Effect of Sedentary Lifestyle on Cardiovascular Disease Risk Among Healthy Adults With Body Mass Indexes 18.5 to 29.9 kg/m2

The impact of cannabis use on erectile dysfunction and sex hormones: a Mendelian randomization analysis

Previous study has highlighted an association between cannabis use (CU) and an increased risk of erectile dysfunction (ED), potentially due to indirect effects on sex hormonal balance. However, the evidence remains controversial, and the causal relationship is unclear. This study utilized genome-wide association study (GWAS) data to investigate the causal relationships between cannabis use disorder (CUD), lifetime cannabis use (LCU), and ED, as well as levels of sex hormones including estradiol (E2), bioavailable testosterone (BT), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) through Mendelian randomization (MR) analysis. The primary method of analysis was the inverse variance weighted (IVW) method. Data from the FinnGen and UK Biobank were used for replication and meta-analysis. The results indicated no causal relationship between genetically predicted CUD (OR = 0.97, 95% CI 0.87-1.10, P = 0.66) and LCU (OR = 1.13, 95% CI 0.84-1.50, P = 0.42) with the risk of ED. The meta-analysis provided consistent evidence (P > 0.05). No causal relationships were found between CUD and LCU with E2(CUD: β = 0.00, 95% CI 0.00-0.01, P = 0.37; LCU: β = 0.00, 95% CI -0.02-0.01, P = 0.62), BT (CUD: β = 0.00, 95% CI -0.03-0.02, P = 0.90; LCU: β = 0.02, 95% CI -0.04-0.09, P = 0.46), FSH (CUD: β = 0.01, 95% CI -0.18-0.20, P = 0.92; LCU: β = 0.01, 95% CI -0.44-0.47, P = 0.95), and LH (CUD: β = 0.01, 95% CI -0.18-0.21, P = 0.90; LCU: β = 0.13, 95% CI -0.22-0.49, P = 0.46). Sensitivity analyses detected no evidence of horizontal pleiotropy or heterogeneity, ensuring the robustness of the results. In conclusion, this MR analysis did not provide evidence supporting a causal relationship between CU and ED or sex hormone levels.

Combination Therapy of Cuban Policosanol (Raydel®, 20 mg) and Intensive Exercise for 12 Weeks Resulted in Improvements in Obesity, Hypertension, and Dyslipidemia without a Decrease in Serum Coenzyme Q10: Enhancement of Lipoproteins Quality and Antioxidant Functionality in Obese Participants

Obesity and overweight, frequently caused by a lack of exercise, are associated with many metabolic diseases, such as hypertension, diabetes, and dyslipidemia. Aerobic exercise effectively increases the high-density lipoproteins-cholesterol (HDL-C) levels and alleviates the triglyceride (TG) levels. The consumption of Cuban policosanol (Raydel®) is also effective in enhancing the HDL-C quantity and HDL functionality to treat dyslipidemia and hypertension. On the other hand, no study has examined the effects of a combination of high-intensity exercise and policosanol consumption in obese subjects to improve metabolic disorders. In the current study, 17 obese subjects (average BMI 30.1 ± 1.1 kg/m2, eight male and nine female) were recruited to participate in a program combining exercise and policosanol (20 mg) consumption for 12 weeks. After completion, their BMI, waist circumference, total fat mass, systolic blood pressure (SBP), and diastolic blood pressure (DBP) reduced significantly up to around -15%, -13%, -33%, -11%, and -13%, respectively. In the serum lipid profile, at Week 12, a significant reduction was observed in the total cholesterol (TC) and triglyceride (TG) levels, up to -17% and -54% from the baseline, respectively. The serum HDL-C was elevated by approximately +12% from the baseline, as well as the percentage of HDL-C in TC, and HDL-C/TC (%), was enhanced by up to +32% at Week 12. The serum coenzyme Q10 (CoQ10) level was increased 1.2-fold from the baseline in all participants at Week 12. In particular, the male participants exhibited a 1.4-fold increase from the baseline. The larger rise in serum CoQ10 was correlated with the larger increase in the serum HDL-C (r = 0.621, p = 0.018). The hepatic function parameters were improved; the serum γ-glutamyl transferase decreased at Week 12 by up to -55% (p < 0.007), while the aspartate aminotransferase and alanine transaminase levels diminished within the normal range. In the lipoprotein level, the extent of oxidation and glycation were reduced significantly with the reduction in TG content. The antioxidant abilities of HDL, such as paraoxonase (PON) and ferric ion reduction ability (FRA), were enhanced significantly by up to 1.8-fold and 1.6-fold at Week 12. The particle size and number of HDL were elevated up to +10% during the 12 weeks, with a remarkable decline in the TG content, glycation extent, and oxidation. The improvements in HDL quality and functionality were linked to the higher survivability of adult zebrafish and their embryos, under the co-presence of carboxymethyllysine (CML), a pro-inflammatory molecule known to cause acute death. In conclusion, 12 weeks of Cuban policosanol (Raydel®, 20 mg) consumption with high-intensity exercise displayed a significant improvement in blood pressure, body fat mass, blood lipid profile without liver damage, CoQ10 metabolism, and renal impairment.

