Michael R. Richardson

Association between alcohol consumption patterns and metabolic syndrome

AIMS Examine associations between self-reported alcohol consumption patterns and metabolic syndrome. MATERIALS AND METHODS Sample (N=7432) included adult (≥20 years) participants in the 1999-2006 National Health and Nutrition Examination Survey. RESULTS Above moderate alcohol consumption (AMAC) was negatively associated with waist circumference among those in the 20-29, 40-49, and 70-79 age groups (β=-6.21, β=-8.34, and β=-6.60, respectively) and moderate alcohol consumption (MAC) was negatively associated with waist circumference among those in the 30-39, 40-49, and 70-79 age groups (β=-4.60, β=-5.69, and β=-2.88, respectively). AMAC was negatively associated with triglycerides among those in the 70-79 and 80+ age groups (β=-23.62 and β=-34.18, respectively) and positively associated with HDL-C levels in all groups (β range 8.96-18.25). MAC was positively associated with HDL-C in the age groups spanning 20-69 years (β range 3.05-5.34) and those over 80 (β=5.26). AMAC and MAC were negatively associated with fasting glucose levels in the 20-29 and 70-79 age groups (β=-3.38 and -15.61, respectively). MAC was negatively associated with fasting glucose levels among those 70-79 and those over 80 years of age (β=-7.06 and β=-5.00, respectively). CONCLUSION MAC and AMAC may favorably impact metabolic health.

The associations between increasing degrees of homeostatic model assessment for insulin resistance and muscular strengthening activities among euglycaemic US adults

Purpose: To examine the associations between the homeostatic model assessment for insulin resistance and self-reported muscular strengthening activity in a nationally representative sample of euglycaemic US adults. Methods: Sample included euglycaemic adults (⩾20 years of age (n = 2009)) from the 1999 to 2004 National Health and Nutrition Examination Survey. Homeostatic model assessment for insulin resistance was categorized into quartiles and was the primary independent variable of interest. No reported muscular strengthening activity was the dependent variable. Results: Following adjustment for covariates, those with homeostatic model assessment for insulin resistance values in fourth (odds ratio: 2.04, 95% confidence interval: 1.35−3.06, p < 0.001) quartile were found to have significantly greater odds of reporting no muscular strengthening activity. Following further adjustment for non-muscular strengthening activity specific aerobic leisure-time physical activity, results remained significant for the fourth (odds ratio: 2.30, 95% confidence interval: 1.50−3.52, p < 0.001) quartile. A significant trend was seen across quartiles of homeostatic model assessment for insulin resistance for increasing prevalence of no muscular strengthening activity (p < 0.001). Conclusion: Having a higher homeostatic model assessment for insulin resistance value is associated with greater odds of reporting no muscular strengthening activity among euglycaemic US adults. This implies that subjects with an increasing degree of insulin resistance are more likely to not engage in muscular strengthening activity, an exercise modality that has been shown to reduce the risk of several cardiometabolic diseases and improve glycaemic status.

Associations Between Low Back Pain and Muscle-strengthening Activity in U.S. Adults

Study Design. This was a cross-sectional study. Objective. The primary aim of the study was to examine the association between low back pain (LBP) and muscle-strengthening activity (MSA) among U.S. adults using gender-stratified analyses. Summary of Background Data. LBP is a common medical condition that impacts quality of life and professional productivity and increases the financial burden on the health care system by augmenting medical treatment costs. Previous studies analyzing gender-dependent relationships between MSA and LBP have produced mixed results. Methods. Our sample included 12,721 participants from the 1999 to 2004 National Health and Nutrition Examination Survey (NHANES). Participants were categorized into one of three levels of self-reported MSA: no MSA, insufficient MSA (1 day/wk), or meeting the 2008 Department of Health and Human Services (DHHS) recommendation for MSA (≥2 days/wk). Results. Gender-stratified analyses revealed significantly lower odds of reporting LBP among women [odds ratio (OR) 0.82, 95% confidence interval (CI) 0.70–0.96, P = 0.03] and men (OR 0.86; 95% CI 0.70–0.96, P = 0.01) who reported amounts of MSA that met the DHHS recommendation compared with those reporting no MSA. Following adjustment for smoking status, the odds remained significant among women (P = 0.03) but not among men (P = 0.21). Conclusion. These findings indicate that engaging in MSA at least 2 days/wk is associated with lower odds of LBP and that smoking may be an important mediating factor that should be considered in future LBP research. Level of Evidence: 4

Associations between mental distress and physical activity in US adults: a dose–response analysis BRFSS 2011

