Association Of Lifestyle Factors Research Articles

Aging & COVID-19 susceptibility, disease severity, and clinical outcomes: The role of entangled risk factors.

The emergence of Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) in late 2019 has been associated with a high rate of mortality and morbidity. It has been determined that the old population are not only at an increased risk for affliction with COVID-19 infection, but also atypical presentations, severe forms of the disease, and mortality are more common in this population. A plethora of mechanisms and risk factors contribute to the higher risk of infection in the old population. For instance, aging is associated with an increment in the expression of Angiotensin-Converting Enzyme-2 (ACE-2), the receptor for SARS-CoV-2 spike protein, which precipitates replication of the virus in the old population. On the other hand, immune dysregulation and changes in gut microbiota as a result of aging can contribute to the cytokine storm, one of the main indicators of disease severity. Decrement in sex steroids, especially in women, as well as growth hormone, both of which have crucial roles in immune regulation, is a key contributor to disease severity in old age. Senescence-associated oxidative stress and mitochondrial dysfunction in both pneumocytes and immune cells contribute to the severity of infection in an exacerbative manner. In addition, lifestyle-associated factors such as nutrition and physical activity, which are compromised in old age, are known as important factors in COVID-19 infection. Aging-associated comorbidities, especially cardiovascular diseases and diabetes mellitus, also put older adults at an increased risk of complications, and disease severity.

Joint association of modifiable lifestyle and metabolic health status with incidence of cardiovascular disease and all-cause mortality: a prospective cohort study.

We aimed to identify the joint associations of modifiable lifestyle and metabolic factors with the incidences of cardiovascular disease and all-cause mortality. We recruited 94,831 participants (men, 79.76%; median age, 51.60 [43.47-58.87]) without a history of cardiovascular disease from the Kailuan study during 2006 and 2007 and followed them until a cardiovascular disease event, or death occurred, or until December 31, 2017. Baseline metabolic health status was assessed using Adult Treatment Panel III criteria, and details of the lifestyles of the participants were recorded using a self-reported questionnaire. We used Cox proportional hazards models to evaluate the joint associations. During a median follow-up of 11.03 years, we recorded 6590 cardiovascular disease events and 9218 all-cause mortality. Participants with the most metabolic risk components and the least healthy lifestyle had higher risk of cardiovascular disease (hazard ratio 2.06 [95% confidence interval (CI) 1.77-2.39]) and mortality (HR 1.53 [95% CI 1.31-1.78]), than participants with fewer metabolic risk components and the healthiest lifestyle. Compared with those in participants with the healthiest lifestyle, the HRs for cardiovascular disease in participants with the least healthy lifestyle were 1.26 (95% CI 1.17-1.37), 1.16 (95% CI 1.03-1.31), and 1.07 (95% CI 0.90-1.27) for those with low, medium, and high metabolic risk, respectively. Healthy lifestyle is associated with a lower risk of cardiovascular disease and there is no significant interaction between metabolic risk and a healthy lifestyle. Therefore, a healthy lifestyle should be promoted, even for people with high metabolic risk.

Risk factors for esophageal cancer in a high-incidence area of Malawi.

To explore associations of nutritional, infectious, and lifestyle factors with esophageal cancer (EC) occurrence in a high-risk area of Malawi. This case-control study was performed with 227 patients undergoing endoscopy for dysphagia or other upper gastrointestinal complaints. Data on clinicopathological characteristics and risk factors were collected using a questionnaire developed for this study specifically. Ninety-eight blood samples were collected and the prevalence of antibodies against human immunodeficiency virus, herpes simplex virus, cytomegalovirus, Epstein-Barr virus, varicella-zoster virus, and Helicobacter pylori were determined serologically. The tumor and control groups comprised 157 (69.2%) and 70 (31.8%) patients, respectively. Patients with tumors were significantly older than controls (55.5 vs. 43.5years, p < 0.001). The male/female ratio did not differ between groups (59% and 54% male, respectively; p = 0.469). EC was associated with smoking (p < 0.001), and alcohol consumption (p = 0.020), but 43% of patients with tumors did not smoke or drink. EC was associated with the consumption of hot food and tea (p = 0.003) and smoked fish (p = 0.011). EC was not associated with any serologically investigated infectious agents. In an age adjusted binary logistic regression analysis of all nutritive factors, only locally made alcohol was significant [odds ratio (OR), 9.252; 95% confidence interval (CI), 1.455-58.822; p = 0.018]. Apart from alcohol consumption and smoking, the consumption of hot food or tea and smoked fish are associated with EC. Locally distilled alcohol consumption increases the EC risk in Malawi.

