Associations Of Health Behaviors Research Articles

Abstract 4125581: Association Between Life’s Essential 8 and Premature Atherosclerotic Cardiovascular Disease: A Cross-sectional Study Among Young Adults in the United States

Background: Among patients presenting with atherosclerotic cardiovascular disease (ASCVD), the proportion of young individuals has increased in recent years. Life’s Essential 8 (LE8), containing two domains of health behaviors and health factors, is an updated monitoring measurement of cardiovascular health by assessing 8 modifiable risk factors. Objective: The objective of this study is to investigate the potential relationship between the LE8 score and a history of premature ASCVD among young adults residing in the United States. Methods: This population-based cross-sectional study utilized data from the National Health and Nutrition Examination Survey spanning 2005 to 2018, focusing specifically on adults aged 20 to 45. LE8 score was measured and categorized into low (0-49), moderate (50-79), and high (80-100) levels (Figure 1). Premature ASCVD status was determined by interviews conducted at enrollment, encompassing a self-reported composite disease history of coronary heart disease, angina pectoris, heart attack, and stroke. Following descriptive statistics, weighted multivariable logistic regression and restricted cubic spline models were employed to evaluate the associations between the LE8 score and premature ASCVD. Additionally, subscale and subgroup analysis were developed. Results: Among 17,499 participants, 9846 were eligible for analysis (weighted mean age, 32.7 years; male, 50.3%), and 167 had premature ASCVD history (weighted percentage, 1.46%). The weighted mean LE8 score of the study population was 71.99 (0.3). Following the adjustment for potential confounders, individuals with higher LE8 scores exhibited a reduced risk of developing premature ASCVD (Table 1). A nonlinear relationship was observed and similar patterns were also identified in the association of health behaviors and health factors scores with premature ASCVD (Figure 2). This inverse association was consistently observed across various subgroups, including sex, age strata, ethnicity, education, and income levels, with no significant interactions identified. Conclusions: The LE8 score and its subscale scores exhibited a negative, nonlinear association with premature ASCVD. Maintaining a healthy lifestyle and controlling modifiable risk factors are crucial in preventing premature ASCVD in the younger demographic. Further studies, encompassing prospective cohorts, are needed to confirm this finding.

Association of health behaviors in life’s essential 8 and hypertension in adolescents: a cross-sectional study from the NHANES database

BackgroundHypertension is a common condition during adolescence with increasing prevalence globally, alongside the epidemic of unhealthy lifestyles and obesity. Health behaviors have been shown to be associated with hypertension risk in adults. Life’s essential 8 (LE8), as a comprehensive indicator to evaluate cardiovascular health (CVH), includes 4 health factors and 4 health behaviors. This study aims to evaluate the association between health behaviors defined in LE8 and hypertension among adolescents.MethodsData of this study were extracted from the National Health and Nutrition Examination Surveys (NHANES) 2007–2018. Health behaviors of LE8 including diet, physical activity and tobacco smoke exposure. The outcome was the odd of hypertension in adolescents. The weighted univariate and multivariate logistic regression was unitized to explore the relationship between CVH score and hypertension in adolescents. Subgroup analysis and sensitivity analysis were further conducted to explore the association across different populations.ResultsTotally 3,941 adolescents aged 12–17 years were included, with the mean aged of 14.48 ± 0.04 years. Of whom, 203 (5.15%) had hypertension. After adjusted all covariates, high CVH score was associated with the lower odds of hypertension (OR = 0.32, 95%CI: 0.17–0.61), especially in boys (OR = 0.23, 95%CI: 0.11–0.51) and adolescents with overweight/obesity (OR = 0.24, 95%CI: 0.10–0.56). Sensitivity analysis reported that the association between CVH score and the odds of hypertension was also robust after excluding self-reported hypertension and medication taking (OR = 0.37, 95%CI: 0.18–0.74).ConclusionA high CVH score, indicating a greater adherence of health behaviors, was associated with a reduced odds of hypertension, especially among boys and overweight/obesity adolescents. Large-scale prospective cohort studies are needed to further explore the association between health behaviors defined in LE8 and hypertension among adolescents.

