Modifiable Risk Factors For Obesity Research Articles

Effect of maternal pre-pregnancy body mass index and gestational weight gain on birth weight and gestational age: An observational cross-sectional study

Background: Studies show that pre-pregnancy body mass index (ppBMI) and gestational weight gain (GWG) are associated with birth weight (BW), gestational age (GA), and neonatal morbidities. Higher BW leads to metabolic syndrome. Preterm and low BW (LBW) have short and long-term morbidities. Monitoring ppBMI and GWG is necessary as these are modifiable risk factors for obesity. In this study, we revisited these findings in an Indian scenario. Aims and Objectives: The primary objective is to study the association of BW and GA with ppBMI and GWG. The secondary objective is to study the association of ppBMI and GWG with cesarean section (CS), infant size, and early neonatal intensive care unit (NICU) requirement. Materials and Methods: This observational cross-sectional study was conducted over 1 year with 230 mothers, after Institutional Ethics Committee approval and informed consent. Data were collected using predesigned pro forma and analyzed by SPSS. Digital weighing scales, stadiometer, and fenton growth charts were used. Results: We found a positive linear correlation of ppBMI and GWG with BW. Obesity and excess GWG were associated with higher BW, large for GA, CS, and NICU stay. Overweight had more CS. Underweight and less GWG had a greater risk of LBW, preterm, and NICU stay. Less GWG had more small for GA. Conclusion: GWG and ppBMI are determinants of BW, GA, and neonatal morbidities. Further studies should focus on exercise and nutrition in pregnant and reproductive age women so that healthy babies with low-risk of obesity, metabolic syndrome, and neurodevelopmental disabilities are born.

Perceptions of Health, Body Size, and Nutritional Risk Factors for Obesity in People with HIV in South Africa.

Metabolic disease is increasing in people with HIV (PWH) in South Africa, but little is known about self-perceptions of body size, health, and nutritional behavior in this population. We performed a cross-sectional analysis of individual-level data from the 2016 South Africa Demographic and Health Survey. This survey measured HIV serostatus and body mass index (BMI). We categorized participants into six BMI groups: 18.5-22kg/m2, 22-25kg/m2, 25-27.5kg/m2, 27.5-30kg/m2, 30-35kg/m2, and ≥ 35kg/m2 and stratified them by HIV serostatus. Our outcomes were self-reported (1) body size and (2) health status among all participants, and intake of (3) chips and (4) sugar-sweetened beverages(SSB) in PWH. We described these metrics and used multivariable regression to evaluate the relationship between the nutritional behaviors and BMI ≥ 25kg/m2 in PWH only, adjusting for age, sex, educational attainment, and household wealth quintile. Of 6138 participants, 1163 (19.7%) were PWH. Among PWH, < 10% with a BMI 25-30kg/m2, < 20% with a BMI 30-35kg/m2 and < 50% with a BMI ≥ 35kg/m2 self-reported as overweight or obese. PWH reported being in poor health at higher rates than those without HIV at each BMI category except ≥ 35kg/m2. In adjusted models, SSB consumption was associated with BMI ≥ 25kg/m2 (1.13 [1.01-1.25], t-statistic = 2.14, p = 0.033) in PWH. Perceptions of body size may challenge efforts to prevent weight gain in PWH in South Africa. SSB intake reduction should be further explored as a modifiable risk factor for obesity.

Association between maternal and infant screen time with child growth and development: A longitudinal study.

Sedentary screen time is an early, modifiable risk factor for obesity and poor child development. To examine the relationship between maternal and infant screen time with child growth and development. Pregnant women were recruited for a cohort study related to maternal and infant development. Screen time was assessed in mothers during pregnancy, and subsequently in children at 3 months, 12 months, and 24 months of age. Child anthropometry was measured, and nuclear magnetic resonance quantified child fat mass. Fat mass index (FMI) was calculated. The Bayley Scales of Infant Development-III were used to assess child development. Linear regression models were used to assess the relationship between screen time and child growth and development, adjusted for covariates and stratified by sex. Mother/child dyads (n = 89) were mainly white (92.1%), and half were boys (52%). Both sexes increased screen time between 12 months and 24 months (ps <0.05). Child screen time was positively associated with FMI and negatively associated with development scores. In adjusted models, screen time was positively associated with FMI in boys, and meeting the screen time guideline was associated with lower FMI in girls. Greater infant screen time was related to higher adiposity. Though few relationships emerged, a cautionary approach to screen time early in life may benefit child health.

