Vitamin D (VD) is involved in a wide variety of physiological processes. The high prevalence of VD deficiency in the population requires stronger preventive measures. The aim was to characterize the dietary and lifestyle determinants of VD levels in blood and of VD deficiency to further develop predictive models of these two outcomes. A total of 63,759 participants from the UK Biobank study with available data on dietary intake of VD, assessed via 24-hour recalls, and with measurements of serum 25(OH)D levels were included. Linear and logistic regression models were applied to identify factors associated with VD levels and VD deficiency outcomes, and to evaluate the influence of covariates on the association between VD in serum and VD in the diet. Predictive models for both VD outcomes were constructed using classical regression models and machine learning methods based on penalized likelihood methods. Approximately 10% of the participants had VD deficiency (VD < 25 nmol/L), and 38.9% were at risk of VD inadequacy (VD 25-49 nmol/L). The dietary intake of VD was significantly lower in the VD deficient group. This latter group showed lower engagement in physical activity (22.1%) compared to the non-deficient group (13.4%; P<.001). Also, overweight and obesity (vs normal weight) were related to a greater likelihood of VD deficiency (OR=1.18 and 1.96, respectively). A similar odds of VD deficiency was observed for abdominal obesity (OR=1.83). A weaker association was observed between dietary VD intake, based on participant reports, and VD levels. With regard to sunlight exposure, darker skin tones (OR dark vs fair skin=3.11), season (OR winter vs autumn=3.76) and less outdoor time activities (OR per 1 h increase=0.96) were also related to VD deficiency. Predictive models for both classical regression and machine learning, showed good accuracy (AUC=0.8-0.9 for VD deficiency). In conclusion, while a rich diet in VD boosts its levels, sun exposure plays a more significant role particularly in populations from the UK or Northern Europe. A predictive model including key determinants could effectively assess VD deficiency.

The association between moderate-to-vigorous physical activity (MVPA) with depression are clear but needs to be investigated considering dynamic changes in MVPA. We investigated the association of longitudinal changes in MVPA with depression-related outcomes among depressed and non-depressed participants. From 209,095 depressed and 3,777,173 non-depressed participants of South Korea, MVPA was assessed from health screenings during period 1 (2014-15) and 2 (2016-17) using self-reported questionnaires. Participants were followed up from January 1, 2018 to 1-year and 3-year for any diagnosis of depression. Adjusted odds ratio (aOR) and 95 % confidence interval (CI) were calculated using multivariable-adjusted logistic regression analysis. From depressed participants, consistently highly active participants showed the lowest odds for incident depression (aOR 0.81; 95 % CI 0.70-0.95), while those who increased MVPA showed the lowest odds for depressive symptom (aOR 0.77; 95 % CI 0.72-0.82). When combining MVPA status during period 0 (2012-13) for the longitudinal analysis, the participant with depression at period 1 showed a lower odds if they maintained to be physically active before and after depression diagnosis (from period 0 to period 2). We found epidemiologic evidence that longitudinal evaluation for MVPA from pre-depression state may be important on analyzing depression-related risk.

Poor sleep is common among young adults and is often associated with pain. This study investigates the relationship between pain-related outcomes, sleep quality, and quality of life (QoL) in young adults with and without knee pain.

This study is a secondary analysis of the 5-year follow-up of a prospective cohort study. Five hundred twenty-three young adults were surveyed for knee pain in 2011 and followed up 5 years later. Respondents reporting knee pain at both points were categorized as having knee pain (n = 177), while controls did not report knee pain (n = 85). Five-year follow-up data assessed clinical pain intensity, pain-related outcomes, QoL, and physical activity. In addition, respondents were scored as having good, moderate, or poor sleep quality.

Respondents in the knee pain group with poor sleep had worse Knee injury and Osteoarthritis Outcome Score (Knee Outcome and Osteoarthritis Score) across all domains ( P < 0.05), decreased QoL ( P < 0.001), impacted mood ( P < 0.05), and impacted everyday life ( P < 0.001) compared with those with good sleep. Respondents with poor sleep in both the knee pain and control group reported more pain sites per month ( P < 0.01) compared with those with good sleep. Finally, respondents in the knee pain group with poor sleep had increased pain medication usage compared with those with good sleep ( P < 0.05).

This study emphasizes the negative association between poor sleep quality and knee pain in young adults. The results indicate a need for strategies to address sleep disturbances in young adults to alleviate pain-related suffering and to increase HRQoL.

This study aims to investigate the prevalence of intermittent fasting (IF) among Chinese residents aged 18-80 and assess its impact on physical activity (PA) levels.

Data were sourced from the Psychology and Behavior Investigation of Chinese Residents, a nationally representative cross-sectional survey conducted between June 20 and 31 August 2022. A multistage stratified cluster sampling method was used. Propensity score matching (PSM) was applied to compare PA levels between individuals practicing IF and those not practicing it. Multiple logistic regression and subgroup analysis were performed to explore associations between PA levels and relevant factors.

IF was practiced by 9.78% of participants, with the highest prevalence (70.78%) among those aged 18-34. While there were no significant differences in baseline characteristics between the IF and non-IF groups, sleep duration differed. IF was significantly associated with reduced PA levels (OR = 0.769, 95%CI: 0.657-0.900), and subgroup analysis highlighted the effect of sleep patterns on PA.

IF is common among younger Chinese residents and correlates with lower PA levels, indicating a potential need for individualized health guidance to balance dietary strategies with PA.

It is unclear whether physical activity can benefit participants with high genetic predisposition to cardiovascular disease. We examined the joint associations of intensity-specific physical activity and genetic predisposition (based on polygenetic risk score) with incident coronary heart disease (CHD), stroke, and atrial fibrillation (AF).

This prospective cohort study included 303,950 adults (age = 56.4 ± 8.0 years, mean ± SD; 52.5% females) from the UK Biobank with physical activity and disease-related genotypes. Moderate-to-vigorous physical activity (MVPA) and intensity-specific activity was classified according to volume (e.g., MVPA was classified as none, low, medium, and high). Genetic predisposition for CHD, stroke, and AF were classified as low (Quintile 1), intermediate (Quintiles 2-4), and high (Quintile 5).

During 11.6 ± 2.1 years of follow-up: 19,865 CHD; 7907 stroke; and 16,688 AF events occurred. Compared to the no MVPA and high genetic risk group, we observed lower CHD risk for increasing levels of MVPA over and above genetic risk groupings. These associations were primarily driven by vigorous-intensity activity. For example, in the high genetic risk group, those with low vigorous-intensity activity levels (compared to none) had a hazard ratio (HR) of 0.78 (95% confidence interval (95% CI):0.72-0.86) compared to an HR of 0.90 (95% CI: 0.83-0.98) for low moderate-intensity activity levels. For stroke incidence, we observed a protective association for MVPA across genetic risk groups that was mostly driven by moderate-intensity activity volume. Among the high genetic risk group, low moderate-intensity had an HR of 0.77 (95% CI:0.66-0.90), whereas low vigorous-intensity had no association (HR = 0.95, 95% CI:0.82-1.09). We did not observe a consistent joint association of MVPA and AF genetic predisposition.

