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Thebault JL, Ringa V, Panjo H, Bloy G, Falcoff H, Rigal L. Accumulation of unhealthy behaviors: Marked social inequalities in men and women. Prev Med Rep 2018; 12:1-5. [PMID: 30116703 PMCID: PMC6084013 DOI: 10.1016/j.pmedr.2018.07.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 07/19/2018] [Accepted: 07/21/2018] [Indexed: 11/25/2022] Open
Abstract
The objective of this study was to compare the accumulation of unhealthy behaviors at the bottom of the social scale in men and women and, secondarily, to compare social and gender-based inequalities. Fifty-two general practitioners from the Paris area volunteered to participate. A sample of 70 patients (stratified by gender) aged 40–74 years was randomly chosen from each physician's patient panel and asked to complete a questionnaire about their social position and health behaviors: tobacco and alcohol use, unhealthy diet, and physical inactivity. Mixed Poisson models were used to describe, with relative risks (RRs) and relative inequality indexes (RIIs), the social inequalities in the accumulation of these four unhealthy behaviors. In 2008–2009, 71% of the 3640 patients returned their questionnaires. Men had an average of 1.59 of the 4 unhealthy behaviors we studied, and women 1.35 (RR = 1.18; 95% CI [1.11–1.25]). The mean number of unhealthy behaviors increased significantly for both genders from the top to the bottom of the social scale. The order of magnitude of RIIs was similar among men and women, ranging from 1.33 (occupational RII among women, 95% CI [1.11–1.60]) through 1.69 (financial RII among women, 95% CI [1.43–1.99]). None of the interaction tests between gender and social position was significant. The social inequalities had significantly wider amplitudes than those between genders for two of the three indicators of social position. The amplitude of social gradients related to unhealthy behaviors was similar between men and women and exceeded the gender inequality between them.
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Affiliation(s)
- Jean-Laurent Thebault
- Université Sorbonne Paris Cité, Université Paris Descartes, Département de médecine générale, Paris, France
| | - Virginie Ringa
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France.,Institut National d'Etudes Démographiques (INED), Paris, France
| | - Henri Panjo
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France.,Institut National d'Etudes Démographiques (INED), Paris, France
| | | | - Hector Falcoff
- Société de Formation Thérapeutique du Généraliste (SFTG), Paris, France
| | - Laurent Rigal
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France.,Institut National d'Etudes Démographiques (INED), Paris, France.,Université Paris-Saclay, Univ. Paris-Sud, General Practice Department, Le Kremlin-Bicêtre, France
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252
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Conrad Z, Raatz S, Jahns L. Greater vegetable variety and amount are associated with lower prevalence of coronary heart disease: National Health and Nutrition Examination Survey, 1999-2014. Nutr J 2018; 17:67. [PMID: 29991345 PMCID: PMC6040059 DOI: 10.1186/s12937-018-0376-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 07/03/2018] [Indexed: 01/04/2023] Open
Abstract
Background The 2015–2020 Dietary Guidelines for Americans (DGA) provides specific intake recommendations for vegetable variety and amount in order to protect against chronic disease. However, to the best of our knowledge, no studies have examined the link between DGA recommended vegetable variety and cardiometabolic disease. To address this research gap, our aim was to estimate the relationship between vegetable variety, vegetable amount, and prevalent cardiometabolic disease subtypes, and to assess potential determinants of vegetable variety. Methods Data on food intake and reported cardiometabolic disease status were acquired for 38,981 adults from the National Health and Nutrition Examination Survey (1999–2014). Vegetable variety was measured using a modified dietary diversity index that was adjusted for the potential confounding effects of vegetable amount. Temporal trends in vegetable variety and amount were assessed using univariate linear regression models. Multivariate logistic regression models were used to estimate the relationship between vegetable variety and prevalent disease, and between vegetable amount and prevalent disease. Multivariate ordered logistic regression models were used to assess the relationship between vegetable variety and explanatory variables. Results Overall, vegetable variety decreased (P = 0.035) from 1999 to 2014, but vegetable amount did not (P = 0.864). Intake of starchy vegetables decreased (P < 0.001), and intake of dark green vegetables increased (P < 0.001) over this 16-year period, but no trends were observed for other subgroups. An inverse linear relationship was observed between vegetable variety and prevalent coronary heart disease (P-trend = 0.032) but not other prevalent diseases; and between vegetable amount and coronary heart disease (P-trend = 0.026) but not other prevalent diseases. Individuals who reported consuming dark green vegetables had lower odds of having cardiovascular disease (0.86, 95% CI: 0.74–0.99) and coronary heart disease (0.78, 0.65–0.94) compared to individuals who reported not consuming any green vegetables. Living with a domestic partner was associated with greater vegetable variety (P = < 0.001), and currently smoking was associated with lower vegetable variety (P = < 0.001). Vegetable variety and amount were positively associated (P < 0.001). Conclusions Vegetable variety and amount were inversely associated with prevalent coronary heart disease. Vegetable variety was strongly associated with vegetable amount, likely mediated by reduced habituation and increased liking. Increasing vegetable variety and amount are still important messages for the public. Electronic supplementary material The online version of this article (10.1186/s12937-018-0376-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zach Conrad
- US Department of Agriculture, Agricultural Research Service, Grand Forks Human Nutrition Research Center, 2420 2nd Ave. N, Grand Forks, ND, 58203, USA.
| | - Susan Raatz
- US Department of Agriculture, Agricultural Research Service, Grand Forks Human Nutrition Research Center, 2420 2nd Ave. N, Grand Forks, ND, 58203, USA.,Department of Food Science and Nutrition, University of Minnesota, Saint Paul, MN, 55108, USA
| | - Lisa Jahns
- US Department of Agriculture, Agricultural Research Service, Grand Forks Human Nutrition Research Center, 2420 2nd Ave. N, Grand Forks, ND, 58203, USA
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253
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Liu SH, Liu B, Li Y. Risk factors associated with multiple correlated health outcomes in the 500 Cities Project. Prev Med 2018; 112:126-129. [PMID: 29654839 DOI: 10.1016/j.ypmed.2018.04.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 02/27/2018] [Accepted: 04/06/2018] [Indexed: 11/26/2022]
Abstract
Reducing chronic disease is a major health challenge. Risk factors for chronic diseases are often studied at the individual level, even though interventions and policies may be implemented at the city level. We use an ecologic study design with city-level data, to simultaneously assess the relative impact of unhealthy behaviors and preventive care measures on multiple chronic disease health outcomes. We analyze a newly available, large national dataset called the 500 Cities Project. We examine the associations between city-level prevalence of unhealthy behaviors, clinical preventive service use, and all chronic disease health outcomes in 500 of the largest U.S. cities for year 2014. After adjusting for age and demographic characteristics, using MANOVA we found that the top three risk factors for all health outcomes are smoking (Pillai's trace = 0.95, approx. F = 688.7, p-value < 0.0001), lack of physical activity (Pillai's trace = 0.91, approx. F = 380.0, p-value < 0.0001) and binge drinking (Pillai's trace = 0.91, approx. F = 348.8, p-value < 0.0001), which are statistically significant after adjusting for multiple comparisons. Higher prevalence of an annual dental checkup, a preventive service use measure, is correlated with lower prevalence of several chronic diseases such as diabetes (correlation coefficient r = -0.88), poor physical health (r = -0.91), stroke (r = -0.85), cardiovascular disease (r = -0.83) and poor mental health (r = -0.82). Identifying important chronic disease risk factors at the city-level may provide more actionable information for policymakers to improve urban health.
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Affiliation(s)
- Shelley H Liu
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, NY 10029, United States.
| | - Bian Liu
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, NY 10029, United States
| | - Yan Li
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, NY 10029, United States; Center for Health Innovation, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, United States
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254
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Christoph MJ, Larson N, Hootman KC, Miller JM, Neumark-Sztainer D. Who Values Gluten-Free? Dietary Intake, Behaviors, and Sociodemographic Characteristics of Young Adults Who Value Gluten-Free Food. J Acad Nutr Diet 2018; 118:1389-1398. [PMID: 29929897 DOI: 10.1016/j.jand.2018.04.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 04/09/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Over the past decade, consumer demand for gluten-free products has increased, but little is known about the public health impact of and factors correlated with valuing gluten-free food. OBJECTIVE Describe the sociodemographic and behavioral characteristics of young adults valuing gluten-free as an important food attribute, and compare their dietary intake with other young adults. DESIGN Cross-sectional analysis of survey data collected in 2015 to 2016 as part of the fourth wave of the Project EAT (Eating and Activity in Teens and Young Adults) cohort study. PARTICIPANTS/SETTING Population-based sample of 1,819 young adults (25 to 36 years) (57% women, 69% white), initially recruited in Minneapolis-St Paul, MN, public middle and senior high schools. MEASURES Valuing gluten-free food, weight goals and weight control behaviors, food production values, eating behaviors, physical activity, and dietary intake. STATISTICAL ANALYSES PERFORMED Logistic regression models were used to investigate associations with potential correlates of valuing gluten-free food. For dietary intake, adjusted mean estimates were calculated for those who did and those who did not value gluten-free foods. RESULTS Approximately 13% of young adults valued gluten-free food, a characteristic most strongly related to valuing food production practices (eg, organic, locally grown); factors such as Nutrition Facts use and having a weight goal were also related to gluten-free food values. Valuing gluten-free food was related to engagement in both healthy behaviors (eg, eating breakfast daily, eating more fruits and vegetables) and unhealthy behaviors (eg, using diet pills to control weight). CONCLUSIONS AND RELEVANCE Young adults valuing gluten-free food generally engaged in healthier behaviors and had better dietary intake; of concern, they were also more likely to engage in unhealthy weight control behaviors. Valuing gluten-free food may be part of a cluster of behaviors representing an interest in making healthier food choices but may also be a marker for unhealthy weight preoccupation and behaviors.
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255
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Mucheru D, Hanlon MC, Campbell LE, McEvoy M, MacDonald-Wicks L. Cardiovascular disease lifestyle risk factors in people with psychosis: a cross-sectional study. BMC Public Health 2018; 18:742. [PMID: 29907101 PMCID: PMC6003197 DOI: 10.1186/s12889-018-5649-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 05/31/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND People with psychosis die on average 25 years earlier than those in the general population, with cardiovascular disease (CVD) contributing to much of the excess mortality. This cross-sectional study aimed to identify the relationship between lifestyle risk factors for CVD - poor nutrition, smoking and low physical activity levels - and dyslipidaemia, hypertension and hyperglycaemia while controlling for potential confounders in 1825 people from the Survey of High Impact Psychosis (SHIP) in Australia. We also aimed to identify clustering patterns of lifestyle risk factors and associated demographic variables. METHODS Three logistic regressions were used to predict the effect of nutrition, smoking and physical activity on dyslipidaemia, hypertension and hyperglycaemia while controlling for clozapine use, sex and age. Clustering patterns of nutrition, smoking and physical activity were examined using the two-step cluster method which is based on hierarchical cluster analysis. Demographic variables associated with different clusters were identified using measures of association. RESULTS Smoking status had a positive association with dyslipidaemia (adjusted odds ratio = 0.50; 95% confidence interval = 0.32-0.78; p = 0.002). Other cardiovascular disease lifestyle risk factors did not have a significant relationship with dyslipidaemia, hypertension and hyperglycaemia. Clustering patterns of lifestyle risk factors showed that younger men, with low education levels, and relying on a government pension, were most likely to display the poorest lifestyle risk behaviours. The largest cluster (42%) of participants was characterised by a mixed demographic profile and were most likely to display poor nutrition and low physical activity levels but less likely to smoke. CONCLUSIONS Only smoking status had a significant positive association with dyslipidaemia which could indicate that there are additional factors affecting the relationship between other cardiovascular lifestyle risk factors and dyslipidaemia, hypertension and hyperglycaemia in people with psychosis. Unknown confounders and traditional lifestyle risk factors may explain the high rates of CVD in this group. Clustering of lifestyle risk factors and their demographic profiles could help the design of intervention programs in people with psychosis.
