Lifestyle Choices Research Articles

Effects of multidisciplinary therapy on energy balance, inflammation, and metabolic diseases in adolescents with obesity: A narrative review.

Obesity is a consequence of multiple factors, including genetics, lifestyle and nutritional choices, physical activity, sleep duration, screen time, and mood disorders. These behavioral elements can impair the regulation of energy balance and obesity management that link obesity to a constellation of chronic conditions that lead to a high prevalence of cardiometabolic risk factors, metabolic syndrome, and nonalcoholic fatty liver disease. Multidisciplinary therapy is defined as an approach delivered by a multidisciplinary-trained health team covering at least two components of behavior, physical activity/exercise, dietary habits, and/or psychological counseling associated with clinical interventions. This narrative review summarizes the effects of multidisciplinary therapy on neuroendocrine regulation of energy balance, inflammatory biomarkers, cardiometabolic risk factors, metabolic syndrome, nonalcoholic fatty liver diseases, behavior, and quality of life. We found that multidisciplinary therapy, including medical, nutritional, exercise, and behavioral counseling, and/or education, was useful for addressing outcomes such as visceral adiposity, neuroendocrine regulation of energy balance, inflammatory biomarkers, cardiometabolic risk factors, nonalcoholic fatty liver disease, and metabolic syndrome. The effects were mediated by improvements in neuroendocrine regulation of energy balance, downregulation of the pro-inflammatory states, and a reduction in comorbidities. Multidisciplinary therapy also improved mood disorders and quality of life.

Decoding determinants of pro-environmental behaviors of higher education students: insights for sustainable future

Purpose The investigation of pro-environmental behaviors (PEB) among college students is essential for future sustainability endeavors. Existing research seldomly concentrated on college students and their PEB. This study aims to address the gap in understanding PEB among college students. Design/methodology/approach This study constructed an integrated model combining the theory of planned behavior (TPB) and the value-belief-norm (VBN) theory, with the novel addition of environmental risk perception. Through an empirical study involving 844 college students, this research analyzed the data with the structural model. Findings The authors identified that environmental values, attitudes, perceived behavioral control, subjective norms and risk perception play crucial roles in shaping PEB. This study also revealed age-related differences, highlighting that older students might be less influenced by attitudes and subjective norms due to more established habits. Findings underscore the importance of fostering PEB through environmental education, promotion of low-carbon lifestyle choices and incentives. This investigation not only enriches the theoretical framework for PEB but also offers practical insights for policymakers and educators to enhance sustainable practices among the youth. Research limitations/implications Though the authors offer valuable findings, this research has two key limitations: the use of observational data for hypothesis testing, which weakens causal inference, and the collection of data through questionnaires, which may be biased by social desirability. Respondents of self-report tend to behave in the socially desired ways. Consequently, they usually exaggerate their pro-environmental intention or PEB. To comprehend the influencing aspects more thoroughly, future research should consider incorporating experimental methods and objective data, such as digitalized data. Practical implications The findings provide valuable evidence for guiding college students’ PEB, including strengthening environmental education, promoting of low-carbon fashion and providing incentives for PEBs. Originality/value First, the authors examine the internal factors influencing PEB among Chinese university students within the “dual-carbon” initiative framework. Second, this research pioneers the use of structural equation modeling to merge TPB and VBN theories, offering a predictive model for university students’ PEB. Third, the authors introduce “environmental risk perception” as a novel variable derived from both TPB and VBN, enhancing the model’s explanatory power.

The Anti-Elixir Triad: Non-Synced Circadian Rhythm, Gut Dysbiosis and Telomeric Damage.

