Important Lifestyle Behavior Research Articles

Evaluating preconception health and behaviour change following a digital intervention: OptimalMe

Abstract Background Reproductive-aged women are a high-risk group for accelerated weight gain and obesity development. The objective of the current study was to assess the impact of a digital healthy lifestyle intervention for women planning a pregnancy, in optimising preconception health and lifestyle behaviours. Methods Australian women with the intention to conceive were invited to participate in OptimalMe. To be eligible women must be aged 18-44 years, not pregnant but wanting to conceive within 12 months of recruitment and have internet access. All participants receive the same digital lifestyle intervention, supported by health coaching and text messages during preconception. A parallel 2-arm design with sequential randomisation to compare telephone with videoconference delivery methods for health coaching was adopted. Results Overall, 298 women enrolled, with a mean ± (SD) age of 31.7 (4.6) years and BMI 25.5 (6.3) kg/m2. Suboptimal preconception behaviours were reported at baseline including alcohol consumption (57.0%), infrequent weighing (37.2%), and incomplete cervical cancer screening (15.8%) and prenatal supplementation (38.6%). The OptimalMe evaluation was completed by 217 women, 72.8% of the study population, an average of 4.5 months after commencing the intervention. At follow-up, a significant shift towards desired behaviours was reported for alcohol consumption (non-drinker) (z = 2.727, p = 0.00634), prenatal supplementation (taking supplement) (z=-11.082, p < 0.00001) and weighing behaviour (frequent weigher) (z=-5.291, p < 0.00001). Conclusions Results indicate that women who are actively planning a pregnancy require support to optimise health and lifestyle in preparation for pregnancy. Post intervention outcomes suggest that remotely delivered preconception interventions improve lifestyle behaviours and engagement with clinical preconception care objectives. Key messages • Digital health interventions show positive change to important lifestyle behaviours. • Women planning a pregnancy demonstrate sub optional health and lifestyle behaviours therefore interventions are needed to improve this.

Physical activity in the new era of antiobesity medications.

Contemporary antiobesity medications (AOMs) are highly efficacious for the treatment of obesity and obesity-related comorbidities. Given this effectiveness, lifestyle factors within the context of AOM treatments need to refocus and move away from efforts to enhance weight loss. Rather, lifestyle considerations should pivot to being complementary to the benefits realized with AOM treatment and be redirected to enhancing holistic patient health and well-being. Physical activity is an important lifestyle behavior that contributes to many health benefits both in conjunction with, and in the absence of, weight loss. Physical activity improves cardiorespiratory fitness, muscle strength, and physical function. Physical activity may attenuate the loss of lean mass that is observed with AOM treatments and may enhance the quality and function of muscle. Physical activity is a key behavior for holistic health within this era of contemporary AOMs that warrants appropriate attention within the clinical care of patients.

Association of physical activity and dietary inflammatory index with overweight/obesity in US adults: NHANES 2007-2018.

Overweight and obesity lead to a range of noncommunicable diseases (NCDs), such as type 2 diabetes, cardiovascular disease, and stroke. Physical activity (PA) is an important lifestyle behavior for controlling body weight. Dietary inflammatory index (DII), which is associated with systemic inflammatory markers, is used to evaluate the potential of dietary inflammation. This is the first study to investigate the independent and joint associations of PA and DII with the risk of overweight/obesity among US adults. Participants and data were obtained from the National Health and Nutrition Examination Survey (NHANES) from 2007-2018, which is designed to examine the health and nutritional status of the non-institutionalized US population by a complex, multi-stage, probability sampling design. A total of 10723 US adults were selected. Physically active participants had lower overweight/obesity risk (total-time PA: OR = 0.756, 95% CI: 0.669-0.855; leisure-time PA: OR = 0.723, 95% CI: 0.643-0.813; and walk/bicycle-time PA: OR = 0.748, 95% CI: 0.639-0.875); however, those with work-time PA showed no significant association between PA and overweight/obesity. Compared with participants in the lowest DII group (Q1), those in the other three groups had high risks of overweight/obesity (Q2: OR = 1.218, 95% CI: 1.054-1.409; Q3: OR = 1.452, 95% CI: 1.245-1.693; Q4: OR = 1.763, 95% CI: 1.495-2.079). In joint analyses, PA was not eligible for reducing risks of weight/obesity if far more pro-inflammatory diet (Q4 of DII = 2.949-5.502) was taken in (total-time PA: OR = 1.725, 95% CI: 1.420-2.097; leisure-time PA: OR = 1.627, 95% CI: 1.258-2.105; walk/bicycle-time PA: OR = 1.583, 95% CI: 1.074-2.332; and work-time PA: OR = 1.919, 95% CI: 1.493-2.467). More leisure-time PA and walk/bicycle-time PA are associated with lower risk of overweight/obesity, and higher DII is associated with higher risk of overweight/obesity. In addition, higher DII impacts overweight/obesity substantially: once the DII score reached Q4, there is still risks of overweight/obesity even if PA is performed.

