Lower Rates Of Obesity Research Articles

The Other Obesity Epidemic-Of Drugs and Bugs.

Chronic psychiatric patients with schizophrenia and related disorders are frequently treatment-resistant and may require higher doses of psychotropic drugs to remain stable. Prolonged exposure to these agents increases the risk of weight gain and cardiometabolic disorders, leading to poorer outcomes and higher medical cost. It is well-established that obesity has reached epidemic proportions throughout the world, however it is less known that its rates are two to three times higher in mentally ill patients compared to the general population. Psychotropic drugs have emerged as a major cause of weight gain, pointing to an urgent need for novel interventions to attenuate this unintended consequence. Recently, the gut microbial community has been linked to psychotropic drugs-induced obesity as these agents were found to possess antimicrobial properties and trigger intestinal dysbiosis, depleting Bacteroidetes phylum. Since germ-free animals exposed to psychotropics have not demonstrated weight gain, altered commensal flora composition is believed to be necessary and sufficient to induce dysmetabolism. Conversely, not only do psychotropics disrupt the composition of gut microbiota but the later alter the metabolism of the former. Here we review the role of gut bacterial community in psychotropic drugs metabolism and dysbiosis. We discuss potential biomarkers reflecting the status of Bacteroidetes phylum and take a closer look at nutritional interventions, fecal microbiota transplantation, and transcranial magnetic stimulation, strategies that may lower obesity rates in chronic psychiatric patients.

Quality of life and olfactory function after suprasellar craniopharyngioma surgery\u2014a single-center experience comparing transcranial and endoscopic endonasal approaches

The endoscopic endonasal approach to suprasellar craniopharyngiomas has become popular as alternative to transcranial approaches. However, the literature lacks data regarding quality of life and olfactory function. The assessment of the long-term quality of life and olfactory function of all patients harboring a suprasellar craniopharyngioma who underwent surgery in our department has been done. Patient characteristics and perioperative data were gathered in a prospectively maintained database. At the last follow-up visit, the olfactory function and the quality of life (ASBQ, SNOT-22) as well as visual and pituitary function were assessed. Thirteen and 17 patients underwent surgery via a transcranial (T) and endonasal (E) route, respectively. No differences were seen in ASBQ, SNOT-22, and olfactory function between T and E, but in E were more full-time worker and less obesity. CSF leaks occurred in 15% of T and 29% of E (p = 0.43). Patients from group E had a superior visual outcome which was most pronounced in the visual field. The degree of new anterior and posterior pituitary gland deficiency after surgery and in the follow-up was lower in group E. The general and sinonasal quality of life and the olfactory function are equal in E and T. E is associated with a superior visual outcome, lower rates of diabetes insipidus, and lower rates of obesity, but has a higher risk for postoperative CSF leaks.

Behavioral Factors For Adolescents' Obesity And Overweight: Physical Activity, Sleep, Sedentary Behavior, And Diet

PURPOSE: To investigate the risk factors in weight status among adolescents regarding dietary habits and movement behavior. METHODS: Primary data were derived from the CDC Youth Risk Behavior Survey (YRBS), a nationally representative sample of 40,130 grade 9-12 students (N=20,340 boys and 19,790 girls) from 2011 to 2017. The prevalence of overweight and obesity was examined using by BMI percentile and then compared based on various demographics (i.e., sex, age, race) and behavioral factors (i.e., physical activity, sedentary time, sleep, soda consumption). Logistic regression analysis was conducted to illustrate the differences in weight status within each group of physical activity levels after control the behavioral and demographic factors. RESULTS: Overall, African-American adolescents had the highest prevalence of overweight or obesity (36%), followed by Hispanics (35%), others (29%), and White (27%). Female students had significantly lower obesity rate than male students (-6.4 ± 0.2%), but also spend less time for behavioral activities (e.g., sedentary time: -0.372 ± 0.015 hours, MVPA -20.4 ± 0.4%, and strength training -20.9 ± 0.3%). The self-diagnosis was relatively accurate, with 69% of true positive and 13% of true negative in comparison to actual overweight and obesity status. For the PA group, students who satisfied both PA recommendations had less likely to be obese compared to non-PA group: Odds Ratio (OR) for PA = 0.89, 95% CI [0.825, 0.961], p = 0.003; OR for strength training = 0.92, 95% CI [0.865, 0.996], p = 0.039). Students who consumed soda on more than one day were more likely to be obese (OR = 1.13, 95% CI [1.049, 1.223]), and students who had more sedentary time tended to be obese (OR=1.03, 95% CI [1.011, 1.041]). CONCLUSIONS: Students who were meeting PA recommendations were less likely to be obese, while students who had more sedentary time and higher levels of soda consumption were more likely to be obese. In addition, African American and Hispanic students were more likely to be overweight and obese.