Aging is an inevitable life process which is accelerated by lifestyle and environmental factors. It is an irreversible accretion of molecular and cellular damage associated with changes in the body composition and deterioration in physiological functions. Each cell (other than stem cells), reaches the limit of its ability to replicate, known as cellular or replicative senescence and consequently, the organs lose their physiological functions resulting in overall impairment. Other factors that promote aging include smoking, alcohol, UV rays, sleep habits, food, stress, sedentary life style and genetic abnormalities. These stress factors, can alter our endogenous clock (the circadian rhythm) and the microbial commensals. As a result of effect of these stressors, the microorganisms that generally support human physiological processes become baleful. The disturbance of natural physiology instigates many age-related pathologies, such as cardiovascular diseases, chronic obstructive pulmonary disorder, cerebrovascular diseases, opportunistic infections, high blood pressure, cancer, diabetes, kidney diseases, dementia, and Alzheimer's disease. The present review covers the three most essential processes of the circadian clock; the circadian gene mechanism and regulation, the mitotic clock (which plays a vital role in the telomere's attrition) and gut microbiota and their metabolome that drive aging and lead to age-related pathologies. In conclusion, maintaining a synchronized circadian rhythm, a healthy gut microbiome and telomere integrity is essential for mitigating the effects of aging and promoting longevity. The interplay among these factors underscores the importance of lifestyle choices in enhancing overall health and lifespan.

Effects of Kalimeris indica on alcohol-induced liver injury through storing Nrf2/HO-1 pathway and gut microbiota

BackgroundKalimeris indica (L.) Sch. Bip., (K. indica) is a plant classified under the genus Kalimeris within the Asteraceae family. The herb of K. indica has been historically utilized as a traditional medicine. The consumption of excessive amounts of alcohol represents a lifestyle choice that can induce tissue damage and contribute to the development of various health conditions.MethodThe HPLC-MS method was used to reveal the chemical composition of K. indica extract. HepG2 cells were used to test the in vitro oxidative stress. C57BL/6 mice were used to construct the in vivo alcohol-induced liver injury. H/E staining and serum ALT and AST levels were tested to assess the in vivo protective effect of ML (50 and 200 mg/kg). GSH, SOD, and CAT levels along with byproduct MDA levels were used to evaluate the in vivo oxidative stress. Immunohistochemical experiments were used to examine the in vivo Nrf2 and HO-1 levels. 16S rRNA gene-based profiling method was used to test the alteration in gut microbiota.Results16 compounds were identified from K. indica extract. K. indica treatment reduced oxidative stress in HepG2 cells treated with 5% alcohol. H/E staining results showed that K. indica (50 and 200 mg/kg) alleviated liver injury caused by alcohol administration, eliciting a similar protective effect to the positive drug silymarin. Serum ALT and AST examination gave a consistent result, showing that ML could restore serum ALT and AST levels in mice treated with alcohol. Furthermore, K. indica could also restore GSH, SOD, CAT, and MDA levels in alcohol-treated mice, showing a potent effect on oxidative stress alleviation. Immunohistochemical experiments indicated that K. indica showed the liver protective effect through Nrf2/HO-1 pathway. 16S rRNA gene-based profiling revealed that alcohol treatment caused the alteration in gut microbiota, while K. indica treatment could result in a significantly richer variety of microbial communities compared to the alcohol group.ConclusionK. indica (ML) has a protective effect on liver injury caused by alcohol administration. The Nrf2/HO-1 pathway and gut microbiota regulation were involved in the ML-induced liver protection. All the results indicate that K. indica has a potential in the treatment of alcohol-induced liver injury.

Guided self help for binge eating in diabetes Binge eating and type 2 diabetes: POSE-D pilot.

People with type 2 diabetes are more likely to experience binge eating than the general population, which may interfere with their diabetes management. Guided Self-Help (GSH) is one of the recommended treatment options for binge eating disorder, but there is currently a lack of evidenced treatment for binge eating in individuals living with type 2 diabetes. The aims of this pilot study were to test the feasibility and acceptability of recruiting and delivering the adapted, online Working to Overcome Eating Difficulties GSH intervention to adults with T2 diabetes and binge eating. The intervention comprises GSH materials presented online in 7 sections delivered over 12-weeks, supported by a trained Guide. 22 participants were recruited in a case series design to receive the intervention and we interviewed 4 Guides and 5 participants afterwards. We measured binge eating, mental wellbeing, quality of life and weight at pre-post and 12-week follow-up. Results showed a significant reduction in binge eating at the end of the intervention, which continued to improve at follow-up. Before the programme 92% of participants scored above cut-off for binge eating. This reduced to 41% post-intervention and no-one at follow-up. These changes were accompanied by significant improvements in depression, anxiety and small changes in eating disorder symptoms. Participants reported making better lifestyle choices, eating more mindfully, and having increased self-confidence. The study shows preliminary evidence for online GSH tailored to the needs of individuals with T2D as a feasible and acceptable approach to improving binge eating, diabetes management and mental wellbeing.

