Smaller Waist Circumference Research Articles

Inverse Association between Omega-3 Index and Severity of COVID-19: A Case-Control Study.

Background: Omega-3 fatty acids enhance immune response and modulate inflammation. This study aimed to determine the relationship between omega-3 fatty acid status and the severity of SARS-CoV-2 infection. Methods: Using a case–control design, we compared hospitalized patients with severe SARS-CoV-2 infection (cases, n = 73) with a group of ambulatory patients with mild SARS-CoV-2 infection (controls, n = 71). No patients were vaccinated against SARS-CoV-2. Results: The cases were older (p = 0.003), less educated (p = 0.001), had larger neck and smaller waist circumferences (p = 0.035 and p = 0.003, respectively), more frequently had diabetes (p < 0.001), consumed less fish (p < 0.001), consumed higher proportions of fried fish (p = 0.001), and had lower Omega-3 Index (O3I) values (p = 0.001) than controls. Cases had significantly lower rates of upper airway symptoms than controls. Lower O3I was associated with an increased likelihood of developing severe COVID-19 after adjusting for potential confounders (OR: 0.52; CI 0.32–0.86). Diabetes (OR: 4.41; CI 1.60–12.12), neck circumference (OR: 1.12; CI 1.03–1.21), and older age (OR: 1.03; CI 1.002–1.062) were also linked to COVID-19 severity. Fried fish consumption and low educational level were independent risk factors for severe COVID-19. Conclusions: This study suggests incorporating nutritional interventions to improve omega-3 status within nonpharmacological measures may help to reduce the severity of COVID-19.

Association between kratom (Mitragyna speciosa) use and metabolic syndrome

Background and aimsThere are evidence about effects of kratom (Mitragyna speciosa) use on parameters related to metabolic syndrome (MetS). The present study aimed to determine the association between kratom use and MetS. MethodsThis study is a cross-sectional study of 581 subjects (kratom users and non-users) aged 18 and over from the Nam Phu sub-district, Surat Thani province, Thailand. The association was determined using multivariate logistic regression. ResultsMetS prevalence in kratom users and non-users was 11.9% (95% CI, 8.4–16.3%) and 21.6 % (95% CI, 17.1–26.8%), respectively. The use of kratom was associated with the lower odds of MetS (adjusted OR, 0.56; 95% CI, 0.33–0.96). Kratom use were associated with smaller waist circumference, lower triglycerides, and higher high-density lipoprotein. ConclusionsThe current study demonstrated a potential protective effect of kratom use against MetS.

The physical activity health paradox and risk factors for cardiovascular disease: A cross-sectional compositional data analysis in the Copenhagen City Heart Study.

Studies indicate that physical activity during leisure and work have opposite associations with cardiovascular disease (CVD) risk factors, referred to as the physical activity health paradox. We investigated how sedentary behaviour and physical activity types during leisure and work are associated with systolic blood pressure (SBP), waist circumference (WC), and low-density lipoprotein cholesterol (LDL-C) in an adult general population sample using compositional data analysis. Participants wore accelerometers for 7 days (right thigh and iliac crest; 24 h/day) and had their SBP, WC, and LDL-C measured. Accelerometer data was analysed using the software Acti4 to derive daily time spent in sedentary behaviour and physical activity types. The measure of association was quantified by reallocating time between sedentary behaviour and 1) walking, and 2) high-intensity physical activity (HIPA; sum of climbing stairs, running, cycling, and rowing), during both domains. In total, 652 participants were included in the analyses (median wear time: 6 days, 23.8 h/day). During leisure, the results indicated that less sedentary behaviour and more walking or more HIPA was associated with lower SBP, while during work, the findings indicated an association with higher SBP. During both domains, the findings indicated that less sedentary behaviour and more HIPA was associated with a smaller WC and lower LDL-C. However, the findings indicated less sedentary behaviour and more walking to be associated with a larger WC and higher LDL-C, regardless of domain. During leisure, less sedentary behaviour and more walking or HIPA seems to be associated with a lower SBP, but, during work, it seems to be associated with a higher SBP. No consistent differences between domains were observed for WC and LDL-C. These findings highlight the importance of considering the physical activity health paradox, at least for some risk factors for CVD.

