bluuebunny/crossref_metadata_2025_split huggingface dataset:
588-P: Probing the Role of Muscle Glycogen Resynthesis on Postexercise AMPK Activation and Metabolic Protein Abundance Using a Novel Genetic Model
Authors: KWAK SEONGEUN , ZHENG AMY , ARIAS EDWARD B. , WANG HAIYAN , PAN XIUFANG , DUAN DONGSHENG , YUE YONGPING , CARTEE GREGORY D. 
Published: June 2023

Acute exercise can alter the abundance of key metabolic proteins in skeletal muscle. These effects are influenced by postexercise (PEX) refeeding. Muscle glycogen resynthesis is a putative mediator of these refeeding effects. However, it is challenging to test this idea, because glycogen resynthesis is only one of many outcomes with refeeding. Therefore, we devised a novel genetic model to modify muscle expression of glycogen synthase 1 (GS1) using injection of rat skeletal muscle with adeno-associated viral (AAV) vectors for short hairpin RNA targeting GS1 (shRNA-GS1). Contralateral muscles were injected with scrambled shRNA (shRNA-Scr). Rats were sedentary (SED) or exercised (120min swim-exercise). Muscles were collected immediately postexercise (IPEX) and 9-hours PEX (9hPEX), along with time-matched SED controls. The 9hPEX and their SED-control rats were either refed (RF) or not-refed (NRF). Muscles were analyzed for glycogen and phosphorylation and abundance of key metabolic proteins. Muscles injected with shRNA-GS1 vs shRNA-Scr had lower GS1 abundance in all groups. Regardless of genotype, in IPEX vs SED rats: glycogen fell to similarly low values and phosphorylation of AMPK Thr172 (pAMPK) and its substrate ACC Ser79 (pACC) were comparably increased. Muscle glycogen was increased in all groups of 9h-RF rats, but it was lower for shRNA-GS1 vs shRNA-Scr from RF-9hPEX rats. In the NRF-9hPEX rats, pAMPK and pACC were greater for shRNA-GS1 vs shRNA-Scr muscles. Muscle pyruvate dehydrogenase kinase-4 abundance from 9hPEX rats (both NRF and RF) was greater for shRNA-GS1 vs shRNA-Scr. Hexokinase II (HKII) abundance was greater for 9hPEX vs SED in NRF rats regardless of genotype. In RF-9hPEX rats, HKII abundance was greater for shRNA-GS1 vs shRNA-Scr. These results support the idea that some PEX effects on metabolic protein abundance are influenced by muscle GS1 abundance and the extent of glycogen resynthesis

Disclosure
S.Kwak: None. A.Zheng: None. E.B.Arias: None. H.Wang: None. X.Pan: None. D.Duan: None. Y.Yue: None. G.D.Cartee: None.

Funding
National Institutes of Health (R01DK071771); University of Michigan
589-P: Impact of Sedentary Behavior on Glycemic Profiles by Real-Time Continuous Glycemic Monitoring in People with Type 1 Diabetes
Authors: HONDA HIROTO , HASHIMOTO NAOKO , ZENIBAYASHI MASAKO , TAKEUCHI TAKEHITO , YAMAMOTO AKANE , HIROTA YUSHI 
Published: June 2023

The purpose of this study was to examine the association between sedentary behavior (SB) and glycemic profiles by real-time continuous glycemic monitoring (rt-CGM) in people with type 1 diabetes (T1D). Fifty-eight Japanese adults with T1D were assessed and analyzed in this study (8 men and 50 women, age: 43.5 [32.0-54.0], HbA1c: 7.1 [6.7-7.8], median [25%-75% quartiles]). The type of physical activity (PA) measured using a triaxial accelerometer was defined according to intensity: SB (≤1.5 metabolic equivalents [METs], light-intensity PA (1.6-2.9 METs), and moderate-to-vigorous-intensity PA (≥3.0 METs). Total SB per day was 506.4 (442.2-575.9) min. A longer prolonged (≥30 min) SB and fewer steps per day were associated with higher mean 24-h sensor glucose values, higher time above range, and lower time in range (prolonged SB: ρ = 0.662 [p &lt; 0.01], 0.627 [p &lt; 0.01], and −0.591 [p &lt; 0.01]; steps: ρ = −0.405 [p &lt; 0.01], −0.401 [p &lt; 0.01], and 0.327 [p &lt; 0.05], respectively) (Figure). Conversely, total SB and other PA had no association with glycemic profiles. These results implied that more time spent on prolonged SB and fewer steps might contribute to the deterioration of glycemic profiles by rt-CGM in people with T1D. It is important to consider these characteristics when managing T1D.

