Food insecurity, inflammation, and immune function among older US adults: Findings from the health and Retirement study.

BACKGROUND: Food insecurity (FI) is a pressing public health concern among older adults and has been associated with adverse cardiovascular outcomes. Greater systemic inflammation may provide a pathway to explain these associations, but few studies have examined the link between FI and markers of inflammation. Thus, the objective of the present study was to evaluate the associations between FI and multiple inflammatory and immune functioning biomarkers using a nationally representative study of US adults aged > 50 years. METHOD: Participants (n = 3,924) were drawn from the longitudinal Health and Retirement Study (HRS). Household FI was assessed using the six-item Short Form Food Security Survey Module from the 2013 HRS Health Care and Nutrition Study. Markers of inflammation (neutrophil-lymphocyte ratio, albumin, hs-CRP, IL6, IL10, IL-1Ra, sTNFR-1, and TGFß-1) and immune functioning (CMV) were collected during the 2016 HRS Venous Blood Study. Multivariate logistic and linear regression models were used to evaluate associations between household FI and inflammatory and immune functioning biomarkers, adjusting for individual and household sociodemographic characteristics. RESULTS: The weighted prevalence of FI was 18.8 %. Age and sex-adjusted mean showed that FI was associated with higher levels of inflammation and impaired immune functioning (Ps-value < 0.05). Older adults with FI had higher mean levels of albumin, hs-CRP, IL6, IL10, IL-1Ra, TGFß-1, and CMV seronegative and borderline (Ps-value < 0.05). Multivariate-adjusted regression model showed that FI was associated with high-risk categories of hs-CRP (OR 1.34, 95 % CI 1.06, 1.68), IL-6 (OR 1.66, 95 % CI 1.28, 2.14), IL-1Ra (OR 0.67, 95 % CI 0.48, 0.93), TGFß-1 (OR 1.87, 95 % CI 1.45, 2.42), seronegativity for CMV (OR 0.48, 95 % CI 0.35, 0.64). CONCLUSION: In this nationally representative sample of older adults, FI was positively associated with multiple markers of systemic inflammation and impaired immune functioning. Public health efforts that directly work to reduce FI among older adults are warranted and may result in further improvements in their health and well-being.

The Mediating Role of Meaning in the Association between Stress and Health.

BACKGROUND: Stress is a common feature of life and has routinely been linked with negative health outcomes. However, meaning has been identified as a possible buffer against stress. PURPOSE: The purpose of the current study was to examine whether the relationship between stress and health was mediated by meaning in life. METHODS: Drawing from Wave 1 of the Landmark Spirituality and Health Study, a nationally representative sample of adults, participants (N = 1871) reported their level of stress in the past 12 months, current meaning in life, health (measured as minor symptoms, major conditions, and overall health), and provided a blood sample for biomarker of immune system functioning (i.e., presence of Epstein-Barr virus antibodies). RESULTS: Results revealed an indirect effects model in which stress was inversely associated with meaning. Higher meaning was related to better self-reported health (across minor, major, and overall health measures), which, in turn, was associated with better immune system functioning. CONCLUSIONS: These findings suggest that part of the negative effect of stress on health is accounted for by reduced meaning.

Association of positive psychological well-being with circulating inflammatory markers: A systematic review and meta-analysis.

Accumulating evidence shows a protective effect of positive psychological well-being (PPWB) on health outcomes. However, the underlying mechanisms remain poorly understood. One pathway relates to enhanced immune functioning (Boehm, 2021). The aim of this project was to conduct a systematic review and meta-analysis of the association between PPWB and circulating inflammatory biomarkers and determine the magnitude of this association. After examining 748 references, 29 studies were included. Results from over 94'700 participants revealed a significant association between PPWB and reduced levels of interleukin (IL)- 6 (r = -0.05; P < .001) and C-reactive protein (CRP) (r = -0.06; P < .001) with a heterogeneity of I2 = 31.5% and I2 = 84.5%, respectively. Only the association of PPWB with CRP was independent of co-variates included in the individual studies (r = -0.04; P = .027). The findings of this systematic review and meta-analysis suggest that PPWB is associated with lower levels of inflammatory biomarkers IL-6 and CRP in the circulation. Such relationships with inflammatory biomarkers may partly explain positive effects of PPWB on health.

