Lifestyle and ADL Are Prioritized Factors Influencing All-Cause Mortality Risk Among Oldest Old: A Population-Based Cohort Study.

To identify key factors affecting all-cause mortality in the elderly aged 80 years and above. Data from Chinese Longitudinal Healthy Longevity Survey (2011-2018) were utilized (N = 3993). A healthy lifestyle score was obtained by assigning 8 factors: smoking, drinking, exercise, sleep duration, social activity, waist circumference, BMI, and healthful plant-based diet index. Cox regression and decision tree model were used to identify factors influencing the mortality risk. Lifestyle and activities of daily living (ADL) were 2 of the most important modifiable factors influencing the mortality risk of the oldest seniors. A higher healthy lifestyle score was associated with lower mortality risk. The HR (95% CI) of death risk in Q2, Q3, and Q4 groups were 0.91 (0.81-1.01), 0.78 (0.71-0.86), and 0.64 (0.58-0.71), respectively, when compared with the Q1 group of healthy lifestyle score. Elderly with ADL disability had a higher mortality rate than those without ADL disability. When the elderly already have ADL disability, the healthier the lifestyle, the lower the mortality rate. Among individuals aged 80 to 89 years with ADL disability, the mortality rate was higher in the healthy lifestyle score Q1-Q2 groups (92.1%) than that in the Q3-Q4 groups (71.6%). Similar results were observed among subjects aged 90 to 99 years with ADL disability (Q1-Q2: 97.9%, Q3-Q4: 92.1%). For centenarians without ADL disability, maintaining a healthy lifestyle significantly reduced mortality (Q1-Q3: 90.5%, Q4: 75.5%). Caregivers should prioritize the consideration of lifestyle and ADL in their healthcare practices of the oldest old.

The Increased Risk of Hypertension Caused by Irrational Dietary Pattern May Be Associated with Th17 Cell in the Middle-Aged and Elderly Rural Residents of Beijing City, Northern China: A 1:1 Matched Case-Control Study.

An irrational diet has been widely considered as one of the vital risk factors of hypertension. Previous studies have indicated that immune dysfunction may be involved in the pathogenic process of hypertension, while fewer studies have mentioned whether CD4+ T cells are involved in the association between dietary pattern and hypertension. This present 1:1 matched case-control study was conducted to analyze the association among dietary pattern, CD4+ T cells and hypertension. A total of 56 patients with diagnosed hypertension and 56 subjects without diagnosed hypertension in the rural area of Beijing City, northern China, were matched by age and gender, and then classified into a case group and a control group, respectively. Compared with the control group, higher frequencies of pro-inflammatory CD4+ T cells, such as Th1, Th1(IFN-γ), Th17(IL-17A), and Th1/17 (IFN-γ/IL-17A), were found in the case group (p < 0.05). A significantly higher level of circulating IL-17A was also found in the case group (7.4 pg/mL vs. 8.2 pg/mL, p < 0.05). Five dietary patterns were identified using exploratory factor analysis. An irrational dietary pattern, characterized by high-factor loadings of refined wheat (0.65), meat (0.78), poultry (0.76), and alcoholic beverage (0.73), was positively associated with SBP (ß = 5.38, 95%CI = 0.73~10.03, p < 0.05) in the multiple linear regression model with the adjustment of potential covariates. The other dietary patterns showed no significant association with blood pressure. Furthermore, meat, processed meat, and animal viscera were positively correlated with the peripheral Th17 or Th1/17. In conclusion, the irrational dietary pattern characterized by refined wheat, meat, poultry, and alcoholic beverage, was positively correlated with blood pressure, and may increase the risk of hypertension in the rural area of Beijing, northern China. Th17, a subset of the CD4+ T helper cells, may be involved in the association between irrational dietary pattern and hypertension.

The effect of diet and exercise on climacteric symptomatology.

