Effect of health lifestyle pattern on dietary change

The clustering of health behaviours in older Australians and its association with physical and psychological status, and sociodemographic indicators

Background

Increasing life expectancies, burgeoning healthcare costs and an emphasis on the management of multiple health-risk behaviours point to a need to delineate health lifestyles in older adults.

Purpose

The aims of this study were to delineate health lifestyles of a cohort of older adults and to examine the association of these lifestyles with biological and psychological states and socio-economic indices.

Methods

Cluster analysis was applied to data derived from the self-reported 45 and Up cohort study (N = 96,276) of Australians over 45 years, regarding exercise, smoking, alcohol consumption, diet and cancer screening behaviours.

Results

Six lifestyle clusters emerged delineated by smoking, screening and physical activity levels. Individuals within health-risk dominant clusters were more likely to be male, living alone, low-income earners, living in a deprived neighbourhood, psychologically distressed and experiencing low quality of life.

Conclusions

Health lifestyle cluster membership can be used to identify older adults at greatest risk for physical and psychological health morbidity.

A primer on the use of cluster analysis or factor analysis to assess co-occurrence of risk behaviors

OBJECTIVE

The aim of this paper is to provide a guideline to a universal understanding of the analysis of co-occurrence of risk behaviors. The use of cluster analysis and factor analysis was clarified.

METHOD

A theoretical introduction to cluster analysis and factor analysis and examples from literature were provided. A representative sample (N=4395) of the Dutch population, aged 16-40 and participating from fall 2005 to spring 2006, was used to illustrate the use of both techniques in assessing the co-occurrence of risk behaviors.

RESULTS

Whereas cluster analysis techniques serve to focus on particular clusters of individuals showing the same behavioral pattern, factor analysis techniques are used to assess possible groups of interrelated health-risk behaviors that can be explained by an unknown common source. Choice between the techniques partly depends on the research question and the aim of the research, and has different implications for inferences and policy.

CONCLUSION

By integrating theory and results from an illustrative example, a guideline has been provided that contributes towards a systematic approach in the assessment of co-occurrence of risk behaviors. Following this guideline, a better comparison between outcomes from various studies is expected, leading to improved effectiveness of multiple behavior change interventions.

Physical activity in the context of clustering patterns of health-promoting behaviors

PURPOSE

To describe differences in physical activity in the context of clustering patterns of health-promoting behaviors.

DESIGN

A cross-sectional study with 1724 participants (response rate, 91.1%).

SETTING

Tadami Town, in a rural area of Fukushima Prefecture, Japan.

SUBJECTS

Part of the general population who participated in annual health checkups (age range, 30-93 years).

MEASURES

The Health-Promoting Lifestyle Profile II was used to assess frequency of health-promoting behaviors (physical activity, health responsibility, spiritual growth, interpersonal relationships, nutrition, and stress management). Smoking status, alcohol consumption, and disease status were self-reported. Public health nurses measured the weight and height of participants.

ANALYSIS

Cluster analysis was conducted to identify clustering patterns of health-promoting behaviors other than physical activity. Differences in physical activity between identified clusters were examined by multiple logistic regression analysis.

RESULTS

Four clusters were identified and labeled as "Most challenged" (20.4%), "Adherence to norms" (30.3%), "Well in mentality" (20.9%), and "Health-promoting" (28.4%). "Health-promoting" was the most physically active cluster, followed by "Adherence to norms" and "Well in mentality."

CONCLUSIONS

Although the survey methodology was subject to selection, self-report, and recall biases, we have described physical activity in the context of clustering patterns of health-promoting behaviors. Laying the groundwork for physical activity in the lifestyle is important for establishing health-promotion strategies to increase physical activity.

They think they know but do they? Misalignment of perceptions of lifestyle modification knowledge among health professionals

OBJECTIVE

The present study aimed to evaluate the knowledge and practices of public-sector primary-care health professionals and final-year students regarding the role of nutrition, physical activity and smoking cessation (lifestyle modification) in the management of chronic diseases of lifestyle within the public health-care sector.

DESIGN

A comparative cross-sectional descriptive quantitative study was conducted in thirty primary health-care facilities and four tertiary institutions offering medical and/or nursing programmes in Cape Town in the Western Cape Metropole. Stratified random sampling, based on geographical location, was used to select the health facilities while convenience sampling was used to select students at the tertiary institutions. A validated self-administered knowledge test was used to obtain data from the health professionals.

RESULTS

Differential lifestyle modification knowledge exists among both health professionals and students, with less than 10 % achieving the desired scores of 80 % or higher. The majority of health professionals seem to be promoting the theoretical concepts of lifestyle modification but experience difficulty in providing practical advice to patients. Of the health professionals evaluated, doctors appeared to have the best knowledge of lifestyle modification. Lack of time, lack of patient adherence and language barriers were given as the main barriers to providing lifestyle counselling.

CONCLUSIONS

The undergraduate curricula of medical and nursing students should include sufficient training on lifestyle modification, particularly practical advice on diet, physical activity and smoking cessation. Health professionals working at primary health-care facilities should be updated by providing lifestyle modification education as part of continuing medical education.

