UKCO - Abstracts | The Association for the Study of Obesity

The abstract poster display will be available in the exhibition space in Conference Room 1 from 08:45 hours on Thursday until the end of the congress.

Displaying 1 - 25 of 115 abstracts

Developing and Monitoring Systemic, Multi-Duty Interventions for Malnutrition in All Its Forms in Southeast Asian Countries and China - Phase 1 of the SYSTAM CHINA SEACS International Consortium

Bai Li 1, Steve Allender 2, Bee Koon Poh 3, Zouyan He 4, Remco Peters 1, Weiwen Zhou 5, Jianfeng Lao 6, Yunfeng Zou 4, Boyd Swinburn 7, on behalf of the SYSTAM CHINA SEACS International Consortium

1 Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom.
2 Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
3 Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
4 School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
5 Institute of Nutrition and School Health, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China
6 Fang Cheng Gang Health Commission, Fangchenggang, Guangxi, China
7 School of Population Health, University of Auckland, Auckland, New Zealand

📌 Allocation: Poster (Board No. 03)

Background

Southeast Asian countries (SEACs) and China are facing a high burden from malnutrition in all its forms (MIAIF, including obesity). Radical changes in the way that nutrition interventions are conceptualised, developed and evaluated are needed to act on shared drivers of MIAIF to maximise and sustain impact. Collaborating with the Consortium members [Ministry of Health (MoH) of SEA countries and China, and academics], the phase 1 of the SYSTAM CHINA SEACS aimed to 1) develop and pilot test culturally sensitive and cost-effective ways to apply established tools from the systems science to develop multi-duty and systemic interventions to reduce MIAIF in these low-and middle-income countries; and 2) identify and evaluate national nutrition surveillance programmes in SEACs and China, and assess whether these programmes can monitor and evaluate systemic nutrition interventions.

Methods

For the first goal, we developed, piloted and implemented three major sets of innovations to the traditional Group Model Building (GMB) process in a strategically selected Chinese city. Methodological adaptations enabled mapping of shared drivers of MIAIF in a single causal loop diagram. Procedural innovations included incorporating additional project engagement events surrounding GMB workshops to suit the Asian setting. Operational changes included developing ‘hybrid’ GMB activities to reduce travel and associated climate impact. For the second goal, we conducted a systematic scoping review using a combination of consultations with MoH nutrition officials and active searches of international databases, as well as established and purposively developed evaluation frameworks.

Results

Our culturally adapted, innovative GMB process led to high engagement of, and wide support from, decision makers from diverse governmental departments, and co-identification and prioritisation of system-level drivers and intervention themes of MIAIF in the pilot city The scoping review identified 83 surveillance programmes in 19 countries. Monitoring of food environment for the purpose of controlling MIAIF and inter-sectoral partnerships and data connection mechanisms are commonly missing in these countries.

Conclusion

The Consortium countries are ready to apply the successfully piloted, innovative GMB process, and are planning focused research to expand the scope of monitoring to include food environment indicators and support building of inter-sectoral data collaboration mechanisms.

Conflicts of interest: We have no conflicts of interest to declare.
Funding: UK Medical Research Council.

Mapping and evaluating national nutrition surveillance programmes in Southeast Asian countries and China: A systematic scoping review for the Systemic Actions to Reduce Malnutrition In All Its Forms in Southeast Asian Countries and China (SYSTAM CHINA-SEACS International Consortium) project

Remco Peters 1, Bai Li 1, Boyd Swinburn 2, Steven Allender 3, Zouyan He 4, Sim Yee Lim 5, Mary Chea 6, Gangqiang Ding 7, Weiwen Zhou 7, Phonesavanh Keonakhone 8, Maikho Vongxay 8, Souphaxay Khamphanthong 8, Rusidah Selamat 9, Azucena Dayanghirang 10, Ellen Abella 10, Filipe Da Costa 11, Saipin Chotivichien 12, Narttaya Ungkanavin 12, Mai Tuyet Truong 13, Son Duy Nguyen 13, Bee Koon Poh 5

1 University of Bristol, Bristol, UK
2 University of Auckland, Auckland, New Zealand
3 Deakin University, Geelong, Victoria, Australia
4 Guangxi Medical University, Nanning, Guangxi, China
5 Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
6 Ministry of Health, Phnom Penh, Cambodia
7 Chinese Center for Disease Control and Prevention, Beijing, China
8 Ministry of Health, Vientiane, Lao PDR
9 Ministry of Health Malaysia, Putrajaya, Malaysia
10 National Nutrition Council, Taguig City, Philippines
11 Office of the Prime Minister, Díli, Timor-Leste
12Ministry of Public Health, Nonthaburi, Thailand.
13 National Institute of Nutrition, Hanoi, Vietnam

📌 Allocation: Poster (Board No. 04)

Southeast Asian (SEA) countries, and China are facing a high burden of malnutrition in all its forms. There is a call for interventions that act on shared drivers of multiple forms of malnutrition and take a systems approach. Use of routinely collected data from long-term national or regional surveillance systems can effectively monitor and evaluate such interventions. However, a comprehensive, up-to-date, overview and evaluation of nutrition/health surveillance programmes led/funded by national health agencies in SEA and China is lacking. A systematic scoping review was conducted to identify and evaluate ongoing nutrition surveillance programmes, and assess whether these can monitor and evaluate multi-sectoral, double-duty, systemic nutrition interventions.

This review searched academic databases, grey literature, and consulted with national health officials iteratively using Arksey and O’Malley’s six-stage framework. The literature search was not restricted by publication type nor publishing language. Member states of WHO SEA region, ASEAN and China were included. Three reviewers independently screened, selected, and extracted publications. In this review, a nutrition surveillance programme is defined as repeated collection, analysis, interpretation, and dissemination of primary data by national agencies on anthropometric, biochemical, behavioural and/or food environment/system indicators relating to nutrition. The identified programmes were mapped and evaluated against a purposively developed framework.

Eighty-three surveillance programmes in 19 countries were identified. Seventeen countries implemented a programme that exclusively collects nutrition and/or dietary outcome indicators continuously/periodically. Seventeen countries incorporated internationally-linked survey programmes which vary in scope. There is lack of monitoring of food environment, wider food system indicators for the purpose of tackling overweight and obesity or other forms of malnutrition, and of nutrition in urban deprived areas. Elderly are generally missing from surveillance in 10 countries. While most surveillance systems collect high quality data through flexible, timely programmes, many are periodic and rely on external agency’s support, which may compromise sustainability. There is an expressed common need to form inter-sectoral partnerships and data sharing/connecting mechanisms.

Future research and development should focus on widening the scope of surveillance to include malnutrition in all its forms among all population groups as well as food environment indicators, and support inter-sectoral data collaboration.

Conflicts of interest: We declare no conflicts of interest.
Funding: UK Medical Research Council

Sedentary time is independently related to adipose tissue insulin resistance in adults with or at risk of type 2 diabetes

Buket Engin 1,2, Scott A. Willis 1,2, Sundus Malaikah 1,2,3, Jack A. Sargeant 2,4, Gregory J. H. Biddle 2,5, Cameron Razieh 2,5,6, Stavroula Argyridou 2,5, Charlotte L. Edwardson 2,5, Charlotte Jelleyman 7, David J. Stensel 1,2,8,9, Joseph Henson 2,5, Alex V. Rowlands 2,5, Melanie J. Davies 2,4,5, Thomas Yates 2,5, James A. King 1,2

1 National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, UK
2 NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, UK
3 Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
4 Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, UK
5 Diabetes Research Centre, College of Life Sciences, University of Leicester, UK
6 Office for National Statistics, Newport, NP10 8XG, UK
7 Human Potential Centre, School of Sport and Recreation, Auckland University of Technology, NZ
8 Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
9 Department of Sports Science and Physical Education, The Chinese University of Hong Kong

📌 Allocation: Poster (Board No. 05)

Introduction: This cross-sectional study examined associations of device-measured sedentary time and moderate-to-vigorous physical activity (MVPA) with adipose tissue insulin resistance in people with or at high risk of type 2 diabetes (T2DM). A secondary aim was to explore whether relevant demographic (i.e. ethnicity and sex) and biological factors (i.e. age and body mass index [BMI]) mediated these associations.
Methods: Data were combined from six previous experimental studies (within our group) involving patients with T2DM or primary risk factors (median (IQR) age 66.2 (66.0 – 70.8) years, BMI 31.1 (28.0 – 34.4) kg.m-2, 62% male, n=179). Adipose tissue insulin resistance was calculated as the product of fasted circulating insulin and non-esterified fatty acids (ADIPO-IR), while sedentary time and MVPA were determined from wrist-worn accelerometry. Generalised linear models examined associations of sedentary time and MVPA with ADIPO-IR with interaction terms added to explore the moderating influence of ethnicity (white European vs. south Asian), BMI, age, and sex. Two sensitivity analyses were performed: 1) removing participants taking statins and/or metformin, and 2) splitting the cohort into those with T2DM and those at high risk.
Results: In finally-adjusted models, sedentary time was positively associated with ADIPO-IR, with every 30 min of sedentary time associated with a 1.80 (95% CI: 0.51 to 3.06; P=0.006) unit higher ADIPO-IR. This relationship strengthened in interaction analyses as BMI increased (β=3.48 [95%CI=1.50 to 5.46], P=0.005 in the upper BMI tertile [≥ 33.2 kg.m-2]). We conducted a further model adjusting for MVPA which revealed that sedentary time was positively associated with ADIPO-IR independent of MVPA (2.52 AU [1.05, 3.96]; P<0.001). In contrast, MVPA was unrelated to ADIPO-IR. These results were consistent in the sensitivity analyses when excluding participants taking statins and/or metformin (n=32), and when separating participants into those with T2DM (n=126) and those at high risk (n=147).
Conclusions: Sedentary time is positively related to adipose tissue insulin resistance in people with or at high risk of T2DM. This relationship strengthens as BMI increases and is independent of MVPA performed, which may help to explain established relationships between greater sedentary time, ectopic lipids, and hyperglycaemia.

Conflicts of interest: No conflict of interest
Funding: The research was supported by the NIHR Leicester Biomedical Research Centres. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. BE was supported by a scholarship from the Republic of Turkey Ministry of National Education.