Dual Heart-kidney Transplant With Total Abdominal Hysterectomy

Introduction Dual heart and kidney transplantation (HKTx) is becoming an increasingly common surgical approach to selected patients with end-stage heart failure and end-stage renal disease. To date, there are no published reports of HKTx performed with near-concurrent total abdominal hysterectomy. Herein we present a case of a female patient who underwent successful HKTx with total abdominal hysterectomy. Case A 39 year old African American woman with a body mass index of 22 kg/m2 with significant uterine fibroids (figure 1), dilated cardiomyopathy from prior viral myocarditis, and chronic kidney disease was transferred to our institution for consideration of dual organ transplant.Upon transfer, the patient presented in SCAI shock Class D on dual inotropes. Despite the high doses of milrinone and dobutamine, her hemodynamics remained suboptimal with a blood pressure of 86/54 and heart rate of 130. Her exam was notable for elevated jugular venous pressure, cool extremities, and a loud systolic murmur with radiation to the apex. Labs revealed a sodium of 127meq/L and a worsening creatinine of 3.7mg/dL from a baseline of 2.5mg/dL. A right heart catheterization revealed elevated biventricular filling pressures and persistently low cardiac index (1.5 L/min/m2). She required the addition of epinephrine and a balloon pump for stabilization.She was then presented for an urgent heart and kidney transplantation, but given significant uterine fibroids, and relatively small BMI and waist circumference, gynecological surgery was consulted for need of total abdominal hysterectomy for the placement of the kidney. A planned surgical approach, to include orthotopic heart transplantation with concurrent total abdominal hysterectomy, followed by next-day kidney transplant, was devised. The patient was counseled regarding future inability of pregnancy. She was successfully transplanted with no intraoperative complications. On post-op day 10, the patient developed hemoperitoneum that required exploratory laparotomy with the evacuation of hemoperitoneum and re-suturing of the vaginal cuff. She was discharged 18 days after transplant. Her follow-up to date has been uneventful. Conclusion Our case demonstrates that heart and kidney transplantation with total abdominal hysterectomy is a safe and effective method in patients with a small BMI and enlarged leiomyoma that may prohibit implantation of the donor kidney. Dual heart and kidney transplantation (HKTx) is becoming an increasingly common surgical approach to selected patients with end-stage heart failure and end-stage renal disease. To date, there are no published reports of HKTx performed with near-concurrent total abdominal hysterectomy. Herein we present a case of a female patient who underwent successful HKTx with total abdominal hysterectomy. A 39 year old African American woman with a body mass index of 22 kg/m2 with significant uterine fibroids (figure 1), dilated cardiomyopathy from prior viral myocarditis, and chronic kidney disease was transferred to our institution for consideration of dual organ transplant.Upon transfer, the patient presented in SCAI shock Class D on dual inotropes. Despite the high doses of milrinone and dobutamine, her hemodynamics remained suboptimal with a blood pressure of 86/54 and heart rate of 130. Her exam was notable for elevated jugular venous pressure, cool extremities, and a loud systolic murmur with radiation to the apex. Labs revealed a sodium of 127meq/L and a worsening creatinine of 3.7mg/dL from a baseline of 2.5mg/dL. A right heart catheterization revealed elevated biventricular filling pressures and persistently low cardiac index (1.5 L/min/m2). She required the addition of epinephrine and a balloon pump for stabilization.She was then presented for an urgent heart and kidney transplantation, but given significant uterine fibroids, and relatively small BMI and waist circumference, gynecological surgery was consulted for need of total abdominal hysterectomy for the placement of the kidney. A planned surgical approach, to include orthotopic heart transplantation with concurrent total abdominal hysterectomy, followed by next-day kidney transplant, was devised. The patient was counseled regarding future inability of pregnancy. She was successfully transplanted with no intraoperative complications. On post-op day 10, the patient developed hemoperitoneum that required exploratory laparotomy with the evacuation of hemoperitoneum and re-suturing of the vaginal cuff. She was discharged 18 days after transplant. Her follow-up to date has been uneventful. Our case demonstrates that heart and kidney transplantation with total abdominal hysterectomy is a safe and effective method in patients with a small BMI and enlarged leiomyoma that may prohibit implantation of the donor kidney.

Prenatal exposure to insecticides and child cardiometabolic risk factors in the VHEMBE birth cohort.

