Healthy Body Weight Research Articles

Correlation between Nutritional Intake, Physical Activity, and Occupational Stress with Blood Pressure in Dockworkers at Indonesia Fishing Port

BACKGROUND: Hypertension in the population can result in lost productivity due to an increased risk of premature death and a decline in work productivity. The study on hypertension in workers in Indonesia has primarily focused on formal workers with regular working hours, with little attention paid to informal workers. AIM: This study aims to analyze the correlation between nutritional intake, physical activity, and occupational stress with blood pressure in dockworkers at the fishing port (TPI) Kendal, Indonesia. METHODS: There were 51 male dockworkers recruited. We used a 24-h recall to assess nutritional intake over three non-consecutive days. The physical activity index was measured using the Questionnaire for the Measurement of a Person’s Habitual Physical Activity. Data on occupational stress were obtained through interviews using the Workplace Stress Scale questionnaire. Pearson’s product moment and Spearman’s rank were used to performing a correlation test between variables. RESULTS: The majority of dockworkers had prehypertension (35.3%). There was a correlation between BMI and systolic (p = 0.001; r = 0.554) and diastolic (p = 0.001; r = 0.459) blood pressure. Meanwhile, age was related to systolic blood pressure (p = 0.022; r = 0.320), and cholesterol intake was associated with diastolic blood pressure (p = 0.040; r = 0.289). Blood pressure was not associated with physical activity and occupational stress. CONCLUSION: Dockworkers should reduce sedentary activities and maintain healthy body weight to prevent hypertension.

Adult BMI change over time and risk of colorectal adenoma.

68 Background: Obesity and adult weigh gain are established risk factors for colorectal cancer (CRC). Few studies have investigated the association between adult body weight change over time and risk of colorectal adenoma. We hypothesize adult BMI change over time is associated with risk in the development of colorectal adenomas. Methods: We tested this hypothesis in 2,993 patients undergoing screening colonoscopy from 2007–2017. Weight at age 20, 30, 40, and 50 were self-reported via computer assisted personal interviews. Height and weight at recruitment were measured at the time of colonoscopy exam. BMI (kg/m2) change was calculated as the difference of BMI at recruitment from the BMI estimate for each of the age periods. Results: Of the 2,993 patients, 984 had pathologically confirmed diagnosis of colon adenoma. Multivariate logistic regression adjusted for potential confounders and BMI at recruitment showed statistically significant increase of risk of adenoma with increase of BMI since age 30, age 40, and age 50. Compared to those with BMI change of less than 5, the ORs for those with BMI gain of 5-10 and ≥10 were: 1) 1.16 (0.92-1.46) and 1.48 (1.08-2.03) respectively for change from age 30 (ptrend = 0.05); 2) 1.11 (0.87-1.43) and 1.60 (1.09-2.35) respectively for change from age 40 (ptrend = 0.05); and 3) 1.36 (0.95-1.94) and 2.95 (1.33-6.90) respectively for change from age 50 (ptrend = 0.01). Stratified analysis did not reveal noticeable gender differences. Conclusions: Large adult weight gain over time is an independent risk factor for colorectal adenoma. Our results suggest maintaining healthy body weight throughout adulthood is an important preventive measure against the development of early colorectal neoplasia. [Table: see text]

Association between physical activity and longitudinal change in body mass index in middle-aged and older adults