Disclosure
H.Honda: None. N.Hashimoto: None. M.Zenibayashi: None. T.Takeuchi: None. A.Yamamoto: None. Y.Hirota: Other Relationship; Lilly, Sanofi K.K., Terumo Corporation, Sumitomo Dainippon Pharma Co., Ltd., Research Support; Sumitomo Dainippon Pharma Co., Ltd.
591-P: Elite Cyclists with Type 1 Diabetes (T1D) Show Acceptable Glycemic Excursions during a Time-Trial Performance under High-Definition Transcranial Direct-Current Stimulation (HD-tDCS)
Authors: CODELLA ROBERTO , GALLO GABRIELE , MELONI ANDREA , LUZI LIVIO , FILIPAS LUCA 
Published: June 2023

Patients with T1D are typically challenged by glycemic fluctuations during exercise. We recently applied HD-tDCS - a neuromodulation enhancer - both in healthy and T1D elite cyclists to improve endurance performance. Here, in a double-blind, counterbalanced, randomized order, nine elite cyclists (28 ± 3.5 years; BMI: 20.8 ± 1.3 kg/m2; VO2peak: 65.3 ± 1.7 mL/min/kg) with T1D (no complications) underwent either HD-tDCS (F3, F4) or control (SHAM) and completed a constant-load trial (CLT) at 75% of the 2nd ventilatory threshold plus a 15-km cycling time-trial (TT). Comparing the two conditions by real-time continuous glucose monitoring (CGM), subjects showed similar glycemic variability in any part of the session (Figure: bold line = mean; dotted lines = min & max), with a significant effect of time (F=26.32; P&lt;0.0001), but no interaction stimulation x time (F=0.08; P&gt;0.99) nor effect of stimulation (F=0.077; P=0.79). Further, CGM data were stable for the 3 days preceding and following the tests. Given that glycemic control becomes of critical interest not only for health but also for performance goals, these findings suggest that HD-tDCS can be safely used as a performance improvement device in athletes with T1D, and possibly in a wider population of active T1D-subjects.

Disclosure
R.Codella: None. G.Gallo: None. A.Meloni: None. L.Luzi: Advisory Panel; Eli Lilly and Company, Medtronic, Research Support; Gelesis, Speaker's Bureau; A. Menarini Diagnostics, Amgen Inc., Boehringer Ingelheim and Eli Lilly Alliance, Eli Lilly and Company, Novo Nordisk, Novartis. L.Filipas: None.
596-P: Exercise Increases Plasma Neuronal Growth Regulator 1 (NEGR1) Concentrations in Human Subjects
Authors: NIGRO PASQUALE , CARBONE NICHOLAS P. , BUENO JUNIOR CARLOS , VAMVINI MARIA , SIMPSON LAURA , HANSBURY GEORGIA A. , HIRSHMAN MICHAEL F. , MIDDELBEEK ROELAND J.W. , GOODYEAR LAURIE 
Published: June 2023

Recent studies suggest that exercise-induced circulating factors are critical for the health benefits of exercise. In rodent models, we have identified NEGR1 as a cell adhesion molecule that is essential for remodeling white adipose tissue (WAT) innervation via sympathetic neurite outgrowth, and that NEGR1 is a secreted factor that may be involved inter-tissue communication. In humans, exercise training increases NEGR1 mRNA in subcutaneous WAT, but whether exercise regulates circulating NEGR1 in humans is not known. Here, we investigated the effects of a single bout of maximal exercise and exercise training on plasma NEGR1 in two different cohorts of obese subjects. Acute exercise (single bout until VO2MAX achieved) increased NEGR1 in plasma in all subjects (p&lt;0.05; n=M3/F4). For the training study, obese subjects were randomized to one of three protocols: two different high intensity interval training (HIIT) protocols and one moderate continuous training (MCT) (Table), and blood samples were taken four days after the last training session. 1-HIIT and 4-HIIT similarly increased plasma NEGR1 concentrations, while there was no significant effect of MCT on NEGR1. In conclusion, we identify NEGR1 as a novel exercise-induced circulating factor in human subjects. We hypothesize that NEGR1 plays a role in tissue cross-talk mediating neuronal refinement in several tissues.