THE ASSOCIATION BETWEEN MEDITERRANEAN DIET ADHERENCE AND ALLOSTATIC LOAD IN OLDER ADULTS

Abstract Allostatic load (AL) is a multisystemic index of biological wear and tear which is associated with poor health outcomes. In recent years, researchers have examined the association between dietary pattern intake and AL; however, no studies to date have examined the relationship between AL and consumption of a Mediterranean diet. Blood and urine samples were collected from 201 community-dwelling older adults who completed a Food Frequency Questionnaire (FFQ). A Mediterranean Diet Score (MDS) was calculated based on previous recommendations and a sex-based AL index was calculated using a count-based approach for 16 biomarkers associated with neuroendocrine, immune, cardiovascular, or metabolic function. It was hypothesized that a higher MDS would associate with lower AL, and that this association would be particularly robust for the immune and metabolic subcomponents of the AL index. In support of the study hypotheses, generalized linear models revealed a significant inverse relationship between MDS and AL (ß = -0.03, P = 0.037). Furthermore, higher MDS was significantly associated with lower immune (ß = -0.06, P = 0.38) and metabolic (ß = -0.05, P = 0.039) subsystem scores, but was not associated with cardiovascular or neuroendocrine subsystem scores. Exploratory analyses further showed that the association was more robust in male than female participants. The current findings are interpreted with caution given the study design and sample characteristics. However, these findings contribute to the literature supporting the Mediterranean diet as an important lifestyle behavior that may support healthy aging.

Can exercise attenuate the negative effects of long COVID syndrome on brain health?

The impetus for many governments globally to treat the novel coronavirus (COVID-19) as an endemic warrant more research into the prevention, and management of long COVID syndrome (LCS). Whilst the data on LCS remains scarce, reports suggest a large proportion of recovered individuals will experience ongoing neuropsychological symptoms, even with mild disease severity. The pathophysiology underlying LCS is multifaceted. Evidence suggests that altered inflammatory, neurotrophic, and neurotransmitter pathways within the brain contribute to neuropsychological symptoms reported following COVID-19. Exercise or regular physical activity has long been shown to have positive effects on brain health and cognition through exerting positive effects on inflammatory markers, neurotransmitters, and neurotropic factors analogous to the neurophysiological pathways proposed to be disrupted by COVID-19 infection. Thus, exercise may serve as an important lifestyle behavior in the management of LCS. In this opinion article, we present the evidence to support the positive role of exercise in the management of cognitive symptom that manifest with LCS and discuss important considerations and interactions with cardiorespiratory and exercise tolerance complications that often present for individuals experiencing LCS. We highlight the need for more research and training of sports medicine practitioners and clinical exercise physiologists in the management of LCS with exercise and call for further research to understand the optimal dose-responses and exercise prescription guidelines for cognitive benefits and minimizing other complications.

The association between Mediterranean diet adherence and allostatic load in older adults

Allostatic load (AL) is a multisystemic index of biological wear and tear which is associated with poor health outcomes. In recent years, researchers have examined the association between dietary pattern intake and AL; however, no studies to date have examined the relationship between AL and consumption of a Mediterranean diet. Blood and urine samples were collected from 201 community-dwelling older adults who completed a Food Frequency Questionnaire (FFQ). A Mediterranean Diet Score (MDS) was calculated based on previous recommendations and a sex-based AL index was calculated using a count-based approach for 16 biomarkers associated with neuroendocrine, immune, cardiovascular, or metabolic function. It was hypothesized that a higher MDS would be associated with lower AL, and that this association would be particularly robust for the immune and metabolic subcomponents of the AL index. In support of the primary study hypotheses, generalized linear models revealed a significant inverse relationship between MDS and AL (ß = −0.03, P = 0.037). However, subcomponents of the AL model were not significantly associated with MDS. Exploratory sub-group analyses by sex suggested that the association between AL and MDS was more robust in male than in female participants. The current findings are interpreted with caution given the study design and sample characteristics. Nonetheless, these findings contribute to the literature supporting the Mediterranean diet as an important lifestyle behavior that may minimize AL, and therefore support healthy aging.

