Lower Rates Of Obesity Research Articles

Children in the Anthroposophical Education System Have Lower Rates of Obesity, and Higher Rates of Health Promoting Behaviors.

The anthroposophical philosophy is a holistic educational and lifestyle approach. Limited information exists on the health-promoting behavioral norms and obesity rates among children living anthroposophical vs. conventional lifestyles. This study aims to compare the prevalence of childhood obesity, and parents' perceptions of their children's food environment, between anthroposophical and conventional education systems. We performed a cross-sectional analysis of the National Anthropometric Measurement Survey for first grade students in Israel, comparing anthroposophical schools with matched conventional schools. Additionally, an online survey was distributed among parents of children in both school systems, assessing children's eating norms and dietary intake. Overweight and obesity rates were higher among students in conventional schools (n = 205,500) compared to anthroposophical schools (n = 2247) (11.2% vs. 9.6%, and 7.8% vs. 4.8%, respectively; Pv < 0.001). Anthroposophical schools were perceived by more parents to have health-promoting curricula, health promoting teacher behavior, and health promoting social dietary norms, while their children's dietary intake was perceived as healthier both in school and in the after-school, social, and familial environment (Pv < 0.001). Children in anthroposophical education exhibited lower overweight and obesity rates, and engaged in more health-promoting behaviors. Further research is needed to explore the relationship between the anthroposophical lifestyle and childhood obesity, and to identify effective anthroposophical strategies for health promotion among children.

Head and Neck Necrotizing Fasciitis: Abbreviated SOFA Score Associated With Death and Infection Spread.

Describe features unique to head and neck (H&N) necrotizing fasciitis (NF) compared to other anatomic regions and specify a prognostic score associated with death and descending necrotizing mediastinitis (DNM). Retrospective cohort. Tertiary care, level 1 trauma center. A single-institution database identified 399 confirmed cases of NF between 2006 and 2021, 33 of which involved the H&N. Patients with confirmed H&N NF were sorted into cohorts based on clinical outcomes, with the "poor" outcomes group defined by death and/or DNM. Thirty-three patients with H&N NF were included. Compared to NF of other regions, patients with H&N NF had a significantly lower mortality rate (6.06% vs 20.8%, p = .041) and significantly lower rates of obesity (27.3% vs 63.7%, p < .001) and hypertension (42.4% vs 60.9%, p = .038). Within the H&N group, there were 2 deaths (6.06%) and 8 cases of DNM (24.2%). Diabetes was associated with poor outcomes (p = .047), as was an abbreviated sequential organ failure assessment score for necrotizing fasciitis (nfSOFA) of 2 or greater (p = .015). H&N NF is unique among other forms of NF, with a lower mortality rate and lower rates of obesity and hypertension in affected patients. Within the H&N cohort, worse outcomes were associated with diabetes as well as a nfSOFA score of 2 or greater. Timely surgical debridement alongside broad-spectrum antibiotics remains the mainstay of treatment for NF; however, this simple prognostic score may play a role during the early stages of care for patients with H&N NF.

Evaluating disparities in pancreatic cancer outcomes in African Americans.

e18657 Background: Pancreatic Adenocarcinoma (PA) is a leading cause of cancer-related death across the world, with poorer outcomes observed in minority populations. The observed variation in outcomes has been attributed to delayed diagnosis, barriers to optimal treatment and health care related disparities. We sought to evaluate the impact of race on clinical presentation and outcomes in pancreatic cancer at a large academic teaching center. Methods: We performed a retrospective review of patients with pancreatic adenocarcinoma diagnosed between January 2016 to December 2021. The demographic characteristics (age, tobacco use, alcohol use, BMI); comorbidities (diabetes, acute/chronic pancreatitis); pathology, treatment (chemotherapy regimen, radiation, surgery) and progression free survival (PFS) based on race were analyzed. Results: The cohort (N = 983) consisted of 154 (16%) African Americans (AA) and 803 (82%) Non-Hispanic Whites (NHW). The median age at diagnosis was 65 years (60, 70) among AA and 71 years (64, 78) in NHW. Thirty-seven (26%) of AA and 104 (14%) of NHW were current smokers; 46 (33%) of AA and 323 (45%) of NHW consumed alcohol regularly. Among AA, 32 (22%) were obese (BMI &gt; 30), compared to 194 (25%) in NHW. Other comorbidities included diabetes (35% in AA vs. 32% in NHW) and acute/chronic pancreatitis (11% among AA vs. 9% among NHW). The treatment modality consisted of chemotherapy (57% in AA vs. 61% in NHW), surgery (26% in AA vs. 27% in NHW) and radiation (10% in AA vs. 12% in NHW). The median time to treatment initiation was 24 (16, 41) months for AA and 34 (20, 56) months for NHW. On univariate analysis, AA race was associated with younger age at diagnosis (p 0.043), higher current tobacco use (p 0.001), lower alcohol use (p 0.012), lower rates of obesity (p 0.024) and higher rate of acute pancreatitis (p 0.037) in pancreatic cancer. On multivariate analysis, race was not associated with difference in progression free survival (12 months in AA vs. 14 months in NHW; p 0.96) when adjusted for age, sex, alcohol use, tobacco use, cancer stage and chemotherapy. Conclusions: Our study revealed that pancreatic cancer in AA was diagnosed at a younger age, associated with active smoking and pancreatitis. Although there was a shorter time to treatment initiation among AA, there was no significant difference in progression free survival compared to NHW when adjusted for other variables. Future studies incorporating novel biomarkers are needed to determine impact of racial health disparities on outcomes in pancreatic cancer.

