Search

Context: "Accelerated aging," assessed by adult DNA methylation, predicts cardiovascular disease (CVD). Adolescent accelerated aging might predict CVD earlier. We investigated whether epigenetic age acceleration (assessed age, 17 years) was associated with adiposity/CVD risk measured (ages 17, 20, and 22 years) and projected CVD by middle age., Design: DNA methylation measured in peripheral blood provided two estimates of epigenetic age acceleration: intrinsic (IEAA; preserved across cell types) and extrinsic (EEAA; dependent on cell admixture and methylation levels within each cell type). Adiposity was assessed by anthropometry, ultrasound, and dual-energy x-ray absorptiometry (ages 17, 20, and 22 years). CVD risk factors [lipids, homeostatic model assessment of insulin resistance (HOMA-IR), blood pressure, inflammatory markers] were assessed at age 17 years. CVD development by age 47 years was calculated by Framingham algorithms. Results are presented as regression coefficients per 5-year epigenetic age acceleration (IEAA/EEAA) for adiposity, CVD risk factors, and CVD development., Results: In 995 participants (49.6% female; age, 17.3 ± 0.6 years), EEAA (per 5 years) was associated with increased body mass index (BMI) of 2.4% (95% CI, 1.2% to 3.6%) and 2.4% (0.8% to 3.9%) at 17 and 22 years, respectively. EEAA was associated with increases of 23% (3% to 33%) in high-sensitivity C-reactive protein, 10% (4% to 17%) in interferon-γ-inducible protein of 10 kDa, and 4% (2% to 6%) in soluble TNF receptor 2, adjusted for BMI and HOMA-IR. EEAA (per 5 years) results in a 4% increase in hard endpoints of CVD by 47 years of age and a 3% increase, after adjustment for conventional risk factors., Conclusions: Accelerated epigenetic age in adolescence was associated with inflammation, BMI measured 5 years later, and probability of middle age CVD. Irrespective of whether this is cause or effect, assessing epigenetic age might refine disease prediction., (Copyright © 2019 Endocrine Society.)

Reduced fat dairy products are generally recommended for adults and children over the age of two years. However, emerging evidence suggests that dairy fat may not have detrimental health effects. We aimed to investigate prospective associations between consumption of regular versus reduced fat dairy products and cardiometabolic risk factors from early to late adolescence. In the West Australian Raine Study, dairy intake was assessed using semi-quantitative food frequency questionnaires in 860 adolescents at 14 and 17-year follow-ups; 582 of these also had blood biochemistry at both points. Using generalized estimating equations, we examined associations with cardiometabolic risk factors. Models incorporated reduced fat and regular fat dairy together (in serves/day) and were adjusted for a range of factors including overall dietary pattern. In boys, there was a mean reduction in diastolic blood pressure of 0.66 mmHg (95% CI 0.23-1.09) per serve of reduced fat dairy and an independent, additional reduction of 0.47 mmHg (95% CI 0.04-0.90) per serve of regular fat dairy. Each additional serve of reduced fat dairy was associated with a 2% reduction in HDL-cholesterol (95% CI 0.97-0.995) and a 2% increase in total: HDL-cholesterol ratio (95% CI 1.002-1.03); these associations were not observed with regular fat products. In girls, there were no significant independent associations observed in fully adjusted models. Although regular fat dairy was associated with a slightly better cholesterol profile in boys, overall, intakes of both regular fat and reduced fat dairy products were associated with similar cardiometabolic associations in adolescents.