Abstract B034: Cancer Health Awareness through Screening and Education (CHANGE): Community health engagement

Abstract Purpose The goal of the CHANGE project is to provide a sustainable model of evidence-based cancer awareness through education – with an emphasis on prevention and early detection behaviors. Methods: Residents of a public housing community were invited to participate in a 4-week education program on breast, prostate, and colorectal cancer, including modifiable risk factors of obesity and tobacco use, screening eligibility, and participation in clinical trials. Each session was led by trained research staff, and lasted approximately one hour. A community site survey was also conducted among 20% of the residents to evaluate community cancer knowledge and screening behaviors. A community advisory board was established to support program implementation and advise on choosing a cancer risk-reducing environmental change. Results: 14 adult participants (7 men and 7 women, 86% African American) completed baseline measurements. 10 participants received a relevant health history notification, which means they were positive for one of the following which put them in the "higher risk" category: Due for one of the following screenings Breast, Colorectal or Prostate; Had family history of cancer; Tobacco use; Overweight/obese - 1 male was referred to the GCC Tobacco Cessation Program. All eligible participants were navigated to local cancer screening providers and will be followed up at 3 months.Community site survey results indicated a need for improved access to fresh fruits and vegetable access. Community advisory board participants and community resources collaborated to provide locally grown fresh fruits and vegetables to the public housing community's internal market. 1 Discussion: This sample represents those most at risk for cancer in the Augusta, GA area. This project will impact health equity by emphasizing a comprehensive approach to care through community environmental change and individual changes in knowledge and risk-reducing behaviors. Additional sites will be enrolled in the program through the end of 2022. Citation Format: Marlo M. Vernon, Samantha Jones, Steven Coughlin, Justin X. Moore, Vahe Heboyan, Martha Tingen. Cancer Health Awareness through Screening and Education (CHANGE): Community health engagement [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B034.

The barriers of home environments for obesity prevention in Indonesian adolescents

BackgroundObesity and its related cardiovascular-metabolic diseases are growing public health concerns. Despite global attention to obesity, its prevalence is steeply increasing in developing countries, especially in children and adolescents. Eating behaviours and physical activity are modifiable risk factors for obesity that can variably be shaped by families. Eating behaviours and physical activity are especially important during adolescence, given its significance as a foundational period for developing healthy lifestyles. This qualitative study aimed to explore barriers and opportunities around creating healthy lifestyles among adolescents in Indonesia, focussing on family environments from diverse socio-demographic backgrounds.MethodIn-depth interviews using a semi-structured guide were undertaken with consecutively recruited 10–18-year-old adolescents with overweight or obesity, and their parents, from three different sites: urban (Jakarta, the capital city of Indonesia), peri-urban (West Java Province) and rural (Banten Province). Thematic analysis was used to identify patterns of meaning.ResultsNineteen dyads were interviewed. Thematic analysis revealed four themes: limited knowledge of healthy lifestyles; healthy lifestyles not a concern of daily life; limited parenting skills, including inequity around gender roles; and aspects of availability and accessibility. These interconnected barriers influenced lifestyle practices at home within the context of daily preferences and decisions around food and activities. Gender role inequity and healthy food accessibility were more prominent in rural families than in those from urban or peri-urban settings.ConclusionsHealthy lifestyles in adolescence may be supported by strategies to enhance parenting skills, build individual motivation, and support the development of more enabling environments.

