BACKGROUND:Metabolic syndrome (MetS) is a significant public health issue in Chile, affecting approximately 40 % of the adult population and increasing the risk of chronic diseases. Although evidence from Mediterranean countries has shown benefits of the Mediterranean diet (MedDiet) improving metabolic parameters and reversing MetS, its impact in non-Mediterranean populations remains unclear. AIM:The CHILEan MEDiterranean (CHILEMED) study is evaluating MetS reversal effectiveness of a MedDiet, with or without well-being support, compared to a low-fat diet. METHODOLOGY:CHILEMED is an ongoing 1-year, parallel-group randomized controlled trial, and this report presents an interim analysis with preliminary findings at 6 months of follow-up. A total of 246 participants (men and women, middle-aged, with comparable baseline cardiometabolic risk profiles) diagnosed with MetS have been assigned to low-fat diet (control), MedDiet, or MedDiet with psychological well-being interventions. Participants received face-to-face and online nutritional counseling specific to their assigned dietary intervention. Clinical assessments, including anthropometry, biochemical parameters, and dietary adherence, were performed at baseline and 6 months. The primary outcome was MetS reversal, while secondary outcomes included changes in dietary adherence and MetS components. RESULTS:Preliminary analyses of 156 participants completing the 6-month follow-up showed a significantly greater increase in MedDiet adherence in the combined MedDiet (with and without psychological well-being intervention) groups compared with the low-fat diet group. Participants in the MedDiet group exhibited greater reduction in waist circumference, triglycerides, and glucose levels compared to the low-fat diet group. Notably, 36 % of individuals in the MedDiet intervention experienced MetS reversal, compared to only 11 % in the low-fat diet group (p < 0.01), with an adjusted hazard ratio of 3.84 for MetS reversal in the MedDiet versus the control group. CONCLUSIONS:These preliminary 6-month results from the ongoing 1-year randomized CHILEMED trial provides evidence supporting MedDiet's effectiveness in improving metabolic health and reversing MetS in Chilean adults. Given changing dietary patterns and rising prevalence of MetS-related conditions, promoting adherence to MedDiet may be a key strategy for chronic disease management and public health policies in Chile.

There has been growing attention on the role of functionality in older adults, as diseases become less lethal and more chronic over time. While lower cognition and poorer physical health are well-established predictors of mortality risk, less is known about their combined effects. This study examines mortality risks across dual functionality, assessed by cognition and physical functioning, among adults aged 60 and older using data from Midlife in the U.S. (MIDUS) (N = 1,578). Cognition and physical functioning were assessed at MIDUS III (2013-2014) via Brief Test of Adult Cognition by Telephone (BTACT) and SF-36. Mortality data were obtained via National Death Index 2023 files. Dual functionality groups were identified based on quartiles of cognitive and physical functioning: Both High (n = 245), Both Mid (n = 445), Both Low (n = 494), Cognition High–Physical Low (n = 170), and Cognition Low–Physical High (n = 224). Results from Cox proportional hazard models showed that imbalance between cognitive and physical functionality predicted greater mortality risks, compared to Both High or Both Mid functioning. Specifically, mortality risks were significantly greater in Cognition High–Physical Low (HR = 3.06; 95% CI = 1.52–6.16) and Cognition Low–Physical High (HR = 3.91; 95% CI = 1.95–7.85) groups, compared with Both High group, and somewhat comparable with Both Mid group (HR = 2.59; 95% CI = 1.35-4.97). Further, the detrimental effects of imbalanced functionality on mortality risks were observed regardless of educational attainment. The findings suggest substantial impacts of imbalanced functionality on mortality risks. It warrants future studies to examine the pathways through which imbalanced functionality increases mortality, which can shed light on possible interventions.

The present study investigated different types of participation in the musical arts and linked them to self-rated mental and physical health. Of central interest was whether such participation mediated or moderated links between race/ethnicity and health. The work was conducted with a subsample (N = 2,157) of the Midlife in the U.S. (MIDUS) Refresher study who completed a self-administered questionnaire about the arts in 2021-22 (63.5% response rate). Assessments included various forms of active music engagement as well as receptive music appreciation. Overall, Black participants were more engaged in varieties of music and performance (singing, dancing, creating) than White participants. Black participants also consumed (appreciated) more jazz, salsa, theatre, dance than White participants. Hispanic participants showed generally similar patterns of music appreciation as Black participants. Mediation analyses showed that the higher active music engagement of Black compared to White individuals was linked with better mental and physical health. Higher receptive music appreciation was not a mediator of race differences in mental and physical health and there was no support for moderation effects. Overall, the findings draw attention to race/ethnicity in considering how participation in the musical arts matter for health and underscore the need for more diverse measures of arts participation, along with quality assessments of mental and physical health tracked longitudinally.

