Wellness
Older adults who stay active have better quality of life
A UK study of nearly 1,500 older adults has shown a link between reduced physical activity and a lower quality of life.
The study conducted by the University of Cambridge on adults aged over 60 has also found that an increase in sedentary time spent watching TV or reading can be similarly connected to a less comfortable, healthy, and enjoyable life in later years.
The researchers say this highlights the need to encourage older adults to remain physically active.
Physical activity – particularly when it is moderate-intensity and raises the heart rate – is known to reduce the risk of contracting a number of diseases, including stroke, diabetes, cancer and heart problems.
The NHS recommends that adults undertake at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous physical exercise a week. This could be anything from a brisk 20 minute daily walk to gardening, riding a bike. dancing or tennis.
Older adults are also recommended to break up prolonged periods of being sedentary with light activity when physically possible, or at least with standing, as this has distinct health benefits.
Activity levels among 1,433 participants aged 60 and above were measured for the study using accelerometers, also known as movement monitors.
The participants had been recruited to the EPIC (European Prospective Investigation into Cancer)-Norfolk study, a population-based evaluation funded by the Medical Research Council and Cancer Research UK, of approximately 30,000 men and women aged 40-79 years taken on between 1993 and 1998.
The participants have continued to provide follow up data and attend additional health checks for over 25 years.
The University of Cambridge team also looked at health-related quality of life. This is a measure of health and wellbeing that includes pain, the ability of a person to care for themselves, and anxiety and mood.
Participants were given a score between 0 (worst quality of life) and 1 (best) based on their responses to a questionnaire.
Lower quality of life scores are characteristically linked with an increased risk of hospitalisation, worse outcomes following such treatment, and early death.
The participants were followed up around six years after enrolling on the study so that changes in their behaviour and quality of life could be tracked.
The results published in the online-only medical journal Health and Quality of Life Outcomes, showed that on average, six years after their first assessment, both men and women were doing around 24 minutes less moderate-to-vigorous physical activity per day.
Simultaneously, the total sedentary time increased by an average of around 33 minutes a day for men and about 38 minutes a day for women.
Those individuals who did more moderate-to-vigorous physical activity and spent less time sedentary at their first assessment had a higher quality of life later on.
An hour a day spent more active was associated with a 0.02 higher quality of life score.
For every minute a day less of moderate-to-vigorous physical activity measured six years after the first assessment, quality of life scores dropped by 0.03. This means that an individual who spent 15 minutes a day less engaged in such activity would have seen their score drop by 0.45.
Increases in inactivity were also associated with poorer quality of life – a drop in the score of 0.012 for every one minute a day rise in total sedentary time six years after the first measurement.
This means that an individual who spent 15 minutes a day more sitting down would have seen their score drop by 0.18.
To put the results into a clinical context, a 0.1 point improvement in quality of life scores has previously been associated with a 6.9% reduction in early death and a 4.2% reduction in risk of hospitalisation.
Dr Dharani Yerrakalva from the Department of Public Health and Primary Care at the University of Cambridge, said: “Keeping yourself active and limiting – and where you can, breaking up – the amount of time you spend sitting down is really important whatever stage of life you’re at.
“This seems to be particularly important in later life, when it can lead to potentially significant improvements to your quality of life and your physical and mental wellbeing.”
Because the team measured physical activity and sedentary behaviour at different points of time, they say they can be reasonably confident that they have shown a causal link – that is, that quality of life improves because people remain more physically active, for example.
Dr Yerrakalva added: “There are several ways in which improvements in our physical behaviours might help maintain a better quality of life. For example, more physical activity reduces pain in common conditions such as osteoarthritis, and we know that being more physically active improves muscle strength which allows older adults to continue to care for themselves.
“Similarly, depression and anxiety are linked to quality of life, and can be improved by being more active and less sedentary.”
Gut-friendly foods such as kimchi and kombucha may carry hidden risks for heart health when eaten in excess, the British Heart Foundation (BHF) has warned.
The charity said foods marketed as prebiotic, probiotic or otherwise good for the gut can support the microbiome, but some may also be high in salt or sugar, which can raise the risk of cardiovascular disease.
