High Rates Of Obesity Research Articles

Nutrition interventions addressing structural racism: a scoping review.

African Americans experience high rates of obesity and food insecurity in part due to structural racism, or overlapping discriminatory systems and practices in housing, education, employment, health care and other settings. Nutrition education and nutrition-focused policy, systems and environmental changes may be able to address structural racism in the food environment. This scoping review aimed to summarise the available literature regarding nutrition interventions for African Americans that address structural racism in the food environment and compare them with the 'Getting to Equity in Obesity Prevention' framework of suggested interventions. An electronic literature search was conducted with the assistance of a research librarian encompassing six databases: MEDLINE, PyscINFO, Agricola, ERIC, SocINDEX and ProQuest Dissertations & Theses. A total of thirty sources were identified detailing interventions addressing structural barriers to healthy eating. The majority of nutrition interventions addressing structural racism consisted of policy, systems and/or environmental changes in combination with nutrition education, strategies focused on proximal causes of racial health disparities. Only two articles each targeted the 'reduce deterrents' and 'improve social and economic resources' aspects of the framework, interventions which may be better suited to addressing structural racism in the food environment. Because African Americans experience high rates of obesity and food insecurity and encounter structural barriers to healthy eating in the food environment, researchers and public health professionals should address this gap in the literature.

MHealth Intervention to Improve Cardiometabolic Health in Rural Hispanic Adults: A Pilot Study.

Hispanic/Latino adults have high rates of hypertension, obesity, and type II diabetes. Mobile health technologies (mHealth) are effective in supporting self-management of lifestyle behaviors; however, the effectiveness in rural Hispanic/Latino adults is unclear. A pilot 12-week self-management mHealth intervention in rural Hispanic/Latino adults with cardiometabolic risk was conducted. A randomized, 2-group (intervention and enhanced usual care) design was used to test the use of the MyFitnessPal app, a smart scale, and text messages to support daily self-monitoring of weight, food intake, and steps. Seventy participants enrolled. The intervention group had greater improvement in body mass index ( P = .052) and waist circumference ( P = .043) at 12 weeks and a trend toward greater fitness at 12 and 24 weeks. Both groups improved hemoglobin A 1c level at 12 and 24 weeks. mHealth using MyFitnessPal, smart scale, and text messages may be effective for improving aspects of cardiometabolic health in rural Hispanic/Latino adults.

"I Want a Program That Looks at My Whole Life." A Focus Group Study on the Ideal Components for an mHealth Weight Management Program for African American Women.

The high rate of obesity, ownership of smartphones, and online search for nutrition and dieting information among African American women (AAW) provide a unique opportunity to develop cost-effective, accessible, and acceptable mHealth weight management programs for them. Furthermore, they should participate in the development and evaluation of these programs. To explore ideal components of a culturally relevant mHealth weight management program for AAW and to examine how these components may vary by age group. Twelve focus group triads were conducted with AAW in north central Florida. The framework method was used to manage, organize, synthesize, and analyze data themes by age groups: 18 to 29 (young), 30 to 50 (middle age), and 51+ (older). Thirty-six smartphone owners who expressed a desire to lose weight were recruited through several community partnerships. Based on body mass index (BMI), young women were classified as overweight (BMI 26.23 ± 6.7), middle-aged women as obese (BMI30.72 ± 8.31), and older women as obese (BMI 31.03 ± 5.67). Most searched online for dieting information within the past 12 months. Five overarching themes for designing mHealth weight management programs were identified: (1) holistic program that goes beyond dieting; (2) social media integration for support and sense of community; (3) self-monitoring app; (4) two-way text messaging; and (5) programs of varying lengths and meaningful incentives. AAW were receptive to mHealth weight management programs, which may be appealing during and after the COVID-19 pandemic. Holistic programs of 4 to 6 weeks that addressed stress eating, had a social media component, and included a few educational texts per week may be appealing to AAW.

The COVID-19, Obesity, and Food Insecurity Syndemic.

