Lifestyle Weight Management Research Articles

Clinical and Angiographic Profiles of Myocardial Infarction in a Young South Indian Population.

Introduction Myocardial infarction (MI) in young South Indians presents a shifting epidemiological landscape, challenging traditional perceptions of cardiovascular diseases. This study investigates the clinical and angiographic profiles of MI in this subgroup of the population in detail, emphasizing the interaction between lifestyle, environmental, and genetic factors that contribute to the incidence of MI in younger people. Methodology Utilizing a descriptive observational design, the study analyzed data from 70 young adults (aged 18-45 years) admitted to Frontier Lifeline Hospital, Chennai, with acute MI over six months. Patient demographics, clinical characteristics, and angiographic findings were collected and analyzed using standardized protocols. Statistical analysis employed chi-square tests and subgroup analyses to assess associations and differences between diabetic and non-diabetic patients. Results The study revealed a predominance of males (84.29%) among MI cases, with ST-elevation myocardial infarction (STEMI) being the most common presentation (52.86%). Anterior wall involvement was prevalent (50%), and left ventricular systolic dysfunction (LVSD) was observed in the majority (67%) of patients. Chest pain (87%) was the predominant symptom, and diabetes (47%) and hypertension (47%) were the risk variables that were most common. Angiographically, the left anterior descending artery (LAD) was often affected (51%), with single-vessel disease predominating (41.43%). Conclusion The findings underscore the significance of early detection and intervention strategies for MI in young South Indians. Gender-specific risk assessment, prompt diagnosis, and tailored treatment approaches are imperative. The high prevalence of LVSD highlights the burden of cardiac morbidity, particularly in diabetic individuals. Lifestyle modifications and weight management interventions are crucial for MI prevention. This study provides insights into the frequency and features of MI in young South Indians, emphasizing the importance of collaborative efforts for early identification and control of modifiable risk factors to mitigate the burden of coronary artery disease (CAD) in this population subset.

Outcomes of a Two-Year Online Dietary and Lifestyle Weight Management Program: EMPOWER

Outcomes of a Two-Year Online Dietary and Lifestyle Weight Management Program: EMPOWER

Engineering Virtuous health habits using Emotion and Neurocognition: Flexibility for Lifestyle Optimization and Weight management (EVEN FLOW)

Interventions to preserve functional independence in older adults are critically needed to optimize ‘successful aging’ among the large and increasing population of older adults in the United States. For most aging adults, the management of chronic diseases is the most common and impactful risk factor for loss of functional independence. Chronic disease management inherently involves the learning and adaptation of new behaviors, such as adopting or modifying physical activity habits and managing weight. Despite the importance of chronic disease management in older adults, vanishingly few individuals optimally manage their health behavior in the service of chronic disease stabilization to preserve functional independence. Contemporary conceptual models of chronic disease management and health habit theory suggest that this lack of optimal management may result from an underappreciated distinction within the health behavior literature: the behavioral domains critical for initiation of new behaviors (Initiation Phase) are largely distinct from those that facilitate their maintenance (Maintenance Phase). Psychological factors, particularly experiential acceptance and trait levels of openness are critical to engagement with new health behaviors, willingness to make difficult lifestyle changes, and the ability to tolerate aversive affective responses in the process. Cognitive factors, particularly executive function, are critical to learning new skills, using them effectively across different areas of life and contextual demands, and updating of skills to facilitate behavioral maintenance. Emerging data therefore suggests that individuals with greater executive function are better able to sustain behavior changes, which in turn protects against cognitive decline. In addition, social and structural supports of behavior change serve a critical buffering role across phases of behavior change. The present review attempts to address these gaps by proposing a novel biobehavioral intervention framework that incorporates both individual-level and social support system-level variables for the purpose of treatment tailoring. Our intervention framework triangulates on the central importance of self-regulatory functioning, proposing that both cognitive and psychological mechanisms ultimately influence an individuals’ ability to engage in different aspects of self-management (individual level) in the service of maintaining independence. Importantly, the proposed linkages of cognitive and affective functioning align with emerging individual difference frameworks, suggesting that lower levels of cognitive and/or psychological flexibility represent an intermediate phenotype of risk. Individuals exhibiting self-regulatory lapses either due to the inability to regulate their emotional responses or due to the presence of executive functioning impairments are therefore the most likely to require assistance to preserve functional independence. In addition, these vulnerabilities will be more easily observable for individuals requiring greater complexity of self-management behavioral demands (e.g. complexity of medication regimen) and/or with lesser social support. Our proposed framework also intuits several distinct intervention pathways based on the profile of self-regulatory behaviors: we propose that individuals with intact affect regulation and impaired executive function will preferentially respond to ‘top-down’ training approaches (e.g., strategy and process work). Individuals with intact executive function and impaired affect regulation will respond to ‘bottom-up’ approaches (e.g., graded exposure). And individuals with impairments in both may require treatments targeting caregiving or structural supports, particularly in the context of elevated behavioral demands.

