Normal-weight Participants Research Articles

619-P: An Isocaloric High Saturated Fat Diet Increases Endogenous Cholesterol Production Which Is Reversed by a Protein-Enriched Diet in Normal-Weight Humans

Lathosterol is a marker of endogenous cholesterol synthesis whereas plant sterols (e. g. campesterol) reflect cholesterol absorption. Obesity and type 2 diabetes mellitus are associated with increased endogenous cholesterol production and decreased cholesterol absorption. Only few studies evaluated cholesterol homeostasis under isocaloric nutritional conditions. This study investigated endogenous cholesterol production in healthy humans after consumption of isocaloric diets enriched with carbohydrates (KH) or saturated fat (HF) or protein (HP). 24 normal weight participants (women and men, age 18 - 70) were investigated for 18 weeks. An isocaloric diet rich in carbohydrates (55% carbohydrates, 30% fat, 15% protein, KH) was applied followed by an isocaloric diet rich in saturated fat (40% carbohydrates, 45% fat, 15% protein, HF) and finally followed by an isocaloric diet enriched with proteins (45% carbohydrates, 30% fat, 25% protein, HP); each for 6 weeks. Body weight (BW), serum total and LDL cholesterol and serum lathosterol and campesterol levels were analyzed after the KH period, after one week (HF1) and 6 weeks (HF6) of the HF and after the HP period. BW did not change during the study. Serum total and LDL cholesterol increased from 4.38±0.2 and 2.74±0.2 mmol/L, respectively at KH to 4.82±0.2 and 2.97±0.2 mmol/L, respectively at HF6 (both P<0.01) and were decreased back to KH levels at HP. Serum lathosterol levels increased 1.26-fold and 1.16-fold, respectively at HF1 and HF6 (P<0.05 compared to LF), however decreased by 10.1% at HP (compared to KH levels, P<0.05). Serum campesterol levels moderately decreased at HF1 and HF6 and were restored to KH levels at HP (P<0.01 compared to HF6). These data show that composition of macronutrients are responsible for diet induced elevation of serum cholesterol levels due to an increased endogenous cholesterol production in normal weight humans regardless of the energy content of the diet. Disclosure M.Kruse: None. S.Matysik: None. D.Hoffmann: None. T.Frahnow: None. A.F.Pfeiffer: Advisory Panel; Abbott Diabetes, Speaker's Bureau; Novo Nordisk, Sanofi-Aventis Deutschland GmbH. Funding German Federal Ministry of Education and Research (0315424)

The paradox of obesity with normal weight; a cross-sectional study.

To evaluate the prevalence of excessive adiposity among normal-weight individuals, and their cardiometabolic risk. This cross-sectional study included 3,001 participants (ages 20-95, 52% men, BMI 28.0 ± 5.5 kg/m2) who completed an anthropometric evaluation, dual x-ray absorptiometry (DXA) scan to measure body composition, and cardiometabolic blood markers. Excess adiposity was defined as ≥25% for men and ≥ 35% for women. Of the entire study participants, 967 were in normal BMI (18.5-24.9 kg/m2) with a wide body fat distribution (4-49%). Of them, 26% of men and 38% of women were classified with excess adiposity. As compared to normal-weight lean participants, normal-weight obese men and women had higher triglycerides (76.5 ± 37.3 vs. 101.2 ± 50.3 mg/dL, p = 0.004 and 84 ± 44.2 vs. 101.4 ± 91.1 mg/dL, p = 0.030; respectively) and elevated low-density lipoprotein cholesterol (103.3 ± 31.7 vs. 119.6 ± 45.5 mg/dL, p = 0.011) and total cholesterol (171.5 ± 40.3 vs. 190.2 ± 39 mg/dL, p = 0.007) for men only. Among NWO, abdominal circumference was prevalent in 60% of the females with NWO (≥88 cm), but only in 4% of males (≥102 cm). Higher adiposity, even within normal weight, increases cardiometabolic risk, and abdominal waist circumference misclassified obesity in normal-weight individuals. This study highlights the need for a body composition evaluation to determine cardiometabolic risk for adults with normal body weight.

