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Obesity is associated with deterioration of T2DM and its complications. Although low serum zinc levels are reportedly associated with obesity in nondiabetic people, clinical evidence regarding the association between dietary intake of zinc and obesity in diabetic individuals is sparse. Thus, we aimed to clarify this issue utilizing our nationwide registry of Japanese patients with diabetes. Analyzed were 1891 patients with T2DM (mean age, 62 y; men, 62%) whose data from a food frequency questionnaire were available. Obesity was defined as BMI of ≥25. The associations between obesity and intake of zinc were determined by multivariate regression as well as quintile analyses. Odds ratio (OR) for obesity was 0.74 (0.65, 0.84) per 1 mg increase in zinc intake. Quintile analysis revealed a stepwise decrease in ORs for obesity at higher quintiles. ORs in Q3-Q5 were significant compared to Q1 as the reference (Table). Food groups strongly related to zinc intake among our patients were meats (correlation coefficients, 0.64), fish (0.49), and vegetables (0.47). These results suggest close associations between zinc intake and obesity in patients with T2DM. This information would be clinically applicable for nutrition education. Disclosure: R. Nedachi: None. K. Fujihara: None. M. Hatta: None. Y. Matsubayashi: None. Y. Takeda: None. D. Ishii: None. C. Horikawa: None. N. Kato: None. H. Maegawa: Research Support; Self; Antares Pharma, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. Speaker's Bureau; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. H. Sone: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kowa Pharmaceutical Europe Co. Ltd., Kyowa Hakko Kirin Co., Ltd., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. [ABSTRACT FROM AUTHOR]

Although cardiovascular risk and mortality increases in the presence of comorbid obesity among patients with T2D while fish intake is known to decrease such risks, the association between obesity and fish intake is only poorly understood. Thus, we aimed to clarify these possible associations, including the effects of fish-related nutrients. Analyzed were 1891 Japanese patients with T2D (mean age, 62 y; men, 62%) who completed the Food Frequency Questionnaire. BMI>25 was defined as obesity. Associations between obesity and intake of fish and related nutrients were analyzed by quintiles. Vitamin B12 (VB12) (correlation coefficient, 0.97), vitamin D (VD) (0.94), and long-chain omega-3 polyunsaturated fatty acids (n-3) (0.74) were significantly and potently associated with fish intake. Odds ratio (OR) for obesity was significantly decreased to approximately 0.6 in patients in Q4 (men, 80-108g; women, 77-103g) and Q5 (>108g; >103g) of fish intake compared to Q1 (<37g; <40g) (Table). Intake of all three nutrients showed significant inverse trends with obesity, as did fish intake. Results were unchanged even after additional adjustment by use of medications, including insulin. Dietary instructions for daily fish intake of ≥100g could be provided to decrease the risk of obesity in Japanese patients with T2D. Underlying mechanisms via the related nutrients examined await further investigation. Disclosure: M. Hatta: None. K. Fujihara: None. Y. Matsubayashi: None. Y. Takeda: None. R. Nedachi: None. D. Ishii: None. C. Horikawa: None. N. Kato: None. H. Maegawa: Research Support; Self; Antares Pharma, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. Speaker's Bureau; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. H. Sone: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kowa Pharmaceutical Europe Co. Ltd., Kyowa Hakko Kirin Co., Ltd., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. [ABSTRACT FROM AUTHOR]

Pediatric obesity is associated with clustered cardiometabolic risk and the future incidence of diabetes. However, few studies have determined the effect of pediatric obesity in Asia, where obesity is less common than in Western countries. Thus, we clarified whether metabolic risk factors are associated with weight status including slight overweight and underweight among Japanese adolescents. We performed a cross-sectional analysis of 2241 Japanese adolescents (1180 boys) aged 13-14 years whose height, weight, HbA1c, blood pressure (BP), and serum lipids were measured. Participants were classified as underweight, normal weight, slightly overweight, overweight, or obese according to both the universal and Asian cutoffs of the International Obesity Task Force, which correspond to adult BMI cutoffs. The clustered cardiometabolic risk (Z-CMR) was estimated by summing standardized sex-specific Z scores of HbA1c, mean arterial pressure (MAP), and non-high-density lipoprotein cholesterol (non-HDL-C). Linear regression analysis showed that MAP (sex-specific Z score), non-HDL-C (sex-specific Z score), and Z-CMR were higher in the slightly overweight, overweight, and obese groups than in the normal weight group after adjusting for confounders. Compared with the normal weight group, the slightly overweight, overweight, and obese groups had significantly higher odds ratios (ORs) for high BP [OR = 1.38 (95% CI, 1.03-1.85); OR = 2.63 (1.77-3.91); and OR = 2.39 (1.57-3.64), respectively]. Compared with the normal weight group, underweight boys, but not girls, had a significantly lower OR for high Z-CMR [OR = 0.20 (0.05-0.84)]. Our results indicated that adolescents classified as slightly overweight had higher levels of BP, serum lipids (but not HbA1c), and clustered cardiometabolic risk than those classified as normal weight. This observation demonstrated that significant associations between weight status and cardiometabolic risk factors could be seen during adolescence even in East Asia. Disclosure: S.Y. Morikawa: None. K. Fujihara: None. D. Ishii: None. R. Nedachi: None. M. Ishizawa: None. H. Ishiguro: None. Y. Matsubayashi: None. T. Yamada: None. S. Kodama: None. H. Sone: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kowa Pharmaceutical Europe Co. Ltd., Kyowa Hakko Kirin Co., Ltd., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. [ABSTRACT FROM AUTHOR]

