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Tag: Physical Activity

  • Mediterranean diet and exercise reshape gut microbiome, aiding weight loss

    Mediterranean diet and exercise reshape gut microbiome, aiding weight loss

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    In a recent study published in The American Journal of Clinical Nutrition, researchers investigate the health benefits of the Mediterranean diet (MedDiet) and physical activity interventions on overweight and obese participants by measuring changes in fecal metabolomic- and gut microbiota.

    Study: Effect of 1-year lifestyle intervention with energy-reduced Mediterranean diet and physical activity promotion on the gut metabolome and microbiota: A randomized clinical trial. Image Credit: Valentyn Volkov / Shutterstock.comStudy: Effect of 1-year lifestyle intervention with energy-reduced Mediterranean diet and physical activity promotion on the gut metabolome and microbiota: A randomized clinical trial. Image Credit: Valentyn Volkov / Shutterstock.com

    Health benefits of the MedDiet

    Characterized by a high intake of healthy vegetables, legumes, fruits, whole cereals, and nuts, moderate intake of seafood, low intake of dairy products and processed meats, as well as olive oil comprising the primary fat source, the traditional MedDiet has been growing in global popularity.

    Previous studies have investigated the health benefits of the MedDiet, which include significant cardiovascular disease (CVD), obesity, neurological, and all-cause mortality risk reductions as compared to suboptimal dietary patterns like the Western diet.

    The high concentrations of dietary fiber and anti-inflammatory nutraceuticals in the MedDiet have also been associated with promoting and persisting beneficial gut microbiota. To date, the metabolomic consequences of these associations remain unknown.

    Exploring the blood metabolome provides important insights into how gut microbiota-derived metabolites correlate with cardiometabolic diseases. Through the use of plasma metabolomics and 16S sequencing, researchers can elucidate how diet, circulating metabolites, and gut microbiota impact cardiovascular health.

    Understanding the influence of dietary interventions on both gut microbial composition and metabolomic profiles can support clinical recommendations to follow the MedDiet and other healthy diets, particularly in high-risk patients. Furthermore, these data can provide foundational insights for future studies investigating the indirect effects of diet on other non-cardiovascular somatic systems.

    About the study

    In the present study, researchers used data from the PREvención con DIeta MEDiterránea (PREDIMED)-Plus randomized trial to investigate the effects of one year of intensive lifestyle intervention on fecal metabolites, gut microbiota, and cardiovascular risk factors, particularly in overweight and obese patients. The study comprised 400 individuals between the ages of 55 and 75 years from Alicante, Barcelona, Reus, and Valencia who were randomly divided between the intervention group (IG) and control group (CG).

    Data collection included dietary and lifestyle information obtained through the er-MedDiet questionnaire, a 17-item derivation of the 14-item Mediterranean Diet Adherence Screener (MEDAS) questionnaire. Blood and stool samples were also collected during baseline assessments and routine follow-up. Anthropometric measurements and demographic data were further obtained from medical and government records.

    The researchers encouraged all study participants to increase their usual physical activity levels to include at least 45 minutes daily of brisk walking or an equivalent activity. All study participants were also encouraged to perform specific exercises that increase their balance, strength, and flexibility to ultimately complete 150 minutes or more of moderate-to-vigorous physical activity each week.

    Changes in physical activity levels were quantified using questionnaires that assigned the metabolic equivalent of tasks (MET) min/week metrics to physical activity status and MET h/day for sedentary behaviors. The study intervention included lifestyle recommendations for physical activity and diet and in-person behavioral support from a licensed dietitian for the IG group. In contrast, CG was treated ad libitum with a regular MedDiet, which was the only intervention.

    Outcomes of interest were measured using liquid chromatography-tandem mass spectrometry (LC-MS) for metabolomics identification, characterization, and quantification and 16S amplicon sequencing for gut microbiome evaluations. Linear regression models and weighted gene co-expression network analysis (WGCNA) were used to identify between-group differences and metabolomic sub-networks, respectively.

    Study findings

    The present study highlights the combined health benefits of a dietitian-guided MedDiet alongside physical activity compared to an ad libitum MedDiet.

    Overweight and obese participants in the IG cohort exhibited a mean weight reduction of 4.2 kg and 4.4 cm lower waist circumference than their CG counterparts. The body mass index (BMI) and total energy intake estimates of the IG group were 1.5 kg/m2 and 113.9 kcal lower than controls, thus explaining the 0.1% observed reductions in glycated hemoglobin values as compared to controls.

    Fecal metabolomic analysis revealed a total of 532 fecal metabolites, four of which were significantly different between IG and CG following one year. These four metabolites included 4,7,10,13,16-docosapentaenoic acid (DPA) and adrenic acid, both of which decreased following the intervention, as well as oleic acid and 3-methyl-adipic acid (3-MAA), both of which increased following intervention. While preliminary analyses suggested an additional 56 metabolites of interest, these were non-significant following false discovery rate (FDR) corrections.

    Network analyses grouped the 532 identified metabolites into 16 subnetworks ranging in size from Grey60 to brown. The Black, Midnight Blue, Pink, and Salmon subnetworks significantly differed between IG and CG cohorts following one year of the study.

    The Black subnetwork comprised ceramides and spingosines, whereas the Midnight blue subnetwork consists of purines. The Pink subnetwork metabolites included fatty acids and carnitines, whereas the Salmon network comprised bile acids.

    Compared to the CG, the IG exhibited reduced levels of the Black, Midnight Blue, and Pink subnetworks. Comparatively, the IG exhibited increased levels of the Salmon subnetwork compared to the CG.  

    Gut microbial analysis determined that IG Shannon and Chao1 alpha diversity indices were significantly higher than CG indices by the end of the study, with the top two axes of the principal coordinate analysis (PCoA) explaining 36% of the observed differences. 

    The Eubacterium hallii group exhibited a significant reduction in population size in the IG compared to the CG. A reduced abundance of Dorea was also observed but to a lesser extent than in the Eubacterium hallii group.

    Conclusions

    The present lifestyle intervention-based clinical trial highlights the benefits of stringent dietary supervision and physical activity engagement for at-risk overweight and obese individuals, even when compared to equal-risk subjects consuming a similarly healthy diet. The energy-reduced MedDiet and physical activity intervention in the IG, when compared with an ad libitum MedDiet for the CG, significantly reduced weight metrics, including waist circumference and BMI.

    Even with similar healthy dietary patterns, the high intensity of the dietary intervention and weight-loss intervention components, such as caloric restriction and physical activity, could have significant benefits on CVD risk factors, potentially through modulation of the fecal microbiota and metabolome. Public health policies and interventions can be tailored to individual microbiome profiles, allowing for more precise and effective strategies for preventing and managing cardiometabolic diseases.”