BACKGROUND AND OBJECTIVES: This study aimed to explore the effects of health education, diet and exercise interventions on the climacteric symptoms of perimenopausal women. METHODS AND STUDY DESIGN: A total of 78 perimenopausal women in a gynaecological clinic from June 2018 to August 2018 were recruited and divided randomly into the following three groups: A (centralised education alone), B (health education + per-sonalised diet guidance) and C (health education + personalised diet guidance + intensive resistance exercise). The changes in diet score, exercise habits and climacteric symptoms were observed after 3 months. RESULTS: There was no difference between groups in food intake scores and total scores before the interventions. After the interventions, the total diet score of group C was higher than in groups A and B, and the red meat score decreased significantly (p<0.05). After the interventions, the number of resistance exercises per week in group B increased significantly. The number of aerobic exercises and resistance exercises per week in group C also increased significantly (p<0.05). The total score for climacteric symptoms in the three groups decreased significantly before and after the interventions (p<0.05), and the scores for insomnia and sexual disorders in group A decreased significantly (p<0.01). In group B, there was a significant effect on the improvement of moderate and severe climacteric symptoms (p<0.01), and the scores for seven other common symptoms (i.e. hot flushes, sweating, irritability, depression, suspicion, fatigue, joint pain, muscle pain, palpitations and sexual disorders) decreased significantly (p<0.05). CONCLUSIONS: Centralised health education, personalised dietary guidance and intensive resistance exercise improved the menopausal symptoms experienced by peri-menopausal women; the most indicative changes of this improvement were obtained using combined health education and personalised dietary guidance.

Intestinal Permeability Associated with the Loss of Skeletal Muscle Strength in Middle-Aged and Older Adults in Rural Area of Beijing, China.

The association between intestinal permeability and sarcopenia remains unclear, and few studies have mentioned the relationship between intestinal permeability and skeletal muscle strength. The present cross-sectional community study was conducted in a rural area of Beijing to explore the association between intestinal permeability and handgrip strength (HGS) in middle-aged and older adults. Serum lipopolysaccharide (LPS), diamine oxidase (DAO) and D-lactate were detected to evaluate intestinal permeability. Gut microbiota (GM) and its potential interaction were also analyzed in the decision tree model. HGS was negatively correlated with DAO (r = −0.396, p < 0.01) in males. The negative association between HGS and DAO remained significant with the adjustment of covariates (ß = −1.401, p < 0.05). Serum DAO and LPS were both negatively associated with HGS in middle-aged and older males, with the significant interactions of GM in the decision tree model, and D-lactate showed a negative association with HGS in females. Therefore, intestinal permeability was associated with the loss of skeletal muscle strength in middle-aged and older adults, and serum DAO may be a novel predictor for the loss of skeletal muscle strength in middle-aged and older males.

Exposure to the Chinese famine in early life and self-reported arthritis risk in adulthood.

Evidence shows that undernutrition during early life is associated with an increased risk of chronic diseases in adulthood. We aimed to investigate whether exposure to the Chinese famine in the fetal or infant stage was associated with self-reported arthritis risk in adulthood. A total of 3,622 participants were included in the final analysis. Participants were classified into non-, fetal-, and infant-exposed group. Arthritis was self-reported doctor-diagnosed arthritis. A multivariate logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of arthritis. The prevalence of arthritis was 27.07%, 27.74%, and 34.09% among individuals in non-, fetal-, infant-exposed group, respectively. Infant-exposed group (OR: 1.32; 95% CI: 1.12-1.56) had a higher arthritis risk then non-exposed group after adjustment for gender, age, area, education level, smoking status, drinking status, and physical activity. Participants who experienced severe famine during infant and fetal period had higher (41.46%, OR=1.71 and 32.94%, OR=1.36) arthritis risk than those exposed to less severe famine. Exposure to the Chinese famine in early life was associated with an increased risk of arthritis in adulthood, which was partially influenced by some factors (e.g., gender, area, body mass index, and born in severely affected area or not).

Dietary and exercise interventions for metabolic health in perimenopausal women in Beijing.

