Sedentary behavior and the biological hallmarks of aging

Adherence to the mediterranean diet and physical activity in relation to sarcopenia: a cross-sectional epidemiological cohort study

BACKGROUND

Adoption of healthy lifestyle habits has been proposed as successful strategies to counteract sarcopenia.

AIMS

To explore the association of physical activity (PA) and adherence to the mediterranean diet (MD), individually and synergically, with sarcopenia.

METHODS

The present cross-sectional study examined data of the Toledo Study of Healthy Ageing. Data of community-dwelling adults aged 65 + years were analyzed. Sarcopenia was defined according to the Foundation for the National Institutes of Health, standardized to our population (sFNIH) and the European Working Group on Sarcopenia (EWGSOP2). PA levels (Physical Activity Scale for the Elderly, PASE) and adherence to the MD (MEDiterranean Diet Adherence Screener-MEDAS) were estimated using self-reported instruments. Binary regression models were conducted to test associations.

RESULTS

Data of 1457 individuals (mean age 74.68 ± 5.77 years; 54.91% women) were analyzed. Among them, 331 (22.72%, sFNIH) and 202 (13.86%, EWGSOP2) met sarcopenia criteria. PA levels (ORs: 0.91-0.95, p < 0.05) and adherence to the MD (ORs: 0.82-0.86, p < 0.05) were significantly and negatively associated with the prevalence of sarcopenia, regardless of the definition used. Nevertheless, no significant interactions were observed among healthy lifestyle habits. According to sarcopenia-related domains, PA levels and adherence to the MD were negatively associated with dynapenia, meanwhile, PA levels were associated with low lean mass (sFNIH) and adherence to the MD was inversely associated with poor mobility.

CONCLUSIONS

PA and adherence to the MD are independently associated with sarcopenia. Moreover, specific associations were observed between sarcopenia domains. Nevertheless, no significant interaction was observed between them.

Effectiveness of Mobile Health Interventions for Reducing Sitting Time in Older Adults: Systematic Review and Meta-Analysis

BACKGROUND

Mobile health (mHealth) provides health information through electronic devices, even at home. The escalating prevalence of sedentary behaviors among older adults, which leads to increased adverse health outcomes, underscores the pressing need for a comprehensive understanding of the effectiveness of mHealth interventions.

OBJECTIVE

This study aims to examine the effectiveness of mHealth interventions in the sitting time of older adults (age 55 years).

METHODS

A systematic review and meta-analysis of randomized controlled trials was conducted to evaluate the effects of mHealth interventions on total sitting time during waking hours, excluding sleep. A literature search was conducted using multiple databases, including PubMed, Embase, Web of Science, and Cochrane, covering articles published from the inception of each database through October 2023. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were explicitly applied to structure this report. Methodological quality was assessed using the Cochrane Risk of Bias (ROB 2) tool for randomized controlled trials and the Methodological Index for Non-Randomized Studies (MINORS) tool for nonrandomized studies. Two independent reviewers screened the studies, extracted data, and assessed methodological quality using established criteria. Meta-analyses were performed using Review Manager (version 5.4; Cochrane Collaboration).

RESULTS

Ten studies were identified, of which 3 were included in the meta-analysis, while the remaining 7 were assessed exclusively in the systematic review. The interventions predominantly took place in community settings (n=3) and home-based settings (n=3). Three studies aimed to decrease sedentary behavior and 7 aimed to increase physical activity. The interventions were primarily conducted once daily (n=7) via mobile devices such as smartphones (n=7) and typically involved a single intervention delivered at different time intervals, such as every 15, 20, or 30 minutes (n=4). The interventions typically lasted 12 weeks (n=4) and used objective assessment tools, such as the ActiGraph GT3X+ (n=8). The included studies applied the habit formation theory (n=1), the self-efficacy theory (n=1), the social cognitive theory (n=1), and the social-ecological theory (n=1) as frameworks. Additionally, behavior change techniques, including "goal setting," "problem-solving," "action planning," and "review behavior goal(s)" (n=6), were used. Meta-analysis of the 3 studies included showed a significant decrease in sedentary behavior with mHealth interventions compared with conventional or no interventions (weighted mean difference [WMD]=59.1 min/d, 95% CI 99.1 to 20.2; P=.003).

CONCLUSIONS

mHealth interventions effectively reduce sitting time in older adults. Strategies using interventions with specific frequencies and durations, dedicated mobile monitoring devices, and behavior change techniques showed the potential to reduce sedentary behavior among older adults. These results also underscore the potential of mHealth as a key tool for promoting the well-being of older adults through technology-driven public health efforts.

TRIAL REGISTRATION

PROSPERO CRD42023443926; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023443926.