Reviewing Publicly Available Reports on Child Health Disparities in Indigenous and Remote Communities of Australia.

Developing programs that ensure a safe start to life for Indigenous children can lead to better health outcomes. To create effective strategies, governments must have accurate and up-to-date information. Accordingly, we reviewed the health disparities of Australian children in Indigenous and remote communities using publicly available reports. A thorough search was performed on Australian government and other organisational websites (including the Australian Bureau of Statistics [ABS] and the Australian Institute of Health and Welfare [AIHW]), electronic databases [MEDLINE] and grey literature sites for articles, documents and project reports related to Indigenous child health outcomes. The study showed Indigenous dwellings had higher rates of crowding when compared to non-Indigenous dwellings. Smoking during pregnancy, teenage motherhood, low birth weight and infant and child mortality were higher among Indigenous and remote communities. Childhood obesity (including central obesity) and inadequate fruit consumption rates were also higher in Indigenous children, but Indigenous children from remote and very remote areas had a lower rate of obesity. Indigenous children performed better in physical activity compared to non-Indigenous children. No difference was observed in vegetable consumption rates, substance-use disorders or mental health conditions between Indigenous and non-Indigenous children. Future interventions for Indigenous children should focus on modifiable risk factors, including unhealthy housing, perinatal adverse health outcomes, childhood obesity, poor dietary intake, physical inactivity and sedentary behaviours.

Obesity in Sexual and Gender Minority Populations: Prevalence and Correlates.

The purpose of this review is to explore the prevalence and correlates of obesity among members of sexual and gender minority (SGM) populations. Research overall finds higher rates of obesity among lesbian and bisexual women than heterosexual women, lower rates of obesity among gay and bisexual men than heterosexual men, and inconsistent findings on obesity among transgender individuals. Rates of mental health disorders and disordered eating are high among all SGM groups. Rates of comorbid medical conditions differ among groups. More research needs to be conducted within all SGM groups but particularly among transgender populations. All members of SGM encounter stigma, including when seeking healthcare, and this may lead to individuals avoiding healthcare. Therefore, it is important to educate providers about population-specific factors. This article serves as an overview of important considerations for providers treating individuals within SGM populations.

Pediatric Obstructive Sleep Apnea and Sickle Cell Disease: Demographic and Polysomnographic Features.

Obstructive sleep apnea (OSA) is prevalent in children with sickle cell disease (SCD). We compared the demographic, clinical, and polysomnographic characteristics of children with and without SCD. This retrospective chart review included children with SCD (n=89) and without SCD (n=192) ages 1-18 years referred for polysomnography (PSG) for OSA. Children with SCD were predominantly African American when compared to the non-SCD group (95% vs. 28%, p < 0.001). The non-SCD group had a higher BMI z-score (1.3 vs. 0.1, p < 0.001) and a higher percentage of patients classified as obese (52% vs. 13%, p < 0.001). In children with SCD, 43% had severe OSA and 5.6% had no OSA. In the non-SCD group, 67% had severe OSA and 4.7% had no OSA. The SCD compared to the non-SCD group had a lower mean apnea-hypopnea index (AHI) (13.6 vs. 22.4, p=0.006) but a higher percent sleep time below 90% oxygen saturation (10.5% vs. 3.5%, p < 0.001). Predicted probability for severe OSA in children with SCD decreased with increasing age (OR=0.81, 95% CI: 0.70-0.93). Children with SCD referred for PSG are at risk for severe OSA. Compared with the non-SCD group, most children were African American with lower rates of obesity and lower AHIs but longer periods of nocturnal hypoxemia. Likelihood for severe OSA decreased with increasing age for the SCD group. 3, retrospective comparative study Laryngoscope, 133:1766-1772, 2023.

