Physical Activity and Sedentary Behavior among US Hispanic/Latino Youth: The SOL Youth Study

Purpose: Physical activity and sedentary behavior among diverse Hispanic/Latino youth in the United States is not well documented. The aim of this study was to describe physical activity and sedentary behavior among a representative sample of Hispanic/Latino youth from four US communities using accelerometry and self-reported measures. Methods: From 2012 to 2014, 1466 Hispanic/Latino youth ages 8 to 16 yr, children of participants in the Hispanic Community Health Study/Study of Latinos, enrolled in the SOL youth. Physical activity and sedentary behavior were assessed by interview. After this, youth wore an Actical accelerometer for 1 wk. All statistical analyses accounted for the complex survey design and used sampling weights. Results: The accelerometer wear time adjusted mean minutes per day was: 604.6, sedentary; 178.9, light; 25.4, moderate; and 10.2, vigorous. Generally, higher levels of moderate and vigorous activity occurred among males, Mexican backgrounds, and youth age 8 to 10 yr compared with older age groups. Higher levels of sedentary behavior occurred among youth age 15 to 16 yr compared with younger age groups. The most common activities (reported, ≥1 per month) were of lower intensity, including listening to music (91.9%), homework (87.0%), riding in car/bus (84.3%), and hanging out with friends (83.4%). Common active pursuits included travel by walking (74.6%), physical education class (71.7%), running (71.4%), and recess (71.3%). Conclusions: Time, intensity, and type of physical activity and sedentary behavior varied among Hispanic/Latino youth. These findings can inform efforts to increase physical activity and reduce sedentary behavior among US Hispanic/Latino youth

Systematic review of the prospective association of daily step counts with risk of mortality, cardiovascular disease, and dysglycemia

Background: Daily step counts is an intuitive metric that has demonstrated success in motivating physical activity in adults and may hold potential for future public health physical activity recommendations. This review seeks to clarify the pattern of the associations between daily steps and subsequent all-cause mortality, cardiovascular disease (CVD) morbidity and mortality, and dysglycemia, as well as the number of daily steps needed for health outcomes. Methods: A systematic review was conducted to identify prospective studies assessing daily step count measured by pedometer or accelerometer and their associations with all-cause mortality, CVD morbidity or mortality, and dysglycemia (dysglycemia or diabetes incidence, insulin sensitivity, fasting glucose, HbA1c). The search was performed across the Medline, Embase, CINAHL, and the Cochrane Library databases from inception to August 1, 2019. Eligibility criteria included longitudinal design with health outcomes assessed at baseline and subsequent timepoints; defining steps per day as the exposure; reporting all-cause mortality, CVD morbidity or mortality, and/or dysglycemia outcomes; adults ≥18 years old; and non-patient populations. Results: Seventeen prospective studies involving over 30,000 adults were identified. Five studies reported on all-cause mortality (follow-up time 4-10 years), four on cardiovascular risk or events (6 months to 6 years), and eight on dysglycemia outcomes (3 months to 5 years). For each 1000 daily step count increase at baseline, risk reductions in all-cause mortality (6-36%) and CVD (5-21%) at follow-up were estimated across a subsample of included studies. There was no evidence of significant interaction by age, sex, health conditions or behaviors (e.g., alcohol use, smoking status, diet) among studies that tested for interactions. Studies examining dysglycemia outcomes report inconsistent findings, partially due to heterogeneity across studies of glycemia-related biomarker outcomes, analytic approaches, and sample characteristics. Conclusions: Evidence from longitudinal data consistently demonstrated that walking an additional 1000 steps per day can help lower the risk of all-cause mortality, and CVD morbidity and mortality in adults, and that health benefits are present below 10,000 steps per day. However, the shape of the dose-response relation is not yet clear. Data are currently lacking to identify a specific minimum threshold of daily step counts needed to obtain overall health benefit

Calibration of activity-related energy expenditure in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Objectives: Usual physical activity (PA) is a complex exposure and typical instruments to measure aspects of PA are subject to measurement error, from systematic biases and biological variability. This error can lead to biased estimates of associations between PA and health outcomes. We developed a calibrated physical activity measure that adjusts for measurement error in both self-reported and accelerometry measures of PA in adults from the US Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a community-based cohort study. Design: Total energy expenditure (TEE) from doubly labeled water and resting energy expenditure (REE) from indirect calorimetry were measured in 445 men and women aged 18–74 years in 2010–2012, as part of the HCHS/SOL Study of Latinos: Nutrition & Physical Activity Assessment Study (SOLNAS). Measurements were repeated in a subset (N = 98) 6 months later. Method: Calibration equations for usual activity-related energy expenditure (AEE = 0.90 × TEE-REE) were developed by regressing this objective biomarker on self-reported PA and sedentary behavior, Actical accelerometer PA, and other subject characteristics. Results: Age, weight and height explained a significant amount of variation in AEE. Actical PA and wear-time were important predictors of AEE; whereas, self-reported PA was not independently associated with AEE. The final calibration equation explained fifty percent of variation in AEE. Conclusions: The developed calibration equations can be used to obtain error-corrected associations between PA and health outcomes in HCHS/SOL. Our study represents a unique opportunity to understand the measurement characteristics of PA instruments in an under-studied Hispanic/Latino cohort