The relationship between clustering health-promoting components of lifestyle and bone status among middle-aged women in a general population

OBJECTIVE

The association between clustering health-promoting components of lifestyle and bone status was examined among middle-aged women.

METHODS

A cross-sectional study was conducted in Tadami Town, Fukushima Prefecture, Japan, in 2007. A total of 305 middle-aged women (mean age 55.2 years) participated. The Health-Promoting Lifestyle Profile II was used to assess health-promoting components of lifestyle. Participants' bone status was examined using quantitative ultrasonic calcaneal measurement.

RESULTS

A total of 139 participants (45.6%) were defined as having low bone stiffness. In the low bone stiffness group, the mean age was significantly higher, and prevalence of interpersonal relationships score over 3.0 was lower than that in the normal bone stiffness group. There were significant trends in the prevalence of low bone stiffness, each health-promoting component of lifestyle, and presence of hypertension and diabetes mellitus, based on the number of frequently selected health-promoting components of lifestyle. The number of frequently selected health-promoting components of lifestyle correlated negatively with the prevalence of low bone stiffness in both crude and adjusted results.

CONCLUSION

This research is particularly important as we suggest health-promotion strategies for the prevention of osteoporosis. A synthetic approach, which includes health responsibility, spiritual growth, interpersonal relations, and stress management, and physical activity and nutrition, may be effective and complement traditional strategies.

Skipping breakfast is associated with dysmenorrhea in young women in Japan

To evaluate the effects of breakfast habits on the quality of life in young women in Japan, the relation between breakfast habits and menstrual and intestinal disorders was estimated by responses to a questionnaire. Subjects were recruited from young Japanese female students of Ashiya College ranging in age from 18 to 20 years. Breakfast habits were classified into three groups (group I, having breakfast every morning, n=289; group II, having breakfast one to six times per week, n=106; group III, having breakfast less than once a week, n=44). The intensity of dysmenorrhea was classified into three grades (score 1, free of pain or painful, but without need for analgesic; score 2, painful, requiring analgesic; score 3, painful, not relieved by analgesic). The grades of bowel movement were classified into three groups (score 1, no more than once a week; score 2, two to six times a week; score 3, every day). Group II and group III had significantly higher scores for dysmenorrhea compared with group I. Students in group III showed a tendency toward constipation. Since dysmenorrhea is a risk factor for psychological disorders as well as gynecological diseases, the present study suggests the importance of eating breakfast to the quality of life of young women.

The influence of health behavior clusters on dietary change

BACKGROUND

The goal of this study was to identify cancer preventive health behavior clusters and to determine if clusters responded differently to a year-long intervention to increase fruit and vegetable consumption.

METHODS

The North Carolina Strategies for Improving Diet, Exercise, and Screening (NC STRIDES) is a health communications intervention (n = 595) among colorectal cancer survivors and a comparison population. Cluster analysis was used to identify nonoverlapping groups based on fruit and vegetable intake (servings/day), physical activity (minutes/day), multivitamin use (yes/no), and body mass index (kg/m2). Logistic regression was performed to assess positive change in fruit and vegetable servings, using the healthiest cluster as the reference group.

RESULTS

Five clusters were formed; they differed significantly by health behaviors and demographics. Clusters 1 and 2 (those following the "Healthy Choices" and "Eating Well" patterns) were eating more than 5 A Day before the intervention (8.6 and 6.9 servings/day), and did not show any increase. Cluster 3 ("Physically Active") reported an increase of 1.3 servings/day to reach 5.4 servings/day, and Clusters 4 and 5 ("Average Americans" and "Most Challenged") improved one serving/day for final intakes of 5.2 and 5.0 servings/day.

CONCLUSIONS

These findings illustrate some differences in magnitude of response to a fruit and vegetable intervention based on health behavior profiles. Creating clusters or other categories from baseline health behaviors may help to further improve targeting and/or tailoring in health promotion interventions.

Current problems of food intake in young women in Japan: Their influence on female reproductive function

Accumulating evidence suggests that food customs are associated with quality of life in women of the reproductive age. In Japan, dietary limitation for cosmetic purposes, skipping food intake, intake of processed foods and the shift from Japanese to Westernized style food have increased among young women. These changes in food habits can cause inadequate intake of calories, micronutrients, unsaturated fat, phytestrogens and fiber as well as increasing environmental toxins. Furthermore, these food habits increase risk as a result of intake of food additives, anti-oxidants, processing agents and sweeteners, which have been demonstrated to be harmful to human health. These factors are speculated to not only influence the present lifestyle, but also to induce gynecologic disorders such as dysmenorrhea and irregular menstruation. The adverse effects of these dietary habits on pregnancy outcome and carcinogenesis of breast and ovarian cancers have also been demonstrated. In addition, latent development of organic diseases such as endometriosis, which are accompanied by dysmenorrhea, is a concern under the current nutritional environment in young women. Thus, it is an urgent issue to evaluate the present situation of eating habits in young Japanese women and estimate the influence of these habits on the quality of life including reproductive functions. (Reprod Med Biol 2004; 3: 107-114).