[Lifestyle medicine: the importance of considering all the causes of disease]

Predictors of physical activity in older adults 65 years and older: findings in health survey of the Valencian Community

Background

Physical activity is part of a healthy lifestyle in the older adult and is related to multiple variables that promote this behavior.

Objective

To identify the relationship and predictive power of sociodemographic variables, multimorbidity, severity index, risk of poor mental health, social support, affective support and confidential support with the time devoted to physical activity in the population over 65 years of age in the Valencian Community.

Methods

Cross-sectional descriptive analytical study of the data collected in the Health Survey of the Valencian Community on a total of 3,199 people over 65 years of age. The study variables were age, sex, educational level, marital status, social class, multimorbidity, severity index collected with the EQ-5D-5L tool, risk of poor mental health collected with the Goldberg general health questionnaire (GHQ-12), and perceived social, affective and confidential support collected with the Duke-Unc social support scale (Duke-UNC-11).

Results

All variables, except affective support, are significantly related to the time of physical activity performed by people older than 65 years. The severity index has a predictive capacity of 13.7% of physical activity performed and age is able to predict 1.2% of this variable.

Conclusion

Sex, age, education, social class, marital status, multimorbidity, risk of poor mental health or social support and confidentiality are related to the physical activity time of the Valencian population over 65 years of age. On the other hand, the variables severity index and age have been identified as variables capable of predicting up to 14.8% of the variance of the physical activity time variable in our study population.

Associations between unhealthy lifestyle and depression: Cross-sectional results from the Spanish National Health Survey

INTRODUCTION

Depression usually worsens lifestyle habits, but previous evidence also suggests that an unhealthy lifestyle (UL) increases the risk of depression. Many studies have analyzed the association between lifestyle and depression in several nationally representative samples, but none have done so in the Spanish adult population. Our aim was to examine the associations between UL habits and depression in Spain.

MATERIALS AND METHODS

Analysis of cross-sectional data from the latest National Health Survey published in 2018 (N=23,089). Data on depression and 4 lifestyle factors (diet, physical exercise, smoking, and alcohol consumption) were used. These factors were combined into an UL index ranging from 0 (healthiest lifestyle) to 4 (unhealthiest lifestyle). The prevalence of depression at different levels of the UL index, and the association between depression and both the cumulative UL index and the 4 UL factors was analyzed using parametric and non-parametric tests.

RESULTS

Sedentarism was the most prevalent UL factor, followed by unhealthy diet, smoking and high-risk alcohol consumption. Having ≥1 UL factors was associated with a higher prevalence of depression compared to having 0 UL factors (2.5% vs. ≥5.2%), regardless of the cumulative number UL factors (1, 2, 3 or 4). Being physically inactive (OR=1.6) and a smoker (OR=1.3) increased the likelihood of depression. Being a high-risk wine drinker (OR=0.26) decreased the likelihood of depression. Dietary intake was not significant.

CONCLUSIONS

The prevalence of depression changes depending on several modifiable lifestyle factors. Policy makers should therefore spare no resources in promoting strategies to encourage healthy lifestyles and prevent the acquisition of UL habits.

The Moderating Role of Lifestyle on Insomnia in Home Quarantine College Students During the COVID-19 Epidemic

There has been sufficient evidence for the relationship between lifestyle and insomnia in the general population, but for individuals who already suffer from insomnia, it is not clear whether a healthy lifestyle can also pose similar benefits. The present study investigated the roles of different aspects of lifestyle in the development of individual insomnia by tracking insomnia symptoms of college students during the COVID-19 lock-down. Two surveys were conducted on 65,200 college students in the process of home isolation in Guangdong Province of China, at the pandemic outbreak period (T1) and the initial remission period (T2), respectively. Given the objectives of the present study, a total of 1,702 college students with clinical insomnia from T1 were selected as subjects. Insomnia symptoms were assessed using the Youth Self Rating Insomnia Scale (YSIS), while demographic information, epidemic exposure, and lifestyle were all measured by self-developed questionnaire, through network survey. The 1,702 college students (mean age ± standard deviation, 20.06 ± 1.46, range 16-25; 71.9% females) with insomnia symptoms were divided into three trajectory groups: recovery group, remission group, and chronic insomnia group according to their insomnia scores in T2 phase. The results showed that there was no significant difference in demographic backgrounds or epidemic exposure among the three groups, however, there were significant differences in food intake, exercise, and Internet use. The regression results further showed that both the recovery group and the remission group adopted more regular food intake than the chronic group. The recovery group exhibited better daily exercise habits than both the remission group and the chronic group. The duration of Internet use was significantly shorter for the recovery group than for the chronic group. These findings indicate a strong relationship between the lifestyle and the recovery of insomnia for college students isolated at home during the epidemic period. Significance of the different aspects of lifestyle on the recovery of insomnia are discussed.