Systematic Review of Physical Activity, Sedentary Behaviour and Sleep Among Adults Living with Chronic Respiratory Disease in Low- and Middle-Income Countries.

Physical activity (PA), sedentary behaviour (SB) and sleep are important lifestyle behaviours associated with chronic respiratory disease (CRD) morbidity and mortality. These behaviours need to be understood in low- and middle-income countries (LMIC) to develop appropriate interventions.PurposeWhere and how have free-living PA, SB and sleep data been collected for adults living with CRD in LMIC? What are the free-living PA, SB and sleep levels of adults living with CRD?Patients and MethodsThe literature on free-living PA, SB and sleep of people living with CRD in LMIC was systematically reviewed in five relevant scientific databases. The review included empirical studies conducted in LMIC, reported in any language. Reviewers screened the articles and extracted data on prevalence, levels and measurement approach of PA, SB and sleep using a standardised form. Quality of reporting was assessed using bespoke criteria.ResultsOf 89 articles, most were conducted in Brazil (n=43). PA was the commonest behaviour measured (n=66). Questionnaires (n=52) were more commonly used to measure physical behaviours than device-based (n=37) methods. International Physical Activity Questionnaire was the commonest for measuring PA/SB (n=11). For sleep, most studies used Pittsburgh Sleep Quality Index (n=18). The most common ways of reporting were steps per day (n=21), energy expenditure (n=21), sedentary time (n=16), standing time (n=13), sitting time (n=11), lying time (n=10) and overall sleep quality (n=32). Studies revealed low PA levels [steps per day (range 2669–7490steps/day)], sedentary lifestyles [sitting time (range 283–418min/day); standing time (range 139–270min/day); lying time (range 76–119min/day)] and poor sleep quality (range 33–100%) among adults with CRD in LMIC.ConclusionData support low PA levels, sedentary lifestyles and poor sleep among people in LMIC living with CRDs. More studies are needed in more diverse populations and would benefit from a harmonised approach to data collection for international comparisons.

Barriers and Facilitators to Healthy Eating and Physical Activity Postpartum: A Qualitative Systematic Review

BackgroundPostpartum weight retention increases the risk of long-term overweight and obesity and associated comorbidities. Healthy eating and physical activity are important lifestyle behaviors for achieving and maintaining a healthy weight. However, these habits may be hard for women to adopt or maintain during the postpartum period. ObjectiveTo identify and describe barriers and facilitators to healthy eating and physical activity among postpartum women in the United States. MethodsA qualitative systematic review was conducted. Qualitative studies on women’s experiences with weight loss, healthy eating, and physical activity in the postpartum period were identified using a comprehensive search strategy. The quality of included studies was assessed using the Critical Appraisal Skills Programme checklist. Data were qualitatively analyzed using thematic synthesis. Resulting themes were mapped onto components of the Social-Ecological Model for Food and Physical Activity Decisions. ResultsThirteen qualitative studies were included in the review. Barriers and facilitators to healthy eating and physical activity during the postpartum period included individual factors (emotional and mindless eating, physical limitations, and social support), settings and sectors (food environments, childcare needs, and structured information and support), and social and cultural norms (time constraints, and prioritization of maternal responsibilities). ConclusionsResearchers and practitioners should consider how factors within various levels of the Social-Ecological Model may influence healthy eating and physical activity in the postpartum period.