Objectives: Offspring of hypertensive pregnancies have increased cardiovascular risk factors during childhood. We hypothesised that offspring of hypertensive pregnancies would demonstrate increased clinical levels of hypertension by young adult life, which would be proportional to the severity of the pregnancy complication., Design: Prospective birth cohort study, Setting: Tertiary obstetric hospital., Participants: 2868 young adult offspring of women enrolled during pregnancy into the Western Australia Pregnancy Cohort (Raine) Study., Main Outcome Measures: Cardiovascular risk, including incidence of hypertension and metabolic disease, in those born to hypertensive compared to normotensive pregnancies., Results: Young adult offspring of hypertensive pregnancies were 2.5 times (95% CI 1.32 to 4.56, p=0.004) more likely to have global lifetime risk (QRISK) scores above the 75th centile. Thirty per cent of 20 year olds with hypertensive blood pressures were born following a hypertensive pregnancy. Pre-eclampsia or hypertension resulting in preterm birth associated with a threefold (95% CI 1.3 to 7.0, p=0.01) greater risk of being hypertensive by age 20 years, with no differences in body mass index. Whereas pregnancy-induced hypertension associated with a smaller 3 ± 1 mm Hg blood pressure rise (p=0.001) and a twofold (95% CI 1.5 to 2.8, p=0.001) greater risk of being obese or overweight. Risk factor associations were consistent throughout early life and independent of other birth-factors., Conclusions: Incidence of offspring hypertension was significantly increased in those whose mothers had a more complicated pregnancy history, including preterm birth and pre-eclampsia., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Introduction: Systematic reviews suggest that a longer duration of breast-feeding is associated with a reduction in the risk of later overweight and obesity. Most studies examining breast-feeding in relation to adiposity have not used longitudinal analysis. In our study, we aimed to examine early infant feeding and adiposity risk in a longitudinal cohort from birth to young adulthood using new as well as published data., Methods: Data from the Western Australian Pregnancy Cohort (Raine) Study in Perth, W.A., Australia, were used to examine associations between breast-feeding and measures of adiposity at 1, 2, 3, 6, 8, 10, 14, 17, and 20 years., Results: Breast-feeding was measured in a number of ways. Longer breast-feeding (in months) was associated with reductions in weight z-scores between birth and 1 year (β = -0.027; p < 0.001) in the adjusted analysis. At 3 years, breast-feeding for <4 months increased the odds of infants experiencing early rapid growth (OR 2.05; 95% CI 1.43-2.94; p < 0.001). From 1 to 8 years, children breast-fed for ≤4 months compared to ≥12 months had a significantly greater probability of exceeding the 95th percentile of weight. The age at which breast-feeding was stopped and a milk other than breast milk was introduced (introduction of formula milk) played a significant role in the trajectory of the BMI from birth to 14 years; the 4-month cutoff point was consistently associated with a higher BMI trajectory. Introduction of a milk other than breast milk before 6 months compared to at 6 months or later was a risk factor for being overweight or obese at 20 years of age (OR 1.47; 95% CI 1.12-1.93; p = 0.005)., Discussion: Breast-feeding until 6 months of age and beyond should be encouraged and is recommended for protection against increased adiposity in childhood, adolescence, and young adulthood. Adverse long-term effects of early growth acceleration are fundamental in later overweight and obesity. Formula feeding stimulates a higher postnatal growth velocity, whereas breast-feeding promotes slower growth and a reduced likelihood of overweight and obesity. Biological mechanisms underlying the protective effect of breast-feeding against obesity are based on the unique composition and metabolic and physiological responses to human milk., (© 2014 S. Karger AG, Basel.)

Aims: Lifestyle behaviours established during adolescence may adversely affect blood pressure (BP) and contribute to gender differences in cardiovascular risk in adulthood. We aimed to assess the association of health behaviours with BP in adolescents, using data from the Western Australian Pregnancy (Raine) Study., Methods: Cross-sectional analysis on 1248 Raine Study adolescents aged 17 years, to examine associations between lifestyle factors and BP., Results: Boys had 8.97 mmHg higher systolic BP, as compared with girls. The 30% of girls using oral contraceptives (OC) had 3.27 and 1.74 mmHg higher systolic and diastolic BP, respectively, compared with non-users. Alcohol consumption in boys, increasing body mass index (BMI) and the sodium-potassium ratio were associated with systolic BP. We found a continuous relationship between BMI and systolic BP in both genders; however, the gradient of this relationship was significantly steeper in boys, compared with girls not taking OC. In boys, systolic BP was 5.7 mmHg greater in alcohol consumers who were in the upper quartile of BMI and the urinary sodium-potassium ratio compared with teetotallers in the lowest quartile. In girls, systolic BP was 5.5 mmHg higher in those taking OC, in the highest BMI and urinary sodium-potassium ratio quartile as compared to those not taking the OC pill and in the lowest quartile., Conclusion: In addition to gender-related differences in the effects of adiposity on BP, we found lifestyle-related health behaviours such as high salt intake for both sexes, consumption of alcohol in boys, and OC use in girls were important factors associated with BP measurements in late adolescence. This suggests that gender-specific behavioural modification in adolescence may prevent adult hypertension.

Background: High sugar-sweetened beverage (SSB) consumption is associated with cardiometabolic disturbances in adults, but this relation is relatively unexplored in children and adolescents., Objective: We tested the hypothesis that higher SSB intakes are associated with increases in cardiometabolic risk factors between 14 and 17 y of age., Design: Data were provided by 1433 adolescent offspring from the Western Australian Pregnancy Cohort (Raine) Study. At 14 and 17 y of age, SSB intakes were estimated by using a food-frequency questionnaire; body mass index (BMI), waist circumference, blood pressure, fasting serum lipids, glucose, and insulin were measured, and overall cardiometabolic risk was estimated. Prospective associations between cardiovascular disease risk factors and SSB intake were examined with adjustment for age, pubertal stage, physical fitness, socioeconomic status, and major dietary patterns., Results: The average SSB intake in consumers (89%) was 335 g/d or 1.3 servings/d. Girls who moved into the top tertile of SSB consumption (>1.3 servings/d) between 14 and 17 y of age had increases in BMI (3.8%; 95% CI: 1.8%, 5.7%), increased overweight and obesity risk (OR: 4.8, 95% CI: 2.1, 11.4), and greater overall cardiometabolic risk (OR: 3.2; 95% CI: 1.6, 6.2) (all P-trend ≤ 0.001). Girls and boys who moved into the top tertile of SSB intake showed increases in triglycerides (7.0-8.4%; P-trend ≤ 0.03), and boys showed reductions in HDL cholesterol (-3.1%; 95% CI: -6.2%, 0.1%; P-trend < 0.04) independent of BMI. Some associations were attenuated after adjustment for major dietary patterns., Conclusion: Increased SSB intake may be an important predictor of cardiometabolic risk in young people, independent of weight status.

