Prevalence of Vertebral Fractures and Non-fracture Deformities in Healthy Adult Men: The Importance of Morphologic Criteria.

Vertebral fractures (VF) are common in older men but data on VF prevalence in young men is limited. The aim of this study was to describe the prevalence of VF and non-fracture vertebral deformities (VD) in healthy young to middle-aged men, and compare the characteristics of men with normal vertebrae, VF and VD. In this cross-sectional study, vertebral fracture assessment by dual-energy X-ray absorptiometry was performed in 650 men, aged 32 to 60 years (mean 46.2), from the population-based SIBLOS-SIBEX cohort. For VF and VD assessment, both the modified algorithm-based qualitative approach (morphologic criteria) to discriminate VF from VD and the semi-quantitative (morphometric) grading system of Genant (GSQ) were used. We found 48 (0.6%) fractured vertebrae, of which 15 were classified grade 1, 29 grade 2 and 4 grade 3 VF. There were 378 (4.7%) VD, of which 296 were scored grade 1, 82 grade 2 and none grade 3 VD. Twenty-six participants (4%) had VF, 15 had one and 11 had 2 or more VF. Two hundred and twenty-eight (35.1%) men had VD. Femoral neck, total hip and lumbar spine areal bone mineral density (aBMD) were lower in men with VF than in those with normal vertebrae or VD. Men with VD, in turn, had aBMD values similar to men with normal vertebrae. Our results suggest that -even in young healthy men-using the GSQ without taking qualitative aspects into account overestimates VF prevalence, confirming the importance of morphologic criteria to correctly diagnose and distinguish VF from VD.

Zinc supplementation raises serum zinc and 5'-nucleotidase activities in healthy, USA middle-aged men.

Background: Many types of people have been noted to show less than maximum zinc functional status. One group that has not been examined is healthy middle-aged, non-vegetarian men in the USA. Aim: To determine if supplementation with zinc improves values for two plasma indicators of zinc status. Methods: Zinc arginate (30 mg zinc/day) was given for 6 weeks to healthy middle-aged men. Results: Supplementation produced statistically significant, but small increases in plasma values for zinc and activity of 5'-nucleotidase, a zinc enzyme. Conclusion: These results suggest that middle-aged, healthy, meat-eating US males tend to show close to maximal zinc functional status. However, such men may not have a safety margin in zinc stores that covers situations where higher than normal zinc needs develop.

Heart rate variability increases following automated acoustic slow wave sleep enhancement.

Acoustic stimulation has been shown to enhance slow wave sleep and in turn, cognition, and now cardiac outcomes in young adults. With the emergence of commercial acoustic devices in the home, we sought to examine the impact of an acoustic, slow wave enhancing device on heart rate variability in healthy, middle-aged males (n = 24, 39.92 ± 4.15 years). Under highly controlled conditions, the participants were randomised to receive closed-loop brain state-dependent stimulation in the form of auditory tones (STIM), or no tones (SHAM), in a crossover design, separated by a 1 week washout period. STIM and SHAM were compared on measures of heart rate variability for the whole night and over the first three sleep cycles. We found an increase in slow wave activity following STIM compared with SHAM. There was a significant increase in high frequency power and standard deviation of the normalised RR-intervals (SDNN) during the STIM condition compared with SHAM (p < 0.05), due to changes observed specifically during N3. In conclusion, heart rate variability appears to improve following acoustic slow wave sleep enhancement.

Engagement in different sport disciplines during university years and risk of locomotive syndrome in older age: J-Fit+ Study.