1152-P: Effect of Initiating Empagliflozin vs. Glucagon-Like Peptide-1 Receptor Agonists on Health-Care Costs among Patients with Type 2 Diabetes

The 2019 ADA’s Standards of Medical Care in Diabetes recommends use of SGLT2 inhibitor (SGLT2i) or GLP-1 receptor agonist (GLP-1RA) as one of the six drug classes after metformin (MET) in T2D patients, and is recommended as the treatment of choice among patients with cardiovascular disease (CVD; empagliflozin [EMPA] and liraglutide showing stronger evidence). To understand the economic impact of these recommendations, we evaluated the effect of EMPA vs. GLP-1 RA initiation on all-cause (AC) healthcare costs in patients with T2D. This retrospective cohort study utilized an U.S. commercial claims database to identify patients with T2D who newly initiated EMPA or a GLP-1RA between 08/2014 - 12/2016. First prescription date (index date) for EMPA or a GLP-1RA was used to classify patients into respective cohorts. T2D diagnosis and baseline covariates were assessed during 1-year pre-index period. During a post-index period of up to 1 year, AC costs were computed on a per patient per month (PPPM) basis; and evaluated using generalized linear models that controlled for pre-index covariates. Compared to the GLP-1RA cohort (N = 13,216), patients in the EMPA cohort (N= 3,857) were younger, more likely to be male, and had lower rates of obesity in the 1-year baseline period; all other measured pre-index covariates were similar. After covariate adjustment, the adjusted total AC PPPM cost difference ($1,137 vs. $1,370; difference (Δ) = -$233 PPPM) remained significantly lower for the EMPA cohort (P<0.001), as compared to GLP-1 RA cohort. Both medical (Δ = -$26 PPPM, p=0.06), and pharmacy (Δ = -$197 PPPM, p<0.001) costs were lower in EMPA cohort, as compared to GLP-1 RA cohort. Use of empagliflozin vs. GLP-1 RA in T2D patients was associated with lower all-cause healthcare costs. Together with ADA guidelines, these findings can aid health care stakeholders in treatment decisions and optimizing clinical and economic outcomes for patients with T2D. Disclosure P. Pimple: Employee; Self; Boehringer Ingelheim Pharmaceuticals, Inc. Employee; Spouse/Partner; CVS Caremark. A. Raju: Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Bristol-Myers Squibb. D. Stafkey-Mailey: None. S. Shetty: Employee; Self; Boehringer Ingelheim Pharmaceuticals, Inc.

COVID-19 in African Countries versus other World Regions: A Review.

This review examines the spread of COVID-19 (coronavirus) in Africa. By May 15, 2020, while the COVID-19 infections were 1,741,129 in Europe, 1,632,167 in North America, 757,924 in Asia, 401,072 in South America, there were only 79,780 infections in Africa, a continent with 1.34 billion people. During this same date, of the total COVID-19 deaths of 308,154 worldwide, Europe accounted for 160,482 (52.1%) deaths; North America accounted for 99,633 (32.3%) deaths; Asia accounted for 23,963 (7.8%) deaths; South America accounted for 21,303 (6.9%) deaths; and Africa accounted for only 2,639 (0.9%) deaths. Among the factors cited for this phenomenon (Africa's low figures) are: low volumes of international tourism to most African nations; a relatively young African population, with 533.5 (39.8%) million under the age of 15; low obesity rates in Africa; low rates of urbanization in most African nations; hot or high temperatures and high humidity in most African nations; low levels of testing, which continues to be the case in countries all across the world and proactive measures by African governments and people to slow the spread of the coronavirus. It is recommended that African countries continue to pursue proactive measures such as use of facemasks, hand sanitizers, regular hand washing and immediate partial or full lockdown when necessary.

