The number of older people choosing to relocate to retirement villages (RVs) is increasing rapidly. This choice is often a way to decrease social isolation while still living independently. Loneliness is a significant health issue and contributes to overall frailty, yet RV resident loneliness is poorly understood. Our aim is to describe the prevalence of loneliness and associated factors in a New Zealand RV population.

A resident survey was used to collect demographics, social engagement, loneliness, and function, as well as a comprehensive geriatric assessment (international Resident Assessment Instrument [interRAI]) as part of the “Older People in Retirement Villages Study.”

RVs, Auckland, New Zealand.

Participants included RV residents living in 33 RVs (n = 578).

Two types of recruitment: randomly sampled cohort (n = 217) and volunteer sample (n = 361). Independently associated factors for loneliness were determined through multiple logistic regression with odds ratios (ORs).

Of the participants, 420 (72.7%) were female, 353 (61.1%) lived alone, with the mean age of 81.3 years. InterRAI assessment loneliness (yes/no question) was 25.8% (n = 149), and the resident survey found that 37.4% (n = 216) feel lonely sometimes/often/always. Factors independently associated with interRAI loneliness included being widowed (adjusted OR 8.27; 95% confidence interval [CI] 4.15–16.48), being divorced/separated/never married (OR 4.76; 95% CI 2.15–10.54), poor/fair quality of life (OR 3.37; 95% CI 1.43–7.94), moving to an RV to gain more social connections (OR 1.55; 95% CI 0.99–2.43), and depression risk (medium risk: OR 2.58, 95% CI 1.53–4.35; high risk: OR 4.20, 95% CI 1.47–11.95).

A considerable proportion of older people living in RVs reported feelings of loneliness, particularly those who were without partners, at risk of depression and decreased quality of life and those who had moved into RVs to increase social connections. Early identification of factors for loneliness in RV residents could support interventions to improve quality of life and positively impact RV resident health and well-being.

An earthquake is a hazard that may cause urgent needs requiring international assistance. To ensure rapid funding for such needs-based humanitarian assistance, swift decisions are needed. However, data to guide needs-based funding decisions are often missing in the acute phase, causing delays. Instead, it may be feasible to use data building on existing indexes that capture hazard and vulnerability information to serve as a rapid tool to prioritize funding according to the scale of needs: needs-based funding. However, to date, it is not known to what extent the indicators in the indexes can predict the scale of disaster needs. The aim of this study was to identify predictors for the scale of disaster needs after earthquakes.

The predictive performance of vulnerability indicators and outcome indicators of four commonly used disaster risk and severity indexes were assessed, both individually and in different combinations, using linear regression. The number of people who reportedly died or who were affected was used as an outcome variable for the scale of needs, using data from the Emergency Events Database (EM-DAT) provided by the Centre for Research on the Epidemiology of Disasters at the Université Catholique de Louvain (CRED; Brussels, Belgium) from 2007 through 2016. Root mean square error (RMSE) was used as the performance measure.

The assessed indicators did not predict the scale of needs. This attempt to create a multivariable model that included the indicators with the lowest RMSE did not result in any substantially improved performance.

None of the indicators, nor any combination of the indicators, used in the four assessed indexes were able to predict the scale of needs in the assessed earthquakes with any precision.

Considering the dramatically increasing incidence of type 2 diabetes (T2D), decreasing glycemic variability in T2D patients is a key challenge to limit the occurrence of diabetic complications. Diet appears as one potential lever that can be set up above medications. Particularly, the ingestion of foods with a high content in slowly digestible starch (SDS) demonstrated both lower postprandial glycemic and insulin responses in healthy and insulin resistant subjects. This study aimed at designing a full high-SDS diet by selecting high-SDS starchy food products and at studying its impact on glycemic response and variability in T2D.

This pilot randomized controlled cross-over study included eight T2D patients (HbA1c = 7.0 ± 0.2%, BMI = 31.7 ± 2.1 kg/m2, treated by Metformin & Sitagliptin) who consumed twice, for one week a controlled diet containing starchy food products screened and selected to be either High (High-SDS) or Low (Low-SDS) in SDS, as determined by the SDS in-vitro method developed by Englyst et al. During each diet period, the glycemic profile was monitored for 6 days using a Continuous Glucose Monitoring System (CGMS). Multiple metrics related to variability and glycemic responses were calculated.

