Healthy Middle-aged Individuals Research Articles

Effects of free weight and body mass-based resistance training on thigh muscle size, strength and intramuscular fat in healthy young and middle-aged individuals.

What is the central question of this study? How do free weight resistance training (RT) and body mass-based RT for 8weeks compare for isometric muscular strength, muscle size and intramuscular fat (IMF) content in the quadriceps femoris? What is the main finding and its importance? Free weight and body mass-based RTs could induce muscle hypertrophy; however, decreased IMF content was observed following the body mass-based RT alone. The objective of this study was to investigate the effects of free weight and body mass-based resistance training (RT) on muscle size and thigh intramuscular fat (IMF) in young and middle-aged individuals. Healthy individuals (aged 30-64years) were assigned to either a free weight RT group (n=21) or a body mass-based RT group (n=16). Both groups performed whole-body resistance exercise twice a week for 8weeks. Free weight resistance exercises (squats, bench press, deadlift, dumbbell rows and back range) involved 70% one repetition maximum, with three sets of 8-12 repetitions per exercise. The nine body mass-based resistance exercises (leg raise, squats, rear raise, overhead shoulder mobility exercise, rowing, dips, lunge, single-leg Romanian deadlifts and push-ups) included the maximum possible repetitions per session, which were performed in one or two sets. Mid-thigh magnetic resonance images using the two-point Dixon method were taken pre- and post-training. The muscle cross-sectional area (CSA) and IMF content in the quadriceps femoris were measured from the images. Both the groups showed significantly increased muscle CSA post-training (free weight RT group, P=0.001; body mass-based RT group, P=0.002). IMF content in the body mass-based RT group significantly decreased (P=0.036) but did not significantly change in the free weight RT group (P=0.076). These results suggest that the free weight and body mass-based RTs could induce muscle hypertrophy; however, in healthy young and middle-aged individuals, decreased IMF content was induced following the body mass-based RT alone.

Comparing the effect of rhythmic stabilization and combination of isotonic technique on grip strength, pinch strength and dexterity of hand among middle aged healthy individuals - a randomized clinical trial

Purpose: The aim of the study was to evaluate and compare the effects of Rhythmic Stabilization and a combination of isotonic technique on grip strength, pinch strength, and dexterity of hand among middle aged healthy individuals. Methods
 Forty middle aged healthy individuals were selected on the basis of inclusion and exclusion criteria. Participants were randomly allocated to two groups, with 20 in group A (Rhythmic Stabilization) and 20 in group B (Combination of Isotonic Technique). Treatment was given for 4 weeks, thrice a week.
 Outcome measures: grip strength, pinch strength, and dexterity were assessed by the Jamar hand dynamometer, the Pinch gauge, and the Perdue peg board, respectively. Outcome measures were assessed at baseline and after 4 weeks of treatment.
 Results
 Notably, Group A participants showed a significant improvement in all outcome measures compared to Group B (p<0.05) when compared. Both the interventions were effective for dexterity outcome in both groups (p<0.05). Conclusion: This study provides evidence that application of Rhythmic Stabilization improves grip strength and pinch strength. This suggests that static Proprioceptive Neuromuscular Facilitation (PNF) exercises performed on the fingers can improve dexterity, grip strength, and pinch strength in the middle-aged population.
 Highlights
 As age increases, there is decrease in grip strength and dexterity of a person.
 The grip strength, finger strength and dexterity are inter-related.
 The Proprioceptive Neuromuscular Facilitation increases strength of muscles.
 The static PNF exercises are more effective than the dynamic PNF exercises to improve strength of grip strength, finger strength and dexterity.

Anticholinergic burden in middle and older age is associated with lower cognitive function, but not with brain atrophy.