Links between inflammation and immune functioning with cognitive status among older Americans in the Health and Retirement Study.

Elevated inflammation and poor immune functioning are tied to worse cognitive health. Both processes are fundamental to aging and are strongly implicated in the development of age-related health outcomes, including cognitive status. However, results from prior studies evaluating links between indicators of inflammation and immune function and cognitive impairment have been inconsistent due to biomarker selection, sample selection, and cognitive outcome. Using the Health and Retirement Study (HRS), a nationally representative study of older adults in the United States, we assessed how indicators of inflammation (neutrophil-lymphocyte ratio (NLR), albumin, CRP, IL6, IL10, IL-1Ra, sTNFR1, and TGFß1) and immune functioning (CMV, CD4+ TN/TM, and CD8+ TN/TM) are associated with cognitive status. First, to examine the association between each biomarker and cognitive status, we tested whether markers of inflammation and immune functioning varied across cognitive status categories. We found that dementia and cognitive impairment without dementia (CIND) were associated with elevated inflammation and poorer immune functioning across biomarkers except for CD4+ TN/TM. Next, we estimated multinomial logistic regression models to assess which biomarkers would continue to be associated with dementia and CIND, net of each other. In these models, albumin, cytokines, CMV, CD4+ TN/TM, and CD8+ TN/TM are associated with cognitive status. Because poor immune functioning and increased inflammation are associated with cognitive impairment, improving immune functioning and reducing inflammation may provide a mechanism for reducing ADRD risk in the population.

Self-Reported Impaired Wound Healing in Young Adults and Their Susceptibility to Experiencing Immune-Related Complaints.

The current study examined to what extent individuals with wound infection (WI group), slow healing wounds (SHW group), or both (COMBI group) report poorer immune fitness and whether they experience immune-related complaints more often as compared to healthy participants (control group). Survey data from 3613 Dutch students was re-analyzed. Compared to the control group, perceived immune fitness was significantly lower by the SHW group (p < 0.001) and the COMBI group (p < 0.001), but no difference was found for the WI group (p = 0.059). Also, perceived immune fitness of the COMBI group was significantly worse compared to the WI group (p = 0.040). Compared to the control group, reduced immune fitness was reported to be significantly more frequently by the SHW group (p < 0.001) and the COMBI group (p < 0.001). Reduced immune fitness was significantly more common for the COMBI group compared to the SHW group (p = 0.011) and WI group (p = 0.001). Immune-related complaints such as headache, runny nose, coughing, sore throat, diarrhea, flu, and fever were significantly more frequently reported by individuals with impaired wound healing. The effects were most pronounced in the COMBI group, followed by the SHW group and a lesser extent the WI group. A highly significant correlation was found between perceived immune fitness and the percentage of individuals that reported impaired wound healing. In conclusion, the findings confirm that poorer immune functioning is characteristic for individuals with impaired wound healing. In follow-up studies, immune biomarkers analyses are needed to support patient-reported outcome measures.

The Assessment of Immune Fitness.

Immune fitness (i.e., adequate functioning of the immune system) is essential to maintain health, prevent and resolve disease, and improve quality of life. This article provides an overview of how to assess immune fitness. It discusses how a single-item rating scale can be used to assess immune fitness. The scale can be used in conjunction with a single "yes" or "no" question asking whether the individual is experiencing reduced immune fitness. Retrospective assessments can be complemented with the Immune Status Questionnaire (ISQ) to provide more insight into the type and frequency of experiencing specific immune-related complaints. Momentary assessments of immune fitness can be complemented with biomarker measurements in body fluids. As individuals may be unaware of systemic inflammation (e.g., biomarker concentrations outside the normal range), it remains critical to combine immune fitness assessments with biomarker measurements of immune functioning.

The Relationship Between Multidimensional Motivation and Endocrine-Related Responses: A Systematic Review.

