Seven years running: Blount County AMR receives national stroke and cardiac care recognition

So, 7 years of incompetence in not moving from 'care' to RECOVERY?

This is the whole problem in stroke enumerated in one word; 'care'; NOT RECOVERY!

If your hospital is touting 'care' it means they are a failure because they are delivering 'care'; NOT RECOVERY! I would never go to a failed hospital!

YOU have to get involved and change this failure mindset of 'care' to 100% RECOVERY! Survivors want RECOVERY, NOT 'CARE'!

I see nothing here that states going for 100% recovery! You need to create EXACT PROTOCOLS FOR THAT!

ASK SURVIVORS WHAT THEY WANT, THEY'LL NEVER RESPOND 'CARE'! This tyranny of low expectations has to be completely rooted out of any stroke conversation! I wouldn't go there because of such incompetency as not having 100% recovery protocols!

RECOVERY IS THE ONLY GOAL IN STROKE! 

GET THERE!'

Seven years running: Blount County AMR receives national stroke and cardiac care recognition

Blount County’s American Medical Response division received the American Heart Association’s highly-coveted Gold Achievement award for excellence in cardiac and stroke-related emergency care(NOT RECOVERY!) Thursday.

Mission: Lifeline EMS is a part of the AMA’s Get with the Guidelines Program, an in-hospital, care(NOT RECOVERY!) improvement program which provides health professionals with enhanced technical, financial and educational support. Lifeline EMS specifically recognizes those organizations which meet or exceed the AMA’s in-field emergency treatment guidelines. To achieve a Gold ranking, an EMS provider has to have achieved an aggregated annual compliance rating of at least 75% across eight different standards.

This marks the seventh year in a row that Blount County AMR crews have been recognized at the national level for providing critical rapid response at or above AMA standards which regulate how fast a suspected heart-attack or stroke should be identified, medications administered and hospital personnel informed ahead of patient arrival.

“Our crews do truly great jobs responding in a timely manner and staying educated on the latest and greatest care(NOT RECOVERY!) standards,” said Blount County AMR Clinical Director Chris McClain. “We operate with two key mantras in mind: time is muscle, and time is brain. It’s crucial we’re identifying cardiac events and strokes quickly to minimize loss of heart muscle or neurons, and I’d say we have some of the best at that.”

In 2024, Blount County AMR responded to nearly 900 stroke and cardiac emergencies. With such volume, McClain said it’s imperative to keep crews fully staffed on full-time schedules and offer weekly training opportunities.

“You look just about anywhere in the country, most EMS organizations are understaffed,” said McClain. “And that’s when you start getting into burnout territory.”

To help combat that, Blount County AMR maintains a consistent training program which takes people “off the street” and gives them on-the-job training toward various certifications. This doesn’t just apply to AMR employees, either; the organization, McClain said, provides emergency first response and paramedic training to several of the area fire and police departments so that no matter who arrives first, there’s almost guaranteed to be someone with a level of aid training.

Internally, Blount County AMR also offers weekly training reviews on Sundays aimed at reinforcing foundational knowledge and introducing new practices.

Meritus Medical Center recognized for stroke care

 

This is the whole problem in stroke enumerated in one word; 'care'; NOT RECOVERY!

If your hospital is touting 'care' it means they are a failure because they are delivering 'care'; NOT RECOVERY! I would never go to a failed hospital!

YOU have to get involved and change this failure mindset of 'care' to 100% RECOVERY! Survivors want RECOVERY, NOT 'CARE'!

I see nothing here that states going for 100% recovery! You need to create EXACT PROTOCOLS FOR THAT!

ASK SURVIVORS WHAT THEY WANT, THEY'LL NEVER RESPOND 'CARE'! This tyranny of low expectations has to be completely rooted out of any stroke conversation! I wouldn't go there because of such incompetency as not having 100% recovery protocols!

RECOVERY IS THE ONLY GOAL IN STROKE! 

GET THERE!'

Meritus Medical Center recognized for stroke care

Meritus Medical Center has received the American Heart Association’s Get With The Guidelines – Stroke Gold Plus quality achievement award for its commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines, ultimately leading to more lives saved and reduced disability.

Stroke is the No. 5 cause of death and a leading cause of disability in the U.S. A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts. When that happens, part of the brain cannot get the blood and oxygen it needs, so brain cells die. Early stroke detection and treatment are key to improving survival, minimizing disability and accelerating recovery times.

