Older adults experiencing loneliness: Nature-based group activities improve wellbeing

 Nature-based group activities can reduce loneliness, improve sleep and cognition, and increase a sense of connection to nature in older adults living in care homes.

Focusing on nature, including outdoor excursions and contacts with the natural world, the activities boosted wellbeing and health through peer support and activity content.

“Group activities once a week over just a nine-week period can already reduce loneliness in research subjects and improve their sleep and memory, as well as their sense of connection to nature. Our study also highlighted the need for older adults in care homes to visit outdoor environments and nature more often,” says Professor Kaisu Pitkälä, Director of the Department of General Practice and Primary Health Care at the University of Helsinki.

Frail and lonely older adults benefitted from natural environments

The researchers were surprised by the good results despite that the subjects had multiple diseases and that the conditions for nature-based activities were sometimes challenging, in terms of both weather and transport, as all subjects travelled to the excursions in wheelchairs and by accessible taxis. According to Pitkälä, activities over a longer duration would only have bolstered the outcome.

The researchers trained 52 group instructors in Helsinki-based care homes, which have subsequently disseminated the nature-based practices.

“Frail older adults have a great deal of resources, and by boosting those we support their wellbeing and health. More than half of care home residents experience loneliness, a risk factor comparable with tobacco and obesity for health and memory. Loneliness is not something you can see on the outside, you have to ask older adults about it,” Pitkälä notes.

Limit ultra processed foods to lower risk of heart disease

 People who eat more ultra processed food (UPF) have a higher risk of cardiovascular disease and death, according to a report published in the European Heart Journal [1] today (Thursday). The report, by a group of cardiology experts from across Europe, brings together the results of all research on UPFs and cardiovascular disease that has been published to date.

 

It highlights the risks of obesity, diabetes, hypertension, chronic kidney disease and death from cardiovascular that have now been linked to eating large amounts of UPF.

 

The authors of the report are calling on doctors to talk to their patients about how much UPF they are eating and give advice on how to reduce UPFs.

 

The clinical consensus statement is from the European Society of Cardiology’s Council for Cardiology Practice and the European Association of Preventive Cardiology, together with a group of topic expert, led by Professor Luigina Guasti from the University of Insubria, Varese, Italy; Dr Marialaura Bonaccio, IRCCS NEUROMED, Pozzilli, Italy; Professor Massimo Piepoli, University of Milan, Italy; and Professor Licia Iacoviello, LUM University, Casamassima, Italy.

Professor Guasti said: “UPFs, made from industrial ingredients and additives, have largely replaced traditional diets. Research suggests these foods are linked to several risk factors for cardiovascular disease, such as obesity, diabetes and high blood pressure, and to the risk of developing and dying from heart disease. However, this evidence has not yet made its way into the advice we give to patients on healthy eating.

 

“We hope that this consensus statement from the European Society of Cardiology will help doctors recognize UPFs as a potential risk factor and provide clear guidance to their patients on limiting UPFs to prevent cardiovascular risk factors, disease and death.”

 

Key findings of the expert consensus report:

• Adults with the highest UPF consumption have up to a 19% higher risk of heart disease, a 13% higher risk of atrial fibrillation, and up to a 65% increased risk of cardiovascular death, compared with those with the lowest consumption.
• These foods also worsen key risk factors, including obesity, type 2 diabetes, high blood pressure and the build-up of unhealthy fats in the blood stream.
• Consumption of UPF is increasing in Europe with the percentage of calories from UPF ranging from 61% in the Netherlands and 54% in the UK, to 25% in Spain, 22% in Portugal and 18% in Italy.
• Most national dietary guidelines prioritise nutrient-based recommendations and do not address the issue of food processing.

 

The report’s authors call for:

• Better public understanding of UPFs through food labelling, food regulation and updated guidelines.