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Affiliation(s)
- Doreen Mucheru
- Faculty Health and Medicine, The University of Newcastle, Callaghan, 2308 Australia
| | - Mary-Claire Hanlon
- Faculty Health and Medicine, The University of Newcastle, Callaghan, 2308 Australia
- Brain and Mental Health Program, Hunter Medical Research Institute, New Lambton, 2305 Australia
- Priority Research Centre for Brain and Mental Health, The University of Newcastle, Callaghan, 2308 Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, 2308 Australia
| | - Linda E. Campbell
- Brain and Mental Health Program, Hunter Medical Research Institute, New Lambton, 2305 Australia
- Faculty of Science, The University of Newcastle, Callaghan, 2308 Australia
- Priority Research Centre GrowUpWell, The University of Newcastle, Callaghan, 2308 Australia
| | - Mark McEvoy
- Faculty Health and Medicine, The University of Newcastle, Callaghan, 2308 Australia
- Centre for Clinical Epidemiology & Biostatistics, Hunter Medical Research Institute, New Lambton, 2305 Australia
| | - Lesley MacDonald-Wicks
- Faculty Health and Medicine, The University of Newcastle, Callaghan, 2308 Australia
- Brain and Mental Health Program, Hunter Medical Research Institute, New Lambton, 2305 Australia
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, 2308 Australia
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256
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Dietz P, Iberl B, Schuett E, van Poppel M, Ulrich R, Sattler MC. Prevalence Estimates for Pharmacological Neuroenhancement in Austrian University Students: Its Relation to Health-Related Risk Attitude and the Framing Effect of Caffeine Tablets. Front Pharmacol 2018; 9:494. [PMID: 29946254 PMCID: PMC6006370 DOI: 10.3389/fphar.2018.00494] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 04/25/2018] [Indexed: 01/22/2023] Open
Abstract
Background: Pharmacological neuroenhancement (PN) is defined as the use of illicit or prescription drugs by healthy individuals for cognitive-enhancing purposes. The present study aimed (i) to investigate whether including caffeine tablets in the definition of PN within a questionnaire increases the PN prevalence estimate (framing effect), (ii) to investigate whether the health-related risk attitude is increased in students who use PN. Materials and methods: Two versions of a paper-and-pencil questionnaire (first version included caffeine tablets in the definition of PN, the second excluded caffeine tablets) were distributed among university students at the University of Graz, Austria. The unrelated question model (UQM) was used to estimate the 12-month PN prevalence and the German version of the 30-item Domain-Specific Risk-Taking (DOSPERT) scale to assess the health-related risk attitude. Moreover, large-sample z-tests (α = 0.05) were performed for comparing the PN prevalence estimates of two groups. Results: Two thousand four hundred and eighty-nine questionnaires were distributed and 2,284 (91.8%) questionnaires were included in analysis. The overall PN prevalence estimate for all students was 11.9%. One-tailed large-sample z-tests revealed that the PN estimate for students with higher health-related risk attitude was significantly higher compared to students with lower health-related risk attitude (15.6 vs. 8.5%; z = 2.65, p = 0.004). Furthermore, when caffeine tablets were included into the example of PN, the prevalence estimate of PN was significantly higher compared to the version without caffeine tablets (14.9 vs. 9.0%; z = 2.20, p = 0.014). Discussion: This study revealed that the PN prevalence estimate increases when caffeine tablets are included in the definition of PN. Therefore, future studies investigating the prevalence of, and predictors for, PN should be performed and interpreted with respect to potential framing effects. This study further revealed that the PN prevalence estimate is increased in students with a higher health-related risk attitude compared to students with a lower one. Therefore, future education and prevention programs addressing PN in the collective of students should not only inform about potential side effects of its use but also address the limited effects on cognition and potential alternatives of PN.
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Affiliation(s)
- Pavel Dietz
- Research Group of Physical Activity and Public Health, Institute of Sports Science, University of Graz, Graz, Austria
- Working Group Social and Health Sciences of Sport, Institute for Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Benedikt Iberl
- Research Group of Cognition and Perception, Institute of Psychology, University of Tübingen, Tübingen, Germany
| | - Emanuel Schuett
- Research Group of Cognition and Perception, Institute of Psychology, University of Tübingen, Tübingen, Germany
| | - Mireille van Poppel
- Research Group of Physical Activity and Public Health, Institute of Sports Science, University of Graz, Graz, Austria
- Working Group Social and Health Sciences of Sport, Institute for Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Rolf Ulrich
- Research Group of Cognition and Perception, Institute of Psychology, University of Tübingen, Tübingen, Germany
| | - Matteo Christian Sattler
- Research Group of Physical Activity and Public Health, Institute of Sports Science, University of Graz, Graz, Austria
- Working Group Social and Health Sciences of Sport, Institute for Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
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257
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Glenn BA, Crespi CM, Rodriguez HP, Nonzee NJ, Phillips SM, Sheinfeld Gorin SN, Johnson SB, Fernandez ME, Estabrooks P, Kessler R, Roby DH, Heurtin-Roberts S, Rohweder CL, Ory MG, Krist AH. Behavioral and mental health risk factor profiles among diverse primary care patients. Prev Med 2018; 111:21-27. [PMID: 29277413 PMCID: PMC5930037 DOI: 10.1016/j.ypmed.2017.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 12/02/2017] [Accepted: 12/13/2017] [Indexed: 10/18/2022]
Abstract
Behavioral and mental health risk factors are prevalent among primary care patients and contribute substantially to premature morbidity and mortality and increased health care utilization and costs. Although prior studies have found most adults screen positive for multiple risk factors, limited research has attempted to identify factors that most commonly co-occur, which may guide future interventions. The purpose of this study was to identify subgroups of primary care patients with co-occurring risk factors and to examine sociodemographic characteristics associated with these subgroups. We assessed 12 behavioral health risk factors in a sample of adults (n=1628) receiving care from nine primary care practices across six U.S. states in 2013. Using latent class analysis, we identified four distinct patient subgroups: a 'Mental Health Risk' class (prevalence=14%; low physical activity, high stress, depressive symptoms, anxiety, and sleepiness), a 'Substance Use Risk' class (29%; highest tobacco, drug, alcohol use), a 'Dietary Risk' class (29%; high BMI, poor diet), and a 'Lower Risk' class (27%). Compared to the Lower Risk class, patients in the Mental Health Risk class were younger and less likely to be Latino/Hispanic, married, college educated, or employed. Patients in the Substance Use class tended to be younger, male, African American, unmarried, and less educated. African Americans were over 7 times more likely to be in the Dietary Risk versus Lower Risk class (OR 7.7, 95% CI 4.0-14.8). Given the heavy burden of behavioral health issues in primary care, efficiently addressing co-occurring risk factors in this setting is critical.
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Affiliation(s)
- Beth A Glenn
- Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Department of Health Policy and Management, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 650 Charles Young Drive South, Los Angeles, CA 90095, USA.
| | - Catherine M Crespi
- Center for Cancer Prevention and Control Research, Department of Biostatistics, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 650 Charles Young Drive South, Los Angeles, CA 90095, USA
| | - Hector P Rodriguez
- Division of Health Policy and Management, University of California, Berkeley School of Public Health, 50 University Hall, Berkeley, CA 94720, USA
| | - Narissa J Nonzee
- Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Department of Health Policy and Management, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 650 Charles Young Drive South, Los Angeles, CA 90095, USA
| | - Siobhan M Phillips
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 North Lake Shore Drive, Chicago, IL 60611, USA
| | - Sherri N Sheinfeld Gorin
- New York Physicians against Cancer (NYPAC), Herbert Irving Comprehensive Cancer Center, New York, NY 10032, USA; Division of Cancer Control and Population Sciences (Leidos Biomedical Research, Inc.), National Cancer Institute, 6130 Executive Plaza, Bethesda, MD 20892, USA
| | - Sallie Beth Johnson
- Department of Health Sciences Administration, Jefferson College of Health Sciences at Carilion Clinic, 101 Elm Avenue, Roanoke, VA 24016, USA; Department of Family and Community Medicine, Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA 24016, USA
| | - Maria E Fernandez
- University of Texas Health Science Center at Houston, School of Public Health, 7000 Fannin Street, Houston, TX 77030, USA
| | - Paul Estabrooks
- Department of Health Promotion, University of Nebraska Medical Center, 986075 Nebraska Medical Center, Omaha, NE 68198, USA
| | - Rodger Kessler
- Doctor of Behavorial Health Program, College of Health Solutions, Arizona State University, 500 North 3rd Street, Phoenix, AZ 85004, USA
| | - Dylan H Roby
- Department of Health Services Administration, University of Maryland School of Public Health, 4200 Valley Drive, College Park, MD 20742, USA
| | - Suzanne Heurtin-Roberts
- Implementation Science Team, Division of Cancer Control and Population Sciences, National Cancer Institute, 6130 Executive Boulevard, Rockville, MD 20852, USA
| | - Catherine L Rohweder
- UNC Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, NC 27599, USA
| | - Marcia G Ory
- Center for Population Health and Aging, Texas A&M Health Sciences Center, College Station, TX 77843, USA
| | - Alex H Krist
- Department of Family Medicine and Population Health, Virginia Commonwealth University, PO Box 980251, Richmond, VA 23298, USA
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258
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Champion KE, Mather M, Spring B, Kay-Lambkin F, Teesson M, Newton NC. Clustering of Multiple Risk Behaviors Among a Sample of 18-Year-Old Australians and Associations With Mental Health Outcomes: A Latent Class Analysis. Front Public Health 2018; 6:135. [PMID: 29868543 PMCID: PMC5949382 DOI: 10.3389/fpubh.2018.00135] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 04/20/2018] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Risk behaviors commonly co-occur, typically emerge in adolescence, and become entrenched by adulthood. This study investigated the clustering of established (physical inactivity, diet, smoking, and alcohol use) and emerging (sedentary behavior and sleep) chronic disease risk factors among young Australian adults, and examined how clusters relate to mental health. METHODS The sample was derived from the long-term follow-up of a cohort of Australians. Participants were initially recruited at school as part of a cluster randomized controlled trial. A total of 853 participants (Mage = 18.88 years, SD = 0.42) completed an online self-report survey as part of the 5-year follow-up for the RCT. The survey assessed six behaviors (binge drinking and smoking in the past 6 months, moderate-to-vigorous physical activity/week, sitting time/day, fruit and vegetable intake/day, and sleep duration/night). Each behavior was represented by a dichotomous variable reflecting adherence to national guidelines. Exploratory analyses were conducted. Clusters were identified using latent class analysis. RESULTS Three classes emerged: "moderate risk" (moderately likely to binge drink and not eat enough fruit, high probability of insufficient vegetable intake; Class 1, 52%); "inactive, non-smokers" (high probabilities of not meeting guidelines for physical activity, sitting time and fruit/vegetable consumption, very low probability of smoking; Class 2, 24%), and "smokers and binge drinkers" (high rates of smoking and binge drinking, poor fruit/vegetable intake; Class 3, 24%). There were significant differences between the classes in terms of psychological distress (p = 0.003), depression (p < 0.001), and anxiety (p = 0.003). Specifically, Class 3 ("smokers and binge drinkers") showed higher levels of distress, depression, and anxiety than Class 1 ("moderate risk"), while Class 2 ("inactive, non-smokers") had greater depression than the "moderate risk" group. DISCUSSION Results indicate that risk behaviors are prevalent and clustered in 18-year old Australians. Mental health symptoms were significantly greater among the two classes that were characterized by high probabilities of engaging in multiple risk behaviors (Classes 2 and 3). An examination of the clustering of lifestyle risk behaviors is important to guide the development of preventive interventions. Our findings reinforce the importance of delivering multiple health interventions to reduce disease risk and improve mental well-being.
