The influence of 15-week exercise training on dietary patterns among young adults

Different sedentary behavior domains present distinct associations with eating-related indicators

BACKGROUND

Unhealthful dietary patterns have been consistently associated with low levels of physical activity (PA), but studies dedicated to sedentary behavior (SB) are scarce, especially in adults. The few studies that investigated the association between SB and dietary patterns focused mostly on specific types of SB, such as TV-watching or screen time. SB can be accumulated in distinct domains (i.e., work, transport, and leisure-time), thus, it is key to investigate in depth the impact that different domains of SB can have on eating-related indicators. We aimed to investigate the associations between different SB domains and eating-related indicators, in a sample of adults.

METHODS

Cross-sectional data from students, teachers, and staff from a Portuguese University was collected in November/2021 through an anonymous online survey. Data analyses were performed using the IBM SPSS software (version 28.0) and included descriptive statistics, partial correlations, and group comparisons using one-way ANOVA. Daily average SB at work/study, transport, and in leisure-time were self-reported and eating-related indicators were measured with several items from the Mediterranean Diet Score. Specific eating-related behaviors reflecting a protective eating pattern (e.g., eating breakfast regularly), and eating behavior traits (e.g., external eating) were also assessed. Body mass index (BMI) was calculated as weight (kg)/height(m)2. The International Physical Activity Questionnaire/Short-Form was used to assess PA.

RESULTS

The sample included 301 adults (60.1% women), with a mean age of 34.5 years. Overall, leisure-time SB was inversely associated with adherence to the Mediterranean diet (r = -0.20; p < 0.001) and with a protective eating profile (r = -0.31; p < 0.001). Higher transport SB was also related to lower adherence to the Mediterranean diet (r = -0.20; p < 0.001) and to an unhealthier eating profile (r = -0.22; p < 0.001), but no associations were found for work-related SB (p > 0.05). These results persisted after the adjustment for BMI, sex, and self-reported PA. These results were impacted by the age tertile.

CONCLUSIONS

Our findings suggest that adults with higher levels of SB in leisure-time and transport domains tend to report less healthy eating-related behaviors, irrespective of BMI, sex, and PA level. However, some differences in these associations were found according to the age tertile. This information may assist public health authorities in focusing their efforts in augmenting literacy on SB, namely on how SB can be accumulated via different settings. Furthermore, public health literacy efforts need to extend besides the more known deleterious effects of SB on health (e.g., diabetes, cardiovascular disease), to also include the interplay with eating indicators. Strategies to reduce SB and unhealthy eating should be particularly focused on promoting physically active forms of commuting and reducing SB in the leisure setting.

Why don't college freshmen meet the US dietary guidelines for added sugar, refined grains, sodium, and saturated fat?

OBJECTIVE

The objective of the study was to evaluate how well college students meet U.S. dietary guidelines by examining the mean intakes of nutrients to limit (sodium, sugar, refined grains, and saturated fat), and what factors lead to exceeding the dietary recommendations.

PARTICIPANTS

Participants were first-year undergraduate students (N = 269).

METHODS

Diet was assessed using a DHQ-III and estimated with food source composition tables. Multivariable logistic regression analysis was used to model variables associated with exceeding the recommendations. One-sample t-tests were performed to compare the cohort with national intakes.

RESULTS

One-third met added sugar guidelines; only 4% met daily refined grains requirements, Fewer than half met saturated fat guidelines, and slightly over half met recommended sodium guidelines. Level of physical activity, race/ethnicity, and living on campus were the important predictors for exceeding recommended intakes.

CONCLUSIONS

Most students do not adhere to the U.S. dietary guidelines for nutrients to limit.

Cross-Sectional Association between Perceived Physical Literacy and Mediterranean Dietary Patterns in Adolescents: The EHDLA Study

PURPOSE

The objective of the current study was to analyze the relationship between perceived physical literacy (PPL) and adherence to the Mediterranean Diet (MedDiet) and its specific components in a sample of Spanish adolescents.

METHODS

In this cross-sectional study, we examined a sample of 845 adolescents (58.1% boys) aged 12-17 years from the Valle de Ricote (Region of Murcia, Spain). PPL was assessed by the Spanish Perceived Physical Literacy Instrument for adolescents (S-PPLI). To assess adherence to the MedDiet, the Mediterranean Diet Quality Index in children and adolescents (KIDMED) was applied.

RESULTS

In unadjusted analyses, adolescents with medium or high PPL were more likely to have optimal adherence to the MedDiet (medium PPL: OR = 1.69, 95% CI 1.20-2.40, p-adjusted = 0.003; high PPL: OR = 2.90, 95% CI 2.03-4.17, p-adjusted < 0.001). These findings remained significant after adjusting for sex, age, socioeconomic status, body mass index, energy intake, overall sleep duration, physical activity, and sedentary behavior (medium PPL: OR = 1.51, 95% CI 1.05-2.19, p-adjusted = 0.003; high PPL: OR = 2.27, 95% CI 1.53-3.39, p-adjusted < 0.001).

