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Young-Silva Y, Berenguera A, Juvinyà-Canal D, Martí-Lluch R, Arroyo-Uriarte P, Tamayo-Morales O, Marcilla-Toribio I, Elizondo-Alzola U, Méndez-López F, Chela-Àlvarez X, Motrico E. Exploring personal aptitudes and personality traits that, together with social determinants, shape health behaviors and conduct: a thematic analysis based on the Capability, Opportunity, Motivation and Behavior (COM-B) change system. Front Public Health 2024; 12:1387528. [PMID: 38898892 PMCID: PMC11186474 DOI: 10.3389/fpubh.2024.1387528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 05/07/2024] [Indexed: 06/21/2024] Open
Abstract
Introduction Effective implementation of strategies to promote health and prevent noncommunicable illnesses requires a profound understanding of the interaction between the individual and society. This study brings to health research the consideration of psychosocial factors that influence the maintenance and change of health behaviors and conduct. From a primary care perspective, it is crucial to propose a biopsychosocial approach for the development of health promotion and self-care programs that embrace personal aptitudes as a relevant individual aspect. Objectives To explore experiences related to personal aptitudes and personality traits that influence health behaviors and conduct, taking into account the social determinants of health, through a thematic analysis based on the capability-opportunity-motivation and behavior (COM-B) system. Methods and analysis This qualitative research is carried out from a descriptive phenomenological perspective, based on 17 focus groups in which 156 people participated. Inductive and deductive analysis techniques were used following Lincoln and Guba's criteria of methodological rigor. In addition to 7 different triangulations of analysts, 6 main categories were identified based on the COM-B system: psychological capacity, physical capacity, physical opportunity, social opportunity, reflective motivation, and automatic motivation. The importance of considering these factors to promote healthy behaviors was stressed. Discussion This study examined how personal experiences related personal aptitudes and personality traits influence health behaviors and conduct in Spain. It was found that personality traits such as health literacy, self-efficacy, activation, and self-determination can influence the adoption of healthy behaviors. Likewise, the need for control, overthinking, and ambivalence made it impossible. Furthermore, social determinants of health and interpersonal relationships also play an important role. Trial registration ClinicalTrials.gov, NCT04386135. Registered on April 30, 2020.
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Affiliation(s)
- Yudy Young-Silva
- Unitat de Suport a la Recerca Girona, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Goli Gurina (IDIAPJGol), Barcelona, Spain
- Escola de doctorat, Universitat de Girona, Girona, España
| | - Anna Berenguera
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Goli Gurina (IDIAPJGol), Barcelona, Spain
- Department d’Infermeria, Universitat de Girona, Girona, Spain
- Departament de Salut Pública. Universitat Autònoma de Barcelona, Bellaterra, España
- Country Network on Chronicity, Primary Care, and Health Prevention and Promotion (RICAPPS), Bellaterra, Spain
| | - Dolors Juvinyà-Canal
- Department d’Infermeria, Universitat de Girona, Girona, Spain
- Grup de Recerca Salut i Atenció sanitària Universitat de Girona, Girona, Spain
- Càtedra de Promoció de la Salut Universitat de Girona, Girona, Spain
| | - Ruth Martí-Lluch
- Departament de Salut Pública. Universitat Autònoma de Barcelona, Bellaterra, España
- Country Network on Chronicity, Primary Care, and Health Prevention and Promotion (RICAPPS), Bellaterra, Spain
- Vascular Health Research Group of Girona, Institut Universitari per a la Recerca a l’Atenció Primària Jordi Gol i Gurina (IDIAPJGol), Girona, Spain
- Parc Hospitalari Martí Julià, Institut d'Investigació Biomèdica de Girona (IDIBGI), Salt, Spain
| | - Paula Arroyo-Uriarte
- Country Network on Chronicity, Primary Care, and Health Prevention and Promotion (RICAPPS), Bellaterra, Spain
- Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Olaya Tamayo-Morales
- Country Network on Chronicity, Primary Care, and Health Prevention and Promotion (RICAPPS), Bellaterra, Spain