• Doctors treating people with cardiovascular disease, or at risk of cardiovascular disease, should ask about UPFs when assessing their patients’ diets.
• Doctors should discuss reducing UPF to lower risk – alongside other advice on diet, physical activity, smoking and drinking – including explaining that foods marketed as ‘healthier’ can often be ultra processed.

 

The authors say that evidence on the risks of UPF is consistent across large, diverse populations and holds true across different cardiovascular risks, diseases and death. However, they caution that most of the research is made up of observational studies, with few long-term interventional trials.

 

Dr Bonaccio adds: “The associations between UPF and heart disease are consistent and biologically plausible. UPFs raise cardiovascular risk mainly by promoting obesity, diabetes, hypertension and the build-up of unhealthy fats in the blood. UPFs tend to be high in sugar, salt, and unhealthy fats. They also have additives, contaminants and an altered food structure, which may trigger inflammation, metabolic disruption, gut microbiome changes and overeating.

 

“We need long-term intervention trials to test whether reducing UPFs improves cardiovascular health. More research is also needed to understand the effects of specific additives, processing compounds and food structures on heart health. Future studies could focus on implementing UPF-focused dietary interventions in clinical practice.

 

“The research on UPFs has been accumulating for a decade, and it highlights the risks of high UPF consumption and the benefits of choosing whole or minimally processed foods. This emphasizes that disease prevention should not focus solely on nutrients, but also on the degree of food processing. Even foods with good nutritional profiles can be harmful if highly processed. Integrating UPF awareness into routine medical care could improve patient’s health without adding significant cost or time.”

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Journal

European Heart Journal

DOI

10.1093/eurheartj/ehag226 

Egg consumption is associated with a lower risk of Alzheimer’s Disease

 Consumption of eggs is associated with a lower risk of being diagnosed with Alzheimer's Disease for those 65 years and older, according to researchers at Loma Linda University Health

Eating one egg per day for at least five days a week reduces risk of Alzheimer’s by up to 27%, researchers found.

“Compared to never eating eggs, eating at least five eggs per week can decrease risk of Alzheimer’s,” said Joan Sabaté, MD, DrPH, a professor at Loma Linda University School of Public Health and the study’s principal investigator.

Even less frequent consumption of eggs significantly reduced the risk of Alzheimer’s. Researchers found that eating eggs 1 to 3 times per month had a 17% decrease in risk, while eating eggs 2 to 4 times per week had a 20% decrease in risk, Sabaté said.

The study, Egg intake and the incidence of Alzheimer’s disease in the Adventist Health Study-2 cohort linked with Medicare data, was published last week in the Journal of Nutrition.

Researchers said they embarked on the study because of a substantial knowledge gap in the relationship between modifiable dietary factors and risk of Alzheimer’s disease risk.

Eggs are known to be a source of key nutrients that support brain health. Sabaté said. Eggs provide choline, a precursor to acetylcholine and phosphatidylcholine, both of which are critical for memory and synaptic function, the study stated. Eggs also contain lutein and zeaxanthin—carotenoids that accumulate in brain tissue and are associated with improved cognitive performance and reduced oxidative stress. Eggs also contain key omega-3 fatty acids, and yolks are particularly rich in phospholipids, which constitute nearly 30% of total egg lipids and are essential for neurotransmitter receptor function.

Researchers said they studied the consumption of eggs in visible ways — such as eating eggs in various forms, like scrambled, fried, boiled, etc. — and hidden ways, such as eggs included in baked goods and packaged foods.

The cases of Alzheimer’s Disease in the Adventist Health Study 2 cohort were diagnosed by physicians, according to Medicare records, among the study population of 40,000 subjects. Eligibility was determined using the Medicare Master Beneficiary Summary Files. The average follow-up period was 15.3 years.

The team emphasized that moderate egg consumption should be  part of a balanced diet.

“Research supports eggs as part of a healthy diet,” said Jisoo Oh, DrPH, MPH, an associate professor of epidemiology at Loma Linda University School of Public Health and the study’s lead author. “Seventh-day Adventists do eat a healthier diet than the general public, and we want people to focus on overall health along with this knowledge about the benefit of eggs.”