Social disadvantage accelerates aging

Social disadvantage, like advanced age, is a risk factor for a broad range of health conditions; however, whether it influences the aging process remains unclear. Here, using a multicohort approach, we investigated the associations of social disadvantage with age-related plasma proteins and age-related diseases. We found proteomic signatures of accelerated immune aging and 14 specific age-related proteins linked to social disadvantage during both early and later life. Individuals experiencing social disadvantage had an increased risk of 66 age-related diseases, with up to 39% of these associations mediated by the 14 age-related proteins (for example, DNAJB9, F2, HSPA1A, BGN). The main enriched pathway involved the upregulation of the pro-inflammatory regulator NF-κB24 and its downstream factor interleukin-8. Our findings support the hypothesis that social disadvantage throughout the life course may accelerate aging, a biological mechanism that could explain why social stratification plays such a fundamental role in determining human health.

Prevention of cardiovascular disease for healthy aging and longevity: A new scoring system and related "mechanisms-hallmarks-biomarkers"

Healthy "environment-sleep-emotion-exercise-diet" intervention [E(e)SEEDi] lifestyle can improve the quality of life, prolong aging and promote longevity due to improvement of human immunity and prevention of cardiovascular diseases (CVD). Here, the author reviewed the associations between these core elements with CVD and cardiovascular aging, and developed a new scoring system based on the healthy E(e)SEEDi lifestyle for prediction and evaluation of life expectancy. These core factors are assigned 20 points each (120 points in total), and a higher score predicts healthier aging and longevity. The E(e)SEEDi represents "a tree of life" bearing the fruits of longevity as well as "a rocket of anti-ageing" carrying people around the world on a journey of longevity. In conclusion, the E(e)SEEDi can delay aging and increase the life expectancy due to the role of a series of cellular and molecular "mechanisms-hallmarks-biomarkers". It's believed that the novel scoring system has a huge potential and beautiful prospects.

Exploring the relationship between daily sedentary time and occurrence of multimorbidity in middle-aged and older adults: results from ELSI-Brazil

AIM

To explore the relationship between varying durations of sedentary time (ST) in hours per day and multimorbidity, while considering covariates such as non-compliance to moderate to vigorous physical activity (MVPA) recommendations, age, sex, and smoking in middle-aged and older adults.

METHODS

Data from the first wave (2015-2016) of the nationally-representative Brazilian Longitudinal Study of Aging (ELSI-Brazil) were analyzed. Ordinary regression analysis was utilized to assess the odds ratio for individuals with varying daily ST durations concerning the escalation in the number of diseases while accounting for covariates such as failure to meet MVPA recommendations, age, sex, and smoking status.

RESULTS

A cohort of 7,314 individuals aged 50-105 years (56,3% females) participated in the study. The most prevalent occurrence of multimorbidity was having 2 conditions (1521/19.3%). A clear trend emerges, showing a rise in the number of multimorbidities as ST increase. Notably, individuals engaging in less than 4 h of daily ST exhibited a significantly lower likelihood of experiencing an increase in the total number of multimorbidity cases, with an odds ratio of 0.842 and a confidence interval of 0.764 to 0.928, even after adjusting for potential covariables.

CONCLUSIONS

Our findings indicate a progressive increase in multimorbidity with longer durations of ST. Moreover, limiting ST to less than 4 h daily was associated with a lower chance of multimorbidity.

Hydroxytyrosol as a Mitochondrial Homeostasis Regulator: Implications in Metabolic Syndrome and Related Diseases

Hydroxytyrosol (HT), a principal bioactive phytochemical abundant in Mediterranean dietary sources, has emerged as a molecule of significant scientific interest owing to its multifaceted health-promoting properties. Accumulating evidence suggests that HT's therapeutic potential in metabolic disorders extends beyond conventional antioxidant capacity to encompass mitochondrial regulatory networks. This review synthesizes contemporary evidence from our systematic investigations and the existing literature to delineate HT's comprehensive modulatory effects on mitochondrial homeostasis. We systematically summarized the impact of HT on mitochondrial dynamics (fusion/fission equilibrium), biogenesis and energy metabolism, mitophagy, inter-organellar communication with the endoplasmic reticulum, and microbiota-mitochondria crosstalk. Through this multidimensional analysis, we established HT as a mitochondrial homeostasis modulator with potential therapeutic applications in metabolic syndrome (MetS) and its related pathologies including type 2 diabetes mellitus, obesity-related metabolic dysfunction, dyslipidemia, non-alcoholic steatohepatitis, and hypertension-related complications. Moreover, we further discussed translational challenges in HT research, emphasizing the imperative for direct target identification, mitochondrial-targeted delivery system development, and combinatorial therapeutic strategies. Collectively, this review provides a mechanistic framework for advancing HT research and accelerating its clinical implementation in MetS and its related diseases.

