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Examine whether religiosity/spirituality are a protective resource against the detrimental effects of monthly adversity on mental health and well-being in a sample of middle-aged adults (ages 50–65).

Sleep is a crucial factor in healthy aging. However, most middle-aged adults experience high levels of sleep disorders. While previous findings have suggested exercise training could benefit the quality of sleep, the effects of multi-component exercise on sleep quality are less examined. Accordingly, the current study aimed to assess the effectiveness of a multi-component exercise program on the quality of sleep among middle-aged adults. Twenty-four middle-aged adults were randomly assigned either to a multi-component exercise (MCE) group or a control group. The participants in the MCE group attended a 90-min session per week for 12 weeks. The control group was instructed to maintain their daily routine for 12 weeks. The primary outcome was the sleep quality evaluated by the Pittsburgh Sleep Quality Index (PSQI). The secondary outcome was physical fitness, including muscular strength and endurance, balance, and flexibility. Regarding sleep quality, the global mean score (p = 028), sleep disturbances (p = 011), and sleep efficiency (p = 035) of the PSQI scores were significantly reduced in the MCE group after the 12-week intervention. Regarding physical fitness, the flexibility of the MCE group improved significantly after the intervention (p = 028), yet, no significant change was observed in the control group. Additionally, the muscular strength of the control group declined significantly after the 12-week period (p = 034). Our results revealed the effectiveness of the MCE intervention in improving sleep quality and physical fitness in middle-aged adults. Further studies using larger sample sizes, objective measures of sleep quality, different types of exercise training, as well as different populations, are warranted to extend our current findings.

Previous research has shown that physical exercise improves memory. In the present study, we investigated the possible effects of the intensity of physical exercise as a function of the affective valence of words on implicit memory. In the study, 79 young adult volunteers were randomly assigned to perform moderate- (50% VO2max) or high-intensity exercise (80% VO2max) on a stationary bike. Once the required exercise intensity was achieved, participants performed an affective and repetition priming task concurrently with the physical exercise. Both groups showed similar repetition priming. The moderate-intensity exercise group showed affective priming with positive words, while affective priming was not found in the high-intensity exercise group. Facilitation occurred in both groups when a negative target word was preceded by a positive prime word. Our results suggest that the positive effect of physical exercise on memory is modulated by the affective valence of the stimuli. It seems that moderate-intensity exercise is more beneficial for implicit memory than high-intensity exercise.

Regular exercise may be associated with better self-rated health and sleep status. However, this correlation among various age groups, such as young, middle-aged, and older people, as well as during the COVID-19 pandemic, has not been examined. This study examined the correlation between regular exercise and self-rated health and sleep quality among adults in Japan during the COVID-19 pandemic. Data were collected using an online survey conducted between February 26 and 27, 2021. A total of 1410 adults in Japan (age range, 20–86 years) completed the online survey. Regular exercise was divided into: (1) more than 30 min of moderate exercise a day, (2) more than 2 days per week, and (3) continuous for 1 year or longer. Self-rated health and sleep quality were assessed using the Likert scale. After adjusting for multiple confounders, regular exercise was correlated with decreased poor self-rated health and poor sleep quality in middle-aged adults, however, no significant correlation was observed among young and older adults. The promotion of regular exercise among middle-aged people during the COVID-19 pandemic may contribute to better self-rated health and sleep quality status.

This study aimed to examine the relationship of physical activity and/or dietary quality and diabetes prevalence in the general population and within specific age groups. It was a cross-sectional study using 2011–2018 National Health and Nutrition Examination Survey and the US Department of Agriculture’s Food Patterns Equivalents data (n = 15,674). Physical activity was measured by Global Physical Activity questionnaire; dietary quality was analyzed using the Healthy Eating Index 2015; diabetes prevalence was determined by reported diagnosis and glycohemoglobin or fasting glucose. Data were analyzed using multiple logistic regression adjusted for demographic variables and weight status. Results revealed that although no statistically significant or non-substantial relationships were observed between dietary quality or physical activity and diabetes prevalence, respondents who did not meet physical activity recommendations regardless of dietary quality had a higher odds of diabetes prevalence than those who met physical activity recommendations and had a higher dietary quality (p < 0.05). In conclusion, meeting physical activity recommendations is an important protective factor for diabetes especially in combination with a higher quality diet. A healthy lifestyle appears to have the greater impact on diabetes prevention in middle-aged men and women.