222 SDS analyses were realized on commercial food products as consumed. 23 High-SDS and 20 Low-SDS food items with associated specific cooking instructions were selected to design two diets consistent with local T2D recommendations. The High-SDS diet demonstrated a significantly higher SDS content compared to the Low-SDS diet (61.6 vs 11.6 g/day; p < 0.0001), mainly driven by selected pasta, rice and high-SDS biscuits (75.6% of the consumed SDS content). The % of total daily energy intake (TDEI) for all macronutrients remained similar between diets (p > 0.05) and the carbohydrate content specifically represented 49 ± 1 % and 47 ± 2 % of the TDEI for High-SDS and Low-SDS diets, respectively. With the high-SDS diet, the Mean Amplitude of Glycemic Excursion, a key parameter of glycemic variability, was significantly decreased (79.6 for Low-SDS vs 61.6 mg/dL for High-SDS; p = 0.0067). The significant correlation between the meals SDS contents and various glycemic parameters such as postprandial iAUC, tAUC (up to 180 min) or peak value strengthen this finding (p < 0.05 for all).

It was the first demonstration that a diet including selected starchy food items and cooking recommendations designed to favor products’ high SDS content beneficially impacts glycemic profile in T2D subjects. Carefully selecting starchy food may be a simple and valuable tool to improve glycemic control in T2D.

Dietary fibers (DF) are considered as beneficial nutrients for health. Current data suggest that their interaction with the gut microbiota largely contributes to their physiological effects. The FiberTAG project(1) innovates in searching for new biomarkers reflecting the health effect of dietary fibers, including chitin-glucan (CG, extracted from the fungal exoskeleton Aspergillus niger). CG improves metabolic disorders associated with obesity in mice, but its effect on gut microbiota composition and function has never been evaluated in vivo in humans.

CG (KitoZyme, Belgium) was given to healthy volunteers (n = 15), during three weeks (4.5g/day). Volatile Organic Compound (VOC) metabolites released in breath were analyzed using SYFT methodology. Fatty acid (FA) profiling was assessed in stool samples, by gas-liquid chromatography(2). The gut microbiome was analyzed by Illumina sequencing (V5-V6 region of 16S rRNA).

Three weeks of CG supplementation was well tolerated and lead to changes in the kinetics of breath VOC, especially the short-chain fatty acid, alcohols and alkanes. Fecal vaccenic acid, produced upon the bacterial metabolism of fatty acids, was significantly increased by CG. Several bacterial genera were correlated with breath VOC (i.e. 2 methylbutyric acid and RuminococcaceaeUCG005). Moreover, Roseburia, often presented as a butyrate producer, was positively correlated with the production of a rumenic acid isomer “cis-9,cis-11-18:2”.

We show that breath VOC analysis, a non-invasive methodology, reveals characteristics of microbiota-CG interactions. We also show that CG selectively changes the profile of FA metabolites, in favor of vaccenic acid, another bioactive metabolite produced by Roseburia, prone to act on host physiology. This study will help to establish a set of new biomarkers linking insoluble DF and gut microbiota, with focus on their interest in human health.

Low 25-hydroxyvitamin D (25(OH)D) has been linked with adverse health outcomes, including cancer, cardiovascular disease and mortality. The Irish Longitudinal Study on Ageing (TILDA) has previously shown that 13.1% of the Irish population over 50 are deficient in 25(OH)D, after adjusting for seasonality. The aim of this study is to assess whether low 25(OH)D concentrations are associated with all-cause mortality in the over 50s in Ireland.

Data from Wave 1 (2009–2011) of TILDA, a prospective population representative study of community dwelling adults aged over 50, were used. Blood was obtained during the health assessment, and analysis of 25(OH)D was performed. Mortality was confirmed through official death records, and all participant deaths between baseline and March 2017 were included. Logistic regression assessed whether baseline levels of 25(OH) D, both continuous and categorised into deficient (25(OH)D < 30 nmol/l), insufficient (30 < = 25(OH)D < 50 nmol/l) or sufficient (25(OH)D > = 50 nmol/l), are associated with mortality.

Of the 8,175 over 50s recruited, 25(OH)D data was available for 5,388 participants. Of these, 366 individuals had died prior to March 2017. Higher concentrations of 25(OH)D were associated with lower odds of mortality (OR 0.70; 95% CI 0.60, 0.81, p-value), controlling for confounders. On categorising 25(OH)D, those with insufficient 25(OH)D concentrations had higher odds of mortality than those with sufficient levels (OR 2.04; 95% CI 1.48, 2.8; p-value < 0.001). Stratifying between men and women, there was no gender difference in this association.

Insufficient baseline 25(OH)D concentrations are associated with an increased odds of all-cause mortality in community dwelling adults over 50 in Ireland. Further research evaluating whether treatment of vitamin D deficiency improves mortality is warranted.

