Lifestyle Exercise Research Articles

Knowledge of Patients' Activation Level Changes Expert US Physicians' Communication in GERD Management.

Gastroesophageal reflux disease (GERD) is common. Treatment is to manage symptoms, but medication nonadherence is common. To date, little emphasis has been on understanding patient behaviors and reasons for medication nonadherence. We performed a cross-sectional survey study among expert gastroenterologists specializing in esophageal disease. Survey studies consisted of a 6-item questionnaire measuring physician knowledge of patient activation, the Clinician Support for Patient Activation Measure (CS-PAM), and an adapted 20-item Patient Assessment of Chronic Illness Care (PACIC). All question stems were specified to GERD management. Thirty-six experts participated. Most indicated hearing the term patient engagement before this survey (88.9%), but fewer were aware of the term patient activation (33.3%). Respondents were then made aware of the clinical significance of patient activation and asked, based on this knowledge, the likelihood that patients' activation level before the clinic would impact their communication. Responses varied between "to a great extent" and "not at all." Overall, CS-PAM activation scores were high, indicating a high level of support for patient activation. Lastly, respondents indicated their frequency of participating in partnership-building behaviors with patients. More than half (52.8%) of expert physicians "almost always" asked how GERD affected their lives, while less often asked patients about their health habits (22.2%), help set specific goals to improve their eating or exercise lifestyle (19.4%), or refer patients to a dietician, health educator, or counselor for their GERD (11.1%). Patient activation is an important strategy and may provide a behavioral approach to address medication adherence in GERD.

Effect of a two-only-meals-a-day and exercise lifestyle on HbA1c and anti-diabetic medication in a follow-up study of subjects with type 2 diabetes attending a free clinic in a north Maharashtra city.

Type 2 Diabetes (T2D) is a global challenge with rising prevalence, inadequate compliance, and poor outcomes. Assess the effect of a 2-only-daily-meals with exercise lifestyle (2-OMEX) on (a) HbA1c, (b) anti-diabetic medication count (ADMC), (c) Kcal intakes, body weight, fasting insulin, and subjective well-being. This is a single-arm follow-up study conducted in a free 2-OMEX clinic in 2019-2020. Information for two meals and exercise compliance was obtained during the clinic visit. HbA1c was tested by HPLC and fasting insulin by the CLIA/CMIA method in private laboratories. Eligible subjects (f = 49, m = 116) completing two or more visits and 60 days of follow-up had a mean age of 55.92 (10.43) years, a T2D duration of 8.20 (6.28) years, and a median observation period of 140 days. Statistically significant changes included HbA1c decline from 7.69 (1.70) to 7.00 (1.20) gm% (equivalent by the LogNormal method to 1.088 gm%), average weight loss at 5%(m), and 2%(f). ADMC declined from 2.32 to 2.14, the difference being significant with the WSR test (z = 2.0087, P = 0.0223). Subjects attaining anti-diabetic medication-free and normoglycemic status (HbA1c < 6.5 gm%) were 20 (12%). The number attaining HbA1c ≤ 7 gm%) significantly rose from 73 (44%) to 101 (61%) with an ADMC of 1.9 (chi-square = 9.531, df1, P = 0.0020203). Participants reported 'feeling energetic' (79%), feeling lighter (50%), and better sleep (35%). Average energy intakes dropped by 120 Kcal to 1580/day. Fasting insulin remained unchanged, from 12.61 (11.06) to 12.34 (11.78) mlU/L. The dropout rate was 35%. The 2-OMEX lifestyle showed a sizeable, favorable, and significant change in HbA1c, body weight, ADMC use in five months, and subjective benefits. Studies are necessary for remission impact and pathways.

