tbuckley/cabot-search huggingface dataset:
Abstract P254: Association Between Protein Intake and Prevalence of Sarcopenia in Japanese Community-Dwelling Older Adults
Authors: Naoko Miyagawa, Sei Harada, Miho Iida, Takuma Shibuki, Minako Matsumoto, Aya Hirata, Kazuyo Kuwabara, Ryota Toki, Shun Edagawa, Tomonori Okamura, Toru Takebayashi
Journal: Circulation (2024)

Background and Aim: To determine the protein intake associated with the prevalence of sarcopenia, we conducted a cross-sectional study of 1251 community-dwelling older Japanese aged 60 years and older. Methods: The mean age of the participants was 68.8 years, and the percentage of women was 56.7%. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 by low muscle mass (skeletal muscle mass), muscle strength (grip strength), and physical performance (gait speed). Protein and energy intake were assessed using a food frequency questionnaire (FFQ). Logistic regression models were used to estimate the multivariate-adjusted odds ratios (ORs) and 95% confidence intervals (95%CIs) of the prevalence of sarcopenia according to gender-specific tertiles of protein intake as a percentage of total energy. Corresponding analyses were done also for protein intake per day and for protein intake per kg of body weight, separately, instead of protein intake as a percentage of total energy. Results: The prevalence of sarcopenia was 8.0% (100/1251). The median protein intake as a percentage of total energy, protein intake per day, and protein intake per body weight by gender were, in order, 11.8%E, 59.2 g/day, and 0.9 g/kg/day for males and 14.1%E, 54.7 g/day, and 1.0 g/kg/day for females. Since there was no gender interaction in the association between each protein intake and the prevalence of sarcopenia, we performed the analysis for males and females combined. The multivariable adjusted ORs (95%CI) of the prevalence of sarcopenia was lower in the high protein intake as a percentage of total energy (&gt;12.6%E in males and &gt;15.2%E in females, respectively) group (0.47 (0.27-0.83)) than in the low intake (&lt;11.1%E in males and &lt;13.4%E in females, respectively) group; the linear trend was significant (p =0.009). Similarly, we found a significantly inverse association for sarcopenia prevalence at protein intakes higher than 54.4 g/day for males and 50.6 g/day for females, compared to those with lower intakes. However, there was no association between protein intake per body weight and the prevalence of sarcopenia. We obtained similar results when the participants were restricted to those 65 years and older as a sensitivity analysis. Conclusion: Significant inverse associations were found between the prevalence of sarcopenia and protein intake in community-dwelling older Japanese. However, we should consider that protein intake assessed by the FFQ is often underestimated when discussing absolute protein intake for sarcopenia prevention.
Abstract P255: The Longitudinal Association Between Dietary Vitamin K Intake and Cognitive Function in the General Population (Tanushimaru Cohort Study)
Authors: Nagisa Morikawa, Mika Enomoto, Ako Fukami, Yume Nohara, Hiromi Sato, Harumi Yoshimura, Hisashi Adachi, Yoshihiro Fukumoto
Journal: Circulation (2024)