    Journal reference:

    • García-Gavilán, J. F., Atzeni, A., Babio, N., et al. (2024). Effect of 1-year lifestyle intervention with energy-reduced Mediterranean diet and physical activity promotion on the gut metabolome and microbiota: A randomized clinical trial. The American Journal of Clinical Nutrition. doi:10.1016/j.ajcnut.2024.02.021

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  • Increased adherence to DASH diet related to decreased probabilities of metabolic disease conditions among adolescents, particularly overweight girls

    Increased adherence to DASH diet related to decreased probabilities of metabolic disease conditions among adolescents, particularly overweight girls

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    In a recent study published in Scientific Reports, researchers evaluated the relationship between Dietary Approaches to Stop Hypertension (DASH) and metabolic health status among Iranian overweight and obese adolescents.

    Study: Association of priori-defined DASH dietary pattern with metabolic health status among Iranian adolescents with overweight and obesity. Image Credit: monticello/Shutterstock.com
    Study: Association of priori-defined DASH dietary pattern with metabolic health status among Iranian adolescents with overweight and obesity. Image Credit: monticello/Shutterstock.com

    Background

    Adolescent overweight and obesity are global health concerns associated with metabolic conditions such as hypertension, blood lipid abnormalities, impaired glucose metabolism, and insulin resistance. These diseases increase the risk of cardiovascular disease, type 2 diabetes, and early death—lifestyle variables such as food and physical exercise influence metabolic health.

     Recent studies report favorable relationships between high vegetable and fruit intake and low sugary beverages and fats, implying a link between healthy diets and metabolically healthy overweight or obesity. The DASH diet, which contains more vegetables, fruits, whole grains, legumes, seeds, and low-fat-type dairy foods, has been researched in adolescents, but disputed findings call for more research.

    About the study

    In the present cross-sectional study, researchers explored the metabolic impact of DASH diets among overweight and obese adolescents.

    The team surveyed 203 adolescents aged 12 to 18 years with overweight or obesity status, as determined by body mass index (BMI) values using the Quetelet formula. Eligible students did not follow weight-loss diets, had no endocrinal or genetic disease, and did not use vitamin or mineral supplements or medications that could alter their metabolic profiles. 

    The researchers obtained dietary intake data using standardized food frequency questionnaires (FFQs). They also collected data on anthropometric parameters such as circulating insulin, blood pressure, lipid profile, and fasting blood sugar. The team characterized DASH scores based on eight components, i.e., higher intake of low-fat dairy foods, whole grains, seeds, nuts, vegetables, fruits, and legumes, and lower consumption of sodium, sweetened beverages, and processed and red meats.

    The team obtained blood samples from all participants for biochemical analysis. They measured insulin levels by enzyme-linked immunosorbent assays (ELISA) and ascertained metabolic health status based on insulin resistance, determined using the International Diabetes Federation (IDF) and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) criteria.

    The researchers assessed physical activity levels using the Physical Activity Questionnaire for Adolescents (PAQ-A) and total calorie intake using the United States Department of Agriculture (USDA) food composition database. They used multivariate logistic regression to calculate the odds ratios (ORs) for the association between DASH diets and metabolic health, adjusting for age, gender, physical activity, socioeconomic status, and total calorie intake.

    Results

    The mean values for age and BMI of the study participants were 14 years and 27 kg/m2, respectively. Among participants, 79 (42 girls and 37 boys, 39%) suffered from metabolically unhealthy overweight or obesity (MUO) by the IDF definition, and 62 (32 girls and 35 boys, 33%) were MUO following the IDF and HOMA-IR guidelines. Using the IDF definition, MUO prevalence in the DASH diet’s highest tertile was lower compared to the lowest statistical tertile (10 vs. 67%). Using HOMA-IR guidelines yielded similar findings (10 vs. 61%).

    Individuals in the uppermost tertile of the DASH diet were more physically active, with higher HDL-c levels and lower blood pressure, fasting blood sugar, insulin, triglyceride, and HOMA-IR levels, compared to those in the lowest tertile. Confounder adjustment showed that individuals in the highest vs. lowest DASH tertile had 91% and 92% lower MUO odds using the IDF/IR (OR, 0.09) and IDF definition (OR, 0.08), respectively.

    The highest vs. lowest DASH adherence was associated with decreased odds of hyperglycemia, hypertriglyceridemia, insulin resistance, and low HDL cholesterolemia, with odds ratios of 0.1, 0.3, 0.1, and 0.3, respectively. Subgroup analysis by BMI and sex indicated that the association was more robust among females (OR, 0.02) than males (OR, 0.09). The DASH diet likely improves metabolic health by lowering inflammation because of its high fiber, antioxidants, potassium, magnesium, and low salt content.

    Conclusions

    Overall, the study findings showed that increased adherence to the DASH diet was related to decreased probabilities of metabolic disease conditions among Iranian adolescents, particularly overweight girls. The study also found that adhering to the DASH diet reduced the risk of hypertriglyceridemia, hyperglycemia, insulin resistance, and low HDL cholesterol. Further research, including prospective surveys, could validate the study findings.

    The inverse association observed between the DASH dietary pattern and the MUO category in the current study indicates that adolescents must increase the intake of health-associated DASH components, including fruits, vegetables, legumes, low-fat-type dairy foods, whole grains, seeds, and nuts while limiting the consumption of unhealthy foods such as processed and red meats, sweetened beverages, and salt to improve dietary quality and decrease the metabolic disease burden.

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  • Can the modulation of the gut microbiome using a prebiotic improve muscle function and cognition?

    Can the modulation of the gut microbiome using a prebiotic improve muscle function and cognition?

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    In a recent study published in Nature Communications, researchers examined the efficacy of a prebiotic in improving muscular and cognitive performance vs. a placebo among elderly individuals.

    Study: Effect of gut microbiome modulation on muscle function and cognition: the PROMOTe randomised controlled trial. Image Credit: Tatiana Shepeleva/Shutterstock.com
    Study: Effect of gut microbiome modulation on muscle function and cognition: the PROMOTe randomised controlled trial. Image Credit: Tatiana Shepeleva/Shutterstock.com

    Background

    As the world’s population ages, age-related disorders such as muscle loss and cognitive impairment become more common. Researchers and physicians must acknowledge cognitive changes as part of healthy aging. Exercise can help reduce muscle loss, although elderly individuals may struggle. Interventions with physical and mental advantages are required.

    According to recent studies, alterations in the gut microbiota might influence muscle physiology and cognitive function, potentially altering anabolic resistance in older muscles and cognition. Prebiotics are associated with improved health in older individuals.

    About the study

    In the present study, researchers explored the role of gut microbiota regulation in enhancing cognition and muscular function benefits from protein supplementation and exercise in elders.