The relationship between dietary phytochemical index and resting metabolic rate mediated by inflammatory factors in overweight and obese women: a cross-sectional study

BackgroundUnhealthy dietary patterns are the most important modifiable risk factors for obesity and overweight. This study aimed to examine the relationship between Dietary Phytochemical Index (DPI) and resting metabolic rate (RMR), mediated by inflammatory factors, in overweight and obese women.MethodsA total of 404 women, aged 18–48 years, were included in the cross-sectional study. DPI was calculated using the 147-item food frequency questionnaire (FFQ). Anthropometric measurements, RMR, and blood biomarkers were assessed using standard protocols.ResultsThere was marginally significant association between adherence to DPI and RMR status in the crude model (OR = 1.41, 95% CI 0.94–2.11, P = 0.09). After adjusting for potential confounders, a significant association was seen between the DPI and increase RMR.per.kg (OR = 2.77, 95% CI 0.98–7.82, P = 0.05). Our results indicated that plasminogen activator inhibitor-1 (PAI-1), transforming growth factor (TGF-β), and monocyte chemoattractant protein-1 (MCP-1) had a mediatory effect on the association between RMR and DPI (P > 0.05). Indeed, it was shown that, PAI-1, TGF-β, and MCP-1 destroyed the significance of this association and could be considered as mediating markers. However, no mediating effect was observed for high-sensitivity C reactive protein (hs-CRP).ConclusionsAdherence to DPI can improve the RMR by reducing levels of inflammatory markers, and may be considered as a treatment for obesity. However, more long-term studies are recommended.

Ultra-processed food intake is associated with children and adolescents with congenital heart disease clustered by high cardiovascular risk factors.

The excessive intake of ultra-processed foods (UPF) is associated with an increase in cardiovascular risk. However, the effect of UPF intake on cardiovascular health in children and adolescents with congenital heart disease (CHD) is unknown. The aim of the present study was to describe UPF intake and evaluate associations with isolated cardiovascular risk factors and children and adolescents with CHD clustered by cardiovascular risk factors. A cross-sectional study was conducted involving 232 children and adolescents with CHD. Dietary intake was assessed using three 24-hour recalls. UPFs were categorized using the NOVA classification. The cardiovascular risk factors evaluated were central adiposity, elevated high-sensitivity C-reactive protein (hs-CRP) and subclinical atherosclerosis. The clustering of cardiovascular risk factors (waist circumference, hs-CRP and carotid intima-media thickness) was performed, allocating the participants to two groups (high versus low cardiovascular risk). UPFs contributed 40.69% (SD 6.21) to total energy intake. The main UPF groups were ready-to-eat and take-away/fast foods (22.2% energy from UPFs). The multivariable logistic regression revealed that an absolute increase of 10% in UPF intake (OR=1.90; 95% CI: 1.01;3.58) was associated with central adiposity. An absolute increase of 10% in UPF intake (OR=3.77; 95% CI: 1.80;7.87) was also associated with children and adolescents with CHD clustered by high cardiovascular risk after adjusting for confounding factors. Our findings demonstrate that UPF intake should be considered a modifiable risk factor for obesity and its cardiovascular consequences in children and adolescents with CHD.

SARCOPENIC OBESITY IN PATIENTS RECEIVING TREATMENT WITH PROGRAMMED HEMODIALYSIS

BACKGROUND . The term "sarcopenic obesity" has been used not so long ago. The epidemiology of this phenomenon during renal replacement therapy in the Russian Federation has not been studied. THE AIM : to assess the prevalence of sarcopenic obesity in patients on hemodialysis (HD). PATIENTS AND METHODS . 140 patients receiving treatment with programmed bicarbonate HD in 2 dialysis centers of St. Petersburg were examined, among them 68 women and 72 men, the average age was 56.8±12.8 years. The main cause of the development of terminal renal insufficiency was chronic glomerulonephritis – in 43, autosomal dominant polycystic kidney disease – in 14, chronic pyelonephritis – in 9, hypertension – in 15, chronic tubulointerstitial nephritis – in 6 and other diseases – in 53 people. The prevalence of these pathological conditions in men and women did not differ. To assess the component composition of the patient's body, we used: 8–point tactile tetrapolar multi–frequency bioimpedance (BIM) on the InBody device (South Korea) with a frequency range of 1 – 1000 kHz, 10 measurements for each of 6 frequencies for each of 5 body segments (right and left arm, right and left leg, torso), followed by the calculation of the index of appendicular skeletal muscles. The criteria of RN. Baumgartner (2000) were used to diagnose sarcopenic obesity. RESULTS . Sarcopenic obesity was detected in 62 patients (44.3 %). There was no correlation with the underlying pathology. Patients with sarcopenic obesity were distinguished by a longer period of renal replacement therapy, the lowest concentration of serum creatinine and the number of points of the physical component of the SF-36 scale, higher levels of C-reactive protein, parathyroid hormone, HOMA-IR index, Charleson index. Also in this group, the lowest score on the IPAQ scale of motor activity and the worst results in the 6-minute walking test were noted. CONCLUSION . Currently, it is not entirely clear what is the primary link in the development of sarcopenic obesity and whether it is realistic to isolate it in a particular patient. We believe that the main cause of the development of this syndrome is obesity, which causes the expression of pro-inflammatory cytokines and insulin resistance. The most important modifiable risk factor for obesity is considered to be the hypercaloric intake of patients, which is due to the lack of nutritionists with experience in the field of nephrology and indexing the amount of calories indicated in clinical recommendations to the real, and not to the recommended body weight.

