Risk Factors In Middle-aged Adults Research Articles

A novel, multidomain, primary care nurse-led and mHealth-assisted intervention for dementia risk reduction in middle-aged adults (HAPPI MIND): study protocol for a cluster randomised controlled trial

IntroductionMiddle-aged multidomain risk reduction interventions targeting modifiable risk factors for dementia may delay or prevent a third of dementia cases in later life. We describe the protocol of a cluster...

Intra-Assessment Resting Metabolic Rate Variability Is Associated with Cardiometabolic Risk Factors in Middle-Aged Adults

The intra-assessment resting metabolic rate variability is related to cardiometabolic health, as suggested by previous literature. We studied whether that variability (expressed as coefficient of variation [CV; %]) for oxygen consumption (VO2), carbon dioxide production (VCO2), respiratory exchange ratio (RER), and resting energy expenditure (REE) is similar between men and women, and if is similarly associated with cardiometabolic risk factors. Gas exchange in 72 middle-aged adults was measured by indirect calorimetry. Anthropometrics and body composition, cardiorespiratory fitness, circulating cardiometabolic risk factors, and heart rhythm parameters were also determined. Men and women presented similar intra-assessment resting metabolic rate variability (all p > 0.05). Notably, in men, CV for RER was positively associated with BMI and adiposity (both standardized β = 0.35, Ps ≤ 0.048), while CVs for VO2, VCO2, and REE were negatively associated (standardized β ranged from −0.37 to −0.46, all p ≤ 0.036) with cardiometabolic risk factors. In women, CVs for VCO2 and REE were negatively associated with adiposity (both standardized β = −0.36, Ps ≤ 0.041) and cardiometabolic risk Z-score (standardized β = −0.40 and −0.38, respectively, Ps ≤ 0.05). In conclusion, intra-assessment resting metabolic rate variability could be considered an indicator of cardiometabolic health in middle-aged adults.

Unveiling the Roadmap to Heart Health: Evaluating Modifiable Cardiovascular Disease Risk Factors in Middle-Aged Adults of Karachi

Background As a result of urbanization and lifestyle modifications, the burden of cardiovascular diseases (CVDs) is rising in developing nations. These nations' scarce resources and low literacy rates make it difficult to effectively manage CVDs. For prevention efforts, knowledge of modifiable risk factors is essential. The purpose of this study was to evaluate knowledge levels among people who had their first acute myocardial infarction and to identify variables related to a thorough comprehension of modifiable CVD risk factors. Methods In a cardiovascular disease centre in Lahore, Pakistan, a cross-sectional study was carried out. Anyone who was admitted to the hospital with an acute myocardial infarction diagnosis was eligible to participate. To assess knowledge of modifiable risk factors, such as fatty food consumption, smoking, obesity, and inactivity, a structured questionnaire was given to participants. For analysis, descriptive statistics were employed. Results 80 participants were included; 60% of them were men, and their average age was 50.2 years. Participants demonstrated good knowledge of smoking and exercise, but there were misconceptions about eating fatty foods and becoming obese. Moreover, the general Pakistani population's knowledge levels were consistent across studies. Conclusion While participants demonstrated reasonable knowledge of modifiable risk factors for CVDs, there were gaps in understanding, particularly related to fatty food consumption, obesity, and exercise. Targeted educational interventions and awareness campaigns are needed to address these gaps and promote healthier lifestyle choices. Increased knowledge can contribute to better prevention and management of CVDs. Keywords Cardiovascular Diseases, Health Education, Knowledge, Risk Factors.

Sedentary Behavior and Cardiometabolic Risk Factors in Middle-aged Adults Living in A Brazilian Eastern Amazon City: A Cross Sectional Study