Baseline Disease Activity and Steroid Therapy Stratify Risk of COVID-19 in Patients With Inflammatory Bowel Disease

Baseline Disease Activity and Steroid Therapy Stratify Risk of COVID-19 in Patients With Inflammatory Bowel Disease

Generational Differences in Food Perception and the Risk of Chronic Disease Among Jamaican Immigrant Families Living in New York City

Abstract Objectives A Quarter of all US-based Jamaicans live in New York City (NYC) (N = 178,750). Compared to African Americans, Black Caribbeans experience lower rates of obesity (36% vs. 29%) and hypertension (38% vs 35%), but similar rates of diabetes (13% vs. 15%). Little is known about how diet and acculturation affect risk of chronic disease among Jamaican immigrants of different age groups. The aims of this study were to identify among three generations of Jamaicans living in NYC: a) how food experiences influence food perceptions and dietary behaviors; and b) how acculturation, social norms, socio-economic status and trans-national movements affect diet and risk of chronic disease. Methods Group and individual interviews with youth (n = 10), parents (n = 6) and grandparents (n = 8) used open-ended questions, were recorded and lasted 45 – 90 min. Participants received $20 gift cards as incentives. Recordings were transcribed, and analyzed using Dedoose 7.0. Results Three major themes emerged: Food perceptions and the concept of clean food impelled participants from all generations to consume a healthier diet consisting of more fresh fruits and vegetables and less processed foods. Among youth, remote acculturation to the US culture and global foods made it more acceptable to replace traditional home cooked foods with processed foods. Third, acculturation provided older Jamaican immigrants with easier access to healthcare and health education. The health advice provided by doctors, dietitians and other healthcare professionals was well respected and older Jamaicans reported high levels of compliance. Conclusions Among youth, early exposure to US culture and foods while living in Jamaica may increase future risk of chronic disease by making it more acceptable to replace cultural foods with American foods. Food perceptions and the concept of clean food play an important role in the way that Jamaicans of all ages think about, purchase and eat food. Truly valuing fruits and vegetables made adult Jamaican immigrants more receptive to health education and more likely to lower their risk of chronic disease. Funding Sources CUNY Graduate School of Public Health and Health Policy, Dean's Dissertation Grant (Dissertation research support for author Horlyck-Romanovsky).

M151. DIFFERENCES IN PATTERN OF OBESITY BETWEEN PEOPLE WITH SCHIZOPHRENIA LIVING IN CHINA AND IN AUSTRALIA

BackgroundPeople with psychotic disorders, including schizophrenia, suffer premature cardiovascular morbidity and mortality. Obesity is a major factor in cardiometabolic disorders in this population. There has been very little research investigating differences in patterns of obesity in diverse ethnic populations. Guidelines for treatment of complex comorbidities in people with schizophrenia and related psychoses may need to provide specific recomendations for different ethnic groups.MethodsThe Chinese sample consisted 192 subjects were recruited from the outpatients and inpatients department of the psychiatry department of the third affiliated hospital of Sun Yat-sen. All enrolled subjects were Chinese Han ethnicity, aged 16–45 years, with a diagnosis of schizophrenia according to ICD-10 criteria for schizophrenia, excluding other acute psychiatric disorders. The Australian sample (N=1825) were drawn from the Survey of High Impact Psychosis.BMI and central obesity were measured in all subjects.Results10.3% of men and 4.7% of women in the China sample were obese (BMI>30). In the Australian sample, 41.6% of men and 50.3% of women were obese. Overall, 7.8% of Chinese sample and 45.1% of the Australian sample were obese.However, amongst the non-obese China sample, 41.7% of men and 53.1% of women had central obesity; the mean for all non-obese Chinese people was 46.7%. 73% of non-obese Australian men and 81.5% of non-obese Australian women had central obesity; the mean for all non-obese Australians was 76%.DiscussionChinese Han people with schizophrenia have much lower rates of obesity than the Australian sample. In both groups, rates of abdominal obesity were higher than rates of obesity as defined by BMI. These ethnic differences may help in understanding the high rates of cardiometabolic disorder in people with psychotic disorders in Western countries. They may also inform interventions to assist Western people with psychoses to maintain better physical health.

Culinary Education Programs for Children in Low-Income Households: A Scoping Review.

