tbuckley/cabot-search huggingface dataset:
Abstract P1165: Dietary Quality Among Pregnant People With Overweight/Obesity: Comparison Between Randomized Controlled Trial Participants in Early Pregnancy With Non-Pregnant NHANES Matched Participants
Authors: Tianxu Chen, Christine McKinney, Emmanuel Drabo, Nae-yuh Wang, Lindsay Martin, Divya Nair, Nowella Durkin, Janelle Wilder Coughliin, Mostafa Borahay, Wendy Bennett
Journal: Circulation (2025)

Background: Poor dietary quality is associated with perinatal obesity, including excess gestational weight gain, a risk factor for future cardiometabolic disease. Despite the need to assess and intervene on dietary quality in pregnancy, few studies have identified screeners that are easy to use and have comparable performance in research as well as the general population. We sought to describe the dietary patterns of participants in early pregnancy using the Dietary Screener Questionnaire (DSQ) and compare the results with a matched non-pregnant sample from the 2009-2010 wave of the National Health and Nutrition Examination Survey (NHANES) who also completed the screener to demonstrate the external validity of our DSQ results. Methods: We compared the baseline dietary quality data from an ongoing randomized controlled trial (RCT) to assess the effectiveness of a remote lifestyle intervention targeting dietary quality on gestational weight gain with matched controls from non-pregnant NHANES participants. Baseline DSQ responses were collected from the RCT participants at ≤ 15 weeks of gestation. We selected a non-pregnant NHANES sample matched for age (20-44), sex (female), BMI (≥ 25), and complete DSQ data. We estimated daily intake of added sugar (total and from sweetened beverages), fiber, fruits and vegetables, and dairy using the standard scoring procedures and compared the samples using the Mann-Whitney U test. Results: At baseline, 383 RCT participants completed the DSQ with a mean age of 34.2 years (SD = 5.0). The NHANES sample included 651 people (mean age = 32.9 years, SD = 7.4 years). Pregnant RCT participants had a significantly lower consumption of daily total sugar (median = 13.2 tsp, IQR = [11.6, 15.0]) and sugar from beverages (median = 4.5 tsp, IQR = [3.9, 6.1]) compared to matched NHANES non-pregnant participants (total: median = 15.3 tsp, IQR = [12.9, 19.8]; beverages: median = 6.6 tsp, IQR = [4.4, 11.0]; both p &lt; 0.001). Other dietary quality measures were comparable between samples (Figure 1). Conclusion: Dietary patterns of RCT participants in early pregnancy and matched non-pregnant NHANES 2009-2010 participants were similar, except for sugar intake, indicating that the DSQ results may be generalizable to a broader population like people in NHANES. The lower intake of added sugar, particularly from sweetened beverages, may reflect decreased intake in early pregnancy or secular changes in the last 15 years.
Abstract P1104: The Association Between Subjective Social Status and Dietary Quality Within Occupational Groups of African Americans: The Jackson Heart Study
Authors: Nathan Conner, Jennifer Reneker, Philip Turk, Olivia Affuso, Sameera Talegawkar
Journal: Circulation (2025)

What people eat is a major contributor to health outcomes, including development of metabolic, cardiovascular, and other chronic diseases. Dietary quality varies widely is influenced by factors including sex, race, geographic location, socioeconomic status, self-perception of community standing, and occupation. These factors potentially interact, making an understanding of dietary quality difficult to fully disaggregate and therefore challenging to modify from a population health perspective. This study sought to analyze the interaction between subjective social status (SSS) and occupation on dietary quality among African Americans in the Deep South, as well as assess their marginal effects. Hypotheses Dietary quality will vary by occupational groups and levels of SSS. There will be an interaction between occupational groups and (SSS) on dietary quality. Methods: A cross-sectional analysis of data from participants of the Jackson Heart Study was completed. Participants ( n = 4,727) who had complete data for occupation, the alternative healthy eating index (AHEI, a measure of diet quality) score, and SSS (as measured by the Community MacArthur Scale) at exam 1 were included in the analysis. A general linear model with main and interaction effects for SSS and occupation group was fit to AHEI. Results: Type III F -tests from ANOVA showed no significant interaction between SSS and occupational groups with respect to mean AHEI scores ( p = 0.7635). Significant main effects were found for both the occupational groups and SSS level ( p &lt; 0.0001). Pairwise comparisons of occupational groups revealed significantly different mean AHEI scores among several groups. Most notably, those in the management/professional occupation appeared to have higher mean AHEI compared to all the other groups. Mean AHEI was estimated to increase by 0.3723 units (SE = 0.0781) for every one-unit increase in SSS. Residual diagnostics and goodness-of-fit methods verified model adequacy. Conclusions In conclusion, occupation and SSS each contribute significantly to dietary quality as measured by AHEI; some occupational groups show significant differences in dietary quality; and there is no evidence of an interaction between occupation groups and SSS, indicating that the positive association between subjective social status and dietary quality is the same for each occupational group.
Abstract P2166: Neighborhood-level socioeconomic deprivation associates with monocyte phenotypes involved in atherogenesis: Results from the Multi-Ethnic Study of Atherosclerosis (MESA)
Authors: Jein Eleanor Seo, Lola Ortiz-Whittingham, Colby Ayers, Yvonne Baumer, Kosuke Tamura, Joseph Delaney, Margaret Doyle, Nels Olson, Bruce Psaty, Russell Tracy, Ana Diez Roux, Matthew Feinstein, Tiffany Powell-Wiley
Journal: Circulation (2025)

