Healthy Lifestyle Behaviors Research Articles

A structural modeling approach to determine the effects of orthorexia nervosa and social appearance anxiety on healthy lifestyle behaviors in young adults

Aims: The aim of this study is to examine the relationship between orthorexia nervosa (ON) and social appearance anxiety (SAA) and to investigate the effects of these variables on healthy lifestyle behaviors (HLB) in young adults aged 18-30 years. Methods: A total of 408 young adult male and female volunteers, with a mean age of 21.7±2.95 years, participated in this study. A structural model was proposed to examine the effects of SAA and ON on HLB. To assess how well the study variables represented the underlying components, we first evaluated a confirmatory measurement model. Subsequently, we analyzed a structural model that allowed for the examination of multiple regression equations involving several dependent variables. Results: SAA had a negative influence on HLB (std β=-0.673; t-value=-8.425), a significant negative relationship between ON, HLB was also promoted (std β=-0.554; t-value=-9.388). It was determined that there is a positive correlation between SAA, ON which is statistically significant (correlation coefficient=0.830; t-value=10.244). Conclusion: It is concluded that the individuals with high social appearance anxiety do not adopt healthy lifestyle behaviors and are more prone to orthorexia nervosa.

Healthy lifestyle associated with dynamic progression of type 2 diabetes: A multi-state analysis of a prospective cohort.

Although the association of a healthy lifestyle with type 2 diabetes (T2D) has been extensively studied, its impact on the dynamic trajectory, including progression, onset and prognosis, of T2D has not been investigated. Using data from the UK Biobank, 461 168 participants without diabetes or diabetes-related events were included. We incorporated four lifestyle factors to construct the healthy lifestyle score (HLS). We employed a multi-state model to examine the relationship between a healthy lifestyle and transition in T2D progression, including transitions from baseline to diabetes, complications, and further to death. The cumulative probability of above transitions based on the health lifestyle score was calculated. The results indicated that adhering to 3-4 healthy lifestyles had an inverse association with the risk of transition from baseline to diabetes (hazard ratio (HR) = 0.966; 95% confidence interval (CI) = 0.935-0.998, P = 0.038), diabetes to complications (HR = 0.869; 95% CI = 0.818-0.923, P = 5.2 × 10-6), baseline to death (HR = 0.528; 95% CI = 0.502-0.553, P < 2 × 10-16, and diabetes to death (HR = 0.765; 95% CI = 0.591-0.990, P = 0.041) compared with maintaining 0-1 healthy lifestyles. In addition, the transition probability of the above transitions can be lower with maintaining 3-4 healthy lifestyles. Healthy lifestyles are negatively associated with the risk of multiple outcomes during the dynamic progression of T2D. Adherence to 3-4 healthy lifestyle behaviours before diabetes onset can lower the risk of developing T2D, further reducing the risk of diabetes complications and death in patients with T2D.

Daily Limited Future Time Perspective Is Associated With More Health Behavior Within Older Adults.

Cross-sectional studies suggest that individuals who perceive a broader future horizon may be more likely to consider the future consequences of their actions and, as a result, engage in healthy lifestyle behaviors. However, research has yet to consider how this association plays out on the daily level. The present study used daily diary data from a sample of 198 older adults aged 60 years and older (M = 63.34, SD = 3.29) to investigate the relationship between daily future time perspective (FTP) and daily health behavior. Participants reported on sociodemographic characteristics during baseline surveys and completed daily diary measures of FTP and health behavior (e.g., nutrition, exercise, social/leisure activity) across 14 days. Multilevel modeling was used to examine within- and between-person associations between daily FTP and health behavior. Daily FTP was significantly associated with daily health behavior at the within- but not at the between-person level. Counter to past cross-sectional work, results revealed that individuals showed increased engagement in health behavior on days when they reported a more limited FTP. Findings highlight the importance of moving beyond the between-person level to consider how FTP fluctuates from day-to-day and relates to health behavior in everyday life. Older adults who view a more limited time horizon may be motivated to increase that future through healthier activities.

