Arterial stiffness expressed as brachial-ankle pulse wave velocity and gait assessment independent of lower extremity strength: a cross-sectional study in the older men population.

BACKGROUND: Older men are more vulnerable to fatal falls than women, and gait disturbances contribute to the risk of falls. Studies have assessed the association between arterial stiffness and gait dysfunction, but the results have been inconclusive. This study aimed to conduct a cross-sectional analysis to evaluate the association between brachial-ankle pulse wave velocity (baPWV) and gait assessment in older men. METHODS: Data from the 2014-2015 Korea Institute of Sport Science Fitness Standards project were used for the analysis. The inclusion criteria were men aged > 65 years with gait assessment [the 30-s chair stand test (30s-CST), the timed up and go (TUG) test, the figure-of-8 walk (F8W) test, the 2-min step test (2MST), and the 6-min walk test (6MWT)] and baPWV measurement data. Generalized linear regression analysis was conducted with multiple confounding factor adjustments, including lower extremity isometric strength. RESULTS: A total of 291 participants were included in the analysis. The mean age was 71.38 ± 4.40 years. The mean values were as follows: (1) 30s-CST, 17.48 ± 5.00; (2) TUG test, 6.01 ± 1.10 s; (3) F8W test, 25.65 ± 4.71 s; (4) 2MST, 102.40 ± 18.83 per 2 min; and (5) 6MWT, 500.02 ± 85.65 m. After multivariable adjustment, baPWV was associated with the 6MWT (ß = -0.037, 95% CI: -0.072--0.002), TUG test (ß = 0, 95% CI: 0.000-0.001), and F8W test (ß = 0.002, 95% CI: 0.000-0.004). baPWV was not associated with the 30s-CST and 2MST. CONCLUSIONS: The current study showed a statistically significant association between gait assessments and arterial stiffness, independent of lower extremity strength. However, this association was modest. Future prospective studies are needed to elucidate the complex relationship between arterial stiffness and gait dysfunction.

A Cross-Sectional Investigation of the Association between Arterial Stiffness and Depressive Symptoms, Anxiety Symptoms, and Quality of Life.

Background and Objectives: Previous studies have assessed the association between arterial stiffness and depressive and anxiety symptoms, but the results were inconsistent. We aimed to conduct a cross-sectional study to assess the relationship between arterial stiffness, depressive and anxiety symptoms, and quality of life. Materials and Methods: We analyzed the 2014-2015 Korea Institute of Sport Science Fitness Standards project data. Brachial-ankle pulse wave velocity (baPWV) was measured to assess arterial stiffness. High baPWV was defined as a baPWV higher than 1400 cm/s. Participants completed Beck's depressive symptoms inventory (BDI), Beck's anxiety symptoms inventory (BAI), and the World Health Organization's Quality of Life Questionnaire (WHOQOL-Bref). We performed a logistic regression analysis by adjusting confounding factors and used the inverse probability of treatment weighting (IPTW) method. Results: 1936 participants were included in the analysis (men 43.9%, median age 47). Participants with a high baPWV had higher odds of depressive symptoms compared to those with a normal baPWV (aOR 1.920, 95% CI 1.062-3.472, p = 0.031; IPTW OR 2.637, 95% CI 1.219-5.704, p = 0.014). In addition, baPWV was significantly associated with depressive symptoms in the IPTW model in men but not in women (OR 2.497, 95% CI 1.004-6.207, p = 0.049). High baPWV was not associated with anxiety symptoms in all models, but it was associated with poor QOL in women (OR 4.561, 95% CI 1.465-14.199, p = 0.009). Conclusions: High baPWV was associated with higher odds of depressive symptoms, especially in men. Our study suggests a modest association between arterial stiffness and depressive symptoms in Korean adults.

Protein-Added Healthy Lunch-Boxes Combined with Exercise for Improving Physical Fitness and Vascular Function in Pre-Frail Older Women: A Community-Based Randomized Controlled Trial.

