Long-term Intervention Studies Research Articles

Acute Effects of Combining Weight and Elastic Resistance Exercise on Vascular Function in Older Adults.

Prior research has suggested that resistance exercise may result in a temporary decrease in vascular function, as measured by flow-mediated dilation (FMD), among untrained young individuals. However, the immediate impact of combined elastic and weight resistance training on older adults remains insufficiently explored. We assessed vascular function before, after, and 30 min after acute exercise under three resistance conditions to evaluate whether a combination of weight and elastic resistance exercises has an acute effect on vascular function in older adults. Fourteen older adults (65.6 ± 2.9 years) executed three sets of 12 repetitions at 65% of one repetition maximum (1 RM) of the bench press (BP) exercise. Testing was performed on three separate days as follows: (1) barbell alone (BA); (2) barbell plus elastic bands (10% of 65% 1 RM) (BE10); and (3) barbell plus elastic bands (20% of 65% 1 RM) (BE20). A two-way (time × condition) repeated measures analysis of variance was employed to assess the time and condition effects on flow-mediated dilation (FMD) and pulse wave velocity (PWV). At 0 min post-exercise, FMD was significantly higher during BE10 than during BA (p < 0.05); however, at 30 min post-exercise, no significant difference (p ≥ 0.05) was observed between the three conditions. In each condition, FMD results did not differ significantly at different times (p ≥ 0.05). For FMD, the main effect of the condition (F[2,26] = 3.86, p = 0.034) and that of the time and condition (F[4,52] = 3.66, p = 0.011) were significant. For PWV, only the difference between the BA and BE10 conditions was significant at 0 min (p < 0.05). PWV increased from baseline in the BA condition (p < 0.05) but not significantly in the BE10 and BE20 conditions (p ≥ 0.05). Therefore, BA, BE10, and BE20 demonstrated various changes in vascular function. Long-term training intervention studies are needed to validate these findings.

A Serious Game for Cognitive Stimulation of Older People With Mild Cognitive Impairment: Design and Pilot Usability Study.

Cognitive stimulation of older people helps prevent, and even treat, age-related diseases, such as mild cognitive impairment. Playing games reduces the probability of experiencing this pathology, which is related to the loss of the ability to carry out some instrumental activities of daily living. This work describes the design and development of a serious game for the cognitive stimulation of older people, with exercises related to the daily life task of shopping. A pilot study for its preliminary usability validation is also presented. The designed serious game includes 4 exercises consisting of shopping in a hypermarket, ordering products, making payments, and organizing the purchase, thus dealing with the most frequent cognitive problems of older people associated with episodic declarative memory, naming, calculation, and organization, respectively. A total of 19 older people participated in the pilot study for the usability validation of the serious game. They indicated that they like the aesthetic and interesting topic of the game. They reported that it provides a high level of entertainment and could be useful in daily life for mental stimulation. The participants found the serious game to be intuitive, but the ease of use and readability of the instructions could be improved. This study suggests that the innovative serious game developed could be accepted by older people for their cognitive stimulation to prevent or treat mild cognitive impairment, although a long-term intervention study should be performed as future work. Its ecological validity design, with everyday tasks, adaptable levels of difficulty, and motivational mechanisms, is a differentiating factor compared to similar serious games.

Reducing meat and/or dairy consumption in adults: a systematic review and meta-analysis of effects on protein intake, anthropometric values, and body composition.

Consumers are increasingly encouraged to reduce meat and dairy consumption. However, few meta-analyses of randomized controlled trials (RCTs) on the effect of reducing meat and/or dairy on (absolute) protein intake, anthropometric values, and body composition are available. The aim of this systematic review and meta-analysis was to evaluate the effect of reducing meat and/or dairy consumption on (absolute) protein intake, anthropometric values, and body composition in adults aged ≥ 45 years. The MEDLINE, Cochrane CENTRAL, Embase, ClinicalTrials.gov, and International Clinical Trials Registry Platform databases were searched up to November 24, 2021. Randomized controlled trials reporting protein intake, anthropometric values, and body composition were included. Data were pooled using random-effects models and expressed as the mean difference (MD) with 95%CI. Heterogeneity was assessed and quantified using Cochran's Q and I2 statistics. In total, 19 RCTs with a median duration of 12 weeks (range, 4-24 weeks) and a total enrollment of 1475 participants were included. Participants who consumed meat- and/or dairy-reduced diets had a significantly lower protein intake than those who consumed control diets (9 RCTs; MD, -14 g/d; 95%CI, -20 to -8; I2 = 81%). Reducing meat and/or dairy consumption had no significant effect on body weight (14 RCTs; MD, -1.2 kg; 95%CI, -3 to 0.7; I2 = 12%), body mass index (13 RCTs; MD, -0.3 kg/m2; 95%CI, -1 to 0.4; I2 = 34%), waist circumference (9 RCTs; MD, -0.5 cm; 95%CI, -2.1 to 1.1; I2 = 26%), amount of body fat (8 RCTs; MD, -1.0 kg; 95%CI, -3.0 to 1.0; I2 = 48%), or lean body mass (9 RCTs; MD, -0.4 kg; 95%CI, -1.5 to 0.7; I2 = 0%). Reduction of meat and/or dairy appears to reduce protein intake. There is no evidence of a significant impact on anthropometric values or body composition. More long-term intervention studies with defined amounts of meat and dairy are needed to investigate the long-term effects on nutrient intakes and health outcomes. PROSPERO registration no. CRD42020207325.