We observed lower CHD and stroke risk for low to high MVPA among participants with high genetic predisposition. The associations of moderate- and vigorous-intensity activity volume differed considerably across cardiovascular disease sub-types. Overall, our findings suggest vigorous intensity activity may mitigate genetic predisposition for CHD while moderate intensity activity may be associated with similar effects for stroke. Joint associations were less consistent across AF genetic predisposition groups. Our results inform precision medicine approaches and future lifestyle modification interventions by quantifying the potential benefits of physical activity among at-risk individuals.

BackgroundIndividuals with dizziness often face balance issues and anxiety, which can result in reduced physical activity levels and decreased participation in their daily activities. Few studies have evaluated physical activity levels in individuals with chronic dizziness, and none have specifically focused on the two most prevalent types: vestibular migraine (VM) and persistent postural perceptual dizziness (PPPD).ObjectiveEvaluate self-reported physical activity levels in individuals diagnosed with PPPD and VM who are awaiting vestibular rehabilitation.MethodsIn a retrospective cross-sectional study, we extracted data from the electronic healthcare records involving 121 individuals presenting either VM or PPPD, referred for vestibular rehabilitation at National Hospital for Neurology and Neurosurgery, University College London. Data on IPAQ (International Physical Activity Questionnaire) and DHI (dizziness handicap inventory) questionnaires were analysed across groups.ResultsThe total sample consisted of 94 (77.7%) women and 27 (22.3%) men with a median age of 56 years old, ranging from 17 to 81 years (P25 = 41 and P75 = 64). Regarding the total sample, a minority (9.1%) of the individuals scored a high activity level on the IPAQ. We observed a significant difference between VM and PPPD in IPAQ score distribution (p = 0.039, Mann-Whitney). Within the category of high physical activity, a larger proportion of individuals had VM compared to PPPD. An inverse correlation was found between DHI and IPAQ (the lower IPAQ, the higher DHI) in the PPPD group (p<0.003).ConclusionsIn a sample of individuals with PPPD and VM referred for vestibular rehabilitation, only a minority demonstrated high physical activity levels on the IPAQ, with PPPD exhibiting lower activity levels compared to those with VM.

this study evaluated the differential effects of two distinct dietary nucleotide supplements, combined with spontaneous physical activity, on neuromuscular, cognitive, and metabolic adaptations in older adults.

Sixty-nine physically independent older adults (aged 60-75 years) were randomly assigned to three groups: (1) a yeast nucleotides formulation (YN) standardized in a high content of free nucleotides (>40%) rich in all macro and micro nutrients naturally occurring in yeast cell (amino acids, minerals and B-group vitamin); (2) a neuro-based formulation (NF) consisting of a blend of monophosphate nucleotides 5'; or (3) a placebo. Participants maintained their spontaneous physical activities without structured exercise during a 10-week intervention. Assessments included physical function, cognitive performance, body composition, quality of life, and serum biomarkers of oxidative stress, inflammation, and neurogenesis.

Both nucleotide-supplemented groups demonstrated significant improvements compared to placebo in physical performance (p ≤ 0.045), cognitive function (Trail Making Test B [TMT-B]: p ≤ 0.012), oxidative stress biomarkers (p ≤ 0.048), inflammatory cytokines (p ≤ 0.023), and quality-of-life parameters (p ≤ 0.047). Body composition remained stable in supplemented groups, whereas placebo increased fat mass (5.04%) and decreased muscle mass (-2.18%).

Dietary nucleotide supplementation enhances the benefits of spontaneous physical activity across all measured variables in older adults, highlighting nucleotides as promising nutritional support for healthy aging. YN exhibited a trend toward greater inflammatory modulation, whereas NF showed a tendency toward enhanced neurotrophic effects and functional improvements, with a statistically significant improvement in the Timed Up and Go Test (p = 0.014). These findings underscore the potential for tailored nucleotide-based interventions to optimize distinct physiological domains in aging populations.

Understanding the physical activity behaviours of adults at risk of poor health is important to inform targeted interventions. We profiled the frequency, intensity, duration and domain (work or non-work) of self-reported physical activities of rural South African adults living with hypertension.

The aim of this study was to provide a profile of the frequency, intensity, duration and domain of self-reported physical activities over a 7-day period in adults with hypertension from a rural sub-district in South Africa.

A total of 429 adults diagnosed with hypertension aged 40 years and above completed the International Physical Activity Questionnaire Long-Form via telephone interview. Data were summarised using means and standard deviations or medians and interquartile ranges. The Mann-Whitney U test and Krustal-Wallis rank test were used to assess physical activity differences by sex and work status. Statistical significance was set at p < 0.05.

The mean age of the participants was 65.1 (standard deviation [s.d.] ± 10.9 years), 58% were women and 52% had paid or unpaid work. Men reported greater (duration and frequency) vigorous physical activity at work compared to women (p = 0.003 and p = 0.002). Walking frequency as a mode of transport was higher for working men and women (p < 0.001). Women reported higher frequency of moderate-intensity physical activity inside the house (p < 0.001) and outside the house (p < 0.001) compared to men. Non-working men and women spent more time sitting during the week compared to their working counterparts (p = 0.009).

The physical activity profile of hypertensive adults varied by sex and work status.

Contextual factors such as gender roles are also related to the physical activity profile of hypertensive adults living in rural South Africa and should be considered when designing specific interventions targeted at improving hypertension control for this population.

Growing evidence suggests that strenuous physical activity (PA) may be associated with an increased risk of developing Amyotrophic Lateral Sclerosis (ALS), a fatal neurodegenerative disease. However, there are inconsistent findings across studies that may reduce our understanding of any potential associations. We propose that these differences may reflect the tools used to record historical PA. We conducted a systematic review evaluating the risk of developing ALS due to PA. The inclusion criteria were met by 22/113 studies, and an association between increasing PA and ALS was found in 15 studies. Studies that found a positive association were more likely to have longer recall periods and convert data into Metabolic Equivalent of Task values. Studies that did not find an association with increasing PA were more likely to use questionnaires with no validity or reliability data. Questionnaires with validity data all showed at least a moderate correlation of PA compared to objective measures, with reliability ranging from poor to good. Study designs included prospective cohort and case-control, which may also contribute to heterogeneity in findings. This work highlights the need for consensus on the type of questionnaire to use to assess potential associations between PA and ALS.