Background To examine the associations between levels of severity of mental distress (MD) and meeting the 2008 physical activity (PA) recommendations using the MD Severity Index (MDSI). Methods Participants (n = 431 313) were adults (≥18 years of age) who responded to the 2011 Behavioral Risk Factor Surveillance System (BRFSS). MD was categorized into five levels of severity: 0-4, 5-10, 11-16, 17-22 and ≥23 days/month. The dependent variable was self-reported PA volume of at least 150 min/wk (or vigorous equivalent, 75 min/wk). Results Following adjustment for age, gender, race/ethnicity, education and body mass index, the odds of reporting meeting the PA recommendations were significantly lower among those reporting the following days per month of MD: 5-10 (odds ratio [OR] = 0.92, 95% confidence interval [CI]: 0.87-0.96), 11-16 (OR = 0.76, 95% CI: 0.71-0.82), 17-22 (OR = 0.69, 95% CI: 0.62-0.76) and ≥23 (OR = 0.64, 95% CI: 0.60-0.67). An inverse dose-response (P < 0.01) was observed between the severity of MD and meeting the current PA recommendations. Conclusions An inverse dose-response relationship was found between the severity of MD and volumes of PA meeting the 2008 recommendation. These findings lend support for the epidemiological utility of the MDSI when examining the relationship between MD and PA.

Sleep Duration and C-Reactive Protein in US Adults

Objective To use gender-stratified logistic regression analysis to examine the associations between elevated C-reactive protein (CRP; >3–10 mg/L) and sleep duration. Methods The study sample included male (n = 5033) and female (n = 4917) adult (20 years old and older) participants in the 2007–2010 National Health and Nutrition Examination Survey. Sleep duration was categorized as short (⩽6 hours/day), adequate (7–8 hours/day), or long (≥9 hours/day). Logistic regression models were adjusted for age, race, smoking status, physical activity, and waist circumference. Results Analysis revealed significantly (P = 0.0151) higher odds of elevated CRP in men reporting ⩽6 hours/day of sleep (odds ratio 1.26, 95% confidence interval 1.05–1.52) when compared with a referent group of men reporting 7 to 8 hours/day of sleep. Similar associations were not revealed in women. Conclusions Short sleep duration was significantly associated with elevated serum CRP concentration independent of waist circumference and moderate physical activity in men but not in women.

Body Mass Index and Physical Inactivity: 2013 BRFSS.

Objectives Examine the odds of adults reporting physical inactivity (PI) across six body mass index (BMI) categories. Methods We used data from the 2013 Behavioral Risk Factor Surveillance System. Six BMI categories were used. Results The odds of reporting PI in underweight men and men in the class I, II, and III obesity categories were 1.65 (95% confidence interval [CI] 1.35–2.02), 1.30 (95% CI 1.21–1.39), 1.73 (95% CI 1.58–1.90), and 2.44 (95% CI 2.17–2.75), respectively, compared with men of desirable weight (odds ratio [OR] 1.00, 18.5–24.9 kg/m2; referent, OR 1.00). The odds of reporting PI in underweight men were similar to class II and class III obese men. The odds of reporting PI in underweight women, overweight women, and women in the class I, II, and III obesity categories were 1.57 (95% CI 1.36–1.81), 1.20 (95% CI 1.14–1.27), 1.65 (95% CI 1.56–1.75), 2.23 (95% CI 2.07–2.40), and 2.89 (95% CI 2.66–3.15), respectively, compared with women of desirable weight (≥18.5–24.9 kg/m2; referent, OR 1.00). The odds of reporting PI were similar in underweight and class I obese women. Women were found to have greater odds than men of reporting PI in four of the five nondesirable BMI categories (P < 0.05). Conclusions The within- and between-sex differences in the odds of reporting PI vary significantly by BMI category. Future research needs to include the underweight BMI category when investigating PI and sedentary time because of the potential clinical relevance.

Gender Differences in C-Reactive Protein and Muscle Strengthening Activity.

BACKGROUND Few studies have examined the gender differences between C-reactive protein (CRP) and muscle strengthening activity (MSA). METHODS The sample (n = 7533) included U.S. adult (≥20 years of age).participants in the 1999-2004 National Health and Nutrition Examination Survey (NHANES). Created categories of MSA participation included no MSA (referent group), some MSA (≥1 to <2 days/week), and meeting the 2008 Department of Health and Human Services (DHHS) recommendation (≥2 days/week). The dependent variable was elevated CRP (>3 to 10 mg/L). RESULTS Analysis revealed significantly lower odds of having elevated CRP for women reporting some MSA (OR 0.64; 95% CI 0.44-0.93, P = .0191). Significantly lower odds of men having elevated CRP was observed in those reporting MSA volumes meeting the DHHS recommendation (OR 0.72; 95% CI 0.59-0.88, P = .0019). Following adjustment for waist circumference (WC) these odds remained significant in men but not women. CONCLUSIONS These results suggest that WC may mediate the associations between MSA and CRP and this relationship may be stronger in women.