Ideal Health Research Articles

School Administrators' Experiences in a 6-Month Health and Wellness Community of Practice.

A statewide 6-month school administrator health and wellness program encouraged participants to use a fitness tracker to self-monitor their physical activity and sleep patterns. The purpose of this study was to examine participants' experience in a school administrator health and wellness program and their perceptions of the impact on health-related behaviors, including activity/movement, nutrition, and sleep. Each of the 45 participants completed a semi-structured interview at three points in the program. Questions were designed to discern school administrators' perceptions of their ideal health and wellness balance at home and work. School administrators reported new insights into their own well-being, benefits of social supports in their personal wellness journey, an expanded understanding of their ideal health and wellness balance at home and work, and a stronger sense of serving as a role model who needs to take care of him/herself. Although the program was helpful in establishing an ideal health and wellness balance at home and work for some school administrators, future programs should better emphasize nutrition and scaffold opportunities to maintain new habits following program completion.

A REVIEW OF HEALTH BEHAVIOUR DYNAMICS IN AYURVEDA

Health behaviour was essentially a part of sociology. It has now evolved as an individual branch focusing on hu- man therapeutic care. The human behaviour or actions that have a definite impact on his health is named health behaviour. Those which complements one's health are known as positive health behaviours. The negative/altered health behaviour is considered one of the major causative factors for diseases. Alterations from the ideal health behaviour (misdeeds) are due to the wrong psychotic process. These unhealthy behaviours are usually focused on few factors like food, physical activities, sleep, sex and substance use. The positive, as well as negative impacts of behaviour on health, should be understood as part of sociology about psychology, medicine and ethics. In ancient literature, there were such descriptions of health behaviour in the form of do’s and don’ts or taboos. Ayurveda considers misdeeds (prajnaparadha) as the root cause of diseases. They are happening by an unsuitable psychotic process like ignorance (unawareness), lack of control/thinking over actions or lack of remembrance. This work attempts to list out the health behaviours mentioned in Ayurveda. The ways to abstain from such misdeeds are also disclosed here. Keywords: health behaviour, Prajnaparadha

Factors associated with work ability in adults with diabetes

AimsThe aims of this study were to explore associations between clinical and diabetes-related factors with work ability in a sample of working adults with diabetes. BackgroundAdults with diabetes may face challenges in the workplace, including managing their diabetes and overall physical and mental health. MethodsThis was a cross-sectional design with a sample of 101 working adults. Subjects completed valid and reliable surveys assessing depressive symptoms, diabetes self-care, fear of hypoglycemia, diabetes distress, cardiovascular health using American Heart Association's Life's Simple 7 (range 0–7) and work ability. Factors significantly associated with work ability at bivariate level were included in linear and logistic regression. ResultsThe majority of the sample was female (65%) (mean age 54.1 ± 10.5), White (74%), non-Hispanic (93%), worked full-time (65%) and had type 2 diabetes (87%) (mean duration 12.4 ± 9.5 years). The majority (55%) had low diabetes distress, but 24% had high distress and 28% had depressive symptoms. The sample achieved 2.5 ± 1.4 ideal AHA heart health indices and 33% rated their work ability as excellent. In linear regression higher depressive scores were associated with lower work ability scores (b = −0.45, p = .002). In logistic regression, scores on heart health (OR = 1.4; 95%CI:1.0–1.9, p = .03) and diabetes distress (OR = 0.6, 95%CI:0.4–0.9, p = .048) were significantly associated with work ability at its best. ConclusionBoth cardiovascular and psychological health may impact work ability in adults with diabetes. Routinely screening for diabetes distress and depression while also promoting ideal cardiovascular health may improve overall health and work ability in this population.