Impacts of gain versus loss frame messages about beverages on boy students, an application of extended parallel process model

BackgroundUnhealthy diet including consumption of high amounts of sugar-sweetened beverages is a key modifiable risk factor for obesity and NCDs which begin in childhood and adolescence. The study aimed to compare the effect of gain frame vs. loss frame messages on SSBs consumption intention and behavior of high school boy students.MethodsIn this quasi-experimental study, 270 students from three boy’s high schools were selected through a multistage random sampling. Data collection was done through a 15 items self-reported questionnaire before and two months after the intervention. Each of the two intervention groups received one of the two types of gain frame or loss frame designed pamphlets inspired with extended parallel process model. The control group received no pamphlet.ResultsIn control, GFM and LFM groups 91, 86 and 89 students participated in the study, respectively. After the intervention, significant differences were observed in perceived efficacy and threat of the GFM group and perceived efficacy, threat and intention in the LFM group compared with before the intervention. The GFM group had higher perceived self-efficacy than the control group and lower perceived severity than the LFM group. Intention to consume SSBs reduced significantly in LFM group, compared with the control group.ConclusionsA combination of LFM and GFM messages could more effectively lead to nutritional behavior change regarding the consumption of SSBs. Results help to design messages for educational programs and nutritional campaigns.

Socioeconomic status and use of obesogenic and anti-obesity medications in the United States: A population-based study

SummaryBackgroundThe Endocrine Society Clinical Practice Guidelines recommend the avoidance of medications that may cause weight gain (i.e., obesogenic medications) in individuals with overweight or obesity. Obesity disproportionately affects people with lower socioeconomic status (SES); however, it is unknown whether the use of obesogenic medications differs by SES.MethodsWe included adults with overweight or obesity and used prescription medications from 2009-2018 of the US National Health and Nutrition Examination Survey. We examined the associations between a composite measure of SES and use of obesogenic medications and anti-obesity medications. The composite SES included <high school education (1 point), household income below federal poverty level (1 point), no insurance (2 points), and public health insurance only (1 point). We defined 3 composite SES groups (0 [high], 1 [intermediate], and ≥2 points [low]).FindingsAmong 10,673 US adults with overweight or obesity, 20.0% had low SES. Use of obesogenic medications was common (37.7%). Low (vs. high) SES was associated with greater obesogenic medication use, independent of demographic characteristics, prescription medication burden, and comorbidities (OR 1.3 [1.2-1.5]). Among 12,133 eligible participants, utilization of anti-obesity medications was very low overall (0.5%) and within all SES groups (low 0.27%, intermediate 0.71, and high 0.65%).InterpretationOur findings highlight common and modifiable risk factors for obesity. Clinicians should screen patient medications for those that may cause weight gain and increase adoption of anti-obesity medications, especially among adults living in low SES.FundingThe National Institute of Diabetes and Digestive and Kidney Disease (R01DK115534, K24HL155861, and K01DK121825).

Early childhood growth trajectories in a Medicaid population.

