Health-related Lifestyle Factors Research Articles

Association between depression and bone mineral density in community-dwelling older men and women in Korea

Objectives Previous research suggested a significant correlation between depression and osteoporosis, but little is known for the elderly Asian population. We investigated an association between depression and bone mineral density (BMD) in the Korean elderly. Study design Cross-sectional data analysis of a community-based study, Kangwha Island, South Korea. Main outcome measures BMD, measured at the os calcis using a quantitative ultrasound device, was expressed as stiffness index and T-score. Depressive symptoms were evaluated by the Korean version of Beck Depression Inventory (K-BDI). Depression was defined as a K-BDI score of 16 or higher. Participants also completed a questionnaire, including demographic factors, metabolic abnormalities, and health-related lifestyle factors. Results A total of 932 local residents (422 men and 510 women) aged 60–80 years completed the questionnaires and baseline BMD evaluation. Men with depression had a significantly lower stiffness index compared to those without depression in an age-adjusted (77.2 ± 5.2 vs. 86.0 ± 1.5, p = 0.002) and a multivariate-adjusted model (78.5 ± 5.2 vs. 85. 9 ± 1.5, p = 0.007). Correspondingly, men with depression had an increased probability of having an osteoporosis ( T-score ≤ −2.5) compared to those without depression; the age-adjusted odds ratio was 2.86 (95% CI, 1.36–6.01) and the multivariate-adjusted odds ratio was 2.69 (95% CI, 1.26–5.76). However, no significant association was observed in older women. Conclusions Depression was significantly associated with lower BMD in Korean older men, but not in women.

Educational differences in disability pension among Swedish middle-aged men: role of factors in late adolescence and work characteristics in adulthood

BackgroundThe association between level of education and disability pension (DP) is well known. Earlier studies have investigated the importance of early life factors and work characteristics but not in combination....

Depressive Symptoms, Social Support, and Risk of Adult Asthma in a Population-Based Cohort Study

To investigate the association between depressive symptoms, social support, and prevalent as well as incident asthma. Depressive symptoms and social support may affect the development of asthma. This relationship could be mediated by health behaviors and/or inflammatory processes. Evidence from prospective cohort studies on depressive symptoms and social support in relation to asthma risk in adults remains sparse. Between 1992 and 1995, a population-based sample of 5114 middle-aged adults completed questionnaires covering depressive symptoms, social support, self-reported asthma, and potential confounders. Among those alive in 2002/2003, 4010 (83%) were followed-up by questionnaires. Associations with prevalent and incident asthma were estimated by prevalence ratios (PR) and risk ratios (RR) along with corresponding 95% confidence intervals (CIs), using Poisson regression. PRs and RRs were adjusted for demographics, family history of asthma, smoking, alcohol consumption, body mass index, and physical exercise. Cross-sectional analyses indicated that the prevalence of asthma was positively associated with depressive symptoms and inversely related to social support. Prospective analysis suggested a 24% increased risk of asthma with each 1-standard deviation increase in depressive symptoms (RR, 1.24; 95% CI, 1.02, 1.50), whereas the social support z score showed an inverse association with asthma incidence (RR, 0.71; 95% CI, 0.58, 0.88). Analyses with tertiles suggested similar, but nonsignificant, associations. Omitting health-related life-style variables from the multivariable models did not substantially alter these associations. Risk of adult asthma was found to increase with depressive symptoms and to decrease with social support. These associations do not seem to be explained by health-related life-style factors.

Lichen planus and dyslipidaemia: a case-control study

Previous reports have demonstrated an association between psoriasis and dyslipidaemia. As lichen planus (LP) is also a chronic inflammatory disorder, we investigated the association between LP and dyslipidaemia in Israel. A case-control study was performed utilizing the database of Clalit Health Services, a large healthcare provider organization in Israel. Patients aged 20-79 years who were diagnosed as having LP were compared with a sample of enrollees without LP regarding the prevalence of dyslipidaemia. Data on other health-related lifestyle factors and comorbidities were collected. The study included 1477 patients with LP and 2856 controls without LP. The prevalence of dyslipidaemia was significantly higher in patients with LP (42.5% vs. 37.8%, P = 0.003; odds ratio, OR 1.21, 95% confidence interval, [CI]: 1.06-1.38). A multivariate logistic regression model demonstrated that LP was significantly associated with dyslipidaemia even after controlling for confounders, including age, sex, smoking, hypothyroidism, diabetes, hypertension, socioeconomic status and obesity (multivariate OR 1.34, 95% CI: 1.14-1.57, P < 0.001). In the present study, LP was found to be associated with dyslipidaemia.