BACKGROUND: Among former Olympic-level athletes, engagement in different sport disciplines has been associated with mortality risk in subsequent years. However, limited evidence is available on whether engagement in different sport disciplines at a young age is associated with locomotive syndrome (LS) risk later in life. This study examined the relationship between engagement in different sport disciplines during university years and LS risk in older age among former university athletes. METHODS: Participants were 274 middle-aged and 294 older men alumni who graduated from a school of physical education in Japan. LS risk was defined as answering "yes" to any of the Loco-check questions. Data on university sports club membership were collected using questionnaires. University clubs were classified into three groups of cardiovascular intensity (low, moderate, high), following the classification system of sport disciplines by the American College of Cardiology. This classification considers the static and dynamic components of an activity, which correspond to the estimated percent of maximal voluntary contraction reached and maximal oxygen uptake achieved, respectively. University clubs were grouped based on the risk of bodily collision (no, yes) and extent of physical contact (low, moderate, high). Relationships between engagement in different sport disciplines and LS risk were analyzed using Cox proportional hazards models, and adjusted for age, height, weight, joint disease, habitual exercise, and smoking and drinking status. RESULTS: Adjusted hazard ratios and 95% confidence intervals associated with the low, moderate, and high cardiovascular intensity sports were 1.00 (reference), 0.48 (0.22-1.06, P = 0.070), and 0.44 (0.20-0.97, P = 0.042) in older men, respectively; however, there was no significant association between these parameters among middle-aged men. Engagement in sports associated with physical contact and collision did not affect LS risk in either group. CONCLUSIONS: Engagement in sports associated with high cardiovascular intensity during university years may reduce the risk of LS in later life. Encouraging young people to participate in such activities might help reduce LS prevalence among older populations.

Differences in male climacteric symptoms with aging among rotating night shift workers.

OBJECTIVE: The aim of this study was to clarify the actual status of male climacteric symptoms in rotating night shift workers and how to cope with the symptoms. METHODS: We planned a self-administered questionnaire survey in male rotating night shift workers. Male climacteric symptoms were evaluated by using the Aging Males' Symptoms (AMS) scale. RESULTS: Of 1891 questionnaires that were sent, 1561 were collected. There were significant differences in total AMS scores among the age groups. In all age groups, there were high proportions of men with increased need for sleep and often feeling tired (64.9%) and decrease in muscular strength (60.7%). There were significant differences in AMS scores for somatic symptoms between men in their 20 s and those in their 40 s or 50 s and between men in their 30 s and those in their 50 s and in AMS scores for sexual symptoms between men in their 20 s and those in their 30 s, 40 s, 50 s or 60 s, between men in their 30 s and those in their 40 s, 50 s or 60 s and between men in their 40 s and those in their 50 s or 60 s. CONCLUSION: Significant age-dependent differences are found in somatic symptoms and sexual symptoms in rotating night shift workers.

Effect of tea catechins with caffeine on energy expenditure in middle-aged men and women: a randomized, double-blind, placebo-controlled, crossover trial.

PURPOSE: It has been reported that tea catechins increase energy metabolism, but their effect on resting metabolic rate (RMR) remains under debate. This study aimed to examine the effect of repeated intake of tea catechins on energy metabolism in the resting state in middle-aged men and women. METHODS: A total of 30 middle-aged men and women [13 women; age (mean ± SD) 52 ± 4 years; BMI 21.9 ± 2.2 kg/m2] were recruited. A randomized, double-blind, crossover study was conducted using a tea catechin-enriched beverage (611 mg catechins, 88 mg caffeine) and a placebo beverage (0 mg catechins, 81 mg caffeine) as test beverages. After 2 weeks of continuous test beverage intake, fasting RMR and energy expenditure (EE) after the ingestion of test beverage were measured. Measurements of forehead temperature (proxy for core temperature) and skin temperature were also obtained simultaneously. RESULTS: Among participants who underwent measurements, 26 (10 women; mean age 52 ± 4 years; mean BMI 22.1 ± 2.1 kg/m2) were analyzed. The EE increased significantly after ingestion of the tea catechin beverage compared with the placebo beverage (placebo treatment: 5502 ± 757 kJ/day; catechin treatment: 5598 ± 800 kJ/day; P = 0.041). No between-treatment differences in fasting RMR or the respiratory quotient were detected. In addition, the forehead and skin temperature did not differ significantly between the placebo and catechin treatments. CONCLUSION: This study revealed that continuous intake of tea catechins with caffeine for 2 weeks significantly increased EE after ingestion of the tea catechin but not fasting RMR in middle-aged men and women. CLINICAL TRIAL REGISTRY NUMBER AND WEBSITE: This trial was registered at www.umin.ac.jp/ctr/ as UMIN000025810 and UMIN000025811.

