Association between a Healthy Lifestyle Score and inflammatory markers among Puerto Rican adults.

BACKGROUND AND AIMS: The relationship between multiple lifestyle components analyzed in combination and inflammation remains understudied. We aimed to assess the association between a Healthy Lifestyle Score (HLS) that includes adherence to five behavioral components (diet, physical activity and sedentary behaviors, smoking, social support and network, and sleep) and inflammatory markers, as well as the role of the HLS in inflammation among individuals with cardiometabolic conditions, in Puerto Rican adults. METHODS AND RESULTS: In a cross-sectional study of 842 Puerto Ricans adults (aged 45-75 y) living in Boston, MA, the HLS (range = 0-190; maximum indicative of healthiest adherence) was analyzed for association with three inflammatory markers: interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP). In multivariable-adjusted models, the HLS was inversely associated with IL-6 (ß ± SE = -0.55 ± 0.13; P < 0.001) and TNF-α (-0.39 ± 0.13; P = 0.004). The dietary and smoking components were associated with both inflammatory markers independently of the other HLS components. Significant inverse associations were observed for each 20-unit increase in HLS and IL-6 and TNF-α for participants with hypertension (n = 600; ß ± SE = -0.58 ± 0.16; -0.46 ± 0.16, respectively) and with overweight/obesity (n = 743; ß ± SE = -0.59 ± 0.13; -0.50 ± 0.14, respectively), but not for those with diabetes (n = 187) or heart disease (n = 192). The HLS was not associated with CRP, after adjustment for potential confounders. CONCLUSION: Higher adherence to multiple lifestyle behaviors was associated with lower concentrations of inflammatory markers. Because low-grade inflammation may precede chronic diseases, following an overall healthy lifestyle may help lower risk of these diseases.

Intake and food sources of macronutrients among older Hispanic adults: association with ethnicity, acculturation, and length of residence in the United States.

OBJECTIVE: To describe the food intake and food sources of macronutrients in diets of older Hispanic adults in the Northeastern United States and to explore relationships between acculturation, years in the United States, and macronutrient intake. DESIGN: Cross-sectional study using a representative sample of older Hispanic adults and a comparison group of non-Hispanic whites. SUBJECTS/SETTING: Hispanic (n = 711) and non-Hispanic white (n = 226) persons, aged 60 years and older, residing in Massachusetts. STATISTICAL ANALYSIS: Macronutrient intakes, collected by 24-hour dietary recall, were compared across ethnic groups by means of the general linear models procedure (with Bonferroni adjustments). Associations between macronutrient intake and predictor variables were tested with Pearson correlations and linear regression. The contribution of foods to total intake of macronutrients was determined by use of a rank procedure. RESULTS: Hispanic elderly subjects consumed significantly less saturated fat and simple sugars and more complex carbohydrates than did non-Hispanic whites. Hispanics residing in the United States for a longer time tended to have macronutrient profiles more similar to those of the non-Hispanic whites. Rice for Hispanic and bread for non-Hispanics were the major contributors of energy. More acculturated Hispanic elders consumed fewer ethnic foods and more foods related to the non-Hispanic-white eating patterns than those less acculturated. APPLICATIONS/CONCLUSIONS: Efforts to promote better diets among Hispanic elders need to emphasize maintenance or adoption of healthful dietary patterns based on ethnic and modern foods that will satisfy their biological, emotional, and social needs. Dietitians and other dietetics practitioners can use the information presented here in studying nutrition-related chronic diseases, in public health planning, and in nutrition education and promotion efforts directed to ethnic-specific, elderly Hispanic groups.

Prevalence and correlates of depressive symptoms among Hispanic elders in Massachusetts.

BACKGROUND: Few studies have addressed depression among Puerto Rican and Dominican elders. This study examined the prevalence of depressive symptomatology and associated situational factors, among a representative sample of Hispanic elders in the state of Massachusetts and a neighborhood comparison group of non-Hispanic whites (NHWs). METHODS: Participants included 715 Hispanic elders (429 Puerto Rican, 128 Dominican, and 149 other Hispanic) in Massachusetts and 238 NHW elders living in the same neighborhoods. Depressive symptomatology was measured with the Center for Epidemiologic Studies Depression Scale (CES-D). The associations between socioeconomic status, household arrangements, acculturation, health problems, and depression score were examined with multiple linear and logistic regression. RESULTS: Puerto Rican and Dominican elders had significantly greater prevalences of high depression scores when compared with neighborhood NHWs. After controlling for various social, demographic, and health characteristics, the scores of Puerto Ricans remained significantly greater than those of the NHWs, but not "Other Hispanic" groups. Higher CES-D scores were significantly associated with being female, living alone, and having a higher number of health problems, but not with income. Effects of acculturation were only found among Dominican elders. CONCLUSIONS: Puerto Rican elders experience high rates of depressive symptomatology that are associated with, but not fully explained by, high numbers of chronic health conditions. Further investigation is needed to both understand and treat this prevalent problem.

Self-reported prevalence and health correlates of functional limitation among Massachusetts elderly Puerto Ricans, Dominicans, and non-Hispanic white neighborhood comparison group.

BACKGROUND: Limited data suggest that Puerto Ricans experience greater disability than other ethnic groups, but few studies have examined the factors associated with this apparent difference. METHODS: We describe the prevalence of functional limitation and disability in a representative sample of Puerto Rican and Dominican elders in Massachusetts, and in a neighborhood comparison group of non-Hispanic whites (NHWs). We then relate disability scores, based on both prevalence and severity of ADL or IADL limitation, with self-reported history of diagnosed health conditions--adjusting for age, sex, body mass index (BMI; weight kg/height m(2)), income, education, living alone, smoking, and alcohol use. RESULTS: Seventy-five percent of Dominican women and 73% of Puerto Rican women reported difficulty with at least one ADL, compared with 64% of NHW women. Puerto Rican men reported significantly more limitation than did NHW or Dominican men. Conditions significantly associated with at least two disability measures among the NHW included smoking, former heavy alcohol use, arthritis, cataract, respiratory disease, and high BMI, but not stroke, diabetes, history of heart attack, or depression. The patterns for Puerto Ricans differed, with the strongest associations between disability and stroke, arthritis, diabetes, and depression, followed by history of heart attack, high BMI, cataract, poverty status, and respiratory disease. Only arthritis and depression were consistently significantly associated with disability among this smaller sample of Dominican elders. CONCLUSIONS: Functional limitation and disability are more prevalent among Puerto Ricans and among Dominican women than among neighborhood NHWs in Massachusetts. Greater disability is associated with the presence of chronic health conditions, which differ by ethnic group. Additional research is needed to further define the social and health factors that contribute to these ethnic differences.