Relationship of serum brain-derived neurotrophic factor (BDNF) and health-related lifestyle in healthy human subjects

The associations between serum brain-derived neurotrophic factor (BDNF) levels and several health-related lifestyle factors were evaluated in 85 healthy human subjects. Results showed that the frequency of fruit intake, exercise and television watching were associated with serum BDNF level. There was a higher serum BDNF level from the group with fruit intake five to six times per week. Subjects with moderate frequency of exercise (1–30 times of 30min exercise per month) showed higher serum BDNF level than the group with exercise more than 30 times per month. There was a significant positive correlation between serum BDNF and the daily average watching television time in the younger age group (18–35). The result of this study supports the need for larger studies with different health-related lifestyle in healthy subjects or subjects with disorders.

Green tea consumption and lung cancer risk: the Ohsaki study

We examined the risk of lung cancer in relation to green tea consumption in a population-based cohort study in Japan among 41 440 men and women, aged 40–79 years, who completed a questionnaire in 1994 regarding green tea consumption and other health-related lifestyle factors. During the follow-up period of 7 years (from 1995 to 2001), 302 cases of lung cancer were identified, and the Cox proportional hazards regression model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). The multivariable-adjusted HRs of lung cancer incidence for green tea consumption of 1 or 2, 3 or 4, and 5 or more cups/day as compared to less than 1 cup/day were 1.14 (95% CI: 0.80–1.62), 1.18 (95% CI: 0.83–1.66), and 1.17 (95% CI: 0.85–1.61), respectively (P for trend=0.48). This cohort study has found no evidence that green tea consumption is associated with lung cancer.

Self-management support and training for patients with chronic and complex conditions improves health-related behaviour and health outcomes

The Sharing Health Care SA chronic disease self-management (CDSM) project in rural South Australia was designed to assist patients with chronic and complex conditions (diabetes, cardiovascular disease and arthritis) to learn how to participate more effectively in the management of their condition and to improve their self-management skills. Participants with chronic and complex conditions were recruited into the Sharing Health Care SA program and offered a range of education and support options (including a 6-week peer-led chronic disease self-management program) as part of the Enhanced Primary Care care planning process. Patient self-reported data were collected at baseline and subsequent 6-month intervals using the Partners in Health (PIH) scale to assess self-management skill and ability for 175 patients across four data collection points. Health providers also scored patient knowledge and self-management skills using the same scale over the same intervals. Patients also completed a modified Stanford 2000 Health Survey for the same time intervals to assess service utilisation and health-related lifestyle factors. Results show that both mean patient self-reported PIH scores and mean health provider PIH scores for patients improved significantly over time, indicating that patients demonstrated improved understanding of their condition and improved their ability to manage and deal with their symptoms. These results suggest that involvement in peer-led self-management education programs has a positive effect on patient self-management skill, confidence and health-related behaviour.

Gesundheitszustand und Gesundheitsverhalten von Auszubildenden im ersten Lehrjahr - Erste Ergebnisse einer Befragung in Bielefelder Berufskollegs

Apprentices form the major subgroup in adolescents aged between 16 and 25 years in Germany. Prospectively today's apprentices will display an important role within the society by being the backbone of the future middle class, a socio-economic group of high significance. However, there is little knowledge about the health of apprentices, a major determinant of economic and social capacity. A number of surveys has focussed on the health of adolescents, but these studies failed to provide specific data regarding the subgroup of apprentices. The aims of this study were to survey the health status and the health behaviour of apprentices in a large range of qualified jobs and to point out possible differences be-tween the occupantional fields and gender-specific items. These differences could serve as a starting point for the development of specially-tailored prevention and health promoting strategies in the dual vocational education system. 528 vocational first-year scholars aged between 16 to 25 years were enrolled in the study. A standardised questionnaire concerning life-style attitudes, (physical activity, smoking, alcolhol consumption, drug-abuse, the amount of sleep and dietary habits) was provided in different vocational school settings. The survey was conducted as a pilot-study in vocational schools of Bielefeld in spring 2005. The response rate was 100%. Health risk behaviours were common in apprentices. The percentage of smokers was higher than 50%, exceeding the average rate found in contemporary students. Physiological activity and sleeping quantity was significantly reduced compared to the period of regular scholarship, while drug-abuse slightly decreased. Gender, graduation and the vocational choice had an influence on the health behaviour of the apprentices. Depending on gender and the vocational choice, apprentices differed in their health risk behaviour and therefore require specially-tailored prevention activities. Health promotion and physical activity programs as an integrated unit in the daily life in schools and at the working places are necessary to increase the awareness for health-related life-style factors and to counterbalance the effects of occupational exposure. Based on the results both partners of the dual vocational training are challenged to implement effective and coordinated programmes to maintain health in this population.