Get With The Guidelines puts the expertise of the American Heart Association and American Stroke Association to work for hospitals nationwide, helping ensure patient care(NOT RECOVERY!) is aligned with the latest research- and evidence-based guidelines. Get With The Guidelines – Stroke is an in-hospital program for improving stroke care(NOT RECOVERY!) by promoting consistent adherence to these guidelines, which can minimize the long-term effects of a stroke and even prevent death.

“Meritus Medical Center is committed to improving patient care(NOT RECOVERY!) by adhering to the latest treatment guidelines,” said Carrie Adams, Pharm.D., hospital chief operating officer. “Get With The Guidelines provides evidence-based guidelines and our team excels implementing these for better outcomes. The end goal is to ensure more people in the region can experience longer, healthier lives.”

Each year, program participants qualify for the award by demonstrating how their organization has committed to providing quality care(NOT RECOVERY!) for stroke patients. In addition to following treatment guidelines, Get With The Guidelines participants also educate patients to help them manage their health and recovery at home.

“We are incredibly pleased to recognize Meritus Medical Center for its commitment to caring for patients with stroke,” said Steven Messe, M.D., volunteer chair of the American Heart Association Stroke System of Care Advisory Group. “Participation in Get With The Guidelines is associated with improved patient outcomes, fewer readmissions and lower mortality rates — a win for health care systems, families and communities.”

In addition, Meritus received the American Heart Association’s Target: Stroke Honor Roll Advanced Therapy award by meeting specific criteria that reduce the time between an eligible patient’s arrival at the hospital and treatment to remove the clot causing the stroke.(That's only the first step; WHAT ARE THE EXACT PROTOCOLS NEXT TO GET TO 100% RECOVERY? Oh, you INCOMPETENTLY DON'T HAVE THEM?)

An investigation of post-stroke fatigue levels and influencing factors in young and middle-aged stroke patients: a cross-sectional study

 

YOU'RE FIRED! Post stroke fatigue has been known forever, solve the problem! YOUR INCOMPETENT? DOCTOR AND HOSPITAL NEEDS TO SOLVE THE FUCKING PROBLEM!

At least half of all stroke survivors experience fatigue Known since March 2017

Or is it 70%? Known since March 2015

Or is it 40%? Known since September 2017

The latest here: 

An investigation of post-stroke fatigue levels and influencing factors in young and middle-aged stroke patients: a cross-sectional study

• Jing Kang, 
• Xiaojun Zhao, 
• Zixiu Zheng, 
• Yuehong Tian, 
• Wanying Tian & 
• Xingyu Miao 

Scientific Reports volume 15, Article number: 25046 (2025) Cite this article

Abstract

There are few reported studies on post-stroke fatigue (PSF) in young and middle-aged stroke patients, however, PSF plays a key role in the patient’s disease regression. Exploring the level of PSF and the influencing factors in young and middle-aged stroke patients is crucial for determining how to reduce the level of PSF and improve the patients’ motivation for rehabilitation treatment. Therefore, this study investigated the level of PSF in young and middle-aged stroke patients and analyzed the factors influencing PSF to provide a reference or basis for healthcare professionals to develop effective and targeted PSF intervention programs. The purpose of this study was to investigate the incidence of fatigue and its related influencing factors in young and middle-aged stroke patients. A total of 300 young and middle-aged stroke patients hospitalized in the Neurology Department of a tertiary hospital in Xi’an, China, from June 13 to December 31, 2024 were consecutively recruited by convenience sampling method. According to the Fatigue Severity scale (FSS), the patients were divided into a fatigue group (FSS ≥ 36 points, 187 cases) and a non-fatigue group (FSS < 36 points, 113 cases). The general situation questionnaire, Modified Rankin Scale (mRS), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI) and Stroke Specific Quality of Life Scale (SS-QOL), Chronic Disease Self-efficacy Scale (CDSES) were used to investigate and study them. A logistic regression model was established and stratified analysis was conducted to explore the factors influencing PSF in young and middle-aged patients. The incidence of PSF among 300 young and middle-aged stroke patients was 62.3%, Univariate analysis showed that Pre-Stroke Fatigue (PrSF), mRS score, SAS score, SDS score, PSQI score, SS-QOL score, CDSES score, marital status and occupation were related to PSF (P < 0.05). Multivariate regression analysis revealed that marital status (OR = 8.908, 95%CI 1.776–44.674), PrSF( OR = 2.909, 95%CI 1.555–5.443), SDS score (OR = 1.099, 95%CI 1.046–1.154) and SS-QOL score (OR = 0.985, 95%CI 0.972–0.998) were associated with the occurrence of PSF. Stratified analysis showed that in the group of patients with PrSF, Be married (OR = 0.438, 95%CI 0.046–4.203), SDS score (OR = 1.052, 95%CI 0.965–1.146), SS-QOL score (OR = 0.960, 95%CI 0.937–0.984), among which the SS-QOL score was associated with the risk of PSF (P < 0.001); In the group of patients without PrSF, SDS score (OR = 1.086, 95%CI 1.033–1.142) was associated with a high risk of PSF (P < 0.001), Be married (OR = 0.060, 95% CI 0.007–0.490) and SS-QOL score (OR = 0.984, 95% CI 0.974–0.995) were associated with a low risk of PSF (P < 0.05). The fatigue status of young and middle-aged stroke patients is more serious. Clinically, we should strengthen the protection of high-risk patients with the above risk factors, and corresponding intervention programs should be formulated in time to reduce the incidence of PSF, alleviate the fatigue symptoms of patients, and enhance their quality of life.