DIET AND EXERCISE HABITS OF NURSING ACADEMICS DURING THE PANDEMIC

This study aimed to examine the effects of social isolation during COVID-19 pandemic on dietary and exercise habits of nursing academics. This cross-sectional study was conducted with 393 nurse academics working in Turkey who agreed to participate in the study. During lockdown due to the COVID-19 pandemic, approximately 10% of the participants received professional support for diet and exercise. The habits such as consumption of foods that strengthen the immune system and the time spent passively increased, whereas the habit of fast food consumption decreased. The nursing academics in this study showed a positive attitude toward diet and exercise because of their increasing age and the presence of chronic diseases; thus, high scores were observed on the diet and physical activity subscales of the Healthy Lifestyle Behaviors Scale (HLBS II) used in this study (p ˂ 0.05). Thus, it is very important for nurse academics to display healthy lifestyle behaviors during the course of the pandemic to be role models for increasing the awareness of the public about the appropriate diet and exercise

Plasma metabolomic signature of healthy lifestyle, structural brain reserve and risk of dementia.

Although the association between healthy lifestyle and dementia risk has been documented, the relationship between a metabolic signature indicative of healthy lifestyle and dementia risk and the mediating role of structural brain impairment remain unknown. We retrieved 136 628 dementia-free participants from UK Biobank. Elastic net regression was used to obtain a metabolic signature that represented lifestyle behaviours. Cox proportional hazard models were fitted to explore the associations of lifestyle-associated metabolic signature with incident dementia. Causal associations between identified metabolites and dementia were investigated using Mendelian randomization. Mediation analysis was also conducted to uncover the potential mechanisms involving 19 imaging-derived phenotypes (brain volume, grey matter volume, white matter volume and regional grey matter volumes). During a follow-up of 12.55 years, 1783 incident cases of all-cause dementia were identified, including 725 cases of Alzheimer's dementia and 418 cases of vascular dementia. We identified 83 metabolites that could represent healthy lifestyle behaviours using elastic net regression. The metabolic signature was associated with a lower dementia risk, and for each standard deviation increment in metabolic signature, the hazard ratio was 0.89 [95% confidence interval (CI): 0.85, 0.93] for all-cause dementia, 0.95 (95% CI: 0.88, 1.03) for Alzheimer's dementia and 0.84 (95% CI: 0.77, 0.91) for vascular dementia. Mendelian randomization revealed potential causal associations between the identified metabolites and risk of dementia. In addition, the specific structural brain reserve, including the hippocampus, grey matter in the hippocampus, parahippocampal gyrus and middle temporal gyrus, were detected to mediate the effects of metabolic signature on dementia risk (mediated proportion ranging from 6.21% to 11.98%). The metabolic signature associated with a healthy lifestyle is inversely associated with dementia risk, and greater structural brain reserve plays an important role in mediating this relationship. These findings have significant implications for understanding the intricate connections between lifestyle, metabolism and brain health.

Abstract B060: Bridging gaps in cancer care: Evaluating community health worker presence in Alabama on rates of cancer screening and lifestyle-related outcomes

