The evolution of human step counts and its association with the risk of chronic disease

The (mis-)measurement of food decisions

Humans have a fascination with quantifying behaviors. While numbers can provide intriguing insights, they can also distort public perceptions and misguide policy design. This article deconstructs the popular belief that individuals make 200 mindless food-related decisions a day, offering alternative perspectives on the conceptualization and measurement of food decisions. Specifically, we argue that existing decision-making theories offer limited guidance in defining and measuring such decisions, and advocate for more precise operationalizations. We emphasize the need for contextual understanding over simplistic numerical representations, propose a comprehensive working definition of food decisions, and consider alternative methods that may be better suited to capturing the complexity and nuance of food decisions. To conclude, we advocate for methodological pluralism in studying food decisions.

Genetic liability to sedentary behaviour and cardiovascular disease incidence in the FinnGen and HUNT cohorts

OBJECTIVE

Energy-saving sedentary behaviour may be an evolutionarily selected trait that is no longer advantageous. We investigated the associations between genetic liability to sedentary behaviour and the incidence of the most common cardiovascular disease (CVD).

METHODS

We constructed and validated a genome-wide polygenic score for leisure screen time (PGS LST) as a measure of genetic liability to sedentary behaviour. We performed survival analyses between higher PGS LST and register-based CVDs using the FinnGen cohort (N=293 250-333 012). Replication and exploratory analyses were conducted in an independent Norwegian Trøndelag Health Study (HUNT) cohort (N=35 289).

RESULTS

In FinnGen, each SD increase in PGS LST was associated with a higher risk of incident CVD (HR: 1.05 (95% CI 1.05 to 1.06)) (168 770 cases over 17 101 133 person-years). The magnitudes of association for the three most common CVDs were 1.09 ((95% CI 1.08 to 1.09), 1.06 ((95% CI 1.05 to 1.07) and 1.05 ((95% CI 1.04 to 1.06) for hypertensive disease, ischaemic heart disease and cerebrovascular disease, respectively. Those in the top decile of PGS LST had 21%, 35%, 26% and 19% higher risk of any CVD, hypertensive disease, ischaemic heart disease and cerebrovascular disease, respectively, than those in the bottom decile. Associations were replicated in HUNT and remained independent of covariates (socioeconomic status, body mass index and smoking) except for cerebrovascular disease. Besides direct effects, reduced physical activity served as a potential mediating pathway for the observed associations.

CONCLUSIONS

We found that genetic liability to sedentary behaviour is associated with incident CVD, although effect sizes with current PGS remained small. These findings suggest that genetic liability to sedentary behaviour is an under-recognised driver of common CVDs.

Foot arch height, arch stiffness, and intrinsic muscle size are not strongly associated with daily physical activity levels in a cross-sectional study of adults in the United States

The feet of people in non-industrial societies often have higher, stiffer longitudinal arches (LAs) and larger intrinsic muscles than those of many people in post-industrial societies. The prevailing explanation for this phenomenon is that people in post-industrial societies commonly wear shoes that restrict foot mobility, while people in non-industrial societies are often habitually barefoot or minimally shod. However, people in post-industrial societies also tend to be less physically active than in non-industrial societies, and it is possible that this, too, is a major determinant of their foot form and function. Here, we test the hypothesis that among people in post-industrial societies, lower physical activity levels are associated with lower, less stiff LAs and smaller intrinsic muscles. In a cross-sectional analysis of 40 adults in the United States, none of whom were habitually barefoot or minimally shod, we measured daily physical activity using accelerometry, LA height and static stiffness using photography, LA dynamic stiffness using kinematic and kinetic data, and intrinsic muscle size using ultrasound. Using Bayesian models, we found very low probabilities of positive associations between physical activity (step count, time spent in moderate-to-vigorous activity) and LA height, LA static stiffness, and muscle size. For LA dynamic stiffness, we found small to moderate probabilities of positive associations with physical activity variables. These findings suggest that physical activity is unlikely a major determinant of variation in LA and intrinsic muscle form and function among post-industrial societies. It remains possible that physical activity affects LA and intrinsic muscle traits, but perhaps primarily among people who are habitually barefoot or minimally shod.

Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR)

Aging, a universal and inevitable process, is characterized by a progressive accumulation of physiological alterations and functional decline over time, leading to increased vulnerability to diseases and ultimately mortality as age advances. Lifestyle factors, notably physical activity (PA) and exercise, significantly modulate aging phenotypes. Physical activity and exercise can prevent or ameliorate lifestyle-related diseases, extend health span, enhance physical function, and reduce the burden of non-communicable chronic diseases including cardiometabolic disease, cancer, musculoskeletal and neurological conditions, and chronic respiratory diseases as well as premature mortality. Physical activity influences the cellular and molecular drivers of biological aging, slowing aging rates-a foundational aspect of geroscience. Thus, PA serves both as preventive medicine and therapeutic agent in pathological states. Sub-optimal PA levels correlate with increased disease prevalence in aging populations. Structured exercise prescriptions should therefore be customized and monitored like any other medical treatment, considering the dose-response relationships and specific adaptations necessary for intended outcomes. Current guidelines recommend a multifaceted exercise regimen that includes aerobic, resistance, balance, and flexibility training through structured and incidental (integrated lifestyle) activities. Tailored exercise programs have proven effective in helping older adults maintain their functional capacities, extending their health span, and enhancing their quality of life. Particularly important are anabolic exercises, such as Progressive resistance training (PRT), which are indispensable for maintaining or improving functional capacity in older adults, particularly those with frailty, sarcopenia or osteoporosis, or those hospitalized or in residential aged care. Multicomponent exercise interventions that include cognitive tasks significantly enhance the hallmarks of frailty (low body mass, strength, mobility, PA level, and energy) and cognitive function, thus preventing falls and optimizing functional capacity during aging. Importantly, PA/exercise displays dose-response characteristics and varies between individuals, necessitating personalized modalities tailored to specific medical conditions. Precision in exercise prescriptions remains a significant area of further research, given the global impact of aging and broad effects of PA. Economic analyses underscore the cost benefits of exercise programs, justifying broader integration into health care for older adults. However, despite these benefits, exercise is far from fully integrated into medical practice for older people. Many healthcare professionals, including geriatricians, need more training to incorporate exercise directly into patient care, whether in settings including hospitals, outpatient clinics, or residential care. Education about the use of exercise as isolated or adjunctive treatment for geriatric syndromes and chronic diseases would do much to ease the problems of polypharmacy and widespread prescription of potentially inappropriate medications. This intersection of prescriptive practices and PA/exercise offers a promising approach to enhance the well-being of older adults. An integrated strategy that combines exercise prescriptions with pharmacotherapy would optimize the vitality and functional independence of older people whilst minimizing adverse drug reactions. This consensus provides the rationale for the integration of PA into health promotion, disease prevention, and management strategies for older adults. Guidelines are included for specific modalities and dosages of exercise with proven efficacy in randomized controlled trials. Descriptions of the beneficial physiological changes, attenuation of aging phenotypes, and role of exercise in chronic disease and disability management in older adults are provided. The use of exercise in cardiometabolic disease, cancer, musculoskeletal conditions, frailty, sarcopenia, and neuropsychological health is emphasized. Recommendations to bridge existing knowledge and implementation gaps and fully integrate PA into the mainstream of geriatric care are provided. Particular attention is paid to the need for personalized medicine as it applies to exercise and geroscience, given the inter-individual variability in adaptation to exercise demonstrated in older adult cohorts. Overall, this consensus provides a foundation for applying and extending the current knowledge base of exercise as medicine for an aging population to optimize health span and quality of life.

Contemporary small-scale subsistence populations offer unique insights into human musculoskeletal health and aging

Human foragers avoid noncommunicable diseases that are leading causes of mortality, partly because physically active lifestyles promote healthy aging. High activity levels also promote tissue damage accumulation from wear-and-tear, increase risk of injury and disability which compromise productivity, and reduce energetic investments in somatic maintenance given constrained energy expenditure. Constraints intensify when nutrient supply is limited and surplus energy is directed toward pathogen defense and reproduction, as occurred throughout hominin evolution. This paper reviews evidence linking exposomes to musculoskeletal health in subsistence populations, focusing on effects of physical activity, pathogens, diet, and reproduction. Chronic musculoskeletal conditions are common for humans and possibly prehistoric hominins but rarer in quadrupedal apes. We propose that transition to bipedalism ~6 to 8 million years ago constituted an early "mismatch scenario," increasing hominin susceptibility to musculoskeletal conditions vis-à-vis quadrupedal apes due to changes in mechanical loading environments. Mismatched musculoskeletal traits were not targets of selection because of trade-offs favoring bipedal extractive foraging and higher fertility.