    The team conducted the PRebiotic and PrOtein on Muscle in Older Twins (PROMOTe) trial remotely using video visits, online surveys, cognitive tests, and the sending of equipment and biological samples. Participants were aged ≥60 years and had a low protein consumption of <1.0 g per kg weight per day, as established by the TwinsUK group.

    The team excluded participants with severe food allergies, ongoing or recent antibiotic use, protein supplementation, prebiotics and probiotics, and advanced renal disease. They also excluded individuals with a weight reduction of ≥5.0% of body weight in the previous year, major surgery or injury that could alter physical functions, and current participation in other interventional trials.

    The team randomized twin pairs to receive either a placebo (7.5g maltodextrin) or a prebiotic (intervention, 3.4 g inulin and 3.5 g fructo-oligosaccharides) daily for 12 weeks. They provided all individuals with 3.3g of branched-chain-type amino acid (BCAA) supplementation and resistance training. The primary objective was to reduce chair rise time (the time required to do five chair raises without using arms). Secondary outcomes included the cognitive battery factor score, the SPPB score (including chair rise time and gait speed), grip strength, gait speed, physical activity levels assessed using the International Physical Activity Questionnaire (IPAQ), and the Simplified Nutritional Assessment Questionnaire (SNAQ) appetite scale.

    The participants completed the Short Physical Performance Battery (SPPB) remotely, including chair rise time and handgrip strength evaluations with a dynamometer with real-time instructions from a qualified researcher. The participants provided stool samples to extract microbial DNA for gut microbiota characterization by shotgun metagenomic sequencing. The CANTAB battery includes cognitive tests for executive function, spatial working memory, and memory. The team evaluated three days of food diary data. They conducted intention-to-treat (ITT), per-protocol (PP), and heritability analyses.

    Results

    Of 626 eligible individuals, 72 were successfully recruited (36 twin pairs). The participants had a mean age of 73 and were 78% female. There were more moderate adverse effects (like abdominal bloating) in the intervention group compared to the placebo group; however, the team found no compliance-related differences, indicating that the supplements were generally well accepted. In either arm, no participants stated gastrointestinal side effects as a cause for non-adherence to the research intervention. No critical adverse effects occurred.

    There were no significant changes in findings between the PP and ITT models. The team found no significant differences between the study groups concerning primary or secondary outcomes. The intervention group outperformed the placebo group in terms of cognition first-factor scores. Furthermore, the specific cognition assessment paired associations learning showed considerably fewer errors in the intervention group than in the placebo group.

    Using Bray-Curtis dissimilarity, twin pairs’ microbiotas were considerably more similar to the microbiota compositions of unrelated people at baseline and the conclusion of the research. The alpha and beta diversity assessments revealed no significant changes between the prebiotic and placebo groups. Compositional bias-adjusted linear modeling controlling for twin- and arm-pair-associated effects showed 144 microbiota characteristics, including 109 microbiome taxa, 33 microbe functions, richness, and Faith’s phylogenetic diversity strongly associated with chair rise time.

    Correlation analysis of changes in microbiota characteristics and chair rise times throughout the research intervention period demonstrated a link between chair rise duration improvement and changes in richness, Shannon diversity, and Faith’s diversity. The study found 11 significant differences between the prebiotic and placebo groups, with the prebiotic group having higher levels of Bifidobacterium, Actinobacteria, Firmicutes, Bacteroidetes, and Phocea massiliensis. Eight microbiome traits were associated with cognitive capacity, including an increase in actinobacteria and improvements in cognition component scores.

    Conclusion

    Overall, the study found that gut microbiome manipulations can enhance cognition in elders, demonstrating the viability of remote trials for older adults. The prebiotic intervention, which was well tolerated and altered gut microbiota, increased the quantity of Bifidobacterium. However, there were no significant changes in chair rise times between the study groups. Future larger-scale research should explore the possibility of gut microbiome-targeted therapies to overcome age-related anabolic resistance.

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  • Study reveals benefits of purposeful walking for total hip replacement patients

    Study reveals benefits of purposeful walking for total hip replacement patients

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    A research paper by scientists at Bournemouth University proposed a randomized pilot trial, which aimed to determine the effect of an intervention where outdoor walking distance is used as a goal to increase daily activity of older adults using a commercial activity monitor at 3 to 6 months post total hip replacement (THR).

    The new research paper, published on Nov. 30 in the journal Cyborg and Bionic Systems, indicated the participants in the intervention group had higher activity levels after THR, compared to those in the control group. The Cohen’s effect sizes were larger for the changes in the gait, Hip Disability and Osteoarthritis Outcome Score, and Psychosocial Impact of Assistive Devices Scale data in the intervention group in contrast to the control group.

    THR should not only be to improve pain but also lead to improving physical activity. This activity should preferably meet the recommended daily activity levels (at least 150 to 300 min of moderate-intensity physical activity per week) by the World Health Organization. THR patients benefit from improved joint range, muscle strength, and coordination through physical activity. This aids in restoring optimal biomechanics and overall mobility.

    Activity monitors have been extensively used as an incentive to encourage people in the wider population to become more active through walking. However, when it comes to the THR cohort, the evidence of distance-based interventions is limited, in particular when it comes to outdoor walking.”


    Shayan Bahadori, study author, professor at Bournemouth University

    The focus of current studies has been merely on monitoring or enhancing the amount of walking using the step count parameter. “This is a shortcoming because a recognized technical problem with the activity monitors is their diminishing accuracy in step counting associated with decreased walking speed which is often a gait characteristic associated with people after THR operation. Additionally, there is currently a lack of attention for personalized plans in the postoperative period which is against the desire of individuals undergoing THR surgery. Further evidence also suggests that individuals undergoing THR surgery are interested and receptive of wearable technologies and, in particular, enjoy the outdoor elements where sensors such as Global Positioning System technology are used to track their daily outdoor activities.” said study authors.

    This study aims to determine the effect of an intervention where an outdoor walking distance is used as a goal to increase daily walking activity, using a commercially available activity monitor, in people after THR 3 to 6 months post THR surgery. “Throughout this protocol, we will refer to the outdoor walk that is recorded with a GPS sensor as a “purposeful walk”” said Shayan Bahadori.

    The study authors suggested that the study was the first randomized trial to report the effect of the outdoor purposeful walk, monitored using a commercial activity monitor. The findings suggest that the purposeful walking intervention was successful in increasing daily walking activity and function in contrast to the control group.

    “In future work, further research with a larger sample size is required to provide tangible evidence on the significance of the effect of the purposeful walk in contrast to step count.” said Shayan Bahadori. Totally, the study can contribute to the fields of the health activity monitoring, and inspiring innovation around it.