A wellness intervention to address weight gain in people living with HIV

Abstract Background Dolutegravir-based antiretrovirals are the cornerstone of HIV treatment in LMICs but has shown to be associated with excessive (≥10%) weight gain. Increased body mass index combined with fat redistribution poses increased risk for diabetes, hypertension, and cardiovascular disease. The South African Diabetes Prevention Program (SA-DPP) is a lifestyle intervention program, including nutrition education, physical activity, and other risky behaviors and has been adapted to poorly resourced communities in Cape Town. We aimed to adapt the SA-DPP intervention for people living with HIV (PLWH) and assess its acceptability and feasibility. Methods PLWH and health staff were drawn from three primary health clinics in Cape Town (n = 35). Purposive sampling was used. Five focus groups (FG) with PLWH; two individual interviews (II) with PLWH; five interviews with health staff, including two II with medical doctors; two with a pair of nurses each and a group of three lay counsellors and three II with experts on diet and exercise lifestyle (n = 6). The FG and interviews explored two parts 1) PLWH experience of HIV treatment, their lifestyle issues, the education and support received from clinics and 2) review, evaluation and perspectives on the current SA-DPP intervention and tools. FG and interviews were transcribed and thematically analyzed. Results The SA-DPP curriculum was positively reviewed by PLWH and health staff. This included acceptability of the content and structure of the material. The content was deemed thorough and detailed in relation to nutrition and exercise. “The physical active part here, is something that I need in my life, this is something that I need in my health, the improve your sleep and the stress”. Practical in its approach, gave options within reach, in terms of availability and cost. Conclusions The intervention content was deemed accessible and covered all important areas. Experts thought it a resource PLWH could use over time and across illnesses. Key messages • This study provides insight into the challenges faced by PLWH in trying to live a healthier lifestyle. • The result of this study will translate into a healthy lifestyle intervention that can easily be adopted in the current primary health care set up for PLWH.

Familial Chylomicronemia Syndrome

Familial Chylomicronemia Syndrome is a severe and very rare metabolic disease characterized by chylomicronemia associated with recurrent episodes of abdominal pain and/or pancreatitis. The worldwide estimate is that Familial Chylomicronemia Syndrome occurs in one for every 500,000 to 1,000,000 people. It often manifests in childhood or adolescence and has been described in all ethnicities, with higher prevalence in some geographic areas, such as Quebec, due to the founder effect. Male patient, 40 years old, accountant, married, father of two daughters (1 and 4 years). Since the age of four, he knows how to have very high triglyceride values by warning from the laboratory. Genetic analysis confirmed deficiency of lipoprotein lipase. Pediatricians recommended the dietary and exercise lifestyle. As a teenager, he had pancreatitis when triglyceride levels reached 5,000 mg/dL. The patient does not present cardiovascular risk factors. We were wanted about three years ago when a second sister with the same condition died. It is noteworthy that his parents are first cousins. After therapeutic trials, little benefit was noticed. In association with the direction of hematology, we began to prescribe weekly and later biweekly dialysis. Since the emergence of volanesorsena, we have been prescribing it. Although its use in this patient is recent, six months, the results showed an important and significant reduction.

Diagnostics of inflammaging in relation to sarcopenia.

One of the theories about aging focuses on the immune response and relates to the activation of subclinical and chronic inflammation. This study was designed to investigate the relationship between inflammation and sarcopenia and to evaluate the influence of lifestyle on the inflammatory profile. Finally, therapeutic strategies to counteract the pathophysiological effect of skeletal muscle aging were also indicated. One hundred seventy-three individuals aged 71.5 ± 6.8 years were divided into two groups: sarcopenia and probable sarcopenia (n = 39) and no sarcopenia (n = 134). Sarcopenia was assessed according to the algorithm of the European Working Group on Sarcopenia in the older adults 2. C-reactive protein (CRP) (p = 0.011) and CRP/albumin ratio (p = 0.030) as well as IL-1β (p = 0.002), cfDNA (p < 0.001) and bilirubin levels (p = 0.002) were significantly higher in the sarcopenia group as opposed to the no sarcopenia group. No significant differences were observed between groups in the concentration of TNFα (p = 0.429) and IL-6 (p = 0.300). An inverse correlation was found between gait speed and cfDNA (rs = -0.234, p < 0.01) and IL-1β (rs = -0.263, p < 0.01). The ROC analysis of cfDNA, CRP, IL-1β and bilirubin ranged from 0.6 to 0.7, which confirms the association between sarcopenia and inflammatory mediators and indicates high clinical usefulness of cfDNA and bilirubin in sarcopenia prediction. We also indicated a link between inflammation and fitness level in the older adult thereby providing evidence that lifestyle exercise should be a key therapeutic strategy in sarcopenia prevention.

P484 Inflammatory Bowel Disease exercise and diet habits (IBDeat) study: chronic metabolic disease risk factors among IBD patients in New Zealand