Abstract 12561: Dietary and Lifestyle Behaviors Among Women of Reproductive Age by Disability Status

Introduction: In the United States (U.S.), 18% of women age 18-44 years report at least one physical, sensory, or cognitive disability. Compared to the general population, women with disabilities are more likely to have multiple comorbidities and experience adverse pregnancy outcomes. Diet and physical activity are important and modifiable lifestyle behaviors for women’s preconception and long-term health, as well as the health of their offspring. This study examined diet quality, physical activity, and related lifestyle factors among women of reproductive age by disability status and disability type. Hypothesis: Diet quality, physical activity, and other lifestyle factors will differ across disability status. Methods: Data were from the U.S. National Health and Nutrition Examination Survey 2013-2018 (n=3,409). Disability status was determined by the Washington Group on Disability Statistics questions regarding difficulty hearing, seeing, concentrating, walking, dressing, or running errands alone. Diet quality was evaluated using the Healthy Eating Index (HEI) 2015, with higher scores indicating better diet quality. Self-reported physical activity, food security, and fast food and ready-to-eat food consumption were also assessed. Chi-square tests and generalized linear regression evaluated differences across disability status and disability type. Results: Compared to women with no disabilities, women with any self-reported disabilities had lower HEI-2015 scores (46.8 and 50.5, respectively; p<0.05), were more likely to report low/very low food security (48% and 18%, respectively; p<0.05), and were less likely to report meeting physical activity recommendations of ≥150 minutes/week of moderate/vigorous activities (27% and 43%, respectively; p<0.05). Differences were also observed by disability type, such that women with self-reported vision difficulty consume more fast food meals in one week compared to women with no disabilities. Conclusions: Women of reproductive age with disabilities report lower diet quality, food security, and physical activity. Future research should focus on identifying and improving modifiable lifestyle behaviors among this population to reduce disparities in maternal and child health outcomes.

Identification of Lifestyle Behaviors Associated with Recurrence and Survival in Colorectal Cancer Patients Using Random Survival Forests.

Simple SummaryCurrent lifestyle recommendations for cancer survivors are the same as those for the general public to decrease their risk of cancer. However, it is unclear what kind of lifestyle behaviors are important for prognosis after a cancer diagnosis. In an observational study among 1180 colorectal cancer patients, we aimed to identify which lifestyle behaviors were most important regarding cancer recurrence and all-cause mortality. We simultaneously evaluated lifestyle behaviors, related to diet, physical activity, adiposity, alcohol use, and smoking. Higher intakes of sugary drinks were associated with increased recurrence risk. For all-cause mortality, fruit and vegetable, liquid fat and oil, and animal protein intake were identified as important lifestyle behaviors. Our exploratory findings identified several lifestyle behaviors related to prognosis after colorectal cancer. These findings should be confirmed in other observational studies before they can be translated into clinical practice.Current lifestyle recommendations for cancer survivors are the same as those for the general public to decrease their risk of cancer. However, it is unclear which lifestyle behaviors are most important for prognosis. We aimed to identify which lifestyle behaviors were most important regarding colorectal cancer (CRC) recurrence and all-cause mortality with a data-driven method. The study consisted of 1180 newly diagnosed stage I–III CRC patients from a prospective cohort study. Lifestyle behaviors included in the current recommendations, as well as additional lifestyle behaviors related to diet, physical activity, adiposity, alcohol use, and smoking were assessed six months after diagnosis. These behaviors were simultaneously analyzed as potential predictors of recurrence or all-cause mortality with Random Survival Forests (RSFs). We observed 148 recurrences during 2.6-year median follow-up and 152 deaths during 4.8-year median follow-up. Higher intakes of sugary drinks were associated with increased recurrence risk. For all-cause mortality, fruit and vegetable, liquid fat and oil, and animal protein intake were identified as the most important lifestyle behaviors. These behaviors showed non-linear associations with all-cause mortality. Our exploratory RSF findings give new ideas on potential associations between certain lifestyle behaviors and CRC prognosis that still need to be confirmed in other cohorts of CRC survivors.

An Association Rule Mining Analysis of Lifestyle Behavioral Risk Factors in Cancer Survivors with High Cardiovascular Disease Risk.