CONCLUSIONS

PPL could play a relevant role in the adoption of healthy eating habits among adolescents. Adolescents with low or medium PPL were less likely to report optimal adherence to the MedDiet. Adolescents with high PPL seem to consume more fruits, vegetables, fish, pulses, nuts, and dairies (for breakfast). Conversely, these adolescents tend to skip breakfast less, as well as to consume less commercially baked goods or pastries at this meal.

The amyotrophic lateral sclerosis exposome: recent advances and future directions

Amyotrophic lateral sclerosis (ALS) is a fatal disease of motor neuron degeneration with typical survival of only 2-5 years from diagnosis. The causes of ALS are multifactorial: known genetic mutations account for only around 70% of cases of familial ALS and 15% of sporadic cases, and heritability estimates range from 8% to 61%, indicating additional causes beyond genetics. Consequently, interest has grown in environmental contributions to ALS risk and progression. The gene-time-environment hypothesis posits that ALS onset occurs through an interaction of genes with environmental exposures during ageing. An alternative hypothesis, the multistep model of ALS, suggests that several hits, at least some of which could be environmental, are required to trigger disease onset, even in the presence of highly penetrant ALS-associated mutations. Studies have sought to characterize the ALS exposome - the lifetime accumulation of environmental exposures that increase disease risk and affect progression. Identifying the full scope of environmental toxicants that enhance ALS risk raises the prospect of preventing disease by eliminating or mitigating exposures. In this Review, we summarize the evidence for an ALS exposome, discussing the strengths and limitations of epidemiological studies that have identified contributions from various sources. We also consider potential mechanisms of exposure-mediated toxicity and suggest future directions for ALS exposome research.

Health behavior of Austrian tertiary students focusing on diet type linked to sports and exercise-first glimpse of results from the "sustainably healthy-from science 2 high school and university" study

Background

There is a strong association between lifestyle behavior and health status. While young adulthood is a critical period for adopting and stabilizing lifelong healthy behavior, university life is independently associated with psychological stressors that may further affect health and well-being.

Objective

The present multidisciplinary study aimed to examine the health behavior of Austrian college and university students, differentiated based on diet types (vegan, vegetarian, and omnivorous) and physical activity (PA) habits.

Methods

Following a cross-sectional study design, a total number of 6,148 students (65.3% females; 66.1% bachelor students, 67.0% from urban areas; mean age: 24.8 years) from 52 Austrian college/universities participated in an online survey and provided data on sociodemographic characteristics, dietary patterns, PA habits, and other lifestyle behavior characteristics, including alcohol intake and smoking.

Results

Across the total sample, 74.0% had a normal weight (BMI = 18.5-25.0 kg/m2), while the prevalence of overweight/obesity (BMI ≥ 30.0 kg/m2) was lower in females than males and more in rural than urban students (p < 0.01). The general prevalence of vegetarian and vegan diets was 22.8 and 6.0%, respectively, with a predominance of females, graduates, and urban students compared to their peers (p < 0.01). The majority of students (79.3%) had a regular engagement in sport/exercise, with a predominance of vegetarian or vegan students compared to omnivores (p < 0.01). Vegans and vegetarians had a lower alcohol intake (p < 0.01) but no differences in smoking habits (p > 0.05) compared to omnivores. Students engaging in sport/exercise had a lower smoking rate and higher intake of fruits, vegetables, and fluids compared to inactive students (p < 0.01).

Conclusion

The present findings suggest that diet type and PA habits of college/university students have an impact on other health behaviors, highlighting the interconnected nature of lifestyle habits and health behavior.

A glimpse of academic staff health behavior on diet type and physical activity at Austrian universities: first findings from the "Sustainably Healthy - From Science 2 Highschool & University" study

Background

The association between lifestyle and health status highlights the importance of assessing health-related behavior in different populations. This multidisciplinary study aimed to examine the health behavior of academic staff of Austrian colleges and universities, with a specific focus on diet types (vegan, vegetarian, omnivorous) and physical activity (PA) reports.

Methods

Following a cross-sectional study design incorporating an online survey, a sample of 1,041 academics from 52 institutes (mean age: 46.4 years) provided data on sociodemographic characteristics, dietary patterns, PA behavior, and other lifestyle behaviors (smoking, alcohol intake, etc.).

Results

The prevalence of vegetarian and vegan diets was 13.2 and 2.0%, respectively, and 33.2% of participants had excess body weight (BMI ≥ 25). The majority of participants (88.5%) reported regularly engaging in leisure-time PA, but 18.6% were active members of sports clubs. No difference between females and males was observed in diet type and the type of sport participation (p > 0.05). Participants with a mixed diet had a higher BMI than vegetarians and vegans (p < 0.05). Leisure-time PA participation was associated with more frequent fruit and vegetable intake (p < 0.05). The prevalence of smoking and alcohol intake was 13.1 and 73.5%, respectively, without any difference between dietary or sports participation subgroups (p > 0.05).