A Systematic Review Exploring Dietary Behaviors, Psychological Determinants and Lifestyle Factors Associated with Weight Regain After Bariatric Surgery

Background: Weight regains after bariatric surgery presents a significant challenge to long-term weight management and overall health outcomes. While clinical and surgical factors influencing bariatric outcomes have been extensively reviewed, there remains a notable gap in understanding how behavioral factors—specifically dietary habits, psychological influences, and lifestyle choices—impact long-term weight maintenance. This systematic review addresses this gap, highlighting the unique role of these behavioral factors in sustaining weight loss post-bariatric surgery. Aim: This systematic review aims to explore the behavioral factors—including dietary, psychological, and lifestyle influences—associated with weight regain after bariatric surgery. Methods: A comprehensive search was conducted across multiple databases, focusing on peer-reviewed articles published in English. We included observational studies exclusively focused on adults who experienced weight regain after bariatric surgery, with an emphasis on behavioral factors. Searches were conducted in MEDLINE via PubMed, Embase, Web of Science, Scopus, and Google Scholar, with the last search completed on 10 July 2024. Studies published within the past 10 years were considered. The Joanna Briggs Institute (JBI) critical appraisal tool for cross-sectional studies was used to assess the risk of bias. A total of 16 studies met the inclusion criteria: 12 cross-sectional studies, 3 cohort studies, and 1 in-depth interview study. Results: The review found inconsistencies in the definitions of weight regain across studies. Nonetheless, three primary behavioral factors were identified as potentially contributing to weight regain: dietary non-adherence and eating patterns, psychological determinants, and lifestyle behaviors. Dietary non-adherence included high-calorie food consumption, excessive intake of sweets, carbohydrates, and sweetened beverages, and low protein intake. Psychological factors such as depression, anxiety, emotional eating, and binge eating were prevalent among individuals experiencing weight regain. Lifestyle behaviors, including physical inactivity, smoking, and sedentary habits, also played significant roles. Conclusions: Post-bariatric weight management is multifaceted, necessitating a comprehensive approach that addresses dietary, psychological, and lifestyle factors. Most studies on behavioral factors linked to weight regain were cross-sectional with small sample sizes, limiting the ability to infer causality. Future research should include detailed information on dietary adherence, standardized tools to assess physical activity and sedentary behavior, and validated measures for psychological health. Tailored interventions and continuous support from healthcare professionals are essential for maximizing the effectiveness of bariatric surgery, promoting sustainable weight loss, and enhancing overall health outcomes.

Influence of Socioeconomic Factors and Nutritional Advice on Diet Quality in Women of Reproductive Age: A FIGO-DQS Assessment

Background/Objectives: Nutritional knowledge, attitudes, and practice are important ways of assuring a healthy pregnancy start, which can be shaped during the pre-pregnancy period by the intervention of healthcare providers. In this cross-sectional study, the main objective was to explore contextual determinants of diet quality in women of fertile age, including socioeconomic factors and sources of information. Methods: Data on socioeconomic background, sources of nutritional advice, and determinants of food choices were collected through an anonymous web-based questionnaire completed by 465 women. Diet quality was assessed with the International Federation of Gynaecology and Obstetrics diet quality score (FIGO-DQS). Results: Better food choices (OR = 1.73; 95% CI: 1.16–2.51), higher knowledge level (OR = 1.66; 95% CI: 1.119–2.466), and healthcare advice (OR = 1.70, 95% CI: 1.119–2.466) increased the chances of having a better diet. Both healthcare providers (β = 0.503, p = 0.018) and determinants of food choices (β = 0.520, p = 0.011) had a significant influence on the FIGO score, although the advice provided by the healthcare professionals did not yield a significant influence on the determinants of food choices (β = 0.310, p = 0.125); Conclusions: Knowledge had a mediator effect on the impact of healthcare guidance on nutrition practices, but it does not fully explain the adherence to healthy lifestyle choices.