Trial registration: Registration number of China Clinical Trials Registration Center ChiCTR2500099037.

Remodeling and repair of the damaged brain: the potential and challenges of organoids for ischaemic stroke

 

We don't SPECIFICALLY know why a neuron gives up its' current job and takes on a neighbors.  Thus nothing on neuroplasticity is scientifically repeatable on demand. So, DEMAND your doctor give you EXACT PROTOCOLS to use. Don't allow your doctor to give you generalities or guidelines. 

The latest here: which tells us nothing helpful

Remodeling and repair of the damaged brain: the potential and challenges of organoids for ischaemic stroke

• Yi-Xuan Hao, 
• Chen-Rui Li, 
• Zhi-Jie Lu, 
• Nan Kong, 
• Rong-Hua Huang, 
• Shu-Yan Ma, 
• Wen-Fei Zhou, 
• Hao Jiao, 
• Yue Qiu, 
• Yuan-Feng Yu, 
• Bing-Wei Lv, 
• Hai-Liang Tang, 
• Jian Chen & 
• Nai-Li Wei 

Journal of Translational Medicine volume 23, Article number: 767 (2025) Cite this article

Abstract

Ischemic stroke induces irreversible cerebral tissue damage, a condition exacerbated by the brain’s limited endogenous neuroplasticity and inability to regenerate neurons. While neural circuit reorganization holds therapeutic potential, its efficacy is hindered by pathological barriers such as glial scarring, chronic inflammation, and neurotrophic factor deficiency. Although pharmacological and interventional methods for stroke have been well developed, their functional recovery outcomes remain suboptimal. Emerging neural regeneration paradigms, particularly stem cell-based strategies (encompassing neural stem cell transplantation, neural progenitors grafts, and 3D brain organoid implantation), offer novel solutions to these challenges. However, critical limitations persist in conventional stem cell approaches: (1) compromised synaptic integration efficacy hinders functional neural circuit reconstruction; (2) the absence of functional vascular niches coupled with deficient astrocyte-mediated support and extracellular matrix signaling; (3) restricted regenerative capacity despite theoretical multipotent differentiation potential. Recent breakthroughs in cerebral organoid technology have revolutionized neurological disease modeling and neural repair research. Building upon this paradigm shift, our study mechanistically interrogates neuroplastic remodeling processes following ischemic stroke, while critically evaluating the therapeutic efficacy and inherent limitations of stem cell-based interventions. This affirms the critical role of 3D human cerebral organoid transplantation in the reconstruction of neural circuits. Additionally, we further summarize the utility of organoid-based disease models and address associated ethical and societal concerns. Future efforts should prioritize the clinical translation of organoid transplantation for ischemic stroke, aiming to mitigate neurological deficits and restore functional recovery.