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Affiliation(s)
- Katrina E. Champion
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Marius Mather
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Bonnie Spring
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Frances Kay-Lambkin
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
- Priority Research Centre for Brain and Mental Health, The University of Newcastle, Newcastle, NSW, Australia
| | - Maree Teesson
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Nicola C. Newton
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
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259
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Mawditt C, Sacker A, Britton A, Kelly Y, Cable N. Social influences on health-related behaviour clustering during adulthood in two British birth cohort studies. Prev Med 2018; 110:67-80. [PMID: 29428172 DOI: 10.1016/j.ypmed.2018.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 01/16/2018] [Accepted: 02/05/2018] [Indexed: 11/18/2022]
Abstract
Building upon evidence linking socio-economic position (SEP) in childhood and adulthood with health-related behaviours (HRB) in adulthood, we examined how pre-adolescent SEP predicted membership of three HRB clusters: "Risky", "Moderate Smokers" and "Mainstream" (the latter pattern consisting of more beneficial HRBs), that were detected in our previous work. Data were taken from two British cohorts (born in 1958 and 1970) in pre-adolescence (age 11 and 10, respectively) and adulthood (age 33 and 34). SEP constructs in pre-adolescence and adulthood were derived through Confirmatory Factor Analysis. Conceptualised paths from pre-adolescent SEP to HRB cluster membership via adult SEP in our path models were tested for statistical significance separately by gender and cohort. Adult SEP mediated the path between pre-adolescent SEP and adult HRB clusters. More disadvantaged SEP in pre-adolescence predicted more disadvantaged SEP in adulthood which was associated with membership of the "Risky" and "Moderate Smokers" clusters compared to the "Mainstream" cluster. For example, large positive indirect effects between pre-adolescent SEP and adult HRB via adult SEP were present (coefficient 1958 Women = 0.39; 1970 Women = 0.36, 1958 Men = 0.51; 1970 Men = 0.39; p < 0.01) when comparing "Risky" and "Mainstream" cluster membership. Amongst men we found a small significant direct association (p < 0.001) between pre-adolescent SEP and HRB cluster membership. Our findings suggest that associations between adult SEP and HRBs are not likely to be pre-determined by earlier social circumstances, providing optimism for interventions relevant to reducing social gradients in HRBs. Observing consistent findings across the cohorts implies the social patterning of adult lifestyles may persist across time.
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Affiliation(s)
- Claire Mawditt
- International Centre for Lifecourse Studies in Society and Health, Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom.
| | - Amanda Sacker
- International Centre for Lifecourse Studies in Society and Health, Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom.
| | - Annie Britton
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom.
| | - Yvonne Kelly
- International Centre for Lifecourse Studies in Society and Health, Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom.
| | - Noriko Cable
- International Centre for Lifecourse Studies in Society and Health, Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom.
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260
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Ho KY, Li HCW, Lam KKW, Chan SSC, Wang MP, Chan VWF, Xia VW, Lam TH. Exploratory study on the relationship between smoking and other risk behaviours among young smokers. J Clin Nurs 2018; 27:2859-2867. [PMID: 29633459 DOI: 10.1111/jocn.14375] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2018] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore the relationship between smoking and other risk behaviours among Chinese young people in Hong Kong. BACKGROUND There is growing concern about coexisting risk behaviours in young smokers. Information about smoking and other risk behaviours is crucial for developing interventions to promote smoking abstinence and adoption of healthy lifestyles. The relationship between smoking and other risk behaviours among Chinese young people in Hong Kong has not been explored. DESIGN This is a mixed-method retrospective population-based study. METHODS A retrospective population-based study was conducted with 1,147 young smokers through Youth Quitline between November 2011-July 2016. Attitudes, behaviours and experiences related to smoking and risk behaviours among Chinese young smokers were examined in semi-structured qualitative interviews with 30 participants randomly selected from the retrospective population-based study. RESULTS In total, 45.5% participants reported engaging in at least one other risk behaviour. The interviews revealed that drinking alcohol may have a significant impact on quitting smoking. In addition, smoking may be a gateway for more serious risk behaviours during adolescence. Low health awareness may explain the unhealthy lifestyles among young smokers. CONCLUSIONS This study bridges a gap in existing literature by exploring relationships between smoking and other risk behaviours among young people in Hong Kong. RELEVANCE TO CLINICAL PRACTICE Given the interrelationships between smoking and other risk behaviours, a holistic approach should be used to promote smoking cessation and healthy lifestyles among young smokers. If young smokers improve their health and quit smoking at the same time, their physical and mental development will benefit as a secondary outcome.
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Affiliation(s)
- Ka Yan Ho
- School of Nursing, University of Hong Kong, Pokfulam, Hong Kong
| | | | | | | | - Man Ping Wang
- School of Nursing, University of Hong Kong, Pokfulam, Hong Kong
| | | | - Viveka Wei Xia
- School of Nursing, University of Hong Kong, Pokfulam, Hong Kong
| | - Tai Hing Lam
- School of Public Health, University of Hong Kong, Pokfulam, Hong Kong
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261
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Hobbs M, Duncan MJ, Collins P, Mckenna J, Schoeppe S, Rebar AL, Alley S, Short C, Vandelanotte C. Clusters of health behaviours in Queensland adults are associated with different socio-demographic characteristics. J Public Health (Oxf) 2018; 41:268-277. [DOI: 10.1093/pubmed/fdy043] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 12/29/2017] [Accepted: 02/13/2018] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The co-occurrence of unhealthy lifestyles, calls for interventions that target multiple health behaviours. This study investigates the clustering of health behaviours and examines demographic differences between each cluster.
Methods
In total, 934 adults from Queensland, Australia completed a cross-sectional survey assessing multiple health behaviours. A two-step hierarchical cluster analysis using multiple iterations identified the optimal number of clusters and the subset of distinguishing health behaviour variables. Univariate analyses of variance and chi-squared tests assessed difference in health behaviours by socio-demographic factors and clusters.
Results
Three clusters were identified: the ‘lower risk’ cluster (n = 436) reported the healthiest profile and met all public health guidelines. The ‘elevated risk’ cluster (n = 105) reported a range of unhealthy behaviours such as excessive alcohol consumption, sitting time, fast-food consumption, smoking, inactivity and a lack of fruit and vegetables. The ‘moderate risk behaviour’ cluster (n = 393) demonstrated some unhealthy behaviours with low physical activity levels and poor dietary outcomes. The ‘elevated risk’ cluster were significantly younger and more socio-economically disadvantaged than both the ‘lower and moderate risk’ clusters.
Discussion
Younger people who live in more deprived areas were largely within the ‘elevated risk’ cluster and represent an important population for MHBC interventions given their wide range of unhealthy behaviours.
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Affiliation(s)
- M Hobbs
- School of Social and Health Sciences, Leeds Trinity University, Leeds, UK
- Centre for Active Lifestyles, Carnegie Faculty, Research Institute of Sport, Physical Activity and Leisure, Leeds Beckett University, 227 Fairfax Hall, Headingley Campus, Leeds, UK
| | - M J Duncan
- School of Medicine & Public Health, Priority Research Centre for Physical Activity and Nutrition, Faculty of Health and Medicine, The University of Newcastle, Newcastle, UK
| | - P Collins
- Centre for Active Lifestyles, Carnegie Faculty, Research Institute of Sport, Physical Activity and Leisure, Leeds Beckett University, 227 Fairfax Hall, Headingley Campus, Leeds, UK
| | - J Mckenna
- School of sport, Leeds Beckett University, Headingley Campus, Leeds, UK
| | - S Schoeppe
- Physical Activity Research Group, Appleton Institute, School of Health Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
| | - A L Rebar
- Physical Activity Research Group, Appleton Institute, School of Health Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
| | - S Alley
- Physical Activity Research Group, Appleton Institute, School of Health Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
| | - C Short
- Freemasons Foundation Centre for Men’s Health, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - C Vandelanotte
- Physical Activity Research Group, Appleton Institute, School of Health Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
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262
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Holahan CJ, Brennan PL, Schutte KK, Holahan CK, Hixon JG, Moos RH. Drinking Level Versus Drinking Pattern and Cigarette Smoking Among Older Adults. Alcohol Clin Exp Res 2018; 42:795-802. [PMID: 29417610 DOI: 10.1111/acer.13607] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 01/30/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND There is a lack of research on the role of alcohol consumption in cigarette smoking among older adults, and the few studies on alcohol use and smoking with older adults have failed to distinguish between average level and pattern of drinking as predictors of smoking. The main purpose of this study was to examine the independent contributions of average level versus pattern of drinking as predictors of cigarette smoking among older adults. A subsidiary purpose was to examine the link between continued smoking and mortality among older smokers. METHODS We investigated average level and pattern of drinking as predictors of current smoking among 1,151 older adults at baseline and of continued smoking and mortality among the subset of 276 baseline smokers tracked across 20 years. We used multiple linear and logistic regression analyses and, to test mediation, bias-corrected bootstrap confidence intervals. RESULTS A high level of average drinking and a pattern of episodic heavy drinking were concurrently associated with smoking at baseline. However, only episodic heavy drinking was prospectively linked to continued smoking among baseline smokers. Continued smoking among baseline smokers increased the odds of 20-year mortality and provided an indirect pathway through which heavy episodic drinking related to mortality. CONCLUSIONS Smokers who misuse alcohol are a challenging population for smoking cessation efforts. Older adults who concurrently misuse alcohol and smoke cigarettes provide a unique target for public health interventions.
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Affiliation(s)
- Charles J Holahan
- Department of Psychology , University of Texas at Austin, Austin, Texas
| | - Penny L Brennan
- Institute for Health and Aging , University of California, San Francisco, San Francisco, California
| | - Kathleen K Schutte
- Center for Health Care Evaluation , VA Palo Alto Health Care System, Palo Alto, California
| | - Carole K Holahan
- Department of Kinesiology and Health Education , University of Texas at Austin, Austin, Texas
| | - J Gregory Hixon
- Department of Psychology , University of Texas at Austin, Austin, Texas
| | - Rudolf H Moos
- Department of Psychiatry and Behavioral Sciences , Stanford University School of Medicine, Stanford, California
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263
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Kino S, Bernabé E, Sabbah W. The role of healthcare and education systems in co-occurrence of health risk behaviours in 27 European countries. Eur J Public Health 2018; 28:186-192. [PMID: 29346661 DOI: 10.1093/eurpub/ckx071] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Contextual factors play an important role in health and related behaviours. This study aims to examine the association of co-occurrence of five health-risk behaviours with healthcare and education contextual factors using nationally representative samples from 27 European countries. Methods Data were from Eurobarometer 72.3, 2009. The outcome was a count variable ranging from 0 to 5 indicating co-occurrence of five health-risk behaviours, namely smoking, excessive alcohol consumption, non-frequent fresh fruit consumption, physical inactivity and non-dental check-ups. Public expenditures on healthcare and education as a percentage of GDP and quality of healthcare and education at a country-level were used as contextual factors. A set of multilevel Poisson regression models were conducted to examine the associations between co-occurrence of health-risk behaviours and each of the contextual factors considering age, gender, marital status, urbanisation, individual socioeconomic positions (education, subjective social status or difficulty in paying bills) and GDP per capita. Results The total population was 23 842. Greater expenditures on healthcare and education, and better quality of healthcare systems had negative associations with co-occurrence of health-risk behaviours in the model adjusted for all individual demographic indicators. However, statistical significance disappeared after adjusting for socioeconomic indicators and GDP per capita. Conclusion While the study highlights the importance of developing high-quality healthcare and education systems generously supported by public fund in relation to co-occurrence of health-risk behaviours, the influence of contextual factors in adopting health-related behaviours is probably attenuated by individual socioeconomic factors.