Association of health behaviors with function and health-related quality of life among patients with Parkinson’s disease

BackgroundCurrent evidence on chronic conditions favors promotion of health behaviors as a mean to positively impact health outcomes. In Parkinson’s disease, performing health behaviors is indicated as a means to fight the long-lasting burden of the disease. Understanding actual engagement in health behaviors and patient activation and their association to function and health-related quality of life is therefore important. Our objectives were, among people with Parkinson’s disease: (1) to characterize health behaviors including utilization of rehabilitative treatments, physical activity, and patient activation levels, and (2) to test the associations between these health behaviors and health outcomes.MethodsA cross-sectional study of 88 people with Parkinson’s disease (age 66.84 ± 8.8) was conducted. Participants answered questionnaires measuring health behaviors including utilization of health professions treatments, physical activity, patient activation, and health outcomes consisting of function and health-related quality of life. Linear regression models were conducted to test associations between measured health behaviors, function and health-related quality of life.ResultsParticipants rarely engage in rehabilitative treatments, but showed high levels of patient activation. Controlled by demographics and disease severity, physical activity and patient activation were associated with function (b = 0.41, p < .001; b = 0.2, p = .02, respectively) and physical activity but not patient activation, which was associated with health-related quality of life (b = 0.19, p = .03). There was also interaction effects of physical activity and non-motor symptoms, and physical activity and motor symptoms on health-related quality of life (b = 0.19, p = .02 and b = − 0.22, p = .01, respectively).ConclusionsIn respect to their potential health-related benefits for people with Parkinson’s disease, health professionals’ treatments are underutilized. Findings supported the importance of health behaviors for maintaining function and health-related quality of life among people with Parkinson’s disease. They also show a differential contribution of motor and non-motor symptoms to the association between physical activity and quality of life. It is suggested that policy makers encourage opportunities for physical activity tailored for people with Parkinson’s disease and adopt a proactive stance towards enhancing awareness and use of rehabilitation services.Trial registration NCT05211700, ClinicalTrials.gov ID: NCT05211700 first release 12/30/2021, https://classic.clinicaltrials.gov/ct2/show/NCT05211700

Association of health behaviors, dietary habits, and oral health with weight gain after 20years of age in community-dwelling Japanese individuals aged 40years and older: a cross-sectional study.

This cross-sectional study investigated the factors associated with weight gain ≥ 10kg after 20years of age in the general Japanese population, with a focus on the number of teeth. We included individuals aged ≥ 40years from Yamagata prefecture, Japan from 2017-2021. A postal survey was conducted using a self-administered questionnaire; 5,940 participants were included in the final analysis. The questionnaire included items on lifestyle factors, medical history, physical and mental conditions, oral health, and dietary intake. A multivariate logistic regression analysis was used to identify independent associations between weight gain ≥ 10kg after 20years of age and various parameters; adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated. Less than 20 teeth, male sex, drinking habit frequency, eating very fast or fast, and a higher frequency of eating-away-from-home were significant factors associated with weight gain ≥ 10kg after 20years of age; individuals with < 20 versus > 20 teeth exhibited a 1.35-fold higher OR (95% CI 1.15-1.59; p < 0.01). Our results suggest that having < 20 teeth may affect weight gain ≥ 10kg after 20years of age. However, owing to the cross-sectional study design, causality could not be determined. Therefore, maintaining healthy lifestyle behaviors to avoid tooth loss may also affect weight gain ≥ 10kg after 20years of age. Having < 20 teeth has the potential to affect long-term weight gain after 20years of age.

The associations of health behaviors and working hours with high-sensitivity C-reactive protein levels in Korean wage workers: a cross-sectional study.