Examining the influence of wealth status on prehypertension risk in women aged 30-49: evidence from the 2018 Benin demographic and health survey

BACKGROUND

There is an interest in the extent to which the wealth status of women predicts their risk of being pre-hypertensive. This understanding is lacking in the current body of empirical literature, particularly within the context of Benin. Thus, indicating a knowledge gap that must be filled. To this end, the present study aimed to assess the association between wealth status and the risk of prehypertension among women aged 30-49 years in Benin.

METHODS

This study used a secondary data from the recent (2018) Demographic and Health Survey of Benin. Bivariate and multivariate logistic regression models were computed to examine the association between wealth index and the risks of prehypertension using Stata version 14. Findings were presented in adjusted odds ratio at 95% confidence level.

RESULTS

Women in the richest wealth index were significantly more likely to have prehypertension than those in the poorest wealth index [AOR = 1.4; 95%CI: 1.26-2.26]. Women aged 45-49 years were more likely to have prehypertension [AOR = 1.5; 95%CI: 1.15-1.98] compared to younger women. Women who used unclean cooking fuel were less likely to have prehypertension compared to those using clean cooking fuel [AOR = 0.6; 95%CI: 0.37,0.87].

CONCLUSION

The study concludes that wealth status is a significant predictor of prehypertension among women in Benin. Therefore, the Ministry of Health in Benin should prioritize health education and prehypertension awareness campaigns specifically targeting women in affluent communities and households. These campaigns should focus on promoting healthy dietary choices and encouraging physical activity to mitigate the elevated risk associated with wealth status. Recognizing the influence of age on prehypertension risk, it is imperative for older-middle aged women to be targeted as primary beneficiaries of health education programs and prehypertension screening programs.

Healthy Lifestyle Index and Risk of Cardiovascular Disease Among Postmenopausal Women With Normal Body Mass Index

Background A lifestyle comprising a healthy diet, light alcohol consumption, no smoking, and moderate or intense physical activity has been associated with reduced risk of cardiovascular disease (CVD). We examined the association of a healthy lifestyle index (HLI), derived from scores for each of these components plus waist circumference, with the risk of incident CVD and CVD subtypes in postmenopausal women with normal body mass index (18.5-<25.0 kg/m2). Methods and Results We studied 40 118 participants in the Women's Health Initiative, aged 50 to 79 years at enrollment, with a normal body mass index and no history of CVD. The HLI score was categorized into quintiles. We estimated multivariable adjusted hazard ratios (HR) and 95% CIs for the association of HLI with risk of CVD and CVD subtypes using Cox regression models. A total of 3821 cases of incident CVD were ascertained during a median follow-up of 20.1 years. Compared with the lowest quintile (unhealthiest lifestyle), higher HLI quintiles showed inverse associations with the risk of CVD (HRquintile-2=0.74 [95% CI, 0.67-0.81]; HRquintile-3=0.66 [95% CI, 0.60-0.72]; HRquintile-4=0.57 [95% CI, 0.51-0.63]; and HRquintile-5=0.48 [95% CI, 0.43-0.54], P-trend=<0.001). HLI was also inversely associated with risks of stroke, coronary heart disease, myocardial infarction, angina, and coronary revascularization. Subgroup analyses, stratified by age (≤63 years vs >63 years), body mass index ( Collapse

