Baduanjinm, a traditional Chinese mind-body practice = brisk walking in lowering blood pressure

 A traditional Chinese mind-body practice that combines slow, structured movement, deep breathing and meditative focus lowered blood pressure as effectively as brisk walking in a large randomized clinical trial published in JACC, the flagship journal of the American College of Cardiology. Blood pressure reductions were seen after three months and sustained for one year.

High blood pressure is one of the leading preventable risk factors for heart disease. Clinical guidelines recommend regular physical activity, yet long-term adherence to exercise programs is challenging for many people, particularly when routines require equipment, dedicated space, gym memberships or ongoing supervision.

Baduanjin is a widely practiced, standardized eight-movement sequence that integrates aerobic, isometric, flexibility and mind–body components. Practiced for centuries and commonly performed in community settings across China, the routine typically takes 10–15 minutes and requires no equipment and only minimal initial instruction, allowing it to be performed in a wide range of settings. Because it is low- to moderate-intensity, it is considered safe and accessible for many adults.

“Given its simplicity, safety and ease at which one can maintain long-term adherence, baduanjin can be implemented as an effective, accessible and scalable lifestyle intervention for individuals trying to reduce their blood pressure,” said Jing Li, MD, PhD, senior author of the study and Director, Department of Preventive Medicine, National Center for Cardiovascular Diseases in Beijing, China.

In the first large, multicenter randomized trial to look at the impact of baduanjin on blood pressure, researchers followed 216 participants across seven communities to determine changes in 24-hour systolic blood pressure from baseline to 12 and 52 weeks. Participants were 40 years old or older and had a systolic blood pressure of 130-139 mm Hg, which according to the ACC/AHA High Blood Pressure Guideline is considered stage 1 hypertension. They were randomly assigned to one of three arms: baduanjin, self-directed exercise alone, or brisk walking for the 52-week intervention.

Compared to self-directed exercise, practicing baduanjin five days a week reduced 24-hour systolic blood pressure approximately 3 mg Hg and office systolic blood pressure by 5 mg Hg at both three months and one year, which is comparable to reductions seen with some first-line medications. Baduanjin showed comparable results and safety profile to brisk walking at one year.

Notably, the benefits were sustained even without ongoing monitoring, a key challenge for many lifestyle interventions that struggle to maintain long-term adherence outside structured programs.

“Baduanjin has been practiced in China for over 800 years, and this study demonstrates how ancient, accessible, low-cost approaches can be validated through high-quality randomized research,” said Harlan M. Krumholz, MD, FACC, Editor-in-Chief of JACC and the Harold H. Hines, Jr Professor at the Yale School of Medicine. “The blood pressure effect size is similar to that seen in landmark drug trials, but achieved without medication, cost or side effects. This makes it highly scalable for community-based prevention, including in resource-limited settings.”

Mindfulness practices found to significantly reduce depression symptoms

 A new study reveals that mindfulness practices may significantly reduce depression symptoms, particularly in people who have experienced early-life adversity, such as childhood abuse and neglect.

Led by Eric Loucks, professor of medicine, epidemiology, and of behavioral and social sciences and director of the Mindfulness Center at Brown, the study enrolled 201 participants, 101 of whom were randomized into the Mindfulness-Based Blood Pressure Reduction Program, while 100 were randomized into an enhanced usual care control, which included home blood-pressure monitors, physician access and health-education materials. Researchers also had a measure of participants’ early-life adversity, particularly their exposure to abuse or neglect.

Loucks and his team followed participants for six months to assess changes in blood pressure, health behaviors and mental health, finding that those in the mindfulness program showed significant improvements in their depression symptoms. Additionally, participants who experienced childhood neglect showed greater improvements in depression symptoms than those who had not. A similar, though less pronounced, trend was observed among people with a history of childhood abuse.

“In this program, that was primarily designed to lower blood pressure while addressing whole-person health, we also saw that mental well-being, particularly around depression symptoms, improved in participants that went through the program,” Loucks said. “The findings suggest that cultivating mindful self-regulation skills–such such as self-awareness, attention control and emotion regulation–may help interrupt maladaptive patterns shaped by past experiences.”