Emotional, external, restrained eating and overweight in Dutch adolescents

The purpose of this study was to determine how emotional, external and restrained eating behavior and other health-related lifestyle factors were associated with being overweight in adolescents. Moreover, demographic and ethnic differences in eating behavior have been examined. The respondents were 10,087 Dutch adolescents aged 11-16 years (M= 13.0, SD= 0.8). Self-reported eating behavior was measured with the DEBQ. Health-related lifestyle was determined by physical activity, breakfasting, fruit consumption and snacking. High restrained, and low external eating were positively associated with being overweight, whereas no significant association between emotional eating and being overweight was found for girls, and a negative association for boys. Adolescents who ate breakfast on a daily basis were less likely to be overweight than those who ate breakfast irregularly or never. Being overweight was positively associated with fruit consumption for girls and negatively with physical activity for boys.

Gastric electrical activity and cardiovascular risk factors in relation to autonomic nervous function, hormonal responses, and health-related lifestyles in young men

Electrogastrography (EGG) is the noninvasive recording of gastric myoelectrical activity. The purpose of the present study was to assess associations of EGG with risk factors for cardiovascular disease (CVD), autonomic nervous function, hormonal responses, and health-related lifestyles. EGG was measured in 435 Japanese men, aged 24-39 years, who worked at the same company. In addition to anthropometric measurements and blood examinations, power spectral analysis of heart rate variability in low-frequency (LF; 0.04-0.15 Hz) and high-frequency (HF; 0.15-0.40 Hz) bands was conducted. LF/HF and HF were used as the indicators of sympathetic and parasympathetic nervous activity, respectively. Serum cortisol and catecholamine levels were measured as well. In univariate analyses, the EGG frequency was associated positively with the serum high-density lipoprotein (HDL) and cholesterol level (both-P < 0.0001) and negatively with age, body mass index (BMI), serum triglyceride level, fasting blood sugar, and diastolic blood pressure (all P < 0.05). The EGG frequency tended to increase with increases in the HF band (P = 0.10) and was not significantly associated with the LF/HF ratio (P = 0.45). Neither hormonal responses nor health-related lifestyle factors such as smoking and alcohol were significant (all P > 0.05). A multivariate analysis indicated that both the HDL cholesterol level and BMI were independent predictors of EGG frequency (both P < 0.05), after adjusting for the significant effects of age, HF, and other CVD factors. Slowed EGG frequency appeared to be linked with various CVD risk factors, including obesity and low HDL cholesterol levels, in young men.

Potential self-selection bias in a nested case-control study on indoor environmental factors and their association with asthma and allergic symptoms among pre-school children

Selection bias means a systematic difference between the characteristics of selected and non-selected individuals in epidemiological studies. Such bias may be introduced if participants select themselves for a study. The present study aims at identifying differences in family characteristics, including health, building characteristics of the home, and socioeconomic factors between participating and non-participating families in a nested case-control study on asthma and allergy among children. Information was collected in a baseline questionnaire to the parents of 14,077 children aged 1-6 years in a first step. In a second step 2,156 of the children were invited to participate in a case-control study. Of these, 198 cases and 202 controls were finally selected. For identifying potential selection bias, information concerning all invited families in the case-control study was obtained from the baseline questionnaire. Results show that there are several possible biases due to self-selection involved in an extensive study on the impact of the home environment on asthma and allergy among children. Factors associated with participating were high socioeconomic status of the family, more health problems in the case families, and health-related lifestyle factors, such as non-smoking parents. The overall conclusion of this study is that there are selection biases involved in studies that need close cooperation with the families involved. One solution to this problem is stratification, i.e. investigating associations between exposures and health in the same socioeconomic strata.