A service evaluation of the barriers and facilitators for clinicians engaging patients in weight management conversations regarding lower limb arthritis

Bethany Neall 1

The University of Southampton, Southampton, UK
Solent NHS Trust, Southampton, UK

📌 Allocation: Poster (Board No. 06)

Background: Osteoarthritis (OA) is a degenerative joint disorder affecting weight-bearing and non-weight-bearing joints, causing pain and limited mobility. Obesity is a risk factor for osteoarthritis and NICE Guidelines specify that weight management and exercise are the first-line treatments for lower limb OA. Within the Solent Musculoskeletal team, there are barriers to having successful weight management conversations.
Aims: To understand healthcare professionals’ experiences when discussing weight management with patients regarding lower limb OA. To identify barriers/facilitators and compare these to previously known barriers/facilitators. To categorise barriers/facilitators into themes and assess how we may overcome these barriers.
Method: Physiotherapists and podiatrists were emailed a survey on 31 September about their experiences discussing weight management with patients with lower limb OA. 10 participants then attended in-depth follow-up interviews. Qualitative themes from the written questions in the survey and the interview transcripts were clarified and analysed by inductive thematic analysis.
Results: 35/185 clinicians completed the questionnaire. 34% (12/35) reported they were somewhat or not so confident approaching weight management conversations. 71% (25/35) reported having no training on how to approach these conversations. Barriers were identified as a lack of training, resources, private rooms, and time. Facilitators were identified as patient acceptance, clinician experience and clinician knowledge. Quotations from the questionnaire reveal conversations are harder when the patient struggles with “low mood” and easier when “linking their weight to their clinical condition”. Quotations seen from the interviews include “In a big open room, I think people get a little bit embarrassed” and “I'm not aware of many good resources”.
Conclusion: There is a need for further training or peer support for clinicians when approaching weight management conversations and more resources to support clinicians and educate patients. It would be beneficial to have a private room available to have these conversations in.
Acknowledgements: I would like to thank my supervisors Isabella Favarin, Eloise Whitaker and Cathy Price for the help in setting up the project

Conflicts of interest: No conflicts of interest
Funding: No funding was allocated

Protocol for an umbrella review of systematic reviews of school-based nutrition interventions to determine outcomes used and their measurement tools

Dilara Olgacher 1, Sarah Aldukair 1, Mike Clarke 1, Danielle McCarthy 2, Jayne V Woodside 1,2

1 Centre for Public Health, Queen’s University Belfast, Belfast, UK.
2 Institute for Global Food Security, Queen's University Belfast, Belfast, UK.

📌 Allocation: Poster (Board No. 08)

Childhood obesity is a serious public health problem worldwide, with short and long-term health consequences. Poor diet is a recognized risk factor in the development of childhood obesity. Many school-based nutrition interventions have aimed to improve diet quality in children and reduce childhood obesity. The outcomes targeted by school-based nutrition interventions vary, ranging from behaviours such as dietary intake and knowledge to longer term impacts such as anthropometric and metabolic measures, and are measured with different methods. The variation in outcomes and the methods by which these are measured makes it difficult to compare and synthesize the effectiveness of interventions and draw definitive conclusions. This protocol outlines the methodology for an umbrella review of systematic reviews to explore the range of outcomes and measurement tools used in studies of school-based nutrition interventions. The umbrella review will be conducted in keeping with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) and Preferred Reporting Items for Overviews of Reviews (PRIOR) guidelines. We will search MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, PsycINFO, CINAHL, Web of Science and Scopus. Reviews will also be identified through grey literature and manual searching of reference lists. Systematic reviews with or without meta-analyses will be eligible if they (1) evaluated the effect of school-based nutrition interventions on diet, health, well-being or education; (2) included primary or secondary school-aged children; and (3) included studies with any comparative effectiveness design. Two reviewers will independently screen title and abstracts and resolve disagreements through discussion or consultation with a third reviewer, followed by full-text screening. Outcomes and their measurement methods will be extracted from eligible reviews and assigned to pre-established outcome domains. Outcome and domain frequencies will be estimated. A narrative synthesis without meta-analysis will be performed. This review will provide a comprehensive overview of outcomes and measurement tools used in evaluations of school-based nutrition interventions. The findings could serve as a foundation for the development of a core outcome set for use in studies of school-based nutrition interventions. This will support comparison and evidence synthesis in the field of school-based nutrition interventions.
Registration: PROSPERO CRD42022378746

Conflicts of interest: The authors declared no potential conflicts of interest with respect to the research, authorship and publication of this abstract.
Funding: Department for the Economy, Northern Ireland

Binge Eating Disorder Prevalence in an Irish Population Attending a Level 3 Obesity Service

Mallory Noone1 , Cara O'Grada 1 , Ciara Brack 1 , Donal O’Shea 1 , Colin Dunlevy 1 , Claire Kearney 1 , Jean O’Connell 1

St Columecilles Hospital, Loughlinstown, Co. Dublin, Ireland

📌 Allocation: Poster (Board No. 09)

Binge Eating Disorder (BED) is characterized by a series of criteria. In 2013, DSM V criteria changed, reducing frequency and duration, and including severity.
International studies show BED occurs in obesity, but prevalence rates vary. The HSE Model of Care for Adult Obesity advises the Edmonton Obesity Staging System for determining the severity of obesity and guiding clinical decisions.
We aimed to establish the prevalence of BED using the new DSM V criteria, according to obesity complexity, in patients accessing a Level 3 Obesity Service in Ireland.

All patients accessing the service over a 12 month period underwent a baseline interview with a Clinical Psychologist using DSM-V diagnostic criteria to diagnose BED. Obesity complexity was established using EOSS following dietetic, medical, psychology, physiotherapy and nursing assessment. Approximately 6 months into treatment pathways, patients were re-assessed for BED status and their interest in bariatric surgery and obesity pharmacotherapy recorded. Statistical analysis was completed using Microsoft Office Excel 2016.

Baseline prevalence of BED was 25% (n43 out of n171 assessments). Severity of BED included 63% mild (n27), 21% moderate (n9), 9% severe (n4), and 0.05% extreme (n2). The majority (83.7%) with moderate to severe BED were EOSS 2 or 3. At 6 month follow-up 53% (n23) no longer met diagnostic criteria for BED. Of the 47% actively binge eating, 45% and 65% respectively were interested in bariatric surgery and/or pharmacotherapy.

BED prevalence in this Level 3 Obesity Service was below known rates of 30% under DSM 4 criteria. We showed a 53% abstinence rate consistent with the literature during initial treatment. The majority of the cohort living with BED are living with moderately complex obesity, which may be an indication for escalated obesity treatment. However, these treatments are controversial in active BED due to potential adverse effects. Developing service pathways to better support this cohort of individuals experiencing BED and complex obesity are needed.

Conflicts of interest: None
Funding: HSE Model of Care

Motivational Interviewing (MI) within a Tier 3 Service -Real World Implementation

Anjali Zalin, Judith Carpenter

Anjali Zalin -Barts Health and Bedfordshire Hospitals NHS Foundation Trust
Judith Carpenter -Derby Hospitals NHS Foundation Trust, Optimal Change Limited

📌 Allocation: Poster (Board No. 10)

BACKGROUND
Rising rates of obesity and associated challenges are well recognised. Existing services are challenged to deliver effective, sustainable care at scale. In the context of novel therapeutics, digital/virtual options and cost pressures , the quality of the consultation in effecting change is often overlooked. Here we describe our experiences of implementing MI -an evidence-based psychological method -within a complex Tier 3 service.

AIM
To implement and evaluate the impact of MI training for staff within a regional Tier 3 service.

METHODS
An experienced trainer (JC) was commissioned to deliver MI training. The content was carefully designed to meet the needs of the service. An initial consultation period with key stakeholders enquired around the challenges, current skills and intended impact of training. Introduction to MI training was delivered virtually over 6 x 2 hour workshops, in which Tier 3 clinicians were introduced to specific MI skills and strategies to integrate into consultations. Case studies were presented and opportunities for practice provided. Key elements included using MI as a guiding style to promote an engaging conversation and strategies to elicit and strengthen intrinsic motivation. Following the training, JC delivered a consolidation workshop and supported service champions. To integrate MI within pathway redesign, she supported the development of tailored resources.

RESULTS:
• It is assumed clinicians already possess skills to navigate complex consultations, however this is often not the case. Staff frequently feel unskilled in change based discussions outside of using a traditional paternalistic model
• The training was well received and attended , given sessions were delivered at the end of a working day
• Staff acquired new skills rapidly and were able to use them immediately in consultations
• Patients responded well to this novel approach and the consultations became more engaging
• There were limitations of on-going skill development due to lack of continued resources

CONCLUSIONS:

MI is a skill set that is valuable in supporting Tier 3 clinicians to improve their consultations and engage in change based conversations. The empathic methods employed support motivation to change. Training requires initial teaching and on-going investment to increase staff efficacy.

Conflicts of interest: Funding was partly supported by Novo Nordisk
Funding: Novo Nordisk and Bedfordshire Hospitals NHS Foundation Trust supported this training

Cultural, Religio- Specific Determinants of Obesity in Ghana

Kingsley Agyemang 1, Subhash Pokhrel 1, Nana Anokye 1

1. Brunel University London, London, UK

📌 Allocation: Poster (Board No. 12)

Obesity is primarily linked to dietary choices and levels of physical activity. However, it is crucial to acknowledge the significant influence of cultural and religious practices, particularly in regions where these aspects hold substantial importance. In the context of Ghana, cultural and religious activities play a significant role in shaping individuals' lifestyles, impacting their eating habits and engagement in physical activities. This underscores the need to consider the cultural and religious dimensions when addressing the obesity epidemic in such regions. This is the first study to examine the relationship between religion, culture, and obesity and how identified factors affect obesity among the different religious and cultural groups in Ghana.
Data from the Ghana Obesity Survey (N=6000), conducted in 2021 was used for the study. Logit models were fitted to identify the correlation between religion, culture (tribes and metropolises), and obesity while adjusting for other explanatory factors.
The study found that individuals practicing the Muslim faith in Ghana had an 11% higher likelihood of being overweight or obese compared to individuals of the Christian faith. A significant relationship was also found between culture and obesity with the Ga tribe having a 9% higher likelihood of being obese compared with the Akan tribe. Additionally, the direction of effect for metropolis of residence was consistent across religious groups with residents of Tamale, whether people of the Muslim or Christian faith, having a decreased likelihood (about 12%) of being overweight/obese compared with those of Kumasi. Regarding other explanatory variables, individuals with high incomes (GH 1000 and above) had a 14%–22% greater risk of being overweight or obese.
The study examined the relationship between culture, religion, and obesity in over 81% of Ghana’s metropolises. The findings identified that religion and culture are key determinants of obesity is a significant contribution to the existing literature and provides a critical insight into an under-researched area in Ghana. The study recommends that culturally sensitive interventions be implemented and awareness about the impact of culture and religion on obesity be promoted. These can be crucial steps toward effective obesity prevention and management strategies in Ghana.