Pessimistic health and optimistic wealth distributions perceptions in Germany and the UK: evidence from an online-survey

BackgroundInequalities in health and wealth distributions are becoming pressing societal problems in many countries. How these inequalities are perceived and to what degree perceptions are aligned with actual distributions, is important for trust in public health services, social and economic policies, and policymakers. This study aims to assess perceived and desired levels of inequality in health and wealth in Germany and the UK.MethodsThe online-survey was filled out by 769 volunteers (322 from Germany, 447 from the UK), recruited from an existing commercial panel (Prolific Academic) or via Facebook advertisements in 2019. Perceived and ideal national health and wealth distributions were assessed and compared to actual health indicators (i.e. days absent from work, number of visits to general practitioners (GPs) and self-rated health), and actual wealth distributions with t-tests.ResultsA pronounced gap emerged between the estimated, ideal and actual inequality. Both samples strikingly underestimated the proportion of (very) good health in the national distribution by a factor of ~ 2.3 (participants estimated that 34% of the German and 36% of the UK population respectively are very healthy or healthy, while the actual proportion in the population was 75% in Germany and 84% in the UK, P < 0.001 for all). Moreover, actual health distributions were much closer to the desired than the perceived health distributions (78% of German and 72% of UK participants ideally being very healthy or healthy). A reversed pattern of results emerged for wealth in both samples, with wealth inequality being strikingly worse than desired and inequality being underestimated by a factor ~ 1.7 (P < 0.001 for all). Results were consistent across demographic groups.ConclusionsRespondents in both Germany and the UK have profoundly negative misperceptions regarding the distribution of health, which contrasts with starkly positive misperceptions regarding the distribution of wealth, indicating that the public is healthier but poorer than they think. More importantly, from a public health perspective, a high level of consensus emerged, with both healthy and wealthy participants misperceiving health and wealth distributions.

Cardiovascular Risk and Health Among People With Human Immunodeficiency Virus (HIV) Eligible for Primary Prevention: Insights From the REPRIEVE Trial.

BackgroundIn addition to traditional cardiovascular (CV) risk factors, antiretroviral therapy, lifestyle, and human immunodeficiency virus (HIV)-related factors may contribute to future CV events in persons with HIV (PWH).MethodsAmong participants in the global REPRIEVE randomized trial, we characterized demographics and HIV characteristics relative to ACC/AHA pooled cohort equations (PCE) for atherosclerotic CV disease predicted risk and CV health evaluated by Life’s Simple 7 (LS7; includes smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and glucose).ResultsAmong 7382 REPRIEVE participants (31% women, 45% Black), the median PCE risk score was 4.5% (lower and upper quartiles Q1, Q3: 2.2, 7.2); 29% had a PCE score <2.5%, and 9% scored above 10%. PCE score was related closely to known CV risk factors and modestly (<1% difference in risk score) to immune function and HIV parameters. The median LS7 score was 9 (Q1, Q3: 7, 10) of a possible 14. Only 24 participants (0.3%) had 7/7 ideal components, and 36% had ≤2 ideal components; 90% had <5 ideal components. The distribution of LS7 did not vary by age or natal sex, although ideal health was more common in low sociodemographic index countries and among Asians. Poor dietary and physical activity patterns on LS7 were seen across all PCE scores, including the lowest risk categories.ConclusionsPoor CV health by LS7 was common among REPRIEVE participants, regardless of PCE. This suggests a critical and independent role for lifestyle interventions in conjunction with conventional treatment to improve CV outcomes in PWH. Clinical Trials Registration: NCT02344290. AIDS Clinical Trials Group study number: A5332.

Nurse Practitioner Students' Perceptions on Delivering Culturally Congruent Care to Vulnerable Mexican Immigrants: A Qualitative Study.

Increasingly, nurse practitioners serve as vanguards in providing primary health care to vulnerable Mexican immigrants. The aims of this study were to explore the lived experiences of nurse practitioner students in caring for Mexican immigrant patients and to capture their meaning of cultural influences deemed essential to the delivery of culturally congruent care. An exploratory descriptive design was employed. Purposive sampling was used to select 17 nurse practitioner students who volunteered to complete a semistructured face-to-face audio-taped interview and follow-up focus group discussion. Constant comparison was utilized to analyze data. From this process, four distinct themes emerged: Culturally congruent care extends beyond race and ethnicity, understands the importance of therapeutic communication, accepts complementary and alternative medical modalities, and recognizes the importance of eating patterns, food choices, and perceptions of ideal weight and health. These findings build on our understanding of key evidence-based cultural beliefs and practices that are important in delivering culturally congruent care to this subgroup.

Ideal Cardiovascular Health Behaviours in Nationally Representative School-Based Samples of Adolescents in the Caribbean.