Combined Lifestyle Behaviors and the Incidence of Common Cancer Types in the Norwegian Women and Cancer Study (NOWAC).

IntroductionOnly a small number of studies have examined the impact of combined lifestyle behaviors on cancer incidence, and never in a Norwegian population.PurposeTo examine linear and nonlinear associations of combined lifestyle factors, assessed through a healthy lifestyle index (HLI), with the incidence of postmenopausal breast, colorectal, lung, postmenopausal endometrial, postmenopausal ovarian, pancreatic, and kidney cancer among women in Norway.MethodsThis prospective study included 96,869 women enrolled in the Norwegian Women and Cancer (NOWAC) cohort. Baseline information on lifestyle factors was collected between 1996 and 2004. The HLI was constructed from five lifestyle factors: physical activity level, body mass index, smoking, alcohol consumption, and diet. Each factor contributed 0 to 4 points to the HLI score, which ranged from 0 to 20, with higher scores representing a healthier lifestyle. Multiple imputation was used to handle missing data. Cox proportional hazard regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Restricted cubic splines were used to examine nonlinearity in the associations.ResultsThe HRs for a one-point increment on the HLI score were 0.97 (95% CI: 0.96–0.98) for postmenopausal breast cancer, 0.98 (0.96–1.00) for colorectal cancer, 0.86 (0.84–0.87) for lung cancer, 0.93 (0.91–0.95) for postmenopausal endometrial cancer, 0.99 (0.96–1.02) for postmenopausal ovarian cancer, 0.92 (0.89–0.95) for pancreatic cancer, and 0.94 (0.91–0.97) for kidney cancer. Nonlinearity was observed for the inverse associations between HLI score and the incidence of lung cancer and postmenopausal breast cancer.ConclusionBased on our results, healthier lifestyle, as assessed by the HLI score, was associated with lower incidence of postmenopausal breast, colorectal, lung, postmenopausal endometrial, pancreatic, and kidney cancer among women, although the magnitude and linearity varied. Adoption of healthier lifestyle behaviors should be a public health priority to reduce the cancer burden among Norwegian women.

Undiagnosed Hypertension in a Workplace: The Case of a Logistics Company in Gauteng, South Africa.

A large proportion of the population with hypertension remains undiagnosed, untreated, or inadequately treated, contributing to the rising burden of cardiovascular diseases in South Africa. A workplace may either mitigate or accentuate the risk factors for hypertension. A cross sectional study was conducted to determine the prevalence of undiagnosed hypertension and associated factors among 312 employees in a Logistics Company, South Africa. A modified, validated, self-administered WHO STEPwise questionnaire was used to collect data on demography, lifestyle factors, anthropometry and blood pressure (BP). Hypertension was defined at BP ≥ 140/90 mmHg. Data was analysed using STATA 14. Mean age of employees was 40 ± 10 years, with a 50% prevalence of undiagnosed hypertension. No significant association was observed between occupation and undiagnosed hypertension, except for high prevalence of undiagnosed hypertension among truck drivers and van assistants (43%), and general workers (27%), having higher odds of increased waist-to-height ratio. Hypertension was associated with age (OR = 2.3, 95%CI; 1.21–4.27), alcohol use (AOR = 1.8, 95%CI; 1.05–2.93), waist circumference (AOR = 2.3, 95%CI; 1.29–4.07) and waist-to-height-ratio (AOR = 3.7, 95%CI; 1.85–7.30). Improved and effective workplace health programs and policies are necessary for management of undiagnosed hypertension among employees. Longitudinal studies on mediation of occupation in association of demographic and lifestyle factors with hypertension in workplaces are needed.

Adherence to Healthy Lifestyle and Attenuation of Biological Aging in Middle-Aged and Older Chinese Adults.