Parental Ethnicity and Adolescent Development: Evidence from a Nationally Representative Dataset.

Adolescent developmental outcomes can vary significantly by differences in ethnicity. While previous studies have examined the impacts of adolescents' own ethnicity on their development, little research has been conducted about the impacts of the ethnicity of both parents as an important family background factor which is likely to expose adolescents to a variety of growth environments. Using nationally representative data from the China Family Panel Studies (CFPS) surveys, we examine the relationship between parental ethnicity (including both monoethnic families and interethnic families with intermarried Han and ethnic minority groups) and adolescent developmental outcomes, measured by academic performance, cognitive development, and health. Our results show that adolescents with interethnic parents had higher scores in literacy and mathematics tests than those of monoethnic non-Han parents, but their scores were not statistically significantly different from those in monoethnic Han families. Adolescents with interethnic parents also performed better in fluid intelligence assessments and had lower obesity rates than those with monoethnic ethnic minority parents. Our results further suggest that socioeconomic status, parental education, and education expectations partially mediate the association between interethnic parents and adolescent development. Moreover, parental ethnic composition acts as a potential moderator that influences the effects of parents' non-agricultural work on adolescent development. Our study expands the growing body of empirical evidence on the relationship between parental ethnicity and adolescent development and is conducive to policy recommendations for interventions in the development of adolescents with ethnic minority parents.

Comparison of clinical outcomes of intensive care patients with COVID-19 pneumonia receiving and not receiving tocilizumab treatment

Aim: In patients with Coronavirus disease 2019 (COVID-19) infection, a situation called cytokine storm and an increase in proinflammatory cytokines such as interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-1 (IL-1) in the blood has been observed and it has been found that this is clinically related to the development of severe disease. Therefore, tocilizumab (TCZ) therapy that blocks IL-6 will reduce the immunological response and thus potentially harm caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aim of this study is to determine the effect of TCZ treatment on length of hospital stay, need for invasive mechanical ventilation and mortality in COVID-19 patients followed in the tertiary intensive care unit.Material and Method: This retrospective cross-sectional study was conducted among patients hospitalized with the diagnosis of COVID-19 pneumonia between 01.09.2020 and 01.01.21 in intensive care units. Data were analyzed and evaluated separately in patients who received and did not receive TCZ treatment. Patients older than 18 years of age, who were hospitalized for at least 24 hours with the diagnosis of COVID-19 pneumonia and needed ≥36 hours of oxygen therapy, were not referred to another health center, were included in this study. Pregnant and lactating women were not included in the study. Patients with missing at least one data in the parameters to be evaluated were excluded from the study. Patients treated with an IL-6 inhibitor other than TCZ were excluded.Results: After excluding patients who did not meet the inclusion criteria, 565 patients were included in the study. It was found that patients who received TCZ treatment after propensity score matching (PSM) had a significantly higher mean age (P&amp;lt;0.001) and lower obesity rates (P=0.002). There was no significant difference between the patients who received and did not receive TCZ treatment in terms of mechanical ventilation need, length of hospital stay and mortality (P=0.505, P=0.661, P=0.834).Conclusion: As a result of our research, it was seen that TCZ treatment did not affect the need for invasive mechanical ventilation, hospital and intensive care unit stay, and mortality.