Abstract Purpose Alabama has the 7th highest cancer mortality in the US. The University of Alabama at Birmingham O’Neal Comprehensive Cancer Center—the only NCI-designated comprehensive cancer center in the state—endeavors to reduce cancer mortality and burden. For 25 years, its Office of Community Outreach and Engagement (OCOE) has applied a community health worker (CHW) outreach and engagement model for cancer awareness, navigation to screening and healthy lifestyle promotion. OCOE hired and trained CHWs to provide services in counties with highest cancer burden. CHW presence fluctuated over time due to grant-funding and other extraneous events. This study evaluates the association of CHW presence with cancer screening and lifestyle-related outcomes. Methods We utilized latest CDC PLACES data (drawn from 2018 and 2020 Behavioral Risk Factor Surveillance System) which provides model-based, population-level age-adjusted prevalence estimates of county-level cancer screening (breast, cervical, colon) and lifestyle outcomes (physical inactivity, obesity, smoking). We evaluated change in rates over time between counties with and without CHW presence using linear mixed effects models. Results Compared to counties without CHW presence, those with CHW presence in 2020 had 0.7% higher mammography rate in 2018 (95% CI: -0.8, 2.3) and 0% difference in mammography rate per year change (95% CI: -0.6, 0.7); counties with CHW presence in both years had 2.8% higher mammography rate (95% CI: 1.1, 4.6) and 0.2% faster increase in mammography rate per year (95% CI: -0.5, 1.0). Counties with CHW presence in both 2018 and 2020 had 1.8% lower rate of colon cancer screening in 2018 (95% CI: -3.6, 0.02) and 1.3% increase in colon cancer screening per year (95% CI: 0.5, 2.1). Counties with CHW presence in 2020 had 1% higher physical inactivity rate in 2018 (95% CI: -2.3, 4.3) and 0.3% faster decrease in physical inactivity rate per year (95% CI: -1.0, 0.4); counties with CHW presence in both years had 3.6% higher physical inactivity rate in 2018 and 0.2% faster decrease in physical inactivity rate per year (95% CI: -0.8, 0.5). Counties with CHW presence in 2020 only had 1.8% higher obesity rate in 2018 (95% CI: -1.7, 5.2) and 0.9% faster decline in obesity rate per year (95% CI: -2.2, 0.4); counties with CHW presence in both years had 5.1% higher obesity rate in 2018 (95% CI: 1.9, 8.3) and 0.3% faster decline in obesity rate per year (95% CI: -1.6, 0.9). There were no statistically significant differences for cervical cancer screening or smoking. Conclusion The OCOE CHW model provided access, education and empowerment for AL residents to obtain cancer screenings and participate in healthy lifestyle behaviors. CHW presence (particularly sustained presence over time) was associated with improved mammography and colon cancer screening, reduced physical inactivity and reduced obesity. Further study of CHW presence and these outcomes during and post COVID-19 is ongoing. Expansion of the CHW model across the entire state is a priority to reduce cancer mortality among Alabamians. Citation Format: Mackenzie E. Fowler, Claudia Hardy, Silvia Gisiger-Camata, Francine Walton, Rochelle Wallace, Tara Bowman, Aldenise P. Ewing, Timiya S. Nolan. Bridging gaps in cancer care: Evaluating community health worker presence in Alabama on rates of cancer screening and lifestyle-related outcomes [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B060.

Examining the Link between Air Quality (PM, SO2, NO2, PAHs) and Childhood Obesity: A Systematic Review.

Background/Objectives: Childhood obesity has emerged as a global health concern with profound implications for long-term health outcomes. In recent years, there has been increasing interest in the potential role of environmental factors in the development of childhood obesity. This comprehensive review aims to elucidate the intricate relationship between various components of air pollution and childhood obesity. Methods: We systematically analyze the existing literature from the past 5 years to explore the mechanistic pathways linking air pollution, including particulate matter (PM), nitrogen oxides (NOx), sulfur dioxide (SO2), and polycyclic aromatic hydrocarbons (PAHs), to childhood obesity. This systematic review examines 33 epidemiological studies on the link between air pollution and childhood obesity, published from 1 January 2018, to 31 January 2024. Results: Studies from counties with low overall air pollution noticed only low to no impact of the exposure to childhood obesity, unlike studies from countries with higher levels of pollution, suggesting that the mitigation of air pollutants can reduce the chance of it being a negative factor for the development of obesity. This relationship was noticed for PM2.5, PM1, PM10, NOx, and SO2 but not for PAHs, which showed a negative effect on children's health across 10 out of 11 studies. Conclusions: This review underscores the need for interdisciplinary approaches to address both environmental and socio-economic determinants of childhood obesity. Efforts aimed at reducing air pollution levels and promoting healthy lifestyle behaviors are essential for safeguarding the health and well-being of children worldwide.

Oral cancer in young adults: incidence, risk factors, prognosis, and molecular biomarkers.

