Effects of acute exercise on drug craving in adults with poly-substance use disorder. A randomized controlled trial

ObjectivesTo examine the short-term effects of exercise on drug craving in poly-drug-dependent inpatients, duration of effects, differences between exercise types, explore the relationship between craving and mood, and possible moderators.DesignMulticenter randomized control trial (RCT) with a crossover design.Methods38 (25 completed) inpatients (37.3 ± 6.4 years; 84 % male) from three treatment centers participated in soccer, circuit training and control condition in random order for 45-min. Craving was assessed with a self-rated visual analog scale (VAS), mood with Feeling scale (FS), immediately before and after each condition and 1, 2, and 4 h post interventions. Ratings of perceived exertion (RPE) and heart rate were assessed. Intervention effects were assessed using linear mixed effects model, including moderator analyses.ResultsExercise sessions were perceived as “somewhat hard” to “hard”. Compared to control, there was an immediate reduction in craving after soccer and circuit training (β = −1.35, 95 %CI: 1.96, −0.75, p = 0.000; β = -1.44, 95 %CI: 2.06, −0.83, p = 0.000) that persisted for 4 h (β = −1.11, 95 %CI: 1.72, −0.49, p = 0.000; β = -0.85, 95 %CI: 1.49, −0.22, p = 0.008). Elevations in mood after soccer (β = 1.08, 95 %CI: 0.41, 1.76, p = 0.002) and circuit training (β = 0.99, 95 %CI: 0.32, 1.67, p = 0.004) were significantly larger than control. Depressive disorder and primary drug of use might moderate the effect.ConclusionReduced drug cravings and elevated mood following soccer and circuit training were observed in people with poly-SUDs. Single exercise sessions can be an effective strategy to alleviate craving and potentially prevent relapse and treatment drop-out.     

Exercise interventions ameliorate neuropsychiatric symptoms in dementia: A meta-analysis

ObjectivesThis meta-analysis was aimed at systematically synthesizing the effects of exercise interventions on neuropsychiatric symptoms in individuals with dementia. The possible moderators that may influence intervention effects were also examined.MethodsWe searched seven databases (PubMed, Web of Science, SCOPUS, SportDiscus, Ebsco, China National Knowledge Infrastructure, and Wanfang) for randomized clinical trials. The pooled effect sizes were computed by the standardized mean difference (SMD) from post-intervention scores using random-effects models. Potential moderators were also explored by performing subgroup analyses and meta-regression. The risk of bias for included studies was evaluated by the Cochrane Risk of Bias 2.0 Tool.ResultsA total of 22 effect sizes from 17 studies (n = 1344) fulfilled the inclusion criteria. The results indicated that exercise interventions had a small but significant effect on neuropsychiatric symptoms in dementia (SMD = −0.27, 95% CI [−0.40,−0.14], p < 0.001). Subgroup analyses showed that intervention frequency and disease severity moderated the effects. Specifically, interventions with medium-frequency (3 times/week) had a positive effect on neuropsychiatric symptoms (SMD = −0.5, 95% CI [−0.65, −0.34], p < 0.001), but not with low-frequency (1–2 times/week) (SMD = −0.07, 95% CI [−0.22, 0.08], p = 0.38) or high-frequency (4–7 times/week) (SMD = −0.11, 95% CI [−0.36, 0.14], p = 0.38). Interventions had a beneficial effect on neuropsychiatric symptoms in people with mild dementia (SMD = −0.48, 95% CI [−0.71, −0.26], p < 0.001), and moderate dementia (SMD = −0.21, 95%CI [−0.37, 0.05], p < 0.05), but not severe dementia (SMD = −0.01, 95% CI [−0.33, 0.3], p = 0.94).ConclusionsExercise interventions effectively improve neuropsychiatric symptoms in mild and moderate dementia patients. Interventions occurring three times per week were associated with significant effects. Our findings provide evidence that exercise interventions may be an accessible and effective means for improving dementia patients' neuropsychiatric symptoms.     

