Measurements of Arterial Occlusion Pressure Using Hand-Held Devices.

ABSTRACT: Vehrs, PR, Reynolds, S, Allen, J, Barrett, R, Blazzard, C, Burbank, T, Hart, H, Kasper, N, Lacey, R, Lopez, D, and Fellingham, GW. Measurements of arterial occlusion pressure using hand-held devices. J Strength Cond Res 38(5): 873-880, 2024-Arterial occlusion pressure (AOP) of the brachial artery was measured simultaneously using Doppler ultrasound (US), a hand-held Doppler (HHDOP), and a pulse oximeter (PO) in the dominant (DOM) and nondominant (NDOM) arms of males ( n = 21) and females ( n = 23) using continuous (CONT) and incremental (INCR) cuff inflation protocols. A mixed-model analysis of variance revealed significant ( p < 0.05) overall main effects between AOP measured using a CONT (115.7 ± 10.9) or INCR (115.0 ± 11.5) cuff inflation protocol; between AOP measured using US (116.3 ± 11.2), HHDOP (115.4 ± 11.2), and PO (114.4 ± 11.2); and between males (120.7 ± 10.6) and females (110.5 ± 9.4). The small overall difference (1.81 ± 3.3) between US and PO measures of AOP was significant ( p < 0.05), but the differences between US and HHDOP and between HHDOP and PO measures of AOP were not significant. There were no overall differences in AOP between the DOM and NDOM arms. Trial-to-trial variance in US measurements of AOP was not significant when using either cuff inflation protocol but was significant when using HHDOP and PO and a CONT cuff inflation protocol. Bland-Altman plots revealed reasonable limits of agreement for both HHDOP and PO measures of AOP. The small differences in US, HHDOP, and PO measurements of AOP when using CONT or INCR cuff inflation protocols are of minimal practical importance. The choice of cuff inflation protocol is one of personal preference. Hand-held Doppler of PO can be used to assess AOP before using blood flow restriction during exercise.

Use of a handheld Doppler to measure brachial and femoral artery occlusion pressure.

Objective: Measurement of arterial occlusion pressure (AOP) is essential to the safe and effective use of blood flow restriction during exercise. Use of a Doppler ultrasound (US) is the "gold standard" method to measure AOP. Validation of a handheld Doppler (HHDOP) device to measure AOP could make the measurement of AOP more accessible to practitioners in the field. The purpose of this study was to determine the accuracy of AOP measurements of the brachial and femoral arteries using an HHDOP. Methods: We simultaneously measured AOP using a "gold standard" US and a HHDOP in the dominant and non-dominant arms (15 males; 15 females) and legs (15 males; 15 females). Results: There were no differences in limb circumference or limb volume in the dominant and non-dominant arms and legs between males and females or between the dominant and non-dominant arms and legs of males and females. The differences between US and HHDOP measures of AOP in the dominant and non-dominant arms and legs were either not significant or small (<10 mmHg) and of little practical importance. There were no sex differences in AOP measurements of the femoral artery (p > 0.60). Bland-Altman analysis yielded an average bias (-0.65 mmHg; -2.93 mmHg) and reasonable limits of agreement (±5.56 mmHg; ±5.58 mmHg) between US and HHDOP measures of brachial and femoral artery AOP, respectively. Conclusion: HHDOP yielded acceptable measures of AOP of the brachial and femoral arteries and can be used to measure AOP by practitioners for the safe and effective use of blood flow restriction. Due to the potential differences in AOP between dominant and non-dominant limbs, AOP should be measured in each limb.

The healthfulness of children's meals when multiple media and devices are present.

Although television viewing during mealtime has been shown to associate with greater consumption of energy-dense foods, little is known about how new technological devices may influence children's food consumption. Because the number and type of media accessible to children continue to increase, this study examines the association between the presence of various media (TVs, mobile devices, video games, laptops) during mealtime and the healthfulness of children's meals. In this study, 61 primary caregivers of children ages 3-5 years and 10-13 years old participated in video-recorded dinner meals, which were reliably coded for media use, including number of media present. The overall healthfulness of the meals was coded using the Healthy Meal Index (HMI). Linear regression models were used to examine associations between number of media devices present during the meal and HMI, adjusting for parental education, income-to-needs ratio, and child race. Results indicate that the number of media present during the meal is inversely associated with HMI Total scores (B = -.29, p < .01; F(4, 53) = 9.97, p < .01). In other words, as the number of mealtime media devices increases, the healthfulness of children's meals decreases. These results suggest that media and device use during mealtime may be an additional childhood risk factor for poor meal quality, and parents should make efforts to limit mealtime media and device use.