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Irene Marcilla-Toribio
- Centro de Estudios Sociosanitarios, Universidad de Castilla-La Mancha, Edificio Melchor Cano, Campus de Cuenca s/n, Cuenca, Spain
- Grupo de Investigación Health, Gender, and Social Determinants, Universidad de Castilla-La Mancha, Edificio Melchor Cano, Campus de Cuenca s/n, Cuenca, Spain
| | - Usue Elizondo-Alzola
- Grupo de Investigación en Ciencias de la Diseminación e Implementación en Servicios Sanitarios, Instituto Investigación de Biocruces, Barakaldo, Spain
- Osakidetza Basque Health Service, Debagoiena-Integrated Health Care Organization, Pharmacy Service (Primary Care), Arrasate, Gipuzkoa, Spain
| | - Fátima Méndez-López
- Country Network on Chronicity, Primary Care, and Health Prevention and Promotion (RICAPPS), Bellaterra, Spain
- Aragonese Primary Care Research Group (GAIAP), Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
| | - Xènia Chela-Àlvarez
- Country Network on Chronicity, Primary Care, and Health Prevention and Promotion (RICAPPS), Bellaterra, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion-Balearic Islands Community (GRAPP-caIB), Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Emma Motrico
- Country Network on Chronicity, Primary Care, and Health Prevention and Promotion (RICAPPS), Bellaterra, Spain
- Department of Developmental and Educational Psychology, Institute of Biomedicine of Seville (IBIS), University of Seville, Seville, Spain
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Matta K, Viallon V, Botteri E, Peveri G, Dahm C, Nannsen AØ, Olsen A, Tjønneland A, Elbaz A, Artaud F, Marques C, Kaaks R, Katzke V, Schulze MB, Llanaj E, Masala G, Pala V, Panico S, Tumino R, Ricceri F, Derksen JWG, Nøst TH, Sandanger TM, Borch KB, Quirós JR, Castro-Espin C, Sánchez MJ, Atxega AA, Cirera L, Guevara M, Manjer J, Tin Tin S, Heath A, Touvier M, Goldberg M, Weiderpass E, Gunter MJ, Freisling H, Riboli E, Ferrari P. Healthy lifestyle change and all-cause and cancer mortality in the European Prospective Investigation into Cancer and Nutrition cohort. BMC Med 2024; 22:210. [PMID: 38807179 PMCID: PMC11134634 DOI: 10.1186/s12916-024-03362-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 03/18/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Healthy lifestyles are inversely associated with the risk of noncommunicable diseases, which are leading causes of death. However, few studies have used longitudinal data to assess the impact of changing lifestyle behaviours on all-cause and cancer mortality. METHODS Within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, lifestyle profiles of 308,497 cancer-free adults (71% female) aged 35-70 years at recruitment across nine countries were assessed with baseline and follow-up questionnaires administered on average of 7 years apart. A healthy lifestyle index (HLI), assessed at two time points, combined information on smoking status, alcohol intake, body mass index, and physical activity, and ranged from 0 to 16 units. A change score was calculated as the difference between HLI at baseline and follow-up. Associations between HLI change and all-cause and cancer mortality were modelled with Cox regression, and the impact of changing HLI on accelerating mortality rate was estimated by rate advancement periods (RAP, in years). RESULTS After the follow-up questionnaire, participants were followed for an average of 9.9 years, with 21,696 deaths (8407 cancer deaths) documented. Compared to participants whose HLIs remained stable (within one unit), improving HLI by more than one unit was inversely associated with all-cause and cancer mortality (hazard ratio [HR]: 0.84; 95% confidence interval [CI]: 0.81, 0.88; and HR: 0.87; 95% CI: 0.82, 0.92; respectively), while worsening HLI by more than one unit was associated with an increase in mortality (all-cause mortality HR: 1.26; 95% CI: 1.20, 1.33; cancer mortality HR: 1.19; 95% CI: 1.09, 1.29). Participants who worsened HLI by more than one advanced their risk of death by 1.62 (1.44, 1.96) years, while participants who improved HLI by the same amount delayed their risk of death by 1.19 (0.65, 2.32) years, compared to those with stable HLI. CONCLUSIONS Making healthier lifestyle changes during adulthood was inversely associated with all-cause and cancer mortality and delayed risk of death. Conversely, making unhealthier lifestyle changes was positively associated with mortality and an accelerated risk of death.