Conflicts of interest: None
Funding: None

Adapting to accommodate group sessions for people living with obesity – the service challenges and solutions from PROGROUP feasibility trial

Dawn Swancutt 1, Jenny Lloyd 2, Ross Watkins 2, Shokraneh Moghadam2, Lily Hawkins 2, Helene Davis 2, Rod Sheaff 1, Mark Tarrant 2, Jonathan Pinkney 1

1 University of Plymouth, Plymouth, UK.
2 University of Exeter, Exeter, UK.

📌 Allocation: Poster (Board No. 13)

Increasing patient referral rates and longer waiting lists are prompting Specialist Weight Management Services to find alternative ways to meet their obligations. Group delivery of care is therefore becoming more attractive to service providers who may have historically only offered one-to-one patient appointments. To transfer to group-based care, new service management logistical issues arise which may pose barriers to implementation. As part of a feasibility randomised controlled trial, this study aimed to investigate the service-related changes that are required when moving from one-to-one to group-based care. Qualitative data were collected at three well established Specialist Weight Management Services across the UK as part of the trial. In-depth interviews with service managers at each site were contrasted with observational data describing how one-to-one care was usually provided. Data was synthesised into case studies across sites using the framework analysis approach to formulate key learnings. The study found that in setting up group-based care, three key areas differed from one-to-one appointments: 1. Room logistics; ensuring enough appropriate chairs, space between chairs, and access to accommodate the group of patients adequately, 2. Session scheduling; balancing the needs of patients and the clinic resources for recurring visits (especially for patients in rural areas), 3. Patient preparation for the group; managing patient expectations of the group sessions. Solutions identified by sites included liaising with other hospital departments, such a physiotherapy, to gain access to rooms and equipment; using Saturday appointments when more rooms are available and patients may be more able to attend; initiating dedicated clinics for collecting baseline measures outside group setting; and contacting patients by phone before the group to help manage expectations and maintain engagement with the programme. Group-based care may enable services to see more patients with less staff time, and hence more effectively manage their caseload. This format also maximises patient-service contact time and offers patients opportunities for social interactions before and during session. Our study concluded that when adopting this format for the first time, attending to room planning, scheduling, and managing patient expectations ensured success in overcoming logistical barriers to implementing group-based care.

Conflicts of interest: None
Funding: Written on behalf of the PROGROUP programme team. This project is funded by the National Institute for Health and Care Research (NIHR) [PROGROUP (NIHR201038)] and in conjunction with the Applied Research Collaboration South West Peninsula [PenARC (NIHR200167)]. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Patient engagement with a group-based specialist weight management programme: Observations from the PROGROUP feasibility randomised controlled trial.

Jenny Lloyd 1, Dawn Swancutt 2, Ross Watkins 1, Shokraneh Moghadam 1, Lily Hawkins 1,
Helene Davis 1, Rod Sheaff 2, Mark Tarrant 1, Jonathan Pinkney 2

1 University of Exeter, Exeter, UK
2 University of Plymouth, Plymouth, UK

📌 Allocation: Poster (Board No. 14)

Severe obesity is a complex condition influenced by psychological, social, and environmental factors. Apart from bariatric surgery, which very few people living with severe obesity choose, treatment options are variable and of uncertain effectiveness. Group based programmes, whilst relieving pressure on services, can be used to achieve better outcomes for patients if facilitation focuses on creating a shared social identity, known to enhance the effectiveness of behaviour change techniques. PROGROUP is an example of such a programme. The aim of the presentation is to evidence programme engagement in relation to the PROGROUP mechanisms of action. Forty-seven participants were randomised to receive PROGROUP (four groups; 3 sites). As part of the embedded realist process evaluation, questionnaire (n= 37) and interview data (n=12) was collected from intervention participants to ascertain and understand engagement with PROGROUP. Interviews ensured a range of demographic factors and engagement levels. Interviews were analysed using inductive thematic analysis, with the Framework approach being used to organise and code the data. Questionnaire data showed a good level of satisfaction with PROGROUP overall (median scores 4/5 across sites). In addition, 89% (16/18) of participants reported having contact with other group members outside of scheduled sessions compared to 33% (11/33) for control participants. PROGROUP participants reported a range of lifestyle behaviour change attributed to receiving the group-based programme. Themes relating to patient engagement emerging from the interview data included learning and awareness, feeling comfortable and safe, sharing information with significant others and use of programme materials/behaviour change strategies during and beyond the programme. Linked mechanisms of action included shared experience and physical identity, connecting to group members, facilitator behaviour and family context. To conclude, group based interventions are increasingly used to deliver behaviour change in healthcare, however, how best to deliver and standardise this care to maximum effect requires more UK-centred evaluation and clearer delineation of group delivery components. Data from the PROGROUP feasibility trial demonstrates how active development of a positive group dynamic and connection between group members through targeted facilitation can increase engagement with strategies to manage weight within, outside and beyond the programme.

Conflicts of interest: None.
Funding: Written on behalf of the PROGROUP programme team. This project is funded by the National Institute for Health and Care Research (NIHR) [PROGROUP (NIHR201038)] and in conjunction with the Applied Research Collaboration South West Peninsula [PenARC (NIHR200167)]. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Exploring the use of service design workshops as a collaborative approach to designing a community Weight Management Service for Children and Young People

Geraldine Sexton1, Karen Gaynor2, Sarah O’Brien1; on behalf of the Obesity National Clinical Programme Children and Young Persons Obesity Expert Working Group.
1Healthy Eating Active Living Programme, HSE; 2National Clinical Programme for Obesity.

1Healthy Eating Active Living Programme, HSE; 2National Clinical Programme for Obesity.

📌 Allocation: Poster (Board No. 15)

Introduction: The Specialist Community Weight Management Service for Children & Young People (CYP) is a new HSE initiative to manage overweight and obesity in CYP. Two multidisciplinary teams (MDT) are funded via the Sláintecare Healthy Communities initiative to deliver this service. The HSE Obesity National Clinical Programme led the service design using the concept of design workshops to foster MDT collaboration from relevant stakeholders and to ensure the patient voice was included.
Aim: To co-design a specialist community CYP weight management service using service design workshop’s.
Method: Parents and healthcare professionals (HCP) from a broad range of clinical disciplines, working with children and young people with overweight and obesity attended the workshops. Each workshop had unique aims and objectives related to service design with each workshop informing the structure of the next.
The nominal group technique (NGT) (1) was used to facilitate group discussion and identify priority needs for implementing the service and to disentangle parent and HCP perceived obstacle’s that impede service user participation and engagement. These needs were mapped to shape next iteration of service design process.
Results: To date, six workshops have been conducted with parents (27), Dietitians (4), Physiotherapists (2), Clinical Psychologists (2), Occupational Therapists (1), Nursing (4), Paediatricians (2), Community Medical Doctors (2), Social Care workers (1), Child Development Officers (1), Service Implementation Leads (1) and Senior management (2) attending each one.
Workshops fostered a collaborative approach and raised awareness of potential challenges ( engagement, high programme attrition, multidisciplinary skills and expertise, oversubscription) and opportunities (focusing on non-weight outcomes, flexibility of the service by meeting families where they are at, building symbiotic relationships with other specialist community services, inclusion of Occupational Therapists and Social Care workers in the team, using social media to promote the service)
These insights were used to develop co-created service design documents and supporting guidelines, information material for families and referrers and communications strategy.
Conclusion: Design workshops are one way to improve service design by bringing elements that may not have otherwise been considered. The benefits of a workshop depend on involving the right mix of participants, including the parent's voice.

Conflicts of interest: none
Funding: None

Exploring the association between weight tracking frequency on a mobile application supporting intermittent fasting and weight loss: a retrospective analysis

Rosemary Huntriss 1, Dimitri Nikogosov 1, Rodion Salimgaraev 1

1 Simple Life Apps Inc, London, UK.

📌 Allocation: Poster (Board No. 16)

This study explores the correlation between the frequency of weight tracking and weight loss in users of a mobile application which supports intermittent fasting alongside self-monitoring of food, fluid and physical activity. Users were divided into groups based on their weight tracking frequency: once per month, once every two weeks, once per week, twice per week, and three or more times per week. The study spanned three observation periods of 12 weeks, 26 weeks, and 52 weeks, and considered adults living with overweight or obesity. The cohorts included 15,345 users in the first observation period, 6,580 in the second, and 2,787 in the third, all of whom met the inclusion criteria of at least one weight track per month. Statistical analysis was performed using the Kruskal-Wallis H-test, followed by Dunn's test with Bonferroni correction. The results demonstrated a positive correlation between weight tracking frequency and weight loss. At 12 weeks, mean weight loss ranged from 1.62% for the group tracking weight once per month to 6.49% for the group tracking weight three or more times per week. Similar trends were observed at 26 weeks and 52 weeks. Statistically significant differences in weight loss were found between all groups of weighing frequency across all timepoints, except between the twice per week and three or more times per week groups, and additionally between the once per week and twice per week groups in the 52-week observation period. The study concludes that while the total number of weight tracks is associated with weight loss, weighing more than twice a week does not yield significantly better results than weighing twice a week. By 52 weeks, there is no additional benefit to weighing more than once per week. The 26-week mark emerged as a critical period for weight loss performance, after which users tended to maintain their weight loss rather than continue to lose weight. This study provides valuable insights into the role of regular weight tracking in weight management, particularly in the context of intermittent fasting, and could help to inform the design of digital weight management interventions.

Conflicts of interest: All authors are employees of Simple Life Apps Inc.
Funding: No external funding was used to finance the study.

Baseline dietary intake of adults with overweight and obesity at risk of cardiovascular disease, assessed by the Prime Diet Quality Score, on the island of Ireland – the PAD-Q study

Marina Ferrari1, Sarah F. Brennan1, Teresa Grohmann2, Aoife Courtney2, Lorraine Brennan2, Jayne V. Woodside1.