Background: A relationship between vitamin K intake and cognition has been shown in several studies, although most of them were cross-sectional studies. Therefore, we investigated the association vitamin K intake and cognitive change in the longitudinal cohort study. Methods: We recruited 976 participants who had a health check-up in 2009 and were followed in 2018 in a prospective Tanushimaru cohort study. We had a dietary interview using brief-type self-administered diet history questionnaire (BDHQ) and Mini-Mental State Examination (MMSE) in 2009 and 2018. Vitamin K intake was calculated based on BDHQ data. We defined people with ≦23, 24-27, 28≦ score of MMSE as dementia-level, mild cognitive impairment (MCI) and normal cognition (NC), respectively. Generalized additive model (GAM) was performed to examine non-linearity of the association between vitamin K intake in 2009 and cognitive change over time. Additionally, we estimated risks for progression from MCI to dementia-level for 9 years by multivariate logistic regression analysis. Results: The mean age was 62.6±9.0 years old and dementia-level, MCI and NC in 2009 were 1.6%, 38.7% and 59.6%, respectively. Vitamin K intake in 2009 was not associated with conversion from NC to MCI/dementia-level, but was inversely associated with progression from MCI to dementia-level. According to GAM (Fig 1), its association was linear and we defined 400 μg/day of vitamin K intake as a cut-off value. MCI participants with and low vitamin K intake (&lt;400μg/day) in 2009 had higher risk for dementia progression compared to those with high vitamin K intake (≧400μg/day) (4.77% vs 0.67%)(Fig 2A). Additionally, regarding its concurrent relationship, MCI participants keeping high vitamin K intake from 2009 to 2018 had quite low dementia risk than those with low vitamin K intake in 2009 and 2018 (0.25% vs 5.65%) (Fig 2B). Conclusion: Higher dietary vitamin K intake was significantly associated with maintaining cognitive function for 9 years and may prevent cognitive decline to dementia-level.
Abstract P127: Health Literacy and COVID-19 Infection and Vaccination: The C4R-MESA Study
Authors: Sharon S Merkin, Yiqun Jin, Pallavi Balte, Karen Hinckley Stukovsky, Norrina B Allen, Alain G Bertoni, Pamela L Lutsey, Jim S Pankow, Wendy S Post, Teresa Seeman, Steven Shea, Karol E Watson, Elizabeth Oelsner
Journal: Circulation (2024)

Rationale: Health literacy (HL) is associated with health prevention behaviors and may influence COVID-19 outcomes. Objective: To test associations of HL, risk of COVID-19 infection, and receipt of COVID-19 vaccines in a multi-ethnic US community-based sample. Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) assessed participant levels of HL via follow-up phone calls in year 18 (2016-18), as well as the impact of the COVID-19 pandemic via questionnaires designed by the Collaborative Cohort of Cohorts for COVID-19 Research (C4R) Study (2020-23). The 4 HL items asked about difficulty in the ability to read, comprehend, and complete medical materials and understand medical statistics (scales 1-5, low to high difficulty); scores were summed and dichotomized into adequate (≤10) or low (&gt;10) HL. COVID-19 data included infection and vaccination status and time (days) until infection and vaccination (March 2020-February 2023). Unadjusted comparisons of COVID-19 data and HL were assessed by Chi-square and T-tests. Cox proportional hazards models were adjusted for age, sex, race/ethnicity, and then additionally for income and education. Results: Of 3412 participants (mean age 77 years; 54% female; 41% White, 13% Chinese, 26% Black 20% Hispanic), 409 (12%) had low HL and 360 (11%) had incident COVID-19 infections. In the subset with vaccination data (N=1781), 94% were vaccinated. While HL was not significantly associated with incident COVID-19 infection, low (vs adequate) HL was significantly associated with longer time-to-vaccination and lower adjusted hazards of vaccination ( Table ). Conclusions: Our findings suggest that low levels of HL are associated with delayed COVID-19 vaccination, even after accounting for demographic and socioeconomic indicators. Improving health literacy in the population may empower and encourage individuals to engage in disease prevention behaviors, including vaccination. Table: Associations of Health Literacy (HL) with COVID-19 Infection and Vaccination
Abstract P125: Association of Cardiology Encounters for Underrepresented Racial and Ethnic Groups With Human Immunodeficiency Virus With Subsequent Lipid and Blood Pressure Control
Authors: Matthew S Durstenfeld, C. Larry Hill, Karen Chiswell, Gretchen Sanders, Nwora Lance Okeke, Eric Meissner, Kevin L Thomas, Caryn Morse, Gerald S Bloomfield, April Pettit, Chris T Longenecker
Journal: Circulation (2024)

