Relationships of Diet Quality, Sedentary Behavior, and DNA Methylation Patterns with Cardiometabolic Risk Factors among Children and Adolescents
Aljahdali, Abeer Ali O
2021
Abstract
Among youth, there has been a parallel increase in the prevalence of obesity and cardiometabolic abnormalities, including central obesity, glucose intolerance, elevated blood pressure, and dyslipidemia. This cluster of cardiometabolic abnormalities is a risk factor for the incidence of cardiovascular disease (CVD), mortality, and other chronic diseases in adulthood. While CVD manifests in adulthood, the atherosclerotic process and impaired cardiometabolic regulation start in childhood and track into adulthood. The recommended first line management protocol for cardiometabolic abnormalities in youth focuses on behavioral modifications of obesity. In fact, particular lifestyle behaviors (i.e., diet and sedentary and physical activity) are options for the prevention and management. Nevertheless, there is little evidence that addresses their effects during periods of rapid growth and maturation using a repeated measures, longitudinal study design. We examined the role of dietary and sedentary patterns in relation to cardiometabolic health using a repeated measures, longitudinal study design. The aforementioned lifestyle factors and genetics are not enough to explain the increased prevalence in cardiometabolic abnormalities across populations. In fact, DNAm, a covalent link between the fifth carbon in a cytosine nucleotide and a methyl group, has been proposed as a potential underlying mechanism of CVD. However, there is a scarcity of population-based studies among youth during this sensitive life period. The current study will address these gaps in knowledge. The three aims of this work used data from a pre-existing birth cohort called, Early Life Exposure in Mexico to ENvironmental Toxicants (ELEMENT), where Mexican children and adolescents aged 8 – 21 years were included in the analysis. Aim 1 investigated the repeated longitudinal associations between diet quality scores, measured using the Dietary Approaches to Stop Hypertension (DASH), Alternate Mediterranean Diet Score (aMedDiet), and Children’s Dietary Inflammatory Index (C-DIITM) scores and cardiometabolic risk factors. Higher DASH scores were associated with better insulin homeostasis. The aMedDiet and C-DII scores were associated with serum triglycerides. The positive association with C-DII and an inverse association with aMedDiet score confirmed a protective effect of these dietary patterns on serum triglycerides. Aim 2 examined the repeated longitudinal associations between sedentary activity patterns and cardiometabolic risk factors. Results suggested screen time was positively associated with blood pressure, and other sedentary time (i.e., doing homework/reading, and commuting) was positively associated with serum glucose. Using substitution paradigm, we observed substituting sedentary time with moderate-vigorous physical activity was inversely associated with waist circumference and serum triglycerides. Furthermore, substituting an uninterrupted five minutes of sedentary time, a sedentary bout, or even one minute of sedentary bout with light activity was inversely associated with serum insulin. Aim 3 studied the associations between DNAm at Long Interspersed Nuclear Element–1 (LINE-1), H19, 11β-Hydroxysteroid Dehydrogenase type-2 (11β-HSD-2), and Peroxisome Proliferator-Activated Receptor alpha (PPAR-α) and cardiometabolic risk factors. DNAm was measured at multiple CpG sites per genomic region. DNAm at LINE-1 was inversely associated with repeated measures of serum glucose at site 1, and positively with high-density lipoprotein cholesterol at site 3. 11β-HSD-2 DNAm at CpG site 4 was positively associated with repeated measures of serum glucose. This dissertation showed that higher diet quality, lower sedentary time, and replacing sedentary activity with higher intensities were associated with a better cardiometabolic profile among Mexican youth. In addition, we detected few associations between DNAm on the selected four genomic regions and cardiometabolic profile.Deep Blue DOI
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Cardiometabolic health Diet quality scores Sedentary behavior DNA methylation Mexican youth Population-based study
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