We investigated differences in high-sensitivity C-reactive protein (hs-CRP) levels by age group according to working hours, socioeconomic level, health behavior and status, and occupational class, and aimed to identify factors affecting hs-CRP levels in various age groups using data from the Korean National Health and Nutrition Examination from 2016 to 2018. The study included a total of 4,786 male wage workers across the nation, aged between 19 and 65. Data from 4,674 workers were analyzed using multiple logistic regression analysis. Obesity, metabolic syndrome, and weekly working hours were associated with hs-CRP, a biomarker of inflammation. Participants with a body mass index (BMI) ≥25.0 kg/m2 showed significantly higher hs-CRP levels than those with a BMI 23.0 to 25.0 kg/m2. Workers with high-risk drinking and metabolic syndrome showed significantly higher hs-CRP levels in the 50 to 65 years group. Obesity, walking 0 to 149 min/wk, and working ≥61 hours a week were associated with significantly higher hs-CRP levels in the 35 to 49 years group. The factors that significantly affected hs-CRP levels were different among age groups. Plans to adjust working hours should be considered health behaviors, such as drinking and physical activity, and health conditions, such as metabolic syndrome and obesity, according to workers' age.

Association of health behaviors with mental health problems in adolescents during COVID-19

Association of health behaviors with mental health problems in adolescents during COVID-19

Associations between life’s essential 8 and non-alcoholic fatty liver disease among US adults

BackgroundNonalcoholic fatty liver disease (NAFLD) is closely associated with Cardiovascular disease (CVD). We aim to examine the association of Life’s Essential 8 (LE8), the recently updated measurement of cardiovascular health (CVH), with the presence of NAFLD among US adults.MethodsThis population-based cross-sectional study used data from the National Health and Nutrition Examination Survey in 2017–2018 and included adults 20 years or older. LE8 score (range 0–100) was measured according to American Heart Association definitions and was categorized into low (0–49), moderate (50–79), and high (80–100) CVH. NAFLD was determined by transient elastography measured hepatic steatosis in the absence of other liver diseases and excess alcohol use. Multivariable logistic and restricted cubic spline models were used to assess the associations.ResultsAmong 3588 participants included (weighted mean age, 48.0 years; 95% confidence interval [CI] 46.4–49.7 years), 1839 were female (weighted percentage, 51.6%; 95% CI 49.0–54.2%) and 1483 were determined to have NAFLD (weighted percentage, 36.5%; 95% CI 33.3–39.7%). The weighted mean LE8 score of the study population was 67.9 (95% CI 66.6–69.2). After the adjustment of potential confounders, higher LE8 scores were associated with reduced odds of NAFLD (odds ratio [OR] for per 10 score increase, 0.67; 95% CI 0.59–0.76) and a nonlinear dose–response relationship was observed. Similar patterns were also identified in the association of health behavior and health factor scores with NAFLD. The inversed association of LE8 score and NAFLD was significantly stronger among younger, Asian, and participants with higher education and income level.ConclusionsLE8 and its subscales scores were negatively associated with the presence of NAFLD in non-linear fashions. Promoting adherence to optimal CVH levels may be beneficial to reduce the burden of NAFLD as well as CVD.

Health behaviors and metabolic risk factors are associated with dyslipidemia in ethnic Miao Chinese adults: the China multi-ethnic cohort study

BackgroundCardiovascular risk factors in Chinese ethnic minority groups are rarely reported.ObjectiveTo quantify the cardiovascular risk factors in Miao Chinese adults and to examine the association of health behaviors and metabolic risk factors with dyslipidemia.MethodsA cross-sectional analysis was conducted using baseline data from the China Multi-Ethnic Cohort (CMEC) study. A representative sample of 5559 Miao participants aged 30 to 79 years were surveyed and given physical and laboratory exams. The proportion of behavioral and metabolic risk factors were described in ethnic Miao adults. Logistic regression was utilized to evaluate the odds ratio (OR) and 95% confidence interval (CI) of the association between health behaviors and metabolic risk factors with dyslipidemia.ResultsIn Miao Chinese adults, the prevalence of dyslipidemia was 32.8%. After multivariate adjustment, subjects with poor waist-to-hip ratio (WHR), body mass index (BMI), fasting blood glucose (FBG) and blood pressure (BP) were more likely to have higher risk of triglycerides (TG) abnormality, regardless of gender and age. Furthermore, the strongly association was detected between poor WHR and low density lipoprotein cholesterol (LDL-C) abnormality (adjusted OR = 5.24, 95%CI: 2.42–11.34) in the older subgroup (≥ 60 years). Males who current smoking were an independent risk factor only for high density lipoprotein cholesterol (HDL-C) abnormality (adjusted OR = 1.44, 95%CI: 1.05–1.99). However, in the subgroup age, current smoker were at greater risk of high TG and low HDL-C. Males with regular drinking were less likely to be high LDL-C (adjusted OR = 0.51, 95%CI: 0.32–0.81).ConclusionsThe present findings indicated that Miao adults with metabolic risk factors were at greater risk of dyslipidemia.