Purpose: Preventive or therapeutic interventions are key to maintaining independence in pre-frail and/or frail elderly. Therefore, we investigated whether multi-component interventions were effective in physical fitness levels and vascular functions in pre-frail older women. Patients and Methods: Sixty participants aged ≥ 65 years (81.5 ± 4.3 yrs) were divided equally into control group, diet group, aerobic exercise and diet group, and aerobic exercise with electromyostimulation and diet group. For 8 weeks, the participants received a set of protein-added meals twice daily on weekdays. The aerobic exercise groups performed 45 mins of stepping exercise at 50-70% of the maximal heart rate for 3 days/week, and the aerobic exercise with electromyostimulation was applied on each limb in 8 weeks. Blood pressure, physical fitness, cardiovascular biomarkers, pulse wave velocity, and flow-mediated dilation were measured before and after the 8-week. Results: There were no group differences in age, height, weight, body mass index, free fat mass, and %body fat at baseline. The right grip strength significantly increased in the diet group, aerobic exercise and diet group, and aerobic exercise with electromyostimulation and diet group (p < 0.05). Short physical performance battery, 6-min walking distance, and flow-mediated dilation significantly increased in the aerobic exercise and diet group and aerobic exercise with electromyostimulation and diet group (p < 0.05). Blood pressure and pulse wave velocity did not differ between interventions. High-density lipoprotein-cholesterol levels significantly increased after 8 weeks in all intervention groups (p < 0.05). There were no significant differences in glucose, HbA1c, total cholesterol, low-density lipoprotein-cholesterol, triglyceride, insulin, Homeostatic Model Assessment for Insulin Resistance, nitric oxide, and C-reactive protein levels. Conclusion: These results show that multi-component interventions appear to improve physical fitness and vascular function in pre-frail older women. Thus, possible strategies to prevent early frailty including proper nutrition and exercise may be needed.

Relationship between physical fitness and arterial stiffness in Korean older adults.

Pulse-wave velocity (PWV) is a widely used clinical marker of arterial stiffness. Associations between several physical fitness measures and arterial stiffness have been examined. However, these results were inconsistent. Therefore, we conducted a cross-sectional study to assess the relationship between various physical fitness parameters and arterial stiffness in older adults. From January 2014 to December 2015, 1500 participants (men, n = 587; mean age, 71.78 ±â€…5.10 years) in South Korea were enrolled in the study. Koreans aged >65 years who agreed to participate in the study were enrolled. Individuals who were unable to exercise because of underlying conditions were excluded. VO2 max (mL/kg/min), handgrip strength (kg), handgrip strength (kg)/body weight (kg) ratio, one-leg standing time (s), and 10-meter walking speed (m/s) were measured. The brachial-ankle pulse wave velocity (baPWV) was measured using a VP-1000 instrument. VO2 max (mL/kg/min), handgrip (kg)/body weight (kg) ratio, one-leg standing time (s), and 10-meter walking speed (m/s) were significantly inversely associated with baPWV. This association was consistent even after adjusting for confounding factors. Our study revealed a significant association between various aspects of physical fitness and arterial stiffness. This study suggests that physical fitness is a useful predictor of arterial stiffness in older adults.

Impact of Sex on the Association between Flexibility and Arterial Stiffness in Older Adults.

Background and Objectives: Flexibility is one of the most important physical fitness parameters in the geriatric population. Brachial-ankle pulse wave velocity (baPWV) is a measure of systemic arterial stiffness. However, data on the association between flexibility and arterial stiffness in the older adult population are limited. Therefore, we aim to investigate this association by using the sit-and-reach test (SRT) and measuring baPWV. Materials and Methods: We reviewed data from the 2014-2015 Korean Institute of Sports Science Fitness Standards Project. Individuals older than 65 years with SRT and baPWV data were included. A generalized linear regression analysis was conducted to assess the association between flexibility and arterial stiffness. Multiple relevant confounding factors were adjusted. Results: A total of 615 individuals were included in the analysis. The mean age of the male and female participants was 71.44 ± 4.42 and 70.64 ± 4.13 years, respectively. The mean SRT result was 6.58 ± 9.97 and 18.04 ± 7.48 cm, respectively. After multivariable adjustment among the male participants, the higher SRT result tertiles were inversely associated with baPWV (ß (95% confidence interval): 3.11-11.00 cm, -74.45 (-140.93, -8.55); ≥11.01 cm, -108.17 (-177.65, -38.70)) in comparison with the lowest tertile. The female participants did not show any significant correlation between the SRT result and baPWV. Conclusions: Our results suggest an inverse association between trunk flexibility and systemic arterial stiffness, expressed as the SRT result and baPWV, respectively, in older Korean men but no association in older Korean women. Sex differences might influence the association between flexibility and arterial stiffness in the older adult population.

