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  • 1.
    Khanolkar, Amal
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Byberg, L.
    Zethelius, B.
    Silverwood, R.
    Koupil, I.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    The Pro12Ala polymorphism of the PPAR-g2 gene interacts with low birth weight in increasing the risk for myocardial infarction2009In: Journal of Developmental Origins of Health and Disease, Vol. 1, no Suppl1Article in journal (Refereed)
  • 2.
    Khanolkar, Amal
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Byberg, Liisa
    Koupil, Ilona
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Parental influences on cardiovascular risk factors in Swedish children aged 5–14 years2012In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 22, no 6, p. 840-847Article in journal (Refereed)
    Abstract [en]

    Background: Precursors of cardiovascular diseases (CVD) originate in childhood. We investigated relationships of children's CVD risk factors with parent's socio-economic position (SEP) and lifestyle and how CVD risk factors correlate within families. Methods: We studied 602 families with 2141 individuals comprising two full sibs; aged 5–14 years, and their biological parents (Uppsala Family Study). Parental SEP (occupational class and education) and lifestyle habits [smoking, physical activity (PA), alcohol consumption] were taken from questionnaires. Associations with cholesterol, ApoB/ApoA1, leptin, adiponectin, blood pressure, body mass index (BMI) and overweight/obesity (OW/OB) were analysed by linear/logistic regression. Results were adjusted for child's age, gender, pubertal stage and family clustering. Results: We observed no consistent associations between parental SEP and children's CVD risk factors. Parental lifestyle had stronger effects, independent of parental SEP. Children of smoking fathers had higher BMI (4%, 95% CI 1–7%) and leptin levels (27%, 95% CI 1.00–61.60%). Children of mothers reporting vigorous PA had lower BMI, cholesterol and decreased odds for OW/OB with a possible dose effect. Compared with mothers reporting no vigorous activity, mothers with ≤75 min and 76–150 min/week of vigorous activity had 43% (OR 0.57, 95% CI 0.22–0.89) and 72% (OR 0.28, 95% CI 0.14–0.60) lower risk of having an OW/OB child, respectively, after adjustment for confounders. Independent, consistently stronger and significant associations were found between all studied parents’ and children's CVD risk factors. Conclusion: Parental behaviours: smoking, alcohol consumption, low PA are associated with higher levels of CVD risk factors (BMI, OW/OB, cholesterol) in children. Strong correlations in CVD risk factors within families not related to parental SEP/lifestyle suggest a role of genetics in influencing children's CVD risk factors. Public health policies should target families with unhealthy lifestyles.

  • 3.
    Khanolkar, Amal
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Sovio, Ulla
    Bartlett, Jonathan W.
    Wallby, Thomas
    Koupil, Ilona
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Socioeconomic and early-life factors and risk of being overweight or obese in children of Swedish- and foreign-born parents2013In: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 74, no 3, p. 356-363Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Ethnic minorities/immigrants have differential health as compared with natives. The epidemic in child overweight/obesity (OW/OB) in Sweden is leveling oft but lower socioeconomic groups and immigrants/ethnic minorities may not have benefited equally from this trend. We investigated whether nonethnic Swedish children are at increased risk for being OW/OB and whether these associations are mediated by parental socioeconomic position (SEP) and/or early-life factors such as birth weight, maternal smoking, BMI, and breastfeeding. METHODS: Data on 10,628 singleton children (51% boys, mean age: 4.8 y, born during the period 2000-2004) residing in Uppsala were analyzed. OW/OB was computed using the International Obesity Task Force's sex- and age-specific cutoffs. The mother's nativity was used as proxy for ethnicity. Logistic regression was used to analyze ethnicity-OW/OB associations. RESULTS: Children of North African, Iranian, South American, and Turkish ethnicity had increased odds for being overweight/obese as compared with children of Swedish ethnicity (adjusted odds ratio (OR): 2.60 (95% confidence interval (CI): 1.57-4.27), 1.67 (1.03-2.72), 3.00 (1.86-4.80), and 2.90 (1.73-4.88), respectively). Finnish children had decreased odds for being overweight/obese (adjusted OR: 0.53 (0.32-0.90)). CONCLUSION: Ethnic differences in a child's risk for OW/OB exist in Sweden that cannot be explained by SEP or maternal or birth factors. As OW/OB often tracks into adulthood, more effective public health policies that intervene at an early age are needed.

  • 4.
    Khanolkar, Amal
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Vågerö, Denny
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Koupil, Ilona
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Social determinants of cardiac disease biomarkers: Investigating a Swedish male cohort at ages 50 and 702012In: European Journal of Preventive Cardiology, ISSN 2047-4873, Vol. 19, no 3, p. 523-533Article in journal (Refereed)
    Abstract [en]

    Aims: To investigate relationships between socioeconomic position (SEP) and common CVD biomarkers including adiponectin not previously investigated in a Swedish-population sample, and to assess if these associations changed with age. Design: Population-based longitudinal cohort study of men born 1920-24 with clinical measurements, blood samples, questionnaire data, and register-based information on SEP and cause of death. Methods: A total of 2322 men attended an investigation at age 50 of which 1221 attended a reinvestigation at age 70. Association between SEP and CVD biomarkers [cholesterol, low-density lipoprotein/high-density lipoprotein (LDL/HDL), apolipoprotein (Apo) ApoB/ApoA1, and adiponectin] were analysed by linear regression (adjusted for age, body mass index, and physical activity). SEP was measured as occupational class and educational level. CVD mortality over 36 years of follow-up was analysed by Cox regression. Results: At age 50, we found a significant inverse association of education with cholesterol level, LDL/HDL ratio and ApoB/ApoA1 ratio. Cholesterol was also associated with occupational class, statistically significant after adjustment for all covariates. At age 70, no significant associations were found between either measurement of SEP and any of the biomarkers studied. Highest educated men had decreased risk for CVD mortality during follow-up. Conclusions: Associations of SEP with cholesterol levels and LDL/HDL ratio that exist at age 50 are no longer apparent in the same group of men at age 70. We found no significant association between SEP and adiponectin levels at age 70.

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