Associations of back muscle endurance with occupational back muscle activity and spinal loading among subsistence farmers and office workers in Rwanda

Over the course of the physical activity transition, machines have largely replaced skeletal muscle as the source of work for locomotion and other forms of occupational physical activity in industrial environments. To better characterize this transition and its effect on back muscles and the spine, we tested to what extent typical occupational activities of rural subsistence farmers demand higher magnitudes and increased variability of back muscle activity and spinal loading compared to occupational activities of urban office workers in Rwanda, and whether these differences were associated with back muscle endurance, the dominant risk factor for back pain. Using electromyography, inertial measurement units, and OpenSim musculoskeletal modeling, we measured back muscle activity and spinal loading continuously while participants performed occupational activities for one hour. We measured back muscle endurance using electromyography median frequency analysis. During occupational work, subsistence farmers activate their back muscles and load their spines at 390% higher magnitudes and with 193% greater variability than office workers. Partial correlations accounting for body mass show magnitude and variability response variables are positively associated with back muscle endurance (R = 0.39-0.90 [P < 0.001-0.210] and R = 0.54-0.72 [P = 0.007-0.071], respectively). Body mass is negatively correlated with back muscle endurance (R = -0.60, P = 0.031), suggesting higher back muscle endurance may be also partly attributable to having lower body mass. Because higher back muscle endurance is a major factor that prevents back pain, these results reinforce evidence that under-activating back muscles and under-loading spines at work increases vulnerability to back pain and may be an evolutionary mismatch. As sedentary occupations become more common, there is a need to study the extent to which occupational and leisure time physical activities that increase back muscle endurance helps prevent back pain.

Myokine secretion during moderate-intensity physical activity: Dose-response of interleukin 6 to walking duration

During vigorous physical activity, contracting muscles secrete a variety of immunomodulatory and metabolic factors called myokines that perform a variety of functions. Foremost among these is interleukin 6 (IL-6), which increases fatty acid mobilization and stimulates anti-inflammatory cytokine release. Despite being well characterized in vigorous exercise contexts, whether IL-6 is secreted during moderate-intensity activities such as walking is unclear. This is especially pertinent as regular walking is one of the oldest and most common forms of physical activity and comes with a variety of health benefits, which may be coordinated in part by IL-6 signaling. To test the hypothesis that IL-6 release occurs during evolutionarily normal physical activity contexts like long distance walking, we performed a dose-response experiment to test the effect of walking duration on IL-6 secretion. Thirteen participants completed four moderate-intensity walking trials (55% HRmax) of varying durations (30 min, 1 h, 2 h, and 3 h) in a randomized order with intervening washout periods of at least 1 week. Using a linear mixed effects model, we found that IL-6 levels modestly increased during only the 2 h and 3 h walking trials. These results suggest that small frequent increases in IL-6 signaling may be an important mechanism underlying the health benefits of regular walking. Furthermore, this finding raises the possibility that IL-6 secretion is an adaptation to fuel physical activity, especially during periods of negative energy balance.

Brain Evolution in the Times of the Pandemic and Multimedia

BACKGROUND

In this paper, we argue that recent unprecedented social changes arising from social media and the internet represent powerful behavioral and environmental forces that are driving human evolutionary adaptive responses in a way that might reshape our brain and the way it perceives reality and interacts with it. These forces include decreases in physical activity, decreases in exposure to light, and face-to-face social interactions, as well as diminished predictability in biological rhythms (i.e., the sleep cycle is no longer dictated by natural light exposure and season).

SUMMARY

We discuss the roles of stress and of creativity and adaptability in Homo sapiens evolution and propose mechanisms for human adaptation to the new forces including epigenetic mechanisms, gene-culture coevolution, and novel mechanisms of evolution of the nervous system.

KEY MESSAGES

We present the provocative idea that evolution under the strong selective pressures of today's society could ultimately enable H. sapiens to thrive despite social, physical, circadian, and cultural deprivation and possible neurological disease, and thus withstand the loss of factors that contribute to H. sapiens survival of today. The new H. sapiens would flourish under a lifestyle in which the current form would feel undervalued and replaceable.