Background: People with HIV (PWH) are at elevated atherosclerotic cardiovascular disease (ASCVD) risk. Underrepresented racial and ethnic groups (UREGs) with HIV in the Southern U.S. are disproportionately affected, yet whether cardiology specialist care for this at-risk group improves blood pressure and lipid control is unknown. Methods: We evaluated a cohort of UREGs with HIV at elevated ASCVD risk without known cardiovascular disease. Participants received HIV-related care from 2015-2018 at four academic medical centers in the Southern United States with follow up through 2020. To create the cardiology and non-cardiology comparator groups, we divided the study into 6-month intervals, creating 8 cohorts and identified eligible patients with a new cardiology encounter during the interval. We included those without a cardiology encounter in that interval or any prior as controls. Primary outcomes were blood pressure control (&lt;140/90 mmHg) and lipid control (LDL-C ≤ 100 mg/dl) assessed during 2 years of follow-up. Statistical analyses were adjusted for cohort, patient factors, HIV measures, and comorbidities, and used random effects to account for repeated use of patients across cohorts. Results: Among 4096 included individuals, 411 (10%) had a cardiology encounter (Table 1). Cardiology encounters were associated with subsequent lipid control (OR 2.55, 95% CI 1.17-5.55, p=0.02), but not blood pressure control (OR 0.94, 95% CI 0.46-1.92, p=0.86). Compared to those without a cardiology encounter, those with a cardiology encounter did not subsequently have lower LDL-C (0.46 mg/dl higher per month, p=0.03) or systolic blood pressure (0.05 mm Hg higher per month, p=0.07). Conclusions: Cardiology encounters are associated with lipid control for UREGs with HIV. The lack of a decrease in LDL or systolic blood pressure suggests cardiology encounters may not be adequate to improve blood pressure and lipid control, two major modifiable risk factors for atherosclerotic cardiovascular disease among PWH.
Abstract P370: Prevalence of the AHA Life's Essential 8 in Midlife Women and Its Prospective Associations With Total Mortality and Cardiovascular Diseases Events: The Study of Women’s Health Across the Nation (SWAN)
Authors: Ziyuan Wang, Emma Barinas-Mitchell, Maria M Brooks, Carol A Derby, Jared W Magnani, Rebecca C Thurston, Samar R El Khoudary
Journal: Circulation (2024)

Objective: Midlife women face significant acceleration in CVD risk during the menopause transition. We aim to determine the cardiovascular health (CVH) as measured by Life's Essential 8 (LE8) in midlife women and to test the associations of midlife LE8 with future CVD events/total mortality. Methods: Participants were from the SWAN study, a multi-ethnic study of the menopause transition. LE8 includes diet, physical activity (PA), nicotine exposure, sleep, BMI, and blood lipids/glucose/pressure. The total and each LE8 scores (0 [lowest] - 100 [highest]) were calculated using AHA definitions. Scores were grouped into low (0-49), intermediate (50-74) and high (75-100) to characterize women. CVD events were self-reported between visits 1-16 and included: myocardial infarction, stroke, heart failure and revascularization. A subset of the events was adjudicated via medical record. Death certificates were obtained. Cox proportional hazards model was used to test the association between continuous LE8 metrics and CVD events/total mortality. Results: A total of 3302 women (mean age 46±3 years, 54% premenopausal) free of CVD at baseline were included. Among them, 28% achieved high total LE8 scores (mean 83±6) and many women had low scores on sleep, PA and diet ( Figure ). During a median (IQR) follow-up of 19 (7) years, 156 deaths and 202 CVD events were recorded. Higher midlife LE8 scores were associated with significantly lower risk of total mortality and CVD events adjusting for demographic and health factors ( Figure ). For individual components, BMI, blood lipids/glucose/pressure, nicotine exposure and sleep were associated with CVD events; BMI, blood glucose/pressure, nicotine exposure and PA were associated with total mortality ( Figure ). Conclusions: The prevalence of healthy diet, physical activity and healthy sleep is low in midlife women. Lower CVH is an independent risk factor of subsequent risk of CVD events/total mortality in midlife women. The findings highlight the need to promote healthy behaviors in midlife women.
Abstract P132: Paso a Paso, Designing a Culturally Relevant Diabetes Prevention Intervention for Hispanic/Latino (H/L) People That Adheres to Evidence Based, Diabetes Prevention Program (DPP) Intervention Principles in the Hispanic/Latino (H/L) Community of Salt Lake County
Authors: Maribel Cedillo, Megan N Miller, Molly B Conroy, Paul Estabrooks, Isabel T Molina, Gabriela Portugal-Bouza, Patricia Cortes
Journal: Circulation (2024)