Oral cavity squamous cell carcinoma (OCSCC) predominantly affects the tongue and the floor of the mouth, primarily in patients over 50 years of age. Incidence and mortality rates vary significantly worldwide, influenced by geographic areas and demographic characteristics. Epidemiological studies revealed an increase in incidence of OCSCC among young adults (YA) <44 years old. This narrative review, provides updated information on the incidence, risk factors, and prognosis of YA-OCSCC using data published from 2018 to 2023 from different geographic locations. The studies indicate that the incidence of YA-OCSCC in Asia is approximately twice that in the US and that the incidence is strongly linked to risk factors such as betel quid chewing, tobacco use, and high alcohol consumption. The prognosis for YA-OCSCC, compared to that in older patients, shows similar or better overall survival, even in cases with relapses, but worse 5-year disease-free survival, despite receiving similar treatments. Consequently, a concerted effort is crucial to raise awareness about the cessation of tobacco and areca nut use, alcohol control, and the promotion of healthy lifestyle behaviors. Recent molecular data on YA-OCSCC suggests a potential profile characterized by epidermal growth factor receptor overexpression, low tumor mutation burden and an attenuated immune response. Upon confirmation in larger cohorts of YA-OCSCC patients from different geographical areas, the validated markers could aid in selecting tailored treatments.

Dental students’ healthy lifestyle behaviors, physical activity levels and social media use: cross sectional study

BackgroundHealthy lifestyle behavior includes appropriate behaviors such as eating habits, physical activity and weight control in order to stay healthy and prevent diseases. The aim of this cross-sectional study is to evaluate healthy lifestyle behaviors, physical activity levels and social media use of dental students.MethodsAn online questionnaire including demographic characteristics, International Physical Activity Questionnaire Short Version (IPAQ-S) and Health Promoting Lifestyle Profile (HPLP) was filed by 420 dental students. The data were evaluated statistically.ResultsThe mean age was 21.6 ± 1.96 years and the majority of the students (71.7%) were living with their families. Obesity and overweight in males and underweight in females were statistically higher. There was no difference between the genders in terms of social media use. The most preferred applications were Instagram (92.7%), YouTube (85%) and Twitter (59.7%). In terms of IPAQ durations and HPLP scores, there was no gender difference. According to the IPAQ classification, while the majority of students (64.3%) were physically low active, 23.1% were physically inactive. As the total HPLP score increased, the total IPAQ score increased.ConclusionIt is concluded that as the university students make up the majority of the young adults, encouraging their health-promoting behaviors is crucial for improving public health.

Feasibility and acceptability of a parent-child intervention to improve step count in childhood cancer survivors exposed to cardiotoxic therapy: The STEP UP for FAMILIES Study.

Late morbidity after childhood cancer may be mitigated by healthy lifestyle behaviors. We piloted a game-based, parent-child digital intervention to increase activity in sedentary survivors. Survivors aged 10-16 treated with cardiotoxic therapy and not meeting US physical activity guidelines were enrolled in a single-arm study with a parent. Following a 14-day run-in, participants chose a prespecified step goal and wore an accelerometer daily for 24weeks (12-week game-based intervention; 12-week follow-up). Participants completed the Acceptability of Intervention Measure (AIM) at 24weeks; a subset of dyads completed qualitative interviews. Among 129 eligible survivors, 27 enrolled (20.9% participation rate) with a parent. Four dyads were removed during the 14-day run-in period due to noncompliance. Among the 23 dyads who continued to the study, the tracker was worn for 95% of days during the 12-week intervention (95% confidence interval [CI]: 94-96) and 81% during the 12-week follow-up (95% CI: 79-82). Overall, the prespecified step goal was met for 64% (95% CI: 63-66) of days during the intervention and 37% (95% CI: 35-38) during the follow-up. At the end of study, 17/23 dyads responded to AIM; 82% of survivors and 94% of parents reported the intervention as acceptable. During qualitative interviews (n=5), dyads noted that they liked the accountability of the "buddy system," but would have liked more personalized goal-setting. Despite high ratings of acceptability among participants, difficulties with sustained adherence and retention were encountered in this parent-child gamification intervention. Alternate, tailored designs should be considered in the future.