Association of Plasma Carotenoid and Malondialdehyde Levels with Physical Performance in Korean Adolescents.

Increased oxidative stress has been shown to lead to muscle damage and reduced physical performance. The antioxidant mechanism is most likely to reduce these relationships, but in the context of the action of carotenoids, more research is needed. This study aimed to investigate whether carotenoids modify the association between plasma malondialdehyde (MDA) and physical performance in Korean adolescents. The study sample consisted of 381 adolescents (164 boys, 217 girls) aged 13-18, who participated in the 2018 National Fitness Award Project. We quantified α-carotene, ß-carotene, ß-cryptoxanthin, lutein, zeaxanthin, lycopene, and MDA levels in plasma using HPLC with photodiode array detection. Among boys but not girls, plasma MDA level was negatively associated (ß = -0.279, p = 0.0030) with total plasma carotenoid levels and marginally negatively associated (ß = -0.907, p = 0.0876) with absolute hand grip strength. After adjustment for covariates in boys, the MDA level was negatively associated with absolute hand grip strength and relative hand grip strength; this association was observed only in groups with individual carotenoid and total carotenoid values below the median. These findings support a significant association between plasma MDA level and hand grip strength, and this association has been potentially modified by plasma levels of carotenoids in Korean male adolescents.

Development of Guidelines on the Primary Prevention of Frailty in Community-Dwelling Older Adults.

BACKGROUND: Despite the increasing number of older adults as the population ages, there is a lack of frailty prevention guidelines for community-dwelling older adults. The Korean Frailty and Aging Cohort Study conducted systematic review on contributors to frailty and developed guidelines on the primary prevention of frailty in community-dwelling older adults. METHODS: This study updated a previous systematic review of contributors to frailty by adding the most recent articles. Based on this updated systematic review, experts in geriatrics and gerontology developed guidelines for preventing frailty using the Delphi method. RESULTS: These guidelines categorized the recommendations into physical activity, resilience, oral health, management of non-communicable diseases, involvement in society, smoking cessation, and eating various kinds of food. CONCLUSION: Unlike previous frailty-related guidelines, this study developed evidence-based frailty prevention guidelines based on a systematic review. The guidelines are expected to contribute to the healthy aging of community-dwelling older adults by the primary prevention of frailty.

Association Between Diet Quality and Cardiorespiratory Fitness in Korean Adults: The 2014-2015 National Fitness Award Project.

Cardiorespiratory fitness (CRF) is a strong and meaningful indicator for predicting mortality, including cardiovascular disease, as well as simple physical capacity. Healthy eating is thought to be one of the crucial factors associated with an individual's CRF status, although little research has been done on the relationship between healthy eating and CRF. This study aimed to investigate the association between overall diet quality and CRF among Korean adults. The study involved 937 adults (380 men and 557 women) aged 19‒64 years who participated in the 2014‒2015 Korea Institute of Sports Science Fitness Standards project. Diet quality was assessed by the recommended food score (RFS), and CRF was determined by maximal oxygen uptake (VO2max) during a treadmill exercise test. Multiple regression model analyses were stratified by age (19-34, 35-49, and 50-64 years) and sex, because both factors greatly influence CRF. After multivariate adjustment, only the 19‒34 age group in both sexes showed a positive association between RFS and VO2max. Additionally, when physical activity was adjusted, it was still significant in men but only marginally related in women. Our results suggest that better overall diet quality may be associated with a better CRF among young adults aged 19‒34 years in Korea.

Association of Carotenoids Concentration in Blood with Physical Performance in Korean Adolescents: The 2018 National Fitness Award Project.

Adolescent physical performance is not only dependent on exercise but also on the role of antioxidants obtained through a healthy diet. However, few studies have specifically identified the relationship between carotenoids, a common antioxidant, and physical performance. This cross-sectional study aims to investigate the association between the level of carotenoids in the blood and physical performance among Korean adolescents aged 13 to 18 years. The study sample consisted of 450 participants (190 males, 260 females) from the 2018 National Fitness Award project. In boys, multiple regression analysis after adjustment for age, body mass index (BMI), smoking, drinking, and physical activity revealed that the α-carotene level was positively associated with a 20-m progressive aerobic cardiovascular endurance run (PACER) (ß = 5.350, p < 0.05) and estimated maximal oxygen consumption (VO2max) (ß = 1.049, p < 0.05). In girls, after adjustment for age, BMI, smoking, drinking, and physical activity, the levels of α-carotene were positively associated with a 20-m PACER (ß = 3.290, p < 0.05), VO2max (ß = 0.644, p < 0.05) and curl-up (ß = 5.782, p < 0.05), and ß-carotene (ß = 2.983, p < 0.05) and total carotenoids (ß = 4.248, p < 0.05) were positively associated with curl-up. Our results suggest that an increased level of carotenoids in the blood may be associated with better physical performance among adolescents in Korea.

