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Diet, cardiovascular disease risk fa...

Bhupathiraju, Shilpa N.

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Diet, cardiovascular disease risk factors, and bone health in older Puerto Ricans.

Record Type:	Language materials, printed : Monograph/item
Title/Author:	Diet, cardiovascular disease risk factors, and bone health in older Puerto Ricans./
Author:	Bhupathiraju, Shilpa N.
Description:	250 p.
Notes:	Source: Dissertation Abstracts International, Volume: 72-06, Section: B, page: .
Contained By:	Dissertation Abstracts International72-06B.
Subject:	Health Sciences, Aging. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3449804
ISBN:	9781124574882

Diet, cardiovascular disease risk factors, and bone health in older Puerto Ricans.
Bhupathiraju, Shilpa N.

Diet, cardiovascular disease risk factors, and bone health in older Puerto Ricans. - 250 p.

Source: Dissertation Abstracts International, Volume: 72-06, Section: B, page: .

Thesis (Ph.D.)--Tufts University, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, 2011.

Background. Cardiovascular diseases (CVD) and osteoporosis are two major public health problems in the aging population. Prior research has established an association between the two conditions. However, it remains unclear how risk factors for CVD, as opposed to incident CVD events, affect bone health. Puerto Rican adults living in Massachusetts have documented health disparities and have a disproportionate cardiometabolic risk burden compared to other Hispanic subgroups, but little is known about bone health in this population. It is therefore important to understand the association between CVD risk factors and bone health in this high risk group.

ISBN: 9781124574882Subjects--Topical Terms:

1669845
Health Sciences, Aging.

Diet, cardiovascular disease risk factors, and bone health in older Puerto Ricans.
LDR:04841nam 2200373 4500 001 1405522
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008 130515s2011 ||||||||||||||||| ||eng d
020 $a 9781124574882
035 $a (UMI)AAI3449804
035 $a AAI3449804
040 $a UMI $c UMI
100 1 $a Bhupathiraju, Shilpa N. $3 1684895
245 1 0 $a Diet, cardiovascular disease risk factors, and bone health in older Puerto Ricans.
300 $a 250 p.
500 $a Source: Dissertation Abstracts International, Volume: 72-06, Section: B, page: .
500 $a Adviser: Katherine L. Tucker.
502 $a Thesis (Ph.D.)--Tufts University, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, 2011.
520 $a Background. Cardiovascular diseases (CVD) and osteoporosis are two major public health problems in the aging population. Prior research has established an association between the two conditions. However, it remains unclear how risk factors for CVD, as opposed to incident CVD events, affect bone health. Puerto Rican adults living in Massachusetts have documented health disparities and have a disproportionate cardiometabolic risk burden compared to other Hispanic subgroups, but little is known about bone health in this population. It is therefore important to understand the association between CVD risk factors and bone health in this high risk group.
520 $a Objectives. The objectives of this dissertation work were to (1) Investigate the association between ten-year risk of coronary heart disease (CHD) and bone health; (2) Explore the association between central fat mass and bone health; (3) Examine the association between C-reactive protein (CRP), pro-inflammatory cytokines (interleukin-6 (IL-6) and tumor necrosis factor- alpha (TNF-alpha)), and bone health; (4) Develop a diet and lifestyle score based on the 2006 American Heart Association (AHA) Diet and Lifestyle recommendations (AHA-DLR) and examine its association (i) with available CVD risk factors, and (ii) bone health.
520 $a Study Design. Participants (n=636, with variation by objective based on data availability and exclusion criteria), aged 47-79 years, were enrolled in the Boston Puerto Rican Osteoporosis study, an ancillary study to the Boston Puerto Rican Health Study.
520 $a Results. Among women, the ten-year Framingham CHD risk score was inversely associated with bone mineral density (BMD) at the femoral neck (FN) (P=0.03). Borderline associations were seen at the trochanter (TR) and total hip (TH) (P>0.05). No associations were seen at the lumbar spine (LS). Central fat mass was inversely associated with BMD (P<0.008) at all four bone sites, among women. Among men, higher central fat mass was associated with lower BMD at all three hip sites (P<0.02) but not at the LS. Postmenopausal women in the second tertile of TNF-alpha (2.4-4.1 pg/mL) and intermediate concentration (1-3 mg/L) of CRP, compared to the lowest categories, had lower LS BMD ( P<0.05). Women in the second tertile of TNF-alpha had lower FN BMD (P< 0.05). An inverse trend at the LS BMD ( P for trend=0.04) was observed across tertiles of IL-6 (pg/mL). Postmenopausal women with multiple exposures to elevated inflammatory markers had a lower LS BMD (P for trend=0.04). In Puerto Rican men and women, greater adherence to the AHA-DLR was significantly associated with higher HDL cholesterol (P=0.001), lower waist circumference ( P<0.0001), ten-year risk of CHD (P=0.01 in women), insulin (P=0.0003), glucose (P=0.01 in those with BMI<25), and CRP concentrations (P=0.02). Among men and women, the AHA diet and lifestyle score was associated with higher BMD at the FN, TR, and TH (P<0.05). No component of the AHA-DLR, alone, was responsible for the observed positive associations.
520 $a Conclusions. CVD risk factors are associated with poor bone health in the Puerto Rican population. Importantly, guidelines intended for CVD risk reduction were consistent with better bone health. This underscores the need to synchronize guidelines for general chronic disease prevention that provide a simpler public health message. The results of this dissertation provide foundational data guiding further research and policy development. They suggest that interventions yielding reductions in CVD risk factors may have significant impact on reducing both CVD and osteoporosis.
590 $a School code: 1546.
650 4 $a Health Sciences, Aging. $3 1669845
650 4 $a Health Sciences, Nutrition. $3 1017801
650 4 $a Health Sciences, Epidemiology. $3 1019544
690 $a 0493
690 $a 0570
690 $a 0766
710 2 $a Tufts University, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy. $b Nutritional Epidemiology. $3 1684896
773 0 $t Dissertation Abstracts International $g 72-06B.
790 1 0 $a Tucker, Katherine L., $e advisor
790 1 0 $a Lichtenstein, Alice H. $e committee member
790 1 0 $a Dawson-Hughes, Bess $e committee member
790 1 0 $a Hannan, Marian T. $e committee member
790 $a 1546
791 $a Ph.D.
792 $a 2011
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3449804