Disclosure
P.Nigro: None. N.P.Carbone: None. C.Bueno junior: None. M.Vamvini: None. L.Simpson: None. G.A.Hansbury: None. M.F.Hirshman: Stock/Shareholder; Abbott, AbbVie Inc., Amgen Inc., Colgate-Palmolive, Eli Lilly and Company, Medtronic. R.J.W.Middelbeek: Research Support; Novo Nordisk. L.Goodyear: None.

Funding
National Institutes of Health (R01DK099511, R01DK101043, K23DK114550, 5T32DK00726042, F32DK12643201); Joslin Diabetes Center (P30DK36836)
603-P: Changes in Insulin Resistance by Protein Source and Level of Saturated Fat—An Analysis of the Animal and Plant Protein and Cardiovascular Health (APPROACH) Trial
Authors: GADGIL MEGHANA D. , KRAUSS RONALD M. 
Published: June 2023

Background: Protein source and saturated fat (SFA) consumption may affect insulin resistance (IR). We aimed to assess IR using the ratio of triglycerides/HDL (TG/HDL) in the context of a randomized, controlled, crossover dietary intervention trial comparing red meat, white meat and non-meat protein sources at high and low SFA levels.
Methods: Healthy men and women aged 21-65 y with BMI 20-35 kg/m2 were randomly assigned to 1 of 2 parallel arms (14% or 7% energy from SFA), and within each consumed diets with protein source derived primarily from red meat, white meat, and nonmeat sources for 4 weeks each in random order. We assessed protein source and log transformed TG/HDL ratio using generalized mixed models adjusting for diet order by level of SFA. A significant interaction was found between SFA and red meat intake (p&lt;0.05).
Results: Participants who completed all diets were included: 62 participants on high SFA diets (27 men, 30 women); 51 on low SFA (17 men, 34 women). Red and white meat consumption were each associated with lower log TG/HDL than non-meat protein consumption at high SFA but not low SFA (Table). There was no difference in log TG/HDL between white and red meat consumption at either level of SFA.
Conclusion: Diets high in both SFA and red or white meat protein have adverse effects on IR compared with either low SF or non-meat protein consumption.

Disclosure
M.D.Gadgil: None. R.M.Krauss: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (R03DK132307); National Heart, Lung, and Blood Institute (R01HL106003); National Center for Advancing Translational Sciences; San Francisco Clinical and Translational Science Institute (UL1TR000004)
61-OR: Mobile Bolus Feature Improves Bolus Behavior in Control-IQ Users Who Bolus &lt;3 Times/Day
Authors: MESSER LAUREL H. , MUELLER LARS , D'SOUZA EDWIN W. , HABIF STEPHANIE , PINSKER JORDAN E. 
Published: June 2023

Background: In 2022, the smartphone application and pump software for the t:slim X2 with Control-IQ technology updated to allow bolus insulin programming from a user’s personal smartphone (mobile bolus, MB) in the United States. The aim of this study was to determine if MB increased bolus frequency in users who bolus &lt;3 times/day.
Methods: De-identified data from users with low bolus frequency and &gt;21 days with 70% CGM pre-and post MB were analyzed for changes in bolusing behavior and Time in Range (TIR) before and after MB.
Results: A total of 4,470 users bolused &lt;3 times/day and upgraded to MB. After MB start, these users increased the number of boluses per day from 2.2 to 2.7 (+0.5 per day, p&lt;0.001, table). After MB upgrade, approximately 1 bolus/day (36% of boluses) were delivered on the smartphone app instead of the insulin pump. TIR improved discreetly, with children &lt;12 years old experiencing 34 more minutes in target range each day (p&lt;0.01). Of all, 87% of users were very satisfied or satisfied with the MB feature.
Conclusions: For users with low bolus frequency, the MB feature meaningfully increased the number of boluses given each day, and can be leveraged as a way to increase daily bolusing behaviors.