Evidence on the role of early growth trajectories and later obesity risk is primarily based on privately insured or universally insured samples. We aimed to characterize and determine factors associated with early growth trajectories and estimate associations with overweight/obesity risk in a Medicaid-insured and uninsured cohort. Infants seen at a large pediatric academic centre in 2010-2016 were included. Weight and length/height measurements were converted to age and sex-specific BMI z-scores (BMIz) based on the World Health Organization (WHO) Growth Standards. Group-based trajectories were modelled using BMIz created groups. Logistic and log-binomial regression models estimated associations between membership in trajectories and maternal/child factors and overweight or obesity at 36, 48, and 60 months, separately. Analyses were performed between 2019 and 2021. The best-fitting model identified five BMIz trajectories among 30 189 children and 310 113 clinical encounters; two trajectories showed rapid rise in BMIz. Lower maternal education, pre-pregnancy maternal overweight/obese status, and maternal smoking were positively associated with both rapid-rising BMIz trajectories. Children in either of the two rapid-rising trajectories were 3.00 (95% CI: 2.85, 3.25), 2.97 (95% CI: 2.77, 3.18) and 2.76 (95% CI: 2.53, 3.01) times more likely to have overweight or obesity at 36, 48, and 60 months, respectively compared to children in the stable trajectory groups. Among Medicaid insured and uninsured children, several maternal and child characteristics were associated with early rapid-rise in BMIz. Clinical monitoring of early rapidly rising BMI may be important to address modifiable risk factors for obesity in families from low-income households.

Outcome of structured health education intervention for obesity-risk reduction among junior high school students: Stratified cluster randomized controlled trial (RCT) in South India.

Obesity has been identified as a serious global health concern whose prevalence doubles almost every 10 years. Health education regarding physical activity and healthy diet imparted to adolescents could prove to be fruitful in reducing obesity-risk. Objectives of this study were to evaluate the effect of health education intervention on knowledge, attitude, and practices (KAP) regarding obesity-risk reduction and to estimate the postinterventional change in body mass index (BMI) and total body fat (%) among adolescent school children in South India. Stratified cluster randomized controlled trial was carried out among 398 students recruited at baseline including 206 and 192 participants in intervention and control group respectively selected through simple random sampling from eligible government aided and private schools to assess KAP regarding physical activity and diet using pretested and validated questionnaire by making three school visits 6 months apart. Anthropometric measurements were recorded in first and third visit only, while health education intervention was given in first visit to intervention and third visit to control group after taking their responses on the questionnaire. Data were entered and analyzed using SPSS version 15. Overall dropout rate was 13.5% with dropout in intervention and control group being 12.6% and 14.5% respectively, making 180 participants in intervention and 164 in control group available for analysis. Mean physical activity KAP score improved significantly from 16.19 ± 4.61 to 19.46 ± 10.07 in intervention group. Mean dietary KAP score also improved significantly from 21.38 ± 4.07 to 23.43 ± 4.53 in intervention group (p < 0.001). Mean BMI decreased significantly within intervention group (p < 0.001) as compared to control group (p = 0.908). Based on cut-off level for total body fat (%) to categorize obesity-risk among participants, statistically significant decline in proportions from 26.1% to 13.3% was observed in intervention group (p < 0.001). Results depicted better KAP in intervention group than control group in all the three visits while it improved significantly within both groups. Hence, the health education was found to be effective in improving the overall KAP regarding modifiable risk factors of obesity among the study participants. Further studies to screen the adolescents for obesity-risk and successive health education sessions must be carried within schools in order to bring about change in knowledge, attitude, and practices regarding obesity-risk.