Health Behaviors, Nocturnal Hypertension, and Non-dipping Blood Pressure: The Coronary Artery Risk Development in Young Adults and Jackson Heart Study.

Several health behaviors have been associated with hypertension based on clinic blood pressure (BP). Data on the association of health behaviors with nocturnal hypertension and non-dipping systolic BP (SBP) are limited. We analyzed data for participants with ambulatory BP monitoring at the Year 30 Coronary Artery Risk Development in Young Adults (CARDIA) study exam in 2015-2016 (n = 781) and the baseline Jackson Heart Study (JHS) exam in 2000-2004 (n = 1,046). Health behaviors (i.e., body mass index, physical activity, smoking, and alcohol intake) were categorized as good, fair, and poor and assigned scores of 2, 1, and 0, respectively. A composite health behavior score was calculated as their sum and categorized as very good (score range = 6-8), good (5), fair (4), and poor (0-3). Nocturnal hypertension was defined as mean asleep SBP ≥ 120 mm Hg or mean asleep diastolic BP ≥ 70 mm Hg and non-dipping SBP as < 10% awake-to-asleep decline in SBP. Among CARDIA study and JHS participants, 41.1% and 56.9% had nocturnal hypertension, respectively, and 32.4% and 72.8% had non-dipping SBP, respectively. The multivariable-adjusted prevalence ratios (95% confidence interval) for nocturnal hypertension associated with good, fair, and poor vs. very good health behavior scores were 1.03 (0.82-1.29), 0.98 (0.79-1.22), and 0.96 (0.77-1.20), respectively in CARDIA study and 0.98 (0.87-1.10), 0.96 (0.86-1.09), and 0.86 (0.74-1.00), respectively in JHS. The health behavior score was not associated non-dipping SBP in CARDIA study or JHS after multivariable adjustment. A health behavior score was not associated with nocturnal hypertension or non-dipping SBP.