Abstract Background Recent literature shows that patients with inflammatory bowel disease (IBD) are at higher risk of developing chronic metabolic diseases which may be amenable to a healthy lifestyle. However, this may be challenging for IBD patients as disease symptoms may result in unfavourable lifestyle habits such as avoidance of healthy foods and reduced physical activity. In this study, we aim to describe the nutritional status and lifestyle habits of adults with IBD in New Zealand (NZ). Methods A cross-sectional nationwide study was undertaken from December 2021 to October 2022 in NZ. Participants were recruited through social media and the Dunedin public hospital patient database. An online questionnaire collected demographics, disease severity scores (harvey-bradshaw index and simple clinical colitis activity index), quality of life (QoL), physical activity, and dietary intake data. A subset of patients living in Dunedin had anthropometrics, handgrip strength, blood pressure, body composition (bioelectrical impedance), blood nutritional markers (lipid profile, iron studies, vitamin D, vitamin B12, folate) and faecal calprotectin measured. Descriptive analysis was conducted and data were compared to population reference values. The study received University of Otago, Dunedin, NZ ethical approval (reference: H21/135). Results The questionnaire was completed by 197 adults, median age 37 (IQR 25, 51) of which 72% were female and predominantly NZ European ethnicity (82.4%). In this IBD cohort, 54% had Crohn’s disease and 46% had ulcerative colitis or IBD-unspecified with quiescent-mild disease activity. Two-thirds of patients had at least one comorbidity aside from IBD and one-third of patients had impaired QoL (defined by a score &amp;lt;45). Most patients had nutritional risk factors including low intakes of fruits (91.3%), vegetables (94.4%), fibre (38.3%), and excessive intakes of fat (73.2%) and saturated fat (98.0%). Two-thirds of patients reported IBD-related barriers to exercise mainly due to fatigue (53.9%), abdominal pain (25.7%), bowel incontinence (23.3%), and joint pain (22.3%) in which only 59.7% met national physical activity recommendations. The Dunedin cohort (n=102) had further chronic metabolic disease risk factors such as central adiposity (63.7%), high body fat percentage (43.9%), high cholesterol/HDL ratio (29.3%), high blood pressure (26.5%), and poor handgrip strength (43.9%). Conclusion Findings suggest that NZ adults with IBD have multiple risk factors for chronic metabolic diseases that could be amendable to lifestyle interventions. Future studies should explore the feasibility and efficacy of nutrition and exercise lifestyle interventions to mitigate these risk factors.

Menopause Osteoporosis and Bone Intervention Using Lifestyle Exercise: A Randomized Controlled Study.

The aim of the study was to examine the feasibility for postmenopausal women of a bone-strengthening jumping intervention, which has been previously successful for premenopausal women. Forty-nine participants (mean ± standard deviation [SD] age = 57.8 ± 4.3 years) were randomized into either an exercise intervention or sham-control group in a double-blinded fashion. The intervention consisted of 10 maximal, rest-inserted countermovement jumps, performed three times a week on a hard surface without shoes for 8 months. Sham-control participants performed unilateral balance exercises of equivalent duration. The jumps were well tolerated, with women in the jumping group completing 95% of the prescribed exercise. Of the participants who completed the study (n = 23 intervention, n = 16 control), there were no significant differences in broadband ultrasound attenuation (BUA) using quantitative ultrasound (QUS) of the calcaneum within and between groups (mean ± SD BUA = 64.9 ± 7.3 and 66.6 ± 6.5 dB/MHz for intervention pre- and post-trial, respectively, versus mean ± SD BUA = 63.6 ± 4.2 and 64.4 ± 4.5 dB/MHz for sham-controls pre- and post-trial, respectively) or for any QUS parameters, although there was a 3% increase in BUA for intervention participants. Recruitment and participation rates were feasible for this duration of study and the exercise was acceptable. For a future study of this nature, 48 participants would be required to ensure adequate power, especially as lifestyle variations and post-menopausal hypoestrogenism prevent substantial gains in bone strength with high-impact exercise.

Enhancing Physical and Psychological Wellbeing of Patients with End-stage Renal Disease: A Pilot In-hospital Tai Chi Group Intervention in Hong Kong

This article presents a pilot group intervention to assist end-stage renal disease (ESRD) patients in developing a regular exercise lifestyle, enhance their wellbeing, and promote mutual support. Sixteen patients with ESRD aged between 45 and 65 participated in the five-week group intervention based on the Eastern Body-Mind-Spirit model with Tai Chi components at a public hospital in Hong Kong. A mix-method approach was used to assess the attainment of objectives: (1) participants were asked to report their frequency and duration of physical exercises outside of the group; (2) the Personal Wellbeing Index – Adult (Cantonese) 4th edition was used to measure the quality of life of the participants; (3) a general group evaluation form was used to evaluate participants’ satisfaction with the group; and (4) observations by the medical social workers during the group and sharing sessions, feedback from the participants, the Tai Chi Instructor, and medical team members of the renal ward were collected to determine the level of mutual support among participants. The group showed promising results: (1) the average time group members spent exercising outside the group increased by 24%; (2) rapport was apparent among most group members; (3) communication between the patients and the medical team was enhanced; and (4) paired sample t-test showed a significant average difference between pre- and post-group Personal Wellbeing scores of the participants (t = -2.9, df = 12, p = 0.01). It is suggested to scale up the intervention and conduct follow-ups to determine the most suitable group duration and format.