    Source:

    Cyborg and Bionic Systems

    Journal reference:

    Bahadori, S., et al. (2023). Can a Purposeful Walk Intervention with a Distance Goal Using an Activity Monitor Improve Individuals’ Daily Activity and Function Post Total Hip Replacement Surgery. A Randomized Pilot Trial. Cyborg and Bionic Systems. doi.org/10.34133/cbsystems.0069.

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  • Cardiovascular health variances in women’s lifespan

    Cardiovascular health variances in women’s lifespan

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    Women’s cardiovascular disease risks and outcomes differ throughout the lifespan from those of men, according to a collection of studies devoted to cardiovascular medicine research focused on women of all ages, published today in a special “spotlight” issue of the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.

    Cardiovascular disease kills more women than all forms of cancer combined. Among females 20 years and older, nearly 45% are living with some form of cardiovascular disease, and less than 50% of women entering pregnancy in the U.S. have good heart health. In addition, more than half of deaths from high blood pressure are in women. Yet, women make up only 38% of participants in cardiovascular disease clinical trials, according to the American Heart Association.

    The special Go Red for Women issue of the Journal, in recognition of American Heart Month, features studies that reveal insights such as: how diet may affect the high preeclampsia risk in pregnant Hispanic/Latina women; how women were less likely than men to receive bystander CPR and automated external defibrillator (AED) treatment, as well as survive the first 30 days post-hospitalization after out-of-hospital cardiac arrest; and how rehospitalization rates differ in women with heart failure and obstructive sleep apnea. In yet another study featured, researchers report that while the incidence of intracerebral hemorrhage (bleeding within the brain), the second most common stroke type, was lower in women, women were more likely to die one year after a stroke than men.

    Below are highlights of some of the manuscripts in this issue,

    • Prospective Associations of Accelerometer-measured Machine-learned Sedentary Behavior with Mortality among Older Women: The OPACH Study

    Steve Nguyen, Ph.D., et al.; University of California, San Diego, La Jolla, California

    This team studied sedentary behavior patterns in nearly 6,000 older women (average age 79 years) to determine the impact of sitting time on death from cardiovascular disease and all causes. Using a measurement tool powered by machine learning to accurately classify sitting time, researchers found those who sat more than 11.6 total hours a day and had longer bouts of uninterrupted sitting had a 57% higher risk of death from all causes and a 78% increased risk of death from cardiovascular disease. This was compared to women who sat less than 9.3 hours a day. The increased risk of death was consistent regardless of age, body mass index, physical functioning, cardiovascular disease risk factors, physical activity intensity and race/ethnicity. Reducing overall sedentary behavior and uninterrupted sitting time would likely have large public health benefits in an aging society, according to researchers.

    • Sex Differences in the Relationship between Schizophrenia and the Development of Cardiovascular Disease

    Hidehiro Kaneko, M.D., Ph.D., et al.; University of Tokyo, Tokyo, Japan

    Researchers studied cardiovascular disease risk in people with schizophrenia, a serious psychotic disorder and one of the top 15 leading causes of disability worldwide. Schizophrenia results in severe, chronic mental illness characterized by disturbances in perception, thought and behavior. The study found a strong association between schizophrenia and risk of developing cardiovascular disease in adults, but particularly in women. This higher risk in women may be related to hormonal changes during pregnancy and menopause, or reports that women are more sedentary than men. Nevertheless, the findings point to the need for health care professionals to take a thorough and gender-focused approach to cardiovascular disease prevention due to the notable role schizophrenia seems to play in cardiovascular disease. The researchers suggest that it’s crucial to promote physical activity, especially among women with schizophrenia, as inactivity may have increased the risk in female participants in this study. Healthcare providers should routinely screen and treat schizophrenia as part of standard clinical practice, with special attention to women, authors wrote.

    • Maternal Dietary Patterns During Pregnancy Are Linked to Hypertensive Disorders of Pregnancy Among a Predominantly Low-Income US Hispanic/Latina Pregnancy Cohort

    Luis E. Maldonado, Ph.D., M.P.H., et al.; Keck School of Medicine, University of Southern California

    In a study of more than 400 predominantly low-income, pregnant Hispanic/Latina women in Los Angeles, researchers found that a diet characterized by higher intakes of solid fats, refined grains and cheese was strongly associated with greater odds of having had a hypertensive disorder of pregnancy including preeclampsia during pregnancy.

    Other papers in the spotlight issue include:

    • Association of Sex With Cardiovascular Outcomes in Heart Failure Patients With Obstructive or Central Sleep Apnea -; Jian Zhang, M.D., Ph.D., et al.; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    • Pregnancy History at 40 Years of Age as a Marker of Cardiovascular Risk -; Liv G. Kvalvik, M.D., Ph.D., et al.; University of Bergen, Bergen, Norway

    • Sex Differences in the Epidemiology of Intracerebral Hemorrhage Over 10 Years in a Population-Based Stroke Registry -; Simona Sacco, M.D., et al.; University of L’Aquila, L’Aquila, Italy

    • Sex Differences in Revascularization, Treatment Goals, and Outcomes of Patients With Chronic Coronary Disease: Insights From the ISCHEMIA Trial -; Harmony R. Reynolds, M.D., FAHA, et al.; NYU Grossman School of Medicine, New York City

    • Sex Differences in Receipt of Bystander CPR Considering Neighborhood Racial and Ethnic Composition -; Audrey L. Blewer, Ph.D., M.P.H., et al.; Duke University, Durham, North Carolina

    • Hypertension in Pregnancy among Immigrant and Swedish Women – A Cohort Study of All Pregnant Women in Sweden -; Axel C. Carlsson, Ph.D., et al.; Karolinska Institutet, Huddinge, Sweden

    • Sex Differences In Out-of-Hospital Cardiac Arrest Survival Trends -; R. L. A. Smits, et al.; Amsterdam University Medical Center, Amsterdam, The Netherlands;

    • Posttraumatic Stress Disorder is Associated With Elevated Risk of Incident Stroke and Transient Ischemic Attack in Women Veterans -; Ramin Ebrahimi, M.D., et al.; University of California, Los Angeles; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles; and

    • Sex differences in Outcomes of Acute Myocardial Injury After Stroke -; Michela Rosso, M.D., et al.; University of Pennsylvania, Philadelphia.

    Source:

    American Heart Association

    Journal reference:

    Mujahid, M. S. & Peterson, P. N., (2024) JAHA Go Red for Women Spotlight on Women and Cardiovascular Disease and Stroke. Journal of the American Heart Association. doi.org/10.1161/JAHA.124.035104.