Association of Health Behaviors and Quality of Life in Lymphoma Survivors

▪Background: Lymphoma survivors are at risk for long term and late effects which may negatively impact quality of life (QOL). Few studies have assessed the impact of change in health behaviors (physical activity (PA), alcohol and smoking) on QOL, specifically in lymphoma survivors.Methods: Patients were prospectively enrolled <9 months of diagnosis into the Lymphoma SPORE Molecular Epidemiology Resource cohort. At baseline and 3-year follow-up (FU3), patients self-reported QOL, smoking, alcohol use and PA. At FU3, survivors reported change in health behaviors since diagnosis. The Godin Leisure Score Index (LSI) was calculated as a measure of PA (Pophali et al. ASH 2017); modeled by tertile. QOL was measured via FACT-G; the total and sub-scales [emotional (EWB), functional (FWB), physical (PWB), and social/family well-being (SFWB)] scores were transformed to a 0-100 scale. Patients who completed <80% of QOL questions were excluded. The association of QOL with health behaviors was evaluated using Kruskal-Wallis test (categorical) and Spearman's rank correlation (continuous).Results: At baseline, 2805 participants were evaluable for QOL of which 2025 were evaluable at FU3. The median age at diagnosis was 62 (IQR 52-69) years. Majority were males (N=1148, 56.8%), with advanced stage III-IV disease (N=941, 62%) and ECOG performance status <2 (N=1935, 96%).At baseline, smoking status was current (N=237), former (N=802), never (N=1310) or not available (NA, N= 456). Current smokers had a significantly lower median QOL scores compared to former and never smokers for EWB (75 vs 79 vs 79, p<0.01), FWB (71 vs 79 vs 79, p<0.01), PWB (86 vs 89 vs 89, p=0.02), SFWB (86 vs 90 vs 89, p=0.02) and total FACT-G (67 vs 82 vs 82, p<0.01). The median number of pack years smoked among current &former smokers was 15.6 (range 0.5-126). There was a significant negative correlation of pack years smoked with FWB (p=0.05), and total FACT-G (p=0.04). At FU3, current smokers had significantly lower median scores compared to former and never smokers for FWB (80 vs 86 vs 86, p=0.01), PWB (89 vs 93 vs 93, p<0.01) and total FACT-G (82 vs 86 vs 87, p<0.01). EWB (83 vs 88 vs 88, p=0.12) and SFWB (83 vs 86 vs 86, p=0.12) were also lower than never and former smokers but not statistically significant. Smoking status was decreased (N=30), increased (N=0) and unchanged (N=1439) at FU3. There was no association of change in smoking with change in QOL.At baseline, alcohol use status was current (N=1189), former (N=506), never (N=518) and NA (N=592). Current alcohol users had the highest FWB (79 vs 75 vs 75, p<0.01) vs former and never users. Former users vs current and never users had the lowest PWB (86 vs 89 vs 89, p<0.01), SFWB (88 vs 89 vs 92, p<0.01) and total FACT-G (80 vs 83 vs 82, p<0.01). EWB was similar in all 3 groups. Among current & former alcohol users, the average number of drinks/week was 3.4. There was no association of the number of drinks/week with QOL except positive correlation with PWB (p=0.01). At FU3, alcohol use was reported as increased (N=40), decreased (N=312) and no change (N=875). There was no association between change in alcohol use and change in QOL.At baseline, participants with PA in the high vs low LSI tertile had significantly better median scores for FWB (79 vs 75, p=0.01), SFWB (93 vs 89, p<0.01) and total FACT-G (83 vs 82, p<0.01). At FU3, participants in the high vs low LSI tertile had significantly better scores on all subscales and total FACT-G with a significant positive correlation between the continuous LSI and QOL (FACT-G total and subscales). PA was reported as increased (N=107), decreased (N=394) and no change (N=495). There was a significant association of increase in PA with change in PWB (p<0.01), EWB (p=0.01), FWB (p<0.01) and total FACT-G (p<0.01) from baseline to FU3, but not with change in SFWB (p=0.06).In a sensitivity analysis, QOL was modeled for health behaviors in the subset of patients with QOL assessed prior to treatment; results were consistent with the QOL in all patients.Conclusions: Health behaviors in lymphoma survivors are significantly associated with QOL: better QOL is associated with not smoking, more PA, and moderate alcohol use. Current alcohol consumption, as opposed to former alcohol use, may be related to overall health status. An increase in PA after lymphoma diagnosis is associated with an increase in the QOL. Thus, modification of health behaviors has the potential to impact QOL in lymphoma survivors. DisclosuresCerhan:Celgene: Research Funding; Nanostring: Research Funding; Jannsen: Other: Scientific Advisory Board.

The Association of Health Behaviors with Stress Perception among High School Students in Korea: Based on 2015 Korean Youth Risk Behavior Survey

Purpose: The aim of this study is to identify Korean high school students’ health behaviors and perceived stress and to examine effects of their health behaviors on their stress perception. Methods: The subjects were 33,744 high school students who participated in the 11th Korea youth risk behavior web-based survey 2015 in Korea. Data were analyzed using complex samples analysis with the PASW 18.0 program. The questionnaire utilized in this study is designed to find the subjects’ general characteristics, health behaviors, and perceived stress. Results: The prevalence of subjects with high level stress was 38.9%(n=13,137) in this study. There were significant differences in the general characteristics and stress perception among the Korean high school students in terms of gender, grade, school achievement, family''s affluence, mother''s education, perceived happiness, perceived health status, and stressor. The variables of health behaviors of Korean high school students were significantly different from stress perception. Under complex samples logistic regression, predictive factors of stress for the high school students include gender, grade, father''s education, family''s affluence, living arrangement, perceived health status, perceived happiness, current smoking, current alcohol experience, and enough sleep. Conclusion: The study suggests multilateral efforts are needed to help high school students'' stress management including health behaviors for high school students.