1 Queen’s University Belfast, Belfast, UK
2 University College Dublin, Dublin, Ireland.

📌 Allocation: Poster (Board No. 17)

Recent dietary guidelines to prevent cardiovascular disease (CVD) focus on food groups, dietary patterns, and diet quality. The PAD-Q intervention aims to use a personalised feedback system to improve diet quality and therefore cardiometabolic health. The PAD-Q system was based on the Prime Diet Quality Score (PDQS), in conjunction with dietary biomarkers. Baseline dietary intake of PAD-Q study participants is explored here.
The PAD-Q study is a six-month, parallel, randomised, controlled, single-blinded intervention, being conducted at Queen’s University Belfast and University College Dublin. Adults with BMI >25 kg/m2, at risk of CVD, and with low PDQS score (≤21 out of 42) were recruited. Diet quality was assessed using the 21-item PDQS where frequencies of food group intake ranged from less than once/week to twice/day or more. Daily or weekly intake of food groups was determined and compared with current UK and ROI dietary guidelines.
The PAD-Q study recruited 149 participants (71% females). Mean (±SD) age was 49±12 y. BMI classified 70.5% of the group with obesity. Total PDQS score at baseline was 16±4 points. The sample had a low intake of fruit and vegetables, where only 7% reached an intake of at least 3 portions/day. Legumes were consumed once/week or less by 79% of the sample. No one met the five-a-day fruit and vegetable recommendation. Nuts were consumed daily by 4% of the sample. In terms of fish intake, 16% reached the minimum recommendation of 2 portions/week. Whole-milk dairy products were consumed by 50% of the sample on a daily basis. Intake of high-sugar foods/beverages was more than one portion/day in 52% of the sample. Processed meat and high-fat foods were consumed at least twice a week by 62% and 50% of the sample.
The main contributors to low diet quality in this population were low intakes of fish, nuts, legumes, fruit and vegetables, and high intakes of whole-milk dairy products, high-sugar foods, processed meat and high-fat foods. The efficiency of personalised dietary feedback systems to improve diet quality in this population will be determined in future analysis.

Conflicts of interest: There are no known conflicts of interest to declare.
Funding: We like to acknowledge funding support of the US-Ireland Tripartite Programme sponsored by the US NIH/NIDDK (DK120870), the Health Research Board (USIRL-2019-1) and the HSC R&D Division, Public Health Agency and the Medical Research Council [STL/5461/2018].

Association between age and change in body weight, body composition, energy intake, and eating behaviours during aerobic exercise training.

James L Dorling 1, John W Apolzan 2, Neil M Johannsen 3, Christoph Höchsmann 4, Daniel S Hsia 2, Tim S Church 2, Corby K Martin 2.

1 University of Glasgow, Glasgow, UK.
2 Pennington Biomedical Research Center, Baton Rouge, USA.
3 Pennington Biomedical Research Center, Baton Rouge, USA & Louisiana State University, Baton Rouge, USA.
4 Technical University of Munich, Munich, Germany.

📌 Allocation: Poster (Board No. 19)

Older adults lose more weight during diet-based lifestyle interventions, possibly because of increased reductions in lean mass and food intake. However, it is not known if age is associated with weight and body composition change during exercise training. The primary aim of this analysis was to test if age was associated with changes in body weight and body composition during aerobic exercise training. A secondary aim was to test if age was associated with free-living energy intake and eating behaviours during the trial. In the Examination of Mechanisms of Exercise-Induced Weight Compensation (E-MECHANIC) study, participants randomised to an exercise condition completed one of two regimens, which differed based on energy expenditure: 8 kcals/kg/week (KKW) or 20 KKW. Body weight was measured, and DXA was used to assess body composition. Additionally, energy intake was examined through doubly labelled water, and food cravings and food preferences were examined via questionnaires. In the statistical analysis, the 8 KKW and 20 KKW groups were combined, and Spearman correlation coefficients assessed the association between age and outcomes (significance threshold: P<0.05). Data are mean±SD unless noted otherwise. Overall, 110 participants with overweight or obesity (31.0±4.5 kg/m2) and an age of 48.5 years (±11.7; range: 21-65) completed either exercise condition. During exercise training, body weight and fat mass significantly changed by -1.1 (±2.6) kg and -0.8 (±2.4) kg, respectively (P<0.01), but lean mass was unchanged (-0.2±1.3 kg; P=0.16). Changes in weight (ρ = 0.07), fat mass (ρ = 0.10), and lean mass (ρ = -0.06) during training were not associated with age (P≥0.30). At baseline, age was negatively associated with energy intake (ρ = -0.20), food cravings (ρ = -0.21), and preference for fats (ρ = -0.21; P≤0.04). During training, however, age was not associated with change in energy intake (ρ = -0.03), food cravings (ρ = -0.10), and preference for fats (ρ = 0.12; P≥0.21). Increased age is associated with lower free-living energy intake, food cravings, and preference for fats. Yet, during six months of aerobic exercise training, age is not associated with weight, body composition, energy intake, and eating behaviour change.
Registration: ClinicalTrials.gov (NCT01264406).

Conflicts of interest: None.
Funding: Study supported by National Institutes of Health (grant: R01 HL102166); NORC Center funds (grant: P30 DK072476, titled “Nutritional Programming: Environmental and Molecular Interactions” sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases); the National Institute of General Medical Sciences (grant: U54 GM104940); and the American Heart Association (grant: 20POST35210907).

How well do experiences of obesity in primary school predict experiencing obesity at age 14: Evidence from the Growing Up in Scotland Study.

Naomi Miall 1, Lorraine Tulloch 2, Anna Pearce 1

1 University of Glasgow, Glasgow, UK
2 Obesity Action Scotland, Glasgow, UK

📌 Allocation: Poster (Board No. 20)

Introduction: There has been little progress in reducing childhood obesity over the past 20 years in Scotland. Identifying children at risk of developing obesity, and the timing at which risks are established, may be important for targeting interventions. We describe associations between overweight/obesity at age 4 years (the timing of national weight measurement programmes in Scotland and England) and 10 years (the timing of the second national weight measurement programme in England) with adolescent obesity.
Methods: The sample included 2238 children in the Growing Up in Scotland cohort, born 2004/5. Height and weight measurements at ages 4, 10, and 14 years were categorised into experiences of obesity using age and sex- standardised thresholds. We estimated how well BMI-status at 4 years, or combinations of BMI-status at 4 and 10 years, predict obesity at 14 years, stratified by area deprivation quintile and sex.
Results: Prevalence of obesity among 14-year-olds was 21.7%. Of these children, only 29.1% also experienced obesity at age 4. Therefore, if interventions to reduce obesity are targeted at children who experienced obesity aged 4, we might expect 70.9% of children who go on to experience obesity at 14 to be missed. Additionally, 37.2% of the targeted 4-year-olds would not have experienced obesity aged 14 years, even without the intervention (unnecessarily targeted). In contrast, offering the intervention to children who experienced obesity at either 4 or 10 years old would cover 64.8% of children who go on to experience obesity, without an increase in unnecessary targeting (32.2%). Offering the intervention to children who experienced obesity at 4 and 10 years would substantially reduce the proportion of children unnecessarily targeted (to 14.2%), without a large reduction in sensitivity (25.3%) compared to the age 4 measure alone. Obesity experience in primary school is a less sensitive predictor of obesity at 14 years among children living in more compared to less deprived areas.
Conclusion: Targeting interventions using BMI-status at the start of primary school is likely to miss many children who are at risk of obesity in adolescence, particularly if these measurements are used in isolation, and especially in more deprived areas.

Conflicts of interest: The authors declare no conflicts of interest.
Funding: This research was funded by Obesity Action Scotland, with support from the Welcome Trust (205412/Z/16/Z), Medical Research Council (MC_UU_00022/2) and the Chief Scientific Office Scotland (SPHSU17). With gratitude to the Scottish Centre for Social Research for access to the Growing Up in Scotland data.

Obesity, psychological factors, and risk of developing seven non-communicable health conditions: evidence from longitudinal studies of UK and US older adults

I Gusti Ngurah Edi Putra 1, Michael Daly 2, Angelina Sutin 3, Andrew Steptoe 4, Eric Robinson 1

1 Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
2 Department of Psychology, Maynooth University, Maynooth, Ireland
3 Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Florida, US
4 Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, Faculty of Population Health Sciences, University College London, London, UK

📌 Allocation: Poster (Board No. 21)

This study examined the role of psychological factors in explaining the prospective associations between obesity and risk of developing seven non-communicable health conditions (hypertension, heart disease, stroke, diabetes, arthritis, cancer, and memory-related disease). We used comparable longitudinal data of UK and US older adults (≥ 50 years) from the English Longitudinal Study of Ageing (ELSA) (baseline: Wave 4 – 2008/2009; n= 8,127) and the Health and Retirement Study (HRS) (baseline: Waves 9 and 10 – 2008/2010; n=12,477) with up to 10-year follow-up period in each study. Baseline body mass index (BMI) assessed by trained interviewers was used to define obesity (BMI ≥ 30 kg/m2). We developed an index of psychological distress separately in each study by combining psychological factors (e.g., depressive symptoms, life satisfaction, loneliness) available in ELSA (n=7) and HRS (n=15) using exploratory factor analysis. Health conditions were defined based on a self-reported doctor diagnosis and/or other assessments (e.g., biomarker data). Longitudinal associations between obesity (vs. normal weight [BMI 18.5 – 24.9]), greater psychological distress, and the risk of developing health conditions were examined using Cox-proportional hazard regression models controlling for sociodemographic covariates (age, sex, ethnicity, marital status, education, employment status, household wealth). Mediation by the index of psychological distress was assessed using causal mediation analysis. Sensitivity analyses included fitting the cumulative incidence of health conditions as the outcome (minimum=0; maximum=7) and examining the mediating role of individual psychological factors. We found that obesity (vs. normal weight) was consistently associated with an increased risk of hypertension, heart disease, diabetes, and arthritis across studies. In both ELSA and HRS, greater psychological distress was associated with an increased risk of heart disease, stroke, arthritis, and memory-related disease. Findings from mediation analyses showed that the index of psychological distress and individual psychological measures did not mediate the associations between obesity and health conditions in both studies, including when health conditions were assessed as the cumulative incidence. Therefore, our findings indicated obesity and psychological factors may be independently associated with future health conditions; and no evidence of the associations between obesity and health conditions explained by psychological factors.

Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: This work received funding from the Economic and Social Research Council (ESRC), a part of the United Kingdom Research and Innovation (UKRI) (ES/V017594/1). The views stated in this work are of the authors only.

A structural equation approach for modeling metabolic syndrome status in an adult and older Northeast Portuguese population

José E. Teixeira1,2,3, José A. Bragada1,2, J.P. Bragada4, Pedro M. Magalhães1,2

1 Research Centre in Sports Sciences, Health and Human Development (CIDESD), 5001-801 Vila Real, Portugal
2 Department of Sport Sciences, Instituto Politécnico de Bragança (IPB), 5300-253 Bragança, Portugal
3 Department of Sport Sciences, Instituto Politécnico de Guarda (IPG), 6300-559 Guarda, Portugal
4 North East Local Health Unit (ULSNE) – Health Care Unit of Santa Maria, 5301-852 Bragança, Portugal

📌 Allocation: Poster (Board No. 23)

The metabolic syndrome (MetS) can be defined as a combination of interrelated major risk factors, which are direct predictors for cardiovascular and metabolic diseases. Specifically, central obesity, dysglycemia, dyslipidemia and hypertension are the risk factors considered for MetS diagnosis. The aim of this study was to analyze the weighting factors in the MetS status (3-, 4-, and 5-MetS components), using a structural equation modelling (SEM) approach. A cross-sectional, observational and retrospective analysis was conducted between January 2019 and December 2020 from patients’ clinical records of two primary health care centres in Northeast Portugal. A total of 3,581 MetS individuals, ranged between 18–102 years, were analyzed using a structural equation model. Model’s goodness-of-fit was confirmed by standardized root mean square residuals (SRMR) through a path-flow method with a two-step maximum likelihood approach. MetS was diagnosed using Joint Interim Statement (JIS) criteria. Confirmatory model had a good adjustement (SRMR = 0.0334), reporting the following links for weighting factors in MetS status: waist circumference (WC) (β = 0.24, 95% CI: 0.19–0.29, p <0.001), fasting glucose (FG) (β = 0.17, 95% CI: 0.12– 0.22; p <0.001), systolic blood pressure (SBP) (β = 0.14, 95% CI: 0.09–0.19; p <0.001), dyastolic blood pressure (DBP) (β = 0.06, 95% CI: 0.01–0.11; p <0.001), high-density lipoprotein cholesterol (HDL-c) (β = 0.18, 95% CI: 0.12–0.23; p ≥0.05), and triglycerides (TG) (β = 0.05, 95% CI: 0–0.10; p ≥0.05). Weighting factors with the greatest effect were WC, FG, SBP and DBP, whereas there were no significant effects for HDL and TG. The action of low-density lipoproteins and triglyceride-rich lipoproteins cannot be discarded in the accumulation of atheroma plaques, as well as in the relationship amongst atherosclerosis and major adverse cardiovascular events (MACE). Therefore, JIS definition has been widely discussed with the aim of adding better screening criterion to the MetS diagnosis such as waist-to-height ratio (WhtR), waist-to-hip ratio (WHR), mean arterial pressure (MAP) and low-density lipoproteins (LDL) levels. Futures multivariate models should include exercise-related variables such as frequency, intensity, time and type (FITT) principles.

Conflicts of interest: The authors declare that there is no conflict of interest.
Funding: This article is a result of the project “GreenHealth - Digital strategies in biological assets to improve well-being and promote green health” (Norte-01-0145-FEDER-000042), supported by North Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF)”.

Comparison of Body Mass Index (BMI), before and post COVID-19, across different age groups in the population of Northeast Portugal

José Augusto Bragada 1,2 , José Eduardo Teixeira 1,2,3, João Pedro Bragada 4, Ana Sofia Ferreira 4, Pedro Miguel Magalhães 2

1 - Research Centre in Sports Sciences, Health and Human Development (CIDESD), 5001-801 Vila Real, Portugal
2 - Department of Sport Sciences, Instituto Politécnico de Bragança (IPB), 5300-253 Bragança, Portugal
3 - Department of Sport Sciences, Instituto Politécnico de Guarda (IPG), 5300-253 Guarda, Portugal
4 - North East Local Health Unit (ULSNE) – Health Care Unit of Santa Maria, 5301-852 Bragança, Portugal

📌 Allocation: Poster (Board No. 24)

Body Mass Index (BMI) is a simple measure to roughly assess obesity. The aim of the study was to assess the progress of BMI across different age groups and compare BMI values obtained in the year 2019 (pre-COVID-19) with the year 2022 (post-COVID-19). The data were collected from patients' clinical records of 22,911 individuals of both sexes (0-98 years) from two healthcare centres. The age groups were as follows: under 10 years old, 10-13 years, 14-16 years, 17-19 years, 20-39 years, 40-59 years, 60-79 years, and 80 years. The comparison of BMI values between 2019 and 2022 in different age groups showed no significant changes, except for under 10 years old group (t=2.88; Δ=0.34; p=0.004). Therefore, we analysed the distribution of BMI values in 2022. There was a significant progressive increase for young individuals in 2022 [F (3)=79.60, p>0.001, η2=0.33]. Also, a significant increase was verified for adults up to 80 years in 2022 [F (3)=55.60, p>0.001, η2=0.02]. The mean values for BMI, in four age groups for the young individuals (<20 years old) were as follows: 16.7±2.9 kg/m2 (n=1050); 20.5±4.6 kg/m2 (n=200); 22.8±5.2 kg/m2 (n=209); 22.9±4.5 kg/m2 (n=175). In the adults (≥20 years old), the BMI values by age group were as follows, respectively: 26.0±5.4 kg/m2 (n=1338); 27.50±4.22 kg/m2 (n=2363); 27.78±4.48 kg/m2 (n=3276); 26.43 ±4.34 kg/m2 (n=870). The age group of over 79 years showed a decrease in the average BMI compared to the previous age group (Δ =-1.35 kg/m2). In young individuals, BMI values were within the normal range, while in adults, they were above 25 and below 30 (overweight). BMI increased continuously across different age groups up to 79 years, and from 80 years, there was a decrease compared to the previous age group. There was only a 0.43 difference in the average BMI between the age group of over 79 years and the age group of 20-39 years. Therefore, we can speculate that BMI seems to be associated with longevity. Further the number of consultations decreased in these two healthcare centres from 2019 to 2022 with the greatest decrease in the last age group (-40%).

Conflicts of interest: The authors declare that there is no conflict of interest.
Funding: This study is a result of the project “GreenHealth - Digital strategies in biological assets to improve well-being and promote green health” (Norte-01-0145-FEDER-000042), supported by North Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF)”. Also, the authors express acknowledgements for all medical staff, patients and human resources of the two primary health care centers.

Household associations between child and adult weight: a cross-sectional quantile regression analysis of linked electronic health records from an ethnically diverse urban population

Marta Wilk MSc 1, Dr Gill Harper PhD 1, Nicola Firman MSc 1, Silvia Liverani PhD 1, Professor Carol Dezateux MD 1

1 Queen Mary University of London, London, E1 2AB, United Kingdom

📌 Allocation: Poster (Board No. 25)

Objectives
Adults sharing households with young children play an important role in shaping their eating and activity habits. We investigated the strength of the relationship between the weight status of adults and children sharing households and its variation by Body Mass Index (BMI) for 5- and 11-year-old children.

Methods
We analysed National Child Measurement Programme records for 41,092 five- and 38,683 11-year-olds attending primary schools in four boroughs in north-east London, linked to their primary care records using pseudonymised NHS numbers. We linked household members using pseudonymised Unique Property Reference Numbers. The primary outcome was child ethnic-adjusted BMI z-score. The exposure was household weight status (‘with obesity’: ≥1adult with BMI ≥30kg/m2; ‘ with overweight’: ≥1adult with BMI 25-29.99kg/m2; ‘healthy’: all adults BMI <25kg/m2). We conducted multivariable quantile regression to estimate regression coefficients (95% Confidence Intervals [CI]) of child BMI z-score change at the 2nd, 50th, 91st and 98th quantile of the UK1990 reference distribution adjusting for child sex, ethnic group, household composition, number of children in household; area-level deprivation (developed in R).
Results
13,091 (31.9%) and 21,080 (51.3%) five-year-olds and 11,489 (29.7%) and 22,106 (57.1%) 11-year-olds lived in households with overweight and obesity, respectively. Five-year-olds living in households with overweight and obesity had a BMI z-score increase of 0.15 [CI: 0.11-0.18] and 0.40 [0.38- 0.43] at the 50th quantile and 0.33 [0.25-0.40] and 0.85 [0.79-0.93] at the 98th quantile, respectively. The BMI z-score increase for 11-year-olds living in households with overweight and obesity was 0.34 [0.30- 0.38] and 0.81 [0.77-0.86] at the 50th quantile and 0.35 [0.29-0.41] and 0.82 [0.76- 0.87] at the 98th quantile. The BMI z-score was increased in children from South Asian ethnic backgrounds, and those living in single-adult or single-child households.
Conclusions
Children sharing households with adults with unhealthy weights are more likely to live with unhealthy weight. This association was strongest for children in households with obesity and for 11- year-olds. Electronic health records can be used to identify households at high risk of child and adult obesity as a basis for evaluating the impact of adult-only household interventions on the weight status of children.

Conflicts of interest: Authors declare no conflicts of interest
Funding: This research was funded by a grant from Barts Charity ref: MGU0419.

Subscapular skinfold thickness, but not other anthropometric and dual x-ray absorptiometry
measured adiposity, is positively associated with the presence of age-related macular degeneration: a cross-sectional study from National Health and Nutrition Examination Survey 2005-2006

Miguel Gedtal [ 1 ] Jayne V Woodside [ 1 ] David Wright [ 1 ] Margaret Rayman [ 2] Ruth Esther Hogg [ 1 ]

[1] Queen’s University Belfast, Belfast, UK
[2] University of Surrey, Guildford, UK

📌 Allocation: Poster (Board No. 26)

Aim:
Some studies have found an association between anthropometric measures of adiposity and age-related macular degeneration (AMD), but few studies have explored the disease association with imaging methods. This study aimed to explore the relationship between AMD status and dual X-ray absorptiometry (DEXA) among a representative sample of the United States population, and compare the disease association to anthropometric methods.

