Lifestyle-related Diseases Research Articles

The role of the Mediterranean Diet in preventing the development and complications of lifestyle diseases – a Review

IntroductionThe Mediterranean diet, inspired by traditional dietary habits of the Mediterranean region, exhibits anti-inflammatory and protective effects, reducing the risk of civilization diseases such as obesity, type 2 diabetes, and cardiovascular disorders. This diet is characterized by a high intake of plant-based foods, olive oil, and moderate consumption of fish and dairy products. These components provide unsaturated fatty acids, polyphenols, and antioxidants, which positively impact metabolic health and lower the risk of chronic diseases. In the face of the global obesity epidemic and an increasing number of individuals affected by lifestyle-related diseases, the Mediterranean diet offers a promising tool to support a healthy lifestyle. Aim of study This article aims to review current scientific studies evaluating the potential of the Mediterranean diet in preventing and managing civilization diseases. Particular attention is given to its effects on weight loss, improvements in glycemic markers, reductions in low density lipoproteins (LDL) cholesterol levels, and blood pressure control. The article also explores its benefits for athletes' health, as well as its potential to reduce oxidative stress and inflammatory states. Material and methods A literature review of the PubMed database was conducted, assessing relevant studies on the Mediterranean diet and its impact on lifestyle diseases.

Abstract 4132120: Down syndrome-trisomy-mediated gene, Dscr-1, protects against lifestyle-related vascular diseases

Epidemiological studies indicate that individuals with Down syndrome (DS) have an increased risk of leukemia and neuronal diseases but a significantly reduced incidence of most solid tumors and advanced vascular dysfunction. This suggests that one or a combination of trisomy genes on human chromosome 21 (HSA21) or murine chromosome 16 ( Mmu16 ) may be responsible for protecting against vasculopathy. Our previous research has shown that the Down syndrome critical region (Dscr)-1 gene, located on HSA21 or Mmu16 , encodes a feedback modulator of calcineurin-NFAT signaling in endothelial cells (ECs). Null mutation or overexpression of Dscr-1 has been found to increase or prevent septic mortality, angiogenesis, liver steatosis, and susceptibility of tumor metastasizing to the lung, respectively, demonstrating its significant role in these processes. In a unique approach, we crossed DS model mice with ApoE -null mice and fed them a high-fat diet (HFD) for 12 weeks to survey the effects of DS-related genes on atherosclerosis. The results were striking, with HFD-mediated increased LDL and triglyceride levels in ApoE -null mice significantly reduced in the combined DS plus ApoE -null mice. This innovative method allowed us to observe a remarkable (~35%) reduction in ApoE-null mediated atheroma formation in the DS model. This finding was also replicated in EC-specific DSCR-1 transgenic (DSCR-1 ECTg ) mice. Furthermore, to test the effect of HSA21, we have collected DS patient-derived trisomy and disomy iPS cells and executed them for the chromatin conformation capture analysis and the in vitro ECs differentiation experiments. DS-derived trisomy iPS cells already changed the whole chromatin structure, typically within the X chromosome. Moreover, the trisomy iPS-derived ECs revealed less proliferation compared to the disomy. RNA-seqs indicated trisomy iPS derived ECs dramatically (21-fold) increased DSCR-1 , but some HSA21 genes, Alzheimer’s related App and Bace2 , e.g., were inversely reduced the expression. Our comprehensive studies not only shed new light on the mechanisms of atherosclerosis in vascular pathology but also offer potential therapeutic strategies. The discovery of the Dscr-1 gene on the DS chromosome, which could be a powerful tool in combating lifestyle-related vascular diseases, underscores the significance of our research.