The aim of this study is to estimate the association between anticholinergic burden, general cognitive ability and various measures of brain structural MRI in relatively healthy middle-aged and older individuals. In the UK Biobank participants with linked health-care records (n = 163,043, aged 40-71 at baseline), of whom about 17 000 had MRI data available, we calculated the total anticholinergic drug burden according to 15 different anticholinergic scales and due to different classes of drugs. We then used linear regression to explore the associations between anticholinergic burden and various measures of cognition and structural MRI, including general cognitive ability, 9 separate cognitive domains, brain atrophy, volumes of 68 cortical and 14 subcortical areas and fractional anisotropy and median diffusivity of 25 white-matter tracts. Anticholinergic burden was modestly associated with poorer cognition across most anticholinergic scales and cognitive tests (7/9 FDR-adjusted significant associations, standardised betas (β) range: -0.039, -0.003). When using the anticholinergic scale exhibiting the strongest association with cognitive functions, anticholinergic burden due to only some classes of drugs exhibited negative associations with cognitive function, with β-lactam antibiotics (β = -0.035, PFDR < 0.001) and opioids (β = -0.026, PFDR < 0.001) exhibiting the strongest effects. Anticholinergic burden was not associated with any measure of brain macrostructure or microstructure (PFDR > 0.08). Anticholinergic burden is weakly associated with poorer cognition, but there is little evidence for associations with brain structure. Future studies might focus more broadly on polypharmacy or more narrowly on distinct drug classes, instead of using purported anticholinergic action to study the effects of drugs on cognitive ability.

Modifiable Lifestyle Activities Affect Cognition in Cognitively Healthy Middle-Aged Individuals at Risk for Late-Life Alzheimer's Disease.

It is now acknowledged that Alzheimer's disease (AD) processes are present decades before the onset of clinical symptoms, but it remains unknown whether lifestyle factors can protect against these early AD processes in mid-life. We asked whether modifiable lifestyle activities impact cognition in middle-aged individuals who are cognitively healthy, but at risk for late life AD. Participants (40-59 years) completed cognitive and clinical assessments at baseline (N = 206) and two years follow-up (N = 174). Mid-life activities were measured with the Lifetime of Experiences Questionnaire. We assessed the impact of lifestyle activities, known risk factors for sporadic late-onset AD (Apolipoprotein E ɛ4 allele status, family history of dementia, and the Cardiovascular Risk Factors Aging and Dementia score), and their interactions on cognition. More frequent engagement in physically, socially, and intellectually stimulating activities was associated with better cognition (verbal, spatial, and relational memory), at baseline and follow-up. Critically, more frequent engagement in these activities was associated with stronger cognition (verbal and visuospatial functions, and conjunctive short-term memory binding) in individuals with family history of dementia. Impaired visuospatial function is one of the earliest cognitive deficits in AD and has previously associated with increased AD risk in this cohort. Additionally, conjunctive memory functions have been found impaired in the pre-symptomatic stages of AD. These findings suggest that modifiable lifestyle activities offset cognitive decrements due to AD risk in mid-life and support the targeting of modifiable lifestyle activities for the prevention of AD.

Joint associations of physical activity and sedentary time with body mass index: A prospective study of mortality risk.

Device-measured physical activity and sedentary time are suggested to be more important determinants of all-cause mortality compared to body mass index (BMI) in mainly older adults. However, the joint associations of physical activity and sedentary time with BMI in relation to mortality risk in relatively healthy middle-aged individuals are unclear. We followed 770 adults (56% women, mean age 55.6 years) from a population-based cohort study for up to 15.3 years. BMI categories were combined with tertiles of total, light, and moderate-to-vigorous physical activity and sedentary time. Cox proportional hazards models estimated hazard ratios (HR) of all-cause mortality with 95% confidence intervals (CI). High total and light intensity physical activity and low sedentary time were associated with a lower risk of mortality in normal weight individuals compared with low active overweight/obese; HR: 0.35 (CI: 0.14, 0.86), HR: 0.33 (CI: 0.12, 0.89), and HR: 0.34 (CI: 0.13, 0.92). Among overweight/obese individuals, those who were medium active in light physical activity had a lower mortality risk, HR: 0.36 (CI: 0.15, 0.83), compared with low active. Medium sedentary individuals had a lower risk, HR: 0.43 (CI: 0.20, 0.94) compared with those who were most sedentary. Associations among the most active or least sedentary tertiles were similar irrespective of BMI category. In conclusion, higher physical activity and lower sedentary time were associated with lower mortality risk irrespective of BMI. Physical activity should be promoted and prescribed to individuals with low physical activity levels irrespective of weight status.