Exploring The Relationship Between Body Mass Index (BMI), Body Weight Perception, And Weight Change Behaviour Among University Students in Urban Gujarat, India: A Cross-Sectional Study

Background: In the context of the rising trend of overweight and obesity, young people are more concerned about their weight. This study investigates the association between measured Body Mass Index (BMI), self-perception of body weight and weight change behavior among university students. Methods: This cross-sectional study assessed a sample of 415 university students aged 18-23 years residing in urban areas of Anand. Measures included weight, height, BMI, body weight perception and weight change behavior. The data were analyzed through descriptive statistics, the student’s t-test and Chi-square test. Results: About 36.1% of the participants misclassified their weight category. More women than men felt overweight in relation to their actual body shape. Among normal-weight or underweight BMI participants, 44.4% of females and 31.8% of males were inappropriately trying to lose weight. Conclusions: The study showed a higher prevalence of weight perception and inappropriate weight change behaviour. It also observed that the correct perception of body weight influences the willingness to lose or gain weight. It is important to consider these issues while designing a public health campaign targeting obesity and healthy lifestyles.

Concurrence of hyperinsulinemia and hyperuricemia significantly augmented all-cause mortality

Background and aimsHyperinsulinemia and hyperuricemia are known to increase the risk of mortality due to certain complications, such as Type 2 Diabetes and cardiovascular disease. However, despite their common comorbidities, their combined effect has not been evaluated. The study's aim was to evaluate the combine effect of hyperinsulinemia and hyperuricemia on all-cause mortality. Methods and resultsNHANES datasets (cycles 2003–2018) were examined. Differences between groups were evaluated using Rao-Scott Chi-square and General Linear Model for categorical and continuous data, respectively. Hazard Ratios (HR) were calculated using Cox regression with 95% confidence intervals (95%CI). There was significant difference (p < 0.05) in the mortality rate between the control group (2.3 ± 0.2%), the hyperinsulinemia only group (3.1 ± 0.3%), the hyperuricemia only group (4.0 ± 0.8%), and both conditions (5.1 ± 0.8%). Individually, when compared to the control group, there was a significant increase in mortality risk for hyperinsulinemia (HR: 1.50, 95%CI: 1.12–2.01, p = 0.007) and hyperuricemia (HR: 1.80, 95%CI:1.18–2.75, p = 0.006). However, when both conditions were present, there appeared an additive effect in the mortality risk (HR: 2.32, 95%CI: 1.66–3.25, p < 0.001). When stratified by BMI class, only normal weight participants presented with a significant risk (HR: 7.00, 95%CI: 2.50–20.30, p < 0.001). Also, when stratified by age, only participants older than 40 years presented a risk (HR: 2.22, 95%CI: 1.56–3.16, p < 0.001). ConclusionAlone, hyperuricemia and hyperinsulinemia significantly increased the mortality rate; however, the combined presence of both pathologies was associated with a significantly augmented mortality rate. Normal weight participant or that were >40 years old had a greater risk for mortality.

Pregnant Women's Perception and Knowledge of the Impact of Obesity on Prenatal Outcomes-A Cross-Sectional Study.

The prevalence of obesity and overweight has been rapidly increasing and is significantly higher among adult females in the Arab States. The aim of the present study was to explore pregnant Emirati women's perception of their weight, their knowledge of the healthy gestational weight gain, and the possible weight-related pregnancy complications. A total of 526 self-administered questionnaires were obtained with a response rate of 72%. The majority (81.8%, n = 429) entered pregnancy as overweight or obese. The percentage of pregnant women who underestimated their weight category was 12.1% in normal weight participants, 48.9% in overweight participants, and 73.5% in obese participants (p < 0.001). The overweight and obese participants were 13 times more likely to underestimate their weight status and 3.6 times more likely to correctly select their healthy gestational weight gain. Women's awareness of pregnancy-related complications due to weight varied from 80.3% for diabetes to 44.5% for fetal complications; their awareness of breastfeeding difficulty was the lowest at 2.5%. Moreover, there was a misconception about personal BMI and the appropriate range for gestational weight gain (GWG). Healthy lifestyle counselling urgently needs to be addressed in preventative health programs such as pre-marital and preconception counselling.