PS-P13-1: DIFFERENTIAL MANAGEMENT OF HYPERTENSION AND DYSLIPIDAEMIA IN URBAN SOUTH AFRICANS BY GLYCAEMIC STATUS

Objective: Considering the sub-optimal care of hypertension and other cardiovascular disease risk factors (CVDRF), this study aimed to describe the management and associations of hypertension and dyslipidaemia in adults with known diabetes (KD), newly diagnosed diabetes (NDD) and normoglycaemia. Design and Method: In this population-based cross-sectional study, participants with KD, and those identified as high-risk for diabetes who subsequently underwent oral glucose tolerance tests, and were classified as NDD or normoglycaemia, were included. Data collection comprised administered interviews, clinical measurements, and biochemical analyses. Multiple logistic regressions determined the associations of sociodemographic and CVDRF with hypertension and dyslipidaemia detection, treatment and control in separate models. Results: Among 618 participants (82% women), aged 49–63 years, there were 339 participants with KD, 70 with NDD and 212 with normoglycaemia. KD participants were older, but had lower rates of obesity, smoking and alcohol use than their counterparts. Prevalence of hypertension (BP &gt; 140/90mmHg or on treatment) and dyslipidaemia (raised low-density lipoprotein cholesterol &gt; 3mmol/l or on treatment) was highest in known diabetes (89% and 83%) compared with NDD (64% and 74%) and normoglycaemia (66% for both) (p &lt; 0.001). Hypertension detection, treatment and control among participants with hypertension (n = 485) was higher in KD (97%, 88%, 74%) compared with NDD (89%, 69%, 44%) and normoglycaemia (80%, 60%, 46%) (all p &lt; 0.005). Dyslipidaemia detection, treatment and control among participants with dyslipidaemia (n = 471) was higher in KD (85%, 73%, 49%) compared with NDD (37%, 23%, 10%) and normoglycaemia (36%, 22%, 14%) (all p &lt; 0.001). Diabetes control was poor; only 20% of KD had HbA1c &lt; 7%. In the regression models, KD compared with normoglycaemia was associated with hypertension detection (OR:6.91, 95%CI:2.25–21.22) and control (OR:2.05, 95%CI:1.04–4.02,). KD compared with normoglycaemia was associated with dyslipidaemia detection (OR:10.29, 95%CI:5.21–20.32) and treatment (OR:3.94, 95%CI:1.68–9.27). Sociodemographic (age, gender, education, income, employment) and CVDRF (smoking, alcohol use, physical inactivity, obesity) were generally not associated with hypertension or dyslipidaemia management. Conclusions: Albeit that diabetes control was poor and requires better management, hypertension and dyslipidaemia prevalence were higher and better managed in KD than their counterparts, likely because of their regular contact with healthcare services for their diabetes management. Improved screening and management of cardiometabolic diseases are required for individuals at high-risk for diabetes, who may not be in regular contact with healthcare services.

Making History: The Academy and the White House Conference

The conference was moved forward by a bipartisan group led by U.S. Rep. Jim McGovern (Mass.), Sen. Mike Braun (Ind.), Sen. Corey Booker (N.J.) and the late Rep. Jackie Walorski (Ind.). In every session, from speaker after speaker and from conversations I had with other participants, I was so pleased to see a spirit of bipartisanship pervading the conference. It is clear to me that we, the people, can achieve the goals of the conference1The White HouseStatement by White House on National Strategy on Nutrition and Health. 2022.https://www.whitehouse.gov/briefing-room/statements-releases/2022/09/27/executive-summary-biden-harris-administration-national-strategy-on-hunger-nutrition-and-health/Date accessed: October 23, 2022Google Scholar by the target date of 2030 by working together across party lines. The White House Conference made clear what we Academy members already knew: Hunger has a huge impact on quality of life. Everyone needs to have access to good, healthy food. We cannot overcome this problem in silos; we must work together on everything from the food supply and agriculture to nutrition education of the public – including school meals. It is clear that current levels of reimbursements are not enough, there is not adequate equipment, and there is not enough nutrition education. Every time universal school meals were mentioned at the White House Conference, there was an unbelievable amount of applause from the audience. On the day following the White House Conference, the Academy held an online town meeting to reflect on the conference and update our members on what comes next. I noted the sad fact that the U.S. leads so many nations in cases of chronic disease and that there is a disproportionate number of people from underrepresented groups with preventable chronic conditions. Another takeaway from the White House Conference for me: the need to integrate nutrition and health. We have to connect the path from the doctor’s office to the hospital and to the community. Universal screening for food insecurity is a must: Assess who is the patient/client, what is their level of food security/ insecurity and then connect that prioritize their nutritional health. We can better make connections and serve our customers via increased reimbursement and nutrition counseling for obesity and diet-related diseases. We have been advocating for these services as part of the Treat and Reduce Obesity Act; TROA would “amend the Social Security Act to enable the Centers for Medicare and Medicaid Services to enhance beneficiary access to the most qualified existing Medicare providers of intensive behavioral therapy for obesity, resulting in decreased health care costs and lower obesity rates among older adults.”2Academy of Nutrition and DieteticsTreat and reduce obesity act.https://www.eatrightpro.org/-/media/eatrightpro-files/advocacy/legislation/issue-brief-troa2021_final.pdf?la=en&hash=DA1946BD29FA4E09C0CC8ED42DAF8B50CCCA86EDDate accessed: October 25, 2022Google Scholar So many wonderful ideas were presented at the White House Conference, and we already are seeing great things happen. In the weeks immediately following the Conference, I attended two follow-up meetings: the U.S. Department of Agriculture’s National Nutrition Security and Healthcare Summit; and the Industry Collective Commitments in Action conference, sponsored by FMI – The Food Industry Association and Tufts University. And groups of Academy members are coming together to see how they can be actively engaged in meeting the White House Conference’s goals. That is so important, because it is now time to take action. The White House asked national organizations to submit commitments to end hunger and increase healthful eating and physical activity by 2030. I am proud that our Academy has made a number of commitments to get it done:1.The Academy will accelerate efforts to diversify the allied health workforce, including the field of nutrition and dietetics.2.By leveraging the role of nutrition and dietetics professionals within different settings to achieve nutrition security, the Academy will advance efforts to bridge gaps in nutrition services from clinical care to the community.3.The Academy will advance efforts to increase access to healthy school meals for all students. Read much more detail about our commitments on eatrightPRO.org.3Academy of Nutrition and DieteticsAcademy Commitment to End Hunger and Improve Health.https://www.eatrightpro.org/news-center/member-updates/white-house-conference-on-hunger-nutrition-and-health/academy-commitment-to-end-hunger-and-improve-healthDate accessed: October 25, 2022Google Scholar My fellow members: The ball is in our court, exactly where it should be. I can’t wait to work together with you to achieve the White House Conference’s goals and the Academy’s commitments!