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  • Study identifies optimal daily steps for heart failure prevention in older women

    Study identifies optimal daily steps for heart failure prevention in older women

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    The science is clear that movement is good for our bodies as we age. But just how much physical activity is beneficial for people over 60? A new study from the University at Buffalo provides an answer, and it’s not 10,000 steps per day.

    In fact, the study -; published Feb. 21 in JAMA Cardiology -; of nearly 6,000 U.S. women aged 63-99 reports that, on average, 3,600 steps per day at a normal pace was associated with a 26% lower risk of developing heart failure.

    The observational study from the Women’s Health Initiative specifically looked at accelerometer-measured physical activity, sedentary time and heart failure risk. There were 407 heart failure cases -; confirmed by physicians -; identified during a mean follow-up of 7.5 years.

    The risk of developing heart failure was, on average, 12% and 16% lower for each 70 minutes per day spent in light intensity activities and each 30 minutes per day spent in moderate-to-vigorous intensity, respectively. To the contrary, each hour-and-a-half of sedentary time was associated, on average, with a 17% higher risk of experiencing heart failure.

    In ambulatory older women, higher amounts of usual daily light and moderate intensity activities were associated with lower risk of developing heart failure with preserved ejection fraction independent of demographic and clinical factors associated with heart failure risk. Accumulating 3,000 steps per day might be a reasonable target that would be consistent with the amount of daily activity performed by women in this study.”


    Michael J. LaMonte, PhD, study’s lead author, research professor of epidemiology and environmental health in UB’s School of Public Health and Health Professions

    Study participants wore an accelerometer on their hip for up to seven consecutive days, except for when in water. Light physical activity included usual daily activities like self-care, chores around the house and caregiving, while moderate to vigorous activity involved walking at a normal pace, climbing the stairs or doing yard work.

    The study is unique in that it looked at two subtypes of heart failure, the most common of which is heart failure with preserved ejection fraction, often abbreviated as HFpEF. A similar pattern of lower risk with more light and moderate intensity daily activity, and higher risk with prolonged sedentary time, was seen for HFpEF.

    “This is a major, unique finding of our study because there is very little published data on physical activity and HFpEF, so we are providing new information upon which other studies can build,” LaMonte says.

    “More importantly, HFpEF is the most common form of heart failure seen in older women and among racial and ethnic minority groups, and at present there are few established treatment options, which makes primary prevention all the more relevant for HFpEF. The potential for light intensity activities of daily life to contribute to the prevention of HFpEF in older women is an exciting and promising result for future studies to evaluate in other groups, including older men,” LaMonte adds.

    The team’s evaluation of the number of steps per day as an approach to quantifying and translating the favorable results for physical activity was also novel, says LaMonte.

    Encouraging older adults to be more active as part of healthy aging is sound advice well-supported by scientific evidence.

    “However, conveying how much activity is always a challenge to incorporate as part of clinical and public health recommendations,” says LaMonte. “Steps per day is easily understood and can be measured by a variety of consumer-level wearable devices to help people monitor their physical activity levels.”

    In this study, the risk of heart failure, including HFpEF, became significantly lower at around 2,500 steps per day. When standardized to 3,600 steps per day (1 standard deviation unit), there was a 25-30% lower risk of heart failure and HFpEF.

    The study’s findings come at a time when the U.S. government is examining its physical activity guidelines for older adults, particularly a target number of steps per day. The steps per day associated with lower heart failure risk cited in the study are far fewer than the often recommended 10,000 steps for health and wellness.

    For perspective, the average number of steps per day among women in the study was 3,588. The average among U.S. women of similar age is 2,340.

    “It appeared that intensity of stepping did not influence the lower risk of heart failure as results were comparable for light intensity steps and for more vigorous steps,” says LaMonte.

    “Our results showing heart failure prevention in older women might be enhanced through walking around 3,000 steps or so per day at usual pace is very relevant given the current emphasis at the federal level on identifying an amount of daily physical activity that can be referenced against steps per day for cardiovascular health and resilience to incorporate in future public health guidelines.”

    Researchers from the University of California San Diego, University of North Carolina at Chapel Hill, Fred Hutchinson Cancer Center, Stanford University, and Brown University contributed to the study.

    Source:

    Journal reference:

    LaMonte, M. J., et al. (2024). Accelerometer-Measured Physical Activity, Sedentary Time, and Heart Failure Risk in Women Aged 63 to 99 Years. JAMA Cardiology. doi.org/10.1001/jamacardio.2023.5692.

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  • Women gain more health benefits from exercise than men

    Women gain more health benefits from exercise than men

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    In a recent study published in the Journal of the American College of Cardiology, researchers investigated the sex-specific all-cause and cardiovascular mortality risk reductions derived from physical activity. They used a large (n = 412,313) cohort American cohort to identify this association and found that women derived greater benefits than their male counterparts from equivalent amounts of physical activity.

    Historically, however, women have generally lagged men in exercise engagement. These findings may help inform clinicians and the health-minded of the advantages of physical exercise in combatting chronic cardiovascular disease (CVD) and bridge observed “gender gaps” by encouraging women to take up leisure-time physical activity.

    Study: Sex Differences in Association of Physical Activity With All-Cause and Cardiovascular Mortality.

    Study: Sex Differences in Association of Physical Activity With All-Cause and Cardiovascular Mortality.

    The gender gap and what this means for sex-specific cardiac health

    Cardiovascular mortality remains one of the leading causes of global human loss of life, alarmingly a likely underestimation when considering that cardiovascular disease (CVD) is a commonly reported comorbidity in numerous non-transmissible and transmissible pathologies. Decades of research have revealed that physical activity (PA) can substantially reduce all-cause and cardiovascular mortality, but records reveal that public involvement in leisure time PA is sorely lacking.

    In the United States of America (US) alone, fewer than 25% of citizens meet the minimum PA recommendations of 150 min/wk. of moderate PA or 75 min/wk. of vigorous PA prescribed by the US Centers for Disease Control and Prevention (CDC) and the American College of Cardiology. Significant inter-sex differences in PA engagement further skew these already suboptimal observations – a substantially larger proportion of men are known to engage in leisuretime PA than women, which, when combined with differences in physiological responses, exercise capacities, and activity tolerances between the sexes, might result in significantly different mortality outcomes between these cohorts.

    Unfortunately, the empirical outcomes of these “gender gaps” between men and women have never been tested within a scientific framework, denying clinicians, policymakers, and the health conscious of the information they need to optimize PA-related outcomes. Understanding the role of sex in these associations would allow for improved guidelines aimed at bridging the gender gap, fostering increased female PA engagement, and reducing overall mortality risk.

    About the study

    In the present study, researchers aimed to elucidate if PA-derived health benefits differ depending on the sex of the PA-engaging individual. Their cohort was derived from the National Health Interview Survey (NHIS), a large-scale collaboratory effort carried out by the CDC and the National Center for Health Statistics. Established in 1957, the NHIS is a prospective cohort maintaining health records of Americans across 50 states and the District of Columbia, representing a proxy for America’s health.

