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Abstract Background Clearance of apoptotic cells by efferocytosis is crucial for prevention of atherosclerosis progress, and impaired efferocytosis contributes to the aggravated atherosclerosis. Results In this study, we found that diabetic ApoE–/– mice showed aggravated atherosclerosis as hyperglycemia damaged the efferocytosis capacity at least partially due to decreased expression of Mer tyrosine kinase (MerTK) on macrophages. To locally restore MerTK in the macrophages in the plaque, hybrid membrane nanovesicles (HMNVs) were thus developed. Briefly, cell membrane from MerTK overexpressing RAW264.7 cell and transferrin receptor (TfR) overexpressing HEK293T cell were mixed with DOPE polymers to produce nanovesicles designated as HMNVs. HMNVs could fuse with the recipient cell membrane and thus increased MerTK in diabetic macrophages, which in turn restored the efferocytosis capacity. Upon intravenous administration into diabetic ApoE–/– mice, superparamagnetic iron oxide nanoparticles (SMN) decorated HMNVs accumulated at the aorta site significantly under magnetic navigation, where the recipient macrophages cleared the apoptotic cells efficiently and thus decreased the inflammation. Conclusions Our study indicates that MerTK decrease in macrophages contributes to the aggravated atherosclerosis in diabetic ApoE–/– mice and regional restoration of MerTK in macrophages of the plaque via HMNVs could be a promising therapeutic approach. Graphic Abstract

ObjectiveAlthough the regular exercise population is a key metric for gaging the success of China’s fitness-for-all activities, effective policy approaches to increase mass sports participation remain unclear. Previous research suggests that GDP, educational attainment, sports resources, and meteorological conditions could influence regular exercise participation. Therefore, this study first analyzed the macro-level correlates influencing China’s regular exercise population.MethodsWe utilize ordinary least squares (OLS) regression and geographical weighted regression (GWR) to theorize the relationship. The analysis encompasses data from the 31 administrative regions of Mainland China, as reported at the end of the 13th Five-Year Plan period. The log–log model enables us to quantify the marginal effect (elasticity) of the explanatory variables.ResultsThe OLS regression showed that regional GDP and the proportion of the population with a university education were significant predictors. In the global model, the marginal effects of regional GDP and university education were 0.048 and 0.173, respectively. Furthermore, the GWR revealed a distinct geographic pattern that corresponds to the classic Hu Line.ConclusionWhile regional GDP was also a significant correlate in our model, the elasticity demonstrates that university education had an asymmetric effect on China’s regular exercise population. Therefore, this paper sheds light on a policy priority for the upcoming 15th Five-Year Plan, emphasizing the strategic importance of expanding university education to enhance mass sports participation. In turn, a better-educated populace may yield significant secondary effects on public health and contribute to the high-quality development of the Chinese path to modernization.

IntroductionThe FIFA World Cup is not only the most lucrative athletic event globally, but it also functions as a platform for promoting peace owing to FIFA's new vision. Nevertheless, the determinants of TV viewership ratings, especially in the Chinese market, which is a critical revenue stream for FIFA TV broadcasting, are still unsolved. Using a distributional regression, this study aimed to quantify the dynamics of viewership ratings for the FIFA World Cup 2022 in mainland China.MethodsThe CCTV viewership ratings were modeled using 12 covariables related to Chinese TV consumer behavior. Given the data structure, a Logit Normal regression model was chosen to fit the location and dispersion parameters of viewership ratings to explanatory variables.ResultsIn the fitted heteroscedastic model, the viewership ratings dynamics in mainland China were driven by the match kick-off time: μ^=logistic[−4.874+0.043×matchkick-offtime]. In addition, the model captures the factors that influence the variations in viewership ratings: σ^=exp[−14.26–1.346 (if, FIFA World Cup champion = “Yes”) + 0.004 × FIFA world ranking]. Thus, it shows that the FIFA World Cup champions tamp down such variations, leading to a more stable viewing behavior among Chinese consumers.ConclusionsTime- and team-sensitive strategies are proposed to aid in crafting uncertainty-suppressing business decisions for the FIFA World Cup 2026. Ultimately, in the more insecure 2020s, a broader live coverage of the FIFA World Cup would be invaluable for promoting peace.

