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Session: Exemplary Trainee Abstracts in Obesity Science Research (Poster Theater Flash Session 4)

(PTFS04-06-23) An Exploratory Factor Analysis of Common Cardiometabolic Measures in People With Obesity for Building a Parsimonious Health Assessment

Sunday, July 23, 2023
10:25 AM – 10:29 AM ET
Location:  Fairfax

    Presenting Author(s)

  • Katie M. Ellison, MS, RDN

    Registered Dietitian Nutritionist and PhD Candidate
    The University of Alabama at Birmingham
    Birmingham, Alabama, United States

    Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • KS

    Kimberly A. Smith, PhD, PhD

    The University of Alabama

  • James O. Hill, PhD

    Professor and Director, Nutrition Obesity Research Center
    University of Alabama at Birmingham
    Birmingham, Alabama, United States

  • HW

    Holly R. Wyatt, MD

    The University of Alabama

  • Drew Sayer, PhD (he/him/his)

    Assistant Professor
    The University of Alabama at Birmingham
    Birmingham, Alabama, United States

Disclosure(s):
Katie M. Ellison, MS, RDN: No relevant financial relationship(s) with ineligible companies to disclose.
James O. Hill, PhD: General Mills: Advisory Committee/Board Member (Ongoing)
McCormick Science Institute: Advisory Committee/Board Member (Ongoing)
Shakabuku, LLC: Ownership Interest (Ongoing)
Drew Sayer, PhD: No relevant financial relationship(s) with ineligible companies to disclose.
Objectives: Obesity is strongly associated with cardiometabolic disease risk and is commonly aggregated with indices of metabolic health including in the diagnosis of metabolic syndrome and established cardiovascular risk scores. However, proponents of body positivity and Heath at Every Size® (HAES®) approaches have questioned whether body size is an important determinant of health and wellbeing. The objective of this research was to conduct an exploratory factor analysis (EFA) to determine if body size measurements factor load with or independent of common clinical measures of metabolic health.

Methods: The EFA was conducted on N=250 adults using baseline data from four weight loss trials (Sample 1: N=40; Sample 2: N =52; Sample 3: N =53; Sample 4: N=105). A principal component analysis of 9 items (systolic blood pressure [SBP], diastolic blood pressure [DBP], hemoglobin A1c [HbA1c], HDL-cholesterol [HDL], LDL-cholesterol [LDL], total cholesterol [TC], body mass index [BMI], body fat percent [%BF], and waist circumference [WC]) was conducted with a Varimax rotation.

Results: Mean BMI was 38.5 kg/m2 ± 6.8, mean age was 55.7 years, and 74.8% of participants were female. Three factors were extracted when the item retention threshold was set to Eigenvalues >1, which produced a model explaining 87.5% of the variance. Six items loaded strongly ( > 0.8) under three components and were selected for retention (Factor 1: LDL and TC; Factor 2: BMI and WC; Factor 3: SBP and DBP).

Conclusions: Measures of body size factor loaded separately from measures of metabolic health among people with obesity who were entering a weight loss trial, and metabolic health was further split into lipid and blood pressure focused factors. These results provide opportunities for both weight-focused (i.e., weight loss) and weight-neutral interventions to improve overall health and wellbeing. Future research requires a confirmatory factor analysis and investigation in additional populations with greater age, sex/gender, and body size diversity.

Funding Sources: Studies included in this research were funded by General Mills Bell Institute of Health and Nutrition, and the Nutrition Obesity Research Center, University of Alabama at Birmingham.