Purpose of ReviewTo introduce and provide evidence for the new Syndemic of COVID-19, Obesity, and Food Insecurity and propose strategies for mitigating its impact, particularly among vulnerable populations.Recent FindingsThe COVID-19 pandemic has exacerbated obesity, food insecurity, and the existing inequities in the essential workforce. Food insecurity is driven by unsustainable dietary patterns and is associated with higher rates of obesity, which increases the risk of COVID-19 infections, hospitalizations, and deaths. The COVID-19 pandemic has disproportionately impacted the essential food supply chain workforce. Strengthening the social safety net and expanding worker protections will increase food security and secure livelihoods during and beyond the scope of the COVID-19 pandemic.SummaryStrengthening local and regional food systems provides a common solution to both the new Syndemic of COVID-19, Obesity, and Food Insecurity and the Global Syndemic of Obesity, Undernutrition, and Climate Change by promoting sustainable food production and consumption, and prioritizing the food supply chain workforce.

Intersetorialidade das ações de alimentação e nutrição: relação com a prevalência de obesidade no estado da Paraíba

ABSTRACT Objective: To identify the managerial profile and forms of intersectoral articulation in the framework of food and nutrition carried out in Primary Health Care and verify its association with the prevalence of obesity in the three health macro-regions of the State of Paraíba. Methods: Cross-sectional survey carried out in 151 municipalities in Paraíba, nested in a national population-based survey. Variables related to the manager, managerial profile, intersectoral forms of articulation, and obesity rates among adults were evaluated according to data from the Food and Nutrition Surveillance System. Results: All macro-regions presented a mean of adults obesity higher than the national reference for individual over 18 years of age described in the National Health Plan 2020-2023. The presence of the technician responsible for food and nutrition actions was associated with higher rates of obesity. The performance of food and nutrition education actions, and intersectoral practices related to the Food and Nutrition Security sector were associated with lower prevalence of obesity. Conclusion: The effectiveness of the actions cannot be guaranteed by the presence of a specific position for the actions. Food and Nutrition Education actions are recommended to reduce the prevalence of obesity.

A Comparative Analysis of Rural versus Urban Preschool Children's Sugar-Sweetened Beverage Consumption, Body Mass Index and Parent's Weight Status.

BackgroundChildhood overweight and obesity continues to be a major public health concern, especially in minority, low-income, and rural populations. In order to develop health promotion interventions aimed at reducing obesity rates, there is a need to identify which populations have the highest rates of obesity and the risk factors associated with these high rates.MethodsData collected from low-income, preschool children and their parents in an urban community and a rural community in Alabama were analyzed and compared. Body Mass Index (BMI) was collected during school based health screenings, and information regarding parent's BMI and child's consumption of sugar-sweetened beverages (SSBs) were collected by parent report.ResultsOf the 363 children screened, 12.8% (15.2% rural and 11.9% urban) were considered overweight, and 15.8% (20.2% rural and 14.2% urban) of the sample was classified as obese. Rates of overweight and obesity for mothers were 27.6% (25.3% rural and 28.4% urban) and 48% (56.3% rural and 44.8% urban) respectively and 39.6% (53.3% rural and 34.4% urban) and 34.6% (28.3% rural and 36.9% urban) for fathers. Parents reported their child consumed 3.82 SSBs per day. Overall, mother's BMI, father's BMI and sugar-sweetened beverage consumption was positively associated with child's BMI. However, there were no significant interactions between the rural and urban groups.ConclusionRates of overweight and obesity remain high in low-income, predominantly minority preschool children and their parents in two communities in Alabama. Consumption of SSBs, mother's BMI, and father's BMI are three factors impacting the weight status of low-income preschool children. These factors are significant in both rural and urban children.

Parental experiences of adopting healthy lifestyles for children with disabilities living with overweight and obesity.

Children with disabilities present with high obesity rates. This study explored the parental experience of adopting healthy lifestyle choices, for children with disabilities, who received dietetic weight management advice. Semi-structured qualitative interviews were carried out with eight parents/carers in their own homes or healthcare setting in an inner London locality, or by telephone. Data was analyzed using an interpretative phenomenological analysis (IPA) approach. Five superordinate themes emerged: 1. Strategies to promote healthy lifestyles: encouraging physical activity, limiting access to food and taking a gradual approach to making lifestyle changes. 2. Challenges to adopting healthy lifestyles: selective eating patterns, the high cost of healthy foods and parental/carer lack of time. 3. The role of healthcare professionals (HCPs): revealed that not all parents/carers received advice or support, prior to dietetic referral, when managing their child's weight. Feeling reassured by HCPs was valued. Parents/carers reported a positive experience of seeing the dietitian, as they appreciated receiving practical and individualized advice. 4. Support needs: family support and support from families with children with disabilities was explored. 5. Parent/carer wellbeing: such as stress was found to have a detrimental impact on parents making healthy lifestyle changes. Adopting a healthy lifestyle involved a variety of strategies and challenges, some of which are specific to this population group and should be considered by HCPs, when having weight-related discussions and offering advice. Parental/carer support needs and wellbeing should also be taken into consideration when planning weight management services for this population group.