Child obesity in the United States is at an all-time high, particularly among underserved populations. Home-cooked meals are associated with lower rates of obesity. Helping children develop culinary skills has been associated with improved nutrition. The purpose of this study is to report results from a scoping review of culinary education interventions with children from low-income families. Three databases and hand searches of relevant articles were examined. Retained articles met inclusionary criteria. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, as appropriate. A data extraction template was developed. Data were independently extracted and verified. Only nine out of 370 articles met the inclusionary criteria and were included in the review. Most interventions were school-based, used a quasi-experimental design, and recruited minority children. Children-only was the primary intervention focus. Primary outcomes were mostly psychosocial from child self-report. Most interventions focused on children only and were guided by Social Cognitive Theory. Most reported stakeholder involvement; however, type and degree varied. All had an in-person component; only one used technology. Few reported training program leaders. Culinary education programs for children from low-income families could benefit from a broader theoretical grounding, program leader training, and greater parental involvement.

Abstract 232: Initiating Empagliflozin vs. Glucagon-like Peptide 1 Receptor Agonists is Associated With Lower Healthcare Cost of Care Among Patients With Type 2 Diabetes and Cardiovascular Disease

Background: The 2019 ADA’s Standards of Medical Care in Diabetes recommend use of SGLT-2 inhibitor (SGLT-2i) or GLP-1 receptor agonist (GLP-1RA) as one of the six drug classes after metformin (MET) in type 2 diabetes (T2D) patients, and is recommended as the treatment of choice among patients with cardiovascular disease (CVD; empagliflozin [EMPA] and liraglutide showing stronger evidence). CVD benefits of empagliflozin and GLP-1 RAs have been demonstrated in clinical trials; however, the impact on all-cause (AC) healthcare costs has not been studied. Methods: This retrospective cohort study utilized an US based, commercial claims database (IQVIA Pharmetrics Plus) to identify patients with T2D and CVD who initiated empagliflozin or a GLP-1 RA between 08/01/2014 - 12/31/2016. First prescription date (index date) for empagliflozin or a GLP-1 RA was used to classify patients into study cohorts. During a post-index period of up to 1 year, AC costs were computed on a per patient per month (PPPM) basis; and evaluated using generalized linear models that controlled for pre-index covariates. A sub-analysis comparing AC costs among patients who initiated second-line treatment with empagliflozin or a GLP-1 RA after metformin monotherapy, was also conducted. Results: As compared to the GLP-1 RA cohort (N = 1376), patients in the empagliflozin cohort (N= 441) were more likely to be males, had a lower Charlson comorbidity score, higher rates of dyslipidemia, and lower rates of obesity in the 1-year pre-index period; all other measured pre-index characteristics were similar. After covariate adjustment, compared to GLP-1 RA cohort, the empagliflozin cohort had lower total AC PPPM (($1,766 vs. $2,096; difference (Δ) = $330, p<0.001 ), medical (Δ = $97, p=0.28 ), and pharmacy (Δ = $228, p<0.001 ) costs. In patients who initiated 2 nd line empagliflozin or GLP-1 RA treatment, the empagliflozin cohort (N = 160) had lower total AC PPPM (($1,432 vs. $1,969; Δ = $536, p<0.001 ), medical (Δ = $275, p=0.02 ), and pharmacy (Δ = $225, p=0.12 ) costs, compared to the GLP-1 RA cohort (N = 477). Conclusions: In patients diagnosed with T2D & CVD, initiating empagliflozin compared to GLP-1 RA was associated with lower all-cause healthcare costs. Together with ADA guidelines, these findings can provide critical insights for health care decision makers for reducing the clinical and economic burden for patients with T2D & CVD.

Health and Lifestyle Factors of Australian Medical Radiation Workers: A Pilot Study Using Nuclear Medicine Technologists.

The health effects of chronic low-dose radiation exposure are a subject of worldwide debate. These effects are difficult to assess because all low-dose exposure mechanisms must be accounted for, including background exposure, personal medical examinations, and environmental exposure such as aviation, as well as lifestyle choices contributing to disease. The current literature recommends investigation of lifestyle factors to fill in these gaps. The aim of this study was to pilot-test a survey developed to assess health and lifestyle factors for Australian medical radiation workers. Methods: A cohort of nuclear medicine technologists (NMTs) was selected to test the survey. The survey consisted of 53 questions relating to demographics, employment, lifestyle, and health. Data from the 2017-2018 Australian National Health Survey were used to compare the lifestyle choices and health of the participants with those of the Australian general population. Results: In total, 101 participants pilot-tested the survey. Overall, Australian NMTs make better lifestyle choices (more exercise, more vegetable intake, lower rates of smoking and alcohol consumption) resulting in lower rates of obesity than the Australian general population. NMTs had a higher reported health status than the Australian population, with lower levels of psychologic distress. Given the low age of NMTs participating in the study, the cancer incidence rate may be higher than that reported for the Australian general population; however, a larger sample size is required to provide more definitive results. Conclusion: This pilot study demonstrated the feasibility of conducting a widespread survey to assess health and lifestyle factors for the Australian medical radiation worker cohort. Comparison of survey results with data for the entire Australian population have highlighted the potential to increase the number of lifestyle questions.