THU651 Testosterone Treatment And Sexual Function In Men With Or At Risk Of T2D: The T4DM Study

Abstract Disclosure: G.A. Wittert: Advisory Board Member; Self; Bayer Schering Pharma. Speaker; Self; Bayer Schering Pharma, Besin. K. Robledo: None. M. Grossmann: None. B.B. Yeap: Advisory Board Member; Self; Bayer Schering Pharma. Grant Recipient; Self; Bayer Schering Pharma, Lawley. B.G. Stuckey: None. W.J. Inder: None. K. Bracken: None. D.R. Jesudason: None. C.A. Allan: None. D.J. Handelsman: None. Background: In T4DM (men aged 50 – 74 yrs., waist circumference (WC) ≥95cm cm, prediabetes, or newly diagnosed type 2 diabetes (T2D) and serum testosterone (T) ≤ 14 nmol/L), 2 years treatment with T-undecanoate (1000 mg IM 3 monthly) vs placebo while enrolled in a lifestyle weight management program, decreased fat mass, and reduced the risk of T2D by 40%. Aim: To determine baseline predictors and T treatment effects on sexual function (SF) over time, including interactions with changes in waist circumference (WC), blood pressure (BP), glucose and mood. Methods: Adjusting for baseline sociodemographic, clinical parameters and serum sex steroid (LCMS) concentrations, linear mixed effects models were fitted to assess T treatment effects on measures of SF (erectile function (EF), sexual desire (SD), orgasmic function (OF), intercourse satisfaction (IS) and overall satisfaction (OS) via questionnaire (IIEF)) completed by each participant at baseline and weeks 30, 54, 78, and 102, together with WC, BP, glucose, trough T, estradiol (E), T:E ratio and mood (Center for Epidemiologic Studies Depression Scale (CES-D) at weeks 0, 54 and 102. Results Among men on T (504) or placebo (503) at baseline, age was inversely associated with all SF scales (p <0.001), and WC and CES-D score inversely associated with EF (p=0.041) and SD (p=0.029). There was no effect of baseline T, E or T:E ratio on SF. T treatment improved all SF measures (p<0.001) peaking at 30-54 weeks). The T treatment effect on SD and OF (both p-int=0.014) was greater in older men. Increasing WC over time was inversely associated with EF (p=0.036) and SD (p=0.043) scores, with no interaction with T treatment. SF scores were unaffected by changes in glucose, BP, or trough T, E or T:E ratio. Increase in depression scores corresponded to decreases in all SF scores (p <0.001). T treatment increased SD more in those with higher depression scores (p int=0.026) while not affecting the CES-D scores. Conclusion: Baseline age, WC, and depression scores, but not T were inversely associated with SF measures which improved with T treatment regardless of baseline T, E, or T:E ratio. T treatment improved SD and OF more in older men, and SD in those with more depressive symptoms. Change in WC was inversely associated with EF and SD, independent of T treatment. A pharmacological effect of T treatment to improve SF, particularly in older and depressed men, coexists with benefits from reduced central adiposity. Presentation: Thursday, June 15, 2023