BackgroundLittle is known about the effects of lifestyle modification on biological aging in population-based studies of middle-aged and older adults.MethodWe examined the individual and joint associations of multiple lifestyle factors with accelerated biological aging measured by change in frailty index (FI) over 8 years in a prospective study of Chinese adults. Data were obtained on 24 813 participants in the China Kadoorie Biobank on lifestyle factors and frailty status at baseline and at 8 years after baseline. Adherence to healthy lifestyle factors included nonsmoking or quitting smoking for reasons other than illness, avoidance of heavy alcohol consumption, daily intake of fruit and vegetables, being physically active, body mass index of 18.5–23.9 kg/m2, and waist-to-hip ratio of <0.90 (men)/0.85 (women). FI was constructed separately at baseline and resurvey using 25 age- and health-related items.ResultsOverall, 8 760 (35.3%) individuals had a worsening frailty status. In multivariable-adjusted logistic regression analyses, adherence to healthy lifestyle was associated with a lower risk of worsening frailty status. Compared with robust participants maintaining 0–1 healthy lifestyle factors, the corresponding odds ratios (95% CIs) were 0.93 (0.83–1.03), 0.75 (0.67–0.84), 0.68 (0.60–0.77), and 0.55 (0.46–0.65) for robust participants with 2, 3, 4, and 5–6 healthy lifestyle factors. The decreased risk of frailty status worsening by adherence to healthy lifestyle factors was similar in both middle-aged and older adults, and in both robust and prefrail participants at baseline.ConclusionsAdherence to a healthy lifestyle may attenuate the rate of change in biological aging in middle-aged and older Chinese adults.

Associations of environment and lifestyle factors with suboptimal health status: a population-based cross-sectional study in urban China

IntroductionSuboptimal health status (SHS), an intermediate state between chronic disease and health, is characterized by chronic fatigue, non-specific pain, headaches, dizziness, anxiety, depression, and functional system disorders with a high prevalence worldwide. Although some lifestyle factors (e.g. smoking, alcohol consumption, physical exercise) and environmental factors (e.g. air quality, noise, living conditions) have already been studied, few studies can comprehensively illustrate the associations of lifestyle and environment factors with general, physical, mental, and social SHS.MethodsA cross-sectional study was conducted among 6750 urban residents aged 14 years or over in five random cities from September 2017 to September 2018 through face-to-face questionnaires. There were 5881 valid questionnaires with a response rate of 87%. A general linear model and structural equation model were developed to quantify the effects of lifestyle behaviors and environment factors on SHS.ResultsThe detection rates of general, physical, mental, and social SHS were 66.7, 67.0, 65.5, and 70.0%, respectively. Good lifestyle behaviors and favorable environment factors positively affected SHS (P < 0.001). Lifestyle behaviors had the largest effect on physical SHS (β = − 0.418), but the least on social SHS (β = − 0.274). Environment factors had the largest effect on mental SHS (β = 0.286), but the least on physical SHS (β = 0.225).ConclusionsLifestyle behaviors and environment factors were important influencing factors of SHS. Physical SHS was more associated with lifestyle. Lifestyle and environment were similarly associated with mental and social SHS.

Genetic Risk for Overall Cancer and the Benefit of Adherence to a Healthy Lifestyle.

Cancer site-specific polygenic risk scores (PRS) effectively identify individuals at high risk of individual cancers, but the effectiveness of PRS on overall cancer risk assessment and the extent to which a high genetic risk of overall cancer can be offset by a healthy lifestyle remain unclear. Here, we constructed an incidence-weighted overall cancer polygenic risk score (CPRS) based on 20 cancer site-specific PRSs. Lifestyle was determined according to smoking, alcohol consumption, physical activity, body mass index, and diet. Cox regression by sex was used to analyze associations of genetic and lifestyle factors with cancer incidence using UK Biobank data (N = 442,501). Compared with participants at low genetic risk (bottom quintile of CPRS), those at intermediate (quintiles 2 to 4) or high (top quintile) genetic risk had HRs of 1.27 (95% confidence interval, 1.21-1.34) or 1.91 (1.81-2.02) for overall cancer, respectively, for men, and 1.21 (1.16-1.27) or 1.62 (1.54-1.71), respectively, for women. A joint effect of genetic and lifestyle factors on overall cancer risk was observed, with HRs reaching 2.99 (2.45-3.64) for men and 2.38 (2.05-2.76) for women with high genetic risk and unfavorable lifestyle compared with those with low genetic risk and favorable lifestyle. Among participants at high genetic risk, the standardized 5-year cancer incidence was significantly reduced from 7.23% to 5.51% for men and from 5.77% to 3.69% for women having a favorable lifestyle. In summary, individuals at high genetic risk of overall cancer can be identified by CPRS, and risk can be attenuated by adopting a healthy lifestyle. SIGNIFICANCE: A new indicator of cancer polygenic risk score measures genetic risk for overall cancer, which could identify individuals with high cancer risk to facilitate decision-making about lifestyle modifications for personalized prevention.

