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Background The coronavirus disease (COVID-19) pandemic exacerbated depression and anxiety worldwide. Resilience is important to maintain mental health during uncertain times, but limited study has systematically reviewed its association with depression or anxiety with an emphasis on the general population. Methods We searched PubMed and Embase for quantitative or mixed-methods studies on the general adult population published between 1 January 2020 and 31 April 2022 (PROSPERO ID: CRD 42022340935). National Institute of the Health quality assessment tools was used to assess the risk of bias. We qualitatively synthesized findings by outcome and study design. Results A total of 2945 studies were screened and 35 studies were included in the narrative analysis (5 on depression, 9 on anxiety, and 21 on both). Overall, 21 studies identified statistically significant inverse associations between resilience and depression, while 24 studies found statistically significant inverse associations between resilience and anxiety. Eight studies reported no statistically significant relationships between resilience with depression or anxiety. Conclusions Resilience was found to be inversely associated with depression and anxiety during the COVID-19 pandemic. The findings highlight the importance of resilience-enhancing intervention in migrating the global mental health burden from outbreaks of infectious diseases. [ABSTRACT FROM AUTHOR]

Background The burden of chronic conditions associated with sugary beverages is increasing but little is known about the role of different types of sugary beverages in the co-occurrence of multiple chronic conditions ('multimorbidity'). To inform future sugar-reduction guidelines, we aimed to examine the associations of sugar-sweetened beverages (SSB), artificially sweetened beverages (ASB) and natural juices (NJ) with multimorbidity. Methods This prospective cohort study included 184 093 UK Biobank participants aged 40–69 years at baseline who completed at least one occasion of 24-h dietary recall between 2009 and 2012. Daily consumptions of SSB, ASB and NJ were assessed using 24-h dietary recall. Participants were followed from the first 24-h assessment until the onset of two or more new chronic conditions, or the end of follow-up (31 March 2017), whichever occurred first. Logistic regression models, Cox proportional hazard models and quasi-Poisson mixed effects models were used to estimate the association of beverages intakes with chronic conditions and multimorbidity. Results A total of 19 057 participants had multimorbidity at baseline and 19 968 participants developed at least two chronic conditions during follow-up. We observed dose–response relationships of SSB and ASB consumptions with the prevalence and incidence of multimorbidity. For example, the adjusted hazard ratios (HRs) and 95% CIs of the incidence of developing at least two chronic conditions ranged from 1.08 (1.01–1.14) for SSB intake of 1.1–2 units/day to 1.23 (1.14–1.32) for >2 units/day compared with 0 units/day. Also, the adjusted HRs (95% CIs) of ASB consumption ranged from 1.08 (1.03–1.13) for 0.1–1 unit/day to 1.28 (1.17–1.40) for >2 units/day compared with non-consumers. Conversely, moderate consumption of NJ was associated with a smaller risk of the prevalence and incidence of multimorbidity. Moreover, higher intakes of SSB and ASB were positively associated whereas moderate intake of NJ was inversely associated with increased number of new-onset chronic conditions during follow-up. Conclusions Higher SSB and ASB intakes were positively associated whereas moderate NJ intake was inversely associated with the higher risk of multimorbidity and increased number of chronic conditions. Current and intended policy options to decrease the burden of chronic conditions and multimorbidity need a formulation of SSB and ASB reduction strategies. [ABSTRACT FROM AUTHOR]

BACKGROUND Health professionals' commitment is needed to address disparities in hypertension control by ancestry, but their perceptions regarding these disparities are understudied. METHODS Cross-sectional mixed methods study in a universal healthcare setting in the Netherlands. Snowball sampling was used to include professionals practicing in a large multicity conglomerate including the capital city. Online surveys were collected, and survey participants were randomly selected for in-depth interviews. We used quantitative and qualitative methods to analyze health professionals' awareness, beliefs, and possible interventions regarding these disparities. RESULTS We analyzed questionnaire data of 77 health professionals (medical doctors n  = 70, nurses = 7), whereas 13 were interviewed. Most professionals were women (59%), general practitioners (81%); and White-European (77%), with 79% caring for patients of diverse ancestry. Disparities in hypertension control by ancestry were perceived to exist nationally (83% [95% CI, 75;91]), but less so in health professionals' own clinics (62% [52;73]), or among their own patients (56% [45;67]). Survey respondents emphasized patient rather than provider-level factors as mediators of poor hypertension control by ancestry. The collection of data on patients' ancestry, updating guidelines, and professional training were considered helpful to reduce disparities. Interviewees further emphasized patient-level factors, but also the need to better educate health professionals and increase their awareness. CONCLUSIONS This explorative study finds that health professionals predominantly attribute disparities in hypertension control to patient-level factors. Awareness of disparities was lower for more proximate healthcare settings. These data emphasize the need to consider health professionals' perceptions when addressing disparities in hypertension control. [ABSTRACT FROM AUTHOR]

