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Tsimikas S.,University of California at San Diego | Mallat Z.,University of Paris Descartes | Talmud P.J.,University College London | Kastelein J.J.P.,University of Amsterdam | And 8 more authors.
Journal of the American College of Cardiology | Year: 2010

Objectives This study sought to assess whether oxidation-specific biomarkers are associated with an increased risk of coronary artery disease (CAD) events. Background The relationship of a panel of oxidative biomarkers and lipoprotein(a) [Lp(a)] to CAD risk is not fully determined. Methods A prospective case-control study nested in the EPIC (European Prospective Investigation of Cancer)-Norfolk cohort of 45- to 79-year-old apparently healthy men and women followed for ∼6 years was designed. Cases consisted of participants in whom fatal or nonfatal CAD developed, matched by sex, age, and enrollment time with controls without CAD. Baseline levels of oxidized phospholipids on apolipoprotein B-100 particles and Lp(a) were measured in 763 cases and 1,397 controls. Their relationship to secretory phospholipase A 2 type IIA mass and activity, myeloperoxidase mass, and lipoprotein-associated phospholipase A2 activity and association with CAD events were determined. Results After adjusting for age, smoking, diabetes, low- and high-density lipoprotein cholesterol, and systolic blood pressure, the highest tertiles of oxidized phospholipids on apolipoprotein B-100 particles and Lp(a) were associated with a significantly higher risk of CAD events (odds ratios: 1.67 and 1.64, respectively; p < 0.001) compared with the lowest tertiles. The odds ratio of CAD events associated with the highest tertiles of oxidized phospholipids on apolipoprotein B-100 particles or Lp(a) was significantly potentiated (approximately doubled) by the highest tertiles of secretory phospholipase A2 activity and mass but less so for myeloperoxidase and lipoprotein-associated phospholipase A2 activity. The odds ratios for fatal CAD were higher than for the combined end point. After taking into account the Framingham Risk Score, c-index values progressively increased when oxidative biomarkers were added to the model. Conclusions This EPIC-Norfolk study links pathophysiologically related oxidation-specific biomarkers and Lp(a) with CAD events. Oxidation-specific biomarkers provide cumulative predictive value when added to traditional cardiovascular risk factors. © 2010 American College of Cardiology Foundation.

Hallal P.C.,Federal University of Pelotas | Andersen L.B.,University of Southern Denmark | Andersen L.B.,Norwegian School of Sport Sciences | Bull F.C.,University of Western Australia | And 4 more authors.
The Lancet | Year: 2012

To implement effective non-communicable disease prevention programmes, policy makers need data for physical activity levels and trends. In this report, we describe physical activity levels worldwide with data for adults (15 years or older) from 122 countries and for adolescents (13-15-years-old) from 105 countries. Worldwide, 31.1% (95% CI 30.9-31.2) of adults are physically inactive, with proportions ranging from 17.0% (16.8-17.2) in southeast Asia to about 43% in the Americas and the eastern Mediterranean. Inactivity rises with age, is higher in women than in men, and is increased in high-income countries. The proportion of 13-15-year-olds doing fewer than 60 min of physical activity of moderate to vigorous intensity per day is 80.3% (80.1-80.5); boys are more active than are girls. Continued improvement in monitoring of physical activity would help to guide development of policies and programmes to increase activity levels and to reduce the burden of non-communicable diseases.

Lynch K.E.,University of Massachusetts Amherst | Landsbaugh J.R.,Medical Research Council Epidemiology Unit | Whitcomb B.W.,University of Massachusetts Amherst | Pekow P.,University of Massachusetts Amherst | And 2 more authors.
American Journal of Preventive Medicine | Year: 2012