Disclosure
L.H.Messer: Advisory Panel; Lilly, Consultant; Dexcom, Inc., Capillary Biomedical, Inc., Employee; Tandem Diabetes Care, Inc., Research Support; Beta Bionics, Inc., Medtronic, Insulet Corporation. L.Mueller: Employee; Tandem Diabetes Care, Inc., Stock/Shareholder; Tandem Diabetes Care, Inc. E.W.D'souza: None. S.Habif: Employee; Tandem Diabetes Care, Inc. J.E.Pinsker: Employee; Tandem Diabetes Care, Inc.

Funding
Tandem Diabetes Care, Inc.
612-P: The Effectiveness of Lifestyle, Metformin, or Dietary Supplements for the Prevention of Gestational Diabetes Mellitus (GDM) by Participant Characteristics—A Systematic Review and Meta-analysis
Authors: LIM SIEW , TAKELE WUBET W. , REDMAN LEANNE M. , VESCO KIMBERLY , GRIEGER JESSICA A. , HABIBI NAHAL , QUINTEROS ALEJANDRA , LEUNG GLORIA , ZHOU SHAO J. , TAYLOR RACHAEL , PATHIRANA MALEESA , LIU KAI , UKKE GEBRESILASEA G. , BONHAM MAXINE P. , CHEN MINGLING , FAWCETT ANDREA J. , CHIVERS SIAN C. , JOSEFSON JAMI L. 
Published: June 2023

The GDM prevalence has been rising, affecting 7-28% of pregnancies worldwide. Prior systematic reviews examining the success of interventions for GDM prevention have presented results where some interventions have modest effect and others, no effect. The impact of individual characteristics on the efficacy of interventions has not been thoroughly investigated. To address this knowledge gap, we performed a systematic review of controlled trials of lifestyle (diet and exercise), metformin and dietary supplement interventions initiated in the preconception, prenatal or postpartum period to assess whether participant characteristics impact the interventions’ effectiveness in GDM prevention. Overall, 116 studies met inclusion criteria (lifestyle n=92, metformin n=13 and dietary supplements n=12). Lifestyle, metformin and dietary supplements reduced GDM risk by 24% (RR 0.76, 95% CI 0.69-0.83), 34% (RR 0.66, 95% CI 0.47-0.93), and 45% (RR 0.55, 95% CI 0.36-0.83). With lifestyle, lower risks of GDM was seen in individuals with overweight or obesity (n=33, RR 0.70, 95% CI 0.59-0.83), without PCOS (n=3, RR 0.62, 95% CI 0.47-0.82) and without a history of GDM (n=13, RR 0.63, 95% CI 0.53-0.70) (p&lt;0.05). With metformin, lower GDM risks were achieved when commenced prior to conception (n=3, RR 0.22, 95% CI 0.11-0.45)(p&lt;0.01). Dietary supplements resulted in lower GDM risks among individuals with normal weight (n=1, RR 0.42, 95% CI 0.24-0.72), with prediabetes (n=1, RR 0.08, 95% CI 0.02-0.31), and when initiated before 20 weeks’ gestation (n=10, RR 0.46, 95% CI 0.30-0.71) (p&lt;0.05). Given the potentially greater effectiveness of these interventions in certain groups of individuals, future research on tailored recommendations in precision GDM prevention, replacing the current ‘one-size-fits-all’ approach, is needed.

Disclosure
S.Lim: None. R.Taylor: None. M.Pathirana: None. K.Liu: None. G.G.Ukke: None. M.P.Bonham: None. M.Chen: None. A.J.Fawcett: None. S.C.Chivers: None. J.L.Josefson: None. W.W.Takele: None. L.M.Redman: Research Support; Dexcom, Inc., Abbott Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, Stock/Shareholder; ABGIL, Teladoc Health. K.Vesco: Research Support; Pfizer Inc. J.A.Grieger: None. N.Habibi: None. A.Quinteros: None. G.Leung: None. S.J.Zhou: None.
614-P: Effect of Non-nutritive Sweetener Sucralose on Cardiometabolic Risk Factors among Overweight and Obese Adults in India—A Randomized Clinical Trial
Authors: MOHAN VISWANATHAN , KUZHANTHAIVELU ABIRAMI , RAJAGOPAL GAYATHRI , VASUDEVAN KAVITHA , NAGAMUTHU GAYATHRI , SHEKINAH DAVID , UNNIKRISHNAN RANJIT , MOHAN ANJANA RANJIT , VASUDEVAN SUDHA , KAMALA KRISHNASWAMY 
Published: June 2023

