Impact of gut microbiota on cardiac aging.

Recent research has suggested imbalances in gut microbiota composition as contributors to cardiac aging. An individual's physical condition, along with lifestyle-associated factors, including diet and medication, are significant determinants of gut microbiota composition. This review discusses evidence of bidirectional associations between aging and gut microbiota, identifying gut microbiota-derived metabolites as potential regulators of cardiac aging. It summarizes the effects of gut microbiota on cardiac aging diseases, including cardiac hypertrophy and fibrosis, heart failure, and atrial fibrillation. Furthermore, this review discusses the potential anti-aging effects of modifying gut microbiota composition through dietary and pharmacological interventions. Lastly, it underscores critical knowledge gaps and outlines future research directions. Given the current limited understanding of the direct relationship between gut microbiota and cardiac aging, there is an urgent need for preclinical and clinical investigations into the mechanistic interactions between gut microbiota and cardiac aging. Such endeavors hold promise for shedding light on the pathophysiology of cardiac aging and uncovering new therapeutic targets for cardiac aging diseases.

Association of open skill exercise and long-chain polyunsaturated fatty acid intake with brain volume changes among older community-dwelling Japanese individuals.

Considering that a multifactorial lifestyle approach may prove more effective than a single factor approach to improve or maintain brain health, we evaluated the association of exercise (open skill exercise [OSE] or closed skill exercise [CSE]) combined with long-chain polyunsaturated fatty acid (LCPUFAs) (docosahexaenoic acid [C22:6n-3, DHA], eicosapentaenoic acid [C20:5n-3, EPA], and arachidonic acid [C20:4n-6, ARA]) intake with brain atrophy among older Japanese individuals (n = 795, aged 60-88 years) without a self-reported history of dementia based on the datasets of a two-year longitudinal study. Brain volumes were measured using three-dimensional T1-weighted brain magnetic resonance imaging for follow-up periods of two years. The associations between multivariate-adjusted changes in brain volumes and OSE or CSE frequency (≥ once/month and < once/month) along with LCPUFA intake (≥ median and < median) at the baseline were assessed using a general linear model. Subgroup analysis was performed by restricting DHA and EPA intakes (n = 263; median, 323 mg/d), which represented levels similar to those in countries with low fish consumption. Higher OSE frequencies, ARA intakes, and their combination were inversely associated with decreases in total gray matter and frontal cortex volumes. In subgroup analysis, a combination of higher OSE frequencies and DHA intakes was also associated with a smaller decrease in total gray matter volume. Overall, our findings suggest that regular OSE engagement and appropriate LCPUFA intake may contribute to preventing brain volume decreases in older individuals.

Estudiar y trabajar como factores de riesgo en estudiantes de enfermería, Universidad Nacional Formosa, 2022 / Study and work as risk factors in nursing students, National University of Formosa,2022

Objetivo: Correlacionar la variable principal sostén del hogar con las variables género, edad, horas de trabajo, horas de sueño y factores de riesgo cardiovascular (índice de masa corporal, hipertensión arterial, dislipemia y diabetes mellitus), en estudiantes de 3º, 4 y 5º año de la Licenciatura en Enfermería, Universidad Nacional de Formosa. Metodología: estudio descriptivo, correlacional, transversal realizado en 214 estudiantes, durante el año 2022, utilizándose un cuestionario on-line autoadministrado, estructurado y medición de peso y talla. Resultados: el 76% fueron mujeres; 64%, principal fueron principal sostén del hogar, 57% refirió dormir menos de 6 horas al día, 15 % trabaja más de 41 horas semanales; 67% tuvo respuestas no saludables a la variable estrés, para la variable actividad física este valor ascendió a 71% y el 53,8% presentó exceso de peso. Se encontró asociación significativa entre ser el principal sostén del hogar con exceso de peso, trabajar 41 horas o más semanalmente, dormir menos de 6 horas al día y con la presencia de 3 o más factores de riesgo cardiovascular. Conclusiones: Las condiciones de vida que afrontan los estudiantes que de manera simultánea estudian, trabajan y son principal sostén del hogar pueden generar estrés, el cual es un factor de riesgo para las enfermedades cardiovasculares[AU]