BackgroundIn middle-aged and particularly older adults, body mass index (BMI) is associated with various health outcomes. We examined associations between physical activity (PA) and longitudinal BMI change in persons aged ≥ 50 years.MethodsThe sample included 5159 community-dwelling individuals aged ≥ 50 years (50.5% males, mean (SD) age 73.0 (10.2) years at baseline) who were enrolled in the Mayo Clinic Study of Aging (MCSA). Participants had information on PA within one year of baseline assessment, BMI at baseline, and potential follow-up assessments (mean (SD) follow-up 4.6 (3.7) years). Linear mixed-effect models were used to calculate the association between PA (moderate-vigorous physical activity, MVPA; and all PA composite score) and the longitudinal change in BMI, adjusted for baseline age, sex, education and medical comorbidities. In addition to interactions between years since baseline and PA, we also included 2- and 3-way interactions with baseline age to further assess whether age modifies the trajectory of BMI over time.ResultsWe observed a decrease in BMI among participants engaging at a mean amount of PA (i.e., MVPA: 2.7; all PA: 6.8) and with a mean age (i.e., 73 years) at baseline (MVPA: estimate = -0.047, 95% CI -0.059, -0.034; all PA: estimate = -0.047, 95% CI -0.060, -0.035), and this decline is accelerated with increasing age. Participants with a mean age (i.e., 73 years) that engage at an increased amount of MVPA or all PA at baseline (i.e., one SD above the mean) do not decrease as fast with regard to BMI (MVPA: estimate = -0.006; all PA: estimate = -0.016), and higher levels of MVPA or all PA at baseline (i.e., two SD above the mean) were even associated with an increase in BMI (MVPA: estimate = 0.035; all PA: estimate = 0.015). Finally, MVPA but not all PA is beneficial at slowing BMI decline with increasing age.ConclusionPA, particularly at moderate-vigorous intensity, is associated with slower decline in longitudinal BMI trajectories. This implies that engaging in PA may be beneficial for healthy body weight regulation in middle and late adulthood.

The correlation between self awareness and prediabetes status in patients with excess weight in polyclinic of Baladhika Husada Hospital Jember

Introduction: Poor lifestyle and eating patterns can cause energy imbalances, which can cause excess weight. Excess weight increase risk of pre-diabetes than healthy body weight. Many people who do not know they have pre-diabetes, they have lack of self-awareness to prevent diabetes mellitus. Objectives: This research aims to determine the relationship between self-awareness and pre-diabetes status in patients with excess weight in Polyclinic of Baladhika Husada Hospital in Jember. Methods: This research uses an analytic design with a cross-sectional approach. There were 84 respondents obtained from the accidental sampling technique. Data were collected from the Self Awareness Diabetes Mellitus and random blood glucose results. Data were analyzed using Spearman-rank. Result: Based on the statistical test results, there was a significant relationship between self-awareness and prediabetes status with the direction of negative correlation, which means the higher the self-awareness, the lower the respondents have prediabetes. In patients who were overweight, there was a buildup of fat in the body that can reduce insulin work, which affects prediabetes. While self-awareness as an attitude that must be possessed by someone with excess weight to prevent the risk of prediabetes. Discussion: This study showed the importance of increasing self-awareness and implementing blood glucose control routinely so that someone who has entered the prediabetes category can improve their lifestyle to prevent diabetes mellitus.

Adherence to a Healthy Lifestyle in Association With Microvascular Complications Among Adults With Type 2 Diabetes

The association between an overall healthy lifestyle and the subsequent risk of microvascular complications among patients with diabetes remains unclear. To examine the association between adherence to a healthy lifestyle before and after diabetes diagnosis and the risk of subsequent microvascular complications among adults with diabetes. This prospective cohort study included incident patients with type 2 diabetes who were free of cardiovascular disease and cancer at the time of diabetes diagnosis and completed the diabetes supplementary questionnaires in the Nurses' Health Study (in 2000 and 2005) and the Health Professionals Follow-Up Study (in 2000, 2004, and 2008) in the US. Data were analyzed from April to August 2021. Diet and lifestyle factors before and after diabetes diagnosis were assessed by validated questionnaires. A healthy lifestyle consisted of nonsmoking, having a healthy body weight (a body mass index of ≥18.5 or <25), engaging in moderate-to-vigorous physical activity (≥150 minutes per week), consuming a high-quality diet (top 40th percentile of the Alternative Healthy Eating Index), and moderate alcohol drinking (5-15 g/d for women and 5-30 g/d for men). Physician-diagnosed microvascular complications including diabetic neuropathy, retinopathy, nephropathy, and foot disorders were self-reported at questionnaire surveys. A total of 7077 patients with type 2 diabetes were included in the cohort (4982 women in NHS and 2095 men in HPFS, mean [SD] age 61 [8.8], 94.2% White). During follow-up, 2878 patients developed microvascular complications. After multivariable adjustment, adherence to a healthy lifestyle before and after diabetes diagnosis were both associated with a lower risk of developing microvascular complications. The relative risk (RR) for participants with 4 or more low-risk lifestyle factors before diabetes diagnosis compared with zero was 0.73 (95% CI, 0.60-0.91) for any microvascular complications, 0.71 (95% CI, 0.54-0.93) for diabetic neuropathy, 0.76 (95% CI, 0.57-1.01) for diabetic retinopathy, 0.42 (95% CI, 0.23-0.79) for diabetic nephropathy, and 0.60 (95% CI, 0.35-1.00) for diabetic foot disorders. Similar results were observed for adherence to a healthy lifestyle after diabetes diagnosis, with an RR of 0.68 (95% CI, 0.55-0.83) for any microvascular complications, 0.67 (95% CI, 0.51-0.88) for diabetic neuropathy, 0.65 (95% CI, 0.48-0.86) for diabetic retinopathy, 0.57 (95% CI, 0.34-0.98) for diabetic nephropathy, and 0.62 (95% CI, 0.37-1.05) for diabetic foot disorders. In addition, greater improvement in lifestyle factors from before to after diabetes diagnosis was also significantly associated with a lower risk of neuropathy or total microvascular complications. Each increment in number of low-risk lifestyle factors was associated with a 6% (RR, 0.94; 95% CI, 0.90-0.98) lower risk for any microvascular complications and a 9% (RR, 0.91; 95% CI, 0.86-0.96) lower risk for diabetic neuropathy. Consistent results were observed when analyses were stratified by age at diabetes diagnosis, sex/cohort, or lifestyle factors before diabetes diagnosis. In this cohort study, adhering to an overall healthy lifestyle was associated with a significantly lower risk of microvascular complications among individuals with diabetes. These findings suggest substantial reduction in the burden of microvascular complications associated with adopting a healthy lifestyle among patients with type 2 diabetes.