Vegetable Salad Improves Lipid and Glucose Metabolism and Enhances Absorption of Specific Nutrients in Vegetables

Vegetables are low in energy and rich in vitamins, minerals, and dietary fiber; various health benefits associated with their intake have been reported. Salads are one of the most convenient ways to consume vegetables and can be made simply by pouring mayonnaise, dressing, olive oil, or other condiments over a selection of vegetables. There are also many reports on the ways in which vegetable intake can improve health. However, there is no comprehensive review summarizing the health functions of vegetables when consumed as a salad. The effects of vegetable salads on amounts of vegetable intake, lifestyle-related diseases, and the absorption of specific nutrients through mayonnaise, as well as the effects of the order in which vegetable salad and carbohydrates are consumed, have been reported. In this review, the health functions of vegetable salad consumption are reported.

Toxic AGEs (TAGE) Cause Lifestyle-Related Diseases

Advanced glycation end-products (AGEs) play a role in the onset/progression of lifestyle-related diseases (LSRD), suggesting that the suppression of AGE-induced effects can be exploited to prevent and treat LSRD. However, AGEs have a variety of structures with different biological effects. Glyceraldehyde (GA) is an intermediate of glucose, and fructose metabolism and GA-derived AGEs (GA-AGEs) have been associated with LSRD, leading to the concept of toxic AGEs (TAGE). Elevated blood TAGE levels have been implicated in the onset/progression of LSRD; therefore, the measurement of TAGE levels may enable disease prediction at an early stage. Moreover, recent studies have revealed the structures and degradation pathways of TAGE. Herein, we provide an overview of the research on TAGE. The TAGE theory provides novel insights into LSRD and is expected to elucidate new targets for many diseases.

Differences in the effects of exercise on blood pressure depending on the physical condition of the subject and the type of exercise: a systematic review and meta-analysis.

Although hypertension is a major cause of cardiovascular disease, the control of blood pressure (BP) is insufficient worldwide. Exercise is an effective treatment for reducing BP, but the differences in the blood pressure lowering effects of exercise according to the underlying pathophysiological condition, the type of exercise, and the geographic region are not fully understood. An umbrella review with a meta-analysis of 435 randomized controlled trials that investigated the BP-lowering effects of exercise was performed using Ovid MEDLINE and the Cochrane Library, covering the period from inception to August 1, 2023. A random effects model meta-analysis was performed to estimate the effect size across multiple studies. Exercise significantly reduced systolic BP in healthy subjects (-3.51 mmHg, 95% confidence interval: -3.90, -3.11; p < 0.001) and in those with lifestyle-related diseases including hypertension (-5.48 mmHg, -6.51, -4.45; p < 0.001), but not in those with cardiovascular diseases (-1.16 mmHg, -4.08, 1.76; p = 0.44). According to the type of exercise, all types significantly reduced systolic BP in healthy subjects and in those with lifestyle-related diseases, but not in those with cardiovascular diseases. According to the region, in Oceania, there were no reductions in systolic BP. In Asia, systolic BP was reduced in patients with cardiovascular diseases. In conclusion, any type of exercise reduced BP in healthy subjects and in those with lifestyle-related diseases, but not in those with cardiovascular diseases, and the region affected the effect of exercise. When using exercise to reduce hypertension, it is important to consider the patient's pathophysiological condition and the region.

An umbrella review of meta-analysis to understand the effect of coffee consumption and the relationship between stroke, cardiovascular heart disease, and dementia among its global users