Design and methods of a translational, community-based, lifestyle weight management pilot intervention trial in breast cancer survivors with overweight or obesity

BackgroundBreast cancer survivors (BCS) with overweight or obesity are at heightened risk of cancer recurrence, cardiometabolic disease, and compromised quality of life. Given the prevalence of significant weight gain during and following breast cancer treatment, there is growing recognition of the need to develop efficacious, widely-accessible, weight management programs for BCS. Unfortunately, access to evidence-based weight management resources for BCS remains limited and little is known of the optimal theoretical basis, program components, and mode of delivery for community-based interventions. The primary aim of the Healthy New Albany Breast Cancer (HNABC) pilot trial was to determine the safety, feasibility, and preliminary efficacy of delivering a translational, evidence-based, and theory-driven lifestyle weight management intervention to BCS with overweight or obesity in the community setting. MethodsHNABC was a single-arm, pilot trial evaluating a 24-week, multi-component intervention leveraging exercise, dietary modification, and group-mediated cognitive behavioral (GMCB) counseling components designed to facilitate lifestyle behavior change and promote sustained independent adherence. Assessments of various objectively-determined and patient-reported outcomes and theory-derived determinants of behavioral adoption and maintenance were obtained at baseline, 3- and 6-month follow-up. Measures of trial feasibility were calculated prospectively throughout the study. ConclusionFindings from the HNABC pilot trial will provide evidence demonstrating the feasibility and preliminary efficacy of a multi-component, community-based, GMCB lifestyle weight management intervention for BCS. Results will inform the design of a future, large-scale, randomized controlled efficacy trial. If successful, this approach could offer a widely accessible, community-based intervention model for weight management programs in BCS.

Joint pain and mobility

This workshop discussed the diagnosis of developmental joint disease and degenerative conditions in dogs and cats, and looked at a multimodal approach to managing pain caused by these conditions, which involves surgery, pain medication, physical therapy, exercise and lifestyle modifications, weight management and joint supplements. It also considers how best to help owners manage these conditions.

Barriers and enabling factors in weight management of patients with nonalcoholic fatty liver disease: A qualitative study using the COM-B model of behaviour.

Nonalcoholic fatty liver disease (NAFLD) is a global public health problem. Lifestyle modifications aimed at promoting weight loss and weight maintenance remain the current first-line treatments for NAFLD. We aim to identify barriers and enabling factors in weight management among patients with NAFLD using the capability, opportunity, motivation, behaviour (COM-B) model of behaviour. This study adopted a qualitative design using semistructured interviews analysed with content analysis and the COM-B framework. Interviews were conducted with 27 patients with NAFLD who experienced successful or unsuccessful weight reduction. Our study included 27 participants: 15 participants with successful weight loss (successful weight loss refers to a decrease in body weight ≥7% of the initial body weight for patients with NAFLD) and 12 participants with unsuccessful weight loss. Thirty-five themes (19 barriers and 16 facilitators) were mapped onto the COM-B model as barriers and facilitators to weight management among patients with NAFLD. The key barriers were lack of time and energy, lack of awareness of weight, lack of attention to NAFLD, treating food as a reward or compensation and social entertainment. The key facilitators were having basic weight loss knowledge and skills, strong motivation, attention to NAFLD, unsuccessful weight loss experiences and positive feedback from phased success. In addition to identifying factors consistent with existing studies, this study identified factors that influence weight management in NAFLD patients, such as basic weight loss skills and rational thinking before weight loss, which were not previously reported. This has clinical implications for clinical healthcare providers and health management services for the improvement of education and support regarding lifestyle improvement and weight management in patients with NAFLD. We recruited potential participants from the Bariatric Clinic, Hepatology Clinicand Physical Examination Center of hospitals between March 2021 and October 2021. Twenty-seven patients with NAFLD who had successful or unsuccessful weight loss experiences participated in the study and responded to questions on weight management.