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Affiliation(s)
- Komodo Matta
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Vivian Viallon
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | | | - Giulia Peveri
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Christina Dahm
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Anja Olsen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Alexis Elbaz
- Inserm, Université Paris Saclay, Institut Gustave Roussy, Team Exposome, Heredity, Cancer and Health, CESP UMR 1018, 94807, Villejuif, France
| | - Fanny Artaud
- Inserm, Université Paris Saclay, Institut Gustave Roussy, Team Exposome, Heredity, Cancer and Health, CESP UMR 1018, 94807, Villejuif, France
| | - Chloé Marques
- Inserm, Université Paris Saclay, Institut Gustave Roussy, Team Exposome, Heredity, Cancer and Health, CESP UMR 1018, 94807, Villejuif, France
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Verena Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Erand Llanaj
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Giovanna Masala
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Valeria Pala
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica, Federico II University, Naples, Italy
| | - Rosario Tumino
- Hyblean Association for Epidemiological Research, AIRE ONLUS, Ragusa, Italy
| | - Fulvio Ricceri
- Centre for Biostatistics, Epidemiology, Department of Clinical and Biological Sciences, and Public Health (C-BEPH), University of Turin, Turin, Italy
| | - Jeroen W G Derksen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Therese Haugdahl Nøst
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Torkjel M Sandanger
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | | | | | - Carlota Castro-Espin
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
- Unit of Nutrition and Cancer, Catalan Institute of Oncology-ICO, L'Hospitalet de Llobregat, Barcelona, Spain
- Nutrition and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Maria-José Sánchez
- Escuela Andaluza de Salud Pública (EASP), 18011, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, 18071, Granada, Spain
| | - Amaia Aizpurua Atxega
- Sub Directorate for Public Health and Addictions of Gipuzkoa, Ministry of Health of the Basque Government, San Sebastian, Spain
- Epidemiology of Chronic and Communicable Diseases Group, Biodonostia Health Research Institute, San Sebastián, Spain
| | - Lluís Cirera
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Department of Health and Social Sciences, University of Murcia, Murcia, Spain
| | - Marcela Guevara
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain
- Instituto de Salud Pública y Laboral de Navarra, 31003, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008, Pamplona, Spain
| | - Jonas Manjer
- Department of Surgery, Skåne University Hospital Malmö, Lund University, Malmö, Sweden
| | - Sandar Tin Tin
- Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, England
| | - Alicia Heath
- School of Public Health, Imperial College London, London, UK
| | - Mathilde Touvier
- L'Institut national de la santé et de la recherche médicale (Inserm), Paris, France
| | | | | | - Marc J Gunter
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
- School of Public Health, Imperial College London, London, UK
| | - Heinz Freisling
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Elio Riboli
- School of Public Health, Imperial College London, London, UK
| | - Pietro Ferrari
- International Agency for Research on Cancer (IARC-WHO), Lyon, France.
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Tu B, Li W, Xiao H, Xu X, Zhang Y. Optimizing lifestyle profiles is potential for preventing nonalcoholic fatty liver disease and enhancing its survival. Sci Rep 2024; 14:5516. [PMID: 38448563 PMCID: PMC10918176 DOI: 10.1038/s41598-024-55566-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/25/2024] [Indexed: 03/08/2024] Open
Abstract
The aim of this study was to evaluate the association between lifestyle profile and disease incidence/mortality in patients with non-alcoholic fatty liver disease (NAFLD). Lifestyle profiles ascertainment was based on the latent profile analysis. The associations of lifestyle profile and outcomes were analyzed by multivariate logistic or Cox regressions. Four lifestyle profiles (profile 1 and 2 for male, profile 3 and 4 for female) were established for all participants. Compared to profile 1, profile 2 (P = 0.042) and profile 3 (P = 0.013) had lower incidence for NAFLD. In contrast, profile 4 showed similar NAFLD prevalence compared to profile 1 (P = 0.756). Individuals with NAFLD within profile 3 had the best long-term survival, and the HR was 0.55 (95% CI 0.40-0.76) for all-cause mortality (compared to profile 1). Profile 4 (P = 0.098) and profile 2 (P = 0.546) had similar all-cause survival compared to profile 1. We explored the associations of healthy lifestyle score with mortality and incidence of NAFLD stratified by lifestyle profiles. We observed that with the increase of healthy lifestyle score, participants within profile 2 did not display lower NAFLD incidence and better long-term survival in NAFLD cases. In this study, lifestyle profiles were constructed in NHANES participants. The distinct lifestyle profiles may help optimize decision-making regarding lifestyle management in preventing NAFLD development, as well as selection of a more personalized approach for improving NAFLD survival.