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Affiliation(s)
- Shiho Kino
- Division of Population and Patient Health, King's College London Dental Institute at Guy's, King's College and St Thomas' Hospitals, London, UK
| | - Eduardo Bernabé
- Division of Population and Patient Health, King's College London Dental Institute at Guy's, King's College and St Thomas' Hospitals, London, UK
| | - Wael Sabbah
- Division of Population and Patient Health, King's College London Dental Institute at Guy's, King's College and St Thomas' Hospitals, London, UK
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264
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Webb LA, McDonnell KK. Not a Death Sentence: Perspectives of African American Women Living With Lung Cancer
. Oncol Nurs Forum 2018; 45:46-54. [PMID: 29251297 DOI: 10.1188/18.onf.46-54] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To conduct a descriptive, qualitative study to describe the experience of female African American lung cancer survivors, their perception of living with lung cancer, and their desire and ability to adopt positive health-related behaviors.
. PARTICIPANTS & SETTING The sample consisted of 18 African American women with a history of stages I-IIIa lung cancer. Three focus groups were conducted in a private conference center in two community hospitals in the southeastern United States.
. METHODOLOGIC APPROACH A 20-item questionnaire was used to collect demographic, health status, and behavior information. A trained moderator led the audio-recorded focus group discussions using a semistructured interview guide.
. FINDINGS Thematic analysis of the professionally transcribed data resulted in identification of four major themes. In addition, participants experienced stigma that influenced their perspectives on living with lung cancer.
. IMPLICATIONS FOR NURSING Healthcare professionals should provide culturally tailored communication and support for female African American lung cancer survivors. Additional research is needed to inform the development of interventions focused on health behavior change to enhance lung cancer survivorship in this vulnerable and understudied group.
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265
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Kritsotakis G, Konstantinidis T, Androulaki Z, Rizou E, Asprogeraka EM, Pitsouni V. The relationship between smoking and convivial, intimate and negative coping alcohol consumption in young adults. J Clin Nurs 2017; 27:2710-2718. [DOI: 10.1111/jocn.13889] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2017] [Indexed: 02/04/2023]
Affiliation(s)
- George Kritsotakis
- Laboratory of Epidemiology, Prevention & Management of Diseases Nursing Department Technological Educational Institute (TEI) of Crete Heraklion Greece
| | - Theocharis Konstantinidis
- Laboratory of Epidemiology, Prevention & Management of Diseases Nursing Department Technological Educational Institute (TEI) of Crete Heraklion Greece
| | - Zacharenia Androulaki
- Laboratory of Epidemiology, Prevention & Management of Diseases Nursing Department Technological Educational Institute (TEI) of Crete Heraklion Greece
| | - Efthymia Rizou
- Laboratory of Epidemiology, Prevention & Management of Diseases Nursing Department Technological Educational Institute (TEI) of Crete Heraklion Greece
| | - Eleni Maria Asprogeraka
- Laboratory of Epidemiology, Prevention & Management of Diseases Nursing Department Technological Educational Institute (TEI) of Crete Heraklion Greece
| | - Vasiliki Pitsouni
- Laboratory of Epidemiology, Prevention & Management of Diseases Nursing Department Technological Educational Institute (TEI) of Crete Heraklion Greece
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266
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Jordão LMR, Malta DC, Freire MDCM. Clustering patterns of oral and general health-risk behaviours in Brazilian adolescents: Findings from a national survey. Community Dent Oral Epidemiol 2017; 46:194-202. [PMID: 29168590 DOI: 10.1111/cdoe.12354] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 10/24/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate how oral and general health-risk behaviours cluster among Brazilian adolescents. METHODS The study comprised a total of 109 104 adolescents (52.2% female) participating in the Brazilian National School-based Student Health Survey (PeNSE). Seventeen behaviours (including diet; oral and hand hygiene; frequency of dental visits; tobacco, alcohol and drug use; sexual behaviour; physical activity, and risk for external causes) were measured using a self-reported questionnaire. Pairwise correlations between the health-risk behaviours were performed, and clustering was assessed by the hierarchical agglomerative cluster analysis (HACA), which was used to identify stable cluster solutions of the health-risk behaviours. RESULTS All health-risk behaviours were correlated with at least 1 behaviour (P < .01). HACA indicated 2 broad stable clusters (n = 105 604). The first cluster included current smoking, illegal drug use, no hand washing before meals, unprotected sex, no helmet use, less frequent toothbrushing, no seatbelt use, physical fighting, skipping breakfast, current drinking, high sugar intake and, at the final stage, no dental visits. The second cluster included insufficient physical activity, eating while watching TV or studying, and low fruit intake. CONCLUSIONS The health-risk behaviours clustered into 2 specific patterns among Brazilian adolescents. One cluster gathered a combination of lack of adherence to preventive behaviours and the undertaking of risky conduct, while the second reflected an unhealthy lifestyle (sedentary habits and low fruit diet). Knowledge about the clustering patterns of oral and general health behaviours in adolescents can better direct the integration of oral and general health promotion interventions.
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Affiliation(s)
- Lidia M R Jordão
- School of Dentistry, Federal University of Goiás, Goiânia-GO, Brazil
| | - Deborah C Malta
- School of Nursing, Federal University of Minas Gerais, Belo Horizonte-MG, Brazil
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267
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Trudel-Fitzgerald C, Tworoger SS, Poole EM, Zhang X, Giovannucci EL, Meyerhardt JA, Kubzansky LD. Psychological symptoms and subsequent healthy lifestyle after a colorectal cancer diagnosis. Health Psychol 2017; 37:207-217. [PMID: 29154605 DOI: 10.1037/hea0000571] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Although medical professionals recommend lifestyle changes following a colorectal cancer (CRC) diagnosis to improve outcomes, such changes are not consistently implemented. This study examines whether higher distress is associated with lower likelihood of engaging in favorable behaviors after CRC diagnosis. METHOD Women from the Nurses' Health Study prospective cohort who completed anxiety (n = 145) and depression (n = 227) symptom scales within 4 years after receiving a CRC diagnosis were included. Measures of lifestyle (diet, physical activity, alcohol, smoking, body mass index [BMI]) were queried prediagnosis, when psychological symptoms were assessed (1988 and 1992, respectively), and then every 4 years thereafter until 2010. Women were categorized according to initial psychological symptoms levels and followed through 2010 or until last follow-up completed. RESULTS Higher versus lower anxiety symptoms were significantly related to unhealthier lifestyle scores throughout follow-up (β = -0.25, CI [-0.44, -0.05]); however, the rate of change over time was similar across groups (pinteraction effect = 0.41). Stratified analyses hinted that higher anxiety and depression symptoms were related to increased odds of reporting a future unhealthy lifestyle within 10-years postdiagnosis. Beyond 10 years, anxiety became statistically unrelated with future lifestyle, and higher depressive symptoms were associated with lower odds of subsequently having an unhealthy lifestyle, albeit nonstatistically significant (OR = 0.35, 95% CI [0.10, 1.24], p = 0.10). CONCLUSIONS Among women with CRC, higher anxiety and depression symptoms were associated with subsequent unhealthier lifestyle in the 10 years following diagnosis. With replication, such findings may suggest that treating psychological symptoms early in the cancer trajectory may not solely reduce psychological distress but also promote healthier lifestyle. (PsycINFO Database Record
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Affiliation(s)
| | - Shelley S Tworoger
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital
| | - Elizabeth M Poole
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital
| | - Xuehong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital
| | | | | | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health
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268
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Effects of Adolescent Sport Practice on Health Outcomes of Adult Amateur Endurance Cyclists: Adulthood Is Not Too Late to Start. J Phys Act Health 2017; 14:876-882. [DOI: 10.1123/jpah.2017-0010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: We investigated the effects of adolescent sport practice on the training, performance, and health outcomes of adult amateur endurance cyclists and compared health outcomes of 3 adult groups: amateur endurance cyclists who practiced sports during adolescence, amateur endurance cyclists who did not practice sports during adolescence, and inactive individuals. Methods: In 859 (751 men and 108 women) adult cyclists and 718 inactive subjects (307 men and 411 women), we examined adolescent sport practice, current training status, quality of life, quality of sleep, anxiety and depression, and cardiometabolic risk: body mass index, physical activity, physical fitness, adherence to Mediterranean diet, and alcohol and tobacco consumption. Results: Independent of gender, no significant differences in training, performance, or health outcomes were observed between amateur endurance cyclists who practiced sports during adolescence and those who did not. Independent of gender, cyclists reported significantly better health outcomes than inactive individuals in all variables, except depression. Conclusions: Training, performance, and health outcomes did not differ between adult amateur endurance cyclists who practiced sports during adolescence and those who did not, but their health outcomes were significantly improved compared with inactive individuals, except for depression.
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269
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Menai M, Brouard B, Vegreville M, Chieh A, Schmidt N, Oppert JM, Lelong H, Loprinzi PD. Cross-Sectional and longitudinal associations of objectively-measured physical activity on blood pressure: evaluation in 37 countries. Health Promot Perspect 2017; 7:190-196. [PMID: 29085795 PMCID: PMC5647353 DOI: 10.15171/hpp.2017.34] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 08/12/2017] [Indexed: 11/24/2022] Open
Abstract
Background: We examined the cross-sectional and longitudinal associations of objectively-measured physical activity (step counts) and blood pressure (BP) among adults spanning 37 countries. Methods: Across 37 countries, we used data from a pool of 9238 adult owners of Withings’ Pulse activity trackers, which measures steps taken each day, and Wireless Blood Pressure Monitor, which measures BP. Analyses were adjusted on age, sex, number of days where the tracker was worn, and number of BP measurements. Data was collected from 2009 to 2013. Results: Subjects had a mean ± standard deviation (SD) age of 51.6 ± 11.3 years and a body mass index (BMI) of 28.7±5.5 kg/m2. A 1-month increase of more than 3000 steps per day was associated with a decrease of systolic BP (SBP) and diastolic BP (DBP) among the obese (1.57mm Hg and 1.29 mm Hg respectively, both P<0.001) and the overweight population (0.79 mm Hg and 0.84 mm Hg respectively, both P≤0.001), but not in the normal weight population (P=0.60 and P=0.36 respectively). Conclusion: One-month increases in daily step counts was associated with a decrease of SBP and DBP in a large obese and overweight free living population.
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Affiliation(s)
| | | | | | - Angela Chieh
- Nokia Digital Health, Issy-les-Moulineaux, France
| | | | - Jean-Michel Oppert
- Department of Nutrition Pitié-Salpêtrière Hospital (AP-HP), Institute of Cardiometabolism and Nutrition (ICAN), Université Pierre et Marie Curie-Paris, Paris, France
| | - Hélène Lelong
- Paris-Descartes University, Faculty of Medicine; Hôtel-Dieu Hospital; AP-HP; Diagnosis and Therapeutic Center, Paris, France
| | - Paul D Loprinzi
- Department of Health, Exercise Science and Recreation Management, Physical Activity Epidemiology Laboratory, University of Mississippi, Mississippi, USA
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270
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Livingstone KM, McNaughton SA. A Health Behavior Score is Associated with Hypertension and Obesity Among Australian Adults. Obesity (Silver Spring) 2017; 25:1610-1617. [PMID: 28712161 DOI: 10.1002/oby.21911] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/28/2017] [Accepted: 05/29/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To investigate associations between a health behavior score and prevalence of hypertension and overweight/obesity. METHODS Adults (n = 4,609; 19-85 years) were included from the cross-sectional Australian National Nutrition and Physical Activity Survey. A health behavior score was derived based on individuals meeting recommendations for diet quality, smoking, physical activity, sedentary time, and sleep. Poisson regression estimated the prevalence ratio (PR) of hypertension and overweight/obesity by health behavior score. RESULTS Individuals meeting three (PR: 0.67, 95% CI: 0.54-0.86; P = 0.001), four (PR: 0.76, 95% CI: 0.59-0.96; P = 0.024), or five (PR: 0.63, 95% CI: 0.43-0.94; P = 0.024) health behavior recommendations had a lower hypertension PR compared with those meeting zero or one recommendation. The PR of overweight/obesity was lower in individuals meeting three (PR: 0.98, 95% CI: 0.95-1.02; P = 0.019), four (PR: 0.95, 95% CI: 0.91-0.99; P = 0.019), or five (PR: 0.94, 95% CI: 0.90-0.99; P = 0.022) recommendations compared with those meeting zero or one. CONCLUSIONS Hypertension and overweight/obesity prevalence were lower in individuals who had above-average diet quality, never smoked, were physically active, spent less time sedentary, and got adequate sleep. These findings support a holistic approach to public health recommendations.
