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  • 1
    Online Resource
    Online Resource
    The Association between Adult Weight Gain and Insulin Resistance at Middle Age: Mediation by Visceral Fat and Liver Fat
    MDPI AG ; 2019
    In:  Journal of Clinical Medicine Vol. 8, No. 10 ( 2019-09-28), p. 1559-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 8, No. 10 ( 2019-09-28), p. 1559-
    Abstract: We aimed to investigate the role of the amount of visceral fat and liver fat in the association between adult weight change and insulin resistance at middle age. In the Netherlands Epidemiology of Obesity study, adult weight change was calculated with recalled body weight at age 20 years and measured body weight at middle age. Measures of insulin resistance were calculated using both fasting and postprandial glucose and insulin concentrations. Visceral fat was assessed by magnetic resonance (MR) imaging and liver fat by proton-MR spectroscopy (N = 1758). We examined the association between adult weight change and insulin resistance with linear regression, adjusted for confounding factors. To investigate mediation, we additionally adjusted for total body fat, visceral fat, and liver fat. In participants who gained ≥50% of body weight during adulthood, homeostatic model assessment for insulin resistance (HOMA-IR) was 3.22 (95% CI 2.76; 3.77) times higher than in weight maintainers. In a joint model, total body fat mediated this association for 8.1% (95% CI −9.2; 25.4), visceral fat for 32.0% (18.6; 45.4%) and liver fat for 22.5% (15.0; 30.1). The association between adult weight gain and insulin resistance at middle age is largely mediated by both visceral fat and liver fat.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm8101559
    Language: English
    Publisher: MDPI AG
    Publication Date: 2019
    detail.hit.zdb_id: 2662592-1
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  • 2
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    Online Resource
    MIND Dietary Pattern and Its Association with Cognition and Incident Dementia in the UK Biobank
    MDPI AG ; 2022
    In:  Nutrients Vol. 15, No. 1 ( 2022-12-21), p. 32-
    Details
    In: Nutrients, MDPI AG, Vol. 15, No. 1 ( 2022-12-21), p. 32-
    Abstract: A high adherence to the Mediterranean-Dietary Approaches to Stop Hypertension Diet Intervention for Neurodegenerative Delay (MIND) has been associated with better cognition and a lower risk of dementia in some but not all studies. We measured adherence to MIND and its association with cognitive health in the UK Biobank (UKB). A MIND score was derived from 24 h diet recall questionnaires for 120,661 participants who completed at least one of seven self-administered cognitive function tests. In a subset of 78,663 participants aged 55+, diagnosis of dementia was determined by linked hospital and death records. Multivariable regression and Cox proportional hazard ratio (HR) models were used to examine associations of MIND with cognitive ability and incident dementia. Higher adherence to MIND was associated with a small but significant worsening in performance on five of seven cognitive tests (p 〈 0.002). Associations were strongest among highly educated participants (p 〈 0.002 for MIND × education interaction). After a mean follow-up time of 10.5 years, 842 participants developed dementia. Overall, MIND adherence was not associated with incident dementia. An inverse association was observed among females (HR = 0.87 per score standard deviation (SD), p = 0.008) but not males (HR = 1.09, p = 0.11) (p = 0.008 for MIND × sex interaction). Similar associations with cognitive ability and dementia were observed for the Alternative Healthy Eating Index-2010 (AHEI-2010) dietary pattern. Associations were not modified by genetic susceptibility. In UKB, the MIND diet was not associated with better cognitive test scores and only with lower dementia risk in women.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    URL: Article
    DOI: 10.3390/nu15010032
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2518386-2
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  • 3
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    Online Resource
    Sleep Duration, Sleep Quality and Physical Activity, but Not Sedentary Behaviour, Are Associated with Positive Mental Health in a Multi-Ethnic Asian Population: A Cross-Sectional Evaluation
    MDPI AG ; 2020
    In:  International Journal of Environmental Research and Public Health Vol. 17, No. 22 ( 2020-11-16), p. 8489-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 17, No. 22 ( 2020-11-16), p. 8489-