ABSTRACT Coffee has long been popular worldwide. The rise in lifestyle-related diseases such as cardiovascular disease, diabetes, stroke, dementia, and others has motivated coffee usage and illness prevalence studies. Some studies show coffee consumers are at risk for such diseases, whereas others show its active components protect them. Policymakers and the public need a comprehensive umbrella review to make healthy choices and enjoy coffee. Coffee consumption and stroke, CHD, and dementia outcomes have been distinguished using the PICO search strategy in PubMed with a filter for meta-analysis. We included 10 years of investigations until October 2023. MeSH terms “coffee intake,” “stroke, dementia,” and “transient ischemic attack,” comparing stroke risk with coffee consumption were used. The study excluded case reports and non-human, non-English observational research. The stroke risk of coffee was examined using RevMan software. Coffee consumption’s stroke risk ratio (RR), 95% CI, and I2 were estimated. Forest plots with P values ≤ 0.05 are significant. The umbrella review includes 11 meta-analyses from 457052 papers, totalling 11.96 million individuals. Drinking up to 4 cups of coffee daily reduced stroke risk by 12% compared with not drinking any coffee (0.88 (CI of 0.84-0.92, I2 of 13%, P &lt; 0.00001)). Coffee drinkers had a 1.19 risk ratio for cardiovascular diseases compared to non-coffee drinkers (CI: 0.99–1.38, I2 = 84%, P &lt; 0.00001). The dementia risk ratio for caffeine users was 0.90 (95% CI: 0.82-0.97, I2 = 46%, P &lt; 0.00001) compared with non-consumers. Our analysis covering 5.42 million individuals found that 4 cups of coffee consumed a day reduced stroke risk by 12%. Coffee may reduce ischemic and haemorrhagic strokes by preserving endothelium and antioxidants. Coffee may lessen dementia risk, according to our study’s 0.94 pooled risk ratio after sensitivity analysis. Heavy coffee drinkers had a greater CHD risk, as per our findings. Heavy coffee drinkers were more at risk.

One Month Whole Food Plant-Based Nutrition Educational Program Lowers LDL, A1C, and Decreases Inflammatory Markers.

Lifestyle-related chronic disease increases in the United States have led to the need for innovative programs targeting dietary choices. Based on growing evidence supporting whole food plant-based (WFPB) nutrition to improve overall health, we devised a one-month WFPB intervention program, Jumpstart Your Health! (JYH), to introduce and encourage adoption of the WFPB dietary lifestyle. This paper investigates its effects on various health indicators associated with cardiovascular and metabolic diseases. Among the total of 150 participants, before and after physical measurements and blood chemistries demonstrate significant (p< 0.05) decreases in weight (-4.2 pounds), cholesterol (-25.3mg/dl), LDL (-19.0mg/dl), HDL (-5.6mg/dl), hemoglobin A1c (-0.2%), and hsCRP (-1.9mg/L). Among the high-risk participants, we found significant decreases in systolic blood pressure (-10mmHg), diastolic blood pressure (-8.7mmHg), weight (-4.3pounds), cholesterol (-38.8mg/dl), LDL (-22.7mg/dl), HDL (-2.8mg/dl), hemoglobin A1c (-0.2 %), and hsCRP (-2.3mg/L). We demonstrate that a simple WFPB intervention implemented over one month resulted in significant reductions in physical measurements and blood chemistries that could translate to lowered risk or improvement for obesity, cardiovascular disease, and type-2 diabetes.

Promoting a sustainable diet among office workers in Sweden: A pilot Study

Abstract Background Society is facing multiple challenges, including lifestyle-related diseases, alongside global climate change. Actions are needed to promote sustainable lifestyles advocating for healthy and environmentally friendly diets. This study aimed to assess how a sustainable lifestyle, compared to conventional healthy lifestyle education at work, affects participants’ energy intake, nutrient consumption, and diet-related CO2e. Methods An 8 week two-armed randomized trial was conducted, comprising a sustainable lifestyle arm (n = 21) and a healthy lifestyle arm (n = 16) based on the theoretical framework of the Behavioral Change Wheel, in total (n = 33) completed the trial. The office workers participated in 6 workshops during working hours. Linear mixed-effects models and analysis of variance tests were used for data analysis. Changes over time are presented as arms combined, along with their respective mean differences. Results A significant decrease in mean diet-related CO2e was observed (p &amp;lt; 0.001), with a decrease on average of 0.74 and 0.71 kg CO2e/day. The mean change in daily kilocalorie intake had a significant decrease over time (p = 0.008), on average of 192 and 386 Kcal. Moreover, a significant decrease in mean protein intake was observed (p &amp;lt; 0.001), with a decrease on average of 16 and 18 grams, possibly explaining the decrease in CO2e. No significant differences were observed between the arms at any timepoint. Conclusions Promoting sustainable lifestyle habits has a similar impact to advocating for a conventional healthy lifestyle regarding diet. This supports the new Nordic Nutrition Recommendations 2023. Despite the small sample size, insights into facilitating sustainable behaviors can influence public health policies across Europe and the workplace as an arena for health promotion. Key messages • The promotion of sustainable and healthy lifestyle habits at work can promote both individual and planetary health by decreasing diet-related CO2e emissions. • Here we demonstrate that the workplace has the potential to act as an arena to combat climate change.