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Affiliation(s)
- Beilin Tu
- Department of Plastic and Burns Surgery, West China Hospital, Sichuan University, 37 Guoxue Road, Chengdu, 610041, China
| | - Wei Li
- Department of Plastic and Burns Surgery, West China Hospital, Sichuan University, 37 Guoxue Road, Chengdu, 610041, China
| | - Haitao Xiao
- Department of Plastic and Burns Surgery, West China Hospital, Sichuan University, 37 Guoxue Road, Chengdu, 610041, China
| | - Xuewen Xu
- Department of Plastic and Burns Surgery, West China Hospital, Sichuan University, 37 Guoxue Road, Chengdu, 610041, China.
| | - Yange Zhang
- Department of Plastic and Burns Surgery, West China Hospital, Sichuan University, 37 Guoxue Road, Chengdu, 610041, China.
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, 610041, China.
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Esteban-Cornejo I, Lara-Jimenez I, Rodriguez-Ayllon M, Verdejo-Roman J, Catena A, Erickson KI, Ortega FB. Early morning physical activity is associated with healthier white matter microstructure and happier children: the ActiveBrains project. Eur Child Adolesc Psychiatry 2024; 33:833-845. [PMID: 37058244 PMCID: PMC10894097 DOI: 10.1007/s00787-023-02197-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 03/10/2023] [Indexed: 04/15/2023]
Abstract
The background of this study is to examine the associations of individual and combined early morning patterns (i.e., active commuting to school, physical activity before school, having breakfast and good sleep) with white matter microstructure (WMM) and, whether the associated white mater microstructure outcomes were related to mental health outcomes in children with overweight or obesity. 103 children with overweight or obesity (10.0 ± 1.1 years old, 42 girls) from the ActiveBrains project participated in this cross-sectional study. Early morning patterns and mental health indicators (i.e., self-esteem, optimism, positive and negative affect, stress, depression and anxiety) were self-reported by the children using validated questionnaires. WMM was assessed by magnetic resonance imaging using diffusion tensor imaging. When examined independently, early morning patterns were not related with WMM (all P > 0.05). However, the combination of early morning patterns was related with WMM (P < 0.05). Specifically, physically active early morning patterns (i.e., active commuting to school and physical activity before school) were associated with global fractional anisotropy (FA) (β = 0.298, P = 0.013) and global radial diffusivity (RD) (β = - 0.272, P = 0.021), as well as with tract-specific FA (β = 0.314, P = 0.004) and RD (β = - 0.234, P = 0.032) in the superior longitudinal fasciculus (SLF). Furthermore, combined physically active early morning pattern-associated global (i.e., FA and RD) and tract-specific (i.e., FA and RD in the SLF) WMM indicators were positively associated with happiness (β absolute value range from 0.252 to 0.298, all P < 0.05). A combination of physically active early morning patterns may positively relate to white matter microstructure in children with overweight or obesity, and, in turn, happiness.
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Affiliation(s)
- Irene Esteban-Cornejo
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Carretera de Alfacar s/n, 18071, Granada, Spain.
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain.