Mental health and lifestyle-related behaviors in medical students in a Jordanian University, and variations by clerkship status

BackgroundThe rigors of medical education often take a toll on students' mental well-being, resulting in heightened stress, anxiety, depression, somatization, and thoughts of self-harm. This study aimed to determine the prevalence of mental health problems among Jordanian medical students (Yarmouk University), explore the links between mental state and demographic and lifestyle factors, and compare mental health profiles between pre-clinical/pre-clerkship (years 1–3) and clinical/clerkship (years 4–6) students.MethodsAn online survey was distributed to undergraduate medical students at Yarmouk University. Mental health was measured using validated tools (depression: Patient Health Questionnaire, PHQ-9; eating disorders: SCOFF; Generalized Anxiety Disorder Scale, GAD-7; Somatic Symptoms: Patient Health Questionnaire, PHQ-15; overall stress (single-item measure); ability to handle stress; stressors and coping mechanisms. Data on sociodemographic factors, academic performance, and lifestyle choices, also were collected. Bivariate and multivariable analyses evaluated the associations between academic level and mental health, accounting for sociodemographic and lifestyle factors.ResultsOf the 618 medical students who responded, 48.4% screened positive for depression, 36.7% for anxiety, and 63.6% for high level of stress. Slightly over half experienced somatic symptoms, and 28.6% exhibited signs of eating disorders. Roughly, 26% had suicidal thoughts, as measured by item 9 of the PHQ-9 scale. Low reported rates of healthy behaviors were observed (e.g. balanced diets, 5.7%; vigorous physical activity, 17.0%). Smoking prevalence was 24.6%, notably higher among clinical students. At the multivariable level, stress, insomnia, eating disorders and cigarette smoking were significantly associated with depression, anxiety and somatization. Higher physical activity scores were associated with lower depression risk. Females were significantly more likely than males to fall in more severe somatization categories.ConclusionThis study highlights the need to address the alarming rates of mental health problems among Jordanian medical students. While few significant differences were observed between pre-clinical and clinical students, the high rates of depression, anxiety, stress, and negative health practices in both groups suggest the need for interventions that begin at enrollment as well as during transitions to clinical settings. Prioritizing mental health support and promoting healthier lifestyles among medical students are vital steps toward nurturing resilient, well-rounded future medical professionals.

The Role of Socioeconomic Factors in Shaping Health Outcomes among Vulnerable Populations

Socioeconomic factors, including income, education, employment, and social support, play a pivotal role in shaping health outcomes, particularly among vulnerable populations. This paper examines how these determinants interact to influence physical and mental health disparities. Drawing on data from multiple studies, the paper highlights the compounded impact of socioeconomic deprivation on access to healthcare, exposure to stressors, and lifestyle choices. Vulnerable populations, such as low-income families, ethnic minorities, and individuals with limited educational attainment, experience disproportionate health risks. This review underscores the need for targeted interventions to address socioeconomic inequalities, which are essential for improving public health and reducing disparities. Emphasis is placed on policy implications, including the need for accessible healthcare, education, and employment opportunities, to promote health equity across socioeconomic groups.

A protocol for linking participants’ retailer ‘loyalty card’ records into the Avon Longitudinal Study of Parents and Children (ALSPAC)