Products highlighted by the British Heart Foundation included kimchi, kombucha, fruit yoghurts, smoothies and sauerkraut. It said there is no harm in including them as part of a healthy diet, but advised people to check labels for added salt and sugar and eat them in moderation.
Tracy Parker, the charity’s nutrition lead, said: “We encourage everyone to choose foods that can keep their gut microbiome healthy. The benefits are clear, and we are continuing to improve our understanding of how a gut-friendly diet may help our hearts.
“A lot of these products can contain high levels of salt or sugar though, so it is important to be aware of the potential drawbacks.
“By ensuring you check package labels for added salt and sugars, and eat each in moderation, you can make sure the risks do not outweigh the benefits for your heart health.”
Fermented foods such as kimchi and sauerkraut are rich in probiotics, the healthy bacteria produced during fermentation that can help support a diverse and healthy gut microbiome.
However, both are traditionally made using a lot of salt, which can raise blood pressure if eaten frequently or in large quantities. High blood pressure is known to increase the risk of heart attack and stroke.
Kombucha, a fermented tea, also contains probiotics and can be a healthier alternative to fizzy drinks, but many commercial and shop-bought versions contain added sugar.
Eating too much sugar can lead to weight gain, which can increase the risk of heart attack, stroke and other cardiovascular disease.
Fruit yoghurts can contain probiotic live bacteria cultures, but may also be high in sugar and have fewer live cultures than plain versions.
The charity said plain yoghurt with live and active cultures on the label can be a lower-sugar option, with whole fruit added at home for sweetness.
Smoothies made with whole fruits provide prebiotic fibre, which feeds beneficial gut bacteria and supports digestive health.
They can also provide vitamins and antioxidants, especially when made with a variety of plant-based ingredients.
But blending breaks down the structure of fruit, releasing free sugars that behave like added sugars in the body and can cause faster rises in blood sugar levels.
Regularly consuming too much sugar can lead to weight gain, which can increase the risk of developing type 2 diabetes, heart disease and kidney disease.
The charity said only one 150ml serving of any smoothie counts towards five-a-day, and suggested adding nuts or seeds for extra protein and fibre to help keep blood sugar levels more stable.
The BHF also noted that some shop-bought sauerkraut is pasteurised, which removes most of the live bacteria.
It advised checking the label, eating small portions and choosing unpasteurised products for those seeking the probiotic benefits.
The charity said beneficial gut bacteria produce short-chain fatty acids during digestion, which are linked to reduced inflammation, better metabolism and better heart and circulatory health.
These good bacteria also help digest polyphenols, natural plant chemicals thought to have antioxidant properties and which may help lower blood pressure.
By contrast, harmful gut bacteria, which thrive on diets high in fat and red meat, produce chemicals that can cause problems in the heart and blood vessels by increasing inflammation and altering how cholesterol is processed in the body.
Beneficial bacteria thrive on varied diets high in prebiotics, non-digestible fibres found in foods such as wholegrains, oats, beans, lentils, bananas and onions.
People with diabetes may have undiagnosed heart failure that could be detected by a simple screening blood test, research suggests.
The TARTAN-HF trial found that one in four patients with diabetes who had at least one other risk factor for heart failure had undiagnosed heart failure detected through screening with a blood test and ultrasound scanning of the heart.
Experts said the findings show the extent of unrecognised heart failure in people with diabetes, and how the condition can be detected using a widely available blood test called NT-proBNP, which measures how much strain the heart is under.
They suggest a heart failure screening programme for diabetics could improve diagnosis rates, lead to earlier treatment and potentially reduce the risk of hospitalisation and death.
The study, involving 700 patients, was led by the University of Glasgow in collaboration with AstraZeneca, Roche Diagnostics, Us2.ai, NHS Greater Glasgow and Clyde and NHS Lanarkshire.
Dr Kieran Docherty, clinical senior lecturer at the University of Glasgow’s School of Cardiovascular and Metabolic Health, said: “Our results from the landmark TARTAN-HF trial identified heart failure in a large proportion of people living with diabetes, emphasising the need for a heart failure screening strategy in this group of patients.