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
| | - Inmaculada Lara-Jimenez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Carretera de Alfacar s/n, 18071, Granada, Spain
| | - Maria Rodriguez-Ayllon
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Juan Verdejo-Roman
- Department of Personality, Assessment and Psychological Treatment, Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Andres Catena
- Department of Experimental Psychology, University of Granada, Granada, Spain
| | - Kirk I Erickson
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Carretera de Alfacar s/n, 18071, Granada, Spain
- Department of Psychology, Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA
- AdventHealth Research Institute, Neuroscience, Orlando, FL, USA
| | - Francisco B Ortega
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Carretera de Alfacar s/n, 18071, Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland
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Dos Santos Pereira DB, Conde WL. Overweight and obesity in adulthood, sociodemographic factors, lifestyle, and the early burden of noncommunicable diseases among Americans: NHANES 2007-2018. Am J Hum Biol 2023; 35:e23905. [PMID: 37067342 DOI: 10.1002/ajhb.23905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 04/18/2023] Open
Abstract
OBJECTIVES To evaluate the association between nutritional status in early adulthood and the burden of noncommunicable diseases (NCDs); To evaluate the influence of sociodemographic factors and lifestyle on the outcomes of BMI kg/m2 ≤24.9, ≥25.0, and ≥30.0; to estimate the population attributable fraction (PAF) to BMI elevated at 25 years old in the burden of NCDs in American adults. METHODS We used data from 15 721 American adults participating in the National Health and Nutrition Examination Survey from 2007 to 2018. The Hazard Ratio (HR), Incidence Rate Ratio (IRR), and 95% confidence intervals (CI) were estimated in the proportional risk regression models of Cox (entire population) and Poisson (restricted to non-patients), respectively. The proportionality of the risk between the burden of NCDs and BMI at 25 years old was drawn by the Kaplan-Meier curve, and the PAF was calculated. All analyses were adjusted taking into account the sample weights. RESULTS Health disparities (sex, age, race/ethnicity, education, poverty index, and education level), and lifestyle (physical activity, smoking, and alcohol consumption) influenced the current nutritional status. Cumulative survival in overweight and obese groups decreased considerably over time (p < .0001). Being overweight and obese in adulthood may increase the risk of early NCDs (HR: 1.68, 95% CI: 1.54-1.84 and HR: 2.87, 95% CI: 2.56-3.21, respectively). About 22.72% (95% CI: 19.99-25.36, p < .001) of the burden NCDs could have been avoided if overweight at age 25 had been prevented. CONCLUSIONS Monitoring weight change from young adulthood can provide a sensitive and useful clinical measure for early detection of adverse trends in NCDs risk.
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Affiliation(s)
- Débora Borges Dos Santos Pereira
- School of Public Health. Department of Nutrition, Postgraduate Program in Nutrition in Public Health, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Wolney Lisboa Conde
- School of Public Health. Department of Nutrition, Postgraduate Program in Nutrition in Public Health, Universidade de São Paulo, São Paulo, São Paulo, Brazil
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Duan MJ, Dekker LH, Carrero JJ, Navis G. Lifestyle patterns and incident type 2 diabetes in the Dutch lifelines cohort study. Prev Med Rep 2022; 30:102012. [PMID: 36237838 PMCID: PMC9551208 DOI: 10.1016/j.pmedr.2022.102012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 09/16/2022] [Accepted: 10/01/2022] [Indexed: 11/05/2022] Open
Abstract
Lifestyle factors clustered in behavioral patterns within the population. Different lifestyle patterns were differentially associated with risk of developing type 2 diabetes. A lifestyle pattern may be a proxy for an underlying variable that is relevant for the prevention of type 2 diabetes.
We aimed to identify the underlying subgroups of the population characterized by distinct lifestyle patterns, and to investigate the associations between lifestyle patterns and risk of incident type 2 diabetes. Using data from the Dutch Lifelines cohort study, latent class analysis was performed to derive lifestyle patterns on five lifestyle factors, i.e., smoking, diet quality, TV watching time, physical activity level, and risk drinking. Associations between lifestyle patterns and incident type 2 diabetes were estimated. Among 61,869 participants analyzed, we identified 900 cases of type 2 diabetes during follow-up (205,696 person-years; incidence rate 4.38 per 1000 person-years). Five lifestyle pattern groups were identified. Using the “healthy lifestyle group” as reference, the “unhealthy lifestyle group” had the highest risk for type 2 diabetes (HR 1.51 [95%CI 1.24, 1.85]), followed by the “poor diet and low physical activity group” (HR 1.26 [95%CI 1.03, 1.55]). The “risk drinker group” and the “couch potato group” (characterized by excessive TV watching) showed no significantly elevated risk. These models were adjusted for age, sex, total energy intake, education, BMI, family history of diabetes, and blood glucose level at baseline. Our study shows that lifestyle factors tended to cluster in unique behavioral patterns within the heterogeneous population. These lifestyle patterns were differentially associated with incident type 2 diabetes. Our findings support the relevance of considering lifestyle patterns in type 2 diabetes prevention. Tailored prevention strategies that target multiple lifestyle risk factors for different lifestyle pattern groups may optimize the effectiveness of diabetes prevention at the population level.