Background: The aim of this free living, randomized parallel arm study was to evaluate the effect of replacing added sugar in beverages with non-nutritive sweetener (NNS)- Sucralose on body weight and metabolic factors in overweight and obese adults.
Method: Adults aged 25-50 years with BMI ≥23 kg/m2, were randomized into Intervention arm (replacement of sugar with NNS) and Control arm (no replacement) for a period of 12 weeks. Change in anthropometric and biochemical measurements were analysed using standard methods.
Results: Data of 154 subjects, was analyzed; significant reduction in waist circumference (p=0.01), fasting blood glucose (p&lt;0.001), HbA1C (p =0.02), total Cholesterol/HDL cholesterol ratio (p=0.03), visceral adiposity index (p=0.04), HOMA IR (p=0.03), Triglyceride/glucose Index (p=0.04) & increase in HDL cholesterol (p=0.004) were seen at the end of trial in the Intervention arm. There was non-significant reduction in body fat, BMI, lipid accumulation product and high sensitivity CRP. Plasma sucralose analyzed in a subset of participants was undetectable indicating sucralose is not systematically absorbed.
Conclusion: In overweight and obese participants, replacement with NNS, helps in reducing adiposity indices, along with improvement in cardio metabolic parameters.

Disclosure
V.Mohan: None. K.Kamala: None. A.Kuzhanthaivelu: None. G.Rajagopal: None. K.Vasudevan: None. G.Nagamuthu: None. D.Shekinah: None. R.Unnikrishnan: None. R.Anjana: None. S.Vasudevan: None.
615-P: Effect of Nonnutritive Sweetener Sucralose on Cardiometabolic Risk Factors among Adults with Type 2 Diabetes in India—A Randomized Clinical Trial
Authors: MOHAN VISWANATHAN , KUZHANTHAIVELU ABIRAMI , RAJAGOPAL GAYATHRI , GUNASEKERAN GEETHA , SOUNDARARAJAN PADMAVATHI , MARIMUTHU RAJALAKSHMI , UNNIKRISHNAN RANJIT , MOHAN ANJANA RANJIT , VASUDEVAN SUDHA , KAMALA KRISHNASWAMY 
Published: June 2023

Background: Non-Nutritive sweeteners (NNS) can help in reducing calorie intake if substituted for sugar. Studies on the effect of replacing sugar with NNS in adults with type 2 diabetes (T2D) from India are sparse. The present study was carried out to evaluate, the effect of replacing added sugar with sucralose-based NNS in daily beverages like coffee, tea and fruit juices on cardiometabolic risk factors.
Method: This randomized parallel arm trial was done among adults (30-50 yrs) with T2D. Participants were randomized into Intervention arm (replacement of added sugar with NNS) and Control arm (no sugar replacement) group for a period of 12 weeks. Change in anthropometric and biochemical markers from baseline were analyzed using standard protocols.
Results: Data of 115 participants who completed the study (Control group, n=42 and intervention group, n=73) was analyzed. Significant reduction in waist circumference (p=0.02), lipid accumulation product (p=0.02), and visceral adiposity index (p= 0.02) was seen in the intervention group, when compared to control group. Plasma sucralose was analyzed in a subset of participants and was undetectable, indicating that sucralose is not absorbed, systematically.
Conclusion: The study shows that replacement of added sugar with NNS, leads to favourable changes in adiposity indices among adults with T2D.

Disclosure
V.Mohan: None. K.Kamala: None. A.Kuzhanthaivelu: None. G.Rajagopal: None. G.Gunasekeran: None. P.Soundararajan: None. R.Marimuthu: None. R.Unnikrishnan: None. R.Anjana: None. S.Vasudevan: None.
628-P: Symptoms of Autonomic Nervous System Dysregulation and Diabetes Distress in T2D Adults
Authors: DE GROOT MARY , MYERS BARBARA A. , STUMP TIMOTHY , DANA DEBORAH , KOLACZ JACEK , PORGES STEPHEN W. 
Published: June 2023