“We know that many of the symptoms and signs of heart failure are non-specific, and may go unrecognised as potentially being due to heart failure for a long time.
“The strategy used in our trial is simple and easy to implement in clinical practice, and will aid in the early identification of heart failure in people with diabetes, and facilitate the initiation of medications that we know improve outcomes in patients with heart failure.”
The study, which began more than three years ago, involved more than 700 people with diabetes from the two health board areas who had at least one other risk factor for heart failure.
They were randomly assigned either to receive heart failure screening or to continue with their usual care.
Researchers found screening uncovered a large number of previously unrecognised cases of heart failure. Around one in four, or 24.9 per cent, of those screened were found to have the condition within six months, compared with 1 per cent in the group continuing their usual care.
The study, involving patients with type 1 and type 2 diabetes, found almost all of the participants found to have heart failure had preserved ejection fraction, which can be difficult to detect without dedicated testing.
The findings of the TARTAN-HF trial were presented at the American College of Cardiology conference taking place from 28 to 30 March in New Orleans in the US.
Dr Edward Piper, medical director at AstraZeneca UK, said: “Delayed diagnosis and treatment of heart failure in people with type 2 diabetes contributes to poor long-term outcomes. TARTAN-HF demonstrates that targeted, risk-based screening can identify previously undiagnosed heart failure in approximately one in four high-risk patients with diabetes, enabling earlier intervention with guideline-directed therapy.”
Dr Christian Simon, head of global medical affairs at Roche Diagnostics, said: “We are proud to have supported the landmark TARTAN-HF trial. These findings demonstrate the transformative power of early, accessible diagnostics like the NT-proBNP blood test.
“By identifying unrecognised heart failure in people with diabetes, we enable clinicians to initiate appropriate treatments sooner, ultimately improving patient outcomes and lives.”
The UK has launched a £6.3m men’s health fund to back local projects aimed at helping men and boys live longer, healthier lives.
The Men’s Health Community Fund is a partnership between the Department of Health and Social Care, Movember and People’s Health Trust.
The government is contributing £3m, while the two charities are more than doubling that to take the total to £6.3m.
Grants will support community projects reaching underserved men and boys aged 16 and over, particularly in the most disadvantaged areas and at key points in their lives such as becoming a father, losing a job or retiring.
Projects could include support for new fathers, activities for men facing loneliness and social isolation, services to help young men engage with the health system, and support for men in work, out of work and moving into retirement.
The programme will bring together voluntary, community and social enterprise organisations to test new ways of reaching men who are least likely to use traditional health services.
An evaluation funded through the National Institute for Health and Care Research will assess what works and help inform future policy and delivery.
Health and social care secretary Wes Streeting said: “Too many men across the country are living shorter, less healthy lives, particularly those in our most disadvantaged communities.
“This new partnership will help men get the support they need in the places they feel most comfortable, their communities, among people they trust.
“By working with expert charities and local organisations, we can reach the men who are too often missed by traditional services and help them take better care of their mental and physical health.”
“It is a key step in delivering our first ever Men’s Health Strategy and driving forward our ambition to halve the gap in healthy life expectancy between the richest and poorest areas.”
The Men’s Health Strategy sets out plans to tackle the physical and mental health challenges men and boys face.
Men can be less likely to seek help and more likely to suffer in silence, while higher rates of smoking, drinking, gambling and drug use are damaging men’s health and affecting families, workplaces and communities.
The government is also investing £3.6m over the next three years in suicide prevention projects for middle-aged men in local communities across areas of England where men are most at risk, many of which are also among the most deprived. Suicide is one of the biggest killers of men under 50, and three-quarters of all suicides are men.
The projects will aim to break down barriers middle-aged men face in seeking support, including stigma around asking for help and a lack of awareness of what is available and how to access it.
They will be co-designed with experts and men with lived experience of mental health crises and suicidal thoughts.
Gut-friendly foods may damage heart, charity warns
Diabetes patients face increased risk of undiagnosed heart failure
UK government announces £6.3m fund to boost men’s health
Brain health collaboratory launches in Gulf South