Association of lifestyle factors with osteoporosis and fracture in postmenopausal women: a Japanese cohort study.

Osteoporosis is a major risk factor for fracture later in life; however, few studies have examined the association of lifestyle factors with osteoporosis and fracture. This study aimed to identify factors associated with osteoporosis and fracture in postmenopausal women. We evaluated the association between baseline characteristics and outcomes (diagnosis of osteoporosis or incidence of fracture) in 4,427 postmenopausal women who participated in the Kyushu University Fukuoka Cohort Study on lifestyle-related diseases (baseline: February 2004 to August 2007; follow-up: February 2010 to December 2012). Among the women, 626 were diagnosed as having osteoporosis without a fracture, 294 sustained a fracture without a diagnosis of osteoporosis, and 137 were diagnosed with both osteoporosis and fracture during the average 5.3-year follow-up period; the remaining 3,370 participants were not diagnosed with osteoporosis or did not sustain a fracture. The association between lifestyle factors and the occurrence of osteoporosis and fracture was evaluated using logistic regression analysis. Skipping breakfast was associated negatively with osteoporosis without fracture (odds ratio [OR] = 0.40, P = 0.009) but positively with fracture without osteoporosis (OR = 2.30, P = 0.0009). Glycated hemoglobin A1c levels were associated negatively with osteoporosis without fracture (OR = 0.81, P = 0.0003) but positively with fracture without osteoporosis (OR = 1.18, P = 0.03). Parental history of fracture and extraversion personality trait were both associated with fracture without osteoporosis. Osteoporosis and fracture showed different association patterns with lifestyle factors, and no factors were correlated with an increase in both osteoporosis and fracture.

Lifestyle factors and prostate-specific antigen

Background: Increasing prostate cancer awareness has meant that more men are seeking out prostate-specific antigen (PSA) testing than ever before. Prostate cancer is now the most common malignancy in men, affecting one in eight. This article addresses lifestyle factors that may elevate PSA readings. Methods: A systematic review of the literature was performed using Medline for studies examining the association of PSA and lifestyle factors, including exercise, diet, sexual function as well as medication use. Further resources were identified from the reference list of retrieved articles. Results: Minimal level 1 evidence on the association of PSA with lifestyle factors was identified. Weak and generally inconsistent evidence was found on the effect of cycling and sexual activity. Diabetes and obesity did have inversely proportional effects on PSA values in large cohort studies. There was no evidence for an independent effect of different types of food to PSA. With regard to medications, the greatest impact is from 5-alpha reductase inhibitors, and these are used as a hair-loss treatment. Statins, non-steroidal anti-inflammatory drugs and thiazide diuretics can also have a clinically significant impact on PSA levels but unlikely to alter management. Discussion: For a small group of patients, cautious counselling on the factors summarised here before they have their blood tests may prevent undue stress and anxiety, particularly in those with borderline PSA results. Due to the inconsistency of results and lack of level 1a evidence, if there is reasonable suspicion for prostate cancer, a patient should still always be referred to a specialist. Level of evidence: Level 4.