Grip strength in midlife can predict physical disability in senior years. Recent evidence shows the critical role of nutritional status on muscle function. We aimed to elucidate whether adherence to a particular dietary pattern would be associated with abnormal muscle strength among middle‐aged people. In this cross‐sectional study, a semiquantitative Food Frequency Questionnaire was used to assess the dietary intake of 2781 participants in the Ravansar Non‐Communicable Chronic Disease (RaNCD) cohort. Major dietary patterns from 28 main food groups were extracted using principal component analysis. Binary logistic regression was used to determine the association between the tertiles of the major dietary patterns and muscle strength status. Two major dietary patterns were identified: the “mixed dietary pattern” that heavily loaded with fruits, vegetables, nuts, dairies, sweets, legumes, dried fruits, fish, red meat, butter, whole grains, natural juices, poultry, pickles, olive, industrial juice, egg, processed meat, and snacks and “unhealthy dietary pattern” that heavily loaded by fats, sugar, refined grains, soft drink, salt, organ meat, tea, and coffee. Adherence to the mixed dietary pattern (OR = 1.03, 95% CI = 0.8–1.33, P for trend = 0.77) and the unhealthy dietary pattern (OR = 1.01, 95% CI = 0.79–0.13, P for trend = 0.89) did not associate with abnormal muscle strength. This study suggests that the dietary pattern involving the consumption of healthy and unhealthy food does not have an effect on muscle strength in middle‐aged adults., We identified two major dietary patterns from data of participants in the Ravansar Non‐Communicable Chronic Disease (RaNCD) study. The first dietary pattern was “mixed” that heavily loaded with fruits, vegetables, nuts, dairies, sweets, legumes, dried fruits, fish, red meat, butter, whole grains, natural juices, poultry, pickles, olive, industrial juice, egg, processed meat, and snacks and the second dietary pattern was “unhealthy” that heavily loaded by fats, sugar, refined grains, soft drink, salt, organ meat, tea, and coffee. Surprisingly we found that adherence to the mixed dietary pattern and the unhealthy dietary pattern did not associate with abnormal muscle strength.

Introduction and objective: This work aims to externally validate the European and American models for calculating cardiovascular risk in the primary prevention. Methods: This is a cross-sectional study of a nation-wide cohort of individuals who are active in the work force. Workers without a medical history cardiovascular disease who attended occupational health check-ups between 2004 and 2007 were included. They were followed-up on until December 2017. Results: A total of 244,236 subjects participated. Of them, 24.5% were women and the mean age was 48.10 years (SD 6.26). According to the European SCORE risk chart, the mean risk was 1.70 (SD 1.81) for men and 0.37 (SD 0.53) for women. According to the North American PCE model, the mean risk was 6.98 (SD 5.66) for men and 1.97 (SD 1.96) for women. A total of 1177 events (0.51%) were registered according to the SCORE tool and 2,330 events (1.00%) were registered according to the PCE tool. The Harrell's C-statistic was 0.746 for SCORE and 0.725 for PCE. Sensitivity and specificity for the SCORE'S 5% cut-off point were 17.59% (95%CI 15.52%-19.87%) and 95.68% (95%CI 95.59%-95.76%). Sensitivity and specificity for the PCE's 20% cut-off point were 9.06% (95%CI 7.96%-10.29%) and 97.55% (95%CI 97.48%-97.61%), respectively. Conclusions: The European SCORE and North American PCE models overestimate the risk in our population but with an acceptable discrimination. SCORE showed better validity indices than the PCE. The population's risk is continuously changing; therefore, it is important continue updating the equations to include information on current populations. (C) 2021 Elsevier Espana, S.L.U. and Sociedad Espanola de Medicina Interna (SEMI). All rights reserved.