Background:As part of malaria control programs, many countries spray dichlorodiphenyltrichloroethane (DDT) or pyrethroid insecticides inside dwellings in a practice called indoor residual spraying that results in high levels of exposure to local populations. Gestational exposure to these endocrine- and metabolism-disrupting chemicals may influence child cardiometabolic health.Methods:We measured the serum concentration of DDT and dichlorodiphenyldichloroethylene (DDE) and urinary concentration of pyrethroid metabolites (cis-DBCA, cis-DCCA, trans-DCCA, 3-PBA) in peripartum samples collected between August 2012 and December 2013 from 637 women participating in the Venda Health Examination of Mothers, Babies and their Environment (VHEMBE), a birth cohort study based in Limpopo, South Africa. We applied marginal structural models to estimate the relationship between biomarker concentrations and child-size (height and weight), adiposity (body mass index [BMI], body fat percentage, waist circumference) and blood pressure at 5 years of age.Results:Maternal concentrations of all four pyrethroid metabolites were associated with lower adiposity including reduced BMI z-scores, smaller waist circumferences, and decreased body fat percentages. Reductions in BMI z-score were observed only among children of mothers with sufficient energy intake during pregnancy (βcis-DCCA, trans-DCCA=−0.4, 95% confidence interval (CI) = −0.7,−0.1; pinteraction=0.03 and 0.04, respectively) but there was no evidence of effect modification for the other measures of adiposity. Maternal p,p’-DDT concentrations were associated with a reduction in body fat percentage (β = −0.4%, 95% CI = −0.8,−0.0).Conclusions:Gestational exposure to pyrethroids may reduce adiposity in children at 5 years of age.

Liver fat in adult survivors of severe acute malnutrition

The association between severe acute malnutrition (SAM) in early childhood and liver fat in adults is unknown. We hypothesized that exposure to SAM, especially severe wasting, is associated with fatty liver later in life. In this observational study, abdominal CT was used to quantify mean liver attenuation (MLA) and liver:spleen attenuation ratio (L/S). Birth weight (BW), serum lipids, insulin resistance (homeostatic model assessment), anthropometry and intrabdominal fat were collected. Mean differences between diagnostic groups were tested and hierarchical regression analysis determined the best predictors of liver fat. We studied 88 adult SAM survivors and 84 community participants (CPs); age 29.0 ± 8.4 years, BMI 23.5 ± 5.0 kg/m2 (mean ± SDs). SAM survivors had less liver fat than CPs (using L/S) (p = 0.025). Severe wasting survivors (SWs) had lower BW (-0.51 kg; p = 0.02), were younger, thinner and had smaller waist circumference than oedematous malnutrition survivors (OMs). In the final regression model adjusting for age, sex, birth weight and SAM phenotype (i.e., oedematous malnutrition or severe wasting), SWs had more liver fat than OMs (using MLA) (B = 2.6 ± 1.3; p = 0.04) but similar liver fat using L/S (p = 0.07) and lower BW infants had less liver fat (MLA) (B = -1.8 ± 0.8; p = 0.03). Greater liver fat in SWs than OMs, despite having less body fat, supports our hypothesis of greater cardiometabolic risk in SWs. Other postnatal factors might influence greater liver fat in survivors of severe wasting, suggesting the need to monitor infants exposed to SAM beyond the acute episode.

Associations of iron status with breast cancer risk factors in adult women: Findings from National Health and Nutrition Examination Survey 2017–2018

ObjectiveThis study examined the association between iron status and a set of breast cancer risk factors among U.S. adult women aged 20–80 years. MethodsData from National Health and Nutrition Examination Survey (2017–2018) were used to examine the relation between serum ferritin, serum iron and transferrin saturation with a set of breast cancer risk factors [body mass index (BMI), waist circumference, glycosylated hemoglobin (HbA1c), fasting plasma glucose, insulin and HOMA-IR]. The multivariable linear regressions were used controlling for age, race/ethnicity, menopause status, education level, smoking status, alcohol consumption, physical activity, high-sensitivity C-reactive protein (hsCRP) and total energy intake. ResultsHbA1c, BMI and waist circumference data were available for 1902 women with a fasting sample (n = 913) for fasting plasma glucose, insulin and HOMA-IR. Transferrin saturation had significant, inverse associations with BMI, waist circumference and HbA1c. The size of difference observed were that participants in the fourth quartile of transferrin saturation had a 4.50 kg/m2 smaller BMI, a 9.36 cm smaller waist circumference and a 0.1 % lower HbA1c level than participants in the first quartile. Similarly, serum iron concentrations were inversely associated with BMI and waist circumference. In addition, serum iron had significant, inverse associations with insulin and HOMA-IR. Sensitivity analyses among men gave similar results. For serum ferritin, there was a trend towards a positive association between waist circumference, HbA1c and fasting plasma glucose with serum ferritin. However, the associations did not reach statistical significance among women. ConclusionsIron status may impact breast cancer risk via effects on adiposity or glucose metabolism. The findings should be confirmed with further prospective data.