Interaction of quercetin and epigallocatechin gallate (EGCG) aggregates with pancreatic lipase under simplified intestinal conditions.

Diets rich in flavonoids have been related with low obesity rates, which could be related with their potential to inhibit pancreatic lipase, the main enzyme of fat assimilation. Some flavonoids can aggregate in aqueous medium suggesting that the inhibition mechanism could occur on both molecular and colloidal levels. This study investigates the interaction of two flavonoid aggregates, quercetin and epigallocatechin gallate (EGCG), with pancreatic lipase under simplified intestinal conditions. The stability and the morphology of these flavonoid aggregates were studied in four different solutions: Control (water), salt, low lipase concentration and high lipase concentration. Particles were found by optical microscopy in almost all the solutions tested, except EGCG-control. The results show that the precipitation rate decreases for quercetin and increases for EGCG in salt solution and that lipase stabilize quercetin aggregates. In addition, both flavonoids were shown to precipitate together with pancreatic lipase resulting in a sequestering of the enzyme.

Incidence and Mortality of Myocardial Infarction and Stroke in Patients with Hyperthyroidism: A Nationwide Cohort Study in Korea.

Background: Hyperthyroidism is associated with various cardiovascular risk factors. However, the relationship between hyperthyroidism and myocardial infarction (MI) or stroke has not been fully elucidated; only a few studies have investigated the association of hyperthyroidism with survival after MI or stroke. Methods: We included 59,021 hyperthyroid patients and a control cohort with 1,180,420 age- and sex-matched subjects from the Korean National Health Insurance database. Blood pressure, body mass index (BMI), glucose and cholesterol levels, and smoking history were obtained during National Health screening examination. We compared the incidence of MI, stroke, and survival after cardiovascular events between subjects with hyperthyroidism and the control cohort. Results: Subjects with hyperthyroidism had higher blood pressure, fasting glucose, and smoking rate, but lower cholesterol levels and a lower obesity rate compared with the control cohort. After adjusting these differences, as well as atrial fibrillation, hyperthyroidism was associated with increased risk of MI and ischemic stroke. Adjusted hazard ratios (HRs) for MI and ischemic stroke with hyperthyroidism was 1.16 [95% confidence interval, CI 1.03-1.30] and 1.12 [CI 1.04-1.20], respectively. In age-, sex-, and BMI-stratified analyses, an increased risk of MI and ischemic stroke remained significant in females, the older age group (≥50 years), and nonobese subjects (BMI <25 kg/m2), but not in males, the younger age group (<50 years), and obese subjects (BMI ≥25 kg/m2). The risk of hemorrhagic stroke was not different between subjects with hyperthyroidism and controls. Adjusted HRs for mortality in subjects with hyperthyroidism who developed MI, ischemic stroke, and hemorrhagic stroke were 1.11 ([CI 0.86-1.43], p = 0.44), 0.89 ([CI 0.75-1.05], p = 0.16), and 1.13 ([CI 0.88-1.47], p = 0.34), respectively. Conclusions: Hyperthyroidism is associated with increased risk of MI and ischemic stroke, independent of cardiovascular risk factors. This association is prominent in subjects with age ≥50 years, in females, and in the nonobese group. Hyperthyroidism did not significantly affect the mortality secondary to cardiovascular events.