The association of pre-war medical conditions to Gulf War Illness

AimsGulf War Illness (GWI) remains a significant health concern for many veterans. The relation of pre-war health conditions and symptoms to GWI could aid in developing a more accurate case definition of GWI. The objective of this study was to investigate pre-war predictors of GWI in a population-based sample of Gulf War veterans using two definitions of GWI. Main methodsData come from the 1995–1997 National Health Survey of Persian Gulf War Era Veterans, a survey of a representative sample of deployed and non-deployed US veterans. Using two definitions of GWI (CDC/Kansas and a newly developed 3-domain definition), we conducted a series of multivariable logistic regression analyses to assess the associations of demographic, lifestyle factors, and pre-war medical conditions and symptoms to subsequent GWI. Key findingsAll pre-war symptom predictor domains were significantly and positively associated with GWI using a new 3-domain definition with aORs for individual domains ranging from 2.17 (95% CI = 1.99–2.38) for dermatologic conditions to 3.06 (95% CI = 2.78–3.37) for neurological conditions. All symptom predictor domains were associated with significantly increased likelihood of GWI using the CDC/Kansas definition, with aORs ranging from 2.54 (95% CI = 2.31–2.81) for inflammatory conditions to 3.22 (95% CI = 2.94–3.55) for neurological conditions. These estimates were attenuated but remained significant after inclusion of all significant symptom predictor domains. SignificanceResults from this study suggest that demographic/lifestyle factors and pre-war medical conditions are strong predictors of GWI. Additional research is needed to confirm these findings, and to clarify the unique characteristics of this common, but still poorly understood illness.

Abstract 816: Genetic variants associated with C-reactive protein and colorectal cancer survival: Sex- and lifestyle factors- specific associations

Abstract Background: Elevated levels of C-reactive protein (CRP) have been linked to colorectal cancer (CRC) survival and CRC prognostic factors, such as obesity, smoking, and alcohol consumption. However, the mechanisms underlying these associations are not well understood. We evaluated genetic variants associated with CRP levels and their interactions with sex and lifestyle factors in association with CRC-specific mortality. Methods: This study included 16,142 CRC cases from the International Survival Analysis in Colorectal Cancer Consortium (ISACC). We identified 741 common single nucleotide polymorphisms (SNPs) associated with CRP (minor allele frequency &amp;gt;5% in European ancestry) from the NHGRI-EBI GWAS Catalog. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for SNP-specific association with CRC-specific mortality adjusting for age, sex, genotyping platform/study, and the first three principal components of genetic ancestry. SNPs were examined using log-additive models. Likelihood ratio tests were used to investigate multiplicative gene-environment interactions between CRP-associated SNPs and sex, obesity, ever smoking, and alcohol consumption. We also conducted stratified analyses according to these factors. P values were adjusted using Bonferroni correction, with corrected P &amp;lt;0.05 considered statistically significant. Results: After a median of 4.7 years (interquartile range = 2.3 to 7.7 years) of follow-up since diagnosis, 5,472 (33.9%) deaths accrued, 3,547 (64.8%) of which were due to CRC. No variants were statistically significantly associated with CRC-specific mortality after multiple comparison correction. We observed strong evidence of interaction between variant rs1933736 at FRK gene and sex in relation to CRC mortality (corrected Pinteraction = 0.0004); women had higher CRC-specific mortality associated with the minor allele (HR = 1.11, 95% CI = 1.04 to 1.19) whereas an inverse association was observed for men (HR = 0.88, 95% CI = 0.82 to 0.94). There was no evidence of statistically significant interactions between CRP-associated SNPs and alcohol, obesity or smoking in association with CRC-specific mortality. Conclusions: Our study observed a statistically significant interaction between sex and a CRP-associated variant in relation to CRC-specific mortality. Future replication of this association and functional annotation of the variant are needed. Citation Format: Yuhan Huang, Xinwei Hua, Julia D. Labadie, Tabitha A. Harrison, James Dai, Sara Lindstrom, Yi Lin, Sonja I. Berndt, Daniel D. Buchanan, Peter T. Campbell, Graham Casey, Steven J. Gallinger, Marc J. Gunter, Michael Hoffmeister, Mark A. Jenkins, Lori C. Sakoda, Robert E. Schoen, Brenda Diergaarde, Martha L. Slattery, Emily White, Roger Milne, Graham Giles, Andrew T. Chan, Ulrike Peters, Polly A. Newcomb. Genetic variants associated with C-reactive protein and colorectal cancer survival: Sex- and lifestyle factors- specific associations [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 816.

Association of lifestyle factors with a high prevalence of overweight and obesity in Greek children aged 10-16years.