Evidence-Based Optimal Cutoff Values with the Validation of Criterion-Referenced Standards for Sarcopenic Elderly Fitness Improvement.

This study provides a newly updated perspective of information on severely screened 21 previous studies of the various measurement methods for improving physical fitness and providing determined cutoff values from our reserved elderly human database. We aimed to provide scientific evidence-based information regarding physical fitness standards for developing useful prognostics, promoting and maintaining health programs for sarcopenic elderly. 21 previous studies emphasizing criterion referenced standards and receiver operator characteristic (ROC) curve analyses for improving physical fitness were screened. For predicting the prevalence of sarcopenia, the t-test, logistic regression, linear regression, ROC curve analyses, and voluntary categorizations such as the twentieth or sixtieth percentile classification were used. Based on these scientific evidences, we determined cutoff values from our reserved DB and realized that 75 years for men and 70 years for women are the transitional period during which there are large declines in muscle and fat mass (p < 0.01), which reflects physical function tests (p < 0.01) in both genders. Using the six factors with ideal cutoff thresholds, an individual exercise program can be designed for alleviating symptoms of frailty caused by sarcopenia for the elderly.

The effect of oral glucose tolerance testing on changes in arterial stiffness and blood pressure in elderly women with hypertension and relationships between the stage of diabetes and physical fitness levels.

PURPOSE: The purpose of this study was to assess changes in blood glucose level, blood pressure, and arterial stiffness after a 75 g oral glucose tolerance test (OGTT) in elderly women aged over 65 years with hypertension and either normal glycemic control, impaired fasting glucose tolerance, or diabetes mellitus. We also wished to investigate the relationship between stages of diabetes and physical fitness. METHODS: A total of 24 elderly women with hypertension were assigned to a control group (CON; n=7), impaired fasting glucose group (IFG; n=9), and diabetes mellitus group (DM; n=8). In each group, blood glucose level, brachial ankle pulse wave velocity (PWV), and blood pressure were measured at baseline as well as 60 and 120 minutes after a 75 g OGTT. Physical fitness factors such as hand grip strength, balance test, 4 m gait speed test, chair stand test, short physical performance battery, and 6-minute walking test were subsequently assessed. RESULTS: In all three groups, blood glucose levels were significantly increased at 60 and 120 minutes after a 75 g OGTT. In the DM group, blood glucose levels were significantly higher before and after a 75 g OGTT than in the CON group. In the CON group, PWV was significantly increased at 60 minutes after a 75 g OGTT; however, there were no changes in other groups after glucose ingestion. In the CON group, systolic and diastolic blood pressures were significantly decreased at 60 and 120 minutes after a 75 g OGTT compared to baseline. However, there was no change in blood pressure after ingestion in the DM group. The IFG group had greater grip strength than the CON group; however, there were no differences in other variables between the groups. CONCLUSION: After a 75 g OGTT, elderly women with hypertension and diabetes maintain higher blood glucose levels compared to those with hypertension alone. Unlike elderly women with hypertension alone, those with hypertension and diabetes did not show changes in arterial stiffness and blood pressure after a 75 g OGTT. Therefore, elderly women with hypertension and diabetes may not be able to control their blood vessels following a 75 g OGTT due to impaired vascular endothelial function. Moreover, there was no association between diabetes stage and physical fitness in elderly women with hypertension.

Effects of exergaming in postmenopausal women with high cardiovascular risk: A randomized controlled trial.

