Healthy lifestyle and risk of incident heart failure with preserved and reduced ejection fraction among post-menopausal women: The Women's Health Initiative study.

We examined associations of diet, physical activity, cigarette smoking, and body mass index (BMI), separately and as a cumulative lifestyle score, with incident hospitalized HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). This analysis included 40,095 postmenopausal women in the Women's Health Initiative clinical trial and observational studies, aged 50-79 years and without self-reported HF at baseline. A healthy lifestyle score (HLS) was developed, in which women received 1 point for each healthy lifestyle. A weighted HLS was also created to examine the independent magnitude of each of the lifestyle factors in HF subtypes. Trained adjudicators determined cases of incident hospitalized HF, HFpEF, HFrEF through March 2018. Multiple variable Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI). During a mean follow-up period of 14.5 years, 659 incident HFrEF and 1276 HFpEF cases were documented. Across unweighted HLS of 0 (referent), 1, 2, 3, and 4, multivariable adjusted HRs (95% CI) for HFrEF were 1.00, 0.52 (0.38, 0.71), 0.40 (0.29, 0.56), 0.33 (0.23, 0.48), and 0.33 (0.19, 0.56) (P-trend = 0.03) and for HFpEF were 1.00, 0.47 (0.37, 0.59), 0.39 (0.30, 0.49), 0.26 (0.20, 0.34), and 0.23 (0.15, 0.35) (P-trend < 0.001). Results were similar for the weighted HLS. Our findings suggest that following a healthy lifestyle pattern is associated with lower risks of HFpEF and HFrEF among postmenopausal women.

Prolonged Exposure to Monosodium Glutamate in Healthy Young Adults Decreases Perceived Umami Taste and Diminishes Appetite for Savory Foods.

Background: Research suggests that increased consumption of sweet, salt, or fat is associated with diminished perceived taste intensity and shifted preferences for the respective stimulus. It is unknown whether a similar effect occurs with the consumption of umami. Objective: The aim of the study was to investigate the influence of habitual exposure to umami stimuli on umami taste perception, hedonics, and satiety. Methods: Fifty-eight healthy men (n = 16) and women (n = 42) participated in a parallel-group, randomized controlled study. The normal-weight [mean ± SD body mass index (kg/m2): 21.8 ± 2.2] group of young adults (mean ± SD age: 22.7 ± 6.2 y) consumed vegetable broth daily for 4 wk. The broth for the treatment group (n = 28) was supplemented with 3.8 g monosodium glutamate (MSG), whereas the control group (n = 30) consumed a sodium-matched broth without MSG. Perceived umami taste intensity and discrimination in MSG solutions; liking, wanting, and preference of a variety of umami-rich foods; satiation and satiety from an ad libitum meal; and anthropometric measures were evaluated at baseline and at week 4. General linear models assessed the effect of treatment on change from baseline for all outcomes and tested for effect modification of sex. Results: Relative to controls, increased consumption of MSG for 4 wk diminished umami taste in women (8.4 units on generalized Labeled Magnitude Scale; 95% CI: -13.8, -3.1 units; P = 0.013). The desire for and intake of savory foods decreased after MSG treatment in both sexes with an ad libitum meal (desire: -7.7 units; 95% CI: -13.7, -1.7 units; P = 0.04; intake: -36 g; 95% CI: -91, 19 g; P = 0.04). Conclusion: Our results highlight that a month-long diet high in umami stimuli attenuates perceived umami taste and appetite for savory foods in a young, healthy population. Our findings contribute to the understanding of food choice, a factor in the development and maintenance of obesity, as well as the etiology of protein-related health conditions such as osteoporosis and kidney disease. This study is registered at www.clinicaltrials.gov as NCT03010930.

College-Aged Males Experience Attenuated Sweet and Salty Taste with Modest Weight Gain.

Background: Human and animal studies report a blunted sense of taste in people who are overweight or obese, with heightened sensitivity also reported after weight loss. However, it is unknown if taste changes concurrently with weight gain.Objective: This study investigated the association of weight gain with changes in suprathreshold taste intensity perception in a free-living population of young adults.Methods: Taste response, anthropometric measures, and diet changes were assessed with a longitudinal study design in first-year college students 3 times throughout the academic year. At baseline, 93 participants (30 males, 63 females) were an average of 18 y old, with a body mass index (in kg/m2) of 21.9. Sweet, umami, salty, sour, and bitter taste intensities were evaluated at 3 concentrations by using the general Labeled Magnitude Scale. Ordinary least-squares regression models assessed the association of weight gain and within-person taste change, adjusting for sex, race, and diet changes.Results: Participants gained an average of 3.9% in weight, ranging from -5.7% to +13.8%. With each 1% increase in body weight, males perceived sweet and salty as less intense, with taste responses decreasing by 11.0% (95% CI: -18.9%, -2.3%; P = 0.015) and 7.5% (95% CI: -13.1%, -1.5%; P = 0.015) from baseline, respectively. Meanwhile, females did not experience this decrement, and even perceived a 6.5% increase (95% CI: 2.6%, 10.5%; P = 0.007) in sour taste with similar amounts of weight gain. Changes in the consumption of meat and other umami-rich foods also negatively correlated with umami taste response (-39.1%; 95% CI: -56.3%, -15.0%; P = 0.004).Conclusions: A modest weight gain is associated with concurrent taste changes in the first year of college, especially in males who experience a decrement in sweet and salty taste. This suggests that young-adult males may be susceptible to taste loss when gaining weight.

Participants with pharmacologically impaired taste function seek out more intense, higher calorie stimuli.