FRUCTOSE DIET INDUCES A METABOLIC REPROGRAMMING TO ENHANCE TUMOR AGGRESSIVENESS

HCC is one of the main causes of cancer-related death worldwide and has third place in mortality. One of the main risk factors is metabolic-associated fatty liver disease (MAFLD), having hepatic steatosis, and related metabolic disorders. Mexican population has the highest obesity rate in both children and adults, and the consumption of hypercaloric diets has been related to that. Also, Mexico is in the top five countries with a higher fructose-enriched diet consumption and has been proved already the relation between fructose consumption and MAFLD. Likewise, fructose has been related to metabolic rewiring in transformed cells, enhancing aggressiveness and survival. To analyze fructose role on aggressiveness promotion of HCC cells. We used C57Bl/6J mice strain (both sex) with a high Fructose diet (Fru) (33% of fructose in the drinking water, ad libitum ). Fru supplementation started with 15 days-old mice, two days after DEN was injected (10 μg/Kg, i.p), and the treatment was ended 8 months later. The UAM ethics committee approved the protocol. In vitro studies were carried out with the Huh-7 HCC cell line and we evaluated metabolic and biochemical parameters. Tissue samples were analyzed by H&E. We observed that the fructose-enriched diet group mice presented fat accumulation in the hepatocytes and also areas with a greater inflammatory infiltrate (Fru). Mice in the fructose-enriched diet + DEN (Fru/HCC) group showed a marked difference between the tumor area and the surrounding tissue and an increase in the number of bile ducts, indicating liver tissue damage. Also, we analyzed the protein content of some lipogenic enzymes and noticed an increment in fatty acid synthase (Fasn) in Fru and Fru/HCC. Due to that, we analyzed if Fru treatment was inducing metabolic rewiring in transformed cells. We obtained metabolic changes in fructose-treated cells, reducing the glycolytic pathway and the traditional Warburg effect. Then we evaluated if the Huh-7 under a Fru treatment was more dependent on mitochondria or glycolysis ATP generation. We observed a reduction in proliferation under oligomycin treatment vs . 2-DG treatment. At least, we evaluated the pentose phosphate pathway (PPP) under a Fru treatment and obtained a higher glucose-6-phosphate dehydrogenase (G-6-P DH) activity with Fru vs. only glucose (Glc). Also, G-6-P DH had a more efficient activity in the presence of Fru because the time to reach the Vmax is lower vs . Glc. Fructose induces a metabolic rewiring in cancer cells to enhance ATP production, NADPH, and nucleotides to sustain the active lipid synthesis and proliferation. The fructose-enriched diets promote an aberrant lipogenic phenotype enhancing tumor aggressiveness. Conacyt, Froteras de la Ciencia 1320. The authors declare that there is no conflict of interest.

Associated Factors of Nutritional Status Among Patients with Both Type 2 Diabetes Mellitus and Hypertension: A Cross-Sectional Study

Background: The growing prevalence of overweight/obesity in patients with diabetes mellitus and hypertension has become a global health concern, which is increasing the risk of deaths. Knowing some factors leading to obesity allows more effective and appropriate prevention. Aims: To identify some related factors to the nutritional status of patients with both type 2 diabetes mellitus and hypertension at the National hospital of Endocrinology in 2019-2020. Methods: A cross-sectional study on 228 patients with type 2 Diabetes mellitus and hypertension at the National Hospital of Endocrinology from September 2019 to December 2019. Results: The results revealed that the elderly group has a higher obesity rate than the middle-aged group (P<0.05). Overweight/obesity subjects had higher protein intake than those with Non-overweight/obesity (P<0.05). Unsatisfactory anthropometric indexes such as waist circumference (WC), waist-hip ratio (WHR), body fat percentage (BFP) had higher odds of overweight/obesity than those who have satisfactory index (OR=10.3, 18.4 and 13.5, respectively). Besides, 24-hours intake, eating habits and physical activity affected the risk of overweight/obesity. Lower frequency consumption of milk for diabetics and participation in physical activities had higher odds of overweight/obesity (OR=2.2, P<0.05). Conclusion: The body mass index of patients is associated with the anthropometric indexes, diets and physical activity.