This study investigated the association of self-reported daily time in sedentary behavior with cardiometabolic risk factors in middle-aged adults living in a Brazilian eastern Amazon city. Middle-aged public civil servant living in Palma’s city participated in this cross-sectional study. Daily sedentary behavior and physical activity were measured, and anthropometric parameters and blood biochemical biomarkers were obtained. The results showed that total daily time in sedentary behavior measured using International Physical Activity Questionnaire associated positively with waist to height ratio [β = 0.008 (95% CI = 0.001; 0.016), p = 0.023] and body adiposity index [β = 0.570 (95% CI = 0.110; 1.020), p = 0.016]; and the time spent in passive transport measured using Longitudinal Aging Study Amsterdam - Sedentary Behavior Questionnaire was positively associated with neck [β = 4.420 (95% CI = 1.360; 7.480), p = 0.005) and waist circumference [β = 7.990 (95% CI = 3.490; 12.500), p = 0.005], waist to hip ratio [β = 0.060 (95% CI = 0.030; 0.100), p = 0.001), conicity index [0.050 (95% CI = 0.010; 0.080), p = 0.002], and the concentrations of triglycerides [β =38.500 (95% CI = 6.640; 70.390), p = 0.019] and insulin [β = 2.490 (95% CI = 1.030; 3.950), p = 0.001]. In conclusion, self-reported sedentary behavior is associated with anthropometric and biochemical risk factors for cardiometabolic diseases in the studied individuals.

High omega-6/omega-3 fatty acid and oxylipin ratio in plasma is linked to an adverse cardiometabolic profile in middle-aged adults

Omega-6 and omega-3 oxylipins may be surrogate markers of systemic inflammation, which is one of the triggers for the development of cardiometabolic disorders. In the current study, we investigated the relationship between plasma levels of omega-6 and omega-3 oxylipins with body composition and cardiometabolic risk factors in middle-aged adults. Seventy-two 72 middle-aged adults (39 women; 53.6±5.1 years old; 26.7±3.8 kg/m2) were included in this cross-sectional study. Plasma levels of omega-6 and omega-3 fatty acids and oxylipins were determined using targeted lipidomic. Body composition, dietary intake, and cardiometabolic risk factors were assessed with standard methods. The plasma levels of the omega-6 fatty acids and derived oxylipins, the hydroxyeicosatetraenoic acids (HETEs; arachidonic acid (AA)-derived oxylipins) and dihydroxy-eicosatrienoic acids (DiHETrEs; AA-derived oxylipins), were positively associated with glucose metabolism parameters (i.e., insulin levels and homeostatic model assessment of insulin resistance index (HOMA); all r≥0.21, P<.05). In contrast, plasma levels of omega-3 fatty acids and derived oxylipins, specifically hydroxyeicosapentaenoic acids (HEPEs; eicosapentaenoic acid-derived oxylipins), as well as series-3 prostaglandins, were negatively associated with plasma glucose metabolism parameters (i.e., insulin levels, HOMA; all r≤0.20, P<.05). The plasma levels of omega-6 fatty acids and derived oxylipins, HETEs and DiHETrEs were also positively correlated with liver function parameters (i.e., glutamic pyruvic transaminase, gamma-glutamyl transferase (GGT), and fatty liver index; all r≥0.22 and P<.05). In addition, individuals with higher omega-6/omega-3 fatty acid and oxylipin ratio showed higher levels of HOMA, total cholesterol, low-density lipoprotein-cholesterol, triglycerides, and GGT (on average +36%), as well as lower levels of high-density lipoprotein cholesterol (-13%) (all P<.05). In conclusion, the omega-6/omega-3 fatty acid and oxylipin ratio, as well as specific omega-6 and omega-3 oxylipins plasma levels, reflect an adverse cardiometabolic profile in terms of higher insulin resistance and impaired liver function in middle-aged adults.

Voluntary Unemployment Is Associated With Increased Prevalence of Stroke and its Risk Factors in Middle-Aged Adults.

The aim of the study is to investigate the association between the prevalence of stroke, its risk factors, and occupational status, with a differentiation between voluntary and involuntary unemployment. This is a cross-sectional study, which included 3013 individuals aged 40 to 65 years. We compared the prevalence of stroke, comorbidities, self-reported stroke-like symptoms, healthy behaviors, and knowledge about stroke among the voluntarily and involuntarily unemployed versus the employed. Voluntary unemployment was associated with increased chances of stroke (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.05-3.57), hypertension (OR, 1.18; 95% CI, 1.06-1.32), diabetes (OR, 1.16; 95% CI, 1.01-1.35), and obesity (OR, 1.16; 95% CI, 1.05-1.29). Involuntary job loss was associated with increased odds of hypertension (OR, 1.69; 95% CI, 1.16-2.50) and more frequent self-reported stroke-like symptoms. We found higher chances of stroke among the voluntarily unemployed middle-aged adults, presumably because of increased prevalence of hypertension, diabetes, and obesity.