Neisseria meningitidis is often asymptomatically carried in the nasopharynx but may cause invasive meningococcal disease, leading to morbidity and mortality. Meningococcal conjugate vaccinations induce functional protective antibodies against capsular antigens, but seroprotection wanes over time. We measured functional antibody titers five years after administration of a single dose of the meningococcal ACWY-polysaccharide-specific tetanus toxoid-conjugated (MenACWY-TT) vaccine in adolescents and middle-aged adults in the Netherlands, using the serum bactericidal antibody with baby rabbit complement (rSBA) assay. Protection was defined as rSBA titer ≥8. The meningococcal ACWY-specific serum IgG concentrations were measured with a multiplex immunoassay. Duration of protection was estimated by a bi-exponential decay model. Sufficient protection for MenC, MenW, and MenY was achieved in 94–96% of the adolescents five years postvaccination, but, in middle-aged adults, only in 32% for MenC, 65% for MenW and 71% for MenY. Median duration of protection for MenCWY was 4, 14, and 21 years, respectively, in middle-aged adults, while, in adolescents, it was 32, 98, and 33 years. Our findings suggest that adolescents, primed in early childhood with MenC conjugate vaccination, remain sufficiently protected after a single dose of MenACWY-TT vaccine. Middle-aged adults without priming vaccination show fast waning of antibodies, particularly MenC, for which protection is lost after four years.

Background The number of older adult gamers who play mobile games is growing worldwide. Earlier studies have reported that digital games provide cognitive, physical, and socioemotional benefits for older adults. However, current mobile games that understand older adults’ gameplay experience and reflect their needs are very scarce. Furthermore, studies that have analyzed older adults’ game experience in a holistic manner are rare. Objective The purpose of this study was to suggest mobile game design guidelines for adults older than 50 years from a holistic gaming experience perspective. Adopting a human-centric approach, this study analyzes middle-aged and older adults’ gameplay experience and suggests practical design guides to increase accessibility and satisfaction. Methods We organized a living laboratory project called the “Intergenerational Play Workshop.” In this workshop, 40 middle-aged and older adults (mean age 66.75 years, age range 50-85 years) played commercial mobile games of various genres with young adult partners for 1 month (8 sessions). Using a convergent parallel mixed-method design, we conducted a qualitative analysis of dialogue, game diaries, and behavioral observations during the workshop and a quantitative analysis of the satisfaction level of the game elements for the mobile games that they played. Results This project was active from April 2019 to December 2021, and the data were collected at the workshops from July 1 to August 28, 2019. Based on the identified themes of positive and negative experiences from the qualitative data, we proposed 45 design guides under 3 categories: (1) cognitive and physical elements, (2) psychological and socioemotional elements, and (3) consumption contextual elements. Our empirical research could reaffirm the proposals from previous studies and provide new guidelines for improving the game design. In addition, we demonstrate how existing commercial games can be evaluated quantitatively by using the satisfaction level of each game’s elements and overall satisfaction level. Conclusions The final guidelines were presented to game designers to easily find related information and enhance the overall understanding of the game experience of middle-aged and older adults.

Objectives: This study investigated whether the habit of consuming sugary snacks was independently associated with the loss of permanent teeth. Materials and Methods: Eight hundred ninety-seven adults aged 35–65 from four communities in the lower regions of Southern Thailand completed a structured questionnaire interview and dental examinations. The independent variable was frequency of sweet snack consumption between meals in the previous week and coded as: never (0 days), occasionally (1–4 days), or frequently (≥5 days). The outcome was the number of permanent teeth (1–19 vs. ≥20 teeth). Multivariate logistic regression was used to examine the adjusted associations between sugary snack consumption and the number of retained teeth. Odds ratio (OR) and 95% confidence intervals (CI) were calculated. Results: Approximately 23% of participants retained fewer than 20 permanent teeth. Approximately 30% of participants reported sugary snack intake most days. Fewer teeth were positively associated with high-frequency sugary snack consumption, older age, Muslim, ≤ 6 years of education, universal healthcare, infrequent tooth brushing, smoking, and alcohol consumption, but not sugar-sweetened beverages. After adjusting for sociodemographic characteristics and other potential confounders, the odds of having fewer teeth were higher among participants who frequently consumed sugary snacks (OR = 2.03, 95% CI = 1.21–3.39), but was not significantly different from those who occasionally consumed sugary snacks (OR = 0.93; 95% CI = 0.58–1.50) compared to nonsugary snack consumers. Conclusion: In this study, habitual sugary snack intake was associated with fewer teeth among middle-aged Thai adults. To improve oral health and prevent further tooth loss, efforts to reduce sugary snack consumption would be needed.