Exposure to Endocrine-Disrupting Chemicals During Pregnancy Is Associated with Weight Change Through 1 Year Postpartum Among Women in the Early-Life Exposure in Mexico to Environmental Toxicants Project.

Background: The postpartum period may be a vulnerable life stage for a woman's cardiometabolic health. We examined associations of exposure to common endocrine-disrupting chemicals (EDCs) during pregnancy with weight from delivery through 1 year postpartum among 199 women in Mexico City. Materials and Methods: During each trimester of pregnancy, we collected a urine sample to assay bisphenol A (BPA), mono-n-butyl phthalate (MnBP), mono-isobutyl phthalate (MiBP), monobenzyl phthalate (MBzP), mono-3-carboxypropyl phthalate (MCPP), mono-2-ethyl-5-carboxypentyl phthalate (MECPP), mono-2-ethyl-5-hydroxyhexyl phthalate (MEHHP), mono-2-ethylhexyl phthalate (MEHP), mono-2-ethyl-5-oxohexyl phthalate (MEOHP), and monoethyl phthalate (MEP). We calculated summary scores for di-2-ethylhexyl phthalate metabolites (ΣDEHP) and dibutyl phthalate metabolites (ΣDBP). We calculated the geometric mean of each EDC across pregnancy for use in the analysis. At delivery and three additional times during the first year postpartum, we measured the women's weight. We used mixed-effects linear regression models to estimate associations of each EDC with weight at delivery (kg) and weight change (kg/year) from delivery through 1 year postpartum. Covariates included urinary specific gravity, maternal age, parity, height, first trimester body mass index, and gestational age at enrollment. Results: Mean ± standard deviation weight change during the first postpartum year was -0.49 ± 4.04 kg. The EDCs were inversely associated with weight at delivery, but positively associated with weight change through 1 year postpartum. For example, each interquartile range of urinary ΣDEHP corresponded with 1.38 (95% confidence interval: 0.44-2.33) kg lower weight at delivery and 1.01 (0.41--1.61) kg/year slower rate of weight loss. We observed similar associations for other EDCs. Conclusions: Prenatal exposure to EDCs is associated with lower weight at delivery, but slower rate of weight loss through the first postpartum year.

Associations between Food Security Status and Diet-Related Outcomes among Students at a Large, Public Midwestern University.

BACKGROUND: Food insecurity is a growing issue of concern on college campuses. While many studies have focused on predictors of food insecurity, fewer studies have examined how food insecurity affects diet and diet-related outcomes among college students. OBJECTIVE: The objective of this study was to examine differences in dietary intake, food and cooking agency, and body mass index (calculated as kg/m2) by food security status in a sample of college students at a large, public midwestern university. DESIGN: We conducted a cross-sectional online survey administered from March to June 2018. PARTICIPANTS: Students were recruited from a random sample (n=2,000) provided by the university, which included an oversample of minority racial/ethnic students from lower-income households and first-generation students. The response rate was 43% (n=851). After excluding students with missing data, the final sample was 754 enrolled students. MAIN OUTCOME MEASURES: Food security status was measured using the US Adult Food Security Survey Module. Dietary intake was assessed using the National Cancer Institute dietary screener questionnaire. Cooking and food agency was measured using the Cooking and Food Provisioning Action Scale, a new validated questionnaire. Body mass index was calculated from self-reported height and weight. STATISTICAL ANALYSIS PERFORMED: Differences between food security categories and diet-related outcomes were examined using generalized linear models. Models adjusted for sociodemographic covariates, such as student's age, sex, race/ethnicity, and receipt of financial aid. RESULTS: Compared to students with high food security, low food security was associated with lower intake of fruits, and very low food security was associated with higher intakes of total added sugar and added sugar from sugar-sweetened beverages. Marginal and very low food security were positively associated with body mass index. Marginal, low, and very low food security were inversely associated with cooking and food agency. CONCLUSIONS: Students with food insecurity experience diet-related challenges that could translate into health disparities over time. More research is needed to understand the longitudinal effects of food insecurity on student health and well being.

Deconstructing the Family Meal: Are Characteristics of the Mealtime Environment Associated with the Healthfulness of Meals Served?