Objetive: to correlate the main variable of primary income earner or primary breadwinner with gender, age, working hours, sleep hours, and cardiovascular disease risk factors (body mass index, hypertension, dyslipidemia, and diabetes mellitus) in 3rd, 4th, and 5th-year nursing students at the Nursing Program at the National University of Formosa. Methodology: The study was a descriptive, correlational, cross-sectional, conducted with 214 students during 2022 using a self-administered structured online questionnaire and measurement of weight and height. Results: 76% were women, 64% were the main breadwinner, 57% reported sleeping less than 6 hours a day, 15% working more than 41 hours per week; 67% had unhealthy responses to the stress variable, this value rose to 71% for the physical activity variable, and 53.8% were overweight. A significant association was found between the main variable of primary breadwinner and being overweight, working 41 or more hours weekly, and the presence of 3 or more cardiovascular risk factors. Conclusions: The living conditions faced by students who simultaneously study and work, and being the main breadwinner in the household can generate stress, which is a risk factor for cardiovascular diseases[AU]

Objetivo:: correlacionar a variável principal de sustento econômico do lar com as variáveis gênero, idade, horas de trabalho, horas de sono e fatores de risco cardiovascular (índice de massa corporal,hipertensão arterial, dislipidemia e diabetes mellitus) em estudantes do 3º, 4º e 5º ano do curso de graduação em Enfermagem, Universidade Nacional de Formosa. Metodologia: O estudo foi descritivo, correlacional e transversal, realizado em 214 estudantes durante o ano de 2022. Foi utilizado um questionário online autoadministrado e estruturado, e a medição de peso e altura dos estudantes foi realizada. Resultados: 76% dos estudantes eram mulheres; 64% eram o principal sustento econômico do lar; 57% relataram dormir menos de 6 horas por dia, 15% responderam que trabalham mais de 41 horas por semana; em relação aos fatores de risco cardiovascular, 67% tiveram respostas não saudáveis para a variável estresse, para a variável atividade física esse valor aumentou para 71% e 53,8% apresentaram excesso de peso. Foi encontrada uma associação significativa entre a variável principal de sustento econômico do lar com as variáveis excesso de peso, trabalhar 41 horas ou mais por semana, dormir menos de 6 horas al día e a presença de 3 ou mais fatores de risco cardiovascular. Conclusões: As condições de vida enfrentadas pelos estudantes que simultaneamente estudam, trabalham e são o principal sustento do lar podem gerar estresse, que é um fator de risco para doenças cardiovasculares[AU]

Infertility Prevention and Health Promotion: The Role of Nurses in Public Health Initiatives.

Infertility is a growing public health concern, affecting millions of individuals and couples worldwide. Despite advancements in medical treatments, prevention remains a critical strategy for reducing the burden of infertility. Nurses, as frontline healthcare providers, play a pivotal role in infertility prevention and health promotion, particularly through public health initiatives. This review aims to explore the diverse roles of nurses in infertility prevention and their contributions to public health strategies. A review of existing literature was conducted to examine the epidemiology of infertility, key risk factors, and the preventive measures that can be employed by nursing professionals. Emphasis is placed on the role of nurses in health education, screening, early detection, and community-based interventions, which are essential in reducing infertility rates. In addition, this review identifies barriers that impede effective nurse-led infertility prevention, such as disparities in access to care, cultural sensitivity challenges, and policy constraints. Evidence suggests that nurses are well-positioned to lead public health campaigns, conduct reproductive health counseling, and advocate for policy reforms to improve infertility prevention. The review concludes with recommendations for future research, suggesting enhanced nursing education and training, as well as the need for stronger integration of nurses into public health policy-making. This study underscores the critical role of nurses in promoting reproductive health and preventing infertility, advocating for their inclusion in comprehensive public health strategies aimed at addressing infertility on a global scale.

Effect of Educational Intervention by Application of PRECEDE-PROCEED Model on Lifestyle Change in Hypertensive Patients.