Following changes in balance and cognitive performance on healthy middleaged people: Evaluation of the effect of two types of concurrent training

Purpose.The study aimed to compare the effects of two different concurrent training protocols applied to healthy middleaged individuals on balance parameters and cognitive functions.Methods.Thirty-three middle-aged adults voluntarily participated in this study. A randomised, between-group design (Strength+Aerobic Group [SAG] and control group Aerobic+Strength Group [ASG]) was used. After collecting data related to the main characteristics of the subjects (i.e., age, sex, medical history, smoking habits), the following assessments were made: Subjects’ physical activity level, balance parameters, and inhibition and attention indicators. The intervention lasted 13 weeks (2 sessions per week, 50 minutes per session).Results.Both protocols (SAG and ASG) significantly improved balance performance. However, as for the group-by-time interaction, no significant difference between the two groups were observed in any of the parameters assessed (F(1–31) = 0.843; 0.760; 0.612; 0.656; &lt;i&gt;p&lt;/i&gt; &gt; 0.05). Thus, it was found that participating in either the SAG or ASG groups had no significant influence on attention accuracy, reaction time, total number of matters processed (participants’ psychomotor speed), and non-marked letters (selective attention) (post-test–pre-test difference: F(1–31) = 0.239, 0.337, 0.738, 0.414; &lt;i&gt;p&lt;/i&gt; &gt; 0.05). It was also observed that both training programs resulted in similar improvements in all balance characteristics and cognitive parameters.Conclusions.It was found that the order of strength or aerobic exercises in the concurrent training for improving balance and cognitive parameters in healthy middle-aged individuals is not significant.

Exoskeleton Training Modulates Complexity in Movement Patterns and Cortical Activity in Able-Bodied Volunteers.

Robot-aided gait training (RAGT) plays a crucial role in providing high-dose and high-intensity task-oriented physical therapy. The human-robot interaction during RAGT remains technically challenging. To achieve this aim, it is necessary to quantify how RAGT impacts brain activity and motor learning. This work quantifies the neuromuscular effect induced by a single RAGT session in healthy middle-aged individuals. Electromyographic (EMG) and motion (IMU) data were recorded and processed during walking trials before and after RAGT. Electroencephalographic (EEG) data were recorded during rest before and after the entire walking session. Linear and nonlinear analyses detected changes in the walking pattern, paralleled by a modulation of cortical activity in the motor, attentive, and visual cortices immediately after RAGT. Increases in alpha and beta EEG spectral power and pattern regularity of the EEG match the increased regularity of body oscillations in the frontal plane, and the loss of alternating muscle activation during the gait cycle, when walking after a RAGT session. These preliminary results improve the understanding of human-machine interaction mechanisms and motor learning and may contribute to more efficient exoskeleton development for assisted walking.

Macro- and Microvascular Function in Middle-Aged Individuals with Low Cardiovascular Disease Risk.

Aims: To investigate the microvascular function in apparently healthy individuals showing signs of early macrovascular endothelial dysfunction. Methods: Healthy participants aged between 30−55 years were recruited for the present study. Baseline measurements included body-mass index (BMI), waist-to-hip ratio (WHR), 24-h blood pressure, as well as fasted venous glucose, triglycerides (TG) and cholesterol (HDL, LDL and total). Brachial artery reactivity was measured using the flow-mediated dilation (FMD) technique and retinal vessel reactivity was assessed by using the Dynamic Retinal Vessel Analyser (DVA) in all individuals. The enrolled participants were separated in two groups, based on either a reduced (group 1: <5%—n = 53) or a normal FMD response (group 2: 7−10%—n = 47). Results: Individuals exhibiting reduced FMD responses showed a reduced baseline-corrected microvascular arterial dilation response to flickering light (p = 0.039). In addition, they also exhibited a reduced arteriolar maximum dilation (p = 0.034), as well as a longer dilation reaction time (p = 0.048) and a lower dilation amplitude (p = 0.042) when compared to those with normal FMD values. Conclusion: In otherwise healthy middle-aged individuals, early signs of vascular dysfunction are reflected simultaneously at both macro- and microvascular levels.

Abstract 12632: Relationships Between Circadian Ambulatory Systolic Blood Pressure Variability With Subclinical Atherosclerosis in Healthy Middle-Aged Individuals