Burden of Cardiovascular Disease Risk Factors Over 13.5 Years in a Rural and Urban South Indian Cohort in Comparison with Global Data

Background: India has high mortality rates from cardiovascular disease (CVD). Understanding the trends and identifying modifiable determinants of CVD risk factors will guide preventive strategies and support policy making. Methods: We estimated the prevalence and incidence of CVD risk factors (overweight, obesity, central obesity, type 2 diabetes (T2D), hypertension, hypercholesterolemia and hypertriglyceridemia) in 962 (male 519) non-migrant adults from Vellore, South India, studied in i) 1998-2002 (baseline, mean age 28.2 years) and ii) 2013-2014 (follow-up, mean age 41.7 years). Prevalence was compared with the Non-Communicable Disease Risk Collaboration (global) data. Incidence was compared with another Indian cohort from New Delhi (NDBC). Regression analysis was used to test baseline predictors of incident CVD risk factors. Findings: The prevalence of CVD risk factors at 28 and 42 years was 17% and 51% for overweight/obesity, 19% and 59% for central obesity, 3% and 16% for type 2 diabetes, 2% and 19% for hypertension and 15% and 30% for hypertriglyceridemia. The prevalence of type 2 diabetes at baseline and follow-up and hypertension at follow-up was comparable with or exceeded that in high income countries despite lower obesity rates. The incidence of most risk factors was lower in Vellore than in the NDBC. Weight gain from 15 to 28 years, and 28-year waist circumference, strongly predicted incident type 2 diabetes, hypertension and hypertriglyceridemia. After adjusting for these, rural residents had a higher incidence of type 2 diabetes and hypertension. Interpretation: A high prevalence of CVD risk factors is evident at a young age among Indians compared with high and upper-middle income countries. The rural prevalence is catching up with urban rates. Adiposity predicted higher risk factors, but the prevalence of hypertension and T2D is higher than expected given a relatively low obesity prevalence in global terms. This suggests greater sensitivity to adiposity and/or other unmeasured causal factors, among Indians. The increasing burden of CVD risk factors in India reinforces the need for strengthening CVD risk-prevention strategies, particularly in rural India and starting from a young age. Funding Statement: British Heart Foundation, UK and Christian Medical College, Vellore, India Declaration of Interests: None. Ethics Approval Statement: The study was approved by the institutional ethics committee of the Christian Medical College, Vellore and all participants provided informed consent.

Abstract P312: Association Between Religious Attendance And Obesity In African American And Afro-Caribbean Men

Introduction: The increasing prevalence of obesity continues to be a public health concern in the United States (US). Religiosity, commonly characterized as the frequency of ritualistic practice and attendance at places of worship has been found to provide favorable cardiovascular health impacts including lower blood pressure and cholesterol levels; however, studies on the effect of religiosity on obesity have been mixed. Furthermore, national surveys have shown obesity prevalence to differ by ethnicity; foreign-born blacks have lower rates of obesity compared to US-born blacks. Research on a potential ethnic interaction on the impact of religious attendance on obesity has also been limited. Hypothesis: It is hypothesized that the association between religious attendance and obesity in black Americans may differ by ethnicity. Methods: Multiple logistic regression models were used to examine the association between religious attendance and obesity for African American (N = 1208) and Afro-Caribbean men (N = 628), 18 years and older, in the National Survey of American Life (2001-2003). Odds ratios (OR) of the association between religious attendance and adult obesity were estimated after adjusting for age, socioeconomic measures, health and lifestyle measures within regression models stratified by ethnicity. Results: The overall prevalence of obesity was 29.15% among African American men and 19.74% among Afro-Caribbean men. The prevalence of obesity among those who attended church weekly or more than weekly was 33.48% for African American men and 13.36% for Afro-Caribbean men. Afro-Caribbean men who attended church weekly or more than weekly had 48% lower odds of obesity than men who attended church less than weekly; age-adjusted OR = 0.52; 95%CI: (0.28, 0.98). The protective association of church attendance remained for Afro-Caribbean men after additionally adjusting for socioeconomic, health and lifestyle factors; adjusted OR = 0.40; 95%CI: (0.23, 0.67). No significant association between religious attendance and obesity was found for African American men. Conclusions: These findings suggest that religious attendance may be a protective factor for obesity among Afro-Caribbean men in the US. Since the prevalence of obesity among the foreign-born increases with length of US residency, religiosity may curb cardiovascular risk by lowering their body mass index trajectories across the life course.

Despite Low Obesity Rates, Body Mass Index Under-Estimated Obesity among Russian Police Officers When Compared to Body Fat Percentage.

