Health Patterns across Adulthood: An Age-Based Investigation of the Nutritional Status, Homocysteine, and CoQ10 of Bank Staff

BACKGROUND

This study aimed to evaluate age-specific variations in the blood levels of micronutrients, homocysteine, and CoQ10, along with physical activity (PA) patterns, among 123 Austrian adult bankers in operational and frontline roles (mean age: 43 years; 50% female).

METHODS

Blood analysis was conducted to assess micronutrients and the serum concentrations of homocysteine and CoQ10. The micronutrient values in whole blood were compared to sex-specific reference ranges and categorized as below, within, or above them. The Global Physical Activity Questionnaire was utilized to assess PA patterns. Participants were classified as young adults (18-34 years), middle-aged adults (35-49 years), and older adults (50-64 years).

RESULTS

Significant age-based differences were found in participants' mean homocysteine levels (p = 0.039) and homocysteine categories (p = 0.034), indicating an increasing prevalence of hyperhomocysteinemia with age. No significant difference between age categories was observed for sex, BMI, diet types, PA levels, sedentary behavior, and CoQ10 (p > 0.05). There was no significant age-based difference in the blood concentrations of most minerals and vitamins (p > 0.05), except for magnesium among females (p = 0.008) and copper among males (p = 0.042).

CONCLUSION

The findings offer initial evidence of the age-related differences in the health status of adult bankers, providing insights for customized approaches to occupational health that support the importance of metabolic health and overall well-being across adulthood.

Differences in training characteristics of recreational endurance runners by race distance - results from the NURMI Study (Step 2)

Background

Although runner's profiles were previously investigated, information on the training frequency and training distance for short (5 km, 10 km) and long-distance (>21 km) running is absent. The present study aimed to investigate the associations between training routines and exercise habits of recreational endurance runners considering self-reported preferred race distance [10 km, half-marathon (HM), and marathon/ultra-marathon (M/UM)] subgroups.

Methods

This is a cross-sectional study, sampling 154 recreational runners of both sexes. A web survey was used for data collection regarding age, sex, preferred distance (10-km, HM, M/UM), training routines, exercise habits, and periodized training routines. The Chi-square test (Cramer's V) and Kruskal-Wallis test (Eta-Squared η2) with effect sizes were used for comparisons between race distances.

Results

Significant differences were shown for anthropometric, training, and periodization characteristics. Highly significant differences were found between subgroups for the number of sessions, running kilometers, and training hours at all periods and within all four preparation conditions. M/UM runners were training more frequently, for longer durations, and ran greater distances each week.

Conclusion

This finding supports the notion that training habits and periodization characteristics are different for different race distances (10-km, half marathon, marathon, and ultramarathon).

Primary school children's health and its association with physical fitness development and health-related factors

The health status (HS) of children is influenced by a variety of factors, including physical fitness (PF) or social and environmental characteristics. We present a 4-year longitudinal study carried out with 263 primary school children. PF was assessed yearly using the German Motor Performance Test 6-18. Demographic data, leisure time behavior and socioeconomic factors were collected using questionnaires for children and parents. Based on parents' ratings in year 4, children were categorized as either "very good health status" (VGHS) or "good health status or below" (GHSB). Children with VGHS (73%) showed a larger improvement of global PF (p < 0.001), a significantly higher proportion of being/playing outside (p < 0.001), significantly lower proportions of overweight (p < 0.001), of media availability in the bedroom (p = 0.011) and of daily media consumption > 2 h (p = 0.033) compared to children with GHSB. Regarding socio-economic factors, children with VGHS revealed significantly fewer parents with lower education (p = 0.002), lower physical activity levels (p = 0.030) and lower migration background (p < 0.001). Physical fitness (p = 0.019) and outdoors exercising (p = 0.050) were the only variables to provide significantly higher chances of perceiving one's own health as very good when tested within a complex model including all the variables studied in this work. Considering the little focus on PF in the current Austrian physical education curriculum and the favorable environmental features of the Tyrolean region, more emphasis should be given to promoting didactical and pedagogical approaches that allow schoolers to be active in the nature.