Prevalence and Determinants of a Blunted Parathyroid Hormone Response in Young Saudi Women with Vitamin D Deficiency: A Cross-Sectional Study

Vitamin D deficiency is highly prevalent among the Saudi population. Increased parathyroid hormone (PTH) secretion is an appropriate homeostatic response to correct the resultant hypocalcemia. However, not all vitamin D deficiency patients have increased PTH levels. This study determined the prevalence of a blunted PTH response to vitamin D deficiency among apparently healthy young Saudi women and assessed anthropometric and biochemical factors associated with this response by performing a secondary analysis of data obtained from a cross-sectional study conducted at the “Center of Excellence for Osteoporosis research.” Overall, 315 women (aged 20–45 years) with vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) levels <30 nmol/L) were included. They were divided into two groups according to the laboratory cutoff value of PTH (<7 or ≥7 pmol/L), and anthropometric and biochemical characteristics of both groups were compared. Women with a blunted PTH response (n = 62, 19.7%) had a significantly lower body mass index (BMI) (P < 0.001) and smaller waist circumference (P=0.001). They also had significantly higher serum 25(OH)D (P=0.001), corrected serum calcium (P < 0.001), and phosphate (P=0.003) levels than those with an elevated PTH response (n = 253, 80.3%). Multiple logistic regression analysis showed that lower BMI (OR = 0.925; 95% CI: 0.949–0.987) and higher 25(OH)D (OR = 1.068; 95% CI: 1.014–1.124) and serum calcium (OR = 8.600; 95% CI: 1.614–45.809) levels were significantly associated with a blunted PTH response (R2 = 0.178). A blunted PTH response to vitamin D deficiency is mainly observed among women with lower BMI. Higher serum calcium and 25(OH)D levels and lower BMI were significant predictors of a blunted PTH response, which may indicate that these subjects are adapting to lower 25(OH)D levels and maintaining normal calcium levels without the need to increase PTH secretion. The mechanisms underlying this adaptation are unclear, and future studies to explore these mechanisms are warranted.

Paleolithic diet fraction in post hoc data analysis of a randomized cross-over study comparing Paleolithic diet with diabetes diet

<h2>Summary</h2><h3>Background</h3> Paleolithic Diet Fraction (PDF), calculated as the fraction of intake from Paleolithic food groups divided by the intake from all food groups, was developed as a measure of compliance hitherto lacking in interventional studies on Paleolithic diet. Mean PDFs in our previously published study comparing Paleolithic diet with a Mediterranean-like diet were around 80% and 40% for the two diets, respectively, and higher PDF was associated with healthier levels in several glucometabolic outcome measures. We now present PDF comparing a Paleolithic diet with a diabetes diet. <h3>Methods</h3> 13 adult patients (3 women and 10 men, mean age 64) with type 2 diabetes followed in 2005–07 a Paleolithic diet and a diabetes diet during two consecutive 3-month periods in a randomized order cross-over design study. Mean daily PDF was calculated using four-day weighed food records. Linear mixed models were used to assess associations between PDF and relative change in the outcome measures used in this study and in aggregated data from this study combined with data from the study comparing Paleolithic diet with a Mediterranean-like diet. <h3>Results</h3> Mean PDF for energy was 77% for the Paleolithic diet and 38% for the diabetes diet. The corresponding percentages for PDF for weight were 81% and 54%. A 10% higher PDF for energy was associated with 0.8% lower weight, 0.7% smaller waist circumference, 2.1% lower total cholesterol, 7.6% lower triglyceride, 2.0% lower HbA1C, 9.9% lower leptin and, in the aggregated data, also with 1.6% lower area under the curve (AUC) for glucose during an oral glucose tolerance test (OGTT). Similar results were found for PDF for weight. <h3>Conclusions</h3> A mean PDF of around 80% for a Paleolithic diet in both this study and our previous study comparing the Paleolithic diet with a Mediterranean-like diet indicate a high reproducibility of the PDF. The mean PDF of around 40% for both the diabetes diet and the Mediterranean-like diet indicates their similarity and how far removed both diets are from a Paleolithic diet in terms of food group content. The associations between higher PDF and healthier glucometabolic outcome measures indicate that this removal is unhealthy. The results from this post hoc data analysis should be corroborated in future studies. <h3>Trial registration</h3> ClinicalTrials.gov. NCT00435240. Registered 14 February 2007. Retrospectively registered, https://www.clinicaltrials.gov/ct2/show/NCT00435240?term=tommy+jönsson&cond=paleolithic&draw=2&rank=2.