Sweet Snacks Are Positively and Fruits and Vegetables Are Negatively Associated with Visceral or Liver Fat Content in Middle-Aged Men and Women.

BACKGROUND: Visceral adipose tissue (VAT) and hepatic triglyceride content (HTGC) are major risk factors for cardiometabolic diseases. OBJECTIVE: We aimed to investigate the association of dietary intake of the main food groups with VAT and HTGC in middle-aged men and women. METHODS: We used data from the Netherlands Epidemiology of Obesity study, a population-based study including 6671 participants aged 45-65 y at baseline. In this cross-sectional analysis, VAT and HTGC were assessed by magnetic resonance imaging and spectroscopy, respectively, as the primary outcomes. Habitual intake of main food groups (dairy, meat, fish, fruits and vegetables, sweet snacks, and fats and oils) was estimated through the use of a food-frequency questionnaire. We examined associations of intake of different food groups with VAT and HTGC by linear regression analysis stratified by sex and adjusted for age, smoking, education, ethnicity, physical activity, basal metabolic rate, energy-restricted diet, menopausal state, and total energy intake. RESULTS: In women, a 100-g/d higher intake of dairy was associated with 2.0 cm2 less VAT (95% CI: -3.4, -0.7 cm2) and a 0.95-fold lower HTGC (95% CI: 0.90-, 0.99-fold). Moreover, a 100-g/d higher intake of fruit and vegetables was associated with 1.6 cm2 less VAT (95% CI: -2.9, -0.2 cm2) in women. Fruit and vegetables were negatively associated (0.95; 95% CI: 0.91, 1.00) with HTGC, and sweet snacks were positively associated (1.29; 95% CI: 1.03, 1.63). Patterns were weaker but similar in men. Fish intake was not associated with VAT or HTGC and plant-based fat and oil intake were only associated with VAT after adjustment for total body fat. CONCLUSIONS: Despite some variation in the strength of the associations between men and women, dietary intake of sweet snacks was positively associated with HTGC, and fruit and vegetable intake were negatively associated with visceral and liver fat content. Prospective studies are needed to confirm these results. The Netherlands Epidemiology of Obesity study is registered at clinicaltrials.gov with identifier NCT03410316.

Myocardial infarction and death findings from a 22-year follow-up of a cohort of 980 employed Swedish men.

OBJECTIVES: In this article, we present death and myocardial infarction (MI) incidences over 22 years in relation to possible risk factors and their explanatory value. STUDY DESIGN: In 1993, 980 middle-aged Swedish men in an automotive industry were surveyed at a health checkup as part of the Renault-Volvo Coeur project. The Swedish cohort was revisited in 2015. METHODS: In 2015, incident MIs were identified using postal questionnaires, hospital records, and the Swedish national MI and death registers. The statistical results were given as odds ratios (ORs) and pseudo-R2 (PR2), showing the proportion of variation in risk explained by logistic models. RESULTS: One hundred and four deaths (4.6 per 1000 person-years) and 89 first MIs (4.2 per 1000 person-years) were identified. The Framingham risk index showed the strongest association with MI (OR = 23; 95% confidence interval [CI] = 5.42, 96.9), comparing the fifth quintile with the first. The all-cause death showed an OR of 3.2 (95% CI = 1.65, 6.08), with a suggested U-shape over quintiles. The percentages of PR2 for MI and death were 8.8% and 6.6%, respectively. All risk factors together explained 22% of the variation in risk of MI. Comparing mortality in men living alone with those married yielded an OR of 3.78, which was found to be statistically significant. The corresponding OR for MI was not significant. CONCLUSIONS: Traditional risk factors were confirmed but explained a modest proportion of the risk variation.

