Healthy lifestyles in relation to cardiometabolic diseases among schoolteachers:A cross-sectional study

Background:We aimed to explore the associations of adherence to an overall healthy lifestyle with cardiometabolic diseases(CMDs)among schoolteachers in China.Methods:We conducted a cross-sectional analysis among 2983 teachers(aged 39.8±9.3 years,73.8%women)in Zhejiang Province,China.A healthy lifestyle score(0–7)was constructed based on seven low-risk factors:healthy diet,noncurrent smoking,noncurrent drinking,regular exercise,normal body mass index(BMI),adequate sleep duration,and limited sedentary behavior.CMDs included self-reported hyperlipidemia,hypertension,diabetes,coronary heart disease,and stroke.Multivariable-adjusted logistic regression models were used to evaluate the associations between healthy lifestyle and CMD.Results:A total of 493(16.5%)participants had at least one CMD,with hyperlipidemia,hypertension,and diabetes being the three leading CMDs.ach point increment in a healthy lifestyle score was associated with 20%lower odds of having CMD(p-trend<0.001).Compared with 0–3 low-risk factors,the odds ratios(ORs)and 95%confidence intervals(CIs)were 0.66(0.50–0.88)for 4 low-risk factors and 0.51(0.39–0.67)for 5–7 low-risk factors.We observed independent associations for normal BMI(OR=0.50,95%CI=0.40–0.63),noncurrent drinking(OR=0.53,95%CI=0.36–0.77),and limited sedentary behavior(OR=0.77,95%CI=0.62–0.96)in relation to CMD.Healthy diet(OR=0.75,95%CI=0.55–1.01)exhibited marginally significant association with CMD.Conclusions:Our findings suggest that adherence to an overall healthy lifestyle is associated with lower odds of CMD among schoolteachers.

Feasibility assessment of invigorating grassrooTs primary healthcare for prevention and management of cardiometabolic diseases in resourcelimited settings in China,Kenya,Nepal,Vietnam(the FAITH study):rationale and design

Background:Cardiometabolic diseases are the leading cause of death and disability in many low-and middleincome countries.As the already severe burden from these conditions continues to increase in low-and middleincome countries,cardiometabolic diseases introduce new and salient public health challenges to primary health care systems.In this mixed-method study,we aim to assess the capacity of grassroots primary health care facilities to deliver essential services for the prevention and control of cardiometabolic diseases.Built on this information,our goal is to propose evidence-based recommendations to promote a stronger primary health care system in resource-limited settings.Methods:The study will be conducted in resource-limited settings in China,Kenya,Nepal,and Vietnam using a mixed-method approach that incorporates a literature review,surveys,and in-depth interviews.The literature,statistics,and document review will extract secondary data on the burden of cardiometabolic diseases in each country,the existing policies and interventions related to strengthening primary health care services,and improving care related to non-communicable disease prevention and control.We will also conduct primary data collection.In each country,ten grassroots primary health care facilities across representative urban-rural regions will be selected.Health care professionals and patients recruited from these facilities will be invited to participate in the facility assessment questionnaire and patients’survey.Stakeholders-including patients,health care professionals,policymakers at the local,regional,and national levels,and local authorities-will be invited to participate in indepth interviews.A standard protocol will be designed to allow for adaption and localization in data collection instruments and procedures within each country.Discussion:With a special focus on the capacity of primary health care facilities in resource-limited settings in lowand middle-income countries,this study has the potential to add new evidence for policymakers and academia by identifying the most common and significant barriers primary health care services face in managing and preventing cardiometabolic diseases.With these findings,we will generate evidence-based recommendations on potential strategies that are feasible for resource-limited settings in combating the increasing challenges of cardiometabolic diseases.

Role of waist circumference-to-height ratio in assessing adiposity,predicting type 2 diabetes mellitus and other cardiometabolic diseases

Although body mass index(BMI)is widely used as a simple tool to assess obesity,it has certain limitations and inaccuracies.It is known that visceral adipose tissue is closely related to cardiometabolic risks and all-cause mortality;however,precise measurement methods for visceral fat(magnetic resonance imaging and computed tomography)cannot be widely used.Thus,simple but accurate alternatives are valuable.Studies have shown that waist circumference-to-height ratio(WHtR)might be a superior and more accurate variable in assessing central or visceral adiposity as well as predicting risks of diabetes and other cardiometabolic diseases.Furthermore,WHtR cutoff values can be consistent across different races,age,and genders,making it a universal metric worth promoting and applying.

