Beyond BMI: The Synergistic Effect of Ultra-Processed Food Consumption and Sedentary Behavior on Gut Microbiota and Systemic Inflammation in Young Adults with Early Metabolic Syndrome – A Longitudinal Cohort Study

Ian Astarina Mas'ud, Restu Auliani, Erba Kalto Manik, Yan Deivita — Mon, 08 Jun 2026 00:00:00 +0000

Background: Body mass index (BMI) inadequately captures metabolic risks driven by modern lifestyles, particularly the combination of ultra-processed food (UPF) intake and sedentary behavior. While each factor independently fosters low-grade systemic inflammation, their synergistic impact on the gut microbiota–inflammation axis in young adults with early metabolic syndrome (MetS) remains unexplored. Objective: This longitudinal cohort study examined the independent and synergistic effects of UPF consumption and sedentary behavior on gut microbiota composition and systemic inflammatory biomarkers in Indonesian young adults with early MetS over 12 months. Methods: We recruited 400 participants aged 20–30 years meeting 1–2 ATP III criteria for MetS. Dietary intake was assessed with a validated semi-quantitative FFQ with NOVA classification; sedentary time was measured via triaxial accelerometers. Gut microbiota was profiled using 16S rRNA sequencing (V3–V4 region), and hs-CRP, IL-6, and TNF-α were quantified at baseline and 12 months. Participants were stratified into four groups by median splits of UPF energy share (%kcal) and daily sedentary time. Generalized estimating equations tested synergistic interactions on inflammation, and mediation analyses evaluated microbiota diversity pathways. Results: The high-UPF/high-sedentary group exhibited the greatest increases in hs-CRP (+1.78 mg/L), IL-6 (+2.95 pg/mL), and TNF-α (+3.12 pg/mL), with a significant multiplicative interaction (p<0.001). Shannon diversity declined most sharply in the high-UPF/high-sedentary group (−0.32), paralleled by a rise in the Firmicutes/Bacteroidetes ratio (+0.47). Mediation analysis showed that 31.4% of the synergistic effect on hs-CRP was mediated by loss of diversity. Conclusion: Co-occurring high UPF consumption and sedentary behavior synergistically amplify systemic inflammation partly through gut dysbiosis in early MetS, underscoring the need to target both dietary and physical activity domains beyond BMI-centric strategies

Nursing Analysis of SEFT and PC6 Acupressure in Reducing Anxiety in Stemi Patients

Fitri Fitri, Zulmah Astuti, Ulfatul Muflihah, Dwi Widiyastuti — Sat, 13 Jun 2026 00:00:00 +0000

Anxiety is one of the most common psychological responses experienced by patients with ST-Elevation Myocardial Infarction (STEMI) during hospitalization in the Intensive Cardiac Care Unit (ICCU), which may affect physiological stability and the recovery process. Therefore, supportive non-pharmacological nursing interventions are needed to help manage anxiety. This study aimed to analyze nursing practice through the application of the Spiritual Emotional Freedom Technique (SEFT) and PC6/Neiguan acupressure on anxiety levels in patients with STEMI. A case analysis was conducted on two patients with STEMI in the ICCU using a nursing care approach. The first patient received standard care combined with SEFT and PC6/Neiguan acupressure interventions, while the second patient received standard care only. Anxiety levels were measured using the State–Trait Anxiety Inventory (STAI). The patient who received SEFT and PC6/Neiguan acupressure experienced a reduction in anxiety level from moderate anxiety to no anxiety, while the patient who received standard care only did not show any reduction in anxiety level and remained in the moderate anxiety category. The application of SEFT and PC6/Neiguan acupressure in nursing practice was associated with reduced anxiety levels in patients with STEMI and may serve as supportive nursing therapies within a holistic nursing care approach for cardiovascular patients

International Journal of Public Health Excellence (IJPHE)

Beyond BMI: The Synergistic Effect of Ultra-Processed Food Consumption and Sedentary Behavior on Gut Microbiota and Systemic Inflammation in Young Adults with Early Metabolic Syndrome – A Longitudinal Cohort Study

Nursing Analysis of SEFT and PC6 Acupressure in Reducing Anxiety in Stemi Patients