Adherence to a Planetary Health Diet, Environmental Impacts, and Mortality in Chinese Adults.

Importance: Although the EAT-Lancet Commission has recently proposed a planetary health diet (PHD) to promote human and environmental health, little is known about how PHD affects environment and mortality risk among an Asian population. Objective: To investigate whether a PHD score is associated with environmental impacts and mortality outcomes in a Chinese cohort living in Singapore. Design, Setting, and Participants: This cohort study used data from the Singapore Chinese Health Study. Eligible participants were without known cardiovascular disease and cancer at baseline; they were recruited between 1993 and 1998 and followed up using record linkage data until 2020. Data were analyzed from September 2022 to April 2023. Exposures: PHD score was calculated based on the reference consumption of 14 dietary components in PHD and individual energy intake assessed using a validated food frequency questionnaire in this cohort. Main Outcomes and Measures: Diet-related environmental impacts were estimated using a food frequency questionnaire. Mortality outcomes (all-cause, cardiovascular disease, cancer, and respiratory disease) were identified via linkage with a nationwide registry. Results: A total of 57 078 participants were included in this study (mean [SD] age, 56.1 (7.9) years; 31 958 women [56.0%]). During a median (IQR) follow-up of 23.4 (18.7-26.2) years, 22 599 deaths occurred. Comparing the highest and lowest quintiles, higher PHD scores were associated with lower greenhouse gas emissions (ß = -0.13 kg CO2 equivalent; 95% CI, -0.14 to -0.12 kg CO2 equivalent), but with higher total water footprint (ß = 0.12 m3; 95% CI, 0.11-0.13 m3) and land use (ß = 0.29 m2; 95% CI, 0.28-0.31 m2). In the adjusted multivariable model, compared with the lowest quintile, participants in the highest quintile of PHD score had lower risk of all-cause mortality (hazard ratio [HR], 0.85; 95% CI, 0.81-0.89), cardiovascular disease mortality (HR, 0.79; 95% CI, 0.73-0.85), cancer mortality (HR, 0.93; 95% CI, 0.86-1.00), and respiratory disease mortality (HR, 0.81; 95% CI, 0.74-0.89). Conclusions and Relevance: In this study of Singapore Chinese adults, higher adherence to PHD was associated with reduced risk of chronic disease mortality. However, environmental impacts were uncertain, as higher adherence was associated with lower greenhouse gas emissions but higher total water footprint and land use.

Improving Photocatalytic Activity for Formaldehyde Degradation by Encapsulating C60 Fullerenes into Graphite-like C3N4 through the Enhancement of Built-in Electric Fields.

The photocatalytic degradation of formaldehyde by graphite-like C3N4 is one of the most attractive and environmentally friendly strategies to address the significant threat to human health posed by indoor air pollutants. Despite its potential, this degradation process still faces issues with suboptimal efficiency, which may be attributed to the rapid recombination of photogenerated excitons and the broad band gap. As a proof of concept, a series of graphite-like C3N4@C60 composites combining graphite-like C3N4 and C60 was developed via an in situ generation strategy. The obtained graphite-like C3N4@C60 composites exhibited a remarkable increase in the photocatalytic degradation efficiency of formaldehyde, of up to 99%, under visible light irradiation, outperforming pure graphite-like C3N4 and C60. This may be due to the composites' enhanced built-in electric field. Additionally, the proposed composites maintained a formaldehyde removal efficiency of 84% even after six cycles, highlighting their potential for indoor air purification and paving the way for the development of efficient photocatalysts.

Trends in Self-Reported Adherence to Healthy Lifestyle Behaviors Among US Adults, 1999 to March 2020.