Association of visceral adiposity index with asymptomatic intracranial arterial stenosis: a population-based study in Shandong, China

Background and objectiveThe visceral adiposity index (VAI), as a composite indictor to evaluate visceral adipose function, has been demonstrated to be correlated with atherosclerosis. The study objective was to explore the association between asymptomatic intracranial arterial stenosis (aICAS) and VAI in Chinese rural dwellers.MethodsThe cross-sectional study consisted of 1942 participants ≥ 40 years old who were living in Pingyin County, Shandong Province and free from history of clinical stroke and transient ischemic attack. The aICAS in the study was diagnosed by transcranial doppler ultrasound combined with magnetic resonance angiography. The multivariate logistic regression models were deployed to explore the correlation of VAI with aICAS, and receiver operating characteristic (ROC) curve were plotted to compare the performance of models.ResultsThe participants with aICAS comparing to those without had a significantly higher VAI. After adjusting for confounding factors including age, hypertension, DM, sex, drinking habit, LDL-C, hsCRP, and smoking habit, the VAI-Tertile 3 (vs. VAI-Tertile 1) was positively associated with aICAS (OR, 2.15; 95% CI, 1.25–3.65; P = 0.005). The VAI-Tertile 3 was still markedly associated with aICAS among the underweight and normal weight (BMI ≤ 23.9 kg/m2) participants (OR, 3.17; 95% CI, 1.15–8.71; P = 0.026) with an AUC = 0.684. A similar relationship between VAI and aICAS was obtained among the participants with no abdominal obesity (WHR < 1, OR, 2.03; 95% CI, 1.14–3.62; P = 0.017).ConclusionsThe possible correlation between VAI and aICAS was found to be positive for the first time among Chinese rural residents over 40 years old. A higher VAI was found to be significantly associated with aICAS among the participants who were underweight or normal weight, and these results may provide additional risk stratification information for aICAS.

Comparative Study of Remnant Cholesterol, Some Lipid Fractions and FBS Level in Overweight and Obese Participants in South East Nigeria

Background: Obesity is one of the characteristics of metabolic disorders, it has been linked to cardiovascular diseases. Remnant cholesterol has been proposed to be a link between obesity and coronary heart disease, thus a risk factor for the development of cardiovascular disease in obese people. We compared the level of calculated non-fasting remnant cholesterol, fasting and non-fasting lipid profile and fasting blood sugar in overweight, obese and normal weight participants in Nnewi, a town in South East Nigeria.&#x0D; Methods: In this cross-sectional study, a total of 90 apparently healthy obese, overweight and normal weight participants who met the inclusion criteria were randomly enrolled. They were grouped using their body mass index of 18.5 to 24.9 kg/m2 (normal weight), 25 to 29.9 kg/m2 (overweight) and ≥30 kg/m2 (obese). The parameters were analyzed using standard methods.&#x0D; Results: Our results shows that there was progressive increase of remnant cholesterol among the group, this increase has no statistical difference (p&gt;0.05) in the mean calculated remnant cholesterol (mmol/l) between the obese (0.72±0.4), overweight (0.68±0.46), and normal weight (0.50±0.28) participants. The mean fasting Very Low Density Lipoprotein (VLDL) and Triglyceride (TG) (mmol/l) were significantly higher (p&lt;0.05) in overweight compared to normal weight participants (0.76±0.31 vs. 0.47±0.22) and (1.72±0.60 vs. 1.09±0.51) and obese participants (0.82±0.23 vs. 0.47±0.22) and (1.85±0.59 vs. 1.09±0.51) when compared to normal weight participants respectively. FBS levels (mmol/l) were significantly lower in normal weight participants when compared to overweight participants (3.45±0.79 vs. 4.46±1.82) and obese participants (3.46± 0.79 vs. 4.94±1.26).&#x0D; Conclusion: The results obtained from this study demonstrated a progressive increase in the level of remnant cholesterol which was not statistically significant among apparently healthy individuals across the group. Furthermore we did not observed Remnant cholesterol as a sole predictor to obesity which will lead to cardiovascular diseases, with the rising prevalence of obesity in developing country as well as its associated complications and risks.