Left ventricular trabeculation in Hominidae: divergence of the human cardiac phenotype

Although the gross morphology of the heart is conserved across mammals, subtle interspecific variations exist in the cardiac phenotype, which may reflect evolutionary divergence among closely-related species. Here, we compare the left ventricle (LV) across all extant members of the Hominidae taxon, using 2D echocardiography, to gain insight into the evolution of the human heart. We present compelling evidence that the human LV has diverged away from a more trabeculated phenotype present in all other great apes, towards a ventricular wall with proportionally greater compact myocardium, which was corroborated by post-mortem chimpanzee (Pan troglodytes) hearts. Speckle-tracking echocardiographic analyses identified a negative curvilinear relationship between the degree of trabeculation and LV systolic twist, revealing lower rotational mechanics in the trabeculated non-human great ape LV. This divergent evolution of the human heart may have facilitated the augmentation of cardiac output to support the metabolic and thermoregulatory demands of the human ecological niche.

Using inertial measurement units to estimate spine joint kinematics and kinetics during walking and running

Optical motion capture (OMC) is considered the best available method for measuring spine kinematics, yet inertial measurement units (IMU) have the potential to collect data outside the laboratory. When combined with musculoskeletal modeling, IMU technology may be used to estimate spinal loads in real-world settings. To date, IMUs have not been validated for estimates of spinal movement and loading during both walking and running. Using OpenSim Thoracolumbar Spine and Ribcage models, we compare IMU and OMC estimates of lumbosacral (L5/S1) and thoracolumbar (T12/L1) joint angles, moments, and reaction forces during gait across six speeds for five participants. For comparisons, time series are ensemble averaged over strides. Comparisons between IMU and OMC ensemble averages have low normalized root mean squared errors (< 0.3 for 81% of comparisons) and high, positive cross-correlations (> 0.5 for 91% of comparisons), suggesting signals are similar in magnitude and trend. As expected, joint moments and reaction forces are higher during running than walking for IMU and OMC. Relative to OMC, IMU overestimates joint moments and underestimates joint reaction forces by 20.9% and 15.7%, respectively. The results suggest using a combination of IMU technology and musculoskeletal modeling is a valid means for estimating spinal movement and loading.

Lifestyle and patterns of physical activity in Hadza foragers

OBJECTIVES

Physically active lifestyles are associated with several health benefits. Physical activity (PA) levels are low in post-industrial populations, but generally high throughout life in subsistence populations. The Hadza are a subsistence-oriented foraging population in Tanzania known for being physically active, but it is unknown how recent increases in market integration may have altered their PA patterns. In this study, we examine PA patterns for Hadza women and men who engage in different amounts of traditional foraging.

MATERIALS AND METHODS

One hundred and seventy seven Hadza participants (51% female, 19-87 years) wore an Axivity accelerometer (dominant wrist) for ~6 days during dry season months. We evaluated the effects of age, sex, and lifestyle measures on four PA measures that capture different aspects of the PA profile.

RESULTS

Participants engaged in high levels of both moderate-intensity PA and inactivity. Although PA levels were negatively associated with age, older participants were still highly active. We found no differences in PA between participants living in more traditional "bush" camps and those living in more settled "village" camps. Mobility was positively associated with step counts for female participants, and schooling was positively associated with inactive time for male participants.

CONCLUSIONS

The similarity in PA patterns between Hadza participants in different camp types suggests that high PA levels characterize subsistence lifestyles generally. The sex-based difference in the effects of mobility and schooling on PA could be a reflection of the Hadza's gender-based division of labor, or indicate that changes to subsistence-oriented lifestyles impact women and men in different ways.

Obesity and the risk of cardiometabolic diseases

The prevalence of obesity has reached pandemic proportions, and now approximately 25% of adults in Westernized countries have obesity. Recognized as a major health concern, obesity is associated with multiple comorbidities, particularly cardiometabolic disorders. In this Review, we present obesity as an evolutionarily novel condition, summarize the epidemiological evidence on its detrimental cardiometabolic consequences and discuss the major mechanisms involved in the association between obesity and the risk of cardiometabolic diseases. We also examine the role of potential moderators of this association, with evidence for and against the so-called 'metabolically healthy obesity phenotype', the 'fatness but fitness' paradox or the 'obesity paradox'. Although maintenance of optimal cardiometabolic status should be a primary goal in individuals with obesity, losing body weight and, particularly, excess visceral adiposity seems to be necessary to minimize the risk of cardiometabolic diseases.