Introduction: Chronic neighborhood stressors contribute to disparate CVD outcomes, with neighborhood socioeconomic deprivation (NSD) linked to inflammation. Separately, relationships have been seen with CVD and specific monocyte phenotypes. However, the connection between neighborhood exposures and monocyte subsets is less clear. Thus, we examined NSD with monocyte phenotypes, hypothesizing that chronic NSD cross-sectionally associates with monocyte subsets. Methods: This study utilized data from the Multi-Ethnic Study of Atherosclerosis (MESA), a population-based prospective cohort of adults aged 45-84 years (N=6814). NSD was scored from principal factor analyses using U.S. Census data (2000), with higher values indicating higher deprivation. Monocyte phenotypes were measured from cryopreserved peripheral blood mononuclear cells by flow cytometry at MESA Exam 1 (2000-02). Subsets were characterized as classical monocytes (CMs, CD14++CD16-), intermediate monocytes (IMs, CD14+CD16+), and non-classical monocytes (NCMs, CD14+CD16++). Linear regression models were used to examine associations between NSD and monocyte phenotypes, adjusting for individual-level covariates. Results: Of the MESA cohort, participants with monocyte phenotypes (n=1527) were included in analyses (age 62.9±10.5 years, 50.5% male, 37.4% White, 28.6% Black, 20.6% Hispanic). Higher NSD was associated with lower CMs but higher IMs and NCMs (Table). When gender-stratified, relationships remained significant for CMs but not for IMs. In men, higher NSD was associated with higher NCMs but not when adjusted for covariates. Conclusion: Neighborhood deprivation as a marker of chronic stress was associated with shifts in monocyte subsets in a partially sex-dependent manner, with differential relationships with CMs, IMs, and NCMs. With IMs and NCMs associated with accelerated CVD, these findings may help illuminate the role of monocytes in how neighborhood exposures lead to CVD. Future analyses will examine interactions with race/ethnicity and inflammatory biomarkers.
Abstract P1166: Sex-Based Disparities in the Referral Pathway for Catheter Ablation for Atrial Fibrillation in a Large Urban Healthcare System
Authors: Kristie Coleman, Jonas Leavitt, Dimitrios Varrias, Nikhil Sharma, Kerry Smith, Louis Miller, Elizabeth Cohn, Jennifer Mieres, Stavros Mountantonakis
Journal: Circulation (2025)

Background: The prevalence of atrial fibrillation is reported to be lower in women, however it remains unclear if this is a biological phenomenon or social construct representative of limited access to healthcare resources. Catheter ablation (CA) is considered first line therapy for patients with symptomatic atrial fibrillation; however, women are less likely to be referred, and when referred are older, with more advanced disease and comorbidities. To elucidate barriers in access to catheter ablation for women, we will assess potential bottlenecks in the AF referral pathway. Methods: Leveraging the large and highly diverse patient population of a large healthcare system the incidence of patients diagnosed with AF between 2015-2023 were established, and time from diagnosis to ablation was calculated. Cox proportional hazard regression analysis was performed to assess sex-specific differences in time from AF diagnosis to ablation. Kaplan Meier survival curves were generated. Results: Between 2015 and 2023, 31,186 female and 41,789 male patients were diagnosed with AF, 1,952(6.3%) and 3,751(9.0%) underwent catheter ablation, respectively. Female patients undergoing CA were significantly older (67.9±9.9 years vs 63.7±10.3, p&lt;0.001) although more likely to be paroxysmal (41.0% vs 35.3%, p&lt;0.00) compared to males. Over the study period, female patients were less likely to undergo catheter ablation following diagnosis of AF (HR 0.93, 95% CI 0.88-0.98, p=0.017) when adjusting for age. The rate of referral for electrophysiology consult [(Females: 68.1% vs Males: 61.5%, p&lt;0.001) Figure 1 Panel A]. was similar, as well as the time from diagnosis to catheter ablation between groups (Males: 591± 804 days vs Females: 613± 822, p=0.37). Kaplan-Meier curve shows the divergence between male and female patients, indicating a higher rate of ablation procedures performed for males [(log rank p&lt;0.001), Figure 1 Panel B]. Conclusion: Over an 8-year follow-up period, in a large urban healthcare system, while women were more likely to be referred for electrophysiology consult, they were less likely to undergo catheter ablation. Further investigation is needed to assess potential barriers to design evidence-based intervention to reduce this disparity.
Abstract P3144: Association Between Perceived Discrimination and Depression/Anxiety Symptoms
Authors: Zhengxin Tang, Nan Lv, Jun Ma
Journal: Circulation (2025)