Screen Time Parenting Practices and Associations with Preschool Children's TV Viewing and Weight-Related Outcomes.

The purpose of this study was to examine associations between screen time (ST) parenting practices and 2–5-year-old children’s TV viewing and weight status. Data were collected from 252 parent–child dyads enrolled in a randomized parent-focused childhood obesity prevention trial from 2009–2012. ST parenting practices were assessed at baseline using a validated parent-reported survey. Parent-reported child TV viewing and objectively measured anthropometrics were assessed at baseline, post-intervention (35 weeks), and follow-up (59 weeks). Marginal effect models were developed to test the association between baseline ST parenting practices and children’s TV viewing, BMI z-score, and waist circumference across all time points. Limiting/monitoring ST was associated with decreased weekly TV viewing (β = −1.79, 95% CI: −2.61; −0.95), while exposure to TV was associated with more weekly TV viewing over 59 weeks (β = 1.23, 95% CI: 0.71; 1.75). Greater parent use of ST as a reward was associated with increased child BMI z-score (β = 0.15, 95% CI: 0.03; 0.27), while limiting/monitoring ST was associated with decreased BMI z-score (β = −0.16, 95% CI: −0.30; −0.01) and smaller waist circumference (β = −0.55, 95% CI: −1.04; −0.06) over the study period. These findings suggest that modifying parent ST practices may be an important strategy to reduce ST and promote healthy weight in young children.

Sex-Specific Association of Left Ventricular Hypertrophy With Rheumatoid Arthritis.

Objectives: Clinical expression of rheumatoid arthritis (RA) varies by gender, but whether cardiovascular disease (CVD) is gender related in RA is unknown. Left ventricular (LV) hypertrophy (LVH) is a hallmark of CVD in RA patients. We investigated whether the association of LVH with RA is gender driven.Methods: Consecutive outpatients with established RA underwent echocardiography with measurement of LVH at baseline and one follow-up. All participants had no prior history of CVD or diabetes mellitus. We assessed CVD risk factors associated with LVH at follow-up, including sex, age, arterial blood pressure, and body mass index (BMI). We also evaluated inflammatory markers, autoimmunity, disease activity, and the use of RA medications as predictors of LVH.Results: We recruited 145 RA patients (121 females, 83%) and reassessed them after a median (interquartile range) of 36 months (24–50). At baseline, women were more dyslipidemic but otherwise had fewer CVD risk factors than men, including less prevalent smoking habit and hypertension, and smaller waist circumference. At follow-up, we detected LVH in 42/145 (44%) RA patients. LV mass significantly increased only in women. In multiple Cox regression analysis, women with RA had the strongest association with LVH, independently from the presence of CVD risk factors (OR, 6.56; 95% CI, 1.34–30.96) or RA-specific characteristics (OR, 5.14; 95% CI, 1.24–21.34). BMI was also significantly and independently associated with LVH.Conclusion: Among established RA patients, women carry the highest predisposition for LVH.

497-P: Weekdays or Weekends? Does Timing of Physical Activity Assessment Matter in Hispanic/Latino Adults with or at Risk for Type 2 Diabetes?

Increasing physical activity (PA) in minority populations with type 2 diabetes (T2D) is likely to have important cardiometabolic benefits. The aim of this study is to determine feasibility and acceptability of using wearable accelerometers to assess PA, as part of creating a unique, real-world dataset on health determinants, in Hispanic/Latino adults with or at risk for T2D. PA was measured using an ActiGraph wGT3X-BT worn on the right hip 24 hours/day for 7 consecutive days. Insulin resistance (HOMA IR) and Metabolic Syndrome Score (MetS z) were calculated in 157 Hispanic/Latino participants [107 women, (mean ±SD) age 56.7 ± 11.0 years, (median [IQR]) HbA1c 7.6 [6.5, 9.4] %]. For those diagnosed with T2D, n=133, duration of diabetes was 13.2±9.0 years. There were significant correlations between Weekday steps and age (-0.31), waist circumference (WC) (-0.30), and BMI (-0.22) (p In conclusion, PA during Weekdays is higher than Weekends for Hispanic/Latino adults with or at risk for T2D. Weekday steps were also associated with a smaller WC and thus lower cardiometabolic risk. In this population, women were significantly more obese and insulin resistant than men. Disclosure W. C. Bevier: Research Support; Self; Abbott Diabetes, Eli Lilly and Company. A. J. Larez: Research Support; Self; Abbott, Eli Lilly and Company. C. Conneely: Research Support; Self; Abbott, Eli Lilly and Company. N. M. Glantz: Research Support; Self; Abbott, Eli Lilly and Company. K. N. Castorino: Consultant; Self; Dexcom, Inc., Research Support; Self; Abbott Diabetes, Abbott Laboratories, Dexcom, Inc., Drawbridge Health, Inc., Lilly Diabetes, Medtronic, Novo Nordisk Inc. D. Kerr: Advisory Panel; Self; Novo Nordisk, Sanofi-Aventis, Research Support; Self; Abbott Diabetes, Elsevier, Lilly Diabetes, Stock/Shareholder; Self; Glooko, Inc. Funding Eli Lilly and Company