Liver Disease Among Mexican Americans Aged 67 Years and Older

Background:The Center for Disease Control and Prevention (CDC) reports that liver disease is a significant cause of morbidity and mortality in the US, afflicting 4.5 million people in 2018, or approximately 1.7% of the American adult population.Objective:To determine the prevalence and risk factors associated with liver disease among older Mexican Americans over 18 years of follow-up.Methods:Non-institutionalized Mexican Americans aged ≥67 years (N = 1938) from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1995/96-2012/13) were studied. Measures included socio-demographic variables, self-reported liver disease, language of interview, medical conditions, hand-grip strength, physical and cognitive function, depressive symptoms, and body mass index. Generalized estimating equation models were used to estimate the odds ratio and 95% confidence interval (CI) of liver disease over time.Results:The mean age at baseline was 74.9 ± 6.0 years and 58.4% were female. The prevalence of liver disease ranged from 2.4% to 8.4%. Over time, the odds ratio of reporting liver disease was 1.17 (CI = 1.12-1.22). Older age, Spanish interview, arthritis, diabetes, heart failure, cancer, and high scores on the Mini-Mental-State-Examination were factors associated with greater odds of reporting liver disease over time. Married participants reported lower odds of liver disease over time.Conclusions:The prevalence of liver disease in this population was high, ranging from 2.4% to 8.4%. Diabetes, heart failure, arthritis, and cancer were risk factors for liver disease. Screening for liver function among patients with these morbidities may help prevent liver disease in this population with high rates of diabetes and obesity.

The NAFLD-MAFLD debate through the lens of the Arab world.

The most common liver disease in the world is fatty liver disease related to metabolic dysfunction, yet neither patients nor medical professionals are fully aware of this. The disease, formerly known for decades as non-alcoholic fatty liver disease (NAFLD), has been renamed metabolic (dysfunction)-associated fatty liver disease (MAFLD), with many international consensus groups making recommendations on how the condition should be diagnosed and treated. This point of view explores the nomenclature change from the standpoint of Arab medical professionals and patients. The call for a name change brought up serious issues with the current nomenclature, which refers to the condition as NAFLD, and its diagnostic criteria, including the necessity for excluding alcohol consumption. The Arab world has its unique situation as regards both old and new nomenclatures. This is because of the low alcohol consumption rates in most Arab Muslim countries besides the reported high prevalence rates of obesity and its related comorbidities in the region. In our opinion, such unclarities acted as a significant roadblock to several crucial aspects of disease management in the Arab countries, including patient-doctor communication, patient awareness, partnership working, patient motivation to make lifestyle changes, and promotion of multiple health behavior changes. Many Arab world hepatologists thus wholeheartedly endorse this call to redefine the disease as they believe it will eventually positively impact the understanding and awareness of fatty liver disease, enhance patient treatment and quality of life, and reduce the load on the healthcare system.

An Examination of the Impact of Social and Cultural Traditions Contributing to Overweight and Obesity Among Black Women.

Black women living in Prince George’s (PG) County, Maryland, have high rates of overweight and obesity. Obesity significantly impacts Black women, leading to poor physical and mental health, decreased social well-being, and a financial strain on the healthcare system. Despite living in an affluent area and having middle to high incomes and high education levels, Black women living in PG County have difficulty managing their weight. This study explores how social and cultural factors and social networks impact the weight of Black women living in PG County, Maryland. A qualitative case study design guided by social cognitive theory was employed to conduct semi-structured interviews and focus groups with 15 women. Key social and cultural factors (income, family network, peer network, and living in PG County) influenced participants’ attitudes and behaviors toward their weight and strategies to manage their weight. Additionally, participants expressed that Black culture is more accepting of larger and curvier body types, and this reinforces a positive body image and less desire to achieve an ideal BMI. Participants also expressed that COVID-19 impacted their weight management strategies. This study adds to the literature by better explaining some of the underlying factors that influence decision-making around weight management among Black women who live in PG County, Maryland.

Relationship Between Left Ventricular Ejection Fraction Variation and Systemic Vascular Resistance: A Prospective Cardiovascular Magnetic Resonance Study.