Interventions for reducing loneliness: An umbrella review of intervention studies

Loneliness is a common phenomenon associated with several negative health outcomes. Current knowledge regarding interventions for reducing loneliness in randomised controlled trials (RCTs) is conflicting. The aim of the present work is to provide an overview of interventions to reduce loneliness, using an umbrella review of previously published systematic reviews and meta-analyses. We searched major databases from database inception to 31 March 2020 for RCTs comparing active versus non-active interventions for reducing loneliness. For each intervention, random-effects summary effect size and 95% confidence intervals (CIs) were calculated. For significant outcomes (p-value < 0.05), the GRADE (Grading of Recommendations Assessment, Development and Evaluation) tool was used, grading the evidence from very low to high. From 211 studies initially evaluated, seven meta-analyses for seven different types of interventions were included (median number of RCTs: 8; median number of participants: 600). Three interventions were statistically significant for reducing loneliness, that is, meditation/mindfulness, social cognitive training and social support. When applying GRADE criteria, meditation/mindfulness (mean difference, MD = −6.03; 95% CI: −9.33 to −2.73; very low strength of the evidence), social cognitive training (8 RCTs; SMD = −0.49; 95% CI: −0.84 to −0.13; very low strength of the evidence) and social support (9 RCTs; SMD = −0.13; 95% CI: −0.25 to −0.01; low strength of the evidence) significantly decreased the perception of loneliness. In conclusion, three intervention types may be utilised for reducing loneliness, but they are supported by a low/very low certainty of evidence indicating the need for future large-scale RCTs to further investigate the efficacy of interventions for reducing loneliness.     

Dropout from physical activity interventions in children and adolescents with attention deficit hyperactivity disorder: A systematic review and meta-analysis

Physical activity (PA) interventions have shown promising in improving core symptoms of children and adolescents with ADHD, yet treatment dropout may pose a challenge to routine implementation in clinical practice. We conducted a meta-analysis to investigate the prevalence and predictors of treatment dropout from PA interventions in children and adolescents with ADHD. Electronic databases were searched from inception until 06/2016. Randomized control trials of PA interventions in children and adolescents with ADHD reporting dropout rates were included. A random effects meta-analysis and meta-regression analyses were performed. In 8 studies involving 9 PA intervention arms, 148 children or adolescents assigned to a PA intervention (mean age range = 8.2–15.8 years, 87.8% male) were included. The trim and fill adjusted treatment dropout rate was 17.5% (95%CI = 9.8%–29.4%). The prevalence of dropouts in exercisers was not significantly different from the dropouts in control conditions (odds ratio, OR = 1.12; 95%CI = 0.48–2.65; I² = 0). Lower dropout was observed in sports interventions compared with structured aerobic exercise or yoga (p = 0.049). A higher proportion of male participants (β = 0.05; 95%CI = 0.001 to 0.10; p = 0.045, R² = 1.0) appeared to moderate higher dropout rates from PA interventions. Our findings suggest that in order to maximize PA participation, and therefore health benefits, sports-related interventions should be offered in the multidisciplinary treatment of children and adolescents with ADHD. Our data also suggest that males with ADHD may be more likely to dropout. Dropout rates are comparable to control conditions, suggesting that PA interventions are feasible in adolescents with ADHD.     

Associations between changes in physical fitness and psychological difficulties status among Norwegian adolescents

