G.B. Post

The association between dietary patterns and cardio vascular disease risk indicators in healthy youngsters: Results covering fifteen years of longitudinal development

Objective: To examine longitudinal relationships between nutrition and risk indicators for cardio vascular diseases (CVD) during adolescence and young adulthood. Design: A longitudinal study over fifteen years. Subjects: 98 females and 84 males, from 13 to 27 years. Methods: By means of six interviews dietary patterns were determined. Blood samples were analyzed for serum concentration of total cholesterol (TC), and high-density-lipoprotein (HDL), bloodpressure, body fat and maximal aerobic power (VO2max) were determined. The longitudinal relations were analyzed with generalized estimation equations (GEE), a statistical technique in which relations at different time-points are tested simultaneously. Results: Compared to Dutch recommendations six out of seven macro nutrients appear to be unfavorable with respect to CVD. Borderline or high CVD risk values are apparent at 27 y in more than 25% of the subjects with respect to percentage body fat and serum total cholesterol in both sexes. In males 40% or more show borderline hypertension. The ‘univariate’ longitudinal analyses showed significantly positive relations: (1) between the intake of animal protein, saturated fat (SFA), cholesterol (Chol) and TC, and HDL; (2) between total energy intake (EN) and systolic blood pressure, and VO2max. Significantly negative associations were found: (1) between EN, poly-unsaturated fat (PUFA) and TC concentrations; (2) between EN and sum of four skinfolds (SSF). Conclusions: With increasing age, over a period of 15 y in both sexes the SFA and Chol intake relate significantly to the development of a negative CVD risk profile. The intake of PUFA relates positive to a CVD risk profile. The significantly negative relation between EN intake and body fat (SSF) is partly explained by the relation between EN and VO2max.

Which Lifestyle Parameters Discriminate High- from Low-Risk Participants for Coronary Heart Disease Risk Factors. Longitudinal Analysis Covering Adolescence and Young Adulthood

Background The purpose of this study was to analyse which lifestyle parameters (daily physical activity, dietary intake, smoking habits and alcohol consumption) discriminate between participants at high-risk and those at low-risk for coronary heart disease (CHD) [systolic and diastolic blood pressure (SBP/DBP), total serum cholesterol (TC), high-density lipoprotein cholesterol (HDL), the TC:HDL ratio, body fatness (sum of skinfolds [SSF]) and cardiopulmonary fitness (VO2-max)]. Methods The data were derived from the Amsterdam Growth and Health Study (AGHS); an observational longitudinal study in which six repeated measurements were carried out over a period of 15 years on 181 participants aged 13 years at entry to the study. To assess possible discriminating factors, generalized estimating equations were used. This method makes use of risk group changing behaviour over time by using all available longitudinal data. Results For DBP no significant relationships were found; high risk for SBP was inversely related to smoking habits (OR = 0.52; P< 0.01). No significant relationships were found for TC; high risk for HDL was positively related to the intake of carbohydrates (OR = 1.2; P = 0.02) and to smoking habits (OR = 1.6; P = 0.04); high risk for the TC: HDL ratio was positively related to the intake of carbohydrates (OR = 1.3; P = 0.01). High risk for SSF was positively related to the intake of protein (OR = 1.5; P< 0.01) and smoking habits (OR = 1.8; P = 0.01) and inversely related to daily physical activity (OR = 0.81; P = 0.01). High risk for VO2-max was inversely related to daily physical activity (OR = 0.67; P< 0.01). Conclusions In the relative young and healthy population of the AGHS during adolescence and young adulthood, physical inactivity was the most important lifestyle parameter related to high risk for CHD.

Longitudinal relationships between resting heart rate and biological risk factors for cardiovascular disease: The Amsterdam Growth and Health Study.

The aim of this study was to analyse longitudinal relationships between resting heart rate and biological risk factors for cardiovascular disease using data from the longitudinal Amsterdam Growth and Health Study (AGHS). In the AGHS, 98 females and 81 males were measured six times between 1977 and 1991. In 1977, the age of the subjects was 13 years. The variables assessed included resting heart rate, diastolic and systolic blood pressure, high-density serum lipoprotein, total serum cholesterol, the sum of four skinfolds, cardiopulmonary fitness (VO 2 max), habitual physical activity and smoking history. To investigate the longitudinal relationships between resting heart rate and diastolic blood pressure, systolic blood pressure, high-density serum lipoprotein, total serum cholesterol, sum of four skinfolds and V O 2 max, generalized estimating equations were used, leading to one standardized longitudinal regression coefficient (beta). Significant univariate relationships were found between resting heart rate and diastolic blood pressure (beta = 0.142; P = 0.00), systolic blood pressure (beta = 0.134; P = 0.00), VO 2 max (beta = -0.091; P = 0.00) and sum of four skinfolds (beta = 0.047; P = 0.021). The relationships between resting heart rate and diastolic blood pressure, systolic blood pressure and VO 2 max did not change substantially when corrected for habitual physical activity and smoking history. The relationship between resting heart rate and sum of four skinfolds was no longer found to be significant when corrected for habitual physical activity and smoking history. For these relationships, no interaction between resting heart rate and sex was found.

Effects of health measurements and health information in youth and young adulthood in dietary intake--20-y study results from the Amsterdam Growth and Health Longitudinal Study.

Background: The Amsterdam Growth and Health Longitudinal Study (AGAHLS) is a 20 y observational study concerning biological, psychological and lifestyle risk factors for cardiovascular disease and osteoporosis. In the AGAHLS two cohorts can be distinguished: the so-called Multi-Measurement Group (MMG), which received eight repeated measurements, and a Bi-Measurement Group (BMG), which received two measurements, one at the beginning and one at the end of the 20 y period.Objective: In health-related longitudinal research, the outcomes of the study may be influenced by the measurements themselves and the health information provided. It was hypothesized that the repeated measurements and the health information given to the MMG would result in a more healthy dietary intake in comparison to the BMG.Design: The MMG consisted of 164 subjects and the BMG consisted of 90 subjects. At the start of the study, subjects were teenagers of 13-y-old. The hypothesis was tested with use of regression analysis, analysing group differences in mean individual change scores.Results: Only the MMG showed a significantly larger decrease in the intake of mono- and disaccharides compared to the BMG.Conclusions: The effect of the repeated measurements and the health information provided on dietary intake was relatively small, since it was only one out of the 14 nutrients that differed between the MMG and the BMG.European Journal of Clinical Nutrition (2001) 55, 819–823