    Abstract: Background: We assessed the associations of sleep, physical activity and sedentary behaviour with positive mental health (PMH) in the multi-ethnic population of Singapore. Methods: The Singapore Health 2 study is a nationally representative cross-sectional survey among residents aged 18–79 years. A PMH instrument was administered to 1925 participants to obtain total PMH and six sub-component scores. Self-rated sleep duration, sleep quality, sedentary behaviour and physical activity were assessed. Multivariable linear regression analyses were conducted. Results: The mean age of the participants was 40.1 (SD 14.3) years. Sleep duration (≥8 h/night: β = 0.17,95% CI: 0.02–0.32; 7– 〈 8 h/night: β = 0.17,95% CI: 0.03–0.30 versus 〈 6 h/night, p = 0.002), sleep quality (very good: β = 0.45,95% CI: 0.29–0.60; fairly good: β = 0.20,95% CI: 0.06–0.33 versus very/fairly bad; ptrend 〈 0.001) and physical activity (high: β = 0.19,95% CI: 0.05–0.32; moderate: β = 0.15, 95% CI: 0.03–0.27 versus low; ptrend 〈 0.001) were directly associated with total PMH. Sedentary behaviour was not significantly associated with PMH. Sleep duration, sleep quality and physical activity were directly associated with the PMH sub-components ‘emotional support’ and ‘personal growth and autonomy’. Conclusions: Duration and quality of sleep and physical activity were directly associated with PMH in an urban Asian population. These findings support incorporating sleep and physical activity interventions to improve population mental health.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph17228489
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2175195-X
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  • 4
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    Online Resource
    Youth Positive Mental Health Concepts and Definitions: A Systematic Review and Qualitative Synthesis
    MDPI AG ; 2022
    In:  International Journal of Environmental Research and Public Health Vol. 19, No. 18 ( 2022-09-13), p. 11506-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 19, No. 18 ( 2022-09-13), p. 11506-
    Abstract: Background: Research on youth positive mental health (PMH) lacks comprehensiveness. We reviewed literature to (i) identify and understand concepts related to youth PMH and (ii) to summarize their definitions under broad conceptual themes. Method: We conducted a systematic review using PRISMA methodology. The protocol was registered in PROSPERO database (ID:CRD42020203712). Pubmed, Embase, PsycINFO, and OpenGrey databases were searched for publications that examined, assessed, explained, or defined PMH concepts in youth populations. Methods included searching, independent screening and review using pre-determined inclusion and exclusion criteria, extraction, coding, and iterative thematic syntheses of literature. Results: Of 3427 unique records identified, 105 articles from 26 countries met review criteria. Qualitative analysis resulted in 22 broad themes of youth PMH. These included interpersonal relationships (interpersonal competence, school connectedness, etc.), positive emotions (feel and create pleasant emotions, gratitude, etc.), self-efficacy (strengths, human agency, etc.), life satisfaction (global assessment of one’s life), and personal growth (goal achievement, life aspirations, etc.). Five novel concepts related to youth PMH were identified. Conclusions: Our review summarized and operationalized multiple concepts of youth PMH for applications in research, evaluation, and public health improvement.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph191811506
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
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  • 5
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    Online Resource
    Diet, Physical Activity and Adiposity as Determinants of Circulating Amino Acid Levels in a Multiethnic Asian Population
    MDPI AG ; 2020
    In:  Nutrients Vol. 12, No. 9 ( 2020-08-27), p. 2603-
    Details
    In: Nutrients, MDPI AG, Vol. 12, No. 9 ( 2020-08-27), p. 2603-
    Abstract: Profiles of circulating amino acids have been associated with cardiometabolic diseases. We investigated the associations between dietary protein intake, physical activity and adiposity and serum amino acid profiles in an Asian population. We used data from 3009 male and female participants from the Singapore Prospective Study Program cohort. Dietary and physical activity data were obtained from validated questionnaires; anthropometric measurements were collected during a health examination; and fasting concentrations of 16 amino acids were measured using targeted LC-MS. The association between lifestyle factors and amino acid levels was modeled using multiple linear regression with adjustment for other sociodemographic and lifestyle factors and correction for multiple testing. We observed significant associations between seafood intake (β-coefficient 0.132, 95% CI 0.006, 0.257 for a 100% increment), physical activity (β-coefficient −0.096, 95% CI −0.183, −0.008 in the highest versus lowest quartile) and adiposity (BMI β-coefficient 0.062, 95% CI 0.054, 0.070 per kg/m2; waist circumference β-coefficient 0.034, 95% CI 0.031, 0.037 per cm) and branched-chain amino acid levels (expressed per-SD). We also observed significant interactions with sex for the association between meat and seafood and total intakes and BCAA levels (P for interaction 0.007), which were stronger in females than in males. Our findings suggest novel associations between modifiable lifestyle factors and amino acid levels in Asian populations.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    URL: Article