Assessment of the health status and risk factors of Kham Tibetan pastoralists in the alpine grasslands of the Tibetan plateau

The health status of Tibetan herders in the Sanjiangyuan region of the Tibetan Plateau, in southwest Qinghai Province, is assessed in this paper. The field study was conducted in 2002 in the context of a broader community development and research framework, the ultimate goal of which is to achieve an effective region-specific programme of preventative health care and training for Tibetan pastoralists. Specifically, the authors analysed the impact of a number of potentially health-related environmental and lifestyle risk factors on self-reported health indicators, with a special emphasis on mother and child health. Several health status indicators were used, including a general morbidity index and a measurement of functional incapacity due to illness in the sample households. Maternal and child health findings were alarming with high rates of miscarriage and infant loss, with no traditional midwives to assist in pregnancy and delivery. Preventable childhood illnesses were also common. Other debilitating diseases included hepatitis, tuberculosis, arthritis (gout), gall bladder disease, peptic ulcers and back pain. Finally, binary logistic regression analysis showed a significant link between general morbidity and the time it takes to obtain water. The survey findings, validated by the focus groups, indicate a real need for increased accessibility and quality of health service provision to women and men and effective preventative health strategies.

Who eats four or more servings of fruit and vegetables per day? Multivariate classification tree analysis of data from the 1998 Survey of Lifestyle, Attitudes and Nutrition in the Republic of Ireland

To identify, using the novel application of multivariate classification trees, the socio-economic, sociodemographic and health-related lifestyle behaviour profile of adults who comply with the recommended 4 or more servings per day of fruit and vegetables. Cross-sectional 1998 Survey of Lifestyle, Attitudes and Nutrition. Community-dwelling adults aged 18 years and over on the Republic of Ireland electoral register. Six thousand five hundred and thirty-nine (response rate 62%) adults responded to a self-administered postal questionnaire, including a semi-quantitative food-frequency questionnaire. The most important determining factor of compliance with the fruit and vegetable dietary recommendations was gender. A complex constellation of sociodemographic and socio-economic factors emerged for males whereas the important predictors of 4 or more servings of fruit and vegetable consumption among females were strongly socio-economic in nature. A separate algorithm was run to investigate the importance of health-related lifestyle and other dietary factors on compliance with the fruit and vegetable recommendations. Following an initial split on compliance with dairy recommendations, a combination of non-dietary behaviours showed a consistent pattern of healthier options more likely to lead to compliance with fruit and vegetable recommendations. There did, however, appear to be a compensatory element between the variables, particularly around smoking, suggesting the non-existence of an exclusive lifestyle for health risk. Material and structural influences matter very much for females in respect to compliance with fruit and vegetable recommendations. For males, while these factors are important they appear to be mediated through other more socially contextual-type factors. Recognition of the role that each of these factors plays in influencing dietary habits of men and women has implications for the manner in which dietary strategies and policies are developed and implemented.

Relationship between Brachial-Ankle Pulse Wave Velocity and Heart Rate Variability in Young Japanese Men

This study examined the relationship between arterial stiffness and autonomic nervous function in a young population. A cross-sectional study was conducted on 382 Japanese males, aged 24 to 39 years, who worked at the same information service company. Brachial-ankle pulse wave velocity (baPWV) was measured using an automatic waveform analyzer, and the spectral power of heart rate variability in the low frequency (LF: 0.04-0.15 Hz) and the high frequency (HF: 0.15-0.40 Hz) band was evaluated by the maximum entropy method. LF/HF and HF were used as the indicators of sympathetic and parasympathetic nervous activity, respectively. Psycho-hormonal responses were examined by the Profile of Mood State (tension-anxiety and anger-hostility scales) and Hamilton's Depression Scale with serum cortisol and catecholamine levels. In a univariate analysis, baPWV was positively associated with the following variables (all p <0.05): LF/HF, age, body mass index, systolic and diastolic blood pressures, heart rate, serum total cholesterol and triglycerides, blood glucose, and plasma cortisol and noradrenaline. Multiple regression analysis indicated that LF/HF was an independent predictor of baPWV (p <0.05), after controlling for significant effects of age, systolic blood pressure, and plasma noradrenaline levels. There was no significant effect of HF on baPWV in this multivariate analysis. Neither mood state nor health-related lifestyle factors such as smoking were significant. It was suggested that baPWV is closely associated with sympathetic nervous activity in young men.

Health-related behaviors and lifestyle factors of patients with breast cancer.