Micro-gyms as a catalyst for healthy aging in university and healthcare settings: applications for the Semmelweis-EUniWell Workplace Health Promotion Model Program

Europe is experiencing a significant demographic shift, with aging populations posing economic and social challenges due to increased healthcare costs and a higher prevalence of age-related diseases. Hungary, in particular, faces these challenges acutely due to higher morbidity and mortality rates from a range of chronic age-related diseases and behavioral risk factors. Addressing these issues requires innovative approaches to promote healthy aging. Semmelweis University, the largest healthcare provider and leading health sciences university in the region, is developing a comprehensive healthy aging program. A critical pillar of this program is the Semmelweis-EUniWell Workplace Health Promotion Model Program, a pioneering initiative aimed at tackling unhealthy aging within Hungary's workforce by leveraging the workplace as a platform for health promotion. Central to this program's goal of combating sedentary lifestyles-a significant contributor to age-related health issues-is the innovative use of micro-gyms and motivational interviewing. Micro-gyms, with their compact size and accessibility, provide convenient exercise opportunities, while motivational interviewing fosters intrinsic motivation and personalized counseling to encourage sustained physical activity. Through concerted efforts and innovative approaches, including the implementation of micro-gyms, the Semmelweis-EUniWell Workplace Health Promotion Model Program aims to set a benchmark for workplace health promotion, fostering a healthier and more resilient aging population in Hungary. This program not only enhances the well-being of employees at Semmelweis University and its EUniWell partner institutions but also catalyzes broader transformations in workplace health promotion and healthy aging nationwide.

Unveiling the link: exploring muscle oxygen saturation in fibromyalgia and its implications for symptomatology and therapeutic strategies

Fibromyalgia, characterized as a complex chronic pain syndrome, presents with symptoms of pervasive musculoskeletal pain, significant fatigue, and pronounced sensitivity at specific anatomical sites. Despite extensive research efforts, the origins of fibromyalgia remain enigmatic. This narrative review explores the intricate relationship between muscle oxygen saturation and fibromyalgia, positing that disruptions in the oxygenation processes within muscle tissues markedly influence the symptom profile of this disorder. Muscle oxygen saturation, crucial for muscle function, has been meticulously investigated in fibromyalgia patients through non-invasive techniques such as near-infrared spectroscopy and magnetic resonance imaging. The body of evidence consistently indicates substantial alterations in oxygen utilization within muscle fibers, manifesting as reduced efficiency in oxygen uptake during both rest and physical activity. These anomalies play a significant role in fibromyalgia's symptomatology, especially in terms of chronic pain and severe fatigue, potentially creating conditions that heighten pain sensitivity and accumulate metabolic byproducts. Hypothesized mechanisms for these findings encompass dysfunctions in microcirculation, mitochondrial irregularities, and autonomic nervous system disturbances, all meriting further research. Understanding the dynamics of muscle oxygen saturation in fibromyalgia is of paramount clinical importance, offering the potential for tailored therapeutic approaches to alleviate symptoms and improve the quality of life for sufferers. This investigation not only opens new avenues for innovative research but also fosters hope for more effective treatment strategies and improved outcomes for individuals with fibromyalgia.

Cellular senescence: from homeostasis to pathological implications and therapeutic strategies

Cellular aging is a multifactorial and intricately regulated physiological process with profound implications. The interaction between cellular senescence and cancer is complex and multifaceted, senescence can both promote and inhibit tumor progression through various mechanisms. M6A methylation modification regulates the aging process of cells and tissues by modulating senescence-related genes. In this review, we comprehensively discuss the characteristics of cellular senescence, the signaling pathways regulating senescence, the biomarkers of senescence, and the mechanisms of anti-senescence drugs. Notably, this review also delves into the complex interactions between senescence and cancer, emphasizing the dual role of the senescent microenvironment in tumor initiation, progression, and treatment. Finally, we thoroughly explore the function and mechanism of m6A methylation modification in cellular senescence, revealing its critical role in regulating gene expression and maintaining cellular homeostasis. In conclusion, this review provides a comprehensive perspective on the molecular mechanisms and biological significance of cellular senescence and offers new insights for the development of anti-senescence strategies.

Leisure-Time Physical Activity, Sedentary Behavior, and Biological Aging: Evidence From Genetic Correlation and Mendelian Randomization Analyses