Effects of a lifestyle intervention on the biomarkers of oxidative stress in non-communicable diseases: A systematic review.

Oxidative stress plays a critical role in the pathogenesis of chronic diseases. Therefore, improvement of oxidative stress status through lifestyle intervention can play a vital role in preventing and treating chronic diseases. This systematic review aims to provide an overview of articles published in the last decade examining the association between lifestyle intervention and oxidative stress biomarkers in the context of non-communicable diseases. The electronic databases PubMed and Web of Science were searched for relevant studies, following the PRISMA (Preferred Reporting of Systematic Reviews and Meta-Analyses) guidelines. This systematic review focused on the four important oxidative stress biomarkers; glutathione (GSH), superoxide dismutase (SOD), catalase, and malondialdehyde. 671 articles were identified, of which nine met the inclusion criteria. A trend emerged, showing that lifestyle modifications that focus on diet and physical health can improve oxidative stress in the form of an increase in superoxide dismutase and CAT levels and a decrease in Malondialdehyde levels in participants with non-communicable diseases (NCDs), GSH levels were not affected. However, the results are difficult to compare because of the heterogeneity of the methods of the biomarkers studied. Our review indicates that oxidative stress can be influenced by lifestyle modifications and may be an effective tool for the prevention and management of non-communicable diseases. This review also elucidated the importance of analyzing multiple oxidative stress biomarkers to evaluate oxidative stress, it further highlights the need to conduct long-term lifestyle intervention studies on oxidative stress biomarkers to understand the connection between oxidative stress biomarkers, NCDs and Lifestyle intervention.

Effect of vitamin K supplementation on serum calcification propensity and arterial stiffness in vitamin K-deficient kidney transplant recipients: A double-blind, randomized, placebo-controlled clinical trial

Vitamin K deficiency is common among kidney transplant recipients (KTRs) and likely contributes to progressive vascular calcification and stiffness. In this single-center, randomized, double-blind, placebo-controlled trial, we aimed to investigate the effects of vitamin K supplementation on the primary end point, serum calcification propensity (calciprotein particle maturation time, T50), and secondary end points arterial stiffness (pulse wave velocity [PWV]) and vitamin K status in 40 vitamin K-deficient KTRs (plasma dephosphorylated uncarboxylated matrix Gla protein [dp-ucMGP] ≥500 pmol/L). Participants (35% female; age, 57 ± 13 years) were randomized 1:1 to vitamin K2 (menaquinone-7, 360 μg/day) or placebo for 12 weeks. Vitamin K supplementation had no effect on calcification propensity (change in T50 vs baseline +2.3 ± 27.4 minutes) compared with placebo (+0.8 ± 34.4 minutes; Pbetween group = .88) but prevented progression of PWV (change vs baseline −0.06 ± 0.26 m/s) compared with placebo (+0.27 ± 0.43 m/s; Pbetween group = .010). Vitamin K supplementation strongly improved vitamin K status (change in dp-ucMGP vs baseline −385 [−631 to −269] pmol/L) compared with placebo (+39 [−188 to +183] pmol/L; Pbetween group < .001), although most patients remained vitamin K-deficient. In conclusion, vitamin K supplementation did not alter serum calcification propensity but prevented progression of arterial stiffness, suggesting that vitamin K has vascular effects independent of calciprotein particles. These results set the stage for longer-term intervention studies with vitamin K supplementation in KTRs. Trial registryEU Clinical Trials Register (EudraCT Number: 2019-004906-88) and the Dutch Trial Register (NTR number: NL7687).

How Many Days Of Monitoring are Necessary to Accurately Characterize Activity of Parkinson's Disease Patients?