Introduction: This cardiovascular magnetic resonance (CMR) study aims to determine whether changes in systemic vascular resistance (SVR), obtained from CMR flow sequences, might explain the significant long-term changes in left ventricular (LV) ejection fraction (EF) observed in subjects with no cardiac disease history.Methods: Cohort subjects without any known cardiac disease but with high rates of hypertension and obesity, underwent CMR with phase-contrast sequences both at baseline and at a median follow-up of 5.2 years. Longitudinal changes in EF were analyzed for any concomitant changes in blood pressure and vascular function, notably the indexed SVR given by the formula: mean brachial blood pressure / cardiac output x body surface area.Results: A total of 118 subjects (53 ± 12 years, 52% women) were included, 26% had hypertension, and 52% were obese. Eighteen (15%) had significant EF variations between baseline and follow-up (7 increased EF and 11 decreased EF). Longitudinal changes in EF were inversely related to concomitant changes in mean and diastolic blood pressures (p = 0.030 and p = 0.027, respectively) and much more significantly to SVR (p < 0.001). On average, these SVR changes were −8.08 ± 9.21 and +8.14 ± 8.28 mmHg.min.m2.L−1, respectively, in subjects with significant increases and decreases in EF, and 3.32 ± 7.53 mmHg.min.m2.L−1 in subjects with a stable EF (overall p < 0.001).Conclusions: Significant EF variations are not uncommon during the long-term CMR follow-up of populations with no evident health issues except for uncomplicated hypertension and obesity. However, most of these variations are linked to SVR changes and may therefore be unrelated to any intrinsic change in LV contractility. This underscores the benefits of specifically assessing LV afterload when EF is monitored in populations at risk of vascular dysfunction.Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT01716819 and NCT02430805.

Changes in physical activity across a 6-month weight loss intervention in adolescents with intellectual and developmental disabilities.

Adolescents and young adults with intellectual and developmental disabilities (IDD) have high rates of obesity and low levels of physical activity. This analysis examined changes in light, moderate-to-vigorous physical activity (MVPA) and sedentary time, and the association between changes in MVPA and weight loss in adolescents and young adults with IDD and overweight and obesity participating in a 6-month multi-component weight loss intervention. Adolescents and young adults with IDD and overweight or obesity (body mass index≥85 percentile, n=110, age ~16years, 52.7% female) and a parent were randomised to one of three intervention groups: face-to-face delivery/conventional reduced energy diet (n=36), remote delivery (RD)/conventional reduced energy diet (n=39), or RD/reduced energy enhanced stop light diet (eSLD) (n=35.) Participants were asked to engage in 60min/day of MVPA on 5 or more days/wk. Participants and a parent attended twice monthly education/behavioural counselling sessions with a health educator to assist participants in complying with dietary and MVPA recommendations. Education/counselling in the RD arms was delivered remotely using video conferencing, and self-monitoring of MVPA and daily steps was completed using a wireless activity tracker. Education/counselling in the face-to-face arm was delivered during home-visits and self-monitoring of MVPA and daily steps was completed by self-report using paper tracking forms designed for individuals with IDD. MVPA, light activity, and sedentary time were assessed over 7days at baseline and 6months using a portable accelerometer (ActiGraph wGT3x-BT). Mixed modelling analysis completed using participants with valid accelerometer data (i.e. ≥4-10h days) at baseline (n=68) and 6months (n=30) revealed no significant changes in light, moderate- MVPA, or sedentary time across the 6-month intervention (all P>0.05). Participants obtained 15.2±21.5min/day of MVPA at baseline and 19.7±19.7min/day at 6months (P=0.119). Mixed modelling indicated no significant effects of group (P=0.79), time (P=0.10), or group-by-time interaction (P=0.21) on changes in MVPA from baseline to 6months. Correlational analysis conducted on participants with valid accelerometer data at both baseline and 6months (n=24) revealed no significant associations between baseline sedentary time (r=0.10, P=0.40) and baseline MVPA (r=-0.22, P=0.30) and change in MVPA across the 6-month intervention. Additionally, attendance at education/counselling sessions (r=0.26, P=0.22) and frequency of self-monitoring of MVPA were not significantly associated with change in MVPA from baseline to 6months (r=0.26, P=0.44). Baseline MVPA (r=0.02, P=0.92) and change in MVPA from baseline to 6months (r=0.13, P=0.30) were not associated with changes in body weight across the 6-month intervention. We observed a non-significant increase in MVPA (30%), which was not associated with the magnitude of weight loss in a sample of adolescents and young adults with IDD who participated in a 6-month multi-component weight loss intervention. Additional strategies to increase MVPA in adolescents and young adults with IDD participating in weight loss interventions need to be developed and evaluated.