Neural correlates of changing food choices while bypassing values

Current theories suggest that altering choices requires value modification. To investigate this, normal-weight female participants’ food choices and values were tested before and after an approach-avoidance training (AAT), while neural activity was recorded during the choice task using functional magnetic resonance imaging (fMRI). During AAT, participants consistently approached low- while avoiding high-calorie food cues. AAT facilitated low-calorie food choices, leaving food values unchanged. Instead, we observed a shift in indifference points, indicating the decreased contribution of food values in food choices. Training-induced choice shifts were associated with increased activity in the posterior cingulate cortex (PCC). In contrast, the medial PFC activity was not changed. Additionally, PCC gray matter density predicted individual differences in training-induced functional changes, suggesting anatomic predispositions to training impact. Our findings demonstrate neural mechanisms underlying choice modulation independent of valuation-related processes, which has substantial theoretical significance for decision-making frameworks and translational implications for health-related decisions resilient to value shifts.

Body composition and mortality from middle to old age: a prospective cohort study from the UK Biobank.

How the association between adiposity and the risk of death changes with age, and which is the optimal level of adiposity to reduce mortality in older ages, is still not completely understood. We aimed to ascertain the age-specific risks of mortality associated with different measures of adiposity. This was a prospective UK Biobank cohort study. Participants were categorized based on five different adiposity and body composition metrics. We explored the age-varying associations between body composition indices and all-cause mortality from 45 to 85 years of age at follow-up using hazard ratios (HR) from flexible parametric survival models with multivariable adjustment and age as timescale. Participants were followed from baseline (2006-2010) through 31 March 2020. We included 369,752 participants (mean baseline age = 56.3 ± 8.1 years; range 38.9-73.7 years; 54.1% women) and 10,660 deaths during a median follow-up of 11.4 years. Associations between body mass index and mortality were similar when using the fat mass index in magnitude and shape. Compared to participants with normal weight, overweight was not associated with the risk of death regardless of age and the adiposity measure used. Participants with obesity class I showed an HR of 1.20 (95% confidence interval [CI]: 1.08, 1.33) and 1.14 (95%CI: 0.98, 1.30) at ages 60 and 80, respectively, and participants with obesity class II an HR about 1.55 across all age. More attenuated associations with higher age were found in individuals with the highest obesity using the fat mass index. Very high lean mass was associated with an increased risk of mortality in those aged 55-75 years (HR about 1.20 across all ages). Obesity should be prevented at any age. Attenuated associations with older age were observed only among the individuals with the highest obesity, but the risk remained higher compared to normal-weight participants. Lean mass did not reduce mortality risk at any age.

Virtual self-conversation using motivational interviewing techniques to promote healthy eating and physical activity: A usability study.

We aim to examine the usability of a Virtual Reality (VR) platform, called ConVRSelf, which has been designed to address the needs of People Living With Obesity (PLWO). Fourteen participants with a desire to eat healthier and exercise more (6 normal weight and 8 PLWO; Mean age = 41.86, SD = 13.89) were assigned to the experimental group (EG) or the control group (CG). EG participants, after being trained on motivational interviewing skills, engaged in a virtual self-conversation using embodiment and body swapping techniques, which aimed to normalize and resolve their ambivalence to change lifestyle habits. CG participants, embodied in their virtual bodies, participated in a pre-established discourse with a virtual counselor giving them psychoeducational advice about how to change lifestyle habits. A mixed-methods design was used, involving a semi-structured interview and self-report questionnaires, including readiness to change habits (Readiness Rulers), body ownership (Body Ownership Questionnaire, BOQ), and system usability (System Evaluation Questionnaire, SEQ). Thematic content analysis was carried out for qualitative data while statistical data analysis was carried out using SPSS 20.0. Participants from both groups showed high readiness to change lifestyle (Readiness Rulers) before engaging with the virtual experiences, which was maintained at the same level after the interventions and their scores on the SEQ and BOQ were satisfactory. Regarding qualitative information obtained from the interviews, almost all participants found the VR experience to be novel, interesting, and enjoyable. A higher acceptability was observed among PLWO from the EG than normal weight participants from the same group, a promising finding for the ConVRSelf platform, which had been specifically designed to address the needs of PLWO. The ConVRSelf system is well-accepted by participants and is ready to be tested with PLWO in a clinical setting.