<h3>Research Objectives</h3> To determine a reliable sampling strategy to accurately characterize physical activity in individuals with Parkinson's disease (PD). <h3>Design</h3> Observational study with individuals with PD wearing a wrist worn activity monitor for 30 days. <h3>Setting</h3> General community. <h3>Participants</h3> Individuals with mild-Moderate Parkinson's disease (N=31). <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> A step/day measurement period of various lengths (2, 3, 4, 5, 6, 7, and 14 days) were selected for consecutive and random days. Two-way intraclass correlation coefficients (ICC) were calculated for ten samples of both consecutive and random days for each participant. The ten samples were averaged for ICC for each measurement period. <h3>Results</h3> The ICC averages for consecutive days ranged from 0.59-0.75, with stability of ICC starting at a 7-day measurement period (95% CI, 0.55- 0.80). The ICC averages for random days ranged from 0.59-0.71, with stability of ICC maintained starting with a random 7-day measurement period (95% CI, 0.51- 0.77). <h3>Conclusions</h3> PD-related variability in motor behavior, and conventional methods of a four day measurement period may not accurately reflect physical activity behavior. Identifying a method to accurately characterize level of physical activity in individuals with PD over time provides those conducting short- and long-term intervention studies and trials with a robust physical activity outcome. The results of this study indicate that seven consecutive days of physical activity monitoring was the most stable measure of physical activity. For random sampling days, seven days also resulted in the greatest and most stable ICC of that sampling method. Therefore, in PD a seven-day consecutive measurement period may be the most representative of physical activity behavior in individuals with PD. <h3>Author(s) Disclosures</h3> No authors have disclosures or conflicts.

PSUN160 Transfusion Related Endocrinopathies and Thalassemia (TREAT) Study

Abstract Thalassemia (Thal), the most common form of inherited anemia worldwide, may require regular blood transfusions and life-long medical care. The introduction of oral chelators and imaging methods to monitor iron overload transformed Thal from a rapidly fatal disease of childhood to a chronic illness compatible with prolonged life expectancy. Regular blood transfusions resulting in tissue iron overload and oxidative stress may lead to liver disease and polyendocrinopathy. In this observational descriptive study, we described the patient characteristics and prevalence of endocrinopathies (growth failure, hypothyroidism, hypogonadism, low bone mass, and impaired glucose intolerance) in a contemporary group of transfusion dependent Thal patients cared for our tertiary care center since 2000. A total of 253 transfusion dependent Thal patients were identified. Of those patients, 51.8% were female; 22% (n=56) were adopted, mainly from China. The following ethnicities were represented: Chinese 19.9%, Indian 12.6%, Laotian 7.8%, Asian 7.8%, Italian 7.8%, Vietnamese 3.9%, Afgani 3.4%, Pakistani 3.4%, Thai 2.9%, Greek 2.4%, Cambodian 2.4%, Filipino, Caucasian, Iranian 1.9% each. Majority of the diagnoses were Beta Thal Major (69.9%), followed by E Beta 0 Thal (14.6%). The median age at first visit was 10.6 years (IQR1-IQR3: 2.2-25), last visit was 27 years (IQR1-IQR3: 12.1–39.4) with 33.5% of the patients ≤18 years of age. Median follow-up time was 10 years. Median final adult height (height z-score) for females was 159.5 cm (-0.53) (IQR1-IQR3: 152.4,160.3cm; height z-score: -1.68, -0.47) and for males 167.5cm (-1.3) (IQR1-IQR3: 161.5, 171cm; height z-score: -2.13, -0.81). Only, 16.5% (n=14) of children were on growth hormone treatment due to low-normal growth hormone surrogates or peak growth hormone &amp;lt;10ng/ml in growth hormone stimulation test. Hypothyroidism was diagnosed in 9.9% (n=25) of the patients and 5 patients had central hypothyroidism. Hypogonadism was diagnosed in 32.4% of adult female (n=24), and 44.6% of adult male (n=29) patients who were subsequently prescribed sex steroid replacement. Low bone mass in those with z-scores ≤2.0 was noted in 22.9% (n=43) female and 26% (n=49) males. The mean bone mineral density z-score for spine was -2.1±1.1 for females and -2.5±1.3 for males. Either impaired glucose tolerance or insulin-dependent DM was observed in 29% of the patients (n=54). Endocrinopathies are common and continue to be a significant morbidity in transfusion dependent Thal patients despite improved chelation agent availability and tissue iron monitoring. Future long-term longitudinal and intervention studies elucidating and mitigating potential effects of iron overload on developing children's developing endocrine organs are needed. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.