Multidimensional motivational theories postulate that the type of motivation is as important as the quantity of motivation, with implications for human functioning and well-being. An extensive amount of research has explored how constructs contained within these theories relate to the activation of the endocrine system. However, research is fragmented across several theories, and determining the current state of the science is complicated. In line with contemporary trends for theoretical integration, this systematic review aims to evaluate the association between multidimensional motivational constructs and endocrine-related responses to determine which theories are commonly used and what inferences can be made. Forty-one studies were identified incorporating five distinct motivation theories and multiple endocrine-related responses. There was evidence across several theories that high-quality motivation attenuated the cortisol response in evaluative environments. There was also evidence that motivational needs for power and affiliation were associated with lower and higher levels of salivary immunoglobulin A, respectively. The need for power may play a role in increasing testosterone when winning a contest; however, this evidence was not conclusive. Overall, this review can shape the future integration of motivational theories by characterizing the nature of physiological responses to motivational processes and examining the implications for well-being.

Neutralizing a Springboard for Inflammation: Physical Activity to Control the Immune Network.

The severe consequences of the present Corona Virus Disease 2019 COVID-19 pandemic seem to be closely related to an already ongoing ('first') pandemic, directly associated with a sedentary lifestyle. It seems evident that the prognosis after infection is substantially worse for individuals suffering from, for example, (visceral) obesity, cardiovascular disease, and diabetes type 2. Consequently, it may be considered highly relevant to gain insight into the potential beneficial effects of exercise interventions to strengthen the immune system, particularly in high-risk populations. For this reason, the exercise protocols that are suggested to strengthen the immune system, which can be executed by all ages and almost all physical conditions, were reviewed and evaluated. Previously published protocols range from interrupting prolonged sitting, to regular low-to-moderate exercise activities, to high intensity, typically interval, sports formats. Reported positive effects on immune functioning appear to be induced either directly or via beneficial metabolic and/or psychological effects and become measurable after 3 weeks to 3 months. Based in these findings, it appeared possible to design an optimal exercise protocol to maximize effects on immune functioning that should be executable for all, even under restricted ('lockdown') circumstances.

Development and Validation of the Immune Status Questionnaire (ISQ).

The self-assessment of perceived immune status is important, as this subjective observation leads individuals to decide whether or not to seek medical help or adapt their lifestyle. In addition, it can be used in clinical settings and research. The aim of this series of studies was to develop and validate a short questionnaire to assess perceived immune functioning. Five surveys were conducted among Dutch and International young healthy adults (18-30 years old), and two others among older age groups with various health complaints. For the first study, an existing immune functioning scale was modified and elaborated resulting in 23 immune-health-related items, of which the occurrence was rated on a 5-point Likert scale. A student sample was surveyed, and the results were used to shorten the 23-item listing into a 7-item scale with a predictive validity of 85%. Items include "sudden high fever", "diarrhea", "headache", "skin problems (e.g., acne and eczema)", "muscle and joint pain", "common cold" and "coughing". The scale is named Immune Status Questionnaire (ISQ), and it aims to assess perceived immune status over the preceding year. The second study revealed that the ISQ score correlated significantly with a 1-item perceived immune functioning (r = 0.383, p < 0.0001). In the third study, the final Likert scale descriptors were determined ("never", "sometimes", "regularly", "often" and "(almost) always)". The fourth study showed that the test-retest reliability of the ISQ is acceptable (r = 0.80). The fifth study demonstrated the association of ISQ scores with various neuropsychological and health correlates in an international sample, including perceived health and immune fitness, as well as levels of stress, fatigue, depression and anxiety. Study 6 demonstrated significant associations between ISQ scores and experiencing irritable bowel syndrome (IBS) symptoms in a sample of insomnia patients. Study 7 compared the effect of a dietary intervention in participants reporting "poor health" versus "normal health". It is shown that ISQ scores can differentiate between those with poor and normal health, and that an effective intervention is associated with a significant improvement in ISQ scores. Data from Study 7 were further used to determine an ISQ cut-off value for reduced immune functioning, and a direct comparison with 1-item perceived immune functioning scores enabled constructing the final scoring format of the ISQ. In conclusion, the ISQ has appropriate face, content, and construct validity and is a reliable, stable and valid method to assess the past 12 month's perceived immune status.

Immunoecology of the short neck clam Paphia malabarica (Chemnitz, 1782) in a tropical monsoon-influenced estuary.