Physical inactivity and sedentary behavior are associated with higher risks of age-related morbidity and mortality. However, whether they causally contribute to accelerating biological aging has not been fully elucidated. Utilizing the largest available genome-wide association study (GWAS) summary data, we implemented a comprehensive analytical framework to investigate the associations between genetically predicted moderate-to-vigorous leisure-time physical activity (MVPA), leisure screen time (LST), and four epigenetic age acceleration (EAA) measures: HannumAgeAccel, intrinsic HorvathAgeAccel, PhenoAgeAccel, and GrimAgeAccel. Shared genetic backgrounds across these traits were quantified through genetic correlation analysis. Overall and independent associations were assessed through univariable and multivariable Mendelian randomization (MR). A recently developed tissue-partitioned MR approach was further adopted to explore potential tissue-specific pathways that contribute to the observed associations. Among the four EAA measures investigated, consistent results were identified for PhenoAgeAccel and GrimAgeAccel. These two measures were negatively genetically correlated with MVPA (rg = -0.18 to -0.29) and positively genetically correlated with LST (rg = 0.22-0.37). Univariable MR yielded a robust effect of genetically predicted LST on GrimAgeAccel (βIVW = 0.69, p = 1.10 × 10-7), while genetically predicted MVPA (βIVW = -1.02, p = 1.50 × 10-2) and LST (βIVW = 0.37, p = 1.90 × 10-2) showed marginal effects on PhenoAgeAccel. Multivariable MR suggested an independent association between genetically predicted LST and GrimAgeAccel after accounting for MVPA and other important confounders. Tissue-partitioned MR suggested skeletal muscle tissue associated variants to be predominantly responsible for driving the effect of LST on GrimAgeAccel. Findings support sedentary lifestyles as a modifiable risk factor in accelerating epigenetic aging, emphasizing the need for preventive strategies to reduce sedentary screen time for healthy aging.

Computational and digital analyses in the INSPIRE mouse cohort to define sex-specific functional determinants of biological aging

Biological age, which reflects the physiological state of an individual, offers a better predictive value than chronological age for age-related diseases and mortality. Nonetheless, determining accurate functional features of biological age remains challenging due to the multifactorial nature of aging. Here, we established a unique mouse cohort comprising 1576 male and female outbred SWISS mice subjected or not to high-fat, high-sucrose diet to investigate multiorgan/system biological aging throughout adulthood. Comprehensive functional and biological phenotyping at ages of 6, 12, 18, and 24 months revealed notable sex-specific disparities in longitudinal locomotion patterns and multifunctional aging parameters. Topological data analysis enabled the identification of functionally similar mouse clusters irrespective of chronological age. Moreover, our study pinpointed critical functional markers of biological aging such as muscle function, anxiety characteristics, urinary patterns, reticulocyte maturation, cardiac remodeling and function, and metabolic alterations, underscoring muscle function as an early indicator of biological age in male mice.

Factors associated with hypercholesterolemia in older adults: A cross-sectional investigation

Objective

To investigate the factors associated with hypercholesterolemia in older adults residing in a small municipality in northeastern Brazil.

Methods

This is a population-based cross-sectional epidemiological study conducted with 232 older adults (women: 58.60%; men: 41.40%) in Aiquara, Bahia, Brazil. Independent variables included socioeconomic, behavioral, and health-related factors. The outcome was self-reported hypercholesterolemia (yes or no). Poisson regression with a robust estimator was used to calculate Prevalence Ratios (PR) and their respective 95% Confidence Intervals (CI) in the inferential analysis. Gross models were initially developed, followed by a hierarchical multiple explanatory model (Level 1: socioeconomic variables; Level 2: behavioral aspects; Level 3: health conditions).

Results

The observed prevalence of hypercholesterolemia was 34.50% (men: 21.90%; women: 43.40%). Additionally, a higher probability of hypercholesterolemia was observed in women (PR: 1.94; 95% CI: 1.27-2.97); participants with high sedentary behavior (PR: 1.47; 95% CI: 1.03-2.09); those with abdominal obesity (PR: 1.65; 95% CI: 1.06-2.57); and those with diabetes mellitus (PR: 1.54; 95% CI: 1.04-2.29).

Conclusion

The main results showed that female sex, high sedentary behavior, abdominal obesity, and diabetes mellitus were positively associated with hypercholesterolemia in the older population of the study.

Association between inflammatory biomarkers and hypertension among sedentary adults in US: NHANES 2009-2018

Our study focuses on the relationship between inflammatory biomarkers and hypertension among sedentary adults in the United States, using data from the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2018. We categorized 24,614 participants into two groups based on their daily sedentary time: 9607 individuals in the sedentary group (≥7 h) and 15,007 in the non-sedentary group (<7 h). We found that the sedentary group had a significantly higher prevalence of hypertension than the non-sedentary group. Using weighted multiple logistic regression and smoothing curves, we assessed the correlation between inflammatory biomarkers and hypertension among the sedentary adults. The odds ratios for hypertension were 1.92 for the monocyte to high-density lipoprotein ratio (MHR), 1.15 for the systemic inflammation response index (SIRI), and 1.19 for the natural logarithm of the systemic immune-inflammation index (lnSII), all showing nonlinear associations. Furthermore, a significant positive correlation was found between sedentary time and inflammatory biomarkers (MHR, SIRI, and lnSII). Our findings suggest that prolonged sedentary behavior in the US significantly increases hypertension risk, likely due to marked increases in inflammation markers.