Longitudinal population studies (LPS) have a long history of providing insights into how individual consumption patterns and other lifestyle choices affect health and socio-economic outcomes. LPS typically operate as research databanks, integrating rich and deep phenotypic data - covering diverse aspects of individual, family and household status - with genomic data and linked records on health and socio-economic outcomes. However, individual consumption and behavioural choices are traditionally studied solely using self-report methods which are prone to known biases. We propose to enrich LPS databanks with a new form of digital footprint data – individual shopping history records. These are collected by supermarkets through “loyalty” card schemes and can provide a new perspective on real world behaviours and history of consumption. However, as a novel class of data in the context of longitudinal research, our ability to assess the quality and completeness of the data is unknown, as is our ability to effectively triangulate between self-reported and linked data. This paper describes a protocol for linking individual level shopping history data into a LPS using Avon Longitudinal Study of Parents and Children (ALSPAC) as a testbed. The protocol covers the process of establishing participant fair processing, an ethical and legal basis for the linkage framework itself, and how these data will be integrated into the ALSPAC databank. It does not cover the subsequent research use of these data. The protocol was built on an extensive participant engagement and acceptability work and has been approved by the ALSPAC Law and Ethics committee.

From Viral Content to Real-Life Cuisine and Beyond: Examining Teenagers' Interactions with TikTok Food Videos and the Influence on their Food Practices

TikTok has gained immense popularity among teenagers, offering access to numerous user-generated content. Notably, food videos have emerged as a prominent theme on this short-form video social platform. The casual and enjoyable nature of short food videos on TikTok belies their potential influence on one of teenagers' most immediate and regular health practices--eating. Understanding how teenagers interact with these videos, their subsequent actions, and the resulting impact on their food practices and eating habits have the potential to provide insight into their broader lifestyle choices and their interactions within their social circles, including parents, friends, and other people online. By examining how teenagers use TikTok food videos online and offline, we gain a deeper understanding of the intricate relationship between social media, teenage lifestyle, and social dynamics surrounding food practices. In this research, we conducted 15 semi-structured interviews with teenagers aged 13 to 19, investigating their consumption of TikTok food videos and the actions inspired by them. By examining the multifaceted influence of TikTok food videos from a temporal perspective, this study contributes to the reflections of teens' use of TikTok food videos and their inspired food practices in the short and long term, online and offline. We propose design and theoretical implications to support teenagers' health. These insights have the potential to extend to various contexts, helping educators, policymakers, and designers in fostering healthy lifestyles among teenagers.

Blood circulation effect of fermented citrus bioconversion product (FCBP) in EA.hy926 endothelial cells and high-fat diet-fed mouse model.

The escalating global burden of cardiovascular diseases, largely driven by unhealthy lifestyle choices and dietary patterns, has intensified the search for effective and safe interventions. With current treatments often marred by significant side effects, the exploration of natural compounds such as flavonoids presents a compelling alternative. This study investigated the effects of fermented citrus bioconversion product (FCBP), a fermented citrus bioflavonoid, on various markers of cardiovascular health in the context of a high-fat diet. In vivo, a high-fat diet-induced mouse model was used to assess the effects of FCBP on body weight, serum nitric oxide (NO) levels, activated partial thromboplastin time (aPTT), phosphatidylserine (PS) exposure on red blood cells, and the expression of inflammatory markers Intercellular Adhesion Molecule (ICAM)-1 and Vascular Cell Adhesion Molecule (VCAM)-1 in the thoracic aorta. In vitro, EA.hy926 endothelial cells were used to evaluate the compound's effects on cell viability, NO production, endothelial nitric oxide synthase (eNOS) expression, and cell adhesion molecule (CAM) levels to further understand the mechanisms behind the in vivo findings. In vivo, FCBP supplementation led to a dose-dependent reduction in weight gain, a significant decrease in serum NO levels at 10 mg/kg, and reduced ICAM-1 and VCAM-1 expressions in the thoracic aorta, indicating anti-inflammatory properties. PS exposure on red blood cells was also reduced, suggesting decreased procoagulant activity, while aPTT remained unchanged. In vitro, FCBP was non-cytotoxic to endothelial cells, showed a trend toward increased NO production and eNOS expression, and reduced the expression of ICAM-1 and VCAM-1, supporting its potential anti-inflammatory effects. FCBP demonstrates potential as a bioactive compound for managing cardiovascular health by reducing inflammation, mitigating weight gain, and influencing blood circulation-related parameters under high-fat diet conditions. Further studies, including diverse models and human trials, are warranted to elucidate its mechanisms and compare its efficacy with established cardiovascular therapeutics.