In some countries, obesity rates among police officers are higher than the general public, despite physically demanding jobs. Obesity rates based on body mass index (BMI) may lack accuracy as BMI does not directly address body composition. Since data are lacking for obesity rates among Russian police officers, this study documented and compared officer obesity rates to the adult Russian population and compared the accuracy of body mass index (BMI) for obesity classification to two direct measures of body composition. Moscow region police officers (N = 182, 84% men) underwent height, weight, waist circumference (WC), and body fat percentage (BF%) bioelectrical impedance measurements during annual medical examinations. BMI-defined obesity rates were 4.6% for men and 17.2% for women, which were >3 and >1.8 times lower than Russian adults, respectively. WC-defined obesity rates were similar to BMI (3.3% for men and 10.3% for women), but BF%-defined obesity rates were much higher (22.2% for men and 55.2% for women). Although obesity rates were lower than those found among police officers in other countries, BMI alone was not a particularly accurate method for classifying weight status among Russian police officers.

New insights on strain-specific impacts of probiotics on insulin resistance: evidence from animal study.

сomparative animal study of effectiveness of intermittent administration of lyophilized single-, three- and alive multistrain probiotic in short courses on insulin resistance (IR) in rats with experimental obesity. 70 rats were divided into 7 groups (n = 10 in each). Rats of group I were left intact. Newborn rats in groups II-VII were administered monosodium glutamate (MSG) (4mg/g) by injection. Rats in group II (MSG-obesity group) were left untreated. The rats in groups III-V received lyophilized mono-probiotics B.animalis VKL, B.animalis VKB, L.casei IMVB-7280 respectively. The rats in group VI received all three of these probiotic strains mixed together. Group VII was treated with multi-probiotic "Symbiter", containing 14 different live probiotic strains (Lactobacillus, Bifidobacterium, Propionibacterium, Acetobacter genera). Treatment of newborn rats with MSG lead to the development of obesity in all MSG-obesity rats and up to 20-70% after probiotic administration. Additions to probiotic composition, with preference to alive strains (group VII), led to significantly lower rates of obesity, decrease in HOMA-IR (p < 0.001), proinflammatory cytokines levels - IL-1β (p = 0.003), IL-12Bp40 (p < 0.001) and elevation of adiponectin (p = 0.003), TGF-β (p = 0.010) in comparison with MSG-obesity group. Analysis of results in groups treated with single-strain probiotics (groups III-V) shows significant decrease in HOMA-IR, but changes were less pronounced as compared to mixture groups and did not achieve intact rats level. Other metabolic parameters were not affected significantly by single strains. Our findings provide major clues for how to design and use probiotics with more efficient compositions in obesity and IR management and may bring new insights into how host-microbe interactions contribute to such protective effects.

Changes in perceptions of neighborhood environment and Cardiometabolic outcomes in two predominantly African American neighborhoods

BackgroundPerceived neighborhood characteristics, including satisfaction with one’s neighborhood as a place to live, are associated with lower obesity rates and more favorable cardiovascular risk factor profiles. Yet, few studies have evaluated whether changes in perceived neighborhood characteristics over time may be associated with cardiometabolic health indicators.MethodsChanges in perception of one’s neighborhood (2013–2016) were determined from a cohort of residents who lived in one of two low-income urban neighborhoods. Changes were categorized into the following: improvement vs. no change or worsening over the three-year time-period. Multivariable linear regression was used to measure the association between perceived improvement in each of the neighborhood characteristics with cardiometabolic outcomes (BMI, SBP, DBP, HbA1c, HDL-c) that were assessed in 2016, and compared with those who perceived no change or worsening of neighborhood characteristics. Models were adjusted for age, sex, income, education, marital status, physical function, neighborhood, and years spent in neighborhood. To examine potential sex differences, follow-up models were conducted and stratified by sex.ResultsAmong the 622 individuals who remained in the same neighborhood during the time period, 93% were African American, 80% were female, and the mean age was 58 years. In covariate-adjusted models, those who perceived improvement in their neighborhood safety over the time period had a significantly higher BMI (kg/m2) than those who perceived no improvement or worsening (β = 1.5, p = 0.0162); however, perceived improvement in safety was also significantly associated with lower SBP (mmHg) (β = − 3.8, p = 0.0361). When results were stratified by sex, the relationship between improved perceived neighborhood safety and BMI was only evident in females.ConclusionsThese findings suggest that perceived neighborhood characteristics may impact cardiometabolic outcomes (BMI, SBP), but through differing pathways. This highlights the complexity of the associations between neighborhood characteristics and underscores the need for more longitudinal studies to confirm the associations with cardiometabolic health in African American populations.