Prevalence and characteristics of obesity in patients with type-2 diabetes mellitus in primary care centers in Bahrain: A cross-sectional study.

Obesity is a complex health problem characterized by abnormal and excessive body weight. Globally, the epidemic of obesity is escalating, and today, around one-third of the world's adult population is overweight or obese. Obesity is a risk factor and a predictor of poor outcomes of diabetes. This study aimed to determine the prevalence and characteristics of obesity in adults with type-2 diabetes mellitus. This study was conducted at five primary care centers in Bahrain. Obesity was assessed using body mass index, while glycemic control status was assessed using glycated hemoglobin (HbA1c). Informed consent was obtained from all participants. Means and standard deviation were computed for continuous variables, while categorical variables were presented as frequencies and percentages. Student's t-test and Mann-WhitneyU test, as appropriate, were performed to determine statistical significance between two continuous variables. Chi-square or Fisher's Exact test were used to test for statistical significance for categorical variables. A total of 732 participants were included; the mean age was 58.4 ± 11.3 years. Hypertension was the most prevalent comorbidity (63.5%), followed by hyperlipidemia (51.9%). Most participants (59.8%) had HbA1c levels of more than 7%, 20.9% had HbA1c levels between 7% and 8%, and 38.9% had HbA1c levels of more than 8%. Of the cohort, 47.5% were obese and 35.0% were overweight. Obesity was significantly higher in Bahraini patients and females (P < 0.001). Lower obesity rates were observed among patients who exercised regularly (P < 0.001) and patients who followed diet control measures (P = 0.039). In addition, we found higher obesity rates were found in patients with uncontrolled diabetes (P = 0.004), hypertension (P = 0.032), and hyperlipidemia (P = 0.048). Obesity is prevalent among type-2 diabetic patients and is associated with poor glycemic outcomes. Thus, more efforts should be taken by physicians to address obesity in diabetic patients as it negatively impacts their glycemic control.

서울시 학교 주변의 식품환경과 청소년 식생활 및 비만 관련성

Objectives: The obesity rate among adolescents in Korea is continuously increasing. This study aimed to examine the relationship between dietary habits and obesity in Korean adolescents by focusing on the food environment around schools in Seoul. Methods: We used data from the 2020 Korea Youth Risk Behavior Survey and 2021 administrative data. In total, 7,691 middle and high school students from four regions in Seoul were included. Multilevel logistic regression analysis was performed to examine the effects of individual level and food environment factors around schools affecting adolescent obesity. Results: Adolescents in the southeastern region of Seoul had higher fruit intake and lower obesity rate compared to others. As a result of multilevel logistic regression analysis, sex and school had a significant effect on adolescent obesity in individual level factors. In school level factors, the number of convenience stores and fast food restaurants around the schools had a significant effect on adolescent obesity. Conclusion: The food environment around schools influenced adolescent dietary habits and obesity in that they spend most of their time in schools. Based on the results, there is need for ordinance enactment and promotion of related policies on improving the food environment around schools to form proper adolescent dietary habits and reduce Korean adolescent obesity.

The implementation of the sugar-sweetened beverage taxes in the UK: A review

Obesity is becoming a serious health issue that affects both industrialized and developing nations, having serious repercussions for societal food security. It is thought that taxing goods with an adverse effect on human health will boost government revenue while lessening the harm. A graduated sugar tax on sugary beverages is now being utilized in the UK to lower the sale of sugary beverages and thus lower obesity rates. Further adjustments are required because this policy may be impacted by industry pressure, tax design, and media engagement.

Trends in U.S. adolescent physical activity and obesity: A 20-year age-period-cohort analysis.