Adult height and diabetes control: is there an association?

Background: Obesity is commonly associated with diabetes mellitus (DM). The most frequent anthropometric index utilised to assess obesity is the body mass index (BMI), which uses height and weight as variables, but eliminates height as an independent analytical variable. Currently there are no data available on the relationship between adult height and glycaemic control in patients living with diabetes (PLWD) within the context of HIV infection.Objectives: This study aimed to determine an association between final adult height and glycaemic control in an HIV endemic area.Methods: Standardised clinic sheets were used from the DM clinic at Edendale Hospital, Pietermaritzburg, South Africa, from January 1, 2019 to December 31, 2019. Statistical analysis was done.Results: This study had 957 PLWD. In the height categories of < 1.40 m, 1.40–1.49 m, 1.50–1.59 m, 1.60–1.69 m, 1.70–1.79 m, 1.80–1.89 m and ≥ 1.90 m, there were 11, 60, 321, 343, 121, 26 and 2 patients respectively (with 73 patients having no height recorded). Taller patients had smaller waist circumferences and had poorer glycaemic control. In the lowest vs. highest height (< 1.40 m vs ≥ 1.90 m) categories, the HbA1c values were 8.49% vs. 12.45%, respectively, p = 0.019. Height had a strong positive association with diastolic blood pressure (DBP) (p = 0.001). Those PLWD in the 1.80–1.89 m height cohort had higher triglyceride levels and lower high-density lipoprotein (HDL) levels when compared with the other height categories. Shorter PLWD with uncontrolled glycaemic control had significantly elevated systolic blood pressure. Gender and HIV infection had a non-significant role on height categories in PLWD.Conclusion: Taller height categories had poorer glycaemic control. Increasing height was strongly associated with increasing DBP. A higher DBP and triglyceride level with lower HDL level places these PLWD in a higher cardiovascular risk category. Strong emphasis needs to be placed on the monitoring of lipids and blood pressure in PLWD, this more especially in taller patients.

Association between the type of physical activity and metabolic syndrome in middle-aged and older adult residents of a semi-mountainous area in Japan

BackgroundPhysical activity is reported to prevent metabolic syndrome. However, it is unclear whether exercise or daily physical activity is more beneficial for residents of semi-mountainous areas. This study aimed to identify whether daily physical activity is more beneficial than exercise for the prevention of metabolic syndrome among middle-aged and older residents in semi-mountainous areas.MethodsWe analyzed secondary data of 636 people who underwent a specific health checkup in a semi-mountainous area of Japan. Physical activity was classified into four types: inactivity (I-type; without exercise and without daily physical activity), only exercise (E-type; with exercise and without daily physical activity), only daily physical activity (D-type; without exercise and with daily physical activity), and full physical activity type (F-type; with exercise and with daily physical activity). We compared the means of risk factors for metabolic syndrome by these four types, followed by logistic regression analysis, to identify whether and to what extent the D-type was less likely to have metabolic syndrome than the E-type.ResultsThe prevalence of metabolic syndrome was 28.5% (men 45.7%, women 15.8%). The proportions of men with exercise and daily physical activity were 38.7% and 52.8%, respectively. For women, the proportions were 33.0% and 47.1%, respectively. In women, the D-type had the significantly lowest BMI, smallest waist circumference, highest HDL-C, and lowest prevalence of metabolic syndrome of the four types; the same was not observed in men. Additionally, D-type activity was more strongly associated with a reduced risk of metabolic syndrome than E-type activity in women (adjusted odds ratio 0.24; 95% confidence interval 0.06–0.85, P = 0.028).ConclusionsCompared to middle-aged and older women residents with exercise in a semi-mountainous area of Japan, those with daily physical activity may effectively prevent metabolic syndrome.

Serum sex hormone-binding globulin is associated with symptomatic late-onset hypogonadism in aging rural males: a community-based study.