Conclusion

The present study provides an overview of the social trends in vegan and vegetarian diets linked to health behaviors in tertiary educational settings. Findings can be used by health scientists, decision-makers, and multipliers in health and education to improve public health.

Physical exercise practice was positively associated with better dietary practices of aged people during COVID-19 social distance: A cross-sectional study

BACKGROUND & AIMS

COVID-19 is a respiratory syndrome caused by SARS-CoV-2. In the absence of effective treatment and vaccines, social distance (SD) is essential to reduce the spread of the virus. However, SD generates several behavioral changes, especially in psychological (i.e., emotions and depressive symptoms) and lifestyle-related parameters (i.e., diet, physical activity, and sleep), and the aged people could be more susceptible to COVID-19 SD-related effects (i.e., loneliness, stress, fear, concerns about life, etc.). As such, we aimed to explore the relationship between lifestyle- (physical exercise practice and sleep quality) and psychological-related factors with the dietary practices derived from the Brazilian National Food Guide of older adult during the COVID-19 SD.

METHODS

A web-based survey was conducted in São Paulo, Brazil. Data were collected between August and December 2020 (a period of social isolation due to the COVID-19 pandemic). The questions were extracted from validated questionnaires to verify dietary practices (score of adhesion to the food guide for the Brazilian population), sleep quality (by Pittsburgh questionnaire), emotional food-related dimensions (by Three-factor Eating Questionnaire), and depression symptoms (by Beck's questionnaire).

RESULTS

Results were from 229 aged people (mean age 66.5 ± 6.02 years old; mean BMI 27.5 ± 4.32 kg/m²; mean sleep duration 8.23 ± 1.41 h; Pittsburg sleep quality score 6.55 ± 4.83; dietary practice score 42.5 ± 6.47). In the adjusted-linear regression model, we verified that physical exercise practice at home (β = 2.179; 95% CI: 0.599 to 3.758; p = 0.007) during COVID-19 SD was positively associated with better dietary practices in aged people. In contrast, emotional eating was negatively associated with dietary practices (β = -0.051; 95% CI: -0.092 to - 0.009; p = 0.015).

CONCLUSION

We conclude that in aged people, physical exercise practice at home during COVID-19 SD was positively associated with better dietary practices, while emotional eating was negatively associated.

Association between Different Types of Exercise and Intake of Nutrients including Carbohydrate, Fat, Protein, and B Vitamins in Young Adults

PURPOSE

This cross-sectional study aimed to investigate the association between different types of exercise and nutrient intake to provide a basis for promoting the overall health of young adults.

METHODS

A total of 427 young adults (217 women) aged 21 to 35 were recruited. Participants self-reported time spent (min/week) in endurance exercise, resistance exercise, sports, walking, and other structured physical activity (PA). Nutrient intake was determined via telephone-administered 24 h recalls.

RESULTS

Resistance exercise was positively associated with intake of protein, vitamins B2, B3, B5, B6, and B12 and the percentage of total calories from protein (PCT-PRO), and negatively associated with the percentage of total calories from carbohydrate (PCT-CHO) (p < 0.05). Time spent in aerobic exercise was positively associated with fiber, pectin, and vitamin B6 intake, and negatively associated with PCT-PRO (p < 0.05). Time spent exercising was negatively associated with fiber and pectin intake (p < 0.05). Time spent performing other structured PA was positively associated with pectin intake (p < 0.05). Participants' total exercise time was positively associated with intake of vitamins B2, B5, B12, and PCT-Fat, PCT-PRO, and negatively associated with PCT-CHO (p < 0.05).

CONCLUSION

The results showed an association between various exercise types and specific nutrients. It may be worthwhile to point out the negative association of exercise with CHO intake, which may need to be examined more closely in active young adults. In addition, the supplementation of B vitamins and pectin may be beneficial for their exercise performance and post-exercise recovery.