    DOI: 10.3390/nu12092603
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2518386-2
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  • 6
    Online Resource
    Online Resource
    Combined Impact of a Faster Self-Reported Eating Rate and Higher Dietary Energy Intake Rate on Energy Intake and Adiposity
    MDPI AG ; 2020
    In:  Nutrients Vol. 12, No. 11 ( 2020-10-25), p. 3264-
    Details
    In: Nutrients, MDPI AG, Vol. 12, No. 11 ( 2020-10-25), p. 3264-
    Abstract: Eating more quickly and consuming foods with a higher energy-intake-rate (EIR: kcal/min) is associated with greater energy intake and adiposity. However, it remains unclear whether individuals who eat more quickly are more likely to consume foods with higher EIR. We investigated the overlap between self-reported eating rate (SRER) and the consumption of higher EIR foods, and their combined impact on daily energy intake and adiposity in a population-based Asian cohort (n = 7011; 21–75y). Food consumption was assessed using a validated Food Frequency Questionnaire. Moderated regression with simple slope analysis was conducted to evaluate whether SRER modified the association between dietary EIR and total dietary energy intakes. Faster eaters consumed a significantly higher proportion of energy from higher EIR foods among overweight individuals, but not among normal-weight individuals. Associations between dietary EIR and total energy intake were stronger among medium (β = 15.04, 95%CI: 13.00–17.08) and fast (β = 15.69, 95%CI: 12.61–18.78) eaters, compared with slower eaters (β = 9.89, 95%CI: 5.11–14.67; p-interaction = 0.032). Higher dietary EIR also tended to be more strongly associated with BMI in fast eaters (β = 0.025, 95%CI: 0.011–0.038) than in slow eaters (β = 0.017, 95%CI: −0.007–0.040). These findings suggest that the combination of eating more quickly and selecting a greater proportion of energy from higher EIR foods (i.e., softly textured, energy dense), promoted higher dietary energy intakes and adiposity.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    URL: Article
    DOI: 10.3390/nu12113264
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
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  • 7
    Online Resource
    Online Resource
    Diet and Physical Activity as Determinants of Continuously Measured Glucose Levels in Persons at High Risk of Type 2 Diabetes
    MDPI AG ; 2022
    In:  Nutrients Vol. 14, No. 2 ( 2022-01-15), p. 366-
    Details
    In: Nutrients, MDPI AG, Vol. 14, No. 2 ( 2022-01-15), p. 366-
    Abstract: We examined how dietary and physical activity behaviors influence fluctuations in blood glucose levels over a seven-day period in people at high risk for diabetes. Twenty-eight participants underwent a mixed meal tolerance test to assess glucose homeostasis at baseline. Subsequently, they wore an accelerometer to assess movement behaviors, recorded their dietary intakes through a mobile phone application, and wore a flash glucose monitoring device that measured glucose levels every 15 min for seven days. Generalized estimating equation models were used to assess the associations of metabolic and lifestyle risk factors with glycemic variability. Higher BMI, amount of body fat, and selected markers of hyperglycemia and insulin resistance from the meal tolerance test were associated with higher mean glucose levels during the seven days. Moderate- to vigorous-intensity physical activity and polyunsaturated fat intake were independently associated with less variation in glucose levels (CV%). Higher protein and polyunsaturated fatty acid intakes were associated with more time-in-range. In contrast, higher carbohydrate intake was associated with less time-in-range. Our findings suggest that dietary composition (a higher intake of polyunsaturated fat and protein and lower intake of carbohydrates) and moderate-to-vigorous physical activity may reduce fluctuations in glucose levels in persons at high risk of diabetes.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    URL: Article
    DOI: 10.3390/nu14020366
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2518386-2
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  • 8
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    Online Resource
    The Effect of Dynamic Food Labels with Real-Time Feedback on Diet Quality: Results from a Randomized Controlled Trial
    MDPI AG ; 2020
    In:  Nutrients Vol. 12, No. 7 ( 2020-07-20), p. 2158-
    Details
    In: Nutrients, MDPI AG, Vol. 12, No. 7 ( 2020-07-20), p. 2158-