Numerous studies document associations between childhood socioeconomic status (SES) and adult health, but less is understood about how macroeconomic context shapes these links. The current study examined whether income and income inequality measured at the state level moderated the association between parent education and functional limitations in a national sample of adults. Time-series economic data, derived from tax records (1917-2014), were merged with Midlife in the United States Study (MIDUS) data (N = 10,685; Mean age = 47.7, SD = 13.6; 51 % female) by state/year to assess economic conditions during four life stages: childhood (0-15), emerging adulthood (20-25), early adulthood (ages 30-35), and midlife (ages 40-45). Results showed that higher state mean income (at all four ages of exposure) was associated with fewer adult functional limitations. Childhood exposure to higher state-level income inequality (but not later periods) predicted more adult functional limitations. Childhood SES-adult health associations weakened with higher state income during childhood (B = 0.023, p = .018) and emerging adulthood (B = 0.036, p = .026), but not in later stages. Income inequality did not moderate SES-health links. Findings suggest that the impact of childhood SES on adult health varies by state economic context, particularly mean income, with effects dependent on exposure timing. Notably, childhood income inequality also independently predicted worse health outcomes, irrespective of state income. Future directions and policy implications are discussed.

A central objective of MIDUS is to study human development as an integrative process that links sociodemographic factors with experiential and psychosocial factors as well as biological factors and health. Such multidisciplinary science is illustrated with decades of research on a eudaimonic model of psychological well-being. First noted are studies showing how well-being is contoured by demographics, such as age, gender, race, and educational status. Other inquiries used aspects of well-being to predict stress hormones, inflammatory markers, and cardiovascular risk factors as well as chronic conditions (morbidity) and length of life (mortality). Still other studies have investigated well-being as mediators or moderators (intervening pathways) between indicators of inequality and health, broadly defined. A final group of studies have probed underlying mechanisms, such as how well-being is linked with brain processes (reward circuitry, amygdala activation, volumetric measures) or genomics (gene expression, epigenetic age acceleration). The historical stage on which MIDUS has unfolded has brought further emphasis to widening inequality, which is compromising the well-being of disadvantaged segments of the population. These problems have been exacerbated by hardships of the Great Recession, and more recently, hardships of the COVID-19 pandemic. Critical questions going forward are whether and how such cumulative hardships combined with persistently low well-being will compromise the health and longevity of less educated adults.

Long-term trajectories of psychological well-being were investigated using data from a national longitudinal study known as MIDUS (Midlife in the U.S.) The central question was whether educational status and age were associated with gains, losses, or persistent disadvantage on widely studied dimensions of eudaimonic well-being such as personal growth, purpose in life, and self-acceptance. Findings from a sample of adults (N = 6908), aged 25-74 at baseline, showed primarily loss across the 20-year period (1995-2015). Those with a high school education or less showed persistently lower levels of six distinct aspects of well-being compared to those with more education across time. In addition, purpose in life declined for all age groups. Losses over time for autonomy, environmental mastery, and personal growth were steeper for the oldest age group (i.e., 61 years and older) compared to younger (i.e., 40 years and younger) and midlife (i.e., 41-60 years) adults, while losses for self-acceptance were steepest for young adults compared to the two older age groups. The role of structural inequalities in understanding variation in these well-being trajectories and their implications for future health are considered.