Over the last 15 years, Loucks has been studying social determinants of health such as early-life adversity and its impacts on cardiovascular health, body mass index and blood pressure. “I came to a point where I wanted to not just document it, but do something about it, and I wondered if mindfulness training might help,” he said. “I’d gone through a lot of mindfulness training myself outside of work and started to get trained up in mindfulness programs that are specific to health contexts.”

Loucks began to study the Mindfulness-Based Stress Reduction program, running it through two clinical trials that were funded by the NIH and finding that it reduced blood pressure in both trials. He also wanted to look at the intervention from a whole-person perspective.

“If we look at everyday folks out in the world, those that had exposure to early life adversity, like abuse and neglect, tend to have worse mental health and also worse cardiovascular health,” Loucks said. “Mindfulness interventions help by regulating our emotions better when different challenges come up. For someone who has experienced childhood neglect or abuse, mindfulness training can help us make sense of that and respond skillfully to this moment in time.” 

Loucks discussed this work during a keynote address at the U.S. DOHaD Society this year. “It felt like a coming-home moment to see that this intervention, originally developed to address psychosocial factors that influence health, had even stronger effects among people with early-life adversity, particularly on depression,” he said. “It’s been about a 15-year arc of research that culminated in these findings.”

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Exercise and nutritional drinks can reduce the need for care in dementia

 A simple combination of daily physical exercise and protein-rich nutritional drinks appears to offer significant health benefits for people with dementia. In a new study from Karolinska Institutet, not only did the participants' physical ability improve, but after three months the researchers also saw signs that they were able to manage more everyday tasks themselves. The study is published in the journal Alzheimer's and Dementia.

Older people living in special housing often have an increased risk of malnutrition, muscle weakness, and frailty, which are factors that affect both health and quality of life. The OPEN study has previously shown that the program improves physical function and has positive effects on muscle mass and nutritional status. The new article analyzes retrospectively how the program can be linked to the participants' need for support in everyday life.

A total of 102 people from eight nursing homes in the Stockholm area participated. For twelve weeks, the intervention group was asked to do standing exercises several times a day and drink one to two nutritional drinks with extra protein. Among other things, the researchers monitored how much support the participants needed with tasks such as hygiene, dressing, and moving around.

When the researchers analyzed all the residents together, no clear differences were apparent. However, when the results were broken down by ward type, a different pattern emerged. In the dementia wards, participants who had followed the program had improved their abilities to such an extent that they required less care time compared to the control group.

“One possible explanation is that people in dementia units had better physical conditions for improving their functional ability and were therefore able to do more things themselves after the intervention,” says Anders Wimo, a researcher at the Department of Neurobiology, Care Sciences and Society at Karolinska Institutet.

The researchers also point out that interviews from previous sub-studies indicate that improved function can affect how much support a person needs in different situations. At the same time, they emphasize that the results should be interpreted with some caution, as the analyses are secondary.

“More studies are needed where care time is a primary outcome and where organizational factors, such as staffing levels and work routines, are closely monitored,” says Anders Wimo

Booster jabs reduce the risks of COVID-19 deaths

Booster vaccines reduced the risk of COVID‑19–related hospitalisation and death, according to a new study of over 3 million adults who had the autumn 2022 vaccine in England.  The research led by the universities of Bristol and Oxford, provides further evidence of the effectiveness of booster vaccination against COVID-19.

The study, published in Vaccine today [18 February], also found that this effectiveness was similar for Moderna (BA.1 mRNA-1273) and Pfizer-BioNTech (BA.1 BNT162b2) booster vaccines, but protection declined over time.

Previous work has shown the initial COVID-19 vaccination was effective in reducing the risk of hospitalisation and death due to COVID-19. This latest research, carried out at the National Institute for Health and Care Research (NIHR) Bristol Biomedical Research Centre (BRC), looked at the impact of giving people a booster vaccine.

The team investigated the effectiveness of Moderna and Pfizer-BioNTech booster vaccines administered during the autumn 2022 booster campaign in England for previously vaccinated people age 50 or over. 