Street-View Greenspace Exposure and Objective Daily Rest-Activity Patterns

BACKGROUND AND AIM: Rest-activity patterns (sleep and physical activity) are modifiable risk factors for obesity. The sparse research on greenspace and sleep or physical activity in children is dominated by satellite-derived measures of greenspace, which do not capture ground-level exposures. Google Street View (GSV) images measure greenspace exposures as participants experience them and may be most relevant for health. We aimed to examine GSV-based greenspace and objective rest-activity patterns in adolescents in Project Viva, a cohort in eastern Massachusetts participating in the Environmental influences on Child Health Outcomes (ECHO) consortium. METHODS: We applied deep learning algorithms to GSV images from 2012-2016 to derive metrics of greenspace (e.g., % trees, %grass within each image) within 250m of participant’s residential addresses. We derived rest-activity metrics from the early adolescence visit (2012-2016; median age 12.7), when participants completed 5 days of wrist actigraphy for 10 hours/day. We used linear regression to examine associations between GSV-based greenspace and rest-activity patterns, adjusting for child’s sex, race/ethnicity, and age; mother’s education and marital status; father’s education; household income; neighborhood median income and population density. RESULTS:In unadjusted cross-sectional analyses (N=505), higher %grass, %trees, %plants, %fields, and %flowers combined (%total greenspace) was associated with lower activity in the least active 5-hour period (L5) in the 24-hour cycle, suggesting more consolidated sleep (L5 difference per IQR [24%] increase in %greenspace: -10.3 [95%CI -16.4,-4.2]), and slightly higher relative amplitude (RA), reflecting both higher activity during wakefulness and more restful sleep at night (RA difference per IQR increase in %greenspace: 0.01 (95%CI 0.01, 0.02)). These associations were consistent for both %grass and %trees. However, in multivariable models, these associations were no longer present. No associations were observed between GSV-based %greenspace exposure and moderate-vigorous nor light physical activity. CONCLUSIONS:GSV-based greenspace exposure was not associated with objective rest-activity patterns among participants in early adolescence. KEYWORDS: Greenspace, Google Street View, Deep Learning, Accelerometry, Rest Activity, Children

Decreasing Older Adult COVID-19 Risk Factors Using Digital Technology to Implement a Plant-Based-Diet: An Opinion Paper.

A disproportionate number of COVID-19 cases affect older, minority populations. Obese older adults are at higher risk of developing severe COVID-19 complications and lower survival rates, and minority older adults often experience higher rates of obesity. A plant-based diet intervention may improve COVID-19-related modifiable risk factors for obesity. Encouraging the consumption of plant-based diets comprising vegetables, fruits, whole grains, legumes, seeds, and nuts by utilizing community outreach strategies and digital technology can contribute to improving COVID-19 risk factors among this population.

The Impact of Obesity and Lifestyle on the Immune System and Susceptibility to Infections Such as COVID-19.

Background: COVID-19 is a global challenge to healthcare. Obesity is common in patients with COVID-19 and seems to aggravate disease prognosis. In this review we explore the link between obesity, chronic disease, lifestyle factors and the immune system, and propose societal interventions to enhance global immunity.Search Strategy and Selection Criteria: We performed three literature searches using the keywords (1) coronavirus AND comorbidities, (2) comorbidities AND immune system, and (3) lifestyle factors AND immune system. Results were screened for relevance by the main author and a total of 215 articles were thoroughly analyzed.Results: The relationship between obesity and unfavorable COVID-19 prognosis is discussed in light of the impact of chronic disease and lifestyle on the immune system. Several modifiable lifestyle factors render us susceptible to viral infections. In this context, we make a case for fostering a healthy lifestyle on a global scale.Conclusions: Obesity, additional chronic disease and an unhealthy lifestyle interactively impair immune function and increase the risk of severe infectious disease. In adverse metabolic and endocrine conditions, the immune system is geared toward inflammation. Collective effort is needed to ameliorate modifiable risk factors for obesity and chronic disease on a global scale and increase resistance to viruses like SARS-CoV-2.

Obesity status and exposure to adverse childhood experiences: Does an association exist?

Background: Childhood obesity is a national public health crisis, with an increasing prevalence of over two-fold in the past 3 decades. Identification of modifiable risk factors for obesity is imperative to develop targeted interventions. Exposure to adverse childhood experiences (ACE) is associated with several health problems; however the association with childhood obesity is inconsistent. To better address this inconsistency, we examined the association between reported ACE scores and obesity status in a large sample size that allowed us to control for potential confounding factors. Methods: …

Trends, prevalence and associated factors of obesity among adults in a rural community in Thailand: serial cross-sectional surveys, 2012 and 2018