Narrative review on role of vitamin D in type II diabetes and hyperlipidemia

t is widely known that type II diabetes and hypo-vitaminosis D are very prevalent health problems worldwide. Vitamin D deficiency has emerged as an important risk factor in the pathogenesis and prevention of type II diabetes and hyperlipidemia. The key goal of this narrative review, through performing literature survey, is to consolidate results of relevant studies and consequently help direct future research in this area. Furthermore, highlighting the influence of vitamin D supplementation on beta-cell function, glycemic control; insulin sensitivity and lipid profile are other key aims of this review. For that end, several observational and interventional studies, conducted during the period (2003–2017) on animals and humans, have been reviewed. The key findings of this review are the significant inverse associations between serum 25(OH)D3 level and insulin resistance, glycemic index, type II diabetes and lipid parameter has been noticed in the majority of such observational studies in human. In addition, both in vivo and in vitro animal studies have proved the significant role of vitamin D in regulating beta-cell function, insulin sensitivity, and cholesterol biosynthesis, while interventional studies revealed contradicting results. The short-term interventional studies reported improvement in fasting blood sugar (FBS), insulin secretion and insulin resistance in vitamin D deficient-type II diabetic patients. On the other hand, the long-term interventional studies did not produce consistent results. Hence, the key value of this work is to provide guidance to researchers and health professionals on such specific subject. Finally, the review concludes with research limitations and puts forward future recommendations.

Effect of Exergame Training on Working Memory and Executive Function in Older Adults

Background: As the population ages, cognitive impairment and dementia have become one of the greatest health threats in older adults. Prior studies suggest that exergaming could improve cognitive function in older adults. To date, few long-term exergames intervention studies on older adults during the COVID-19 epidemic exist. This study aimed to investigate the effects of exergame on cognitive function in Chinese older adults, and to examine whether exergame was more effective than aerobic dancing for executive function and working memory. Methods: 55 participants (mean age = 65.4 ± 3.7 years) were randomly assigned to an exergame training (ET) group, an aerobic dancing training (ADT) group, or a control (CON) group. The ET and ADT groups received 36 sessions (three 75-min training sessions per week, exercise intensity = 65 to 75% HRmax) during a 12-week period. The outcome measures for cognitive function included working memory measured by the N-back test, and executive function measured by the Stroop test. Results: The ET group showed a significantly positive effect in working memory, relative to the ADT (accuracy in 1-back test: ES = 0.76, p &lt; 0.01), and CON group (accuracy in 1-back test: ES = 0.87, p = 0.02). Moreover, the performance in the Stroop test showed some improvements in executive function after intervention in the ET and ADT groups (Stroop intervention effect: ES = 0.38; p = 0.25). Conclusions: Exergame had a positive benefit in improving cognitive functions in older adults without cognitive impairment. Long-term exergame training could improve working memory in older adults. Exergame and aerobic dancing can efficiently improve inhibitory control of executive function in older adults. Maintaining an active lifestyle is protective of cognitive health in older adults.

Olive Pomace Oil versus High Oleic Sunflower Oil and Sunflower Oil: A Comparative Study in Healthy and Cardiovascular Risk Humans.

Olive pomace oil (OPO) is mainly a source of monounsaturated fat together with a wide variety of bioactive compounds, such as triterpenic acids and dialcohols, squalene, tocopherols, sterols and aliphatic fatty alcohols. To date, two long-term intervention studies have evaluated OPO’s health effects in comparison with high oleic sunflower oil (HOSO, study-1) and sunflower oil (SO study-2) in healthy and cardiovascular risk subjects. The present study integrates the health effects observed with the three oils. Two randomized, blinded, cross-over controlled clinical trials were carried out in 65 normocholesterolemic and 67 moderately hypercholesterolemic subjects. Each study lasted fourteen weeks, with two four-week intervention phases (OPO versus HOSO or SO), each preceded by a three-week run-in or washout period. Regular OPO consumption reduced total cholesterol (p = 0.017) and LDL cholesterol (p = 0.018) levels as well as waist circumference (p = 0.026), and only within the healthy group did malondialdehyde (p = 0.004) levels decrease after OPO intake versus HOSO. Contrarily, after the SO intervention, apolipoprotein (APO) B (p < 0.001) and Apo B/Apo A ratio (p < 0.001) increased, and to a lower extent APO B increased with OPO. There were no differences between the study groups. OPO intake may improve cardiometabolic risk, particularly through reducing cholesterol-related parameters and waist circumference in healthy and hypercholesterolemic subjects.