The NHS England approved study analysed linked GP and hospital records available within the OpenSAFELY research platform. The team compared 3,464,877 adults eligible for booster vaccination during the autumn 2022 COVID-19 vaccine rollout with the same number of unboosted people.

They matched them with people who were similar in terms of age, date of last COVID-19 vaccine dose, brand of prior vaccination, clinical vulnerability and geographical region. The researchers then followed these people up for nearly a year and tracked hospitalisation and death due to COVID-19.

Across 2.5 million people followed up over a year, the study recorded 14,436 COVID‑19 hospitalisations, 1,152 COVID‑19 deaths, 32,184 non‑COVID‑19 deaths and 52,758 fractures.

The study found boosted individuals had much lower 350‑day risks of COVID‑19 hospitalisation (3.78 vs 6.81 per 1,000) and death (0.29 vs 0.61 per 1,000).  Boosters halved the risks of COVID‑19 hospitalisation and death. Protection waned over time, strongest in the first 70 days. Moderna and Pfizer‑BioNTech boosters performed similarly for COVID‑19 outcomes, though non‑COVID‑19 mortality was slightly higher in the mRNA‑1273 group.

The study also assessed the relationship between booster vaccination and fracture, an outcome not considered likely to be causally related. A small reduction in fracture risk was found for boosted individuals. This suggests that not all confounders (common causes of booster vaccinations and outcomes) were accounted for, but the much smaller effect for fracture is reassuring for the validity of the study’s conclusions.

Dr Paul Madley-Dowd, Research Fellow in Medical Statistics and Health Data Science, and corresponding author at University of Bristol, said: “Our findings reinforce the importance of booster vaccination against COVID-19 among people over 50 years old.

“The study also provides further evidence that COVID-19 booster vaccinations reduced the risk of hospitalisation and death.” 

Adolescent cannabis use linked to doubling risk of psychotic and bipolar disorders

 

 Adolescents who use cannabis could face a significantly higher risk of developing serious psychiatric disorders by young adulthood, according to a large new study published today in JAMA Health Forum. The longitudinal study followed 463,396 adolescents ages 13 to 17 through age 26 and found that past-year cannabis use during adolescence was associated with a significantly higher risk of incident psychotic (doubled), bipolar (doubled), depressive and anxiety disorders. The study was conducted by researchers from Kaiser Permanente, the Public Health Institute’s Getting it Right from the Start, the University of California, San Francisco and the University of Southern California, and was funded by a grant from NIH’s National Institute on Drug Abuse (R01DA0531920).

The study analyzed electronic health record data from routine pediatric visits between 2016 and 2023. Cannabis use preceded psychiatric diagnoses by an average of 1.7 to 2.3 years. The study’s longitudinal design strengthens evidence that adolescent cannabis exposure is a potential risk factor for developing mental illness.

“As cannabis becomes more potent and aggressively marketed, this study indicates that adolescent cannabis use is associated with double the risk of incident psychotic and bipolar disorders, two of the most serious mental health conditions,” said Lynn Silver, M.D., program director of the Getting it Right from the Start, a program of the Public Health Institute, and a study co-author. “The evidence increasingly points to the need for an urgent public health response — one that reduces product potency, prioritizes prevention, limits youth exposure and marketing and treats adolescent cannabis use as a serious health issue, not a benign behavior.”

Cannabis is the most used illicit drug among U.S. adolescents. The Monitoring the Future study shows use rising with grade level — from about 8% in 8th grade to 26% in 12th grade — and according to the 2024 National Survey on Drug Use and Health, more than 10% of all U.S. teens aged 12 to 17 report past-year use. At the same time, average THC levels in California cannabis flower now exceed 20%, far higher than in previous decades, and concentrates can exceed 95% THC.

Unlike many prior studies, the research examined any self-reported past-year cannabis use, with universal screening of teens during standard pediatric care, rather than focusing only on heavy use or cannabis use disorder.