Orally Ingested Probiotics, Prebiotics, and Synbiotics as Countermeasures for Respiratory Tract Infections in Nonelderly Adults: A Systematic Review and Meta-Analysis

The impact of gut microbiota-targeted interventions on the incidence, duration, and severity of respiratory tract infections (RTIs) in nonelderly adults, and factors moderating any such effects, are unclear. This systematic review and meta-analysis aimed to determine the effects of orally ingested probiotics, prebiotics, and synbiotics compared with placebo on RTI incidence, duration, and severity in nonelderly adults, and to identify potential sources of heterogeneity. Studies were identified by searching CENTRAL, PubMed, Scopus, and Web of Science up to December 2021. English-language, peer-reviewed publications of randomized, placebo-controlled studies that tested an orally ingested probiotic, prebiotic, or synbiotic intervention of any dose for ≥1 wk in adults aged 18-65 y were included. Results were synthesized using intention-to-treat and per-protocol random-effects meta-analysis. Heterogeneity was explored by subgroup meta-analysis and meta-regression. Risk of bias was assessed using the Cochrane risk-of-bias assessment tool for randomized trials version 2 (RoB2). Forty-two manuscripts reporting effects of probiotics (n = 38), prebiotics (n = 2), synbiotics (n = 1) or multiple -biotic types (n = 1) were identified (n = 9179 subjects). Probiotics reduced the risk of experiencing ≥1 RTI (relative risk = 0.91; 95% CI: 0.84, 0.98; P = 0.01), and total days (rate ratio = 0.77; 95% CI: 0.71, 0.83; P < 0.001), duration (Hedges' g = -0.23; 95% CI: -0.39, -0.08; P = 0.004), and severity (Hedges' g = -0.16; 95% CI: -0.29, -0.03; P = 0.02) of RTIs. Effects were relatively consistent across different strain combinations, doses, and durations, although reductions in RTI duration were larger with fermented dairy as the delivery matrix, and beneficial effects of probiotics were not observed in physically active populations. Overall risk of bias was rated as "some  concerns" for most studies. In conclusion, orally ingested probiotics, relative to placebo, modestly reduce the incidence, duration, and severity of RTIs in nonelderly adults. Physical activity and delivery matrix may moderate some of these effects. Whether prebiotic and synbiotic interventions confer similar protection remains unclear due to few relevant studies. This trial was registered at https://www.crd.york.ac.uk/prospero/ as CRD42020220213.

Identifying dietary patterns across age, educational level and physical activity level in a cross-sectional study: the Tromsø Study 2015 - 2016

Background

A healthy diet can decrease the risk of several lifestyle diseases. From studying the health effects of single foods, research now focuses on examining complete diets and dietary patterns reflecting the combined intake of different foods. The main goals of the current study were to identify dietary patterns and then investigate how these differ in terms of sex, age, educational level and physical activity level (PAL) in a general Nordic population.

Methods

We used data from the seventh survey of the population-based Tromsø Study in Norway, conducted in 2015-2016. The study included 21,083 participants aged \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$40-99$$\end{document}40-99 years, of which \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$72\%$$\end{document}72% completed a comprehensive food frequency questionnaire (FFQ). After exclusion, the study sample included 10,899 participants with valid FFQ data. First, to cluster food variables, the participants were partitioned in homogeneous cohorts according to sex, age, educational level and PAL. Non-overlapping diet groups were then identified using repeated hierarchical cluster analysis on the food variables. Second, average standardized diet intake scores were calculated for all individuals for each diet group. The individual diet (intake) scores were then modelled in terms of age, education and PAL using regression models. Differences in diet scores according to education and PAL were investigated by pairwise hypothesis tests, controlling the nominal significance level using Tukey’s method.

Results

The cluster analysis revealed three dietary patterns, here named the Meat and Sweets diet, the Traditional diet, and the Plant-based- and Tea diet. Women had a lower intake of the Traditional diet and a higher preference for the Plant-based- and Tea diet compared to men. Preference for the Meat and Sweets diet and Traditional diet showed significant negative and positive trends as function of age, respectively. Adjusting for age, the group having high education and high PAL compared favourably with the group having low education and low PAL, having a significant lower intake of the Meat and Sweets and the Traditional diets and a significant higher intake of the Plant-based- and Tea diet.

Conclusions

Three dietary patterns (Meat and Sweets, Traditional, and Plant-based- and Tea) were found by repeated clustering of randomly sampled homogeneous cohorts of individuals. Diet preferences depended significantly on sex, age, education and PAL, showing a more unhealthy dietary pattern with lower age, low education and low PAL.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40795-022-00599-4.

Gut Microbiota and Serum Metabolome in Elite Cross-Country Skiers: A Controlled Study

Exercise has been shown to affect gut the microbiome and metabolic health, with athletes typically displaying a higher microbial diversity. However, research on the gut microbiota and systemic metabolism in elite athletes remains scarce. In this study, we compared the gut microbiota profiles and serum metabolome of national team cross-country skiers at the end of an exhausting training and competitive season to those of normally physically-active controls. The gut microbiota were analyzed using 16S rRNA amplicon sequencing. Serum metabolites were analyzed using nuclear magnetic resonance. Phylogenetic diversity and the abundance of several mucin-degrading gut microbial taxa, including Akkermansia, were lower in the athletes. The athletes had a healthier serum lipid profile than the controls, which was only partly explained by body mass index. Butyricicoccus associated positively with HDL cholesterol, HDL2 cholesterol and HDL particle size. The Ruminococcus torques group was less abundant in the athlete group and positively associated with total cholesterol and VLDL and LDL particles. We found the healthier lipid profile of elite athletes to co-occur with known health-beneficial gut microbes. Further studies should elucidate these links and whether athletes are prone to mucin depletion related microbial changes during the competitive season.