BACKGROUND: Multiple studies and guidelines emphasize the benefits associated with family meals. However, family meals are not well defined and little research has been conducted to determine whether mealtime characteristics are associated with the healthfulness of foods served. OBJECTIVE: The objective of this study was to define and measure specific mealtime characteristics and examine whether these characteristics are associated with the healthfulness of meals served to young children from low-income families, as measured by the Healthy Meal Index (HMI). PARTICIPANTS/SETTING: Study participants included 272 young children from low-income families residing in southeast Michigan during 2011 to 2013. DESIGN: For this cross-sectional study, parents videorecorded 757 mealtimes that were coded for four mealtime variables and meal healthfulness using the HMI. Mealtime characteristics included Eating at a Table (vs not), Served Family-Style (vs not), TV Off (vs not), and Parent Partakes (sits and eats or drinks with child) (vs not). A Family Meal was defined as a meal that had all four measured mealtime characteristics. MAIN OUTCOME MEASURES: All meals were scored using the HMI, which has two components: the HMI Adequacy score (based on the presence of foods that are recommended for a healthy diet) and the HMI Moderation score (based on the absence of foods recommended to be consumed in moderation). The scores are summed to obtain the HMI Total score. STATISTICAL ANALYSES PERFORMED: Generalized estimating equations tested the associations of mealtime characteristics with HMI scores, controlling for child sex and age, and parent education and race/ethnicity. RESULTS: In adjusted models, Family Meals were positively associated with HMI Adequacy (P=0.02) and Total (P=0.05) scores. Eating at a Table was positively associated with HMI Moderation (P=0.01) and HMI Total (P=0.01) scores. Served Family-Style was positively associated with HMI Adequacy scores (P=0.04). TV Off was associated with higher HMI Total scores (P=0.05). Parent Partakes was not associated with HMI scores. CONCLUSIONS: Family Meals were associated with greater healthfulness of the foods served. Characteristics of mealtime that are commonly utilized to define Family Meal were differentially associated with meal healthfulness.

Changes in household food insecurity are related to changes in BMI and diet quality among Michigan Head Start preschoolers in a sex-specific manner.

Children living in households that have recently become food insecure may be particularly vulnerable to adverse weight and dietary changes, but longitudinal studies examining these associations are lacking. Using data from 501 Head Start preschoolers from Michigan (48% male) who were followed during one school year as a part of a randomized obesity prevention trial, we examined changes in children's adiposity indices and dietary quality according to changes in household food insecurity. Household food insecurity change status was categorized as persistently food secure, became food secure, persistently food insecure, or became food insecure. Linear mixed effects models were used to estimate relative changes in BMI-for-age z scores (BAZ), triceps skinfolds-for-age z scores (TAZ), or diet quality (assessed with the 2010 Healthy Eating Index) over the school year according to food insecurity category. We found that girls from households that became food insecure over the year had a 0.21 unit higher gain in BAZ than girls from households that were persistently food secure, after adjustment for potential confounders (95% CI 0.02 to 0.39, P = 0.03). Girls from households that became food secure had improvements in dietary quality over the year compared to girls from persistently food insecure households (adjusted difference in Healthy Eating Index score change = 9.1 points; 95% CI 3.0 to 15.0; p = 0.003). There were no statistically significant associations with changes in TAZ. Among boys, there were no associations between changes in household food insecurity and changes in BAZ, TAZ, or dietary quality. In summary, we found that BMI and diet quality changes of Head Start preschool girls were correlated with short-term changes in household food insecurity. Continued research efforts should focus on identifying the most effective ways to promote the health of children in food insecure households, especially those who may have recently transitioned or are transitioning into food insecurity.

Predictors of college-student food security and fruit and vegetable intake differ by housing type.

OBJECTIVE: We assessed whether college-student characteristics associate with food security and fruit and vegetable (FV) intake and whether these associations differ in students in housing with and without food provision. PARTICIPANTS: 514 randomly-sampled students from a large, Midwestern, public university in 2012 and 2013 METHODS: Ordered logistic regression tested how student characteristics associate with food security. Linear regression tested how student characteristics associate with FV intake. Analyses were stratified by housing type - that is, housing with food provision (dormitory, fraternity/sorority house, cooperative) vs. housing without food provision. RESULTS: Only among those living in housing without food provision, males (p = 0.04), students without car access (p = 0.005), and those with marginal (p = 0.001) or low (p = 0.001) food security demonstrated lower FV intake. CONCLUSIONS: Housing with food provision may buffer the effects of student characteristics on food.