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Almost all plant-based meat alternatives contain mycotoxins

New research into plant-based food and drinks has found a prevalence of mycotoxins – naturally occurring poisonous compounds produced by fungi - in hundreds of vegetarian and vegan products.  212 plant-based meat alternatives (PMBAs) and plant-based beverages (PBBs) from UK shelves were tested – and all of them contained at least one of 19 mycotoxins, with multiple products containing more than one.

The study, led by the University of Parma in Italy and co-authored by Cranfield University, tested a broad spectrum of products readily available to UK consumers such as burgers, vegetarian chicken pieces, vegan sausages, oat-, almond- and soy-based milks.

Mycotoxin exposure can lead to health concerns

Mycotoxins are particularly prevalent in plant-based foods because the raw materials those foods are made from – such as grains, legumes and seeds – can be exposed to mould during cultivation and storage.

The research team found that mycotoxin levels in the UK foods that they tested were lower than the recommended EU guideline levels, reflecting the high quality standards of the UK food industry.

However, previous research studies have shown that even low levels, if consumed often, can build up exposure and lead to potential health concerns. So while consuming these products in isolation is unlikely to pose issues, a diet solely based on plant-based foods could lead to a cumulative build-up of mycotoxins, potentially resulting in health problems if not managed properly. In very serious cases, mycotoxin exposure can cause health issues like liver and kidney damage, immune system suppression, and cancer.

The data from this study provides a foundation for assessing dietary exposure and producing more accurate risk assessments in the UK.

Raw material monitoring should be extended, say experts

Andrea Patriarca, Senior Lecturer in Mycology at Cranfield University, said:

“Mycotoxins occur naturally in foods and cannot be completely avoided. As consumers, we should not be frightened or deterred from enjoying a variety of products.

However, a significant concern arises when new foods enter the market, as there are currently no established regulations to monitor mycotoxins. We collaborate closely with various sectors in the food industry, from farmers to food companies, to help implement effective mycotoxin management integrated within food safety standards. The data from our research helps food safety organisations in assessing risks, particularly in complex multi-ingredient products.

We are currently collaborating with the University of Parma to evaluate the risks faced by the population based on different dietary habits. Our aim is to advise policymakers and raise awareness among vulnerable consumers.”

The full research paper: Mycotoxin contamination in plant-based beverages and meat alternatives: A survey of the UK market is published in Food Control. 

The “optimal exercise pattern” for cardiovascular health

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Systematic aerobic PA can exert a range of positive health effects on cardiovascular health by mitigating multiple pathogeneses associated with CVD. Primarily, it enhances metabolic health by improving insulin sensitivity and increasing energy expenditure, which are crucial for preventing and managing conditions like hypertension, hyperlipidemia, diabetes, and obesity. At the same time, it can also enhance the capacity and efficiency of the aerobic energy supply system, effectively improving CRF and the innate ability of muscles to extract and utilize oxygen from the blood. Evidence also suggests that regular aerobic PA can stimulate the development of coronary collateral blood vessels, increasing myocardial perfusion, and release exerkines that promote angiogenesis and vascularization, contributing to lowered BP and improved endothelial function, etc. It has also proven to play a major role in helping to promote cellular maintenance and repair processes. Collectively, these effects, in concert with other benefits including formulating a healthier metabolic milieu with attenuation of systemic chronic inflammation, adaptations at the vascular (antiatherogenic effects) and heart tissue (myocardial regeneration and cardioprotection) levels, as well as improvement in mitochondrial homeostasis, oxidative stress, autonomic balance and other risk factors, constitute the key biological basis for the role of aerobic PA in the prevention and treatment of CVD.