BackgroundIdeal cardiovascular health behaviour (CVHB) measures four ideal health behaviours (non-smoking, body mass index <85th Percentile, healthy diet, and physical activity). This study aimed to determine the prevalence, distribution, and correlates of ideal CVHB among adolescents in the Caribbean.MethodsNationally representative cross-sectional data of 2016 or 2017 with complete CVHB measurements were analysed from 7556 school adolescents from four Caribbean countries.ResultsThe prevalence of 0–1 ideal metrics CVHB was 20.4%, 2 ideal metrics 48.7%, and 3–4 ideal metrics 30.8%. Only 5.0% had all 4 ideal CVHB metrics, 41.0% intermediate CVH (≥1 metric in the intermediate category and none in the poor category), and 54.0% had poor CVH (≥1 metric in poor category). In adjusted logistic regression analysis, compared to students from Dominican Republic, students from Jamaica (Adjusted Odds Ratio-AOR: 1.36, 95% confidence interval-CI: 1.01–1.85), students from Trinidad and Tobago (AOR: 1.46, 95% CI: 1.17–1.82) and male sex (AOR: 1.35, 95% CI: 1.11–1.64) were positively associated with meeting 3–4 ideal CVHB metrics. In addition, in unadjusted analysis, rarely or sometimes experiencing hunger was negatively and high peer and parent support were positively associated with meeting 3–4 ideal CVHB metrics.ConclusionThe proportion of meeting 3–4 ideal CVHB metrics was low among adolescents in four Caribbean countries. Both high-risk and school-wide intervention programmes should be implemented in aiding to improve CVHB in Caribbean countries. Several factors associated with ideal CVHB were identified, which can be targeted in school health interventions.

A scoping review of workplace wellness audit tools assessing physical activity and sedentary behaviour.

Regular physical inactivity and excessive sedentary behaviour are public and population health concerns. The workplace is an ideal health promotion intervention setting to support employees, particularly office workers. Workplace assessments are a critical component of workplace health promotion programming. The aim of this project was to conduct a scoping review to systematically identify and describe workplace audit tools that assess physical activity and sedentary behaviour influences, as two independent behaviours, through a social ecological lens. Fourteen electronic databases were searched for academic literature and 69 web-based resources were searched for grey literature in May 2017. English language workplace audit tools with items on physical activity or sedentary behaviour established in western countries were included. Key characteristics (ie, aim, type, health behaviour, validity, reliability and theory/model/framework) of the audit tools, checklists or questionnaires for office-based workplaces were identified, described and summarised. The scoping review identified 21 relevant tools. Most tools focused on physical activity alone and did not address sedentary behaviour as a distinct behaviour. Few tools included items assessing physical activity and sedentary behaviour influences across multiple levels of the social ecological model. The most common social ecological focuses in the tools were policy and environmental influences. Numerous workplace physical activity and/or sedentary behaviour audit tools were available. However, a gap was identified as tools and resources that assess and support organisational changes to influence physical activity and sedentary behaviour as two independent health behaviours across multiple social ecological levels within the workplace had not been developed.

Ideal Cardiovascular Health in a Nationally Representative Population-Based Sample of Adults in Malawi.

Background:Ideal cardiovascular health (ICH) measures four ideal health behaviours (non-smoking, body mass index <25 kg/m2, healthy diet, and physical activity) and three health factors (total cholesterol <200 mg/dL, blood pressure <120/<80 mmHg, and fasting blood glucose <100 mg/dL).Objective:This study aimed to determine the prevalence, distribution, and correlates of ICH among adults in Malawi.Methods:National cross-sectional survey data of 3,441 persons aged 18–69 years with complete ICH measurements in Malawi in 2017 were analysed.Results:Almost one in ten (7.4%) of respondents had 0–2 ICH metric), 21.2% 3–4 ICH metrics, and 71.5% 5–7 ICH metrics). Only 3.3% had all seven ICH metrics, 15.3% had intermediate ICH (≥1 metric in the intermediate category and none in the poor category), and 81.5% poor ICH (≥1 metric in poor category). In adjusted logistic regression analysis, older age (50–69 years) (Adjusted Odds Ratio-AOR: 0.25, 95% Confidence Interval-CI: 0.17–0.36) and urban residence (AOR: 0.56, 95% CI: 0.40–0.78) were negatively associated with meeting 5–7 ICH metrics. In addition, in unadjusted analysis, higher education was positively associated with meeting 5–7 ICH metrics.Conclusion:The proportion of meeting 5–7 ICH metrics was high in Malawian adults. Both high-risk and population-wide intervention programmes targeting older adults and urban residents should be implemented in aiding to improve cardiovascular health in Malawi.HighlightsThe proportion of meeting 5–7 ideal cardiovascular health (ICH) metrics was 71.5% in Malawian adults (18–69 years, median age 32 years).In a sub-group analysis (45–69 years, median age 55 years), 55.9% had 5–7 ideal ICH metrics.ICH was lower with increasing age and among urban residents.

