Abstract For centuries, the search for nutritional interventions to underpin cardiovascular treatment and prevention guidelines has contributed to the rapid development of the field of dietary patterns and cardiometabolic disease (CMD). Numerous studies have demonstrated that healthy dietary patterns with emphasis on food‐based recommendations are the gold standard for extending lifespan and reducing the risks of CMD and mortality. Healthy dietary patterns include various permutations of energy restriction, macronutrients, and food intake patterns such as calorie restriction, intermittent fasting, Mediterranean diet, plant‐based diets, etc. Early implementation of healthy dietary patterns in patients with CMD is encouraged, but an understanding of the mechanisms by which these patterns trigger cardiometabolic benefits remains incomplete. Hence, this review examined several dietary patterns that may improve cardiometabolic health, including restrictive dietary patterns, regional dietary patterns, and diets based on controlled macronutrients and food groups, summarizing cutting‐edge evidence and potential mechanisms for CMD prevention and treatment. Particularly, considering individual differences in responses to dietary composition and nutritional changes in organ tissue diversity, we highlighted the critical role of individual gut microbiota in the crosstalk between diet and CMD and recommend a more precise and dynamic nutritional strategy for CMD by developing dietary patterns based on individual gut microbiota profiles.

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/mco2.212

Dietary patterns and cardiometabolic health: Clinical evidence and mechanism

Background: Lifestyle Medicine (LM) aims to address six main behavioral domains: diet/nutrition, substance use (SU), physical activity (PA), social relationships, stress management, and sleep. Digital Health Interventions (DHIs) have been used to improve these domains. However, there is no consensus on how to measure lifestyle and its intermediate outcomes aside from measuring each behavior separately. We aimed to describe (1) the most frequent lifestyle domains addressed by DHIs, (2) the most frequent outcomes used to measure lifestyle changes, and (3) the most frequent DHI delivery methods. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR) Extension for Scoping Reviews. A literature search was conducted using MEDLINE, Cochrane Library, EMBASE, and Web of Science for publications since 2010. We included systematic reviews and meta-analyses of clinical trials using DHI to promote health, behavioral, or lifestyle change. Results: Overall, 954 records were identified, and 72 systematic reviews were included. Of those, 35 conducted meta-analyses, 58 addressed diet/nutrition, and 60 focused on PA. Only one systematic review evaluated all six lifestyle domains simultaneously; 1 systematic review evaluated five lifestyle domains; 5 systematic reviews evaluated 4 lifestyle domains; 14 systematic reviews evaluated 3 lifestyle domains; and the remaining 52 systematic reviews evaluated only one or two domains. The most frequently evaluated domains were diet/nutrition and PA. The most frequent DHI delivery methods were smartphone apps and websites. Discussion: The concept of lifestyle is still unclear and fragmented, making it hard to evaluate the complex interconnections of unhealthy behaviors, and their impact on health. Clarifying this concept, refining its operationalization, and defining the reporting guidelines should be considered as the current research priorities. DHIs have the potential to improve lifestyle at primary, secondary, and tertiary levels of prevention—but most of them are targeting clinical populations. Although important advances have been made to evaluate DHIs, some of their characteristics, such as the rate at which they become obsolete, will require innovative research designs to evaluate long-term outcomes in health.

/pdf/what-are-we-measuring-when-we-evaluate-digital-interventions-3hejwtij.pdf

What Are We Measuring When We Evaluate Digital Interventions for Improving Lifestyle? A Scoping Meta-Review

https://www.arca.fiocruz.br/bitstream/icict/48906/2/The%20cumulative_Marcelo_Alves_etal_INI_2021_COVID-19.pdf

The cumulative effect of multiple dimensions of lifestyle on risky drinking during the Covid-19 pandemic.

BACKGROUND AND OBJECTIVES
Dementia prevalence continues to rise. It is therefore essential to provide feasible and effective recommendations to encourage healthy brain ageing and reduce dementia risk across the population. Appropriate nutrition represents a potential strategy to mitigate dementia risk and could be recommended by clinicians as part of mid-life health checks and other health initiatives to reduce dementia prevalence. The purpose of this review is to provide a clinician-focused update on the current state of the knowledge on nutrition and dementia prevention.


METHODS
Narrative review.


RESULTS
Strong evidence exists to support the consumption of healthy, plant-based dietary patterns (e.g. Mediterranean, MIND or Nordic diet) for maintaining cognitive function and reducing dementia risk in later life and is supported by dementia prevention guideline from leading public health bodies (e.g. World Health Organization). Emerging evidence suggests potential cognitive benefits of consuming specific nutrients/foods (e.g. n-3 fatty acids or fish, flavonols and B-vitamins) and multi-nutrient compounds (e.g. Fortasyn Connect). Challenges and opportunities for integrating nutritional/dietary interventions for dementia prevention into clinical practice are explored in this review.