Introduction: Research linking perceived discrimination and depression and anxiety symptoms as well as brain function is limited. Objective: To examine the relationship between perceived discrimination, particularly racial/ethnic discrimination, and depression and anxiety symptoms, as well as brain function related to emotion and cognition, in individuals with depression and/or anxiety. Differences by race and ethnicity were also explored. Methods: We analyzed baseline data on perceived discrimination, depression and anxiety symptoms, and brain activities in an ongoing clinical trial, which investigates a voice-based virtual coach for problem-solving treatment. Perceived discrimination was measured using the PhenX Major Experiences and Everyday Discrimination Scales. Depression and anxiety were assessed using the PHQ-9 and GAD-7, respectively. Activity of a priori neural targets, amygdala for emotional reactivity and dorsolateral prefrontal cortex (dlPFC) for cognitive control, was measured using fMRI. Results: Among 161 participants (mean age 36.6 [SD 11.8] years; 80.8% female; 19.3% Non-Hispanic White, 23.6% Black American, 21.7% AAPI, 31.1% Hispanic), major (r=0.14; p=.01) and everyday (r=0.19; p=.02) discrimination scores were significantly positively correlated with GAD-7 scores. Racial/ethnic discrimination was significantly positively associated with GAD-7 scores (r=.19; p=.01) when reported for everyday discrimination. The association was also positive but not statistically significant when reported for major discrimination (r=.14; p=.07). For differences by race/ethnicity, Black Americans reported the highest levels of both general (p=.002) and racial/ethnic major discrimination (p&lt;.0001). Black Americans, AAPI, and Latinos reported significantly greater racial/ethnic everyday discrimination than non-Hispanic White participants (p&lt;.0001). Neither major or everyday discrimination correlated significantly with PHQ-9 scores or with the neural targets (dlPFC and amygdala). Conclusion: Heightened anxiety but not depressive symptoms or the prespecified neural targets are associated with experiences of discrimination, particularly racial/ethnic discrimination, in adults with depression or anxiety. Research on how to address social determinants of health such as discrimination in mental health interventions is warranted.
Abstract P1127: Socioeconomic Influences on Physical Activity in Middle-Aged Adults from Rural US: The Bogalusa Heart Study
Authors: Vanessa Fonseca Lomeli, Shirine Moukaled, Iyinope Sivebukola, Camilo Fernandez, Phillip Hwang, Robert Newton, Ileana De Anda-Duran, Lydia Bazzano
Journal: Circulation (2025)