The impact of metabolic endotoxaemia on the browning process in human adipocytes

BackgroundDysfunctional adipose tissue (AT) is known to contribute to the pathophysiology of metabolic disease, including type 2 diabetes mellitus (T2DM). This dysfunction may occur, in part, as a consequence of gut-derived endotoxaemia inducing changes in adipocyte mitochondrial function and reducing the proportion of BRITE (brown-in-white) adipocytes. Therefore, the present study investigated whether endotoxin (lipopolysaccharide; LPS) directly contributes to impaired human adipocyte mitochondrial function and browning in human adipocytes, and the relevant impact of obesity status pre and post bariatric surgery.MethodsHuman differentiated abdominal subcutaneous (AbdSc) adipocytes from participants with obesity and normal-weight participants were treated with endotoxin to assess in vitro changes in mitochondrial function and BRITE phenotype. Ex vivo human AbdSc AT from different groups of participants (normal-weight, obesity, pre- and 6 months post-bariatric surgery) were assessed for similar analyses including circulating endotoxin levels.ResultsEx vivo AT analysis (lean & obese, weight loss post-bariatric surgery) identified that systemic endotoxin negatively correlated with BAT gene expression (p < 0.05). In vitro endotoxin treatment of AbdSc adipocytes (lean & obese) reduced mitochondrial dynamics (74.6% reduction; p < 0.0001), biogenesis (81.2% reduction; p < 0.0001) and the BRITE phenotype (93.8% reduction; p < 0.0001). Lean AbdSc adipocytes were more responsive to adrenergic signalling than obese AbdSc adipocytes; although endotoxin mitigated this response (92.6% reduction; p < 0.0001).ConclusionsTaken together, these data suggest that systemic gut-derived endotoxaemia contributes to both individual adipocyte dysfunction and reduced browning capacity of the adipocyte cell population, exacerbating metabolic consequences. As bariatric surgery reduces endotoxin levels and is associated with improving adipocyte functionality, this may provide further evidence regarding the metabolic benefits of such surgical interventions.

Abstract 3018: Demographic and social patterns of average values of inflammatorymarkers in US adults: A 2009-2016 NHANES analysis

Abstract Several studies report the negative impact of elevated Neutrophil-to-Lymphocyte ratio (NLR) and elevated Platelet-to-Lymphocyte ratio (PLR) on outcomes in many surgical and medical conditions, including cancer. In order to use these inflammatory biomarkers as prognostic factors in disease, a normal value in disease-free individuals must be identified first. This study aims to (1) establish average values of various inflammatory markers using a healthy and nationally representative U.S. adult population and (2) explore heterogeneity in average values by sociodemographic and behavioral risk factors to better specify cut-off points accordingly. The National Health and Nutrition Examination Survey (NHANES) of aggregated cross-sectional data collected from 2009 to 2016 was analyzed; data extracted included markers of systemic inflammation and demographic variables. We excluded participants who were under 20 or had a history of inflammatory diseases such as arthritis and gout. Adjusted linear regression models were used to examine the association between demographic and behavioral characteristics and neutrophil counts, platelet counts, lymphocyte counts, NLR, and PLR. The average NLR is 2.16 and the average PLR is 121.31. Non-Hispanic Black participants have significantly lower mean NLR values (1.78, 95% CI 1.74–1.83 and 2.10, 95% CI 2.04–2.16 respectively) when compared to non-Hispanic Whites (2.27, 95% CI 2.22–2.30–p&amp;lt;0.0001). Participants who reported any no smoking history had significantly lower NLR than subjects who reported any smoking history and higher PLR than current smokers. The average PLR for non-Hispanic blacks is significantly lower compared to non-Hispanic whites. Participants ages 20-29 have significantly lower mean PLR vs. participants in the age groups 30-59, 60-79, and 80 and older. Additionally, current smokers have significantly higher mean PLR compared to those who never smoke. Participants in the obese category also had higher mean PLR compared to normal weight participants. This study provides nationally representative estimates for demographic and behavioral effects on NLR, and PLR, which have been associated with several chronic disease outcomes, suggesting that different cut-off points for inflammatory markers should be set according to social factors. Citation Format: Marlene Camacho-Rivera, Zachary Ye, Raisa Haq, Rose Calixte. Demographic and social patterns of average values of inflammatorymarkers in US adults: A 2009-2016 NHANES analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3018.