The gut microbiota in obesity and weight management: microbes as friends or foe?

Obesity is caused by a long-term difference between energy intake and expenditure - an imbalance that is seemingly easily restored by increasing exercise and reducing caloric consumption. However, as simple as this solution appears, for many people, losing excess weight is difficult to achieve and even more difficult to maintain. The reason for this difficulty is that energy intake and expenditure, and by extension body weight, are regulated through complex hormonal, neural and metabolic mechanisms that are under the influence of many environmental factors and internal responses. Adding to this complexity, the microorganisms (microbes) that comprise the gut microbiota exert direct effects on the digestion, absorption and metabolism of food. Furthermore, the gut microbiota exerts a miscellany of protective, structural and metabolic effects both on the intestinal milieu and peripheral tissues, thus affecting body weight by modulating metabolism, appetite, bile acid metabolism, and the hormonal and immune systems. In this Review, we outline historical and recent advances in understanding how the gut microbiota is involved in regulating body weight homeostasis. We also discuss the opportunities, limitations and challenges of using gut microbiota-related approaches as a means to achieve and maintain a healthy body weight.

Association between Sleep Quality and Body Weight Status in Adults during the COVID-19 Pandemic

Introduction: The COVID-19 pandemic is a new emerging situation that has dramatically impacted sleep quality and body weight status. This study aimed to determine the association between sleep quality and body weight status in Malaysian adults during the COVID-19 pandemic. Methods: An online cross-sectional study involved 427 Malaysian adults aged 18 to 59. The convenience sampling method was used. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI). Self-administered socio-demographic, height, and weight for BMI were obtained. Pearson correlation test was conducted to measure the association between sleep quality and body weight status using IBM SPSS Statistics for Windows version 22.0. Results: A total of 78.5% of them were females, and 84.8% of Malaysian adults reported poor sleep quality. The participants’ mean global PSQI score and body mass index were 8.1 (±2.7) and 24.6 (±6.1) kg/m2, respectively. 8.0% were underweight, followed by 55.5% of normal BMI, 17.5% overweight, and 19.0% obese. The study showed a significant and positive correlation between global PSQI score and body mass index (r=0.137, p=0.005). Conclusion: Sleep quality is significantly associated with body weight status. Adults with poorer sleep quality should be targeted when promoting healthy body weight. Future research on the interventions to improve adults’ sleep quality is essential, particularly during the pandemic.

