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Background A growing proportion of adolescents have poor cardiovascular health behaviors, including low levels of physical activity and high levels of sedentary behavior, thus increasing the likelihood of poor heart health in later years. This study tested the hypothesis that low perceived neighborhood safety would be associated with low levels of physical activity and high levels of recreational sedentary behavior in high-school students. Methods Using cross-sectional, weighted data from the 2015 Pennsylvania (USA) State and Philadelphia city Youth Risk Behavior Survey, multivariable logistic regression modeling was used to examine the association between perceived neighborhood safety, and physical activity levels and recreational screen-based sedentary behavior time respectively, while controlling for potential confounders. Results After adjustment for other significant correlates of physical activity, students with low perceived neighborhood safety had a 21% reduced odds of being physically active on 5 or more days of the last week as compared to those who felt safe ( p  = 0.044). Perceived safety was not related to sedentary behavior; but sports team participation emerged as a strong correlate of low screen-based sedentary behavior (OR = 0.73, p  = .002). Conclusion These data add to a growing body of work demonstrating the importance of perceived safety with physical activity levels in youth. Sports team participation may be a viable target to reduce screen-based sedentary time.

Sleep duration and morningness/eveningness (circadian preference) have separately been associated with cardiovascular risk factors (i.e. tobacco use, physical inactivity). Interactive effects are plausible, resulting from combinations of sleep homeostatic and circadian influences. These have not been examined in a population sample. Multivariable regression models were used to test the associations between combinations of sleep duration (short [≤6 h], adequate [7-8 h], long [≥9 h]) and morning/evening preference (morning, somewhat morning, somewhat evening, evening) with the cardiovascular risk factors of tobacco use, physical inactivity, high sedentary behaviour, obesity/overweight and eating fewer than 5 daily servings of fruit and vegetables, in a cross-sectional sample of 439 933 adults enrolled in the United Kingdom Biobank project. Participants were 56% female, 95% white and mean age was 56.5 (SD = 8.1) years. Compared with adequate sleep with morning preference (referent group), long sleep with evening preference had a relative odds of 3.23 for tobacco use, a 2.02-fold relative odds of not meeting physical activity recommendations, a 2.19-fold relative odds of high screen-based sedentary behaviour, a 1.47-fold relative odds of being obese/overweight and a 1.62-fold relative odds of <5 fruit and vegetable daily servings. Adequate sleep with either morning or somewhat morning preference was associated with a lower prevalence and odds for all cardiovascular risk behaviours except fruit and vegetable intake. Long sleepers with evening preference may be a sleep phenotype at high cardiovascular risk. Further work is needed to examine these relationships longitudinally and to assess the effects of chronotherapeutic interventions on cardiovascular risk behaviours.

Hypertension diagnosed via peripheral (brachial) blood pressure (pBP) is a strong independent predictor of overt cardiovascular disease (CVD). However, central (aortic) blood pressure (cBP), which is influenced by arterial stiffness, may be more strongly associated with CVD risk. Young Black women (BLW) demonstrate higher pBP than White women (WHW), but investigations of racial differences in central haemodynamics and arterial stiffness in young women are lacking. We assessed pBP, central haemodynamics and arterial stiffness in young, non‐hypertensive BLW and WHW. We hypothesized that pBP, central haemodynamics (cBP, augmentation pressure (AP), augmentation index normalized to a heart rate of 75 beats per minute (AIx75), arterial wave reflections), and arterial stiffness (carotid–femoral pulse wave velocity (cf‐PWV)) would be higher in BLW. Under standardized resting conditions, supine brachial pBP was measured, and central haemodynamics were estimated via pulse wave analysis using partial cuff inflation. cf‐PWV was assessed via simultaneous carotid artery applanation tonometry and partial cuff inflation over the femoral artery. Participants were young, apparently healthy women who self‐identified their race as Black (BLW: n  = 44) or White (WHW: n  = 40). Systolic pBP ( P  = 0.04) and diastolic pBP ( P  < 0.01) were higher among BLW. Systolic cBP ( P  < 0.01), diastolic cBP ( P  < 0.01), heart rate ( P  < 0.001), AP ( P  = 0.02), AIx75 ( P  < 0.001), arterial wave reflection magnitude ( P  = 0.40) and cf‐PWV ( P  = 0.04) were all higher among BLW. Findings demonstrate elevations in pBP, central haemodynamics and arterial stiffness in young BLW versus WHW. Central haemodynamics and arterial stiffness may be promising targets in the early assessment of CVD risk in young BLW. What is the central question of this study? Are there racial differences in peripheral blood pressure, central haemodynamics and arterial stiffness between young, generally healthy, non‐hypertensive Black and White women? What is the main finding and its importance? Findings demonstrate increased peripheral blood pressure (BP), central BP, augmentation index, and arterial stiffness in young Black women compared with White women.  It is well‐documented that Black women have the highest prevalence of hypertension, a major but modifiable risk factor for cardiovascular disease (CVD). Increased central BP and arterial stiffness are strong independent risk factors for CVD and findings indicate that these may also be important intervention targets for the prevention of CVD in Black women.