Effects of a Six-Month Physical Activity Program on Health Risk Factors and Body Composition Among Overweight and Obese Middle-Aged Adults.

Introduction. Physical activity is vital for preventing and managing lifestyle-related diseases, which pose significant health and socio-economic challenges. This study aimed to evaluate the effects of a six-month supervised physical activity program on health risk factors and body composition in middle-aged individuals with overweight or obesity. Methods. The study involved 166 men and women aged 30 to 65 years, with a body mass index (BMI) ranging from 26 to 35 and moderate to severe health risks. Participants of the study were engaged in a six-month physical activity training program designed in accordance with World Health Organization guidelines. Comprehensive assessments were performed at baseline and after the intervention, including measurements of various anthropometric and body composition parameters, as well as evaluations of functional performance. Fitness tests were also conducted to assess participants' physical capacity and to monitor improvements throughout the training period. Results. Baseline measures of body mass composition and age demonstrated a strong positive correlation with visceral fat rating (VFR) in both men (r = 0.364, p < 0.001) and women (r = 0.420, p = 0.002). Following the six-month training program, participants exhibited an average improvement of 30% (p < 0.001) in their Cooper endurance test results. The physical activity intervention positively impacted body mass index (BMI) and various body composition metrics, including fat mass, VFR, and muscle mass, across all participants and most subgroups (gender, BMI, and age). In males, training at higher maximum heart rate (HRmax) zones significantly contributed to a reduction in the percentage of fat mass (80-89% HRmax) and an increase in the percentage of muscle mass (70-79% and 80-89% HRmax). Conclusions. The study indicates that a six-month supervised physical activity program significantly improves health risk factors and body composition (visceral fat reduction and improvement in percent of fat and muscle mass) among middle-aged individuals with overweight or obesity. Therefore, we advocate for the integration of structured physical activity interventions into healthcare practices to effectively enhance health outcomes in this population.

Effect of COVID-19 pandemic on the management of hypertension and the prevalence of lifestyle disease

Abstract Background/Introduction Behavior restrictions after the advent of COVID-19 dramatically changed our lifestyle, which may have affected self-management of metabolic factors in individuals. Purpose We examined possible changes in the prevalence and management of lifestyle-related diseases in the general population. Methods We enrolled 2582 consecutive participants aged ≥20 years (male=6984, 49.5±11.9 year-old) who visited our hospital for their annual physical check-up at least five times between 2017 and 2022. Participants were divided into 2 groups (with [n=739] or without antihypertensive medication [n=1843]) and changes in parameters that are closely related with lifestyle were examined before (2017-2019) and after (2020-2022) the pandemic of COVID-19. Hypertension was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or the use of antihypertensive medications. Diabetes mellitus was defined as fasting plasma glucose ≥126 mg/dL, HbA1c ≥ 6.5% or the use of antidiabetic medications. Dyslipidemia was defined as LDL-cholesterol ≥140 mg/dL, HDL-cholesterol &amp;lt;40 mg/dL, triglyceride ≥150 mg/dL, or the use of antidyslipidemic medications. Hyperuricemia was defined as uric acid &amp;gt;7.0 mg/dL for men, &amp;gt;6.0 mg/dL for women or the use of anti-hyperuricemic medications. Metabolic syndrome was defined based on Japanese diagnostic criteria (2005). Results The main results are shown in Table. The levels of all parameters were worse in participants with than without anti-hypertensive medication. The prevalence of hypertension, diabetes, dyslipidemia, hyperuricemia and metabolic syndrome which was higher in subjects with than without anti-hypertensive medication increased after the COVID-19 pandemic. Although the most of parameters were deteriorated after the pandemic, only the management of blood pressure in subjects under antihypertensive medication was improved. Conclusion Behavior restrictions during the pandemic might have unfavorable impact on the prevalence of lifestyle-related diseases. Although the control of blood pressure was not worsened, total management was not excellent during the pandemic in hypertensive individuals under medication.Characteristics of study participants

