Health-related Lifestyle Research Articles

Impact Of Pandemic Covid 19 On Obesity in Adolescent: A Review Article

The COVID-19 pandemic has changed human life, including health-related lifestyles. This literature review aims to analyse the incidence of obesity in adolescents during the Covid 19 pandemic. This study used the article analysis method to obtain an overview of the incidence of obesity in adolescents during the Covid 19 pandemic. Of the ten articles that met the criteria for our analysis, we found that influencing obesity during the Covid 19 period is the problem of lack of activity, increasing sedentary lifestyle, high excessive calorie intake, and the emergence of anxiety factors. Therefore, in dealing with the problem of obesity in adolescents during the COVID-19 period, they are more likely to pay attention to shifting lifestyle conditions and mental health awareness in handling it.

Responsibility in Universal Healthcare

Responsibility in Universal Healthcare

Responsibility in Universal Healthcare

Responsibility in Universal Healthcare

Does Education Influence Life-Course Depression in Middle-Aged and Elderly in China? Evidence from the China Health and Retirement Longitudinal Study (CHARLS).

Mental health problems have become a major public health problem worldwide and are more common among middle-aged and elderly people in China. Research on the effect of education on depression is limited, and whether the relationship between education and depression changes over the life course remains unclear. This study was based on the cross-sectional data of 15,767 middle-aged and elderly individuals in the 2018 tracking survey (Wave 4) of the China Health and Retirement Longitudinal Study (CHARLS) database. Multiple linear regression and bootstrap methods were developed to detect the mediating effect of education on depression. In all samples or different age groups, education was significantly positively associated with depression. Three mediators (economic level, health-related lifestyle, and cognitive level) were significantly positively associated with depression, and cognitive level had a greater effect on depression than economic level and health-related lifestyle. The total, direct, and indirect effects of the whole samples and elderly samples were significant; however, the direct effect of the middle-aged samples was insignificant, and the total and indirect effects of the three mediating pathways were all significant, that is, economic level, health-related lifestyle, and cognitive level should produce complete mediation. The multiple linear regression and bootstrap methods could successfully detect the mediating effect of education on depression. On the basis of the education, economic level, health-related lifestyle, cognitive level, and depression of middle-aged and elderly people, we established and compared the total, direct, and mediating effects of education on depression under the life course. The mediating variables should be further increased, and the measurement methods of depression should be developed to improve the credibility of the research results.

Assessment of the eating habit in the health-related lifestyle among Spanish adults from 22 to 72 years of age

Introduction: eating habits are one of the main predictors of health within a person lifestyle. The assessment of these habits will be essential to confirm health-related habits and orientate behaviors of risk for health. Objectives: to assess the eating habits within the health-related lifestyle among Spanish adults from 22 to 72 years of age. Methods: the Health-Related Lifestyle Assessment Scale (E-VEVSA) was applied to a sample of 788 subjects between the ages of 22 and 72. This scale is made up of 52 items and structured in seven dimensions, among which the healthy eating habit was evaluated, which explained a variance of 8.67 % of the total scale (66.87 %) and a Cronbach's alpha of 0.794 for a total alpha of 0.894. Results: sixteen percent of the adults surveyed have healthy eating habits, 68.3 % tend towards health and 15.7 % are unhealthy. Pearson's 2 tests show a positive and significant association of women with healthy eating habits and a significant improvement with age. The inferential data (Student's t-tests and one-factor ANOVA) confirm these differences according to gender and age. Conclusions: it is necessary to promote preventive programs to improve eating habits in the adult population, especially in the 15.7 % that have an unhealthy level of nutrition in their lifestyle.

Implications of lifestyle medicine in medical practice.