OBJECTIVE:Cellular epigenetic aging has become an important marker of healthy or unhealthy aging. The current study examined whether lifelong cumulative stressors across multiple domains were linked with epigenetic age acceleration (EAA; i.e., epigenetic age greater than chronological age) and whether psychological factors moderated this association. Dimensions of psychological well-being were hypothesized as protective factors, while neuroticism was posited as a vulnerability factor. METHOD:Data from the Midlife in the United States (MIDUS) Genomics Project (N = 1,006) were used, which include deoxyribonucleic acid methylation data from a subset of participants in MIDUS Core Wave 2 and MIDUS Refresher Wave 1. Epigenetic aging values were calculated using the deoxyribonucleic acid methylation profiles at cytosine-phosphate-guanine sites. Cumulative stressors and psychological factors were assessed using the survey data at MIDUS Core Wave 2 and MIDUS Refresher Wave 1. RESULTS:The results revealed that cumulative stressors were not directly associated with EAA but were contingent on the levels of psychological well-being and neuroticism. Specifically, higher levels of cumulative stressors were significantly linked to EAA, measured by GrimAge2, among those who had lower levels of psychological well-being (β = -.23 to -.36, SE = .12 to .13, p = .04 to < .01) or higher neuroticism (β = .26, SE = .12, p = .03). Conversely, EAA in individuals who had higher levels of psychological well-being or lower neuroticism was not impacted by the levels of cumulative stressors. CONCLUSIONS:The findings underscore the importance of considering individual psychological assets and vulnerabilities in the pathways linking cumulative stressors to epigenetic aging. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The experience of discrimination can have significant health implications, especially during a global pandemic. This study examines how lifetime discrimination, educational attainment (measured in years of education), and family support individually and interactively predict COVID-19 vaccine uptake. Low educational attainment may amplify the impact of discrimination due to increased vulnerability to misinformation. Conversely, family support can buffer the negative effects of discrimination on health behaviors by mitigating how stressors adversely influence health decisions. We utilized national data from the Midlife in the United States (N = 2004; aged 25-74). The results showed that although lifetime discrimination did not predict vaccine uptake, interaction analyses revealed that lifetime discrimination, in combination with higher educational attainment predicted lower vaccine uptake. In addition, family support moderated the relationship between lifetime discrimination and vaccine uptake, buffering its negative impact. These findings highlight the complex interplay of factors influencing COVID-19 vaccination decisions.

IntroductionA greater sense of purpose in life is associated with several health benefits relevant for active aging, but the mechanisms remain unclear. We evaluated if purpose in life was associated with indices of brain health.MethodsWe examined data from the Midlife in the United States (MIDUS) Neuroscience Project. Diffusion weighted magnetic resonance imaging data (n=138; mean age 65.2 years, age range 48-95; 80 females; 37 black, indigenous, and people of color) were used to estimate microstructural indices of brain health such as axonal density, and axonal orientation. The seven-item purpose in life scale was used. Permutation analysis of linear models was used to examine associations between purpose in life scores and the diffusion metrics in white matter and in the bilateral hippocampus, adjusting for age, sex, education, and race.Results and discussionGreater sense of purpose in life was associated with brain microstructural features consistent with better brain health. Positive associations were found in both white matter and the right hippocampus, where multiple convergent associations were detected. The hippocampus is a brain structure involved in learning and memory that is vulnerable to stress but retains the capacity to grow and adapt through old age. Our findings suggest pathways through which an enhanced sense of purpose in life may contribute to better brain health and promote healthy aging. Since purpose in life is known to decline with age, interventions and policy changes that facilitate a greater sense of purpose may extend and improve the brain health of individuals and thus improve public health.

Happiness has been empirically studied since the middle of the last century. This chapter provides a historical overview of decades of prior research, beginning with the social indicators movement in the 1950s, which advocated for augmenting economic indicators of how the U.S. was doing with subjective indicators of life quality, such a life satisfaction and positive and negative affect. Social gerontology emerged during the same period and focused on life satisfaction and morale as key indicators of successful aging. During the 70s, 80s, and 90s psychologists, working with smaller, nonrepresentative samples brought new topics to the study of subjective well-being (SWB), such how it is influenced by personality characteristics, goals, and coping strategies. These studies maintained the focus, largely atheoretical, on life satisfaction and affect as key indicators of happiness. A theory-guided perspective, built on the integration of ideas from clinical, developmental, existential, and humanistic psychology, along with insights from Aristotle, emerged in the 1990s. This eudaimonic formulation focused on different indicators of happiness, such as purposeful life engagement and personal growth. Since the turn of the century, there has been a return to population-based inquiries that assess both hedonic and eudaimonic aspects of well-being. Illustrative findings are summarized, concluding with emphasis on recent historical events (Great Recession, COVID-19 pandemic), which are undermining the well-being of disadvantaged segments of society.