Association of Bisphenol A Exposure with Breastfeeding and Perceived Insufficient Milk Supply in Mexican Women.

Introduction Estrogen inhibits lactation and bisphenol A (BPA) is a high production environmental estrogen. We hypothesize an inhibitory effect of BPA on lactation and aim to analyze the association between third trimester pregnancy urinary BPA and breastfeeding rates 1 month postpartum. Methods Odds ratios (OR) and 95 % confidence intervals (95 % CI) of breastfeeding and perceived insufficient milk supply (PIM) in relation to maternal peripartum urinary BPA concentrations were calculated in 216 mothers. Results 97.2 % of mothers in the lowest BPA tertile were breastfeeding at 1 month postpartum, compared to 89.9 % in highest (p = 0.01). Adjusted ORs (95 % CI) for not breastfeeding at 1 month were 1.9 (0.3, 10.7) and 4.3 (0.8, 21.6) for second and third BPA tertiles, respectively, compared to the lowest (p = 0.06, trend). 4.2 % reported PIM in the lowest BPA tertile, compared to 8.7 % in the highest (p = 0.03). Adjusted ORs (95 % CI) for PIM were 1.8 (0.4, 7.7) and 2.2 (0.5, 9.5), for the second and third BPA tertiles, respectively, compared to the lowest (p = 0.29, trend). Discussion These results suggest an association between maternal BPA exposure and decreased breastfeeding.

The Healthy Meal Index: A tool for measuring the healthfulness of meals served to children.

Family meals have been associated with higher diet quality and reduced risk of obesity in children. Observational studies of the family meal have been employed with increasing frequency, yet there is currently no tool available for measuring the healthfulness of food served during the meal. Here we present the development and validation of the Healthy Meal Index (HMI), a novel tool for scoring the healthfulness of foods served to children during a meal, as well as sociodemographic predictors of meal scores. Parents of 233 children, aged 4-8 years, self-recorded three home dinners. A research assistant obtained a list of foods available during the meal (meal report) via phone call on the night of each video-recorded meal. This meal report was coded into component food groups. Subsequently, meals were scored based on the availability of more healthy "Adequacy foods" and the absence of "Moderation foods", (of which reduced consumption is recommended, according to pediatric dietary guidelines). Adjusted linear regression tested the association of sociodemographic characteristics with HMI scores. A validation study was conducted in a separate sample of 133 children with detailed meal data. In adjusted models, female children had higher HMI Moderation scores (p = 0.02), but did not differ in HMI Adequacy or Total scores. Parents with more education served meals with higher HMI Adequacy (p = 0.001) and Total scores (p = 0.001), though no significant difference was seen in HMI Moderation score (p = 0.21). The validation study demonstrated that the HMI was highly correlated with servings of foods and nutrients estimated from observations conducted by research staff. The HMI is a valuable tool for measuring the quality of meals served to children.

Association of Dietary Variety and Diversity With Body Mass Index in US Preschool Children.

BACKGROUND AND OBJECTIVES: Dietary variety and diversity are recommended in dietary guidelines, but their association with BMI in US preschool-aged children is unknown. This study examined predictors of dietary variety and diversity and their association with child BMI z score (BMIz). METHODS: Primary caregivers responded to a food frequency questionnaire. Child anthropometry was obtained concurrently (n = 340) and prospectively (n = 264). Dietary variety scores and dietary diversity scores were computed. Multivariable linear regression was used to model predictors of these scores and their association with BMIz concurrently and BMIz change per year prospectively. RESULTS: The sample was 49.4% boys; 69.4% of the primary caregivers were non-Hispanic white and 46.2% had a high school education or less. Girls and older children had greater Fruit and Vegetable Variety (gender: P = .03, age: P < .001), Healthy Foods Variety (P = .02, P < .001), and Dietary Diversity (P = .04, P = .03) scores. Older children also had greater scores for Overall Variety (P < .001) and Moderation Foods (eg, high-fat, high-sugar foods recommended to be consumed in moderation) (P < .001). Having a non-Hispanic white primary caregiver (versus not) was associated with lower Dietary Diversity (P = .01). Greater Healthy Variety, Overall Variety, and Dietary Diversity were associated with greater annual increases in BMIz prospectively (ß[SE] = 0.009 [0.004], P = .04; ß[SE] = 0.007 [0.003], P = .02; ß[SE] = 0.003 [0.001], P = .02, respectively), adjusted for energy intake. CONCLUSIONS: Greater dietary variety and diversity were prospectively associated with higher BMIz. Targeting dietary variety and diversity as an obesity prevention strategy in children requires careful consideration.