Key Words

• body mass index
• cardiovascular disease
• healthy lifestyle index
• postmenopausal women
• prospective study

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MESH Headings

• Humans
• Female
• Cardiovascular Diseases/diagnosis
• Cardiovascular Diseases/epidemiology
• Risk Factors
• Body Mass Index
• Postmenopause
• Prospective Studies
• Healthy Lifestyle

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Grants

• P30 DK092950 NIDDK NIH HHS
• P30 DK111022 NIDDK NIH HHS
• National Institutes of Health

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Affiliation(s)

Rita Peila Department of Epidemiology and Population HealthAlbert Einstein College of Medicine, BronxNYNew York CityUSA
Xiaonan Xue Department of Epidemiology and Population HealthAlbert Einstein College of Medicine, BronxNYNew York CityUSA
Qibin Qi Department of Epidemiology and Population HealthAlbert Einstein College of Medicine, BronxNYNew York CityUSA
Andrew J. Dannenberg Emerald BioventuresNYNew YorkUSA
Matthew A. Allison Family Medicine and Public HealthUniversity of CaliforniaCASan DiegoUSA
Karen C. Johnson Department of Preventive MedicineThe University of TennesseeTNMemphisUSA
Michael J. LaMonte Department of Epidemiology and Environmental HealthUniversity of BuffaloNYUSA
Robert A. Wild Department of Obstetrics and Gynecology and Biostatistics and EpidemiologyUniversity of Oklahoma Health Sciences CenterOKOklahoma CityUSA
Bernhard Haring Department of CardiologyUniversity Heart Center Graz, Medical University of GrazGrazAustria
Kathy Pan Department of Hematology/OncologyKaiser Permanente Southern CaliforniaCADowneyUSA
Hilary A. Tindle Department of MedicineVanderbilt University Medical CenterTNNashvilleUSA
Randi Foraker Department of MedicineWashington University at St. LouisMOSt. LouisUSA
Nazmus Saquib College of Medicine at Sulaiman Al Rajhi UniversityBukariyahSaudi Arabia
Ana Barac MedStar Heart and Vascular InstituteGeorgetown UniversityDCWashingtonUSA
Thomas E. Rohan Department of Epidemiology and Population HealthAlbert Einstein College of Medicine, BronxNYNew York CityUSA

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Enhancement of High-Density Lipoprotein (HDL) Quantity and Quality by Regular and Habitual Exercise in Middle-Aged Women with Improvements in Lipid and Apolipoprotein Profiles: Larger Particle Size and Higher Antioxidant Ability of HDL

Regular exercise, especially aerobic exercise, is beneficial for increasing serum high-density lipoprotein-cholesterol (HDL-C) levels in the general population. In addition to the HDL-C quantity, exercise enhances HDL functionality, antioxidants, and cholesterol efflux. On the other hand, the optimal intensity and frequency of exercise to increase HDL quantity and enhance HDL quality in middle-aged women need to be determined. The current study was designed to compare the changes in HDL quantity and quality among middle-aged women depending on exercise intensity, frequency, and duration; participants were divided into a sedentary group (group 1), a middle-intensity group (group 2), and a high-intensity group (group 3). There were no differences in anthropometric parameters among the groups, including blood pressure, muscle mass, and handgrip strength. Although there was no difference in serum total cholesterol (TC) among the groups, the serum HDL-C and apolipoprotein (apo)A-I levels remarkably increased to 17% and 12%, respectively, in group 3. Serum low-density lipoprotein-cholesterol (LDL-C), glucose, triglyceride, and the apo-B/apoA-I ratio were remarkably decreased in the exercise groups depending on the exercise intensity; group 3 showed 13%, 10%, and 45% lower LDL-C, glucose, and triglyceride (TG), respectively, than group 1. The hepatic and muscle damage parameter, aspartate aminotransferase (AST), was significantly decreased in the exercise groups, but high-sensitivity C-reactive protein (CRP), alanine aminotransferase (ALT), and γ-glutamyl transferase (γ-GTP) were similar in the three groups. In LDL, the particle size was increased 1.5-fold (p < 0.001), and the oxidation extent was decreased by 40% with a 23% lower TG content in group 3 than in group 1. In the exercise groups (groups 2 and 3), LDL showed the slowest electromobility with a distinct band intensity compared to the sedentary group (group 1). In HDL2, the particle size was 2.1-fold increased (p < 0.001) in the exercise group (group 3) with a 1.5-fold increase in TC content compared to that in group 1, as well as significantly enhanced antioxidant abilities, paraoxonase (PON) activity, and ferric ion reduction ability (FRA). In HDL3, the particle size was increased 1.2-fold with a 45% reduction in TG in group 3 compared to group 1. With increasing exercise intensity, apoA-I expression was increased in HDL2 and HDL3, and PON activity and FRA were enhanced (p < 0.001). In conclusion, regular exercise in middle-aged women is associated with the elevation of serum HDL-C and apoA-I with the enhancement of HDL quality and functionality and an increase in the TC content, particle size, and antioxidant abilities. With the reduction in TG and oxidized products in LDL and HDL, lipoproteins could have more anti-atherogenic properties through regular exercise in an intensity-dependent manner.