    Abstract: The rising prevalence of non-communicable diseases has brought attention to the importance of consuming a healthy diet. One strategy to improve diet quality is through front-of-pack (FOP) nutrition labels. Taking advantage of an online grocery store, we allowed consumers to choose the FOP labels they preferred, and combined this information with real-time feedback on the overall nutritional quality of the shopping basket. We hypothesized that these dynamic food labels with real-time feedback (DFLF) would improve nutritional quality of food purchases. This trial followed a two-arm (no-label control and DFLF) crossover design with 125 participants exposed to each condition once in random order via an online grocery store. A first difference regression model allowed for estimating the unbiased effect of the DFLF on diet quality, measured by the weighted average Nutri-Score (ranging 1 to 5) per serving (primary) and changes in select nutrients and calories. The mean weighted Nutri-Score was 0.4 (12.6%) higher in the DFLF arm (CI: [0.2, 0.6] ) relative to the control. The DFLF also decreased the amount of sugar per serving by 0.9 g (CI: [−1.7, −0.0]) and total sugar per shop by 169.5 g (CI: [−284.5, −54.5] ). The DFLF features significantly improved nutrition quality relative to no labelling, as measured by average Nutri-Score values. These results shed light on the considerable potential of the online shopping environment to improve diet quality through customization and real time feedback.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    URL: Article
    DOI: 10.3390/nu12072158
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2518386-2
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  • 9
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    Online Resource
    Longitudinal Associations of Marital, Parenting, and Employment Transitions with Weight Gain in a Multi-Ethnic Asian Population Aged 21 Years and Above
    MDPI AG ; 2021
    In:  International Journal of Environmental Research and Public Health Vol. 18, No. 15 ( 2021-07-31), p. 8115-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 18, No. 15 ( 2021-07-31), p. 8115-
    Abstract: Identifying when most weight gain occurs throughout the life course can inform targeted public health interventions. We evaluated the association of childbirth, marriage, and employment changes with weight changes in a multi-ethnic Asian cohort. Singapore Multi-Ethnic Cohort participants ≥21 years (n = 9655) who identified as ethnic Chinese, Malay, or Indian were weighed and interviewed about marital status, employment, and number of children at baseline and after about four years. We used multivariable regression to evaluate life transitions in relation to weight change and major gain (≥5 kg), and adjusted for socio-demographic covariates. Weight gain was 3.55 kg (95% CI 3.17, 3.94) higher in young adults (21–30 years) compared with participants older than 60 years at baseline. Getting married was associated with weight gain in women, but not men (p interaction 〈 0.01). Women who got married gained 1.63 kg (95% CI 0.88, 2.38) more weight and were more likely to gain ≥5 kg (OR 1.99, 95% CI 1.35, 2.93) than those remaining unmarried. Having children was not associated with weight gain. Only among ethnic Indians, remaining a homemaker was associated with less weight gain than remaining employed. In this multi-ethnic Asian population, obesity prevention efforts should target young adulthood and, in women, the transition into marriage.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph18158115
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
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  • 10
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    Online Resource
    Volume and Intensity of Stepping Activity and Cardiometabolic Risk Factors in a Multi-ethnic Asian Population
    MDPI AG ; 2020
    In:  International Journal of Environmental Research and Public Health Vol. 17, No. 3 ( 2020-01-30), p. 863-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 17, No. 3 ( 2020-01-30), p. 863-
    Abstract: The health benefits of objectively measured physical activity volume versus intensity have rarely been studied, particularly in non-western populations. The aim of this study was to investigate the association between cardiometabolic risk factors and stepping activity including; volume (step count), intensity (cadence) or inactivity (zero-steps/minute/day), in a multi-ethnic Asian population. Participants clinical data was collected at baseline and their physical activity was monitored for seven days, using an accelerometer (Actigraph GT3X+) in 2016. Tertiles (low, moderate, high) of the mean daily step count, peak one-minute, 30-min, 60-min cadences and time/day spent at zero-steps/minute were calculated. Adjusted linear regressions explored the association between stepping activity tertiles and cardiometabolic risk factors. A total of 635 participants (41% male, 67% Chinese, mean age 48.4 years) were included in the analyses. The mean daily step count was 7605 (median daily step count 7310) and 7.8 h of awake time per day were spent inactive (zero-steps/minute). A greater number of associations were found for step intensity than volume. Higher step intensity was associated with reduced body mass index (BMI), waist circumference, blood pressures and higher high-density lipoprotein (HDL). Future health promotion initiatives should consider the greater role of step intensity to reduce cardiometabolic risk.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph17030863
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
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