The effect of an educational intervention on healthy lifestyle knowledge and behaviour among middle-aged women

Objectives: This study aimed to assess the impact of an educational intervention on middle-aged women’s knowledge and behaviour regarding various aspects of a healthy lifestyle. Design: Quasi-experimental study involving 150 middle-aged women (divided into experimental and control groups). Setting: Participants were selected from health centres of Tehran, Iran. Method: Data collection included demographic information, knowledge of a healthy lifestyle and healthy lifestyle behaviour. Participants in both the intervention and control groups completed the questionnaires before and 2 months after the educational intervention. The intervention involved 10 minutes of face-to-face training followed by distribution of training booklets provided by the Ministry of Health in Iran. Statistical analyses were conducted using SPSS. Results: Within the intervention group, significant differences were observed in total healthy lifestyle knowledge and subscales for physical activity knowledge, anthropometry knowledge, healthy diet knowledge, and smoking knowledge, between the pre- and post-intervention periods. Other than for smoking behaviour, there was no significant difference in healthy behaviours pre- and post-intervention for the experimental and also the control group. Conclusion: While there was an increase in knowledge about healthy lifestyles following the intervention, this knowledge increase was not associated with a change in healthy lifestyle behaviours. Attention should therefore be given to other influences including socio-economic factors, mental health status, environmental factors, cultural influences, duration of the intervention and psychological factors if changes in healthy behaviour are to be achieved.

Association between personality, lifestyle behaviors, and cardiovascular diseases in type 2 diabetes mellitus: a population-based cohort study of UK Biobank data

IntroductionVarious strategies aim to better assess risks and refine prevention for patients with type 2 diabetes mellitus (T2DM), who vary in cardiovascular disease (CVD) risk. However, the prognostic value of...

Effect of Comprehensive Educational Program on Preeclamptic Women's Risk Perception of Cardiovascular Disease, Self-Efficacy, and Adherence to Healthy Lifestyle Behaviors.

To evaluate the effect of a comprehensive educational program on preeclamptic women's knowledge, risk perception of cardiovascular disease, self-efficacy, and adherence to healthy lifestyle behaviors. This study employed a pretest-posttest design. One hundred and two women who previously had preeclampsia were enrolled from July 2022 to December 2022 from outpatient obstetrics, gynecology, and family planning clinics. The primary and secondary outcomes were measured at baseline, after eight weeks, and after three months of the educational intervention. The data were analyzed using SPSS version 23, descriptive and inferential statistics, specifically the Chi-square test, independent t-tests, and repeated measures ANOVA. A statistically significant difference was found between the two groups immediately post-intervention and the three-month follow-up, with a significant improvement among the intervention group than control group regarding cardiovascular disease knowledge (p < 0.001), risk perception (p < 0.001), self-efficacy (p < 0.001), and healthy lifestyle behaviors (p < 0.001). There was a statistically significant interaction between group and time regarding total cardiovascular disease risk perception (F = 203.67, p < 0.001, η2 = 0.673), self-efficacy (F = 70.06, p < 0.001, η2 = 0.405), and adherence to healthy lifestyle behaviors (F = 145.08, p < 0.001, η2 = 0.597). This study concluded that the comprehensive educational program had a positive effect on improving preeclamptic women's knowledge and risk perception of CVD, self-efficacy, and adherence to healthy lifestyle behaviors following preeclampsia.

Supportive Workplace Wellness Cultures and Mattering Are Associated With Less Burnout and Mental Health Issues in Nurse Managers.

The aims of this study were to describe burnout, mental health, and healthy lifestyle behaviors of nurses in a managerial role and assess associations among workplace culture factors (perceived culture, mattering, support, and staff shortages) with burnout, mental health outcomes, and healthy lifestyle behaviors. Nurse managers foster unit-based wellness cultures, yet burnout and mental health problems adversely impact the culture and well-being of staff. A cross-sectional, descriptive correlational design was used. The Florida Organization for Nursing Leadership enabled distribution of a wellness survey to nurse managers. There were 125 participants. Healthy lifestyle behaviors were infrequently practiced. Analysis revealed significant correlations among workplace culture factors, burnout, and mental health outcomes. When compared with nurse managers with staff shortages, those without staff shortages were 6.11 times more likely to not screen positive for burnout. Health systems should address workplace culture factors and staff shortages to reduce burnout, improve mental health, and enhance healthy behaviors in nurse managers.