ObjectivesTo investigate the associations for one-year changes in cardiorespiratory fitness, muscular strength and body mass index, with psychological difficulties status in adolescents.MethodsNorwegian 14-15-year-olds (n = 925) participated in data collection at two time points separated by one year. Psychological difficulties were assessed via the Strengths and Difficulties questionnaire and data from follow-up serve as the dependent variable. Cardiorespiratory fitness (the Andersen-test), muscular strength (Eurofit) and body mass index were measured. Change scores were calculated from the physical fitness variables and serve as independent variables in linear mixed effects models.ResultsThere was no association between change in body mass index and psychological difficulties. Sex and socioeconomic status moderated the association between cardiorespiratory fitness and psychological difficulties. Immigrant status moderated the association between muscular strength and psychological difficulties. Subgroup results indicated inverse associations between change in cardiorespiratory fitness and psychological difficulties among boys (b = −0.009; 95% CI = −0.015 to −0.003; p = .006); change in muscular strength and psychological difficulties among immigrants (b = −1.97; 95% CI = −4.03 to 0.09; p = .061). Subgroup results also indicated an association between change in cardiorespiratory fitness and psychological difficulties among girls in the highest socioeconomic group (b = 0.014; 95% CI = 0.003 to 0.025; p = .014).ConclusionsThe associations for different fitness components were dependent on different moderators. Possibly, this indicates that associations in different subgroups are mediated by different mechanisms. Moderated associations should be addressed in future investigations.     

Depressive symptoms associated with psychological correlates of physical activity and perceived helpfulness of intervention features

The anti-depressive benefits of physical activity are well-evidenced; however little is known about whether people with more frequent depressive symptoms have different psychological correlates of physical activity than people with less frequent symptoms, or whether special consideration is needed in targeting web-based physical activity interventions toward people with frequent depressive symptoms. An online cross-sectional survey was used to collect data from 511 adults (age = 45.99 ± 14.73 years). Two multiple regression analyses were conducted to test the relationship between frequency of depressive symptoms and (1) psychological correlates of physical activity (i.e., intentions, perceived behavioral control, affective attitudes, instrumental attitudes, and perceived physical activity effectiveness), and (2) perceived helpfulness of a variety of web-based physical activity intervention features. People with more frequent depressive symptoms had lower perceived behavioral control of physical activity (β = −0.19), were more likely to report that goal-setting intervention tools (β = 0.10) and personally-relevant information (β = 0.09) would be helpful, and were less likely to report intervention features portraying information about how similar people are being regularly active as helpful (β = −0.10) than those with less frequent symptoms. These findings highlight key components for designing web-based physical activity intervention content for people with depressive symptoms.     

Multiple metabolic risk factors and mammographic breast density

PurposeWe examined whether obesity and a history of diabetes, hypertension, and elevated cholesterol, individually and in combination, are associated with breast density, a strong risk factor for breast cancer.MethodsWe measured percent density and dense area using a computer-assisted method (n = 191; age range = 40–61 years). We used linear regression models to examine the associations of each metabolic condition and the number of metabolic conditions (zero, one, two, and three or four conditions) with breast density.ResultsAmong individual metabolic conditions, only high blood cholesterol was inversely associated with percent density (β = −5.4, 95% confidence interval [CI]: −8.5, −2.2) and dense area (β = −6.7, 95% CI = −11.1, −2.4). Having multiple metabolic conditions was also associated with lower breast density, with two conditions and three or four conditions versus zero conditions associated with 6.4% (95% CI: −11.2, −1.6) and 7.4% (95% CI: −12.9, −1.9) reduction in percent density and with 6.5 cm² (95% CI: −13.1, −0.1) and 9.5 cm² (95% CI: −17.1, −1.9) decrease in dense area.ConclusionsA history of high blood cholesterol and multiple metabolic conditions were associated with lower relative and absolute measures of breast density. The positive association between metabolic abnormalities and breast cancer risk may be driven by pathways unrelated to mammographic breast density.     