Background: One of the most important causes of cardiovascular disease is hypertension. Lifestyle modification has been emphasized in preventing and controlling blood pressure. This research aimed to determine the effect of educational intervention by application of PRECEDE-PROCEED model on lifestyle change in hypertensive patients in the villages of Fasa City, Fars Province, Iran. Methods: This research is a quasi-experimental study that was conducted on 300 hypertensive patients in 2020-2021. Data gathering tools were a demographic information questionnaire, a questionnaire based on the PRECEDE-PROCEED model, and a lifestyle questionnaire (LSQ). The educational intervention consisted of ten sessions lasting 45 or 50 min. Before and 6 months after the educational intervention, the two groups each completed a questionnaire. The systolic and diastolic blood pressure (DBP) levels, as well as physical exercise and health variables, nutrition and weight control, mental health, and spiritual health were measured before and 6 months after the educational intervention. Results: The results showed that there was no significant difference between the two groups before in cues of PRECEDE-PROCEED model; however, the experimental group had a significant increase in cues of PRECEDE-PROCEED model 6 months after the intervention. The results showed that the experimental group had a significant increase 6 months after the intervention in terms of physical exercise and health variables, nutrition and weight control, mental health, and spiritual health. The mean blood pressure (both diastolic and systolic) in the experimental group was significantly reduced after the intervention. Conclusions: The study's results showed the effectiveness of an educational intervention based on the PRECEDE-PROCEED model on lifestyle change in hypertensive patients. It also highlights the need to pay further attention to the education aimed at controlling hypertension through a healthy lifestyle and correct behavioral habits.

Effects of household air pollution and healthy lifestyle associated with gestational diabetes mellitus.

This study investigated the effect of household air pollution on pregnant women with GDM, and assessed the modifying effect of a healthy lifestyle on this relationship. Household solid fuel exposure was defined as using solid fuels (coal, crop residue, and wood) for cooking and heating. Four individually modifiable lifestyle factors were assessed in early pregnancy: body mass index, diet, sleep, and vitamin D supplementation. Multifactorial logistic regression modeling was used to assess the relationship between household air pollution and GDM. A stratified analysis and additive interaction tested the effects of healthy lifestyle scores. After adjusting for potential confounders, we found that using solid fuels for heating was significantly associated with an increased risk of GDM (adjusted OR = 1.60, 95% CI 1.18-2.18). GDM risk showed a decreasing trend in the medium versus the high score group when compared to the low score group, with a consistent trend regardless of household fuel type used (adjusted OR = 0.39, 95% CI 0.27-0.57) (adjusted OR = 0.12, 95% CI 0.05-0.28), respectively. Importantly, when the healthy lifestyle score increased, exposure to household air pollution was no longer associated with a higher GDM risk. There was a negative additive interaction between exposure to household solid fuels exposure and a healthy lifestyle (FERI: -5.10 [-16.48, -2.04]; AP: -1.29 [-2.80, -0.39]; SI: -0.37 [-0.20, -0.67]). We determined that exposure to household air pollution may be an important GDM risk factor. In addition, A healthy lifestyle may have a protective effect on women with GDM exposed to indoor fuel air pollution.

The association of adolescent to midlife weight change with age at natural menopause: a population study of 263,586 women in Norway.

Age at menopause varies considerably among women and is linked to health after menopause. Body mass index is associated with age at natural menopause, but the influence of weight change remains unclear. Thus, we studied associations of adolescent to midlife weight change with age at natural menopause. We performed a retrospective population-based cohort study of 263,586 women aged 50-69 years attending BreastScreen Norway (2006-2015). The associations were estimated as hazard ratios (HRs) for having reached menopause using Cox proportional hazard models. We included nine categories of weight change based on recalls of adolescent weight compared to peers and quartiles of midlife weight in kilograms. We adjusted for year and country of birth, education, number of childbirths, height, smoking, and exercise. Women with the largest estimated weight loss had highest hazard of reaching menopause (adjusted HR 1.11, 95% CI: 1.06-1.17) compared to women with estimated stable average weight. Conversely, women with the largest estimated weight gain had lower hazard (adjusted HR 0.96, 95% CI: 0.93-0.99). Women with estimated stable high weight had lowest hazard of reaching menopause (adjusted HR 0.93, 95% CI: 0.90-0.95). Our findings suggest that changes in body weight across the life course may influence the timing of menopause.

Differentials in lifestyle practices and determinants among hypertensive adults from three geopolitical zones in Nigeria.