Increasing awareness of the high frequency, wide spectrum and disabling nature of symptoms that can persist following COVID-19 infection has prompted the investigation of management strategies. Our study aims to determine the effectiveness of atorvastatin on cognitive function, physical activity, mood, health-related quality of life and features of neurovascular impairment and neuroinflammation in adults with ongoing neurological symptoms after COVID-19 infection.

The STatin TReatment for COVID-19 to Optimise NeuroloGical recovERy study is an ongoing international, investigator-initiated and conducted, multicentre, prospective, randomised, open label, blinded endpoint trial with fixed time points for outcome assessments. A total of 410 participants with long covid neurological symptoms were planned to be randomly assigned to either the intervention group to receive 40 mg atorvastatin for 12 months or to a control group of no treatment, on top of usual care.

This study protocol was designed, implemented and reported, in accordance with the International Conference on Harmonisation guidelines for Good Clinical Practice, the National Health and Medical Research Council of Australia, the National Statement on Ethical Conduct in Human Research and with the ethical principles laid down in the World Medical Association Declaration of Helsinki. Central ethics committee approval was obtained from Sydney Local Health District Royal Prince Alfred Hospital Ethics (No: X21-0113 and 2021/ETH00777 10) in Australia. Site-specific ethics committee approvals were obtained elsewhere before any local study activities. All participants provided written informed consent.

The study protocol is registered at Clinicaltrials.gov (NCT04904536).

Physical-functional fitness (PFF) assessments have become crucial tools for identifying physical frailty syndrome (PFS) in older adults, helping guide preventive and interventional strategies.

This study aimed to evaluate the predictive value of performance-based PFF tests for detecting PFS among community-dwelling older adults in Tehran, Iran. Additionally, it sought to compare PFF variables between PFS groups to assess the applicability of these tests as practical screening tools in clinical and community settings.

Data were collected from 161 participants (91 males, 56.5%; 70 females, 43.5%), including sociodemographic, anthropometric, medical history, PFF, and PFS assessments.

Frail participants exhibited significantly lower scores in various PFF tests, including the Tinetti balance, walking, and total score components, physical activity levels (PAL), mean hand grip strength (MGS), 30-s arm curl (30 s-AC), 30 s-chair stand (30 s-CS), Standing Stork Balance (SSB), and back stretch (BST) tests (p < 0.001). Frail individuals also had lower levels of education, shorter stature, and higher BMI compared to non-frail/pre-frail participants, highlighting broader vulnerabilities. Logistic regression analyses showed that all PFF tests, including Tinetti balance and walking components, MGS, 30 s-AC, 30 s-CS, were significant protective factors against FS. However, ROC curve analysis revealed optimal cutoff points for PFS identification, with PAL and MGS demonstrating the highest sensitivity and specificity for predicting PFS. The all components of Tinetti scale also proved to be strong predictors of FS.

Our findings demonstrate that, regardless of age, sex, education level, stature, and fall incidence, PFF assessments remain critical for identifying older adults at risk for PFS. The study highlights the predictive strength of key variables, such as PAL, MGS, and the Tinetti-POMA components, offering novel insights into the role of these tests in improving PFS screening accuracy. These results underscore the importance of integrating PFF assessments into routine clinical and community-based health evaluations, enabling early detection and timely interventions to promote healthier aging trajectories.

Whether healthy behaviors can attenuate the adverse association between ambient fine particulate matter (PM2.5) and cardiovascular disease (CVD) is inconclusive.

The parametric g-formula was used to quantify the potential reduction in PM2.5 effect on CVD under different scenarios of hypothetical behavioral interventions (including dietary patterns, physical activity, body mass index, alcohol consumption, smoking, and dietary supplements). Feasible intervention scenarios, defined on the basis of values considered feasible in previous real-world interventions (eg, overweight participants lose 6.69% of their weight). Intensive scenarios, in which all participants are adopting completely healthy behaviors (eg, maintain normal weight). We also estimate the effect of joint interventions that incorporate the above behaviors. Long-term PM2.5 exposure was associated with incident CVD in both cohorts, with the risk difference per 1000 person-years for a 5 μg/m3 increase in PM2.5 being 1.42 (95% CI, 1.04-1.79) in the UKB (UK Biobank) and 2.15 (95% CI, 1.65-2.59) in the Sichuan Cohort (China Multi-Ethnic Cohort, Sichuan Region). In both feasible and intensive scenarios, improving diet, physical activity, and body mass index could significantly reduce the risk difference of PM2.5 on CVD, with the reduced proportion ranging from 4.59% to 37.22%. A feasible joint hypothetical intervention on 6 behaviors would reduce the effect of PM2.5 on CVD by 31.47% (10.13%-57.26%) and 19.75% (10.78%-42.89%) in the low-pollution UK Biobank and high-pollution Sichuan cohort, respectively. A combination of more intensive interventions would reduce risk difference by 57.51% (21.64%-100.69%) and 45.54% (22.66%-106.66%), respectively.

Healthier behaviors could serve as individual-level complementary strategies to emission control for minimizing the health impact of PM2.5, whether in high- or low-pollution areas.

Frailty and pre-frailty are major public health concerns. While frailty is typically associated with older adults, evidence suggests that pre-frailty commonly starts in middle-age. This study examined associations between behavioural and psychological correlates of pre-frailty and frailty in adults from 40 years to help identify at-risk individuals and inform interventions. Participants (N = 321, mean age = 56 (10.55), 83% female) completed questionnaires on frailty status, physical activity, co-morbidities, quality of life, loneliness, social isolation, and attitudes towards ageing. Participants were classified as non-frail (35%), pre-frail (60%), or frail (5%). One-way ANCOVAs, controlling for age, BMI, and co-morbidities, found that pre-frail participants reported feeling older than their chronological age (F = 2.37, p < .014, η2 = .398); and pre-frail and frail participants reported greater loneliness (F = 6.31, p = .022, η2 = .073) and negative attitudes toward ageing (F = 2.41, p = .004, η2 = .210) compared to non-frail participants. These findings indicate the need for targeted holistic interventions in middle age to prevent or delay frailty.

Triglyceride glucose-body mass (TyG-BMI) index, sedentary behavior (SB) and physical activity (PA) are independently associated with all-cause mortality and myocardial infarction (MI). However, it remains unclear whether TyG-BMI index and the combination of SB and PA exhibit joint effects on all-cause mortality and MI.