Amount of smoking, pulmonary function, and bone mineral density in middle-aged Korean men: KNHANES 2008-2011.

Smoking induces bone loss; however, data on the relationship between smoking history and bone mineral density (BMD) are lacking. Age and pulmonary function can affect BMD. We investigated the relationships among pack-years (PYs) of smoking, pulmonary function, and BMD in middle-aged Korean men (50-64 years old). This cross-sectional study used data from the Korean National Health and Nutrition Examination Survey, 2008-2011. All participants underwent BMD measurements using dual energy X-ray absorptiometry and pulmonary function tests using standardized spirometry. In total, 388 never-smokers and 1088 ever-smokers were analyzed. The number of PYs of smoking was negatively correlated with total hip BMD (r = -0.088; P = 0.004) after adjusting for age, height, and weight. Ever-smokers were classified into 3 groups according to PYs of smoking. The highest tertile (n = 482) exhibited significantly lower total hip bone mass than the lowest tertile (n = 214) after adjusting for confounding factors (age, height, weight, forced expiratory volume in 1 s (FEV1), alcohol consumption, physical activity, and vitamin D levels) that could affect bone metabolism (P = 0.003). In conclusion, smoking for >30 PYs was significantly associated with low hip BMD after adjusting for pulmonary function in middle-aged Korean men. Long-term smoking may be a risk factor for bone loss in middle-aged men independent of age, height, weight, and pulmonary function.

Preoperative sexual status of Japanese localized prostate cancer patients: comparison of sexual activity and EPIC scores.

OBJECTIVE: This study aimed to evaluate the relationship between sexual activity and sexual function using questionnaires distributed to middle-aged Japanese patients with localized prostate cancer. METHODS: A total of 145 patients who underwent radical prostatectomy were enrolled in the survey reported on herein. Sexual activity and sexual function were investigated via the Expanded Prostate Cancer Index Composite (EPIC) and an original self-reported questionnaire. RESULTS: Of participants, 24.1% and 20.7% had sexual activity within a month period as investigated via the EPIC and original questionnaire, respectively. However, 29.7% of all those who reported sexual activity rate reported "about once every 2 months to a year," as shown in the original questionnaire. Regarding sexual function as addressed through EPIC, no results within that questionnaire's measure of sexual function showed significant differences among patients with a rate of actual sexual activity. CONCLUSIONS: The present survey showed that more than quarter of preoperative middle-aged Japanese prostate cancer patients surveyed had actual sexual activity, though not within the preceding 4 weeks. To precisely evaluate sexual function of middle-aged Japanese patients, it is necessary to consider actual sexual activity.

Relationship between volume of the seminal vesicles and sexual activity in middle-aged men.

The relationship between volume of the seminal vesicles and the frequency of sex and sexual function in middle-aged men is not clear. This study included 81 patients who were diagnosed with localized prostate cancer. Volume of the seminal vesicles was examined using a volume analyser from computed tomography. Sexual function was subjectively evaluated using the Expanded Prostate Cancer Index Composite and Erection Hardness Score. The frequency of sex was surveyed using our original questionnaire. The mean ± SD age of the patients was 67.7 ± 5.3 years. There was no relationship between the volume of seminal vesicles and age of the patients. Volume of the seminal vesicles in patients who answered that they had sexual activity at least once a year was significantly larger than in those who answered no sexual activity for several years (P < .01) Moreover, among sexually active, middle-aged men, volume of the seminal vesicles was significantly larger in those who had a sexual frequency once every 3 months than in those who had a sexual frequency once every 6 months or once a year (P < .05). Our study suggests that the volume of seminal vesicles of middle-aged men is correlated with sexual activity.