A population-based cross-sectional study was conducted in Zhejiang rural communities. A total of 965 men (aged 40-80 years) were admitted to the aging males' symptoms (AMS) scale and related physical examinations including body mass index (BMI) and waist circumference were conducted. Serum total testosterone (TT), free testosterone (FT), sex hormone-binding globulin (SHBG) and serum lipid levels were measured separately. Serum level of bioavailable testosterone (Bio-T) was calculated. A total of 965 participants were divided into two groups, symptomatic late-onset hypogonadism (SLOH) group (n = 202) (AMS score ≥27) and control group (n = 763), according to total AMS score. Men in the SLOH group were older (61.57±9.06 vs 54.95±8.27 years) and had a smaller waist circumference (81.06±6.89 vs 82.54±6.60 cm) than those in the control group. Moreover, a relatively higher level of SHBG and lower levels of FT, Bio-T, triglyceride (TG) and total cholesterol (T-CHOL) were found in the SLOH group compared with that in the control group (P < 0.05). Receiver operating characteristic curves (ROC) analysis showed that age (AUC = 0.702, P < 0.001) and SHBG (AUC = 0.617, P < 0.001) were potential predictive indicators for SLOH diagnosis, with the best cut-off values of 59 years for age and 44.40 nmol/L for SHBG. SHBG might be a potential predictor in men with hypogonadism, whereas BMI had no proportionality to the measurement of AMS. Age and SHBG should be used for SLOH diagnosis.

Behavioral components of pro-healthy lifestyle and bioelectrical impedance body composition in Polish young adults: Preliminary results

Introduction: Adverse health behaviors changes are reported during emerging adulthood, inter alia the reduced level of physical activity (PA), worse diet quality etc. There are only very few studies concerned with the relationship between health behaviors and body composition in healthy young adults. Aim: The aim was to investigate the relationship between behavioral components of prohealthy lifestyle and body composition assessed by bioelectrical impedance (BIA) in the cohort of Polish young adults. Material and methods: A cross-sectional observational study of health behaviors, anthropometric indices and BIA body composition was conducted in Polish young adults (n = 92) aged 18–24 (mean 19.33, SD 0.915), 71 females. Behavioral variables included: general health behaviors, PA, eating behaviors and nutritional knowledge. Body composition was analyzed by means of the BIA phase-sensitive 8-electrode medical SECA mBCA 525 device. Results and discussion: A higher level of PA was associated with a lower volume of visceral adipose tissue in females (r = –0.27; P &lt; 0.05). In the males, the intensification of unhealthy diet was negatively correlated with the muscle mass (r = 0.65; P &lt; 0.01), and the higher level of nutritional knowledge resulted in a smaller waist circumference (r = –0.45; P &lt; 0.05). Behavioral components of pro-healthy lifestyle were not significant predictors of body composition/anthropometric indices such as waist circumference, fat mass index, fat free mass index and body mass index. Conclusions: The reported studies provide an important insight into the sex-specific correlations between the behavioral components of the pro-healthy lifestyle and body composition in healthy young adults.

Nutritional Status, Health Status, and Work Productivity of Cocoa Farmers in Polewali Mandar, Indonesia

The objective of this study was to analyze the associations between nutritional status, health status, other determining factors with work productivity of cocoa farmers. This cross-sectional study involved 58 male cocoa farmers aged 18–65 years old in two districts of Polewali Mandar. Data on food consumption and habit as well as health status were collected via structured interviews. While, blood pressure and anthropometric parameters were measured using standard equipment of blood pressure meter, weight scale, and height scale. Spearman’s test and Principal Components Regression (PCR) analysis were implemented to explore factors associated with farmers’ work productivity. There was no relationship between Body Mass Index (BMI) and work productivity. However, there was a significant positive association between central obesity with days of absent (r=0.275; p=0.037). We also found negativeassociation between blood pressure and the amount of cocoa picked daily (r=-0.366; p=0.005). PCR statistical analysis results showed that the amount of cocoa picked per day were significantly associated with smaller waist circumference, coffee consumption, and good exercise habit. While, decrease in consumption of fruits and vegetables was significantly associated with the number of absence days due to health problems. Thus, it can be concluded that work productivity of male cocoa farmers was associated with food consumption, physical activity, and lifestyle factors.