Method:
Using a representative sample in the National Health and Nutrition Examination Study 2005-2006 (n=1,632), the differences in DEXA measures of fat mass across the body and around the waist (i.e., android), and relative fat distribution (e.g., percentage fat, android-to-total body ratio) were analysed between groups according to AMD status, namely, those with no AMD vs any AMD and those with no AMD vs early/intermediate AMD. The bivariate analyses across AMD status were similarly performed for anthropometric measures [i.e., body mass index , waist circumference and skinfold thickness of the shoulder and the tricep] and for potential confounders (i.e., demographics, lifestyle, clinical and other health-related variables). Any significant adiposity measures were further analysed using logistic regression, adjusting for potential confounders.

Results:
The participants in the sample were aged 40-69 years [median age (IQR)= 51(13)], were mainly female (52%) and mainly Caucasian(76.5%). Bivariate analysis indicated that having any or early/intermediate AMD was positively associated with android-to-total fat ratio and subscapular skinfold thickness (SSFT). Other anthropometric and DEXA-measured variables were not signficant. After controlling for age, gender and prescription of cholesterol-lowering medicine, only SSFT remained positively associated.

Conclusion:
SSFT represents an independent risk factor for presence of AMD compared to other anthropometric and DEXA measurements. SSFT is an established method of measuring subcutaneous adiposity: subcutaneous fat may be more relevant in explaining the adiposity-AMD link due to physiological properties specific to the tissue.

Conflicts of interest: None
Funding: This PhD was funded by UK Research and Innovation doctoral training grant no: BB/T008776/1

Trial Design of a Double-Blind, Randomized, Placebo-Controlled, Phase 3 Study of Setmelanotide in Patients With Hypothalamic Obesity

Christian L. Roth 1,2; Ashley H. Shoemaker 3; Michael Gottschalk 4; Jennifer L. Miller 5; Guojun Yuan 6; Sonali Malhotra 6-8; Cecilia Scimia 6; Shana E. McCormack 9-10; M. Jennifer Abuzzahab 11

1 Seattle Children’s Research Institute, Seattle, WA, USA; 2 Division of Endocrinology, Department of Pediatrics, University of Washington, Seattle, WA, USA; 3 Ian Burr Division of Endocrinology and Diabetes, Vanderbilt University Medical Center, Nashville, TN, USA; 4 Pediatric Endocrinology, University of California San Diego/Rady Children’s Hospital, San Diego, CA, USA; 5 Pediatric Endocrinology, Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL, USA; 6 Rhythm Pharmaceuticals, Inc., Boston, MA, USA; 7 Massachusetts General Hospital, Boston, MA, USA; 8 Harvard Medical School, Boston, MA, USA; 9 Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA, USA; 10 Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 11 Pediatric Endocrinology and Diabetes, Children’s Minnesota, Saint Paul, MN, USA

📌 Allocation: Poster (Board No. 27)

Damage to the hypothalamus can impair the melanocortin signaling pathway and reduce energy expenditure, potentially leading to hypothalamic obesity (HO), a severe form of obesity with no current specific therapeutic option. Recently, the melanocortin-4 receptor agonist setmelanotide demonstrated reduction in weight and hunger for patients with HO in a Phase 2 trial. We describe the study design of a planned double-blind, randomized, placebo-controlled, Phase 3 trial of setmelanotide in patients with HO.
Approximately 120 patients will be enrolled across ≤35 sites globally. Eligibility criteria include age ≥4 years with documentation of acquired HO, weight gain before and/or with tumor treatment, and body mass index (BMI) ≥30 kg/m^2 (≥18 years) or BMI ≥95th percentile (≥4 to <18 years). Key exclusion criteria include diagnosis of syndromic obesity, weight or BMI loss >2% based on age in the prior 3 months, bariatric surgery within the past 2 years, glycated hemoglobin >11.0%, and glomerular filtration rate <30 mL/min/1.73 m^2. Patients will be randomized 2:1 and stratified by age to receive setmelanotide or placebo. Setmelanotide will be titrated over 2 to 8 weeks to a maximum daily dose of 1.5 to 3.0 mg based on age and weight. Treatment will continue for up to 60 weeks. The primary endpoint is the mean percent change in BMI after 52 weeks of treatment for setmelanotide versus placebo. Key secondary endpoints after 52 weeks are the proportion of patients aged ≥18 years with ≥5% reduction in BMI, proportion of patients aged <18 years with ≥0.2-point reduction in BMI Z score, and mean change in weekly average of the daily “most hunger” score in patients aged ≥12 years. Additional secondary endpoints include hunger-related, additional weight-related, and quality-of-life outcomes. Exploratory endpoints include change in physical activity, fatigue, Impacts of Hyperphagia score, caregiver health status, cardiometabolic parameters, and waist circumference. Safety will be assessed by the frequency and severity of adverse events.
This Phase 3 trial designed to assess the efficacy and safety of setmelanotide for weight loss and hunger reduction in patients ≥4 years of age with acquired HO is planned to initiate in early 2023.

Conflicts of interest: CLR’s institution has received research support from Rhythm Pharmaceuticals, Inc. AHS has received payments from Rhythm Pharmaceuticals, Inc. and Saniona for advisory boards and lectures. AHS’s institution has received research support from Rhythm Pharmaceuticals, Inc. MG has received compensation for consulting and participation on advisory boards from Rhythm Pharmaceuticals, Inc. MG’s institution has received funding for clinical trials from Rhythm Pharmaceuticals, Inc. JLM has received study funding from Rhythm Pharmaceuticals, Inc. GY, CS, and SM are employees of Rhythm Pharmaceuticals, Inc. and have company-awarded RSU and options. SEM received grants from Levo Therapeutics and the Doris Duke Charitable Foundation. SEM received honoraria for an Obesity Medicine Association lecture. SEM reports being a co-chair for the Endocrine Society Research Affairs Committee and a consultant for Rhythm Pharmaceuticals, Inc. and Saniona. MJA has received compensation for consulting, advisory board participation, and speaking engagements from Consynance, Endo Pharmaceutical, Pfizer, and Rhythm Pharmaceuticals, Inc. MJA’s institution has received research support from Ascendis, Levo Pharmaceuticals, Lumos, NovoNordisk, Rhythm Pharmaceuticals, Inc., Saniona, and Soleno.
Funding: This study was sponsored by Rhythm Pharmaceuticals, Inc. Medical writing and editorial assistance was provided under the direction of the authors by MedThink SciCom and funded by Rhythm Pharmaceuticals, Inc.

Setmelanotide in Patients With Heterozygous POMC, LEPR, SRC1, or SH2B1 Obesity: Design of EMANATE – A Placebo-Controlled Phase 3 Trial

Sadaf Farooqi 1, Jesús Argente 2,3, Erica van den Akker 4, Guojun Yuan 5, Olga Ohayon 5, Cecilia Scimia 5, Martin Wabitsch 6

1 Wellcome-MRC Institute of Metabolic Science and NIHR Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK; 2 Department of Pediatrics and Pediatric Endocrinology, Universidad Autónoma de Madrid, University Hospital Niño Jesús, CIBER “Fisiopatología de la obesidad y nutrición” (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; 3 IMDEA Food Institute, Madrid, Spain; 4 Division of Pediatric Endocrinology, Department of Pediatrics, Sophia Children’s Hospital and Obesity Center CGG, Erasmus University Medical Center, Rotterdam, The Netherlands; 5 Rhythm Pharmaceuticals, Inc., Boston, MA, USA; 6 Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University of Ulm, Ulm, Germany

📌 Allocation: Poster (Board No. 28)

The melanocortin-4 receptor (MC4R) pathway regulates energy balance. Certain variants in genes upstream of MC4R, including LEPR, POMC, NCOA1 (encodes steroid receptor coactivator 1), PCSK1, and SH2B1, lead to impaired MC4R pathway signaling and rare genetic diseases of obesity. Although deficiencies resulting from these genetic variants differ in some clinical features, they are all characterized by hyperphagia (pathologic insatiable hunger) and early-onset obesity. Setmelanotide, an MC4R agonist, reduced body weight and hyperphagia after 3 months in patients with heterozygous POMC, PCSK1, LEPR, NCOA1, and SH2B1 variants in an earlier Phase 2 trial. In this trial, 34% of patients with heterozygous POMC, PCSK1, or LEPR variants; 30% with heterozygous NCOA1 variants; and 37% with heterozygous SH2B1 variants achieved ≥5% weight loss after 3 months of setmelanotide treatment.
EMANATE is a randomized, double-blind, placebo-controlled Phase 3 trial (NCT05093634) comprising 5 similar independent sub-studies based on genetic variants. Eligible patients aged 6 to 65 years must have history of hyperphagia and childhood obesity and have current obesity (aged ≥18 years, body mass index [BMI] ≥30 kg/m^2; aged 6-17 years, BMI ≥95th percentile). Patients must have a heterozygous genetic variant in POMC or PCSK1; heterozygous genetic variant in LEPR; homozygous, heterozygous, or compound heterozygous variant in NCOA1 or SH2B1 (including a chromosomal deletion of 16p11.2 including SH2B1); or heterozygous N221D variant in PCSK1. Patients with ≥2% weight loss in the prior 3 months; HbA1C >10%; clinically significant pulmonary, cardiac, or oncologic disease; or history of significant liver or serious kidney disease are not eligible. Within each sub-study, patients will be randomized 1:1 to receive setmelanotide or placebo daily for 52 weeks. The primary outcome is mean change in body weight of setmelanotide-treated patients compared with placebo-treated patients. Safety will be assessed by frequency and severity of adverse events.
EMANATE is underway and began enrolling patients in early 2022. The planned enrollment is 560 patients. If successful, this placebo-controlled Phase 3 trial will support setmelanotide treatment for improvements in body weight–related measures and hunger in an expanded population of patients living with rare genetic diseases of obesity.

Conflicts of interest: SF has no conflicts of interest to disclose. JA has received payments from Rhythm Pharmaceuticals, Inc. for advisory boards and lectures. EvdA’s institution has received research support from Rhythm Pharmaceuticals, Inc. GY and OO are employees of Rhythm Pharmaceuticals, Inc. and have company-awarded RSU and options. CS is an employee of Rhythm Pharmaceuticals, Inc., has company-awarded RSU and options, and has received payments from Rhythm Pharmaceuticals, Inc. for advisory boards. MW has received payments from Rhythm Pharmaceuticals, Inc. for consultations and lectures.
Funding: This study was sponsored by Rhythm Pharmaceuticals, Inc. Medical writing and editorial assistance was provided under the direction of the authors by MedThink SciCom and funded by Rhythm Pharmaceuticals, Inc.