Drivers of Healthy Lifestyle Behaviors among Arable Crop Farmers: Evidence from Kwara State, Nigeria

Globally, a healthy lifestyle is important in maintaining the balance between man and the environment as well as the prevention and avoidance of Non-Communicable Diseases (NCDs) especially among rural dwellers in developing economies where the state of quality healthcare is in chaos. In theory, individuals are products of investments made in their health which are either health-promoting or health-damaging behavior. We causally identify the motives of healthy lifestyle practices among arable crop farmers in Kwara state, Nigeria using a cross-sectional survey. We found out that less than average of the arable crop farmers sampled practiced healthy lifestyles and the factors that strongly influenced the healthy lifestyle behavior of arable crop farmers were gender, age, education, farm size, farm income as well as distance to healthcare. A policy simulation illustrates that taking consideration of the socioeconomic characteristics that drive the practice of healthy lifestyles will improve the health status of the populace, especially the rural dwellers, and also avoid lifestyle-related diseases in the future.

The relationship of stigma level and healthy lifestyle behaviors in individuals with type 2 diabetes

Aim: This study is a descriptive research aiming to examine the relationship between the level of stigma and healthy lifestyle behaviors in patients with Type 2 diabetes. Materials and Methods: This study was conducted with 142 patients who were admitted to a university hospital between October 1 and December 15, 2022. Data were obtained with the sociodemographic form, Stigma Assessment Scale (SAS) and Healthy Lifestyle Behaviors Scales (HLBS). Results: The mean SAS score of the patients participating in the study was 43.66±12.09, and the mean HLBS score was 125.83±21.48. The highest scores were in physical activity and interpersonal relationships, HLBS was generally at a moderate level, and a statistically significant negative correlation was found between SAS and HLBS scores (p&amp;lt;0.05). Conclusion: It was observed that the SAS and HLBS scores were at a moderate level in type 2 diabetes patients, education affected the level of stigma, gender and marital status affected the HLBS score, and healthy lifestyle scores significantly decreased as the level of stigma increased.

Discordance Between Mealtimes Reported by Trial Participants with Type 2 Diabetes and Healthcare Professionals.

Healthy lifestyle behaviors are essential in the treatment of type 2 diabetes, and meal registration is therefore important. Manual meal registration is cumbersome and could be automated using continuous glucose monitoring (CGM). If such an algorithm is based on patient-reported meals, potential errors might be induced. Thus, the aim was to investigate potential errors in patient-reported mealtimes and the effect on automatic meal detection. Two healthcare professionals (HCPs) reported the mealtimes of the 18 included patients based on the patients' CGM data to assess the agreement between HCP- and patient-reported mealtimes. A developed meal detection algorithm based on detecting the post-prandial glucose response using cross-correlation was used to assess the impact of errors in patient-reported meals. The results showed poor disagreement between HCP- and patient-reported meals and that the meal detection algorithm had a moderately better performance on the HCP-reported meals. Therefore, the possibility of errors in patient-reported mealtimes should be considered in the development of meal detection algorithms. However, more research is needed to confirm the results of this study.

Development, validity and reliability of the healthy lifestyle behavior scale

BackgroundHealthy lifestyle behaviors encompass activities aimed at promoting, maintaining, or reclaiming health. Evaluating these behaviors accurately requires comprehensive, valid, and reliable tools.AimsThis study aimed to develop the Healthy Lifestyle Behavior Scale and evaluate its psychometric properties in the Turkish population.MethodsFor this methodological research, a cross-sectional online-based survey was conducted between 21 March 2023 and 31 March 2023 among 330 participants who were recruited via convenience sampling. The initial item pool included 90 items across seven domains (exercise, health responsibility, preventive health actions, sleep, stress and social support, nutrition, smoking, and alcohol). The content validity of the scale was verified by taking expert opinions. Construct validity and reliability were assessed using principal component analysis (PCA) and Cronbach's alpha.ResultsA total of 330 people were recruited for the study (65.2% female, mean age 34.2 ± 9.4 years). The final scale comprised 34 items: 5 on exercise, 4 on health responsibility, 4 on preventive health actions, 2 on sleep, 5 on social support, 3 on stress management, 5 on nutrition, 4 on smoking and 2 on alcohol. The construct validity analysis revealed a 9-factor structure explaining 62.35% of the variance (Kaiser–Meyer–Olkin value = 0.807). Internal consistency was confirmed with Cronbach's alpha (α = 0.863 for the scale, > 0.7 for subscales) and high item-total correlation.ConclusionsOur newly developed Healthy Lifestyle Behavior Scale demonstrated good validity and reliability. It outperformed existing scales, boasting higher alpha values for subfactors and explained variance. This scale is a robust tool for assessing healthy lifestyle behaviors in adults.