Background: Short-term fluctuations in blood pressure (BP) as measured by 24-hr ambulatory BP monitoring (ABPM) is associated with subclinical atherosclerosis in the general population. However, whether short-term blood pressure variability (BPV) in the day versus night-time has differential effects on the development of subclinical atherosclerosis is uncertain. Methods and Results: We investigated the relationship between mean 24-hr BP and BPV parameters with common carotid artery intima-media thickness (CIMT) in 305 middle-aged Chinese (mean age 54±7years, 45% male) free from hypertension, hyperlipidaemia, diabetes or cardiovascular diseases. Subclinical atherosclerosis with elevated CIMT was defined as &gt;75th percentile of CIMT of the overall study cohort. Linear regression models adjusted for age, sex, body mass index and smoking status revealed significant associations between office, day- and night-time mean SBP, day-time SBP standard deviation (SD) and coefficient of variation (CV) with elevated CIMT (all p&lt;0.05). As shown in the Table , logistic regression analysis demonstrated that only ABPM day-time mean SBP (odds ratio [OR]:2.54, 95% confidence interval [95%CI]:1.29-5.00), night-time mean SBP (OR:3.23, 95%CI:1.67-6.22), night-time mean DBP (OR:2.27, 95%CI:1.16-4.42), day-time SBP CV (OR:0.47, 95%CI:0.26-0.86) and night-time SBP SD (OR1.94, 1.05-3.58) predicted the occurrence of subclinical atherosclerosis (all p&lt;0.05). Conclusions: In healthy middle-age individuals without known hypertension, mean day and night-time SBP as measured using ABPM provided the strongest positive predictive value for elevated CIMT. Interestingly, increase day-time SBP CV versus night-time SBP SD have opposite effects on CIMT, suggesting circadian changes in SBP might have distinct contributions to the development of subclinical atherosclerosis.

Factors associated with the location of perivascular space enlargement in middle-aged individuals undergoing brain screening in Japan

ObjectiveIn elderly populations, the enlargement of the perivascular space is related to small vessel disease and the glymphatic system. Enlarged perivascular spaces (EPVS) in the basal ganglia (EPVS–BG) and EPVS in the centrum semiovale (EPVS–CSO) are associated with different pathophysiological processes. However, the prevalence of EPVS and the factors associated with EPVS location in healthy middle-aged individuals are still unclear. We aimed to determine the prevalence of EPVS and the factors associated with EPVS location among healthy individuals in their 40 s MethodsThis study included 5000 consecutive healthy individuals who underwent screening for brain diseases in Japan from August to December 2018. Of them, the data of individuals in their 40 s were extracted and analyzed. The associations of age, sex, body mass index, smoking and drinking history, and medical history with EPVS location were investigated. Similar analyses were performed for the other age groups. A literature review on the factors associated with EPVS location was also performed. ResultsA total of 1720 individuals in their 40 s were finally included. The prevalence of EPVS–BG and EPVS–CSO was 7.7% and 9.2%, respectively. Age (years), smoking history, and hypertension were associated with EPVS–BG; none of the studied factors were found to be associated with EPVS–CSO. In the elderly, the factors previously reported to be associated with EPVS–BG included atherosclerosis change, while the factors associated with EPVS–CSO were cerebral amyloid angiopathy-related formation. ConclusionBoth EPVS–BG and EPVS–CSO occurred among healthy individuals in their 40 s, but they did so rarely, and less prevalently than in older age groups. EPVS–BG and EPVS–CSO may represent early imaging signs of the atherosclerotic and cerebral amyloid angiopathy processes, respectively. Data AvailabilityThe anonymized data for this study will be shared upon any qualified investigator’s request to the corresponding author. Primary data from this study will be made available upon reasonable request in accordance with the review board of the research institute.

Distribution of cardiovascular disease risk according to SCORE2 and potential need for cholesterol and blood pressure lowering therapy in apparently healthy middle-aged individuals

