We aimed to relate circulating plasma zinc and copper to a broad spectrum of adiposity-related traits in a cross-sectional Northern German study (n = 841, 42% female, age: 61 ± 12 years). Zinc and copper were measured by inductively coupled plasma–mass spectrometry. Subcutaneous (SAT) and visceral (VAT) adipose tissue and liver fat were derived from 534 and 538 participants, respectively, via magnet resonance imaging. Associations were assessed using multivariable-adjusted linear regression analysis. An increase per one standard deviation (SD) in zinc was associated with direct linear increases in body mass index (BMI) (1.17%; 95% confidence interval (95%CI) 0.15–2.20%), waist circumference (0.85%; 95%CI 0.04–1.67%) and waist-to-hip ratio (0.64%; 95%CI 0.18–1.09%). A 1-SD increment in copper was directly associated with BMI (1.64%; 0.41–2.88%) and waist circumference (1.22%; 95%CI 0.25–2.20%) but not waist-to-hip ratio. Independent of fat intake, zinc displayed associations with VAT (5.73%; 95%CI 2.04–9.56%) and with liver fat (3.84%; 95%CI 1.49–6.25%), the latter association being also independent of BMI. Copper was directly associated with SAT (4.64%; 95%CI 0.31–9.15%) before accounting for BMI, but showed no association with VAT or liver fat. Observed associations suggest a possible relevance of zinc and copper to adiposity. Particularly zinc displayed associations with traits of abdominal adiposity and liver fat.

Purpose: Dietary pattern scores reflecting a high intake of beneficial food groups were associated with reduced mortality risk. Data on associations of such dietary pattern scores in population-based samples from northern Germany are lacking. Therefore, we examined the association of three dietary pattern scores with all-cause mortality in a moderate-sized prospective sample from northern Germany. Methods: The study sample comprised 836 participants (43.8% females, median age 62.4 years). Based on a validated, self-administered Food Frequency Questionnaire, the dietary scores Dietary Approaches to Stop Hypertension (DASH), Modified Mediterranean Diet Score (MMDS), and Healthy Nordic Food Index (HNFI) were calculated. Cox proportional hazard regression models, adjusted for age, sex, body mass index, waist to hip ratio, education, smoking status, total energy intake, and physical activity, were used to separately relate DASH, MMDS, and HNFI to all-cause mortality. Results: During a median follow-up period of 11 years, 93 individuals died. While DASH and MMDS scores were not associated with all-cause mortality, greater adherence to HNFI was associated with lower mortality hazards (HR: 0.47 [95% CI 0.25–0.89] when comparing the highest score quartile to the lowest; HR: 0.79 [95% CI 0.64–0.98] for HNFI modeled as a 1-Standard Deviation increment). Among different HNFI components, higher intake of oats and cereals displayed the most conclusive association with all-cause mortality (HR: 0.59 [95% CI 0.38–0.91] when comparing high and low intake). Conclusion: In an elderly general population sample from northern Germany, we observed greater adherence to HNFI to be associated with lower all-cause mortality.

Background: Holo-Transcobalamin (holo-TC) is the biologically active form of vitamin B12, an essential vitamin that is only contained in animal derived food products. While severe vitamin B12 deficiency has well known clinical consequences, the relation of holo-TC within the physiological range to various metabolic and lifestyle parameters in the general population is largely unknown. Objective: We aimed to identify cross-sectional metabolic, lifestyle, and dietary correlates of serum holo-TC in a population-based sample. Methods: Serum holo-TC was measured by electro-chemiluminescence in n = 788 individuals (44.0% females, age 61.3 [52.8; 70.2] years). Significant metabolic and lifestyle correlates of serum holo-TC were identified in a backward selection process and included in a final linear regression model. We used a validated Food Frequency Questionnaire to determine daily dietary intake of dairy products, eggs, fish and seafood, and meat and meat products. Associations of food group intake with holo-TC were tested in multivariable-adjusted analyses, both continuously by linear regression models and across holo-TC tertiles by ANCOVA. Results: Median serum holo-TC was measured at 83.6 [66.9; 115.2] pmol/L. We identified a 10% increase in alanine aminotransferase, total cholesterol, diastolic blood pressure, or alcohol consumption to confer a 2.03% [1.46; 2.60], 4.58% [1.79; 7.45], −2.66% [−4.78; −0.48], or −0.25% [−0.45; −0.05] change in serum holo-TC, respectively. Compared to no supplementation, vitamin B complex supplementation conferred 19.59% [9.72; 30.34] and females compared to males showed 11.55% [5.38; 18.08] higher serum holo-TC levels. Furthermore, a higher consumption of dairy products (in males and females) and fish and seafood (in males) was associated with significantly higher levels of serum holo-TC. Conclusions: Vitamin B complex supplementation, dairy products and fish and seafood were identified as major sources of vitamin B12 uptake being reflected in serum holo-TC. Furthermore, sex, total cholesterol, a biomarker of liver function, diastolic blood pressure, and alcohol consumption were associated with serum holo-TC in the northern German population.

