Table 2.
Summary of exposures associated with cardio-metabolic risk markers among Indigenous children and adolescents, with the number of studies and direction of the association indicated.
| Exposure Level | Exposures 1 | Outcomes 2 | Age 3 | ||||
|---|---|---|---|---|---|---|---|
| Obesity | BP | Glucose | Lipids | MetS | |||
| Individual | Higher age | ~2 | C,Y | ||||
| Female sex | ~3 | ~3 | ~3 | Ø2 | ~3 | P,C,Y | |
| Higher obesity measures | ↑3 | ↑5 | ↑4 | ↑1 | P,C,Y | ||
| Larger birth size | ~4 (↑3) | Ø2 | ~1 | ~1 | P,C,Y | ||
| Smaller kidney size | ↑1 | C | |||||
| Maternal obesity | ~2 | ↑1 | ↑1 | P,C,Y | |||
| Maternal smoking in pregnancy | ~2 | Ø2 | P,C,Y | ||||
| Lower maternal parity | ↑1 | C,Y | |||||
| Higher maternal age | ↑1 | P,C | |||||
| Lower physical activity | ↑1 | C,Y | |||||
| Lower sleep duration | ↑1 | C | |||||
| Higher high-fat food consumption | ↑1 | P,C | |||||
| Higher sugar-sweetened beverage consumption | ↑1 | P,C | |||||
| Higher dugong consumption | ↑1 | C,Y | |||||
| Family/Peer | Higher caregiver SBP | ↑1 | P,C,Y | ||||
| Social | Racism | ~2 | C,Y | ||||
| Lower maternal education | ~2 | P,C | |||||
| Maternal cultural-based resilience | ↑1 | P,C | |||||
| Longer incarceration period ‡ | ↑1 | C,Y | |||||
| No car in the household | ↑1♀ | Y | |||||
| Environmental | Higher area-level SES | ~4 (↑3) | ↑1 | ~1 | P,C,Y | ||
| Less remote or urban area | ~3 | ↑1 | ~1 | ~1 | ~1 | P,C,Y | |
| Interventions | Oral health intervention | ~1 | P | ||||
Numbers indicate the number of distinct studies reporting an association; ↑ indicates higher likelihood of the outcome; ~ indicates mixed/inconclusive results; Ø indicates consistent null associations; parentheses are used to highlight two instances where most evidence indicates an association; ♀ association only found among females. 1: ‡ among a custodial sample; SES = socioeconomic status. 2: Outcomes: Obesity = elevated obesity measures; BP = elevated blood pressure; Glucose = elevated blood glucose, insulin, or diabetes; Lipids = elevated blood lipids (or lower high-density lipoprotein cholesterol); MetS = the metabolic syndrome, or cardio-metabolic risk marker clustering. 3: Age group: P = preschool (0–5 years); C = childhood (6–14 years); Y = youth (15–24 years).