The importance of health behaviours in childhood for the development of internalizing disorders during adolescence

BackgroundPoor mental health constitutes a considerable global public health burden with approximately half of all cases of poor mental health having their onset before the age of 14 years. The identification of modifiable risk factors early in life is therefore essential to prevention, however, there are presently very few longitudinal studies on health behaviours for mental health to inform public health decision makers and to justify preventive action. We examined the importance of diet quality, physical activity (PA) and sedentary behaviours in childhood for internalizing disorder throughout adolescence.MethodsWe linked data from a population-based lifestyle survey among 10 and 11 year old grade five students in the Canadian province of Nova Scotia with physician diagnoses of internalizing disorders from administrative health records. We applied negative binomial regressions to examine the associations of health behaviours with the number of health care provider contacts with a diagnosis of internalizing disorder.ResultsOf the 4875 students, 23.9% had one or more diagnoses for internalizing disorder between the age of 10 or 11 years and 18 years. The number of health care provider contacts with a diagnosis of internalizing disorder was statistically significant higher among students with less variety in their diets, and among students who reported less PA and more time using computers and video games. The number of health care provider contacts was also higher for girls, and for students with low self-esteem and from low-income households.ConclusionsThese findings suggest that diets and active lifestyles in childhood affect mental health during adolescence, and imply that succxessful health promotion programs targeting children’s diets and activity will contribute to the prevention of mental health disorders in addition to the prevention of chronic diseases later in life.

Is the practice of yoga or meditation associated with a healthy lifestyle? Results of a national cross-sectional survey of 28,695 Australian women

ObjectivesTo examine the relationship between yoga/meditation practice and health behavior in Australian women. MethodsWomen aged 19–25years, 31–36years, and 62–67years from the Australian Longitudinal Study on Women's Health (ALSWH) were surveyed regarding smoking, alcohol or drug use, physical activity and dietary behavior; and whether they practiced yoga/meditation on a regular basis. Associations of health behaviors with yoga/meditation practice were analyzed using multiple logistic regression modelling. Results11,344, 8200, and 9151 women aged 19–25years, 31–36years, and 62–67years, respectively, were included of which 29.0%, 21.7%, and 20.7%, respectively, practiced yoga/meditation. Women practicing yoga/meditation were significantly more likely to report at least moderate physical activity levels (OR=1.50–2.79), to follow a vegetarian (OR=1.67–3.22) or vegan (OR=2.26–3.68) diet, and to report the use of marijuana (OR=1.28–1.89) and illicit drugs in the last 12 months (OR=1.23–1.98). ConclusionsYoga/meditation practice was associated with higher physical activity levels, a higher likelihood of vegetarian or vegan diet use, and a higher likelihood of drug use. While health professionals should keep the potential vulnerability of yoga/meditation practitioners to drug use in mind, the positive associations of yoga/meditation with a variety of positive health behaviors warrant its consideration in preventive medicine and healthcare.

An association of health behaviors with depression and metabolic risks: Data from 2007 to 2014 U.S. National Health and Nutrition Examination Survey

BackgroundBoth depression and metabolic syndrome (MetS) confer an increased risk of developing type 2 diabetes (T2D) and cardiovascular disease. Accumulating evidence suggests healthy behaviors are crucial to maintain, improve and manage chronical disease and mental health; and unhealthy diet and sedentary behavior were found two major risk factors of MetS. The objective of this study was to investigate whether health behaviors (alcohol consumption, smoking, diet and recreational physical activity) are associated with depression and metabolic syndrome simultaneously. MethodsThis study included 1300 participants aged 20 years and over who had answered mental health-depression screener questions (PHQ-9) and finished examinations and laboratory tests related to five risk factors of MetS during the U.S. National Health and Nutrition Examination Survey (NHANES) 2007–2014. A set of series of weighted logistic regression models were used to investigate the aforementioned relationship. ResultsThe prevalence of depression among U.S. adults is 15.08%. The two most often reported depression symptoms were “Trouble sleeping or sleeping too much” and “Feeling tired or having little energy”, with rates of14.68% and 13.09%, respectively. Participants who engaged in only light physical activity were more likely to have been identified as experiencing depression and MetS than those who engaged in vigorous physical activity with odd ratios 3.18 (95% CI: 1.59, 6.37) and 3.50 (95%CI: 2.17, 5.63), respectively. Individuals in the study having poor diets were more likely to suffer from depression than those eating good diets (OR=2.17, 95%CI: 1.47, 3.22). ConclusionPhysical activity is strongly and inversely associated with depression and MetS. Diet is significantly associated with depression rather than MetS in this study.