Changes In Self-Determination Constructs Among Breast Cancer Survivors Participating In A Community-Based Lifestyle Weight Management Program

Changes In Self-Determination Constructs Among Breast Cancer Survivors Participating In A Community-Based Lifestyle Weight Management Program

Barriers and enablers of weight management after breast cancer: a thematic analysis of free text survey responses using the COM-B model

BackgroundWeight gain is common after breast cancer. The aim of this study was to identify and describe the barriers to and enablers of successful weight management for women with breast cancer.MethodsThis was a combined inductive and deductive framework analysis of free text responses to an anonymous cross-sectional survey on weight after breast cancer. Women were recruited mainly through the Breast Cancer Network Australia Review and Survey Group. We applied deductive thematic analysis to free text responses to questions on barriers, enablers, research priorities, and one open-ended question at the end of the survey using the Capability, Opportunity, Motivation and Behaviour (COM-B) model as a framework. Subthemes that arose from the inductive analysis were mapped onto the COM-B model framework. Findings were used to identify behaviour change intervention functions.ResultsOne hundred thirty-three women provided free text responses. Most women were of Caucasian origin and had been diagnosed with non-metastatic breast cancer, with a mean age of 59.1 years. Women's physical capability to adopt and sustain healthy lifestyle habits was significantly affected by treatment effects and physical illness, and some lacked psychological capability to self-regulate the face of stress and other triggers. Limited time and finances, and the social impact of undergoing cancer treatment affected the ability to control their diet. Frustration and futility around weight management were prominent. However, some women were confident in their abilities to self-regulate and self-monitor lifestyle behaviours, described support from friends and health professionals as enablers, and welcomed the physical and psychological benefits of being active in the context of embracing transformation and self-care after cancer.ConclusionWomen need specific advice and support from peers, friends and families and health professionals. There is a substantial gap in provision of supportive care to enable women to adopt and sustain healthy lifestyles. Environmental restructuring (including financial support), incentivization (creating an expectation of looking and feeling better), persuasion and coercion (aiming to prevent recurrence), and equipping women with specific knowledge and skills, would also facilitate optimal lifestyle behaviours and weight management.

Obesity in Pediatric Transplant and the Use of Liraglutide

<h3>Introduction</h3> Obesity and metabolic disorders are associated with increased mortality post heart transplant. We report the case of a 17-year-old female with obesity pre and post transplant obesity whose body mass index (BMI) and metabolic profile improved with the GLP-1 analog, liraglutide. <h3>Case Report</h3> AG is a 17 year-old diagnosed with Dannon syndrome, an X-linked disorder, characterized by a triad of arrhythmia, muscle weakness and cardiomyopathy. Due to progressive decline in ventricular systolic function, she underwent heart transplantation. Her weight was 106.4 kg and BMI 34.35 kg/m² at the time of transplant. Post-transplant, despite healthy lifestyle recommendations, weight management and nutrition clinics, AG's hyperphagia persisted and her BMI continued to increase. AG was started on liraglutide and she lost 17kg over 6 months (Fig. 1). Her BMI improved from 38 kg/m² to 32 kg/m². Her HgbA1c normalized and lipid profile also improved. AGs only complaint was of nausea and vomiting however these symptoms were related to her immunosuppression medications and improved after adjusting her regimen. <h3>Summary</h3> Use of behavioral interventions to improve BMI pre- and post-transplant is of limited success in lowering BMI. The U.S. Food and Drug Administration approved liraglutide for chronic weight management among patients aged 12 and older with obesity. Liraglutide, a long-acting analog of human glucagon-like peptide-1, increases glucose-dependent insulin secretion, decreases inappropriate glucagon secretion, increases B-cell growth/replication, and slows gastric emptying. This case demonstrated successful use of liraglutide to aid in weight loss in a post-transplant pediatric patient. Among motivated patients who maintain good communication with their clinician and adhere to a multidisciplinary approach, this regimen can improve previously unattainable weight loss goals. Close monitoring for side effects is crucial especially in populations where confounding regimens may require dose adjustments.