Observed changes in cardiovascular risk factors among high-risk middle-aged men who received lifestyle counselling: a 5-year follow-up.

OBJECTIVE: To examine the long-term impact of health counselling among middle-aged men at high risk of CVD. DESIGN: An observational study with a 5-year follow-up. SETTING AND INTERVENTION: All men aged 40 years in Helsinki have been invited to a visit to evaluate CVD risk from 2006 onwards. A modified version of the North Karelia project risk tool (CVD risk score) served to assess the risk. High-risk men received lifestyle counselling based on their individual risk profile in 2006 and were invited to a follow-up visit in 2011. SUBJECTS: Of the 389 originally high-risk men, 159 participated in the follow-up visits in 2011. Based on their follow-up in relation the further risk communication, we divided the participants into three groups: primary health care, occupational health care and no control visits. MAIN OUTCOME MEASURES: Lifestyle and CVD risk score change. RESULTS: All groups showed improvements in lifestyles. The CVD risk score decreased the most in the group that continued the risk communication visits in their primary health care centre (6.1 to 4.8 [95% CI -1.6 to -0.6]) compared to those who continued risk communication visits in their occupational health care (6.0 to 5.4 [95% CI -1.3 to 0.3]), and to those with no risk communication visits (6.0 to 5.9 [95% CI -0.5 to 0.4]). CONCLUSIONS: These findings indicate that individualized lifestyle counselling improves health behaviour and reduces total CVD risk among middle-aged men at high risk of CVD. Sustained improvement in risk factor status requires ongoing risk communication with health care providers. KEY POINTS Studies of short duration have shown that lifestyle changes reduce the risk of cardiovascular disease among high-risk individuals. Sustaining these lifestyle changes and maintaining the lower disease risk attained can prove challenging. Cardiovascular disease (CVD) risk assessment and individualized health counselling for high-risk men, when implemented in primary health care, have the potential to initiate lifestyle changes that support risk reduction. Attaining a sustainable reduction in CVD risk requires a willingness to engage in risk-related communication from both health care providers and the individual at high risk.

Associations of physical activity with self-rated health and well-being in middle-aged Finnish men.

AIMS: We examined the associations of physical activity (PA) frequency with self-rated health (SRH), self-rated well-being (SRW) and depressive symptoms, in middle-aged men in Finland. METHODS: The cross-sectional study comprised 665 men (mean age 41 ± 3 SD years; body mass index (BMI) 26.8 ± 4.2 SD kg/m(2)), who had completed the screening questionnaire of an intervention for men with cardiovascular risk factors. Their weekly frequency of PA was assessed by a questionnaire, SRH and SRW by visual analog scales (VAS), and depressive symptoms by the Patient Health Questionnaire-2 (PHQ-2). RESULTS: The mean SRH ± SD (range of scale 0-100) by PA frequency categories was 56.2 ± 18.5 for PA sometimes or never, 63.8 ± 16.2 for PA about 1-2 times/week, and 71.1 ± 15.5 for PA at least 3 times/week. The mean SRW ± SD (range of scale 0-100) was 59.0 ± 20.4, 65.6 ± 17.6, and 68.9 ± 17.1, respectively. The mean PHQ-2 score ± SD (range of scale 0-6) by PA categories was 1.83 ± 1.40 for PA sometimes or never, 1.68 ± 1.28 for PA about 1-2 times/week, and 1.60 ± 1.31 for the PA at least 3 times/week group. SRH and SRW improved linearly with increasing PA frequency (both p < 0.001), and the results remained similar after adjustment for BMI, education and smoking status. No association existed between PA frequency and PHQ-2. CONCLUSIONS: More frequent PA was linearly associated with better SRH and SRW, but not with depressive symptoms that were measured by a brief depression screening tool.

Reproductive function in middle-aged males: healthy men versus male partners of infertile couples.

