Is outdoor recreational activity an independent predictor of cardiovascular disease mortality – NHANES III?

Donneyong, Macarius; Taylor, K.C.; Kerber, Rich; Hornung, Carlton A.; Scragg, Robert

doi:10.1016/j.numecd.2016.02.008

Cited by 26 publications

(8 citation statements)

References 25 publications

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“…Some studies suggest that high levels of exposure to sunlight early in life delays CVD by 0.6 to 2.1 years, 51, 52 and that spending times outdoors (presumably leading to greater sunlight exposure) is inversely related to CVD mortality. 53 Significantly, in these studies the extent of increase in CVD mortality due to a lack of sunlight exposure was similar to smoking. 52 In a survey of all the 200 districts in the UK, the hours of sunshine per annum were negatively associated with CVD mortality.…”

Section: The Natural Enviornmentmentioning

confidence: 60%

Environmental Determinants of Cardiovascular Disease

Bhatnagar

2017

Circulation Research

413

268

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Many features of the environment have been found to exert an important influence on cardiovascular disease (CVD) risk, progression, and severity. Changes in the environment due to migration to different geographic locations, modifications in lifestyle choices, and shifts in social policies and cultural practices alter CVD risk, even in the absence of genetic changes. Nevertheless, the cumulative impact of the environment on CVD risk has been difficult to assess and the mechanisms by which some environment factors influence CVD remain obscure. Human environments are complex; and their natural, social and personal domains are highly variable due to diversity in human ecosystems, evolutionary histories, social structures, and individual choices. Accumulating evidence supports the notion that ecological features such as the diurnal cycles of light and day, sunlight exposure, seasons, and geographic characteristics of the natural environment such altitude, latitude and greenspaces are important determinants of cardiovascular health and CVD risk. In highly developed societies, the influence of the natural environment is moderated by the physical characteristics of the social environments such as the built environment and pollution, as well as by socioeconomic status and social networks. These attributes of the social environment shape lifestyle choices that significantly modify CVD risk. An understanding of how different domains of the environment, individually and collectively, affect CVD risk could lead to a better appraisal of CVD, and aid in the development of new preventive and therapeutic strategies to limit the increasingly high global burden of heart disease and stroke.

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Section: The Natural Enviornmentmentioning

confidence: 60%

Environmental Determinants of Cardiovascular Disease

Bhatnagar

2017

Circulation Research

413

268

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“…The relationship between vitamin D and cardiovascular disease may be explained by mechanisms involving inflammation, the renin-angiotensin-aldosterone system, insulin sensitivity, or vascular calcification [16–22]. Alternatively, it is also possible that this association may be confounded by other variables related to overall health status including physical activity, sunlight exposure, and obesity [23–25]. Our work suggests that the association between 25(OH)D deficiency and cardiovascular risk may be related to a particular at-risk phenotype rather than one particular risk factor.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D deficiency and non-lipid biomarkers of cardiovascular risk

Faridi

Lupton

Martin

et al. 2017

aoms

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IntroductionDeficient 25-hydroxyvitamin D (25(OH)D) levels have been associated with dyslipidemia and cardiovascular diseases, though the underlying mechanism of these associations is uncertain. We analyzed associations between vitamin D and other non-lipid biomarkers of cardiovascular risk to better elucidate possible relationships between deficient 25(OH)D and cardiovascular disease.Material and methodsWe performed a cross-sectional analysis of 4,591 adults included in a clinical laboratory database from 2009 to 2011 with available measurements for 25(OH)D and the following biomarkers: homocysteine (Hcy), high-sensitivity C-reactive protein (hs-CRP), cystatin-C, creatinine, γ-glutamyltransferase (GGT), uric acid, and hemoglobin A1c (HbA1c). We calculated odds ratios (OR) of having high levels of each biomarker associated with 25(OH)D deficiency (< 20 ng/ml) compared to optimal levels (≥ 30 ng/ml) using logistic regression adjusted for age, sex, and lipids.ResultsThe mean ± SD age was 60 ±14 years and 46% of patients were women. In multivariable-adjusted models, adults with deficient 25(OH)D compared to those with optimal levels had increased odds of elevated biomarkers as follows: Hcy (OR = 2.53, 95% CI: 1.92–3.34), hs-CRP (1.62, 1.36–1.93), cystatin-C (2.02, 1.52–2.68), creatinine (2.06, 1.35–3.14), GGT (1.39, 1.07–1.80), uric acid (1.60, 1.31–1.95), and HbA1c (2.47, 1.95–3.13). In analyses evaluating women and men separately, 25(OH)D deficient women but not men had increased odds of elevated levels of all biomarkers studied. There were significant interactions based on sex between 25(OH)D and Hcy (p = 0.003), creatinine (p = 0.004), uric acid (p = 0.040), and HbA1c (p = 0.037).ConclusionsDeficient 25(OH)D is associated with elevated levels of many biomarkers of cardiovascular risk, particularly among women, in a United States population.