BACKGROUND AND OBJECTIVES: This study aims to investigate the effects of individualised dietary guidance and anti-resistance exercise intervention on blood pressure and metabolic indexes of perimenopausal women. METHODS AND STUDY DESIGN: Between June 2018 to August 2018, 78 perimenopausal women were recruited at the Gynaecological Outpatient Department of Beijing Pinggu District Hospital. After coding, they were randomly divided into three groups, A, B and C, by lottery. Group A was required to participate in educational seminars. Group B was required to participate in educational seminars and received individualised dietary guidance from professional nutritionists. Group C had the same intensive education classes and individualised dietary guidance as Group B, along with intensive resistance exercise. The difference in the various observation indexes was reviewed after three months of intervention. RESULTS: The number of patients with abnormal metabolic indexes in the diet and comprehensive groups decreased significantly after intervention, compared with the statistics before intervention. The number of patients with a waist circumference ≥80 cm in the diet and comprehensive groups decreased significantly, and the difference was statistically significant (χ2=5.976, p=0.014; χ2=4.433, p=0.035). Before and after observation, the control and diet groups had a higher incidence of HDL <1.29 mmol/L than the comprehensive group, and the difference was statistically significant (p<0.05). After intervention, TGs in the comprehensive group were significantly lower than the control group (≥1.7 mmol/L), and the difference was statistically significant. CONCLUSIONS: Individualised dietary intervention combined with anti-resistance exercise can significantly improve eating and exercise habits, correct metabolic disorders and reduce the occurrence of metabolic syndrome.

Effect of Improving Dietary Structure on Serum 25(OH)VitD3 Level in Hypertensive Patients in a Chinese Rural Area.

BACKGROUND In this study, we explored the effect of an improved dietary pattern on 25-hydroxyvitamin D3 [25(OH)VitD3] level in hypertensive patients in a rural setting and investigated the possible mechanism for lowering blood pressure. MATERIAL AND METHODS Thirty-three participants with overweight or obesity were randomly divided into 2 groups. A 24-h dietary review method was used for dietary assessment. Participants in both groups were provided the same balanced diet except for the breakfast staple food for 4 weeks. General characteristics, body composition analysis, blood pressure, serum lipid profile, inflammatory indices, and serum 25(OH)VitD3 level were assessed at baseline and at the completion of the 4-week dietary intervention. Nutrient intake was analyzed by dietary analysis software, and SPSS software was used for correlation and regression analyses. RESULTS Thirty-one participants completed the study. The prevalence of vitamin D deficiency was 100% at baseline. After the dietary intervention, the prevalence of vitamin D deficiency decreased to 45%. Levels of dietary intake of vitamin D, cholesterol, protein, fat, and calcium showed a significantly positive correlation with the serum 25(OH)VitD3 level. Body fat, visceral fat, waist-to-hip ratio, serum triglyceride, and Toll-2 expression were negatively correlated with the serum 25(OH)VitD3 level. Blood pressure had a significant negative correlation with 25(OH)VitD3 level. Participants in both groups experienced a significant decrease in blood pressure. CONCLUSIONS Intake of a balanced diet rich in vitamin D, with appropriate amounts of cholesterol, protein, calcium, and fat, helped improve body composition, ameliorated lipid metabolism disorder, reduced inflammation, and improved serum 25(OH)VitD3 level, thus lowering blood pressure.

WeChat-assisted dietary and exercise intervention for prevention of gestational diabetes mellitus in overweight/obese pregnant women: a two-arm randomized clinical trial.

PURPOSE: This study aimed to examine the influence of a WeChat-based dietary and exercise intervention on gestational diabetes mellitus (GDM) prevention in overweight/obese pregnant women in Beijing. METHODS: Overweight/obese pregnant women were recruited in the early stages of pregnancy. After screening by include and exclude standards, eligible women were randomly divided into two groups, intervention and control groups. The control group received a general advice session about pregnancy nutrition and weight management. The intervention group received three face-to-face sessions about personalized dietary and exercise intervention, with the help of WeChat as a monitoring tool to promote treatment plan adherence. At 24-28 weeks of pregnancy, GDM was diagnosed according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Gestational weight gain (GWG), maternal and neonatal outcomes were also collected. RESULTS: This study analyzed 215 participants. At the mid-trimester, 42 (37.8%) women in the control group were diagnosed with GDM (n = 111) versus 25 (24.5%) in the intervention group (n = 104; p < 0.05). The intervention group gained 11.2 ± 4.9 kg during the whole gestation period, with 4.9 ± 3.1 kg-weight increment in the first 25 weeks of pregnancy, versus 13.4 ± 5.0 kg and 6.9 ± 3.2 kg in the first 25 weeks in the control group (between groups: p < 0.001/p = 0.002). Incidence of macrosomia was not significantly lower in the intervention group than in the control group (8/7.9% vs 11/9.9%) (p > 0.05). No significant difference was found in the rate of natural labor and occurrence of perinatal complications (e.g., preterm birth, gestational hypertension, and preeclampsia) between the groups (p > 0.05). CONCLUSIONS: The WeChat-assisted dietary and exercise intervention was effective in reducing the occurrence of GDM and excessive weight gain in overweight/obese pregnant women. Disseminating knowledge of pregnancy and childbirth through social media platforms like WeChat could be an important part of antenatal care.