Purpose: To test the association of autonomic nervous system (ANS) dysregulation symptoms and diabetes distress (DD) in adults with type 2 diabetes (T2D). US adults (n=299) with self-identified type 2 diabetes completed a web-based survey in October 2022, including demographics, ANS reactivity symptoms (Body Perception Questionnaire; BPQ), diabetes-related distress (Diabetes Distress Scale-17; DDS-17), depressive symptoms (PHQ-8) and anxiety (GAD-7). Mean age was 60.2 years (S.D. = 13.6), 58.7% female, 82.9% White, with a median annual household income of $40,000-$60,000. Mean self-reported A1c was 7.0% (S.D. 1.2%). Self-reported medications: oral hypoglycemic agents (51.8%), oral medications and injectable insulin or other medications (26.7%), and diet and exercise alone (8.4%). Mean glucose checks was 1.5 times/day (S.D. = 4.9). The sample reported high levels of comorbid hypertension (65.4%), dyslipidemia (55.8%), sleep apnea (33.9%) and depression (36.2%). Mean DDS-17 score was 2.3 (S.D. 1.0; moderate severity). The highest scores were observed in the emotional burden (mean = 2.6; S.D. 1.3) and regimen-related distress (mean = 2.7; S.D. 1.2) subscales. Mean PHQ-8 score was 6.7 (S.D. = 6.0; mild) and the mean GAD-7 score was 4.74 (S.D. 5.6, mild). BPQ mean T scores were 49.9 (S.D. 9.4) for Supradiaphragmatic and 52.0 (S.D. 8.8) for Subdiaphragmatic Reactivity subscales. Positive correlations between the DDS-17 and BPQ subscales (range: r=0.53-0.58, all p’s&lt;.05) were observed. Controlling for covariates, significant differences in BPQ subscale T scores were observed across clinical severity levels of the DDS on all subscales, with the highest BPQ scores observed in the ‘high’ distress DDS category compared to ‘no/mild distress’ (p’s &lt; 0.05). Findings confirm a relationship between ANS reactivity symptoms and diabetes-related distress, consistent with the Polyvagal Theory. Development of interventions that target ANS regulation to treat DD for T2D adults are needed.

Disclosure
M.De groot: Consultant; Barbara Kenner Family Foundation, Medscape, Mediflix, Inc. B.A.Myers: None. T.Stump: None. D.Dana: None. J.Kolacz: None. S.W.Porges: None.
638-P: Social Media as a Source of Personalized Weight-Loss Information
Authors: CLARK CALLAHAN , STREMMEL JOEL , MCCOY ROZALINA G. , JARVIS MEGAN , ARD JAMY D. , LAMBERT NATALIE 
Published: June 2023

People with obesity may seek clinical, nutritional, activity, and psychosocial guidance, but recommendations they receive in clinical settings may be inadequate or lack sufficient personalization to be implemented into their lives. Understanding unmet information needs may enable more tailored weight guidance. We used health narratives posted in a weight loss forum to research topics of information being sought. Public posts (N=52,576) from 1/2020-1/2022 were extracted from r/LoseIt, a Reddit weight loss forum of 3.8M members. From these, 63,006 questions were extracted using a research-purpose BERT language model tested and fine-tuned on 500 hand-annotated questions. Extracted questions were clustered into distinct topics by Top2Vec and hierarchical clustering. Excluding 2 uninterpretable topics, 27 of 28 (96%) topics represented requests for personalized recommendations. Topics focused on diet (7%), exercise (7%), sensemaking (11%), how to implement a behavior change or solve a weight-loss problem (11%), tips for specific stages of weight loss (beginning, plateau) (7%), and comparing weight loss experiences (11%). Weight-loss forum users requested personalized recommendations to support sensemaking of frustrating weight loss problems and ask for help choosing and deploying behavior change. Results call for interventions customized to individuals’ weight loss stage, process, experiences, and motivations.

Disclosure
C.Clark: Employee; UnitedHealth Group, Stock/Shareholder; UnitedHealth Group. J.Stremmel: None. R.G.Mccoy: Consultant; Emmi. M.Jarvis: Employee; Optum Labs, UnitedHealth Group, Stock/Shareholder; Oramed Pharmaceuticals, UnitedHealth Group, Dexcom, Inc., Apple, Hologic Inc., Intuitive Surgical. J.D.Ard: Advisory Panel; Novo Nordisk, Consultant; Eli Lilly and Company, Intuitive Surgical, Regeneron, Other Relationship; Optum Labs, Weight Watchers International, Research Support; Nestlé Health Science, Boehringer Ingelheim Inc., Epitomee, KVK Tech. N.Lambert: Employee; Optum Labs.