Associations of health behaviors with human papillomavirus vaccine uptake, completion, and intentions among female undergraduate students.

This study explored associations between health behaviors and human papillomavirus vaccine receipt/intentions among female undergraduates. Participants (N = 286) completed a survey assessing human papillomavirus vaccine uptake (receiving 1-3 shots vs no shots), completion (receiving 3 shots vs 1-2 shots), and intentions as well as various health behaviors. Human papillomavirus vaccine uptake and completion were associated with receipt of other preventive medical care; completion was associated with having a regular healthcare provider. Among unvaccinated students (n = 115), increased human papillomavirus vaccine intentions were associated with flu shot and human immunodeficiency virus test receipt. Findings suggest promoting human papillomavirus vaccination with other preventive medical care might improve vaccine receipt.

Associations of health behaviours with return to work outcomes after colorectal cancer.

Engaging in positive health behaviours can improve quality of life amongst cancer survivors, whether this facilitates return to work is unknown. We examined associations of health behaviours with return to work outcomes following a diagnosis of colorectal cancer in middle-aged men and women (45-64 years). We recruited 239 participants through the Queensland Cancer Registry between January 2010 and September 2011. Data were collected through telephone-administered interviews and postal questionnaires at 6 and 12 months post-diagnosis. Logistic regression examined likelihood of ceasing or reducing work, and Cox regression examined factors associated with time to return to work. No significant associations were observed between health behaviours (fruit and vegetables consumption, alcohol consumption, smoking status, physical activity or sitting time) at 6 months and ceasing or reducing work at 12 months post-diagnosis. Participants who reported excessive sleep (≥9 h/day) were 2.69 times more likely to reduce work time or retire (relative to those sleeping the recommended 7 to <9 h/day; 95 % CI 1.06, 6.87, adjusted for cancer treatment). In Cox regression analysis, excessive sleep was associated with a longer work re-entry time (relative to sleeping 7 to <9 h/day; HR = 0.47; 95 % CI 0.22, 1.00, adjusted for education and cancer treatment). Further research into how excessive sleep might be related to return to work amongst colorectal cancer survivors is warranted. Interventions focused on achieving optimal sleep patterns may assist colorectal cancer survivors to return to work and should be tested in future studies.

Associations of health behaviors, school performance and psychosocial problems in adolescents in The Netherlands

School-based health-promoting interventions show promising results in improving various health outcomes of adolescents. Unfortunately, much is still unknown about the relations between health behaviors and school performances, while improving these would give schools a stronger incentive to invest in health promotion. This paper presents the associations of several health behaviors with school performances and studies the mediating effects of psychosocial problems. Health behavior and socio-demographic data were gathered from 905 Dutch high school students via an online survey, completed in-class. These data were matched with school records of the students' overall grade average (GA) on the three core subjects in Dutch high schools (Dutch, English and Math). The associations between health behaviors and school performances, and the potentially mediating effects of psychosocial problems, were studied via mixed-effects regression models. Smoking, being bullied, compulsive and excessive internet use and low physical activity were directly associated with lower school grades. Additionally, being bullied, bullying, smoking, excessive and compulsive internet use were associated with students' grades via mediation of psychosocial problems. This means that lower school grades were (also) associated with those behaviors through the effects of psychosocial problems in those students. This study showed the strong links between health behaviors and academic achievements among adolescents. Schools and health promoters should be educated more on these relations, so that they are aware of this common interest to get more support for health-promoting interventions. Additionally, the role of psychosocial problems in the relations between behaviors and school performances should be studied further in future research.