Lifestyle Interventions and Weight Management in Systemic Lupus Erythematosus Patients: A Systematic Literature Review and Metanalysis.

BackgroundWe aimed to identify and describe different types of lifestyle interventions primarily or secondarily focused on weight loss in SLE patients.MethodsA systematic search of controlled trials published until June 2021 that assigned adults patients after dietary or exercise intervention resulted in 248 studies initially screened.ResultsSix studies with seven interventions (3 dietary and 4 exercise training programs) fulfilled the eligibility criteria and were included in the meta-analysis with a median of age 35.8 (31.3 to 49.0 years); median of BMI 26.6 (25.2 to 33.6 kg/m2). After six to twelve weeks of diet or exercise program, no differences were observed in body weight [-1.539 (-4.482 to 1.405) kg (CI 95%), p = 0.306]. Also, a subgroup analysis also revelated no body weight difference following dietary intervention [-3.561 (-9.604 to 2.481) kg (CI 95%), p = 0.248] or exercise intervention [-0.910 (-4.279 to 2.460) kg (CI 95%), p = 0.597].ConclusionThe results showed that different protocols of exercise intervention or diets were not effective to reduce body weight in patients with SLE. However, only one of the selected trials had a specific study design and protocol focusing on weight loss management.

Exploring Health in the UK Biobank: Sociodemographic, Psychosocial, Lifestyle and Environmental Factors

A greater understanding of factors associated with favourable health may help increase longevity and healthy life expectancy. We examined sociodemographic, psychosocial, lifestyle, and environmental exposures associated with multiple health indicators. The UK Biobank study recruited >500,000 participants, aged 37-73, between 2006–2010. Health indicators examined were 81 cancer and 443 non-cancer illnesses used to classify participants by health status; long-standing illness; and self-rated health. Exposures were sociodemographic (age, sex, ethnicity, education, income and deprivation), psychosocial (loneliness and social isolation), lifestyle (smoking, alcohol intake, sleep duration, BMI, physical activity and stair climbing) and environmental (air pollution, noise and residential greenspace) factors. 307,378 participants (mean age = 56.1 years [SD = 8.07], 51.9% female) were selected for cross-sectional analyses. Low income, being male, neighbourhood deprivation, loneliness, social isolation, short or long sleep duration, low or high BMI and smoking was associated with poor health. Walking, vigorous-intensity physical activity and more frequent alcohol intake was associated with good health. There was some evidence that airborne pollutants (PM2.5, PM10, and NO2) and noise (Lden) were associated with poor health, though findings were not consistent across all models. Our findings highlight the multifactorial nature of health, the importance of non-medical factors, such as loneliness, healthy lifestyle behaviours and weight management, and the need to examine efforts to improve health outcomes of individuals with low income.

Racial and weight discrimination associations with pain intensity and pain interference in an ethnically diverse sample of adults with obesity: a baseline analysis of the clustered randomized-controlled clinical trial the goals for eating and moving (GEM) study

BackgroundEveryday experiences with racial (RD) and weight discrimination (WD) are risk factors for chronic pain in ethnically diverse adults with obesity. However, the individual or combined effects of RD and WD on pain in adults with obesity is not well understood. There are gender differences and sexual dimorphisms in nociception and pain, but the effect of gender on relationships between RD, WD, and pain outcomes in ethnically diverse adults with obesity is unclear. Thus, the purposes of this study were to: 1) examine whether RD and WD are associated with pain intensity and interference, and 2) explore gender as a moderator of the associations between RD, WD, and pain.MethodsThis is a baseline data analysis from a randomized, controlled clinical trial of a lifestyle weight-management intervention. Eligible participants were English or Spanish-speaking (ages 18–69 years) and had either a body mass index of ≥30 kg/m2 or ≥ 25 kg/m2 with weight-related comorbidity. RD and WD were measured using questions derived from the Experiences of Discrimination questionnaire (EOD). Pain interference and intensity were measured using the PROMIS 29 adult profile V2.1. Linear regression models were performed to determine the associations between WD, RD, gender, and pain outcomes.ResultsParticipants (n = 483) reported mild pain interference (T-score: 52.65 ± 10.29) and moderate pain intensity (4.23 ± 3.15). RD was more strongly associated with pain interference in women (b = .47, SE = .08, p < 001), compared to men (b = .14, SE = .07, p = .06). Also, there were no significant interaction effects between RD and gender on pain intensity, or between WD and gender on pain interference or pain intensity.ConclusionsPain is highly prevalent in adults with obesity, and is impacted by the frequencies of experiences with RD and WD. Further, discrimination against adults with obesity and chronic pain could exacerbate existing racial disparities in pain and weight management. Asking ethnically diverse adults with obesity about their pain and their experiences of RD and WD could help clinicians make culturally informed assessment and intervention decisions that address barriers to pain relief and weight loss.Trial registrationNCT03006328

