tbuckley/cabot-search huggingface dataset:
Abstract P1131: Comparisons of daily patterns of accelerometry-derived physical activity between interdialytic and dialysis days, by session, among patients on hemodialysis.
Authors: Pablo Martinez-Amezcua, Alfredo Fuentes, Erika Jaime Borja, Rodrigo Gopar-Nieto, Fernanda Garza Romero, Salvador Lopez Gil
Journal: Circulation (2025)

Introduction: Patients with end-stage chronic kidney disease (CKD) are less physically active than those without CKD. Those who receive hemodialysis (HD) may be less active, especially on HD days, given that most patients are sited for ~3 hours during HD. Nevertheless, limited evidence exists on quantifying activity differences across HD and interdialytic days. Methods: In a cross-sectional study of patients 18 years and older undergoing HD three times per week in a tertiary hospital in Mexico City without contraindications for physical activity or significant mobility limitations, we measured free-living physical activity using wrist accelerometry. Patients have three interdialytic periods each week and three days. On an HD day, some patients have morning sessions (starting at 7 AM), some mid-day sessions (beginning between 11 AM-12:30 PM), and some have evening sessions (starting between 3:30-4:30 PM). The patients wore a triaxial accelerometer in their non-dominant wrist (only removing it for water activities longer than 30 minutes) for 7 days. Valid days had ≥90% of wear time. We derived total activity counts (TAC), time spent active (minutes), and the active-to-sedentary transition probability (ASTP, a measure of fragmentation; higher ASTP= more fragmented activity). With linear regressions accounting for correlation of repeated measures, we estimated differences in TAC, active time, and ASTP. We plotted minute-level median activity counts separately for interdialytic days and HD days by session for descriptive purposes. Results: In a sample of 27 adults (mean age=39.6, SD=12.5, 41% females), the mean TAC was 2.34 million (SD=0.77 million), time spent active 447 minutes (SD=137.12), and ASTP 25% (SD=7). Compared to interdialytic days, during HD days, patients were less active, and their activity was more fragmented (beta coefficient for TAC= -0.7 million [95% CI -0.9, -0.4], for active time=-103 minutes [-148.5, -58.6] and ASTP= 5% [95% CI 3, 7]). In diurnal plots, we also saw that activity began earlier on HD days and was constantly lower across the day relative to interdialytic days (figure) Conclusion: Patients undergoing HD were significantly less physically active and had more fragmented activity patterns on HD days compared to interdialytic days. Interventions aimed at increasing physical activity and reducing sedentary behavior on HD days may be beneficial for improving overall health and quality of life in this population.
Abstract P1040: Characterizing Metabolically Unhealthy Normal Weight In Hispanic / Latino adults: Results from HCHS/SOL
Authors: MILTON SUAREZ ORTEGON, Paola Filigrana, Wenyan Ma, Amber Pirzada, Martha Daviglus, Mason Krueger, Christina Cordero, Daniela Sotres-Alvarez, Ana Siega-Riz, Linda Gallo, Carmen Isasi
Journal: Circulation (2025)