Among 502 356 participants from the UK Biobank, 297 761 eligible participants were selected. The Cox proportional hazards model and the restricted cubic spline regression model were used to assess the associations of TyG-BMI with all-cause mortality and MI. To conduct stratified analysis, participants were classified into four groups by SB (<6 h/d and ≥ 6 h/d) and moderate to vigorous physical activity (MVPA) (<150 min/wk and ≥ 150 min/wk). Additionally, the multiplicative interaction was assessed between TyG-BMI and SB & MVPA. Furthermore, to estimate their joint associations, participants were conjointly classified into twelve new groups by TyG-BMI (tertiles) and SB & MVPA (four groups).

During a median follow-up of 13.8 and 13.6 years, 21 335 deaths and 9 116 MI were observed, respectively. The dose-response relationship of TyG-BMI with all-cause mortality was U-shaped with a cut-off point at 225.09, whereas the relationship with MI was positive nonlinear with a cut-off point at 266.87. A synergistic effect on all-cause mortality was observed between TyG-BMI tertile 1 and ≥ 6 h/d SB & <150 min/wk MVPA (P for interaction < 0.001). When MVPA ≥ 150 min/wk combined with SB either <6 h/d or not, TyG-BMI tertile 2 showed no significant association with all-cause mortality risk, with HRs(95%CIs) of 0.98 (0.93-1.03) for <6 h/d SB and 1.00 (0.94-1.07) for ≥ 6 h/d SB. When one of the two healthy behaviors was present (i.e., either <6 h/d SB with <150 min/wk MVPA, or ≥ 150 min/wk MVPA with ≥ 6 h/d SB), its combination with TyG-BMI tertile 1 showed no significant association with MI risk, with HRs(95%CIs) of 1.07(0.95-1.20) and 1.09(0.94-1.25), respectively.

TyG-BMI index and the combination of SB and PA were independently and jointly associated with risks of all-cause mortality and MI. Our findings highlight the importance of improving insulin resistance to reduce all-cause mortality risk, particularly in individuals with long-term SB and insufficient PA, who are more susceptible to the adverse effects of TyG-BMI index. In long-term sedentary individuals, meeting PA guidelines (≥ 150 min/wk of MVPA) effectively mitigated risks of all-cause mortality and MI associated with TyG-BMI index.

Physical activity (PA) is regarded as a non-pharmacological preventive strategy against cognitive decline. This study aimed to examine the relationship between PA and cognitive function in cognitively normal older Malaysian adults from a multi-ethnic, urban-dwelling community. Participants completed a questionnaire with questions on demographic details, socioeconomic status, health conditions, and short form of the International Physical Activity Questionnaire (IPAQ). Bivariate analyses and hierarchical linear regression were conducted to examine the relationship between IPAQ and Montreal Cognitive Assessment (MoCA) scores. Among the 382 participants (median age = 66 years), 51.6% were female. Median MoCA score was 24; and IPAQ levels were 28%, 39% and 33% 'Low', 'Moderate' and 'High' respectively. Bivariate analysis showed MoCA scores significantly differed across IPAQ levels (p-value < 0.001). Pairwise comparisons showed significant differences between MoCA scores and 'High' and 'Low' (p-value < 0.001) and 'Moderate' and 'Low' (p-value = 0.001) IPAQ levels. Hierarchical regression of potential confounding factors showed that while lower PA, being older, being Malay and hypertension were initially associated with lower MoCA scores, the association was explained by the greater influence of education and savings. Additional research is required to gain a more comprehensive understanding of these relationships.

To evaluate the association of poor oral health conditions, such as caries, tooth loss, and tooth loss, with overweight and obesity in older adults and to complement evidence from the Chinese community to confirm this association. Additionally, we evaluated the sociodemographic characteristics, health status, and impact of health-related behavior on the BMI of older adults.

This retrospective study involved health examination and follow-up data of 953 older adults from the Sichuan Province of China from 2021 to 2023. The caries status assessed by the Decayed, Missing, and Filled Teeth (DMFT) index, was used as the exposure factor, whereas body mass index (BMI) was used as the outcome indicator. The influence of confounding variables, namely the sociodemographic characteristics, health status, and oral health-related behavior, was controlled. BMI changes in older adults with different levels of oral health over 3 years were retrospectively followed up. Additionally, a Cox proportional hazard model was used to determine the association.

Overweight and obesity were prevalent in 29.3% and 20.4% of older adults with poor and good oral health status, respectively (P < 0.01). After controlling for the confounding factors, the Cox proportional hazards model demonstrated that the DMFT index was associated with overweight or obesity (BMI) (hazards ratio = 1.86, 95% confidence interval: 1.52-2.28). Overweight and obesity were less prevalent in older adults with fewer chronic diseases, higher frequency of physical exercise, and better oral health-related behaviors.

Oral health status is positively associated with overweight and obesity in older adults, particularly in older adults presenting with caries, missing teeth, and tooth loss as their primary symptoms.

Normal quality of life is an ultimate target in the therapeutic approach to inflammatory bowel diseases (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC) in the context of which regular physical activity (PA) is often a chimeric parameter that is not standardized in terms of quality/quantity. The study aimed to profile a sample of IBD patients about the relationship between PA-partner status and social network support.

A post hoc analysis of the "BE-FIT-IBD" study was set up by stratifying the data of PA with that of partner status and the support that the patient's social network (i.e., relatives, friends) provided in inciting the patient to practice regular PA.

In the 219 patients included, there was a greater tendency for patients with stable partners to view the risk of reactivation/worsening of IBD as a barrier to conducting regular PA (p<0.0001). Single patients considered PA more as a protective factor (p=0.045). Patients without a PA-supporting social network retained IBD-related treatment as a PA barrier (p=0.016) and PA as a risk for IBD complications (p=0.01), with less confidence that PA could improve the course of IBD (p<0.001). Rectal syndrome was an IBD-related barrier more represented in patients with PA-deterring social network (p<0.0001).

These factors are potential targets for recovering the IBD patient's adherence to regular PA.

Fatigue and inactivity are linked to decreased health-related quality of life (HRQoL) in chronic conditions. A multidimensional approach to activity pacing may improve HRQoL by promoting physical activity (PA) and alleviating fatigue. Addressing fatigue across chronic conditions is crucial, especially when underlying causes are unknown. This study aimed to (1) examine associations between HRQoL, fatigue, pacing, risk of overactivity, PA, and self-regulation of PA in adults with chronic conditions and (2) examine if these associations differ across HRQoL domains: physical, social, emotional, and functional well-being.

Sixty-six adults with chronic conditions were recruited from UK fatigue clinics and the community. HRQoL, pacing, risk of overactivity, PA, and self-regulation of PA were assessed with standardised questionnaires and Actigraph monitor. Associations were analysed with linear mixed models, correcting for confounders.