Short, disturbed, and irregular sleep may contribute to blunted nocturnal blood pressure (BP) dipping, a predictor of cardiovascular disease. Black women (BLW) demonstrate less BP dipping and poorer sleep health than White women (WHW). However, it remains unclear whether device‐estimated sleep health metrics mediate the relation between race and BP dipping in young women. We hypothesized that the relation between race and BP dipping would be partly mediated by sleep health metrics of sleep duration, sleep efficiency, and sleep regularity. Participants (20 BLW, 17 WHW) were 18–29 years old, normotensive, nonobese, and without evidence of sleep disorders. Systolic and diastolic BP dipping were derived from 24‐h ambulatory BP monitoring. Habitual sleep duration and sleep efficiency were estimated via 14 days of wrist actigraphy. Sleep duration regularity was calculated as the standard deviation (SD) of nightly sleep duration (SDSD). Sleep timing regularity metrics were calculated as the SD of sleep onset and sleep midpoint (SMSD). Mediation analysis tested the mediating effect of each sleep metric on the relation between race and BP dipping. BLW experienced less systolic ( P  = .02) and diastolic ( P  = .01) BP dipping. Sleep duration ( P  = .14) was not different between groups. BLW had lower sleep efficiency ( P  < .01) and higher SDSD ( P  = .02), sleep onset SD ( P  < .01) and SMSD ( P  = .01). No sleep metrics mediated the relation between race and BP dipping (all indirect effects P  > .38). In conclusion, mediation pathways of sleep health metrics do not explain racial differences in nocturnal BP dipping between young BLW and WHW.

Background Data suggest that sedentary behavior is an independent risk factor for obesity; however, the extent to which physical activity (PA) and sex alter this relationship remains unclear. To address this gap, the current study examined the association between television (TV) viewing time and percent body fat (%BF) as a function of PA level and sex. Methods Trained interviewers assessed 454 adults at their place of residence. Participants completed questionnaires to determine h of TV watched per week, PA level (inactive = not meeting PA guidelines vs. active = meeting PA guideline), and covariates including demographics (e.g., sex), depression symptoms, perceived stress, fruit and vegetable intake, and environmental support for PA. Foot-to-foot bioelectrical impedance (Tanita TBF-300, Tokyo, Japan) was used to assess %BF. Mixed models were generated to examine the association between TV h/wk. and %BF as a function of PA level and sex while accounting for the multi-level nature of the data (neighborhood- and individual-levels) and covariates. Results Participants were 44.4 ± 14.0 (Mean + Standard Deviation) years of age with 33.2 ± 11.1%BF, and watched 19.3 ± 15.5 h/wk. of TV. Most were female (70.9%) and inactive (63.2%). Mixed model regression demonstrated that among inactive participants, each additional h of TV viewed/wk. was associated with a 1.03% increase in %BF; TV h/wk. and %BF were not associated in active adults. When models were further stratified by sex, h of TV viewed/wk. were significantly associated with %BF only in inactive females. Each additional h of TV viewed/wk. was associated with an increase in %BF of 1.14%. Conclusion: Interventions targeting PA and/or TV viewing time may be a high-priority to curb excess BF accumulation especially among inactive females.

Background Research suggests that men are less likely to seek help for depression, substance abuse, and stressful life events due to negative perceptions of asking for and receiving help. This may be exacerbated in male military cadets who exhibit higher levels of gender role conflict because of military culture. Methods This exploratory study examined the perceptions of 78 male military cadets toward help-seeking behaviors. Cadets completed the 31-item Barriers to Help Seeking Scale (BHSS) and a component factor analysis was used to generate five composite variables and compare to validated factors. Perceptual mapping and vector modeling, which produce 3-dimensional models of a group’s perceptions, were then used to model how they conceptualize help-seeking. Results Factor analysis showed slightly different groupings than the BHSS, perhaps attributed to different characteristics of respondents, who are situated in a military school compared to general university males. Perceptual maps show that cadets perceive trust of doctors closest to them and help-seeking farthest, supporting the concept that these males have rigid beliefs about having control and its relationship to health seeking. Differences were seen when comparing maps of White and non-White cadets. White cadets positioned themselves far away from all variables, while non-White cadets were closest to “emotional control”. Conclusion To move these cadets toward help-seeking, vector modeling suggests that interventions should focus on their general trust of doctors, accepting lack of control, and decreasing feelings of weakness when asking for help. For non-White cadets a focus on self-reliance may also need to be emphasized. Use of these unique methods resulted in articulation of specific barriers that if addressed early, may have lasting effects on help-seeking behavior as these young men become adults. Future studies are needed to develop and test specific interventions to promote help-seeking among military cadets.