OBJECTIVE: Recently, exergames have been used an exercise modality as aerobic fitness activities. However, evidence of its effectiveness on cardiovascular (CV)-related risk factors remain unclear. HYPOTHESIS: We evaluate the effects of exergaming on CV-related risk factors compared with traditional aerobic exercise in high CV risk patients. METHODS: Sixty-five postmenopausal women with high CV risk were randomized among exergame (n = 22), treadmill (n = 22), and control (n = 21) groups. The exergame group was engaged in the running-based exergame using Exer Heart and the treadmill group walked or jogged on a treadmill. Cardiorespiratory fitness, flow-mediated dilation, endothelial progenitor cells (EPCs), epicardial fat thickness, metabolic parameters, and anthropometric parameters were measured in patients before and 12 weeks after the training. RESULTS: Exergaming significantly improved VO2 peak (P < .001; different from control, P < .05), flow-mediated dilation (P < .001; different from control, P < .05), EPCs (CD34/CD117+ , P < .01). Treadmill exercise was effective at improving VO2 peak (P < .01; different from control, P < .05), flow-mediated dilation (P < .05), EPCs (CD34/CD117+ , P < .01; different from control P < .05). Epicardial fat thickness decreased after both exercise programs (exergame, P < .01; treadmill, P < .01; no different from control). CONCLUSION: Exergaming showed similar effects to traditional aerobic exercise in improving cardiorespiratory fitness and endothelial function in postmenopausal women with high CV risk. These findings suggest that the exergames may serve as an alternative to conventional aerobic exercises for prevention and treatment in high CV risk patients.

Reference Values for Cardiorespiratory Fitness in Healthy Koreans.

We investigated reference values for cardiorespiratory fitness (CRF) for healthy Koreans and Koreans with coronary heart disease (CHD) and used them to identify inter-ethnic differences in CRF, differences over time in CRF, and differences in CRF between the healthy population and patients with CHD. The study population for healthy Koreans was derived from the database of KISS FitS (Korea Institute of Sports Science Fitness Standards) between 2014 and 2015. The study population for Koreans with CHD was derived from the database of the Korea University Guro Hospital Cardiac Rehabilitation Registry between June 2015 and December 2018. In healthy Koreans, there was a significant difference between sex and age groups for VO2 max. The VO2 max of healthy Koreans differed from that of Westerners in age-related reference values. Our results were not significantly different from those of the Korean population in the past, except for a small decline in the young population. There seemed to be a clear inter-ethnic difference in CRF. We could also identify signs of small change in CRF in younger age groups. Therefore, CRF should be assessed according to ethnic or national standards, and it will be necessary to establish a reference for each nation or ethnicity with periodic updates.

Characterization and Validation of an "Acute Aerobic Exercise Load" as a Tool to Assess Antioxidative and Anti-inflammatory Nutrition in Healthy Subjects Using a Statistically Integrated Approach in a Comprehensive Clinical Trial.

The homeostatic challenge may provide unique opportunities for quantitative assessment of the health-promoting effects of nutritional interventions in healthy individuals. Objective. The present study is aimed at characterizing and validating the use of acute aerobic exercise (AAE) on a treadmill at 60% of VO2max for 30 min, in assessing the antioxidative and anti-inflammatory effects of a nutritional intervention. In a controlled, randomized, parallel trial of Korean black raspberry (KBR) (n = 24/group), fasting blood and urine samples collected before and following the AAE load at either baseline or 4-week follow-up were analyzed for biochemical markers, 1H-NMR metabolomics, and transcriptomics. The AAE was characterized using the placebo data only, and either the placebo or the treatment data were used in the validation. The AAE load generated a total of 50 correlations of 44 selected markers, based on Pearson's correlation coefficient analysis of 105 differential markers. Subsequent mapping of selected markers onto the KEGG pathway dataset showed 127 pathways relevant to the AAE load. Of these, 54 pathways involving 18 key targets were annotated to be related to oxidative stress and inflammation. The biochemical responses were amplified with the AAE load as compared to those with no load, whereas, the metabolomic and transcriptomic responses were downgraded. Furthermore, target-pathway network analysis revealed that the AAE load provided more explanations on how KBR exerted antioxidant effects in healthy subjects (29 pathways involving 12 key targets with AAE vs. 12 pathways involving 2 key targets without AAE). This study provides considerable insight into the molecular changes incurred by AAE and furthers our understanding that AAE-induced homeostatic perturbation could magnify oxidative and inflammatory responses, thereby providing a unique opportunity to test functional foods for antioxidant and anti-inflammatory purposes in clinical settings with healthy subjects.

Association of Diet Quality with Low Muscle Mass-Function in Korean Elderly.