The Role of Physical Education in Preventing Unhealthy Lifestyles in Immigrant Adolescents.

In recent years, migratory phenomena have changed the composition of Spanish society. There are many studies that explore the healthy habits of young adolescents, but few focus on young immigrants. The purpose of this study is to examine the causal relationships between certain factors that influence the health of immigrant youth and sports. The sample consisted of 173 students enrolled in secondary education in the city of Cuenca. The structural model confirms the relationship between the latent variables and sports. Specifically, we obtained a positive influence of an active lifestyle (regular physical activity and exercise) and a negative influence for the remaining variables (alcohol consumption, unhealthy foods, self-medication and tobacco consumption in the family). Physical education should promote healthy lifestyles; greater coordination between physical education and other subjects involved in education and the promotion of health are necessary because we consider that this task is not exclusive to physical education.

MO798: Impact of Body Composition on Erythropoietin Resistance Index in Patients Receiving Chronic Hemodialysis

Abstract BACKGROUND AND AIMS Erythropoietin resistance index (ERI) seems to be a predictor for adverse outcomes in patients receiving chronic hemodialysis. Despite the role of erythropoietin in non-hematopoietic tissues such as skeletal muscle or fat, clinical studies investigating the association between body composition and ERI are still lacking. The aim of this study was to examine the longitudinal impact of body composition on ERI in patients on chronic hemodialysis. METHOD This study included outpatients on chronic hemodialysis who received body composition analysis, which was performed every 6 months. The ERI was calculated by dividing the weekly body weight-adjusted erythropoietin dose by the hemoglobin concentration, and the values were averaged every 3 months period. The relationship between body composition and baseline ERI was evaluated in the multiple linear regression analysis, and the trend of ERI over time according to the changes in body composition was analyzed using a linear mixed effect model. RESULTS There were 65 (52.8%) men and 58 (47.2%) women, and they were followed up for 24 (5, 75) months. Subjects with higher mean ERI during the study period had increased risks for all-cause death, cardiovascular events and infection requiring hospitalization, compared with those with lower mean ERI (P = .009, .076 and .051). Linear regression analyses found that the ERI was negatively correlated to body mass index, % body fat, arm circumference, arm muscle circumference, and visceral fat area (P = .067, .065, .002, .021 and .040). However, the ratio of extracellular water to total body water and skeletal muscle mass index was not related to ERI. The longitudinal trend of ERI was compared according to the slope of body composition parameters over time. The increase in ERI was associated with the increase in the ratio of extracellular water to total body water (P = .007). On the other hand, the trajectory of ERI was inversely related to the longitudinal changes in arm circumference, arm muscle circumference and visceral fat area (P = .002, P &amp;lt; .001 and P = .026). CONCLUSION The ERI seems to be associated with body composition; therefore, body composition analysis can be useful to predict erythropoietin resistance in patients receiving chronic hemodialysis. Further studies are needed to investigate whether lifestyle modifications, including nutrition and exercise, can result in positive effects on body composition and responsiveness to erythropoietin.

Adherence to a Multidisciplinary Lifestyle Program for Patients With Atrial Fibrillation and Obesity: Feasibility Study.

