Feasibility of Using a Mobile App for Stress in Middle-Aged Men and Women. (Preprint)

2021 ◽  
Author(s):  
Breanne Michelle Laird ◽  
Megan Puzia ◽  
Linda Larkey ◽  
Diane Ehlers ◽  
Jennifer Huberty

BACKGROUND Middle-aged adults (40 to 65 years) report higher stress than most age groups. There is a need to test the feasibility of using a meditation app to reduce stress and improve stress-related outcomes in both middle-aged men and women. OBJECTIVE Therefore, the purpose of this study was to: (1) determine the feasibility (i.e., acceptability and demand) of a consumer-based meditation app (i.e., Calm) to reduce stress in middle-aged adults reporting elevated stress; and (2) explore the preliminary effects of Calm on perceived stress, psychological outcomes (i.e., anxiety, depressive symptoms, mindfulness, general coping), health behaviors (i.e., physical activity, eating habits), and perceptions of COVID-19. METHODS The current study is a double-blind randomized controlled feasibility study testing a brief app-based meditation (i.e., Calm) intervention in middle-aged adults (N=83) with elevated stress levels (i.e., score greater than or equal to 15 on the Perceived Stress Scale) and limited or no previous experience with meditation. Participants were randomized to an app-based meditation intervention (Calm) or app-based education control group (POD). Participants completed self-report assessments at baseline and post-intervention (Week 4). Feasibility was measured as acceptability and demand using Bowen’s framework. Feasibility and COVID-19 perceptions data were examined via descriptive statistics. Preliminary effects were examined using repeated-measures analysis of variance. RESULTS Participants were satisfied with the meditation intervention (96.4%; 27/28) and found it appropriate/useful (92.9%; 26/28). Most reported that they were likely to continue using Calm in the future (64.3%; 18/28). More participants in the Calm group reported satisfaction, appropriateness/usefulness, and intent to continue use compared to the control. Calm participants (n=33) averaged 20.0±31.1 minutes of meditation on the days they meditated and 103±109.1 minutes of meditation per week during the study. On average there was a 70.8% adherence rate to the prescribed meditation, compared to 62.2% in POD. Recruitment of men into the study was 34.9% (29/83). Of those randomized to Calm, 55.2% (15/29) were men. Retention among men was 93.3% (14/15) compared to 60% (12/20) for women. No significant within or between group differences in stress or psychological outcomes related to stress were observed nor were significant differences in health behaviors related to stress. CONCLUSIONS A four-week, app-based mindfulness meditation intervention (i.e., Calm) may be feasible in middle-aged adults. Calm participants expressed satisfaction with the intervention and felt it was appropriate and useful. However, significant improvements in perceived stress and psychological outcomes (i.e., anxiety, depressive symptoms, mindfulness and general coping) or health behaviors related to stress (i.e., physical activity, eating habits) were not observed. The majority of participants reported that COVID-19 negatively impacted their stress, mental health, and physical health. More research is needed for improving stress and stress related outcomes in middle-aged men and women using mindfulness meditation apps. CLINICALTRIAL ClinicalTrials.gov NCT04272138; http://clinicaltrials.gov/ct2/show/NCT04272138.

Author(s):  
Jaehee Yoon ◽  
Jeewuan Kim ◽  
Heesook Son

This study examined gender differences in health behaviors for the risk of metabolic syndrome (MetS) among middle-aged adults using nationally representative data from the Seventh Korea National Health and Nutrition Examination Survey (2016–2018). The sample included data from 8677 middle-aged adults. The Health Practice Index measured health behaviors, including smoking, alcohol use, physical activity, sleeping, eating breakfast, working hours, nutritionally balanced diet, and mental stress. Complex sample multiple logistic regression analyses were conducted to determine the association between the Health Practice Index (HPI) and MetS. Men and women with poor or moderate HPI scores had significantly higher risks of having MetS than those with good HPI scores. Controlling for covariates, high-risk alcohol use (p < 0.001) and physical activity (p = 0.008) were associated with the risk of MetS in men and women, respectively. Men reporting alcohol use and women lacking a healthy diet were, respectively, 2.056 times (adjusted odds ratio (OR) = 2.056, 95% CI: 1.681–2.514) and 1.306 times (adjusted OR = 1.306, 95% CI: 1.075–1.587) more likely to have increased risks of MetS. Given these gender differences in health behaviors, developing tailored interventions could be beneficial in preventing MetS among middle-aged men and women.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Shingo Nakayama ◽  
Michihiro Satoh ◽  
Takahisa Murakami ◽  
Yukako Tatsumi ◽  
Tomoko Muroya ◽  
...  