Introduction: Metabolically unhealthy normal weight (MUNW) individuals exhibit metabolic abnormalities linked to obesity, increasing their risk of cardiometabolic diseases. MUNW is often overlooked in clinical practice, as guidelines generally focus on overweight or obesity. Additionally, the long-term stability of MUNW and its potential role in future weight gain remain unclear. This study aimed to identify factors associated with prevalent and incident MUNW and examine its stability over time. Hypothesis: MUNW evolves into excess weight phenotypes, and among those with stable MUNW over time, the number of cardiometabolic risk factors (CRFs) increases. Methods: We examined 2,343 individuals with normal weight (BMI ≥18.5, &lt;25 Kg/m 2 ) free of diabetes and cardiovascular disease (baseline) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) [18-74 years old], a community-based cohort of Hispanic/Latino adults living in the U.S. MUNW was defined as having a normal weight with at least one of the following CRFs: elevated fasting glucose, triglycerides, blood pressure, or low HDL cholesterol. Survey multivariable models were used to explain prevalent and incident MUNW at baseline and after 7 years of follow-up. The stability of MUNW was assessed by tracking transitions to other weight phenotypes. Results: At baseline, 69% of individuals had MUNW. In a multivariable model, older age [Odds Ratio (OR): 1.05, 95%CI: 1.03-1.06], being foreign-born with ≥10 years in the U.S. (vs. U.S.-born) [OR: 1.65, 95%CI: 1.17-2.33], and a household income over $40,000 (vs.&lt;$20,000) [OR: 0.56, 95%CI: 0.39-0.81] were associated with prevalent MUNW. Waist circumference (continuous) was also associated [OR: 1.06, 95%CI: 1.03-1.08]. Among 264 individuals free of metabolic abnormalities at baseline who maintained normal weight over 7 years, 33.3% developed MUNW. Age [Relative Risk (RR): 1.04, 95%CI: 1.02-1.06] and male sex [RR: 1.76, 95%CI: 1.13-2.73] were predictors of incident MUNW. Among individuals with MUNW at baseline, 30.6% progressed to metabolically unhealthy overweight/obesity (MUO) and 3.7% to metabolically healthy overweight/obesity. Stable MUNW individuals (57.3%) showed an increase in the number of CRFs over time (p&lt;0.05). Conclusion: MUNW is not stable, as many individuals transition to MUO, and those remaining MUNW accumulate more CRFs over time. Metabolic health needs to be assessed in normal-weight adults, particularly those with high waist circumference.
Abstract P3107: Relationship between adherence to Canada’s Food Guide 2019 and the risk of cardiovascular disease in Canada: A Protocol
Authors: Matthew Tatur, Didier Brassard, Mavra Ahmed, Laura Chiavaroli, Anthony Hanley, Wendy Lou, Vasanti Malik
Journal: Circulation (2025)

Introduction: Cardiovascular disease (CVD) is a leading cause of death in Canada. A healthy diet plays an integral role in CVD prevention. In 2019, Canada’s Food Guide (CFG) was updated to reflect current evidence on healthy eating. The Healthy Eating Food Index (HEFI) was developed as a tool to measure adherence to CFG. However, the extent to which adherence to CFG influences CVD remains unexplored within Canada. Objective: 1.) Assess the association between HEFI scores and the risk of CVD in a population-based cohort. 2.) Estimate the number of preventable CVD-related deaths from improvements in HEFI scores. 3.) Estimate potential healthcare cost savings from improvements in HEFI scores. Methods: Data linkages between the Canadian Community Health Survey – Nutrition (2004) and the Canadian Vital Statistics Death and Discharge Abstract Database (2017) will be used, with over 80% of CCHS respondents successfully linked to these databases. Weighted Cox proportional hazards models will be used to examine the prospective association between HEFI scores and CVD outcomes. Analyses will be stratified by sex to account for potential differences in associations between males and females. Multivariate models will be adjusted for dietary recall-related factors (e.g. weekday/weekend, sequence of recall), sociodemographic factors (e.g., age, education) and lifestyle-related factors (e.g., alcohol consumption, physical activity, smoking). The population attributable fraction (PAF) will be estimated for the number of preventable CVD deaths attributable to improvements in HEFI scores. To estimate the potential economic impact of HEFI improvements, the PAF will be multiplied by direct and indirect costs of CVD. Significance: This study will be the first to explore the prospective association between HEFI scores and CVD risk in a Canadian population as well as to quantify the number of preventable deaths and potential economic savings associated with improvements in HEFI scores. Analyses are currently underway, and results are forthcoming. Findings will inform dietary guidance and shape Canadian health and economic policy strategies, enhancing both public health and financial outcomes.
Abstract P2106: Serum Metabolomic Markers of Dietary Potassium and Incident Chronic Kidney Disease Risk
Authors: Lauren Bernard, Jiaqi Yang, Jingsha Chen, Valerie Sullivan, Bing Yu, Eugene Rhee, Rebholz Casey
Journal: Circulation (2025)