    The current study used participant data from 1997 to 2017 and was initially comprised of 646,279 individuals. Excluding participants with severe cardiovascular conditions (e.g., coronary heart disease), cancers, or missing demographic or medical data resulted in a final cohort of 412,413 adults. Data collection included demographic and medical information (from the NHIS database) and a consistent, standardized questionnaire for PA frequency, duration, and type assessment, presented at both baseline and follow-up evaluations.

    Cox proportional hazard regression models corrected from demographic and clinical covariates were used to assess primary outcomes. Likelihood ratio tests were used to compute sex-specific differences in outcome estimates.

    Study findings

    Demographic data collation revealed that 54.7% of included participants were women, more than 68% of whom were of White ethnicity. The average age of the study cohort was 43.9 years, and the study collected a total of 4,911,178 person-years of follow-up data. During the course of the study, 39,935 participants died from all causes, 11,670 of which were cardiovascular.

    Previously observed discrepancies in sex-specific PA engagement were validated in this study, with only 32.5% of women engaging in weekly aerobic PA compared to 43.1% of male participants. Every PA metric measured in the survey revealed greater male engagement than female, with 15.2% of men achieving the prescription weekly PA goal of 150 min/wk. In contrast, only 10.3% of women met this goal.

    However, hazard analyses present that the few women who do engage in physical activity derive far greater relative health benefits than their male counterparts. Compared to inactivity, female PA engagement results in a 24% risk reduction (all-cause mortality), while equivalent PA engagement in men only decreased their mortality risk by 15%.

    “In dose-dependent analyses for the entire cohort, the benefit of PA on all-cause mortality peaked at ∼300 min/wk of MVPA and then plateaued. The greatest mortality benefit in men was achieved at 300 min/wk of MVPA with an 18% lower hazard in all-cause mortality. Women derived a similar magnitude of benefit at 140 min/wk of MVPA, and continued to benefit with increasing min/wk of MVPA until the greatest benefit of 24% lower hazard (HR: 0.76; 95% CI: 0.72-0.80) was achieved at ∼300 min/wk.”

    While these findings do require validation in non-American cohorts, where observed results, especially those pertaining to engagement, might vary drastically from those observed herein, this study highlights the profound benefits of PA engagement for both sexes and may play a crucial role in motivating traditionally hesitant women to take up these activities given the health rewards they provide.

    Journal reference:

    • Ji, H., Gulati, M., Huang, T. Y., Kwan, A. C., Ouyang, D., Ebinger, J. E., Casaletto, K., Moreau, K. L., Skali, H., & Cheng, S. (2024). Sex Differences in Association of Physical Activity With All-Cause and Cardiovascular Mortality. Journal of the American College of Cardiology, 83(8), 783-793, DOI – 10.1016/j.jacc.2023.12.019,  https://www.sciencedirect.com/science/article/pii/S0735109723083134?via%3Dihub

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  • Women reap greater health benefits from exercise than men

    Women reap greater health benefits from exercise than men

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    Women who exercise regularly have a significantly lower risk of an early death or fatal cardiovascular event than men who exercise regularly, even when women put in less effort, according to a National Institutes of Health-supported study. The findings, published in the Journal of the American College of Cardiology, are based on a prospective analysis of data from more than 400,000 U.S. adults ages 27-61 which showed that over two decades, women were 24% less likely than those who do not exercise to experience death from any cause, while men were 15% less likely. Women also had a 36% reduced risk for a fatal heart attack, stroke, or other cardiovascular event, while men had a 14% reduced risk. 

    We hope this study will help everyone, especially women, understand they are poised to gain tremendous benefits from exercise. It is an incredibly powerful way to live healthier and longer. Women on average tend to exercise less than men and hopefully these findings inspire more women to add extra movement to their lives.” 


    Susan Cheng, M.D., cardiologist and the Erika J. Glazer Chair in Women’s Cardiovascular Health and Population Science in the Smidt Heart Institute at Cedars-Sinai, Los Angeles

    The researchers found a link between women experiencing greater reduced risks for death compared to men among all types of exercise. This included moderate aerobic activity, such as brisk walking; vigorous exercise, such as taking a spinning class or jumping rope; and strength training, which could include body-weight exercises.

    Scientists found that for moderate aerobic physical activity, the reduced risk for death plateaued for both men and women at 300 minutes, or five hours, per week. At this level of activity, women and men reduced their risk of premature death by 24% and 18% respectively. Similar trends were seen with 110 minutes of weekly vigorous aerobic exercise, which correlated with a 24% reduced risk of death for women and a 19% reduced risk for men.

    Women also achieved the same benefits as men but in shorter amounts of time. For moderate aerobic exercise, they met the 18% reduced risk mark in half the time needed for men: 140 minutes, or under 2.5 hours, per week, compared to 300 minutes for men. With vigorous aerobic exercise, women met the 19% reduced risk mark with just 57 minutes a week, compared to 110 minutes needed by men.

    This benefit applied to weekly strength training exercises, too. Women and men who participated in strength-based exercises had a 19% and 11% reduced risk for death, respectively, compared to those who did not participate in these exercises. Women who did strength training saw an even greater reduced risk of cardiovascular-related deaths – a 30% reduced risk, compared to 11% for men. 

    For all the health benefits of exercise for both groups, however, only 33% of women and 43% of men in the study met the standard for weekly aerobic exercise, while 20% of women and 28% of men completed a weekly strength training session.

    “Even a limited amount of regular exercise can provide a major benefit, and it turns out this is especially true for women,” said Cheng. “Taking some regular time out for exercise, even if it’s just 20-30 minutes of vigorous exercise a few times each week, can offer a lot more gain than they may realize.”

    “This study emphasizes that there is no singular approach for exercise,” said Eric J. Shiroma, Sc.D., a program director in the Clinical Applications and Prevention branch at the National Heart, Lung, and Blood Institute (NHLBI). “A person’s physical activity needs and goals may change based on their age, health status, and schedule – but the value of any type of exercise is irrefutable.”

    The authors said multiple factors, including variations in anatomy and physiology, may account for the differences in outcomes between the sexes. For example, men often have increased lung capacity, larger hearts, more lean-body mass, and a greater proportion of fast-twitch muscle fibers compared to women. As a result, women may use added respiratory, metabolic, and strength demands to conduct the same movement and in turn reap greater health rewards.

    The Physical Activity Guidelines for Americans recommend adults get at least 2.5-5 hours of moderate-intensity exercise or 1.25-2.5 hours of vigorous exercise each week, or a combination of both, and participate in two or more days a week of strength-based activities.

