few studies have investigated the associations between flavored milk consumption and body composition in children. We aimed to examine the prospective relationships between flavored milk consumption and body fat. Subjects included 2270 children from the Avon Longitudinal Study of Parents and Children. Flavored milk consumption at age 10 years was assessed using dietary records; consumption was dichotomized as consumers and non-consumers. Percent body fat was measured using dual-energy X-ray absorptiometry at 11 and 13 years. Body weight at 11 and 13 years was included as a secondary outcome. Associations were also examined in a subset of plausible reporters to evaluate the influence of dietary reporting errors. There was an effect of interaction between flavored milk and baseline weight on body fat (P-interaction

ObjectiveThe proportion of the Latin American population aged >60 years is expected to double during the next few decades. Metabolic syndrome (MetS) is associated with high morbidity and mortality worldwide. However, little is known about MetS in Latin America in general, and in Ecuador in particular. The present study aimed to examine the prevalence of MetS and its association with blood micronutrient, homocysteine (Hcy) and C-reactive protein (CRP) concentrations in the elderly living in a low-income urban area.DesignWe performed a cross-sectional study. MetS, using the International Diabetes Federation definition, dietary intake and plasma micronutrient, CRP and Hcy concentrations were assessed.SubjectsA total of 352 elderly (≥65 years) Ecuadorians.SettingQuito, Ecuador.ResultsMetS was prevalent (40 %) – considerably more so among women (81 %) than men (19 %;χ2= 32·6,P< 0·0001). Further, 53 % of those without MetS exhibited two or more of its components. Micronutrient deficiencies were prevalent, including those of vitamin C, zinc, vitamin B12and folate. Vitamin C and E concentrations were inversely (OR = 0·78, 95 % CI 0·71, 0·86; OR = 0·16, 95 % CI 0·03, 0·81, respectively) and CRP (OR = 1·79, 95 % CI 1·04, 3·06) was positively associated with MetS.ConclusionsThe coexistence of MetS with micronutrient deficiencies suggests that elderly Ecuadorians suffer from the double burden of diseases that are increasingly being observed in less developed countries. More research is needed to determine the causal factors, but results presented suggest that these older adults would benefit from interventions to reduce the risk factors for MetS, in particular higher consumption of micronutrient-rich foods.

Background: Reporting errors have been quantified in epidemiologic studies by comparing reported intakes with predicted energy requirements (pERs). Several studies lacking measures of physical activity level (PAL) assigned low-active levels to obtain pERs. Objective: We applied objective physical activity measures to current methods to quantify dietary reporting errors and compared associations with anthropometric and dietary variables among plausible and implausible reporters. Design: This study included 2868 adolescents with an average age of 13 y. Three-day dietary records, accelerometers, and dual-energy X-ray absorptiometry were used to assess diet, activity, and body composition, respectively. Three variations of physical activity coefficients were used: 1) assigning low physical activity coefficients (PAlow), 2) calculating PAL values (PAPAL), and 3) applying minutes of moderate-to-vigorous physical activity (PAMVPA). Results: Of the total participants, 51.5%, 51.8%, and 37.1% of the PAlow, PAPAL, and PAMVPA groups, respectively, were classified as underreporters, and 40.8%, 37.9%, and 42.4% of the respective groups were classified as plausible reporters. Underreporters had a higher body mass index, body fat, and waist circumference than did plausible reporters (P < 0.001 for all). Overreporters had a lower weight and body fat than did plausible reporters (P < 0.001 for all). Underreporters reported lower dairy and calcium intakes than did plausible reporters; the results were attenuated with adjustment for total energy. Conclusion: Accounting for objective physical activity measures to quantify reporting errors resulted in different and potentially more reasonable proportions of implausible reporters.