Introduction

Stroke, a cerebrovascular disease, is the second leading cause of death globally and the third leading cause when disability and mortality are included as compounding factors [1]. Accounting for 62.4% of all strokes, ischemic stroke is the most frequent type and is the leading cause of neurological dysfunction encountered in clinical practice. Stroke imposes a significant economic and social burden and severely impacts the healthy lives of individuals worldwide [2]. Despite the high incidence of cerebrovascular diseases such as stroke, only a limited number of effective therapies are available in clinical practice. This, along with the fact that most patients do not seek timely medical attention for treatment, delays the optimal time for treatment and leads to extensive necrosis in the infarcted area, which can cause irreversible damage to the neurons in the brain. After patients progress through the acute phase of a stroke, they are left with serious sequelae, such as motor dysfunction. Post-stroke motor impairments typically affect the face, arms, and legs on one side of the body, impacting approximately 80% of patients [3]. Recovery is often prolonged and can severely impact the patient’s daily work and life. Longitudinal follow-up data reveal that approximately 50% of patients continue to experience motor deficits four years after their stroke occurred [4]. Clinics currently use pharmacological thrombolysis as the primary treatment to restore cerebral perfusion [5]. Although many drugs show neuroprotective effects in both preclinical studies and animal models, they have not demonstrated satisfactory results in clinical practice. Differences in physiology between species pose a challenge to the clinical translation of disease research [6].

Neurorestorative therapies for stroke typically extended therapeutic timeframes from days to weeks after stroke onset and aim to improve neurovascular remodelling and synaptogenesis while decreasing inflammatory and immune responses [7]. Stem cell therapy in regenerative medicine offers novel therapeutic paradigms [9]. Cell therapy enhances the recovery of neurological function of the body through sophisticated neuroimmune modulation and trophic factor secretion [8], thereby avoiding the suboptimal functional outcomes associated with conventional stroke treatments and showing substantial developmental potential [10]. Neural stem cells (NSCs) exhibit multimodal therapeutic actions that can stimulate functional neural replacement or induce multimodal therapeutic actions across multiple central nervous system (CNS) regions [11]. Effectively combining the anti-neuroinflammatory, anti-apoptotic, and pro-angiogenic capacities properties of NSCs with other interventions (e.g., recombinant tissue plasminogen activator) may mitigate apoptosis and necrosis caused by the generation of excess reactive oxygen species (ROS). This excess ROS is generated when the therapeutic time window for restoring blood flow during rt-PA therapy is missed, resulting in reperfusion injury (RI). However, transplantation of cells after 2D monolayer culture is less effective in repairing the tissue structure of the infarcted core compared with culturing cortical organoid systems in a 3D structure. More importantly, cerebral organoids (COs) not only demonstrate efficacy in repairing the ischemic core but also exhibit lesion-targeted neurogenesis into lesion-specific neurons. These neurons extend axons to cortical-basal ganglia-thalamic circuits, establishing functional synaptic connections with the host neural network to reconstruct complete neural circuits. They also demonstrates measurable efficacy in ameliorating post-stroke sensorimotor dysfunction [12]. Currently, several technologies are available to improve the reproducibility of cerebral organoid culture, such as 3D printing to help manipulate the size, shape, and organisation of organoids [13] and Notch signalling inhibition to prevent cell proliferation, induce terminal differentiation, and promote cerebral organoid maturation [14]. Therefore, based on the feasibility and therapeutic potential of generating and optimizing human cerebral organoids, the clinical translation of organoids for enhancing the neuroregenerative capacity and functional remodelling of the brain is a translational research priority.