Introduction: Potassium is found in many foods and has been inversely associated with incident chronic kidney disease (CKD). Untargeted metabolomic profiling is a powerful approach for discovery of novel diet biomarkers and to highlight metabolic pathways that explain associations between dietary potassium and CKD. Methods: Dietary potassium was derived from food items assessed using an interviewer-administered questionnaire administered at visit 1 (1987-89). Incident CKD was a composite outcome using reduced estimated glomerular filtration rate (&lt;60 mL/min/1.73 m 2 and ≥25% eGFR decline), hospitalization and death codes related to CKD stage 3+, or end-stage kidney disease identified via US Renal Data System registry. Participants were followed for CKD until December 31, 2020. Cross-sectional associations between dietary potassium (mg/1000 kcal) and 359 serum metabolites were evaluated with linear regression models. Prospective associations between significant potassium-related metabolites and CKD were studied with Cox regression models. Analyses were adjusted for covariates and accounted for multiple comparisons. Results: In 3,822 U.S. adults, we identified 53 significant associations between dietary potassium and serum metabolites, representing 6 super-pathways (amino acids, n=17; lipids, n=11; cofactors and vitamins, n=9; xenobiotics, n=8; carbohydrate, n=5; peptides, n=3). Over two decades of follow-up, 1,618 (42%) of participants developed incident CKD. Ten of the 53 metabolites from the cross-sectional analysis were prospectively associated with incident CKD. Two metabolites, kynurenine and glycerate, had the a priori expected directions of associations with dietary potassium and CKD ( Table ). There was a significant trend of CKD risk across quartiles of kynurenine and glycerate. Conclusions: Kynurenine and glycerate and their respective pathways may be representative of dietary potassium’s metabolic impact on CKD development.
Abstract P1136: Fetal C-Reactive Protein rs1205 Genotype Associated with Maternal Pre-eclampsia
Authors: Lyle Best, Crystal Azure, Hailey Davis, Lauryn Jeanotte, Shyanna LaRocque, Sabra Poitra, Shayden Standish, Tyler Parisien, Kelsey Morin
Journal: Circulation (2025)

Introduction: Maternal variants including C-Reactive Protein, CRP rs1205 have previously been associated with risk of pre-eclampsia (PE). These findings were replicated in two non-American Indian populations. The rs1205 T allele is associated with reduced serum levels of CRP. Our objective was to determine if the fetal rs1205 genotype contributed to maternal risk of PE independent of maternal rs1205 genotype. Methods: Only offspring of both case and control mothers heterozygous for rs1205 were enrolled, thus controlling for maternal genetic influence at this locus. Offspring were then genotyped for rs1205 by TaqMan assay. Association was assessed by chi-square and multivariate logistic regression. Results: Offspring of 35 of 45 normal pregnancies and 12 of 23 PE pregnancies exhibited the rs1205 T allele dominant genotype (Pearson chi square p=0.031). Multivariate logistic regression analysis adjusted for maternal age, nulliparity and BMI demonstrates an odds ratio of 0.255, p=0.032, 95% CI 0.073-0.891 for the fetal, T-dominant genotype. Discussion: Among 68 women, heterozygous for the rs1205 allele, both chi-square and multivariate adjusted logistic analysis show reduced risk of PE among pregnancies with fetal T allele dominant genotypes. This is consistent with previous findings of reduced risk associated with this maternal genotype, and with a pathophysiologic model wherein less placental CRP expression reduces risk of PE.
Abstract P1142: Small for Gestational Age and Lipid Parameters During the First 14-16 Months of Life
Authors: Sofie Nielsen, Rikke Mohr Lytsen, Anne-Sophie Sillesen, Anna Axelsson, Ruth Ottilia Birgitta Voegg, PIA KAMSTRUP, Kasper Iversen, Henning Bundgaard, Ruth Frikke-Schmidt
Journal: Circulation (2025)

