Wolfberry Consumption with a Healthy Dietary Pattern Lowers Oxidative Stress and Improves Carotenoids Status in Middle-Aged and Older Adults: A Randomized Controlled Trial

Abstract Objectives The incorporation of zeaxanthin rich wolfberry (Lycium barbarum) into a healthy dietary pattern may augment its antioxidant effects although evidence evaluating whole fruits is lacking. The objectives of this study are to (1) investigate the impact of dietary counselling, either with or without whole dried wolfberry on oxidative stress status in middle-aged and older Singaporean adults and (2) delineate underlying mechanisms by examining associations with the corresponding changes in carotenoids status. Methods In this 16-week, parallel design randomized controlled trial, 40 subjects (29 F, 11 M; aged 50 to 64 y) received dietary counselling to follow a healthy dietary pattern. Compared to the control group (CG, n = 18), the wolfberry group (WG, n = 22) additionally cooked and consumed 15 g/d whole dried wolfberry with their main meals. Biomarkers of oxidative stress (plasma malondialdehyde (MDA) by thiobarbituric acid reactive substance assay and 8-isoprostanes by ELISA) were measured at baseline and week 16. Plasma and dietary carotenoids analyzed by HPLC and 3-day food records respectively were measured at baseline, week 8 and week 16 while skin carotenoids status (SCS) by resonance Raman spectroscopy was assayed every 4 weeks. Results Plasma 8-isoprostanes showed a time effect (P < 0.05), attributed to the marked decline in the WG only (WG: −19.0 ± 43.6 ng/L; CG: −7.7 ± 38.7 ng/L, mean ± SD) though no effect was observed for MDA. A significant interaction effect (P < 0.001), driven by higher plasma zeaxanthin (WG: +0.08 ± 0.13 nmol/L; CG: −0.03 ± 0.05 nmol/L) and SCS (WG: +4242 ± 4938 a.u.; CG: +1713 ± 5921 a.u.) was observed in the WG with a marked increase evident from week 8 onwards although concentrations of the other plasma carotenoids were maintained. Moreover, the change value for plasma zeaxanthin in the WG was inversely associated with the corresponding changes in plasma 8-isoprostanes (−0.21 (−0.43, 0.00) ng/µmol, regression coefficient (95% CI); P = 0.05). This same association was absent in the CG. Conclusions Consuming wolfberry with a healthy dietary pattern attenuates oxidative stress in middle-aged and older adults and this may be attributed to the rich zeaxanthin content in wolfberry. Funding Sources National University of Singapore Ministry of Education, Singapore Agency for Science, Technology and Research.

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Wolfberry (Lycium barbarum) Consumption with a Healthy Dietary Pattern Lowers Oxidative Stress in Middle-Aged and Older Adults: A Randomized Controlled Trial

Antioxidants ◽

10.3390/antiox10040567 ◽

2021 ◽

Vol 10 (4) ◽

pp. 567

Author(s):

Darel Wee Kiat Toh ◽

Wan Yee Lee ◽

Hanzhang Zhou ◽

Clarinda Nataria Sutanto ◽

Delia Pei Shan Lee ◽

...

Keyword(s):

Oxidative Stress ◽

Older Adults ◽

Dietary Pattern ◽

Controlled Trial ◽

Antioxidant Properties ◽

Prostaglandin F2α ◽

Middle Aged ◽

Lycium Barbarum ◽

Randomized Controlled ◽

Healthy Dietary Pattern

Incorporating zeaxanthin-rich wolfberry (Lycium barbarum) into a healthy dietary pattern may augment its antioxidant potential. The present 16-week, parallel design randomized controlled trial aimed to investigate the impact of adhering to a healthy dietary pattern, either with or without whole dried wolfberry (15 g/d) on oxidative stress status (plasma malondialdehyde and 8-iso-prostaglandin F2α) in middle-aged and older adults. Changes to carotenoids status (plasma and skin carotenoids) and body composition were further evaluated to explore potential mechanisms which underlie the antioxidant properties of wolfberry. Plasma 8-iso-prostaglandin F2α, plasma zeaxanthin and skin carotenoids status were significantly raised in the wolfberry consuming group (n = 22; p < 0.05) compared to the control group which showed no changes (n = 18). Likewise in the wolfberry group only, inverse association was observed between the change values of plasma zeaxanthin and plasma 8-iso-prostaglandin F2α (−0.21 (−0.43, 0.00) ng/µmol, regression coefficient (95% CI); p = 0.05). Wolfberry consumption with a healthy dietary pattern may serve as a dietary strategy to attenuate lipid peroxidation among middle-aged and older adults who are at a heightened risk of oxidative stress induced age-related disorders. The antioxidant properties of wolfberry may be attributed to its rich zeaxanthin content.