Comparison of Health Care Expenditures Among U.S. Older Adults With Pain Who Reported Frequent Exercise Versus Nonfrequent Exercise

This cross-sectional study included a nationally representative sample of U.S. adults aged ≥50 years with self-reported pain in the past 4 weeks from the 2018 Medical Expenditure Panel Survey. Adjusted linear regression analyses accounted for the complex survey design and assessed differences in several types of annual health care expenditures between individuals who reported frequent exercise (≥30 min of moderate-vigorous intensity physical activity ≥5 times per week) and those who did not. Approximately 23,940,144 of 56,979,267 older U.S. adults with pain reported frequent exercise. In adjusted analyses, individuals who reported frequent exercise had 15% lower annual prescription medication expenditures compared with those who did not report frequent exercise (p = .007). There were no statistical differences between frequent exercise status for other health care expenditure types (p > .05). In conclusion, adjusted annual prescription medication expenditures were 15% lower among older U.S. adults with pain who reported frequent exercise versus those who did not.

Health Behaviors of Austrian Secondary Level Pupils at a Glance: First Results of the From Science 2 School Study Focusing on Sports Linked to Mixed, Vegetarian, and Vegan Diets

Attaining healthy behaviors is essential at any life stage, particularly childhood, due to the strong link between children’s lifestyle and the subsequent adult state of health. This multidisciplinary study aimed to assess lifestyle behaviors of Austrian pupils of secondary schools I and II, with a specific focus on PA habits and diet types based on a large sample. In total, 8845 children/adolescents participated in the short standardized online survey on relevant health-related aspects nationwide. Valid and complete data was provided by 8799 pupils, including 1.14% of the eligible 771,525; 63% girls, 76% having a normal body weight, 70% attending secondary schools II, and more pupils/students living in rural vs. urban areas (3:1 ratio). Across the total sample, 11.8% were considered overweight/obese with a higher prevalence of overweight/obesity in boys than girls (15.5% vs. 9.6%) and urban vs. rural participants (13.9% vs. 10.8%; p < 0.05). The majority of participants (84.5%) reported a mixed diet, while 7.2% and 8.5% reported a vegan and vegetarian diet, respectively. Vegans reported a lesser alcohol intake (p < 0.05) compared to non-vegan pupils (no difference in dietary subgroups for smoking). Although overall PA and dietary behaviors suggest an appropriate health status among Austrian youth, attention should be focused on policies to increase healthy lifestyle habits at best through a dual approach to health permanently combining regular PA, sports, and exercise with a healthy diet, which would contribute to matching the current recommendations for improving individual and public health.

Adherence to the Mediterranean Diet and Its Association with the Level of Physical Activity in Fitness Center Users: Croatian-Based Study

The Mediterranean diet (MD) is based on the traditional cuisine of south European countries, and it is considered one of the healthiest dietary patterns worldwide. The promotion of combined MD and physical activity has shown major benefits. However, the association between physical activity and the MD in regular fitness center users is still insufficiently investigated. This cross-sectional survey-based study was conducted on 1220 fitness center users in Croatia. The survey consisted of three parts: general information, the Mediterranean Diet Serving Score (MDSS) and the International Physical Activity Questionnaire Short Form (IPAQ-SF). The results showed that 18.6% of fitness center users were adherent to the MD, and there was a significant positive correlation between the level of physical activity and the MDSS score (r = 0.302, p < 0.001). Moreover, after dividing the sample into tertiles based on the IPAQ-SF score, the third tertile (MET > 3150 min/wk) had the most fitness center users (34.4%) adherent to the MD, while the first tertile (MET < 1750 min/wk) had the least (6.1%). These outcomes emphasize the importance of physical activity as they imply that, with higher levels of physical activity, people are also possibly more aware of the importance that a healthy and balanced diet has on their well-being.

The immunological influence of physical exercise on TBI-induced pathophysiology: Crosstalk between the spleen, gut, and brain

Traumatic brain injury (TBI) is a non-degenerative and non-congenital insult to the brain and is recognized as a global public health problem, with a high incidence of neurological disorders. Despite the causal relationship not being entirely known, it has been suggested that multiorgan inflammatory response involving the autonomic nervous system and the spleen-gut brain axis dysfunction exacerbate the TBI pathogenesis in the brain. Thus, applying new therapeutic tools, such as physical exercise, have been described in the literature to act on the immune modulation induced by brain injuries. However, there are caveats to consider when interpreting the effects of physical exercise on this neurological injury. Given the above, this review will highlight the main findings of the literature involving peripheral immune responses in TBI-induced neurological damage and how changes in the cellular metabolism of the spleen-gut brain axis elicited by different protocols of physical exercise alter the pathophysiology induced by this neurological injury.