BackgroundAtrial fibrillation is commonly associated with obesity. Observational studies have shown that weight loss is associated with improved prognosis and a decrease in atrial fibrillation frequency and severity. However, despite these benefits, nonadherence to lifestyle programs is common.ObjectiveIn this study, we evaluated adherence to and feasibility of a multidisciplinary lifestyle program focusing on behavior change in patients with atrial fibrillation and obesity.MethodsPatients with atrial fibrillation and obesity participated in a 1-year goal-oriented cardiac rehabilitation program. After baseline assessment, the first 3 months included a cardiac rehabilitation intervention with 4 fixed modules: lifestyle counseling (with an advanced nurse practitioner), exercise training, dietary consultation, and psychosocial therapy; relaxation sessions were an additional optional treatment module. An advanced nurse practitioner monitored the personal lifestyle of each individual patient, with assessments and consultations at 3 months (ie, immediately after the intervention) and at the end of the year (ie, 9 months after the intervention). At each timepoint, level of physical activity, personal goals and progress, atrial fibrillation symptoms and frequency (Atrial Fibrillation Severity Scale), psychosocial stress (Generalized Anxiety Disorder–7), and depression (Patient Health Questionnaire–9) were assessed. The primary endpoints were adherence (defined as the number of visits attended as percentage of the number of planned visits) and completion rates of the cardiac rehabilitation intervention (defined as performing at least of 80% of the prescribed sessions). In addition, we performed an exploratory analysis of effects of the cardiac rehabilitation program on weight and atrial fibrillation symptom frequency and severity.ResultsPatients with atrial fibrillation and obesity (male: n=8; female: n=2; age: mean 57.2 years, SD 9.0; baseline weight: mean 107.2 kg, SD 11.8; baseline BMI: mean 32.4 kg/m2, SD 3.5) were recruited. Of the 10 participants, 8 participants completed the 3-month cardiac rehabilitation intervention, and 2 participants did not complete the cardiac rehabilitation intervention (both because of personal issues). Adherence to the fixed treatment modules was 95% (mean 3.8 sessions attended out of mean 4 planned) for lifestyle counseling, 86% (mean 15.2 sessions attended out of mean 17.6 planned) for physiotherapy sessions, 88% (mean 3.7 sessions attended out of mean 4.1 planned) for dietician consultations, and 60% (mean 0.6 sessions attended out of mean 1.0 planned) for psychosocial therapy; 70% of participants (7/10) were referred to the optional relaxation sessions, for which adherence was 86% (mean 2 sessions attended out of mean 2.4 planned). The frequency of atrial fibrillation symptoms was reduced immediately after the intervention (before: mean 35.6, SD 3.8; after: mean 31.2, SD 3.3), and this was sustained at 12 months (mean 24.8, SD 3.2). The severity of atrial fibrillation complaints immediately after the intervention (mean 20.0, SD 3.7) and at 12 months (mean 9.3, SD 3.6) were comparable to that at baseline (mean 16.6, SD 3.3).ConclusionsA 1-year multidisciplinary lifestyle program for obese patients with atrial fibrillation was found to be feasible, with high adherence and completion rates. Exploratory analysis revealed a sustained reduction in atrial fibrillation symptoms; however, these results remain to be confirmed in large-scale studies.

Development and validation of the Health Education Adherence Scale for Stroke Patients: a cross-sectional study

BackgroundDue to the lack of health education adherence assessment tools for stroke patients, the assessment of health education adherence in this population is insufficient, which hinders the prevention and rehabilitation of stroke. This study aims to develop and validate a Health Education Adherence Scale for Stroke Patients (HEAS-SP).MethodsA cross-sectional design with a purposive sampling method was used for this study. Six hundred and fifty-four eligible participants completed the demographic questionnaire and the HEAS-SP. The data collection lasted for 7 months, from March 1stto September 30th in 2019. Item analysis and exploratory and confirmatory factor analysis were employed to develop and validate the HEAS-SP.ResultsThe item analysis, exploratory and confirmatory factor analysis resulted in a 20-item HEAS-SP with 4 domains: medication adherence, diet adherence, rehabilitation exercise adherence, and healthy lifestyle adherence. The four-domain model demonstrated acceptable model fit indexes and the 20-item HEAS-SP demonstrated acceptable reliability and validity.ConclusionThe 20-item HEAS-SP was shown to have acceptable reliability and validity for assessing health education adherence with respect to diet, medication, rehabilitation exercise and healthy lifestyle in stroke patients, making it a potential basis for developing targeted interventions for stroke patients.

Exposure to O3 and NO2 in physically active adults: an evaluation of physiological parameters and health risk assessment.

The gaseous air pollutants ozone (O3) and nitrogen dioxide (NO2) have a large public health relevance and trigger environmental health risk. On the other hand, despite the health benefits, exercise practices might increase the susceptibility to air pollutants exposure. However, there are innumerous lifestyle factors besides physical activity habits that must be considered in the daily air pollution exposure and are still not fully comprehended. This study aimed to evaluate the effects of O3 and NO2 exposure on cardiorespiratory fitness, lipid accumulation product (LAP), and environmental health risk during the entire daily routine of physically active adults that exercise in outdoor and indoor environments. One hundred and twenty healthy young men were assigned to untrained (n = 52), indoor exercise (n = 36), and outdoor exercise (n = 32) groups, following their lifestyle exercise habits, and O3 and NO2 were assessed by personal monitoring. Exercised groups demonstrated higher healthy eating index (HEI) (p < 0.001), physical activity (PA) (p < 0.001), metabolic equivalent of task (MET) (p < 0.001), and peak oxygen uptake VO2peak (p < 0.001), while outdoor group had lower LAP index (p < 0.001) and higher O3 concentration (p = 0.0442). Environmental health risk demonstrated no difference (p > 0.05). The higher O3 concentration was positively correlated with the risk quotient (p = 0.003) and MET (p = 0.020), and a negative correlation between LAP and VO2peak was observed (p < 0.001). In conclusion, physically active individuals might have a lower risk of developing cardiovascular and metabolic diseases despite the higher O3 concentration exposure, and the exposure during exercise did not represent an additional health risk.