HRQoL was significantly associated with fatigue (B=-7.82), pacing (B=-0.23), and self-regulation of PA (B = 0.11). Interaction effects revealed fatigue's impact on HRQoL varied significantly in physical (β=-13.49), social (β=-6.81), and emotional (β=-4.10) domains. Pacing showed significant differences in physical (β=-0.49), social (β=-7.12), and emotional (β=-7.45) domains. Perceived overactivity differed in social domain (β=-6.27), while device-based PA differed in physical (β = 0.35) and social (β = 5.73).

The negative association between fatigue and HRQoL underscores the importance of effective fatigue management. Higher pacing engagement and lower HRQoL may indicate higher fatigue. Positive associations between self-regulation and PA with HRQoL emphasise benefits of appropriate PA behaviours. The stronger impact of decreased fatigue, increased pacing, and PA on physical well-being suggests a multidimensional fatigue management approach.

We examined the reliability and validity of the Brief Physical Activity Assessment Tool (BPAAT) when administered by telephone interview compared to in-person administration. We analyzed data from the Epi-asthma study. Adult participants registered in the participating Portuguese primary health care centres (PCC) completed the BPAAT via telephone. After ~3 days (range 0-5 days), they had a face-to-face visit at their PCC and completed BPAAT using a tablet. The BPAAT classify individuals as "insufficiently active" (score 0-3) or "sufficiently active" (score 4-8). 355 subjects (60.8% female, 54[IQR 42-66] years) were included. The median BPAAT score was 2[0-4] for both methods, with a significant correlation (rho = 0.58, p<0.001). Test-retest reliability was moderate (ICC = 0.56, 95%CI 0.49-0.63). Agreement in physical activity classification was fair (71.5%, kappa = 0.31, 95%CI 0.21-0.41), with telephone administration classifying more individuals as "sufficiently active" (37.2%) than in-person (15.5%). Telephone administration of the BPAAT is a valid and reliable approach for monitoring of physical activity in the general population. However, it may slightly overestimate activity levels compared to face-to-face administration, particularly among subjects aged 65 years and older.

This study compared the effects of two different warm-up protocols (normal vs. priming) on the oxygen plateau (V ˙ ⁢ O 2 ⁢ p ⁢ l ) incidence rate during a ramp test. It also compared the cardiopulmonary responses during the ramp test and subsequent verification phase.

Eleven recreational cyclists performed two experimental visits. The first visit required a normal warm-up (cycling at 50 W for 10 min) followed by the ramp test (30 W.min-1) and supramaximal verification phase with 30 min rest between tests. The second visit required a priming warm-up (cycling at 50 W for 4 min increasing to 70% difference between the gas exchange threshold [GET] and maximum work rate [WRmax] for 6 min) followed by the same protocol as in the first visit. Physiological responses were collected during the exercise and compared. Oxygen kinetics (V ˙ ⁢ O 2 Kinetics) andV ˙ ⁢ O 2 ⁢ p ⁢ l incidence rate were determined during the ramp tests for both visits.

As planned, following the warm-up the priming visit experienced greater physiological response. However, the incidence rate ofV ˙ ⁢ O 2 ⁢ p ⁢ l during the ramp test was the same between visits (73%), and maximal oxygen uptake was not different between visits after the ramp test (normal, 4.0 ± 0.8; primed, 4.0 ± 0.7 L·min-1, p = 0.230) and verification phase (normal, 3.8 ± 0.6; primed, 3.8 ± 0.7 L·min-1, p = 0.924) using a Holm-Bonferroni correction for controlling family-wise error rate.V ˙ ⁢ O 2 Kinetics were not different between visits during the ramp test (normal, 10.8 ± 1.1; primed, 10.8 ± 1.2 mL·min-1·W-1, p = 0.407). The verification phase confirmedV ˙ ⁢ O 2 ⁢ m ⁢ a ⁢ x in 100% for both the normal and priming visits.

Our hypothesis that a priming warm-up facilitates the incidence rate ofV ˙ ⁢ O 2 ⁢ p ⁢ l during a ramp test is not supported by the results. The verification phase remains a prudent option when determining a 'true'V ˙ ⁢ O 2 ⁢ m ⁢ a ⁢ x is required.

The symptoms, comorbidities and treatment burden associated with chronic kidney disease (CKD) can be debilitating and limit life participation in patients with CKD not requiring kidney replacement therapy (KRT). The aim of this study was to identify the characteristics, content and psychometric properties of patient-reported outcome measures (PROMs) used to assess life participation in patients with CKD.

We searched MEDLINE, Embase, PsycINFO and CINAHL from database inception to February 2023 for all studies that reported life participation in patients with CKD (stages 1-5 not requiring kidney replacement therapy). We analysed the characteristics, dimensions of life participation and psychometric properties of the measures.

From the 114 studies included, 20 (18%) were randomized trials, 3 (3%) were non-randomized trials and 91 (80%) were observational studies. Forty-one different measures were used to assess life participation, of which six (15%) were author-developed measures. Twelve (29%) measures assessed life participation specifically, while 29 (71%) measures assessed broader constructs such as quality of life, which included questions relevant to life participation. The 36-Item Short Form Health Survey (SF-36) and Kidney Disease Quality of Life Short Form (KDQOL-SF) were the most frequently used, in 39 (34%) and 24 (21%) studies, respectively. Many content domains for life participation were assessed, including physical activities (walking, running and sports), social activities, leisure activities, work or study and self-care. None of the measures for life participation were developed specifically for CKD. Four measures (EuroQol 5-dimension 3-level (EQ-5D-3L), Functional Assessment of Cancer Therapy - Anemia, Short Form 6-dimension and Short-From 36-dimension (SF-36)) had validation data collected in patients with CKD.

The measures for life participation used in patients with CKD vary in content, with few validated in the CKD population. There is a need for a validated measure to assess life participation in a meaningful and consistent way in all patients with CKD worldwide.

The Korean National Health Information Database (NHID), which contains nationwide real-world claims data including sociodemographic data, health care utilization data, health screening data, and healthcare provider information, is a powerful resource to test various hypotheses. It is also longitudinal in nature due to the recommended health checkup every 2 years and is appropriate for long-term follow-up study as well as evaluating the relationships between health outcomes and changes in parameters such as lifestyle factors, anthropometric measurements, and laboratory results. However, because these data are not collected for research purposes, precise operational definitions of diseases are required to facilitate big data analysis using the Korean NHID. In this review, we describe the characteristics of the Korean NHID, operational definitions of diseases used for research related to diabetes, and introduce representative research for diabetes-related diseases using the Korean NHID.

Plant-based diets may protect against cognitive impairment; however, observational data have not been consistent.

This study aimed to evaluate the association between plant-based dietary patterns and cognitive function.