Assessing the Patient-Perceived Monetary Value of Patient-Reported Outcome Improvement for Patients With Chronic Knee Conditions

The high cost of orthopaedic care has attracted criticism in the current value-based health care environment. The objective of this work was to assess the properties of a willingness to pay (WTP)-based approach to estimate the monetary value that patients place on health improvements in chronic knee conditions following orthopaedic treatment. A sample of patients with a chronic knee condition were surveyed between January and May of 2018 at a large orthopaedic practice. Each patient provided their WTP for restoration to ideal knee health and completed the Single Assessment Numerical Evaluation (SANE) to describe their baseline knee state. Average WTP was calculated for the total sample and stratified by income, age, and baseline SANE (for which 0 is the worst and 100 is the best) levels. The patient-perceived monetary value of each unit of SANE improvement was assessed. The study sample included 86 patients seeking orthopaedic care for a chronic knee condition. Mean baseline SANE score was 45.5 (standard deviation: 25.0). Mean WTP to obtain ideal knee function from baseline was $18,704 (standard deviation: $18,040). For the full sample, patients valued a 1-unit improvement in SANE score at $291.1 (β: 291.1; P<0.05). The amount of money patients were willing to pay to achieve ideal knee function varied with age, income, and baseline knee state. Patients appear to highly value improvement in chronic knee conditions. Willingness-to-pay survey results appear to track expected variation in patient outcome valuation by income and baseline knee condition and could be a valuable approach to assess value-based care in orthopaedics.

Confucian ideal personality traits (&amp;lt;italic&amp;gt;Junzi personality&amp;lt;/italic&amp;gt;) and mental health: The serial mediating roles of self-control and authenticity

Confucian ideal personality traits (&amp;lt;italic&amp;gt;Junzi personality&amp;lt;/italic&amp;gt;) and mental health: The serial mediating roles of self-control and authenticity

Pineal Gland Tumors: A Review.

Simple SummaryPineal neoplasms are tumors with different and variable morphological, histological, and radiological characteristics and, consequently different diagnosis and management. Due to their rarity, pineal tumors may be misdiagnosed. Pineal tumors, are divided into germ cell tumors, pineal parenchymal tumors and tumors that derive from adjacent structures. In this review, we report the clinical relevance of the main pineal gland tumors, underlining the importance of studying the triggering causes of pineal region carcinogenesis, to realize appropriate diagnosis and, consequently, better clinical management.The pineal gland is a small, pinecone-shaped endocrine gland that participates in the biological rhythm regulation of vertebrates. The recognized major product of the pineal gland is melatonin—a multifunctional endogenous indoleamine. Accumulating evidence suggests that the pineal gland is important for preserving ideal health conditions in vertebrate. Tumors of the pineal region account for approximately 3–11% of pediatric brain neoplasms but fewer than 1% of brain neoplasms in adults. It is fundamental to expand advanced imaging techniques together with both clinical and laboratory knowledge, to help to differentiate among pineal neoplasms and thus facilitate accurate primary diagnoses and proper therapeutic interventions. In this review, we report the gross anatomy of the pineal gland and its functional significance and discuss the clinical relevance of pineal gland tumors, underlining the importance of identifying the leading causes of pineal region masses.