Population study of the gut microbiome: associations with diet, lifestyle, and cardiometabolic disease

BackgroundThe human gut harbors trillions of microbes that play dynamic roles in health. While the microbiome contributes to many cardiometabolic traits by modulating host inflammation and metabolism, there is an incomplete understanding regarding the extent that and mechanisms by which individual microbes impact risk and development of cardiovascular disease (CVD). The Framingham Heart Study (FHS) is a multi-generational observational study following participants over decades to identify risk factors for CVD by correlating genetic and phenotypic factors with clinical outcomes. As a large-scale population-based cohort with extensive clinical phenotyping, FHS provides a rich landscape to explore the relationships between the gut microbiome and cardiometabolic traits.MethodsWe performed 16S rRNA gene sequencing on stool from 1423 participants of the FHS Generation 3, OMNI2, and New Offspring Spouse cohorts. Data processing and taxonomic assignment were performed with the 16S bioBakery workflow using the UPARSE pipeline. We conducted statistical analyses to investigate trends in overall microbiome composition and diversity in relation to disease states and systematically examined taxonomic associations with a variety of clinical traits, disease phenotypes, clinical blood markers, and medications.ResultsWe demonstrate that overall microbial diversity decreases with increasing 10-year CVD risk and body mass index measures. We link lifestyle factors, especially diet and exercise, to microbial diversity. Our association analyses reveal both known and unreported microbial associations with CVD and diabetes, related prescription medications, as well as many anthropometric and blood test measurements. In particular, we observe a set of microbial species that demonstrate significant associations with CVD risk, metabolic syndrome, and type 2 diabetes as well as a number of shared associations between microbial species and cardiometabolic subphenotypes.ConclusionsThe identification of significant microbial taxa associated with prevalent CVD and diabetes, as well as risk for developing CVD, adds to increasing evidence that the microbiome may contribute to CVD pathogenesis. Our findings support new hypothesis generation around shared microbe-mediated mechanisms that influence metabolic syndrome, diabetes, and CVD risk. Further investigation of the gut microbiomes of CVD patients in a targeted manner may elucidate microbial mechanisms with diagnostic and therapeutic implications.

Abstract 10496: Cardiac Function in Postmenopausal Women Are Unaltered by Two Decades of Different Physical Activity Levels

Rationale: In women, the risk of coronary heart disease increases significantly after the onsetof menopause. Exercise and active lifestyle have known benefits such as a significantly reducedrisk of heart failure. To date, most of the knowledge on physical activity induced changes incardiac function in older individuals are based on males and with a sparsity of data from healthypostmenopausal women with differing physical activity and fitness. Aim: The aim was to determine the impact of more than twenty years of differing physicalactivity levels and maximal oxygen consumption on cardiac morphology and function inpostmenopausal women. Method: The study design was cross-sectional with age-matched non-smoking, non-medicatedhealthy women divided in to three groups based on their self-reported physical activity levelwith regard to intensity and volume over the past two decades. Forty-one women was included(age of 61 ± 1 years; 11 ± 2 postmenopausal years; body mass index 23 ± 3 kg • m 2 ) and dividedinto groups based on activity level categorized as sedentary (SED; ≤1 h exercise weekly; n=14);Moderate (MOD; ≥2 ≤6h low/moderate intensity exercise weekly; n=12) and high (HIGH; &lt;4h of moderate/high intensity exercise weekly; n=15). Cardiac function and dimensions wereassessed with transthoracic echocardiography and maximal pulmonary oxygen uptake wasdetermined by graded bike ergometer exercise to exhaustion. Results: The three groups displayed significantly different levels of maximum oxygen uptake(24.9 ± 5.8; 30.5 ± 5.8; 38.4 ± 4.4 ml/kg, for SED, MOD and HIGH respectively) (p &lt; 0.01).No differences were observed in resting left ventricular (LV) morphology (LVmass, LVmassindex) systolic function (EF%, GLS and mitral valve S′), diastolic function (E/A ratio, IVRT)or right ventricular function (TAPSE and tricuspid annular velocity S’) between the threegroups. Conclusions: These data show that the level of lifelong physical activity and correspondingdifferences in maximal oxygen consumption, may have less impact on left ventricularmorphology and systolic/diastolic function in healthy postmenopausal women than previouslyexpected.