The purpose of this article is to examine differences in the relationship of selected lifestyle factors and health-related behaviors between two groups of women. The study used part of the data gathered in a national Jordanian case-control survey of 100 women with breast cancer and an equal sample of controls. Controls were selected to match the cases (patients) in terms of their age, education, and place of residence. The Health Belief Model and the basic Epidemiological Model were the theoretical framework used in this study. Data were collected using an interview form that was specifically constructed for the national survey. It contained 6 sections: demographics, history of cancer in the family, reproductive history, environmental factors, lifestyle factors, and health education about breast self-examination. The study revealed that there were no significant differences between the patients and controls with regard to their intake of fat, vegetable oil, beef and lamb meat, and smoked food. Higher proportions of patients were found to consume more of the canned and spicy food and caffeinated drinks. Neither smoking nor living or working with someone who smokes showed any significant differences between the patients and controls. Most of the women with breast cancer were found to have exercised in the last 5 years before diagnosis. Having been exposed to stressful events was a major significant risk factor discriminating patients from controls. Finally, having prior knowledge of breast self-examination was a health-related factor that made these women more attentive to their health.

Feelings of exhaustion, emotional distress, and pituitary and adrenocortical hormones in borderline hypertension.

To examine whether feelings of exhaustion and emotional distress reflecting chronic perceived stress contribute to a pattern of pituitary and adrenocortical responses that would in turn be able to distinguish borderline hypertensives from normotensive controls. A cross-sectional study. Helsinki University Central Hospital. Twenty-one middle-aged, male borderline hypertensives (140/90 mmHg < or = blood pressure < 160/95 mmHg) and 69 healthy normotensive controls (blood pressure < 140/90 mmHg). Main outcome measures Basal pituitary-adrenocortical activity was assessed by measurements of plasma cortisol and adrenocorticotrophin concentrations during the oral glucose tolerance test. Cortisol responses to dexamethasone suppression and adrenocorticotrophin stimulation tests were measured to determine the functional pituitary-adrenocortical activity. Feelings of exhaustion, namely, feelings of excess fatigue, loss of energy, increased irritability, demoralization and emotional distress were measured using a questionnaire. As has previously been shown, feelings of exhaustion and emotional distress are associated with a hormonal pattern consisting primarily of an elevation in cortisol response to adrenocorticotrophin stimulation and secondarily of dominance of cortisol in the ratio of mean basal cortisol level to mean basal adrenocorticotrophin level. This particular neuroendocrine pattern, denoting a defeat type of reaction to stress, was in turn able to distinguish borderline hypertensives from normotensive controls significantly. Adjustment for age and health-related lifestyle factors including smoking, alcohol consumption and physical activity did not alter the difference found between the groups. The results suggest that the variance shared by feelings of exhaustion, emotional distress and pituitary-adrenocortical hormones could elucidate the mechanisms by which stress exerts its influence towards an increased risk for hypertension.

A prospective cohort study investigating the explanation of socio-economic inequalities in health in the Netherlands

In this paper, the objectives, design, data-collection procedures and enrolment rates of the Longitudinal Study on Socio-Economic Health Differences (LS-SEHD) are described. This study started in 1991, and is the first large-scale longitudinal study of the explanation of socio-economic inequalities in health in the Netherlands. The LS-SEHD aims at making a quantitative assessment of the contribution of different mechanisms and factors to the explanation of socio-economic inequalities in health. It is based on a research model incorporating both ‘selection’ and ‘causation’ mechanisms, and a wide range of specific factors possibly involved in these mechanisms: health-related life-style factors, structural/environmental factors, psychosocial stress-related factors, childhood environment, cultural factors, psychological factors, and health in childhood. The design of the LS-SEHD is that of a prospective cohort study. An aselect sample, stratified by age, degree of urbanization and socio-economic status, for approx. 27,000 persons was drawn from the population registers in a region in the Southeastern part of The Netherlands. The persons in this sample received a postal questionnaire. An aselect subsample of approx. 3500 persons from the respondents to the postal questionnaire was, in addition, approached for an oral interview. The follow-up of these samples will use routinely collected data (mortality by cause of death, hospital admissions by diagnosis, cancer incidence), as well as repeated postal questionnaires and oral interviews. The response rate to the base-line postal questionnaire was 70.1% ( n = 18,973), and that to the base-line oral interview was 79.4% ( n = 2802). If the LS-SEHD is compared to a number of frequently cited longitudinal studies of socio-economic inequalities in health from the United Kingdom, it appears that the differences with the OPCS Longitudinal Study and the birth cohort studies (such as the National Survey of Health and Development) are huge. The LS-SEHD is more akin to the Whitehall(I)-study and the West of Scotland 20-07 study. For example it has the sample size of the former but the open population and emphasis on social factors of the latter. A comparison of the results of various longitudinal studies of socio-economic inequalities in health is recommended.