Understanding the variability in organism's immunological response is crucial for predicting changes at population or community level. The present study investigated the immunoecology of a commercially valuable clam Paphia malabarica in a tropical monsoon-influenced estuary. Clams were collected monthly during a year cycle, which coincided with pre-monsoon (February-May), monsoon (June-September) and post-monsoon seasons (October-January). For assessment of immune functioning, selected hemocyte parameters (total hemocyte concentration, hemocyte mortality, lysosomal content, esterase activity, reactive oxygen species production, and phagocytic activity) were analyzed using flow cytometry. Simultaneously, clam's condition index, nutrients, chlorophyll a, dissolved oxygen, pH, temperature and bacterial density were also measured at the sampling site. Our results exhibited seasonal patterns in hemocyte functioning with the highest activity during the pre-monsoon season (suggestive of a suitable harvesting period) and lowest during monsoon (suggestive of a critical biological period). The critical biological period for P. malabarica was marked with compromised immune parameters inflicted by low salinity, food availability, and possibly high bacterial abundance. Also, the involvement of reproductive stress altering the hematological functioning in P. malabarica cannot be ruled out. Nutrients, dissolved oxygen, pH and temperature could not explain much of the hemocyte variability. The present study has further validated the usefulness of hemocyte as a suitable marker for understanding immunoecology of P. malabarica which is of prime importance, especially in a monsoon-influenced tropical estuarine environment. The findings of our research will be constructive in monitoring natural as well as cultivated bivalve populations of economic and ecological relevance.

Effect of raw milk consumption on perceived health, mood and immune functioning among US adults with a poor and normal health: A retrospective questionnaire based study.

INTRODUCTION: Raw milk consumption is controversially discussed, and people are looking for raw milk due to expected positive health impacts. The purpose of this consumer survey was to evaluate health conditions prior to and after consuming of raw milk (RM). METHODS: An on-line survey was distributed in Spring 2018 among existing consumers of raw milk. One-Item health score, 1-item immunity score, immune status (ISQ), mood, bowel and skin conditions were rated retrospectively based on validated questionnaires. Data from 327 participants (age 54 years) were included, of which 156 (48%) were allocated to the poor health group after they reported being immune depressed or suffering from a chronic disease. Others were allocated to the normal health group. Milk consumption pattern before and after changing of the milk diet were recorded. All health outcomes were evaluated according a linear mixed model in SPSS. RESULTS: Health, perceived immunity, bowel and mood scores increased post RM consumption with around 35% in the poor health group (P < 0.001), and around 9% in the normal health group (P < 0.001). Bowel and mood scores were overall lower in women than in men. Outcomes were independent of the origin of raw farm milk. CONCLUSIONS: This consumer survey suggests that positive health and mood changes are associated with the consumption of raw milk. Effects were strongest in people with a self-reported poor health status as well as in women.

Impact of mental resilience and perceived immune functioning on the severity of alcohol hangover.

OBJECTIVE: Recent research comparing hangover sensitive drinkers with hangover resistant drinkers has revealed that experiencing alcohol hangovers is associated with significantly poorer self-reported immune functioning (p < 0.0001). No significant difference between the groups was found on mental resilience. The objective of the current survey was to examine the association between hangover severity, perceived immune status, and mental resilience. N = 341 Dutch students, all hangover sensitive drinkers, completed an online survey. The Brief Resilience Scale was completed, and perceived immune functioning and overall hangover severity for their latest past month hangover were assessed. RESULTS: Students consumed a mean (SD) of 12.3 (5.9) alcoholic drinks the evening before their latest hangover. A significant positive association was found between mental resilience and perceived immune functioning (r = 0.372, p = 0.000). No significant associations of hangover severity were found with mental resilience (r = - 0.010, p = 0.858), or perceived immune functioning (r = - 0.025, p = 0.645). Previous research revealed that hangover resistant and hangover sensitive drinkers report having significantly different levels of immune functioning, and that the immune system is involved in the development of alcohol hangover. These findings suggest that levels of mental resilience and perceived immune functioning are not related to the severity of hangovers in hangover sensitive drinkers.

The Association of Insomnia, Perceived Immune Functioning, and Irritable Bowel Syndrome Complaints.