To investigate the prevalence of overweight, obesity and central obesity in students of primary and secondary education, and the association with lifestyle parameters. A total of 3504students, aged 10-16years old, from Western Greece participated in this cross-sectional epidemiological study (participation rate: 90%). Demographic, socioeconomic, dietary, physical activity and screen time data were obtained using a questionnaire. Anthropometric measurements were also obtained. Overweight and obesity were estimated using the Centers for Disease Control and Prevention (CDC) and International Obesity Task Force (IOTF) criteria and central obesity using the WHtR ≥0.5 and IDF criteria. The prevalence of overweight and obesity was 19.2% and 12.1% with CDC criteria, respectively, and 20.9% and 7.2%, with IOTF criteria respectively. Central obesity was 31.1 and 32.8% using the Waist-to-Height ratio (WHtR) ≥0.5 and International Diabetes Federation (IDF) criteria respectively. Male gender, small number of meals, breakfast skipping, frequent consumption of school food and sweets and the presence of a computer in children's rooms, were identified as the strongest lifestyle factors affecting weight. Overweight, obesity and central obesity rates remain high among children and adolescents in Greece. The identification of risk factors associated with the manifestation of obesity and central obesity, may contribute to the implementation of targeted prevention and treatment interventions.

Exposure to waterpipe smoke and blood heavy metal concentrations

Waterpipe (WP) smoking is a global phenomenon, with the most consumers in Middle East countries and China. Heavy metals exposure related to WP smoking has been associated with many adverse health effects. However, the association of lifestyle factors and smoking habits with blood heavy metals concentration in WP smokers is unclear yet. Therefore, we aimed to investigate the relationship of lifestyle factors (i.e., diet and physical activity) and smoking habits (i.e., duration of the use of WP and times of smoking WP per week) with blood concentrations of lead (Pb) and cadmium (Cd). This cross-sectional study was based on 86 WP smokers in Khalkhal, Iran (2018). Graphite furnace atomic absorption spectrometry (GFAAS) was used to measure heavy metals. The median (interquartile range (IQR)) of Pb and Cd concentrations were 39 (24) and 1.3 (1.2) μg/L. The blood Pb and Cd levels were significantly higher in participants with lower education level (P-value = 0.049 and 0.041, respectively). An IQR increase in physical activity per week was associated with −0.12 μg/L (95% confidence interval (CI): −0.23, −0.01, P-value = 0.04) decrease in Pb concentration. An increase in the times of consuming fruit per week was negatively associated with the concentration of Cd. Overall, our findings suggested that physical activity and healthy diet have been associated with lower blood heavy metal concentrations in WP smokers; however, further studies are needed to confirm these findings.

Interactions of Lifestyle Factors on the Risk of Anemia Among Taiwanese Adults

ObjectivesThe aim of this study was to investigate the association of lifestyle factors with the risk of anemia among adults in Taiwan. MethodsThis cross sectional study included 118,924 (43,055 men and 75,869 women) participants aged 20–45 years, who had health examination including blood tests, anthropometric measurements, and questionnaires to collect demographic, lifestyle, and dietary data at Mei Jau (MJ) Health Screening Center between 2000 to 2015. We evaluated the interactive associations of smoking, alcohol drinking, sleeping habit, physical activity, and dietary habit on the risk of anemia among study participants. The multivariable regression analysis was performed to examine the interactive correlations of lifestyle factors on the risk of anemia. Relative excess risk due to interaction (RERI) and attributable proportion (AP) were used for the estimation of additive interactions. The dietary pattern was derived by reduced rank regression. ResultsThe anemia-inflammatory dietary pattern was heavily loaded on eggs, meat, organ meats, rice and flour products, fried rice or flour, sugary beverages, fried foods, and processed foods. Participants who actively smoked and had less sleep duration (< 6 hours/day) significantly increased the risk of anemia (OR = 1.03, 95% CI: 1.01, 1.30, RERI = 0.13, 95% CI: 0.01, 0.24, AP = 0.31, 95% CI: 0.19, 0.35, all Pinteraction < 0.05) compared to those who were non-smokers and had longer sleep duration (3 7 hours/day). In addition, the interaction of less physically active (≤2 hours/week) and high adherence to anemia-inflammatory dietary pattern was positively correlate with the risk of anemia (OR = 1.10, 95% CI: 1.03, 1.18, RERI = 0.18, 95% CI: 0.02, 0.34, AP = 0.15, 95% CI: 0.08, 0.23, all Pinteraction < 0.05). ConclusionsSmoking, less sleep duration (<6 hours/day), less physical activity (≤2 hours/week), and high adherence to anemia-inflammatory dietary pattern are associated with an increased risk of anemia. Funding SourcesThis study had no funding source.

