The relationship of obesity and cardiovascular disease

Aim. To review published literature on the relationship of obesity and cardiovascular disease.^ Methods. To look at all the studies published on the topic from 2005.^ Results. In the studies done prior to 2011, body mass index and in particular waist to hip ratio (51.57) was found to be associated with coronary heart disease. But, this relationship was challenged by the latest Lancet 2011meta-analysis 1 which concluded that singly or in combination, body-mass index, waist circumference, and waist-to-hip ratio did not importantly improve prediction of first-onset cardiovascular disease when additional information exists on blood pressure, history of diabetes, and cholesterol measures were available. Furthermore, they also found long-term reproducibility of BMI to be superior to that of waist-to-hip ratio (or waist circumference). Interestingly, body mass index in later childhood and early adult life showed positive association with coronary heart disease later in life 2. In US female health professionals 3 increasing body mass index was found to be associated with increased coronary heart disease risk. Overall 4, physical activity was found to be independently associated with fewer risk factors, less coronary artery disease, and fewer adverse events in women. Finally, obesity was found to be associated with increased overall cardiovascular mortality and coronary heart disease mortality 5.^ Conclusions. There is insufficient data to draw guidelines regarding parameters of obesity affecting cardiovascular disease. But there is data to support that lower body mass index would lead to decreased cardiovascular disease mortality. And physical activity has a direct association with less coronary artery disease in women.^

Teacher support and encouragement in the classroom and its impact on childhood obesity

Objectives. Obesity is a growing problem in the United States among children. Great efforts are being made to target this problem, both at home and at school. While parents and peers have proven an effective means of distributing information, the well of the influence of teacher encouragement of health behaviors remains untapped. The purpose of this study is to assess the association of teacher encouragement with diet and physical activity behaviors and obesity in a sample of eighth grade students in central Texas. ^ Methods. In the spring of 2011, the Coordinated Approach to Child Health (CATCH) study distributed teacher surveys to each of the teachers in the schools on the grant. In addition to questions concerning the implementation of CATCH, this survey employed social support questions to gauge the prevalence of teacher encouragement of health behaviors in the classroom. During the same time frame, eighth graders in these same schools completed student surveys which assessed dietary and physical activity knowledge and behaviors and demographics and participated in objective measures of student height and weight. A cross-sectional secondary data analysis was conducted in order to compare self-reported teacher encouragement to student behaviors and several student obesity measures on a by school basis. ^ Results. 1150 teachers and 2582 students from 29 of the 30 measurement schools returned completed surveys. No statistically significant relationship was found between the six teacher encouragement measures and their corresponding student reported health behaviors, nor was one found the mean support per school and child percent overweight. A menial positive relationship was found between the mean support per school and child BMI z-scores, BMI, and percent obese (p = 0.035, 0.003 and 0.003, respectively); however, these relationships were not in the predicted direction. ^ Conclusion. While the findings of this investigation show primarily null results, motivating questions as to the impact to teacher encouragement on middle school student's health remain. It is possible that in order to draw more effective conclusions, more comprehensive studies are warranted which specifically target these relationships.^

Impact of traffic pollution on telomere length and chronic diseases: Results from the multi-ethnic study of atherosclerosis and the Mexican-American cohort study

Exposure to air pollutants in urban locales has been associated with increased risk for chronic diseases including cardiovascular disease (CVD) and pulmonary diseases in epidemiological studies. The exact mechanism explaining how air pollution affects chronic disease is still unknown. However, oxidative stress and inflammatory pathways have been posited as likely mechanisms. ^ Data from the Multi-Ethnic Study of Atherosclerosis (MESA) and the Mexican-American Cohort Study (2003-2009) were used to examine the following aims, respectively: 1) to evaluate the association between long-term exposure to ambient particulate matter (PM) (PM10 and PM2.5) and nitrogen oxides (NO x) and telomere length (TL) among approximately 1,000 participants within MESA; and 2) to evaluate the association between traffic-related air pollution with self-reported asthma, diabetes, and hypertension among Mexican-Americans in Houston, Texas. ^ Our results from MESA were inconsistent regarding associations between long-term exposure to air pollution and shorter telomere length based on whether the participants came from New York (NY) or Los Angeles (LA). Although not statistically significant, we observed a negative association between long-term air pollution exposure and mean telomere length for NY participants, which was consistent with our hypothesis. Positive (statistically insignificant) associations were observed for LA participants. It is possible that our findings were more influenced by both outcome and exposure misclassification than by the absence of a relationship between pollution and TL. Future studies are needed that include longitudinal measures of telomere length as well as focus on effects of specific constituents of PM and other pollutant exposures on changes in telomere length over time. ^ This research provides support that Mexican-American adults who live near a major roadway or in close proximity to a dense street network have a higher prevalence of asthma. There was a non-significant trend towards an increased prevalence of adult asthma with increasing residential traffic exposure especially for residents who lived three or more years at their baseline address. Even though the prevalence of asthma is low in the Mexican-origin population, it is the fastest growing minority group in the U.S. and we would expect a growing number of Mexican-Americans who suffer from asthma in the future. Future studies are needed to better characterize risks for asthma associated with air pollution in this population.^