The study recruited 937 participants who were asked to complete food frequency questionnaires to assess the quality of their plant-based diets using the overall plant-based diet index (PDI), the healthful PDI (hPDI), and the unhealthful PDI (uPDI). Cognitive function evaluated using the Montreal Cognitive Assessment (MoCA) test. Logistic regression was used to explore the association between plant-based dietary patterns and the prevalence of mild cognitive impairment (MCI), while multiple linear regression was used to analyze the association between plant-based dietary patterns and cognitive scores.

The prevalence of MCI was 26% among the 937 participants. There was a significant association between higher uPDI scores and higher odds of MCI, with Quintile 4 compared with Quintile 1 showing an odds ratio of 2.21 (95% confidence interval 1.35, 3.60). Higher uPDI scores were associated with a lower total MoCA score and poorer performance in various cognitive domains. There were no significant associations between the PDI, the hPDI, and cognitive function. Consuming whole grains, nuts, and eggs once a week or more were associated with a lower risk of MCI, whereas frequently consumption of pickled vegetables was associated with an increased risk of MCI.

Unhealthy plant-based diets were associated with cognitive impairment, while whole grains, nuts, and eggs may protect cognitive function; pickled vegetables are associated with cognitive impairment.

Background: Haematological malignancies and their treatment regimens often lead to various complications that impair patients' physical functioning. This study aimed to assess the level of physical activity and exercise capacity in patients with haematological malignancies who were qualified for haematopoietic stem cell transplantation (HSCT). Methods: A prospective, single-centre study was conducted on patients with haematological malignancies qualified for HSCT (study group, n = 103) and a cohort of healthy volunteers (reference group, n = 100). The assessment protocol included the International Physical Activity Questionnaire (IPAQ) and the 6-Minute Walk Test (6MWT). Results: The median age was 57 years in the study group and 56 years in the reference group. In the IPAQ assessment, at least 50% of the study group reported no engagement in moderate or intense physical activity. In the 6MWT, the study group demonstrated a significantly shorter walking distance compared to the reference group (p < 0.0001). Factors such as group membership (study vs. reference group), age, gender, and body mass index (BMI) were found to have a significant impact on 6MWT performance. No significant differences were observed in IPAQ or 6MWT results among subgroups within the study group when categorized by diagnosis. Conclusions: Patients with haematological malignancies who qualified for HSCT often show physical activity levels below recommended standards, which can negatively impact their ability to endure physical exertion. Insufficient activity prior to transplantation may contribute to reduced exercise capacity. Therefore, prehabilitation programmes aimed at improving physical activity and structured exercise should be an integral part of their care.

Stroke is one of the leading causes of death in developing countries, and China bears the largest global burden of stroke. This study aims to investigate the relationship between different dimensions of physical activity levels and stroke risk using a nationally representative database. We performed a cross-sectional analysis using data from the China Health and Retirement Longitudinal Study (CHARLS) 2020. Binary logistic regression models were used to analyze the associations between different dimensions of physical activity levels (intensity, frequency, duration, and total physical activity (TPA)) and stroke risk in Chinese middle-aged and older adults. Subgroups were analyzed according to participants' age, sex, residency, hypertension, dyslipidemia, and diabetes stratification. The results showed that after adjusting for all covariates, almost all frequencies and durations of moderate physical activity (MPA), and high-frequency and long-duration vigorous physical activity (VPA) were associated with lower stroke risk. No significant relationship was observed between light physical activity (LPA) and stroke risk. TPA was categorized into quartiles (Q1, Q2, Q3, Q4). Compared with the first quartile, the third and fourth quartiles were significantly associated with lower stroke risk, with risk reductions of 35% (OR 0.65, 95% CI 0.50-0.84) and 42% (OR 0.58, 95% CI 0.44-0.76), respectively. Subgroup analysis revealed differences in the association between TPA and stroke risk in different populations, and the interaction test indicated no significant interactions between these variables and TPA. Our findings suggested that appropriate participation in physical activity is effective in preventing stroke in middle-aged and older adults. Both MPA and high-frequency or long-duration VPA were significantly associated with lower stroke risk, and keeping TPA at a high level was significantly associated with lower stroke risk.

Phase angle (PhA) is a prognostic factor for predicting and monitoring geriatric syndromes. However, multiple factors associated with increased PhA values as an outcome remain unclear in the older population. This study aimed to examine the association of socio-demographic, anthropometric and behavioural factors with PhA among older Taiwanese adults.

This cross-sectional study was conducted between May and August 2023.

The study was carried out in northern Taiwan, specifically Taipei city and Yilan county.

Participants aged ≥65 years who were able to walk independently and had no artificial implants, such as cardiac pacemakers or joint replacements, were recruited using convenience sampling. A total of 198 participants were initially recruited for this study.

Data on socio-demographic and behavioural variables were collected using self-administered questionnaires. Anthropometric variables and PhA were measured using a multi-frequency bioelectrical impedance analyser (MC-780MA, TANITA). PhA was categorised into 'high' and 'low' using gender-specific cut-off points. A logistic regression analysis was performed.

A total of 152 participants (mean age: 72.0±5.5 years; 121 women (79.6%)) were included. Male (OR=0.72, 95% CI=0.02 to 0.33), unmarried (OR=0.22, 95% CI=0.06 to 0.82) and unemployed older adults (OR=0.16, 95% CI=0.03 to 0.87) were less probable to achieve high PhA values. After adjusting for potential confounders, older individuals with an increased body mass index (BMI) (OR=2.56, 95% CI=1.61 to 4.07) and greater muscle mass (OR=1.34, 95% CI=1.12 to 1.60) may have higher PhA values, whereas those with a greater fat mass may have lower PhA values (OR=0.61, 95% CI=0.48 to 0.78). No significant associations were observed between behavioural factors and PhA values.

The interventions designed to improve PhA should prioritise strategies tailored to male, unmarried or unemployed older adults, as well as those with low BMI, low muscle mass and high fat mass. Future studies with larger sample sizes are needed to confirm and strengthen our findings.

Nitrate is abundant in natural foods, especially plant-based foods, having the potential to enhance muscle function. However, its relationship with sarcopenia in the context of daily diet remains unexplored. This cohort study investigated the associations between dietary nitrate intake and sarcopenia, as well as related symptoms, using data including 28,229 participants with a mean follow-up of 9.37 years from the UK Biobank. Dietary nitrate intake was estimated using a comprehensive nitrate food database. Adjusted logistic regression models suggested potential inverse associations between total nitrate intake and risks of sarcopenia plus pre-sarcopenia (Sarc-Presarc), low hand grip strength (HGS), and low walking pace. Similar results were primarily observed for nitrate from plant-based foods. With higher intake, females appeared to have higher HGS and a decreased risk of Sarc-Presarc, while males exhibited a reduced risk of low walking pace. The inverse association between nitrate intake and low skeletal muscle mass index was more evident in individuals aged 65 and above. These associations seemed independent of antioxidants, though higher antioxidants might augment the protective effect against low walking pace. Mediation analyses indicated that protein homeostasis and blood pressure might mediate these associations. These findings suggested that a higher dietary nitrate intake from plant-based foods could contribute to sarcopenia prevention, though further research is needed to confirm these observations.