How do we support walking prescriptions for type 2 diabetes management? Facilitators and barriers following a 3-month prescription

INTRODUCTION Prescribing physical activity is an inexpensive method to promote patients' long-term health, but determinants of adherence with physical activity prescriptions are seldom considered. AIM To identify facilitators and barriers experienced by adults with type 2 diabetes when prescribed regular walking. METHODS Participants were prescribed a regular walking routine that met current physical activity guidelines for type 2 diabetes management for a period of 3 months. Pre- and post-intervention questions considered participants' self-rated health and physical activity amount. Thematic analysis of recorded interviews held after the 3-month prescription identified barriers and facilitators to adherence for participants. RESULTS Twenty-eight adults (aged 60±9 years, body mass index 32.3±4.0kg/m2, HbA1c 59±16mmol/mol) participated in the 3-month intervention, providing 7 years of lived experience. Self-rated health (14%; 95% confidence interval (CI) 7-22%) and time spent walking (+11 min/day; 95% CI 4-18 min/day) increased following the prescription. Major themes motivating participants were: establishing a walking routine; the support of their family members; observing health benefits; and being monitored by a health professional. The greatest barriers were associated with walking in the evening and included feelings of insecurity in the dark or a preference for sedentary behaviour. DISCUSSION A prescription to walk increased time spent in physical activity and self-rated health in adults with type 2 diabetes. Health-care professionals can support walking prescriptions by promoting facilitators and reducing barriers to prescription adherence. Practical solutions to barriers include identifying alternative physical activity opportunities within the house or advice to develop support networks to provide company while walking.

Metabolic syndrome and the aging retina

PURPOSE OF REVIEW

This review explores metabolic syndrome (MetS) as a risk factor that accelerates aging in retinal neurons and may contribute to the neurodegeneration seen in glaucomatous optic neuropathy (GON) and age-related macular degeneration (AMD).

RECENT FINDINGS

Both animal model experiments and epidemiologic studies suggest that metabolic stress may lead to aberrant regulation of a number of cellular pathways that ultimately lead to premature aging of the cell, including those of a neuronal lineage.

SUMMARY

GON and AMD are each leading causes of irreversible blindness worldwide. Aging is a significant risk factor in the specific retinal neuron loss that is seen with each condition. Though aging at a cellular level is difficult to define, there are many mechanistic modifiers of aging. Metabolic-related stresses induce inflammation, oxidative stress, mitochondrial dysfunction, endoplasmic reticulum stress, alterations to the unfolded protein response, defects in autophagy, alterations to the microbiome, and deposition of advanced glycation end products that can all hasten the aging process. Due to the number of variables related to metabolic health, defining criteria to enable the study of risk factors at a population level is challenging. MetS is a definable constellation of related metabolic risk factors that includes enlarged waist circumference, dyslipidemia, systemic hypertension, and hyperglycemia. MetS has been associated with both GON and AMD and may contribute to disease onset and/or progression in each disease.

Metabolic Syndrome Is Associated With Ocular Hypertension and Glaucoma

Glaucoma remains the world's leading cause of irreversible blindness and though intraocular pressure (IOP) is the most prevalent risk factor and only reliable therapeutic target, a number of systemic disease associations have been reported. Metabolic syndrome (MetS) is a constellation of findings that includes systemic hypertension, abdominal obesity, glucose intolerance, and dyslipidemia. MetS is becoming increasingly common worldwide, with prevalence up to 40% in some countries. Not only is MetS a significant cause of morbidity, but it is also associated with an increase in all-cause mortality. Reports have been conflicting regarding the association of individual components of MetS, including systemic hypertension and diabetes, with elevated IOP or glaucoma. However, though limitations in the existing literature are present, current evidence suggests that MetS is associated with IOP as well as glaucoma. Additional studies are needed to clarify this association by incorporating additional metrics including assessment of central corneal thickness as well as optic nerve structure and function. Future studies are also needed to determine whether lifestyle modification or systemic treatment of MetS could reduce the incidence or progression of glaucoma.

Preference and detrimental effects of high fat, sugar, and salt diet in wild-caught Drosophila simulans are reversed by flight exercise

High saturated fat, sugar, and salt contents are a staple of a Western diet (WD), contributing to obesity, metabolic syndrome, and a plethora of other health risks. However, the combinatorial effects of these ingredients have not been fully evaluated. Here, using the wild-caught Drosophila simulans, we show that a diet enriched with saturated fat, sugar, and salt is more detrimental than each ingredient separately, resulting in a significantly decreased lifespan, locomotor activity, sleep, reproductive function, and mitochondrial function. These detrimental effects were more pronounced in female than in male flies. Adding regular flight exercise to flies on the WD markedly negated the adverse effects of a WD. At the molecular level, the WD significantly increased levels of triglycerides and caused mitochondrial dysfunction, while exercise counterbalanced these effects. Interestingly, fruit flies developed a preference for the WD after pre-exposure, which was averted by flight exercise. The results demonstrate that regular aerobic exercise can mitigate adverse dietary effects on fly mitochondrial function, physiology, and feeding behavior. Our data establish Drosophila simulans as a novel model of diet-exercise interaction that bears a strong similarity to the pathophysiology of obesity and eating disorders in humans.