ObjectiveAging is associated with decreased nicotinamide adenine dinucleotide (NAD) levels, which in turn cause dysfunctional mitochondria and indirectly affect a myriad of diseases. Intracellular nicotinamide phosphoribosyltransferase (iNAMPT) serves as a central rate-limiting enzyme in NAD synthesis, making it an indispensable health mediator. This meta-analysis examined the effect of exercise training on the expression of iNAMPT in humans.MethodsWe searched PubMed, Scopus, ClinicalTrials.gov, and the International Clinical Trials Registry Platform for studies published between the inception of the database and July 5, 2023. Using the common-effect model, evidence for the change in iNAMPT following exercise training was synthesized as Cohen’s d.ResultsThe search yielded five eligible studies. The overall effect size is 0.81, with a 95% confidence interval of 0.55 to 1.07. Therefore, a random adult will have a 71.7% probability that iNAMPT will be up-regulated following exercise training. In general, exercise training resulted in a 1.46-fold increase in iNAMPT. Our probability statistics indicate that subgroups of interest may differ practically. Specifically, there is a 79.3% probability of increased iNAMPT in men, compared to a 69.0% probability in the overall population; young adults have a 75.6% probability of having an increased iNAMPT, whereas aged adults have a 68.7% probability; and, iNAMPT has a 75.1% probability increase after aerobic exercise and a 66.4% probability increase after resistance exercise.ConclusionExercise training is effective for increasing iNAMPT levels in skeletal muscles. This essential enzyme regulates not only cellular energetics but also healthspan. Therefore, exercise should be promoted as a natural slow-aging lifestyle.

BackgroundThis study aims to evaluate the psychometric properties of the Sport Anxiety Scale-2 (SAS-2) in Chinese adolescent sports exam candidates.MethodsOne day before the National Sports College Entrance Examination, 965 Chinese athletes rated the Chinese-language SAS-2. Confirmatory factor analysis was performed to test the three-factor structure. Factorial invariance was tested by comparing the configural invariance model to three more constrained models. Construct validity and reliability were determined.ResultsFit indices meet the critical values: CFI = 0.953, TLI = 0.943, RMSEA = 0.048 [90% CI, 0.041–0.054], and SRMR = 0.042. All path factor loadings exceed 0.5. The changes in CFI and RMSEA across the configural, metric, scalar, and uniqueness invariance are within the critical values, demonstrating strict measurement invariance across gender, years of training, and type of sports. The average variance extracted of the worry sub-scale is above the cutoff criteria, and McDonald's omega coefficients are over 0.70. Significant correlations exist between the SAS-2, SCAT, and CSAI-2. Factor correlations are all below 0.8. The measurement also distinguishes the known gender effect, with females showing a probability of 58.6% higher anxiety levels. The intraclass correlation coefficient ranges from 0.706 to 0.801.ConclusionThis study validated the Chinese-language SAS-2 in measuring competitive anxiety among Chinese adolescent athletes taking the National Sports College Entrance Examination. The development of the scale's applicability in China is discussed.

Abstract Background Exosome mediated mRNA delivery is a promising strategy for the treatment of multiple diseases. However, the low yield of exosomes is a bottleneck for clinical translation. In this study, we boosted exosome production via simultaneously reducing the expression of genes inhibiting exosome biogenesis and supplementing the culture medium with red cell membrane components. Results Among the candidate genes, knocking down of Rab4 was identified to have the highest efficacy in promoting exosome biogenesis while without any obvious cytotoxicity. Additionally, supplementing red cell membrane particles (RCMPs) in the culture medium further promoted exosome production. Combination of Rab4 knockdown and RCMP supplement increased exosome yield up to 14-fold. As a proof-of-concept study, low-density lipoprotein receptor (Ldlr) mRNA was forced expressed in the exosome donor cells and passively encapsulated into the exosomes during biogenesis with this strategy. Though exosome production per cell increased, the booster strategy didn’t alter the loading efficiency of therapeutic Ldlr mRNA per exosome. Consistently, the therapeutic exosomes derived by the strategy alleviated liver steatosis and atherosclerosis in Ldlr −/− mice, similar as the exosomes produced by routine methods. Conclusions Together, the proposed exosome booster strategy conquers the low yield bottleneck to some extent and would certainly facilitate the clinical translation of exosomes.