Forkhead Box O 3 (FOXO3) genotype is strongly associated with human longevity and may be protective against neurodegeneration. Air pollution is a risk factor for cognitive decline and dementia. We aimed to study the individual and combined effects of FOXO3 and air pollution on cognitive function in a large prospective cohort with up to 14 years of follow-up. We measured cognitive function and impairment using the Mini-Mental State Examination (MMSE). We used tagging SNPs rs2253310, rs2802292, and rs4946936 to identify the FOXO3 gene, of which roughly half of the population had the longevity-associated polymorphism. We matched annual average fine particulate matter (PM2.5) concentrations within a 1 km2 grid. We conducted cross-sectional and longitudinal analyses using multivariable linear and logistic regression models and generalized estimating equations. At baseline, carriers of the longevity-associated homozygous minor alleles of FOXO3 SNPs had a higher MMSE score than the carriers of homozygous major alleles. In the longitudinal follow-up, carriers of FOXO3 homozygous minor alleles had lower odds of cognitive impairment compared with noncarriers. Higher PM2.5 was associated with a lower MMSE score and higher odds of cognitive impairment. The positive effects of FOXO3 were the strongest in females, older people, and residents in areas with lower air pollution. [ABSTRACT FROM AUTHOR]

SIRT1 and FOXO3 are both associated with longevity. Molecular biology research in many organisms (yeast, nematode worm Caenorhabditis elegans, and mice mammalian models) shows SIRT1 acts on the FOXO family of forkhead transcription factors to respond to oxidative stress better, shifting processes away from cell death toward stress resistance. Human population studies need epidemiologic evidence. We used an open cohort of 3 166 community-dwelling participants in China with follow-up from 2008 to 2018. The mean age at baseline was 84.6 years. In 16 375 person-years of follow-up, there were 1 968 mortality events. SIRT1 and FOXO3 exhibited Mendelian randomization as there was no correlation with each other and with baseline study population characteristics. Some SIRT1 and FOXO3 single-nucleotide polymorphisms showed protective effects for mortality risk. The FOXO3 protective effect was stronger in females, and the SIRT1 protective effect was stronger in male study participants. We did not see evidence of a synergistic effect of being carriers of both SIRT1 and FOXO3 advantageous alleles. [ABSTRACT FROM AUTHOR]

Forkhead box O3 (FOXO3) is a candidate longevity gene. Urban residents are also positively associated with longer life expectancy. We conducted a gene-environment interaction to assess the synergistic effect of FOXO3 and urban/rural environments on mortality. We included 3 085 older adults from the Chinese Longitudinal Healthy Longevity Survey. We used single-nucleotide polymorphisms (SNPs) rs2253310, rs2802292, and rs4946936 to identify the FOXO3 gene and classified residential locations as "urban" and "rural." Given the open cohort design, we used the Cox-proportional hazard regression models to assess the mortality risk. We found the minor allele homozygotes of FOXO3 to have a protective effect on mortality (HR [95% CI] for rs4946936 TT vs CC: 0.807 [0.653-0.996]; rs2802292 GG vs TT: 0.812 [0.67-0.985]; rs2253310 CC vs GG: 0.808 [0.667-0.978]). Participants living in urban areas had a lower risk of mortality (HR of the urban vs the rural: 0.854 [0.759-0.962]). The interaction between FOXO3 and urban and rural regions was statistically significant (pinteraction < .01). Higher air pollution (fine particulate matter: PM2.5) and lower residential greenness (Normalized Difference Vegetation Index [NDVI]) both contributed to higher mortality. After adjusting for NDVI and PM2.5, the protective effect size of FOXO3 SNPs was slightly attenuated while the protective effect size of living in an urban environment increased. The effect size of the beneficial effect of FOXO3 on mortality is roughly equivalent to that of living in urban areas. Our research findings indicate that the effect of places of residence and genetic predisposition of longevity are intertwined. [ABSTRACT FROM AUTHOR]