Background: High-density lipoprotein-cholesterol (HDL-C) levels are influenced by gender and by genetic and environmental factors. We aimed to assess the impact of passive smoking exposure since birth on HDL-C levels of nonsmoking adolescents at age 17 years and to determine whether there was a gender difference in the relationship between smoking exposure and HDL-C., Methods: A total of 804 nonsmoking adolescents with biochemical, anthropometric, and lifestyle data from a cohort of 1754 adolescents (mean age, 17 ± 0.25 y) of the Western Australian Pregnancy Cohort (Raine) Study had data of maternal smoking during pregnancy and smoking exposure in the household over 17 years. HDL-C was analyzed using multivariable linear regression, with adjustment for early-life, adiposity, and current lifestyle confounders., Results: HDL-C levels were significantly lower in girls exposed to passive smoking compared to those not exposed (regression coefficient b = -0.09 [95% confidence interval, -0.15, -0.03]); this was not observed in boys (b = 0.02 [95% confidence interval, -0.04, 0.08]), with a significant sex interaction P = .009. The effects of passive smoking in girls persisted after adjusting for oral contraceptive use., Conclusions: This study has shown a gender difference in the relationship between passive smoking exposure since birth and HDL-C in late adolescence. Exposure to passive smoking in girls could have adverse consequences on their risk of cardiovascular disease in adulthood. These findings reinforce the need for future public health measures to reduce children's exposure to passive smoking.

Objective: The current prevalence of mental health problems in Western populations is approximately 20% and half of all adult mental health disorders are estimated to originate in adolescence. Diet plays an important role in modulating psychological wellbeing and B-vitamins are vital for the synthesis of neurotransmitters such as serotonin. We aimed to examine the relationship between B-group vitamins and adolescent mental health and behaviour., Methods: This is a cross-sectional analysis of the West Australian Pregnancy Cohort (Raine) Study. The 17-year follow-up included collection of a food frequency questionnaire allowing B-vitamin intake calculation. Mental health was assessed using the Youth Self Report (YSR) which measures total, internalising (withdrawn/depressed) and externalising (aggressive/delinquent) behaviour scores. Multiple linear regression was used to analyse associations between B-vitamins and mental health with adjustment for relevant confounders (n=709)., Results: Lower intake of vitamins B1, B2, B3, B5, B6, and folate was associated with higher externalising behaviour scores (p ≤ 0.05). Reduced intake of vitamin B6 and folate was associated with higher internalising behaviour scores (p ≤ 0.05)., Conclusions: Poor nutrition may contribute to the pathogenesis of mental health problems in adolescence. The role of B-vitamins requires further investigation in randomised controlled trials., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Objectives: The aim of the study was to compare commonly used anthropometry for cardiovascular risk factors in 14-year-olds., Methods: A total of 1 149 children of an Australian pregnancy (Raine) cohort with recruitment 1989-1991 were assessed for anthropometry and fasting lipids, insulin, and blood pressure., Results: There were significant distinctions in the associations between anthropometry and groups of cardiovascular risk factors. These distinctions differed by gender. Insulin resistance, triglycerides, C-reactive protein levels, low density lipoprotein (LDH)/high density lipoprotein (HDL) and total/HDL cholesterol ratios had the strongest association with waist, waist/height ratio and body mass index. By contrast, in boys, height was the strongest independent predictor (in a negative direction) of total and LDL-cholesterol. Blood pressure and uric acid was most strongly correlated with body weight and height (heavier and taller boys). Taller male adolescents had highest blood pressures and lowest cholesterol levels., Conclusions: No single adolescent anthropometric measure best predicted all cardiovascular risk factors. Each measure showed distinct relationships with specific groups of risk factors. Contrasting associations may reflect different pathogenesis by which gender, puberty, and adiposity affect metabolic risk. No single anthropometric measurement in childhood would appear to be superior or sufficient when investigating the developmental origins of cardiovascular health and related metabolic disease.