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Affiliation(s)
- Ming-Jie Duan
- Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands,Corresponding author at: Hanzeplein 1, P.O. Box 30 001, 9700RB Groningen, The Netherlands.
| | - Louise H. Dekker
- Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands,National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Juan-Jesus Carrero
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Gerjan Navis
- Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands
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Zhang Q, Zeng G, Wang X, Wu KH. Associations of exposure to secondhand smoke with hypertension risk and blood pressure values in adults. Environ Health Prev Med 2021; 26:86. [PMID: 34488622 PMCID: PMC8422707 DOI: 10.1186/s12199-021-01009-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/21/2021] [Indexed: 12/19/2022] Open
Abstract
Background The effects of environmental chemical exposure on blood pressure (BP) have been confirmed, but the association between exposure to secondhand smoke (SHS) and hypertension risk and BP in the general population remains unknown. Methods Cross-sectional associations between SHS exposure and hypertension risk and BP values were evaluated using data for subjects who participated in the National Health and Nutrition Examination Survey (NHANES), 1999–2016. Logistic regression and linear regression were performed after adjusting for age, sex, race, alcohol consumption, poverty-to-income ratio (PIR), body mass index (BMI), estimated glomerular filtration rate, physical activity, diabetes, cardiovascular disease, and NHANES cycle. Restricted cubic spline models were created to display the potential nonlinear association between SHS and BP levels. Results Higher risk of hypertension was found at the highest SHS concentrations (OR = 1.13, 95% CI 1.04, 1.24, P for trend = 0.007). Additionally, SHS exposure had a strong positive association with systolic blood pressure (SBP) but was negatively associated with diastolic blood pressure (DBP). Furthermore, the nonlinear model result showed a significant association between SHS and SBP (P = 0.017); however, the nonlinear model result was not significant for SHS or DBP. Conclusions Our results suggest a potential association between high SHS exposure and the risk of hypertension. Further research is needed to elucidate the underlying mechanisms. Supplementary Information The online version contains supplementary material available at 10.1186/s12199-021-01009-0.
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Affiliation(s)
- Qi Zhang
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China
| | - Guowei Zeng
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China
| | - Xiaowei Wang
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Kai-Hong Wu
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China.
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Schaberg MN, Smith KS, Greene MW, Frugé AD. Characterizing Demographic and Geographical Differences in Health Beliefs and Dietary Habits Related to Colon Cancer Risk in US Adults. Front Nutr 2020; 7:568643. [PMID: 33117842 PMCID: PMC7577229 DOI: 10.3389/fnut.2020.568643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 08/28/2020] [Indexed: 12/18/2022] Open
Abstract
Background: Colon cancer (CC) risk is increased by behavioral factors including a diet high in red meat (RM) and processed meat; excess adiposity has contributed to a rise in CC in younger adults. The willingness of at-risk adults to modify behaviors to reduce CC risk warrants further investigation. Methods: The previously validated Dietary Habits and Colon Cancer Beliefs Survey (DHCCBS) was used to assess attitudes and beliefs related to CC risk and diet behavior. An abbreviated food frequency questionnaire was included in the survey to quantify RM and green leafy vegetable (GLV) intake over the previous 30 days. Independent samples t-tests compared RM and GLV intake and DHCCBS responses. One-way analysis of variance with post-hoc LSD correction was completed to assess these differences within three age groups (<35, 35–44, and 45–54 years old) and between U.S. Census Bureau geographical regions. Results: Eight hundred and thirty eight survey responses were analyzed. Perceived severity of CC diagnosis was significantly lower in younger adults (<35) compared to older adults (35–44, p = 0.042; 45–54, p = 0.003). Furthermore, younger adults (<35) perceived fewer barriers (i.e., taste preference) to GLV consumption than their older adult counterparts (35–44, p = 0.019; 45–54, p = 0.002). Few regional differences in habitual RM consumption were observed, however, several disparities were observed with GLV. Conclusion: These findings from the DHCCBS indicate health beliefs toward CC risk are influenced by an individual's age and dietary habits. Additionally, regional differences in GLV consumption indicate opportunities for risk-reduction-focused health messages, particularly in the southern United States where CC incidence and mortality are highest.