10.G. Practice session: Innovation technology to promote healthy lifestyles: teachings from multi-national EU funded projects

Abstract The global burden of disease attributable to lifestyle risk factors is constantly escalating on a worldwide scale. Inadequate diet and sedentary behaviors stand out as particularly impactful contributors to chronic non-communicable diseases, resulting in millions of deaths annually and projecting stable, alarming trends for the foreseeable future. These statistics raise significant concerns among public health experts, particularly regarding the pervasive influence of unhealthy lifestyles on younger generations. This demographic cohort’s susceptibility poses a substantial threat to the future trajectory of non-communicable diseases and places immense strain on healthcare systems and global health outcomes. In light of these challenges, the imperative for public health initiatives and interventions aimed at promoting healthy lifestyles becomes glaringly apparent. Addressing the root causes of unhealthy behaviors through targeted interventions is essential to reverse the projected trends and mitigate future health risks. Public health authorities shoulder the responsibility of prioritizing such endeavors, as they play a pivotal role in shaping environments conducive to healthy living for present and future generations alike. Embracing innovative methodologies, leveraging technological advancements, and adopting modern approaches are imperative to engage and mobilize younger populations effectively. Initiatives funded by entities such as the European Union serve as promising examples, highlighting the potential for collaborative efforts to drive meaningful change. Sharing the methodologies and findings of such projects within the public health community can catalyze knowledge dissemination and foster collaboration, ultimately amplifying the impact of intervention strategies worldwide. By prioritizing intervention studies for behavioral change, stakeholders can collectively address the pressing challenge of lifestyle-related diseases and pave the way for healthier, more resilient communities. The aim of this workshop is to provide an overview of multi-national EU funded projects aiming to promote healthy lifestyles in the Mediterranean region. Key messages • Innovative and more modern approaches are needed to improve the diet in the Mediterranean region. • Children and adolescents are the main targets to counteract the rise of non-communicable diseases.

Rural–Urban Divide of COVID-19 Fatalities in India—Investigating the Role of Lifestyle Disorder Diseases

AbstractUsing data on weekly COVID-19 infections and fatalities at the district level for 19 states and 4 union territories of India, we investigate the determinants of COVID-19 deaths focusing exclusively on the second wave of infections. We include several macroeconomic and structural indicators for districts namely, per capita district domestic product, the degree of urbanization, population density, percentage of aged population, share of agriculture, poverty, among several others. Our findings suggest that fatalities have a clear rural–urban divide. Rural agricultural districts with more poor people have experienced less cases and fatalities. Fatalities are more clustered in prosperous and dense industrial districts. Regions having higher COVID-19 fatalities also have a higher proportion of ageing population with urban life-style disorder related diseases such as obesity, diabetes, and hypertension. Prevalence of respiratory illnesses further aggravates the effects of some of these life-style disorder diseases on COVID-19 fatalities.

Factors Related to mHealth App Use Among Japanese Workers: Cross-Sectional Survey.