Ideal cardiovascular health at age 5\u20136\u2009years and cardiometabolic outcomes in preadolescence

BackgroundThe American Heart Association (AHA) developed a definition of ideal cardiovascular health (ICH) based on the presence of both ideal health behaviours (diet, physical activity, weight status and smoking) and ideal health factors (glucose, total cholesterol and blood pressure levels). However, research of ICH in the paediatric population is scarce. We aimed to study ICH at age 5–6 years by extending the original ICH score with the health behaviours: sleep duration, screen time and prenatal smoke exposure, and to evaluate its association with cardiometabolic outcomes at age 11–12.MethodsA total of 1666 children aged 5–6 years were selected from the database of the ABCD-study, a prospective cohort study on the health and development of children born in Amsterdam, the Netherlands. Of these, 846 (50.8%) were boys and 1460 (87.6%) had a healthy weight. Data on self-reported health behaviours and health factors were used to calculate the ICH scores (original and extended) by adding the frequency of scoring ‘healthy’ on each indicator, based on international cut-offs. The children were followed up for 6 years and cardiometabolic outcomes (carotid intima-media thickness (CIMT), blood pressure, glucose and lipids) were measured. Associations between ICH (both original and extended) and cardiometabolic outcomes were examined using multivariable regression models.ResultsAt age 5–6 years, 11% scored poor (score 1–5), 56% intermediate (score 6–7) and 33% good (score 8–9) on extended ICH. Healthy diet and normal total cholesterol concentrations were the least prevalent. Neither the original nor the extended ICH scores were associated with CIMT at age 11–12. A higher score on the extended ICH was associated with lower total cholesterol (p for trend < 0.001), lower systolic (p for trend = 0.012) and diastolic blood pressure (p for trend = 0.011), and lower body mass index (BMI) (p < 0.001) at age 11–12. The original ICH score was associated with lower total cholesterol (p < 0.001) and BMI (p < 0.001) only.ConclusionOur findings suggest that extending the ICH score in young children with additional health behaviours improves prediction of some cardiometabolic outcomes, but not CIMT in preadolescence, compared to the original ICH score. We would recommend other researchers to incorporate objective measures of health behaviours and longer follow-up to find out whether associations persist into adulthood.

Cardiovascular Risk Factors Are Associated With Future Cancer

BackgroundThe extent to which co-occurrence of cardiovascular disease (CVD) and cancer is due to shared risk factors or other mechanisms is unknown. ObjectivesThis study investigated the association of standard CVD risk factors, CVD biomarkers, pre-existing CVD, and ideal cardiovascular (CV) health metrics with the development of future cancer. MethodsThis study prospectively followed Framingham Heart Study and PREVEND (Prevention of Renal and Vascular End-Stage Disease) study participants free of cancer at baseline and ascertained histology-proven cancer. This study assessed the association of baseline CV risk factors, 10-year atherosclerotic (ASCVD) risk score, established CVD biomarkers, prevalent CVD, and the American Heart Association (AHA) Life’s Simple 7 CV health score with incident cancer using multivariable Cox models. Analyses of interim CVD events with incident cancer used time-dependent covariates. ResultsAmong 20,305 participants (mean age 50 ± 14 years; 54% women), 2,548 incident cancer cases occurred over a median follow-up of 15.0 years (quartile 1 to 3: 13.3 to 15.0 years). Traditional CVD risk factors, including age, sex, and smoking status, were independently associated with cancer (p < 0.001 for all). Estimated 10-year ASCVD risk was also associated with future cancer (hazard ratio [HR]: 1.16 per 5% increase in risk; 95% confidence interval [CI] 1.14 to 1.17; p < 0.001). The study found that natriuretic peptides (tertile 3 vs. tertile 1; HR: 1.40; 95% CI: 1.03 to 1.91; p = 0.035) were associated with incident cancer but not high-sensitivity troponin (p = 0.47). Prevalent CVD and the development of interim CV events were not associated with higher risk of subsequent cancer. However, ideal CV health was associated with lower future cancer risk (HR: 0.95 per 1-point increase in the AHA health score; 95% CI: 0.92 to 0.99; p = 0.009). ConclusionsCVD risk, as captured by traditional CVD risk factors, 10-year ASCVD risk score, and natriuretic peptide concentrations are associated with increased risk of future cancer. Conversely, a heart healthy lifestyle is associated with a lower risk of future cancer. These data suggest that the association between CVD and future cancer is attributable to shared risk factors.