Neighborhood social cohesion and physical activity and obesity outcomes among Native Hawaiian and Pacific Islander individuals.

Native Hawaiian and Pacific Islander (NHPI) individuals report high obesity rates and low physical activity (PA) levels. This study examined associations between neighborhood social cohesion, obesity, and PA among NHPI adults. Cross-sectional data from the 2014 NHPI National Health Interview Survey were analyzed. Social cohesion was assessed using a summative scale and categorized as low, medium, and high. PA was measured via self-report and categorized as insufficiently active (0-149 min/wk) or sufficiently active (150+ min/wk). Obesity status was based on self-reported height and weight measures converted into standard BMI categories. Multivariable logistic regression models estimated odds of obesity and sufficient PA associated with social cohesion level. The study sample included n = 2,590 NHPI adults. Compared with those in low social cohesion neighborhoods, participants in high social cohesion neighborhoods had increased sufficient PA odds (odds ratio [OR] = 1.59, 95% CI: 1.19-2.12; p = 0.003) and decreased obesity odds (OR = 0.57, 95% CI: 0.40-0.83; p = 0.005). No associations were observed between social cohesion and obesity and PA outcomes comparing individuals in medium versus low social cohesion neighborhoods. High social cohesion was associated with reduced obesity odds and increased sufficient PA odds. Findings highlight the importance of enhancing social connectivity as a potential strategy to promote PA and healthy weight among NHPI individuals.

Growing our future: Introducing the Pacific School Food Network to support healthy school food and nutrition environments for better nourished children in the Pacific Islands

Food systems in the Pacific Islands (P.I.) are transitioning from local, traditional diets to those with low fruit and vegetable intake and largely based on ultra-processed foods that are often, but not always, imported. Alongside changes in diet and health outcomes, there is a loss of traditional and sociocultural dimensions of food, resulting in poor quality diets in many P.I. populations, including children. Besides high rates of overweight and obesity, in some areas stunting rates are up to 48.4%,1 and prevalence of anaemia (5-14 years) as high as 45%.

500. A Real-World Cohort Study of Bamlanivimab Versus Bamlanivimab-Etesevimab for Non-severe COVID-19

BackgroundAnti-spike monoclonal antibodies (mAb) including Bamlanivimab (BAM) and Bamlanivimab-Etesevimab (BAM/E) have shown reduced hospitalization rates for non-severe coronavirus disease 2019 (COVID-19) in clinical trials. Recent studies provided real-world hospitalization rates for BAM. But, similar data on those who received BAM/E are lacking. In spring 2021, Michigan experienced a surge of COVID-19 with more cases per capita than any other state. We sought to quantify the impact of BAM monotherapy versus BAM/E combination on hospitalization and mortality among a real-world high-risk cohort of outpatients with COVID-19.MethodsThis retrospective cohort study evaluated outpatients ≥18 years with laboratory-confirmed mild/moderate COVID-19 who received mAb in a Detroit health system based on emergency use authorization criteria. Inclusion began on December 3rd 2020 with BAM monotherapy, changed to BAM/E combination on March 27, 2021, and included patients until April 19th 2021 (Figure 1). Demographics, comorbidities, and clinical characteristics were compared between patients who received BAM verses BAM/E using Chi-square and Mann-Whitney U test. Primary outcome was 30-day COVID-19 related hospitalization. Secondary outcomes were 30-day mortality and length of stay (LOS). Inclusion began on December 3rd 2020 with BAM monotherapy, changed to BAM/E combination on March 27, 2021, and included patients until April 19th 2021. In spring 2021, Michigan experienced a surge of COVID-19 with more cases per capita than any other state resulting in a large sample of real-world patients for analysis.Results643 patients received mAb (294 in BAM group and 349 in BAM/E group). Patients in the BAM/E cohort were younger and more obese with lower rates of diabetes, myocardial infarction, and cancer. Other characteristics were similar (Table 1). BAM/E patients had longer time from symptom onset to infusion (6 vs 4 days, p< 0.001). COVID-19 related 30-day hospitalization rates did not differ between groups (7.8 vs 7.2%, p=0.751). LOS and 30-day mortality (1% vs 0.3%, p=0.238) were also similar (Table 2). Patients in the BAM/E cohort were younger and more obese with lower rates of diabetes, myocardial infarction, and cancer. Other characteristics were similar BAM/E patients had longer time from symptom onset to infusion (6 vs 4 days, p<0.001). COVID-19 related 30-day hospitalization rates did not differ between groups. Length of stay and 30-day mortality were also similar.ConclusionRates of hospitalization in our study were higher than in clinical trials of mAB and may reflect differences in study populations (Table 3). Compared to other real-world studies, our cohort of young, obese, and Black patients, had similar hospitalization rates of 7.5%. The lack of difference in outcomes noted among the mAB formulations in our study may be related to longer time from symptom onset to infusion in the BAM/E combination group. Our patients were older with higher rates of obesity and other comorbidities than those in clinical trials (shown in orange). Compared to other real-world studies (in blue), our cohort of younger, more obese Black patients had similar hospitalization rates of 7.5%.Disclosures All Authors: No reported disclosures