Introduction: hypertension is a major public health problem globally. The occurrence has been associated with unhealthy lifestyles (such as high salt consumption, physical inactivity, excessive intake of alcohol and unhealthy diet), which are very critical for hypertension control. The study was conducted to assess the lifestyle practices and their determinants among adults with hypertension in Nigeria. Methods: data on 762 adults living with hypertension were extracted from a cross-sectional survey conducted across three States (Abia, Kano and Oyo States) in Nigeria. A semi-structured pre-tested, interviewer-administered questionnaire was used for data collection. Knowledge of lifestyle practices was categorized into good and poor at 25th percentile cut-off point. Overall lifestyle practice was grouped into healthy and unhealthy practices. Healthy lifestyle practice was defined as score of four and above while unhealthy lifestyle practice was defined as score of three and below; in all the 7 specific domains of lifestyle practices assessed (maximum obtainable was 7). The cut off was chosen based on 90% sensitivity from the Receiver Operating Curve (ROC) distribution of the scores. Data was summarized using descriptive statistics, Chi-square test and binary logistic regression were used to explore associations and determine predictors of lifestyle practices. Level of significance was set at 5%. Results: the mean age of the respondents was 55.4±16.3 years. About one-quarter of the respondents (24.3%) had good knowledge of lifestyle practices. Overall, 11.8% of respondents were engaged in good lifestyle practices. Independent predictors of good lifestyle practices were earning monthly income of N30,000 and above [AOR=1.58; 95% CI (1.03-2.42)], being a farmer [AOR=1.09; 95% CI (0.55-2.18)] and artisan [AOR=1.50; 95% CI (0.70-3.14)]. Conclusion: the poor knowledge of lifestyle practices and engagement among adults with hypertension found in this study underscore the need to emphasize integrating lifestyle education for effective management of hypertension.

Navigating online health information: Insights into consumer influence and decision-making strategies-An overview of reviews.

Objective: Communities' use of technology and the internet for online health information (OHI) is increasing exponentially. An understanding of how and why individuals access OHI, and how this information influences decisions on health, medicines and self-care practices is critical. This review aims to: (1) identify the factors influencing OHI-seeking behaviour; (2) evaluate the evidence of OHI on self-care practices; and (3) outline strategies to improve online informed decision-making and assess the impact of these strategies on consumer outcomes. Methods: A review of systematic reviews was conducted in November of 2023, following the Cochrane Handbook and PRISMA guidelines, and using PubMed, Scopus, Web of Science and EBSCOhost databases. The methodological quality of retrieved reviews was appraised using the AMSTAR 2 tool. Results: The search retrieved 1725 records. Of these, 943 were screened, and 33 were included in the final analysis. The most frequently identified reasons for seeking OHI were to retrieve diagnostic and treatment information, and well-being and emotional support. Level of education and socio-economic status influenced OHI-seeking. OHI directly influenced self-care decision-making by individuals and their relationships and communication with healthcare providers. Overall, OHI-seeking (and interventions to promote the use of OHI) enhanced individuals' confidence, skills and knowledge. Conclusions: The findings highlight the benefits of OHI-seeking and its potential influence on self-care decisions. Future research should focus on strategies that would promote the pursuit of high-quality, up-to-date OHI and on the development of interventions for healthcare professionals to improve patients' use of OHI in self-care and self-efficacy.

Web-based telemedicine approach for treatment of post-COVID-19 in Thuringia (WATCH).

Objective: After infection with SARS-CoV-2, a substantial proportion of patients develop long-lasting sequelae. These sequelae include fatigue (potentially as severe as that seen in ME/CFS cases), cognitive dysfunction, and psychiatric symptoms. Because the pathophysiology of these sequelae remains unclear, existing therapeutic concepts address the symptoms through pacing strategies, cognitive training, and psychological therapy. Methods: Here, we present a protocol for a digital multimodal structured intervention addressing common symptoms through three intervention modules: BRAIN, BODY, and SOUL. This intervention includes an assessment conducted via a mobile "post-COVID-19 bus" near the patient's home, as well as the use of wearable devices and mobile applications to support pacing strategies and collection of data, including ecological momentary assessment. Results: We will focus on physical component subscore of the SF36 as Quality of Life parameter as the primary outcome parameter for WATCH to take into account the holistic approach that is necessary for care of post-COVID patients. Conclusion: In the current project, we present a protocol for a holistic and multimodal structured therapeutic concept which is easily accessible, and scalable for post-COVID patients.

Impact of the simultaneous distribution of e-learning and exercise videos on the health literacy and lifestyle of college students during the COVID-19 pandemic: a randomized controlled trial.