The Association of Physical Activity Level with Micronutrient and Health Status of Austrian Bank Employees

BACKGROUND

Favorable health benefits of an active lifestyle have been clearly documented within the context of occupational health. However, a knowledge gap exists regarding the monitoring and comparison of micronutrient status across varying levels of physical activity (PA). This study aimed to investigate the association of PA level with micronutrient status and the associated health biomarkers among a cohort of Austrian bank employees.

METHODS

Using a cross-sectional design, this study involved the participation of bank employees (n = 123; average age: 43 years; 49% males) from the federal state of Tyrol, located in the western part of Austria. To assess PA levels and sedentary behavior, the Global Physical Activity Questionnaire (GPAQ; developed by the WHO) was administered. Accordingly, participants were categorized into three groups: low PA, moderate PA, and high PA. Participants' blood samples were obtained to measure blood levels of micronutrients, homocysteine, and CoQ10. The values of vitamins and minerals in whole-blood were compared to sex-specific reference ranges and grouped into three categories: below, within, or exceeding the reference range.

RESULTS

The prevalence of a high PA level was 61%, while 18% of participants had a low PA level. Overweight/obesity was significantly less prevalent among participants with high PA levels (22%) compared to those with moderate (50%) and low (50%) PA levels (p = 0.045). No significant differences between PA levels were found for sex, age, diet type, homocysteine, or CoQ10 markers (p > 0.05). There was no significant PA-based difference in blood concentrations of most vitamins and minerals (p > 0.05), except for vitamin D (p = 0.001) among females, as well as selenium (p = 0.040) and vitamin B12 (p = 0.048) among males.

CONCLUSION

The present findings offer initial insights into the link between PA behaviors, micronutrient status, and health, highlighting potential implications in occupational health and lifestyle, specifically in developing tailored approaches based on PA levels.

Differences in race history by distance of recreational endurance runners from The NURMI Study (Step 2)

Few studies were developed to understand the relationship between running characteristics and motivation. The purpose of this study was to assess the relationship between running event history, running experience, and best race performances in recreational distance runners. We used a web survey to obtain information regarding running experience, racing history, and periodization training routines/exercise habits, including weekly volumes and daily mileage and duration across periods and conditions. Associations between variables were conducted with the Chi-square test (χ2; nominal scale) and Wilcoxon test. Multiple linear regression analysis and multivariate linear regression were performed. Concerning the participants' motive for exercising, a significant difference was identified between the race distance subgroups (p < 0.001), where 58% of M/UM runners exercised for performance (n = 38) and 64% of HM runners (n = 57) and 57% of 10 km runners (n = 52) exercised for recreational purposes. A significant difference was found in the number of years of running completed without taking a break (p = 0.004), with marathoners/ultramarathoners reporting the most years. Runners competing in different race distances such as 10 km, half-marathon, marathon, and ultra-marathon presented differences in training background and habits according to the distance of preference.

Racing Experiences of Recreational Distance Runners following Omnivorous, Vegetarian, and Vegan Diets (Part B)-Results from the NURMI Study (Step 2)

The potential running or endurance performance difference based on following different general types of diets, such as omnivorous, vegetarian, or vegan, remains questionable. Several underlying modifiable factors of long-distance running performance, especially runner training behaviors and experience, diminish the clarity of results when analyzing dietary subgroups. Based on the cross-sectional design (survey), the NURMI Study Step 2 aimed to investigate a plethora of training behaviors among recreational long-distance running athletes and the relationship of general diet types with best time race performance. The statistical analysis was based on Chi-squared and Wilcoxon tests. The final sample (n = 245) included fit recreational long-distance runners following an omnivorous diet (n = 109), a vegetarian diet (n = 45), or a vegan diet (n = 91). Significant differences were found between the dietary subgroups in body mass index (p = 0.001), sex (p = 0.004), marital status (p = 0.029), and running-related motivations for well-being (p < 0.05) but not in age (p = 0.054). No significant difference was found for best time half-marathon, marathon, and/or ultra-marathon race performance based on diet type (p > 0.05). Whether the vegan diet is associated with enhanced endurance performance remains unclear. Although, the present results are suggestive that 100% plant-based (vegan) nutrition is compatible with distance running performance at the least.