Importance: Adherence to a healthy lifestyle is associated with lower risks of adverse outcomes. However, trends in multiple lifestyle factors and overall healthy lifestyle status among US adults in recent years are unknown. Objective: To examine trends in multiple lifestyle factors and overall healthy lifestyle among US adults. Design, Setting, and Participants: This serial cross-sectional study used nationally representative data from 10 National Health and Nutrition Examination Survey (NHANES) cycles (nine 2-year cycles from 1999 to 2016 and 1 combined cycle from 2017 to March 2020) among adults 20 years or older. Data were analyzed from December 10, 2021, to January 11, 2023. Exposure: Survey cycle. Main Outcomes and Measures: Five healthy lifestyle factors: never smoking, moderate or lighter alcohol consumption (for women: ≤7 drinks/wk; for men: ≤14 drinks/wk), healthy diet (Healthy Eating Index-2015 scores ≥60.0), sufficient physical activity (≥150 min/wk of equivalent moderate physical activity), and healthy weight (body mass index [calculated as weight in kilograms divided by height in meters squared] 18.5-24.9). Results: A total of 47 852 adults were included in this study. The weighted mean [SE] age was 47.3 [0.2] years; 24 539 (weighted proportion, 51.5%) were women. From the 1999-2000 cycle to the 2017 to March 2020 cycle, the estimated prevalence of the 5 lifestyle factors showed divergent trends, with increasing prevalence of never smoking (from 49.4% [95% CI, 46.4%-52.4%] to 57.7% [95% CI, 55.5%-59.9%]; difference, 8.2% [95% CI, 4.5%-12.0%]), healthy diet (from 19.3% [95% CI, 16.0%-22.6%] to 24.5% [95% CI, 21.5%-27.5%]; difference, 5.2% [95% CI, 0.8%-9.7%]), and sufficient physical activity (from 55.7% [95% CI, 51.8%-59.6%] to 69.1% [95% CI, 67.2%-71.1%]; difference, 13.4% [95% CI, 9.0%-17.8%]), while prevalence of healthy weight decreased from 33.1% (95% CI, 30.5%-35.6%) to 24.6% (95% CI, 22.6%-26.7%; difference, -8.4% [95% CI, -11.8% to -5.1%]) (all P < .001 for trend). Meanwhile, there was no significant trend in moderate or lighter alcohol consumption. Overall, the estimated prevalence of at least 4 healthy lifestyle factors increased from 15.7% (95% CI, 12.8%-18.7%) to 20.3% (95% CI, 17.8%-22.7%; difference, 4.5% [95% CI, 0.7%-8.4%]; P < .001 for trend). Disparities in healthy lifestyle were widened by age group, with little improvement among adults 65 years and older (difference, 0.04% [95% CI, -4.28% to 4.35%]). There were persistent disparities in healthy lifestyle by race and ethnicity, educational level, and income level. Conclusions and Relevance: The findings of this cross-sectional study of NHANES data over a 22-year period suggest diverse change patterns across 5 healthy lifestyle factors and a modest improvement in overall lifestyle existed among US adults, with worsening or persistent disparities in lifestyle.

Long-term glycemic variability and risk of adverse health outcomes in patients with diabetes: A systematic review and meta-analysis of cohort studies.

AIMS: To quantify associations of different metrics of long-term glycemic variability (GV) with multiple adverse diabetes-related outcomes. METHODS: We searched PubMed and Embase from database inception to 23 August 2021. GV was based on measurements of HbA1c or fasting plasma glucose (FPG) and calculated by standard deviation (SD), coefficient of variance (CV) or other metrics. Outcomes included mortality, cardiovascular disease (CVD), renal disease, peripheral neuropathy, retinopathy, dementia and cancer. Random-effects meta-analyses were adopted to pool the relative risks (RRs). RESULTS: Seventy-five articles with 2,051,701 participants were included. When comparing top with bottom quartiles, HbA1c variabilities were associated with all-cause mortality (RRCV = 1.63, 95 % CI 1.37-1.92; RRSD = 1.87, 1.55-2.26), CVD (RRCV = 1.38, 1.07-1.78; RRSD = 1.34, 1.12-1.59), renal disease (RRCV = 1.43, 1.18-1.74; RRSD = 1.44, 1.24-1.67), and peripheral neuropathy (RRCV = 1.84, 1.40-2.43; RRSD = 1.98, 1.51-2.61), but not retinopathy. FPG variabilities were associated with all-cause mortality (RRCV = 1.59, 1.43-1.78; RRSD = 1.67, 1.26-2.20), renal disease (RRCV = 1.77, 1.32-2.38), and retinopathy (RRCV = 1.92, 1.10-3.35), but not CVD and peripheral neuropathy. Associations of GV with Alzheimer's disease (RRHbA1c-CV = 1.38, 1.13-1.70; RRFPG-CV = 1.32, 1.07-1.63) and cancer (RRHbA1c-SD = 2.19, 1.52-3.17; RRFPG-CV = 3.64, 2.21-5.98) were each found significant in one study. CONCLUSIONS: Long-term GV was associated with multiple adverse diabetes-related outcomes, while the strength of associations varied. The findings support the use of long-term GV for diabetes management in clinical practice.