Lifestyle Behaviors and Psychological Health in Adolescents with Overweight or Obesity: Cross-sectional Associations with Weight Underestimation.

Encouraging adolescents with overweight/obesity to accurately perceive their weight in the belief that this will improve their lifestyle behaviors (physical activity (PA), sedentary behavior (SB), eating behavior (EB)) may be detrimental to their psychological health. This study aimed to investigate associations between weight underestimation and lifestyle behaviors along with psychological health in French adolescents with overweight or obesity. Baseline data from adolescents who participated in a school-based trial were used. Lifestyle behaviors and psychological health (anxiety, depression, eating disorders, quality of life (QoL)) were self-reported. Weight underestimation was measured by matching objective and perceived weight status. Multilevel models were computed to investigate associations between weight underestimation and lifestyle behaviors and psychological health, by gender. Of the 1245 adolescents included (15.3 ± 0.7years), 15.8% underestimated their objective weight (boys 24.2%; girls 8.2%). Boys with underestimation had higher vigorous PA energy expenditure (β = 372.7 MET-min/week, 95%CI [25.1;720.4]), and lower daily sugar-sweetened beverages and foods consumption (β = - 0.3 points, 95%CI [- 0.7; - 0.0]) than those with accurate perception. Girls with weight underestimation had lower eating disorder (β = - 6.0 points, 95%CI [- 9.6; - 2.5]), anxiety (β = - 7.8 points, 95%CI [- 13.8; - 1.9]), and higher QoL (β = 3.3 points, 95%CI [0.0; 6.5]) scores than girls with accurate perception. Weight underestimation among adolescents with overweight or obesity was associated with healthier lifestyle behaviors in boys, and better psychological health (eating disorder, anxiety and QoL) in girls. Accurate perception of weight status may not be a relevant lever to improve lifestyle behaviors and psychological health.

Association of Lifestyle Behaviors with Quality of Life in Patients with COPD: A Cross-Sectional Study in Primary Care.

Background/Objectives: The association between healthy lifestyle behaviors and their effect on quality of life among patients with COPD remains unclear. Therefore, the aim of this study was to explore the lifestyle behaviors and their association with the disease-specific quality of life among a primary care population with COPD in Greece. Methods: This cross-sectional study included 236 participants aged 40 years and older from the COCARE COPD study. The healthy lifestyle index (HLI) was created based on smoking, alcohol consumption, BMI, physical activity, and sleep duration, with each factor categorized as either healthy (1) or unhealthy (0). The HLI ranged from 0 (least healthy) to 5 (healthiest). COPD-specific quality of life was assessed using the COPD assessment test (CAT), where higher scores indicate poorer health status. Multiple logistic regression was used to analyze the association between HLI and CAT scores, adjusting for confounders. Results: Half of the participants were non-smokers or former smokers, while 92% reported consuming low levels of alcohol (less than 14 units per week). Additionally, 56% had a BMI below 30, indicating they were not obese. Surprisingly, only 32% engaged in regular exercise, with at least 150 min per week, and only 25% reported getting adequate sleep, ranging from 7 to 9 h per night. Importantly, poorer health status was inversely associated with non/former smoking (OR: 0.543, 95% CI: 0.282-1.049), physical activity (OR: 0.238, 95% CI: 0.122-0.463), and adequate sleep (OR: 0.337, 95% CI: 0.160-0.710). Patients with higher HLI scores were less likely to have poor health status. Conclusions: In conclusion, our findings indicate that a significant proportion of patients with COPD failed to adhere to a minimum of three out of five healthy behaviors. Additionally, a higher number of healthy lifestyle factors defined by a high HLI score were independently associated with a better disease-specific quality of life. This is particularly important for COPD where quality of life is in the epicenter of management. Therefore, healthcare providers could significantly improve the management of COPD and patient outcomes by targeting and improving these lifestyle behaviors with targeted and holistic intervention strategies.