HYPERURICEMIA AND ITS ASSOCIATION WITH HYPERTENSION: RISK FACTORS AND MANAGEMENT

Hyperuricemia is a medical condition that arises due to the increased concentration of uric acid in the body. Worldwide, a surge in the number of hyperuricemia cases has been seen over the last ten years. Hyperuricemia develops when the concentration of uric acid persistently crossed its normal threshold value (6 mg/dL). Uric acid is a metabolic product of purine catabolism. During the metabolism of purine, hypoxanthine is formed which is later on converted to xanthine and uric acid by the action of the xanthine oxidase enzyme. A continual increase in levels of uric acid is a major biomarker of developing gouty arthritis. Clinically, gouty arthritis is characterized by inflammation and pain in joints due to the accumulation of urate crystals in and around the affected area.1 Recently, hyperuricemia-induced renal and cardiovascular diseases have gained more consideration. Hyperuricemia is not only associated with gout but also linked with other comorbidities, including diabetes type II, heart diseases, and hypertension. A cohort study has demonstrated a threefold rise in the incidence of diabetes, hypertension, and kidney diseases in patients suffering from hyperuricemia. Epidemiological reports have revealed that factors leading to hypertension, hyperlipidemia, and obesity are commonly existed side-by-side and may considerably increase the threat of organ damage.2,3 According to estimation, 1.13 billion people around the globe are suffering from hypertension. Also, the World Health Organization has indicated that 13% of deaths happen worldwide due to hypertension and they have also set a goal of decreasing its frequency by 25% from the baseline year 2010 by the year 2025. The concept of association between blood pressure and uric acid is perhaps quite old and has been identified years ago. Multiple studies have established an independent association between uric acid and blood pressure. However, the impact of this association on direct causality is yet to be determined.4,5 In the 1870s, first time Mahomed et al had presented a hypothesis on hypertension and uric acid association. Later, Cannon et al. had conducted a study, and their research results have verified that 47% of patients were hypertensive and had elevated levels of uric acids. Previous findings have suggested that hyperuricemia participates in the pathological process of cardiovascular disorder. However, there is still no credible information is available that reveals decreasing uric acid levels will control blood pressure in adults. So far, it is not known that the use of uric acid-lowering agents will improve the condition of hypertensive patients. Xanthine oxidase inhibitors are quite effective in decreasing the serum uric acid concentration and helpful in impeding the production of reactive oxygen species (ROS). However, their potential benefit in controlling blood pressure has not been appraised and more studies are required in this regard. Hyperuricemia is linked with metabolic, renal, and cardiovascular diseases, and it is suggested that monitoring of serum uric acid is essential in hypertensive patients (blood pressure: &gt;140/90 mmHg) and in patients who have a family history of prehypertension (blood pressure: 120–139/80–89 mmHg) with other comorbidities like obesity and diabetes. Uricosuric antihypertensive drugs (for example losartan) with diet management can be proved useful. However, diuretics should be avoided in these patients. At present, we haven’t enough evidence based on well-made clinical trials that advocate the use of xanthine oxidase inhibitors for the treatment of hypertension and above all mention their potentially harmful effects. Febuxostat can become a better alternative because it is more effective, better tolerated, and more specific than allopurinol. In this regard, long-term interventional studies are required.6 Conversely, as hypertension and hyperuricemia are linked together, a drug having antihypertensive effects might have the potential to reduce serum uric acid concentration. Traditional medicine systems can be a better option for the management and treatment of several ailments, particularly in developing countries. Currently, scientists showed more interest in natural remedies as these are safe, effective, and economical. Medicinal plants are enriched sources of various active metabolites such as flavonoids, tannins, saponins, and alkaloids that demonstrated many therapeutic activities in different studies. In the future, more experimental studies are needed to validate their usefulness and explore their possible pharmacological and toxicological effects.7,8

Calcifediol (25OH Vitamin D3) Deficiency: A Risk Factor from Early to Old Age.