Dietary and Exercise Interventions for Perimenopausal Women: A Health Status Impact Study.

PURPOSE: To explore the impact of different intervention methods on physical health indexes of perimenopausal women. METHODS: Seventy-eight perimenopausal women were divided into three groups. Group A received routine gynecological diagnosis and treatment and participated in centralized lifestyle health education. Group B was required to participate in all intensive education content, and professional dietitians gave individualized dietary guidance. Group C received intensive education, individualized diet intervention and intensified resistance exercise. Dietary scores, exercise habits, waist circumference, body mass index, fat and muscle mass were observed after three months. RESULTS: After the intervention, the total diet score of group C was higher than groups A and B, and the red meat score was significantly reduced. The number of patients in groups B and C who exercised >3 times per week and the number of resistance exercises were significantly increased, while the number of aerobic exercises per week in group C was significantly increased. The body fat and waist circumference were significantly reduced, and skeletal muscle weight was significantly increased. Body mass index, trunk fat ratio and waist-to-hip ratio were significantly decreased in groups B and C, while trunk muscle was significantly increased in group C. CONCLUSION: The combined intervention of the three methods can give full play to the synergistic effect of various interventions. The improvement effect of increasing the appropriate amount of resistance exercise is more obvious, which is worthy of further promotion and application.

Effects of a dietary supplement on inflammatory marker expression in middle-aged and elderly hypertensive patients.

OBJECTIVES: We aimed to explore the effects of diet on the inflammatory response in middle-aged and elderly people with hypertension. METHODS: Thirty overweight or obese patients with stage one hypertension (age range, 45-75 years) were allocated to either the intervention or control group (n=15 per group; age- and sex-matched). Patients in the intervention group consumed a food powder supplement (100 g) instead of a regular meal. The control group maintained their normal dietary habits. This study lasted for six weeks. Blood pressure, inflammatory marker levels, and energy intake were measured before and after the study. RESULTS: After 6 weeks, the diet composition of the intervention group changed significantly (p<0.05). The intake of proteins, dietary fibre, monounsaturated fat, and polyunsaturated fat increased significantly (p<0.05), while the total energy intake trended towards an increase (p>0.05). In the control group, the total energy intake decreased significantly (p<0.05). The levels of nuclear factor-κB (NF-κB), soluble intercellular adhesion molecule-1 (sICAM-1) and high sensitivity C-reactive protein (hs-CRP) decreased, and adiponectin increased significantly in the intervention group (p<0.05); however, no significant changes were observed in the inflammatory marker levels of the control group. In the intervention group, systolic blood pressure decreased significantly (p<0.05), and diastolic blood pressure also exhibited a decreasing trend. No significant change in blood pressure was observed in the control group. CONCLUSION: The consumption of a food powder supplement can improve diet composition, decrease blood pressure and reduce inflammation in middle-aged and elderly overweight or obese hypertensive patients. The food powder supplement may also have an anti-atherosclerotic effect in hypertensive patients.

Effects of a dietary supplement on inflammatory marker expression in middle-aged and elderly hypertensive patients

OBJECTIVES: We aimed to explore the effects of diet on the inflammatory response in middle-aged and elderly people with hypertension. METHODS: Thirty overweight or obese patients with stage one hypertension (age range, 45-75 years) were allocated to either the intervention or control group (n=15 per group; age- and sex-matched). Patients in the intervention group consumed a food powder supplement (100 g) instead of a regular meal. The control group maintained their normal dietary habits. This study lasted for six weeks. Blood pressure, inflammatory marker levels, and energy intake were measured before and after the study. RESULTS: After 6 weeks, the diet composition of the intervention group changed significantly (p<0.05). The intake of proteins, dietary fibre, monounsaturated fat, and polyunsaturated fat increased significantly (p<0.05), while the total energy intake trended towards an increase (p>0.05). In the control group, the total energy intake decreased significantly (p<0.05). The levels of nuclear factor-κB (NF-κB), soluble intercellular adhesion molecule-1 (sICAM-1) and high sensitivity C-reactive protein (hs-CRP) decreased, and adiponectin increased significantly in the intervention group (p<0.05); however, no significant changes were observed in the inflammatory marker levels of the control group. In the intervention group, systolic blood pressure decreased significantly (p<0.05), and diastolic blood pressure also exhibited a decreasing trend. No significant change in blood pressure was observed in the control group. CONCLUSION: The consumption of a food powder supplement can improve diet composition, decrease blood pressure and reduce inflammation in middle-aged and elderly overweight or obese hypertensive patients. The food powder supplement may also have an anti-atherosclerotic effect in hypertensive patients.

