title: Association between a Healthy Lifestyle Score and inflammatory markers among Puerto Rican adults.
abstract: OBJECTIVE
  The relationship between multiple lifestyle components analyzed in combination and inflammation remains understudied. We aimed to assess the association between a Healthy Lifestyle Score (HLS) that includes adherence to five behavioral components (diet, physical activity and sedentary behaviors, smoking, social support and network, and sleep) and inflammatory markers, as well as the role of the HLS in inflammation among individuals with cardiometabolic conditions, in Puerto Rican adults.
  
  
  RESULTS
  In a cross-sectional study of 842 Puerto Ricans adults (aged 45-75 y) living in Boston, MA, the HLS (range = 0-190; maximum indicative of healthiest adherence) was analyzed for association with three inflammatory markers: interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP). In multivariable-adjusted models, the HLS was inversely associated with IL-6 (β ± SE = -0.55 ± 0.13; P < 0.001) and TNF-α (-0.39 ± 0.13; P = 0.004). The dietary and smoking components were associated with both inflammatory markers independently of the other HLS components. Significant inverse associations were observed for each 20-unit increase in HLS and IL-6 and TNF-α for participants with hypertension (n = 600; β ± SE = -0.58 ± 0.16; -0.46 ± 0.16, respectively) and with overweight/obesity (n = 743; β ± SE = -0.59 ± 0.13; -0.50 ± 0.14, respectively), but not for those with diabetes (n = 187) or heart disease (n = 192). The HLS was not associated with CRP, after adjustment for potential confounders.
  
  
  CONCLUSIONS
  Higher adherence to multiple lifestyle behaviors was associated with lower concentrations of inflammatory markers. Because low-grade inflammation may precede chronic diseases, following an overall healthy lifestyle may help lower risk of these diseases.
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Sotos-Prieto
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: S N
authors.initials: SN
authors.lastname: Bhupathiraju
authors.affiliation: College of Fine Arts, Humanities and Social Sciences, University of Massachusetts, Lowell, MA, USA.
authors.forename: L M
authors.initials: LM
authors.lastname: Falcon
authors.affiliation: Department of Nutritional Sciences, The Pennsylvania State University, State College, PA, USA.
authors.forename: X
authors.initials: X
authors.lastname: Gao
authors.affiliation: Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts, Lowell, MA, USA.
authors.forename: K L
authors.initials: KL
authors.lastname: Tucker
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Electronic address: jmattei@hsph.harvard.edu.
authors.forename: J
authors.initials: J
authors.lastname: Mattei
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D001900:Boston / Q000453:epidemiology; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000208:ethnology / Q000517:prevention & control; D003430:Cross-Sectional Studies; D000072001:Diet, Healthy; D015444:Exercise; D005260:Female; D015438:Health Behavior; D000070497:Healthy Lifestyle; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000208:ethnology / Q000517:prevention & control; D007249:Inflammation / Q000097:blood* / Q000208:ethnology / Q000517:prevention & control; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000208:ethnology / Q000517:prevention & control; D008875:Middle Aged; D015596:Nutrition Assessment; D009765:Obesity / Q000097:blood / Q000517:prevention & control; D011647:Puerto Rico / Q000208:ethnology; D012307:Risk Factors; D057185:Sedentary Behavior; D012890:Sleep; D012907:Smoking; D012944:Social Support; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein
keywords: Hispanics; Inflammatory markers; Lifestyle score
references.citation: Diabetes Res Clin Pract. 2014 Aug;105(2):141-50
references.pmid: 24798950
references.citation: Ann Behav Med. 2011 Oct;42(2):141-52
references.pmid: 21604067
references.citation: Res Nurs Health. 1984 Mar;7(1):61-71
references.pmid: 6565302
references.citation: Am J Epidemiol. 1998 Sep 1;148(5):507-18
references.pmid: 9737563
references.citation: J Gerontol B Psychol Sci Soc Sci. 2000 Mar;55(2):S108-16
references.pmid: 10794195
references.citation: Am J Cardiol. 2014 Oct 15;114(8):1192-7
references.pmid: 25173442
references.citation: J Am Coll Cardiol. 2004 Jul 7;44(1):152-8
references.pmid: 15234425
references.citation: N Engl J Med. 2012 Oct 4;367(14):1310-20
references.pmid: 23034020
references.citation: West J Nurs Res. 2010 Oct;32(6):730-60
references.pmid: 20624936
references.citation: J Natl Cancer Inst. 2014 Nov;106(11). pii: dju294. doi: 10.1093/jnci/dju294
references.pmid: 25274579
references.citation: Am J Clin Nutr. 2006 Jun;83(6):1369-79
references.pmid: 16762949
references.citation: Am J Clin Nutr. 2005 Jul;82(1):163-73
references.pmid: 16002815
references.citation: J Nutr. 2004 Apr;134(4):913-8
references.pmid: 15051846
references.citation: Circulation. 2012 Aug 21;126(8):928-33
references.pmid: 22891048
references.citation: Am J Med. 2015 Feb;128(2):152-160.e4
references.pmid: 25305231
references.citation: Curr Gerontol Geriatr Res. 2014;2014:535071
references.pmid: 25136359
references.citation: J Nutr. 2015 Jul;145(7):1531-40
references.pmid: 25948783
references.citation: Nutr Metab Cardiovasc Dis. 2012 Mar;22(3):223-30
references.pmid: 21111583
references.citation: BMC Public Health. 2010;10:107
references.pmid: 20193082
references.citation: Ann Behav Med. 2012 Dec;44(3):399-407
references.pmid: 22865468
references.citation: East Mediterr Health J. 2012 Jul;18(7):735-41
references.pmid: 22891522
references.citation: Ann Behav Med. 2014 Jun;47(3):335-46
references.pmid: 24151097
references.citation: J Nutr Metab. 2012;2012:542698
references.pmid: 23316349
references.citation: Nutr Metab Cardiovasc Dis. 2014 Sep;24(9):956-62
references.pmid: 24925122
references.citation: Am J Clin Nutr. 2001 Jan;73(1):61-7
references.pmid: 11124751
references.citation: Circulation. 2014 Feb 18;129(7):737-46
references.pmid: 24226807
references.citation: Diabetes Metab. 2013 Apr;39(2):99-110
references.pmid: 23062863
references.citation: Arterioscler Thromb Vasc Biol. 2003 Jul 1;23(7):1255-61
references.pmid: 12775578
references.citation: Br J Sports Med. 2015 Feb;49(4):255-8
references.pmid: 24550208
references.citation: N Engl J Med. 1993 Feb 25;328(8):538-45
references.pmid: 8426621