Vitamin D deficiency is the main cause of nutritional rickets in children and osteomalacia in adults. There is consensus that nutritional access to vitamin D can be estimated by measuring serum concentrations of 25OHD and vitamin D deficiency can thus be considered as calcifediol deficiency. However, the threshold for vitamin D/calcifediol sufficiency remains a matter of debate. Vitamin D/calcifediol deficiency has been associated with musculoskeletal effects but also multiple adverse extra-skeletal consequences. If these consequences improve or if they can be treated with vitamin D supplementation is still unclear. Observational studies suggest a higher infection risk in people with low calcifediol levels. There is also a consistent association between serum calcifediol and cardiovascular events and deaths, but large-scale, long-term intervention studies did not show any benefit on cardiovascular outcomes from supplementation, at least not in subjects without clear vitamin D deficiency. Cancer risk also did not change with vitamin D treatment, although there are some data that higher serum calcifediol is associated with longer survival in cancer patients. In pregnant women, vitamin D supplementation decreases the risk of pre-eclampsia, gestational diabetes mellitus, and low birth weight. Although preclinical studies showed that the vitamin D endocrine system plays a role in certain neural cells as well as brain structure and function, there is no evidence to support a beneficial effect of vitamin D in neurodegenerative diseases. Vitamin D supplementation may marginally affect overall mortality risk especially in elderly subjects with low serum calcifediol concentrations.

The effect of physical activity interventions on cognitive function of older adults: A systematic review of clinical trials.

Prevalence of dementia or of milder form of cognitive impairment is increasing and a pharmaceutical treatment remains pending. These facts underline the need of identifying modifiable factors and targeted interventions that could reduce the incidence or control disease progression. Physical activity (PA) has been shown to have a beneficial effect on cognitive function, however findings to date remain controversial. The aim of this systematic review is to summarize the most recent data from clinical studies investigating the relationship between cognitive impairment and PA in adults older than 60 years of age. For this purpose, PubMed, Scopus and Google Scholar, search was conducted, and a total of thirty-five studies were selected to review. Eleven studies investigated the effect of PA on individuals without cognitive impairment and seven of them presented some significant improvement, mostly on specific cognitive domains and only one in global cognition. Fourteen studies included populations with mild cognitive impairment (MCI) and twelve of them reported significant improvements in cognitive function. The majority of them presented a beneficial effect on global cognition and executive function. Finally, nine studies investigated interventions on populations with a diagnosis of dementia and only four of them showed any cognitive benefit following their interventions. There was no consistent observed association of a specific type of exercise and greater improvement or improvement in certain domains of cognition nor was there a minimum duration of intervention required for the improvements to take effect. In conclusion, the majority of the latest published literature suggests a protective role of PA on cognitive function. People with MCI seem to benefit the most from PA interventions, benefits in people with normal cognition are more subtle and harder to detect, while findings from studies in people with dementia remain contradictory. As findings are not currently in total agreement, further long-term prospective intervention studies are required in order to elucidate the reasons of this heterogeneity.

Association between Tea Consumption and Hypertension Risk among Middle-Aged and Older Chinese Adults

BackgroundCurrent evidence on tea consumption and hypertension is inconclusive, and prospective studies among habitual tea drinkers remain limited. ObjectiveWe investigated the associations of habitual tea consumption with hypertension risk and longitudinal blood pressure changes in 2 large cohorts. MethodsThis study included participants aged 40–75 y from the Shanghai Women's Health Study (n = 31,351) and the Shanghai Men's Health Study (n = 28,342), without hypertension, diabetes, cardiovascular disease, or cancer at baseline. Information on tea consumption was assessed during in-person interviews at enrollment and follow-up visits. Incident hypertension was identified by self-reported diagnosis, medication use, or blood pressure measurements. ResultsCurrent tea drinkers had a 7% higher risk than the non–current tea drinker group [HRs (95% CIs): women, 1.07 (1.01, 1.14); men, 1.07 (1.02, 1.12)]. The amount of tea drinking showed significant dose–response associations with hypertension: compared with the non-current group, HRs (95% CIs) for women and men were 1.01 (0.90, 1.14) and 1.02 (0.96, 1.08) for low (women/men: <100/200 g/mo), 1.07 (1.01, 1.15) and 1.05 (0.99, 1.12) for medium (women/men: 100–250/200–250 g/mo), and 1.18 (1.01, 1.39) and 1.10 (1.03, 1.17) for the high-amount group (women/men: >250 g/mo). Among participants without hypertension, compared with non–current tea drinkers, least-squares means of 3-y changes in blood pressure were 0.3–0.4 mm Hg higher for women and men as current drinkers and 0.7–0.9 mm Hg higher for men in the high-consumption group. Compared with those who never drank tea, women who drank tea consistently had 0.5 (0.2, 0.7) mm Hg higher diastolic blood pressure (DBP), whereas men had 0.5 (0.04, 0.9) mm Hg higher systolic blood pressure and 0.3 (0.04, 0.6) mm Hg higher DBP, respectively. ConclusionsOur findings suggest that habitual tea drinking is associated with a slightly higher risk of hypertension and a minor increase in blood pressure among middle-aged and older Chinese adults, which warrants confirmation by long-term intervention studies.