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Affiliation(s)
- Katherine M Livingstone
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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271
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Grosso G, Micek A, Godos J, Pajak A, Sciacca S, Galvano F, Boffetta P. Health risk factors associated with meat, fruit and vegetable consumption in cohort studies: A comprehensive meta-analysis. PLoS One 2017; 12:e0183787. [PMID: 28850610 PMCID: PMC5574618 DOI: 10.1371/journal.pone.0183787] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 08/11/2017] [Indexed: 12/17/2022] Open
Abstract
The aim of this study was to perform a meta-analysis to test the association between red, processed, and total meat, as well as fruit and vegetable consumption, and selected health risk factors, including body weight status, smoking habit, physical activity level, level of education, and alcohol drinking in cohort studies on non-communicable disease. A systematic search of electronic databases was performed to identify relevant articles published up to March 2017. In a two-stage approach, frequency-weighted linear regression coefficients were first calculated for each variable, and then combined across studies through meta-regression. Ninety-eight studies including 20 on red meat, 6 on processed meat, 12 on total meat, 37 on fruit and vegetable combined, 21 on fruit and 24 on vegetable consumption were analyzed. Intake of red meat was positively associated with BMI, percentage of overweight and obese, low physical activity, and current and ever smoking and inversely associated with percentage of non-smokers and high physically active individuals. Similar associations were found for red meat were found, although based on fewer data. Intake of fruits and vegetables was positively associated with prevalence of non-smokers, high education and high physical activity, and similar results were found when examining fruit and vegetable consumption separately. Stratification by geographical area revealed that some associations were stronger in US rather than European or Asian cohorts. In conclusions, the distribution of health risk factors associated with high meat and fruit/vegetable consumption may differ from those of low-consumers. Some of these differences may mediate, confound, or modify the relation between diet and non-communicable disease risk.
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Affiliation(s)
- Giuseppe Grosso
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Azienda Ospedaliera Policlinico-Universitaria “Vittorio Emanuele”, Catania, Italy
- The Need for Nutrition Education/Innovation Programme (NNEdPro), University of Cambridge, Cambridge, United Kingdom
- * E-mail:
| | - Agnieszka Micek
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - Justyna Godos
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Azienda Ospedaliera Policlinico-Universitaria “Vittorio Emanuele”, Catania, Italy
| | - Andrzej Pajak
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - Salvatore Sciacca
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Azienda Ospedaliera Policlinico-Universitaria “Vittorio Emanuele”, Catania, Italy
| | - Fabio Galvano
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Paolo Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
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Nooijen CFJ, Möller J, Forsell Y, Ekblom M, Galanti MR, Engström K. Do unfavourable alcohol, smoking, nutrition and physical activity predict sustained leisure time sedentary behaviour? A population-based cohort study. Prev Med 2017; 101:23-27. [PMID: 28529160 DOI: 10.1016/j.ypmed.2017.05.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 04/25/2017] [Accepted: 05/17/2017] [Indexed: 12/20/2022]
Abstract
Comparing lifestyle of people remaining sedentary during longer periods of their life with those favourably changing their behaviour can provide cues to optimize interventions targeting sedentary behaviour. The objective of this study was to determine lifestyle predictors of sustained leisure time sedentary behaviour and assess whether these predictors were dependent on gender, age, socioeconomic position and occupational sedentary behaviour. Data from a large longitudinal population-based cohort of adults (aged 18-97years) in Stockholm responding to public health surveys in 2010 and 2014 were analysed (n=49,133). Leisure time sedentary behaviour was defined as >3h per day of leisure sitting time e.g. watching TV, reading or using tablet. Individuals classified as sedentary at baseline (n=9562) were subsequently categorized as remaining sedentary (n=6357) or reduced sedentary behaviour (n=3205) at follow-up. Lifestyle predictors were unfavourable alcohol consumption, smoking, nutrition, and physical activity. Odds ratios (OR) and corresponding 95% Confidence Intervals (CI) were calculated, adjusting for potential confounders. Unfavourable alcohol consumption (OR=1.22, CI:1.11-1.34), unfavourable candy- or cake consumption (OR=1.15, CI:1.05-1.25), and unfavourable physical activity in different contexts were found to predict sustained sedentary behaviour, with negligible differences according to gender, age, socioeconomic position and occupational sedentary behaviour. People with unfavourable lifestyle profiles regarding alcohol, sweets, or physical activity are more likely to remain sedentary compared to sedentary persons with healthier lifestyle. The impact of combining interventions to reduce leisure time sedentary behaviour with reducing alcohol drinking, sweet consumption and increasing physical activity should be tested as a promising strategy for behavioural modification.
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Affiliation(s)
- Carla F J Nooijen
- Department of Public Health Sciences, Karolinska Institutet, Solnavägen 1E, plan 6, 11365 Stockholm, Sweden.
| | - Jette Möller
- Department of Public Health Sciences, Karolinska Institutet, Solnavägen 1E, plan 6, 11365 Stockholm, Sweden
| | - Yvonne Forsell
- Department of Public Health Sciences, Karolinska Institutet, Solnavägen 1E, plan 6, 11365 Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm Health Care District, Solnavägen 1E, plan 6, 11365 Stockholm, Sweden
| | - Maria Ekblom
- The Swedish School of Sport and Health Sciences (GIH), Lidingövägen 1, 114 33 Stockholm, Sweden; The Department of Neuroscience, Karolinska Institutet, Retzius Väg 8, 171 65 Solna, Sweden
| | - Maria R Galanti
- Department of Public Health Sciences, Karolinska Institutet, Solnavägen 1E, plan 6, 11365 Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm Health Care District, Solnavägen 1E, plan 6, 11365 Stockholm, Sweden
| | - Karin Engström
- Department of Public Health Sciences, Karolinska Institutet, Solnavägen 1E, plan 6, 11365 Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm Health Care District, Solnavägen 1E, plan 6, 11365 Stockholm, Sweden
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273
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Jentsch F, Allen J, Fuchs J, von der Lippe E. Typical patterns of modifiable health risk factors (MHRFs) in elderly women in Germany: results from the cross-sectional German Health Update (GEDA) study, 2009 and 2010. BMC Womens Health 2017; 17:23. [PMID: 28372561 PMCID: PMC5379506 DOI: 10.1186/s12905-017-0380-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 03/15/2017] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Modifiable health risk factors (MHRFs) significantly affect morbidity and mortality rates and frequently occur in specific combinations or risk clusters. Using five MHRFs (smoking, high-risk alcohol consumption, physical inactivity, low intake of fruits and vegetables, and obesity) this study investigates the extent to which risk clusters are observed in a representative sample of women aged 65 and older in Germany. Additionally, the structural composition of the clusters is systematically compared with data and findings from other countries. METHODS A pooled data set of Germany's representative cross-sectional surveys GEDA09 and GEDA10 was used. The cohort comprised 4,617 women aged 65 and older. Specific risk clusters based on five MHRFs are identified, using hierarchical cluster analysis. The MHRFs were defined as current smoking (daily or occasionally), risk alcohol consumption (according to the Alcohol Use Disorders Identification Test, a sum score of 4 or more points), physical inactivity (less active than 5 days per week for at least 30 min and lack of sports-related activity in the last three months), low intake of fruits and vegetables (less than one serving of fruits and one of vegetables per day), and obesity (a body mass index equal to or greater than 30). A total of 4,292 cases with full information on these factors are included in the cluster analysis. Extended analyses were also performed to include the number of chronic diseases by age and socioeconomic status of group members. RESULTS A total of seven risk clusters were identified. In a comparison with data from international studies, the seven risk clusters were found to be stable with a high degree of structural equivalency. CONCLUSION Evidence of the stability of risk clusters across various study populations provides a useful starting point for long-term targeted health interventions. The structural clusters provide information through which various MHRFs can be evaluated simultaneously.
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Affiliation(s)
- Franziska Jentsch
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, Berlin, D-12101 Germany
| | - Jennifer Allen
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, Berlin, D-12101 Germany
| | - Judith Fuchs
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, Berlin, D-12101 Germany
| | - Elena von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, Berlin, D-12101 Germany
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274
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An R, Loehmer E, Khan N, Scott MK, Rindfleisch K, McCaffrey J. Community partnerships in healthy eating and lifestyle promotion: A network analysis. Prev Med Rep 2017; 6:294-301. [PMID: 28417062 PMCID: PMC5390690 DOI: 10.1016/j.pmedr.2017.03.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 02/07/2017] [Accepted: 03/13/2017] [Indexed: 11/25/2022] Open
Abstract
Promoting healthy eating and lifestyles among populations with limited resources is a complex undertaking that often requires strong partnerships between various agencies. In local communities, these agencies are typically located in different areas, serve diverse subgroups, and operate distinct programs, limiting their communication and interactions with each other. This study assessed the network of agencies in local communities that promote healthy eating and lifestyles among populations with limited resources. Network surveys were administered in 2016 among 89 agencies located in 4 rural counties in Michigan that served limited-resource audiences. The agencies were categorized into 8 types: K-12 schools, early childhood centers, emergency food providers, health-related agencies, social resource centers, low-income/subsidized housing complexes, continuing education organizations, and others. Network analysis was conducted to examine 4 network structures-communication, funding, cooperation, and collaboration networks between agencies within each county. Agencies had a moderate level of cooperation, but were only loosely connected in the other 3 networks, indicated by low network density. Agencies in a network were decentralized rather than centralized around a few influential agencies, indicated by low centralization. There was evidence regarding homophily in a network, indicated by some significant correlations within agencies of the same type. Agencies connected in any one network were considerably more likely to be connected in all the other networks as well. In conclusion, promoting healthy eating and lifestyles among populations with limited resources warrants strong partnership between agencies in communities. Network analysis serves as a useful tool to evaluate community partnerships and facilitate coalition building.