Background Decline in mental health and cognitive status starts to show its sign during middle-age and is affected by dietary factors, namely the polyphenols intake. Polyphenols have received attention in improving health issues related to aging, including decline in mental health and cognitive. The aim of this study is to determine the prevalence of poor mental health and cognitive status among middle-aged adults and its predictors in relation to polyphenols intake. Methods Subjects’ food intakes were calculated by using dietary history questionnaire and food frequency questionnaire for polyphenols. The subjects’ mental health and cognitive status were measured by general health questionnaire-28 (GHQ-28) and Rey’s auditory verbal learning test (RAVLT). Results More than 40% of middle-aged adults were identified as having signs of poor mental health. A total of 67.9% of the subjects had poor cognitive status according to RAVLT immediate recall. Hierarchical binary logistic regression indicated that fat intake was associated with somatic symptoms for both men [adjusted odds ratio (AOR) = 1.04; P < 0.05] and women (AOR = 1.06; P < 0.05). Intake of lignan (AOR = 1.071; P < 0.05) was associated with better RAVLT immediate recall among women. Additionally, high cholesterol (AOR = 3.14; P < 0.05) was associated with poor score of RAVLT delayed recall for women. Conclusions Early detection of poor mental health and cognitive is crucial to prevent Alzheimer’s disease in old age.

Background-\ud \ud The limited available literature suggests that sleep problems are linked to an increased risk of mild cognitive impairment (MCI). However, this association has been little studied to date in low-income settings.\ud \ud Objective-\ud \ud To investigate the association between sleep problems and MCI in a large sample of adults from six low-and middle-income countries (LMICs).\ud \ud Design-\ud \ud Cross-sectional.\ud \ud Setting-\ud \ud Study on Global Ageing and Adult Health (SAGE).\ud \ud Subjects-\ud \ud 32,715 individuals aged ≥50 years with preservation in functional abilities [age range 50–114 years; 51.7% females].\ud \ud Methods-\ud \ud MCI was defined using the National Institute on Aging-Alzheimer's Association criteria. Sleep problems were assessed by the question “Overall in the last 30 days, how much of a problem did you have with sleeping, such as falling asleep, waking up frequently during the night or waking up too early in the morning?” and categorized as “None”, “Mild”, “Moderate”, “Severe/Extreme”. Multivariable logistic regression analysis and meta-analysis were conducted.\ud \ud Results-\ud \ud Compared to no sleep problems, mild, moderate, and severe/extreme sleep problems were associated with significant 1.40, 1.83, and 2.69 times higher odds for MCI with similar associations being observed between age groups and sex. Severe/extreme sleep problems were positively associated with MCI (i.e., OR > 1) in the six countries studied with the overall estimate being OR = 1.80 (95% CI = 1.50–2.16), and a low level of between-country heterogeneity was observed (I2 = 28.2%).\ud \ud Conclusions-\ud \ud Sleep problems were associated with higher odds for MCI. Interventions to improve sleep quality among middle-aged and older adults in LMICs may be an effective strategy in reducing risk of MCI and dementia.

BACKGROUND: Previous research suggests an association between anxiety disorders and worse cognitive function. However, this association may vary depending on the type of disorder and age. We analysed the association of panic attack, 12-month and lifetime panic disorder (PD), and generalized anxiety disorder (GAD), with cognitive function in a representative sample of Spanish adults, and compared three age groups (18-49, 50-64, and 65+). METHODS: Some 4,582 participants were interviewed with an adapted CIDI interview. Unadjusted and adjusted linear regression models were calculated by age group, using T scores of verbal fluency and episodic memory as the outcomes. RESULTS: In young adults, 12-month GAD was associated with significantly lower scores of memory performance and verbal fluency, and 12-month PD with worse verbal fluency. In middle-aged participants, lifetime panic attack was related to better performance in verbal fluency, whereas having a diagnosis of lifetime PD was associated with lower scores. However, only participants aged 18-49 with 12-month GAD showed lower memory and verbal fluency, at almost one standard deviation below participants without 12-month GAD. LIMITATIONS: Low prevalence rates of anxiety disorder could have led to biased results. CONCLUSIONS: In young adults, a concurrent GAD might be particularly associated with memory and verbal fluency deficits, whereas only verbal fluency is affected in middle-aged adults with a history of PD, although this association is small. In older adults, anxiety disorders are not clearly associated with worse cognition, probably because in this age group other confounder variables might be attenuating this link. Overall, our findings suggest that cognitive interventions for anxiety disorders may be relevant, especially for young and middle-aged adults.