This article provides an overview of a model of psychological well-being put forth over 30 years ago. The intent was to advance new dimensions of positive functioning based on integration of clinical, developmental, existential, and humanistic thinking along with Aristotle's writings about eudaimonia. The operationalization and validation of the model are briefly described, followed by an overview of scientific findings organized around (a) demographic and experiential predictors of well-being, (b) well-being as predictors of health and biomedical outcomes, (c) pathway studies that examine intervening processes (moderators, mediators), and (d) underlying mechanistic processes (neuroscience, genomics). Much prior work underscores the benefits of well-being, including for longevity. Widening socioeconomic inequality is, however, increasingly compromising the well-being of disadvantaged segments of the population. These problems have been exacerbated by recent historical stressors (Great Recession, COVID-19 pandemic). Cumulative hardships from these events and their implications for health are critical targets for future science and practice.

Background: The aim of this study was to identify the blood lipidomic profile associated with a healthy eating pattern in a middle-aged US population sample and to determine its relationship with metabolic disorders and cardiovascular risk (CVR). Methodology: Self-reported information about diet and blood samples were obtained from 2114 adult participants in the Midlife in the United States study (MIDUS). Food intake data were used to design a Healthy Diet Index (MIDUS-HEI) and to evaluate the predictive value by examining its association with health variables. The associated lipid signature (HEI-LS) was constructed using Lasso regression, from lipidomic data (LC/MS). Associations between HEI-LS, cardiometabolic biomarkers, and estimated CVR were assessed using multiple linear regression. Results: MIDUS-HEI score was a robust indicator of dietary quality and inversely associated with body mass index (p < 0.001) and metabolic syndrome (p = 0.012). A lipidomic signature comprising 57 distinct lipid species was highly correlated with the MIDUS-HEI score (r = 0.39, p < 10⁻16). It was characterized by lower levels of saturated fatty acid and adrenic acid (n-6) and higher levels of docosahexaenoic acid (n-3). Healthier HEI-LS scores were strongly associated with better cardiometabolic indicators and lower estimated CVR (OR 0.89 CI 95% 0.87–0.91). Conclusions: The MIDUS-HEI effectively assessed dietary quality, confirming the link between poor diet quality and metabolic disorders in American population. Lipidomic profiling offered an objective assessment of dietary patterns and provided insights into the relationship between diet quality, metabolic responses, and CVR. This approach supports precision nutrition strategies for at-risk populations.

Abstract The death of a child is a highly traumatic event that may impact the subsequent health of parents. Prior research shows greater risk of early deaths in bereaved parents relative to non-bereaved parents. This study examined whether the associations between the death of a child and parents’ mortality risk are mediated by subjective cognitive decline (SCD), known to be predictive of mortality and Alzheimer’s disease, contingent on parents’ age. The analytic sample consists of participants in Midlife in the U.S. (MIDUS) waves II and III (2004-2005, 2013-2014, respectively); parents who experienced the death of a child prior to MIDUS II (n=341) and non-bereaved parents who did not experience the death of a child (n=2,219). SCD was assessed at MIDUS III and mortality data were obtained via National Death Index 2022 files. Results of moderated mediation analysis revealed significant mediation effects of SCD between death of a child and parental mortality risks over time among parents who were aged 65 and older at SCD assessment, but not among parents who were younger than 65. Bereaved parents who reported a decline in memory at age 65 or older had greater risks of mortality over 8-9 years relative to their counterparts. Findings suggest that increased risks of mortality in bereaved parents during old age can be detected by a relatively simple assessment of SCD, which can be utilized to screen vulnerable bereaved parent groups who may benefit from interventions to mitigate detrimental impacts of bereavement on mortality risks.