BackgroundStudies on blood pressure (BP) in high-altitude areas are scarce and the results are controversial. Tibetans live in regions at high altitudes, and data on the prevalence of hypertension in this population is not currently well known.MethodsAll Tibetans aged 40 years and older living in the township of Yangbajing (4,300 m) in Tibet, China were invited to participate in the 2009 survey. BP was measured with electronic sphygmomanometers (calibrated by the results of a previous study). Histories of hypertension and medication use were collected through face-to-face interviews. Hypertension was defined as systolic BP (SBP) ≥140 mm Hg and/or diastolic BP (DBP) ≥90 mm Hg, or antihypertensive medication use in the past 2 weeks.ResultsA total of 701 adults (aged 40-89, 42.9% male, 94.9% herdsmen) were recruited. The mean (s.d.) SBP/DBP was 146.6 (31.3)/92.0 (15.7) mm Hg and the prevalence of hypertension was 55.9%. Of note, 61.2% of those with hypertension had stage 2 hypertension (SBP ≥160 or DBP ≥100 mm Hg). At age 70 years and older, the mean (s.d.) SBP/DBP were 182.8 (30.9)/102.6 (13.4) mm Hg. Among those with hypertension (n = 392), only 19.9% were aware of their condition, 2.6% were taking medication, and only one participant had controlled BP.ConclusionAccording to our survey in Yangbajing, Tibetan adults aged 40 years and older living at high altitudes had high BP and prevalence of hypertension with low awareness, treatment, and control. Future studies are needed to clarify the association between BP, altitude, and other possible causes.American Journal of Hypertension 2012; doi:10.1038/ajh.2012.9 [ABSTRACT FROM AUTHOR]

Numerous studies have found an association between shorter sleep duration and higher body mass index (BMI) in adults. Most previous studies have been cross-sectional and relied on self-reported sleep duration, which may not be very accurate. In the Coronary Artery Risk Development in Young Adults (CARDIA) Sleep Study (2000–2006), the authors examine whether objectively measured sleep is associated with BMI and change in BMI. They use several nights of wrist actigraphy to measure sleep among participants in an ongoing cohort of middle-aged adults. By use of linear regression, the authors examine whether average sleep duration or fragmentation is associated with BMI and 5-year change in BMI, adjusting for confounders. Among 612 participants, sleep duration averaged 6.1 hours and was grouped into 4 categories. Both shorter sleep and greater fragmentation were strongly associated with higher BMI in unadjusted cross-sectional analysis. After adjustment, BMI decreased by 0.78 kg/m2 (95% confidence interval: −1.6, −0.002) for each increasing sleep category. The association was very strong in persons who reported snoring and weak in those who did not. There were no longitudinal associations between sleep measurements and change in BMI. The authors confirmed a cross-sectional association between sleep duration and BMI using objective sleep measures, but they did not find that sleep predicted change in BMI. The mechanism underlying the cross-sectional association is not clear. [ABSTRACT FROM PUBLISHER]

Despite mounting evidence that sleep duration is a risk factor across diverse health and functional domains, little is known about the distribution and determinants of sleep. In 2003–2004, the authors used wrist activity monitoring and sleep logs to measure time in bed, sleep latency (time required to fall asleep), sleep duration, and sleep efficiency (percentage of time in bed spent sleeping) over 3 days for 669 participants at one of the four sites of the Coronary Artery Risk Development in Young Adults (CARDIA) study (Chicago, Illinois). Participants were aged 38–50 years, 58% were women, and 44% were Black. For the entire sample, mean time in bed was 7.5 (standard deviation (SD), 1.2) hours, mean sleep latency was 21.9 (SD, 29.0) minutes, mean sleep duration was 6.1 (SD, 1.2) hours, and mean sleep efficiency was 80.9 (SD, 11.3)%. All four parameters varied by race-sex group. Average sleep duration was 6.7 hours for White women, 6.1 hours for White men, 5.9 hours for Black women, and 5.1 hours for Black men. Race-sex differences (p < 0.001) remained after adjustment for socioeconomic, employment, household, and lifestyle factors and for apnea risk. Income was independently associated with sleep latency and efficiency. Sleep duration and quality, which have consequences for health, are strongly associated with race, sex, and socioeconomic status. [ABSTRACT FROM AUTHOR]

A response by Diane S. Lauderdale and colleagues to a letter to the editor about their article "Cross-sectional and Longitudinal Associations Between Objectively Measured Sleep Duration and Body Mass Index: The CARDIA Sleep Study" in the 2010 issue of the "American Journal of Epidemiology" is presented.

The article presents the authors' response to a commentary about their report on sleep duration and body mass index published in this issue. They claim that their report is a negative study for the hypothesis that shorter sleep increases are associated with the risk of weight gain. They note that they were able to examine the possible association of greater self-reported sleep with lower body mass index.

The authors respond to the commentary "How Much Do We Really Sleep?," by Stuart Quan. They express enjoyment in reading Quan's perspective on the importance of sleep. They note that Quan addressed two possible sources of bias: that actigraphy might underestimate sleep compared with other measurement modes and that actigraphy is sleep deprived. The authors agree that persons in metropolitan areas in the U.S. might sleep less than other persons. They express excitement about the growing epidemiologic interest in sleep.