Erişkin Bireylerde Algılanan Stres Düzeyinin Sağlıklı Beslenme Tutumu ve Vücut Ağırlığı ile İlişkisi: Tanımlayıcı ve Kesitsel Çalışma

Erişkin Bireylerde Algılanan Stres Düzeyinin Sağlıklı Beslenme Tutumu ve Vücut Ağırlığı ile İlişkisi: Tanımlayıcı ve Kesitsel Çalışma

Razlike u fizičkoj aktivnosti adolescenata različitih polova uzrasta od 12 do 15 godina različitim danima u nedelji

Achieving the recommended daily level of physical activity (PA) in adolescent boys and girls helps improve their cardiovascular health, maintain a healthy body weight, and promote mental health. The purpose of our study was to determine whether there were statistically significant differences between boys and girls aged 12 to 15 years with respect to age and amount of PA on different days of the week. The sample included 606 7th, 8th, and 9th grade students from four Slovenian elementary schools who participated in the study by completing a questionnaire (IPAQ; International Physical Activity Questionnaire, 2006). We used a quantitative research approach and the method was causal-non-experimental. The Shapiro-Wilk test was used to determine whether the data were normally distributed at a statistically significant level of risk (p &gt; 0.05). Because of the non-normal distribution of the variables (p &lt; 0.001), the non-parametric Mann-Whitney test was used to determine statistically significant differences between genders, and the Kruskal-Wallis test was used to determine statistically significant differences between age groups. Boys were statistically significantly more active than girls on all days of the week except Wednesday (Mon.: p=0.018; Tues.: p=0.001; Thurs.: p=0.020; Fri.: p=0.015, Sat.: p=0.012; Sun.: p=0.001). Significant differences in PA levels between seventh-, eighth-, and ninthgraders occurred only on Sundays (p&lt;0.001), with PA levels changing with student age. The study's findings that adolescent boys are statistically significantly more active than girls raise concerns about gender differences in PA participation during this critical developmental period. Such differences may contribute to long-term health consequences and perpetuate gender inequalities in overall fitness and well-being. The observed differences in PA between boys and girls during adolescence highlight the need for targeted interventions and strategies to promote and improve PA among girls. Addressing the underlying factors that contribute to lower activity levels among girls is essential to promoting a more equitable and inclusive approach to PA promotion.

Faster rehabilitation weight gain is associated with liver fat in adult survivors of childhood severe acute malnutrition

BackgroundNutritional rehabilitation during severe acute malnutrition (SAM) aims to quickly restore a healthy body weight, but rapid weight gain has been associated with later cardiovascular risk. We hypothesized that faster weight gain during SAM rehabilitation and post-hospitalization is associated with liver fat in adult survivors.MethodJamaican adult survivors of childhood SAM underwent abdominal CT scan to estimate liver fat as mean liver attenuation (MLA) and liver spleen ratio (L/S). Birth weight (BW) and anthropometry measured during, and post-hospitalization were abstracted from admission records.ResultsWe studied 42 marasmus survivors (MRs) and 40 kwashiorkor survivors (KWs). MRs had a lower mean BW (SD) 2.5 (0.8) vs 3.0 (0.7) kg; p=0.01) and were more wasted (p&lt;0.001) and stunted (p=0.03) than KWs on admission to hospital. MRs and KWs had similar rates of rehabilitation weight gain, which was inversely associated with MLA among all survivors of SM (r=-0.246, p=0.029), but only in MRs when assessed by diagnosis (r= -0.449, p=0.004). The association between rehabilitation weight gain and adult liver fat in MRs was not altered by BW, admission wasting or stunting. In KWs, post-hospitalization height gain was inversely associated with MLA (difference = -0.64, 95%CI: -0.64 to -0.13; p=0.006).ConclusionsFaster rehabilitation weight gain is associated with liver fat in adult survivors of childhood severe acute malnutrition. The finding that BW did not influence these outcomes may reflect the timing of the nutritional insult in utero. Target weight gain during nutritional rehabilitation may need to be lowered to optimize long-term outcomes in these children.