There is a growing body of evidence that links nutrition to muscle mass and function in the elderly, suggesting that it has an important role to play both in the prevention and management of age-related sarcopenia. Some nutrients have been studied, but less is known about the influence of overall diet quality on the loss of skeletal muscle mass and function. This study investigated the interrelationship between the recommended food score (RFS), as an indicator of overall diet quality, and muscle mass function among the Korean elderly. The sample consisted of 521 participants (263 men and 258 women), aged >65 years, who participated in the 2014-2015 National Fitness Award project. Appendicular skeletal muscle mass (ASM) was assessed by bioelectrical impedance analysis. Low muscle mass was defined as having an ASM corrected for height lower than the cutoff value established by the European Working Group on Sarcopenia in Older People. Muscle function, assessed by handgrip strength (HGS), was defined as low if it was below the 20th percentile of elderly men and women. Low muscle mass-function, defined as low muscle mass with low muscle strength (HGS), was found in 29 men (11.0%) and 22 women (8.5%). In elderly men, the low muscle mass-function group had significantly lower RFS values than the normal group after adjustments for age, body fat percentage, drinking, smoking, education, and physical activity (p = 0.019). However, there was no association between RFS and muscle mass-function in elderly women. Our findings suggest that better diet quality may be associated with higher muscle mass in elderly Korean men.

Association of recommended food score with depression, anxiety, and quality of life in Korean adults: the 2014-2015 National Fitness Award Project.

BACKGROUND: A healthy diet is a key determinant of an individual's health status and is closely related to mental health and quality of life (QoL); however, the exact nature of the relationship is unknown. This study hypothesized that a higher diet quality score is associated with a lower observance of symptoms of depression and anxiety and a higher QoL. METHODS: This study evaluated 1,295 adults (521 men; 774 women) aged 19-64 years, who participated in the 2014-2015 National Fitness Award Project. Diet quality was measured by the recommended food score (RFS), and mental health and QoL were assessed by the beck depression inventory (BDI), beck anxiety inventory (BAI), and the World Health Organization QoL-Brief (WHOQoL-BREF). RESULTS: After adjusting for covariates, the individuals with depression had a significantly lower RFS value compared to those without depression, and the group with a QoL score above the median had a higher RFS value than the group with a QoL score below the median. These trends occurred in both men and women. Subjects in the highest tertile of RFS showed a lower odds of depression (OR = 0.51, 95% CI = 0.32-0.81, p-trend = 0.0043) and a QoL score below the median (OR = 0.40, 95% CI = 0.30-0.54, p-trend < 0.0001) compared with those in the lowest tertile. The RFS was not associated with anxiety. CONCLUSIONS: Our data suggest that higher diet quality may be associated with lower depressive symptoms and a better QoL in Korean adults.

A Multidomain Intervention for Modifying Lifestyle Habits Reduces the Dementia Risk in Community-Dwelling Older Adults: A Single-Blinded Randomized Controlled Pilot Study.

We aimed to examine the feasibility and effectiveness of a multidomain intervention including intensive and maintenance programs for reducing the risk of dementia in at-risk older adults. Community-dwelling older adults (aged ≥60 years) without dementia but having several risk factors for dementia (N = 32; 89% female; mean age±standard deviation, 76.8±4.7 years) were assigned to three parallel programs: intensive plus maintenance (INT+MNT), intensive only (INT-only), and active control. Subjects in INT+MNT and INT-only groups participated in a 4-week intensive group-based lifestyle modification program that focused on physical activity, vascular risk factors, dietary habits, cognitive activities, and social engagement. INT+MNT participants underwent an additional 20-week maintenance program to consolidate modified habits. The modified Australian National University-Alzheimer's Disease Risk Index (ANU-ADRI) score was used as the primary outcome measure for dementia risk. The changes in ANU-ADRI scores exhibited a significant group-by-time interaction: the INT+MNT group showed significant improvement at 24 weeks (ß= -6.05; SE = 1.86; p = 0.002), while the INT-only group did not. Additional exploratory analyses showed that the reduction in ANU-ADRI scores was caused by changes in protective factors rather than in risk factors. The INT + MNT group also showed greater improvement in executive function at 4 and 24 weeks (both p = 0.044), whereas changes in global cognitive function did not reach significance (p = 0.055). A 24-week multidomain dementia prevention involving a maintenance strategy for sustaining modified lifestyle habits reduced the risk of dementia and improved executive function in at-risk older adults.

Percent Body Fat Cut-Off Points for Diagnosing Metabolic Syndrome in Korean Adolescents.