Introduction: Middle age is a pivotal period for implementing cardiovascular (CV) preventive measures, with physical activity (PA) being a key factor in preventing CV disease. However, the determinants of PA in this life stage, especially among minoritized populations in rural US areas, are not fully understood. This study investigates the relationship between socioeconomic, cardiometabolic conditions, and PA in midlife. Hypothesis: Middle-aged adults with worse socioeconomic and more CV risk factors are more likely to engage in lower levels of PA compared to moderate or high PA levels. Methods: We examined 1,289 participants (mean age 48 ± 5.24 years, 34.7% Black, 65.3% White) from the Bogalusa Heart Study, a long-term longitudinal rural study. Multinomial regression models assessed associations between education (&gt;college), employment status, self-reported diabetes and hypertension medication use with PA scores low (minimal or no PA), moderate (&gt;=600 MET-Minutes/week), high (&gt;=3,000 MET-Minutes/week) measured by the International Physical Activity Questionnaire (IPAQ) long form. Models were adjusted for age, race, and sex. Results: Employed individuals were more likely to meet moderate PA score (OR=2.23, 95% CI=1.66-2.99, p&lt;0.001 ) and high PA score (OR=2.56, 95% CI=1.83-3.59, p&lt;0.001 ) compared to low PA, after adjusting for covariates. Similarly, higher educated (&gt;college) individuals were more likely to engage in moderate PA in adjusted models (O =1.29, 95% CI=1.12-1.49, p&lt;0.001 ). Diabetes medication use was associated with lower odds of moderate PA (OR=0.65, 95% CI=0.44-0.96, p =0.033) on unadjusted models, and lower odds of reporting high PA compared to low PA in adjusted models (OR=0.57, 95% CI=0.35-0.93, p =0.024). Hypertension medication use was associated with lower odds of reporting moderate PA (OR = 0.67, 95% CI=0.51-0.89, p =0.006) and high PA (OR=0.66, 95% CI=0.48-0.92, p =0.001) in unadjusted models. (Table 2) Conclusions: Education, employment, and diabetes medication use significantly influence PA levels in midlife. Participants with higher education and employment were more likely to engage in moderate to high PA, while diabetes medication users were less likely to achieve high PA. These findings highlight the need for further research into how socioeconomic factors shape PA and influence long-term CV health in vulnerable rural mixed middle-aged populations.
Abstract P2042: Descriptive Analysis of Geographic and Sociodemographic Patterns in Poor Cardiovascular Health Across U.S. Census Tracts
Authors: Azar Abadi, Melissa Flores, Elleni Hailu, Arnab Ghosh, Jeffrey Wickliffe, Erin Dooley, Kelley Gabriel, Emily Levitan
Journal: Circulation (2025)

Introduction: Examining geographic and sociodemographic differences in Poor Cardiovascular Health (PCVH) across U.S. neighborhoods can help identify where the most significant disparities in cardiovascular disease exist. We sought to map and examine the distribution of PCVH across U.S. census tracts by levels of social vulnerability and rurality from 2017 to 2021. Hypothesis: We hypothesize that PCVH will be more prevalent in regions with greater social vulnerability and in rural areas. Methods: We examined area-level PCVH score based on the Life’s Essential 8 (LE8) framework across 60,632 U.S. census tracts (~85% of Continental U.S. census tracts). Prevalence data for seven LE8 components (high blood pressure, poor sleep, physical inactivity, diabetes, smoking, obesity, and high cholesterol), as well as the Social Vulnerability Index (SVI) were from the Centers for Disease Control and Prevention. Rural-Urban Commuting Area (RUCA) codes and limited access to healthy food, used as a proxy for poor diet, were obtained from the U.S. Department of Agriculture. Percentile estimates from the eight components were averaged to generate a composite PCVH score for each tract (range 0-100), then classified as quartiles based on percentile ranking (Q4=poorest PCVH). We then mapped PCVH quartiles across census tracts (Figure 1). Differences in PCVH score were analyzed across SVI quartiles, urbanicity status (metro vs. rural), U.S. census regions, and racial/ethnic groups. Results: The median PCVH score was 62.5, with an interquartile range of 46.8 to 78.1. The mean PCVH score was higher in rural (61.2, SD = 16.6) compared to metropolitan (47.2, SD = 22.7) tracts. Tracts with the lowest SVI (less vulnerable) had a mean PCVH of 30.9 (SD = 15.2), while those in the highest quartile had 69.4 (SD = 17.4) (data not shown). Additionally, tracts in the South [60.7 (SD = 22.1)] and Midwest [52.9 (SD = 21.4)] states had a higher PCVH score compared to West and Northeast [35.3 (SD = 18.1] and 44.5 (SD = 19.5), respectively]. Tracts with larger Black or African American populations were overrepresented in the upper PCVH quartiles [30.1% (SD = 31.79) in PCVH Q4 vs 4.6% (SD = 7.1) in Q1]. Conclusion: These findings highlight geographic and sociodemographic disparities in PCVH across U.S. census tracts, with a higher burden found in the South and Midwest, as well as in rural and more socially vulnerable census tracts.
Abstract P1068: Comparative Analysis of Children’s Persistence in a Lifestyle Modification Program and Body Mass Index Z-Score Changes According to the Access to a Family Grant Program at a Pediatric Obesity Management Clinic
Authors: Marie Cyrenne-Dussault, Julie St-Pierre, Jean-Philippe Drouin-Chartier
Journal: Circulation (2025)

