Assistant Professor of Behavioral Medicine

Center for Behavioral Cardiovascular Health, Division of Cardiology, Department of Medicine, Columbia University Medical Center

Interrupting prolonged sitting to improve cardiometabolic biomarkers: a cross-over trial


Middle- and older-aged adults in developed nations are alarmingly sedentary, spending, on average, 11-12 hours per day in sedentary behavior. Evidence suggests that sedentary behavior itself is “toxic” and is a major contributor to cardiovascular disease. Several health agencies have provided general recommendations that all age groups minimize the amount of time spent sedentary for extended periods by interspersing brief periods of activity. These guidelines, however, stop short of making specific recommendations about how to break up prolonged sedentary time. Given the vast amount of time middle- and older- aged adults in developed nations spend sedentary and the health hazards incurred with prolonged sedentariness, there is a clear and pressing need for empirical evidence to inform specific, actionable guidelines that describe how often and how long sedentary time should be interrupted.  This project may be seen as a groundbreaking step towards developing evidence-based guidelines for interrupting periods of prolonged sedentary behavior that can be added to current recommendations for healthy aging.



Associate Professor of Epidemiology

Department of Epidemiology, Mailman School of Public Health

Aging well with alcohol? Harnessing longitudinal data from 20 countries to understand health impacts of moderate drinking among older adults


Moderate alcohol consumption is claimed to be associated with positive health effects, including cardiovascular benefits, prevention of disability, social engagement, and enjoying a long and healthy life. Yet there is an increasing confluence of evidence that suggests that observed moderate-drinking ‘benefits’ may not be what they seem in all populations. While harm related to alcohol use is typically seen as an issue affecting youth, alcohol is also an important determinant of health in older age. New evidence suggests that excessive consumption is on the rise in older adults, including in the US, China, and many countries in Europe. An estimated 3.8% of all global deaths and 4.6% of all disability-adjusted life years are attributable to alcohol, including cardiovascular disease and many cancers. This project is the first to examine country-level social and economic predictors of variation in alcohol consumption and mortality. It takes an interdisciplinary, multi-level, and dynamic approach to analyzing interactions between biological, behavioral, and contextual factors that explain whether and why moderate alcohol consumption is sometimes beneficial yet other times is detrimental to aging well. Clarifying the nature of the relationship between alcohol consumption and health is critical to formulating policies adapted to societies of long lives.



Assistant Professor

Department of Health Policy and Management, Mailman School of Public Health Effect of Skilled Nursing Facility Referral Concentration on PATIENT OUTCOMES


Examining the fact that 20% of hospitalized Medicare fee-for-service beneficiaries are discharged to skilled nursing facilities (SNFs), it seems that readmission penalties may induce hospitals to concentrate referrals to fewer SNFs, and concentration has been shown to reduce rehospitalizations.  This could potentially have an effect on the positive modifiability of the aging process, as patients may feel less stress and more support through enhanced care management processes. Prior research has not analyzed the within-market effects of concentration and on average whether penalties have led to greater concentration of referrals and whether concentration has had a positive or negative association with patients’ functional status. The McHugh team will conduct a market-level difference-in-difference analysis to estimate the effect of changes in concentration within markets. In other words, does one hospital’s choice to concentrate referrals elevate the overall market, or does it create greater disparities if facilities are forced to send patients to lower quality SNFs. The intent of this work is to explore the association between concentration and patient outcomes, understanding that better organizational coordination can potentially lead to positive modifiability of the aging process.



Assistant Professor of Behavioral Medicine (in Psychiatry and Neurology)

Division of Behavioral Medicine, Departments of Psychiatry and Neurology, Columbia University Medical Center

Mitochondrial Regulation of Aging in Humans: A Transdisciplinary Investigation


An emerging theory of aging implicates the dysfunction of mitochondria, a subcellular organelle that sustains life and enables stress adaptation via energy production and signaling. Mitochondrial signals influence processes within the cell nucleus, including epigenetic modifications and telomere shortening, both of which have been used as “aging clocks”. Moreover, of significance to understand how psychosocial factors influence the aging process, neuroendocrine mediators such as cortisol, catecholamines, and sex hormones released in response to psychosocial experiences directly influence mitochondrial functions. Thus, mitochondria may sit at the interface of psychosocial experiences and genetic/epigenetic processes that mark biological aging. This insight has been supported by our recent preclinical data in mouse models of mitochondrial disease, and a transdisciplinary synthesis of the aging literature, indicating that mitochondria modulate stress responses. But no study to date has investigated this idea in humans. This project will begin to investigate biological aging in relation to mitochondrial dysfunction and psychological stress in humans.