Inactivity is a correlate of adverse health. Adults with an intellectual disability (ID) are more inactive than the general population and often present with more complex health issues. Self-reported activity questionnaires such as the International Physical Activity Questionnaire - Short Form (IPAQ-SF) and Rapid Assessment of Physical Activity (RAPA) questionnaire are the predominant source of activity information because of their low cost, non-invasive nature, ease of administration and interpretation of results.

Correlates of inactivity among the general and ID populations were identified through a literature scoping review. Inactivity was measured using the RAPA and the IPAQ-SF. A multiple-imputation chained equation was used to impute missing data. Using Pearson chi-squared analyses, relationships between these correlates as well as covariates of age, sex, level of ID, body mass index (BMI) and aetiology, and RAPA and IPAQ-SF categories were explored. Logistic regression provided more detailed analyses. Results were summarised using the Systems of Sedentary Behaviour framework. Spearman correlations examined the IPAQ-SF and RAPA relationships.

Three correlates for inactivity emerged from the IPAQ-SF and RAPA questionnaire. Up after 07:00 h was a correlate for both. Difficulty walking 100 yards and epilepsy were additional correlates of inactivity. Weak but significant correlations were seen between IPAQ-SF and RAPA scores.

High inactivity levels are present in adults with an ID. The IPAQ-SF and RAPA questionnaires are weakly correlated.

Previous research has shown an association between migraine and cardiovascular diseases (CVDs). However, limited studies have explored the progression of cardiovascular health (CVH) among individuals with migraine. This cohort study aimed to explore the relationship between changes in CVH and migraine among women of Chinese descent in Hong Kong.

Data from a cohort study titled "Migraine Exposures and Cardiovascular Health in Hong Kong Chinese Women (MECH-HK)" were analysed. A total of 2,603 women, averaging 56.5 ± 8.5 years of age, were selected, all with complete data at baseline and at a follow-up occurring on average 1.27 years later. CVH profile was assessed by an adapted Life's Essential 8, comprising dietary habits, physical activity, nicotine exposure, sleep duration, body mass index (BMI), lipid levels, blood pressure, and stress. Each component was scored from 0 to 100, with overall CVH as the average. CVH levels were categorized as low (0-49), moderate (50-79), and high (80-100), representing poor to excellent health. Changes in CVH were defined as shifts between these categories from baseline to subsequent follow-up. Migraine cases were identified utilizing the International Classification of Headache Disorders 3.

A total of 275 (10.6%) women were identified as having migraine. By follow-up, both women with and without migraine experienced significant declines in CVH profiles (all p-value < 0.05). In the fully adjusted model, women with migraine had a 1.36 times higher risk (OR 95% CI: 1.33, 1.39) of decline in overall CVH compared to non-migraineurs. They also had a higher likelihood of shifting to worse CVH levels in several individual CVH components, including physical activity (OR: 1.09), nicotine exposure (OR: 4.27), sleep quality (OR: 1.80), blood lipid levels (OR: 1.03), and stress (OR: 1.23) (all p-value < 0.05). Among women with migraine, those experiencing aura had a higher risk of poorer physical activity, greater nicotine exposure, higher BMI, and increased stress than those without aura (all p-value < 0.05).

Women with migraine exhibited worse progression in CVH compared to those without migraine. Targeted monitoring and management of CVH-related factors in this population are crucial to reducing their elevated risk of CVDs.

To clarify the relationship between self-reported and device-measured physical activity (PA) and disability incidences in community-dwelling older adults.

Prospective cohort study.

In total, 4504 (median age 75 [range, 72-79] years; women, 52.1%) community-dwelling older adults were included in this study.

Device-measured moderate-to-vigorous PA (MVPA) was measured using a triaxial accelerometer. Self-reported MVPA was assessed using the Japanese version of the International Physical Activity Questionnaire, Short Form. The cutoff MVPA was 150 min/wk. PA was divided into 4 groups based on self-reported and device-measured assessments: (1) self-reported/device-measured inactive, (2) self-reported active/device-measured inactive, (3) self-reported inactive/device-measured active, and (4) self-reported/device-measured active. The disability incidence, defined as a long-term care insurance certification of any level indicating a requirement for support or continuous care, was prospectively determined using data extracted from the Japanese long-term care insurance system.

Of the participants, 892 (19.8%) developed disabilities within 62 (range, 60-64) months. The prevalence of self-reported inactive/device-measured inactive, self-reported active/device-measured inactive, self-reported inactive/device-measured active, and self-reported active/device-measured active were 884 (34.9%), 441 (17.4%), 693 (27.3%), and 515 (20.3%) participants, respectively. Multivariate Cox regression analysis showed that self-reported/device-measured active, self-reported inactive/device-measured active, and self-reported active/device-measured inactive independently decreased the disability incidence risk (self-reported/device-measured active: hazard ratio [HR], 0.555, 95% confidence interval [CI], 0.412-0.749; self-report inactive/device-measured active: HR, 0.656; 95% CI, 0.518-0.831; self-reported active/device-measured inactive: HR, 0.718; 95% CI, 0.556-0.928). In the post hoc analysis, those who were self-reported active/device-measured inactive were divided into 2 groups according to involvement in sports. Those who played sports had a lower disability risk; however, the difference was not significant.

Combined self-reported and device-measured PA assessments may allow for disability risk stratification in older adults. The findings will also help in creating methods for evaluating PA levels to prevent disability incidences among older adults.

Previous genome-wide association studies (GWAS) have identified genetic loci associated with the circulating levels of FAs, but the biological mechanisms of these genetic associations remain largely unexplored. Here, we conducted GWAS to identify additional genetic loci for 19 circulating fatty acid (FA) traits in UK Biobank participants of European ancestry (N = 239,268) and five other ancestries (N = 508 - 4,663). We leveraged the GWAS findings to characterize genetic correlations and colocalized regions among FAs, explore sex differences, examine FA loci influenced by lipoprotein metabolism, and apply statistical fine-mapping to pinpoint putative causal variants. We integrated GWAS signals with multi-omics quantitative trait loci (QTL) to reveal intermediate molecular phenotypes mediating the associations between the genetic loci and FA levels. Altogether, we identified 215 significant loci for polyunsaturated fatty acids (PUFAs)-related traits in European participants, 163 loci for monounsaturated fatty acids (MUFAs)-related traits, and 119 loci for saturated fatty acids (SFAs)-related traits, including 70, 61, and 54 novel loci, respectively. A novel locus for total FAs, the percentage of omega-6 PUFAs in total FAs, and total MUFAs (around genes GSTT1/2/2B) overlapped with QTL signals for all six molecular phenotypes examined, including gene expression, protein abundance, DNA methylation, splicing, histone modification, and chromatin accessibility. Across 19 FA traits, 65% of GWAS loci overlapped with QTL signals for at least one molecular phenotype. Our study identifies novel genetic loci for circulating FA levels and systematically uncovers their underlying molecular mechanisms.