Abstract Background and Aims While previous studies have reported the association between serum uric acid (SUA) and chronic kidney disease (CKD) incidence, the sex differences in this association remain controversial. Therefore, we examined the association between SUA levels and CKD incidence in middle-aged adults stratified by sex using data from a large-scale health check-up. Method We analyzed information from the JMDC database, which included the annual health check-up data of Japanese employees and their dependents aged &lt;75 years. Among those individuals, we analyzed data from 138,511 individuals without CKD, kidney disease, or a history of cardiovascular disease at baseline. CKD was defined as an estimated glomerular filtration rate (eGFR) &lt;60 mL/min/1.73 m2 and/or proteinuria. We divided the participants into 9 and 7 groups according to SUA levels for men and women, respectively. A Cox model was applied to assess the adjusted hazard ratios (HRs) for CKD incidence in each SUA level group using an SUA concentration of 4.0–4.9 mg/dL as the reference after adjusting for age, body mass index, current or ex-smoker, current or ex-drinker, diabetes mellitus, dyslipidemia, systolic blood pressure, use of anti-hyperuricemic drugs, and baseline eGFR. Results The mean participant age was 44.1 years, and 29.6% were women. The mean SUA levels were 5.9 mg/dL and 4.1 mg/dL in men and women, respectively. During the mean follow-up period of 4.68 years, 12,589 participants developed CKD. The age-standardized incidence rates for CKD were 17.88/17.80 per 1000 person-years in men/women with SUA concentrations of 4.0–4.9 mg/dL, 209.76 per 1000 person-years in men with SUA ≥11.0 mg/dL, and 73.38 per 1000 person-years in women with SUA ≥ 9.0 mg/dL. The fully adjusted HRs (95% confidence interval [CI], P value) for CKD incidence in the groups with SUA concentrations of &lt;4.0, 10.0–10.9, and ≥11.0 mg/dL compared with those with SUA of 4.0–4.9 mg/dL among men were 1.13 (1.01–1.26, P=0.030), 1.98 (1.32–2.97, P=0.0010), and 3.74 (1.68–8.35, P=0.0013), respectively. In women, the fully adjusted HRs for CKD incidence in the groups with SUA concentrations of &lt;4.0, 8.0–8.9, and ≥9.0 mg/dL were 1.08 (1.01–1.16, P=0.032), 2.39 (1.07–5.35, P=0.034), and 3.20 (0.80–12.8, P=0.10), respectively. Similar results were observed when we performed the sensitivity analysis excluding 8,411 individuals with hypertensive treatment from the main analysis. The HRs for the outcomes caused by the onset of eGFR &lt;60 mL/min/1.73 m2 or proteinuria separately were similar to those for the main results. Conclusion The results of the present study demonstrated an increased risk of CKD in men with SUA concentrations of &lt;4.0 and ≥10.0 mg/dL and &lt;4.0 and ≥8.0 mg/dL in women compared to those with SUA concentrations of 4.0–4.9 mg/dL after adjusting for various covariates. Both high and low SUA levels were risk factors for CKD in middle-aged men and women. Hyperuricemia was demonstrated to cause renal injury due to the intraluminal deposition of uric acid crystals in the renal collecting duct. Hyperuricemia may also induce endothelial dysfunction, activation of the renin-angiotensin system, and induction of inflammation and stimulation of vascular smooth muscle cell proliferation by the induction of cyclooxygenase-2. However, as uric acid is one of the most important antioxidants in human plasma, low SUA levels may increase the risk of CKD incidence through decreased antioxidant activity. These mechanisms are implicated in the pathogenesis of CKD caused by high and low SUA levels. In addition, the SUA levels and ranges associated with increased risks of CKD incidence differed by sex.


