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Aim Million Veteran Program (MVP) is the largest ongoing mega-cohort biobank program in the US with 570,131 enrollees as of May 2017. The primary aim is to describe demographics, military service, and major diseases and comorbidities of the MVP cohort. Our secondary aim is to examine body mass index (BMI), a proxy for general health, among enrollees. Materials and Method The study population consists of Veterans who actively use the Veterans Health Administration in the US. Data evaluated in this paper combine health information from multiple sources to provide the most comprehensive demographic profile and information on height and weight of MVP enrollees. A standardized cleaning algorithm was used to curate the demographic variables for each participant in MVP. For height and weight, we derived a final data point for each participant to evaluate BMI. Statistical Analysis Used Multivariable logistic regression was used to compare the differences in BMI categories across enrollment years adjusting for gender, race, and age. P < 0.05 was considered statistically significant. All analyses were conducted using Statistical Analysis System 9.2. Results The MVP cohort consists of 90.4% of males with an average age of 61.9 years (standard deviation [SD] = 13.9). MVP is the largest multiethnic biobank cohort within the Veteran population with 73.9% White, 19.0% Black, and 6.5% Hispanic. The most common self-reported disease was hypertension (62.6%) for males and depression (47.5%) for females. Mean BMI was 29.7 kg/m2 (SD = 5.8) with 38.2% obese and 42.3% overweight. Conclusions Our findings suggest that demographic representation in MVP is similar to the Veterans Health Administration population and contrasts with the overall National Health and Nutrition Examination Survey US population. The prevalence of overweight and obese is high among US Veterans, and future studies will examine the role of BMI and disease risk in the Veteran population.

Background: While previous studies have reported the prevalence of Life’s Simple Seven (LSS) in the general population, no data exist in a national sample of US veterans. Objective: To assess the prevalence of ideal LSS in a cross-sectional study of 500,000 US Veterans participating in the Million Veteran Program (MVP) from 2011-2016. Methods: We assigned one of three possible values (0=poor, 1=intermediate, 2=ideal) for each of the seven LSS metrics (adiposity /BMI), smoking status, total cholesterol, blood pressure, plasma glucose, diet, physical activity) at baseline using self-reported data and electronic health records. A total score of 0 across all seven metrics indicated overall poor cardiovascular health and a score of 14 indicated ideal cardiovascular health. Results: Complete data on all LSS factors were available for 171,146 Veterans (92% men and mean age 65.5yrs ±11.5 SD). Average LSS score was 6.1 ±1.9. Ideal BMI, smoking status, total cholesterol, blood pressure and plasma glucose (fasting and non-fasting) was present in 23.8%, 30%, 22.2%, 22.5% and 42.9%, respectively, in the study population (Fig). Prevalence of ideal diet was 0.4%. Among dietary factors, recommendation for fruits and vegetables (at least 4.5cups/day) was the least likely to be achieved. Physical activity at the workplace, home or at leisure was reported among 25.6% of Veterans (21.8% intermediate and 3.8% ideal physical activity). Conclusions: Our data show a low prevalence of ideal LSS among Veterans in the MVP, especially diet (0.4%) and physical activity (3.8%). Compared to NHANES 2005-2006 unadjusted prevalence estimates for AHA 2020 goals, Veterans in MVP have a lower prevalence of all ideal LSS metrics except for diet: BMI (23.8 vs 33%), physical activity (3.8 vs 45%), smoking status (30 vs 73%), total cholesterol (22.2 vs 45%) blood pressure (22.5 vs 42%) and glucose (42.9 vs 58%). These findings underscore the need to improve adherence to modifiable lifestyle factors with subsequent reduction in CVD burden among Veterans.

Introduction: Moderate alcohol consumption has been shown to protect against coronary artery disease (CAD) in the general population, but this relationship has not been well studied among U.S. Veterans. Methods: 61,587 Million Veteran Program (MVP) participants completed a baseline and lifestyle survey that included questions about frequency and volume of alcohol consumption. We combined grams of ethanol in wine, beer, and spirits to create the exposure variable for this analysis. Using the VA electronical health record, incident CAD events included myocardial infarction, angina pectoris, other forms of chronic ischemic heart disease (ICD9 codes 410-414.9) or coronary procedures (ICD9 procedure codes 36.0-36.99). Participants with prevalent CAD (n=27,844) before the baseline survey date or alcohol abuse using ICD9 codes 303.0 and 305.0 (n=16,048) were excluded from the analysis. We used a Cox Proportional Hazard model to estimate hazard ratios (HR) and 95% confidence intervals (CI) for CAD adjusting for age, sex, body mass index, and smoking status. Results: Among 59,288 participants analyzed, the mean age was 65y (SD=11.9), mean BMI was 28.9 kg/m 2 , 90% were men, 33% were never smokers, 86% self-reported as White, 11% Black, and 6% Hispanic. Participants were categorized into 6 alcohol consumption categories: Never, former, and current drinkers of half drink/d, >half to 1 drink/d, >1 to 2 drinks/d, >2 to 3 drinks/d, >3 to 4 drinks/d, and >4 drinks/d. During a mean follow up of 3.3 years, 3,670 CAD events were documented. Using current drinkers of ≤half a drink/d as the reference group, we found a 19% lower risk of CAD in drinkers of >1 to 2 drinks/d, a 25% lower risk of CAD with alcohol intake of >3 to 4 drinks/d, and 34% lower risk in the highest alcohol category in a multivariable adjusted model (Table 1). As expected, former drinkers had a slightly higher risk of CAD. We did not have enough data on women to conduct sex-specific analyses. Conclusion: Our data show a lower risk of CAD with moderate alcohol consumption among MVP participants.

Background: More than one-third of US adults are obese and the prevalence has remained stable since 2003. In the largest cohort of 515,912 men and women participating in the Million Veteran Program (MVP), we analyzed trends in baseline weight/obesity across the years of enrollment. Objective: The goal of this study is to examine prevalence and trends in baseline characteristics among US Veterans enrolled in MVP between 2011 and 2016. We highlight the trends in BMI over the enrollment period. Methods: BMI was computed for 479,521 Veterans who enrolled in MVP between 2011 to September 2016. Participants reported weight and height on the baseline survey. Missing survey data was supplemented with patient EMR data taken closest to enrollment date and stratified by year of enrollment. Results: Mean age was 61.2 (SD=13.8), 91.6% (391,124/427,187) were men, 73.8% (353,720/479,520) White, 18.8% (90,020/479,520) Black, and 7.4% (35,593/479,520) Hispanic. Overall, mean BMI was 29.7 [range 11.3 to 78.5]. Prevalence of underweight, normal weight, and overweight was 0.7% (3,164/479,521), 19.4% (93,318/479,521), 38.4% (184,625/479,521), respectively, in this cohort. While the prevalence of obesity increased with consecutive years of enrollment in men and overall, we did not observe such trend for other categories of adiposity (Fig). When stratified by race we did not observe any difference in prevalence of underweight and normal weight among White and Black participants. Prevalence of obesity was higher in Blacks, but the rate of obesity among Whites appears to be growing at a faster rate than in Blacks. Compared to the general VHA (Veterans Health Administration) population, prevalence of obesity and the distributions of race, gender, and ethnicity were similar among participants in MVP. Conclusion: Our data show that the prevalence of overweight/obesity is high among US Veterans. Across consecutive years of enrollment, prevalence of obesity but not overweight appears to increase across each ethnic group.