Crosstalk between bone and brain in Alzheimer's disease: Mechanisms, applications, and perspectives

Alzheimer's disease (AD) is a neurodegenerative disease that involves multiple systems in the body. Numerous recent studies have revealed bidirectional crosstalk between the brain and bone, but the interaction between bone and brain in AD remains unclear. In this review, we summarize human studies of the association between bone and brain and provide an overview of their interactions and the underlying mechanisms in AD. We review the effects of AD on bone from the aspects of AD pathogenic proteins, AD risk genes, neurohormones, neuropeptides, neurotransmitters, brain-derived extracellular vesicles (EVs), and the autonomic nervous system. Correspondingly, we elucidate the underlying mechanisms of the involvement of bone in the pathogenesis of AD, including bone-derived hormones, bone marrow-derived cells, bone-derived EVs, and inflammation. On the basis of the crosstalk between bone and the brain, we propose potential strategies for the management of AD with the hope of offering novel perspectives on its prevention and treatment. HIGHLIGHTS: The pathogenesis of AD, along with its consequent changes in the brain, may involve disturbing bone homeostasis. Degenerative bone disorders may influence the progression of AD through a series of pathophysiological mechanisms. Therefore, relevant bone intervention strategies may be beneficial for the comprehensive management of AD.

Association of chronotropic incompetence with reduced cardiorespiratory fitness in older adults with HIV

OBJECTIVE

Understanding the physiological drivers of reduced cardiorespiratory fitness in people with HIV (PWH) will inform strategies to optimize healthspan. Chronotropic incompetence is common in heart failure and associated with low cardiorespiratory fitness yet is understudied in PWH. The objective was to determine the prevalence of chronotropic incompetence and its relationship with cardiorespiratory fitness.

DESIGN

Participants were PWH at least 50 years of age with no prior history of heart failure or coronary heart disease who were enrolled in a randomized exercise trial. Baseline cardiopulmonary exercise testing (CPET) was used to measure cardiorespiratory fitness as peak oxygen consumption (VO2peak) and calculate the chronotropic index from heart rate values. Chronotropic incompetence was defined as an index less than 80%.

RESULTS

The 74 participants were on average 61 years old, 80% Black or African American, and 93% men. Chronotropic incompetence was present in 31.1%. VO2peak was significantly lower among participants with chronotropic incompetence compared with participants without chronotropic incompetence [mean (SD) ml/min/kg: 20.9 (5.1) vs. 25.0 (4.5), P = 0.001]. Linear regression showed that chronotropic incompetence and age were independent predictors of VO2peak, but smoking and comorbidity were not. The chronotropic index correlated with VO2peak (r = 0.48, P < 0.001).

CONCLUSION

Among older PWH without heart failure or coronary heart disease, chronotropic incompetence was present in approximately one-third of individuals and was associated with clinically relevant impaired cardiorespiratory fitness. Investigation of chronotropic incompetence in large cohorts which includes PWH and heart failure may contribute to strategies that promote healthy aging with HIV infection and offer a preclinical window for intervention.

Hematopoietic Stem Cells as an Integrative Hub Linking Lifestyle to Cardiovascular Health

Despite breakthroughs in modern medical care, the incidence of cardiovascular disease (CVD) is even more prevalent globally. Increasing epidemiologic evidence indicates that emerging cardiovascular risk factors arising from the modern lifestyle, including psychosocial stress, sleep problems, unhealthy diet patterns, physical inactivity/sedentary behavior, alcohol consumption, and tobacco smoking, contribute significantly to this worldwide epidemic, while its underpinning mechanisms are enigmatic. Hematological and immune systems were recently demonstrated to play integrative roles in linking lifestyle to cardiovascular health. In particular, alterations in hematopoietic stem cell (HSC) homeostasis, which is usually characterized by proliferation, expansion, mobilization, megakaryocyte/myeloid-biased differentiation, and/or the pro-inflammatory priming of HSCs, have been shown to be involved in the persistent overproduction of pro-inflammatory myeloid leukocytes and platelets, the cellular protagonists of cardiovascular inflammation and thrombosis, respectively. Furthermore, certain lifestyle factors, such as a healthy diet pattern and physical exercise, have been documented to exert cardiovascular protective effects through promoting quiescence, bone marrow retention, balanced differentiation, and/or the anti-inflammatory priming of HSCs. Here, we review the current understanding of and progression in research on the mechanistic interrelationships among lifestyle, HSC homeostasis, and cardiovascular health. Given that adhering to a healthy lifestyle has become a mainstream primary preventative approach to lowering the cardiovascular burden, unmasking the causal links between lifestyle and cardiovascular health from the perspective of hematopoiesis would open new opportunities to prevent and treat CVD in the present age.

Association of physical behaviours with sarcopenia in older adults: a systematic review and meta-analysis of observational studies

BACKGROUND

Physical behaviours (ie, physical activity and sedentary behaviour) might have a role in the development of sarcopenia, although the evidence is unclear. We aimed to explore the association of total and intensity-specific levels of physical activity and sedentary behaviour with sarcopenia and its components (ie, muscle mass, muscle strength, and physical performance) in older adults.