PHYSICAL EXERCISE IN REMOTE EMPLOYEES DURING COVID-19

ABSTRACT Introduction: During COVID-19, home office activity increased significantly for professionals, especially high-tech companies dominated by information production. Physical health problems attracted great attention from departments responsible for exercise prescriptions. Objective: Discuss the positive and negative effects of home exercise behavior on the health of people working from home, and propose countermeasures to prevent and improve physical health during the epidemic. Methods: Survey questionnaires and mathematical statistics were used to analyze the factors influencing home exercise behavior on the physical health of remote employees. Results: Mathematical statistics from the questionnaire showed that among all investigated factors, more than 90% showed that home exercise behavior positively impacted remote employees' physical health, and less than 10% showed that home exercise behavior did not correlate with physical health. Conclusion: Under the significance level of α= 0.05, it is believed that home exercise behavior can effectively improve physical health. Therefore, if the epidemic control policy cannot be changed, it is recommended to further promote home exercise. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

Self-Reported Sedentary Behavior and Metabolic Syndrome among Children Aged 6-14 Years in Beijing, China

(1) Objective: This study aimed to examine the prevalence of metabolic syndrome (MetS) in children aged 6−14 years in Beijing, and to determine whether sedentary behavior is a risk factor. (2) Methods: Using a multistage stratified cluster random sampling method, 3460 students were selected for the Nutrition and Health Surveillance in Schoolchildren of Beijing (NHSSB). Data on children’s sedentary behavior time and MetS indicators were collected using the questionnaires, physical measurements, and laboratory tests. MetS was defined according to the CHN2012 criteria, and logistic regression analysis was used to compare the effects of different sedentary time on MetS and its components. (3) Results: The overall prevalence of MetS among children aged 6−14 in Beijing was 2.4%, and boys, suburban children, and older age were associated with a higher prevalence (χ2 values were 3.947, 9.982, and 27.463, respectively; p < 0.05). In boys, the prevalence rates of abdominal obesity, hyperglycemia, high triglycerides (TG), and low high-density lipoprotein cholesterol (HDL-C) were higher in the high-level sedentary behavior group than those in the low-level sedentary behavior group (p < 0.05); and in girls, the prevalence rates of high TG, low HDL-C, and MetS were higher in the high-level sedentary behavior group than those in the low-level sedentary behavior group (p < 0.05). After adjusting for confounding factors, the multivariate logistic regression results showed that compared with children with low-level sedentary behavior, the risks of abdominal obesity and low HDL-C were higher in boys with high-level sedentary behavior (odds ratio (OR) 1.51, 95% confidence interval (CI) 1.10−2.07, p = 0.011; OR 2.25, 95% CI 1.06−4.76, p = 0.034, respectively); while the risk of abdominal obesity was higher in girls with medium and high-level sedentary behavior (OR 1.52, 95% CI 1.01−2.27, p = 0.043; OR 1.59, 95% CI 1.04−2.43, p = 0.032, respectively). (4) Conclusions: Higher sedentary behavior time was related to the higher risk of MetS components among children aged 6−14 in Beijing. Reducing sedentary behavior may be an important method for preventing metabolic diseases.