ObjectivesAs a common form of sedentary behaviour, television viewing is associated with an increase in body mass index (BMI) as well as overall cardiovascular disease (CVD) risk. This study examined the extent to which meeting the recommended volume of weekly physical activity (PA) reduced the association between television viewing with the outcomes of BMI and CVD risk. A second aim was to determine the number of hours (ie, cut-point) of daily television viewing that conferred a higher BMI and CVD risk for a large population-based sample of adults.DesignPopulation-based, cross-sectional study.SettingUK Biobank recruited across 35 centres in the UK between 2006 and 2010.Primary outcomeCVD risk, as measured by the 30-year Framingham risk score.ResultsLinear regression models indicated that every additional hour of television viewing per day was associated with a 3% increase in CVD risk (aCoeff=0.03, d=0.16, p<0.0001); the interaction between television viewing with meeting PA guidelines was marginally associated with CVD risk (aCoeff=0.0010, d=0.01, p=0.014). Each additional hour of television viewing per day was associated with a 0.54 increase in BMI (aCoeff=0.54, d=0.13, p<0.0001); the interaction between television viewing with meeting PA guidelines was not significantly associated with BMI. Regression tree models of the study outcomes revealed that 2.5 hours of television viewing was associated with pronounced increases in BMI and CVD risk.ConclusionsThese data underscore the independent association between television viewing with cardiovascular risk and suggest that reducing television viewing to less than 2.5 hours per day, even in physically active adults, is a clinical and public health priority.

Introduction Disparities in sleep health and metabolic syndrome (MetS) components co-exist in ethnic/racial minorities. Late adolescents (18-21 y.o.) are a high-risk, yet overlooked population to study sleep disparities and the associated metabolic health. This study aimed to examine the interaction between race and sleep health metrics on MetS components in late adolescents. Methods In this cross-sectional study, we enrolled a convenience sample of 60 college students (19.22±1.06 y.o.). Actigraph accelerometers assessed total sleep time (TST), sleep efficiency (SE), and wake after sleep onset (WASO) over one week. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and questions about demographic/socioeconomic information and risk behaviors. A point-of-care test provided the fasting glucose and cholesterol panel. The number (0 vs. >1) of MetS components, including high waist circumference, blood pressure, fasting triglycerides and glucose, and low High-Density Lipoprotein, indicated metabolic health. Logistic regression tested interaction terms controlling for adolescents’ age, sex, alcohol consumption, and parents’ education, marital status, and family income. Results Most participants (n=55; 92%) slept < 7 hours and 43% reported poor sleep (PSQI>5). More than half (n=33; 55%) had at least one MetS component. On average, White (non-Hispanic) participants had higher TST (6.07 vs. 5.63, t=1.93, p=0.06) and SE (84.89% vs. 81.07%, t=2.31, p=0.02) than their racial/ethnic minority (Black/Hispanic/Asian American/other) peers. Race significantly interacted with TST (OR=0.24, p=0.04), SE (OR=0.69, OR=0.10), and WASO (OR=1.08, p=0.02), such that associations of decreasing odds of MetS with increasing TST and SE and decreasing WASO were significant only in the racial/ethnic minority group. Furthermore, racial/ethnic minority adolescents (vs. White) had a greater MetS risk, when TST hours were at low levels (i.e., < 6 hours). Similarly, low SE (< 85%) and high WASO (>60 min) were associated with greater odds of MetS in racial/ethnic minority (vs. White) adolescents. PSQI scores were not independently associated with MetS or interacted with race in the association with MetS. Conclusion Unhealthy sleep is associated with increased MetS risk, particularly for racial/ethnic minority adolescents. Given the greater sensitivity to sleep health, improving sleep quantity and quality may be candidate targets for MetS interventions in at-risk populations who experience health disparities. Support (if any) American Nurses Foundation (18A01422). Center of Biomedical Research Excellence (COBRE) in cardiovascular health (P20GM113125)

Tobacco use and obesity lead to significant morbidity and mortality. This study was conducted to investigate the factors maintaining smoking behavior in lean and obese individuals by utilizing a mouse/human cross-validation model of nicotine reward. In humans, a cigarette choice paradigm was used to examine the relative reinforcing value of nicotine in obese and non-obese smokers. Conditioned place preference (CPP) for nicotine was assessed in mice fed standard low fat rodent chow and mice rendered obese by a high fat diet. In humans, obese smokers self-administered nicotine via cigarettes significantly less often than non-obese smokers and showed attenuated hedonic effects of nicotine-containing cigarettes compared to denicotinized cigarettes. Similarly, mice exposed to a high fat diet did not exhibit nicotine CPP, relative to control mice. mRNA levels for mu-opiate and leptin receptors were also downregulated in the ventral tegmental area of these mice. Together, these studies provide the first evidence for reduced nicotine reward in obese subjects and suggest that this may be mediated by dietary influences on the endogenous opioid system.