Evidence for diet quality representing a modifiable risk factor for age-related cognitive decline and mood disturbances has typically come from retrospective, cross-sectional analyses. Here a diet screening tool (DST) was used to categorize healthy middle-aged volunteers (n = 141, 40&ndash, 65 years) into &ldquo, optimal&rdquo, or &ldquo, sub-optimal&rdquo, diet groups to investigate cross-sectional associations between diet quality, cognitive function, and mood. The DST distinguished levels of nutrient intake as assessed by Automated Self-Administered 24-h dietary recall and nutrient status, as assessed by blood biomarker measures. Compared with the &ldquo, group, the &ldquo, diet group showed significantly higher intake of vitamin E (p = 0.007), magnesium (p = 0.001), zinc (p = 0.043) and fiber (p = 0.015), higher circulating levels of vitamin B6 (p = 0.030) and red blood cell folate (p = 0.026) and lower saturated fatty acids (p = 0.012). Regarding psychological outcomes, the &ldquo, diet group had significantly better Stroop processing than those with a &ldquo, diet (p = 0.013). Regression analysis revealed that higher DST scores were associated with fewer mood disturbances (p = 0.002) and lower perceived stress (p = 0.031), although these differences were not significant when comparing &ldquo, versus &ldquo, as discrete groups. This study demonstrates the potential of a 20-item diet screen to identify both nutritional and psychological status in an Australian setting.

STUDY OBJECTIVES Although several studies have linked short and long sleep duration to weight gain, mixed results exist. Contrarily, few studies associated objectively measured sleep characteristics with weight gain. We investigated the association between several sleep characteristics measured by questionnaire and polysomnography with prospective weight gain in a population-based, middle-aged cohort. METHODS Three samples were analyzed: sample 1 (n = 2551, 47.3% men, 56.9 ± 10.3 years) had data for subjective sleep characteristics, sample 2 (n = 1422, 49.4% men, 57.6 ± 10.4 years) had objective sleep assessment (polysomnography), and sample 3 consisting of 1259 subjects included in both samples. Multivariable logistic regressions were performed to assess the relationship between sleep characteristics and ≥5 kg weight gain during a median follow-up of 5.3 years. RESULTS In both study samples, 12% of the subjects gained ≥5 kg during follow-up. Multivariable analyses showed poor subjective sleep quality (as assessed by Pittsburgh Sleep Quality Index: odds ratio [95% confidence interval] = 1.54 [1.19 to 1.99]), percentage of sleep spent in stage 2 (1.32 [1.10 to 1.58]), and less than 90% oxygen saturation (SpO2 < 90) (1.23 [1.07 to 1.41]); moderate/severe Oxygen Desaturation Index (1.70 [1.01 to 2.85]) and autonomic arousal duration (1.22 [1.02 to 1.45]) were related to ≥5 kg weight gain. Only poor subjective sleep quality was robustly associated with weight gain in all sensitivity analyses, except in female subsamples. CONCLUSIONS Poor subjective sleep quality, and to some extent moderate to severe oxygen desaturation, but no other sleep characteristics, were robustly associated with weight gain. Future studies should confirm the relationship between sleep quality and weight gain, assess sex differences, and investigate underlying mechanisms.

Introduction: Successful vaccination of elderly persons is often hampered by immunological ageing, leaving part of the elderly population vulnerable for infectious diseases. As an alternative, timely vaccinations might be administered at middle-age, before reaching old age. Studies evaluating the immunological fitness of middle-aged adults are warranted. In this study we compared the immunogenicity of a primary meningococcal vaccination in Dutch middle-aged adults with that in adolescents, in order to gain knowledge on the early signs of immune ageing.Methods: In this study, we compared the antibody responses after a primary meningococcal vaccination between middle-aged adults (50-65 years of age, N = 204) and adolescents (10-15 years of age, N = 225). Blood samples were taken pre-, as well as 28 days and 1 year post-vaccination. Functional antibody titers were measured with the serum bactericidal killing assay using baby rabbit complement (rSBA). Meningococcal polysaccharide (PS) specific IgG and IgM concentrations were determined with a fluorescent bead-based multiplex immunoassay.Results: Lower post-vaccination functional antibody titers against meningococcal group W and Y were observed in the middle-aged adults compared to the adolescents. One year post-vaccination, also a significantly higher proportion of the middle-aged adults possessed an rSBA titer below protection level. A large reduction in postvaccination IgM concentrations was observed in the middle-aged adults, whereas IgG concentrations were only marginally different between the two age groups. Strong correlations between the post-vaccination rSBA titers and IgM concentrations were found both in the middle-aged adults and the adolescents.Conclusion: Although protective antibody titers were initiated after primary meningococcal vaccination in middle-aged adults, antibody functionality was significantly lower as compared to that in adolescents. This difference was mainly caused by lower IgM responses. Our results indicate early signs of immune ageing in middle-aged adults, which is important knowledge for the development of future vaccine strategies to better protect elderly persons against infectious diseases.

