You might be interested in…Lifestyle Issues

There have been several papers published recently looking at various aspects of lifestyle as it effects health. Here is a summary of five studies that I consider to be the most impactful.

Disability is a key marker of overall physical health in older adults and is often preceded by chronic disease. Although air pollution is a well -recognised risk factor for multiple chronic diseases, its association with physical disability has not been well characterised. This study1 investigated the associations of air pollutants with physical disability in a large cohort representative of older adults in the USA.

The authors used biennial data on incident activities of daily living (ADL) disability collected from respondents of the Health and Retirement Survey between 2000 and 2016. Among 15,411 respondents aged 65 years and older (mean age 70⋅2 years; 55 per cent female), 48 per cent of respondents reported having a new ADL disability during a mean follow-up of 7⋅9 years. In fully adjusted models, the authors found greater risks of ADL disability associated with higher concentrations of atmospheric pollutants. Their conclusion is that air pollution might be an underappreciated risk factor for physical disability in later life, although additional research is needed.

Alcohol consumption is a leading cause of morbidity and mortality that may be more important in older adults with socioeconomic or health-related risk factors. The objective of this prospective cohort study using data from the UK Biobank2 was to examine the association of alcohol consumption patterns with 12-year mortality and its modification by health-related or socioeconomic risk factors.

Participants were current drinkers aged 60 years or older. According to their mean alcohol intake in grams per day, participants’ drinking patterns were classified as occasional:<2.86 g/d), low risk (men: >2.86-20.00 g/d; women: >2.86-10.00 g/d), moderate risk (men: >20.00-40.00 g/d; women: >10.00-20.00 g/d) and high risk (men: >40.00 g/d; women: >20.00 g/d).

Health-related risk factors were assessed with the frailty index, and socioeconomic risk factors were assessed with the Townsend deprivation index. All-cause and cause-specific mortality were obtained from death certificates held by the national registries.

A total of 135,103 participants (median age, 64.0 years; 50.1 per cent women) were included. In the total analytical sample, compared with occasional drinking, high-risk drinking was associated with higher all-cause (hazard ratio [HR], 1.33), cancer (HR, 1.39), and cardiovascular (HR, 1.21) mortality; moderate-risk drinking was associated with higher all-cause (HR, 1.10) and cancer (HR, 1.15) mortality, and low-risk drinking was associated with higher cancer mortality (HR, 1.11).

Wine preference (>80 per cent of alcohol from wine) and drinking with meals showed small protective associations with mortality, which requires further study. The startling conclusion is that even low-risk drinking was associated with higher mortality among older adults with health-related or socioeconomic risk factors.

This systematic review and meta-analysis3 aimed to assess the effect of home-based exercise interventions on walking performance in patients with peripheral artery disease (PAD) and intermittent claudication (IC). A total of eight studies were included in the meta-analysis. The duration of interventions in the included studies ranged from six to 52 weeks. In the pooled analysis, compared with control groups, the home-based exercise intervention groups showed improved pain-free walking distance and maximal walking distance.

The next study has shown the benefits of physical activity on frailty. The investigators looked at the relationship between changes in physical activity and frailty among middle-aged and older adults. This was a retrospective observational study based in Korea,4 using panel data from the 2006–2022 Korean Longitudinal Study of Aging (KLoSA). The investigators analysed data from 5,594 participants (2,855 males and 2,739 females) extracted from KLoSA data collected between 2006 and 2022. The frailty index was calculated based on six clinical domains comprising 34 age-related health deficits. Changes in physical activity were categorised as persistently inactive, decreased, increased or persistently active.

The persistently active group (OR=0.45) showed a lower likelihood of frailty than did the persistently inactive group. Therefore, participation in physical activity in the older adults is one of the important ways to prevent frailty.

The aim of this umbrella review5 was to provide an updated comprehensive evaluation of the quality and evidence association of existing studies on health outcomes related to intermittent fasting (IF). The authors conducted a systematic search of the literature. Twelve meta-analysis studies and 122 health outcome associations with IF were identified.

High-quality evidence indicated significant associations between time-restricted eating (TRE) and weight loss, fat mass reduction, decreased fasting insulin and glycosylated haemoglobin levels in overweight or obese adults. Moderate-to-low-quality evidence suggested associations between modified alternate-day fasting and improvements in body weight, lipid profile and blood pressure. Additionally, high-to-low-quality evidence showed that IF regimens effectively improved liver health in non-alcoholic fatty liver disease. The authors also highlight the need for further extensive research to understand the long-term effects, individualized IF plans and potential adverse effects of IF in different populations.

References:

1. Gao J et al. Long-term air pollution exposure and incident physical disability in older US adults: a cohort study. Lancet Healthy Longev 2024;5: 100629. Published Online September 26, 2024.   https://doi.org/10.1016/j.lanhl.2024.07.012
2. Ortola R et al. Alcohol Consumption Patterns and Mortality Among Older Adults With Health-Related or Socioeconomic Risk Factors. JAMA Network Open. 2024;7(8):e2424495. doi:10.1001/jamanetworkopen.2024.24495
3. Xu Z, et al. Effectiveness of home-based walking exercise for patients with peripheral artery disease and intermittent claudication: a systematic review and meta-analysis. BMJ Open 2025;15:e086013. doi:10.1136/bmjopen-2024-086013
4. Jung YJ et al. Retrospective observational study of the association between changes in physical activity and frailty in middle-aged and older adults: evidence from the Korean Longitudinal Study of Aging (2006–2022). BMJ Open 2025;15:e092072. doi:10.1136/bmjopen-2024-092072
5. Hua Z et al. Intermittent fasting for weight management and metabolic health: An updated comprehensive umbrella review of health outcomes. Diabetes Obes Metab. 2025;27:920–932. doi: 10.1111/dom.16092