[Purpose] The coronavirus disease of 2019 (COVID-19) pandemic and its associated restrictions have raised concerns regarding the lack of exercise among college students. Videos on digital platforms have addressed this issue, although their effects on student behavior are unclear. The present study investigated whether the simultaneous distribution of e-learning and exercise videos among college students during the lifting of behavioral restrictions during the COVID-19 pandemic was effective in promoting health. [Participants and Methods] We conducted a randomized controlled trial in which 100 college students were recruited. The data of 61 students (e-learning and exercise video group=21, exercise video group=20, and control group=20) who completed baseline surveys were analyzed. The preliminary outcomes were physical activity, health habits, eHealth literacy, health-related quality of life, subjective well-being, and psychological stress. A mixed-model repeated-measures analysis of variance was used to compare these variables before and after the intervention. [Results] Health practice and eHealth literacy scales exhibited significant interactions in the e-learning and exercise video groups compared to the other groups. [Conclusion] The combined distribution of e-learning and exercise videos did not significantly enhance physical activity among college students during the COVID-19 pandemic; however, health literacy and habits improved.

Mediterranean Diet adherence, physical activity level, and quality of life in patients affected by thyroid diseases: Comparison between pre- and post-lockdown assessment.

Background: SARS-CoV-2 pandemic resulted in lifestyle change of world's population because of the measures adopted by governments to contain the virus spread. Design and Methods: This study examined whether lockdown impacted anthropometric indices, Mediterranean Diet (MD) adherence, Physical Activity Level (PAL), and Quality of Life (SF-12) in a cohort of 116 patients (96 F, aged 57.2 ± 13.1 years) affected by thyroid disorders. Before lockdown, data were collected during the endocrinological examination; after lockdown they were collected through a tele-phone interview (via video call). Results: Data revealed an overweight condition in 59% of patients, with no significant differences between the two observations (BMI values: 26.5 ± 4.9 vs 26.6 ± 4.9 kg/m2), whereas waist circumference values significantly increased over time (93.3 ± 12.6 vs 94.4 ± 12.5 cm; p = 0.003). Moreover, a lower adherence to the MD (PREDIMED score: 7.3 ± 1.8 vs 7.0 ± 1.8; p = 0.003) and a significant increase of sitting time (6.4 ± 3.2 h/die vs 9.0 ± 4.2; p < 0.001) were observed. A not significant decrease in PAL, which revealed a sedentary condition in pre- and post-lockdown (648 and 562 METs/week respectively), was found. The SF-12 score did not show relevant changes between the two observations. Conclusion: Our study highlights that patients with thyroid diseases are often sedentary and exhibit a high prevalence of over-weight, underscoring the need for a systematic anthropometric evaluation and, at times, lifestyle interventions.

A critical review on diabetes mellitus type 1 and type 2 management approaches: from lifestyle modification to current and novel targets and therapeutic agents.

Diabetes mellitus (DM) has emerged as an international health epidemic due to its rapid rise in prevalence. Consequently, scientists and or researchers will continue to find novel, safe, effective, and affordable anti-diabetic medications. The goal of this review is to provide a thorough overview of the role that lifestyle changes play in managing diabetes, as well as the standard medications that are currently being used to treat the condition and the most recent advancements in the development of novel medical treatments that may be used as future interventions for the disease. A literature search was conducted using research databases such as PubMed, Web of Science, Scopus, ScienceDirect, Wiley Online Library, Google Scholar, etc. Data were then abstracted from these publications using words or Phrases like "pathophysiology of diabetes", "Signe and symptoms of diabetes", "types of diabetes", "major risk factors and complication of diabetes", "diagnosis of diabetes", "lifestyle modification for diabetes", "current antidiabetic agents", and "novel drugs and targets for diabetes management" that were published in English and had a strong scientific foundation. Special emphasis was given to the importance of lifestyle modification, as well as current, novel, and emerging/promising drugs and targets helpful for the management of both T1DM and T2DM.

The lifestyle factors of medical doctors in academic hospitals, Bloemfontein, Free State.