BackgroundObesity is one principle risk factor increasing the risk of noncommunicable diseases including diabetes, hypertension and atherosclerosis. In Thailand, a 2014 study reported obesity (BMI ≥25 kg/m2) in a Thai population aged ≥15 years was 37.5, 32.9 and 41.8% overall and among males and females, respectively. The study aimed to determine trends in the prevalence of obesity among adults residing in a Thai rural community between 2012 and 2018 and investigate the associations between obesity and behavioral factors.MethodsSerial cross-sectional studies were conducted in 2012 and 2018 among adults in Na-Ngam rural community. In 2012 and 2018, all 635 and 627 individuals, respectively, were interviewed using structured questionnaires related to demographics, risk behaviors, comorbidities and arthrometric measurement. Spot urine was collected by participants and obesity was defined as BMI ≥25 kg/m2. The risk factors for obesity were analyzed in the 2018 survey.ResultsA total of 1262 adults in Na-Ngam rural community were included in the study. The prevalence of obesity was 33.9% in 2012 and 44.8% in 2018 (P < 0.001). The average BMI increased from 23.9 ± 4.2 kg/m2 in 2012 to 25.0 ± 4.52 kg/m2 in 2018 (P < 0.001). Obesity was associated with higher age (AOR 0.99; 95%CI 0.97–0.99), smoking (AOR 0.52; 95%CI 0.28–0.94), instant coffee-mix consumption > 1 cup/week (AOR 1.44; 95%CI 1.02–2.04), higher number of chronic diseases (≥1 disease AOR 1.82; 95%CI 1.01–2.68, > 2 diseases AOR 2.15; 95%CI 1.32–3.50), and higher spot urine sodium level (AOR 1.002; 95%CI 0.99–1.01).ConclusionOur data emphasized that obesity constituted a serious problem among adults residing in a rural community. A trend in significant increase was found regarding the prevalence of obesity and average BMI in the rural community over 6 years. Effective public health interventions should be provided at the community level to reduce BMI. Moreover, modifiable risk factors for obesity should be attenuated to inhibit the progression of metabolic syndrome, noncommunicable diseases and their complications.

1257-P: Impact of Parental Smoking on Adipokine Profiles and Cardiometabolic Risk Factors in Chinese Children: The Beijing Child and Adolescent Metabolic Syndrome Cohort Study

Exposure to secondhand smoke has relatively recently been recognized to be an important modifiable risk factor for obesity and cardiovascular disease, along with unhealthy diet, sedentary lifestyle and insufficient sleep. The mechanism(s) by which passive smoking imparts this risk and the tissues involved still require elucidation. We aimed to evaluate the association between parental smoking exposure (PSE), secretion of adipokines and cardiometabolic risk in Chinese children. A total of 3150 children (6-18ys) from the Beijing Child and Adolescent Metabolic Syndrome (MetS) study with data on PSE and potential confounders (pubertal stage, physical activity, diet and socioeconomic factors plus family history) were included. Six adipokines related to insulin resistance and MetS (leptin, adiponectin, retinol binding protein 4 (RBP4), fibroblast growth factor 21 (FGF-21), resistin and osteonectin) were measured. Of those children studied, nearly 65% reported PSE, defined as smoking in either parent. After adjusting for covariates, including pubertal stage, lifestyle factors, and family history, PSE was independently associated with increases of 39.2% in leptin and 3.9% in RBP-4 and decreases of 11.4% in FGF-21 and 4.6% in adiponectin levels (P &amp;lt; 0.05 for all). The risks of central obesity (OR 1.59, 95% CI 1.33-1.90, P &amp;lt; 0.001), hyperglycemia (OR 1.30, 95%CI 1.02-1.66, P&amp;lt;0.05), hypertension (1.22, 1.02-1.46, P = 0.001) and MetS (1.43, 1.11-1.85, P &amp;lt; 0.001) were all increased with PSE. However, the associations of PSE with hypertension and MetS were abolished after adjusting for adiposity parameters or the above-mentioned adipokines. In contrast, PSE was still associated with increased risk of hyperglycemia after adjusting for BMI in boys (OR 1.42, 95%CI: 1.01-2.00, P&amp;lt;0.05). Our findings suggest that PSE was associated with dysregulation of adipokine levels, which may mediate the development of MetS in early life. Disclosure M. Li: None. Q. Zhang: None. S. Gao: None. S.M. Willi: Advisory Panel; Self; Boehringer Ingelheim International GmbH. Research Support; Self; Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Tolerion, Inc. Other Relationship; Self; Caladrius Biosciences, Inc. Funding National Natural Science Foundation of China (81970732); National Key Research and Development Program of China (2016YFC1304801); Key Program of Beijing Municipal Science and Technology Commission (D111100000611001, D111100000611002); Beijing Natural Science Foundation (7172169); Beijing Science and Technology Star Program (2004A027); Novo Nordisk Union Diabetes Research Talent Fund (2011A002); National Key Program of Clinical Science (WBYZ2011-873); Central Research Institute Fund of Chinese Academy of Medical Sciences (2017PT32020, 2018PT32001)

