Periodic Reporting for period 2 - PANINI (Physical Activity and Nutrition INfluences In ageing) Reporting period: 2018-01-01 to 2019-12-31 Summary of the context and overall objectives of the project The ageing of the population is a global challenge and the period of life spent in good health, although increasing, is not keeping pace with lifespan. Consequently, understanding the important factors that contribute to healthy ageing and validating interventions and influencing policy to promote healthy ageing are vital research priorities. The PANINI project is a collaboration of 20 partners across Europe examining the influence of physical activity and nutrition in ageing. PANINI uses a wide range of research methods and treatments to understand and improve healthy ageing. These range from the biological to the social; from genetics to the influence of social context. For example, epigenetic, immune system, and psychological assessments, and nutritional and sports science-based interventions have been used among older adults, as well as mathematical modelling and following up disease across the lifespan. The projects are multi-disciplinary and examine health outcomes in ageing from a range of perspectives to contribute to our understanding of predictors of healthy and unhealthy ageing. PANINI also conducted significant public engagement activities with older adults, health professionals and key organisations to disseminate the latest evidence-based health messages to important audiences. PANINI has developed a toolkit of standardized best practice measures for assessing physical activity and nutrition as well as other important related outcomes for older people in a range of settings. These include hospital inpatient, outpatient, care home and community-dwelling older adults. This is important so we can compare the effectiveness of different treatments. This toolkit will be made widely available on the PANINI website. PANINI researchers have produced extensive reviews of the scientific literature on relevant topics such as the occurrence of frailty in hospital patients, sedentary behaviour prevalence, sedentary behaviour and physical function, dietary pattern impact on cognition and brain imaging measures, and the impact of interventions to reduce sedentary time. Across PANINI it was possible to combine and share datasets and test key markers of ageing, and model the contribution of factors such as genetics and muscle metabolomics to muscle function, frailty and survival. PANINI researchers have studied in detail the predictors of different measures of health and wellbeing among middle-aged and older people including hormones, muscle strength and function, genetics, and stress. The biological mechanisms have been investigated including how these factors interact with nutrition choices and physical activity engagement. PANINI has also explored the factors predicting knowledge and choice of different dietary and physical activity advice, providing vital information regarding the potential targets for intervention and policy guidance. Finally, PANINI has developed and tested nutritional and physical activity interventions in a range of settings and older adult populations in terms of their impact on cognitive, psychological, social, and physical function measures, leading to conclusions regarding the feasibility of such interventions as well as the impact of intervention adherence. The PANINI project has been addressing the impact of physical activity and nutrition on healthy ageing from diverse but interlinked perspectives. It emphasises the importance of using standardized measures and the advantages of combining data to compare biomarkers and interventions across different settings and typologies of older adults. As the projects conclude, the current results and final data will form part of a shared dataset, which will be made open access for other researchers into ageing processes. Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far The ageing of the population is a global challenge: current data suggests that by the year 2020 about one fifth of the population of Europe will be aged 65+ years and there will be a tripling of the number of individuals aged 85+ years by 2050. Although life expectancy is increasing by 2 years per decade on average, the period of life spent in good health (health span) although also longer, is not keeping pace with lifespan to the same extent. This means that most Europeans spend their later years in poor health. Thus, understanding the important factors that contribute to healthy ageing versus frailty and validating interventions and influencing policy to promote healthy ageing is a cross-cutting research priority in Europe. Healthy ageing is life spent in relatively good health with independence and good quality of life across physical and mental domains versus living with limited independence and poor quality of life. The PANINI project is filling a key knowledge gap by considering the impact of lifestyle factors on healthy ageing and disease, specifically physical activity and nutrition. These factors and their influence on various bodily systems and the net effect on the individual should not be considered in isolation. Consequently, the PANINI project is an innovative multi-disciplinary training and research network examining the influence of physical activity and nutrition on age-related changes from gene to societal level. As a result, PANINI is very diverse in the nature of research conducted. However, it devised a toolkit of multi-factorial important measures of physical activity, nutrition, physical function and wellbeing in ageing using existing gold standards and/or previously validated and commonly used measures across existing datasets. This means that each project, as far as was possible, has integrated the measurement of a standard set or part of a standard set of measures for comparison across populations in addition to answering their own specific research questions. Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far) The impact of the project will not be fully realised until after the project’s completion, but we contributed to the employability of the ESRs and career longevity. Specifically, the impact goals were to; • Enhancing research and innovation-related human resources, skills, and working conditions to realise the potential of individuals and to provide new career perspectives • Key Skills, Career Prospects, Employability• Fostering Creativity and Entrepreneurial Skills• Contribution of the non-academic sector to the doctoral research training, as appropriate to the implementation mode and research• Effectiveness of the proposed communication and dissemination of results • Communication and public engagement strategy of the project• Dissemination of the research results:• Exploitation of results and intellectual property (IP) To meet these impact goals we ensured that our ESRs were trained in complementary skills as well as specific and generic research skills at the individual beneficiary sites as well as through the ATCs and secondments. ATCs were developed to offer careers advice, enhance employability and entrepreneurship as well as increasing their ability to organise a conference. The group and lab secondments involved our non-academic partners in training and secondments, giving them access and experience in a range of different settings. PANINI have continued to exploit our research through its articles, community based research and event presentations. The ESRs have received formal and informal training that will enhance their CVs to make them more employable in academia and industry.