Advancing age affects gait adaptability, but it is unclear if such adaptations to split-belt perturbations are already affected at middle-age. Changes in neuromuscular control, that already start at middle-age, may underlie the age-related changes in gait adaptation. Thus, we examined the effects of age on adaptations in gait and muscle activation patterns during split-belt walking in healthy young and middle-aged adults. Young (23.3 ± 3.13 years) and middle-aged adults (55.3 ± 2.91 years) walked on an instrumented split-belt treadmill. Both age groups adapted similarly by reducing asymmetry in step length and double support time. Surface EMG was recorded from eight leg muscles bilaterally. Principal Component Analysis (PCA) was applied to the EMG data of all subjects, for the fast and slow leg separately, to identify muscle activation patterns. The principal components consisted of i.e. temporal projections that were analyzed with Statistical Parametric Mapping (SPM). The functional muscle groups, identified by PCA, increased activation during early adaptation and post-adaptation, and decreased activation over time similarly in both age groups. Extra activation peaks of the plantar- and dorsiflexors suggest a role in gait modulation during split-belt walking. Both young and middle-aged adults re-established gait symmetry and showed adaptation effects in the muscle activation patterns. Since the adaptation of muscle activation patterns parallels adaptation of gait symmetry, changes in muscle activation likely underlie the changes in step parameters during split-belt adaptation. In conclusion, split-belt adaptation, in terms of gait and muscle activation patterns, is still preserved at middle-age, suggesting that age-related differences occur later in the lifespan.

BackgroundStrategies to prevent or attenuate the age-related decline in physical and physiological function and reduce chronic disease risk factors are of clinical importance.ObjectiveTo examine the health benefits of recreational soccer in middle-aged and older adults.DesignSystematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesAll available records up until 9 June 2017 in PubMed, Web of Science, SPORTDiscus, MEDLINE, Embase, CINAHL Plus, PsycINFO and Cochrane Library databases.Eligibility criteria for selecting studiesAll randomised trials with or without a control group (randomised controlled trials or randomised uncontrolled trials) and non-randomised controlled trials that used recreational soccer, which includes small-sided soccer games, as the sole or principal intervention, and reported relevant effects in untrained/sedentary, healthy or unhealthy adults aged 40 years and above were included.ResultsFive trials described in 13 articles were included, which scored 6–9 out of 12 points on the modified Delphi quality rating scale. The duration was from 12 to 52 weeks, with various frequencies, volumes and game formats performed both outdoors and indoors with men and women. The trials indicate that recreational soccer may result in improvement in cardiovascular function, body composition and functional ability, although no significant changes were observed in postural balance.ConclusionRecreational soccer should be considered an alternative exercise modality for untrained, healthy or unhealthy middle-aged and older adults of both sexes to maintain an active lifestyle and mitigate a wide array of physical and physiological age-related changes.

Proactive nutrition screening is an effective public health strategy for identifying and targeting individuals who could benefit from making dietary improvements for primary and secondary prevention of disease. The Dietary Screening Tool (DST) was developed and validated to assess nutritional risk among rural older adults. The purpose of this study was to evaluate the utility and validity of the DST to identify nutritional risk in middle-aged adults. This cross-sectional study in middle-aged adults (45–64 year olds, n = 87) who reside in Appalachia, examined nutritional status using an online health survey, biochemical measures, anthropometry, and three representative 24-h dietary recalls. The Healthy Eating Index (HEI) was calculated to describe overall diet quality. Adults identified by the DST with a nutrition risk had lower HEI scores (50 vs. 64, p < 0.001) and were much more likely to also be considered at dietary risk by the HEI (OR 11.6; 3.2–42.6) when compared to those not at risk. Those at risk had higher energy-adjusted total fat, saturated fat, and added sugar intakes and lower intakes of dietary fiber, and several micronutrients than those classified as not at risk by the DST. Similarly, the at-risk group had significantly lower serum levels of α-carotene, β-carotene, cryptoxanthin, lutein, and zeaxanthin but did not differ in retinol or methylmalonic acid compared with those not at risk. The DST is a valid tool to identify middle-aged adults with nutritional risk.