BACKGROUND: Irritable bowel syndrome (IBS) can have a significant negative impact on quality of life, mood and wellbeing. The aim of this study was to investigate the association between experiencing IBS symptoms and insomnia, and perceived health status. METHOD: An online survey was conducted among n = 1950 Dutch university students (83.6% women). IBS was assessed with the Birmingham IBS Symptom Questionnaire, quality of life with the WHO-5 wellbeing index, and sleep outcomes with the SLEEP-50 questionnaire. Perceived immune functioning and general health were assessed using 1-item scales. RESULTS: IBS symptom severity was significantly associated with insomnia complaints (r = 0.32, p = 0.0001), sleep quality (r = -0.21, p = 0.0001), sleep onset latency (r = 0.11, p = 0.0001) and the number of nightly awakenings (r = 0.24, p = 0.0001). Total sleep time was not significantly associated with IBS symptom severity. Significant correlations were also found between IBS symptom severity and perceived general health (r = -0.30, p = 0.0001), perceived immune functioning (r= -0.25, p = 0.0001), and quality of life (r = -0.24, p = 0.0001). CONCLUSIONS: Experiencing IBS complaints is associated with reduced perceived immune functioning, a poorer perception of general health, and sleep disturbances. These effects are reflected in a significantly lower reported quality of life in subjects with more IBS and/or sleep complaints.

The application of mindfulness for individuals living with HIV in South Africa: A hybrid effectiveness-implementation pilot study.

Despite the recent growth of mindfulness research worldwide, there remains little research examining the application of mindfulness-based interventions in resource-limited, international settings. This study examined the application of Mindfulness Based Stress Reduction (MBSR) for HIV-infected individuals in South Africa, where rates of HIV are highest in the world. Mixed methods were used to examine the following over a three-month follow up: (1) feasibility, acceptability, and preliminary adaptation of MBSR for this new context; and (2) effects of MBSR on immune functioning, self-reported mindfulness (MAAS, FFMQ), depression, anxiety, and stress (DASS-21). Ten individuals initiated MBSR, and seven completed all eight sessions. Results indicated medium effect size improvements in immune functioning (CD4 count and t-cell count; d = .5) through the three-month follow up, though the small sample size limited power to detect a statistically significant effect. From baseline to post-treatment, improvements in "Observing" and "Non-reactivity" (FFMQ) approached statistical significance with large effect sizes (observing: d = 1.5; p = .08; non-reactivity: d = .7; p = .07). There were no statistically significant changes in depression, anxiety, or stress throughout the study period. Primary areas for adaptation of MBSR included emphasis on informal practice, ways to create "space" without much privacy, and ways to concretize the concepts and definitions of mindfulness. Feedback from participants can shape future adaptations to MBSR for this and similar populations. Findings provide preliminary evidence regarding the implementation of MBSR for individuals living with HIV in South Africa. A future randomized clinical trial with a larger sample size is warranted.

Differential Gender Effects in the Relationship between Perceived Immune Functioning and Autistic Traits.

Altered immune functioning has been demonstrated in individuals with autism spectrum disorder (ASD). The current study explores the relationship between perceived immune functioning and experiencing ASD traits in healthy young adults. N = 410 students from Utrecht University completed a survey on immune functioning and autistic traits. In addition to a 1-item perceived immune functioning rating, the Immune Function Questionnaire (IFQ) was completed to assess perceived immune functioning. The Dutch translation of the Autism-Spectrum Quotient (AQ) was completed to examine variation in autistic traits, including the domains "social insights and behavior", "difficulties with change", "communication", "phantasy and imagination", and "detail orientation". The 1-item perceived immune functioning score did not significantly correlate with the total AQ score. However, a significant negative correlation was found between perceived immune functioning and the AQ subscale "difficulties with change" (r = -0.119, p = 0.019). In women, 1-item perceived immune functioning correlated significantly with the AQ subscales "difficulties with change" (r = -0.149, p = 0.029) and "communication" (r = -0.145, p = 0.032). In men, none of the AQ subscales significantly correlated with 1-item perceived immune functioning. In conclusion, a modest relationship between perceived immune functioning and several autistic traits was found.

Dietary intake of fibers: differential effects in men and women on perceived general health and immune functioning.