We aimed to assess which lifestyle risk behaviors have the greatest influence on the risk of cardiovascular disease in cancer survivors and which of these behaviors are most prominently clustered in cancer survivors, using logistic regression and association rule mining (ARM). We analyzed a consecutive series of 897 cancer survivors from the Korean National Health and Nutritional Exam Survey (2012–2016). Cardiovascular disease risks were assessed using the atherosclerotic cardiovascular disease score (ASCVDs). We classified participants as being in a low-risk group if their calculated ASCVDs was less than 10% and as being in a high-risk group if their score was 10% or higher. We used association rule mining to analyze patterns of lifestyle risk behaviors by ASCVDs risk group, based upon public health recommendations described in the Alameda 7 health behaviors (current smoking, heavy drinking, physical inactivity, obesity, breakfast skipping, frequent snacking, and suboptimal sleep duration). Forty-two percent of cancer survivors had a high ASCVD. Current smoking (common odds ratio, 11.19; 95% confidence interval, 3.66–34.20, p < 0.001) and obesity (common odds ratio, 2.67; 95% confidence interval, 1.40–5.08, p < 0.001) were significant predictors of high ASCVD in cancer survivors within a multivariate model. In ARM analysis, current smoking and obesity were identified as important lifestyle risk behaviors in cancer survivors. In addition, various lifestyle risk behaviors co-occurred with smoking in male cancer survivors.

Lifestyle behaviors, psychological distress, and well-being: A daily diary study.

Many lifestyle behaviors such as diet, exercise, social interaction, and substance use are related to physical and mental health. Less understood are the day-to-day associations of these behaviors with both psychological distress, well-being, and with each other. This study investigated how a number of common lifestyle behaviors were associated with psychological distress and well-being using a daily diary study with multilevel modeling. Associations among behaviors were analyzed with multilevel mediation and network models. An online participant pool consisting of seventy-six adults (age range: 19-64; mean age: 40.29; 58% female) completed daily diary surveys over 14 days and reported their engagement in lifestyle behaviors, psychological distress, hedonic well-being, and eudaimonic well-being. Time spent in social interaction was the most consistent within-person correlate of psychological distress and well-being. The association between daily time in nature and well-being was mediated by social interaction and exercise. Network models found within-person associations among the lifestyle behaviors. The results indicate that social interaction may be an especially important lifestyle behavior to consider when promoting well-being. Future research should recognize that daily fluctuations in many lifestyle behaviors cluster together.

First effective mHealth nutrition and lifestyle coaching program for subfertile couples undergoing in vitro fertilization treatment: a single-blinded multicenter randomized controlled trial

To study compliance and effectiveness of the mHealth nutrition and lifestyle coaching program Smarter Pregnancy in couples undergoing invitro fertilization (IVF) treatment with or without intracytoplasmic sperm injection (ICSI). Multicenter, single-blinded, randomized controlled trial, conducted from July 2014 to March2017. IVF clinics. A total of 626 women undergoing IVF treatment with or without ICSI and 222 male partners. Couples were randomly assigned to the light (control group) or regular (intervention group) Smarter Pregnancy program. Both groups filled out a baseline screening questionnaire on nutrition and lifestyle behaviors, and the intervention group received coaching tailored to inadequate behaviors during the 24-week period. Difference in improvement of a composite dietary and lifestyle risk score for the intake of vegetables, fruits, folic acid supplements, smoking, and alcohol use after 24 weeks of the program. Compared with control subjects, women and men in the intervention group showed a significantly larger improvement of inadequate nutrition behaviors after 24 weeks of coaching. At the same time, the women also showed a significantly larger improvement of inadequate lifestyle behaviors. The mHealth coaching program Smarter Pregnancy is effective and improves the most important nutritional and lifestyle behaviors among couples undergoing IVF/ICSI treatment. International multicenter randomized trials are recommended to study the effect of using Smarter Pregnancy on pregnancy, live birth, and neonatal outcome. NTR4150.

Investigation Of Physical Activity Instruction In United States Nurse Practitioner Curricula

PURPOSE: The purpose of this study is to investigate formalized physical activity (PA) training in United States (US) Nurse Practitioner (NP) curricula. There are over 270,000 currently certified NPs with over 72% delivering primary care. PA is an important lifestyle behavior that can aid in prevention and treatment of chronic conditions therefore, having primary care providers trained in PA assessment and counseling to patients is vital in disease prevention and chronic conditions management. METHODS: Data was collected in 3 faculty-student teams in the Pacific Northwest, Eastern, and Southern US from 1083 NP training programs through website evaluation. Examined program descriptions, course titles and course descriptions for mention of general health keywords, PA and nutrition. General health key words included: health promotion, chronic disease, disease prevention. Exclusion criteria included: programs unaccredited at time data extraction or with non-primary care focus. Chi-square and Fisher’s exact tests were used to compare differences in keywords within course titles and descriptions by institution type, program type, program specialty, and program delivery were assessed. RESULTS: There was a dearth PA keywords in program descriptions. Differences were found for general keywords in course titles by program specialty (p<0.001) and program delivery (p<0.001); general keywords in a course descriptions by program specialty (p<0.001) and program delivery (p=0.011); and nutrition keywords in a course descriptions by institution type (p=0.038). CONCLUSION: These results are the first step in the process of ensuring that NPs have a working knowledge of PA and the skills to provide PA counseling to their patients. Direct assessment of NP programs should be done to confirm our findings. The presence of general keywords is promising and can be built upon, and this will lead to the next step of confirming findings through survey collection.