Prevalence of Selected Risk Factors for Cardiometabolic Disease among University Staff in the Western Cape, South Africa

Introduction: This study aimed to determine the prevalence of selected risk factors for cardiometabolic disease among university staff at the University in the Western Cape, Cape Town, South Africa. The secondary objective was to examine the association between the indicators of obesity and CMD risk factors. Methods: A total of 73 (men = 20 (27.4%); women = 53 (72.6%)) healthy university staff members, which include academics, administrators, and support staff, with a mean age of 39.2 years partook in the study. Anthropometric and physiological variables were assessed and analysed. Results: The categorisation of body mass index showed that 35% and 45.3% of men and women were obese, respectively. The prevalence of central obesity and waist-to-height ratio (WHtR) showed that 25% of men and 60.4% of women were at a high risk of developing a CMD, while 25% and 71.7% of men and women were at high risk for waist-to-hip ratio (WHR), respectively. The prevalence of hypertension revealed that 35% and 20.8%, 5% and 17%, and 15% and 9.4% of men and women had elevated hypertension (stage I) and hypertension (stage II) status, respectively. Furthermore, 25% and 35.8%, and 5% and 11.3% of men and women were pre-diabetic and diabetic, respectively, while for total cholesterol levels, 40% and 34%, and 15% and 15.1% of men and women were at borderline high and high risk, respectively. Conclusion: There was a high prevalence of selected cardiometabolic disease risk factors among university staff that requires urgent intervention. Lifestyle modification, weight management, and wellness programmes focusing on health education, regular physical activity participation, and a healthy diet should be prioritized.

Obstructive sleep apnoea and 12-month weight loss in adults with class 3 obesity attending a multidisciplinary weight management program

BackgroundAlthough there is a strong association between obesity and obstructive sleep apnoea (OSA), the effects of OSA and CPAP therapy on weight loss are less well known. The aim of this study in adults with class 3 obesity attending a multidisciplinary weight management program was to assess the relationship between OSA and CPAP usage, and 12-month weight change.MethodsA retrospective cohort study of all patients commencing an intensive multidisciplinary publicly funded weight management program in Sydney, Australia, between March 2018 and March 2019. OSA was diagnosed using laboratory overnight sleep studies. Demographic and clinical data, and use of CPAP therapy was collected at baseline and 12 months. CPAP use was confirmed if used ≥4 h on average per night on download.ResultsOf the 178 patients who joined the program, 111 (62.4 %) completed 12 months in the program. At baseline, 63.1 % (n=70) of patients had OSA, of whom 54.3 % (n=38) were using CPAP. The non-OSA group had more females compared to the OSA with CPAP group and OSA without CPAP group (90.2 % vs. 57.9 % and 62.5 %, respectively; p=0.003), but there were no significant baseline differences in BMI (50.4±9.3 vs. 52.1±8.7 and 50.3±9.5 kg/m2, respectively; p=0.636). There was significant weight loss across all three groups at 12 months. However, there were no statistically significant differences across groups in the percentage of body weight loss (OSA with CPAP: 6.3±5.6 %, OSA without CPAP: 6.8±6.9 %, non-OSA: 7.2±6.5 %; p=0.844), or the proportion of patients who achieved ≥5 % body weight loss (OSA with CPAP: 57.9 %, OSA without CPAP: 59.4 %, non-OSA: 65.9 %; p=0.743). In patients with T2DM, there was a significant reduction in HbA1c from baseline to 12 months (7.8±1.7 % to 7.3±1.4 %, p=0.03), with no difference between groups (p=0.997).ConclusionsThis multidisciplinary weight management program resulted in significant weight loss at 12 months, regardless of OSA diagnosis or CPAP use in adults with class 3 obesity. Larger studies are needed to further investigate the effects of severity of OSA status and CPAP use in weight management programs. Until completed, this study suggests that the focus should remain on implementing lifestyle changes and weight management regardless of OSA status.