Diet Intervention: Choice for Cancer Prevention and Patients Survival

Cancer remains a second leading cause of death in the world, despite significant advances in treatment. It is well known that diet has a significant impact on overall health, calorie restriction may be beneficial for treating a number of diseases and even lengthening patients survival. Obesity and cancer have been shown to have strong epidemiological links, and healthy diets have been shown to lower the risk of developing cancer. There is also evidence that obese patients have a worse outcome and a higher mortality rate after being diagnosed with breast, colon, prostate, pancreatic, ovarian, and hematologic cancers. However, little is known about how nutrition may affect cancer once it has been detected, particularly how diet may influence cancer therapy [1].&#x0D; The American Institute for Cancer Research (AICR) developed lifestyle recommendations based on the most recent evidence. Following these suggestions may increase overall survival after cancer diagnosis: preserving a healthy body weight; engaging in physical activity; eating a diet high in fiber and soy; and limiting the consumption of fats, particularly saturated fatty acids. Previous study also supports the clinical utility of diet interventions in cancer patients. These interventions aim to ensure adequate energy and nutrient intake during chemotherapy, which may also improve patient response to and alleviate the toxicity of pharmacological anti-cancer therapies. Furthermore, by reducing cancer comorbidities, modifications in lifestyle, like as diet and exercise, might lessen the long-term negative effects of treatment regimens and improve general health over the long term [2].&#x0D; Consumption of lignans, raw vegetables, dietary fiber, the Mediterranean diet, various dietary sources, low meat consumption, vegetarianism, or veganism, dietary intake (or biomarkers) of specific vitamins, like vitamin D, vitamin K2, or vitamin C, were all linked to a lower risk of developing cancer. An increased risk of cancer mortality was associated with poor food quality, alcohol usage, the intake of soft beverages like juice, and to a lesser extent, the consumption of certain fatty acids. The risk of dying from cancer was significantly enhanced by obesity [3].&#x0D; The diet play important role in the lifestyle, disease prevention and may act as an immune booster but diet intervention is not surprising topic of discussion in the therapy of cancer. If the dietary intervention found beneficial in cancer treatment and prevention with therapeutic efficacy, it may have little or no toxicity. At this point, it is impossible to be sure which dietary strategy is best, and diet efficacies are likely to vary depending on patient, therapeutic regimen and cancer type. When implementing these strategies in the clinic, some personalization may be required because physician who treat overweight and obese patients are aware that sometimes the best diet is the one the patient is willing and able to follow. Further studies are needed on better diet intervention to cancer patients in order to improve cancer prognosis and patients survival

The Pain-Related Fear Scale: The validation of an instrument to measure pain-related fear in younger adults under 45 years of age with obesity

Background: The existence of pain-related fear appears to present an obstacle for health promoting behaviour change, particularly among younger adults with obesity. Measures developed and validated for middle-and-older age groups lack validity in younger adults under 45 years of age. This paper reports on the development and psychometric properties of a new instrument, based on a conceptual framework, to measure pain-related fear in younger adults. Methods: A cross sectional survey design was employed. 236 participants aged 18 to 45 years were recruited to participate. Participants completed three existing pain-related fear instruments mapped to a conceptual framework. Exploratory and confirmatory factor analysis identified the dimensions of the new Pain-Related Fear Scale. Construct validity was assessed by comparing scores between physical activity groups; criterion validity by correlation with the Tampa Scale of Kinesiophobia and reliability by Cronbach’s alpha. Differences in scores in the Pain-Related Fear Scale were explored across BMI subgroups. Results: A four-factor model with 12 items met the most acceptability thresholds for a good fitting model (CFI = 0.983; GFI = 0.953; RMSEA = 0.046; SRMR = 0.0301). Higher mean scores on the PainRelated Fear Scale were seen among those reporting low activity compared to high activity levels (F= 4.684; P= 0.01). Modest correlation was observed between the new instrument and Tampa Scale of Kinesiophobia (r= 0.508;95% CI= 0.389-0.612). Cronbach’s alpha was 0.842. Scores were higher in the obese subgroup compared to the healthy bodyweight group (mean difference= -7.42; CI= -12.26 - -2.58; P= 0.001). Conclusion: The Pain-Related Fear Scale is a psychometrically valid measurement of pain-related fear for adults with obesity aged between 18 to 45 years. The instrument can support research relating to barriers to physical activity, and potentially has clinical utility as a screening and outcome measurement.