Health care providers can make health guidance more effective by using mobile health technologies such as health apps. Although health care providers need to know who uses health apps, existing studies have yielded inconsistent results. The aim of the study was (1) to clarify the prevalence and patterns of health app use to improve health behaviors for preventing lifestyle-related diseases among Japanese workers and (2) to identify the associations among demographic characteristics, health behavior, and internet use and health app use by gender. Data were collected from a cross-sectional internet survey in 2023. In total, 2200 participants were included, with an even distribution of men and women in each age group aged 20 to 60 years. The participants were workers with smartphones and reported their gender, age, residence area, marital status, education, employment status, occupation, work pattern, diseases under treatment, health checkups, health guidance, health behaviors, internet use duration, and number of devices used. We asked about current and previous health app use for 1 month. A multivariate logistic regression analysis was conducted by gender. Of the participants, 472 (21.5%) and 189 (8.6%) were current and previous health app users, respectively. Most current and previous health app users used features that record and track their physical activity and other health behaviors. Health app users-both men and women-were more likely to have health checkups (odds ratio [OR] 1.53, 95% CI 1.12-2.11 and OR 1.51, 95% CI 1.10-2.07, respectively), receive health guidance (OR 2.01, 95% CI 1.47-2.74 and OR 1.86, 95% CI 1.32-2.62, respectively), engage in regular physical activity (OR 2.57, 95% CI 1.91-3.47 and OR 1.94, 95% CI 1.41-2.67, respectively), use the internet for 120-179 minutes per day (OR 1.76, 95% CI 1.13-2.75 and OR 1.70, 95% CI 1.12-2.57, respectively), and were less likely to be older (50-59 years: OR 0.54, 95% CI 0.33-0.88 and OR 0.40, 95% CI 0.25-0.6, respectively, and 60-69 years: OR 0.37, 95% CI 0.22-0.62 and OR 0.47, 95% CI 0.28-0.77, respectively). According to gender, male health app users were more likely to be married (OR 1.69, 95% CI 1.23-2.33) and less likely to work in the security, agriculture, forestry, fishing, manufacturing, or transportation industries (OR 0.62, 95% CI 0.41-0.95). Female health app users were more likely to have a university education or higher (OR 1.55, 95% CI 1.061-2.26), maintain an appropriate body weight (OR 1.52, 95% CI 1.10-2.11), and use 3 or more devices (OR 2.13, 95% CI 1.41-3.23). Physical activity and health guidance are strong predictors of app use. Health care providers should assess the target populations' preferences for app use based on their characteristics, support their app use, and enhance the effectiveness of health guidance.

A Study of the Factors Impeding Proper Dietary Habits: An Investigation Using the Japanese Comprehensive Survey of Living Conditions

(1) Background: Diet is significant for nutritional intake and serves as an essential element for improving quality of life (QOL). Poor dietary management skills increase the risk of onset or progression of lifestyle-related diseases, and, in particular, are a factor in reduced QOL during old age. This study aimed to clarify the physical and social background factors impeding dietary self-management. (2) Methods: The study participants were 3814 men (age range, 30–69 years) extracted from anonymous data comprising 15,294 persons provided from the Japanese national statistics database. The participants were classified into two groups (Concerned vs. Unconcerned) according to whether they were concerned about their diet. Adjusted odds ratios (ORs) for diet-conscious behaviors were then obtained by means of binomial logistic regression analysis performed following univariate analysis. (3) Results: The Concerned and Unconcerned groups comprised 2548 (66.8%) and 1266 subjects (33.2%), respectively. The diet-conscious behavior with the highest response rate was eating regularly (46.7%). The most frequent items in the Unconcerned group were the subjective symptom “irritable” (48.9%), high stress (46.3%), working more than 56 h/week (43.8%), and smoking (41.9%). The only item with a large significant OR in the binomial logistic regression analysis was smoking (OR: 2.2). (4) Conclusions: These results suggest that a smoking habit and stress are factors that impede diet management behaviors.

Lifestyle Factors in Diabetes Management: Insights from the Kerala Paradox for the Indian Diaspora

With an estimated 101 million people living with diabetes, India ranks second in the world for the highest number of cases. In particular, Kerala, a state in southern India, faces what is known as the "Kerala Paradox", where strong socio-economic indicators fail to translate into lower levels of lifestyle-related diseases. As a result, Kerala has one of the highest diabetes prevalence rates in the country, ranking among the top three. This research paper aims to thoroughly analyse the Kerala Paradox and explore the factors contributing to it. It then extends the analysis through primary data to assess whether these lifestyle factors also influence the prevalence of diabetes in the Delhi NCR region. The latter half of the paper builds on findings from the literature review and primary research to evaluate the implications for diabetes management across the Indian diaspora. Keywords: India, Kerala paradox, Diabetes, Lifestyle factors, Physical activity, Dietary habits, Diabetes Management