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Enhancing the Cardiovascular Protective Effects of a Healthy Dietary Pattern with Wolfberry (Lycium barbarum): A Randomized Controlled Trial

Current Developments in Nutrition ◽

10.1093/cdn/nzaa040_082 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 82-82

Author(s):

Darel Wee Kiat Toh ◽

Xuejuan Xia ◽

Jasmine Hui Min Low ◽

Clarinda Sutanto ◽

Wan Yee Lee ◽

...

Keyword(s):

Older Adults ◽

Randomized Controlled Trial ◽

Dietary Pattern ◽

Cardiovascular Health ◽

Controlled Trial ◽

Protective Effects ◽

Lycium Barbarum ◽

Endothelin 1 ◽

Randomized Controlled ◽

Healthy Dietary Pattern

Abstract Objectives The study aimed to investigate the impact of wolfberry (Lycium barbarum) consumption as part of a healthy dietary pattern on cardiovascular health in Singaporean middle-aged and older adults. It was hypothesized that the consumption of wolfberry could further enhance the cardiovascular protective effects of a healthy dietary pattern. Methods This was a 16 week, parallel design, randomized controlled trial where 40 Singaporean men and women (aged 50 to 64 years) received dietary counselling to follow a healthy dietary pattern either with or without 15 g/day of dried whole wolfberry, cooked and consumed as part of their meals. Blood pressure, serum lipid-lipoprotein concentrations and dietary compliance using 3-day food records were monitored every 4 weeks. Further evaluation of cardiovascular disease (CVD) biomarkers, broadly classified as serological (total nitrate/nitrite, endothelin-1, intercellular adhesion molecule-1, angiopoietin-1, angiopoietin-2 and von-Willebrand factor), structural (carotid intima-media thickness using B-mode ultrasonography) and functional (flow-mediated dilation using B-mode ultrasonography and circulating endothelial progenitor cells (CD34+/KDR+) by fluorescence-activated cell sorting) were analyzed before and after intervention. Results Adherence to a healthy dietary pattern contributed to a time dependent effect on both the plasma total nitrate/nitrite (P < 0.01) and plasma endothelin-1 (P < 0.005) which were raised and lowered respectively at week 16. However, changes were significant only in the wolfberry group (total nitrate/nitrite: 15.9 ± 1.8 to 19.4 ± 2.2 μmol/L, P < 0.05; endothelin-1: 1.31 ± 0.12 to 1.11 ± 0.10 ng/L, P < 0.01) and not in the control group. Moreover, a significant increase in serum high density lipoprotein (HDL) cholesterol was also detected solely in the wolfberry group (1.56 ± 0.10 to 1.65 ± 0.10 mmol/L, P < 0.05). The other serological, structural and functional biomarkers of cardiovascular health showed no observable change after the intervention. Conclusions Incorporating wolfberry to your daily meals may augment the cardiovascular protective benefits of a healthy dietary pattern by improving the regulation of vascular tone and plasma lipid-lipoprotein profile in Singaporean middle-aged and older adults. Funding Sources Ministry of Education, Singapore.

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Effect of concurrent self-massage and resistance training in middle-aged and older adults: a randomized controlled trial

The Journal of Physical Fitness and Sports Medicine ◽

10.7600/jpfsm.7.47 ◽

2018 ◽

Vol 7 (1) ◽

pp. 47-55

Author(s):

Kazufumi Terada ◽

Toshiaki Nakatani

Keyword(s):

Older Adults ◽

Randomized Controlled Trial ◽

Resistance Training ◽

Controlled Trial ◽

Middle Aged ◽

Randomized Controlled

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Effect of concurrent self-massage and resistance training in middle-aged and older adults: a randomized controlled trial [J Phys Fitness Sports Med, 7 (1): 47-55 (2018)]

The Journal of Physical Fitness and Sports Medicine ◽

10.7600/jpfsm.7.151 ◽

2018 ◽

Vol 7 (2) ◽

pp. 151-151

Keyword(s):