Training Behaviors and Periodization Outline of Omnivorous, Vegetarian, and Vegan Recreational Runners (Part A)-Results from the NURMI Study (Step 2)

Runners train for long-distance competitions based on underlying motivations, which may be similar to individual dietary motivations (e.g., well-being and performance). Fundamental training differences may arise in recreational runners following different diet types (omnivore, vegetarian, vegan) considering possible motive variations. Following a cross-sectional design, distance runners completed a survey (online), including a thorough assessment of training behaviors with generic training details and periodization specifics in three phases: 1. an intermediary and rebound stage, 2. a main preparatory stage, and 3. a main event stage (tapering or interim event level/s). Kruskal-Wallis and chi-squared tests were used in the statistical analysis. A total of 245 fit recreational runners following omnivore (n = 109), vegetarian (n = 45), and vegan diets (n = 91) were included. Significant differences in the initial running motivation were found across dietary subgroups (p = 0.033) as well as for current motivations (p = 0.038), with vegetarians being the least health motivated (27% and 9%, respectively). No differences in each of the specific periods were found between diet types across the outline (p > 0.05). The present evidence shows that there is a lack of fundamental training differences based on recreational runners following different generic types of diets. The results of the present investigation may be especially relevant for future studies on safety, sustainability, and performance-enhancing dietary practices among athletes.

Sex Differences in Training Behaviors of 10 km to Ultra-Endurance Runners (Part A)-Results from the NURMI Study (Step 2)

Training for running events is fundamental for successful participation in various running events such as 10 km, half-marathon, marathon, or ultra-marathon distances. Training behaviors are likely based on runner motivations and social constraints, particularly for females. Participants completed a questionnaire following a cross-sectional approach, including questions on sociodemographics, general training behaviors, and periodization training strategies. The final sample included 245 participants (141 females, 104 males), mostly from Germany (72%), Austria (18%), and Switzerland (5%), with a median age of 39 years (IQR 17) and a BMI of 21.7 kg/m² (IQR 3.5). Males more often trained alone and independently, whereas females were most likely to follow an external resource (p = 0.037). Non-parametric ANOVA revealed significant training differences between sexes in daily training mileages and durations at each phase and stage (p < 0.05) as well as in weekly training mileages and durations for general basic training and race-specific training (p < 0.05). Critical sex differences in training behaviors may arise from physiological differences and social expectations, which may be related to the distances they prefer to race at as well as their motivations for running and racing. This study provides a wide overview of training behaviors for endurance runners or professionals guiding healthy running performance.

Sex Differences in Racing History of Recreational 10 km to Ultra Runners (Part B)-Results from the NURMI Study (Step 2)

Sex differences in anatomy and physiology are the primary underlying factor for distinctions in running performance. Overall participation in recreational running events has been dominated by males, although increasing female participation has been reported in recent years. The NURMI study participants filled in a survey following the cross-sectional study design with questions on sociodemographic data, running and racing motivations, training behaviors, and racing history and experience. Data analysis included 141 female and 104 male participants aged 39 (IQR 17) with a healthy median BMI (21.7 kg/m²; IQR 3.5). Statistical analyses revealed sex differences with the males performing faster at half-marathon (p < 0.001) and marathon (p < 0.001) events but no difference at ultra-marathons (p = 0.760). Mediation analyses revealed no significant sex differences in the performance of half-marathon and marathon when considering training behaviors (p > 0.05), racing history (p > 0.05), or racing experience (p > 0.05). Differences in recreational performance may be more closely related to social constraints and expectations of females rather than the physiological advantages of the male athlete. Health professionals who guide and support recreational runners as well as the runners themselves and their coaches may benefit from this study's results in order to improve the best time performance through a deeper understanding of the areas that mediate sex differences.