A Market Basket Assessment: Prices and Availability of Healthy Foods Across SNAP-Authorized Food Outlets in Counties With High Obesity Rates in Mississippi.

IntroductionThe Mississippi Delta is predominantly rural and ranks among the US regions with the highest obesity rates. Throughout the US, rural and low-income communities have limited access to healthy foods. Given the interrelation between the quality of the food environment and the healthfulness of diets and obesity rates, the food environment is an important public health concern in these communities.MethodsWe conducted a retail assessment in July 2019 in the Delta region of Mississippi and evaluated prices and availability of healthy foods at Supplemental Nutrition Assistance Program–accepting retail establishments using the validated Market Basket Assessment Tool. We used regression analysis to identify differences in prices and availability of healthy foods across food retail formats.ResultsThe healthy foods availability and quality score for convenience stores, which comprise the highest proportion of store formats in the region, was 70% lower than for supermarkets. Compared with the prices at supermarkets, the prices at convenience stores were 48% higher for grains, 35% higher for fruit and vegetables, 73% higher for meats, and 95% higher for beans, seeds, and nuts. The healthfulness of foods available at dollar stores was also lower than the healthfulness at supermarkets, but prices were generally similar.ConclusionThe availability of supermarkets and grocery stores was limited in the study area, but the concentration of convenience stores was high. Overall, access and affordability of healthy foods were restricted in the counties studied; these findings are useful for intervention development.

Clinical implication of preoperative psoas muscle area in endometrial cancer patients.

Obesity is a significant risk factor for endometrial cancer. In contrast, sarcopenia describes a loss of the body's muscle mass that is closely related to unfavorable clinical outcomes. Even endometrial cancer patients have high rates of obesity, and they should have a significantly higher risk for undiagnosed sarcopenia or fragile muscle quality. This is a retrospective study that included an endometrial cancer database collected from a tertiary gynecologic cancer center. We investigated the relationship between preoperative psoas muscle area by magnetic resonance imaging, surgical outcomes and pathological features. The study included 116 patients, the mean height was 160 cm (Standart deviation 7), weight was 72 kg (Standart deviation 18), and the median duration of hospitalization was 4 days (Interquartile range 2-9) in the whole study group. Sarcopenia was diagnosed in 25 (21.6%) patients, according to the magnetic resonance imaging findings. Three (6.5%) obese patients had sarcopenia, but it was 31.4% in nonobese patients (p=0.026). The median duration of hospitalization was five days (3-9 days) in the sarcopenia group, and it was four days (2-7 days) in the non-sarcopenia group. Sarcopenic patients did not have increased surgical complication rates following uterine cancer surgery. We should be aware of hospitalization duration in those patients, and sarcopenic counterparts necessitate longer follow-up after the surgery.

The prevalence of diabetic cardiomyopathy in the urban and rural areas in Malaysia

Diabetic cardiomyopathy (DCM) is defined as the presence of specific cardiac manifestations that lead to heart failure in a diabetic in the absence of significant coronary artery disease and valvular disease. It affects between 16.9 and 74% of diabetics. The prevalence of DCM is not known in Malaysia. Being a nation with the highest rate of obesity in South East Asia, knowledge of its prevalence may help project a plan for better healthcare management and health outcome. Objective: To determine the prevalence of DCM in the Malaysian cohort.