Atherosclerosis is characterized by inflammation in the arterial wall, which is known to be exacerbated by diabetes. Therapeutic repression of inflammation is a promising strategy for treating atherosclerosis. In this study, we showed that diabetes aggravated atherosclerosis in apolipoproteinE knockout (ApoE−/-) mice, in which increased expression of long-chain acyl-CoA synthetase 1 (Acsl1) in macrophages played an important role. Knockdown of Acsl1 in macrophages (MφshAcsl1) reprogrammed macrophages to an anti-inflammatory phenotype, especially under hyperglycemic conditions. Injection of MφshAcsl1 reprogrammed macrophages into streptozotocin (STZ)-induced diabetic ApoE−/- mice (ApoE−/-+ STZ) alleviated inflammation locally in the plaque, liver and spleen. Consistent with the reduction in inflammation, plaques became smaller and more stable after the adoptive transfer of reprogrammed macrophages. Taken together, our findings indicate that increased Acsl1 expression in macrophages play a key role in aggravated atherosclerosis of diabetic mice, possibly by promoting inflammation. Adoptive transfer of Acsl1 silenced macrophages may serve as a potential therapeutic strategy for atherosclerosis.

PurposeThis study examined the role of Evergrande FC's club debt on the Chinese Super League (CSL)'s profitability from 2014 to 2019.MethodsWe extracted the financial statements of Evergrande FC and evaluated its correlation with the profitability of CSL and Evergrande Group, which serves as a direct indicator of commercial growth.ResultsThe association between Evergrande FC's net loss and gross debt and CSL's profitability is positive, strong (all correlation coefficients > .89), and statistically significant (all p

According to the Olympic Charter, the construction of new permanent venues or infrastructure for the purposes of the organization of the Olympics shall only be considered on the basis of sustainable legacy plans. However, as time passes, the Olympic legacies grow increasingly unsustainable and create conflicts between humans and nature. This perspective examined the spatial distribution of the Beijing 2022 Winter Olympics venue legacy. We presented a spatial assessment of Olympic venues’ legacy experience in terms of construction and sustainability. The findings indicate that the Beijing 2022 Winter Olympics venues incorporated sustainable land management and green ecology concepts from the Olympic Movement, and that the legacy could serve as an example for future development of Olympic infrastructure, natural sites, and resource management.

Abstract Background Efficient and topical delivery of drugs is essential for maximized efficacy and minimized toxicity. In this study, we aimed to design an exosome-based drug delivery platform endowed with the ability of escaping from phagocytosis at non-target organs and controllably releasing drugs at targeted location. Results The swtichable stealth coat CP05-TK-mPEG was synthesized and anchored onto exosomes through the interaction between peptide CP05 and exosomal surface marker CD63. Chlorin e6 (Ce6) was loaded into exosomes by direct incubation. Controllable removal of PEG could be achieved by breaking thioketal (TK) through reactive oxygen species (ROS), which was produced by Ce6 under ultrasound irradiation. The whole platform was called SmartExo. The stealth effects were analyzed in RAW264.7 cells and C57BL/6 mice via tracing the exosomes. To confirm the efficacy of the engineered smart exosomes, Bone morphogenetic protein 7 (Bmp7) mRNA was encapsulated into exosomes by transfection of overexpressing plasmid, followed by stealth coating, with the exosomes designated as SmartExo@Bmp7. Therapeutic advantages of SmartExo@Bmp7 were proved by targeted delivering Bmp7 mRNA to omental adipose tissue (OAT) of obese C57BL/6 mice for browning induction. SmartExo platform was successfully constructed without changing the basic characteristics of exosomes. The engineered exosomes effectively escaped from the phagocytosis by RAW264.7 and non-target organs. In addition, the SmartExo could be uptaken locally on-demand by ultrasound mediated removal of the stealth coat. Compared with control exosomes, SmartExo@Bmp7 effectively delivered Bmp7 mRNA into OAT upon ultrasound irradiation, and induced OAT browning, as evidenced by the histology of OAT and increased expression of uncoupling protein 1 (Ucp1). Conclusions The proposed SmartExo-based delivery platform, which minimizes side effects and maximizing drug efficacy, offers a novel safe and efficient approach for targeted drug delivery. As a proof, the SmartExo@Bmp7 induced local white adipose tissue browning, and it would be a promising strategy for anti-obesity therapy. Graphical Abstract