Introduction: A lipid profile with high concentrations of apolipoprotein B-containing lipoproteins - non-HDL cholesterol - is a risk factor for atherosclerotic cardiovascular disease. Accumulation of these lipoproteins is cumulative over the lifespan and high concentrations in childhood are associated with high concentrations later in life. Recently, we described developments of lipid traits from birth to 14-16 months of age, and showed that sex of the child, gestational age, and breastfeeding are influencing factors during this period. It is however unknown whether small for gestational age –a state with an unfavorable metabolic profile – influences lipid traits in early life. Hypothesis: We tested the hypothesis that small for gestational age children have a more atherogenic lipid profile. Methods: For this purpose, we used the Copenhagen Baby Heart Study comprising 13,354 umbilical cord blood samples and parallel venous blood samples from children and parents at birth (n=444), at two months (n=363), and at 14-16 months (n=158). All lipid traits were measured in mmol/L. Results: In cord blood medians (25 th -75 th percentiles) for small, appropriate, and large for gestational age newborns were 0.98 (0.81-1.18), 0.95 (0.77-1.15), and 0.92 (0.72-1.15) for non-HDL cholesterol, 0.22 (0.17-0.31), 0.18 (0.13-0.23), and 0.14 (0.11-0.20) for remnant cholesterol, 0.50 (0.37-0.68), 0.39 (0.29-0.51), and 0.32 (0.25-0.44) for triglycerides, and 0.62 (0.46-0.79), 0.73 (0.58-0.91), and 0.78 (0.62-0.96) for HDL cholesterol (all p-values=0.0001). For total cholesterol and LDL cholesterol no differences were found according to size for gestational age. Girls have higher concentrations of lipid traits compared to boys but differences according to size for gestational age were similar in both sexes. Small for gestational age newborns of mothers with preeclampsia had the highest concentrations of non-HDL cholesterol, remnant cholesterol, and triglycerides. Differences according to size for gestational age were also found in venous blood samples at birth, at two months, and at 14-16 months for remnant cholesterol, triglycerides, and HDL cholesterol. Conclusion: Small for gestational age newborns have higher concentrations of the atherogenic lipoprotein fractions non-HDL cholesterol and remnant cholesterol. These differences between small, appropriate, and large for gestational age observed early in life suggest increased risk of atherosclerotic cardiovascular disease later in life.
Abstract MP47: Cardiovascular risk factors for dementia: Causal estimates on individual-level data
Authors: Jiao Luo, Ida Juul Rasmussen, Jesper Qvist Thomassen, Ruth Frikke-Schmidt
Journal: Circulation (2025)

Background: The 2024 Lancet Commission report highlights 14 modifiable risk factors that if eliminated can prevent nearly half of dementia, of which most are cardiovascular risk factors. The causal aspects remain however unclear, hence we aimed to establish causal estimates for these cardiovascular risk factors. Methods: We used individual-level data from 408,788 European participants from the UK Biobank. We computed polygenetic risk scores of individual risk factors for each participant, exploiting independent instrumental variants from the largest genomic consortia for each risk factor. We conducted univariable and multivariable linear Mendelian randomization analyses and assessed genetic shapes by nonlinear approaches. Findings: Genetically predicted high BMI (OR, 95% CI: 1.04, 1.02-1.07), smoking (1.18, 1.06-1.32), high systolic (1.14, 1.09-1.20) and diastolic (1.10, 1.02-1.19) blood pressure, type 2 diabetes (1.04, 1.00-1.09), high LDL cholesterol (1.12, 1.01-1.23) and high triglycerides (1.19, 1.01-1.41) were associated with increased risk of all-cause dementia. Results for Alzheimer’s disease and vascular dementia were in the same direction. Moreover, genetically predicted high physical activity was associated with reduced risk of Alzheimer’s disease (0.58, 0.33-0.99), and longer education was associated with all-cause dementia (0.72, 0.65-0.79), Alzheimer’s disease (0.71, 0.62-0.81), and vascular dementia (0.64, 0.52-0.77) Sensitivity analyses supported the main results, and no nonlinear shapes were detected. Interpretation: These findings provide causal insights into cardiovascular risk factors for dementia, underscore the importance of more targeted interventions to mitigate these risk factors for dementia prevention, and give hope for maintaining brain health by timely treatment of high cholesterol and triglycerides alongside hypertensive medication, smoking cessation and maintenance of normal weight.
Abstract P2161: Validation Of a Novel Method to Evaluate Local-scale Community-based Interventions That Improve Access to Fruits and Vegetables
Authors: Louisa Ewald, Claire Ugo-Ike, Kate LeGrand, Sally Honeycutt, Jennifer Hall, Emmanuela Gakidou, Ali Mokdad, Gregory Roth
Journal: Circulation (2025)