Oral hygiene predicts lower life satisfaction and subjective health: experience of post-Soviet countries

Oral diseases are among the most common non-communicable diseases around the globe and become a public health challenge that considerably impact general health and well-being in all ages across the lifespan. Oral health is an integral part of general health, where poor oral health and other lifestyle-related chronic diseases have a common risk factor background. The underlying causes of oral health inequalities are often complex and related to country-specific historical, economic, cultural, social, or political factors. For more than a decade, data from the Health Behavior in School-aged Children (HBSC) survey showed that tooth brushing rates are very low in post-Soviet countries. The general aim of our study was to focus on a more detailed profile of schoolchildren from post-Soviet countries, who have poor habits of teeth brushing, in terms of their family, social support, physical activity, nutrition, and other health-related behaviors. Data for this study was extrapolated from the Health Behavior in School-aged Children study, a World Health Organization collaborative cross-national study, conducted every 4 years since 1983/1984. For this study, the post-Soviet countries from Eastern Europe and Central Asia were selected: Armenia, Azerbaijan, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Lithuania, Latvia, Moldova, Tajikistan, Ukraine, and Uzbekistan. Data from all countries (some exceptions for Kyrgyzstan, Tajikistan, and Uzbekistan) were collected within 2017–2018 HBSC study, following international research protocol. The sample consisted of 44,760 schoolchildren, aged 11, 13, and 15 years from 12 countries. Irregular tooth brushing is more common among boys, elder adolescents, and schoolchildren from less affluent families. Low own health measures, low life satisfaction, low physical activity, and low FAS relate to poorer adolescent dental hygiene in post-Soviet countries. Adolescents characterized by irregular tooth brushing were more likely to assess their health as fair or poor rather than excellent or good (OR = 1.22), and also had greater odds of reporting low life satisfaction (OR = 1.36). Individual mental health complaints—feeling low, being irritable, being nervous, and having sleep difficulties—were assessed as a possible outcome of irregular tooth brushing. However, irregular tooth brushing was not associated with poorer mental health outcomes (p > 0.05). Conclusions: Oral hygiene in post-Soviet countries is still a major public health challenge and have to be addressed properly.What is Known:• Oral health strongly affects the overall health of children and adolescents in the future.• Oral diseases often share common determinants and risk factors with other chronic diseases.• The underlying causes of oral health inequalities are often complex and related to country-specific historical, economic, cultural, social, or political factors.What is New:• Irregular tooth brushing was more common among adolescents with low life satisfaction and poor or fair health as well as in less affluent families.• Irregular tooth brushing was not found to be associated with poorer mental health among post-Soviet countries adolescents.

Sports and Exercise Medicine: Present and Future

Sports and exercise medicine is a newly emerging medical speciality in association with sports and physical education. As the lifestyle of the average population has changed drastically with sedentary type and lack of physical exercise, thus, inviting various lifestyle-related diseases in society, this speciality has been gaining tremendous popularity in medical practices. This discipline is a combination of sports medicine and exercise medicine (therapy). Clinical and interventional physiology which is the resultant of these two components, plays an important role in injury management and for the promotion of health and wellbeing, devoid of any side effects. In the present editorial, with the objectives, an attempt has been made to discuss the present scenario of the discipline of sports and exercise medicine along with its future prospects, as in spite of its numerous benefits, not enough attention has been given to the holistic improvement of the healthcare system.

The chronic wound characterisation study and biobank: a study protocol for a prospective observational cohort investigation of bacterial community composition, inflammatory responses and wound-healing trajectories in non-healing wounds

IntroductionChronic wounds affect 1%–2% of the global population, with rising incidence due to ageing and lifestyle-related diseases. Bacterial biofilms, found in 80% of chronic wounds, and scattered single-cell bacteria may...

Non-alcohlic Fatty Liver Disease (NAFLD): Is it a Dormant Volcano or Tip of an Iceberg?