Lifestyle Modification Using a Wearable Biometric Ring and Guided Feedback Improve Sleep and Exercise Behaviors: A 12-Month Randomized, Placebo-Controlled Study

Purpose: Wearable biometric monitoring devices (WBMD) show promise as a cutting edge means to improve health and prevent disease through increasing accountability. By regularly providing real-time quantitative data regarding activity, sleep quality, and recovery, users may become more aware of the impact that their lifestyle has on their health. The purpose of this study was to examine the efficacy of a biometric tracking ring on improving sleep quality and increasing physical fitness over a one-year period. Methods: Fifty-six participants received a biometric tracking ring and were placed in one of two groups. One group received a 3-month interactive behavioral modification intervention (INT) that was delivered virtually via a smartphone app with guided text message feedback (GTF). The other received a 3-month non-directive wellness education control (CON). After three months, the INT group was divided into a long-term feedback group (LT-GTF) that continued to receive GTF for another nine months or short-term feedback group (ST-GTF) that stopped receiving GTF. Weight, body composition, and VO2max were assessed at baseline, 3months, and 12months for all participants and additionally at 6 and 9months for the ST-GTF and LT-GTF groups. To establish baseline measurements, sleep and physical activity data were collected daily over a 30-day period. Daily measurements were also conducted throughout the 12-month duration of the study. Results: Over the first 3months, the INT group had significant (p<0.001) improvements in sleep onset latency, daily step count, % time jogging, VO2max, body fat percentage, and heart rate variability (rMSSD HRV) compared to the CON group. Over the next 9months, the LT-GTF group continued to improve significantly (p<0.001) in sleep onset latency, daily step count, % time jogging, VO2max, and rMSSD HRV. The ST-GTF group neither improved nor regressed over the latter 9months except for a small increase in sleep latency. Conclusion: Using a WBMD concomitantly with personalized education, encouragement, and feedback, elicits greater change than using a WBMD alone. Additionally, the improvements achieved from a short duration of personalized coaching are largely maintained with the continued use of a WBMD.

Joint Associations of Multiple Dietary Components With Cardiovascular Disease Risk: A Machine-Learning Approach

The human diet consists of a complex mixture of components. To realistically assess dietary impacts on health, new statistical tools that can better address nonlinear, collinear, and interactive relationships are necessary. Using data from 1,928 healthy participants in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort (1985-2006), we explored the association between 12 dietary factors and 10-year predicted risk of atherosclerotic cardiovascular disease (ASCVD) using an innovative approach, Bayesian kernel machine regression (BKMR). Employing BKMR, we found that among women, unprocessed red meat was most strongly related to the outcome: An interquartile range increase in unprocessed red meat consumption was associated with a 0.07-unit (95% credible interval: 0.01, 0.13) increase in ASCVD risk when intakes of other dietary components were fixed at their median values (similar results were obtained when other components were fixed at their 25th and 75th percentile values). Among men, fruits had the strongest association: An interquartile range increase in fruit consumption was associated with -0.09-unit (95% credible interval (CrI): -0.16, -0.02), -0.10-unit (95% CrI: -0.16, -0.03), and -0.11-unit (95% CrI: -0.18, -0.04) lower ASCVD risk when other dietary components were fixed at their 25th, 50th (median), and 75th percentile values, respectively. Using BKMR to explore the complex structure of the total diet, we found distinct sex-specific diet-ASCVD relationships and synergistic interaction between whole grain and fruit consumption.

Does Education Close the Black-White Physical Activity and Obesity Gaps?

Objective: The purpose of the study was to investigate physical activity patterns and body mass index (BMI) among black and white women in college to determine if attending college acts as a catalyst for sustaining physical activity and for closing the black-white physical activity and obesity gaps. Participants/Methods: 111 undergraduate women (black N = 42; white N = 69) aged 18-25 volunteered to wear Fitbit Zip^TM activity trackers for 7 days. Height and weight measurements were used to compute BMI. Results: White women had higher levels of physical activity, lower weight status, and lower BMIs than black women. Conclusions: Racial disparities were evident; however, both groups had low to moderate levels of physical activity. Required physical education programing that targets women in college could lead to sustained physical activity.