Globally, we are seeing a rise in non-communicable diseases such as obesity, hypertension, diabetes, metabolic syndrome, chronic respiratory diseases, cancer, etc., due to stressful lifestyle in this competitive world. Most of the non-communicable diseases are associated with lifestyle behavior. Presently, the role of lifestyle medicine is very critical and important in the management of chronic lifestyle-associated disorders. Considering the above facts, we decided to review the literature to gain a deeper insight into the implications of lifestyle medicine in medical practice. A literature search was conducted on PubMed, Scopus and Google Scholar databases. We observed that lifestyle medicine intervention is a growing and newer discipline and is being employed along with conventional management of non-communicable diseases by medical practitioners today, as they are strongly associated with lifestyle behaviors and practices. Motivation for change in lifestyle is challenging because it depends on the patient's determination and eagerness to adapt and accommodate to the newer lifestyle pattern. The medical practitioners should spend time in coaching patients on lifestyle-related health education. Guidance and coaching by medical practitioners will help patients adapt to practices of maintaining regular physical activity, a balanced diet, good sleep hygiene, and avoid addictions of tobacco and alcohol as part of life. Introducing real and progressive evidence-based behavioral changes to reduce the risks of lifestyle-related acute and chronic diseases in medical practice will reduce the burden of non-communicable disease.

Feasibility, Usability and Acceptability of a mHealth Intervention to Reduce Cardiovascular Risk in Rural Hispanic Adults: Descriptive Study.

Mobile health (mHealth) technology using apps or devices to self-manage health behaviors is an effective strategy to improve lifestyle-related health problems such as hypertension, obesity, and diabetes. However, few studies have tested an mHealth intervention with Hispanic/Latino adults, and no studies were found testing mHealth with rural Hispanic/Latino adults, the fastest-growing population in rural areas. The purpose of this study was to evaluate the feasibility, usability, and acceptability of an mHealth cardiovascular risk self-management intervention with rural Hispanic/Latino adults. A descriptive study using quantitative and qualitative methods was used to evaluate the feasibility, usability, and acceptability of delivering a 12-week mHealth self-management intervention to reduce cardiovascular risk with rural Hispanic/Latino adults who were randomized to 1 of 2 groups. Both groups were asked to use MyFitnessPal to self-monitor daily steps, weight, and calories. The intervention group received support to download, initiate, and troubleshoot technology challenges with MyFitnessPal (Under Armour) and a smart scale, while the enhanced usual care group received only a general recommendation to use MyFitnessPal to support healthy behaviors. The usability of MyFitnessPal and the smart scale was measured using an adapted Health Information Technology Usability EvaluationScale (Health-ITUES). Adherence data in the intervention group (daily steps, weight, and calories) were downloaded from MyFitnessPal. Acceptability was evaluated using semistructured interviews in a subsample (n=5) of intervention group participants. A sample of 70 eligible participants (enhanced usual care group n=34; intervention group n=36) were enrolled between May and December 2019. The overall attrition was 28% at 12 weeks and 54% at 24 weeks. mHealth usability in the intervention group increased at each time point (6, 12, and 24 weeks). Adherence to self-monitoring using mHealth in the intervention group after week 1 was 55% for steps, 39% for calories, and 35% for weights; at the end of the 12-week intervention, the adherence to self-monitoring was 31% for steps, 11% for weight, and 8% for calories. Spikes in adherence coincided with scheduled in-person study visits. Structured interviews identified common technology challenges including scale and steps not syncing with the app and the need for additional technology support for those with limited mHealth experience. Recruitment of rural Hispanic/Latino adults into the mHealth study was feasible using provider and participant referrals. The use of MyFitnessPal, the smart scale, and SMS text messages to self-monitor daily steps, weights, and calories was acceptable and feasible if technology support was provided. Future research should evaluate and support participants' baseline technology skill level, provide training if needed, and use a phone call or SMS text message follow-ups as a strategy to minimize attrition. A wearable device, separate from the smartphone app, is recommended for activity tracking.

The impact of multifactorial factors on the Quality of Life of Behçet's patients over 10 years.