Dietary Habits and Psychological States during COVID-19 Home Isolation in Italian College Students: The Role of Physical Exercise

Social isolation has adverse effects on mental health, physical exercise, and dietary habits. This longitudinal observational study aimed to investigate the effects of mood states and exercise on nutritional choices, on 176 college students (92 males, 84 females; 23 ± 4 years old) during the COVID-19 lockdown. During 21 days, nutrition and exercise were daily monitored, and the mood states assessed. A factor analysis was used to reduce the number of nutritional variables collected. The relationships between exercise, mood and nutrition were investigated using a multivariate general linear model and a mediation model. Seven factors were found, reflecting different nutritional choices. Exercise was positively associated with fruit, vegetables and fish consumption (p = 0.004). Depression and quality of life were, directly and inversely, associated with cereals, legumes (p = 0.005; p = 0.004) and low-fat meat intake (p = 0.040; p = 0.004). Exercise mediated the effect of mood states on fruit, vegetables and fish consumption, respectively, accounting for 4.2% and 1.8% of the total variance. Poorer mood states possibly led to unhealthy dietary habits, which can themselves be linked to negative mood levels. Exercise led to healthier nutritional choices, and mediating the effects of mood states, it might represent a key measure in uncommon situations, such as home-confinement.

Effect of Physical Exercise on Taste Perceptions: A Systematic Review

The effect of physical exercise on nutrition has gained substantial interest in the last decade. Meaningful results have been produced concerning the effect of physical exercise on different appetite hormones and food choice/preference. While it is well known that taste and nutrition are related, the relation between taste and physical activity has not yet been fully explored. This systematic review aims to provide a detailed view of the literature on physical exercise and its effect on taste perceptions. Five tastes were included in this review: sweet, salty, bitter, sour, and umami. Sweet taste intensity, sensitivity, and preference were increased by acute physical exercise, but sweet preference was reduced by chronic physical activity. Perceived intensity and sensitivity decreased overall for salty taste, but an increased preference was noted during/following exercise. Sour taste intensity ratings were decreased following exercise and preference was enhanced. Umami taste intensity and sensitivity increased following exercise and preference was decreased. No significant results were obtained for bitter taste. While evidence regarding the effect of exercise on taste has arisen from this review, the pre-testing nutrition, testing conditions, type of test, and exercise modality must be standardized in order to produce meaningful and reproducible results in the future.

Displacing Sedentary Behaviour with Light Intensity Physical Activity Spontaneously Alters Habitual Macronutrient Intake and Enhances Dietary Quality in Older Females

Displacing Sedentary Behaviour (SB) with light intensity physical activity (LIPA) is increasingly viewed as a viable means of health enhancement. It is, however, unclear whether any behavioural compensations accompany such an intervention. Therefore, the aim of this study was to identify any dietary changes that accompany SB displacement. We hypothesised that SB displacement would improve dietary quality. Thirty-five elderly females (73 ± 5 years) were randomly allocated to one of three groups: (1) sedentary behaviour fragmentation (SBF) (n = 14), (2) continuous LIPA (n = 14), or (3) control (n = 7). Habitual diet (four-day food diary) and physical behaviour (accelerometery) were assessed at weeks 0 and 8. Out of 45 nutrients examined, only glucose exhibited a group × time interaction (p = 0.03), mediated by an exclusive reduction following SBF (-31%). SBF was also the sole experimental group to increase nutrients promoting bone health (SBF: 17%, LIPA: -34%. control: 21%), whereas both experimental groups consumed more nutrients promoting anabolism (SBF: 13%, LIPA: 4%, control: -34%) (z-scores). New ambulators (n = 8) also consumed more nutrients promoting bone health (16%)/anabolism (2%) (z-scores), including significantly increased Zinc intake (p = 0.05, 29%). Displacing SB with LIPA improves dietary quality in older females. Furthermore, SB fragmentation appears advantageous for various dietary outcomes.