Breakfast Skipping, Weight, Cardiometabolic Risk, and Nutrition Quality in Children and Adolescents: A Systematic Review of Randomized Controlled and Intervention Longitudinal Trials.

Breakfast skipping increases with age, and an association with a high risk of being overweight (OW) and of obesity (OB), cardiometabolic risk, and unhealthy diet regimen has been demonstrated in observational studies with children and adults. Short-term intervention trials in adults reported conflicting results. The purpose of this systematic review was to summarize the association of breakfast skipping with body weight, metabolic features, and nutrition quality in the groups of young people that underwent randomized controlled (RCT) or intervention longitudinal trials lasting more than two months. We searched relevant databases (2000–2021) and identified 584 articles, of which 16 were suitable for inclusion. Overall, 50,066 children and adolescents were included. No studies analyzed cardiometabolic features. Interventions were efficacious in reducing breakfast skipping prevalence when multi-level approaches were used. Two longitudinal studies reported a high prevalence of OW/OB in breakfast skippers, whereas RCTs had negligible effects. Ten studies reported a lower-quality dietary intake in breakfast skippers. This review provides insight into the fact that breakfast skipping is a modifiable marker of the risk of OW/OB and unhealthy nutritional habits in children and adolescents. Further long-term multi-level intervention studies are needed to investigate the relationship between breakfast, nutrition quality, chronotypes, and cardiometabolic risk in youths.

Effect of an extract of Pinus koraiensis leaves, Lycium chinense fruit, and Saururus chinensis (Lour.) Baill. leaves on liver function in excessive drinkers: A randomized, double-blind, placebo-controlled trial

• GGT significantly decreased in the women PLC group compared with the placebo group. • TC, LDL-C, and HDL-C significantly decreased in the PLC group after 12-weeks. • Some item of FSS questionnaire improved in PLC group after 12-weeks. • No adverse event and safety issue for 12-week intake PLC. Chronic alcohol consumption is a major risk factor for alcoholic liver disease. In this study, we examined the effect of an extract of Pinus koraiensis leaves, Lycium chinense fruit, and Saururus chinensis (Lour.) Baill. leaves (PLC) on liver function in Korean. A randomized, double-blind, placebo-controlled study was performed in 50 excessive drinkers. The subjects were randomly assigned to PLC (n = 25, 2,000 mg/day) or placebo (n = 25) groups. Blood liver enzymes, lipid profiles, and antioxidant enzymes were assessed at baseline and 12 weeks. GGT level significantly decreased in women in the test group compared with the placebo group (-2.50 ± 3.54 U/L vs. 3.80 ± 11.23 U/L, P = 0.006). TC (-13.04 ± 25.65 mg/dL, P = 0.020) and LDL-C (-10.33 ± 24.15 mg/dL, P = 0.047) levels reduced in the test group after 12 weeks. Although PLC, appears the possibility of improving liver function in excessive drinkers, however, a larger scale and long-term intervention study should be performed.

Dietary Total Antioxidant Capacity Was Associated With Bone Mass and the Risk of Osteoporosis in Postmenopausal Women

Abstract Objectives Antioxidant intake has been suggested to be associated with the risk of osteoporosis. However, the effect of dietary total antioxidant capacity (TAC) on bone health is not clear. The aim of the present study was to assess the hypothesis that dietary TAC was positively associated with bone mass and negatively with the risk of osteoporosis in Korean women. Methods This cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey, 2008–2011. Dietary TAC was estimated by using task automation technique and algorithm to calculate the theoretical TAC from one day of 24-hour recall data using a TAC database comprising antioxidant capacities of 42 dietary antioxidants, developed for common Korean foods. In total, 8230 women were divided into a postmenopausal and premenopausal group, and each group was subdivided into four groups according to quartiles of dietary TAC. Multiple regression analysis was performed to assess relationships between dietary TAC with bone mass and the risk of osteoporosis risk. Results Dietary TAC was negatively associated with the risk of osteoporosis (odds ratio: 0.73, 95% confidence interval: 0.54–0.99; p-trend = 0.045) in postmenopausal women, but not in premenopausal women. Dietary TAC was positively associated with bone mineral content (BMC) and bone mineral density of the femoral neck and lumbar spine in postmenopausal women, and BMC of total femur and lumbar spine in premenopausal women. Conclusions The present study suggested that dietary TAC was inversely associated with the risk of osteoporosis in postmenopausal women, and positively associated with bone mass in pre- and post-menopausal women. Further long-term cohort or intervention study will be necessary to confirm the effect of a high dietary TAC diet on bone health. Funding Sources This research was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Korean government.