Older Adults ◽

Randomized Controlled Trial ◽

Resistance Training ◽

Controlled Trial ◽

Middle Aged ◽

Randomized Controlled

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The Aging trial: Design of a randomized controlled trial to increase physical activity in middle-aged and older adults

Contemporary Clinical Trials ◽

10.1016/j.cct.2020.106105 ◽

2020 ◽

Vol 96 ◽

pp. 106105

Author(s):

Manfred Diehl ◽

Abigail Nehrkorn-Bailey ◽

Katherine Thompson ◽

Diana Rodriguez ◽

Kaigang Li ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Randomized Controlled Trial ◽

Trial Design ◽

Controlled Trial ◽

Middle Aged ◽

Randomized Controlled

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The impact of life review on depression in older adults: a randomized controlled trial

International Psychogeriatrics ◽

10.1017/s104161020999175x ◽

2010 ◽

Vol 22 (4) ◽

pp. 572-581 ◽

Cited By ~ 43

Author(s):

Anne Margriet Pot ◽

Ernst T. Bohlmeijer ◽

Simone Onrust ◽

Anne-Sophie Melenhorst ◽

Marjolein Veerbeek ◽

...

Keyword(s):

Older Adults ◽

Randomized Controlled Trial ◽

Depressive Symptoms ◽

Effect Size ◽

Comparison Group ◽

Controlled Trial ◽

Life Review ◽

Group Effect ◽

Randomized Controlled ◽

The Impact

ABSTRACTBackground: We developed an indicated preventive life-review course, “Looking for Meaning”, based on the assumption that reminiscence styles influence coping with depressive symptoms. This study describes the impact of this course in a pragmatic randomized controlled trial.Methods: Inclusion criteria were >50 years, a score of 5 or higher on the Center for Epidemiological Studies Depression Scale (CES-D), and no depressive disorder or psychotropic or psychological treatment. Participants were randomized and stratified by gender: the experimental group (N = 83) was offered the course and the comparison group (N = 88) a movie. There were three measurements: pre-treatment, post-treatment and 6 months after post-treatment. Depressive symptoms constituted the primary outcome. Secondary outcomes were anxiety symptoms, satisfaction with life, mastery and reminiscence styles. All analyses were conducted according to the intention-to-treat principle. Missing values were replaced by regression imputation.Results: The course reduced depressive symptoms, a decrease that was retained during follow-up. A significant between-group effect size was found (d = 0.58). There was also a reduction in symptoms of anxiety; however, the comparison group showed the same reduction, resulting in a small between-group effect size. Gender and level of depressive symptoms were found to be prognostic factors for the change in depressive symptoms; age was not. Post hoc analyses showed significant between-group effect sizes for females and those with a score above the cut-off of the CES-D.Conclusion: The course “Looking for Meaning” can be recommended for people aged over 50 years, females and older adults with a clinically relevant level of depressive symptoms (above cut-off) in particular.

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Randomized controlled trial of geriatric consultation versus standard care in older adults with hematologic malignancies

Haematologica ◽

10.3324/haematol.2021.278802 ◽

2021 ◽

Author(s):

Clark DuMontier ◽

Hajime Uno ◽

Tammy Hshieh ◽

Guohai Zhou ◽

Richard Chen ◽

...

Keyword(s):

Older Adults ◽

Randomized Controlled Trial ◽

Standard Care ◽

Controlled Trial ◽

Hematologic Malignancies ◽

Care Utilization ◽

Goals Of Care ◽

Randomized Controlled ◽

Geriatric Consultation ◽

The Impact

We conducted a randomized controlled trial in older adults with hematologic malignancies to determine the impact of geriatrician consultation embedded in our oncology clinic alongside standard care. From February 2015 to May 2018, transplant-ineligible patients age ii75 years who presented for initial consultation for lymphoma, leukemia, or multiple myeloma at Dana-Farber Cancer Institute (Boston, MA) were eligible. Pre-frail and frail patients, classified based on phenotypic and deficitaccumulation approaches, were randomized to receive either standard oncologic care with or without consultation with a geriatrician. The primary outcome was 1-year overall survival. Secondary outcomes included unplanned care utilization within 6 months of follow-up and documented end of life (EOL) goals of care discussions. Clinicians were surveyed as to their impressions of geriatric consultation. One hundred sixty patients were randomized to either geriatric consultation plus standard care (n = 60) or standard care alone (n = 100). Median age was 80.4 years (SD = 4.2). Of those randomized to geriatric consultation, 48 (80%) completed at least one visit with a geriatrician. Consultation did not improve survival at one year compared to standard care (difference: 2.9%, 95% CI = -9.5% to 15.2%, p = 0.65), and did not significantly reduce the incidence of ED visits, hospitalizations, or days in hospital. Consultation did improve the odds of having EOL goals of care discussions (odds ratio = 3.12, 95% CI = 1.03 to 9.41) and was valued by surveyed hematologiconcology clinicians, with 62.9%-88.2% rating consultation as useful in the management of several geriatric domains.