Author version made available in accordance with the publisher's policy., The current study used a randomised, double-blind, placebo-controlled design to investigate the effects of saccharide supplementation on cognition and well-being in middle-aged adults. Participants (N=109; 45 - 60 years) took a teaspoon of a combination of saccharides or a placebo twice daily for 12 weeks (3.6 g per day). Before and after this supplementation period, participants completed alternate forms of standardised tests of cognition and self-report measures of well-being. Significant beneficial effects of saccharide supplementation were found for memory performance and indicators of well-being. The potential for these nutrients to optimise cognitive function and well-being in older adults warrants on-going investigation.

This randomized controlled trial study aimed to investigate the effects of a lifestyle intervention on metabolic syndrome (MetS) among middle-aged Koreans. A total of 243 middle-aged Koreans with MetS were randomly assigned to either of 2 types of lifestyle intervention for MetS and followed for 12 months. Health examinations and interventions were implemented at 16 regional branch facilities of a Korean medical institution from 2010, following the NCEP-ATP III criteria and recommendations. Lifestyle intervention (LI) group (n = 137) participated in a 12-week multi-component intervention including individual counseling, group sessions, and self-help materials. Basic usual intervention (BI) group (n = 106) was provided with one-page health information sheet on MetS and MetS management at baseline. Prevalence of MetS and each of MetS components, except for low HDL-cholesterol, in both groups were significantly reduced and maintained after the intervention. Notably, prevalence of hypertension and abdominal obesity continued to improve during the follow-up period. Between-group differences in results were not found. Both interventions were effective when they were accompanied with repeated check-ups and notification of MetS status. It is recommended to design clear guidelines for the notification of MetS after MetS screening and to encourage checking MetS status periodically for effective MetS management (KCT 0000446). Graphical Abstract

Objective: Certain plant polysaccharides may provide psychological health benefits. The aim of this study was to evaluate whether they can acutely improve mood and cognitive function. Discussion: This is the first report of acute behavioural improvement following plant polysaccharide intake in healthy middle-aged adults under conditions of mental fatigue. The findings suggest that certain NSP may enhance memory performance through mechanisms other than elevated blood glucose. Method: In a randomized, double-blind, placebo-controlled, between subjects design trial, 73 middle-aged adults consumed 4 g of a proprietary mixture of non-starch polysaccharides (NSPs) (Ambrotose® complex), a rice flour placebo, or a sucrose control. Participants completed testing at baseline and 30 minutes postconsumption. Acute effects of consumption on mood, cognition, and blood glucose were evaluated during mental tests designed to induce mental fatigue. Results: Significant improvement in recognition and working memory performance was observed in the group that consumed NSP compared with placebo or sucrose. Improvements in memory performance following NSP intake were independent of changes in blood glucose. Refereed/Peer-reviewed

The purpose of this study was to investigate the reproducibility and utility of a standardised and externally paced field test (15-m Incremental Shuttle Walk and Run Test [15 mISWRT]) to assess aerobic fitness in middle-aged adults. 14 middle-aged participants performed the 15-m ISWRT 3 times within one week (Test 1, Test 2, Test 3). Reproducibility of the 15-m ISWRT was tested by comparing 15-m ISWRT performance (distance completed), HRmax, and V˙O2max for each test. The utility of the 15-m ISWRT for evaluating V˙O2max over a wide range in middle-aged adults was tested by comparing the range of V˙O2max obtained from the portable expired gas analyzer with the V˙O2max reference values and ranges for health promotion published by Japan's Ministry of Health, Labour and Welfare. A multiple comparison of distance completed in the 15-m ISWRT Test 1, Test 2, and Test 3 found no significant difference between Test 2 and Test 3. The ICC was 0.99 for Test 2 vs. Test 3. V˙O2max measured from the 15-m ISWRT in Test 3 had a minimum value of 22.8 ml/kg/min and a maximum value of 38.7 ml/kg/min. In conclusion, the 15-m ISWRT is reliable and useful for evaluating V˙O2max in middle-aged adults., International Journal of Sports Medicine, 33(05), pp.346-350; 2012

