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Background: The study was conducted in a Dallas lead smelter community following an Environmental Protection Agency (EPA) Superfund Cleanup project. Lead smelters operated in the Dallas community since the mid-1930s.Aim: To test the hypothesis that cadmium (Cd) exposure is associated with chronic kidney disease (CKD) ≥ stage 3.Subjects and methods: Subjects were African American residents aged ≥19 to ≤ 89 years (n=835). CKD ≥ stage 3 was predicted by blood Cd concentration with covariates.Results: In logistic regression analysis, CKD ≥ stage 3 was predicted by age ≥ 50 years (OR = 4.41, p < 0.0001), Cd level (OR = 1.89, p <.05), hypertension (OR = 3.15, p < 0.03), decades living in the community (OR = 1.34, p < 0.003) and T2DM (OR = 2.51, p < 0.01). Meta-analysis of 11 studies of Cd and CKD ≥ stage 3 yielded an ORRANDOM of 1.40 (p < 0.0001). Chronic environmental Cd exposure is associated with CKD ≥ stage 3 in a Dallas lead smelter community controlling covariates.Conclusion: Public health implications include screening for heavy metals including Cd, cleanup efforts to remove Cd from the environment and treating CKD with newer renal-sparing medications (e.g., SGLT-2 inhibitors, GLP-1s). [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to analyze factors associated with oral health‐related quality of life (OHRQoL) between type 2 diabetes mellitus (T2DM) and nondiabetic US adults. Methods: The study sample included 2945 participants (aged ≥20) selected from National Health and Nutrition Examination Survey (NHANES) 2003–2004 that represented 130,689,262 million persons in a probability weighted sample. Oral health outcomes were measured by the NHANES version of Oral Health Impact Profile (OHIP) for OHRQoL and summarized as additive scores (OHIP‐ADD) and as prevalence of negative impacts (OHIP‐SC). Multiple logistic regression models used dichotomous outcome variables OHIP‐ADD and OHIP‐SC. The cut‐off values for poor OHRQoL were heuristically defined as OHIP‐ADD ≥6 and as OHIP‐SC > 0. Results: Poor OHRQoL was significantly (p < 0.0001) predicted by T2DM (ORSC‐controlled = 1.43, ORSC‐uncontrolled = 1.73), obesity (ORSC = 1.24), untreated dental caries (ORSC = 1.79), periodontal disease (ORADD = 1.07), evaluated unmet denture need (ORSC = 1.72), low income (ORADD = 1.22), smoking (ORSC‐former‐smoker = 1.04, ORSC‐current‐smoker = 1.99), African‐American (ORSC = 1.19), and female (ORSC = 1.66) in both logistic regression models. In contrast, protective factors significantly (p < 0.0001) associated with poor OHRQoL were private dental insurance (ORSC = 0.81), college education (ORSC = 0.85), and annual dental prophylaxis (ORSC = 0.83), after adjustment for covariates. Conclusions: This study showed that private insurance coverage and annual prophylaxis are associated with better average OHRQoL among individuals with T2DM. Improved OHRQoL may be associated with glycaemia control, decreased BMI, and smoking cessation. The highest odds for poor OHRQoL were found among US adults with T2DM with uncontrolled HbA1c, untreated dental caries, and current smoking. [ABSTRACT FROM AUTHOR]

Objective: This study examined the impact of in utero exposure to Ramadan, the Islamic fasting month, by trimester on height at ages 0 to 18 for a sample of children from Tehran, Iran. If exposure to Ramadan is associated with significant nutritional stress to the fetus, the fetus's adaptive responses to nutritional insufficiency could manifest as changes in height during childhood, long before any effects on aging or disease risk at older ages. Methods: Children who were exposed and not exposed to Ramadan in utero were compared to identify any systematic difference between their parents' and households' characteristics (including height, age, education, and indicators of wealth). Also, the seasonal pattern of food consumption in Tehran was analyzed. Finally, the association of child height with prenatal exposure to Ramadan was measured, controlling for seasonality and parent and household. Results: Ramadan associated fasting in the second trimester of gestation was associated with 0.091 age‐adjusted SDs (ie, 0.60‐0.67 cm) decrease in children's height at age 10 years or older. The negative association was largest in male children and was approximately 1 cm at age 12 years or older among male children. Conclusion: Maternal Ramadan fasting in the second trimester, the critical period for long bone development, was associated with decreased height. Exposure to ritual fasting is important because approximately 75% of all Muslim children are exposed to Ramadan in utero. [ABSTRACT FROM AUTHOR]

Aims: To analyse the causal relationships of nutrition intake and physical activity on haemoglobin A1c (HbA1C) in patients diagnosed with type 2 diabetes mellitus (T2DM) stratified by gender and ethnicity. Materials and Methods: An historical cohort of patients with diagnosed T2DM (n = 2831) was extracted from the National Health and Nutrition Examination Survey (NHANES) 2011‐2014 public database, including but not limited to, measurements of physical activity, nutrition, body mass index (BMI) and HbA1c. Multivariate analyses and path analyses were employed to estimate the regression coefficients and path coefficients (ρ) of causal path models of physical activity and nutrition intake on HbA1c stratified by gender and three ethnicity groups (ie non‐Hispanic white, non‐Hispanic black and Mexican American). Results: A significant causal path from increased physical activity to increased magnesium (Mg) intake to decreased HbA1c was found. In addition, increased physical activity significantly decreased BMI, which further decreased HbA1c. These results varied by gender and ethnicity but were directionally consistent. Physical activity decreased HbA1c through BMI for males and through Mg intake for females. Mexican American decreased HbA1c through Mg intake, while non‐Hispanic black had an increased HbA1c due to its ethnicity and through increased BMI. Conclusions: The beneficial effects of physical activity on decreased HbA1c were mediated through the increased Mg intake and decreased BMI. This aligned with recent investigations of the inverse causal association of Mg intake with insulin resistance and with decreased inflammation. [ABSTRACT FROM AUTHOR]