METHODS

We conducted a systematic review and meta-analysis and searched MEDLINE (via PubMed), Scopus, and Web of Science from inception to July 26, 2022, for peer-reviewed, observational studies or baseline data from randomised clinical trials conducted in older adults (ie, individual age ≥60 years or mean age ≥65 years) and published in English that reported on the association of physical activity or sedentary behaviour or both with sarcopenia (or its determinants: muscle mass or strength, and physical performance). Physical activity and sedentary behaviour were measured by any method. The main outcome was sarcopenia, which could be diagnosed by any means. Estimates were extracted and pooled using Bayesian meta-analytic models and publication bias was assessed using the Egger's test. This study is registered with PROSPERO, CRD42022315865.

FINDINGS

We identified 15 766 records, of which 124 studies (230 174 older adults; 121 301 [52·7%] were female and 108 873 [47·3%] were male) were included in the systematic review. 86 studies were subsequently included in the meta-analysis. Higher levels of total physical activity were inversely associated with sarcopenia both cross-sectionally (21 studies, n=59 572; odds ratio 0·49, 95% credible interval 0·37-0·62) and longitudinally (four studies, n=7545; 0·51, 0·27-0·94). A protective association was also identified for moderate-to-vigorous physical activity in cross-sectional research (five studies, n=6787; 0·85, 0·71-0·99), whereas no association was identified for the remaining physical behaviours (ie, steps, light physical activity, or sedentary behaviour).

INTERPRETATION

Total and moderate-to-vigorous physical activity are inversely associated with sarcopenia. These findings might support the importance of moderate-to-vigorous, rather than light, intensity physical activity-based interventions to prevent sarcopenia.

FUNDING

None.

TRANSLATION

For the Spanish translation of the abstract see Supplementary Materials section.

The hallmarks of aging as a conceptual framework for health and longevity research

The inexorability of the aging process has sparked the curiosity of human beings since ancient times. However, despite this interest and the extraordinary scientific advances in the field, the complexity of the process has hampered its comprehension. In this context, The Hallmarks of Aging were defined in 2013 with the aim of establishing an organized, systematic and integrative view of this topic, which would serve as a conceptual framework for aging research. Ten years later and promoted by the progress in the area, an updated version included three new hallmarks while maintaining the original scope. The aim of this review is to determine to what extent The Hallmarks of Aging achieved the purpose that gave rise to them. For this aim, we have reviewed the literature citing any of the two versions of The Hallmarks of Aging and conclude that they have served as a conceptual framework not only for aging research but also for related areas of knowledge. Finally, this review discusses the new candidates to become part of the Hallmarks list, analyzing the evidence that supports whether they should or should not be incorporated.

Lifestyle effects on aging and CVD: A spotlight on the nutrient-sensing network

Aging is widespread worldwide and a significant risk factor for cardiovascular disease (CVD). Mechanisms underlying aging have attracted considerable attention in recent years. Remarkably, aging and CVD overlap in numerous ways, with deregulated nutrient sensing as a common mechanism and lifestyle as a communal modifier. Interestingly, lifestyle triggers or suppresses multiple nutrient-related signaling pathways. In this review, we first present the composition of the nutrient-sensing network (NSN) and its metabolic impact on aging and CVD. Secondly, we review how risk factors closely associated with CVD, including adverse life states such as sedentary behavior, sleep disorders, high-fat diet, and psychosocial stress, contribute to aging and CVD, with a focus on the bridging role of the NSN. Finally, we focus on the positive effects of beneficial dietary interventions, specifically dietary restriction and the Mediterranean diet, on the regulation of nutrient metabolism and the delayed effects of aging and CVD that depend on the balance of the NSN. In summary, we expound on the interaction between lifestyle, NSN, aging, and CVD.

Hallmarks of ageing in human skeletal muscle and implications for understanding the pathophysiology of sarcopenia in women and men

Ageing is a complex biological process associated with increased morbidity and mortality. Nine classic, interdependent hallmarks of ageing have been proposed involving genetic and biochemical pathways that collectively influence ageing trajectories and susceptibility to pathology in humans. Ageing skeletal muscle undergoes profound morphological and physiological changes associated with loss of strength, mass, and function, a condition known as sarcopenia. The aetiology of sarcopenia is complex and whilst research in this area is growing rapidly, there is a relative paucity of human studies, particularly in older women. Here, we evaluate how the nine classic hallmarks of ageing: genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, and altered intercellular communication contribute to skeletal muscle ageing and the pathophysiology of sarcopenia. We also highlight five novel hallmarks of particular significance to skeletal muscle ageing: inflammation, neural dysfunction, extracellular matrix dysfunction, reduced vascular perfusion, and ionic dyshomeostasis, and discuss how the classic and novel hallmarks are interconnected. Their clinical relevance and translational potential are also considered.