The purpose of this study was to determine relationship between balance performance and pain in lower body among healthy adults. Two hundred and forty volunteer subjects (125 middle aged and 115 elderly people) aged 50 years and above participated. The average age was 61.52 ± 8.22 years (range 50-75 years). The functional reach test (FRT) was used to measure balance ability. The visual analog scale (VAS) was used to measure pain intensity. Subjects were also asked to indicate sites they experienced pain in their lower body (e.g., low back, hip, knee, ankle, toes). Falls history was also recorded. The elderly people had a lower FRT score as compared to the middle-aged adults (p < 0.001). Knee, low back, and hip pain were most common in both groups. The elderly people reported more frequency of falls than the middle-aged adults. The score of the FRT was higher among men (20.67 ± 7.16 cm) than among women (18.77 ± 6.59 cm). In both groups; the women had a higher VAS score than those of matched the men. Although the middle-aged adults had higher and better scores than the elderly people, the data showed that the middle-aged adults are also at risk and should be prepared properly for healthy aging. © 2006 Elsevier Ireland Ltd. All rights reserved.

Background and aim As an evaluation of fatty acid intake measurement, our aim was to examine associations between diet and plasma phospholipid (PL) fatty acids, and whether these were modified by age, sex, country of birth, fasting status, use of cholesterol-lowering medication, body size, chronic disease and other lifestyle factors. Methods and results Cross-sectional analysis of plasma PL fatty acid composition and dietary fatty acid intake over 12 months from a 121-item food frequency questionnaire (FFQ) in 4439 men and women aged 40–69 years, born in Australia, Greece or Italy. Crude correlation coefficients ranged from 0.18 to 0.40; and corrected correlation coefficients from 0.38 to 0.78 for total monounsaturated, polyunsaturated, n-6, n-3 fatty acids, oleic acid, linoleic acid, EPA and DHA. Weaker associations were observed for other fatty acids. The associations did not vary significantly by fasting status, use of lipid lowering medication or alcohol intake, but for some fatty acids did vary by sex, age, body mass index, country of birth, smoking and previous heart attack or diabetes. Conclusions The FFQ provides useful information on intakes of mono- and polyunsaturated fatty acids. Correlations did not differ by fasting status, or use of lipid-lowering medication.

CONTEXT: Although the heritability of atrial fibrillation (AF) is established, the contribution of familial AF to predicting new-onset AF remains unknown.OBJECTIVE: To determine whether familial occurrence of AF is associated with new-onset AF beyond established risk factors.DESIGN, SETTING, AND PARTICIPANTS: The Framingham Heart Study, a prospective community-based cohort study started in 1948. Original and Offspring Cohort participants were aged at least 30 years, were free of AF at the baseline examination, and had at least 1 parent or sibling enrolled in the study. The 4421 participants in this analysis (mean age, 54 [SD, 13] years; 54% women) were followed up through December 31, 2007.MAIN OUTCOME MEASURES: Incremental predictive value of incorporating different features of familial AF (any familial AF, premature familial AF [onset ≤65 years old], number of affected relatives, and youngest age of onset in a relative) into a risk model for new-onset AF.RESULTS: Across 11,971 examinations during the period 1968-2007, 440 participants developed AF. Familial AF occurred among 1185 participants (26.8%) and premature familial AF occurred among 351 participants (7.9%). Atrial fibrillation occurred more frequently among participants with familial AF than without familial AF (unadjusted absolute event rates of 5.8% and 3.1%, respectively). The association was not attenuated by adjustment for AF risk factors (multivariable-adjusted hazard ratio, 1.40; 95% confidence interval [CI], 1.13-1.74) or reported AF-related genetic variants. Among the different features of familial AF examined, premature familial AF was associated with improved discrimination beyond traditional risk factors to the greatest extent (traditional risk factors, C statistic, 0.842 [95% CI, 0.826-0.858]; premature familial AF, C statistic, 0.846 [95% CI, 0.831-0.862]; P = .004). Modest changes in integrated discrimination improvement were observed with premature familial AF (2.1%). Net reclassification improvement (assessed using 8-year risk thresholds of 10%) did not change significantly with premature familial AF (index statistic, 0.011; 95% CI, -0.021 to 0.042; P = .51), although categoryless net reclassification was improved (index statistic, 0.127; 95% CI, 0.064-0.189; P = .009).CONCLUSIONS: In this cohort, familial AF was associated with an increased risk of AF that was not attenuated by adjustment for AF risk factors including genetic variants. Assessment of premature familial AF was associated with a very slight increase in predictive accuracy compared with traditional risk factors.