Usual Dietary Intake and Adherence to Dietary Recommendations among Southwest American-Indian Youths at Risk of Type 2 Diabetes

ABSTRACTBackgroundAmerican Indians are disproportionately affected by obesity and diabetes, and American-Indian youths have the highest prevalence of obesity and diabetes among all ethnic groups in the USA.ObjectivesThe purposes of this study were to assess the usual dietary intake in American-Indian youths who attended a wellness camp program; adherence to the Dietary Guidelines for Americans 2015–2020 (DGA) and to the Healthy People 2020 Objectives; and to compare pre- and postcamp reported diets.MethodsA total of six 24-h dietary recalls were conducted in person with American-Indian youths (aged 10–15 y; n = 26) from 3 different Southwest tribes. Three recalls were conducted before the wellness camp, and 3 were conducted after the camp. A series of 2-factor ANOVA were conducted, using a mixed model, to compare the nutrition differences before and after the health camp using a statistical program, R.ResultsAdherence to federal dietary recommendations was low, with few of the youths meeting the DGA recommendations for fruits (15%, average serving 0.69 cup/d) and vegetables (35%, average serving 0.59 cup/d). All of the participants exceeded the DGA recommended limit on empty calories. Nutrient analysis of total fat intake showed a significant decrease in intake after the camp, F (1, 52) = 5.68, P = 0.02.ConclusionsDiet is a modifiable risk factor for obesity and chronic diseases such as type 2 diabetes and needs to be an integral part of any healthy lifestyle intervention. The camp-based nutrition education had a positive effect on youths, as observed through the total fat intake decreasing after camp. To reinforce nutrition education, future nutrition education should involve parents, be delivered beyond the week at camp, and encompass social determinants of health and access to healthy foods.

Global, Regional, and National Levels of Fruit and Vegetable Consumption from the ROUND (WoRld Map of COnsUmption of Fruit and Vegetables and Nutrient Deficits) Project (P18-067-19)

ObjectivesLow fruit and vegetable consumption is one of the most important modifiable risk factors for obesity and chronic diseases, especially cardiovascular diseases and some types of cancer. The aim of the ROUND (WoRld Map of COnsUmption of Fruit and Vegetables and Nutrient Deficits) Project is to evaluate global consumption of fruit and vegetables and to characterize the distribution of related nutrient deficiencies. MethodsData relating to adult consumers from dietary surveys worldwide were identified, obtained, and assessed. Analyses were performed using Bayesian hierarchical models. ResultsData from different worldwide surveys were included in the analysis. Results show considerably variation between countries, even for those of middle-high income. For example in 2007, the mean per capita daily consumption of fruit (including fruit juice) and vegetables (and total) were: USA 325 g and 505 g (830 g, Census data); Germany 624 g and 106 g (730 g); Finland 429 g and 130 g (559 g); Netherlands 345 g and 133 g (478 g), and France 238 g and 145 g (382 g); (EFSA data). In 2012, an estimated 6.7 million deaths worldwide were attributable to a low intake of fruit and vegetables in both high and low-middle income countries. ConclusionsROUND analysis of data on adult fruit and vegetable consumption identifies diversity across nations, which can inform policies and assist in setting priorities for improving global health. Funding SourcesZETA RESEARCH S.r.l.