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A Social Group-Based Information-Motivation-Behavior Skill Intervention to Promote Acceptability and Adoption of Wearable Activity Trackers Among Middle-Aged and Older Adults: Cluster Randomized Controlled Trial

JMIR mhealth and uhealth ◽

10.2196/14969 ◽

2020 ◽

Vol 8 (4) ◽

pp. e14969

Author(s):

Jing Liao ◽

Hai-Yan Xiao ◽

Xue-Qi Li ◽

Shu-Hua Sun ◽

Shi-Xing Liu ◽

...

Keyword(s):

Older Adults ◽

Randomized Controlled Trial ◽

Social Group ◽

Controlled Trial ◽

Daily Step ◽

Middle Aged ◽

Randomized Controlled ◽

Activity Trackers ◽

Wearable Activity Trackers ◽

Cluster Randomized

Background Wearable activity trackers offer potential to optimize behavior and support self-management. To assist older adults in benefiting from mobile technologies, theory-driven deployment strategies are needed to overcome personal, technological, and sociocontextual barriers in technology adoption. Objective To test the effectiveness of a social group–based strategy to improve the acceptability and adoption of activity trackers by middle-aged and older adults. Methods A cluster randomized controlled trial was conducted among 13 groups of middle-aged and older adults (≥45 years) performing group dancing (ie, square dancing) as a form of exercise in Guangzhou from November 2017 to October 2018. These dancing groups were randomized 1:1 into two arms, and both received wrist-worn activity trackers and instructions at the baseline face-to-face assessment. Based on the Information-Motivation-Behavior Skill framework, the intervention arm was also given a tutorial on the purpose of exercise monitoring (Information), encouraged to participate in exercise and share their exercise records with their dancing peers (Motivation), and were further assisted with the use of the activity tracker (Behavior Skill). We examined two process outcomes: acceptability evaluated by a 14-item questionnaire, and adoption assessed by the uploaded step count data. Intention-to-treat analysis was applied, with the treatment effects estimated by multilevel models. Results All dancing groups were followed up for the postintervention reassessment, with 61/69 (88%) participants of the intervention arm (7 groups) and 56/80 (70%) participants of the control arm (6 groups). Participants’ sociodemographic characteristics (mean age 62 years, retired) and health status were comparable between the two arms, except the intervention arm had fewer female participants and lower cognitive test scores. Our intervention significantly increased the participants’ overall acceptability by 6.8 points (95% CI 2.2-11.4), mainly driven by promoted motivation (adjusted group difference 2.0, 95% CI 0.5-3.6), increased usefulness (adjusted group difference 2.5, 95% CI 0.9-4.1), and better perceived ease of use (adjusted group difference 1.2, 95% CI 0.1-2.4), whereas enjoyment and comfort were not increased (adjusted group difference 0.9, 95% CI –0.4-2.3). Higher adoption was also observed among participants in the intervention arm, who were twice as likely to have valid daily step account data than their controlled counterparts (adjusted incidence relative risk [IRR]=2.0, 95% CI 1.2-3.3). The average daily step counts (7803 vs 5653 steps/day for the intervention and control, respectively) were similar between the two arms (adjusted IRR=1.4, 95% CI 0.7-2.5). Conclusions Our social group–based deployment strategy incorporating information, motivation, and behavior skill components effectively promoted acceptability and adoption of activity trackers among community-dwelling middle-aged and older adults. Future studies are needed to examine the long-term effectiveness and apply this social engagement strategy in other group settings or meeting places. Trial Registration Chinese Clinical Trial Registry ChiCTR-IOC-17013185; https://tinyurl.com/vedwc7h.

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