The Influence of Tart Cherry (Prunus cerasus, cv Montmorency) Concentrate Supplementation for 3 Months on Cardiometabolic Risk Factors in Middle-Aged Adults: A Randomised, Placebo-Controlled Trial.

Background: Tart Montmorency cherries (MC) have been shown to be rich in anthocyanins and other phytochemicals known to have anti-inflammatory properties and influence pathways that might improve cardiometabolic health. However, there is limited evidence for the longer-term use of tart cherries on these indices. The aim of the current study was to investigate the influence of MC concentrate on cardiometabolic health indices following a 3-month supplementation period. Methods: Fifty middle-aged adults (34 males and 16 females; mean ± SD age: 48 ± 6 years and BMI: 27.6 ± 3.7 kg/m2) completed a randomised, placebo-controlled parallel study in which they either received MC or an isocaloric placebo. Participants drank 30 mL of their allocated treatment twice per day for 3 months. Vascular function (blood pressure [BP], heart rate [HR], pulse wave velocity and analysis [PWV/A], and flow mediated dilation [FMD]) as well as indices of metabolic health (insulin, glucose, lipid profiles, and high sensitivity C reactive protein) were measured following an overnight fast before and after the 3 months. Results: No effect of the intervention between the groups was observed for vascular function or metabolic health variables following the intervention (p > 0.05). However, MC concentrate was shown to be safe and well-tolerated and, importantly, did not have any deleterious effects on these outcomes. In conclusion, MC has no influence on cardiometabolic indices in middle-aged adults.

Lifestyle intervention to improve cardiovascular risk factors in middle-aged adults with metabolic syndrome

Objectives: Metabolic syndrome prevalence among Korean adults is high and even though efforts have been made to reduce it, the numbers have remained steady for the past 9 years. This study aimed to develop a lifestyle intervention for the management and prevention of metabolic syndrome using a theoretical approach. Methods: Intervention contents were developed in a 2-phased process, the initial phase consisted in the review of theory and evidence, and in the second phase the intervention content was developed, including the creation of an intervention matrix. The development of the content was informed by the Transtheoretical Model. Results: The lifestyle intervention included two components, a 12-week counseling program, including strategies to target specific constructs (e.g. decisional balance, self-efficacy, stimulus control) and the distribution of twelve-monthly newsletters including information such as healthy recipes and other healthy lifestyle behaviors (e.g. stress management, exercising). Conclusions: To be able to develop an intervention that can be further tested for its effectiveness is paramount to create an intervention matrix and to systematically report the process through which the intervention contents were developed. This study can be useful to inform the development of new interventions for health behavior modification.

The Lifestyle and Behavioural Risk Factors of Future Doctors in Universiti Teknologi MARA, Malaysia

Introduction: Lifestyle and behavioural risk factors in middle-aged adults are proven to have an impact on later-life outcomes; hence health promotion activities should aim at the population before they reach their mid-life. Medical students will be representing a community in promoting health, henceforth they should have a healthy lifestyle and behaviour in order to facilitate and adoption of preventive practices in their future life as physicians. Therefore, this study was aimed to determine the lifestyle and behavioural risk factors among future doctors in a public university in Malaysia. Methods: A cross-sectional study was conducted at the Faculty of Medicine, Universiti Teknologi MARA (Sungai Buloh Campus). Simple random sampling was used to select eligible subjects among undergraduate medical students (pre-clinical years). A self-administered pro forma checklist was given to the subjects who consented. Descriptive analysis was performed, and univariate analysis was done by Chi-square, Fisher’s Exact test and independent t-test. Results: A total of 252 subjects participated. The majority (96.8%) were of Malay ethnicity and three-quarter of the subjects were females (76.2%). A small number of subjects were smokers (2.4%) and alcoholic consumers (1.2%). Approximately half (57.3%) of the female subjects had normal body mass indices, while this was only seen in one-third (35.0%) of male subjects. Most subjects (72.2%) exercised at least once a week, however only 17.1% of the subjects exercised at the recommended levels. There was a significantly higher proportion of males who had adequate exercise compared to that of females. Conclusion: Inadequate physical activity and imperfect BMI of the study subjects warrant exclusive promotion and education of healthy lifestyle in this population. It would probably be beneficial if assessment of lifestyle and behavioural risk factors could be conducted before these subjects embark into their professional working life. KEYWORDS: lifestyle, behaviour, risk factors, future doctors, Selangor.