The Relationship of Lifestyle with Disease Activity among Patients with Systemic Lupus Erythematosus: A Descriptive-Correlational Study

Objective:

The objective of this study was to evaluate the relationship of lifestyle with disease activity among patients with systemic lupus erythematosus.

Methods:

This cross-sectional descriptive-correlational study was conducted in 2019 on 209 patients with systemic lupus erythematosus. Data were collected using a demographic and clinical characteristics questionnaire, the Health-Promoting Lifestyle Profile II, and the systemic lupus erythematosus disease activity Index. The data were analysed through the mixed model and the logistic regression analyses.

Results:

In total, 67.5% of participants had active disease. The mean score of lifestyle was 2.49±0.30 and the lowest and the highest lifestyle dimensional mean scores were respectively related to the physical activity and the health responsibility dimensions (1.55±0.60 and 3.25±0.45). The analysis showed that each one point increase in the mean score of lifestyle was associated with 0.79 point decrease in the odds of disease activity (P = 0.006). Moreover, disease activity had significant positive relationship with body mass index (P = 0.015).

Conclusion:

Interventions for promoting lifestyle among these patients and improving healthcare providers’ knowledge about Systemic lupus erythematosus and lifestyle modification are recommended to reduce disease activity.

Introduce a New Intervention Model Based on Islamic Lifestyle for Decreasing the Risk of Cardiovascular Disease in People at Risk: A Comparative Study

The main purpose of the present study was designing and assessing the common lifestyle and Islamic lifestyle interventions and comparison of them. Sample of the study was thirty-nine subjects participated in a healthy lifestyle program. The Islamic group were received the Islamic healthy lifestyle program. In comparison with common, in the Islamic group the CVD risk was significantly lower; the psychological well-being was increased significantly; the psychological distress was decreased significantly; and the spiritual well-being was increased significantly. The most powerful element of Islamic lifestyle was to strengthen the spirituality that can positively affect the life.

Religion, Age, Education, Lifestyle, and Health: Structural Equation Modeling

This study aimed to analyze the moderating effect of religion between sociodemographic variables, lifestyle, and self-referred physical and mental health. Cross-sectional study with non-randomized sample of 392 participants. The Eight Natural Remedies Questionnaire was used to assess lifestyle. Religion was found to be positive predictor between age, education and lifestyle, better physical and mental health. Being an Adventist positively influenced the lifestyle (r = 0.680; p < 0.05) and consequently physical (r = 0.222) and mental health (r = 0.220). Belonging to a religion that emphasizes a healthy lifestyle is a contributing factor toward better lifestyle, physical and mental health.

Lifestyle, chronic diseases and self-rated health among Malaysian adults: results from the 2011 National Health and Morbidity Survey (NHMS)

BACKGROUND

Self-rated health (SRH) has been demonstrated as a valid and appropriate predictor of incident mortality and chronic morbidity. Associations between lifestyle, chronic diseases, and SRH have been reported by various population studies but few have included data from developing countries. The aim of this study was to determine the prevalence of poor SRH in Malaysia and its association with lifestyle factors and chronic diseases among Malaysian adults.