Abstract Background The 2021 European Society of Cardiology (ESC) prevention guidelines recommend the Systemic Coronary Risk Estimation 2 algorithm (SCORE2) to estimate the 10-year risk of cardiovascular disease (CVD) events to guide pharmacological treatment for primary prevention in apparently healthy individuals aged 40–69 years. Purpose To assess the distribution of CVD risk according to SCORE2 and the proportion of individuals who could be eligible for pharmacological treatment of blood cholesterol and blood pressure in an apparently healthy middle-aged population in Sweden. Methods We used data from the Swedish Cardiopulmonary Bioimage Study (SCAPIS) which used population registers to randomly recruit individuals aged 50–64 years at six Swedish study sites. Information was collected from the study participants through clinical examinations, national registries, and questionnaires. We excluded individuals with previously known atherosclerotic CVD, diabetes mellitus, or chronic kidney disease with eGFR &amp;lt;60 mL/min/1.73 m2. The SCORE2 algorithm designed for countries with moderate baseline CVD risk was used to categorize study participants' 10-year CVD risk as low-moderate (&amp;lt;5% risk); high (5-&amp;lt;10% risk); and very-high (≥10% risk). The proportions of the population who could be eligible, according to the 2021 ESC prevention guidelines, for pharmacological treatment of LDL-cholesterol (LDL-C) were assessed. Treatment thresholds for LDL-C according to SCORE2 risk were ≥1.8 mmol/L (high risk) and ≥1.4 mmol/L (very-high risk). Treatment threshold for hypertension was defined as a blood pressure ≥140/90 mmHg regardless of CVD risk. Results SCAPIS included 30,082 individuals. After exclusion criteria were applied 26,877 individuals remained (median age 57.2 years; 52.8% women). The median 10-year risk of CVD according to SCORE2 was 5.0 (interquartile range 3.0, 7.0) %. In total, 47.5% were classified as low-moderate risk, 45.9% as high risk, and 6.6% as very-high risk, with men having higher risk than women (figure). Almost all of those with high and very-high risk had LDL-C levels above the treatment thresholds. As such, according to the guidelines, lipid-lowering treatment should be considered (high risk) or was generally recommended (very-high risk) in 51.7% of the total population (Figure 1). The proportion of individuals with blood pressure ≥140/90 mmHg was 21.9%. The self-reported use of lipid-lowering therapy among low-moderate, high risk, and very-high risk individuals was 3.1%, 6.9%, and 6.3%, respectively. The use of blood pressure lowering therapy was 13.1% for those with blood pressure &amp;lt;140/80 mmHg and 29.2% for those ≥140/90 mmHg. Conclusions In this population-based study of nearly 27,000 apparently healthy middle-aged individuals in Sweden, around half of the individuals could be eligible for LDL-C-lowering therapy and around one in five could be eligible for antihypertensive therapy according to the 2021 ESC prevention guidelines. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): SCAPIS funding: The Swedish Heart-Lung Foundation and Knut and Alice Wallenberg Foundation.

Cerebral gray matter volume correlates with fatigue and varies between desk workers and non-desk workers.

Chronic fatigue syndrome (CFS), a clinical entity of chronic fatigue, has been associated with a decrease in regional gray matter volume (rGMV). In this study targeting a large number of healthy middle-aged individuals without CFS, the relationship between fatigue perception and rGMV was investigated. Considering that the work setting is an environmental factor that influences fatigue perception among healthy individuals, the differences between desk workers and non-desk workers were investigated. Chalder Fatigue Questionnaire (CFQ) scores were used for perceptional evaluation of fatigue, and rGMV of 110 brain regions was adapted with Statistical Parametric Mapping (SPM) 8 on 1.5 T magnetic resonance imaging (MRI) results for the volumetric calculation of gray matter. The CFQ scores were negatively correlated with the right supplementary motor area (SMC) and positively correlated with the right superior parietal lobule (SPL) and left basal forebrain in all participants (n = 1,618). In desk workers and non-desk workers, the CFQ scores correlated with different regions and yielded different mechanisms of fatigue perception in the brain. Identifying the gray matter regions correlated with fatigue perception in healthy individuals may help understand the early stage of fatigue progression and establish future preventive measures.

Frontal grey matter microstructure is associated with sleep slow waves characteristics in late midlife.

The ability to generate slow waves (SW) during non-rapid eye movement (NREM) sleep decreases as early as the 5th decade of life, predominantly over frontal regions. This decrease may concern prominently SW characterized by a fast switch from hyperpolarized to depolarized, or down-to-up, state. Yet, the relationship between these fast and slow switcher SW and cerebral microstructure in ageing is not established. We recorded habitual sleep under EEG in 99 healthy late midlife individuals (mean age = 59.3 ± 5.3 years; 68 women) and extracted SW parameters (density, amplitude, frequency) for all SW as well as according to their switcher type (slow vs. fast). We further used neurite orientation dispersion and density imaging (NODDI) to assess microstructural integrity over a frontal grey matter region of interest (ROI). In statistical models adjusted for age, sex, and sleep duration, we found that a lower SW density, particularly for fast switcher SW, was associated with a reduced orientation dispersion of neurites in the frontal ROI (p = 0.018, R2β* = 0.06). In addition, overall SW frequency was positively associated with neurite density (p = 0.03, R2β* = 0.05). By contrast, we found no significant relationships between SW amplitude and NODDI metrics. Our findings suggest that the complexity of neurite organization contributes specifically to the rate of fast switcher SW occurrence in healthy middle-aged individuals, corroborating slow and fast switcher SW as distinct types of SW. They further suggest that the density of frontal neurites plays a key role for neural synchronization during sleep. EudraCT 2016-001436-35.