A Delirium Risk Modification Program Is Associated With Hospital Outcomes

BackgroundDelirium has been associated with negative health consequences, which can potentially be improved by delirium risk modification. This study sought to determine if a quality improvement project to identify and modify delirium risk and discharge to rehabilitation is associated with improved outcomes for patients and health care systems.MethodsIn older veterans admitted to a tertiary VA hospital, delirium risk was assessed using cognitive impairment, vision impairment, and dehydration. Delirium risk was communicated to providers via electronic medical record. To modify delirium risk, interventions were provided in cognitive stimulation, sensory improvement, and sleep promotion. Primary outcomes included length of stay, restraint use, discharge to rehabilitation, and hospital variable direct costs. Outcomes were compared using a propensity-matched cohort of patients without intervention. Number of intervention categories was compared with primary outcomes.ResultsPatients (n = 1527) were older (78.2 ± 8.3 years) and male (98%). Propensity-matched patients (n = 566) were well matched for age, gender, cognitive deficits, vision impairment, and dehydration. Patients with interventions were discharged to rehabilitation similarly (mean difference [MD] 2.2%, 95% CI −2.5−6.9) and had lower lengths of stay (MD −0.7 day, 95% CI −1.3 to −0.1), lower restraint use (MD −4.0%, 95% CI −6.7 to −1.2) and trended toward lower variable direct costs (MD −$1390, 95% CI −3586−807). Increasing number of interventions was associated with shorter length of stay, lower rate of restraint use, and lower variable direct costs.ConclusionsThis delirium risk modification project was associated with patient outcomes and reduced costs. Serious consideration should be given to delirium risk identification and modification programs.     

Use of an adapted participatory learning and action cycle to increase knowledge and uptake of child vaccination in internally displaced persons camps (IVACS): A cluster-randomised controlled trial

BackgroundVaccination is a key public health intervention that can reduce excess mortality in humanitarian contexts. Vaccine hesitancy is thought to be a significant problem requiring demand side interventions. Participatory Learning and Action (PLA) approaches have proven effective in reducing perinatal mortality in low income settings and we aimed to apply an adapted approach in Somalia.MethodsA randomised cluster trial was implemented in camps for internally displaced people near Mogadishu, from June to October 2021. An adapted PLA approach (hPLA) was used in partnership with indigenous ‘Abaay-Abaay’ women’s social groups. Trained facilitators ran 6 meeting cycles that addressed topics of child health and vaccination, analysed challenges, and planned and implemented potential solutions. Solutions included a stakeholder exchange meeting involving Abaay-Abaay group members and services providers from humanitarian organisations. Data was collected at baseline and after completion of the 3 month intervention cycle.ResultsOverall, 64.6% of mothers were group members at baseline and this increased in both arms during the intervention (p = 0.016). Maternal preference for getting young children vaccinated was >95% at baseline and did not change. The hPLA intervention improved the adjusted maternal/caregiver knowledge score by 7.9 points (maximum possible score 21) compared to the control (95% CI 6.93, 8.85; p < 0.0001). Coverage of both measles vaccination (MCV1) (aOR 2.43 95% CI 1.96, 3.01; p < 0.001) and completion of the pentavalent vaccination series (aOR 2.45 95% CI 1.27, 4.74; p = 0.008) also improved. However, adherence to timely vaccination did not (aOR 1.12 95% CI 0.39, 3.26; p = 0.828). Possession of a home-based, child health record card increased in the intervention arm from 18 to 35% (aOR 2.86 95% CI 1.35, 6.06; p = 0.006).ConclusionA hPLA approach, run in partnership with indigenous social groups, can achieve important changes in public health knowledge and practice in a humanitarian context. Further work to scale up the approach and address other vaccines and population groups is warranted.     

Effect of zinc supplementation on blood sugar control in the overweight and obese population: A systematic review and meta-analysis of randomized controlled trials