Objectives: In 2022, 55 million Chinese children participate in campus football; however, there is no physical fitness standard, making it a priority task to enhance the current national program. This study aimed to explore a pilot method for the development of a reliable physical fitness standard.Methods: This study examined 765 male football players aged 9 to 11 in 2020 and 2022. The anthropometric and physical fitness assessments were conducted in accordance with the Chinese Football Association’s field manuel. Physical fitness tests include sit and reach test, t test, 30 m run test, and vertical jump test. Physical fitness standard was modeled using the generalized additive models for location, scale, and shape (GAMLSS). Data were fitted with appropriate GAMLSS distributions and smoothing term. P-splines were applied to smooth the model’s parameters using the default local maximum likelihood method and link functions. Following diagnostics of fitted models, age-specific centile estimations were computed for physical fitness tests. In addition, players in each age group were categorized according to their body mass index as normal weight or overweight/obese. Welch’s t-test was utilized to compare the group differences in physical fitness testing. The significance level was chosen at p < 0.05.Results: Sit and reach test, t test, 30 m run test, and vertical jump test data were fitted with original Sinh-Arcsinh, Box-Cox power exponential, Box-Cox power exponential, and Box-Cox Cole and Green, respectively. Physical fitness standard for each age group is presented as tabulated centiles (1p, 3p, 5p, 15p, 25p, 50p, 75p, 85p, 95p, 97p, 99p). Overweight/obese campus football players did significantly worse (p < 0.05) on the t test, 30 m run test, and vertical jump test than their normal-weight peers of the same age.Conclusion: This study developed the first physical fitness standard for 9 to 11-year-old campus football players in China. We made three recommendations to Chinese policymakers on sample size, data management, and field procedure for the creation of a national physical fitness standard.

ObjectivesParticipation in mass sports is one of the most efficient strategies for people to attain physical and mental health in China. Prosocial behavior has a positive effect on social development. This study developed a conceptual model with mass sports activity as the independent variable, prosocial behavior as the dependent variable, and flow trait and subjective wellbeing as the mediating variables.MethodsParticipants (N = 351) completed an online survey. Mass sports activity, flow trait, subjective wellbeing, and prosocial behavior were measured using the physical activity rank scale-3 (PARS-3), short dispositional flow scale (SDFS), index of wellbeing (IWB), and prosocial tendencies measure (PTM), respectively. Descriptive statistics compared differences between sports population (PARS-3, ≥ 36) and non-sports population (PARS-3,

ObjectivesHealth communication campaign that promotes physical activity may aid in reducing the prevalence of childhood and adolescent obesity in China. This study examined the effects of message framing and psychological distance on the exercise attitude of Chinese adolescents, along with the interactive role of risk perception.MethodsParticipants in this study were between 10 and 19 years of age. Three experiments were conducted independently. In experiment 1, 76 participants were recruited to assess the effectiveness of message manipulation. In experiment 2, 40 participants were recruited to compare the effects of gain- and loss-framed messages on the exercise attitude. In experiment 3, 37 participants were recruited to explore the interaction between message framing (gain vs. loss), temporal distance (proximal vs. distal), and risk perception (low vs. high) on the exercise attitude. Exercise attitude and risk perception were assessed by Likert-type questionnaires.ResultsThere was a significant main effect of message framing (P < 0.05), with the gain-framed message inducing a stronger exercise attitude than the loss-framed message. There was a significant main effect of temporal distance (P < 0.05), with the proximal temporal distance condition inducing a stronger exercise attitude than the distal temporal distance condition. In addition, a significant interaction (P < 0.05) was observed, and the perception of obesity-related risk was a crucial moderator of the message framing and temporal distance. Regardless of whether they were exposed to a gain- or loss-framed message, the proximal temporal distance condition induced a stronger exercise attitude in participants with a high risk perception (P < 0.05).ConclusionMessages promoting exercise that are framed as having a near-future gain effect and that emphasize disease risks are effective in motivating adolescents to engage in physical activity.

ObjectivePhysical inactivity and sensory integration dysfunction are public health concerns among Chinese preschool children. The purpose of this study was to determine the efficacy of a novel functional training program focused on motor development for healthy children aged 5 to 6 years.MethodsA total of 101 healthy children aged 5 to 6 years in Tianjin were randomly assigned to the experimental group (N = 51), which received 12-week functional training featuring essential motor skills, whilst the control group (N = 50) continued with their kindergarten-based physical education curriculum. Test of Gross Motor Development-2, national physical fitness measurement, and sensory integration were evaluated before and after the intervention. Children's height, body weight, and the corresponding pre-intervention test scores were utilized as covariates to compare the post-intervention outcomes between the groups.ResultsAfter the intervention, the experimental group scored considerably higher (P < 0.01) on the locomotor composite score, object control composite score, and overall gross motor score than the control group; the experimental group scored higher (P < 0.05) on the run, gallop, leap, stationary dribble, kick, striking a stationary ball, overhand throw, and underhand roll motor skill tests than the control group; the experimental group performed considerably better (P < 0.01) on the balance beam walking test and sit-and-reach test than the control group; and, the experimental group performed considerably better (P < 0.01) on the vestibular function, tactile defensiveness, and proprioception than the control group.ConclusionA 12-week functional training focused on motor development effectively enhanced gross motor, physical fitness, and sensory integration in 5–6-year-old healthy Chinese children.