Body Mass Index based Health drink vending machine using Programmable Logic Controllers

As the consumer enters his/her height and weight the BMI of the person is calculated. If the BMI indicates that the person is fit, then the machine makes an ideal health drink with all nutrient content. If the BMI of the person indicates he/she is skinny or obese the combinations of the drink mixes vary accordingly. Once the BMI is calculated, a pump connected to a water sump is activated and it allows some amount of water to the mixing container. The mixes are allowed to fall through a screw conveyor to maintain constant discharge irrespective of the amount of the mix in the container. The amount of mix to be discharged is controlled by a PLC which is already programmed using Ladder Logics. Timers are used in the program for exact measurement. Then the motors attached to the screw conveyors start working for a certain period of time as programmed and allow the mixes to fall into the mixing container. As soon as the motors complete its rotation, a motor attached to the mixer starts rotating for some time to blend all the ingredients. A solenoid valve that connects the mixing container and the dispensing cup is opened when the mixer completes it’s mixing. Then the user can collect the drink. The whole process takes a maximum time of 3 minutes approximately.

Co-Designing a Mobile App to Improve Mental Health and Well-Being: Focus Group Study.

BackgroundRecent advances in mobile technology have created opportunities to develop mobile apps to aid and assist people in achieving various health and wellness goals. Mental health apps hold significant potential to assist people affected by various mental health issues at any time they may need it, considering the ubiquitous nature of mobile phones. However, there is a need for research to explore and understand end users’ perceptions, needs, and concerns with respect to such technologies.ObjectiveThe aim of this paper is to explore the opinions, perceptions, preferences, and experiences of people who have experienced some form of mental health issues based on self-diagnosis to inform the design of a next-generation mental health app that would be substantially more engaging and effective than the currently available apps to improve mental health and well-being.MethodsWe conducted six focus group sessions with people who had experienced mental health issues based on self-diagnosis (average age 26.7 years, SD 23.63; 16/32, 50% male; 16/32, 50% female). We asked participants about their experiences with mental health issues and their viewpoints regarding two existing mental health apps (the Happify app and the Self-Help Anxiety Management app). Finally, participants were engaged in a design session where they each sketched a design for their ideal mental health and well-being mobile app.ResultsOur findings revealed that participants used strategies to deal with their mental health issues: doing something to distract themselves from their current negative mood, using relaxation exercises and methods to relieve symptoms, interacting with others to share their issues, looking for an external source to solve their problems, and motivating themselves by repeating motivational sentences to support themselves or by following inspirational people. Moreover, regarding the design of mental health apps, participants identified that general design characteristics; personalization of the app, including tracking and feedback, live support, and social community; and providing motivational content and relaxation exercises are the most important features that users want in a mental health app. In contrast, games, relaxation audio, the Google map function, personal assistance to provide suggestions, goal setting, and privacy preservation were surprisingly the least requested features.ConclusionsUnderstanding end users’ needs and concerns about mental health apps will inform the future design of mental health apps that are useful to and used by many people.

Embedding Learning in a Learning Health Care System to Improve Clinical Practice.

In an ideal learning health care system (LHS), clinicians learn from what they do and do what they learn, closing the evidence-to-practice gap. In operationalizing an LHS, great strides have been made in knowledge generation. Yet, considerable challenges remain to the broad uptake of identified best practices. To bridge the gap from generating actionable knowledge to applying that knowledge in clinical practice, and ultimately to improving outcomes, new information must be disseminated to and implemented by frontline clinicians. To date, the dissemination of this knowledge through traditional avenues has not achieved meaningful practice change quickly. Vanderbilt University Medical Center (VUMC) developed QuizTime, a smartphone application learning platform, to provide a mechanism for embedding workplace-based clinician learning in the LHS. QuizTime leverages spaced education and retrieval-based practice to facilitate practice change. Beginning in January 2020, clinician-researchers and educators at VUMC designed a randomized, controlled trial to test whether the QuizTime learning system influenced clinician behavior in the context of recent evidence supporting the use of balanced crystalloids rather than saline for intravenous fluid management and new regulations around opioid prescribing. Whether spaced education and retrieval-based practice influence clinician behavior and patient outcomes at the VUMC system level will be tested using the data currently being collected. These findings will inform future directions for developing and deploying learning approaches at scale in an LHS, with the goal of closing the evidence-to-practice gap.