PH-responsive and targeted delivery of chrysin via folic acid-functionalized mesoporous silica nanocarrier for breast cancer therapy

Cancer is a disease of global importance. In order to mitigate conventional chemotherapy-related side effects, phytochemicals with inherent anticancer efficacy have been opted. However, the use of nanotechnology is essential to enhance the bioavailability and therapeutic efficacy of these phytochemicals. Herein, we have formulated folic acid conjugated polyacrylic acid capped mesoporous silica nanoparticles (∼47.6 nm in diameter) for pH-dependent targeted delivery of chrysin to breast cancer (MCF-7) cells. Chrysin loaded mesoporous silica nanoparticles (Chr- mSiO2@PAA/FA) have been noted to induce apoptosis in MCF-7 cells through oxidative insult and mitochondrial dysfunction with subsequent G1 arrest. Further, in tumor bearing mice, intravenous incorporation of Chr-mSiO2@PAA/FA has been noticed to enhance the anti-neoplastic effects of chrysin via tumor site-specific accumulation. Enhanced cytotoxicity of chrysin contributed towards in vivo tumor regression, restoration of normalized tissue architecture and maintenance of healthy body weight. Besides, no serious systemic toxicity was manifested in response to Chr-mSiO2@PAA/FA administration in vivo. Thus, the study evokes about the anticancer potentiality of chrysin and its increased therapeutic activity via incorporation into folic acid conjugated mesoporous silica nanoparticles, which may hold greater impact in field of future biomedical research.

Deletion of the Alzheimer's disease risk gene Abi3 locus results in obesity and systemic metabolic disruption in mice.

Alzheimer's disease (AD) genetics studies have identified a coding variant within ABI3 gene that increases the risk of developing AD. Recently, we demonstrated that deletion of the Abi3 gene locus dramatically exacerbates AD neuropathology in a transgenic mouse model of amyloidosis. In the course of this AD project, we unexpectedly found that deletion of the Abi3 gene locus resulted in a dramatic obese phenotype in non-transgenic mice. Here, we report our investigation into this serendipitous metabolic finding. Specifically, we demonstrate that mice with deletion of the Abi3 gene locus (Abi3-/- ) have dramatically increased body weight and body fat. Further, we determined that Abi3-/- mice have impaired energy expenditure. Additionally, we found that deletion of the Abi3 gene locus altered gene expression within the hypothalamus, particularly within immune-related pathways. Subsequent immunohistological analysis of the central nervous system (CNS) revealed that microglia number and area were decreased specifically within the mediobasal hypothalamus of Abi3-/- mice. Altogether, this investigation establishes the functional importance of the Abi3 gene locus in the regulation of systemic metabolism and maintenance of healthy body weight. While our previous findings indicated the importance of Abi3 in neurodegeneration, this study indicates that Abi3 related functions are also essential for metabolic regulation.

Relationship of self-regulation and lifestyle behaviour with overweight among male and female adolescents in Selangor

Introduction: The ability of a person to self-regulate and practise healthy lifestyle behaviours determine one’s weight status. The objective of this study was to determine the relationship of self-regulation, dietary practices, and physical activity with overweight status among male and female adolescents. Methods: This crosssectional study used multistage cluster sampling involving government secondary school students aged between 13 and 14 years old in Hulu Langat, Selangor. Students answered a validated self-administered questionnaire comprising socio-demography, dietary practices, physical activity, and self-regulation items. Their body mass index (BMI) was calculated, and weight status was determined using the Centers for Disease Control and Prevention (CDC) BMI chart. Results: Among 636 students, 27.0% were “overweight”, affecting more male than female students (p=0.032). Majority of them (96.7%) were motivated to maintain healthy body weight, but only a third of the students took vegetables, fruits and grains (32.4%), and performed vigorous physical activity (31.1%) regularly. Regardless of the “overweight” status, there were no significant differences in dietary practices, physical activity, and autonomous regulation for both genders. Female students showed a higher level of controlled regulation than male students in non-overweight (p=0.005) and overweight (p&lt;0.001) groups. Higher controlled regulation increased the odds of being overweight among female students (AOR=1.04, 95% CI=1.04-1.08, p=0.010). Conclusion: Thus, health authorities need to develop programmes to assist, particularly female students, in practising higher autonomous regulation to combat overweight and obesity, as this group exhibits a high level of controlled regulation, which increases the likelihood of being overweight.

Determining the Role of SGLT2 Inhibition with Dapagliflozin in the Development of Diabetic Retinopathy.