Importance of ideal cardiovascular health metrics in the risk of colorectal cancer among people aged 50 years or older: a UK Biobank cohort study.

OBJECTIVE: To explore the correlation between the ideal cardiovascular health metrics (ICVHMs) and the incidence of colorectal cancer (CRC) among people aged 50 years or older. DESIGN: Prospective cohort study. SETTING: The UK Biobank, a prospective cohort of middle-aged participants recruited between 2006 and 2010. PARTICIPANTS: The study included 342 226 participants from the UK Biobank aged 50 years or older without prevalent cancer. EXPOSURE: The ICVHMs consist of four behavioural factors (abstinence from smoking, ideal body mass index (BMI), physical activity at goal and consumption of healthy diet) and three cardiometabolic factors (untreated total cholesterol <200 mg/dL, untreated blood pressure <120/80 mm Hg and untreated fasting plasma glucose <100 mg/dL). MAIN OUTCOMES: The outcome was ascertained by linkage to cancer and death registries using the International Classification of Diseases, Tenth codes C18-C20. RESULTS: During a median follow-up time of 8.72 years, 3060 CRC cases were identified. Compared with the reference (participants with ICVHMs ≤2), the multivariable-adjusted HRs for subgroups with 3, 4, 5 and ≥6 ICVHM factors were 0.98 (95% CI 0.85 to 1.12), 0.90 (95% CI 0.77 to 1.02), 0.85 (95% CI 0.71 to 0.98) and 0.69 (95% CI 0.48 to 0.90), respectively. Among the seven ICVHM factors, lower BMI, healthier diet and ideal fasting plasma glucose were significantly associated with lower risk of CRC (HR: 0.86, 95% CI 0.78 to 0.95; HR: 0.92, 95% CI 0.84 to 0.99; HR: 0.90, 95% CI 0.80 to 0.99). CONCLUSIONS: Adherence to the ICVHMs was associated with a lower risk of CRC among people aged 50 years or older. Among the seven ICVHM factors, BMI, diet and fasting plasma glucose played a more critical role in the prevention of CRC. These findings imply that adherence to ICVHMs should be encouraged to reduce the burden of cardiovascular disease as well as CRC.

Altered regulation of CD200 receptor in monocyte-derived macrophages from individuals with Parkinson's disease.

Microglia are the representative myeloid cells in the brain, and their over-activation plays an important role in the pathogenesis of Parkinson's disease (PD). Microglia activation is believed to be regulated by the CD200-CD200R signaling. As the peripheral counterpart of microglia, monocyte-derived macrophages (MDMs) share the same progenitor and antigen markers, and they have similar biological behaviors and mirror microglial function in the brain. Here, we studied CD200R expression and its regulation in MDMs from 32 PD cases, 27 age-matched old controls, and 28 young controls. We found that the basal CD200R expression is similar in MDMs from young control, old control and PD patients. However, the induction of CD200R expression in MDMs under various conditions is impaired in the old groups, especially in PD patients. There was a selective decrease in CD200R expression induced by co-culture with dying PC12 cells in MDMs from PD cases, as compared with MDMs from the age-matched controls. We also found that the inducible CD200R expression correlated inversely with the onset age of PD and to tumor necrosis factor-alpha (TNF-alpha) released from MDMs. These results suggest an intrinsic abnormality in the CD200-CD200R signaling in MDMs during aging and, especially, in PD. We speculate that in the PD brain,microglia might undergo abnormalities similar to MDMs.