Adolescent obesity can lead to long-term health problems and is a topic of major concern in pediatric and broader medical and public health spheres. Numerous national and state-wide initiatives aimed at increasing physical activity and/or improving nutrition in this age group have assumed the goal of reducing the prevalence adolescent obesity. We assess trends in U.S. adolescent physical activity and body mass index between 1999 and 2019. Using data from the U.S. Youth Risk Behaviour Surveillance System, we analyse data from 144 544 14-to-18-year-old respondents. We use multilevel linear and logistic regression to perform age-period-cohort analyses attributing changes in physical activity and body mass index over time to these three sources. Age and period effects are strong in all outcomes studied. Physical activity consistently decreases with age across the study period. Age trends in obesity have reversed in recent years, with older adolescents now more likely to be have obesity than younger adolescents. Both female and Asian adolescents report less physical activity but lower rates of obesity than their male and non-Asian counterparts. The reversal of obesity trends by age with little change in physical activity over the study period suggests other lifestyle factors have changed over the study period to increase the prevalence of obesity in older adolescents.

The impact of urbanisation on the cardiometabolic health of Indigenous Brazilian peoples: a systematic review and meta-analysis, and data from the Brazilian Health registry

Indigenous Brazilian peoples have faced an unparalleled increase in the rate of cardiovascular diseases following rapid nutritional transition to more urban diets. We aimed to conduct a systematic review and meta-analysis to evaluate the association between urbanisation (including data from Amazon rainforest deforestation) and cardiometabolic risk factors and outcomes. In this systematic review and meta-analysis, we searched Pubmed, Embase, Web of Science, and Scopus for articles published in any language between the year 1950 and March 10, 2022. Studies conducted in Indigenous Brazilian adults that evaluated metabolic health were included. Data for deforestation was obtained by the Amazon Deforestation Monitoring Project. Cardiovascular mortality was obtained from the Brazilian Health registry. Two independent reviewers evaluated studies for risk of bias, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. The main outcomes assessed were the prevalence of obesity and related cardiometabolic risk factors among Indigenous Brazilian peoples and its association with urbanisation. Summary data were extracted from published reports for the meta-analyses. We calculated pooled estimates of the prevalence of each cardiometabolic outcome by using a random-effects model (DerSimonian-Laird method). This study is registered with the International Prospective Register of Systematic Reviews, CRD42021285480. 46 studies were identified, including a total of 20 574 adults from at least 33 Indigenous Brazilian ethnicities. Meta-analyses of the prevalence of obesity showed that there were higher rates of obesity (midwest region: 23% [95% CI 17-29]; and south region 23% [13-34]) and hypertension (south region: 30% [10-50]) in Indigenous peoples living in urban regions of Brazil, while the lowest rates of obesity (11% [95% CI 8-15]) and hypertension (1% [1-2]) were observed in those in the less urbanised (north) regions of Brazil. The prevalence of obesity was 3·5 times higher in participants living in urbanised Indigenous territories (28%) than in those living in lands with >80% native Amazon rainforest (8%). In meta-analyses that evaluated blood pressure level, there was no incremental change in blood pressure with ageing in Indigenous peoples who lived according to traditional lifestyle, in contrast to those living in urbanised regions. For Indigenous men with traditional lifestyles, systolic blood pressure changed from 109·8 mm Hg to 104·4 mm Hg between the youngest (<30 years) and the oldest (>60 years) age groups, and diastolic blood pressure changed from 69·8 mm Hg to 66·1 mm Hg. For Indigenous women with traditional lifestyles, systolic blood pressure was 100·0 mm Hg for the youngest age group with no changes for older age groups, and diastolic blood pressure was 62 mm Hg for the youngest age group with no changes for older age groups. For Indigenous men with urbanised lifestyles, systolic blood pressure changed from 117·3 mm Hg to 124·9 mm Hg between the youngest and the oldest age groups, and diastolic blood pressure changed from 72·7 mm Hg to 76·4 mm Hg. For Indigenous women with urbanised lifestyles, systolic blood pressure changed from 110·0 mm Hg to 116·0 mm Hg between the youngest and the oldest age groups, and diastolic blood pressure changed from 68·3 mm Hg to 74·0 mm Hg. For the years 1997 and 2019, the cardiovascular mortality rate in individuals living in the southeast region (the most urbanised) was 2·5 times greater than that observed in the north. Conversely, the incremental rise in cardiovascular mortality in the past two decades among Indigenous Brazilians living in the north or northeast (2·7 times increase) stands in stark contrast to the stable rates in those living in already urbanised regions. The macrosocial changes of Indigenous peoples' traditional ways of living consequent to urbanisation are associated with an increased prevalence of adverse cardiometabolic outcomes. These data highlight the urgent need for environmental policies to ensure the conservation of the natural ecosystem within Indigenous territories, as well as the development of socio-health policies to improve the cardiovascular health of Indigenous Brazilians peoples living in urban areas. None.