Habitual daily intake of a sweet and fatty snack modulates reward processing in humans

Western diets rich in fat and sugar promote excess calorie intake and weight gain; however, the underlying mechanisms are unclear. Despite a well-documented association between obesity and altered brain dopamine function, it remains elusive whether these alterations are (1) pre-existing, increasing the individual susceptibility to weight gain, (2) secondary to obesity, or (3) directly attributable to repeated exposure to western diet. To close this gap, we performed a randomized, controlled study (NCT05574660) with normal-weight participants exposed to a high-fat/high-sugar snack or a low-fat/low-sugar snack for 8weeks in addition to their regular diet. The high-fat/high-sugar intervention decreased the preference for low-fat food while increasing brain response to food and associative learning independent of food cues or reward. These alterations were independent of changes in body weight and metabolic parameters, indicating a direct effect of high-fat, high-sugar foods on neurobehavioral adaptations that may increase the risk for overeating and weight gain.

Association between metabolically healthy overweight/obesity and gallstones in Chinese adults

BackgroundMetabolic syndrome and obesity are risk factors for gallstones. However, these two factors often occur together, and few studies have focused on the association between metabolically healthy overweight/obesity (MHOW/MHO) and gallstones. We hypothesized that MHO individuals would be associated with the prevalence of gallstones.MethodsThis cross-sectional study included 125,668 participants aged 18–80 years at the Health Promotion Center of Run Run Run Shaw Hospital, Zhejiang University School of Medicine during 2017–2019 years. Each participant underwent a comprehensive health checkup. Gallstones were diagnosed by abdominal ultrasonography. Metabolically health was defined as not meeting the diagnostic criteria for metabolic syndrome (MetS). Obesity was measured by BMI. MetS and weight stratification were combined to classify the metabolism-obesity phenotypes. Logistic regression models were used to estimate adjusted odds ratios (ORs) and 95% CIs.ResultsAmong 125,668 participants, 5486 (4.4%) had gallstones. 21407 (17.0%) were MHOW individuals, and 3322 (2.6%) were MHO individuals. MHOW (OR 1.40; 95%CI: 1.29–1.53) and MHO (OR 1.80; 95%CI: 1.53–2.12) participants were at higher risk of gallstones and had larger and more numerous gallstones than metabolically healthy normal weight participants. Obesity, MetS, premenopausal women and advanced age were significantly associated with the prevalence of gallstones.ConclusionsMHOW/MHO individuals exhibited a higher risk of gallstones. In metabolically healthy individuals, the risk of gallstones increased with increasing BMI. Thus, obesity was associated with the prevalence of gallstones, even in relatively metabolically healthy adults.