CONCLUSIONS
Appropriate nutrition represents an important factor to help facilitate healthy cognitive ageing and allay dementia risk. The information provided in this article can help clinicians provide informed opinions on appropriate nutritional strategies as part of mid-life Health Checks and other risk reduction initiatives.

Nutrition for dementia prevention: a state of the art update for clinicians.

Identifying factors that affect mortality requires a robust statistical approach. This study’s objective is to assess an optimal set of variables that are independently associated with the mortality risk of 433 older comorbid adults that have been discharged from the geriatric ward. We used both the stepwise backward variable selection and the iterative Bayesian model averaging (BMA) approaches to the Cox proportional hazards models. Potential predictors of the mortality rate were based on a broad range of clinical data; functional and laboratory tests, including geriatric nutritional risk index (GNRI); lymphocyte count; vitamin D, and the age-weighted Charlson comorbidity index. The results of the multivariable analysis identified seven explanatory variables that are independently associated with the length of survival. The mortality rate was higher in males than in females; it increased with the comorbidity level and C-reactive proteins plasma level but was negatively affected by a person’s mobility, GNRI and lymphocyte count, as well as the vitamin D plasma level.

https://www.mdpi.com/2072-6643/13/4/1098/pdf

Identification of Mortality Risks in the Advancement of Old Age: Application of Proportional Hazard Models Based on the Stepwise Variable Selection and the Bayesian Model Averaging Approach.

Background this article investigates the association between life satisfaction and disability-free survival, and explores the roles of chronic diseases and healthy lifestyle in this association. Method a cohort of 2,116 functionally independent adults aged ≥60 was followed up to 12 years. At baseline, life satisfaction was assessed with the Life Satisfaction Index A (LSI-A). Disability-free survival was defined as the survival till the first occurrence of either death, dementia or physical disability. Information on lifestyle factors was collected via questionnaire. Chronic diseases were ascertained through clinical examinations at baseline and each follow-up. Data were analysed using Cox proportional hazard regression models and Laplace regression. Results over follow-up, 1,121 participants died, developed dementia, or became disabled. High LSI-A versus Low LSI-A had a lower risk of death, dementia and physical disability (hazard ratio [HR] 0.79, 95% confidence intervals [CI] 0.67-0.94), and had a longer disability-free period by 1.73 (95% CI 0.18-3.32) years. In mediation analysis, accumulation of chronic diseases mediated 17.8% of the association between LSI-A and disability-free survival. In joint effect analysis, participants with high LSI-A and a favourable lifestyle profile had a HR of 0.53 (95% CI 0.41-0.69) for the composite endpoint, and lived 3.2 (95% CI 1.35-5.11) disability-free years longer than those with low life satisfaction and an unfavourable lifestyle profile. Discussion high life satisfaction is independently associated with longer disability-free survival. This association is partially mediated by a lower burden of chronic diseases and is reinforced by healthy lifestyle.

Association of life satisfaction with disability-free survival: role of chronic diseases and healthy lifestyle.

Background It remains unclear whether and to what extent health behaviours may prolong survival and compress the period of survival with disability. Objective To identify modifiable health behaviours that are associated with later disability onset and longer disability-free survival. Design This population-based cohort study used data from the Swedish National Study on Ageing and Care in Kungsholmen (SNAC-K) ranging between 2001 and 2016. Setting and subjects A total of 3,041 disability-free adults aged ≥60 years were followed up to 15 years. Methods Data on health behaviours were collected at baseline. Information on limitations in activities of daily living was obtained at baseline and during the follow-up. Laplace regression was used to model the median age at death and disability occurrence as a function of health behaviours. Results Never smoking, moderate alcohol drinking, rich social network and high leisure activity were individually related to longer survival by 1-3 years. Participants with high leisure activity lived 1.6 years (95% CI: 0.9-2.3) more without a disability. After combining lifestyle factors, social network, and leisure activities into a 4-level 'health behaviour profile', people with the healthiest behaviour profile lived 2.8 years (95% CI: 1.3-4.2) longer, had disability 3.5 years (95% CI: 1.7-5.3) later and lived 0.7 years (95% CI, 0.4-1.1) more without a disability compared to those with the least healthy behaviours profile. Conclusions These findings suggest that health behaviours could prolong the lifespan, and leisure activities may further compress years lived with disability among older adults.

Can health behaviours prolong survival and compress the period of survival with the disability? A population-based cohort study

The Nordic prudent diet prolongs survival with good mental and physical functioning among older adults: The role of healthy lifestyle.

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Papers

Association of life satisfaction with disability-free survival: role of chronic diseases and healthy lifestyle.

Can health behaviours prolong survival and compress the period of survival with the disability? A population-based cohort study

The Nordic prudent diet prolongs survival with good mental and physical functioning among older adults: The role of healthy lifestyle.