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Affiliation(s)
- Megan N Schaberg
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL, United States
| | - Kristen S Smith
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL, United States
| | - Michael W Greene
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL, United States
| | - Andrew D Frugé
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL, United States
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Staessen JA, Thijs L, Yang WY, Yu CG, Wei FF, Roels HA, Nawrot TS, Zhang ZY. Interpretation of Population Health Metrics: Environmental Lead Exposure as Exemplary Case. Hypertension 2020; 75:603-614. [PMID: 32008462 PMCID: PMC8032208 DOI: 10.1161/hypertensionaha.119.14217] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Our objective was to gain insight in the calculation and interpretation of population health metrics that inform disease prevention. Using as model environmental exposure to lead (ELE), a global pollutant, we assessed population health metrics derived from the Third National Health and Nutrition Examination Survey (1988 to 1994), the GBD (Global Burden of Disease Study 2010), and the Organization for Economic Co-operation and Development. In the National Health and Nutrition Examination Survey, the hazard ratio relating mortality over 19.3 years of follow-up to a blood lead increase at baseline from 1.0 to 6.7 µg/dL (10th–90th percentile interval) was 1.37 (95% CI, 1.17–1.60). The population-attributable fraction of blood lead was 18.0% (10.9%–26.1%). The number of preventable ELE-related deaths in the United States would be 412 000 per year (250 000–598 000). In GBD 2010, deaths and disability-adjusted life-years globally lost due to ELE were 0.67 million (0.58–0.78 million) and 0.56% (0.47%–0.66%), respectively. According to the 2017 Organization for Economic Co-operation and Development statistics, ELE-related welfare costs were $1 676 224 million worldwide. Extrapolations from the foregoing metrics assumed causality and reversibility of the association between mortality and blood lead, which at present-day ELE levels in developed nations is not established. Other issues limiting the interpretation of ELE-related population health metrics are the inflation of relative risk based on outdated blood lead levels, not differentiating relative from absolute risk, clustering of risk factors and exposures within individuals, residual confounding, and disregarding noncardiovascular disease and immigration in national ELE-associated welfare estimates. In conclusion, this review highlights the importance of critical thinking in translating population health metrics into cost-effective preventive strategies.
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Affiliation(s)
- Jan A Staessen
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S, L.T., W.-Y.Y., C.-G.Y., F.-F.W., Z.-Y.Z.).,Cardiovascular Research Institute Maastricht, Maastricht University, The Netherlands (J.A.S.).,NPA Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium (J.A.S.)
| | - Lutgarde Thijs
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S, L.T., W.-Y.Y., C.-G.Y., F.-F.W., Z.-Y.Z.)
| | - Wen-Yi Yang
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S, L.T., W.-Y.Y., C.-G.Y., F.-F.W., Z.-Y.Z.).,Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, China (W.-Y.Y.)
| | - Cai-Guo Yu
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S, L.T., W.-Y.Y., C.-G.Y., F.-F.W., Z.-Y.Z.).,Department of Endocrinology, Beijing Lu He Hospital and Key Laboratory of Diabetes Prevention and Research, Capital Medical University, China (C.-G.Y.)
| | - Fang-Fei Wei
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S, L.T., W.-Y.Y., C.-G.Y., F.-F.W., Z.-Y.Z.)
| | - Harry A Roels
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium (H.A.R., T.S.N.)
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium (H.A.R., T.S.N.)
| | - Zhen-Yu Zhang
- From the Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S, L.T., W.-Y.Y., C.-G.Y., F.-F.W., Z.-Y.Z.)
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