Sedentary lifestyle among office workers and coronary heart disease risk factors due to the COVID-19 quarantine

The COVID-19 pandemic has affected the entire world. It is difficult to follow protocols and regulations set forth by governments, designed by the World Health Organization. The most common protocol set forth by governments is quarantining at home. Many occupations must stay home to comply with this protocol. Among these occupations, office workers are the most common group to comply and work from home. This has led to a lack of daily movement and increased sedentary lifestyle, which has made employees prone to developing coronary heart disease (CHD). Additionally, obesity is a known risk factor for this group. This commentary presents feasible protocols aimed at helping home-based office workers stay healthy and decrease the risk of developing CHD.

Development and Validation of a County-Level Social Determinants of Health Risk Assessment Tool for Cardiovascular Disease

PURPOSE

Social determinants of health (SDoH) have been linked to a variety of health conditions, but there are no multivariate measures of these determinants to estimate the risk of morbidity or mortality in a community. We developed a score derived from multivariate measures of SDoH that predicts county-level cardiovascular disease (CVD) mortality.

METHODS

Using county-level data from 3,026 US counties, we developed a score considering variables of neighborhood socioeconomic status, food/lifestyle environment, and health care resource availability and accessibility to predict the 3-year average (2015-2017) age-adjusted county-level mortality rate for all CVD. We used one 50% random sample to develop the score and the other to validate the score. A Poisson regression model was developed to estimate parameters of variables while accounting for intrastate correlation.

RESULTS

The index score was based on 7 SDoH factors: percentage of the population of minority (nonwhite) race, poverty rate, percentage of the population without a high school diploma, grocery store ratio, fast-food restaurant ratio, after-tax soda price, and primary care physician supply. The area under the curve for the development and validation groups was similar, 0.851 (95% CI, 0.829-0.872) and 0.840 (95% CI, 0.817-0.863), respectively, indicating excellent discriminative ability. The index had better predictive performance for CVD burden than other area-level indexes: poverty only (area under the curve= 0.808, P <.001); the Centers for Disease Control and Prevention's Social Vulnerability Index (CDC-SVI) (area under the curve =0.786, P <.001); and the Agency for Healthcare Research and Quality's Socioeconomic Status (AHRQ-SES) index (area under the curve =0.835, P = .03).

CONCLUSIONS

Our validated multivariate SDoH index score accurately classifies counties with high CVD burden and therefore has the potential to improve CVD risk prediction for vulnerable populations and interventions for CVD at the county level.

Effects of physical activity and smoking on cardio-ankle vascular index, respiratory muscle strength, and exercise performance in early normal weight adulthood: a cross-sectional study

Few studies have shown the impact of unhealthy habits on arterial stiffness, respiratory muscle strength and exercise performance in early normal weight adulthood. This study sought to determine the effects of physical activity and smoking on its parameters in normal weight male participants. Forty-eight participants were divided into four groups: physically inactive nonsmokers and smokers and physically active nonsmokers and smokers (n=12 in each group). All of the participants were measured for body composition, arterial stiffness, respiratory muscle strength and exercise performance. Two-way analysis of variance design was used to test the main and interaction effects of physical activity by group (smokers vs. nonsmokers). P-value of less than 0.05 was considered as a statistically significant difference. As a result, cardio-ankle vascular index and respiratory muscle strength were diminished in smokers and physically inactive participants, while body and visceral fat mass were increased in both those groups. Fat-free mass was lower in only physically inactive participants. This study also found the interaction effects on body fat and arterial stiffness. In conclusion, participants with healthy normal weight, but smoked and performed inappropriate physical activity, exhibited body composition imbalance, decreased respiratory muscle strength, exercise performance, and increased arterial stiffness. Therefore, smoking cessation and exercise in younger adults are appropriate ways of improving body composition, respiratory muscle strength, aerobic capacity and arterial stiffness instead of trying to control their weight by smoking.