Correlates of Weight Bias in Adults From the NutriNet-Santé Study

Explicit weight bias is an underlying cause of weight stigma, but its associations with individual characteristics are not well known. This study aimed to assess explicit weight bias in French adults and to explore the associations with weight status and sociodemographic characteristics. Adults from the NutriNet-Santé cross-sectional study (France, 2020, n=33,948, 52% women after weighting procedures) completed the Anti-Fat Attitudes Questionnaire assessing three dimensions: Dislike (antipathy toward people with obesity), Fear of fat (concerns about body weight), and Willpower (belief in weight controllability). Associations with weight status and sociodemographic characteristics were examined using multivariable ANCOVA models in 2022. Fear of fat and Willpower scores were higher than Dislike scores (mean [SD]=4.0 [2.0], 3.3 [1.7] and 1.9 [1.3], respectively). Fear of fat was higher among women, whereas Dislike and Willpower were higher among men (all p<0.0001). Obesity was associated with greater Fear of fat scores (p<0.0001, mean difference versus normal-weight participants [95% CI]=0.35 [0.24, 0.46] in women, 0.36 [0.17, 0.56] in men), lower Dislike scores (-0.38 [-0.45, -0.32] in women, -0.43 [-0.56, -0.30] in men), and lower Willpower scores (-1.00 [-0.18, -0.90] in women, -0.40 [-0.57, -0.23] in men). In both genders, lower income was associated with lower Dislike, Fear of fat, and Willpower scores (all p<0.0001), and lower education was associated with greater Fear of fat and Willpower scores (all p<0.0001). Explicit weight bias was driven by the fear of gaining weight and the belief in weight controllability. This study provides new insights into which population subgroups should be targeted by interventions aimed at reducing explicit weight bias.

Abstract MP31: Serum Metabolite Signatures for Metabolic Healthy and Unhealthy Obesity: The Bogalusa Heart Study

Introduction: Mechanisms for metabolically healthy obesity (MHO) are not well studied. Methods: We performed cross-sectional analyses among 1,261 participants of the Bogalusa Heart Study 2013-2016 survey. A total of 887 known serum metabolites were profiled using an untargeted approach. Participants who met all the following five criteria were considered metabolically healthy, otherwise, unhealthy: 1) SBP &lt;130 mm Hg and DBP &lt;85 mm Hg; 2) fasting glucose &lt;100 mg/dl; 3) triglycerides &lt;150 mg/dl; 4) HDL ≥40 mg/dl in men and ≥50 mg/dl in women; and 5) not taking medications for hypertension, diabetes, or dyslipidemia. We tested associations of metabolites with metabolic health status, controlling for age, sex, race, education, smoking, drinking, and kidney function. Results: Among 648 obese participants (BMI≥30 kg/m 2 ), 66 (10.2%) had MHO. After Bonferroni correction, 26 metabolites differed between MHO and metabolically unhealthy obesity (MUO) groups. Amino acids serine , glycine, and histidine , fatty acid N-linoleoylserine , 4 sphingolipids, and 3 plasmalogens were significantly higher among MHO individuals. These metabolites are functionally relevant to metabolic health ( Table ). Carbohydrates mannose , lactate, and pyruvate , urate , amino acids glutamate , 1-carboxyethylvaline , 1-carboxyethylleucine , 3-methyl-2-oxovalerate , and 3-methyl-2-oxobutyrate , PE(18:0/18:2(9Z,12Z)) , and 5 diacylglycerols were significantly higher in the MUO group. These metabolites are mostly food additives or reduce gut microbiota diversity ( Table ). Furthermore, histidine was associated with metabolic health only among overweight and obese participants. Odds ratios of being metabolically healthy per SD increase of histidine among normal weight, overweight, and obese participants were 1.05 (95% CI: 0.83-1.32), 1.54 (95% CI: 1.10-2.14), and 2.12 (95% CI: 1.56-2.89), respectively (P for group difference=1.41E-4). Conclusion: We identified potential intervention targets to improve metabolic health in obesity.

Body Mass Index Measured Repeatedly over 42 Years as a Risk Factor for Ischemic Stroke: The HUNT Study

Higher BMI in middle age is associated with ischemic stroke, but little is known about BMI over adulthood, and the risk for ischemic stroke as most studies relied on a single measurement of BMI. BMI was measured four times over a period of 42 years. We calculated average BMI values and group-based trajectory models and related these to the prospective risk of ischemic stroke after the last examination in Cox models with a follow-up time of 12 years. A total of 14,139 participants, with a mean age of 65.2 years and 55.4% women, had information on BMI from all four examinations, and we observed 856 ischemic strokes. People with overweight and obesity over adulthood had a higher risk for ischemic stroke with a multivariable-adjusted hazard ratio of 1.29 (95% CI 1.11-1.48) and 1.27 (95% CI 0.96-1.67), respectively, when compared to normal weight participants. Excess weight tended to have stronger effects earlier than later in life. A trajectory of developing obesity throughout life was associated with higher risk than other trajectories. High average BMI, especially at an early age, is a risk factor for ischemic stroke. Early weight control and long-term weight reduction for those with high BMI may decrease the later occurrence of ischemic stroke.