Risk Profiles of Alzheimer Disease

Alzheimer disease (AD) is a dementing, neurodegenerative disorder that affects approximately 500,000 Canadians and its prevalence is expected to double over the next 30 years. Although several medications may temporarily augment cognitive abilities in AD, there presently exists no proven method to avoid the inevitable clinical deterioration in this devastating condition. The delineation of risk factors for the development of AD offers hope for the advent of effective prevention or interventions that might retard the onset of symptoms. In this article, we provide a comprehensive review of midlife risk factors implicated in the etiopathogenesis of sporadic AD. Although some risk factors are heritable and largely beyond our control, others are determined by lifestyle or environment and are potentially modifiable. In a companion paper, we introduce the concept of an Alzheimer Risk Assessment Clinic for ascertainment and mitigation of these and other putative dementia risk factors in middle-aged adults.

Home-based exercise for middle-aged Chinese at diabetic risk: A randomized controlled trial

ObjectiveTo evaluate short- (3months) and long-term (9months) effects of home-based exercise on adiponectin, exercise behavior and metabolic risk factors in middle-aged adults at diabetic risk. MethodsOne hundred and thirty-five middle-aged adults (38 men, 97 women) with at least one diabetic risk factor were randomly assigned to either a home-based exercise group (Ex-group) or a usual care group (C-group). Outcome measures included plasma adiponectin, exercise self-efficacy, physical activity, and metabolic risk factors, as follows: insulin levels, insulin resistance by homeostasis model assessment (HOMA-IR), physical fitness, and components of metabolic syndrome. This study was conducted in metropolitan Taipei from 2004 to 2005. ResultsThe Ex-group had improvements in exercise self-efficacy (+2.5, p=0.01), body mass index (BMI) (−0.6kg/m2, p<0.001) and flexibility (+2.4cm, p<0.001) at 3-month follow-up and maintained BMI and flexibility at 9-month follow-up. The Ex-group exhibited significantly increased physical activity while the C-group exhibited decreased physical activity at 9-month follow-up (p<0.001). No intervention effect was found on adiponectin (p=0.64) or other outcome measures over time. ConclusionsHome-based exercise did not improve adiponectin levels, but significantly improved exercise behavior, and certain metabolic risk factors, with the effects maintained for 9-months in subjects with type 2 diabetic risk.

Correlation of Plasma Protein C Levels with Cardiovascular Risk Factors in Middle-Aged Adults: The Atherosclerosis Risk in Communities (ARIC) Study

To evaluate the association of plasma protein C levels with constitutional, socioeconomic, life-style and biochemical factors important in cardiovascular diseases, we measured protein C levels in 12,290 middle aged (45-64 years) subjects participating in the ARIC study. Protein C levels had a normal distribution with a mean value of 3.17 micrograms/ml. They were higher in women than men and in whites than blacks; higher in postmenopausal women and further increased by hormonal supplements. The age influence was inconsistent and was considered to be inconsequential. Protein C levels were positively correlated with body mass index, LDL-cholesterol, HDL-cholesterol, and triglycerides and negatively associated with cigarette smoking. These factors should be taken into consideration when establishing normal protein C levels and when analyzing the relation between protein C and arterial and venous thrombotic disorders.

Relations between hemostasis variables and cardiovascular risk factors in middle-aged adults. Atherosclerosis Risk in Communities (ARIC) Study Investigators.

The relations between hemostatic variables and cardiovascular risk factors were examined in a biracial population sample of middle-aged adults. Fibrinogen, factor VII, factor VIII, von Willebrand factor, protein C, and antithrombin III levels varied considerably by age, sex, and race. Hemostatic variables also were associated with several life-style and biochemical risk factors. For the most part, higher levels of the risk factors were associated with higher levels of the hemostatic variables. The findings point to potential confounders that warrant consideration in cardiovascular disease studies, and/or mechanisms by which cardiovascular risk is conferred. They also suggest that modification of the cardiovascular risk factors may have the potential to alter the risk of thrombosis.