    Source:

    NIH/National Heart, Lung and Blood Institute

    Journal reference:

    Ji, H., et al. (2024) Sex Differences in Association of Physical Activity With All-Cause and Cardiovascular Mortality. Journal of the American College of Cardiology. doi.org/10.1016/j.jacc.2023.12.019.

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  • Associations between food additive emulsifiers and cancer risk

    Associations between food additive emulsifiers and cancer risk

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    In a recent study published in PLoS Medicine, researchers assessed associations between food emulsifier intake and cancer risk among NutriNet-Santé study participants.

    Study: Food additive emulsifiers and cancer risk: Results from the French prospective NutriNet-Santé cohort. Image Credit: Abramov Michael/Shutterstock.com
    Study: Food additive emulsifiers and cancer risk: Results from the French prospective NutriNet-Santé cohort. Image Credit: Abramov Michael/Shutterstock.com

    Background

    Emulsifiers, common in industrially processed foods, have been linked to chronic inflammation and an increased risk of cancer. These additives help stabilize lipid-containing food preparations, which account for a considerable amount of dietary energy consumption.

    Recent research shows that unfavorable consequences, such as changes in the gut microbiota and increased inflammation, may raise the risk of gut diseases and chronic diseases such as extraintestinal malignancies. Large-scale epidemiological studies are required to determine the long-term influence on human health.

    About the study

    In the present population-based prospective cohort study, researchers investigated whether consuming food additive emulsifiers increases cancer risk.

    The French NutriNet-Santé study involved 92,000 adult participants without prevalent cancer at recruitment, aged 45 years, and 79% female. They completed five questionnaires querying their dietary intake, health, anthropometric data, physical activity, sociodemographic data, and lifestyle data.

    The team followed the participants for seven years and estimated food additive emulsifier intakes for those with three or more 24-hour dietary records over two weeks during their initial two years of follow-up. They excluded individuals underreporting total calorie intake (17%, n=21,423).

    The researchers matched the food items consumed in specific dietary records against three databases to determine food additive presence: Observatoire de la qualité de l’alimentation (OQALI), Mintel Global New Products Database (GNPD), and Open Food Facts. They estimated the number of additives consumed based on ad hoc assays, generic food groups, and doses, following the European Food Safety Authority (EFSA) and Codex General Standard for Food Additives (GSFA) guidelines.

    Among food additive substances quantified from participant dietary records, the team identified 60 as emulsifying salts or emulsifiers and summed their intakes to determine the total food emulsifier exposure. They totaled individual emulsifier substances with those having identical chemical bonds into eight groups: lactylates, phosphates, polyglycerol ester molecules of fatty acids (FAs, monoglycerides, and diglycerides), carrageenans, celluloses, alginates, and modified starches.

    The researchers asked participants to report health occurrences on an online interface, verified by expert physicians after evaluating participant medical records and gathering additional data from hospitals and their treating doctors when required. They used the International Classification of Diseases, Clinical Modification Codes (ICD-CM, 10th revision) to classify cancers.

    The team conducted a study on primary cancer cases diagnosed two years after enrollment through 5 October 2021, using multivariable Cox regression modeling to determine the hazard ratios (HRs) for the association between food emulsifiers and cancer risk. They adjusted the model for factors such as age, sex, BMI, height, physical activity, smoking status, educational level, dietary records, family history of cancer, energy intake without alcohol, daily alcohol intake, lipids, sugars, sodium, fiber, consumption levels of fruits and vegetables, red and processed meats, and dairy products.

    Results

    The mean age of the study participants was 45 years. They provided six dietary records; on average, 99.8% of the study participants consumed one or more food emulsifiers. Compared to individuals with low emulsifiers, those with high intake were younger and showed a lower likelihood of smoking, lower alcohol intake, higher body mass index, educational attainment, physical exercise levels, dietary calorie intake, and ultra-processed food proportion in their diets.

    The team reported 2,604 new-onset cancer cases over two years of follow-up, including 90 lymphomas, 110 squamous cell carcinomas, 124 lung cancers, 162 melanomas, 207 colorectal, 322 prostate cancers, and 750 breast cancers. Increased monoglyceride and diglyceride fatty acid intake (especially E471) was related to higher cancer risk (hazard ratio, 1.2 for high versus low category), breast malignancy (HR, 1.2), and prostate tumors (HR, 1.5).

    Additionally, the team observed associations with the risk of breast cancer for increased total carrageenan intake (HR, 1.3) and E407 carrageenan consumption (HR, 1.3). They found no significant link between emulsifier intake and colorectal cancer incidence, and although they identified some links with other food emulsifiers, none were robust in the sensitivity analyses.

    The most common breast cancers were of the estrogen-positive (ER+, 85%) and progesterone-positive (PR+, 75%) types, while triple-negative breast cancers denoted 10% of all breast cancer cases. At diagnosis, 69.6% of breast cancers were local, 28.9% were advanced, and the remaining were metastatic. Regarding prostate cancers, 42%, 45%, and 13% were low-risk, intermediate-risk, and high-risk, respectively, as assessed using Gleason scores.

    Conclusion

    Overall, the study findings showed exposure to seven food emulsifiers was associated with an increased risk of cancer in French individuals. The findings may lead to changes in food industry laws on emulsifier use.

    The researchers also discovered links between greater consumption of carrageenans and fatty acid monoglycerides and diglycerides and overall prostate and breast cancer risk. To ensure consumer safety, public health officials advocate restricting cosmetic additive intake. Further research is required to replicate these findings in different populations.

    Journal reference:

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  • Healthy lifestyles linked to specific metabolic markers, large study finds

    Healthy lifestyles linked to specific metabolic markers, large study finds

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    In a recent study published in the journal Med, researchers used a collated dataset comprising four American sample cohorts to identify the metabolomic markers of a healthy lifestyle and, potentially, the mechanisms underlying their production. They used a combination of analytical techniques, particularly liquid chromatography-mass spectrometry, on the 13,056 datasets and observed that the healthy lifestyle metabolomic signature was largely reflective of lipid metabolism pathways.

    Shorter and more saturated di—and triacylglycerol metabolite sets were found to be inversely associated with healthy lifestyles, while phosphatidylcholine plasmalogens and cholesteryl esters were directly associated with the condition. Encouragingly, the relative concentrations of these biomarkers accounted for a 17% lower risk of all-cause mortality, a 19% reduced risk of cardiovascular disease-related mortality, a 17% lower risk of cancer-related mortality, and a 25% improved probability of attaining longevity.