To examine associations between the amount and changes in regular physical activity (PA) before and after diagnosis of dementia and all-cause mortality risk, and whether these associations differ by PA intensity (light, moderate or vigorous).

This retrospective cohort study used data from the Korean National Health Insurance Service Database, including 60 252 individuals newly diagnosed with dementia between 2010 and 2016 who underwent health examinations both before and after diagnosis. PA was assessed using the International Physical Activity Questionnaire-Short Form. Multivariable Cox proportional hazards regression models were used to analyse the associations between PA (amount and changes) and all-cause mortality risk.

During a mean follow-up of 3.7 years, 16 431 (27.3%) deaths occurred. Higher PA levels after dementia diagnosis were associated with a dose-dependent decrease in mortality risk (p for trend <0.001). Maintaining regular PA, compared with remaining inactive, was associated with the lowest mortality risk (HR=0.71, 95% CI 0.65 to 0.79). Sustained engagement in PA of any intensity was associated with decreased mortality risk: light (HR=0.70, 95% CI 0.67 to 0.75), moderate (HR=0.74, 95% CI 0.64 to 0.86) and vigorous PA (HR=0.70, 95% CI 0.61 to 0.79). Initiating any PA intensity after dementia diagnosis was associated with at least 20% reduced mortality risk. These associations were consistent in Alzheimer's disease.

Maintaining or initiating regular PA, regardless of intensity, after dementia diagnosis was associated with a reduced risk of all-cause mortality. Lifestyle modifications promoting PA might offer survival benefits for individuals with dementia.

This study aimed to develop and evaluate the Brief Older Adults' Physical Activity Questionnaire (BOPAQ), which was designed to quickly assess moderate-to-vigorous physical activity (MVPA) in community-dwelling older adults.

We used a cross-sectional study design involving 165 older participants. The BOPAQ calculated weekly MVPA duration based on two questions regarding the number of days per week engaged in MVPA and the daily duration of activity. Validity was assessed by correlating the MVPA durations derived from the BOPAQ with those obtained from the ActiGraph and International Physical Activity Questionnaire short form. Reliability was evaluated using the intraclass correlation coefficient, and measurement errors were analyzed using Bland-Altman plots.

The BOPAQ reasonably correlated with accelerometer-based MVPA (rho = 0.297) and showed good test-retest reliability (intraclass correlation coefficient of 0.78, 95% CI 0.64-0.87). In contrast, the correlation between the International Physical Activity Questionnaire short form and accelerometer-based MVPA was poor (rho = 0.139). The cut-off value for the BOPAQ was set to identify participants engaging in <150 min of objectively measured physical activity per week, corresponding to the 150-min threshold. However, the area under the curve in the receiver operating characteristic analyses was not significantly high (0.601, 95% CI 0.514-0.688). The Bland-Altman plots showed an underestimation bias of 51.72 min/week (95% CI 1.61-101.84) and showed heteroscedasticity.

Despite some measurement errors, the BOPAQ is an available tool for assessing MVPA in community-dwelling older adults. Geriatr Gerontol Int 2024; 24: 1150-1155.

Heavy metal contamination from occupational sources is a cause for concern due to its potential accumulation in the environment and the body of living organisms, which leads to long-term toxic effects. There is limited evidence on the concentration of heavy metals in the body fluids of welding workers. This study aimed to measure the concentration of nickel (Ni) and chromium (Cr) as two main toxic heavy metals in the urine samples of welders and determine the potential relationship of various environmental factors on their concentration levels. This study was conducted in Iran in 2022-2023. Eighty-five urine samples were collected from the studied welding workers. Inductively coupled plasma optical emission spectrometry (ICP-OES) was used to measure the concentration of Ni and Cr. Data related to socio-demographic characteristics (education level, income, work experience, age, and body mass index (BMI)), lifestyle profile (consumption of seafood and canned food, smoking, physical activity), type of ventilation and preventive devices at work, and suffering from underlying diseases (cardiovascular and high blood pressure) were collected using valid questionnaires. Ni and Cr were present in 100% of urine samples with mean concentrations of (1.09 ± 0.294) and (11.45 ± 16.751) µg/g creatinine, respectively. A significant correlation was observed between the mean concentration of Ni and Cr with the level of education, income, work experience, age, consumption of seafood and canned food, smoking, type of ventilation and preventive devices, and underlying diseases (p-value < 0.05). Also, there was no significant difference between Ni concentration and physical activity and Cr concentration with BMI. Lifestyle determinants and not using preventive devices are important predictors of urinary heavy metals in welding workers. Therefore, more research is required to determine the adverse effects of long-term exposure to these heavy metals.

Background/Objectives: Old age and illnesses can limit physical activity (PA). We have assessed the level of PA and its limitations in older people with diabetes (DM). Methods: Cross-sectional study, period: January and June 2024, place: Diabetes Center, subjects: patients (N = 207) > 64 years with DM), Surveying using: IPAQ, Accompanying Survey (AS). The significance was assessed by: Student's t-test, Mann-Whitney U test, Pearson's test. The relationships between the IPAQ and the AS results were analyzed based on a meta-analysis model for variable effects, OR with a 95% CI. ROC curve was used to determine the threshold values for age, BMI. Correlations between selected key variables were evaluated using the PCA. Results: The median age: 72 years (65-87), BMI: 28.70 (18.61-49.69). The median PA level: 1837 MET-min/week (0-9.891). The individuals who obtained insufficient (n = 28), sufficient (n = 75), and high levels of PA (n = 53) were 17.95%, 48.08%, and 33.97%, respectively. Diseases were the main factor limiting PA (53.54%) in patient's opinion, followed by the lack of a companion or motivation. The meta-analysis found no diseases linked to insufficient PA, but those with BMI > 33.3 and over 75 years old more often had insufficient PA. PCA revealed several characteristics that predispose individuals to insufficient PA. Conclusions: People over 75 years of age tend to avoid PA more than younger seniors, leading to its insufficient level, similarly like higher BMI. The individual with DM who has an insufficient level of PA is typically a single, woman, over 75, BMI > 33.