Longitudinal changes on liver proton density fat fraction differ between liver segments

To study the spatial heterogeneity of liver fat fraction changes during a long-term lifestyle intervention study using magnetic resonance imaging (MRI). Thirty-two subjects underwent two MRI-scans in a span of one year. A chemical shift encoding-based water-fat separation method was applied to measure liver proton density fat fraction (PDFF) maps. The PDFF changes in the two liver lobes and the Couinaud segments were compared with the mean liver PDFF change. The slope of the relationship between mean liver PDFF changes and PDFF liver lobe changes was higher in the right compared to the left lobe (slopemean PDFF whole liver ~ mean PDFF right lobe =1.08, slopemean PDFF whole liver ~ mean PDFF left lobe =0.93, P<0.001). The highest slope of agreement between PDFF changes in each specific liver segment and mean liver PDFF changes was observed in segment VII (slope =1.12). The lowest slope of agreement between PDFF changes in each specific liver segment and mean liver PDFF changes was observed in segment I (slope =0.77). Larger PDFF changes in the right liver lobe were observed compared to PDFF changes in the left liver lobe (LLL) in subjects with both increasing and decreasing mean liver PDFF after one year. The results are in line with the existing literature reporting a heterogeneous spatial distribution of liver fat and highlight the need to spatially resolve liver fat fraction changes in longitudinal studies.

Effects of Combined Exercise and Low Carbohydrate Ketogenic Diet Interventions on Waist Circumference and Triglycerides in Overweight and Obese Individuals: A Systematic Review and Meta-Analysis.

(1) Background: The purpose of this meta-analysis was to investigate the effects of combined exercise and low carbohydrate ketogenic diet interventions (CELCKD) for overweight and obese individuals. (2) Methods: Relevant studies were searched by using the MEDLINE and EMBASE databases up to October 2020. Study Inclusion and Exclusion Criteria: Inclusion criteria were reporting effects of the CELCKD for overweight and obese individuals from randomized controlled trials. Studies that did not match the inclusion criteria were excluded. The methods for CELCKD and outcomes of selected studies were extracted. The effect sizes for interventions that included cardiorespiratory fitness, body composition, fasting glucose, and lipid profiles were calculated by using the standardized mean difference statistic. (3) Results: A total of seven studies and 278 overweight and obese individuals were included. The average intervention of selected studies consisted of moderate to vigorous intensity, 4 times per week for 9.2 weeks. Participating in CELCKD interventions was decreased triglycerides (d = −0.34, CI; −0.68–−0.01, p = 0.04) and waist circumference (d = −0.74, 95% confidence interval [CI]; −1.28–−1.20, p = 0.01), while cardiovascular fitness, body composition, fasting glucose, total cholesterol, high density lipoprotein (HDL) cholesterol, and low density lipoprotein (LDL) cholesterol were not statistically different after the interventions. No adverse side effects were reported. (4) Conclusions: Participation in interventions by overweight and obese individuals had beneficial effects including decreased waist circumference and triglycerides. Longer term intervention studies with homogenous control groups may be needed.

Thromboembolism in Muscle-Invasive Bladder Cancer. A Population-based Nationwide Study.

Routine VTE prophylaxis within 30 days of radical cystectomy (RC) for urinary bladder cancer (UBC) is used to protect from venous thromboembolism (VTE). However, randomized studies and nationwide population-based studies are lacking. To study VTE and risk factors for VTE in muscle-invasive UBC in a nationwide population-based series, with a focus on the association with RC with and without chemotherapy. We studied all patients with clinical stage T2-T4 UBC diagnosed 1997 to 2014 in the Bladder Cancer Data Base Sweden (BladderBaSe). Previous VTE events and risk factors for VTE were registered from 1987. Cox regression analyses and Kaplan-Meier curves were performed to study risk factors for VTE and cumulative incidence of VTE. In 9720 patients (71%males) with a median age of 74 years 546 (5.6%) had VTE after diagnosis. In Cox analyses controlling for patient's and tumour characteristics, and risk factors for VTE, VTE after diagnosis and first treatment date were associated with chemotherapy with or without RC. Cumulative incidence of VTE increased during 24 months after diagnosis and first treatment date. VTE were less common in patients with previous cardiovascular disease. VTE was commonly observed after 30 days from diagnosis and from first treatment date in patients with T2-T4 UBC, particularly after chemotherapy. The findings suggest that long-term intervention studies of benefit and possible harms of VTE prophylaxis after UBC should be undertaken.