Intima-media Thickness Measured at the Common-carotid Artery in Patients Treated with Lipoprotein Apheresis

<h3>Lead Author's Financial Disclosures</h3> Nothing to disclose. <h3>Study Funding</h3> None. <h3>Background/Synopsis</h3> Common carotid intima-thickness (CIMT) is as a marker of arterial wall injury and arteriosclerosis. Healthy asymptomatic young and middle-aged individuals of the European-ancestry show mean CIMT of 610 + /-110μmmicrometers with a strong linear relation between age and CIMT. In the general population, an annual rate of change in mean common CIMT is estimated at 15μm (95% CI, 12 to 17), with a median standard deviation of 53. <h3>Objective/Purpose</h3> We sought to compare annual CIMT progression rates in 10 patients with severe hypercholesterolemia treated with lipoprotein apheresis with published annual CIMT progression estimates in age-comparable 1) healthy individuals based on the nomograms, 2) patients with elevated lipoprotein(a), and 3) familial hypercholesterolemia (FH). <h3>Methods</h3> Patients (mean age 60+/-9 years, 70% female, 80% statin intolerant) were treated with the dextran sulfate adsorption apheresis system for primary and secondary atherosclerotic cardiovascular disease (ASCVD) prevention every two weeks between 2005 and 2020 (mean duration, 10+/-4 years). To minimize intra-individual and inter-individual variability in CIMT assessment we used computerized algorithms with measurements performed by the same sonographer. <h3>Results</h3> The baseline mean CIMT was 850+/-170μm and maximum CIMT was 1040+/-220um across the age range of 46 to 70 years. The baseline median levels of total cholesterol were 317 (interquartile range (IQR), 262 to 361); LDL-C, 214 (133 to 253); HDL-C, 56 (44 to 68); triglycerides, 170 (121 to 215), lipoprotein(a), 26 (9 to 120), all in mg/dL. Acute effects of lipoprotein apheresis determined as a difference before and immediately after the procedure were estimated as a median of 72+/-8% and 75+/-7% reduction in the LDL-C and lipoprotein(a) levels, respectively. Regular treatment with lipoprotein apheresis resulted in average reduction in the mean CIMT of −40μm (IQR, −50 to 20). An annual CIMT progression rate was associated with the combined percentage reduction in the lipoprotein(a) (P=0.032) and LDL-C levels (P=0.029). Using the Bayesian Estimation Supersedes the t -Test (BEST) method, the annual rate of CIMT progression was compared to those reported in the literature (Table 1). <h3>Conclusions</h3> Composite CIMT progression rates were slowed with lipoprotein apheresis. In this cohort of high-risk patients with poor statin tolerance, the use of CIMT surveillance was noted to increase compliance with long-term lipid-modifying therapies in the clinical setting.

Four-Week Supplementation of Water-Soluble Tomato Extract Attenuates Platelet Function in Chinese Healthy Middle-Aged and Older Individuals: A Randomized, Double-Blinded, and Crossover Clinical Trial.

Background and AimsPlatelets are linked to atherosclerotic development and pathological thrombosis. Single dose of water-soluble tomato extract (WTE) which is a natural extraction can exert anti-platelet effects after 3 or 7 h in British healthy people. However, the effects of WTE supplementation on platelet function in Chinese healthy middle-aged and older individuals have not been studied, and the effects or safety of 4-week WTE supplementation also remain unclear. The present study aims to determine the effects of WTE on platelet function, and explore the safety of 4-week WTE supplementation in Chinese healthy middle-aged and older individuals.MethodsA randomized, double-blinded, and crossover clinical trial was conducted. Firstly, 105 individuals were randomly divided into two groups that received WTE (150 mg/day) or placebo for 4 weeks. Then, after a washout period of 2 weeks, two groups exchanged groups and continued for another 4-week intervention. Platelet aggregation, P-selectin, activated GPIIbIIIa, plasma platelet factor 4 (PF4), β-thromboglobulin (β-TG), and thromboxane B2 (TXB2) were tested at baseline, 4, 6, and 10 weeks.ResultsCompared with the placebo group, 150 mg/day WTE supplement for 4 weeks significantly reduced ADP-induced or collagen-induced platelet aggregation (−10.8 ± 1.8 or −3.9 ± 1.5%, P < 0.05), ADP-induced or collagen-induced platelet P-selectin expression (−6.9 ± 1.5 or −6.6 ± 1.3%, P < 0.05), ADP-induced or collagen-induced activated GPIIbIIIa (−6.2 ± 2.0 or −3.8 ± 2.0%, P < 0.05). Besides, 4-week intervention of 150 mg WTE per day also resulted in significant reductions in plasma PF4 (−120.6 ± 33.2 ng/mL, P < 0.05) and β-TG (−129.7 ± 27.5 ng/mL, P < 0.05) and TXB2 (−42.0 ± 4.0 ng/mL, P < 0.05), while had no effects on coagulation function and liver or renal function. Interestingly, 2-week washout period is enough to reverse the inhibitory effect of 4-week WTE supplementation on platelet function.ConclusionWTE supplementation for 4 weeks could moderately reduce platelet activation, aggregation, and granule secretion in Chinese healthy middle-aged and older individuals, and these effects are safe. After 2-week washout period, the inhibitory effect of 4-week WTE on platelet function can be eliminated.Clinical Trial Registration[http://www.chictr.org.cn/], identifier [ChiCTR-POR-17012927].