The aim of this study was to compare the reproductive parameters and the health-related, lifestyle and educational factors in middle-aged healthy men and male partners of infertile couples. Our patient group included 164 male partners of infertile couples with a preceding period of infertility of at least 12 months and 61 men attending a prostate health screening and considering themselves healthy. Significant differences between the groups were found in testicular volume, total sperm output, density and morphology as well as oestradiol levels in serum. The analysis showed significant positive correlations between testicular volume and semen quality, while negative correlations were observed between gonadotrophin levels and sperm parameters in both groups. Physical activity and sexual capability were higher in healthy men, while coital frequency and a history of sexually transmitted diseases were higher in male partners of infertile couples. The impact of physical activity and sexual capability on semen quality for all subjects was revealed. We can conclude that impaired reproductive function, that is, semen quality, in men >45 years is related not only with general male ageing but obvious differences between subjects of infertile couples and healthy middle-aged men can be seen. Their relations with lifestyle, environmental or physiological factors need further study.

Effects of aquatic and land high intensity interval training on hemodynamics and vascular function of middle-aged men.

Objective: To investigate the effects of 8-week aquatic and land high intensity interval training (HIIT) on hemodynamics and vascular function in middle-aged men. Methods: Thirty middle-aged men with low physical activity were selected and divided into 15 men (52.43 ± 4.11) in aquatic group and 15 men (52.74 ± 5.62) in land group by random number table. They performed HIIT exercise in aquatic and land 3 times a week for 8 weeks. Pre-test, inter-test and post-test respectively measure hemodynamics and blood vessel function. Results: (1) Body composition: After 8 weeks of exercise, weight, body mass index (BMI) and body fat rate (BF) were lower than before exercise (aquatic group: p < 0.01, land group: p < 0.05). The improvement of BF in the aquatic group was better than that in the land group (p < 0.05); (2) Cardiac function: After 8 weeks of exercise, stroke volume (SV), left ventricular end-diastolic volume (EDV), cardiac output (CO), and left ventricular fractional shortening (FS), were higher than before exercise (aquatic group: p < 0.01, land group: p < 0.05), heart rate (HR) and left ventricular end-systolic volume (ESV) were lower than before exercise (aquatic group: p < 0.01, land group: p < 0.05). The improvement of SV, HR, EDV, ESV, CO and FS in the aquatic group was better than that in the land group (p < 0.05); (3) Hemodynamics: After 8 weeks of exercise, systolic blood pressure (SBP), diastolic blood pressure (DBP) were lower than before exercise (aquatic group: p < 0.01, land group: p < 0.05), wall shear stress (WSS) and peak systolic velocity (PSV) were higher than before exercise (aquatic group: p < 0.01, land group: p < 0.05). The improvement of SBP, WSS and PSV in the aquatic group was better than that in the land group (p < 0.05); (4) Vascular function: basal diameter and brachial artery flow-mediated dilatation (FMD) level in aquatic group and land group was higher than before exercise, pulse wave velocity (PWV) level was lower than before exercise (aquatic and land group: p < 0.05). The improvement of FMD in the aquatic group was better than that in the land group. Conclusion: The body composition, hemodynamics and vascular function of middle-aged men were improved by 8-week aquatic and land HIIT. Aquatic HIIT has better effect on body fat rate, hemodynamics and vascular endothelial function in middle-aged men due to the effect of aquatic pressure and temperature.

Association of step counts with cognitive function in apparently healthy middle-aged and older Japanese men.