Mechanisms of neuroplasticity after stroke onset

Brain recovery after stroke injury is dynamic and phase-dependent process. In early neurodevelopment (0–3 years), as the brain begins to develops, a large number of synapses are formed to sensory processing and multimodal integration and explore the comprehensive neural network [15]. During the initial development of the brain, the number of dendritic spines and synapses increases substantially, peaking at five years of age, after which the number decreases [15]. As brain volume expansion slows in the later stages, the energy needs of neuronal and synaptic activities cause the brain to adjust the density of these structures through selective synaptic elimination, transitioning from high plasticity to functional [16]. Stroke survivors show a sustained recovery of motor abilities over many years following brain injury. This recovery process is somewhat similar to how infants learn motor function [17]. The Stroke Recovery and Rehabilitation Roundtable has established a time frame for recovery of stroke patients, which is differentiated into the following four phases: the hyper-acute phase (0–24 h), the early subacute phase (7 days–3 months), the late subacute phase (3–6 months), and the chronic phase (>6 months) [18]. After a stroke occurs, the brain undergoes a series of ischemic cascade changes during the acute phase. Due to the disruption of blood flow to the brain and ATP depletion, neurons are unable to maintain normal transmembrane ion concentrations, resulting in a cascade of apoptosis and necrosis [19]. Hypoxia and depletion of metabolic substrates, as well as a substantial reduction in neuronal energy failure, subsequently causes structural damage to the brain [20].Therefore, ionic imbalance and cell death are the primary mechanisms at the onset of a stroke. In the subacute phase of stroke recovery, neuroinflammation diminishes while functional brain networks exhibit activity-dependent neuroplastic changes [21]. Microglia and monocyte-derived macrophages (MDMs) release factors that facilitate adaptation to resolving inflammation by removing neutrophils, cellular debris, and apoptotic cells [22]. These spontaneous neuroplastic changes include the release of brain-derived neurotrophic factor [23], structural remodelling at synaptic, axonal, and dendritic levels [24], and the activation, migration, and differentiation of endogenous neural stem cells [25]. During the chronic phase, experience-dependent reorganization of the neural network stabilizes, and long-term adaptation begins. At this point, “auto-reactive” lymphocytes sensitive to brain antigens return to the brain, triggering chronic inflammation and cytotoxicity, which likely contribute to the chronic sequelae of stroke [26]. Figure 1 Rehabilitation during the early subacute phase, when heightened neuroplasticity is at its peak, substantially increases both the speed and extent of patient recovery [18]. Although spontaneous remodeling occurs after ischemic stroke, these changes alone are insufficient to produce significant functional recovery [27]. In the future, functional recovery through cortical neuronal replacement may be the key to curing human neurodegenerative diseases [28, 29]. Compared with the use of dissociated neural progenitor cells, cerebral organoid transplantation offers several advantages, including a diverse cellular composition, maintenance of a native microenvironment, greater surgical feasibility, and higher vascularization potential, making it a promising therapeutic approach for restoring brain function in both the subacute and chronic phases of the disease [30].

Fig. 1

The main pathophysiological mechanisms of IS in the acute and convalescent phases. In the acute phase of IS, the ischaemia and reperfusion injury lead to mitochondrial dysfunction, cellular damage, and impairment of the blood–brain barrier. As IS interrupts the normal synaptic plasticity, during the recovery period, homeostatic plasticity is up-regulated and neurogenesis and synaptic remodelling occur. In addition, new synapse formation builds new circuits and aids brain recovery. In the cellular response mode, astrocytes secrete neurotrophic and angiogenic factors to repair damaged blood vessels and nerves. IS ischaemic stroke

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Dietary Carbohydrate Intake, Carbohydrate Quality, and Healthy Aging in Women

 Do you really think your competent? doctor will get the dietician to create diet protocols with this in mind?

I'm sure your incompetent? doctor did nothing with this from September 2017 and won't get the diet protocol refined because it doesn't exist!

New Study Favors Fat Over Carbs  September 2017 

The latest here:

Dietary Carbohydrate Intake, Carbohydrate Quality, and Healthy Aging in Women

Andres V. Ardisson Korat, ScD^1,2; Ecaterina Duscova, MPH¹; M. Kyla Shea, PhD¹; et al

Author Affiliations Article Information

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JAMA Netw Open

Published Online: May 16, 2025

2025;8;(5):e2511056. doi:10.1001/jamanetworkopen.2025.11056

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Key Points

Question  Is dietary carbohydrate intake in midlife prospectively associated with healthy aging considering chronic diseases, physical and cognitive function, and mental health?

Findings  In this cohort study of 47 513 women, intakes of total and high-quality carbohydrates; carbohydrates from whole grains, fruits, vegetables, and legumes; and total dietary fiber in midlife were associated with increased odds of healthy aging and several domains of positive health status in older adulthood. Conversely, refined carbohydrate intake was associated with lower odds of healthy aging.

Meaning  These findings suggest that intakes of dietary fiber, high-quality, and refined carbohydrates may be important determinants of overall health status in older adulthood.

Abstract

Importance  Dietary carbohydrate quality is inversely associated with risks of chronic disease and all-cause mortality. However, limited evidence exists regarding the role of carbohydrate quality and dietary carbohydrate types in promoting healthy aging.

Objective  To evaluate the long-term role of dietary carbohydrate intake and carbohydrate quality in healthy aging.

Design, Setting, and Participants  This prospective cohort study used data from the Nurses’ Health Study (NHS) from January 1984 to December 2016 and included participants aged younger than 60 years in 1984. Data were analyzed from January 2023 to February 2025.