Purpose: Higher dietary intake or higher circulating levels of the trace element boron have been associated with beneficial effects on human health. However, the relationship between plasma boron levels and survival in the general population is not known. Therefore, we aimed to assess the association between plasma boron concentrations and all-cause mortality in a population-based cohort from northern Germany (n = 863 individuals; median age 62.3 years, 42.8% women). Methods: Plasma boron concentrations (median 31.9 µg/L [22.9; 43.5]) were measured by inductively coupled plasma-mass spectrometry. Cox proportional hazards regression models adjusted for relevant confounders were used to associate plasma boron concentrations with all-cause mortality. Results: After a median follow-up time of 11 years, n = 99 individuals had died. In the overall sample, plasma boron concentrations were associated with all-cause mortality in the crude model (HR: 1.07 [95% CI 1.03–1.11] per 5-unit-increment). However, multivariable adjustment rendered the association non-significant (HR: 1.03 [95% CI 0.99–1.07]). Sex-stratified analyses revealed slightly higher mortality hazards with increasing plasma boron concentrations in women (HR: 1.11 [95% CI 1.03–1.18], p_Interaction = 0.034), but not in men (HR: 1.00 [95% CI 0.95–1.06]). Conclusion: We conclude that in a moderate-sized sample from the general population, higher plasma boron concentrations were associated with a higher risk of all-cause mortality in women, but not in men. Due to the low number of events in the female subsample (n = 27), this observation has to be interpreted with caution.

Frailty, defined as increased vulnerability to stressors and impaired recovery of homeostasis, poses a major health challenge among older and multimorbid adults. Frailty is also observed in middle-aged and disease-free adults, though evidence remains scarce. Understanding the physiological characteristics of frail individuals free of chronic diseases may inform about the underlying mechanisms of frailty and its clinical management. We assessed frailty in a large disease-free middle-aged cohort and examined the associations of markers of physiological function with frailty. We analyzed data from 117,163 middle-aged adults (mean age 53.9 ± 8.0 years) free of known chronic conditions from the UK Biobank. Associations between frailty status (robust, prefrail, frail; defined using the Fried Frailty Phenotype) and 29 physiological markers were examined using multinomial logistic regression adjusted for sociodemographic and lifestyle factors. Overall, 1,293 (1.1%) participants were frail and 38,401 (32.8%) prefrail. Anthropometric measures (body fat % waist-to-hip ratio), triglycerides, some markers of hepatic (gamma-glutamyl transferase, alkaline phosphatase) and renal function (cystatin C), glucose metabolism (HbA1c), inflammation (hsCRP), and white blood cell count including leukocyte and neutrophil count and the neutrophil-to-lymphocyte ratio were directly associated with frailty. In contrast, blood pressure, lung function markers (FEV1, FVC), other hepatic (aspartate aminotransferase, bilirubin) and renal markers (creatinine and creatinine-to-cystatin C ratio), and the endocrine marker IGF-1 were inversely associated with frailty. Associations were generally similar but weaker for prefrailty. Frailty in disease-free middle-aged adults was associated with multisystem physiological alterations resembling those observed in older and multimorbid populations, suggesting early physiological dysregulation preceding clinically manifest chronic disease. Graphical Abstract

Background: Insufficient physical activity is a leading global cause of premature mortality, yet how light-, moderate-, and vigorous-intensity activity differ in their associations with mortality and the implications of reallocating time across intensities remain unclear. Methods: We prospectively analysed individually pooled baseline device-measured physical activity from 147,414 participants aged 40–74 years in the German National Cohort (NAKO) and UK Biobank, the largest pooled accelerometer dataset to date. Multivariable Cox models estimated hazard ratios (HR) and 95% confidence intervals (CI) for mortality across activity intensities and under time-reallocation models holding total active time constant. Results: Over a mean follow-up of 7.9 years, 5,545 deaths occurred. Compared with no activity, 150 min per week of moderate-intensity activity was associated with lower mortality (HR: 0.70; 95% CI: 0.67, 0.72). Similar associations were observed for approximately 510 min per week of light-intensity activity or 12 min per week of vigorous-intensity activity. Additional activity beyond these levels was associated with further risk reduction. Replacing 15–60 min per week of light- or moderate-intensity activity with vigorous-intensity activity was associated with 18–30% lower mortality risk. Conclusions: Physical activity at all intensities was associated with lower mortality, with vigorous-intensity activity showing strong inverse associations even at low volumes. Shifting modest amounts of active time toward higher intensities was associated with further risk reductions. These findings provide quantitative evidence to inform the interpretation of physical activity recommendations.