Aug 2026· British Journal of Nutrition· pp.
1-35
· 0 citations
Medicine
TL;DR
It is shown that a combination of appropriate PA and higher DQ is associated with reduced odds of stroke and mortality among stroke survivors, and this findings support lifestyle modification as a strategy for stroke prevention and survivor care.
Abstract
Little is known about the combined association of physical activity (PA) and dietary quality (DQ) with stroke and its mortality outcomes. This study aims to investigate the individual and combined association of PA and DQ on odds of prevalent stroke and mortality among stroke survivors. We analyzed data from 20,225 adults participating in the 2007-2018 National Health and Nutrition Examination Survey, including 838 stroke survivors. PA was measured by the self-reported metabolic equivalent to task (MET) minutes per week, and DQ by Healthy Eating Index 2020 (HEI-2020). Logistic regression models evaluated associations with the odds of prevalent stroke, and Cox proportional hazards regression models assessed mortality risks among stroke survivors. Compared to no PA - lower DQ (reference), low PA - lower DQ (adjusted OR 0.49, 95%CI 0.32-0.75), low PA - higher DQ (adjusted OR 0.56, 95%CI 0.34-0.92), high PA - lower DQ (adjusted OR 0.66, 95%CI 0.44 - 0.99), and high PA - higher DQ (adjusted OR 0.50, 95%CI 0.34-0.73) were significantly associated with lower odds of stroke. Among stroke survivors, reduced mortality was observed for low PA-higher DQ (adjusted HR 0.43; 95% CI, 0.19-0.95), high PA-lower DQ (HR 0.36; 95% CI, 0.17-0.75), and high PA-higher DQ (HR 0.47; 95% CI, 0.27-0.83). This large observational study showed that a combination of appropriate PA and higher DQ is associated with reduced odds of stroke and mortality among stroke survivors. These findings support lifestyle modification as a strategy for stroke prevention and survivor care.
AHEI and DII were significantly associated with all-cause mortality among stroke survivors, highlighting the potential clinical relevance of dietary quality in long-term prognosis, although prospective studies are needed to confirm these associations.
Junjie Pei, Yangzheng Li, Haixin Song et al.· Journal of Stroke & Cerebrov...· 0 citations
Objective We investigated the association between physical activity (PA) and arterial stiffness (AS) in Chinese middle-aged and older adults, systematically evaluating the potential mediating role of the Metabolic Score For Visceral Fat. Subjects and methods Data were drawn from the 2015 China Health and Retirement Longitudinal Study. PA was assessed using the International Physical Activity Questionnaire, and AS was determined by estimated pulse wave velocity. Multivariable logistic regression, restricted cubic spline models, and Bootstrap mediation analysis were applied for statistical analyses. Results In the fully adjusted model, each standard deviation increase in PA intensity was associated with a 22% reduction in AS risk (odds ratio [OR] = 0.78, 95% confidence interval [CI]: 0.72–0.84, p < 0.001). Compared to low-intensity PA, both moderate-intensity (OR = 0.75, 95% CI: 0.61–0.92, p = 0.005) and high-intensity PA (OR = 0.57, 95% CI: 0.48–0.68, p < 0.001) were significantly associated with a lower risk of AS. Restricted cubic spline analysis revealed a nonlinear association, with AS risk decreasing as PA intensity increased (p-nonlinear = 0.034). Mediation analysis indicated that Metabolic Score For Visceral Fat significantly mediated the negative correlation between PA and AS, accounting for 11.4% of the total effect. Conclusion Among middle-aged and older Chinese adults, higher levels of PA are associated with a lower risk of AS, with this association partially mediated by improvements in visceral fat metabolism.
Huihua Jiang, Xiaoli Shao, Li-Qin Jiang et al.· Archives of Endocrinology an...· 0 citations
HEI-2020 was inversely associated with PSD, with nonlinear and race-specific patterns and DI-GM showed a significant but inconsistent indirect association, suggesting a suppressive rather than mediating role.
Can Xing, Zhenhui Lu, Xiaoming Guo et al.· BMC Psychiatry· 0 citations
The aim of this study is to examine the independent and combined associations of physical activity (PA) and sedentary behavior (SB) with metabolic syndrome (MS) components in older adults. This cross-sectional study included 473 older adults aged ≥60 years, living in the urban area of the municipality of Alcobaça, Brazil, and enrolled in the municipality's Family Health Strategy. Sociodemographic information, anthropometric measurements, laboratory and behavioral data were collected. The prevalence of MS was 52.8%. Longer time spent in SB was associated with central obesity (OR 2.85; 95% CI: 1.52-5.25) and hypertension (OR 1.86; 95% CI: 1.23-2.85). In the combined analysis, insufficiently active older adults with longer SB time were more likely to have two (OR 3.90; 95% CI: 1.46-10.42) to four (OR 4.18; 95% CI: 1.12-15.62) components. Even sufficiently active older adults with longer SB time had higher odds of central obesity (OR 3.44; 95% CI: 1.51-7.87), hypertension (OR 2.30; 95% CI: 1.30-4.05), and low HDL-c levels (OR 1.84; 95% CI: 1.03-3.28). SB is a determining factor in the prevalence of MS in older adults, with implications for public health policies that promote frequent interruptions of sedentary time and encourage regular PA.