Exploring health in the UK Biobank: associations with sociodemographic characteristics, psychosocial factors, lifestyle and environmental exposures

BackgroundA greater understanding of the factors that are associated with favourable health may help increase longevity and healthy life expectancy. We examined sociodemographic, psychosocial, lifestyle and environmental exposures associated with multiple health indicators.MethodsUK Biobank recruited > 500,000 participants, aged 37–73, between 2006 and 2010. Health indicators examined were 81 cancer and 443 non-cancer illnesses used to classify participants' health status; long-standing illness; and self-rated health. Exposures were sociodemographic (age, sex, ethnicity, education, income and deprivation), psychosocial (loneliness and social isolation), lifestyle (smoking, alcohol intake, sleep duration, BMI, physical activity and stair climbing) and environmental (air pollution, noise and residential greenspace) factors. Associations were estimated using logistic and ordinal logistic regression.ResultsIn total, 307,378 participants (mean age = 56.1 years [SD = 8.07], 51.9% female) were selected for cross-sectional analyses. Low income, being male, neighbourhood deprivation, loneliness, social isolation, short or long sleep duration, low or high BMI and smoking were associated with poor health. Walking, vigorous-intensity physical activity and more frequent alcohol intake were associated with good health. There was some evidence that airborne pollutants (PM2.5, PM10 and NO2) and noise (Lden) were associated with poor health, though findings were not consistent across all models.ConclusionsOur findings highlight the multifactorial nature of health, the importance of non-medical factors, such as loneliness, healthy lifestyle behaviours and weight management, and the need to examine efforts to improve the health outcomes of individuals on low incomes.

242Exploring health in the UK Biobank: cross-sectional analyses of sociodemographic, psychosocial, lifestyle and environmental factors

Abstract Background Our aim was to examine sociodemographic characteristics, psychosocial factors, lifestyle and environmental exposures associated with health. Methods The UK Biobank recruited &amp;gt;500,000 participants, aged 37-73, between 2006-2010. Data on 81 cancer and 443 non-cancer illnesses were used to classify participants by insurance health status (non-standard risk/standard risk). Long-standing illness (yes/no) and self-rated health (poor/fair/good/excellent) constituted secondary outcomes. Logistic and ordinal regression models were fit to estimate associations between explanatory variables and health. Results 307,378 participants (mean age=56.1; 51.9% female) were selected for cross-sectional analyses. Low household income, high levels of neighbourhood deprivation, being male, loneliness and social isolation were associated with poor health. Walking frequency and engaging in vigorous-intensity physical activity were associated with positive health, whereas long sleep duration, high body mass index and smoking were associated with poor health. Alcohol intake less frequent than 1-2 times per week was associated with poor health. There was some evidence that high levels of airborne pollutants (PM2.5, PM10 and NO2) and noise (Lden) were associated with poor health, although findings were inconsistent once other factors had been adjusted for. Neighbourhood greenspace was associated with positive self-rated health. Conclusions Public health could put greater focus on non-medical factors such as loneliness, further encourage healthy lifestyle behaviours and weight management, and examine efforts to improve health outcomes of individuals in the lowest income groups. Key message Multiple sociodemographic, psychosocial, lifestyle and environmental factors are associated with health.