Background: Increasing physical activity may prevent cognitive decline. Previous studies primarily focused on older adults and used self-reported questionnaires to assess physical activity. We examined the relationship between step count, an objective measure of physical activity, and cognitive function in community-based middle-aged and older Japanese men. Methods: The Shiga Epidemiological Study of Subclinical Atherosclerosis randomly recruited community-dwelling healthy men aged 40-79 years from Shiga, Japan, and measured their step counts over 7 consecutive days using a pedometer at baseline (2006-2008). Among men who returned for follow-up (2009-2014), we assessed their cognitive function using the Cognitive Abilities Screening Instrument (CASI) score. We restricted our analyses to those with valid 7-day average step counts at baseline and those who remained free of stroke at follow-up (n = 676). Using analysis of covariance, we calculated the adjusted means of the CASI score according to the quartiles of the average step counts. Results: The mean (standard deviation) of age and unadjusted CASI score were 63.8 (9.1) years and 90.8 (5.8), respectively. The CASI score was elevated in higher quartiles of step counts (90.2, 90.4, 90.6, and 91.8 from the lowest to the highest quartile, respectively, [p for trend = 0.004]) in a model adjusted for age and education. Further adjustment for smoking, drinking, and other cardiovascular risk factors resulted in a similar pattern of association (p for trend = 0.005). Conclusion: In apparently healthy middle-aged and older Japanese men, a greater 7-day average step count at baseline was associated with significantly higher cognitive function score.

Time Changes of Survival and Cardiovascular Determinants in a Cohort of Middle-Aged Men Followed Up for 61 Years until Extinction.

OBJECTIVE: To study possible determinants of longevity in a cohort of middle-aged men followed for 61 years until extinction using measurements taken at baseline and at years 31 or 61 of follow-up. MATERIAL AND METHODS: In 1960, two rural cohorts including a total of 1712 men aged 40-59 years were enrolled within the Italian section of the Seven Countries Study of Cardiovascular Diseases, and measurements related to mainly cardiovascular risk factors, lifestyle behaviors, and chronic diseases were taken at year 0 and year 31 of follow-up (when only 390 could be examined). Multiple linear regression models were computed to relate personal characteristics with the length of survival in both dead men and survivors. RESULTS: Baseline cardiovascular risk factors, smoking and dietary habits, and chronic diseases (taken at year 0 with men aged 40-59 years) were significant predictors of the length of survival both from year 0 to year 31 and from year 0 to year 61, but only chronic diseases were independent predictors for the period of 31 to 61 years. Significant predictors of survival using measurements taken at year 31 (age range 71 to 90 years) were only smoking and dietary habits and chronic diseases. CONCLUSIONS: During a lifetime of follow-up, the personal characteristics with continuous predictive power of survival were only lifestyle behaviors and major chronic diseases.

Association of subclinical carotid artery atherosclerosis assessed by carotid ultrasound with nonalcoholic fatty liver disease fibrosis score in young and middle-aged men.

BACKGROUND: Non-alcoholic Fatty Liver Disease (NAFLD) is a widespread liver disorder caused by excess fat accumulation in the liver with no significant alcohol consumption. This condition has been linked to the development of cardiovascular diseases (CVD) and atherosclerosis. Carotid intima-media thickness (CIMT) and carotid plaques, which are established markers of subclinical atherosclerosis, were used to assess CVD risk. However, few studies have explored the correlation between NAFLD and subclinical atherosclerosis, especially in young and middle-aged men. A study on 200 male patients aged 18-55 years aimed to investigate the association between NAFLD fibrosis score (NFS) and CIMT, as well as carotid plaque presence. METHODS: The study, conducted between July 2023 and January 2024, included CIMT measurements and plaque assessments performed using B-mode ultrasound. Participants were divided into two groups based on CIMT values and plaque presence, and NFS was analyzed for its association with CIMT and plaque. RESULTS: Participants with higher CIMT values had a significantly higher NFS (-2.9 ± 1.13 vs. -1.9 ± 1.4, P < 0.001) than those with lower CIMT values. Similarly, participants with carotid plaque also exhibited a higher NFS (-2.5 ± 1.3 vs. -1.7 ± 1.4, P = 0.002). Multivariate logistic regression analysis showed that NFS was a strong predictor of both increased CIMT (odds ratio [OR]: 1.564%95 CI 1.035-2.363; P = 0.034) and carotid plaque presence (OR: 1.605%95 CI 1.118-2.290; P = 0.010). CONCLUSION: These results emphasize the potential role of NFS as a marker of subclinical atherosclerosis in young and middle-aged men.