Survey of cardiovascular disease and risk factor management in patients with rheumatoid arthritis across 5 world regions: results from the SURF-RA

Abstract Background Patients with rheumatoid arthritis (RA) are at high risk for cardiovascular disease (CVD). Purpose The aim of this survey was to evaluate updated information on CVD risk factors, comorbidities, RA disease characteristics, RA and CVD preventive medication in patient with RA. Methods The audit is termed SUrvey of cardiovascular disease Risk Factors in patients with Rheumatoid Arthritis (SURF-RA) and was performed in 53 centres/19 countries/5 world regions in 2014–2019. SURF-RA have been performed in patients with coronary heart disease, in primary care, and now in patients with stroke, SLE and antiphophlipid syndrome. The survey was approved by the Data Protection Officer (2017/7243) and a GDPR evaluation has been performed (10/10–2018). Results Among 14 503 patients with RA in West (n=8 493) and East (n=923) Europe, Latin (n=407) and North (n=4 030) America and Asia (n=650) the mean (SD) age was 59.9 (13.6) years, and 2/3 or more were female (table). RA disease duration was comparable across the world regions, ranging from 9.9 to 12.6 years. The prevalence of atherosclerotic CVD (ASCVD) was lowest in Latin America (2.5%) and highest in East Europe (21.4%), and this pattern was similar regarding familial premature CVD. The mean prevalence (% of each entity) of blood pressure above 140/90 mmHg was 5.3%, of low density lipoprotein cholesterol &amp;gt;2.5 mmol/L: 63.3%. Overall, 29% used antihypertensive medication, lowest in West Europe (17.4%) and highest in East Europe (57.0%), and 26.4% used lipid lowering agent(s), lowest in Asia (7.2%) and highest in North America (31.1%). Body mass index &amp;gt;30 kg/m2 was present in 26.6%, with the smallest waist circumference in Asia [mean (SD): 84.1 (13.6) cm] and highest in East Europe [92.5 (15.5) cm]. The proportion of current smokers was on average: 16.2%, lowest in Asia (7.8%) and highest in East Europe (28.5%). Conclusion The high prevalence of CVD risk factors and ASCVD in patients with RA across five world regions shows that there is still an unmet need for vigilance and improved implementation of preventive measures in this high CVD risk patient population. Funding Acknowledgement Type of funding source: Other. Main funding source(s): Lilly

Predictors of attrition from a weight loss program. A study of adult patients with obesity in a community setting

PurposeObesity unit attrition is frequent and contributes to treatment failure. Many studies evaluating attrition predictors were part of randomized trials, and different terminology and criteria were used in the engagement field. We aimed to investigate the factors potentially implicated in early (< 12 weeks) and late (> 12 weeks) attrition from an obesity unit in a community settingMethodsThis was a retrospective cohort study of 250 patients with obesity who were followed-up at our obesity unit. Our program included at least 6 meetings in 12 months. Sociodemographic and anthropometric data, and psychometric questionnaires were collected from all participants.ResultsOne-hundred thirty-four (53.6%) participants dropped out. Those individuals showed lower BMI, lower overall health status, and increased depression scores. In a multiple regression model, BMI (inversely; OR = 0.90; 95%CI 0.84–0.96) and depression score (directly, OR = 1.05; 1.00–1.10) were associated with attrition risk. Early dropouts (n = 47) had lower weights, smaller waist circumferences and worse mental health scores than late dropouts (n = 87) and more frequently lived alone. When compared to completers, early dropouts had lower weights, BMIs, waist circumferences, overall health and mental status scores, increased depression scores and percentage of individuals living alone. In a multiple regression, lower BMI (OR = 0.83; 0.75–0.92), lower mental status score (OR = 3.17; 1.17–8.59) and living alone (OR = 2.25; 1.02–4.97) were associated with early attrition risk.ConclusionLower BMI and increased depression score were associated with attrition. Early attrition was associated with lower weight, decreased mental well-being, and living alone. Individuals with these characteristics might need tailored approaches to enhance their engagement.Level of evidenceLevel V, retrospective descriptive study.

Associations Between Office Location and Adiposity in Office Workers.

Evaluate whether having to walk longer distances to common destinations within office buildings is associated with less adiposity and greater occupational physical activity. Distances between offices and amenities were measured for 108 office-based workers, as was body fat percentage, waist circumference, number of sedentary breaks at work, and duration and intensity of activity at work. Being further away from the building entrance was correlated with lower body fat percentage. Greater distance from a participant's office to the copier was associated with smaller waist circumferences. Correlations were found between distance to the bathroom and work activity, and sedentary breaks with distance to the break room and distance from the printer or copier. Worksites interested in improving the health of their employees should consider how building design affects occupational physical activity and health.