Abstract 12938: Intrathoracic Visceral Adiposity is Inversely Associated With Insulin Like Growth Factor Binding Protein 1: The Longenity Study

Introduction: Higher insulin-like growth factor binding protein 1 (IGFBP-1) level in serum has been variably associated with better insulin sensitivity and lower rates of obesity, diabetes mellitus, and atherosclerosis; suggesting that it may have a protective role in cardiometabolic aging. We hypothesized that epicardial, intrathoracic, or total thoracic adiposity (EAT, IAT, or TTA, respectively) measured on thoracic CT, were inversely associated with IGFBP-1, providing an assessment of cardiometabolic status by computed tomography (CT). Methods: Participants (n=104) were prospectively enrolled from the LonGenity study at Albert Einstein Institute of Aging. Participants were of Ashkenazi descent and ≥65 years, 53% were offspring of parents with exceptional longevity (OPEL) and 47% were offspring with usual survival (OPUS). Exclusion criteria were prior coronary artery bypass or stent, heart rate &gt; 100 beats/minute or not in sinus rhythm. Participants underwent a non-contrast gated CT. Adiposity was quantified using QFAT software (Cedars Sinai, CA). IGFBP-1 measures closest to the CT were used, ranging from 58 months before to 16 months after, with the majority within 1 year of the scan. Associations between IGFBP-1 and the adiposity were evaluated with linear regression with square-root of adiposity measures as the outcome. Each subject was weighted by the inverse of the years between CT and closest IGFBP-1 measurement. Results: IGFBP-1 levels were inversely associated with EAT (p =0.007), IAT (p = 0.003) and TTA (p = 0.003) after adjustment for age, sex, body mass index, OPEL/OPUS, diabetic medication, statin use, and high- and low-density lipoprotein levels. BMI explained 27.2% of the variation of TTA (p &lt; 0.001) and IGFBP-1 explained an additional 6% of the variation. There was no association of OPEL/OPUS status with adiposity measures. Conclusion: In conclusion, higher IGFBP-1 was associated with lower cross-sectional TTA, suggesting that IGFBP-1 may be indicative of a favorable cardiometabolic environment in aging. Future studies should evaluate the utility of IGFBP-1, epicardial and thoracic visceral adiposity as indicators of cardiometabolic disease.

Abstract 14204: Impact of Concomitant Tobacco Use on Major Adverse Cardiovascular Events in Young Adults Hospitalized With Known Cannabis Use Disorder

Introduction: Cannabis use disorder (CUD) and tobacco use disorder (TUD) are both independent CVD risk factors. However, with the increasing use of recreational cannabis use, the impact of concomitant TUD on major adverse cardiovascular/cerebrovascular events (MACCE) remains unexplored. Hypothesis: Evaluating the impact of concomitant CUD &amp; TUD on MACCE. Methods: We queried 2019's National Inpatient Sample to identify young adults hospitalized with CUD, with vs. without TUD. Baseline demographics, comorbidities, major adverse cardiac events, and the need for revascularization were compared. Multivariable regression analysis was performed, adjusting for confounders to assess the odds of MACCE. Results: Of 539125 patients with CUD, 288260 (53.5%) were TUD+ [median age 31 (25-37)]. TUD+ cohort often had males (60% vs 51.6%), white (58.1% vs 46.8%) patients than TUD- cohort (all p&lt;0.001). The TUD+ cohort showed higher rates of uncomplicated hypertension (15.0% vs 11.6%), alcohol abuse (21.0% vs 12.9%) but lower rates of obesity (9.2% vs. 11.6%), diabetes with chronic complications (4.5% vs. 5.4%), complicated hypertension (3.7% vs 4.4%) and metastatic cancer (0.2% vs. 0.5%) (all p&lt;0.001). After adjusting for covariates, the TUD+ arm had significantly higher odds of acute MI (OR:1.37), Acute PE (OR:1.46), Type 1-DM (OR:1.66), PCI (OR:1.78), CABG (OR:2.62) but lower odds of all-cause mortality (OR:0.55), cardiac arrest including VF (OR:0.59), AF (OR:0.67) and dysrhythmia (OR:0.75) (all p&lt;0.001) [Fig. 1]. The TUD+ cohort incurred lower hospital charges than TUD- cohort (p&lt;0.001). No statistical significance was observed in the odds of stroke and MACCE. Conclusions: Concomitant tobacco &amp; cannabis use had higher odds of Acute MI, PE, PCI and CABG but, interestingly, lower odds of all-cause mortality, dysrhythmia, AF and cardiac arrest including VF. The association between cannabis use and concomitant tobacco use on MACCE needs to be further studied.