This study analyses the 2020 survey and reviews the 2009, 2014 surveys to ascertain which Behçet's symptoms, personal and family status, patients' lifestyle, and work-related outcomes impacted on Health-Related Quality of Life (HRQoL). Four hundred and fifty-nine Behçet's patients submitted an online survey/questionnaire. Patients provided information on socio-demographic characteristics, disease duration, historical and current symptoms, systemic and topical medication, health related lifestyle, work-related outcomes regarding employment status and claiming benefits and Quality of Life (QoL) measured by EQ-5D index. Four hundred and nineteen patients met the inclusion criteria, and 371 who had full data (Males: Females: Others = 84:285:2, mean-age = 41.1 ± 23.3:38 ± 13.2:40 ± 5). The main symptoms associated with patients seeking medical care were mouth ulcers 30% and genital ulcers 23%, joint 14%, and eye problems 9%. The EQ-5D index for 2009, 2014, 2020 was (mean ± SD); 0.47 ± 0.38, 0.42 ± 0.37, 0.34 ± 0.40, respectively, p < 0.05. 2020 patients had the worst values of the five domains compared to 2014 and 2009. Interestingly, mobility value was the same over the 10 years of monitoring patients. Behçet's syndrome (BS) symptoms that had significant negative impact on QoL were; 2009 (arthropathy, neurological problems, pathergy reaction, and stomach/bowel symptoms), 2014 (arthropathy, headache, neurological problems, pathergy reaction, and skin lesions), 2020 (arthropathy, neurological problems, and stomach/bowel symptoms). The 2014 and 2020 surveys reported the QoL is significantly better in patients on immunosuppressant, who did sport, continued in employment and not receiving benefits. Joints and neurological symptoms are the main symptoms which had negative impact on BS patients over the 10 years, sociodemographic (gender, age, marital, and education status), lifestyle (medication, cannabis, drinking wine, and regular exercise), employment status (employee and no career change), and accessing benefits (never claim benefit) had significant influence on patients' HRQoL.

Temporal changes in health-related lifestyle during the COVID-19 epidemic in Finland – a series of cross-sectional surveys

BackgroundPublic health recommendations and governmental restrictions during the COVID-19 epidemic have affect everyday life. This study aimed to examine temporal changes in health-related lifestyle and the accumulation of positive and negative changes in the key lifestyle factors (vegetable consumption, leisure-time physical activity, sleeping, alcohol consumption, smoking) in the same individuals among Finnish adults during the epidemic.MethodsThis study was based on a series of cross-sectional surveys conducted between April 2020 and June 2021 to investigate antibody levels for the new coronavirus in the population. In each survey, a random sample of adults (18 to 69 years) from five university hospital regions were invited. A total of 5655 (response rate 32%) responded to the questionnaire including questions on lifestyle changes during epidemic.ResultsOn average one-sixth of respondents (17%) reported at least two negative changes in the key lifestyle factors during the study period. An increase in snacking and sleep problems and decrease in leisure-time physical activity and active commuting to work were the most common of individual negative changes. The proportion of negative changes in physical activity increased as the epidemic drags on. In contrast, on average every seventh of the respondents (14%) reported at least two positive lifestyle changes in the key lifestyle factors. The most common individual positive changes were increased consumption of fruit, berries and vegetables and decreased consumption of alcohol. More negative changes were reported on average, when both negative and positive changes in the key lifestyle factors were summed. The most negative changes were reported in the late 2020.ConclusionThe results of the present study suggest that the lifestyle changes during the COVID-19 epidemic have been diverse being on average more commonly unfavorable than favorable for health. The deteriorated epidemic situation in the late 2020 and, on the other hand, prolonged epidemic predisposed to negative lifestyle changes. Further studies are important to examine whether these changes are maintained over time and to identify the factors that contribute to changes and their accumulation in the same individuals. Health promotion actions are needed to prevent the long-term effects of the epidemic on health and welfare.

How socioeconomic status affects weight status through health-related lifestyles: a latent class analysis.