Background: A growing body of evidence suggests that physical activity during pregnancy can reduce risk of pregnancy complications. However, factors influencing activity in pregnant Hispanic women, who have high rates of sedentary activity as compared to non-Hispanic whites, are not well characterized. Purpose: To assess patterns and correlates of physical activity among 1355 participants in Proyecto Buena Salud, a prospective cohort of pregnant Hispanic women in Massachusetts from 2006 to 2011. Methods: Analyses were conducted in 2012. Pre-, early-, mid-, and late-pregnancy physical activity were assessed using the Pregnancy Physical Activity Questionnaire. Women reported the frequency and duration of household/caregiving, occupational, sports/exercise, and transportation activities and were classified according to compliance with American College of Obstetricians and Gynecologists guidelines for physical activity. Results: Household/caregiving activity was the primary mode of pregnancy activity ranging from 56% to 60% of total activity while sports/exercise contributed the least (<10%). Compared to nulliparous women, women with two or more children were 85% less likely to become inactive at any time during pregnancy (OR=0.15, 95% CI=0.04, 0.56, p-trend <0.01). Women with one or more children increased their total physical activity on average 9.73±2.04 MET-hours/week and 12.04±2.39 MET-hours/week, respectively, with the onset of pregnancy (p<0.01). Those with the highest levels of total physical activity prior to pregnancy were 87% less likely to become inactive with the onset of pregnancy than those who were inactive prior to pregnancy (OR=0.13, 95% CI= 0.05, 0.29). Conclusions: Findings can inform culturally appropriate interventions designed to reduce pregnancy complications through the promotion of physical activity during pregnancy. © 2012 American Journal of Preventive Medicine.

Myint P.K.,University of East Anglia | Myint P.K.,Norwich University | Myint P.K.,University of Cambridge | Luben R.N.,University of Cambridge | And 2 more authors.
Hypertension | Year: 2011

The effect of fruit and vegetable consumption and blood pressure is unclear. A population-based cross-sectional study was conducted in 20 926 men and women aged 40 to 79 years participating in the European Prospective Investigation Into Cancer-Norfolk who completed a health questionnaire and attended a clinic from 1993 to 1997. The relationship between plasma vitamin C concentrations, as an indicator of fruit and vegetable intake, and systolic BP was examined. The magnitude of their association was assessed using dichotomized values of high (≥140 mm Hg) and low (<140 mm Hg) systolic blood pressure. A total of 20 926 participants (46% men; mean [SD] 58.5 years [9.2 years]) were included after excluding participants with any missing data for variables of interest. People with high vitamin C concentrations had lower clinic blood pressure. The likelihood of having high blood pressure was 22% lower (odds ratio: 0.78 [95% CI: 0.71 to 0.86]) for those who were in the top quartiles of plasma vitamin C levels compared with the bottom quartiles after adjusting for age, sex, body mass index, cholesterol, prevalent medical conditions, smoking, physical activity, alcohol consumption, social class, education, use of vitamin C-containing supplement, and antihypertensive medication. Sex-specific analysis, as well as repeated analysis after exclusion of people who used vitamin C-containing supplements or who were taking antihypertensive medication, did not alter the results. There appears to be a strong association between vitamin C concentrations, an indicator of fruit and vegetable consumption, and a lower level of blood pressure. This may provide further evidence for health benefits of dietary patterns with higher fruit and vegetable consumption. © 2011 American Heart Association, Inc.

Wilks D.C.,Medical Research Council Human Nutrition Research | Besson H.,Medical Research Council Epidemiology Unit | Lindroos A.K.,Medical Research Council Human Nutrition Research | Ekelund U.,Medical Research Council Epidemiology Unit
Obesity Reviews | Year: 2011

This study aimed at synthesizing the prospective associations between measured physical activity (PA) and change in adiposity in children, adolescents and adults following from two previous reviews. Search terms were adapted and a systematic literature search was conducted (January 2000-September 2008) and later updated (up to October 2009), considering observational and intervention studies of weight gain that measured both PA and body composition. Sixteen observational studies (six comprising adults) and five trials (one comprising adults) were eligible. For consistency, whenever possible either baseline PA energy expenditure or accelerometer output (counts min-1) and change in per cent body fat were the extracted exposure and outcome measures. Results of observational studies suggest that PA is not strongly prospectively related with adiposity: five studies on children and three on adults reported no association between baseline PA and change in adiposity, one study found a weak positive association and the other studies observed a weak negative association. Negative associations were more frequently observed in studies that analysed the association between change in the exposure and outcome. Intervention studies show generally no effect on either PA or adiposity. In conclusion, despite the well-established health benefits of PA, it may not be a key determinant of excessive gain in adiposity. © 2010 The Authors. obesity reviews © 2010 International Association for the Study of Obesity.

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