Association of Attending a High-Performing High School With Substance Use Disorder Rate and Health Outcomes in Young Adults

Interventions directly targeting social factors, such as education, may have the potential to greatly improve health. To examine the association of attending a high-performing public charter high school with rates of substance use disorder and physical and mental health. This cohort study used the random school admissions lottery system of high-performing public charter high schools in low-income neighborhoods of Los Angeles, California, to examine the health outcomes of students who applied to at least 1 of 5 of these high schools. Participants attended 147 different high schools and were randomly selected from those who won the admissions lottery (intervention group) and those who were placed on a waiting list (control group). Participants were surveyed at the end of grade 8 through transition into grade 9 and then from grade 10 through 3 years after high school completion (at age 21 years). Surveys were conducted from March 2013 through November 2021. Attendance at a high-performing public charter high school. Self-reported alcohol use disorder and cannabis misuse, delinquent behaviors, physical and mental health, and body mass index. Of the 1270 participants at baseline (mean [SD] age, 14.2 [0.47] years; 668 female individuals [52.6%]). The control group included 576 individuals (45.4%), and 694 individuals (54.6%) were in the intervention group. Both groups were similar in almost all characteristics at baseline, and the median (IQR) follow-up was 6.4 (6.0-6.7) years. Participants attending a high-performing public charter high school had a 53.33% lower rate of hazardous or dependent alcohol use disorder compared with those in the control group (5.43% vs 11.64%; difference, -6.21% [95% CI, -11.87% to -0.55%]; P = .03). Among male participants, the intervention group had a 42.05% lower rate of self-reported fair or poor physical health (13.33% vs 23.01%; difference, -9.67% [95% CI, -18.30% to -1.05%]; P = .03) and a 32.94% lower rate of obesity or overweight (29.28% vs 43.67%; difference, -14.38% [95% CI, -25.74% to -3.02%]; P = .02) compared with the control group. Among female participants, attending a high-performing public charter high school was associated with worse physical health outcomes (30.29% vs 13.47% reporting fair or poor health; difference, 16.82% [95% CI, 0.36% to 33.28%]; P = .045) and higher rates of overweight or obesity (52.20% vs 32.91%; difference, 19.30% [95% CI, 3.37% to 35.22%]; P = .02) at age 21 years. Few differences in mental health outcomes were observed. Adjusting for educational outcomes did not significantly change these findings. Results of this study suggest that attending a high-performing public charter high school was associated with lower rates of substance use disorder independent of academic achievement. Physical health and obesity outcomes were also better but only for young men; the intervention group had worse physical health outcomes among young women for unclear reasons. Schools are a potent social determinant of health and an important target for future health interventions.

Health literacy as a key to improving weight status among Palestinian adolescents living in chronic conflict conditions: a cross-sectional study

ObjectiveTo examine the moderating role of health literacy in the association between direct exposure to violence and weight status among Palestinian adolescents.DesignA household cross-sectional study conducted in 2017.SettingA Palestinian district...

Effect of HIV and antiretroviral therapy use on body weight changes in a cohort of U.S. veterans living with and without HIV.

People living with HIV have high rates of obesity and obesity-related comorbidities. Our study sought to evaluate weight trajectory in a retrospective cohort of people living with HIV and matched HIV-negative veterans (controls) and to evaluate risk factors for weight gain. This was a retrospective database analysis of data extracted from the VA Corporate Data Warehouse that included people living with HIV (n=22 421) and age-matched HIV-negative controls (n=63 072). The main outcomes were baseline body weight and weight change from baseline at 1, 2, and 5 years after diagnosis (baseline visit for controls). Body weight at baseline was lower in people living with HIV than in controls. People living with HIV on antiretroviral therapy (ART) gained more weight than did controls. In a sub-analysis of ART-exposed people living with HIV, age >50 years, African American race, body mass index (BMI) <25, CD4 ≤200, and HIV diagnosis year after 2000 were associated with more weight gain at year 1. Nucleoside reverse transcriptase inhibitors (NRTI)plus non-NRTIs (NNRTIs) were associated with less weight gain than NRTIs plus protease inhibitors, NRTIs plus integrase inhibitors, or NRTIs plus other agents at year 1. Among US veterans, those living with HIV had lower rates of obesity than age-matched HIV-negative controls; however, primarily in the first 2 years after starting ART, people living with HIV gained more weight than did controls.