Increased adiposity, dyslipidemia and insulin resistance are associated with increased risk of developing cardiometabolic diseases (CM). Such deleterious phenotypes have been shown to be associated with a low gene-richness microbiota that can partly be restored by a short-term dietary intervention (energy-restricted high-protein diet, low glycemic index, enrichment with fibers) in parallel to an improvement of CM profile. In this study, we aimed at increasing fiber intake in quantity and diversity through a two-month consumption of bread enriched with a mix of selected fibers and evaluated the impact of this dietary intervention on gut microbiota gene richness and CM risk profile in subjects at risk of developing CM.

In a randomized double blind cross-over design, thirty-nine subjects with CM risk profile (18–70 years old, BMI: 25–35 kg/m2, waist circumference > 80 cm for women and > 96 cm for men, fiber intake < 20g/day, low fiber diversity) consumed daily for 8 weeks 150 g of standard bread vs. 150 g of bread enriched with a 7-selected fibers mix (5.55 g vs. 16.35 g of fiber respectively; 4-week washout). Gut microbiota and CM risk factors’ analyzes were conducted before and after intervention. Stool samples were analyzed by shotgun metagenomics; microbial genes and metagenomics species (MSP) profiles were generated by mapping reads on a reference genes catalog (1529 MSP).

The included dyslipidemic subjects with CM risk profile presented a lower microbiota gene richness compared to reference healthy cohorts. The two-month consumption of fiber-rich bread did not alter microbiota gene richness but modified microbiota composition with a significant decrease of Bacteroides vulgatus (q = 1.7e-4) and a significant increase of Parabacteroides distasonis (q = 2.8e-6), Fusicatenibacter saccharivorans (q = 5e-5) and Clostridiales (q = 3.8e-2). We observed in parallel a significant decrease in total cholesterol (- 0.26 mmol/L; - 5%; p = 0.021), LDL-cholesterol (- 0.2 mmol/L; - 6%, p = 0.0061) and an improvement of insulin sensibility estimated by HOMA index (3.23–2.54 mUI/L; - 21%; p = 0.0079).These effects were even significantly more pronounced for subjects presenting the higher waist circumference. Anthropometric parameters were not altered.

The enrichment of the diet with a mix of selected fibers for 2 months altered microbiota composition by modifying the relative abundance of specific gut bacterial species, in parallel to a significant improvement of cholesterol and insulin sensitivity parameters. Increasing the quantity and diversity of dietary fiber intake could be used as an efficient tool to favorably impact CM profile.

The scientific rationale for the recommendation in dietary fiber (DF) intake comes from the recognition of their health benefits. European Food Safety Authority (EFSA) recommend 25 g/d, based on the amount needed for intestinal laxation. Gut microbiota related health benefits are not yet included in the current dietary recommendations. Appropriate (and consensual) quantitative and qualitative analysis of DF are missing in food composition tables. One of the aim of the FiberTAG(1) project was to develop a dedicated database and a food frequency questionnaire (FFQ) allowing DF intake estimation including prebiotic (oligo)saccharides.

A repertoire of DF detailing total, soluble and insoluble DF in food products consumed in Europe has been established based on the Souci-Fachmann-Kraut database, completed for soluble versus insoluble DF () and for prebiotic (oligo)saccharide levels using published data. The FiberTAG FFQ was submitted to healthy volunteers (7 men, 8 women; mean age: 21 yrs; mean BMI: 22kg/m2) and DF intakes were calculated using the new FiberTAG repertoire.

The FiberTAG repertoire detailed DF in 400 food items allocated into 4 categories (fruits, vegetables, cereal products and others) and 15 subcategories. The fiberTAG FFQ consists in 280 items regrouped in 4 high DF-containing food groups (vegetables including legumes, fruits including nuts and seed, cereal products and others) using frequency scale (6 categories), photographs for portion size and taking into account the seasonal occurrence for some vegetables or fruits. Data obtained from FiberTAG FFQ indicate a total DF intake of 36.44 g/d. This reveals a higher DF intake compared to previously reported intake for adults in Europe ranging from 16 to 24 g/d based on 24 h-recall or 3–7 days records(2). This difference might be explained by a more adequate inclusion of fruits and vegetables intake in FFQ than with other methods, as previously reported(3). Our data also showed that fructan, inulin and fructo-oligosaccharides intakes were 4.18, 2.95 and 1.00 g/day, respectively whereas galacto-oligosaccharides intake was 0.28 g/d.

The new FiberTAG DF repertoire and FFQ are tools to evaluate the total amount of DF including prebiotic (oligo)saccharides ingested by healthy volunteers. The FiberTAG project generates scientific knowledge that helps to take into account microbiota-nutrient interactions to establish DF intake recommendations as part of healthy lifestyles.

