Comparison of non-HDL cholesterol and waist circumference vs. triglyceride levels and waist circumference in predicting coronary heart disease risk

BACKGROUND: Dyslipidemia is recognized as a major cause of coronary heart disease (CHD). Emerged evidence suggests that the combination of triglycerides (TG) and waist circumference can be used to predict the risk of CHD. However, considering the known limitations of TG, non-high-density lipoprotein (non-HDL = Total cholesterol - HDL cholesterol) cholesterol and waist circumference model may be a better predictor of CHD. PURPOSE: The Framingham Offspring Study data were used to determine if combined non-HDL cholesterol and waist circumference is equivalent to or better than TG and waist circumference (hypertriglyceridemic waist phenotype) in predicting risk of CHD. METHODS: A total of3,196 individuals from Framingham Offspring Study, aged ~ 40 years old, who fasted overnight for ~ 9 hours, and had no missing information on nonHDL cholesterol, TG levels, and waist circumference measurements, were included in the analysis. Receiver Operator Characteristic Curve (ROC) Area Under the Curve (AUC) was used to compare the predictive ability of non-HDL cholesterol and waist circumference and TG and waist circumference. Cox proportional-hazards models were used to examine the association between the joint distributions of non-HDL cholesterol, waist circumference, and non-fatal CHD; TG, waist circumference, and non-fatal CHD; and the joint distribution of non-HDL cholesterol and TG by waist circumference strata, after adjusting for age, gender, smoking, alcohol consumption, diabetes, and hypertension status. RESULTS: The ROC AUC associated with non-HDL cholesterol and waist circumference and TG and waist circumference are 0.6428 (CI: 0.6183, 0.6673) and 0.6299 (CI: 0.6049, 0.6548) respectively. The difference in the ROC AVC is 1.29%. The p-value testing if the difference in the ROC AVCs between the two models is zero is 0.10. There was a strong positive association between non-HDL cholesterol and the risk for non-fatal CHD within each TO levels than that for TO levels within each level of nonHDL cholesterol, especially in individuals with high waist circumference status. CONCLUSION: The results suggest that the model including non-HDL cholesterol and waist circumference may be superior at predicting CHD compared to the model including TO and waist circumference.

Climbers' perceptions toward sustainable bouldering at the Niagara Glen Nature Reserve

Currently, there are a variety of concerns about the future of bouldering, a form of rock climbing, a t the Niagara Glen Nature Reserve near Niagara Falls, Ontario due to environmental impacts at the site. The purpose of this study was to describe the perceptions ofbouldering participants toward sustainable bouldering practices at the Niagara Glen. The methodological framework for this study was based on action research, which attempts to solve specific problems through having people in a community study, discuss, and act on those problems. Five separate focus group interviews elicited data from nineteen men and seven women, while there were twenty one men and ten women observed through participant observations at the Niagara Glen. Analysis was conducted through coding processes where data were compared repeatedly and then organized into themes. From the open coding process, two main themes were identified and interpreted as 1) Barriers to Sustainable Bouldering at the Niagara Glen Nature Reserve, and 2) Environmental and Social Role and Responsibility ofBoulde r ing Participants at the Niagara Glen. The implications of the findings include a variety of recommendations for the bouldering community and the Niagara Parks Commission to consider for future collaborative planning. Some of these recommendations include more open communication between all stakeholders at the Glen, additional leadership from local climbing access coalitions and the Niagara Parks Commission, and greater implementation of minimum impact practices from the bouldering community. Additionally, these implications are discussed through a three-part framework based on a conceptual intersection of sense of place, community empowerment, and sustainable recreational use as a way to potentially unify the bouldering community's voice and vision toward sustainable practice.