BackgroundAlthough overweight and obese people have a higher risk of type 2 diabetes incidence than normal-weight individuals, the efficacy of zinc supplementation in blood sugar control in overweight and obese people remained unknown. This meta-analysis attempted to address this issue.MethodsDatabases including PubMed, Embase, and the Cochrane Library were searched from inception until May 2022 to identify randomized controlled trials (RCTs) investigating the effects of zinc supplementation among participants who were overweight or obese without language restriction. It is a random-effect meta-analysis that analyzed the impact of zinc supplementation on fasting glucose (FG) (i.e., primary outcome) and other variables including fasting insulin (FI), homeostasis model assessment-insulin resistance index (HOMA-IR), glycated hemoglobin (HbA1c), high-sensitivity C-reactive protein (hs-CRP), and 2-hour postprandial glucose (2 h- PG).ResultsAnalysis of 12 eligible RCTs involving 651 overweight/obese participants demonstrated that zinc supplementation significantly improves FG (weighted mean difference [WMD]: −8.57 mg/dL; 95% confidence interval [CI]: −14.04 to −3.09 mg/dL, p = 0.002), HOMA-IR (WMD: −0.54; 95% CI: −0.78 to −0.30, p < 0.001), HbA1c (WMD: −0.25%; 95% CI: −0.43% to −0.07%, p = 0.006), and 2 h-PG (WMD: −18.42 mg/dL; 95% CI: −25.04 to −11.79 mg/dL, p < 0.001) compared to those in the control group. After conducting subgroup analyses, we found that the primary outcome, FG, showed more significant results in the subgroups with Asia, Zinc supplementation alone, higher dose (≥30 mg) and patients with diabetes.ConclusionOur meta-analysis indicated that zinc supplementation benefits blood sugar control in overweight and obese populations, with an especially significant reduction in FG.     

Anti-Müllerian Hormone levels after metformin treatment in polycystic ovary syndrome: A systematic review and meta-analysis

This systematic review and meta-analysis aim to evaluate whether treatment with metformin would reduce Anti-Müllerian Hormone levels in patients with polycystic ovary syndrome. A search was performed in Medline, Embase, Web of Science, and Cochrane Library databases and grey literature (Google Scholar). The following keywords were used in the search strategy: “Polycystic Ovary Syndrome”, “Anti-Mullerian Hormone”, “Metformin”. The search was limited to human studies, with no language restriction. 328 studies were found, 45 studies were selected for full-text reading and 16 of those studies, six randomized controlled trial and 10 non-randomized studies were included. The synthesis of randomized controlled trials, metformin showed a reduction in serum levels of Anti-Müllerian Hormone compared to control groups (SMD – 0.53, 95 %CI − 0.84 to − 0.22, p < 0.001, I² = 0 %, four studies, 171 participants, high quality of evidence). Six non-randomized studies evaluated data before and after the metformin intervention. The synthesis showed that using metformin reduced serum Anti-Müllerian Hormone values (SMD – 0.79, 95 %CI − 1.03 to − 0.56, p < 0.001, I² = 0 %, six studies, 299 participants, low quality of evidence). Metformin administration in women with polycystic ovary syndrome is associated significantly with reduced Anti-Müllerian Hormone serum levels.     

Cardiorespiratory fitness levels and moderators in people with HIV: A systematic review and meta-analysis

Cardiorespiratory fitness (CRF) is a modifiable risk factor for cardiovascular disease and premature mortality. CRF levels and moderators among people living with HIV (PLWH) are unknown. The aim of the current meta-analysis was to (1) determine mean CRF in PLWH and compare levels with age- and gender-matched healthy controls (HCs), (2) explore moderators of CRF, (3) and (4) explore moderators of CRF outcomes following physical activity (PA) interventions. Major electronic databases were searched systematically for articles reporting CRF expressed as maximum or peak oxygen uptake (ml/min/kg) in PLWH. A random effects meta-analysis calculating the pooled mean CRF including subgroup- and meta-regression analyses was undertaken. Across 21 eligible studies, the CRF level was 26.4 ml/kg/min (95% CI = 24.6 to 28.1) (n = 1010; mean age = 41 years). There were insufficient data to compare CRF levels with HCs. A higher body mass index (β = − 0.99, 95% CI = − 1.93 to − 0.06, P = 0.04), older age (β = − 0.31, 95% CI = − 0.58 to − 0.04, P = 0.02) and the presence of lipodystrophy (β = − 4.63, 95% CI = − 7.88 to − 1.39, P = 0.005) were significant moderators of lower CRF levels. Higher CD4 + counts (β = 0.004, 95% CI = 0.0007 to 0.007, P = 0.016), supervised interventions (P < 0.001) and interventions with a lower frequency of weekly sessions (2 or 3 versus 4 times) (P < 0.001) predicted a better CRF-outcome following PA. CRF levels of PLWH are among the lowest in comparison to other vulnerable populations. More research on the most optimal physical activity intervention characteristics is needed.     