BackgroundType 2 diabetes (T2D) has become a worldwide pandemic. While ceramides may serve as intermediary between obesity-related lipotoxicity and T2D, the relationship with simple glycosphingolipids remains uncertain. The aim of this study was to characterize the associations between blood glycosphingolipid and ceramide species with T2D and to identify a circulating sphingolipid profile that could serve as novel biomarker for T2D risk.MethodsCross-sectional relationship between sphingolipid levels, insulin resistance, and T2D prevalence were evaluated in 2,072 American adults from MIDUS cohort. Prospectively, the association between sphingolipid species and the incidence of T2D was analyzed using a case-cohort design nested within the PREDIMED trial (250 cases and a random sample of 692 participants, with 3.8 years of median follow-up). Circulating levels of sphingolipid species in both populations were measured using LC/MS. Hazard ratios were estimated with weighted Cox regression models using Barlow weights.ResultsIn American adults, only CER18:0 and CER22:0 were linked to insulin resistance and a higher prevalence of T2D. Conversely, three lactosylceramides (LCER 14:0, 16:0, and 24:1) showed a strong inverse relationship with both insulin resistance and T2D. These findings led to development of two sphingolipid scores. In the prospective analysis, these scores consistently predicted a reduced risk of T2D incidence in PREDIMED (HR: 0.64, 95% CI 0.44 to 0.94 and 0.58, 0.40 to 0.85 respectively) between extreme quartiles, with 5-year absolute risk differences of 9.6% (95% CI: 0.3-20.5%) and 11.4% (1.0-21.6%). They were validated in the same trial with samples obtained after 1 year of follow-up.ConclusionsOur findings support the potential usefulness of circulating sphingolipid profiles as novel biomarkers for T2D risk. Moreover, this study opens the door for future research on the predictive value and possible protective roles of lactosylceramides in T2D.

Public Significance Statement The results of this study suggest notable shifts in experiences of discrimination and social isolation during the COVID-19 pandemic. In particular, the findings indicate that Black young adults experienced increases in discrimination, which exacerbated Black-White racial disparities in social isolation. Determining the degree to which the reported changes are enduring, evident in other demographic groups, and of longer term developmental and public health significance will be important next steps to inform a continuing pandemic response, and responses to future societal-level stressful events. Objective: The objective of this study was to examine whether experiences of discrimination have increased during the pandemic, particularly among negatively stigmatized racial/ethnic groups, and whether such experiences have exacerbated feelings of social isolation. Method: Discrimination and social isolation were assessed before and during the pandemic in a sample of 263 Black and White young adults attending a large, predominantly White 4-year research university in the Southeastern region of the United States (52% Black, 48% White, 53% female, mean age = 19.2). Results: Increases in discrimination were evident among Black but not White participants. Black participants also reported greater increases in social isolation than White participants, and changes in discrimination partially mediated the emergent racial disparity in social isolation. Conclusions: Findings are consistent with theoretical perspectives on discrimination during times of stress and suggest the need for broader attention to the impact of the pandemic on unfair treatment of stigmatized groups.

Enduring heroism defined as persistent efforts to confront inequality and injustice is the focus of this article. Six exemplars are considered: Harriet Tubman, Crazy Horse, Jane Addams, Mohandas Gandhi, Nelson Mandela, Malcolm X. Similarities and differences in their pursuits are considered and linked to the larger literature on heroism. They are also contrasted with enduring anti-heroes to elevate roles of virtue and benevolence in long-term efforts to correct societal ills. What motivates enduring heroism is a central question. A hypothesis put forth is that distinct dimensions of eudaimonic well-being - especially, purpose in life, autonomy, environmental mastery, and personal growth - may be key elements that fuel efforts of enduring heroes. A final section underscores the need for such individuals in our era, drawing on wide-ranging evidence that inequality and injustice are worsening and have been exacerbated by major historical events (Great Recession, COVID-19 pandemic). Now more than ever enduring heroes are needed to help redress the enormous suffering around us.

Historically, mental health research and practice has focused primarily on mental illness or distress. In such a framework, health usually means the absence of the negative. It is increasingly recognized, however, that mental health must also encompass the presence of the positive. One aspect of positive functioning receiving growing attention is purposeful life engagement: perceiving that one's life has direction and meaning. The conceptual and philosophical foundations of this aspect of well-being are examined, followed by a look at select empirical findings, including how purpose in life is linked in beneficent ways to multiple aspects of health (biological risk factors, preventive health behaviors, brain-based regulation of emotion, morbidity, and mortality). Such evidence underscores the need to sharpen understanding of factors that undermine or nurture purpose in life. Growing inequality is an obstacle to purposeful engagement that brings social structural influences on mental health to the fore. Alternatively, the arts and humanities, increasingly studied for their positive effects on health, are influences that may help cultivate life purpose and direction. Unique among mental health indicators, purposeful life engagement invokes virtue and ethics, thereby elevating issues of social justice and responsibility that need attention in our current world.