Background: It has been reported previously that dietary fiber intake provides health benefits. Nevertheless, only a limited number of human studies have investigated whether gender differences exist in the relationship between fiber intake and perceived health and immune status. Objective: To investigate potential gender differences in the effects of dietary fiber intake on perceived health and immune status of healthy young adults. Design: A survey was conducted among university students in Utrecht, the Netherlands. Data were collected on perceived general health status and perceived immune functioning. Dietary intake of fibers was assessed using a food frequency questionnaire. Perceived general health status and immune functioning were associated with daily intake of fibers using nonparametric (Spearman) correlations. Statistical analyses were conducted for the group as a whole, and for men and women separately. Results: N = 509 subjects completed the survey. Mean (SD) age was 20.8 (2.6) years old. 71.9% of the samples were females. Mean daily dietary fiber intake was 15.5 (6.9) g. Daily dietary fiber intake correlated significantly with general health rate (r = 0.171, p = 0.0001) and perceived immune functioning (r = 0.124, p = 0.008). After controlling for total caloric intake, the partial correlation between fiber intake and general health remained significant (r = 0.151, p = 0.002). In men, dietary fiber intake correlated significantly with perceived general health status (r = 0.320, p = 0.0001) and immune functioning (r = 0.281, p = 0.002). After controlling for caloric intake, the association between dietary fiber intake and perceived general health (r = 0.261, p = 0.005) remained significant. Remarkably, no significant correlations were observed in women. Conclusion: A significant association between daily dietary fiber intake and perceived general health status and immune rate was found in men, but not in women. Future studies should further address the nature and causes of the observed gender differences, including validated biomarkers for immune responsiveness. Abbreviations: FFQ: Food frequency questionnaire; GIT: Gastrointestinal tract; NCDs: Non-communicable diseases; SCFA: Short-chain fatty acid.

Mental resilience, perceived immune functioning, and health.

BACKGROUND: Mental resilience can be seen as a trait that enables an individual to recover from stress and to face the next stressor with optimism. People with resilient traits are considered to have a better mental and physical health. However, there are limited data available assessing the relationship between resilient individuals and their perspective of their health and immune status. Therefore, this study was conducted to examine the relationship between mental resilience, perceived health, and perceived immune status. METHODS: A total of 779 participants recruited at Utrecht University completed a questionnaire consisting of demographic characteristics, the brief resilience scale for the assessment of mental resilience, the immune function questionnaire (IFQ), and questions regarding their perceived health and immune status. RESULTS: When correcting for gender, age, height, weight, smoker status, amount of cigarettes smoked per week, alcohol consumption status, amount of drinks consumed per week, drug use, and frequency of past year drug use, mental resilience was significantly correlated with perceived health (r=0.233, p=0.0001), perceived immune functioning (r=0.124, p=0.002), and IFQ score (r=-0.185, p=0.0001). CONCLUSION: A significant, albeit modest, relationship was found between mental resilience and perceived immune functioning and health.

The effect of exercise training on disease progression, fitness, quality of life, and mental health in people living with HIV on antiretroviral therapy: a systematic review.

BACKGROUND: Exercise has been associated with improvements in adverse physiological and psychological effects of long-term antiretroviral therapy (ART) in people living with HIV (PLWH). AIM: To summarizes the findings on the effects of aerobic or resistance training alone or combined aerobic and resistance exercise training (CARET) on disease progression, fitness, physical functioning, mental health, and quality of life (QOL) in PLWH receiving ART. A systematic search of articles was performed in several databases, and 20 articles that met inclusion criteria were summarized. RELEVANCE FOR PATIENTS: Aerobic exercise was associated with improvements in aerobic capacity, QOL, and depressive symptoms, while resistance training improved strength. CARET was related to improved aerobic fitness, strength, physical functioning, QOL, and self-efficacy. At least one of the exercise interventions resulted in improvements in CD4+ cell count and HIV RNA viral load. Moreover, another study showed that HIV-specific biomarkers remained unchanged in the exercise intervention group, while they significantly worsened in the non-exercise group. In general, in spite of their well-known benefits, exercise programs have not been extensively utilized or widely recognized as viable therapeutic treatment options for this patient population. Knowing the possible health benefits of increasing physical activity level is important to better recommend exercise programs. However, the prescription must be done carefully and on an individual basis. Additional studies investigating the efficiency and effectiveness of different exercise training regimens for PLWH are needed.