Prostate cancer screening practices and diagnoses in patients age 50 and older,Southeastern Michigan,pre/post 2012

IntroductionStudies investigating the regional impact of the 2012 U.S. Preventive Services Task Force (USPSTF) recommendation against the use of prostate specific antigen (PSA) screening for prostate cancer have been limited.MethodsA retrospective cohort study was conducted on men age 50 years and older in Southeastern Michigan pre (n = 3647) and post (n = 3618) USPSTF recommendation. PSA screening, transrectal ultrasound, and prostate biopsy rates were evaluated pre/post using a generalized piecewise linear model with a Poisson distribution, and log link. A knot was placed at year 2011 to estimate pre/post slope coefficients. Generalized estimating equations were used to estimate the marginal probability of a prostate diagnosis as a logistic function of pre and post-period, and comorbidities.ResultsPSA utilization significantly increased (β = 0.28; 95% CI: 0.25, 0.31) during the pre-period, but significantly decreased in the post-period (β = − 0.29; 95% CI: − 0.34, − 0.25). Prostate biopsies decreased pre (β = − 0.16; 95% CI: − 0.25, − 0.08) and did not change post (β = 0.01; 95% CI: − 0.09, 0.12). Transrectal ultrasounds were stable pre (β = 0.16; 95% CI: − 0.03, 0.35) and significantly decreased post (β = − 0.27; 95% CI: − 0.50, − 0.04). Patients in the post-period had a decreased probability of having a diagnosis of prostate cancer (OR: 0.81; 95% CI: 0.74–0.89) compared to the pre-period.ConclusionOur study demonstrates how PSA tests are still being frequently used in Southeastern Michigan. Further research is needed to better understand regional variation in prostate cancer screening practices in the U.S.     

Coffee consumption and cancer risk: a Mendelian randomisation study

BackgroundCoffee contains many bioactive chemicals and associations with cancer have been reported in observational studies. In this Mendelian randomisation (MR) study we investigated the causal associations of coffee consumption with a broad range of cancers.Materials and methodsTwelve independent genetic variants proxied coffee consumption. Genetically-predicted risk of any cancer (59,647 cases) and 22 site-specific cancers was estimated in European-descent individuals in UK Biobank. Univariable and multivariable MR analyses were conducted.ResultsGenetically-predicted coffee consumption was not associated with risk of any cancer in the main analysis (OR 1.05, 95% CI 0.98–1.14, p = 0.183) but was associated with an increased risk of digestive system cancer (OR 1.28, 95% CI 1.09–1.51, p = 0.003), driven by a strong association with oesophageal cancer (OR 2.79, 95% CI 1.73–4.50, p = 2.5×10^?5). This association was consistent after adjustment for genetically-predicted body mass index, smoking and alcohol consumption. There was no strong evidence supporting a causal relationship between genetically-predicted coffee consumption and the majority of cancers studied. However, genetically-predicted coffee consumption was associated with increased risk of multiple myeloma (OR 2.25, 95% CI 1.30–3.89, p = 0.004) and reduced ovarian cancer risk (OR 0.63, 95% CI 0.43–0.93, p = 0.020).ConclusionsThis MR study provides strong support for a causal association of coffee consumption with oesophageal cancer, but not for the majority of cancer types, and the underlying mechanisms require investigation.     