ObjectiveBy 2022, the Chinese government intends to have more than 30 million primary-, middle- and high-school children and adolescents regularly participate in campus football. In contrast, epidemiology of campus football injuries is completely missing. The goal of this descriptive epidemiological study was to determine the current state of campus football injuries and then to recommend appropriate prevention and management strategies.MethodsThis retrospective epidemiological study conducted a survey of students, physical education and football teachers in primary, middle and high schools in the Ningxia Autonomous Region to determine the campus football injuries that occurred throughout the preceding 12-month period. The survey comprised questions on demographic characteristics, the occurrence, causes, and management of campus football injuries.ResultsA total of 1,285 students and 200 teachers returned eligible surveys. 25.7% of students had encountered injury accidents while participating in campus football activities. 31.3% of high school students, 23.8% of middle school students, and 19.2% of primary school students have sustained injuries. Football competition, accounting for 45.4% of all injuries, is the leading cause of injury. Football class teaching, which accounted for 3.0% of all injuries, had the lowest injury rate of any campus football activity. Students and teachers reported that a lack of safety awareness and injury prevention education were the primary causes of injuries. Only 18.7% and 11.4% of students are familiar with first aid basics and cardiopulmonary resuscitation, respectively. 10.6% and 7.5% of students lack any first aid basics and skills, respectively. 43.9% of students lack insurance coverage for athletic injuries. 62.5% and 38.5% of teachers reported that schools lack first aid training and an emergency plan for injuries, respectively.ConclusionStudents in Ningxia's campus football programs have a high injury risk. Injury prevention and management strategies lag significantly behind the mainstream nationwide promotion of campus football in China.

BackgroundPhysical fitness comprises both health- and skill-related components that have been shown to correlate with the competitive ability of the athletes. Competitive ability of the athletes is strongly related to the positive or poor characteristics of physical fitness. Additionally, the adolescent stage is critical for the development of physical fitness. Physical fitness training for young tennis players should receive more attention. However, the current literature is deficient in in-depth reviews of the effects of exercise training on the physical fitness of young tennis players.ObjectiveThis review is aimed to investigate the effects of exercise training on physical fitness among young tennis players.MethodsFrom October 2020, a comprehensive search was undertaken in four electronic databases (SCOPUS, PubMed, EBSCOhost (SPORTDiscus), and CINAHL Plus) and also on Google Scholar and other sources of gray literature references. The methodological quality of included studies was assessed using the Physiotherapy Evidence Database scale and the over scientific evidence was determined using the best evidence synthesis (BES). This review included only studies that employed an experimental design to assess the physical fitness components of young tennis players.ResultsNine articles on exercise training met all inclusion criteria and were included in this systematic review. The studies were of a high standard of quality. The research findings are relatively credible. The results indicated that speed (n = 8) and agility (n = 8) were the most often investigated performance characteristics in exercise training interventions with young tennis players, followed by power (n = 7), strength (n = 4), and flexibility (n = 1). Exercise training significantly increased the physical fitness of young tennis players in terms of speed and agility. There is a lack of evidence about strength and flexibility. Meanwhile, there is conflicting evidence regarding the effect on power, and yet there is no evidence regarding the effect of exercise training on endurance.ConclusionsThis systematic review established a compelling case for the beneficial effects of exercise training interventions on physical fitness in youngtennis players. The review identifies current research gaps (i.e., athlete gender, with a particular emphasis on female athletes) that should be addressed in future experimental studies.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero, identifier CRD 42020213145.

