P0689 - Relationship between Obesity, Cognitive Function, and Quality of Life Among Inner-City Minority Youth

Background: The prevalence of obesity and severe obesity is increasing among minority youth. We examined the relationship between cognitive function, and obesity, obesity-risk behaviors, and quality of life in an inner-city primarily Hispanic youth cohort.

Methods: A cross-sectional observational study of youth 13-18 years of age, visiting an inner-city hospital-based Adolescent Clinic was conducted between June 2019 – March 2020. Demographic data were obtained, and the Short Acculturation Scale for Hispanics (SASH) and the obesity risk behavior self-report questionnaire adapted from the Youth Risk Behavior Surveillance System (YRBSS) were administered. Blood pressure and anthropometrics were collected. In addition, youth completed the 7-item PROMIS® pediatric cognitive self-report questionnaire and the PedsQLTM Pediatric Quality of Life Inventory with emotional, social, and school functioning sub-scales.

Results: Ninety-seven youth (43 boys and 54 girls), were enrolled over a 10-month period. Mean age was 15.6 (SD = 1.2) years. Most (93%) were of Hispanic ethnicity. In 45 (46.4%), both parents were less than high school educated. Mean SASH score was 3.8 (SD = 0.7) indicating high acculturation among youth. Mean modified age-sex-specific BMI z-score was 1.1 (SD = 1.3) (Figure 1) and mean waist circumference z-score was 0.8 (SD = 0.9). 23% of the study cohort were overweight, 32% were obese, and 35% had central obesity (waist circumference percentile ≥90%). The prevalence of obesity was significantly higher in our study cohort than nationally representative data (Ogden et al., JAMA 2018) [32% (95% CI, 23.8%-43.3%) vs. 17.8% (95% CI, 16.1%-19.6%), P=0.03]. Prevalence of severe obesity (age-sex-specific BMI ≥120% of 95th percentile) in the study cohort was also significantly higher in the study cohort than in national data [15.5% (95% CI, 8.9%-24.2%) vs. (5.8% (95% CI, 4.8%-6.9%), P=0.04] Based on the AAP 2017 guidelines, 19.6% youth had elevated blood pressure and 14.4% had Stage 1 hypertension. Mean arteriolar pressure was significantly positively associated with BMI (β=0.31 per 5-mmHg, P=0.002) and waist circumference (β=0.38 per 5-mmHg, P<0.001). In comparing with the national YRBSS population, our study cohort was neither more nor less active, but less variable in physical activity (Figure 2). Mean neurocognitive T-score on the cognitive self-report questionnaire was 38 (SD ± 5.6). Cognitive function was not significantly associated with adiposity measures such as BMI or waist circumference, but was positively associated with all sub-scales of Quality of Life [Physical: r=0.32, p=0.001; Emotional: r =0.37, p<0.001; Social: r =0.30, p=0.003; School: r =0.61, p<0.001].

Conclusion: Prevalence of obesity and severe obesity were higher and physical activity levels were less variable in this inner-city minority youth population compared to their national peers. Neurocognitive function in this study cohort was not associated with adiposity but was significantly associated with all aspects of quality of life.