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Affiliation(s)
- Ruopeng An
- Kinesiology & Community Health, University of Illinois at Urbana-Champaign, 1206 South Fourth Street, Room 2013 Huff Hall, Champaign, IL 61820, USA
| | - Emily Loehmer
- University of Illinois Extension, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
| | - Naiman Khan
- Kinesiology & Community Health, University of Illinois at Urbana-Champaign, 1206 South Fourth Street, Room 2013 Huff Hall, Champaign, IL 61820, USA
| | | | | | - Jennifer McCaffrey
- University of Illinois Extension, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
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275
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Kopperstad Ø, Skogen JC, Sivertsen B, Tell GS, Sæther SMM. Physical activity is independently associated with reduced mortality: 15-years follow-up of the Hordaland Health Study (HUSK). PLoS One 2017; 12:e0172932. [PMID: 28328994 PMCID: PMC5362079 DOI: 10.1371/journal.pone.0172932] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 02/13/2017] [Indexed: 12/25/2022] Open
Abstract
Background Physical activity (PA) is associated with lower risk for non-communicable diseases and mortality. We aimed to investigate the prospective association between PA and all-cause and cause-specific mortality, and the impact of other potentially contributing factors. Method Data from the community-based Hordaland Health Study (HUSK, 1997–99) were linked to the Norwegian Cause of Death Registry. The study included 20,506 individuals born 1950–1957 and 2,225 born in 1925–1927 (baseline age 40–49 and 70–74). Based on self-report, individuals were grouped as habitually performing low intensity, short duration, low intensity, longer duration or high intensity PA. The hazard ratios (HR) for all-cause and cause-specific mortality during follow-up were calculated. Measures of socioeconomic status, physical health, mental health, smoking and alcohol consumption were added separately and cumulatively to the model. Results PA was associated with lower all-cause mortality in both older (HR 0.75 (95% CI 0.67–0.84)) and younger individuals (HR 0.82 (95% CI 0.72–0.92)) (crude models, HR: risk associated with moving from low intensity, short duration to low intensity, longer duration PA, and from low intensity, longer duration to high intensity). Smoking, education, somatic diagnoses and mental health accounted for some of the association between physical activity and mortality, but a separate protective effect of PA remained in fully adjusted models for cardiovascular (HR 0.78 (95% CI 0.66–0.92)) and respiratory (HR 0.45 (95% CI 0.32–0.63) mortality (both age-groups together), as well as all-cause mortality in the older age group (HR 0.74, 95%CI 0.66–0.83). Conclusion Low intensity, longer duration and high intensity physical activity was associated with reduced all-cause, respiratory and cardiovascular mortality, indicating that physical activity is beneficial also among older individuals, and that a moderate increase in PA can be beneficial.
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Affiliation(s)
- Øyvind Kopperstad
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Center for Alcohol & Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- The Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway
- Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway
| | - Grethe S. Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Solbjørg Makalani Myrtveit Sæther
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
- * E-mail:
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276
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Mayolas-Pi C, Simón-Grima J, Peñarrubia-Lozano C, Munguía-Izquierdo D, Moliner-Urdiales D, Legaz-Arrese A. Exercise addiction risk and health in male and female amateur endurance cyclists. J Behav Addict 2017; 6:74-83. [PMID: 28358644 PMCID: PMC5573003 DOI: 10.1556/2006.6.2017.018] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background and aims To determine the relationship between the risk of exercise addiction (REA) and health status in amateur endurance cyclists. Methods In 859 (751 men and 108 women) cyclists and 718 inactive subjects (307 men and 411 women), we examined the REA (Exercise Addiction Inventory), training status (volume, frequency, experience, and performance), socioeconomic status, quality of life (QoL) (SF-12), quality of sleep (Pittsburgh Sleep Quality Index), anxiety and depression (Hospital Anxiety and Depression Scale), and cardiometabolic risk: body mass index, physical activity (International Physical Activity Questionnaire), physical condition (International Fitness Scale), adherence to the Mediterranean diet (Mediterranean Diet Adherence Screener), alcohol and tobacco consumption. Results In total, 17% of the cyclists showed evidence of REA and 83% showed low REA. REA occurred independent of age, sex, training, and socioeconomic status (all ps > .05). Regardless of REA, the cyclists displayed a better physical QoL and a lower cardiometabolic risk than the inactive subjects (all ps < .05). The cyclists with REA displayed worse values of mental QoL, quality of sleep, and anxiety than cyclists with low REA (all ps < .05). The REA group had better values of mental QoL and anxiety and similar values of quality of sleep than the inactive subjects. The differences in mental QoL between the REA and low REA groups were significantly greater in women (p = .013). There was no Addiction × Sex interaction in the other analyzed variables. Conclusion Our results suggest that an increased prevalence of REA limits the benefits that amateur endurance cycling has on mental health and quality of sleep.
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Affiliation(s)
- Carmen Mayolas-Pi
- Section of Physical Education and Sports,
University of Zaragoza, Zaragoza,
Spain,Corresponding author: Dra. Carmen Mayolas-Pi; Section
of Physical Education and Sports, University of Zaragoza, Calle Domingo Miral s/n,
50009 Zaragoza, Spain; Phone: +34 976761719; Fax: +34 976761720; E-mail:
| | - Javier Simón-Grima
- Section of Physical Education and Sports,
University of Zaragoza, Zaragoza,
Spain
| | | | - Diego Munguía-Izquierdo
- Department of Sports and Computer Science, Section of
Physical Education and Sports, University Pablo de
Olavide, Seville, Spain
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277
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Eom SY, Hwang MS, Lim JA, Choi BS, Kwon HJ, Park JD, Kim YD, Kim H. Exome-wide association study identifies genetic polymorphisms of C12orf51, MYL2, and ALDH2 associated with blood lead levels in the general Korean population. Environ Health 2017; 16:11. [PMID: 28212632 PMCID: PMC5316181 DOI: 10.1186/s12940-017-0220-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 02/14/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Lead (Pb) is a ubiquitous toxic metal present in the environment that poses adverse health effects to humans. Inter-individual variation in blood Pb levels is affected by various factors, including genetic makeup. However, limited data are available on the association between genetic variation and blood Pb levels. The purpose of this study was to identify the genetic markers associated with blood Pb levels in the Korean population. METHODS The study subjects consisted of 1,483 healthy adults with no history of occupational exposure to Pb. We measured blood Pb levels and calculated probable daily intake of Pb according to dietary data collected using 24-hour recall. We conducted exome-wide association screening using Illumina Human Exome-12v1.2 platform (n = 500) and a replication analysis using VeraCode Goldengate assay (n = 1,483). RESULTS Among the 244,770 single nucleotide polymorphisms (SNPs) tested, 12 SNPs associated with blood Pb level were identified, with suggestive significance level (P < 1 × 10-4). In the Goldengate assay for replication, three SNPs (C12orf51 rs11066280, MYL2 rs12229654, and ALDH2 rs671) were associated with statistically suggestively significant differences in blood Pb levels. When stratified by drinking status, a potential association of C12orf51 rs11066280, MYL2 rs12229654, and ALDH2 rs671 with blood Pb level was observed only in drinkers. A marginally significant gene-environment interaction between ALDH2 rs671 and alcohol consumption was observed in relation to blood Pb levels. The effects of the three suggestively significant SNPs on blood Pb levels was dependent on daily calcium intake amounts. CONCLUSIONS This exome-wide association study indicated that C12orf51 rs11066280, MYL2 rs12229654, and ALDH2 rs671 polymorphisms are linked to blood Pb levels in the Korean population. Our results suggest that these three SNPs are involved in the determination of Pb levels in Koreans via the regulation of alcohol drinking behavior, and that their negative effects may be compensated by appropriate calcium intake.
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Affiliation(s)
- Sang-Yong Eom
- Department of Preventive Medicine, College of Medicine, Chungbuk National University, 1 Chungdae-Ro, Seowon-Gu, Cheongju, Chungbuk 28644 Korea
| | - Myung Sil Hwang
- Food Risk Analysis Division, National Institute of Food and Drug Safety Evaluation, 187 Osongsaengmyeong 2-Ro, Heungdeok-Gu, Cheongju 28159 Korea
| | - Ji-Ae Lim
- Department of Preventive Medicine, Dankook University College of Medicine, 119 Dandae-Ro, Dongnam-Gu, Cheonan, Chungnam 31116 Korea
| | - Byung-Sun Choi
- Department of Preventive Medicine, Chung-Ang University College of Medicine, 84 Heukseok-Ro, Dongjak-Gu, Seoul, 06974 Korea
| | - Ho-Jang Kwon
- Department of Preventive Medicine, Dankook University College of Medicine, 119 Dandae-Ro, Dongnam-Gu, Cheonan, Chungnam 31116 Korea
| | - Jung-Duck Park
- Department of Preventive Medicine, Chung-Ang University College of Medicine, 84 Heukseok-Ro, Dongjak-Gu, Seoul, 06974 Korea
| | - Yong-Dae Kim
- Department of Preventive Medicine, College of Medicine, Chungbuk National University, 1 Chungdae-Ro, Seowon-Gu, Cheongju, Chungbuk 28644 Korea
| | - Heon Kim
- Department of Preventive Medicine, College of Medicine, Chungbuk National University, 1 Chungdae-Ro, Seowon-Gu, Cheongju, Chungbuk 28644 Korea
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278
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Meader N. Promising evidence for nutrition interventions in people with serious mental illness. Br J Psychiatry 2017; 210:94-95. [PMID: 28148515 DOI: 10.1192/bjp.bp.116.193318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 11/10/2016] [Indexed: 01/06/2023]
Abstract
People with serious mental illness (SMI) are more likely to engage in health risk behaviours such as unhealthy eating, physical inactivity and smoking. The review by Teasdale et al in this issue shows the potential for nutrition interventions to help people with SMI to manage their weight.
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Affiliation(s)
- Nick Meader
- Nick Meader, PhD, Centre for Reviews and Dissemination, University of York, York YO10 5DD, UK.
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279
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Mucheru D, Hanlon MC, Campbell LE, McEvoy M, MacDonald-Wicks L. Social Dysfunction and Diet Outcomes in People with Psychosis. Nutrients 2017; 9:nu9010080. [PMID: 28106815 PMCID: PMC5295124 DOI: 10.3390/nu9010080] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 12/26/2016] [Accepted: 01/11/2017] [Indexed: 11/16/2022] Open
Abstract
This analysis aimed to examine the association of social dysfunction with food security status, fruit intake, vegetable intake, meal frequency and breakfast consumption in people with psychosis from the Hunter New England (HNE) catchment site of the Survey of High Impact Psychosis (SHIP). Social dysfunction and dietary information were collected using standardised tools. Independent binary logistic regressions were used to examine the association between social dysfunction and food security status, fruit intake, vegetable intake, meal frequency and breakfast consumption. Although social dysfunction did not have a statistically significant association with most diet variables, participants with obvious to severe social dysfunction were 0.872 (95% CI (0.778, 0.976)) less likely to eat breakfast than those with no social dysfunction p < 0.05. Participants with social dysfunction were therefore, 13% less likely to have breakfast. This paper highlights high rates of social dysfunction, significant food insecurity, and intakes of fruits and vegetables below recommendations in people with psychosis. In light of this, a greater focus needs to be given to dietary behaviours and social dysfunction in lifestyle interventions delivered to people with psychosis. Well-designed observational research is also needed to further examine the relationship between social dysfunction and dietary behaviour in people with psychosis.
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MESH Headings
- Adolescent
- Adult
- Australia
- Breakfast
- Cohort Studies
- Cross-Sectional Studies
- Diet, Healthy/economics
- Diet, Healthy/psychology
- Feeding Behavior/psychology
- Female
- Food Supply/economics
- Humans
- Male
- Middle Aged
- Nutrition Surveys
- Patient Compliance/psychology
- Phobia, Social/economics
- Phobia, Social/etiology
- Phobia, Social/prevention & control
- Phobia, Social/psychology
- Psychotic Disorders/economics
- Psychotic Disorders/physiopathology
- Psychotic Disorders/psychology
- Psychotic Disorders/therapy
- Retrospective Studies
- Social Behavior Disorders/economics
- Social Behavior Disorders/etiology
- Social Behavior Disorders/prevention & control
- Social Behavior Disorders/psychology
- Social Isolation/psychology
- Socioeconomic Factors
- Stress, Psychological/economics
- Stress, Psychological/etiology
- Stress, Psychological/prevention & control
- Stress, Psychological/psychology
- Young Adult
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Affiliation(s)
- Doreen Mucheru
- Faculty Health and Medicine, The University of Newcastle, Callaghan 2308, Australia.
| | - Mary-Claire Hanlon
- Faculty Health and Medicine, The University of Newcastle, Callaghan 2308, Australia.
- Brain and Mental Health Program, Hunter Medical Research Institute, New Lambton 2305, Australia.
- Priority Research Centre for Brain and Mental Health, Mater Hospital, Waratah 2298, Australia.
- Department of Radiation Oncology, Calvary Mater Newcastle, Waratah 2298, Australia.