Measuring psychosocial stress with heart rate variability-based methods in different health and age groups

Objective. Autonomic nervous system function and thereby bodily stress and recovery reactions may be assessed by wearable devices measuring heart rate (HR) and its variability (HRV). So far, the validity of HRV-based stress assessments has been mainly studied in healthy populations. In this study, we determined how psychosocial stress affects physiological and psychological stress responses in both young (18–30 years) and middle-aged (45–64 years) healthy individuals as well as in patients with arterial hypertension and/or either prior evidence of prediabetes or type 2 diabetes. We also studied how an HRV-based stress index (Relax-Stress Intensity, RSI) relates to perceived stress (PS) and cortisol (CRT) responses during psychosocial stress. Approach. A total of 197 participants were divided into three groups: (1) healthy young (HY, N = 63), (2) healthy middle-aged (HM, N = 61) and (3) patients with cardiometabolic risk factors (Pts, N = 73, 32–65 years). The participants underwent a group version of Trier Social Stress Test (TSST-G). HR, HRV (quantified as root mean square of successive differences of R–R intervals, RMSSD), RSI, PS, and salivary CRT were measured regularly during TSST-G and a subsequent recovery period. Main results. All groups showed significant stress reactions during TSST-G as indicated by significant responses of HR, RMSSD, RSI, PS, and salivary CRT. Between-group differences were also observed in all measures. Correlation and regression analyses implied RSI being the strongest predictor of CRT response, while HR was more closely associated with PS. Significance. The HRV-based stress index mirrors responses of CRT, which is an independent marker for physiological stress, around TSST-G. Thus, the HRV-based stress index may be used to quantify physiological responses to psychosocial stress across various health and age groups.

Remote Gait Analysis as a Proxy for Traditional Gait Laboratories: Utilizing Smartphones for Subject-Driven Gait Assessment across Differing Terrains

Gait analysis has applications in medical diagnosis, biometrics, and development of therapeutic rehabilitation interventions (such as orthotics, prosthetics, and exoskeletons). While offering accurate measurements, gait laboratories are expensive, not scalable, and not easily accessible. In a pandemic-afflicted world, where telemedicine is crucial, there is need for subject-driven data remote collection. This study proposed a remote and purely subject-driven procedure for reproducible and scalable collection of real-life gait data. To evaluate the feasibility of our proposed procedure, the spatiotemporal parameters of gait were compared across two real-life terrains using a smartphone application on a focus population of healthy middle-aged individuals. Previous research validated smartphone motion sensors as accurate instruments for gait analysis, but required highly supervised, controlled environments on smaller sample sizes, thereby limiting application in real-life gait analysis. To this end, a custom-designed mobile application was developed to record lower extremity angular velocities on 69 healthy middle-aged adults; factoring in a subject-driven data submission error rate (DSER) of 17.4%, there were 57 usable data sets for analysis. Comparisons of spatiotemporal gait parameters across primary outcome measures on grass versus asphalt revealed significant measurable increases in gait duration (stride time), valley depth (max swing phase), and peak-to-valley (max stance phase to max swing phase). These results demonstrated the feasibility of using smartphones for a remote and fully subject-driven gait data collection. Additionally, our data analysis showed that even in short trials, a physical environmental load has a substantial and measurable effect on the gait of the understudied middle-aged population.