Introduction: Improving access to healthcare for childhood obesity is crucial, especially in contexts where social vulnerability is a significant risk factor for developing obesity in childhood. Little is known about whether family grant programs (FGP) help remove systemic and institutional barriers to lifestyle therapies for children with obesity. Hypothesis: We tested the hypothesis that access to a FGP favors engagement in a lifestyle modification program and body mass index z-score (BMIz) reduction of children with overweight or obesity at a pediatric obesity management clinic, the Maison de santé prévention – Approche 180, in Montreal (QC, Canada). Methods: This study is designed as a retrospective, longitudinal, comparative analysis of medical records of children (2 to 17 years) with overweight or obesity. Data were collected between April 8, 2021 (FGP implementation) and March 31, 2023. Children in youth centers, foster families, with refugee status or whose parents had a low-income per Canada’s Revenue Agency were eligible for the FGP, which fully covered the costs of multiprofessional services at the clinic. Persistence in the lifestyle program, measured by the number of appointments and follow-up duration, and changes in BMIz over the study period were compared between children based on access to the FGP. Results: Among the 198 included children (100 girls, 98 boys; mean age=11.1 years ± standard deviation (SD)=3.0; mean BMIz=3.30 ± SD=1.05), 62 benefited from the FGP and 136 were not eligible to it. Children from non-two-parent families were 2.46 times more likely to receive the grant compared to those from two-parent families (95% confidence interval (CI): 1.46, 4.13; P=0.0007). Children with the grant had longer follow-up duration [10.29 (95%CI: 8.59, 11.99) vs 6.71 (95%CI: 5.48, 7.93) months; P=0.0007] and similar number of appointments per month [0.81 (95%CI: 0.66, 0.95) vs 0.92 (95%CI: 0.81, 1.02); P=0.42] compared to those without it. Children with the grant achieved similar BMIz changes compared to those without it [-0.31 (95%CI: -0.61, -0.01) vs -0.32 (95%CI: -0.57, -0.06); P=0.92]. Conclusions: FGP was associated with persistence in a lifestyle program that surpassed that of those who were not eligible to it. It enabled children with social vulnerabilities to achieve BMIz reductions comparable to those of children without such vulnerabilities. Free care could help address systemic and institutional barriers to childhood obesity management.
Abstract P2128: Can We Swim Our Way to Better Health? A Cross-sectional National Survey
Authors: Eduard Tiozzo, Cynthia Henley, Nicole Pontee, Joslyn Gober, Adriana Valbuena Valecillos, Lance Reccoppa, JONATHAN PRESLEY, Jessica Mitchell, Lawrence Cahalin, Sandra DeMel, Hannah Gardener, Kerstin Yu
Journal: Circulation (2025)

Background: This study examined obesity and comorbidity rates, physical activity levels, and cardiovascular health, using Life’s Essential 8 (LE8), among the United States Masters Swimming (USMS) adult swimmers. Methods: A cross-sectional Qualtrics survey was distributed by USMS via an online newsletter and by 52 local masters swimming organizations via email. Results: We received responses from 1,097 USMS members. The participants’ mean age was 42.8 (range 18-84), body mass index was 25.1 (range 17-47), and 59.0% identified as women and 89.5% as White. The obesity rates among USMS participants were four times lower than the national rate (10.9% vs 41.9%). The obesity prevalence did vary significantly by race, education, and household income but not by age or occupational physical activity. USMS and national rate comparisons were 23.0% vs. 44.5% for hypertension, 5.6% vs. 14.3% for type 2 diabetes, 8.6% vs. 11.4% for high total cholesterol, and 6.3% vs. 17.2% for low high-density lipoprotein cholesterol, respectively. The rate of USMS swimmers who met the recommended ≥150 minutes of aerobic activity a week, ≥two muscle-strengthening activities a week, and both was 96.6%, 65.6%, and 64.5%, respectively. When it comes to LE8 total score, USMS participants had 20% higher score than U.S. young adults free from cardiovascular disease (83.5 and 69.6, respectively, p=0.0001). In our sample, three in four adults had an ideal LE8 total score (≥80), compared to one in four from the NHANES sample that represents an estimated 90 million of the U.S. population. Overall, older USMS participants (mean age of 43; range 18-85) had significantly better LE8 score and estimated cardiovascular health than younger U.S. adults (mean age of 31; range 18-44). Conclusion: We observed low obesity and comorbidity rates and ideal estimated cardiovascular health among adult swimmers who are part of supervised and educational exercise environment overseen by the USMS.