“Even after accounting for prior mental health conditions and other substance use, adolescents who reported cannabis use had a substantially higher risk of developing psychiatric disorders — particularly psychotic and bipolar disorders,” said Kelly Young-Wolff, Ph.D., lead author of the study and senior research scientist at the Kaiser Permanente Division of Research. “This study adds to the growing body of evidence that cannabis use during adolescence could have potentially detrimental, long-term health effects. It’s imperative that parents and their children have accurate, trusted, and evidence-based information about the risks of adolescent cannabis use.”  

 The study also found that cannabis use was more common among adolescents enrolled in Medicaid and those living in more socioeconomically deprived neighborhoods, raising concerns that expanding cannabis commercialization could exacerbate existing mental health disparities.

The Public Health Institute is an independent nonprofit organization that advances wellbeing and health equity with communities around the world. PHI develops research, leadership and partnerships to build strong public health policy, programs, systems and practices. For more information, visit www.phi.org.

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Journal

JAMA Health Forum

DOI

10.1001/jamahealthforum.2025.6839 

For women over 60, muscle strength is associated = significantly lower risk of death over eight-years

 You don’t need to look like a bodybuilder, but for healthy aging, maintaining muscle strength is likely just as important as getting enough aerobic activity.

That’s according to the findings of a University at Buffalo-led study of more than 5,000 women between the ages of 63 and 99 published Feb. 13 in JAMA Network Open. It found that women with higher levels of grip strength and those who completed five unassisted sit-to-stand chair raises in the fastest amount of time had significantly lower death risk over an eight-year follow-up.

The lower mortality rates were evident even after accounting for physical activity and sedentary behavior, as measured by accelerometer data, gait speed (an indicator of cardiovascular fitness) and C-reactive protein, a blood biomarker of inflammation believed to be a major driver both of losing muscle function and premature death.

In fact, for every 7 kilograms of grip strength, there was, on average, a 12% lower mortality rate. When it came to chair stands, moving from the slowest time to the fastest time in 6-second increments, researchers saw a 4% lower mortality rate.

Grip strength and chair stands are two tests commonly used to determine strength levels among older patients in a clinical setting.

“If you don’t have enough muscle strength to get up, it is going to be hard to do aerobic activities, such as walking, which is the most commonly reported recreational activity in U.S. adults ages 65 and older,” says study lead author Michael LaMonte, PhD, research professor of epidemiology and environmental health in UB’s School of Public Health and Health Professions.

“Muscular strength, in many ways, enables one to move their body from one point to another, particularly when moving against gravity,” LaMonte adds. “Healthy aging probably is best pursued through adequate amounts of both aerobic and muscle-strengthening physical activities. When we no longer can get out of the chair and move around, we are in trouble.”

The study is the largest to date to evaluate muscle strength in relation to longevity in women over 60, LaMonte says, adding that most previous large-scale epidemiologic studies did not have the measures of physical activity, inflammation and cardiovascular fitness used for this study. Those measures helped LaMonte and colleagues simultaneously account for these important mortality factors in order to better isolate the association with muscular strength.

“We also showed that differences in body size did not explain the muscular strength relationship with death,” he says. “When we scaled the strength measures to body weight and even to lean body mass, there remained significantly lower mortality.”

Even among women who did not meet current physical activity guidelines for adults — 150 minutes of moderate intensity aerobic activity — those with higher muscular strength had significantly lower mortality. LaMonte says that’s “a major advancement” to the available evidence supporting the inclusion of muscle strength in public health messaging on physical activity, especially in older adults — a particularly important age group.

“Because women ages 80 and older are the fastest growing U.S. age group, the importance of monitoring and maintaining muscular strength will have huge public health implications in the coming decades,” he says.

There are many ways to build muscle, including using conventional free weights and dumbbells or weight machines, or bodyweight exercises such as modified push-ups, wall presses and knee bends.

LaMonte adds that a trip to the gym may not even be necessary. “Even using soup cans or books as a form of resistance provides stimulus to skeletal muscles and could be used by individuals for whom other options are not feasible.”

Older adults, in particular, should consult with their health care provider about the safety of beginning muscle-strengthening exercises, LaMonte notes, adding that those not familiar with these types of activities should consult with a physical therapist or exercise specialist to ensure safety as well as achieving targeted strength goals.