The Association of Anti-Inflammatory Diet Ingredients and Lifestyle Exercise with Inflammaging.

One of the latest theories on ageing focuses on immune response, and considers the activation of subclinical and chronic inflammation. The study was designed to explain whether anti-inflammatory diet and lifestyle exercise affect an inflammatory profile in the Polish elderly population. Sixty individuals (80.2 ± 7.9 years) were allocated to a low-grade inflammation (LGI n = 33) or high-grade inflammation (HGI n = 27) group, based on C-reactive protein concentration (<3 or ≥3 mg/L) as a conventional marker of systemic inflammation. Diet analysis focused on vitamins D, C, E, A, β-carotene, n-3 and n-6 PUFA using single 24-h dietary recall. LGI demonstrated a lower n-6/n-3 PUFA but higher vitamin D intake than HGI. Physical performance based on 6-min walk test (6MWT) classified the elderly as physically inactive, whereby LGI demonstrated a significantly higher gait speed (1.09 ± 0.26 m/s) than HGI (0.72 ± 0.28 m/s). Circulating interleukins IL-1β, IL-6, IL-13, TNFα and cfDNA demonstrated high concentrations in the elderly with low 6MWT, confirming an impairment of physical performance by persistent systemic inflammation. These findings reveal that increased intake of anti-inflammatory diet ingredients and physical activity sustained throughout life attenuate progression of inflammaging in the elderly and indicate potential therapeutic strategies to counteract pathophysiological effects of ageing.

The Effects of Diet and Exercise on Endogenous Estrogens and Subsequent Breast Cancer Risk in Postmenopausal Women.

Endogenous estrogens have been associated with overall breast cancer risk, particularly for postmenopausal women, and ways to reduce these estrogens have served as a primary means to decrease overall risk. This narrative review of clinical studies details how various nutritional and exercise lifestyle interventions have been used to modify estrogen levels and metabolism to provide a protective impact against breast cancer incidence. We also summarized the evidence supporting the efficacy of interventions, outcomes of interest and identified emerging research themes. A systematic PubMed MEDLINE search identified scholarly articles or reviews published between 2000-2020 that contained either a cohort, cross-sectional, or interventional study design and focused on the relationships between diet and/or exercise and overall levels of different forms of estrogen and breast cancer risk and occurrence. Screening and data extraction was undertaken by two researchers. Data synthesis was narrative due to the heterogeneous nature of studies. A total of 1625 titles/abstracts were screened, 198 full texts reviewed; and 43 met eligibility criteria. Of the 43 studies, 28 were randomized controlled trials, and 15 were observational studies. Overall, studies that incorporated both diet and exercise interventions demonstrated better control of detrimental estrogen forms and levels and thus likely represent the best strategies for preventing breast cancer development for postmenopausal women. Some of the strongest associations included weight loss via diet and diet + exercise interventions, reducing alcohol consumption, and consuming a varied dietary pattern, similar to the Mediterranean diet. More research should be done on the effects of specific nutritional components on endogenous estrogen levels to understand the effect that the components have on their own and in combination within the diet.

Иммунобиологические препараты в терапии ревматических заболеваний

Ревматические заболевания (РЗ) являются одними из самых распространенных хронических заболеваний опорно-двигательного аппарата и соединительной ткани, которые встречаются как у взрослых, так и у детей. Причиной этих патологических состояний могут быть изменения в функционировании иммунной системы, воспаление, инфекции и другие факторы. В некоторых случаях они приводят к инвалидности и оказывают значительное влияние на качество и продолжительность жизни. Существуют нефармакологические и фармакологические методы лечения РЗ. Первая линия (нефармакологическая) лечения большинства РЗ состоит в изменении образа жизни (физические упражнения, правильное питание, отказ от курения). К фармакологическому стандартному лечению относятся нестероидные противовоспалительные препараты (НПВП), глюкокортикоиды, противоревматические препараты, которые подавляют реакцию острой фазы, способствуют снижению уровня аутоантител. К сожалению, хотя НПВП и помогают контролировать симптомы РЗ, уменьшая боль, отек и воспаление, тем не менее они не замедляют прогрессирование заболевания. Это относится и к глюкокортикоидам, которые являются противовоспалительными гормонами, связанными с кортизолом — стероидом, вырабатываемым естественным путем в организме. Несмотря на свои преимущества, глюкокортикоиды дают значительные побочные эффекты, включающие диабет, остеопороз, гипертонию, катаракту и подверженность инфекциям. За последние годы получены новые данные о патогенезе ревматических заболеваний, что способствовало возможности создания инновационных иммунобиологических препаратов. Разработка таких лекарственных средств произвела революцию в терапевтическом подходе при хронических ревматических заболеваниях, особенно у пациентов, устойчивых к стандартному лечению. Механизм действия этих иммунобиологических препаратов основан на целенаправленном ингибировании специфических или молекулярных мишеней, непосредственно вовлеченных в патогенез заболевания. К ним относятся блокаторы фактора некроза опухоли, антагонисты интерлейкинов-1, -6, -17А, блокаторы CD20, CD80/CD86, ингибитор Т-клеточной костимуляции. Их использование позволяет улучшить прогноз и достичь клинической ремиссии у значительного количества пациентов.