Obesity levels have increased worldwide with serious public health concerns. However, weight status is related to socioeconomic status (SES), which may also influence health-related lifestyles. Here, we study the association between SES and obesity mediated by diet and physical activity. Using cross-sectional data from 2006, 2011, 2014, and 2017 Spanish health surveys (the final sample consisted of 61 768 adults aged between 18 and 64 years), we conducted a latent class analysis to estimate health-related lifestyle clusters (based on dietary patterns and physical activity) and mediation analyses to evaluate the association of SES and obesity through the clustering of health-related lifestyles. In both men and women, SES was inversely related to obesity (P < 0.001) and positively related to healthier lifestyle classes (P < 0.001). Obesity was inversely related to healthier lifestyle classes (P < 0.001). A small-although significant-proportion mediated by the clustering of lifestyles was found as follows: 4.9%, 95% CI (6.6%, 3.2%) in men and 2.3%, 95% CI (3.4%, 1.3%) in women for educational attainment, 5.3%, 95% CI (7.2%, 3.6%) in men and 2.0%, 95% CI (2.9%, 1.1%) in women for occupational social class, and 4.9%, 95% CI (6.5%, 3.1%) and 1.9%, 95% CI (2.9%, 1.1%) combining the above two SES indicators. SES is related to obesity through clustering health-related lifestyles, with greater emphasis on men. However, the complex relationship between SES and weight status also suggests other indicators that contribute to the social gradient of obesity.

Health-Related Lifestyles in Relation to Body Mass Index Among Young and Middle-Aged Women in Japan.

Being underweight, overweight, or obese can lead to adverse health effects. Hence, it is important to understand the specific factors that change the burden of underweight and overweight to target appropriate disease control strategies. This study was designed to examine the prevalence and factors associated with underweight and overweight among young and middle-aged women in Japan. A cross-sectional study was conducted among women aged 20-59 years who participated in health checkups at a regional health care center in 2018 and 2019 (N = 1722). The assessments included anthropometric, blood pressure measurements, and a standardized self-administered questionnaire. Multivariable logistic regression analysis assessed lifestyle factors associated with body mass index for underweight <18.5 kg/m2) and overweight/obesity (25.0 kg/m2 and above). The prevalence of underweight and overweight/obesity were 12.3%, and 22.5%, respectively. No lifestyle factors were found to be significantly associated with being underweight. Having dinner within 2 hours before bed was positively associated with being overweight/obese [adjusted odds ratio (AOR): 1.448, 95% confidence interval (CI): 1.014-2.068]. Women who gained 10 kg since their 20s were more likely to fall into overweight/obesity category (AOR: 9.674, 95% CI: 1.014-2.068). Women who were using a lipid-lowering medication (AOR: 3.150, CI: 1.892-5.246) were associated with three times higher risk of being overweight/obese. Hypertension and dyslipidemia were significantly associated with overweight/obesity (AOR: 3.094, 95% CI: 2.201-4.351 and AOR: 2.498, 95% CI: 1.831-3.409, respectively). One in five middle-aged women was overweight or obese, whereas one in eight was underweight. In relation to the prevention of overweight/obesity, specific health promotion messages regarding eating timing should be developed.

중ㆍ노년기 건강 라이프스타일의 변화와 노년기 인지기능의 연관성: 2006년과 2020년 고령화연구패널 자료 분석

Objectives: This research study aimed to compare and analyze changes in health related lifestyles in middle age and the relevant association of cognitive function in old age. Methods: The change in health-related lifestyles and the influence on cognitive function between the first and eighth panels of 3,404 participants aged 45 to 64 were examined using multiple regression analysis. Results: First, improved health behavior for 14 years, but health status and social networks and social activities decreased. Second, older age, low levels of education, depression, and diabetes were found to be related to cognitive deterioration. Third, the predictive factors of middle age that affect cognitive decline in old age were low education level, physical activity time of 150 minutes or more, and diagnosis of diabetes. Moreover, regular health examinations and one or more organizational activities in a month appeared to have a positive effect on cognitive function in old age. Conclusion: These findings highlight the significance of health behavior and health management and the need for intervention in middle-aged people who are experiencing various life tasks and chronic diseases in order to maintain cognitive function in old age.

The associations of the national health and productivity management program with corporate profits in Japan.