Diabetic retinopathy (DR) is a major cause of blindness globally. Sodium Glucose Cotransporter-2 (SGLT2) inhibitors have been demonstrated to exert cardiorenal protection in patients with diabetes. However, their potential beneficial effect on DR is less well studied. The aim of the present study was to determine the effects of the SGLT2 inhibition with Dapagliflozin (DAPA) on DR in well-characterised DR mouse models and controls. Dapagliflozin was administered to mice with and without diabetes for 8 weeks via their drinking water at 25 mg/kg/day. Urine glucose levels were measured weekly and their response to glucose was tested at week 7. After 8 weeks of treatment, eye tissue was harvested under terminal anaesthesia. The retinal vasculature and neural structure were assessed using immunofluorescence, immunohistochemistry and electron microscopy techniques. Dapagliflozin treated DR mice exhibited metabolic benefits reflected by healthy body weight gain and pronounced glucose tolerance. Dapagliflozin reduced the development of retinal microvascular and neural abnormalities, increased the beneficial growth factor FGF21 (Fibroblast Growth Factor 21). We highlight for the first time that SGLT2 inhibition results in the upregulation of SGLT1 protein in the retina and that SGLT1 is significantly increased in the diabetic retina. Blockade of SGLT2 activity with DAPA may reduce retinal microvascular lesions in our novel DR mouse model. In conclusion, our data demonstrates the exciting future potential of SGLT1 and/or SGLT2 inhibition as a therapeutic for DR.

Practice-relevant dietary recommendations in uro-oncology

Ahealthy lifestyle is recommended for prevention, during therapy and in the survivorship of various medical conditions. This article aims to give an overview of the current dietary recommendations and currently discussed topics which are useful for patient counseling. The literature with afocus on uro-oncology, on prevention, during cancer therapy and survivorship was reviewed for healthy lifestyle recommendations. In addition, issues perceived in practice were researched, discussed with examples, and critically evaluated. The current recommendations of the professional associations are intended to encourage all healthy or already ill patients to adopt ahealthy lifestyle that includes abalanced diet, physical activity and healthy body weight. Consistent with current evidence, neither general supplementation of dietary supplements nor avoidance of entire food groups (such as meat or dairy products) is recommended. In the counseling situation, patients should be encouraged in ahealthy lifestyle or supported in an appropriate change of behavior. Any perceived uncertainty or questions from patient's perspective should be clarified and, if necessary, referred to adietician, oecotrophologist or nutritionist.

The Benefits of Exercise in Breast Cancer.

Breast cancer is the most prevalent cancer among women, accounting for nearly 30% of all cancers, while in men, it represents only 1% of cases. Breast cancer is the main cause of death for cancer, and its incidence and mortality vary according to patients' ethnicity, geographic region, and socioeconomic status. Due to the low prevalence of breast cancer among men and the scarcity of studies in the literature, exercises have been prescribed based on extrapolations from studies on female patients. Scientific evidence has suggested beneficial effects of physical exercises on breast cancer prevention, treatment, and post-treatment. In addition to combatting sedentary behavior, it is essential to maintain a healthy body weight, limit alcohol consumption, and follow a balanced diet, rich in fruit, vegetables, grains and fibers, and limited in red meat. The effects of exercises are not restricted to breast cancer, but extend to controlling modifiable risk factors, and reducing the incidence of cardiovascular diseases, and all-cause and cardiovascular mortality.

Transitions of self-management behaviors and frailty status among community-dwelling older adults: a national longitudinal population-based cohort study