Modifiable lifestyle behaviours impact the health-related quality of life of bladder cancer survivors.

ObjectiveTo examine health behaviours in bladder cancer survivors including physical activity (PA), body mass index, diet quality, smoking and alcohol consumption, and to explore their relationship with health‐related quality of life (HRQoL).Subjects/Patients and MethodsCross‐sectional questionnaire packages were distributed to bladder cancer survivors (muscle‐invasive bladder cancer [MIBC] and non‐muscle‐invasive bladder cancer [NMIBC]) aged >18 years, and proficient in English. Lifestyle behaviours were measured using established measures/questions, and reported using descriptive statistics. HRQoL was assessed using the validated Bladder Utility Symptom Scale, and its association with lifestyle behaviours was evaluated using analysis of covariance (ancova) and multivariate regression analyses.ResultsA total of 586 participants completed the questionnaire (52% response rate). The mean (SD) age was 67.3 (10.2) years, and 68% were male. PA guidelines were met by 20% (n = 117) and 22.7% (n = 133) met dietary guidelines. In all, 60.9% (n = 357) were overweight/obese, and the vast majority met alcohol recommendations (n = 521, 92.5%) and were current non‐smokers (n = 535, 91.0%). Health behaviours did not differ between MIBC and NMIBC, and cancer treatment stages. Sufficient PA, healthy diet, and non‐smoking were significantly associated with HRQoL, and the number of health behaviours participants engaged in was positively associated with HRQoL (P < 0.001).ConclusionBladder cancer survivors are not meeting guidelines for important lifestyle behaviours that may improve their overall HRQoL. Future research should investigate the impact of behavioural and educational interventions for health behaviours on HRQoL in this population.

A Review of Devra Davis’s (2007) The Secret History of the War on Cancer: Can the Science of Behavior Contribute to the War on Cancer?

Devra Davis’s (2007) The Secret History of the War on Cancer, despite being published several years ago, is an important treatise for behavior analysts interested in utilizing behavioral principles to change important lifestyle behaviors that have been linked to long-term chronic conditions. This review summarizes the important points of the book, most specifically the role of government and industry in the etiology of chronic conditions such as cancer. Research on behavioral interventions for health-related behaviors is proposed as one possible means by which behavior analysis might contribute to the war on cancer, but so too might larger scale research on cultural change, including the study of meta- and macrocontingencies and the promotion of skeptical thinking and scientific literacy.

Insufficient Sleep Duration And Its Association With Breakfast Intake, Overweight/Obesity, Socio-Demographics And Selected Lifestyle Behaviors Among Saudi School Children.

ObjectiveAdequate sleep is an important factor for maintaining good health among children. However, there have been few studies reporting on the association of sleep duration with breakfast intake frequency. This study examined the prevalence of nocturnal sleep duration among Saudi children and its association with breakfast intake, screen time, physical activity levels and socio-demographic variables.MethodsA multistage stratified cluster random sampling technique was used to select 1051 elementary school children in Riyadh. Weight and height were measured and body mass index was computed. The sleep duration, daily breakfast intake frequency, socio-demographic and lifestyle behaviors were assessed using a specifically designed self-reported questionnaire filled by the children’s parents.ResultsOver 71% of the Saudi school children did not attain the recommended sufficient sleep duration at night. Results of logistic regression analysis, adjusted for confounders, exhibited significant associations between longer sleep duration and younger age (aOR=1.12, p=0.046), being female (aOR=1.39, p=0.037), higher father educational levels, daily breakfast intake (aOR=1.44, p=0.049) and lower screen time (aOR for >2 hrs/day=0.69, p=0.033). However, no significant (p> 0.05) association was found for mother education, family income, number of family member in the house, overweight/obesity, or physical activity levels.ConclusionThe prevalence of insufficient nocturnal sleep among Saudi children was high. Insufficient sleep was associated with breakfast and several important socio-demographic and lifestyle behaviors. The findings of this study support the development of interventions to prevent insufficient sleep and help Saudi children improve their sleeping habits.