The illness experience of middle-aged men with oral cancer.

AIMS AND OBJECTIVES: To explore the essence of the illness experiences of middle-aged men with oral cancer. BACKGROUND: Having oral cancer creates great challenges in the lives of middle-aged men and their families. Understanding patients' experiences provides a sound basis for patient-centred and individualised care. Research is limited regarding the illness experience of middle-aged men with oral cancer with regard to facing both the invasion of disease and the responsibilities of middle age. DESIGN: A phenomenology approach was used. METHODS: Nine men diagnosed with oral cancer within one year were recruited during 2009 and 2010. Data were collected through individual in-depth interviews and analysed using Colaizzi's phenomenological analysis procedures. RESULTS: The following five themes emerged from the patterns of categorised interview data: the psychological journey in facing oral cancer, the question of how patients can control their disease as well as the sequelae of cancer treatment, the continuous disturbance and turmoil resulting from the disease, the appreciation of the support from family and friends, and the ability to learn to actively face the future. CONCLUSIONS: Patients with oral cancer experienced tremendous physical, psychosocial and financial challenges. Although burdened with multiple stressors, these middle-aged men were able to learn from their experiences and exhibit positive growth in life. RELEVANCE TO CLINICAL PRACTICE: Patients with oral cancer have to constantly adjust to the impact of their disease. The study results may serve as a reference for improving clinical practice and the quality of care among patients with oral cancer. Cancer care is multidimensional and holistic. Healthcare professionals should develop a set of plans by which patients receive complete medical care and support, as well as assistance from professionals and family members, as their treatment progresses to help patients face the challenges of cancer.

Evaluation of dietary food intakes and anthropometric measures in middle-aged men with aggressive symptoms.

BACKGROUND: Aggression is one of the most prevalent behavioral disorders in men. OBJECTIVE: This study aimed to assess the possible association between dietary intake of food groups and aggression in middle-aged married men. METHODS: This case-control study included 336 participants (168 men with aggressive behaviors and 168 healthy controls) aged 35-55 years. Demographic information was collected using a socio-demographic questionnaire. A food frequency questionnaire was used to investigate the diet group intake last year. Based on the normality of the data distribution, Independent t-tests and Mann-Whitney tests were used to compare quantitative variables between the two groups. Categorical variables were compared between cases and controls using the Chi-squared test. Logistic regression analysis was used to examine the possible association between food intake and aggression. RESULTS: Compared to controls, aggressive men had significantly higher mean weight, height, and waist circumference (WC), p = 0.007, p = 0.001, and p = 0.043, respectively. After adjusting WC, energy intake, and educational level, in Model 1, intake of milk, cheese, poultry, red meat, legumes, egg, fruits, and vegetables had a significant protective role on the occurrence of aggression, (Odd Ratio (OR) = 0.36; 95% (Confidence Interval (CI) = 0.204, 0.670; P = 0.001), (OR = 0.440; 95% CI = 0.284, 0.781; P = 0.005), (OR = 0.621; 95% CI = 0.284, 0.781; P = 0.046), (OR = 0.358; 95% CI = 0.198, 0.647; P = 0.001), (OR = 0.434; 95% CI = 0.243, 0.773; P = 0.005), (OR = 0.411; 95% CI = 0.229, 0.736; P = 0.003), (OR = 0.332; 95% CI = 0.180, 0.614; P < 0.001), (OR = 0.310; 95% CI = 0.168, 0.572; P < 0.001), respectively. CONCLUSIONS: Lower WC and a diet containing high-quality protein, fruits, and vegetables can have a protective role against aggression and are recommended for men with an aggressive mood. This diet can affect plasma levels of tryptophan and, therefore, brain levels of serotonin.