Association between ultraprocessed food intake and cardiovascular health in US adults: a cross-sectional analysis of the NHANES 2011–2016

Higher intake of ultraprocessed foods (UPFs) might be associated with increased risk of cardiovascular disease. Our objective was to examine the association between usual percentage of calories (%kcal) from UPFs and the American Heart Association's "Life's Simple 7" cardiovascular health (CVH) metrics in US adults. We analyzed data from 11,246 adults aged≥20 y from the NHANES 2011-2016 (a cross-sectional, nationally representative survey). UPF designation was assigned on the basis of the NOVA classification system, according to the extent and purpose of food processing. Each CVH metric was given a score of 0, 1, or 2 representing poor, intermediate, or ideal health, respectively. Scores of the 6 metrics (excluding diet) were summed, and CVH was categorized as inadequate (0-4), average (5-8), or optimum (9-12). We used the National Cancer Institute's methods to estimate the usual %kcal from UPFs, and multivariable linear and multinomial logistic regression to assess the association between UPFs and CVH, adjusted for age, sex, race and Hispanic origin, education, and poverty. The weighted prevalence of inadequate, average, and optimum CVH was 8.0%, 51.7%, and 40.3%, respectively. The mean usual %kcal from UPFs was 55.4%, and midpoint of quartiles of intake ranged from 40.4% (quartile 1) to 70.5% (quartile 4). Every 5% increase in calories from UPFs was associated with 0.14 points lower CVH score (P<0.001). The adjusted ORs for inadequate CVH were 1.40 (95% CI: 1.23, 1.60), 1.82 (1.45, 2.29), and 2.57 (1.79, 3.70), respectively, comparing quartiles 2, 3, and 4 with quartile 1 of UPF intake. The pattern of association was largely consistent across subgroups. Usual %kcal from UPFs represented more than half of total calorie intake in US adults. A graded inverse association between %kcal from UPFs and CVH was observed.

Morbidly Excited Soil: Sylvester Graham and the Environmental Ethos of Antebellum Reform

Abstract A long intellectual tradition holds that gathering local waste, turning it into compost, and applying it to fields can remind us of ostensibly natural connections among humans, animals, and plants. Yet, in the nineteenth century, physiological reformers led by Sylvester Graham saw the application of manure as an overstimulating, prurient, noxious, and unnatural practice with consequences for individual health and the social body. These reformers developed a powerful narrative about the interdependence between human and earthly metabolism. They believed humans, animals, plants, and soil were bound together in an unhealthy stew of stimulation, viciously and violently acting upon one another, and always reflecting the diseased condition of broader American society. Mid-nineteenth-century physiological reformers constituted a countercurrent regarding the meaning of nature and its implications for ideal agricultural practice and health, one that sheds new light on historical connections between medical discourse, agricultural practice, and environmental thought. Graham’s views lost salience with the decline of antebellum reform movements and with a shift away from the medical model of overstimulation. Yet agricultural experts argued for the self-sustaining power of the soil without amendments through the early twentieth century, and the Grahamite notion of “hygienic” agriculture, while marginal, found a following for well over a century.

Cardiovascular health behaviours of young adolescents: Results from the global school-based student health survey.

Levels of American Heart Association-defined cardiovascular (CV) health behaviours have not been fully reported among young adolescents in low- and middle-income countries (LMICs). We describe poor, intermediate and ideal levels of American Heart Association-defined CV health behaviours among young adolescents in LMICs. We categorised the levels of CV health behaviours (smoking, body mass index, physical activity and diet) as poor, intermediate, or ideal and calculated the prevalence of each level and the cumulative number of ideal CV health behaviours using the latest data from the global school-based health survey during 2009-2015. The weighted prevalence and 95% confidential intervals were calculated for the whole sample and for sub-groups stratified by gender and age. Pooled overall and regional estimates were calculated using a random-effects model. This study included 153 759 young adolescents from 45 countries. Overall, 86.3% (95% confidence interval, 82.7-89.9), 80.1% (79.8-80.4), 15.4% (13.7-17.2) and 1.7% (1.1-2.2) of respondents reported ideal levels for smoking, body mass index, physical activity and a healthy diet score, respectively. Overall, 0.3% (0.2-0.4) of respondents had 'four' cumulative ideal CV health behaviours. This 'percentage' was lowest in the Americas (0.2%) and highest in Southeast Asia (0.5%). Consistently low proportions of young adolescents in LMICs met the ideal levels of physical activity and a healthy diet score or had 'four' ideal CV health behaviours. For this population, physical activity and a healthy dietary pattern should be strongly prioritised.