{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:44:06Z","timestamp":1792809846829,"version":"4.5.0"},"reference-count":60,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,9,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Previous studies have found that exposure to childhood environmental stress is associated with cardiometabolic risk. However, it is not known whether individual health behaviors disrupt this relationship. This study prospectively evaluated the relationship between cumulative environmental stress in a low\u2010income sample and cardiometabolic risk in middle childhood and examined whether child health behaviors attenuated this relationship.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In a cohort of children (n=338; 57% Hispanic children; 25% Black children), environmental stressors (family and neighborhood factors representing disadvantage\/deprivation) and child health behaviors (accelerometry measured physical activity; parent\u2010reported screen time and diet recalls) were measured over 5 time points beginning when children were aged 2 to 4\u2009years and ending when they were aged 7 to 11\u2009years. Children's cardiometabolic risk factors (body mass index, blood pressure, triglyceride\/high\u2010density lipoprotein ratio, glucose, hemoglobin A\n              <jats:sub>1c<\/jats:sub>\n              , C\u2010reactive protein) were measured at 7 to 11\u2009years. Emerging cardiometabolic risk was defined as having \u22651 elevations that exceeded clinical thresholds. In adjusted path analyses, greater cumulative environmental stress was associated with higher likelihood of emerging cardiometabolic risk in middle childhood (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Higher levels of moderate to vigorous physical activity and fewer sedentary minutes attenuated the positive relationship between stress and cardiometabolic risk (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05). Children with\n              <jats:underline underline-style=\"single\">&gt;<\/jats:underline>\n              2\u2009hours of average daily screen time had a higher likelihood of elevated cardiometabolic risk (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01), but screen time did not moderate the stress\u2013cardiometabolic risk relationship. Dietary intake was not related to cardiometabolic risk.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Interventions that promote moderate to vigorous physical activity and limit sedentary behavior may have particular importance for the cardiometabolic health of children exposed to high levels of cumulative environmental stress.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.032492","type":"journal-article","created":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T11:16:22Z","timestamp":1725880582000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Do Children's Health Behaviors Buffer the Impact of Cumulative Environmental Stress on Emerging Cardiometabolic Risk?"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7607-5602","authenticated-orcid":false,"given":"Alicia S.","family":"Kunin\u2010Batson","sequence":"first","affiliation":[{"name":"Department of Pediatrics and Center for Pediatric Obesity Medicine University of Minnesota Medical School Minneapolis MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5050-945X","authenticated-orcid":false,"given":"A. 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