One of five Salt Lake County residents identify as Hispanic/Latino(H/L) and are at higher risk for type 2 diabetes(T2D) compared to non-Hispanic whites. Evidence-based interventions to reduce T2D have not been as effective for H/Ls as for non-H/L whites. This study uses a shared-leadership, community-engaged approach to develop a model for H/L T2D prevention based on DPP with members of the H/L community, community-based organization partners (Utah Mexican Consulate; University Neighborhood Partners), and an interdisciplinary University of Utah team. Two groups of 10-15 people each (one for community members (CM) eligible to participate in a diabetes prevention program; one for community organization members(CBO) potential DPP-like program implementers). As part of a comprehensive participatory planning and evaluation(CPPE) process, each group met to (1)review existing Spanish DPP program components, learning objectives, and materials, (2)identify barriers to successful T2D prevention, and (3)suggest facilitators and areas for adaptation specific to H/L audiences. Participants in each group rated the DPP program structure and content related to healthy eating, increasing physical activity (PA), self-monitoring and meal planning using validated measures of acceptability, appropriateness, and feasibility. In addition, qualitative data was gathered and reduced to provide directions for potential adaptations. Quantitative data (Figure 1) indicates CM and CBO agree on importance of DPP program structure and content, however CBO members rated the acceptability, appropriateness, and feasibility more neutrally than CM participants. Qualitative data indicated a stronger focus on collective support, culturally aligned healthful eating options, and PA promotion that addressed safe activities for laborers. Conclusions CM and CBO participants found DPP to be an important resource for the H/L community, but also identified adaptations that could improve program reach, retention, and effectiveness.
Abstract P368: Differences in Perceived General Health and Health Care Utilization by Race and Ethnicity During the COVID Pandemic: The C4R-MESA Study
Authors: Oluwabunmi V Ogungbe, Wang Tianyou, Pallavi Balte, Akshaya Krishnaswamy, Sarah Slone, Diane Meyer, Jana Hirsch, Norrina B Allen, Karen Hinckley Stukovsky, R. Graham Barr, Elizabeth Oelsner, Wendy S Post
Journal: Circulation (2024)

Background: The COVID-19 pandemic reshaped individuals' lives with potential impacts on perceptions of their general health and healthcare utilization. Objective: Examine patterns of self-reported general health perceptions and routine healthcare utilization during the pandemic, and assess differences by race and ethnicity, in a community-based sample of US adults. Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) assessed the impact of the pandemic on participants via questionnaires designed by the Collaborative Cohort of Cohorts for COVID-19 Research (C4R) Study. For the question, “How does your general health compare to before the pandemic?”, responses of “worse” were compared to “about the same” or “better.” For the question, “Since March 2020, did you have to delay or miss out on any healthcare services?”; “yes” responses were compared to “no.” Associations with race and ethnicity were tested using logistic regression models, adjusting for covariates. Results: Of 1929 MESA participants (age 75±8 years; 55% female; 40% White; 23% Hispanic; 22% Black; 15% Chinese), worse general health during the pandemic was reported by 15% of participants and 32% reported missed or delayed healthcare services. Race and ethnicity were not associated with worse general health ( Table ). Black (vs White) participants were less likely to report having missed or delayed healthcare (aOR:0.56;95%CI:0.37-0.84). There were no significant differences in missed or delayed healthcare for Chinese and Hispanic participants compared to White participants. Conclusion: These findings suggest that 1 in 7 adults experienced worsening general health and 1 in 3 missed or delayed healthcare during the pandemic. However, race and ethnicity were not associated with perceived general health and associations with missed/delayed healthcare were limited. Longer-term effects of the pandemic on general health and utilization, and related health disparities, are being evaluated in this prospective cohort.
Abstract P135: Effect of Cardiovascular Health Improvement at Midlife on Cardiovascular Event and Mortality Risk in Diabetes
Authors: Elisabeth L Sattler, Camille Lassale, Donald M Lloyd-Jones, Marie-Cécile PERIER, Joshua J Joseph, Xavier Jouven, Bamba Gaye
Journal: Circulation (2024)