METHODS

This study was based on 18,184 adults aged 18 and above who participated in the 2011 National Health and Morbidity Survey (NHMS). The NHMS was a cross-sectional survey (two-stage stratified sample) designed to collect health information on a nationally representative sample of the Malaysian adult population. Data were obtained via face-to-face interviews using validated questionnaires. Two categories were used to measure SRH: "good" (very good and good) and "poor" (moderate, not good and very bad). The association of lifestyle factors and chronic diseases with poor SRH was examined using univariate and multivariate logistic regression.

RESULTS

Approximately one-fifth of the Malaysian adult population (20.1 %) rated their health as poor (men: 18.4 % and women: 21.7 %). Prevalence increases with age from 16.2 % (aged 18-29) to 32.0 % (aged ≥60). In the multivariate logistic regression analysis, lifestyle factors associated with poor SRH included: underweight (OR = 1.29; 95 % CI: 1.05-1.57), physical inactivity (OR = 1.25; 95 % CI: 1.11-1.39), former smoker (OR = 1.38; 95 % CI: 1.12-1.70), former drinker (OR = 1.27; 95 % CI: 1.01-1.62), and current drinker (OR = 1.35; 95 % CI: 1.08-1.68). Chronic diseases associated with poor SRH included: asthma (OR = 1.66; 95 % CI: 1.36-2.03), arthritis (OR = 1.87; 95 % CI: 1.52-2.29), hypertension (OR = 1.39; 95 % CI: 1.18-1.64), hypercholesterolemia (OR = 1.43; 95 % CI: 1.18-1.74), and heart disease (OR = 1.85; 95 % CI: 1.43-2.39).

CONCLUSIONS

This study indicates that several unhealthy lifestyle behaviours and chronic diseases are significantly associated with poor SRH among Malaysian adults. Effective public health strategies are needed to promote healthy lifestyles, and disease prevention interventions should be enhanced at the community level to improve overall health.

Effectiveness of a multi-component Smoking Cessation Support Programme (McSCSP) for patients with severe mental disorders: study design

Only a few studies have examined the efficacy and safety of smoking cessation programmes in patients with mental disorders. The aim of this paper is to describe in detail the methodology used in the study as well as the Multi-component Smoking Cessation Support Programme in terms of pharmacological treatments and psychological interventions. An open-label 9-month follow-up study was conducted in Spain. A total of 82 clinically stable outpatients with schizophrenia, schizoaffective or bipolar disorder were enrolled. Treatment consisted of a programme specifically developed by the research team for individuals with severe mental disorders. The programme consisted of two phases: (1) weekly individual motivational therapy for 4–12 weeks, and (2) a 12-week active treatment phase. During this phase, at each study visit patients received a one- or two-week supply of medication (transdermal nicotine patches, varenicline or bupropion) with instructions on how to take it, in addition to group psychotherapy for smoking cessation. Evaluations were performed: (1) at the time of enrolment in the study, (2) during the 12-week active treatment phase of the study (weekly for the first 4 weeks and then biweekly), and (3) after the end of this phase (two follow-up assessments at weeks 12 and 24). Evaluations included: (1) smoking history, (2) substance use, (3) psychopathology, (4) adverse events, and (5) laboratory tests. The importance of this study lies in addressing a topical issue often ignored by psychiatrists: the unacceptably high rates of tobacco use in patients with severe mental disorders.

Adherence to lifestyle recommendations by patients with depression

INTRODUCTION

There is an increasing amount of evidence showing that physical activity and sun exposure are effective coadjuvant treatments for patients with mild to moderate depression. However, there is a lack of information regarding patient's adherence to these recommendations in daily clinical practice.

METHODS

We conducted a study including 15 depressive patients who had been under antidepressant treatment for at least one month. They wore a wrist-watch-like actimetry sensor to measure physical activity and sun exposure 24 hours a day. After one week of baseline assessment, patients were randomised into one of the two arms of the study. Patients in the experimental group received a brief note in which they were explicitly asked to increase both their physical activity level and time of sun exposure, while control group patients did not receive these explicit recommendations.

RESULTS

One week after recommendations were delivered, only patients in the experimental group had increased time of sun exposure and physical activity (25.8% and 14.3%, respectively).

CONCLUSIONS

Depressive patients are able to follow prescribed lifestyle recommendations in the short-term.