Associations between teacher support and students' fruit and vegetable consumption in low-income elementary schools in central Texas

Background. Similar to parent support in the home environment, teacher support at school may positively influence children's fruit and vegetable (FV) consumption. This study assessed the relationship between teacher support for FV consumption and the FV intake of 4th and 5th grade students in low-income elementary schools in central Texas. Methods. A secondary analysis was performed on baseline data collected from 496 parent-child dyads during the Marathon Kids study carried out by the Michael & Susan Dell Center for Healthy Living at the University of Texas School of Public Health. A hierarchical linear regression analysis adjusting for key demographic variables, parent support, and home FV availability was conducted. In addition, separate linear regression models stratified by quartiles of home FV availability were conducted to assess the relationship between teacher support and FV intake by level of home FV availability. Results. Teacher support was not significantly related to students' FV intake (p = .44). However, the interaction of teacher support and home FV availability was positively associated with students' FV consumption (p < .05). For students in the lowest quartile of home FV availability, teacher support accounted for approximately 6% of the FV intake variance (p = .02). For higher levels of FV availability, teacher support and FV intake were not related. Conclusions. For lower income elementary school-aged children with low FV availability at home, greater teacher support may lead to modest increases in FV consumption.^

Relationships, Income Support and Decision Making: A Qualitative Synopsis

This qualitative study of one midwestern state’s child protective services addresses whether an income support measure for poor biological caregivers reduces the length of time that their children spend in foster care. The overall findings suggest that workers do value the worker-family relationship. However, some view the immediate worker-client relationship as secondary to the inclusion of extended familial supports particularly as related to sustained more long-term outcome achievement. Most workers additionally agree that client involvement during all phases of the reunification process is critical.

Relation between acid back -diffusion and luminal surface hydrophobicity in canine gastric mucosa: Effects of salicylate and prostaglandin

The stomach is thought to be protected from luminal acid by a gastric mucosal barrier that restricts the diffusion of acid into tissue. This study tested the hypothesis that the hydrophobic luminal surface of canine gastric mucosa incubated in Ussing chambers, impedes the back-diffusion of luminal acid into the tissue. Isolated sheets of mucosa were treated with cimetidine to inhibit spontaneous acid secretion, and incubated under conditions that prevented significant secretion of luminal bicarbonate. By measuring acid loss from the luminal compartment using the pH-stat technique, acid back-diffusion was continuously monitored; potential difference (PD) was measured as an index of tissue viability. Tissue luminal surface hydrophobicity was estimated by contact angle analysis at the end of each experiment. Addition of 16,16-dimethyl prostaglandin E$\sb2$ to the nutrient compartment enhanced luminal surface hydrophobicity, but did not reduce acid back-diffusion in tissues that maintained a constant PD. 10 mM salicylate at pH 4.00 in the luminal compartment reduced surface hydrophobicity, but this decrease did not occur if 1 ug/ml prostaglandin was present in the nutrient solution. Despite possessing relatively hydrophilic and relatively hydrophobic surface properties, respectively, acid back-diffusion in the absence of salicylate was not significantly different between these two groups. Neither group maintained a PD after incubation with salicylate. Lastly, radiolabelled salicylate was used to calculate the free (non-salicylate associated) acid loss in tissues incubated with salicylate and/or prostaglandin. No significant correlation was found between free acid back-diffusion and luminal surface hydrophobicity. These data do not support the hypothesis that acid back-diffusion in impeded by the hydrophobic surface presented by isolated canine gastric mucosa. ^