BACKGROUND: This study aimed to identify percent body fat cut-off points related to metabolic syndrome in a large sample of Korean adolescents. METHODS: The subjects (n=2120; boys=1107, girls=1013) were middle and high school students aged 12-17 yr who participated in the Korean National Fitness Award Project in 2013. Percent body fat was estimated via eight-polar bioelectrical impedance analysis. Metabolic syndrome was classified using established standards based on the National Cholesterol Education Program with the definition modified for age. Age- and sex-specific percent body fat z-scores were calculated for every adolescent using skewness, median, and coefficient of variation curves to account for growth and development. Receiver operating characteristic curve analysis was used to identify the percent body fat cut-off points using percent body fat z-scores from skewness, median, and coefficient of variation curves as the test and metabolic syndrome as the criterion. RESULTS: Based on the modified National Cholesterol Education Program criteria for metabolic syndrome, the areas under the receiver operating characteristic curve for percent body fat were 0.882 and 0.893 for boys and girls, respectively. The percent body fat percentiles were 82.2 and 87.3 for boys and girls, respectively. According to the skewness, median, and coefficient of variation curves, the percent body fat cut-off points based on the modified National Cholesterol Education Program criteria were 23.6%-25.7% for boys and 32.8%-37.3% for girls, both aged 12-17 yr. Age- and sex-specific percent body fat cut-off points were identified in relation to the metabolic syndrome status of Korean adolescents. CONCLUSION: These percent body fat cut-offs might be useful for identifying metabolic abnormality due to obesity in Korean adolescents.

Associations of recommended food score and physical performance in Korean elderly.

BACKGROUND: A single nutrient or dietary pattern has been associated with physical performance. However, little is still known about the association of overall dietary quality with physical performance. This study aimed to investigate the link between the recommended food score (RFS), defined as an indicator of overall diet quality, and physical performance among the Korean elderly aged over 65 years. METHODS: The study subjects consisted of 622 participants (294 men and 328 women) aged over 65 years from the 2014-2015 National Fitness Award project. RESULTS: The mean value of RFS was higher in elderly women (30.7 ± 7.6) than elderly men (29.5 ± 8.8), but the difference was only marginally significant (P = 0.065). In elderly women, multiple regression linear models, adjusted for potential confounders, showed that RFS was positively related to absolute hand grip strength (kg) (ß = 0.066, 95% CI = 0.010 to 0.122) and relative hand grip strength (%) (ß =0.109, 95% CI = 0.016 to 0.201); other physical performance indicators did not show any association with RFS. In elderly men, none of the physical performance indexes were associated with RFS. CONCLUSIONS: These results suggest that a better overall diet quality may be associated with improved grip strength among elderly women in Korea.

Changes in Doppler echocardiography depending on type of elite athletes immediately after maximal exercise.

BACKGROUND: This study explores physiologic differences in the cardiac structure and function of elite athletes during the resting state and immediately after maximum exercise by training type compared to healthy controls. METHODS: The study focuses on elite middle-long distance group (MLDG), weightlifter group (WG), and a control group (CG). Cardiac structure, systolic function, and diastolic function were measured for all subjects at resting state and immediately after maximum exercise using echocardiography. RESULTS: During the resting state, the athlete groups had significantly larger inter-ventricular septum thickness end diastolic (IVSd) and inter-ventricular septum thickness end systolic (IVSs); the left ventricular posterior wall thickness end-diastolic (LVPWd) in MLDG was significantly larger than the CG. Moreover, the athlete groups had significantly higher left ventricular internal dimension end-diastolic (LVIDd), left ventricular internal dimension end-systolic (LVIDs), left ventricular mass (LVM), LVM index, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and left ventricular fraction shortening (LVFS) compared to the CG. Also, the MLDG had higher LVIDd, LVIDs, LVM, LVM-index, LVEDV, LVESV than the WG. The LVSV and LVSV index in MLDG were significantly higher than the CG and WG. The LVEF of CG was significantly higher than the athlete groups. Immediately following the maximum exercise test, MLDG had a significantly higher LVEDV, LVSV, LVSV-index, LVCO, LVCO index, E/A and DT than WG and CG. CONCLUSIONS: The MLDG showed high LVCO with comparatively better compliance in left ventricular diastolic function following maximum exercise, with a low heart rate as consequence of good LV contractility due their excellent LV diastolic function.