Human health in peril: The need to upgrade medical education in light of COVID-19

While we might leave the COVID-19 pandemic behind, future health professionals are still confronted with another global phenomenon: the increasing pandemic of non-communicable diseases (NCDs). Both issues are strongly interwoven, yet current medical education fails to address their syndemic nature accordingly. There is scientific consensus that (i) most emerging infectious diseases are zoonotic, (ii) the overexploitation of earth's resources for animal protein production (i.e., tropical deforestation) rapidly escalates human contact with unknown pathogens, and (iii) people following a healthy plant-based diet present fewer rates of NCDs as well as severe illness and mortality from COVID-19. A shift toward whole food plant-based nutrition in the general population thus holds the potential to tackle both public health threats. We are convinced that it is every physician's responsibility to care for individual, public, and global health issues; however, future health professionals are not trained and educated regarding the health potential of plants and plant-based diets. The COVID-19 pandemic has demonstrated the urgent need for a "prevention first" approach. Therefore, in order to upgrade medical education worldwide and protect current and future human health properly, greater medical professional awareness of evidence on plant-based diets is urgently needed in classes, universities, and hospitals.

Dietary Intake of Recreational Endurance Runners Associated with Race Distance-Results from the NURMI Study (Step 2)

While the popularity of distance running is growing worldwide, endurance runners’ dietary challenges associated with their prolonged training and racing activities have not yet been fully understood. The present investigation was conducted with the aim of examining the association between race distance and dietary intake of distance runners. A total of 317 runners initially participated, and after data clearance, 211 endurance runners (57% females) were finally considered the study sample. Runners were assigned to three race distance groups: 10-km (n = 74), half-marathon (n = 83), and marathon/ultra-marathon (n = 54). An online survey was used to collect data; dietary intake was monitored using a comprehensive food frequency questionnaire, including 53 food groups categorized in 14 basic and three umbrella clusters. There was no significant difference (p > 0.05) between race distance groups in consumption of most food clusters except for “fruits and vegetables” and “total of protein”, with a predominance of 10-km runners compared to half-marathoners and (ultra-)marathoners (p ≤ 0.05). Age was a significant predictor for the consumption of only five (out of 17) food clusters (p ≤ 0.05), including “fruit and vegetables”, “unprocessed meat”, “processed meat”, “eggs”, and “plant protein”. Future investigations with a larger sample size and more differentiated (sub)groups may help provide comparable data to develop a better understanding of the dietary behaviors among shorter versus longer distance runners.

Female Endurance Runners Have a Healthier Diet than Males-Results from the NURMI Study (Step 2)

Sex has been recognized to be an important indicator of physiological, psychological, and nutritional characteristics among endurance athletes. However, there are limited data addressing sex-based differences in dietary behaviors of distance runners. The aim of the present study is to explore the sex-specific differences in dietary intake of female and male distance runners competing at >10-km distances. From the initial number of 317 participants, 211 endurance runners (121 females and 90 males) were selected as the final sample after a multi-level data clearance. Participants were classified to race distance (10-km, half-marathon, marathon/ultra-marathon) and type of diet (omnivorous, vegetarian, vegan) subgroups. An online survey was conducted to collect data on sociodemographic information and dietary intake (using a comprehensive food frequency questionnaire with 53 food groups categorized in 14 basic and three umbrella food clusters). Compared to male runners, female runners had a significantly greater intake in four food clusters, including “beans and seeds”, “fruit and vegetables”, “dairy alternatives”, and “water”. Males reported higher intakes of seven food clusters, including “meat”, “fish”, “eggs”, “oils”, “grains”, “alcohol”, and “processed foods”. Generally, it can be suggested that female runners have a tendency to consume healthier foods than males. The predominance of females with healthy dietary behavior can be potentially linked to the well-known differences between females and males in health attitudes and lifestyle patterns.

P220 Behcet"s disease with right ventricular aneurysm

Funding Acknowledgements

Nil

Introduction

Behcet’s disease (BD) is a rare inflammatory disorder, which predominantly impacts people of Mediterranean and East Asian origin. While the aetiology is unknown, the prevailing disorder is vasculitis. Oral, skin and ocular lesions are common: cardiac involvement is rare.

Case description

A sixty-three year old male with Behcet’s disease (BD) presented for review. On clinical examination, atrial fibrillation, prominent V waves, mild pedal oedema and a ‘to and fro’ murmur were noted. Marked elevation of right ventricular (RV) end diastolic pressure was measured by cardiac catheter.