The Effect of a Family-Based Lifestyle Education Program on Dietary Habits, Hepatic Fat and Adiposity Markers in 8-12-Year-Old Children with Overweight/Obesity

Healthy lifestyle education programs are recommended for obesity prevention and treatment. However, there is no previous information on the effects of these programs on the reduction of hepatic fat percentage. The aims were (i) to examine the effectiveness of a 22-week family-based lifestyle education program on dietary habits, and (ii) to explore the associations of changes in dietary intake with percent hepatic fat reduction and adiposity in children with overweight/obesity. A total of 81 children with overweight/obesity (aged 10.6 ± 1.1 years, 53.1% girls) and their parents attended a 22-week family based healthy lifestyle and psychoeducational program accompanied with (intensive group) or without (control) an exercise program. Hepatic fat (magnetic resonance imaging), adiposity (dual energy X-ray absorptiometry) and dietary habits (two non-consecutive 24 h-recalls) were assessed before and after the intervention. Energy (p < 0.01) fat (p < 0.01) and added sugar (p < 0.03) intake were significantly reduced in both groups at the end of the program, while, in addition, carbohydrates intake (p < 0.04) was reduced exclusively in the control group, and simple sugar (p < 0.05) and cholesterol (p < 0.03) intake was reduced in the exercise group. Fruit (p < 0.03) and low-fat/skimmed dairy consumption (p < 0.02), the adherence to the Mediterranean Diet Quality Index for children and teenagers (KIDMED, p < 0.01) and breakfast quality index (p < 0.03) were significantly higher in both control and intervention groups after the intervention. Moreover, participants in the exercise group increased the adherence to the Dietary Approaches to Stop Hypertension (DASH) diet (p < 0.001), whereas the ratio of evening-morning energy intake was significantly lower exclusively in the control group after the program (p < 0.02). Changes in energy intake were significantly associated with changes in fat mass index (FMI) in the exercise group, whereas changes in sugar-sweetened beverages (SSB) consumption was associated with percent hepatic fat reduction (p < 0.05) in the control group. A 22-week family-based healthy lifestyle program seems to be effective on improving diet quality and health in children with overweight/obesity and these should focus on SSB avoidance and physical activity.

High-intensity Interval Training Promotes the Shift to a Health-Supporting Dietary Pattern in Young Adults

A healthy lifestyle is based on a correct diet and regular exercise. Little is known about the effect of different types of exercise on dietary preferences. To address the question of whether high-intensity interval training (HIIT) could modulate spontaneous food choices, an experimental study was carried out on 32 young, healthy normal-weight subjects. The spontaneous diet of each subject has been monitored over nine weeks of indoor-cycling training, divided into three mesocycles with an incremental pattern: total energy intake, macronutrients and micronutrients have been analysed. A two-way mixed model has been used to assess differences in dietary variables; a principal factor analysis has been performed to identify sample subgroups. An increased energy intake (+17.8% at T3; p < 0.01) has been observed, although macronutrients' proportions did not vary over time, without differences between sexes. An increase of free fat mass was found in the last mesocycle (+3.8%), without an augmentation of body weight, when, despite the increased training load, a stabilization of energy intake occurred. Three different subgroups characterized by different dietary modifications could be identified among participants that showed a common trend towards a healthier diet. Nine weeks of HIIT promoted a spontaneous modulation of food choices and regulation of dietary intake in young normal-weight subjects aged 21-24. Importantly, this life-period is critical to lay the foundation of correct lifestyles to prevent metabolic diseases and secure a healthy future with advancing age.

Diet Mimicking "Fast Food" Causes Structural Changes to the Retina Relevant to Age-Related Macular Degeneration

Introduction: Metabolic syndrome is a disorder characterized by a constellation of findings including truncal obesity, elevated blood pressure, abnormal cholesterol levels, and high blood glucose. Recent evidence suggests that metabolic syndrome may be associated with increased risk of age-related macular degeneration (AMD) and other eye diseases. Recently, C57BL/6J wild-type mice fed with a "fast food" diet consisting of high fat, cholesterol, and fructose-supplemented water showed unique systemic pathology consistent with metabolic syndrome and nonalcoholic steatohepatitis. Additionally, these mice showed higher levels of fibrosis, inflammation, endoplasmic reticulum stress, and mitochondrial dysfunction compared to mice fed with only a high-fat diet alone. Since similar pathways are activated in AMD, we sought to determine whether mice fed a "fast food" diet exhibited retinal changes.Methods: 3-month-old wild-type mice were randomized to a standard chow (n = 11) or a "fast food" (n = 18) diet and fed for 9 months. At 1 year of age, tissues were collected and retinas were analyzed using transmission electron microscopy. Quantitative measures of Bruch's membrane thickness and retinal pigment epithelium (RPE) cell counts were performed.Results: "Fast food" fed mice showed ocular pathology relevant to various stages of AMD including basal laminar deposits, focal thickening of Bruch's membrane, and a significant loss of RPE cells.Discussion/conclusion: A wild-type mouse model of metabolic syndrome fed a "fast food" diet developed changes to the retina similar to some of the pathologic features seen in AMD. Further investigations into this and similar animal models as well as further epidemiological studies are needed to more clearly define the association between metabolic syndrome and AMD.