BackgroundFrailty in older adults is a common geriatric syndrome that could be prevented; thus, coping strategies for the aging population are essential. Self-management behaviors may represent cost-effective strategies to prevent physical frailty in community-dwelling older adults. This study aimed to describe the changes in frailty status among community-dwelling older adults in Taiwan and investigate the association between transitions of self-management behaviors and frailty status over 4 years of follow-up (2007 to 2011).MethodsData were retrieved from the Taiwan Longitudinal Study of Aging (TLSA), years 2007 and 2011. In this prospective cohort study, 1283 community-dwelling older adults aged 65 years and older without cognitive impairment were recruited. Frailty was defined based on Fried’s frailty phenotype. Self-management behaviors (maintaining body weight, quitting smoking or no smoking, drinking less or no drinking, exercising, keeping diet control, and maintaining a regular lifestyle) were assessed using a questionnaire. Multinomial logistic regression analyses were used to investigate the associations between changes in self-management behaviors and in frailty status. The age group was further stratified to examine the moderation effect in the relationship between changes in self-management behaviors and in frailty status among older adults.ResultsThe prevalence of frailty was 8.7% at baseline and 14.9% after 4 years of follow-up, with 196 (15.3%) deaths. Overall, 514 (40.1%) participants maintained their frailty status, 424 (33.0%) worsened, and only 149 (11.6%) improved. Being aged ≥75 years old, having chronic diseases, and an absence of self-management behaviors were associated with frailty at baseline and after follow-up. Among individuals aged 65–74, compared to those who maintained no self-management behaviors, those who decreased the exercise behaviors (yes-to-no) had a higher risk of worsening (RRR = 2.518), while increasing (no-to-yes) and maintaining (yes-to-yes) frequent physical exercise were associated with a lower risk of worsening (RRR = 0.466 and 0.572, respectively) than stable frailty; those who maintained body weight (yes-to-yes) were associated with a lower risk of worsening (RRR = 0.327) than stable frailty after controlling for individual covariates and chronic diseases. Among individuals over 75 years old, compared to no exerciser, older old who decreased their physical exercise had a higher risk of frailty worsening (RRR = 3.255), and increasing frequent physical exercise (no-to-yes) was associated with an improvement in frailty status (RRR = 3.684). Age was a moderator between the effects of maintaining body weight on frailty worsening. There were no associations between the behavioral transitions of smoking, drinking, diet control, or regular lifestyle on the frailty status changes.ConclusionsMaintaining body weight and frequent physical exercise increased the ratio of frailty stability among individuals 65–74 years old. Increasing exercise behavior is the only factor to improve their frailty status among older adults aged 75 years and over. Older adults should be encouraged to perform adequate physical exercise and maintain a healthy body weight to maintain the frailty status in younger old aged 65–74 years, and especially perform more frequent exercise to improve frailty status in older old over 75 years.

Abstract 10535: Relation of Multiple Low-Risk Lifestyle Behaviors With Cardiovascular Disease and All-Cause Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies

Introduction: The association of combined low-risk lifestyle behaviors (LRLBs) with cardiovascular disease (CVD) and all-cause mortality has not been systematically quantified. Objective: We undertook a systematic review and dose-response meta-analysis to assess the association of combined LRLBs with CVD and all-cause mortality. Methods: MEDLINE, EMBASE and Cochrane were searched up to December 29, 2021. Prospective cohort studies reporting the association between a minimum of 3 combined LRLBs (including healthy diet) with CVD, coronary heart disease (CHD) and stroke incidence and mortality were included. Independent reviewers extracted data and assessed study quality. Highest vs. lowest LRLB score was pooled using random effects. Heterogeneity was assessed (Cochran Q) and quantified (I 2 ). Global dose response meta-analysis (DRM) for maximum adherence was estimated using one-stage linear mixed model. The certainty of the evidence was assessed using GRADE. Results: 116 cohort comparisons (n=9,775,191) involving 382,922 cases were included. Comparing highest with lowest adherence LRLBs were associated with lower risk of CHD incidence (RR, 0.29 [95% CI, 0.21, 0.42]), stroke incidence (0.56 [0.50, 0.62]), CVD incidence (0.47 [0.37, 0.58]), CHD mortality (0.32 [0.25, 0.41]), stroke mortality (0.37 [0.30, 0.46]), CVD mortality (0.41 [0.34, 0.49]) and all-cause mortality (0.46 [0.41 to 0.52]). DRM analysis showed a linear association between LRLBs and all outcomes reaching a global DRM between 59-76% protection. LRLBs were defined with variable ranges as a healthy body weight (body mass index &lt;30kg/m 2 ), healthy diet (healthy diet score &gt;median), regular physical activity (1/week to &gt;30 minutes/day), smoking cessation (never smoked or smoking cessation), light alcohol intake (≤30g/day) and adequate sleep (5.5-9 hours). The certainty of the evidence was graded as moderate to high owing to downgrades for inconsistency and/or upgrades for a large magnitude of effect and significant dose-response gradient. Conclusions: Pooled analyses show that the combination of LRLBs was associated with a substantial lower risk of CVD outcomes and all-cause mortality. The available evidence provides a very good indication of the benefit of combined LRLBs.