Information seeking behaviour of informal caregivers at the premier tertiary teaching hospital in Nigeria

This study was conducted to examine the information behaviour of informal caregivers in a university college hospital in Ibadan, Nigeria. Informal caregivers in the teaching hospitals constitute critical pubic health care players whose information behaviours have not been studied. Data was collected from 208 caregivers using a questionnaire that consisted of structured and open-ended questions. The study found that healthcare providers were the primary source of health for caregivers, with 34.1% actively seeking information from them. The caregivers seldom utilised sources like the internet, community organizations, books, family, and friends. The preference for healthcare providers as sources is due to their accessibility and ability to provide prompt and accurate answers. Caregivers have diverse information needs, including medication-related information, first aid techniques, nutrition, exercise, mental health, and lifestyle choices. They seek this knowledge to make informed decisions that improve their loved ones’ well-being. The study also revealed that caregivers heavily rely on information technology for health information due to its accessibility and reliability. The study highlights the need for ongoing training and proactive information sharing by healthcare providers to better support informal caregivers in Nigeria, emphasizing the importance of integrated support systems within healthcare facilities. To meet diverse information needs, healthcare institutions should diversify dissemination strategies, including culturally sensitive materials and digital literacy programs, while developing tailored mobile applications and online support communities for caregivers. Policymakers must focus on creating supportive healthcare policies, funding caregiver programs, and expanding insurance coverage to alleviate financial burdens, ensuring that caregivers have access to necessary resources and information.

A Comprehensive Review of Breast Cancer: Prevalence, Diagnosis, and Gender Disparities

Breast cancer remains a leading cause of cancer-related morbidity and mortality worldwide, with significant variations in prevalence, diagnosis, and outcomes across different regions and genders. This comprehensive review examines the global and regional epidemiology of breast cancer, highlighting the increasing incidence driven by demographic changes, lifestyle factors, and urbanization. It explores the impact of gender on breast cancer, noting unique challenges faced by men and women, including diagnostic delays and treatment disparities. The review delves into the risk factors associated with breast cancer, such as genetic mutations, hormonal influences, and lifestyle choices, and discusses advancements in diagnostic technologies, including mammography, ultrasound, MRI, and emerging tools like liquid biopsies and AI-based imaging. Treatment options are analyzed, focusing on personalized medicine, targeted therapies, and the challenges of therapy resistance and recurrence. Preventive strategies, including lifestyle modifications, prophylactic surgeries, and chemoprevention, are reviewed alongside public health initiatives aimed at increasing awareness and screening. The psychosocial impact of breast cancer on patients and their families is also addressed, emphasizing the need for supportive care, patient advocacy, and integrative approaches to improve quality of life. The review concludes with recommendations for future research, policy initiatives, and strategies to address gender disparities and enhance breast cancer care globally. Keywords: Breast Cancer, Epidemiology, Gender Disparities, Risk Factors, Diagnosis

Dry eye disease – how our lifestyle choices can affect the disease?

Introduction: In today’s world, we know how important it is to keep healthy habits because many diseases begin with daily lifestyle choices. Dry eye disease is a disease of the ocular surface and there are many risk factors, that lead to developing this disorder. As the possible factors we can underline deficiency of vitamin D or Omega-3 fatty acids, lack of physical exercise, long screen time, or smoking tobacco. Aim of the study: This review seeks to highlight the issue of dry eye disease linked to everyday routines by examining clinical trial outcomes. Furthermore, it offers an analysis of potential strategies to prevent ocular alterations by critically evaluating the existing data. State of knowledge: The listed lifestyle choices cause a higher risk of developing dry eye disease and affect ocular health on many levels, leading to unpleasant feelings and affecting people’s lives. However, with some lifestyle changes, the risk of developing this disease can be decreased, and negative symptoms can be minimized. It is important to remember vitamin D, and Omega-3 supplementation, daily physical activity, minimalization of the time spent in front of the visual display terminals, and quitting smoking. Conclusions: Many daily habits are connected to developing dry eye disease, and it is very important to remember about the small daily changes, which can decrease the risk of the disease.