To promote healthy aging, focus on the environment

To build health equity for an aging world marked by dramatic disparities in healthy lifespan between countries, regions and population groups, research at the intersections of biology, toxicology and the social and behavioral sciences points the way: to promote healthy aging, focus on the environment. In this Perspective, we suggest that ideas and tools from the emerging field of geroscience offer opportunities to advance the environmental science of aging. Specifically, the capacity to measure the pace and progress of biological processes of aging within individuals from relatively young ages makes it possible to study how changing environments can change aging trajectories from early in life, in time to prevent or delay aging-related disease and disability and build aging health equity.

Sedentary Behavior Impacts on the Epigenome and Transcriptome: Lessons from Muscle Inactivation in Drosophila Larvae

The biological mechanisms linking sedentary lifestyles and metabolic derangements are incompletely understood. In this study, temporal muscle inactivation in Drosophila larvae carrying a temperature-sensitive mutation in the shibire (shi1) gene was induced to mimic sedentary behavior during early life and study its transcriptional outcome. Our findings indicated a significant change in the epigenetic profile, as well as the genomic profile, of RNA Pol II binding in the inactive muscles relative to control, within a relatively short time period. Whole-genome analysis of RNA-Pol II binding to DNA by muscle-specific targeted DamID (TaDa) protocol revealed that muscle inactivity altered Pol II binding in 121 out of 2010 genes (6%), with a three-fold enrichment of genes coding for lncRNAs. The suppressed protein-coding genes included genes associated with longevity, DNA repair, muscle function, and ubiquitin-dependent proteostasis. Moreover, inducing muscle inactivation exerted a multi-level impact upon chromatin modifications, triggering an altered epigenetic balance of active versus inactive marks. The downregulated genes in the inactive muscles included genes essential for muscle structure and function, carbohydrate metabolism, longevity, and others. Given the multiple analogous genes in Drosophila for many human genes, extrapolating our findings to humans may hold promise for establishing a molecular link between sedentary behavior and metabolic diseases.

Mechanisms of Extraorbital Lacrimal Gland Aging in Mice: An Integrative Analysis of the Temporal Transcriptome

Purpose

This study used high-throughput RNA sequencing (RNA-Seq) and bioinformatics analysis to investigate the altered transcriptome profile of aging lacrimal glands in mice that occurs over the course of a 24-hour cycle.

Methods

Male C57BL/6J mice aged 12 weeks (young) and 20 months (aging) were housed in a pathogen-free setting with a 12-hour light/12-hour dark cycle. Throughout a 24-hour cycle, mouse extraorbital lacrimal glands (ELGs) were collected at eight time points at three-hour intervals. To prepare for the high-throughput RNA-Seq, whole mRNA was extracted. Differentially expressed genes (DEGs) in the young and aging groups were subjected to bioinformatic analysis based on diurnal patterns. Furthermore, the cell populations in which significant DEGs express and signaling pathways occur were validated at the single-cell RNA sequencing (scRNA-seq) level.

Results

The total transcriptome composition was significantly altered in aging ELGs compared with that in young mouse ELGs at eight time points during the 24-hour cycle, with 864 upregulated and 228 downregulated DEGs, which were primarily enriched in inflammatory pathways. Further comparative analysis of the point-to-point transcriptome revealed that aging ELGs underwent alterations in the temporal transcriptome profile in several pathways, including the inflammation-related, metabolism-related, mitochondrial bioenergetic function-associated, synaptome neural activity-associated, cell processes-associated, DNA processing-associated and fibrosis-associated pathways. Most of these pathways occurred separately in distinct cell populations.

Conclusions

Transcriptome profiles of aging lacrimal glands undergo considerable diurnal time-dependent changes; this finding offers a comprehensive source of information to better understand the pathophysiology of lacrimal gland aging and its underlying mechanisms.

Life's Essential 8: Optimizing Health in Older Adults

The population worldwide is getting older as a result of advances in public health, medicine, and technology. Older individuals are living longer with a higher prevalence of subclinical and clinical cardiovascular disease (CVD). In 2010, the American Heart Association introduced a list of key prevention targets, known as "Life's Simple 7" to increase CVD-free survival, longevity, and quality of life. In 2022, sleep health was added to expand the recommendations to "Life's Essential 8" (eat better, be more active, stop smoking, get adequate sleep, manage weight, manage cholesterol, manage blood pressure, and manage diabetes). These prevention targets are intended to apply regardless of chronologic age. During this same time, the understanding of aging biology and goals of care for older adults further enhanced the relevance of prevention across the range of functions. From a biological perspective, aging is a complex cellular process characterized by genomic instability, telomere attrition, loss of proteostasis, inflammation, deregulated nutrient-sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, and altered intercellular communication. These aging hallmarks are triggered by and enhanced by traditional CVD risk factors leading to geriatric syndromes (eg, frailty, sarcopenia, functional limitation, and cognitive impairment) which complicate efforts toward prevention. Therefore, we review Life's Essential 8 through the lens of aging biology, geroscience, and geriatric precepts to guide clinicians taking care of older adults.