Obesity prevalence in Colombian adults is increasing fastest in lower socio-economic status groups and urban residents: results from two nationally representative surveys.

OBJECTIVE: Low- and middle-income countries are experiencing rises in the prevalence of adult obesity. Whether these increases disproportionately affect vulnerable subpopulations is unclear because most previous investigations were not nationally representative, were limited to women, or relied on self-reported anthropometric data which are subject to bias. The aim of the present study was to assess changes in the prevalence of obesity from 2005 to 2010 in Colombian adults; overall and by levels of sociodemographic characteristics. DESIGN: Two cross-sectional, nationally representative surveys. SETTING: Colombia. SUBJECTS: Men and women 18-64 years old (n 31 105 in 2005; n 81 115 in 2010). RESULTS: The prevalence of obesity (BMI ≥30 kg/m2) was 13·9 % in 2005 and 16·4 % in 2010 (prevalence difference = 2·7 %; 95 % CI 1·9, 3·4 %). In multivariable analyses, obesity was positively associated with female sex, age, wealth, and living in the Pacific or National Territories regions in each year. In 2010, obesity was also associated with living in an urban area. The change in the prevalence of obesity from 2005 to 2010 varied significantly according to wealth; 5·0 % (95 % CI 3·3, 6·7 %) among the poorest and 0·3 % (95 % CI -1·6, 2·2 %) in the wealthiest (P, test for interaction = 0·007), after adjustment. Obesity rates also increased faster in older than younger people (P, test for interaction = 0·01), among people from urban compared with non-urban areas (P, test for interaction = 0·06) and in adults living in the Atlantic region compared with others. CONCLUSIONS: Adult obesity prevalence has increased in Colombia and its burden is shifting towards the poor and urban populations.

Recent trends in healthcare utilization among children and adolescents with hypertension in the United States.

The objective of this study was to evaluate the healthcare utilization of hospitalized children with hypertension. The Healthcare Cost and Utilization Project Kids' Inpatient Database, years 1997, 2000, 2003, and 2006, was used to identify hypertension hospitalizations. We examined the association of patient and hospital characteristics on hypertension charges. Data from each cohort year were used to analyze trends in charges. We found that 71282 pediatric hypertension hospitalizations generated $3.1 billion in total charges from 1997 to 2006. Approximately 68% were 10 to 18 years old, 55% were boys, and 47% were white. Six percent of claims with a diagnosis code for hypertension also had a diagnosis code for end-stage renal disease or renal transplant. The frequency of hypertension discharges increased over time (P=0.02 for each of age groups 2-9 years and 2-18 years; P=0.03 for age group 10-18 years), as well as the fraction of inpatient charges attributed to hypertension (P<0.0001). Length of stay and end-stage renal disease were associated with increases in hospitalization associated charges (P<0.0001 and P=0.03, respectively). During the 10-year study period, the frequency of hypertension-associated hospitalizations was increasing across all of the age groups, and the fraction of charges related to hypertension was also increasing. The coexisting condition of end-stage renal disease resulted in a significant increase in healthcare charges.

Molecular concepts analysis links tumors, pathways, mechanisms, and drugs.

Global molecular profiling of cancers has shown broad utility in delineating pathways and processes underlying disease, in predicting prognosis and response to therapy, and in suggesting novel treatments. To gain further insights from such data, we have integrated and analyzed a comprehensive collection of "molecular concepts" representing > 2500 cancer-related gene expression signatures from Oncomine and manual curation of the literature, drug treatment signatures from the Connectivity Map, target gene sets from genome-scale regulatory motif analyses, and reference gene sets from several gene and protein annotation databases. We computed pairwise association analysis on all 13,364 molecular concepts and identified > 290,000 significant associations, generating hypotheses that link cancer types and subtypes, pathways, mechanisms, and drugs. To navigate a network of associations, we developed an analysis platform, the Molecular Concepts Map. We demonstrate the utility of the approach by highlighting molecular concepts analyses of Myc pathway activation, breast cancer relapse, and retinoic acid treatment.