Although obesity is closely associated with development and progression of type 2 diabetes mellitus (T2DM) and its complications, food group intake associated with obesity in diabetic patients has been very poorly investigated to date largely due to lack of large-scale databases with details on dietary intake. Thus, we aimed to determine intake of food groups by utilizing our nationwide database for people with diabetes with adjustment for confounders including energy intake. Analyzed were 1891 Japanese patients with T2DM (mean age, 62 y; men, 62%) who completed the Food Frequency Questionnaire. Obesity was defined by BMI>25. The associations between obesity and food groups were determined by multivariate quartile analysis. Among 15 food groups, both green and yellow and light-colored vegetables had significant negative associations with the presence of obesity among both men and women (Table). In addition, fruit and beans in men and fish in women were also negatively associated with obesity. Conversely, confectionery had positive associations with obesity in both men and women. Other food groups such as rice, meat or eggs did not show significant trends toward the presence of obesity. These results identified favorable dietary patterns for people with T2DM, which could be used for effective nutritional education to prevent obesity. Disclosure: M. Hatta: None. K. Fujihara: None. Y. Takeda: None. R. Nedachi: None. D. Ishii: None. S.Y. Morikawa: None. C. Horikawa: None. M. Kato: None. H. Maegawa: Research Support; Self; Antares Pharma, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. Speaker's Bureau; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. H. Sone: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kowa Pharmaceutical Europe Co. Ltd., Kyowa Hakko Kirin Co., Ltd., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. [ABSTRACT FROM AUTHOR]

Dietary energy density (DED) is receiving increased attention reflecting recent reports of inverse associations with health outcomes. Although high DED meals are reportedly associated with low diet quality in the general population, such evidence in patients with diabetes is sparse, which led us clarify this issue in Japanese patients with T2DM. Analyzed were 1,615 outpatients with T2DM (men 62.2%) who attended 24 clinics specializing in diabetes care nationwide. Dietary habits were obtained using a food frequency questionnaire (FFQg) based on 18 food groups. DED (kcal/g) was calculated by dividing EI (kcal) from foods (excluding beverages) by weights of these foods (g). Mean DED (±SD) was 1.53±0.23 (kcal/g). Typical dietary patterns comprised of some significant food groups were extracted by principal component analysis. Pearson's correlation analysis was used to evaluate the associations between identified food patterns and DED. We could extract and validate three dietary patterns, which we labeled as "Healthy," "Western," and "Animal foods and confectionery." Two patterns were significantly correlated with DED (Healthy: r=-0.48, Animal foods and confectionery: r=-0.69). A multivariate linear regression model was used to determine food groups that were independently related to DED. DED was positively associated with confectioneries (standardized β=0.19, P<0.001), bread (0.10, P<0.001), and fat and oil (0.09, P<0.001). On the contrary, DED was negatively associated with brightly colored vegetables (-0.25, P<0.001), fruits (-0.31, P<0.001), and light-colored vegetables (-0.43, P<0.001). In conclusion, lower DED, which is related to higher intakes of vegetables and fruits was associated with a healthy diet pattern in T2DM patients. DED is a useful indicator of diet quality and could be utilized in nutritional education for people with T2DM. Disclosure: Y. Takeda: None. K. Fujihara: None. M. Hatta: None. S.Y. Morikawa: None. C. Horikawa: None. D. Ishii: None. R. Nedachi: None. H. Maegawa: Research Support; Self; Antares Pharma, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. Speaker's Bureau; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. H. Sone: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kowa Pharmaceutical Europe Co. Ltd., Kyowa Hakko Kirin Co., Ltd., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. [ABSTRACT FROM AUTHOR]