Using a dataset from a survey on national health and productivity management, we identified health and productivity factors associated with organizational profitability. The Ministry of Economy, Trade and Industry conducted an annual survey on Health and Productivity Management between 2014 and 2021. We assessed the associations of organizational health and productivity management using survey questions collected in 2017 and 2018, with the rate of change in profits from 2017 and 2018 to 2020. We identified factors associated with organizational profitability using eXtreme Gradient Boosting, and calculated SHapley Additive exPlanation (SHAP) values for each factor. Among 1,593 companies (n= 4,359,834 employees), the mean age of employees at baseline was 40.3 years and the proportion of women was 25.8%. A confusion matrix for evaluating model performance had an accuracy of 0.997, precision of 0.993, recall of 0.997, and area under the precision-recall curve of 0.999. The most important factors related to an increase in corporate profits were the percentage of current smokers (SHAP value, 0.121), per-employee cost of health services (0.084) and medical services (0.050); the percentage of full-time employees working in sales departments (0.074) and distribution or customer service departments (0.054); the percentage of employees who slept well (0.055); and the percentage of employees within a company who regularly exercised (0.043). Employees' lifestyle-related health risk factors and organizations' management systems were associated with organizational profitability. Lifestyle medicine professionals may demonstrate a significant return on investment by creating a healthier and more productive workforce.

Healthy lifestyle over the life course: Population trends and individual changes over 30 years of the Doetinchem Cohort Study.

For five health-related lifestyle factors (physical activity, weight, smoking, sleep, and alcohol consumption) we describe both population trends and individual changes over a period of 30 years in the same adult population. Dichotomous indicators (healthy/unhealthy) of lifestyle were analyzed for 3,139 participants measured every 5 years in the Doetinchem Cohort Study (1987–2017). Population trends over 30 years in physical inactivity and “unhealthy” alcohol consumption were flat (i.e., stable); overweight and unhealthy sleep prevalence increased; smoking prevalence decreased. The proportion of the population being healthy on all five lifestyle factors declined from 17% in the round 1 to 10.8% in round 6. Underlying these trends a dynamic pattern of changes at the individual level was seen: sleep duration and physical activity level changed in almost half of the individuals; Body Mass Index (BMI) and alcohol consumption in one-third; smoking in one-fourth. Population trends don't give insight into change at the individual level. In order to be able to gauge the potential for change of health-related lifestyle, it is important to take changes at the individual level into account.

Impact of the restrictions on community activities policy during the COVID-19 on psychological health in Indonesia's urban and rural residents: A cross-sectional study.

Background and AimsAlthough extensive research has been conducted on the psychological impact after exposure to the COVID‐19 pandemic, very few studies simultaneously investigated the negative and positive impacts on urban and rural residents. This study aims to compare the extent of psychological impact on Indonesian living in urban and rural areas a year after the first case of COVID‐19 was reported.Design, Methodology and ApproachWe employed a cross‐sectional study design. A total of 428 participants completed a set of web‐based questionnaires from February to March 2021, consisting of the Impact of Event Scale‐Revised (IES‐R), the Perceived Social‐Support (PSS), the mental health‐related lifestyle (MHLS), and 6‐item negative impacts, and the Jenkins' Sleep Scale (JSS).FindingsOver 40% of the participants reported moderate to severe trauma‐related distress; 30%–40% increased stress at work, home, and financial stress, and 50% more social support gained from their family and friends. Although 62.1% of participants paid more attention to their mental health, only 30% engaged in a healthier lifestyle, and 36.7% had sleep problems. No significant differences were found between urban and rural residents on psychological impact, changes in mental health and related lifestyles, and sleep quality. Urban residents perceived more negative impacts, in parallel with increased social support, compared to rural residents. We also found a significant correlation between psychological impact, sleep disturbance, and increased social support. However, there was no significant association between mental health‐related lifestyles and other scales.Originality and ValueThis is among the first studies that examine the urban–rural disparity on the positive and negative impact of the COVID‐19 in the later stage of the pandemic. Our findings offer insights to provide equal effort to mitigate the negative impacts of the COVID‐19 crisis as well as promote healthy lifestyle behaviors in both urban and rural residencies.

Health-Related Lifestyle Among College-Going Youth in Bhubaneswar, Odisha.