2016 ◽  
Vol 11 (3) ◽  
Author(s):  
Bart Dewulf ◽  
Tijs Neutens ◽  
Delfien Van Dyck ◽  
Ilse De Bourdeaudhuij ◽  
Steven Broekx ◽  
...  

Physical activity is an important facilitator for health and wellbeing, especially for late middle-aged adults, who are more susceptible to cardiovascular diseases. Physical activity performed in green areas is supposed to be particularly beneficial, so we studied whether late middle- aged adults are more active in green areas than in non-green areas and how this is influenced by individual characteristics and the level of neighbourhood greenness. We tracked 180 late middle-aged (58 to 65 years) adults using global positioning system and accelerometer data to know whether and where they were sedentary or active. These data were combined with information on land use to obtain information on the greenness of sedentary and active hotspots. We found that late middle-aged adults are more physically active when spending more time in green areas than in non-green areas. Spending more time at home and in non-green areas was found to be associated with more sedentary behaviour. Time spent in non-green areas was found to be related to more moderate-to-vigorous physical activity (MVPA) for males and to less MVPA for females. The positive association between time spent in green areas and MVPA was the strongest for highly educated people and for those living in a green neighbourhood. This study shows that the combined use of global positioning system and accelerometer data facilitates understanding of where people are sedentary or physically active, which can help policy makers encourage activity in this age cohort.


2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Seungho Ryu ◽  
Yoosoo Chang ◽  
Jeonggyu Kang ◽  
Kyung Eun Yun ◽  
Hyun-Suk Jung ◽  
...  

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Minsuk Oh ◽  
Kelley Pettee Gabriel ◽  
David R Jacobs ◽  
James G Terry ◽  
Jingzhong Ding ◽  
...  

Introduction: Pericardial adipose tissue (PAT), an ectopic adipose depot surrounding the coronary arteries, is a pathogenic risk factor for cardiometabolic disease; however, the association of sedentary behavior with PAT is poorly understood. We examined the longitudinal association of 10-year change in TV viewing with concurrent change in PAT. Hypothesis: Increased h/day of TV viewing over 10 years are associated with larger mean increases in PAT during the same 10-year period. Methods: Middle-aged adults (N=1659, mean age=40.4, 912 females, 733 blacks) from the Coronary Artery Risk Development in Young Adults (CARDIA) Study at the exam years 15 (2000-2001) and 25 (2010-2011) were included. Both TV viewing (h/day) and the volume of PAT (mL) were measured at Years 15 and 25 using the CARDIA physical activity questionnaire and computed tomography, respectively. Covariates measured at year 15 included PAT, sociodemographic factors, cardiovascular disease risk factors, diet quality, TV viewing, moderate-to-vigorous intensity physical activity (MVPA), inflammatory cytokines, and waist circumference. Multivariable linear regression was used to estimate 10-year change in PAT across increasing tertiles (≤ -1, > -1 to < 1, ≥ 1 h/day) of 10-year changes in TV viewing. Results: On average, TV viewing and PAT increased between the two exam years by 0.2 h/day (8.7% increase, mean: 2.3 → 2.5 h/day) and 11.8 mL (25.9% increase, mean: 45.6 → 57.4 mL), respectively (all p < 0.01). In the fully adjusted model including MVPA and other major confounders, the highest tertile of 10-year change in TV viewing was associated with greater change in PAT (β = 2.97 mL, p < 0.01) when compared with the lowest tertile (see Figure 1 ), while mean PAT change was intermediate in the middle tertile. Conclusions: A greater 10-year increase in TV viewing is associated with a greater concurrent increase in PAT, independent of MVPA and other important confounders. Reducing TV viewing time may be associated with less PAT accumulation with age.


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