Abstract 5058: MTHFR and health behaviors: A meta-analysis of epigenetic risks for breast cancer prevention

Abstract Purpose: Breast cancer is the most common malignancy and the second leading cause of cancer death among women worldwide. Methylenetetrahydrofolate reductase (MTHFR) is one of the most studied low penetrant genes that are critical for methylation pathways for deoxyribonucleic acid (DNA) repair and normal cellular development. Methylation pathways are affected by health behaviors such as folate intake, alcohol consumption, and tobacco smoking. While there were several meta-analyses on the associations of MTHFR gene variations and BC, by far, no meta-analysis has been noted on the associations of health behaviors and MTHFR gene variations, with breast cancer. Procedure: PubMed databases were searched by using a combination of key words including “breast cancer”, “MTHFR”, “folate”, “alcohol”, “smoking”, and “health determinants”. Initial search resulted 135 articles from 1999 to 2013. Studies were reviewed for case-control studies, and scored for quality using the standard rating indicators from Quality of Reporting of Meta-analyses. Repeated data from same authors and those with poor quality scores were excluded. Inter-rater reliabilities on data coding and quality scores were established for the selection of studies. Findings: Preliminary results included 55 studies for a total of 22,077 breast cancer cases and 25,419 controls including 27 studies with Whites, 21 studies with Asians, and 7 studies with mixed Euramericans. Twelve studies included MTHFR gene counts with folate intake levels for 8,032 cases and 10,482 controls; 5 studies with alcohol consumption for 3,068 cases and 5,157 controls; and 5 studies with tobacco smoking status for 909 cases and 1233 controls. Preliminary analysis indicated that MTHFR 677CT was associated with increased risk of BC (P &amp;lt; 0.005). The results also suggested that low folate intake, heavy alcohol consumption, and tobacco smoking contributed to increased risks for BC. Conclusion: Investigating the epigenetic risks including healthy life style factors in relation to gene variations has the potential to explain the influence of health behaviors on carcinogenesis. Translating the results from the meta-analysis of health behaviors in relation to epigenetics can provide meaningful insights on the prevention of breast cancer. The findings from the meta-analysis per various race-ethnicity groups can be useful for future development of culturally sensitive and personalized interventions to prevent and reverse breast cancer by promoting the healthy methylation pathways for cancer prevention. Citation Format: Mildred Crisostomo Gonzales, S. Pamela Shiao, Amanda Lie. MTHFR and health behaviors: A meta-analysis of epigenetic risks for breast cancer prevention. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 5058. doi:10.1158/1538-7445.AM2014-5058

Associations of Health Behaviors on Depressive Symptoms among Employed Men in Japan

The associations between health behaviors and depressive symptoms have been demonstrated in many studies. However, job strain has also been associated with health behaviors. The aim of this study was to analyze whether health behaviors such as physical activity, sleeping, smoking and alcohol intake are associated with depressive symptoms after adjusting for job strain. Workers were recruited from nine companies and factories located in east and central areas of Japan. The Center for Epidemiologic Studies Depression (CES-D) Scale was used to assess depressive symptoms. Psychological demand and control (decision-latitude) at work were measured with the Job Content Questionnaire. Multiple logistic regression analysis was used to determine the independent contribution of each health behavior to depressive symptoms. Among the total participants, 3,748 (22.7%) had depressive symptoms, which was defined as scoring 16 or higher on the CES-D scale. Using the multiple logistic regression analysis, depressive symptoms were significantly associated with physical activity less than once a week (adjusted relative risk [ARR] = 1.18, 95% confidence interval [CI], 1.14 to 1.25) and daily hours of sleep of 6 h or less (ARR, 1.25; 95% CI, 1.14 to 1.35). Smoking and frequency of alcohol intake were not significantly associated with depressive symptoms. This study suggests some health behaviors such as physical activity or daily hours of sleep are associated with depressive symptoms after adjusting for job strain.