IntroductionYouth is a period where a number of healthy and unhealthy habits get acquired that last throughout a person's life. Youth health promotion has become a key study focus around the world. Thus this study is undertaken to understand health-related lifestyles affecting college-going youth.MethodsA cross-sectional survey was done in the junior colleges in Bhubaneswar, India, which included college-going youth. The sample size was 636. The sampling technique was a two-stage stratified sampling method. Firstly, one college was selected from each of five administrative regions (east, west, north, south, and central zone) in Bhubaneswar randomly by lottery method to provide a representative sample. From each college, 128 students were selected randomly from the list of students.ResultsIn this study, 237 (37.3%) of the participants ate green leafy vegetables on a daily basis, with 39.3% of females and just 31.2% of males. This difference in preference of green leafy vegetables among males and females was found to be statistically significant with a p-value of 0.019. Out of 180 (28.3%) of the participants who consumed milk products daily, 25% were females, while 38.1% were males (p-value of 0.004). In the present study, out of 247 (38.8%) participants who preferred eating fast food, 37.6% were females, while 42.5% were males. Out of 213 (33.5%) of them who preferred sweets (candy/chocolate), 37.2% were females, while only 22.5% were males. This difference in gender in regards to junk food preference was found to be statistically significant with a p-value of 0.001. In the current study, out of 243 (42%) of the participants who spent 30 minutes to one hour on exercise per day, 43.4% were females, while 37.4% were males. Out of 133 (23%) of them who spent one to two hours on exercise per day, 23.6% were females, while only 20.9% were males (p-value of 0.003). Out of 208 (35.9%) of the participants who preferred walking as the main mode of exercise, 40.2% were females, while 22.3% were males (p-value <0.0001).ConclusionThe main findings of this study demonstrated that the majority of the youth followed proper meal routines and engaged in regular physical exercise. However, when compared to junk food consumption, participants consumed far fewer green leafy vegetables. This would prove to be harmful to their health. Since the youth of today are the future of tomorrow, they should be provided with proper health education regarding the harmful effects of regular intake of junk food.

Lifestyle associated with the obesity in children under 5 years of age in Hilla city, Iraq

Background: Poorer communities have disproportionately higher rates of overweight and obesity, but there are few research that looks at child health-related lifestyles that may guide the development of useful treatments. The Aim of study is to identify lifestyle factors associated with obesity in children under 5 years. Subjects and Methods: A case-control study was conducted on 100 children with obesity and 100 healthy participants in primary health care centers at Hilla city. The study used a convenience sampling technique (non-random sampling technique) to choose the children with obesity and control groups via take body anthropometry and direct interviews. The data collection continued for a period of 3 months starting on 2nd January 2022 and ending on 1st April,2022. Results: the results found that the children who practice physical activity inside the home for 1-2 per week are likely at higher risk for obesity at 17.680 times than those who practice physical activity inside the home daily. While the participants who do not eat while watching TV are likely at less risk for obesity than those who eat while watching TV (B=-0.679-; P. value=0.032; OR= 0.507; 95% C.I 0.272-0.945). &#x0D;

Smokeless Tobacco: Pattern and Awareness in a Rural Area of Bangladesh

Background: Smokeless tobacco consumption has contributed nothing except diseases, disability and death. But assessment of awareness and knowledge regarding its use has less been studied to the extent as that of smoking. The study was undertaken to assess the pattern of use and awareness of smokeless tobacco among rural community.&#x0D; Materials and methods: This descriptive cross-sectional study was conducted among 310 respondents selected through systemic sampling method, aged 18 years, residing at least for 10 years in Noakhali district in Bangladesh. This study was conducted from May to November 2013. Data were collected with a pretested questionnaire through face-to-face interview. &#x0D; Results: Smokeless Tobacco (SLT) use was prevalent among 45.8% of respondents. Higher proportion of females than males used SLT. Zarda was the common form in more than half of the users. Among daily users, self-interest was the main factor for initiation and mean age of starting was 35 years. Per day frequency of SLT use for 1-8 times was in two-thirds of the daily users. Most of the respondents knew that SLT is injurious to health. About two-thirds of them mentioned SLT as addictive. More than one-thirds of the respondents had knowledge that smoking is more injurious than SLT. However, 30% of the respondents knew that both smoking and SLT were equally addictive. Excluding the former users, majority of the respondents knew that SLT might be quitted. &#x0D; Conclusion: Multistage effective behavioral change intervention programs are the preferable way to overcome this lifestyle-related health problem.&#x0D; JCMCTA 2022 ; 33 (1) : 166-172