Relationship between the exercise and severity of androgenic alopecia.

Androgenic alopecia (AGA) is the most common type of alopecia. At present, the study on AGA mostly focuses on drugs, laser technology and hair transplantation, while the lifestyle factor that may delay the course of AGA and improve the condition of AGA is neglected. This study aims to investigate the relationship between the exercise and severity of androgenic alopecia, and to help AGA patients to choose suitable forms and amounts of exercise. Patients, who were diagnosed with AGA from May 13, 2020 to August 25, 2020, were the subjects of the survey. Through the internet online questionnaire survey, the information regarding demographics, exercise forms (lifestyle exercises, stretching exercises, aerobic exercises, and anaerobic exercises), exercise frequency (0-2 times/week, 3-4 times/week, and 5-7 times/week), exercise duration (<30, 30-60, and >60 min/time), and family history (androgenic alopecia, alopecia areata, and scarring alopecia) was obtained. Combination of patient self-assessment and doctor's photo examination was used to evaluate the changes (improvement, aggravation, and natural course) of the condition after 6 months of exercise. Single factor analysis and logistic regression analysis were used to study the factors related to the changes before and after exercise. A total of 592 AGA patients were recruited. Among them, 215 were male patients (36.32%), and 377 were female patients (63.68%); 91 patients (15.37%) were improved after 6 months of exercise, 448 patients (75.68%) were in natural progress, and 53 patients (8.95%) were aggravated. A total of 439 AGA patients were involved in non-life sports. After 6 months of exercise, 137 patients (31.21%) with scalp itching and scaling were reduced, 65 patients (14.81%) with greasy scalp was reduced, and 204 patients (46.47%) with anxiety and depression symptoms were improved compared with the previous period, and 356 patients (81.10%) showed that their sleep quality was improved compared with before. The changes in the condition before and after exercise are related to exercise style (P<0.001), exercise frequency (P=0.033), exercise duration (P=0.044), but not related to gender (P=0.358) and family history (P=0.052). The degree of improvement in AGA patients, who performed aerobic exercise, was 5.416 times of those who only performed life-like exercises (OR=5.416, P<0.001); the degree of improvement in AGA patients with each exercise time >60 min was 3.106 times of those with each exercise time <30 min (OR=3.106, P=0009). Doing aerobic exercise or each exercise time >60 min helps to delay the progress of AGA and improve the symptom of AGA.

Adherence to a Lifestyle Exercise and Nutrition Intervention in University Employees during the COVID-19 Pandemic: A Randomized Controlled Trial.

Healthy lifestyles should be encouraged in the workplace through the occupational health teams of the companies. The objective of the present study was to evaluate the adherence to a lifestyle intervention carried out in university employees during the COVID-19 pandemic and its impact on health-related quality of life (HrQoL). A randomized controlled trial following the CONSORT guidelines was performed, consisting of three supervised interventions lasting for 18 weeks: an educational intervention on healthy habits, a nutritional intervention, and a telematic aerobic and strength exercise intervention. Lifestyle and HrQoL were analyzed six months post-intervention to assess adherence. Twenty-three middle-aged participants completed the study. The intervention group significantly improved their lifestyle according to the Health Promoting Lifestyle Profile II questionnaire, especially in the categories of Health Responsibility, Physical Activity, and Nutrition, with a large effect size. Sitting time was reduced by 2.5 h per day, with a moderate effect size. Regarding HrQoL, the intervention group showed a clinically significant improvement in the Physical Component Summary. Despite the lockdown and the mobility restrictions caused by the COVID-19 pandemic, this intervention performed on university employees achieved adherence to a healthier lifestyle and improved their HrQoL, which is of great clinical relevance.