Accelerometer-measured physical activity patterns are associated with phenotypic age: Isotemporal substitution effects

Prolonged sitting appears to accelerate aging, while optimal physical activity patterns have been found to delay the process. It is an emerging topic, and no conclusions have been reached regarding the relationship between physical activity patterns and biomarkers-measured aging. Hence, the aim of this study was to investigate the association between sensor-based objectively measured physical activity and phenotypic age using a nationwide population from the National Health and Nutrition Examination Survey (NHANES) in the United States. Weighted linear regression models were performed to evaluate the association between sedentary behavior, light-intensity physical activity (LPA), moderate-to-vigorous physical activity (MVPA) and phenotypic age. A total of 6439 eligible participants were included and the weighted respondents were 49,964,300. Results showed that prolonged sitting was positively associated with phenotypic age in the fully adjusted model [β (95% CI): 0.009(0.007,0.011), p < 0.001], while increasing volume of LPA and MVPA was associated with younger phenotypic age using the fully adjusted model [β (95% CI): -0.010(-0.013,-0.006), p < 0.001; -0.062(-0.075,-0.048), p < 0.001]. By utilizing the Isotemporal Substitution Model, it was found that replacing 30 min of sedentary behavior with 30 min of LPA or MVPA per day was associated with estimated 0.4 or 1.9 years of phenotypic age reduction. According to the study's findings, maintaining a certain level of physical activity could delay the process of aging and intensity matters.

Pathological mechanisms of cigarette smoking, dietary, and sedentary lifestyle risks in vascular dysfunction: mitochondria as a common target of risk factors

In the past century, the lifespan of the human population has dramatically increased to the 80 s, but it is hindered by a limited health span to the 60 s due to an epidemic increase in the cardiovascular disease which is a main cause of morbidity and mortality. We cannot underestimate the progress in understanding the major cardiovascular risk factors which include cigarette smoking, dietary, and sedentary lifestyle risks. Despite their clinical significance, these modifiable risk factors are still the major contributors to cardiovascular disease. It is, therefore, important to understand the specific molecular mechanisms behind their pathological effects to develop new therapies to improve the treatment of cardiovascular disease. In recent years, our group and others have made a progress in understanding how these risk factors can promote endothelial dysfunction, smooth muscle dysregulation, vascular inflammation, hypertension, lung, and heart diseases. These factors, despite differences in their nature, lead to stereotypical alterations in vascular metabolism and function. Interestingly, cigarette smoking has a tremendous impact on a very distant site from the initial epithelial exposure, namely circulation and vascular cells mediated by a variety of stable cigarette smoke components which promote vascular oxidative stress and alter vascular metabolism and function. Similarly, dietary and sedentary lifestyle risks facilitate vascular cell metabolic reprogramming promoting vascular oxidative stress and dysfunction. Mitochondria are critical in cellular metabolism, and in this work, we discuss a new concept that mitochondria are a common pathobiological target for these risk factors, and mitochondria-targeted treatments may have a therapeutic effect in the patients with cardiovascular disease.

Mediterranean diet lowers all-cause and cardiovascular mortality for patients with metabolic syndrome

A Mediterranean-style diet (MED) can promote people lengthen the span of life and avoid atherosclerotic cardiovascular disease (ASCVD) in primary prevention. Metabolic syndrome (MetS) can significantly reduce life expectancy and increase the risk of ASCVD. However, few studies have focused on the role of the Mediterranean diet in patients with MetS. Participants in the National Health and Nutrition Examination Survey (NHANES) with MetS (N = 8301) from 2007 to 2018 were examined. A 9-point evaluation scorewas used to measure the degree of adherence to the MED diet. In order to compare the various levels of adherence to the MED diet and the effects of the specific MED diet components on all-cause and cardiovascular mortality, Cox regression models were utilized. Among the 8301 participants with MetS, about 13.0% (1080 of 8301) died after a median follow-up of 6.3 years. In this study, participants with MetS with adherence to high-quality and moderate-quality Mediterranean diet were significantly associated with lower all-cause mortality as well as cardiovascular mortality during the follow-up period. Futhermore, in joint analysis of the Mediterranean diet and sedentary behavior or depression, we found that high-quality or moderate-quality Mediterranean diet could attenuate, even reverse the adverse effects of sedentary behavior and depression on all-cause and cardiovascular mortality in participants with MetS. Among the components of the MED diet, greater intakes of vegetables, legumes, nuts and high MUFA/SFA ratio were significantly associated with lower all-cause mortality and greater vegetables intake was significantly associated with lower cardiovascular mortality, while more red/processed meat intake was significantly associated with higher cardiovascular mortality in participants with MetS.