High Blood Pressure and Changes in the Body Mass Index Category Among Japanese Children: A Follow-Up Study Using the Updated American Academy of Pediatrics Guidelines.

BackgroundHigh blood pressure (HBP) has become a public health issue worldwide. The relationship between high BP and changes in the body mass index (BMI) category in Japanese pubertal children has not yet been examined. To resolve this issue, we examined existing data with a focus on the primordial prevention of high BP signs, including elevated BP, among pubertal children aged 12 and 15 years.MethodsHeight, body weight, and BP data were examined from health checkups of 18,247 children conducted between 1993 and 2000 in the Karatsu Study, which was a cohort of pediatric lifestyle-related disease prevention medical health checkups in Japan. BP and BMI were assessed using the updated American Academy of Pediatrics (AAP) guidelines and Endocrine Society’s clinical practice guidelines definitions, respectively.ResultsFollow-up data were obtained from 7,090 subjects (50.5% boys). Stage 2 hypertension (HTN) was detected in 3% and 2.7% of boys and girls aged 12 years, respectively, and in 2.7% and 1% of boys and girls aged 15 years, respectively. Among children aged 15 years, 1.4% were newly classified with stage 2 hypertension, and 15.6% exhibited improvements to a normal BP. A binomial logistic regression analysis of high BP and BMI category changes revealed odds ratios (OR) in the group with a deteriorated BMI category of 1.51 (95% confidence interval (CI), 1.17-1.94), 2.30 (95%CI, 1.66-3.17), and 6.83 (95%CI, 4.14-11.29) for elevated BP, stage 1 hypertension, and stage 2 hypertension, respectively.ConclusionHigh BP in puberty positively correlated with BMI category changes. Considering the presence of the tracking phenomenon in hypertension, BP monitoring is an essential part of the early strategy for the prevention of lifestyle-related diseases in childhood, and improvements in BP control are crucial in early life.

An Evaluation of Alternative Technology-Supported Counseling Approaches to Promote Multiple Lifestyle Behavior Changes in Patients With Type 2 Diabetes and Chronic Kidney Disease

Although technology-supported interventions are effective for reducing chronic disease risk, little is known about the relative and combined efficacy of mobile health strategies aimed at multiple lifestyle factors. The purpose of this clinical trial is to evaluate the efficacy of technology-supported behavioral intervention strategies for managing multiple lifestyle-related health outcomes in overweight adults with type 2 diabetes (T2D) and chronic kidney disease (CKD). Using a 2×2 factorial design, adults with excess body weight (body mass index ≥27kg/m2, age ≥40years), T2D, and CKD stages 2-4 were randomized to an advice control group, or remotely delivered programs consisting of synchronous group-based education (all groups), plus (1) Social Cognitive Theory-based behavioral counseling and/or (2) mobile self-monitoring of diet and physical activity. All programs targeted weight loss, greater physical activity, and lower intakes of sodium and phosphorus-containing food additives. Of 256 randomized participants, 186 (73%) completed 6-month assessments. Compared to the ADVICE group, mHealth interventions did not result in significant changes in weight loss, or urinary sodium and phosphorus excretion. In aggregate analyses, groups receiving mobile self-monitoring had greater weight loss at 3months (P=.02), but between 3 and 6months, weight losses plateaued, and by 6months, the differences were no longer statistically significant. When engaging patients with T2D and CKD in multiple behavior changes, self-monitoring diet and physical activity demonstrated significantly larger short-term weight losses. Theory-based behavioral counseling alone was no better than baseline advice and demonstrated no interaction effect with self-monitoring.