Background: Adequate intake of fruits and vegetables (FV) is important for cardiovascular health. Evaluating community-based dietary programs in under-resourced areas is challenging, necessitating innovative data collection methods. These methods must adapt to community contexts, enhancing the accessibility of impact evaluation for programs operating in neighborhood settings, including community centers, schools, and farmers’ markets. Aims: This study aimed to develop and pilot a survey instrument designed to overcome barriers in data collection within community-based programs, focusing on measuring changes in health behaviors. The tool aims to validate a concise set of process and outcome measures, addressing the evaluation challenges of small, local initiatives. Methods: The survey development was a theory-driven, participatory process with stakeholders to ensure the tool was culturally sensitive and capable of capturing data relevant to health outcomes. The survey was pilot tested in four Social Impact Fund programs in California, Florida, and Georgia. One program provided free meals, two provided discounted produce, and one was a traditional farmers’ market stand. The bilingual survey (English and Spanish) covered demographics, program participation, frequency of FV intake, and barriers to healthy eating. It was delivered via in-person interviews, tablets, and personal smartphones. Results: The pilot achieved high feasibility, with a 98.2% completion rate from 111 participants for the 20-item survey, taking an average of eight minutes. Overall, 62.5% (95% CI 49.7, 75.3) of participants said that their FV intake increased due to the programs, with the top reasons being affordability and quality. Participants also reported barriers to increasing FV intake, Figure 1, with 50% (95% CI 39.9, 60.1) saying cost, followed by time constraints and accessibility. Conclusion: The pilot results affirm the feasibility of evaluating programs aiming to improve diet in high-disparity neighborhoods. The results indicate a strong community desire for such programs and underscore a pivotal finding: when fruits and vegetables are affordable and accessible and meals are readily available at a low cost, community members are more likely to adopt healthier diets. This participatory approach proves that a well-validated, concise survey tool can efficiently collect health data in unconventional settings, promoting health equity by adapting to specific needs of communities.
Abstract P1148: Coping with stressors: Does it predict health behaviors over more than a decade?
Authors: Pamela Mondragon, Laura Kubzansky, Scott Smith, Claudia Trudel-Fitzgerald
Journal: Circulation (2025)

Objective: Emerging research suggests the use of certain strategies to cope with stressors relate to disease and mortality risk, and lifestyle habits may be underlying mechanisms. Studies show psychological symptoms (e.g., anxiety) and states (e.g., happiness) predict the likelihood of adopting an integrated lifestyle that encompasses key health-related behaviors, like smoking. Yet, whether psychological processes , including stress-related coping, influence the adoption of a healthy lifestyle is unknown. We investigated whether coping strategies typically deemed adaptive (e.g., seeking emotional support) and maladaptive (e.g., denial) relate to sustaining a healthy lifestyle over a 16-year follow-up. We also explored whether variability in use of these strategies, reflecting attempts to find the best strategy for a given stressor, subsequently relates to lifestyle. Methods: Women (N=46,067) from the Nurses’ Health Study II reported their use of eight coping strategies in 2001, from which we also derived coping variability levels (lower, moderate, greater). Health behaviors (e.g., physical activity, smoking, sleep) self-reported every four years from baseline until 2017, were combined into a lifestyle score. Generalized estimating equations, controlling for baseline demographics and health status, were performed. Results: Most adaptive strategies and greater variability levels were associated with higher likelihood of sustaining a healthy lifestyle (e.g., Active Coping, Relative Risk [RR]=1.09, 95% Confidence Interval [CI]=1.08-1.10), with the reverse evident with maladaptive strategies (e.g., Behavioral Disengagement, RR=0.93, CI=0.92-0.94), but some unexpected results also emerged. Conclusions: Findings highlight the importance of going beyond the usual (mal)adaptive categorization of coping strategies when investigating their predictive value with behavioral outcomes.