Associations of Lifestyle Factors with Osteopenia and Osteoporosis in Polish Patients with Inflammatory Bowel Disease.

Reduced physical activity (PA), smoking, and coffee and alcohol drinking constitute risk factors of osteoporosis in patients with inflammatory bowel disease (IBD). The aim of the study was to measure the bone mineral density (BMD) and frequency of osteopenia and osteoporosis in patients with IBD and their correlation with PA, smoking, coffee, and alcohol. The study group consisted of 208 patients with IBD-103 with Crohn’s disease (CD), 105 suffering from ulcerative colitis (UC). Densitometric measurements were performed using the DXA. All patients completed a questionnaire concerning PA, smoking, and coffee and alcohol consumption. The prevalence of osteopenia and osteoporosis (L2–L4) in the IBD group was 48.1%; in the CD group, it amounted to 48.6%, and in the UC group, the prevalence was equal to 33.3%. Patients with CD who were diagnosed with osteopenia and osteoporosis demonstrated reduced PA compared to patients with a normal BMD who exercised regularly (p = 0.0335). A similar observation was made in the group of women with IBD. Women with a normal BMD exercised significantly more often than women suffering from osteopenia and osteoporosis (p = 0.0146). However, no differences in BMD were observed with regard to coffee use, alcohol consumption, or smoking. Thus, since the incidence of osteoporosis in IBD patients is high, it may be dependent on PA.

Host traits, lifestyle and environment are associated with human skin bacteria

The human skin offers diverse ecosystems for microbial symbionts. However, the factors shaping skin-microbiome interactions are still insufficiently characterized. This contrasts with the broader knowledge about factors influencing gut microbiota. We aimed to investigate major patterns of association of host traits, lifestyle and environmental factors with skin bacteria in two German populations. This is a cross-sectional study with 647 participants from two population-based German cohorts, PopGen (n=294) and KORA FF4 (n=353), totalling 1794 skin samples. The V1-V2 regions of the 16S ribosomal RNA (rRNA) gene were sequenced. Associations were tested with two bacterial levels, community (beta diversity) and 16S rRNA gene amplicon sequence variants (ASVs). We validated known associations of the skin microbiota with skin microenvironment, age, body mass index and sex. These factors were associated with beta diversity and abundance of ASVs in PopGen, which was largely replicated in KORA FF4. Most intriguingly, dietary macronutrients and total dietary energy were associated with several ASVs. ASVs were also associated with smoking, alcohol consumption, skin pH, skin type, transepidermal water loss, education and several environmental exposures, including hours spent outdoors. Associated ASVs included members of the genera Propionibacterium, Corynebacterium and Staphylococcus. We expand the current understanding of factors associated with the skin bacterial community. We show the association of diet with skin bacteria. Finally, we hypothesize that the skin microenvironment and host physiology would shape the skin bacterial community to a greater extent compared with a single skin physiological feature, lifestyle and environmental exposure.

Metabolic syndrome and lifestyle-associated factors in the ethnically diverse population of Khuzestan, Iran: a cross-sectional study.