The Impact of K-pop on Chinese Fan Culture

The influence of K-pop as a global cultural phenomenon extends beyond just music and fashion - it also impacts social patterns in today’s society. This study seeks to delve into the unique characteristics of K-pop and how it shapes the lives of its fans. By conducting surveys through questionnaires, the author has uncovered the profound impact that K-pop has had on Chinese fans in both life and spiritual aspects. In terms of lifestyle choices, it is evident that K-pop has left an indelible mark on its followers. Fans have adopted new aesthetic preferences inspired by their favorite idols while also adapting their language style and even eating habits based on what they see from these stars. It is common for enthusiasts to emulate the appearance and behavior of their beloved idols as a means to establish their own sense of identity. Furthermore, at a deeper level - spiritually - we found that K-pop has significantly shaped the outlooks held by its followers towards life itself along with influencing their consumer behaviors as well as criteria for selecting potential partners or mates. The resilience exhibited by these idols serves not only as inspiration for remaining optimistic during personal challenges but also prompts shifts in personal aspirations leading towards self-realization.

Exploring non-smokers’ attitudes toward e-smoking: results from the Minerva Project Europe

Abstract Background In the shifting paradigm of tobacco use, the attitudes of non-smokers toward e-cigarettes are crucial for public health planning, as in the literature it has been suggested that non-smokers who use e-cigarettes could be more prone to switch to tobacco. This multi-center study investigates the interplay between traditional smoking and the potential benefits of transitioning to e-smoking, through a comprehensive examination of smoking behaviors, dietary, and lifestyle practices. Methods MINERVA (My changINg lifEstyles, our Research, and eVeryone’s heAlth) is an ongoing prospective international cohort study aimed at investigating the association between smoking habits and dietary and lifestyle habits among the study participants. The secondary objective pertains to the assessment of subjects’ willingness to try e-cigarettes. We implemented an univariable logistic regression analysis on a dataset comprising 2367 nonsmokers to identify factors influencing their willingness to smoke e-cigarettes. Results Employment significantly predicted willingness, with employed non-smokers showing a higher likelihood to consider e-smoking (OR 2.5, p = 0.002). Household dynamics, specifically the presence of children, also affected the decision, indicating a protective effect against adopting e-smoking (OR 1.26, p < 0.001). Lifestyle choices, particularly fitness and dietary habits, played a discernible role. Surprisingly, age inversely correlated with the willingness to try e-smoking, as younger non-smokers were more likely to consider it (OR 0.97 per year increase, p < 0.001), suggesting that this openness could increase their risk of future tobacco use, which carries important public health consequences. Conclusions The study’s outcomes underscore the impact of socio-economic and lifestyle factors on non-smokers’ openness to e-cigarettes. These insights are pivotal for devising culturally competent educational campaigns and regulatory policies. Key messages • In the shifting paradigm of tobacco use, the attitudes of non-smokers toward e-cigarettes are crucial for public health planning. • By thoroughly analyzing smoking habits, diet, and lifestyle choices, the Minerva Project research aims to shed light on the complex dynamics between health behaviors and smoking.

Changes in opinions on health insurance benefits deservingness in the Netherlands between 2013-2023

Abstract Background In many European countries, including the Netherlands, the healthcare system is financed according to the principles of solidarity. Although people are generally highly supportive of collectively financed healthcare services, some groups are considered more deserving of health insurance benefits than others. Increasing knowledge of the health risks of certain lifestyle choices and pressure on healthcare systems may result in changing opinions on the allocation of resources. Our study looks into changes in citizen’s opinions on the deservingness of different groups between 2013 and 2023. Methods Questionnaires were sent out to samples of 1.500 members of the Dutch Health Care Consumer Panel in 2013, 2015, 2017, 2019, 2021, and 2023. Response rates varied between 42% (2015) and 56% (2021). Deservingness was studied by asking respondents about their opinions on the amount of health insurance premium for different, opposing groups, for example older and younger people and those with a healthy and unhealthy lifestyle (group A should pay more, both groups should pay the same amount, or group B should pay more). Multinominal logistic regression models were used to examine changes in deservingness opinions over time. Results Our study showed year-to-year fluctuations in opinions on the premium amount for health insurance for different, opposing groups. However, no distinct increases or decreases were observed over the whole time period. This applies to both the general population and to people who do and do not belong to the different groups. Conclusions Although there are differences in the degree to which groups are considered deserving of health insurance benefits, deservingness opinions were found to be fairly stable in the Netherlands between 2013 and 2023. Our results do not point to increasing support for premium differentiation based on personal characteristics. This suggests that support for solidarity in healthcare financing is not in decline. Key messages • Opinions on the deservingness of health insurance benefits of different groups were found to be fairly stable in the Netherlands between 2013 and 2023. • No evidence of increasing support for premium differentiation based on personal characteristics was found.