OBJECTIVE: Research suggests a weaker sense of taste in people with obesity, with the assumption that a debilitated taste response increases the desire for more intensely tasting stimuli to compensate for decreased taste input. However, empirical testing of this supposition remains largely absent. METHOD: In a randomized, repeated measures design, 51 healthy subjects were treated with varying concentrations of a tea containing Gymnema sylvestre (GS), to temporarily and selectively diminish sweet taste perception, or a control tea. Following treatment in the four testing sessions, taste intensity ratings for various sweet stimuli were captured on the generalized Labeled Magnitude Scale (gLMS), liking for real foods assessed on the hedonic gLMS, and optimal level of sweetness quantified via an ad-libitum mixing task. Data were analyzed with mixed models assessing both treatment condition and each subject's resultant sweet response with various taste-related outcomes, controlling for covariates. RESULTS: GS treatment diminished sweet intensity perception (p < 0.001), reduced liking for sweet foods (p < 0.001), and increased the desired sucrose content of these foods (p < 0.001). Regression modeling revealed a 1% reduction in sweet taste response was associated with a 0.40 g/L increase in optimal concentration of sucrose (p < 0.001). DISCUSSION: Our results show that an attenuation in the perceived taste intensity of sweeteners correlates with shifted preference and altered hedonic response to select sweet foods. This suggests that those with a diminished sense of taste may desire more intense stimuli to attain a satisfactory level of reward, potentially influencing eating habits to compensate for a lower gustatory input.

Lessons Learned From Developing Dashboards to Support Decision-Making for Community Opioid Response by Community Stakeholders: Mixed Methods and Multisite Study.

BACKGROUND: Data dashboards are published tools that present visualizations; they are increasingly used to display data about behavioral health, social determinants of health, and chronic and infectious disease risks to inform or support public health endeavors. Dashboards can be an evidence-based approach used by communities to influence decision-making in health care for specific populations. Despite widespread use, evidence on how to best design and use dashboards in the public health realm is limited. There is also a notable dearth of studies that examine and document the complexity and heterogeneity of dashboards in community settings. OBJECTIVE: Community stakeholders engaged in the community response to the opioid overdose crisis could benefit from the use of data dashboards for decision-making. As part of the Communities That HEAL (CTH) intervention, community data dashboards were created for stakeholders to support decision-making. We assessed stakeholders' perceptions of the usability and use of the CTH dashboards for decision-making. METHODS: We conducted a mixed methods assessment between June and July 2021 on the use of CTH dashboards. We administered the System Usability Scale (SUS) and conducted semistructured group interviews with users in 33 communities across 4 states of the United States. The SUS comprises 10 five-point Likert-scale questions measuring usability, each scored from 0 to 4. The interview guides were informed by the technology adoption model (TAM) and focused on perceived usefulness, perceived ease of use, intention to use, and contextual factors. RESULTS: Overall, 62 users of the CTH dashboards completed the SUS and interviews. SUS scores (grand mean 73, SD 4.6) indicated that CTH dashboards were within the acceptable range for usability. From the qualitative interview data, we inductively created subthemes within the 4 dimensions of the TAM to contextualize stakeholders' perceptions of the dashboard's usefulness and ease of use, their intention to use, and contextual factors. These data also highlighted gaps in knowledge, design, and use, which could help focus efforts to improve the use and comprehension of dashboards by stakeholders. CONCLUSIONS: We present a set of prioritized gaps identified by our national group and list a set of lessons learned for improved data dashboard design and use for community stakeholders. Findings from our novel application of both the SUS and TAM provide insights and highlight important gaps and lessons learned to inform the design of data dashboards for use by decision-making community stakeholders. TRIAL REGISTRATION: ClinicalTrials.gov NCT04111939; https://clinicaltrials.gov/study/NCT04111939.

Association of Sedentary Time and Incident Heart Failure Hospitalization in Postmenopausal Women.

BACKGROUND: The 2018 US Physical Activity Guidelines recommend reducing sedentary behavior (SB) for cardiovascular health. SB's role in heart failure (HF) is unclear. METHODS: We studied 80 982 women in the Women's Health Initiative Observational Study, aged 50 to 79 years, who were without known HF and reported ability to walk ≥1 block unassisted at baseline. Mean follow-up was 9 years for physician-adjudicated incident HF hospitalization (1402 cases). SB was assessed repeatedly by questionnaire. Time-varying total SB was categorized according to awake time spent sitting or lying down (≤6.5, 6.6-9.5, >9.5 h/d); sitting time (≤4.5, 4.6-8.5, >8.5 h/d) was also evaluated. Hazard ratios and 95% CI were estimated using Cox regression. RESULTS: Controlling for age, race/ethnicity, education, income, smoking, alcohol, menopausal hormone therapy, and hysterectomy status, higher HF risk was observed across incremental tertiles of time-varying total SB (hazard ratios [95% CI], 1.00 [referent], 1.15 [1.01-1.31], 1.42 [1.25-1.61], trend P<0.001) and sitting time (1.00 [referent], 1.14 [1.01-1.28], 1.54 [1.34-1.78], trend P<0.001). The inverse trends remained significant after further controlling for comorbidities including time-varying myocardial infarction and coronary revascularization (hazard ratios: SB, 1.00, 1.11, 1.27; sitting, 1.00, 1.09, 1.37, trend P<0.001 each) and for baseline physical activity (hazard ratios: SB 1.00, 1.10, 1.24; sitting 1.00, 1.08, 1.33, trend P<0.001 each). Associations with SB exposures were not different according to categories of baseline age, race/ethnicity, body mass index, physical activity, physical functioning, diabetes, hypertension, or coronary heart disease. CONCLUSIONS: SB was associated with increased risk of incident HF hospitalization in postmenopausal women. Targeted efforts to reduce SB could enhance HF prevention in later life.