Clinical Characteristics of Variants in POMC, PCSK1, LEPR, NCOA1, and SH2B1

Jesús Argente 1,2, Sadaf Farooqi 3, Erica van den Akker 4, Sonali Malhotra 5-7, Peter Kühnen 8, Karine Clément 9,10, Martin Wabitsch 11

1 Department of Pediatrics & Pediatric Endocrinology, Universidad Autónoma de Madrid, University Hospital Niño Jesús, CIBER “Fisiopatología de la obesidad y nutrición” (CIBEROBN), Instituto de Salud Carlos III, IMDEA Institute, Madrid, Spain; 2 IMDEA Food Institute, Madrid, Spain; 3 Wellcome-MRC Institute of Metabolic Science and NIHR Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, United Kingdom; 4 Division of Pediatric Endocrinology, Department of Pediatrics, Sophia Children’s Hospital and Obesity Center CGG, Erasmus University Medical Center, Rotterdam, The Netherlands; 5 Rhythm Pharmaceuticals, Inc., Boston, MA, USA; 6 Massachusetts General Hospital, Boston, MA, USA; 7 Harvard Medical School, Boston, MA, USA; 8 Institute for Experimental Pediatric Endocrinology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; 9 Nutrition Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France; 10 Sorbonne University, Inserm, Nutrition and Obesity; Systemic Approaches (NutriOmique) Research Group, Paris, France; 11 Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University of Ulm, Ulm, Germany

📌 Allocation: Poster (Board No. 29)

The melanocortin-4 receptor (MC4R) pathway is an important regulator of energy balance and body weight. Several key genes are associated with the MC4R pathway, including POMC, PCSK1, LEPR, NCOA1, and SH2B1. These genes work in concert within the hypothalamus to regulate leptin signaling and activation of MC4R. However, the molecular mechanisms of these genes and the clinical characteristics of individuals with heterozygous variants in POMC, PCSK1, and LEPR, or heterozygous or biallelic variants in NCOA1 and SH2B1, may differ and thus affect individualized treatment strategies for these patients.
A nonsystematic literature search was conducted in PubMed of articles published through August 2022 with search strings to identify publications reporting on the etiology and clinical characteristics of patients with heterozygous variants in POMC, PCSK1, and LEPR or heterozygous or biallelic variants in NCOA1 and SH2B1. Abstracts of identified manuscripts were reviewed for relevance. Results were summarized narratively.
Published research suggests that heterozygous variants in POMC, PCSK1, and LEPR and deficiencies in SRC1 and SH2B1 are all associated with pathologic insatiable hunger (or hyperphagia) and early-onset, severe obesity. Patients with these variants and associated deficiencies also share commonalities in clinical manifestations beyond hyperphagia and early-onset, severe obesity, including hypogonadism and leptin and insulin resistance. A limitation of this analysis is the nonsystematic search approach. Current efforts to address the underlying hyperphagia and obesity associated with heterozygous variants in POMC, PCSK1, and LEPR and variants in NCOA1 and SH2B1 include targeting the MC4R pathway through the MC4R agonist setmelanotide. In Phase 2 clinical trials, administration of setmelanotide led to reduced hunger scores and body weight in patients with these variants.
This analysis of published literature supports the concept that individuals with heterozygous or biallelic variants in the MC4R pathway (POMC, PCSK1, LEPR, NCOA1, and SH2B1) share many common clinical characteristics related to early-onset obesity and hunger, as well as obesity-associated comorbidities.

Conflicts of interest: JA has received payments from Rhythm Pharmaceuticals, Inc. for advisory boards and lectures. SF has no conflicts of interest to disclose. EvdA’s institution has received research support from Rhythm Pharmaceuticals, Inc. SM is an employee of and stockholder in Rhythm Pharmaceuticals, Inc. PK has received payments from Rhythm Pharmaceuticals, Inc. for safety boards. KC has received payments from Ysopia, Integrative Phenomics, and Confo-therapeutics for scientific collaboration. MW has received payments from Rhythm Pharmaceuticals, Inc. for consultations and lectures.
Funding: This study was supported by Rhythm Pharmaceuticals, Inc. Writing assistance and editorial support were provided under the direction of the authors by Dorothy Dobbins, PhD, and David Boffa, ELS, and funded by Rhythm Pharmaceuticals, Inc.

Protocol for the PROMISE CARE Study: Improving the long-term care of patients who have had bariatric surgery

Helen M Parretti 1, Nick Cavill 2, Ken Clare 3, Karen Coulman 4, Colin Greaves 5, Kate Jolly 6, Laura L Jones 6, Emma Shuttlewood 7, Ross Watkins 1

1 Norwich Medical School, University of East Anglia, Norwich, UK
2 Cavill Associates Ltd, Manchester, UK
3 Obesity Institute, Leeds Beckett University, Leeds, UK
4 Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
5 School of Sports, Exercise and Rehabilitation, University of Birmingham, Birmingham, UK
6 Institute of Applied Health Research, University of Birmingham, Birmingham, UK
7 University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK

📌 Allocation: Poster (Board No. 30)

Bariatric surgery is recognised as a clinically and cost-effective management option for severe/complex obesity and can lead to significant health benefits. The National Institute of Health and Care Excellence recommends follow-up care in a bariatric surgery unit for the first two years post-surgery, followed by lifelong follow-up in primary care within a shared care model.
However, research suggests that long-term follow-up care is not being delivered and GPs lack confidence in managing patients post-bariatric surgery. The delivery of long-term post-bariatric surgery care is challenging, and it is unclear how, where or by whom long-term care should be delivered, including patients’ preferences. There are uncertainties that need to be better understood to design and test a future intervention to improve care, including:
o inconsistent availability of weight management services
o healthcare professional training needs
o role of self-management
o healthcare capacity
o variation/complexity in patient’s needs.

The PROMISE CARE study seeks to gain a comprehensive understanding of the issues involved in delivering long-term care post-bariatric surgery including barriers and enablers to effective care and stakeholder views. The study will consist of three main work packages. These will include semi-structured interviews informed by behavioural theory with healthcare professionals as well as remote stakeholder workshops to develop a system map of the current issues in post-bariatric care incorporating different stakeholder perspectives and key factors (at individual, social, organisational and wider system levels) influencing outcomes. Finally, a remote panel meeting with key stakeholders will be held, informed by findings of earlier work packages, to agree key design elements for a future intervention.

The PROMISE CARE study will run for 18 months from November 2022 and will gain key insights to help plan future research to develop and evaluate an intervention to improve long-term care post-bariatric surgery. Findings will be disseminated to patient, clinical, academic and policy groups.

Conflicts of interest: HP and ES are British Obesity and Metabolic Surgery Society (BOMSS) council members and have organised educational events supported by Ethicon for BOMSS members (honoraria received for educational events). HP has developed an algorithm for the management of obesity in primary care (as well as accompanying supplement, video and conference presentation) for MGP publishing which were all supported by arm's length sponsorship from Novo Nordisk (honoraria received). HP is a co-author on a publication of UK data from a Novo Nordisk funded study (no personal fees received). HP is a member of the steering group for the Obesity Empowerment Network and the current NICE weight management guidelines committee.
KCo is the BOMSS research co-lead for dietetics and a member of the scientific advisory board for Oxford Medical Products.
KC is a director of bariatric surgery, Obesity UK and chair of the European Coalition for People Living with Obesity, a trustee for the Association for the Study of Obesity and has been a member of a Novo Nordisk Disease Experience Expert Panel since 2017 and a Patient Advisory Board member for Boehringer Ingelheim since 2020 (honoraria received for these last two roles).
Funding: This study is funded by the NIHR [Programme Development Grant NIHR 204271]. KJ is part-funded by the NIHR Applied Research Collaboration West-Midlands. KCo is funded by a HEE/NIHR ICA clinical lectureship. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

The Impact of the COVID-19 Pandemic on Childhood Obesity Rates by Health Board Area in Wales UK.

Claire Beynon 1, Llion Davies 2.

1. Cardiff and Vale University Health Board
2. Public Health Wales

📌 Allocation: Poster (Board No. 31)

Background
The aim of this prevalence study was to examine the rates of obesity and severe childhood obesity pre- and post-pandemic by Health Board area in Wales, UK.

Methods
Data for all children included as part of the Wales Childhood Measurement Programme (2014/15-2018/19) were utilised as the pre-pandemic data set. The 2021/22 Child Measurement Programme data were used as the post-pandemic data set. Body Mass Index for obesity and severe obesity were defined as above the 95th centile, and 99.6th centile respectively.

Results
Of the 119,917 reception aged children (4-5 years) measured prior to the pandemic the overall prevalence of obesity and severe obesity were 12.1% and 3.2% respectively. Post-pandemic measurements in 2021/22 revealed that the proportion of 4-5 year olds in Wales with obesity (n= 2,986) and severe obesity had increased and were 15.5% and 4.8% respectively. Data for one of the seven Local Health Boards in Wales were not reported for 2021/22. However, historically this region had the highest proportion of children with obesity, suggesting that the increase in obesity reported is likely to be an underestimate. When considering the data at Health Board level, higher proportions of children with obesity were noted in 2021/22 compared to pre-pandemic in all bar one Health Board area. Higher proportions of children with severe obesity were observed in 2021/22 in all six Health Boards that reported data.

Conclusion
This study identified that the proportion of children with obesity and severe obesity reported in 2021/22 in Wales appears to be higher than the proportions observed in the 5 years prior to the pandemic.

This study will be of interest to those planning health services, policy makers and academics working in the field of obesity.

Conflicts of interest: None
Funding: None

The UK Congress on Obesity has been instigated and organised by ASO. Sponsors have contributed funding towards this event in return for exhibition space. They have had no input into the agenda or the selection of speakers with the exception of any sponsored symposia which are clearly indicated. View a full list of sponsors.

UKCO Abstracts

Bai Li 1, Steve Allender 2, Bee Koon Poh 3, Zouyan He 4, Remco Peters 1, Weiwen Zhou 5, Jianfeng Lao 6, Yunfeng Zou 4, Boyd Swinburn 7, on behalf of the SYSTAM CHINA SEACS International Consortium

📌 Allocation: Poster (Board No. 03)

Conflicts of interest: We have no conflicts of interest to declare. Funding: UK Medical Research Council.