Echocardiography and magnetic resonance imaging revealed significant RV abnormalities. The mid and apical RV regions were heavily trabeculated, and an anterior aneurysm was identified (see 2D image in abstract picture). A prominent horizontal muscular ridge in the basal RV was noted, and the RV outflow tract was narrowed. While the tricuspid valve was not apically displaced, leaflet coaptation was absent with subsequent severe tricuspid regurgitation into a grossly enlarged right atrium (see colour image in abstract picture). Management included diuretics and continuing immunosuppressives.

Discussion

BD is a rare (chronic) inflammatory disorder, which mainly affects people of Mediterranean and East Asian origin, and is often first diagnosed (in the third or fourth decades of life) following recurrent oral ulcerations, skin and ocular lesions. With BD, the prevailing disorder is vasculitis. Blood vessels of all sizes, both arteries and veins, are impacted: true or false aneurysms can occur.

BD rarely affects the heart. If there is cardiac involvement, pericarditis is the most common lesion - others include myocarditis, mitral valve prolapse, intra-cardiac thrombus and myocardial infarction. We present a rare (and possibly unique) cardiac manifestation of BD, anterior RV aneurysm.

Conclusion

In this case report we present a rare cardiac manifestation of BD, anterior RV aneurysm.

Abstract P220 Figure. Echocardiography Images

Sudden cardiac death in adults with congenitally corrected transposition of the great arteries

Background

Congenitally corrected transposition of the great arteries (ccTGA) is a rare congenital heart disease. There have been only few reports of sudden cardiac death (SCD) in patients with ccTGA and reasonable ventricular function.

Methods

A retrospective review of the medical records of all patients attending our adult congenital heart centre, with known ccTGA.

Results

From a database of over 3500 adult patients with congenital heart disease, we identified 39 (∼1%) with ccTGA and ‘two-ventricle’ circulations. 65% were male. The mean age at diagnosis was 12.4±11.4 years and the mean age at last time of review was 34.3±11.3 years. 24 patients (56%) had a history of surgical intervention. 8 (19%) had had pacemaker implantation and 2 had had a defibrillator implanted for non-sustained ventricular tachycardia (NSVT). In 544 years of patient follow-up, there had been five cases of SCD in our population; 1 death per 109 patient-years. Two of these patients had had previously documented supraventricular or NSVT. However, they were all classified as New York Heart Association (NYHA) class I or II, and systemic (right) ventricular function had been recorded as normal, mildly or mildly–moderately impaired, at most recent follow-up.

Conclusions

Our experience suggests the need for improved risk stratification and/or surveillance for malignant arrhythmia in adults with ccTGA, even in those with reasonable functional class on ventricular function.

Late outcomes in adults with coarctation of the aorta

AIMS

Previous cohort studies of patients with coarctation of the aorta (CoA) demonstrate reduced long-term survival. Improved surgical outcomes in children and evolution of adult congenital heart disease (ACHD) services have resulted in improved survival in patients with other CHDs. We hypothesise that for young adult patients with CoA long-term outcomes have improved in the contemporary era.

METHODS

151 patients (58% men) with simple CoA followed up at a tertiary ACHD service in Sydney, Australia, from 1993 to 2013 were included. We documented mortality and major morbidity such as the need for re-intervention for re-coarctation or aneurysms.

RESULTS

140 patients (mean age 35±15 years) underwent CoA repair at median age of 5 (IQR 0-10) years. Initial surgical strategy included end-to-end repair in 43, subclavian flap aortoplasty in 28 and patch aortoplasty in 31 patients (and was not documented in 28 cases). 6 patients had endovascular repair, 4 had interposition tube grafts and 11 were unrepaired. There were a total of seven deaths at a median age of 60 years. Actuarial survival was 98% at 40, 98% at 50 and 89% at 60 years of age. Re-coarctation occurred in 34% and descending aortic aneurysms were noted in 18%. Patients with end-to-end repair had lower rates of significant re-coarctation or descending aortic aneurysms (p=0.026 and <0.001, respectively). 66% had bicuspid aortic valve and 44% were hypertensive.

CONCLUSIONS

Patients with CoA who reach adolescence demonstrate very good long-term survival up to age 60 years. Long-term morbidity is common, however, related largely to aortic complications and late hypertension.