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“…Thus, in addition to muscle function, adequate magnesium intake levels or Ca:Mg ratios could lead to optimal vitamin D status. Further, previous studies found physical activity may only be related to reduced risks of incident CVD and mortality due to CVD when serum levels of 25(OH)D were sufficient (20 to <30 ng/ml) or optimal (≥30 ng/ml) while moderate physical activity was significantly associated with a reduced risk of incident CVD only when serum 25(OH)D levels were optimal . Although there is no exiting study on cancer outcomes, taken together, it is possible that magnesium levels above RDA are critical for optimal vitamin D status and, in turn, for the beneficial effect of moderate physical activity.…”

Section: Discussionmentioning

confidence: 99%

“…Two previous reports indicate that physical activity may only be related to reduced risks of incident cardiovascular disease (CVD) and mortality due to CVD when serum levels of 25‐hydroxyvitamin D (25(OH)D) were sufficient (20 to <30 ng/ml) or optimal (≥30 ng/ml). In particular, moderate physical activity was significantly associated with a reduced risk of incident CVD when serum 25(OH)D levels were optimal .…”

Section: Introductionmentioning

confidence: 99%

Physical activity, dietary calcium to magnesium intake and mortality in the National Health and Examination Survey 1999–2006 cohort

Hibler

Zhu

Shrubsole

et al. 2019

Intl Journal of Cancer

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Calcium and magnesium affect muscle mass and function. Magnesium and calcium are also important for optimal vitamin D status. Vitamin D status modifies the associations between physical activity and risk of incident cardiovascular disease (CVD) and CVD mortality. However, no study examined whether levels of magnesium and calcium and the ratio of dietary calcium to magnesium (Ca:Mg) intake modify the relationship between physical activity and mortality. We included 20,295 National Health and Nutrition Examination Survey participants (1999–2006) aged >20 years with complete dietary, physical activity and mortality data (2,663 deaths). We assessed physical activity based on public health guidelines and sex‐specific tertiles of MET‐minutes/week. We used Cox proportional hazards models adjusted for potential confounding factors and stratified by the intakes of magnesium, calcium, Ca:Mg ratio. We found higher physical activity was significantly associated with reduced risk of total mortality and cause‐specific mortality, regardless of Ca:Mg ratio, magnesium or calcium intake. In contrast, both moderate and high physical activity were significantly associated with substantially reduced risks of mortality due to cancer when magnesium intake was above the RDA level. We also found higher physical activity was significantly associated with a reduced risk of mortality due to cancer only when Ca:Mg ratios were between 1.7 and 2.6, although the interaction was not significant. Overall, dietary magnesium and, potentially, the Ca:Mg ratio modify the relationship between physical activity and cause‐specific mortality. Further study is important to understand the modifying effects of the balance between calcium and magnesium intake on physical activity for chronic disease prevention.

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Is outdoor recreational activity an independent predictor of cardiovascular disease mortality – NHANES III?

Cited by 26 publications

References 25 publications

Environmental Determinants of Cardiovascular Disease

Environmental Determinants of Cardiovascular Disease

Vitamin D deficiency and non-lipid biomarkers of cardiovascular risk

Physical activity, dietary calcium to magnesium intake and mortality in the National Health and Examination Survey 1999–2006 cohort

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