Efficacy and Generalizability of Falls Prevention Interventions in Nursing Homes: A Systematic Review and Meta-analysis

ObjectivesTo determine the efficacy of fall intervention programs in nursing homes (NHs) and the generalizability of these interventions to people living with cognitive impairment and dementia.DesignSystematic review and meta-analysis.Setting and ParticipantsNH residents (n = 30,057) living in NHs defined as residential facilities that provide 24-hours-a-day surveillance, personal care, and some clinical care for persons who are typically aged ≥65 years with multiple complex chronic health conditions.MethodsMeta-analysis of falls prevention interventions on number of falls, fallers, and recurrent fallers.ResultsThirty-six studies met inclusion criteria for the systematic review. Overall, fall prevention interventions reduced the number of falls [risk ratio (RR) = 0.73, 95% confidence interval (CI) = 0.60-0.88], fallers (RR = 0.80, 95% CI = 0.72-0.89), and recurrent fallers (RR = 0.70, 95% CI = 0.60-0.81). Subanalyses revealed that single interventions have a significant effect on reducing fallers (RR = 0.78, 95% CI = 0.69-0.89) and recurrent fallers (RR = 0.60, 95% CI = 0.52-0.70), whereas multiple interventions reduce fallers (RR = 0.69, 95% CI = 0.39-0.97) and multifactorial interventions reduce number of falls (RR = 0.65, 95% CI = 0.45-0.94).Conclusions and ImplicationsExercise as a single intervention reduced the number of fallers and recurrent fallers by 36% and 41%, respectively, in people living in NHs. Other effective interventions included staff education and multiple and multifactorial interventions. However, more research on exercise including people with cognitive impairment and dementia is needed to improve the generalizability of these interventions to the typical NH resident.     

Physical activity trajectories and cognitive function: A national cohort study

ObjectiveTo examine the prospective associations between physical activity trajectories, measured from repeated assessments over time, and cognitive function.MethodA total of 2972 participants aged 45 years old and over (median age: 56.0 [interquartile range - IQR 50.0–62.0], 50.8% males]) from the Chinese Health and Retirement Longitudinal Study (CHARLS) study were included. First, our study used the growth mixture modeling to identify physical activity trajectories from the first three surveys of the CHARLS. Second, we performed regression analysis to explore the associations of the trajectories with 3-year cognitive function.ResultsWe identified four physical activity trajectories, characterized by persistently low (N = 1880), initially low then increasing (154), initially moderate then decreasing (584), and initially high then decreasing (354). After 3-year follow-up, compared to individuals with persistently low trajectory, those with initially moderate then decreasing (β = −0.74, 95% CI = (−1.38, −1.10), p = 0.024) and initially high then decreasing (β = −1.12, 95% CI = (−1.91, −0.33), p = 0.005) were significantly associated with cognitive decline. The effects of the decline in physical activity on cognitive function varied by sex. Females’ cognitive function (β = −1.79, 95% CI = (−2.82, −0.77) was more likely to be influenced by decreasing physical activity, but this association was not significant in males. We did not find the significant effect of initially low then increasing trajectory on cognitive function.ConclusionsFast decline in physical activity is related to a higher risk of cognitive decline, especially in females.     

Neighborhood social environment and changes in leukocyte telomere length: The Multi-Ethnic Study of Atherosclerosis (MESA)

Given limited research on the impact of neighborhood environments on accelerated biological aging, we examined whether changes in neighborhood socioeconomic and social conditions were associated with change in leukocyte telomere length using 10 years of longitudinal data from the Multi-Ethnic Study of Atherosclerosis (years 2000–2011; N = 1031; mean age = 61, SD = 9.4). Leukocyte telomere length change was corrected for regression to the mean and neighborhood was defined as census tract. Neighborhood socioeconomic indicators (factor-based score of income, education, occupation, and wealth of neighborhood) and neighborhood social environment indicators (aesthetic quality, social cohesion, safety) were obtained from the U.S Census/American Community Survey and via study questionnaire, respectively. Results of linear mixed-effects models showed that independent of individual sociodemographic characteristics, each unit of improvement in neighborhood socioeconomic status was associated with slower telomere length attrition over 10-years (β = 0.002; 95% Confidence Interval (CI): 0.0001, 0.004); whereas each unit of increase in safety (β = −0.043; 95% CI: -0.069, −0.016) and overall neighborhood social environment score (β = -0.005; 95% CI: -0.009, −0.0004) were associated with more pronounced telomere attrition, after additionally adjusting for neighborhood socioeconomic status. This study provides support for considerations of the broader social and socioeconomic contexts in relation to biological aging. Future research should explore potential psychosocial mechanisms underlying these associations using longitudinal study designs with repeated observations.     