Healthy lifestyle promotion project among healthcare workers

Abstract Background The psychosocial risks generated from difficult work conditions are damaging not only for the workers’ health and safety, but also have a huge impact on the organization and management efficiency. Description Some of the primary challenges that health workers face are demanding schedules and stressful shift patterns which lead to higher levels of worker burnout. Ensuring the well-being of healthcare staff is crucial not only for the individual workers, but it also brings important lessons to the community creating an environment built on a culture of health. Results In the past year, the Hospital of Cittadella (Province of Padua) has launched a set of programmes structured to help the staff make better lifestyle choices that affect not only their personal life but also create a more sustainable work environment. One of the projects involved various meetings with a Physical Medicine-Rehabilitation physician, a physical therapist, an Occupational Medicine physician and a medical yoga teacher. The encounters, attended by nearly 10% of the hospital staff, were aimed to help healthcare workers create a more balanced lifestyle and to implement physical activity and posture exercises in their daily routine. Four nutrition classes were also organized with the help of a nutritional biologist. The aim of this course was to show the basics of healthy diets supported by scientific data and guide the participants towards realistic and healthy meal plans. Lessons In conclusion, increasing the general wellbeing within the healthcare context is not an easy task, especially when organizational circumstances like staff reduction are being faced. These projects represent a small step towards facing these difficulties. It is important to note that the motivation, collaboration, inclusivity, flexibility and reliance are all elements that contribute to better mental and physical health of the healthcare staff which is crucial on an individual, organizational and societal level. Key messages • Increasing personal well being amongst healthcare workers can help create a more sustainable work environment. • A healthy work environment is crucial for a better functioning organization.

The relationship between sleep quality and emotional eating during the pandemic in Croatian adults

Abstract Background Social isolation during pandemics has adverse effects on sleep quality which in connection with COVID-19 distress facilitates the development of emotional eating patterns in various populations. This study aimed to evaluate the interconnection between sleep quality and emotional eating in the Croatian adult population during the COVID-19 pandemic. Methods This cross-sectional questionnaire study was conducted from February to June 2021 period. A validated, anonymous questionnaire that contained questions regarding demographic data, data on eating habits, and the Pittsburgh Sleep Quality Index (PSQI), was self-administered to a convenient sample of Croatian adults from central and northwestern Croatia. Results The study sample included 939 subjects with, a median age of 42 years (interquartile range 35-48), 35.4% males, and 64.6% females. At the PSQI 22.6% of subjects presented sleep disturbances. Sleep disturbances were more frequent among females (p < 0.001), and inhabitants of the Croatian capital Zagreb (p = 0.001). Subjects with sleep disturbances detected by PSQI during pandemics consumed a larger amount of food than usual (p < 0.001), consumed snacks more frequently (p < 0.001), and cooked more in their households (p = 0.006). Conclusions Poor sleep quality caused by the COVID-19 pandemic led to emotional eating patterns in the Croatian adult population. Health promotion programs directed toward healthy lifestyle choices need to be implemented to successfully tackle observed poor health indicators in the studied population. Key messages • Following the COVID-19 pandemic the obvious deterioration of sleep quality and eating habits is seen in the Croatian general population. • Comprehensive health promotion programs directed toward healthy lifestyle choices adoption are needed.