BACKGROUND:  Lifestyle factors of medical doctors are essential to their health and well-being. Previous studies omitted factors that constituted a healthy lifestyle and did not differentiate between various medical specialties or level of seniority which may expose doctors to different stress levels, workload and responsibility. The study assessed the lifestyle factors of medical doctors and compared them between departments, levels of seniority, years of experience and gender according to globally recognised health standards. METHODS:  This descriptive cross-sectional study collected data using a questionnaire created by the researchers based on healthy lifestyle factors and was administered online. Access was given to all doctors from four large departments, employed at two academic hospitals in Bloemfontein, Free State who agreed to participate in the study. RESULTS:  Consultants from paediatrics, with 6+ years in medical practice, had the healthiest lifestyles. Registrars and interns from surgical disciplines such as obstetrics and gynaecology and surgery, with 1-5 years of medical practice, showed unhealthy lifestyles with inadequate sleep and exercise. CONCLUSION:  The challenge remains how medical doctors can live a healthy lifestyle while managing a demanding schedule. This may impact on the management of their patients and the doctors' overall health and well-being. We recommend improving the working conditions by providing healthy meals on-site at hospitals with adequate breaks, reducing the heavy workload and providing exercise facilities.Contribution: The findings from this article may help improve the lifestyles of the identified groups of at-risk doctors and assist them in seeking ways to improve upon this.

A longitudinal investigation of the determinants of stroke survivors' utilisation of a healthy lifestyle for stroke rehabilitation in Australia.

This study aimed to determine the longitudinal predictors of lifestyle behaviours among stroke survivors in New South Wales, Australia. This longitudinal study utilised data from the baseline survey (2005-2009) and a sub-study survey (2017) of the 45 and Up Study. Physical activity, alcohol consumption, smoking status, and supplement use were included as dependent variables. Generalised estimating equation models were employed to assess the longitudinal association between the dependent variable and demographic and health status measures. The average age of the participants (n = 576) was 67 (SD = 9) years at baseline and 76 (SD = 9) years at the sub-study survey time, with 54.9% being male. The longitudinal analysis revealed that the likelihood of moderate/high physical activity significantly declined over time and was lower among participants with diabetes, but was higher among those with university education. The likelihood of smoking was significantly higher in females, moderate/high-risk alcohol consumers, and those with depression, but was lower among supplement users. The likelihood of moderate/high-risk alcohol consumption significantly declined with time, and was lower among females, but higher among smokers. The likelihood of supplement use significantly declined over time, but was higher among females and/or those with asthma. Our findings help illustrate that many stroke survivors may benefit from further support in adopting and maintaining a healthy lifestyle as part of their stroke management and long-term rehabilitation, which is crucial to optimising their quality of life and successful secondary stroke prevention.

Nepali oral microbiomes reflect a gradient of lifestyles from traditional to industrialized.

BACKGROUND: Lifestyle plays an important role in shaping the gut microbiome. However, its contributions to the oral microbiome remain less clear, due to the confounding effects of geography and methodology in investigations of populations studied to date. Furthermore, while the oral microbiome seems to differ between foraging and industrialized populations, we lack insight into whether transitions to and away from agrarian lifestyles shape the oral microbiota. Given the growing interest in so-called "vanishing microbiomes" potentially being a risk factor for increased disease prevalence in industrialized populations, it is important that we distinguish lifestyle from geography in the study of microbiomes across populations. RESULTS: Here, we investigate salivary microbiomes of 63 Nepali individuals representing a spectrum of lifestyles: foraging, subsistence farming (individuals that transitioned from foraging to farming within the last 50 years), agriculturalists (individuals that have transitioned to farming for at least 300 years), and industrialists (expatriates that immigrated to the USA within the last 20 years). We characterize the role of lifestyle in microbial diversity, identify microbes that differ between lifestyles, and pinpoint specific lifestyle factors that may be contributing to differences in the microbiomes across populations. Contrary to prevailing views, when geography is controlled for, oral microbiome alpha diversity does not differ significantly across lifestyles. Microbiome composition, however, follows the gradient of lifestyles from foraging through agrarianism to industrialism, supporting the notion that lifestyle indeed plays a role in the oral microbiome. Relative abundances of several individual taxa, including Streptobacillus and an unclassified Porphyromonadaceae genus, also mirror lifestyle. Finally, we identify specific lifestyle factors associated with microbiome composition across the gradient of lifestyles, including smoking and grain sources. CONCLUSION: Our findings demonstrate that by studying populations within Nepal, we can isolate an important role of lifestyle in determining oral microbiome composition. In doing so, we highlight the potential contributions of several lifestyle factors, underlining the importance of carefully examining the oral microbiome across lifestyles to improve our understanding of global microbiomes. Video Abstract.

Association between the oxidative balance score with metabolic syndrome traits in US adults.