Bending the Curve in Cardiovascular Disease Mortality: Bethesda + 40 and beyond

More than 40 years after the 1978 Bethesda Conference on the Declining Mortality from Coronary Heart Disease provided the scientific community with a blueprint for systematic analysis to understand declining rates of coronary heart disease, there are indications the decline has ended or even reversed despite advances in our knowledge about the condition and treatment. Recent data show a more complex situation, with mortality rates for overall cardiovascular disease, including coronary heart disease and stroke, decelerating, whereas those for heart failure are increasing. To mark the 40th anniversary of the Bethesda Conference, the National Heart, Lung, and Blood Institute and the American Heart Association cosponsored the "Bending the Curve in Cardiovascular Disease Mortality: Bethesda + 40" symposium. The objective was to examine the immediate and long-term outcomes of the 1978 conference and understand the current environment. Symposium themes included trends and future projections in cardiovascular disease (in the United States and internationally), the evolving obesity and diabetes epidemics, and harnessing emerging and innovative opportunities to preserve and promote cardiovascular health and prevent cardiovascular disease. In addition, participant-led discussion explored the challenges and barriers in promoting cardiovascular health across the lifespan and established a potential framework for observational research and interventions that would begin in early childhood (or ideally in utero). This report summarizes the relevant research, policy, and practice opportunities discussed at the symposium

Association of the Interaction Between Smoking and Depressive Symptom Clusters With Coronary Artery Calcification: The CARDIA Study.

Depressive symptom clusters are differentially associated with prognosis among patients with cardiovascular disease (CVD). Few studies have prospectively evaluated the association between depressive symptom clusters and risk of CVD. Previously, we observed that smoking and global depressive symptoms were synergistically associated with coronary artery calcification (CAC). The purpose of this study was to determine whether the smoking by depressive symptoms interaction, measured cumulatively over 25 years, differed by depressive symptom cluster (negative affect, anhedonia, and somatic symptoms) in association with CAC. Participants (N = 3,189: 54.5% female; 51.5% Black; average age = 50.1 years) were followed from 1985-1986 through 2010-2011 in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Smoking exposure was measured by cumulative cigarette pack-years (cigarette packs smoked per day × number of years smoking; year 0 through year 25). Depressive symptoms were measured using a 14-item, 3-factor (negative affect, anhedonia, somatic symptoms) model of the Center for Epidemiologic Studies Depression (CES-D) Scale (years 5, 10, 15, 20, and 25). CAC was assessed at year 25. Logistic regression models were used to evaluate the association between the smoking by depressive symptom clusters interactions with CAC ( = 0 vs. > 0), adjusted for CVD-related sociodemographic, behavioral, and clinical covariates. 907 participants (28% of the sample) had CAC > 0 at year 25. The depressive symptom clusters did not differ significantly between the two groups. Only the cumulative somatic symptom cluster by cumulative smoking exposure interaction was significantly associated with CAC > 0 at year 25 (p = .028). Specifically, adults with elevated somatic symptoms (score 9 out of 18) who had 10, 20, or 30 pack-years of smoking exposure had respective odds ratios (95% confidence intervals) of 2.06 [1.08, 3.93], 3.71 [1.81, 7.57], and 6.68 [2.87, 15.53], ps < .05. Negative affect and anhedonia did not significantly interact with smoking exposure associated with CAC >0, ps > .05. Somatic symptoms appear to be a particularly relevant cluster of depressive symptomatology in the relationship between smoking and CVD risk

Novel correlates between antimüllerian hormone and menstrual cycle characteristics in African-American women (23-35 years-old)

Objective: To characterize normative antimüllerian hormone (AMH) levels and ascertain which factors are associated with AMH in a large cohort of reproductive-age women. Design: Cross-sectional study. Setting: Not applicable. Patient(s): A total of 1,654 African-American women (AAW) ages 23-34 at recruitment. Intervention(s): Not applicable. Main Outcome Measure(s): Serum AMH measured using an ultrasensitive ELISA. Result(s): The median AMH was 3.18 ng/mL, and there was a significant, but nonlinear, relationship between age and AMH, with levels peaking at age 25. As AMH was not normally distributed, log transformation was performed and used for all analyses. In a multivariable age-adjusted model, body mass index, current use o