Non-alcoholic fatty liver disease (NAFLD), a major cause of chronic liver disease, is known to affect a quarter of the global adults. Natural history of NAFLD shows interindividual variation, traditionally it progresses from simple steatosis to steatohepatitis to fibrosis/cirrhosis and finally yet rarely to hepatocellular carcinoma. It is largely a lifestyle-related disease and is often labeled as the hepatic manifestation of metabolic syndrome. Both prevention and control of NAFLD include controlling risk factors (obesity, diabetes mellitus, hypertension and dyslipidemia), through lifestyle modification and medications. Drug therapy for NAFLD per se is still evolving and till date, no drugs are approved. It is clinically silent, especially in the early stages, and is a diagnosis of exclusion. Certain easily calculated indices can stratify cases into high or low risk for advanced fibrosis, thereby dictating appropriate monitoring and treatment measures. In addition to complications specific to liver disease in those who do progress to advanced fibrosis or cirrhosis, an increased risk of nonliver disease-related morbidity and mortality is also present. Challenges are manifold and include rising burden due to ever-growing epidemic of diabetes and obesity, low public awareness, fragmented healthcare, no approved drugs, and dearth of data on magnitude and epidemiology of the disease. The recent integration of NAFLD into the National Program for Prevention and Control of Non-Communicable Diseases (NPCDCS) by the Ministry of Health and Family Welfare of India is a welcome step in this direction as the contributory factors are mostly the same for all diseases and controlling any one or all of them will have a desired impact on the prevalence of all the diseases under this program.

Sex differences in genotype frequency and the risk of polycythemia associated with rs13419896 and rs2790859 among Tibetan highlanders living in Tsarang, Mustang, Nepal

BackgroundTibetan highlanders have adapted to hypoxic environments through genetic mechanisms that avoid hemoglobin concentration increases and prevent polycythemia. Recently, sex differences in hemoglobin dynamics with age have been reported among Tibetan highlanders living in Tsarang. Additionally, concerns have been raised that dietary changes associated with modernization may increase the risk of polycythemia and lifestyle-related diseases among Tibetan highlanders. However, the relationship between genetic polymorphisms and the risk of lifestyle-related diseases in Tibetan highlanders has been investigated in only a few regions. This study aims to elucidate whether polymorphisms in genes related to hypoxic adaptation are associated with the incidence of lifestyle-related diseases and polycythemia and whether these polymorphisms affect hemoglobin dynamics in the residents of Tsarang, Mustang, Nepal.MethodsHealth checkup data from individuals living in Tsarang in Mustang District, Nepal, collected in 2017, were used to determine the prevalence of obesity, hypertension, diabetes, hypoxemia, and polycythemia. DNA was extracted from whole-blood samples, and data for the single-nucleotide polymorphisms (SNPs) rs13419896 (EPAS1), rs12619696 (EPAS1), and rs2790859 (EGLN1) were obtained using real-time PCR. The health checkup data were statistically analyzed to determine the associations of these diseases with polymorphisms in genes related to hypoxic adaptation.ResultsA total of 168 participants, comprising 78 males and 90 females, were included in the final analysis. In terms of the prevalence of each disease, only the prevalence of polycythemia significantly differed between sexes (p < 0.01). Additionally, among the three analyzed SNPs, significant sex differences in genotype frequency were observed for rs13419896 and rs2790859. For rs2790859 in females, Tibetan highlanders with the adaptive genotype had a significantly lower incidence of polycythemia (p < 0.01) and significantly lower hemoglobin concentrations (p < 0.01).ConclusionsThis study revealed that there are sex differences in the genotype frequency of gene-related hypoxic adaptations among the residents of Tsarang. The findings also suggested that the rs2790859 polymorphism might be involved in the recent incidence of polycythemia among Tsarang residents. If the frequency of non-Tibetan genotypes increases due to intermixing with other populations in the Mustang District, polycythemia may emerge as a modern disease. It is essential to continue investigating the health status of Mustang residents to elucidate various aspects of hypoxic adaptation and disease susceptibility.