Objective: This prospective cohort study examined the relationships between changes in CVH during midlife, as assessed by the Life's Simple 7, and risks of CVD events and all-cause mortality among individuals with diabetes and compared to individuals without diabetes. Methods: The study utilized data from the Atherosclerosis Risk in Communities Study, collected during visits 1 (1987-1989) and visit 3 (1993-1995) with a median follow-up of 23 years. Results: Among the final sample (N=8,741), 806 had diabetes (9.2%). Among participants with diabetes at baseline, 62.3% had consistently low CVH at both visits, 12.0% maintained moderate CVH, and 0.4% maintained favorable CVH. Meanwhile, 15.0% showed improvement, and 10.3% experienced a decline in CVH. Those who improved their CVH status had lower CVD event risks (HR=0.69; 95% CI: 0.50 to 0.93), as did those who maintained moderate CVH (HR=0.68; 95% CI: 0.50 to 0.94) or shifted from moderate to low CVH (HR=0.60; 95% CI: 0.41 to 0.88). These results were largely influenced by positive changes in blood pressure, cholesterol levels, physical activity, and smoking. Similar patterns were observed for all-cause mortality. In comparison to participants without diabetes who maintained a favorable CVH trajectory at midlife, those with diabetes consistently displayed higher risks of CVD events and mortality, regardless of their CVH trajectory (Figure 1). However, individuals with diabetes who maintained a favorable CVH trajectory at midlife had CVD event and mortality risks similar to those without diabetes who had consistently low CVH. Conclusions: For individuals with diabetes at midlife, achieving or maintaining ideal CVH levels through lifestyle factors may help reduce excess CVD events and mortality risk. Nonetheless, CVD risk in diabetes is not completely mitigated by favorable cardiovascular risk factor trajectories.
“Excited delirium”: can the world lose this controversial term, which is accused of covering up deaths in police custody?
Authors: Chris Stokel-Walker
Journal: BMJ (2024)

Updating of medical guidance on the term has been brought forward, <i>The BMJ</i> learns, in the latest sign of the tide turning against its use. <b>Chris Stokel-Walker</b> explores whether "excited delirium" is ever fit for purpose—and what should happen next
Abstract P488: Diet Significantly Alters Metabolic Gene Expression Associated With Probiotic Administration in Mice
Authors: Jonathan Westlake, Brian Kagel, Nathan Lichti, Shreya Singh, Jeffrey Houghton, Joseph Gigliotti
Journal: Circulation (2024)

The microbial flora in the gastrointestinal tract is known to be mediated by diet and is thus one potential mechanism by which diet influences health. Furthermore, probiotic supplementation also affects various biological markers, however it is unclear if a diet and probiotic interaction exists. Therefore, the goal of our study was to assess how diet and probiotic administration influenced metabolic health in mice. Weanling, male C57Bl/6 mice were randomly assigned to receive one of three diets: chow, American Institute of Nutrition 93 formulation (AIN93), or our novel Americanized diet (AD) formulated to match the 50 th percentile of nutrient intake in Americans. Mice were then administered a commercially-available probiotic for 2-weeks and then euthanized. Insulin sensitivity was determined by performing an insulin-tolerance test (ITT) in a separate cohort. Blood was collected for serum analysis of circulating metabolic markers. Liver and adipose tissue were collected and processed to quantify the mRNA expression of key metabolic genes by real-time RT-PCR. All data were analyzed using General Linear Model Procedures in SPSS with significance determined at P&lt;0.05. Diet (P=0.001), but not probiotic supplementation (P=0.27), significantly affected ITT with the AD group having the lowest responsiveness to insulin ( P ≤0.001). Chow fed mice tended ( P =0.09) to have lower HDL than the AIN-93 and AD fed mice. Probiotic administration alone resulted in an upregulation of liver mRNA expression of SREBF2, particularly the AIN-93 diet group (P=0.024). Probiotic supplementation also modulated liver transcription of NF-κB1 with an increase in chow-fed mice, but decreased in those fed AD (P=0.016). Increased transcription of the key carbohydrate metabolism regulating gene, Mlxipl , was found to occur in liver of the chow and AIN-93 and also tended to differ in mice fed the AD (P=0.06). In the adipose tissue, diet (P&lt;0.001), probiotic (P&lt;0.001), and their interaction (P=0.01) influenced transcription of the androgen receptor ( Ar ) gene. The chow group had the most Ar transcription, while the AD had the lowest transcription in both the diet alone and probiotic treated group. Taken together, our data highlight the significance of diet in mediating the beneficial metabolic effects of probiotic administration. Diet appears to play a greater role in dictating the expression of key metabolic enzymes and transcription factors and future studies are needed to validate these findings and determine their physiological significance.