Quality of knee strengthening exercises performed at home deteriorates after one week

BackgroundTo compare the performance (as determined by lower extremity kinematics) of knee exercises in healthy middle-aged and older individuals immediately after instruction and one week later.MethodsThis is a cross-sectional study in a laboratory setting. Nineteen healthy volunteers (age [y] 63.1 ± 8.6, mass [kg] 76.3 ± 14.7, height [m] 1.7 ± 0.1) participated in this study. High speed video and reflective markers were used to track motion during four exercises. The exercises were knee flexion, straight leg raise, and “V “in supine position, and hip abduction in side lying position. All participants received verbal and tactile cues during the training phase and the therapist observed and, if necessary, corrected the exercises. Upon return a week later the participants performed the same exercises without any further instructions. Knee and hip sagittal and rotational angles were extracted from the motion capture. A repeated measures t-test was used to compare the motions between two visits.ResultsParticipants demonstrated more knee flexion during straight leg raise and “V in” exercises at the 2nd visit compared to the 1st visit (both p < 0.05). During the “V out” exercise, they performed more external rotation (p < 0.05) while they showed more internal rotation during the “V in” exercise at the 2nd visit compared to the 1st visit.ConclusionsExercise performance declined significantly in healthy middle-aged and older individuals one week after instruction. This decline occurred despite an instructional exercise sheet being given to every participant. Other approaches designed to help individuals retain the ability to perform rehabilitative exercises correctly need to be explored.

Offering Fiber-Enriched Foods Increases Fiber Intake in Adults With or Without Cardiometabolic Risk: A Randomized Controlled Trial.

IntroductionPrevious efforts to increase fiber intake in the general population were disappointing despite growing awareness of the multiple benefits of a high fiber intake. Aim of the study was to investigate the acceptance and consumption of fiber-enriched foods.MethodsOne hundred and fifteen middle-aged healthy individuals with and without elevated waist circumference (> 102 cm in males and > 88 cm in females) were recruited and randomized to an intervention or an age- and sex-matched control group. Subjects assigned to the intervention group were invited to select fiber-enriched foods from a broad portfolio of products to increase fiber intake by 10 g/day. Control subjects could choose items from the same food basket without fiber enrichment. The primary outcome was the increase in dietary fiber intake, and secondary outcomes were changes in cardiometabolic risk factors, microbiota composition, food choices, and consumer acceptance of the fiber-enriched foods.ResultsCompared to baseline, daily fiber intake increased from 22.5 ± 8.0 to 34.0 ± 9.6 g/day after 4 weeks (p < 0.001) and to 36.0 ± 8.9 g/day after 12 weeks (p < 0.001) in the intervention group, whereas fiber intake remained unchanged in the control group. Participants rated the taste of the food products as pleasant without group differences. In both groups, the most liked foods included popular convenience foods such as pretzel breadstick, pizza salami, and pizza vegetarian. After 12 weeks of intervention, there were minor improvements in plasma lipids and parameters of glucose metabolism in both the intervention and control group compared to baseline, but no differences between the two groups. Increased fiber consumption resulted in an increased (p < 0.001) relative abundance of Tannerellaceae.ConclusionsFiber-enrichment of popular foods increases fiber intake in a middle-aged population with and without cardiometabolic risk and may provide a simple, novel strategy to increase fiber intake in the population.

Effect of yogic practices on thyroid hormones

The beneficial effect of Yoga on the parameters of thyroid hormone has been evaluated through the various clinical trials. Since its review has not been recorded earlier, this study has been performed to investigate the effectiveness of Yogic practices on thyroid hormones, more specifically T3, T4, and TSH. Searches were performed through February–June, 2020 using the PUBMED and GOOGLE. The keyword used for search was Yoga and thyroid or thyroid disorder. Only experimental studies were selected which were reported in English, printed in prevailed publications, and inspecting the effectiveness of the regular practice on thyroid hormones in these studies. A total of 41 studies were selected through various searches, among which 11 met criteria for the final review. Hypothyroid patients showed decrease in thyroid-stimulating hormone (TSH), hyperthyroid patients showed decrease in tetraidothyronine (T4), polar tri-idothyronine (T3) syndrome population also showed positive effect of Yoga. Perimenopausal women showed not so significant change in these parameters. Healthy middle-aged individuals showed increase in TSH in the male population and near significant increase in this hormone was shown in the female population, also there was decrease in basal T3 and T4 in both male and female. All these changes were in normal range. Other two studies on healthy individuals did not show any significant change in T3, T4 or TSH. 1 study was done on hypothyroid patients using hand mudra only, showed significant changes in level of these parameters. In conclusion, it may stated that yogic practice may regularize thyroid hormone functioning and improve total health.