Relationship between depression and lifestyle factors in Chinese adults using multi-level generalized estimation equation model.

Relationship between depression and lifestyle factors in Chinese adults using multi-level generalized estimation equation model.

Vascular dysfunction and body mass index in African adults with HIV

BackgroundImpaired vascular compliance is common among persons with HIV (PWH) and a risk factor for cardiovascular disease (CVD), though many studies documenting this are from regions with a high prevalence of overweight and obesity. The prevalence and characteristics of impaired vascular compliance among PWH with low body mass index (BMI) is not well described, particularly in sub-Saharan Africa (SSA) where the majority of PWH live, a low BMI is more common, and the burden of CVD is rising.AimTo assess non-invasive vascular compliance measurements, including augmentation index (AIX), pulse wave velocity (PWV) and pulse waveforms, in underweight, normal weight, and overweight PWH on long-term antiretroviral therapy (ART) in SSA.MethodsA cross-sectional study among PWH on ART at the University Teaching Hospital in Lusaka, Zambia. All participants had been on a regimen of efavirenz, emtricitabine, and tenofovir disoproxil fumarate for five or more years. Carotid-femoral PWV (cfPWV), carotid-radial PWV (crPWV), and the corresponding augmentation indexes (cfAIX and crAIX), were measured in all participants, in addition to aortic pressure waveforms, classified as type A, B, C and D according to reflected wave timings and amplitude. Multiple linear regression assessed relationships between demographic and clinical factors with vascular measurement endpoints.ResultsNinety one PWH on long-term ART were enrolled; 38 (42%) were underweight (BMI < 18.5 kg/m2), 43 (47%) were normal weight (18.5–24.9 kg/m2) and 10 (11%) were overweight (> 25 kg/m2). Median age was 41, 40 and 40 years, among the three groups, respectively, and the proportion of women increased with BMI level. Overweight participants had a 39% higher cfAIX compared to normal-weight participants, while being underweight was associated with 27% lower cfAIX, after adjusting for age, sex and blood pressure (P = 0.02 and P = 0.01, respectively), but measurements of cfPWV, crPWV and crAIX did not differ.ConclusionUnderweight PWH in SSA had lower cfAIX measurements compared to normal weight individuals, indicating less arterial stiffness. However, similar cfPWV, crPWV and crAIX values among the underweight and overweight PWH suggest a low BMI may not confer substantial protection against impaired vascular compliance as a contributor to CVD risk among individuals on ART.

The Association Between Physical Activity and Peripheral Neuropathy in Diabetic Patients: A Cross-Sectional Multicenter Study From Saudi Arabia.

Background Peripheral diabetic neuropathy (PDN) is a serious consequence of diabetes mellitus (DM) that can impair quality of life and result in physical disability. This study aimed to investigate the relationship between physical activity and the severity of PDN among a sample of Saudi diabetic patients in Medina city, Saudi Arabia. Methodology A total of 204 diabetic patients participated in this multicenter, cross-sectional study. A validated self-administered questionnaire was distributed electronically to patients on-site during follow-up. Physical activity and diabetic neuropathy (DN) were assessed using the validated International Physical Activity Questionnaire (IPAQ) and the validated Diabetic Neuropathy Score (DNS), respectively. Results The mean (SD) age of the participants was 56.9 (14.8) years. The majority of the participants reported low physical activity (65.7%). The prevalence of PDN was 37.2%. There was a significant correlation between the severity of DN and the duration of the disease (p = 0.047). Higher neuropathy score was noticed in those with hemoglobin A1C (HbA1c) level ≥7 compared to those with lower HBA1c (p = 0.045). Overweight and obese participants had higher scores compared to normal-weight participants (p = 0.041). The severity of neuropathy decreased significantly when the level of physical activity increased (p = 0.039). Conclusions There is a significant association between neuropathy and physical activity, body mass index, duration of diabetes mellitus, and HbA1c level.