Body dissatisfaction and disordered eating are prevalent problems among U.S. young people from diverse socioeconomic backgrounds: Findings from the EAT 2010–2018 study

PurposeBody dissatisfaction and disordered eating are linked to adverse health consequences. Research describing socioeconomic patterns in the prevalence of these problems is important for informing the design of health services and efforts to improve health equity. MethodsPopulation-based cohort study (EAT 2010–2018: Eating and Activity over Time) of socioeconomically and ethnically/racially diverse U.S. young people who completed surveys as adolescents in 2009–2010 (mean age = 14.5 years) and as emerging adults in 2018 (mean age = 22.0 years). Participants were recruited from 20 schools in Minneapolis-St. Paul, Minnesota. Household socioeconomic status was determined using adolescent report of parental education, employment, and public assistance benefits. Analyses were conducted using data from 1531 participants and regression models that accounted for repeated measures within individuals. ResultsAmong females, high body dissatisfaction and unhealthy weight control behaviors (e.g., skipping meals) were more prevalent and regular use of lifestyle weight management behaviors (e.g., exercise) was less prevalent in the low SES group as compared to the middle and/or upper SES groups (p ≤ .010). Among males, thinness-oriented dieting, unhealthy weight control behaviors, and extreme weight control behaviors (e.g., taking diet pills) were all more prevalent in the low SES group as compared to the middle and/or upper SES groups (p ≤ .010). Few differences were observed across SES groups in models that adjusted for ethnic/racial identity and body mass index. ConclusionsThere is a need for greater attention to the reach and relevance of efforts to prevent disordered eating and improve body satisfaction to ensure efforts benefit young people across SES groups.

Survivorship, Version 1.2021.

The NCCN Guidelines for Survivorship are intended to help healthcare professionals working with cancer survivors to ensure that each survivor's complex and varied needs are addressed. The Guidelines provide screening, evaluation, and treatment recommendations for consequences of adult-onset cancer and its treatment; recommendations to help promote healthful lifestyle behaviors, weight management, and immunizations in survivors; and a framework for care coordination. This article summarizes the recommendations regarding employment and return to work for cancer survivors that were added in the 2021 version of the NCCN Guidelines.

Preliminary efficacy of a community-based, group-mediated cognitive behavioral lifestyle intervention among breast cancer survivors.

e24035 Background: Post-treatment weight gain places breast cancer (BCa) survivors at heightened risk for cardiovascular disease, metabolic syndrome, and functional decline. Lifestyle weight management (LWM) interventions combining exercise and dietary weight loss represents an effective approach to mitigating the adverse cardiometabolic and functional effects frequently observed in BCa survivors. Unfortunately, community access to cost-effective, sustainable, LWM interventions among BCa survivors remains limited. The purpose of this study is to determine the preliminary efficacy of a community-based LWM intervention in BCa survivors on select body composition (BC), physical function, and social cognitive outcomes of the first wave of participants in the Healthy New Albany Breast Cancer (HNABC) pilot trial. Methods: The 24-week, community-based pilot trial promotes lifestyle behavior changes through a group-mediated cognitive behavioral (GMCB) approach driven by Social Cognitive Theory. The measures analyzed were BC done via Dual-energy X-ray Absorptiometry, physical function via the 400m walk test, and social cognitive outcomes via satisfaction with function and appearance and perceived competence with exercise and diet at 6-months via effect size calculations using Cohen’s d. Results: Meaningful changes were observed in fat mass ( d= -0.46), percent lean mass ( d= 0.33), lean mass ( d= -0.45), and physical function ( d= -0.59), some of which reached clinical relevance. Select self-reported outcomes also saw meaningful improvements from this LWM intervention. Conclusions: Findings from this study demonstrate the preliminary efficacy of implementing a GMCB-based LWM intervention among overweight or obese BCa survivors. Given the meaningful impact that successful weight management has on reducing risk for chronic diseases, these results highlight the utility of implementing a LWM intervention in the community for BCa survivors in an effort to extend the access, reach, and scalability of supportive care approaches during BCa survivorship.