- Hunter Cancer Research Alliance, The University of Newcastle, Callaghan 2308, Australia.
| | - Linda E Campbell
- Brain and Mental Health Program, Hunter Medical Research Institute, New Lambton 2305, Australia.
- Faculty of Science, The University of Newcastle, Callaghan 2308, Australia.
- Priority Research Centre GrowUpWell, The University of Newcastle, Callaghan 2308, Australia.
| | - Mark McEvoy
- Faculty Health and Medicine, The University of Newcastle, Callaghan 2308, Australia.
- Centre for Clinical Epidemiology & Biostatistics, Hunter Medical Research Institute, New Lambton 2305, Australia.
| | - Lesley MacDonald-Wicks
- Faculty Health and Medicine, The University of Newcastle, Callaghan 2308, Australia.
- Brain and Mental Health Program, Hunter Medical Research Institute, New Lambton 2305, Australia.
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan 2308, Australia.
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280
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Leech RM, Worsley A, Timperio A, McNaughton SA. Temporal eating patterns: a latent class analysis approach. Int J Behav Nutr Phys Act 2017; 14:3. [PMID: 28061795 PMCID: PMC5219683 DOI: 10.1186/s12966-016-0459-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 12/20/2016] [Indexed: 12/04/2022] Open
Abstract
Background There is some evidence that large energy intakes towards the end of the day are associated with adverse health outcomes, however, studies of temporal eating patterns across the day are rare. This study examines the temporal eating patterns of Australian adults using latent class analysis (LCA), as a novel approach. Methods Dietary data (n = 2402 men and n = 2840 women, ≥19 years) from two 24-h recalls collected during the 2011–12 Australian National Nutrition and Physical Activity Survey were analyzed. LCA was performed to identify distinct temporal eating patterns based on whether or not an eating occasion (EO) occurred within each hour of the day. F and adjusted-chi2 tests assessed differences in sociodemographic and eating patterns (e.g., meal, snack and EO frequency) between latent classes. Results Three patterns, labelled “Conventional” (men: 43%, women: 41%), “Later lunch” (men: 34%, women: 34%) and “Grazing” (men: 23%, women: 25%) were identified. Men and women with a “Grazing” pattern were significantly younger (P < 0.001) and a higher proportion were from major cities (P < 0.01) and were not married (men only, P = 0.01), compared to the “Conventional” and “Later lunch” patterns. The “Grazing” pattern was also characterized by a higher EO frequency (P < 0.01) and snack frequency (P < 0.001) and consumption of a higher proportion of total energy intake from snacks but a lower proportion of total energy intake from meals (P < 0.001). Conclusions This study identified three distinct temporal eating patterns in adults that varied by age, EO frequency, snack frequency and energy intake pattern. LCA is a useful approach to capture differences in EO timing across the day. Future research should examine associations between temporal eating patterns and health.
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Affiliation(s)
- Rebecca M Leech
- The Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
| | - Anthony Worsley
- The Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Anna Timperio
- The Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Sarah A McNaughton
- The Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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281
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Pengpid S, Peltzer K. Prevalence and behavioural risk factors of light or moderate and heavy cigarette smoking in 32 countries. JOURNAL OF PSYCHOLOGY IN AFRICA 2016. [DOI: 10.1080/14330237.2016.1250424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand
- Department of Research & Innovation, University of Limpopo, Polokwane, South Africa
| | - Karl Peltzer
- ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand
- Department of Research & Innovation, University of Limpopo, Polokwane, South Africa
- HIV/AIDS/STIs and TB (HAST), Human Sciences Research Council, Pretoria, South Africa
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282
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Multiple health behaviours among mothers and partners in England: Clustering, social patterning and intra-couple concordance. SSM Popul Health 2016; 2:824-833. [PMID: 28018962 PMCID: PMC5165044 DOI: 10.1016/j.ssmph.2016.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/08/2016] [Accepted: 10/20/2016] [Indexed: 01/01/2023] Open
Abstract
Research on multiple health behaviours is increasing but little is known about parental behaviours and how they covary. Our study investigates cigarette smoking, alcohol intake, fruit and vegetable (F&V) consumption and physical activity among mothers and co-resident partners in England. Using the UK Household Longitudinal Study, we examined (i) clustering of health behaviours using observed-expected ratios and latent class analysis (ii) socio-demographic correlates of the derived latent classes and (iii) intra-couple concordance of individual health behaviours and their latent classes. We identified five latent classes for mothers and partners: Never smoked drinkers (28% of mothers; 29% of partners), Abstainers (25%; 17%), Drinkers and ex-smokers (19%; 26%), Unhealthy low frequency drinkers (18%; 16%) and Unhealthiest behaviour group (11%; 12%). These had distinctive social profiles. Never smoked drinkers were more likely than those in other groups to be white and socially advantaged: married, older, and with higher educational qualifications and incomes. Abstainers were non-smokers who never or occasionally drank, and were disproportionately drawn from ethnic minority groups and middle/lower income families. Drinkers and ex-smokers were the most physically active group and were more likely to be socially advantaged. Unhealthy low frequency drinkers were more likely to be disadvantaged and have a limiting long-standing illness. The Unhealthiest behaviour group had the highest proportion of smokers, heavy smokers and binge drinkers and the lowest F&V intake and physical activity levels. They were largely white and socially disadvantaged: younger, non-married and with lower educational levels. Mothers and their partners typically shared the same risk behaviours, and 44 per cent of partners and mothers belonged to the same latent class. Our findings point to the potential for a broadening of research and policy perspectives, from separate behaviours to combinations of behaviours, and from individuals to the domestic units and communities of which they are part.
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283
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Paul C, Tzelepis F, Bisquera A, Noble N, Wiggers J. Just how high-risk are ongoing smokers? Exploring clusters of health risk behaviours among current and ex-smokers. Prev Med 2016; 93:70-75. [PMID: 27670372 DOI: 10.1016/j.ypmed.2016.09.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 09/13/2016] [Accepted: 09/19/2016] [Indexed: 02/02/2023]
Abstract
There is limited research about the patterns of multiple health risks among smokers, despite the associated increased risk of poor health. This study aimed to identify which risk behaviours were evident in a sample of smokers and ex-smokers who had previously been offered cessation support. A cross-sectional telephone interview in 2013 involved participants from New South Wales, Australia, from the control condition (self-help materials only) of a randomised smoking cessation trial conducted approximately five years earlier. The interview assessed smoking, weight, height, fruit and vegetable intake, physical activity, alcohol intake and depression. Of the 626 eligible participants, 321 were interviewed (consent rate=85.6%, response rate=51.3%); 62% were current smokers. Most participants (57%) reported four or five health risk behaviours. Three risk clusters were identified using latent class analysis: i) 'high risk' (42% of sample): smokers, overweight, inadequate intake of fruit and vegetables and low levels of physical activity; ii) 'lower risk non-depressed' (22% of sample): adequate physical activity and an absence of depression; and iii) 'lower risk, low alcohol' (36% of sample): low alcohol consumption, overweight and depressed. Males and current smokers were more likely to be 'high risk', while women and ex-smokers were more likely to be members of the 'lower risk, low alcohol' cluster. Those who continue to smoke have multiple additional health risks; as do ex-smokers in the 'lower risk, low alcohol' cluster. Achieving good health outcomes for these sizeable groups will require tailored, intensive or case-management approaches which can address multiple health risk behaviours.
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Affiliation(s)
- Christine Paul
- Priority Research Centre for Health Behaviour (PRCHB), School of Medicine and Public Health, Callaghan, University of Newcastle, New South Wales, Australia; Hunter Medical Research Institute (HMRI), New Lambton, New South Wales, Australia
| | - Flora Tzelepis
- Priority Research Centre for Health Behaviour (PRCHB), School of Medicine and Public Health, Callaghan, University of Newcastle, New South Wales, Australia; Hunter Medical Research Institute (HMRI), New Lambton, New South Wales, Australia; Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia
| | - Alessandra Bisquera
- Hunter Medical Research Institute (HMRI), New Lambton, New South Wales, Australia
| | - Natasha Noble
- Priority Research Centre for Health Behaviour (PRCHB), School of Medicine and Public Health, Callaghan, University of Newcastle, New South Wales, Australia; Hunter Medical Research Institute (HMRI), New Lambton, New South Wales, Australia.
| | - John Wiggers
- Priority Research Centre for Health Behaviour (PRCHB), School of Medicine and Public Health, Callaghan, University of Newcastle, New South Wales, Australia; Hunter Medical Research Institute (HMRI), New Lambton, New South Wales, Australia; Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia
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284
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Falkstedt D, Möller J, Zeebari Z, Engström K. Prevalence, co-occurrence, and clustering of health-risk behaviors among people with different socio-economic trajectories: A population-based study. Prev Med 2016; 93:64-69. [PMID: 27663427 DOI: 10.1016/j.ypmed.2016.09.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 09/08/2016] [Accepted: 09/19/2016] [Indexed: 11/25/2022]
Abstract
Only a few previously published studies have investigated the co-occurrence and clustering of health-risk behaviors in people with different socio-economic trajectories from childhood to adulthood. This study was based on data collected through the Stockholm County Council's public health surveys. We selected the 24,241 participants aged 30 to 65years, who responded to a postal questionnaire in 2010. Information on parents' and participants' educational levels was used for classification of four socio-economic trajectories, from childhood to adulthood: the 'stable high', the 'upwardly mobile', the 'downwardly mobile', and the 'stable low'. Information on daily smoking, risky drinking, physical inactivity, and poor diet was used for assessment of health-risk behaviors: their prevalence, co-occurrence, and clustering. We found all health-risk behaviors to be more prevalent among women and men with a downwardly mobile or stable low socio-economic trajectory. Accordingly, having three or four co-occurring health-risk behaviors were much more likely (up to 4 times, in terms of odds ratios) in these groups as compared to the women and men with an upwardly mobile or a stable high socio-economic trajectory. However, clustering of the health-risk behaviors was not found to be stronger in those with a downwardly mobile or stable low socio-economic trajectory. Thus, the fact that women and men with a disadvantageous socio-economic career were found to have co-occurring health-risk behaviors more often than people with an advantageous socio-economic career seemed to be generated by differences in prevalence of the health-risk behaviors, not by differences in clustering of the behaviors.
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Affiliation(s)
- Daniel Falkstedt
- Department of Public Health Sciences, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
| | - Jette Möller
- Department of Public Health Sciences, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Zangin Zeebari
- Department of Public Health Sciences, Karolinska Institutet, SE-171 77 Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm County Council, Sweden
| | - Karin Engström
- Department of Public Health Sciences, Karolinska Institutet, SE-171 77 Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm County Council, Sweden
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285
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Rahe C, Khil L, Wellmann J, Baune BT, Arolt V, Berger K. Impact of major depressive disorder, distinct subtypes, and symptom severity on lifestyle in the BiDirect Study. Psychiatry Res 2016; 245:164-171. [PMID: 27543830 DOI: 10.1016/j.psychres.2016.08.035] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 07/28/2016] [Accepted: 08/10/2016] [Indexed: 11/26/2022]
Abstract
The aim of this study was to examine associations of major depressive disorder (MDD), its distinct subtypes, and symptom severity with the individual lifestyle factors smoking, diet quality, physical activity, and body mass index as well as with a combined lifestyle index measuring the co-occurrence of these lifestyle factors. A sample of 823 patients with MDD and 597 non-depressed controls was examined. The psychiatric assessment was based on a clinical interview including the Mini International Neuropsychiatric Interview and the Hamilton Depression Rating Scale. Each lifestyle factor was scored as either healthy or unhealthy, and the number of unhealthy lifestyle factors was added up in a combined lifestyle index. Cross-sectional analyses were performed using alternating logistic regression and ordinal logistic regression, adjusted for socio-demographic characteristics. After adjustment, MDD was significantly associated with smoking, low physical activity, and overweight. Likewise, MDD was significantly related to the overall lifestyle index. When stratifying for subtypes, all subtypes showed higher odds for an overall unhealthier lifestyle than controls, but the associations with the individual lifestyle factors were partly different. Symptom severity was associated with the lifestyle index in a dose-response manner. In conclusion, patients with MDD represent an important target group for lifestyle interventions.