ObjectiveAccording to the seventh demographic census, China's elderly population reached 260 million, accounting for 18.7% of the total population, indicating that China is on the verge of transitioning from a relatively mild aging to a moderately aging society, and an aging society inevitably brings concerns about the elderly people's health. The purpose of this study was to better understand the effect of economic development on the physical fitness of the elderly people aged 60–69 in China during the first two decades of the twenty-first century, as well as to establish a correlation between China's gross domestic product (GDP) and changes in the elderly people's passing rate of national physical fitness standards.MethodsA linear regression analysis was performed on the data of GDP and the passing rate of national physical fitness standards of Chinese elderly people aged 60–69 in 2000, 2005, 2010, 2014, and 2020.ResultsThe passing rate of national physical fitness standards for elderly people aged 60–69 increased linearly (R2 = 80.56%, p < 0.05), indicating that the physical fitness of the elderly tends to increase steadily with GDP expansion.ConclusionsBetween 2000 and 2020, the annual improvement in the physical fitness of the elderly people in China is inextricably linked to rapid economic development. Increased financial investments in public sports services and a corresponding national fitness plan all contribute to an overall improvement in the physical fitness of the elderly people. This outcome is the effect of fiscal and policy coordination, which may represent a distinctive Chinese model and contribution to the global effort to manage and improve population physical fitness.

This narrative review of the literature assessed whether regular physical exercise and sleep patterns, fasting and autophagy, altogether can be an adequate strategy for achieving healthy longevity and well-being within different stage of life. There are a large number of studies dealing with well-being and healthy longevity; however, few of them have given us a specific formula for how to live long and healthy. Despite all the advances that have been made to create adequate physical exercise programs, sleep patterns or nutritional protocols, the relation between different types of fasting, nutritional supplementation as well as regular physical exercise and sleep patterns have not yet been satisfactorily resolved to cause the best effects of autophagy and, therefore, well-being and healthy longevity. In this way, future studies should clarify more efficiently the relationship between these variables to understand the association between regular physical exercise, sleep patterns, fasting and autophagy for healthy longevity and well-being.

There is evidence that functional training is beneficial for the overall physical fitness of athletes. However, there is a lack of a systematic review focused on the effects of functional training on athletes' physical fitness. Thus, the aimed of the present review is to clarify the effects of functional training on physical fitness among athletes. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) Statement guidelines, the systematic search of PubMed, SCOPUS, EBSCOhost (SPORTDiscus), and CINAHL Plus databases was undertaken on the 2nd November 2020 to identify the reported studies, using a combination of keywords related to functional training, physical fitness, and athletes. From the 145 studies, only nine articles met all eligibility criteria and were included in the systematic review. The assessment was performed on the Pedro scale, and the quality of the study included in the nine studies was fair (ranging from 3 to 4). The results showed that speed (n = 6) was the aspect of physical fitness studied in functional training interventions, followed by muscular strength (n = 5), power (n = 4), balance (n = 3), body composition (n = 3), agility (n = 3), flexibility (n = 1) and muscular endurance (n = 1). Existing evidence concludes that functional training significantly impacts speed, muscular strength, power, balance, and agility. Furthermore, there are still limit numbers of evidence showing effect of functional training on flexibility and muscular endurance. In contrast, no significant improvement was found in body composition where functional training was conducted.Systematic Review Registration:https://www.crd.york.ac.uk/prospero, identifier: CRD4202123092.

Obesity represents a major risk factor for population health. No studies have evaluated how economic expansion impacts the prevalence of obesity. The purpose of this study was to assess the relationship between national economic development and body mass index (BMI) in Chinese children and adolescents. Data of mean BMI in children and adolescents aged 5–19 from 1986 to 2019 were extracted from an international database of cardiometabolic risk factors. Chinese economic development was quantified by the gross domestic product (GDP), which was extracted from the International Monetary Fund. The relationships between GDP and BMI were assessed in 1-year age groups for ages 5–19 years. In addition, the linear regression from the main data and estimated GDP growth allowed the projections of mean BMI for each age group between 2020 and 2025. The results suggest there was a linear increase in BMI over years, which means that there has been a steady increase in BMI over the economic expansion. Overall, 97% of the variance (Pearson correlation coefficient) of BMI in boys can be explained by the GDP expansion, and the same pattern (98% of the variance) occurred in girls. Projected mean BMI were provided for constructing future national strategies to prevent overweight and obesity in youth. In conclusion, BMI in children and adolescents aged 5–19 trended upwards between 1986 and 2019. Our analyses for the first time suggest that globalization has a major impact on BMI in China. Economic expansion was highly predictive of BMI increases.

This short report discusses the current cost of the healthcare system in the United States. The affordability problems in the United States stem directly from insufficient competition of drug prices from the Medicare system. This report provided evidence about how the proposed Medicare reforms are skewed and would unlikely end the blank-check approach to pricing of Medicare that drives our healthcare spending and affordability problems.