Association of Race and Ethnicity with Vascular Access Type Selection and Outcomes

Black patients with end-stage renal disease (ESRD) represent 30.5% of the prevalent ESRD population in the United States, despite only accounting for 18% of the total population. Black patients are less likely to have pre-ESRD care compared with their white counterparts and are 3-4 times more likely to progress from chronic kidney disease to ESRD than whites, suggesting that black patients are particularly vulnerable to disparities in outcomes related to hemodialysis and ESRD. The objective of this study is to examine the association of race with outcomes of hemodialysis access and selection of arteriovenous fistula (AVF) versus arteriovenous graft (AVG). Patients with chronic kidney disease who initiated dialysis through a tunneled hemodialysis catheter (THC) were identified in the Optum's De-identified Clinformatics® Data Mart (OptumInsight, Eden Prairie, MN) claims database (2011-2017). The odds of AVF versus AVG creation and the odds of repeat vascular access creation were analyzed using logistic regression. Time from initial AVF/AVG to THC removal and time to repeat AVF/AVG were analyzed using Cox proportional hazards. About 7,584 vascular access patients met the inclusion criteria: 5,852 (77%) AVF and 1,732 (23%) AVG. Median follow-up was 583days overall (range, 1-2,543), 589days among AVF patients (range, 1-2,543), and 260days among AVG patients (range, 1-2,529). Between races, there was no clinically significant variation in characteristics or comorbidities, with the exception of a much lower rate of obesity among Asians. Black patients had 36% lower odds of AVF index versus AVG index (P<0.001). Patients 70 years or older and patients with diabetes had lower odds of AVF index, whereas men and obese patients had greater odds of receiving AVF. Overall, graft patients were 73% more likely to have a shorter time to THC removal than fistula patients, but Hispanic graft patients were 25% more likely to have a shorter time to THC removal than whites. Patients with diabetes, patients with cardiac arrhythmia, and obesity were more likely to have a longer time to THC removal. About 1,589 (21%) patients underwent a repeat vascular access creation during the follow-up period: 19% of whites (n=802), 26% of blacks (n=483), 19% of Hispanics (n=250), and 19% of Asians (n=54) (P<0.001). Multivariate analysis demonstrated that black patients had 58% greater odds of requiring a second access than white patients (P<0.001). Graft patients, patients 70 years or older, and men had lower odds of repeat access. Black patients were 45% more likely to have a shorter time until second access creation. Graft patients, patients aged 70 years or older, and men were more likely to have a longer time until second access. Patients with obesity were more likely to have a shorter time until second access. This study's findings suggest that after initial vascular access, compared with whites, blacks have no difference in time to index access success, but their access fails earlier and more frequently, independent of access type, age, and comorbidities. Given blacks constitute 30.5% of the hemodialysis population in the United States, it is imperative that future research investigate the root causes of these disparities.

A “fitness” Theme May Mitigate Regional Prevalence of Overweight and Obesity: Evidence from Google Search and Tweets

Taking ecological perspectives to overweight and obesity, the current study applies data mining approach to examine the association between information and social environments and regional prevalence of overweight and obesity. In particular, we focus on online search and social media data since the increasing popularity of location-based geo-targeting could be an influential source of regional differences in health information and social environment. In Study 1, we calculated the correlation between regional overweight and obesity rates with regional Google searches for a time period of 12 years (2004 to 2016). The findings showed that in regions with high overweight and obesity rates, people were looking for and obtaining information on weight-loss and diet;, but in regions with low overweight and obesity rates, people were looking for and obtaining information on fitness services and facilities. In Study 2, we analyzed and compared 4010 tweets from Houston, a city with a high overweight and obesity rate, and 3281 tweets from San Diego, a city with a low overweight and obesity rate. The tweets were collected from August 2015 to August of 2016. We analyzed the textual content of tweets by word frequency analysis and topic modeling. The findings suggest that San Diego has a social environment that focuses on fitness and combining exercising with dieting. In contrast, Houston’s social environment emphasizes dieting. The implication of these findings is that health practitioners should push a paradigm shift to a stronger focus on “healthy life” (combining exercising and dieting) in regions with high overweight and obesity rates.