Physical activity is one of the most accessible and cost-effective strategies for improving cardiovascular health. Current guidelines recommend that healthy adults engage in at least 150–300 minutes of moderate-intensity or 75–150 minutes of vigorous-intensity aerobic activity per week, or an equivalent combination, supplemented by muscle-strengthening activities on at least two days. However, systematic mechanistic elucidation and precise guidance regarding the specific associations of different exercise modalities and doses with cardiovascular health remain lacking. So, Fangchao Liu and colleagues set out to do so.

The review indicates a non-linear dose-response relationship between aerobic exercise duration and cardiovascular disease risk, with significant risk reduction observed across the entire range, and greater benefits for inactive populations. Objectively measured physical activity information suggests that performing aerobic exercise in the evening may yield greater health benefits; for individuals unable to maintain a daily routine, concentrating activity into one or two weekends (“weekend warrior” pattern) also significantly reduces cardiovascular risk.

Regarding muscle-strengthening exercise, evidence shows a “J-shaped” association with risk, peaking at 40–60 minutes per week, though more objective data are still needed to verify whether excessive muscle-strengthening activity poses potential risks.

Notably, this review emphasizes the significant advantage of combined (aerobic and muscle-strengthening) physical activity in improving cardiovascular outcomes, generating synergistic protection through hemodynamic improvement, metabolic regulation, and body composition optimization.

The review specifically notes that the cardiovascular benefits of physical activity are more pronounced in populations with pre-existing risk factors. However, while pursuing greater benefits, these individuals must pay more attention to safety limits to avoid exercise-related adverse events. The team says further studies are needed, leveraging objectively measured physical activity data to further deepen the understanding of mechanisms by which it improves health and identifying key biomarkers. Furthermore, with the integration of electronic health records and wearable technology, artificial intelligence and big data analytics are driving the development of intelligent personalized physical activity management systems.

 

The critical role of exercise in the GLP-1 era

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Steven B. Heymsfield, MD, LSU Boyd Professor and Director, Metabolism and Body Composition Laboratory at Pennington Biomedical Research Center

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Credit: PBRC

As GLP-1 receptor agonists reshape obesity treatment, a new medical perspective published in the Journal of the American Medical Association, or JAMA, underscores a persistent gap in care: integrating exercise into weight management in ways patients can sustain.

The perspective, “The Conundrum of Exercise for Weight Management in the GLP-1 Receptor Agonist Era,” examines the evolving role of physical activity alongside medications such as semaglutide, liraglutide and other GLP-1-based therapies. Authors included Pennington Biomedical’s Steven B. Heymsfield, M.D., and Harvard University’s Daniel E. Lieberman, Ph.D., and Daniel H. Aslan, Ph.D.

GLP-1 therapies have been shown to reduce caloric intake by up to 39% and produce substantial weight loss. By comparison, standard physical activity recommendations (150 minutes per week) yield relatively modest calorie expenditure.

The authors emphasize that exercise’s value extends far beyond energy balance – it has important complementary effects, including improved insulin sensitivity, increased fat oxidation and, perhaps most importantly, preservation of fat-free mass. Exercise plays a critical role in preserving muscle mass – an area of concern with GLP-1 therapies. Studies show that a large percentage of weight loss on GLP-1 medications may come from fat-free mass, including muscle, increasing the risk of sarcopenia.

The perspective also highlights a key clinical concern: Up to 60% of patients discontinue GLP-1 medications within a year, with many regaining a significant portion of lost weight. Regular physical activity, particularly at higher volumes, plays an important role in mitigating this regain.

Despite its proven benefits, exercise remains difficult for many patients to sustain. Barriers include time constraints, physical limitations, lack of access to facilities and that, for some, exercise can feel difficult and unrewarding.

To improve outcomes, the authors encourage clinicians to move beyond general advice and instead develop individualized, practical strategies. These include assessing activity levels, addressing patient-specific barriers, emphasizing health benefits beyond weight loss and helping patients identify enjoyable, sustainable forms of movement.

The perspective concludes that GLP-1 therapies should complement – not replace – exercise, and that improving adherence is now the central challenge in translating exercise’s proven benefits into real-world impact.