The role of resistance training in influencing insulin resistance among adults living with obesity/overweight without diabetes: A systematic review and meta-analysis

The purpose of this study was to systematically examine the independent effect of resistance training (RT) on markers of insulin resistance (IR) (fasting insulin and HOMA-IR) among individuals with overweight/obesity without diabetes. PubMed, SPORTdiscus, SCOPUS, Prospero, and clinicaltrials.gov were searched through December 19, 2022. Article screening was conducted in three phases: title screen (n = 5020), abstract screen (n = 202), and full text screen (n = 73). A total of 27 studies with 402 individual data points were used for the meta-analysis. Comprehensive Meta-Analysis software version 3.0 was used to interpret pre- and post-IR measurements with a random-effects model. Exploratory sub-analyses were conducted on studies for only females, only males, and age (< 40 and ≥ 40 years). RT had a significant effect on fasting insulin (− 1.03, 95 % CI − 1.03, − 0.75 p < 0.001) and HOMA-IR (− 1.05, 95 % CI − 1.33, − 0.76, p < 0.001). Sub-analyses revealed that males had a more pronounced effect compared to females and those < 40 years of age had a more pronounced effect compared to those ≥ 40 years. The results of this meta-analysis illustrate that RT plays an independent role in improving IR among adults with overweight/obesity. RT should continue to be recommended as part of preventive measures among these populations. Future studies examining the effect of RT on IR should consider dose centered on the current U.S. physical activity guidelines.     

A systematic review of SNAPO (Smoking,Nutrition, Alcohol,Physical activity and Obesity) randomized controlled trials in young adult men

ObjectivesTo investigate the effectiveness of Smoking, Nutrition, Alcohol, Physical activity and Obesity (SNAPO) interventions in young men exclusively. The secondary aim was to evaluate the recruitment, retention and engagement strategies.MethodsA search with no date restrictions was conducted across seven databases. Randomized controlled trials recruiting young men only (aged 18–35 years) into interventions targeting any SNAPO risk factors were included.ResultsTen studies were included (two nutrition, six alcohol use, two targeting multiple SNAPO risk factors). Six studies (two nutrition, three alcohol use and one targeting multiple SNAPO risk factors) demonstrated significant positive short-term intervention effects, but impact was either not assessed beyond the intervention (n = 3), had short-term follow-up (≤ 6 months) (n = 2) or not sustained beyond six months (n = 1). Overall, a high risk of bias was identified across studies. Only one study undertook a power calculation and recruited the required sample size. Adequate retention was achieved in three studies. Effectiveness of engagement strategies was not reported in any studies.ConclusionsDespite preliminary evidence of short-term effectiveness of SNAPO interventions in young men, few studies characterized by a high risk of bias were identified. High quality SNAPO interventions for young men are warranted.     

Impact of Buddhist Lent Dry Campaign on alcohol consumption behaviour: A community level study

“Buddhist Lent Dry Campaign” is an alcohol‐control programme that uses religious opportunities to promote behavioural changes among the Thai population. It is undertaken at the national and community levels. This study aimed to systematically evaluate the effectiveness of the community‐level intervention under the campaign on alcohol consumption behaviour. A prospective cohort study was conducted. The sample comprised 447 drinkers from four intervention communities and 388 from four non‐intervention communities. All were subjected to a series of sequential interviews. Our findings showed that the availability of the community intervention had a significant effect on alcohol abstinence not only during Buddhist Lent (OR = 2.74, 95% CI = 1.96, 3.85), but also 3 months after the end of Buddhist Lent (OR = 2.19, 95% CI = 1.42, 3.38). Furthermore, the intervention was very effective among drinkers who took an abstinence pledge (OR = 7.04, 95% CI = 4.49, 11.04). However, the effectiveness of the community intervention weakened after the intervention it ended. Additional interventions might be required to maintain the effects of the community intervention.