📌 Allocation: Poster (Board No. 04)

Conflicts of interest: We declare no conflicts of interest. Funding: UK Medical Research Council

📌 Allocation: Poster (Board No. 05)

Bethany Neall 1

The University of Southampton, Southampton, UK Solent NHS Trust, Southampton, UK

📌 Allocation: Poster (Board No. 06)

Conflicts of interest: No conflicts of interest Funding: No funding was allocated

Dilara Olgacher 1, Sarah Aldukair 1, Mike Clarke 1, Danielle McCarthy 2, Jayne V Woodside 1,2

1 Centre for Public Health, Queen’s University Belfast, Belfast, UK. 2 Institute for Global Food Security, Queen's University Belfast, Belfast, UK.

📌 Allocation: Poster (Board No. 08)

Conflicts of interest: The authors declared no potential conflicts of interest with respect to the research, authorship and publication of this abstract. Funding: Department for the Economy, Northern Ireland

Mallory Noone1 , Cara O'Grada 1 , Ciara Brack 1 , Donal O’Shea 1 , Colin Dunlevy 1 , Claire Kearney 1 , Jean O’Connell 1

St Columecilles Hospital, Loughlinstown, Co. Dublin, Ireland

📌 Allocation: Poster (Board No. 09)

Conflicts of interest: None Funding: HSE Model of Care

Anjali Zalin, Judith Carpenter

Anjali Zalin -Barts Health and Bedfordshire Hospitals NHS Foundation Trust Judith Carpenter -Derby Hospitals NHS Foundation Trust, Optimal Change Limited

📌 Allocation: Poster (Board No. 10)

Conflicts of interest: Funding was partly supported by Novo Nordisk Funding: Novo Nordisk and Bedfordshire Hospitals NHS Foundation Trust supported this training

Kingsley Agyemang 1, Subhash Pokhrel 1, Nana Anokye 1

1. Brunel University London, London, UK

📌 Allocation: Poster (Board No. 12)

Conflicts of interest: None Funding: None

Dawn Swancutt 1, Jenny Lloyd 2, Ross Watkins 2, Shokraneh Moghadam2, Lily Hawkins 2, Helene Davis 2, Rod Sheaff 1, Mark Tarrant 2, Jonathan Pinkney 1

1 University of Plymouth, Plymouth, UK. 2 University of Exeter, Exeter, UK.

📌 Allocation: Poster (Board No. 13)

Jenny Lloyd 1, Dawn Swancutt 2, Ross Watkins 1, Shokraneh Moghadam 1, Lily Hawkins 1, Helene Davis 1, Rod Sheaff 2, Mark Tarrant 1, Jonathan Pinkney 2

1 University of Exeter, Exeter, UK 2 University of Plymouth, Plymouth, UK

📌 Allocation: Poster (Board No. 14)

Geraldine Sexton1, Karen Gaynor2, Sarah O’Brien1; on behalf of the Obesity National Clinical Programme Children and Young Persons Obesity Expert Working Group. 1Healthy Eating Active Living Programme, HSE; 2National Clinical Programme for Obesity.

1Healthy Eating Active Living Programme, HSE; 2National Clinical Programme for Obesity.

📌 Allocation: Poster (Board No. 15)

Conflicts of interest: none Funding: None

Rosemary Huntriss 1, Dimitri Nikogosov 1, Rodion Salimgaraev 1

1 Simple Life Apps Inc, London, UK.

📌 Allocation: Poster (Board No. 16)

Conflicts of interest: All authors are employees of Simple Life Apps Inc. Funding: No external funding was used to finance the study.

Marina Ferrari1, Sarah F. Brennan1, Teresa Grohmann2, Aoife Courtney2, Lorraine Brennan2, Jayne V. Woodside1.

1 Queen’s University Belfast, Belfast, UK 2 University College Dublin, Dublin, Ireland.

📌 Allocation: Poster (Board No. 17)

James L Dorling 1, John W Apolzan 2, Neil M Johannsen 3, Christoph Höchsmann 4, Daniel S Hsia 2, Tim S Church 2, Corby K Martin 2.

1 University of Glasgow, Glasgow, UK. 2 Pennington Biomedical Research Center, Baton Rouge, USA. 3 Pennington Biomedical Research Center, Baton Rouge, USA & Louisiana State University, Baton Rouge, USA. 4 Technical University of Munich, Munich, Germany.

📌 Allocation: Poster (Board No. 19)

Naomi Miall 1, Lorraine Tulloch 2, Anna Pearce 1

1 University of Glasgow, Glasgow, UK 2 Obesity Action Scotland, Glasgow, UK

📌 Allocation: Poster (Board No. 20)

I Gusti Ngurah Edi Putra 1, Michael Daly 2, Angelina Sutin 3, Andrew Steptoe 4, Eric Robinson 1

📌 Allocation: Poster (Board No. 21)

José E. Teixeira1,2,3, José A. Bragada1,2, J.P. Bragada4, Pedro M. Magalhães1,2

📌 Allocation: Poster (Board No. 23)

José Augusto Bragada 1,2 , José Eduardo Teixeira 1,2,3, João Pedro Bragada 4, Ana Sofia Ferreira 4, Pedro Miguel Magalhães 2

📌 Allocation: Poster (Board No. 24)

Marta Wilk MSc 1, Dr Gill Harper PhD 1, Nicola Firman MSc 1, Silvia Liverani PhD 1, Professor Carol Dezateux MD 1

1 Queen Mary University of London, London, E1 2AB, United Kingdom

📌 Allocation: Poster (Board No. 25)

Conflicts of interest: Authors declare no conflicts of interest Funding: This research was funded by a grant from Barts Charity ref: MGU0419.

Miguel Gedtal [ 1 ] Jayne V Woodside [ 1 ] David Wright [ 1 ] Margaret Rayman [ 2] Ruth Esther Hogg [ 1 ]

[1] Queen’s University Belfast, Belfast, UK [2] University of Surrey, Guildford, UK

📌 Allocation: Poster (Board No. 26)

Conflicts of interest: None Funding: This PhD was funded by UK Research and Innovation doctoral training grant no: BB/T008776/1

Christian L. Roth 1,2; Ashley H. Shoemaker 3; Michael Gottschalk 4; Jennifer L. Miller 5; Guojun Yuan 6; Sonali Malhotra 6-8; Cecilia Scimia 6; Shana E. McCormack 9-10; M. Jennifer Abuzzahab 11

📌 Allocation: Poster (Board No. 27)

Sadaf Farooqi 1, Jesús Argente 2,3, Erica van den Akker 4, Guojun Yuan 5, Olga Ohayon 5, Cecilia Scimia 5, Martin Wabitsch 6

📌 Allocation: Poster (Board No. 28)

Jesús Argente 1,2, Sadaf Farooqi 3, Erica van den Akker 4, Sonali Malhotra 5-7, Peter Kühnen 8, Karine Clément 9,10, Martin Wabitsch 11

📌 Allocation: Poster (Board No. 29)

Helen M Parretti 1, Nick Cavill 2, Ken Clare 3, Karen Coulman 4, Colin Greaves 5, Kate Jolly 6, Laura L Jones 6, Emma Shuttlewood 7, Ross Watkins 1

📌 Allocation: Poster (Board No. 30)

Claire Beynon 1, Llion Davies 2.

1. Cardiff and Vale University Health Board 2. Public Health Wales

📌 Allocation: Poster (Board No. 31)

Conflicts of interest: None Funding: None

UKCO Key Dates

Conflicts of interest: We have no conflicts of interest to declare.
Funding: UK Medical Research Council.

Conflicts of interest: We declare no conflicts of interest.
Funding: UK Medical Research Council

The University of Southampton, Southampton, UK
Solent NHS Trust, Southampton, UK

Conflicts of interest: No conflicts of interest
Funding: No funding was allocated

1 Centre for Public Health, Queen’s University Belfast, Belfast, UK.
2 Institute for Global Food Security, Queen's University Belfast, Belfast, UK.

Conflicts of interest: The authors declared no potential conflicts of interest with respect to the research, authorship and publication of this abstract.
Funding: Department for the Economy, Northern Ireland

Conflicts of interest: None
Funding: HSE Model of Care

Anjali Zalin -Barts Health and Bedfordshire Hospitals NHS Foundation Trust
Judith Carpenter -Derby Hospitals NHS Foundation Trust, Optimal Change Limited

Conflicts of interest: Funding was partly supported by Novo Nordisk
Funding: Novo Nordisk and Bedfordshire Hospitals NHS Foundation Trust supported this training

Conflicts of interest: None
Funding: None

1 University of Plymouth, Plymouth, UK.
2 University of Exeter, Exeter, UK.

Jenny Lloyd 1, Dawn Swancutt 2, Ross Watkins 1, Shokraneh Moghadam 1, Lily Hawkins 1,
Helene Davis 1, Rod Sheaff 2, Mark Tarrant 1, Jonathan Pinkney 2

1 University of Exeter, Exeter, UK
2 University of Plymouth, Plymouth, UK

Geraldine Sexton1, Karen Gaynor2, Sarah O’Brien1; on behalf of the Obesity National Clinical Programme Children and Young Persons Obesity Expert Working Group.
1Healthy Eating Active Living Programme, HSE; 2National Clinical Programme for Obesity.

Conflicts of interest: none
Funding: None

Conflicts of interest: All authors are employees of Simple Life Apps Inc.
Funding: No external funding was used to finance the study.

1 Queen’s University Belfast, Belfast, UK
2 University College Dublin, Dublin, Ireland.

1 University of Glasgow, Glasgow, UK.
2 Pennington Biomedical Research Center, Baton Rouge, USA.
3 Pennington Biomedical Research Center, Baton Rouge, USA & Louisiana State University, Baton Rouge, USA.
4 Technical University of Munich, Munich, Germany.

1 University of Glasgow, Glasgow, UK
2 Obesity Action Scotland, Glasgow, UK

Conflicts of interest: Authors declare no conflicts of interest
Funding: This research was funded by a grant from Barts Charity ref: MGU0419.

[1] Queen’s University Belfast, Belfast, UK
[2] University of Surrey, Guildford, UK

Conflicts of interest: None
Funding: This PhD was funded by UK Research and Innovation doctoral training grant no: BB/T008776/1

1. Cardiff and Vale University Health Board
2. Public Health Wales

Conflicts of interest: None
Funding: None