“Although GLP-1 receptor agonists offer powerful new opportunities for losing weight, they do not diminish the manifold benefits of exercise and instead highlight the need to translate exercise’s efficacy into effectiveness,” the authors concluded.

Maintaining a healthy heart may require regular doses of positivity

 Positive psychology interventions such as mindfulness, gratitude journaling and optimism training can consistently improve blood pressure, inflammation markers and other cardiovascular disease risk factors within a matter of weeks, a recent study found. However, since these benefits are associated with lifestyle changes such as eating healthier and greater physical activity, the researchers suggested that ongoing reinforcements may be needed to stay on course long term.

Rosalba (Rose) Hernandez, a professor of social work at the University of Illinois Urbana-Champaign, led a team that analyzed the findings of 18 randomized controlled trials that used positive psychological and mindfulness interventions to enhance mental or physical health.

The programs that the team reviewed included individual methods — such as structured telephone sessions, journaling with brief check-ins and digital platforms such as apps and text messaging — and interactive in-person group sessions, as well as hybrid formats that blended these with online tools and virtual meetings. Most of the programs consisted of weekly sessions and at-home activities that reinforced the skills taught, with the majority of programs lasting from six to 12 weeks, the team found.

In general, the programs included 50-200 adults with elevated cardiovascular risk factors such as uncontrolled hypertension, heart failure or other conditions. Typically, the participants were in their late 50s to mid-60s, and women comprised 35-55% of the samples across those studies that reported their participants’ gender, according to the researchers.

“In hypertension and postacute coronary syndrome cohorts, mindfulness-based programs delivered over an eight-week period reduced systolic blood pressure and lowered inflammatory markers such as high-sensitivity C-reactive protein and fibrinogen,” said Hernandez, who is a Fellow of the American Heart Association. “A 12-week spirituality-based digital intervention achieved one of the largest reductions — reducing systolic blood pressure measured with a standard cuff by 7.6 points, and central systolic pressure — which is measured in the aorta as it leaves the heart — by 4.1 points.”

In prior research on positive psychology interventions, scientists seldom defined the dose that was needed to obtain the beneficial effects, Hernandez said. She and the team members sought to clarify the frequency and duration that was most likely to improve individuals’ cardiovascular health.

Programs that had more frequent contact with their participants yielded the most consistent physiological benefits, underscoring the opportunity to embed positive psychological strategies into long-term cardiovascular care, Hernandez said.

The team found that the strongest behavioral improvements were achieved by an eight-week program delivered over WhatsApp that combined weekly sessions with daily microtasks, motivating participants to engage in greater physical activity, eat a healthier diet and take their medication as prescribed. A program that included motivational interviewing succeeded in increasing cardiac patients’ levels of physical activity by 1,800 steps a day and their medication adherence, while the mindfulness programs improved participants’ activity levels and diets only, according to the study.

“The therapeutic dose that was most consistently linked with improvements in blood pressure, inflammation and endothelial function was daily practice reinforced by weekly sessions over eight to 12-week periods,” Hernandez said. “Therapeutic dosing typically involved high-frequency dosing over this time period to obtain short-term physiologic benefits, while ongoing less-intensive contact may be needed to sustain behavioral change.”

Published in the journal Cardiology Clinics, the study was co-written by University of South Florida social work professor Soonhyung Kwon; Alyssa M. Vela, a professor of surgery and of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine; and Katharine S. Edwards, a professor of cardiovascular medicine and of psychiatry and behavioral medicine at Stanford Medicine.

“The findings of this study further point to the importance of attending to mental and behavioral health for cardiovascular disease prevention and cardiovascular health optimization,” Vela said. “This speaks to the need for routine screening and integration of cardiac behavioral medicine to allow for access to important interventions.”

The current study adds to a growing body of research linking psychological well-being — including traits such as optimism, positive affect and gratitude — with cardioprotective benefits.