OBJECTIVE: To explore the association between the Oxidative Balance Score (OBS), which represents the balance of multiple oxidative stress-related dietary and lifestyle exposures, and the risk of metabolic syndrome (MetS). METHODS: A population-based cross-sectional study design was adopted and 16,850 participants in NHANES database were included in the statistics analysis stage. The OBS was constructed by combining information from 20 a priori selected pro- and antioxidant factors. Weighted logistic regression and restricted cubic splines (RCS) were used to estimate the association between OBS and MetS. RESULTS: Participants in the highest OBS quartile, indicating low oxidative stress (OS) levels, exhibited a significantly lower risk of MetS (odds Ratio [OR] = 0.55, 95% confidence Interval [CI]: 0.47-0.64) compared to the lowest quartile. Specifically, higher OBS was inversely associated with abdominal obesity (OR = 0.61, 95% CI: 0.54-0.69), hypertension (OR = 0.69, 95% CI: 0.58-0.83), elevated triglycerides (OR = 0.68, 95% CI: 0.57-0.82), low high-density lipoprotein cholesterol (HDL-C) levels (OR = 0.60, 95% CI: 0.50-0.70) and fasting blood glucose (FBG) levels (OR = 0.74, 95% CI: 0.62-0.88). The observed inverse association between OBS and hypertension or FBG levels appeared to primarily influenced by BMI. The association between dietary OBS intervals and elevated FBG levels was not statistically significant in men, whereas the risk was lower by 25% in women. CONCLUSIONS: A higher OBS, representing a balance of multiple oxidative stress-related dietary and lifestyle exposures, is associated with a lower risk of MetS. Therefore, adhering to an antioxidant diet and lifestyle may help prevent the occurrence of metabolic disorders.

Education in lifestyle medicine for future physicians - a strategy to reduce the burden of cardiovascular disease.

There is a compelling need to improve all physicians' knowledge on lifestyle medicine (LM). This training needs to start early during medical education. This case report describes the feasibility and effects of integrating LM into an existing core curriculum of a Swedish undergraduate medical programme. A curriculum development project was organized using a six-step model: general needs assessment, targeted needs assessment, goals and objectives, educational strategies, implementation, and evaluation. New learning objectives regarding health, prevention and lifestyle medicine were formulated throughout the five-and-a-half-year programme. Learning activities and examinations were integrated in all courses with a structured progression and with focus on preventive activities in the workplace learning. The project was evaluated using student surveys of curricular quality, teacher survey of curricular content and integration in 2020, and an external review of adherence to the national qualitative target on preventive medicine. The project was executed during 2017-2018. Course evaluations and exit poll at graduation showed an overall high-quality student rating of education in prevention and in lifestyle counselling: on average, a score of 4.1/5 and 4.1/6, respectively. The teacher survey showed that over 70% of courses had a lasting increase in LM curricular content and that this content was to a large extent integrated into the existing course material. The external review concluded that the topic was well covered and integrated into the curriculum. LM could be successfully integrated into an existing medical programme curriculum with positive effects on student learning.

Physical Therapy as Part of a Telehealth Multidisciplinary Lifestyle Modification Program (IM FIT): Preliminary Outcomes and Program Feedback From Cancer Survivors.

BACKGROUND: Physical therapy (PT) has an important role in Integrative Oncology programs, addressing the unique physical health needs of individuals with cancer through exercise counseling. We share our experience with the PT component of our telehealth comprehensive lifestyle modification program including data from our first cohort of patients. METHODS: The PT component of our lifestyle modification program included 6 one-hour synchronous video sessions (30 minutes exercise education, 30 minutes exercise) over the 12-week program. Participants received handouts electronically that included information regarding each week's exercise-related topic, as well as weekly exercise assignments. Outcomes included weight, days of aerobic exercise, minutes of aerobic exercise, and days of strengthening exercise. Six patients completed the program and submitted an anonymous exit survey providing qualitative feedback on the program. RESULTS: On average, patients reported engaging in aerobic exercise 4 days per week and strength training 2 days per week after the intervention. There were notable increases in days of strength training. Patients lost an average of 4.2% of their body weight over the course of the 12-week program. Qualitative feedback showed that the first cohort of patients described the telehealth program as enjoyable, valuable, and convenient. DISCUSSION: Physical therapy exercise programs can be modified and tailored for delivery in a telehealth environment. Increased patient access remains a strength of this model, serving to equip patients with the tools needed for increasing aerobic and strength training activity. Overall, the program was implemented successfully, and the anonymous feedback survey completed after program completion showed high patient satisfaction.