Prevention and Treatment of Alzheimer's Disease: Biological Mechanisms of Exercise.

Alzheimer's disease (AD) is the most common form of dementia. With an aging population and no disease modifying treatments available, AD is quickly becoming a global pandemic. A substantial body of research indicates that lifestyle behaviors contribute to the development of AD, and that it may be worthwhile to approach AD like other chronic diseases such as cardiovascular disease, in which prevention is paramount. Exercise is an important lifestyle behavior that may influence the course and pathology of AD, but the biological mechanisms underpinning these effects remain unclear. This review focuses on how exercise can modify four possible mechanisms which are involved with the pathology of AD: oxidative stress, inflammation, peripheral organ and metabolic health, and direct interaction with AD pathology. Exercise is just one of many lifestyle behaviors that may assist in preventing AD, but understanding the systemic and neurobiological mechanisms by which exercise affects AD could help guide the development of novel pharmaceutical agents and non-pharmacological personalized lifestyle interventions for at-risk populations.

Physical Activity and the Prevention of Weight Gain in Adults: A Systematic Review.

To conduct a systematic literature review to determine if physical activity is associated with prevention of weight gain in adults. The primary literature search was conducted for the 2018 Physical Activity Guidelines Advisory Committee and encompassed literature through June 2017, with an additional literature search conducted to include literature published through March 2018 for inclusion in this systematic review. The literature review identified 40 articles pertinent to the research question. There is strong evidence of an association between physical activity and prevention of weight gain in adults, with the majority of the evidence from prospective cohort studies. Based on limited evidence in adults, however, there is a dose-response relationship and the prevention of weight gain is most pronounced when moderate-to-vigorous intensity physical activity (≥3 METs) is above 150 min·wk. Although there is strong evidence to demonstrate that the relationship between greater time spent in physical activity and attenuated weight gain in adults is observed with moderate-to-vigorous intensity physical activity, there is insufficient evidence available to determine if there is an association between light-intensity activity (<3 METs) and attenuated weight gain in adults. The scientific evidence supports that physical activity can be an effective lifestyle behavior to prevent or minimize weight gain in adults. Therefore, public health initiatives to prevent weight gain, overweight, and obesity should include physical activity as an important lifestyle behavior.

Diagnostic status and age at diagnosis of hypertension on adherence to lifestyle recommendations.

Regular physical activity, smoking cessation, and moderate alcohol consumption are important lifestyle behaviors that can be modified when managing hypertension. This study examined the associations of diagnostic status and age at hypertension diagnosis with lifestyle behaviors among individuals with hypertension. Data came from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2012 (N = 5231). Multinomial logistic regression models were used to estimate the relative risk (RR) of adopting lifestyle behaviors. A diagnosis of hypertension was associated with an individual being a past smoker (RR = 1.26, 95% CI: 1.05, 1.52). There was an association between duration since diagnosis and being a past smoker (RR = 1.01; 95% CI 1.01, 1.02; P = 0.004). Excessive drinking was inversely associated with duration since diagnosis (RR = 0.95; 95% CI 0.94, 0.96; P < 0.001). Older age at diagnosis was associated with the risk of being a past smoker (RR = 1.03; 95% CI 1.02, 1.04; P-value<0.001) and negatively associated with excessive drinking (RR = 0.96; 95% CI 0.95, 0.97; P < 0.001). Individuals who exercised, even though less than the recommended time, were more likely to have younger age at diagnosis (RR = 0.98; 95% CI 0.97, 0.99; P < 0.001) and shorter duration since diagnosis (RR = 0.98; 95% CI 0.96, 0.99; P < 0.001) compared to individuals with who did not engage in physical activity. Individuals with diagnosed hypertension were more likely to quit smoking, and those with younger age at diagnosis or shorter duration tended to exercise regularly. Regular visits to doctors should focus on hypertension control and health behavior modifications.