Exposure  Intakes of total carbohydrates; refined carbohydrates; high-quality carbohydrates from whole grains, fruits, vegetables, and legumes; dietary fiber; and the dietary glycemic index (GI) and glycemic load (GL).

Main Outcomes and Measures  Nutrient intakes were derived from 1984 and 1986 food frequency questionnaires. The primary outcome was healthy aging, defined as the absence of major chronic diseases, lack of cognitive and physical function impairments, and having good mental health, according to 2014 or 2016 NHS questionnaire data. Multivariate logistic regression was used to calculate associations of each carbohydrate variable with healthy aging.

Results  Among 47 513 participants (mean [SD] baseline age, 48.5 [6.2] years), 3706 (7.8%) met our healthy aging definition. Every 10%-calorie increment in intakes of total carbohydrates (odds ratio [OR], 1.17; 95% CI, 1.10-1.25) and high-quality carbohydrates (OR, 1.31; 95% CI, 1.22-1.41) was positively associated with healthy aging. Refined carbohydrates were associated with lower odds of healthy aging (OR, 0.87; 95% CI, 0.80-0.95). Intakes of carbohydrates from fruits, vegetables, and whole grains were positively associated with odds of healthy aging (ORs ranging from 1.11; 95% CI, 1.07-1.15 to 1.37; 95% CI, 1.20-1.57 per 5% energy increment). Additionally, intakes of total dietary fiber and fiber from fruits, vegetables, and cereals were associated with higher odds of healthy aging (ORs ranging from 1.07; 95% CI, 1.03-1.11 to 1.17; 95% CI, 1.13-1.22 per 1-SD increment). GL was positively associated with healthy aging, which was attenuated by dietary fiber adjustment. A higher GI (OR, 0.76; 95% CI, 0.67-0.87) and carbohydrate-to-fiber ratio (OR, 0.71; 95% CI, 0.62-0.81) were inversely associated with healthy aging when comparing extreme quintiles. There were positive associations for isocaloric replacements of refined carbohydrates, animal protein, total fat, or trans fats with high-quality carbohydrates (ORs ranging from 1.08; 95% CI, 1.01-1.16 to 1.16; 95% CI, 1.11-1.21).

Conclusions and Relevance  In this cohort study of women, intakes of high-quality carbohydrates and dietary fiber were associated with positive health status in older adulthood, suggesting that dietary carbohydrate quality may be an important determinant of healthy aging.

Introduction

The population of older adults in the US is expected to double in the next 4 decades. Importantly, this group bears a disproportionately large burden of chronic diseases and declining physical and cognitive function.^1-4 Diet is an important determinant of chronic diseases,^5,6 premature death,⁷ physical frailty,⁸ and healthy aging.⁹ Dietary carbohydrate accounts for approximately 50% of energy intake in the US diet.¹⁰ However, most of it consists of refined carbohydrates (42% of total calories), while only 8% consists of high-quality carbohydrates from whole grains, legumes, fruits, and vegetables.¹⁰ The association of total carbohydrate intake with all-cause mortality risk follows a U-shaped curve with the lowest risk for 50% to 55% of total calories.¹¹ In contrast, intakes of high-quality carbohydrate sources are consistently associated with reduced risk of chronic disease incidence and mortality.^12-14 However, limited evidence exists regarding the role of dietary carbohydrate in the development of healthy aging.¹⁵

Similarly, the associations of carbohydrate quality indices with healthy aging have not been elucidated. A high carbohydrate-to-fiber ratio has been associated with higher risks of all-cause and cardiovascular disease mortality; however, it has not been evaluated in the context of healthy aging.^16-18 The glycemic index (GI) and glycemic load (GL) reflect the glycemic effects of carbohydrate intake.^19,20 GI is a relative measure of the incremental blood glucose response per gram of carbohydrate,²¹ and the GL considers the glucose response to both the quantity of carbohydrate intake and its GI.²² The association of GI and GL with various health outcomes has been extensively evaluated²⁰; however, their role in healthy aging remains inconclusive.¹⁵ This study aims to comprehensively evaluate the association of dietary carbohydrate quantity and quality assessed in midlife with the likelihood of healthy aging, defined as longevity with no major chronic diseases, good mental health, and no impairments in either cognitive or physical function, in the Nurses’ Health Study (NHS).²³ We hypothesized that high-quality carbohydrate intake would be positively associated with healthy aging.

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