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Affiliation(s)
- Corinna Rahe
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany.
| | - Laura Khil
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Jürgen Wellmann
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Bernhard T Baune
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Volker Arolt
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany
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286
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Abstract
Chronic non-communicable diseases (NCDs) are the leading causes of morbidity and mortality in the United States and globally, and are attributable largely to poor nutrition and suboptimal lifestyle behaviors. The 2015-2020 Dietary Guidelines for Americans promote healthy eating and lifestyle patterns across the lifespan to reduce risk of NCDs. Physicians are well positioned to provide lifestyle preventive interventions that are personalized to their patients' biological needs and cultural preferences through multidisciplinary team activities or referral to professional nutrition and physical activity experts. They can also advocate for environmental changes in healthcare and community settings that promote healthful lifestyle behaviors.
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Affiliation(s)
- Ruth W Kimokoti
- Department of Nutrition, Simmons College, 300 The Fenway, Boston, MA 02115, USA.
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287
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Graham H, White PCL. Social determinants and lifestyles: integrating environmental and public health perspectives. Public Health 2016; 141:270-278. [PMID: 27814893 DOI: 10.1016/j.puhe.2016.09.019] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Revised: 08/27/2016] [Accepted: 09/13/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Industrialization and urbanization have been associated with an epidemiological transition, from communicable to non-communicable disease, and a geological transition that is moving the planet beyond the stable Holocene epoch in which human societies have prospered. The lifestyles of high-income countries are major drivers of these twin processes. Our objective is to highlight the common causes of chronic disease and environmental change and, thereby, contribute to shared perspectives across public health and the environment. STUDY DESIGN Integrative reviews focused on social determinants and lifestyles as two 'bridging' concepts between the fields of public health and environmental sustainability. METHODS We drew on established frameworks to consider the position of the natural environment within social determinants of health (SDH) frameworks and the position of social determinants within environmental frameworks. We drew on evidence on lifestyle factors central to both public health and environmental change (mobility- and diet-related factors). We investigated how public health's focus on individual behaviour can be enriched by environmental perspectives that give attention to household consumption practices. RESULTS While SDH frameworks can incorporate the biophysical environment, their causal structure positions it as a determinant and one largely separate from the social factors that shape it. Environmental frameworks are more likely to represent the environment and its ecosystems as socially determined. A few frameworks also include human health as an outcome, providing the basis for a combined public health/environmental sustainability framework. Environmental analyses of household impacts broaden public health's concern with individual risk behaviours, pointing to the more damaging lifestyles of high-income households. CONCLUSION The conditions for health are being undermined by rapid environmental change. There is scope for frameworks reaching across public health and environmental sustainability and a shared evidence base that captures the health- and environmentally damaging impacts of high-consumption lifestyles.
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Affiliation(s)
- H Graham
- Department of Health Sciences, University of York, Seebohm Rowntree Building, University of York, YO10 5DD, UK.
| | - P C L White
- Environment Department, Wentworth Way, University of York, York, YO10 5NG, UK
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288
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Balto JM, Ensari I, Hubbard EA, Khan N, Barnes JL, Motl RW. Individual and Co-occurring SNAP Risk Factors: Smoking, Nutrition, Alcohol Consumption, and Physical Activity in People with Multiple Sclerosis. Int J MS Care 2016; 18:298-304. [PMID: 27999524 DOI: 10.7224/1537-2073.2016-040] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Smoking, poor nutrition, excess alcohol consumption, and insufficient physical activity underlie most preventable causes of morbidity in the general population and may be associated with comorbidities and health outcomes in multiple sclerosis (MS). However, the frequency of co-occurrence of these risk factors in people with MS remains unclear. Methods: Sixty-nine individuals with MS completed self-report measures of smoking status, nutrition, alcohol use, physical activity levels, and sociodemographic and clinical characteristics. The data were analyzed using t tests and χ2 analyses. Results: Poor diet was the most common risk factor, with 85.5% of the sample not meeting dietary guidelines. Of participants with two risk factors, 90.3% were not meeting dietary and physical activity guidelines. Seventy-three percent of women were not meeting physical activity guidelines, compared with 38% of men (χ2 = 7.5, P < .01). There were also differential rates by sex of the most commonly co-occurring risk factors: 65% of women reported the co-occurrence of insufficient physical activity and poor diet, compared with 38% of men (χ2 = 4.2, P = .05). Conclusions: These results indicate that 85.5% of the sample was not meeting nutrition guidelines, 90.3% of participants with two risk factors reported the co-occurrence of poor diet and insufficient levels of physical activity, and physical activity levels and the total number of risk factors varied across sex.
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289
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Meader N, King K, Moe-Byrne T, Wright K, Graham H, Petticrew M, Power C, White M, Sowden AJ. A systematic review on the clustering and co-occurrence of multiple risk behaviours. BMC Public Health 2016; 16:657. [PMID: 27473458 PMCID: PMC4966774 DOI: 10.1186/s12889-016-3373-6] [Citation(s) in RCA: 309] [Impact Index Per Article: 38.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 07/26/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Risk behaviours, such as smoking and physical inactivity account for up to two-thirds of all cardiovascular deaths, and are associated with substantial increased mortality in many conditions including cancer and diabetes. As risk behaviours are thought to co-occur in individuals we conducted a systematic review of studies addressing clustering or co-occurrence of risk behaviours and their predictors. As the main aim of the review was to inform public health policy in England we limited inclusion to studies conducted in the UK. METHODS Key databases were searched from 1990 to 2016. We included UK based cross-sectional and longitudinal studies that investigated risk behaviours such as smoking, physical inactivity, unhealthy diet. High heterogeneity precluded meta-analyses. RESULTS Thirty-seven studies were included in the review (32 cross-sectional and five longitudinal). Most studies investigated unhealthy diet, physical inactivity, alcohol misuse, and smoking. In general adult populations, there was relatively strong evidence of clustering between alcohol misuse and smoking; and unhealthy diet and smoking. For young adults, there was evidence of clustering between sexual risk behaviour and smoking, sexual risk behaviour and illicit drug use, and sexual risk behaviour and alcohol misuse. The strongest associations with co-occurrence and clustering of multiple risk behaviours were occupation (up to 4-fold increased odds in lower SES groups) and education (up to 5-fold increased odds in those with no qualifications). CONCLUSIONS Among general adult populations, alcohol misuse and smoking was the most commonly identified risk behaviour cluster. Among young adults, there was consistent evidence of clustering found between sexual risk behaviour and substance misuse. Socio-economic status was the strongest predictor of engaging in multiple risk behaviours. This suggests the potential for interventions targeting multiple risk behaviours either sequentially or concurrently particularly where there is evidence of clustering. In addition, there is potential for intervening at the social or environmental level due to the strong association with socio-economic status.
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Affiliation(s)
- Nick Meader
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD UK
| | - Kristelle King
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD UK
| | - Thirimon Moe-Byrne
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD UK
| | - Kath Wright
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD UK
| | - Hilary Graham
- Department of Health Sciences, University of York, York, UK
| | - Mark Petticrew
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Chris Power
- Population, Policy and Practice, UCL Institute of Child Health, London, UK
| | - Martin White
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Amanda J. Sowden
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD UK
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290
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Kritsotakis G, Psarrou M, Vassilaki M, Androulaki Z, Philalithis AE. Gender differences in the prevalence and clustering of multiple health risk behaviours in young adults. J Adv Nurs 2016; 72:2098-113. [PMID: 27102085 DOI: 10.1111/jan.12981] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2016] [Indexed: 12/24/2022]
Abstract
AIMS To estimate the sex-stratified prevalence and clustering of 14 behavioural and metabolic health risk factors in emerging adulthood. BACKGROUND The high prevalence and the clustering of risk factors multiply health consequences and increase the threat to the future health and quality of life of young adults. DESIGN Descriptive cross-sectional study. METHODS During November-December 2012, we assessed 14 lifestyle characteristics of 1058 1st year university students' that were classified as: healthy (score = 0), unhealthy (score = 1) and high-risk unhealthy (score = 2). We subsequently created a Multiple Health Risk Behaviours Index by summing the score of each behaviour adjusted to 0-100. RESULTS Only 0·3% of the students had one risk behaviour and 21·3% (male: 31·5%; female: 12·6%) had ≥10 of 14. Male students had higher risk index score. In adjusted regression analyses, female students had higher odds of reporting healthier behaviours in oral hygiene (tooth brushing), red meat and junk food consumption, binge drinking, cannabis/hashish/marijuana use and lower number of sexual partners and Body Mass Index. Male students reported higher physical activity. No statistically significant gender differences were noted for screen time/sedentary behaviours, condom use, smoking, sunburns, breakfast and fruit and vegetable consumption. CONCLUSION Although health-compromising behaviours are highly prevalent in both men and women, they are gender-related, with males engaging in more health risk behaviours than females. Preventive interventions may need to focus on gender-informed approaches when targeting multiple health risk behaviours.
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Affiliation(s)
- George Kritsotakis
- Laboratory of Epidemiology, Prevention and Management of Diseases, Nursing Department, Technological Educational Institute (TEI) of Crete, Heraklion, Greece
| | - Maria Psarrou
- Laboratory of Epidemiology, Prevention and Management of Diseases, Nursing Department, Technological Educational Institute (TEI) of Crete, Heraklion, Greece
| | - Maria Vassilaki
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA.,Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Zacharenia Androulaki
- Laboratory of Epidemiology, Prevention and Management of Diseases, Nursing Department, Technological Educational Institute (TEI) of Crete, Heraklion, Greece
| | - Anastas E Philalithis
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
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291
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Miller R, Spiro A, Stanner S. Micronutrient status and intake in the UK - where might we be in 10 years' time? NUTR BULL 2016. [DOI: 10.1111/nbu.12187] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- R. Miller
- British Nutrition Foundation; London UK
| | - A. Spiro
- British Nutrition Foundation; London UK
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292
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The association between habitual physical activity and cigarette cravings, and influence of smokers' characteristics in disadvantaged smokers not ready to quit. Psychopharmacology (Berl) 2016; 233:2765-74. [PMID: 27256353 PMCID: PMC4917568 DOI: 10.1007/s00213-016-4326-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 05/05/2016] [Indexed: 12/17/2022]
Abstract
RATIONALE Habitual physical activity (PA) may have an important role in suppressing cigarette cravings. Systematic reviews show a strong acute effect of bouts of PA on reducing cigarette cravings, and it may be that these effects accumulate. OBJECTIVES The aim was to investigate the relationship between habitual levels of PA and cigarette cravings in disadvantaged smokers not ready to quit by examining baseline cross-sectional data from the Exercise Assisted Reduction then Stop smoking study (EARS). METHODS A series of linear regression models were applied to investigate the relationship between habitual PA and cigarette cravings and to identify additional predictors of cigarette cravings. The analyses were extended by including interaction terms with PA to identify potential moderators of the relationship between PA and cravings. RESULTS A higher level of moderate intensity PA was associated with lower cravings (p = 0.033). Additional predictors were the mood and physical symptoms scale (p = 0.007; higher scores were associated with higher cravings) and alcohol consumption (p = 0.002; higher consumption was associated with lower cravings). In addition, a moderation effect of alcohol consumption was found; at higher levels of alcohol consumption, higher PA was significantly associated with higher cravings (p = 0.023). CONCLUSIONS Overall, participation in regular PA is associated with reduced cigarette cravings; among those with heavy alcohol consumption, this participation is associated with higher cravings. These exploratory analyses suggest that further research into the relationship between PA, alcohol consumption and cigarette cravings is needed.
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