Preventive Medicine

Adolescent obesity predicts higher adult mortality, driven by cardiovascular deaths

This systematic review of 18 cohort studies found that adolescent obesity is consistently associated with increased all-cause adult mortality. Most studies were from high-income settings with a median follow-up of about 30 years, capturing premature and midlife deaths. Hazard ratios for all-cause mortality ranged from 1.3 to 2.7, with the highest risk among adolescents with severe obesity. Cardiovascular disease accounted for much of the excess mortality associated with adolescent obesity. Most included cohorts were methodologically robust, though heterogeneity precluded meta-analysis, limiting precise pooled estimates. 1

Afternoon–evening MVPA is associated with lower incident type 2 diabetes risk

This study related accelerometer-derived MVPA timing to incident type 2 diabetes in 84,528 UK Biobank participants and glycemic measures in NHANES. Using early-morning MVPA as reference, afternoon–evening MVPA showed the lowest incident diabetes risk after adjusting for total MVPA volume. In NHANES, afternoon or early evening MVPA was weakly associated with more favorable glycemic profiles and lower diabetes prevalence after volume adjustment. When total MVPA was held constant, clustering MVPA in the afternoon–evening consistently conferred the greatest diabetes risk reduction. 2

Unfavorable social determinants double CVD risk, partially via Life’s Essential 8

Using NHANES 2005-2018, this cohort analysis linked a composite unfavorable SDoH score to cardiovascular morbidity and mortality. Low education, low income-to-poverty ratio, lack of private insurance, and unemployment were the most frequent adverse determinants. Unfavorable SDoH exposure was associated with higher CVD morbidity (OR 2.36) and CVD mortality (HR 2.70). Life’s Essential 8 metrics mediated about 30% of the SDoH–CVD morbidity association and roughly one quarter of mortality associations. Nicotine exposure, physical activity, and sleep health were key mediators, with contributions varying across racial and ethnic groups. 3

Modeling suggests 2025 Medicaid restrictions may reduce cancer screening and worsen outcomes

This decision-analytic model projected cancer screening and outcomes under Medicaid funding and eligibility restrictions from the 2025 Budget Reconciliation Bill. The study simulated how tightened eligibility would alter insurance coverage and, in turn, population-level screening uptake. Modeled changes in screening translated into shifts in stage at diagnosis and downstream cancer outcomes. The projections indicate that restricting Medicaid eligibility is likely to reduce preventive screening and worsen cancer prognoses among low-income adults. 4