For the 11th version of the International Classification of Diseases, the WHO recommended to rename transgender transidentity as “gender incongruence”, to remove it from the chapter of mental and behavioral disorders, and to put it in a new category titled “Conditions related to sexual health”. This should contribute to reduce stigmatisation while maintaining access to medical care. One argument in favor of depsychiatrisation is to demonstrate that essential features of gender identity disorders, namely psychological distress and functional impairment, are not necessarily reported by every transgender person, and may result from social rejection and violence rather than dysphoria itself. Initially confirmed in Mexico, these hypotheses were tested in a specific French medical context, where access to care does not require any prior mental health evaluation or diagnosis.

In 2017, 72 transgender persons completed retrospective interviews which focused on the period when they became aware that they might be transgender and perhaps would need to do something about it.

Results showed that psychological distress and functional impairment were not reported by every participant, that they may result from rejection and violence, and especially from rejection and violence coming from coworkers and schoolmates. Additional data showed that the use of health services for body transformation did not depend on distress and dysfunction. Finally, participants preferred ICD 11 to employ “transgender” or “transidentity” rather than “gender incongruence”.

Results support depsychiatrisation. They are discussed in terms of medical, ethical, legal, and social, added values and implications of depsychiatrisation.

Six healthy women (29.7 ± 1.7 years old, BMI: 23.2 ± 0.9kg/m2, fiber intake: 23 ± 1g/d) consumed in research settings a controlled breakfast containing eight 13C-labelled wheat bran biscuits (50 g of labelled wheat bran, 3.0At%13C). 13C-labelled wheat bran was obtained from wheat cultivated under 13CO2 enriched atmosphere. Samples of expired gases were collected during 24 h after ingestion in order to measure H2 and CH4 by gas chromatography (GC) with piezoelectric detection and 13CO2 and 13CH4 by gas chromatography coupled with an isotope ratio mass spectrometer (GC-IRMS). Apart test breakfast, subjects only consumed standardized meals without fibers.

The analysis of H2 and CH4 24h-kinetic measurements distinguished 2 groups in terms of fermentation related gas excretion: the high-CH4 producers with high baseline CH4 concentrations (42.1 ± 13.7ppm) and low baseline H2 concentrations (7.3 ± 5.8ppm) and the low-CH4 producers with low baseline CH4 concentrations (6.5 ± 3.6ppm) and high baseline H2 concentrations (20.8 ± 16.0ppm). Following the 13C-wheat bran biscuits’ ingestion, postprandial H2 and CH4 concentrations increased more significantly in the high-CH4 producer subjects. 13C enrichment was detectable in expired gases in all subjects. 13CO2 kinetics were similar for all subjects and correspond to the oxidation of the digestible part of the bran. The appearance of 13CH4 was significantly enhanced and prolonged after 180 min in high-CH4 producers compared to low-CH4 producers, suggesting distinct fiber fermentation profile.

This pilot study allowed to consider novel procedures for development of non-invasive breath biomarkers of fiber-gut microbiota interactions. Assessment of expired gas excretion following 13C-labelled fiber ingestion allowed deciphering distinct fermentation profiles: high-CH4 producers vs low-CH4 producers and accordingly provide a related non-invasive breath metabolic signature of the fiber fermentation for each profile. Further gut microbiota and 13C-metabolites analysis will permit to relate the gut bacteria composition with breath gas excretion kinetics according to fiber fermentation profile.

Childhood maltreatment (CM) plays an important role in the development of major depressive disorder (MDD). The aim of this study was to examine whether CM severity and type are associated with MDD-related brain alterations, and how they interact with sex and age.

Within the ENIGMA-MDD network, severity and subtypes of CM using the Childhood Trauma Questionnaire were assessed and structural magnetic resonance imaging data from patients with MDD and healthy controls were analyzed in a mega-analysis comprising a total of 3872 participants aged between 13 and 89 years. Cortical thickness and surface area were extracted at each site using FreeSurfer.

CM severity was associated with reduced cortical thickness in the banks of the superior temporal sulcus and supramarginal gyrus as well as with reduced surface area of the middle temporal lobe. Participants reporting both childhood neglect and abuse had a lower cortical thickness in the inferior parietal lobe, middle temporal lobe, and precuneus compared to participants not exposed to CM. In males only, regardless of diagnosis, CM severity was associated with higher cortical thickness of the rostral anterior cingulate cortex. Finally, a significant interaction between CM and age in predicting thickness was seen across several prefrontal, temporal, and temporo-parietal regions.

Severity and type of CM may impact cortical thickness and surface area. Importantly, CM may influence age-dependent brain maturation, particularly in regions related to the default mode network, perception, and theory of mind.