Bile acid coordinates microbiota homeostasis and systemic immunometabolism in cardiometabolic diseases

Cardiometabolic disease(CMD), characterized with metabolic disorder triggered cardiovascular events, is a leading cause of death and disability. Metabolic disorders trigger chronic low-grade inflammation, and actually, a new concept of metaflammation has been proposed to define the state of metabolism connected with immunological adaptations. Amongst the continuously increased list of systemic metabolites in regulation of immune system, bile acids(BAs) represent a distinct class of metabolites implicated in the whole process of CMD development because of its multifaceted roles in shaping systemic immunometabolism. BAs can directly modulate the immune system by either boosting or inhibiting inflammatory responses via diverse mechanisms. Moreover, BAs are key determinants in maintaining the dynamic communication between the host and microbiota. Importantly, BAs via targeting Farnesoid X receptor(FXR) and diverse other nuclear receptors play key roles in regulating metabolic homeostasis of lipids, glucose, and amino acids. Moreover, BAs axis per se is susceptible to inflammatory and metabolic intervention, and thereby BAs axis may constitute a reciprocal regulatory loop in metaflammation. We thus propose that BAs axis represents a core coordinator in integrating systemic immunometabolism implicated in the process of CMD. We provide an updated summary and an intensive discussion about how BAs shape both the innate and adaptive immune system, and how BAs axis function as a core coordinator in integrating metabolic disorder to chronic inflammation in conditions of CMD.

Effects of chronic decaffeinated green tea extract supplementation on lipolysis and substrate utilization during upper body exercise

Background:Decaffeinated green tea extract(dGTE)can increase fat oxidation during leg exercise,but dGTE is unsuitable for many people(e.g.,those with injuries/disabilities),and its effects on arm exercise and women are unknown.Methods:Eight adults(23-37 years old,4 women)performed an incremental arm cycle test to measure peak oxygen uptake(VO_(2_(peak))),followed by four 1-h trials at 50%VO_(2_(peak).Subjects were randomly assigned to 650 mg of dGTE or placebo(PLA)for 4 weeks followed by a 4-week washout and crossover trial.Blood samples were obtained pre-exercise and post-exercise for glycerol and free fatty acid analysis.Respiratory gases were collected continuously.Results:VO_(2) showed no differences across trials((0.83-0.89)±(0.19-0.25)L/min,p=0.460),neither did energy expenditure((264-266)±(59-77)kcal,p=0.420)nor fat oxidation(dGTE=0.11 to 0.12 g/min vs.PLA=0.10 to 0.09 g/min,p=0.220).Fat oxidation as percentage of energy expenditure was not different for dGTE vs.PLA(23%±12%to 25%±11%vs.23%±10%to 21%±9%,p=0.532).Glycerol concentration increased post-exercise in all trials,independent of treatments(pre=(3.4-5.1)±(0.6-2.6)mg/dL vs.post=(7.9-9.8)±(2.6-3.7)mg/dL,p=0.867,η^(2)=0.005 for interaction),as did free fatty acid((3.5-4.8)±(1.4-2.2)mg/dL vs.(7.2-9.1)±(2.6-4.5)mg/dL,p=0.981,η^(2)=0.000).Conclusion:Chronic dGTE supplementation had no effect on lipolysis and fat oxidation during arm cycle exercise in men and women.

Application of wearable devices for monitoring cardiometabolic dysfunction under the exposome paradigm

Environmental factors,including chemical/physical pollutants,as well as lifestyle and psychological factors,contribute greatly to the pathways leading to cardiometabolic diseases with a heavy disease burden and economic loss.The concept of exposomes provides a novel paradigm for combining all exposure characteristics to evaluate disease risk.A solution-like exposome requires technological support to provide continuous data to monitor vital signs and detect abnormal fluctuations.Wearable devices allow people to conveniently monitor signals during their daily routines.These new technologies empower users to more actively prevent and manage cardiometabolic disease by reviewing risk factors of the disease,especially lifestyle factors,such as sleeping time,screen time,and mental health condition.Devices with multiple sensors can monitor electrocardiography data,oxygen saturation,intraocular pressure,respiratory rate,and heart rate to enhance the exposome study and provide precise suggestions for disease prevention and management.