    Study: Plasma metabolites of a healthy lifestyle in relation to mortality and longevity: Four prospective US cohort studies

    The relationship between lifestyle choices and metabolic health

    Chronic, non-transmissible disease prevalence is currently higher than it has ever been and has primarily been attributed to the increased adoption of sub-optimal health behavioral choices, including diets (e.g., the Western-style diet) and physical activity levels (e.g., the sedentary lifestyle). Previous research has highlighted the profound benefits of adopting a healthy lifestyle, with research on American cohorts revealing 55-71% reduced all-cause mortality risk in individuals who maintained their body mass index (BMI) between 18.5-24.9 kg/m2, consumed alcohol in moderation, partook in physical activity, and abstained from smoking.

    Unfortunately, the mechanisms underpinning these interactions remain largely unknown. Some studies have suggested that individuals’ health behavior components such as body weight, diet, alcohol consumption, physical activity, and smoking may have associated metabolomic signatures indicative of their current and historical health. Still, these hypotheses have rarely been tested within a scientific framework. The limited information in the field, despite being at times confounding, suggests that polyunsaturated fatty acids (PUFAs), phosphatidylcholines (PCs), and glutamate and similar amino acids (AAs) are associated with improved health outcomes, while triacylglycerols (TAG), sphingomyelins (SMs), and carnitines are associated with suboptimal ones.

    “However, most studies only examined diet and physical activity factors, with small sample sizes and limited sets of metabolites profiled. Thus, a comprehensive understanding of the metabolic pathways underlying healthy lifestyle behaviors remains to be discovered. By studying several modifiable lifestyle factors simultaneously, a better understanding of the common biological mechanisms as well as the key differences may be acquired.”

    About the study

    In the present study, researchers used lifestyle, metabolomic, and clinical information from four American cohorts comprising more than 13,000 individuals to compute a metabolomic-based combined healthy lifestyle score during mid-life and further examine the relationship between this score and mortality and longevity outcomes. Outcome follow-up was extensive and had a mean duration of 28 years. The cohorts included the Nurses’ Health Study (NHS; 1976), the second iteration of the same prospective cohort (NHSII; 1989), the Women’s Health Initiative (WHI; 1993), and the Health Professionals Follow-up Study (HPFS; 1986). They comprised primarily middle-aged (mean 54.3 years) women (85.8%) belonging to the White ethnicity (96.7%).

    Lifestyle information was participant-reported, clinical information was obtained from the prospective cohort database, and metabolomic information was derived from (fasting) blood plasma samples obtained at the time of study initiation and subsequent follow-up. Individuals lacking data on measured outcomes (BMI, alcohol consumption, metabolomic profiling, diets, physical activity levels, smoking status) were excluded. The WHI cohort was used as an external validation cohort for results obtained from the three remaining cohorts.

    Plasma metabolomic profiling was carried out using acetonitrile/methanol/formic acid extraction followed by hydrophilic interaction liquid chromatography (HILIC) and positive ionization mass spectrometry (MS) for polar compounds (e.g., amino acids) and isopropanol extraction followed by octyl high-performance liquid chromatography (HPLC) and positive ionization MS for lipids. The Metabolite Standard Initiative (MSI) database was used to identify obtained metabolites.

    Lifestyle factors (treatments) were of five main categories – diet, alcohol consumption, physical activity, smoking, and BMI, and were assessed using questionnaires and the Alternative Healthy Eating Index (AHEI). Mortality and longevity (outcomes) were obtained from family-member reports (for death), State statistics records, and the National Death Index database. Multivariable linear regressions, logistic regression, and elastic linear regressions were used for statistical data analyses. Cox proportional hazard ratios were computed to translate these results into relative disease risk.

    Study findings

    Results reveal that the metabolomic signature most reflective of healthy lifestyles is the lipid metabolism pathway comprising PC, TAG, CE, and DAG metabolite families. Diet composition and BMI were found to be the best predictors of positive metabolite signatures. Metabolite characterization identified more than 400 metabolites associated with lifestyle choices. Elastic regression analyses identified 187 of these metabolites as descriptive of healthy lifestyle behaviors – 58 were positively associated, while 129 were inversely associated with beneficial mortality and longevity outcomes.

    “…the MSEA revealed CEs, mainly of PUFAs, and PCs as the most enriched metabolite sets positively associated with a healthy lifestyle. CEs serve as a mean for the storage and transportation of cholesterol and other lipids in the blood and were shown to be reflective of dietary fat intake. PCs are naturally found in the body but also in foods such as eggs, fatty fish, and soybeans. They are well known for their essential role in cell membranes and membrane signaling.”

    Animo acids and metabolites involved in purine metabolism were also highlighted as signatures of healthy lifestyles. Vegetarian diets that are rich in circulating glycine, trigonelline, asparagine, hippurate, and glutamine and poor in valine, isoleucine, and leucine were found beneficial over dietary intakes of red meats, chicken, and energy drinks.

    Outcome analyses revealed a surprising fact – the metabolomic signatures identified herein were more accurate predictors of mortality and longevity than patient-reported fitness and health levels.  

    “Indeed, the metabolomic signature explained 38.0% of the association between the self-reported healthy lifestyle score and mortality, pointing to unique biological pathways captured by metabolomics. Consistent with the literature and with our mortality results, we found an association of the healthy lifestyle metabolomic signature with longevity, and the signature explained 48.6% of the association between self-reported healthy lifestyle score and longevity.”

    Conclusion

    The present study uses a large combined American cohort comprising more than 13,000 participants to identify metabolomic signatures associated with positive mortality and longevity outcomes as a consequence of healthy lifestyle and dietary choices. Study findings reveal that more than 100 metabolites are associated with (positive or negative) health lifestyle outcomes, most of which are involved in the lipid metabolism pathways.

    “…our findings suggest that greater adherence to a healthy lifestyle may lead to alterations in the metabolome that are associated with lower premature mortality risk and higher likelihood of longevity. We identified a metabolomic signature associated with a combined healthy lifestyle in US adults that is strongly reflective of lipid metabolism pathways. We found that those with a higher multimetabolite score had a lower risk of total and cause-specific mortality and a greater likelihood of living longer.”

    Journal reference:

    • Tessier, A.-J., Wang, F., Liang, L., Wittenbecher, C., Haslam, D. E., Eliassen, A. H., Tobias, D. K., Li, J., Zeleznik, O. A., Ascherio, A., Sun, Q., Stampfer, M. J., Grodstein, F., Rexrode, K. M., Manson, J. E., Balasubramanian, R., Clish, C. B., Martínez-González, M. A., Chavarro, J. E., … Guasch-Ferré, M. (2024). Plasma metabolites of a healthy lifestyle in relation to mortality and longevity: Four prospective US cohort studies. In Med. Elsevier BV, DOI – 10.1016/j.medj.2024.01.010,  https://www.cell.com/med/fulltext/S2666-6340(24)00040-0

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