Dietary intake and cardiometabolic biomarkers in relation to insulin resistance and hypertension in a middle-aged and elderly population in Beijing, China.

This study investigated the relationships of dietary intake and cardiometabolic biomarkers with insulin resistance and hypertension in rural middle-aged and elderly people in China. One hundred and eight middle-aged and elderly adults were recruited in Zhangfang village in May 2014. We measured blood pressure, anthropometric parameters, and biochemical indexes, including high-sensitivity C-reactive protein (hsCRP), soluble intercellular adhesion molecule-1 (sICAM-1), glucose, insulin, and blood lipids. Homeostasis model assessment of insulin resistance index (HOMA-IR) was assessed on the basis of fasting glucose and insulin. We recorded participant demographic characteristics, dietary intake, and lifestyle using questionnaires. Hypertensive participants had higher levels of triglycerides (TG), hsCRP, sICAM-1, body fat percentage (BF%), arm muscle circumference (AMC) and HOMA-IR than nonhypertensive individuals. Hypertensive participants had higher carbohydrate intake but lower intakes of protein and fat. Carbohydrate intake was positively correlated with hsCRP, sICAM-1, TG, BF%, and HOMA-IR, and was negatively correlated with AMC. Protein and fat intakes were negatively correlated with hsCRP and sICAM-1. Protein intake was also significantly negatively correlated with TG and HOMA-IR, and positively correlated with AMC. HOMA-IR was positively correlated with hsCRP, sICAM-1, TG and BF%, and negatively correlated with AMC. Multivariable linear regression indicated that TG, sICAM-1, and hsCRP were significantly associated with HOMA-IR. In conclusion, in a rural Chinese population, high intake of carbohydrate and low intake of fat and protein were associated with insulin resistance and hypertension, possibly by increasing inflammatory factors such as sICAM-1 and hsCRP, increasing BF% and increasing the level of plasma TG.

Associations of prepregnancy body mass index and gestational weight gain with pregnancy outcomes in nulliparous women delivering single live babies.

The study was to assess the associations of prepregnancy body mass index (BMI) and gestational weight gain (GWG) with pregnancy outcomes. This was a retrospective analysis of 2973 nulliparous women who delivered single live babies. Prepregnancy BMI was categorized as underweight (<18.5 kg/m(2)), normal weight (18.5-24.9 kg/m(2)) or overweight/obese (≥25.0 kg/m(2)). GWG was categorized as inadequate, adequate or excessive. 567 (19.1%) women were overweight/obese, and 1600 (53.8%) exhibited excessive GWG. Compared with women of normal weight, overweight/obese women had a higher incidence of cesarean section (odds ratio, 95% confidence interval: 2.02, 1.59-2.56), postpartum hemorrhage (1.50, 1.05-2.14), preterm delivery (2.51, 1.83-3.45), preterm premature rupture of membranes (2.11, 1.32-3.38), gestational diabetes mellitus (2.04, 1.65-2.53), gestational hypertension (7.68, 4.21-14.00), preeclampsia (1.98, 1.18-3.33) and small for gestational age (2.81, 1.21-6.54). Compared with adequate GWG, excessive GWG increased the incidence of cesarean section (2.02, 1.59-2.56), preterm delivery (1.48, 1.05-2.71), preeclampsia (1.78, 1.34-4.27) and macrosomia (2.61, 1.61-4.25), and reduced the incidence of gestational diabetes mellitus (0.75, 0.62-0.92). High prepregnancy BMI and excessive GWG in nulliparous Chinese women are associated with adverse pregnancy outcomes. Weight control before and during pregnancy could reduce the complications of pregnancy.