Metabolic syndrome (MetS) is a cluster of risk factors, mainly central obesity, insulin resistance, and dyslipidemia, leading to life-threatening cardiovascular diseases. The prevalence of MetS can vary based on different ethnicities and many cultural and lifestyle factors. We aimed to evaluate the prevalence of MetS and possible correlations with lifestyle-associated factors among different ethnicities in Khuzestan, Iran. This cross-sectional study was conducted in Khuzestan province of Iran, among 30,504 participants aged 20-65years, between October 2016 and November 2019. Data was collected through questionnaires along with anthropometric and biological measurements. The National Cholesterol Education Program Adult Treatment Panel III definition was used to estimate MetS prevalence. Overall, 31.9% (95% CI 31.4-32.4) had MetS (34.2% [95% CI 33.3-35.1] among males; 30.7% [95% CI 30.0-31.3] among females [p < 0.001]). Central obesity, elevated fasting blood sugar levels, and dyslipidemia were the most common abnormalities among those with MetS. The risk of MetS was estimated to increase by age, male gender, residing in urban regions, lower educational levels, lower physical activity levels, lower sleep time, and a positive family history of diabetes mellitus (p < 0.001). Individuals of the Arab and Bakhtiary ethnicities had the highest and lowest risk of MetS, respectively. MetS prevalence varied among different ethnicities. Aging and some lifestyle-associated factors such as physical activity and sleep time were related to the risk of MetS. Raising awareness about risk factors of MetS would be of great value in setting new health policies to manage the rising trend of MetS.

Associations between family social circumstances and psychological distress among the university students of Bangladesh: To what extent do the lifestyle factors mediate?

BackgroundWhile there is a growing body of empirical studies focusing on the social and behavioral predictors of psychological health, the mechanisms that may underlie the reported associations have not been adequately explored. This study aimed to examine the association of social and lifestyle factors with psychological distress, and the potential mediating role of the lifestyle factors in the estimated associations between social circumstances and psychological distress.MethodsA total of 742 tertiary level students (53% females) from a range of socio-economic backgrounds and multiple educational institutions participated in this cross-sectional study. The 12-items General Health Questionnaire (GHQ-12) was utilized for measuring psychological distress. Data related to students’ socio-demographic characteristics, family social circumstances, and lifestyle factors were also collected. Modified Poisson regression analysis was used to estimate the risk ratios (RR) and their 95% confidence intervals (CI).ResultsThe multivariable regression analysis suggests heightened risks of psychological distress associated with low parental Socio-Economic Position (SEP) (RR: 1.36; 95% CI: 1.07, 1.76), childhood poverty (RR: 1.31; 95% CI: 1.11, 1.55), and living away from the family (RR: 1.28; 95% CI: 1.07, 1.54). Among the lifestyle factors, past smoking, physical inactivity, inadequate fruit intake, and poor sleep quality were strongly associated with psychological distress and these associations persisted when the family social circumstances and lifestyle factors were mutually adjusted for. The lifestyle factors did not considerably mediate the estimated associations between family social circumstances and psychological distress.ConclusionThe social and lifestyle factors operated independently to increase students’ risk of psychological distress. Accordingly, while promoting students’ healthy lifestyles may reduce the overall burden of psychological distress, any equity initiative aiming to minimize the social inequalities in psychological health should be targeted to improving the living conditions in early life.

Lifestyle factors and venous thromboembolism in two cohort studies

IntroductionEvidence on the associations of lifestyle factors with venous thromboembolism (VTE) is inconsistent. We aimed to investigate the associations of modifiable lifestyle factors with VTE in women and men. MethodsWe used data from two cohorts comprising 30,137 women and 36,193 men aged over 45 years and free of cancer and VTE. Information on lifestyle factors was collected in 1997 via a self-administrated questionnaire. VTE cases were ascertained by linkage with the National Patient Register until the end of 2019. ResultsDuring a mean of 16.9-years follow-up, 1784 women and 2043 men were diagnosed with VTE. Compared with individuals with <10 min/day of physical activity, the multivariable hazard ratios (HRs) of VTE were 0.67 (95% confidence interval (CI), 0.58, 0.79) and 0.78 (95% CI, 0.67, 0.92) in women and men with >60 min/day, respectively. Compared with individuals with the lowest adherence to a modified Dietary Approaches to Stop Hypertension diet, the multivariable HRs of VTE were 0.87 (95% CI, 0.75, 0.99) and 0.88 (95% CI, 0.80, 1.00) for women and men with the highest adherence. In women, the multivariable HRs of VTE were 1.16 (95% CI, 1.03, 1.29) for past smoker and 1.28 (95% CI, 1.14, 1.45) for current smoker compared with never smoker. Alcohol and coffee consumption were not associated with VTE. ConclusionsThis study suggests that being physically active and adhering to a healthy diet may lower the risk of VTE in women and men. Cigarette smoking was positively associated with VTE in women.