Co-authors on the paper include researchers from the National Cancer Institute, University of California San Diego, Texas A&M University, Brown University, Stanford University and Fred Hutch Cancer Center.

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Journal

JAMA Network Open

DOI

10.1001/jamanetworkopen.2025.59367 

Sleep‑aligned fasting improves key heart and blood‑sugar markers

• Nighttime blood pressure dipped by 3.5%, heart rate dipped by 5% compared to controls
• Given high adherence rate (nearly 90%), novel approach may be a more accessible non-pharmacological strategy for improving cardiometabolic health
• ‘It’s not only how much and what you eat, but also when you eat relative to sleep that is important’

A new Northwestern Medicine study has personalized overnight fasting by aligning it with individuals’ circadian sleep-wake rhythm — an important regulator of cardiovascular and metabolic function — without changing their caloric intake. 

The study found that among middle-age and older adults who are at higher risk for cardiometabolic disease, extending the participants’ overnight fast by about two hours, dimming the lights and not eating for three hours prior to bedtime improved measures of cardiovascular and metabolic health during sleep, as well as during the daytime. 

“Timing our fasting window to work with the body’s natural wake-sleep rhythms can improve the coordination between the heart, metabolism and sleep, all of which work together to protect cardiovascular health,” said first author Dr. Daniela Grimaldi, research associate professor of neurology in the division of sleep medicine at Northwestern University Feinberg School of Medicine.

The study will be published Feb. 12 in the journal Arteriosclerosis, Thrombosis, and Vascular Biology, part of the American Heart Association.

“It’s not only how much and what you eat, but also when you eat relative to sleep that is important for the physiological benefits of time-restricted eating,” said corresponding author Dr. Phyllis Zee, director of the Center for Circadian and Sleep Medicine and the chief of sleep medicine in the department of neurology at Feinberg.

Previous research has found only 6.8% of U.S. adults had optimal cardiometabolic health in 2017 to 2018. Poor cardiometabolic health can lead to chronic illness, including type 2 diabetes, non-alcoholic fatty liver disease and cardiovascular diseases.

Time-restricted eating has continued to surge in popularity because research has shown it can improve cardiometabolic health and rival traditional calorie‑restricted diets, but most studies have focused on how long people fast, not how their fast lines up with their sleep schedule — a key factor in metabolic regulation.

Given the nearly 90% adherence rate in the study, the study’s novel approach of leveraging the sleep period as an anchor for the timing of time-restricted eating may be a more accessible non-pharmacological strategy for improving cardiometabolic health, particularly in middle-aged and older adults who are at higher risk for cardiometabolic disease, the study authors said.

The study authors said they plan refine the protocol from this study and take it to larger multi-center trials. 

Improved blood pressure, heart rate, blood-sugar control

In the 7.5‑week study, people who finished eating at least three hours before going to bed saw meaningful improvements compared with those who kept their usual eating routines. They experienced:

• Improved nighttime patterns in blood pressure (dipping by 3.5%) and heart rate (dipping by 5%): Their bodies showed a more natural drop in both measures during sleep, which is an important sign of cardiovascular health. Notably, their hearts beat faster during the day when they were active and slowed at night when they were resting. A stronger day-night pattern is linked to better cardiovascular health.
• Better daytime blood‑sugar control: Their pancreas responded more efficiently when challenged with glucose, suggesting it could release insulin more effectively and keep blood sugar steadier.

In the study, 39 overweight/obese participants (36 to 75 years old) completed either an extended overnight fasting intervention (13 to 16 hours of fasting) or a control condition (habitual fast of 11 to 13 hours). Both groups dimmed the lights three hours before bedtime. The intervention group consisted of 80% women.

The study is titled “Sleep-aligned Extended Overnight Fasting Improves Nighttime and Daytime Cardiometabolic Function.” Other Northwestern study authors include Kathryn Reid, Dr. Sabra Abbott and Kristen Knutson.

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Journal

Arteriosclerosis Thrombosis and Vascular Biology