L. L. Galvão, Rizia Rocha-Silva, Leonardo C D Lima et al.· Anais da Academia Brasileira...· 0 citations
Physical activity (PA) is a pivotal modifiable determinant of intrinsic capacity (IC), a core component of healthy aging.
This study aimed to examine the association between PA and the risk of IC impairment among middle-aged and older adults using nationally representative cohorts from China and the United States.
Data from CHARLS (2011–2015) and HRS (2010–2018) were used, including 781 and 2,601 participants, respectively. PA was quantified by metabolic equivalents (MET), and IC impairment was defined as dysfunction in one or more of five domains. Cox proportional hazards regression, restricted cubic splines (RCS), subgroup analysis and nomograms were used for statistical analysis.
PA was inversely associated with the risk of IC impairment in both cohorts. In CHARLS, low and moderate PA significantly reduced IC impairment risk [Hazard Ratio (HR) = 0.691, 0.687;
P
< 0.05), while high-intensity PA had no significant effect. In HRS, all PA levels were protective (HR = 0.720, 0.736, 0.739;
P
< 0.05). RCS showed non-linear dose-response relationships between PA and IC impairment risk. Subgroup analysis indicated the protective effect of PA was consistent in CHARLS, but modified by marital status in HRS (only significant in married people). The nomograms showed modest discriminative ability [Area Under the Curve (AUC) > 0.6].
The protective association between PA and IC impairment varied by cohort and PA intensity.
PA was associated with a reduced risk of IC impairment, supporting targeted PA-based interventions for healthy aging.
Not applicable.
Xiao-Xian Yang, Yan Zhuang, Hui Huang· Aging Clinical and Experimen...· 0 citations
Background: Current dietary guidelines are largely based on evidence from the general population, and data on dietary patterns and survival after myocardial infarction (MI) remain limited. We evaluated post-MI adherence to multiple healthy dietary patterns, as well as changes in adherence from before to after MI diagnosis, in relation to mortality among MI survivors. Methods: We included 3,277 women from the Nurses’ Health Study and 2,618 men from the Health Professionals Follow-up Study who survived a non-fatal MI. The mean age at MI diagnosis was 68.2 (standard deviation, 10.2) years. Diet was assessed using validated food frequency questionnaires and updated every two to four years. We calculated post-MI adherence scores for eight healthy patterns: the Alternate Healthy Eating Index (AHEI), the Healthy Eating Index-2015 (HEI-2015), the Alternate Mediterranean Diet Score (AMED), the Dietary Approaches to Stop Hypertension (DASH), the healthful Plant-Based Diet Index (hPDI), the reversed empirical dietary inflammatory pattern (rEDIP), the reversed empirical dietary index for hyperinsulinemia (rEDIH), and the reversed empirical dietary index for insulin resistance (rEDIR). The main outcome was total mortality, with cardiovascular disease (CVD) mortality and recurrent non-fatal MI as secondary outcomes. Results: During 15.7 years of follow-up after MI, 3,858 deaths (65.4%) were documented, including 1,639 CVD deaths (42.5% of deaths). Comparing the highest with the lowest quintile, higher post-MI dietary scores were consistently associated with lower total mortality, with the hazard ratio (HR) of 0.67 (95% confidence interval [CI]: 0.60–0.74) for AHEI, 0.73 (0.65–0.81) for HEI-2015, 0.66 (0.59–0.75) for AMED, 0.77 (0.69–0.86) for DASH, 0.74 (0.66–0.83) for hPDI, 0.77 (0.68–0.86) for rEDIP, 0.73 (0.65–0.83) for rEDIR, and 0.71 (0.64–0.80) for rEDIH. Similar inverse associations were observed for CVD mortality and recurrent non-fatal MI. Improved AHEI adherence from before to after MI was associated with lower mortality (HR: 0.86; 95% CI: 0.76–0.97), whereas decreased adherence to most patterns was associated with higher mortality. Conclusions: Among individuals who survived MI, adherence to post-MI dietary patterns emphasizing higher diet quality was associated with better long-term survival. These findings support dietary guidance focusing on overall diet quality for the secondary prevention of deaths among MI survivors.
L. Ma, Yang Hu, Gang Liu et al.· Circulation· 0 citations
