Longitudinal Survey Of Health Research Articles

Contextualising the job demands-resources model: a cross-sectional study of the psychosocial work environment across different healthcare professions.

The deteriorating psychosocial work environment among healthcare workers in Sweden, influenced by demanding working conditions and resource constraints, affects individual well-being and patient care quality. Healthcare workers, including physicians, registered nurses, and nursing assistants, often work interdependently and share workplaces, yet are three completely different professions. Nonetheless, comprehensive studies comparing their psychosocial work environments are scarce; often focusing on healthcare workers either separately or as a homogenous group, but rarely comparative. Utilising the job demands-resources model, this study investigated variations in the psychosocial work environment among Swedish healthcare workers. We wanted to identify how the antecedents of individual well-being, in the form of demands and resources, differed between healthcare workers. Data from the 2022 Longitudinal Occupational Health Survey for Health Care in Sweden were analysed; the participants included 7589 physicians, registered nurses, and nursing assistants. The analysis involved descriptive statistics, including measures of means and analysis of covariance (ANCOVA), employing the Bonferroni correction for multiple post hoc comparisons. The ANCOVA was also stratified by working factors, including years of work experience and employment within the private/public sector. The study revealed significant variations in how healthcare workers perceive their psychosocial work environment. Physicians faced the highest level of Quantitative Demands (mean (x̄) 3.15; 95% CI 3.11-3.19), while registered nurses reported the most Emotional Demands (x̄ 3.37; 95% CI 3.32-3.41). Nursing assistants had the highest grand means for the imbalance between Efforts and Rewards (Effort Reward Imbalance) (x̄ 1.49; 95% CI 1.49-1.49) and an imbalance between Work and Private Life (Work-Life Interference) (x̄ 3.20, 95% CI 3.15-3.25), along with limited resources. The stratified analysis showed that years of experience and the sector affected healthcare workers' perceptions of their psychosocial working environment. For example, registered nurses working in the private sector reported better working conditions thanregistered nurses working in the public sector. The situation for nursing assistants was reversed. Psychosocial work environments are experienced differently between and within healthcare professions in Sweden. This study provides crucial insights for improving workplace conditions and consequently enhancing healthcare professionals' well-being and quality of patient care.

Abstract 4135338: Associations between plant-based diets and total mortality among Chinese older participants with cardiometabolic diseases: a prospective cohort study

Background and Aims: Plant-based diets have been associated with a lower risk of total mortality among generally health populations. However, the associations of plant-based diets with total mortality remain unclear among older people with cardiometabolic diseases, who have an elevated risk of mortality. Methods: We prospectively followed 4,485 participants (mean age: 84 years) from the China Prospective Longitudinal Survey of Health and Longevity (2006-2018), who had cardiometabolic disease in 2006. Dietary data were collected at baseline using a food-frequency questionnaire. Using these data, we created an overall plant-based diet index (PDI), in which plant-based foods received positive scores while animal foods (meat, fish and aquatic products, eggs, milk, animal fats) received reversed scores accordingly. We also created a healthful plant-based diet index (hPDI), where healthy plant-based foods (whole grains, vegetables, vegetable oils, fresh fruits, legumes, beans, garlic, nuts, tea) received positive scores, while less healthy plant-based foods (refined grains, pickles, sugar, preserved vegetables) and animal-based foods were given reversed scores. In addition, an unhealthful plant-based diet index (uPDI) was created by assigning positive scores to less healthy plant-based foods while reverse scores to healthy plant-based foods and animal-based foods. We used Cox proportional hazards regression to compute hazard ratios (HRs) and 95% CIs for total mortality, with adjustment for demographics, dietary and lifestyle factors, and medical history. Results: During a 12 years of follow-up, 2,881 deaths were recorded. A higher score from PDI and hPDI was associated with a lower risk total mortality among participants with cardiometabolic diseases (HR and 95% CI for extreme quintiles of PDIs: 0.85, 95% CI 0.75–0.96, P trend < 0.001; hPDI: 0.84 (0.74–0.94), P trend < 0.001). A higher uPDI score was associated with a higher total mortality among participants with cardiometabolic diseases (uPDI: 1.28 (1.13-1.47), P trend < 0.001). These results were consistent in subgroup analyses by age, sex, smoking status, alcohol consumption, education level, physical activity, and BMI. Conclusion: Our study suggests that among older Chinese participants with cardiometabolic diseases, adherence to an overall plant-based diet or a healthful plant-based diet, is associated with a lower total mortality, while an unhealthful plant-based diet was associated with a higher total mortality.

Suicidal ideation and thoughts of self-harm during the COVID-19 pandemic among Swedish employees: a cohort study on the role of job instability and job insecurity

BackgroundSuicidal ideation may be a warning sign for suicide and previous work has indicated a higher prevalence of suicidal ideation during the COVID-19 pandemic. Job loss and job insecurity are potential risk factors for suicidal ideation, but their importance during the pandemic, and the role of organizational changes for suicidal ideation, is unclear. This study examined the association between various experiences associated with job loss and job insecurity during the pandemic and thoughts of suicide/self-harm in Sweden.MethodsThe study sample was drawn from the Swedish Longitudinal Occupational Survey of Health (SLOSH). Auxiliary data collections in February 2021 and 2022 assessed exposure to job loss/unemployment, furlough, workplace downsizing, or increased job insecurity versus stable employment and thoughts of suicide or self-harm (PHQ-9) during the pandemic. The analyses were based on 1558 individuals (2 349 observations) participating in either or both waves and who had been working before the pandemic. Logistic regression models with cluster-robust standard errors were fitted, including sociodemographic factors and prior mental health problems to control for potential confounding. Measures of personality based on a brief version of the Big-Five personality inventory were also added.ResultsThe results indicated an association between all experiences, except furlough, and thoughts of suicide/self-harm, when adjusting for sex, age, civil status, socioeconomic status and prior mental health (job loss odds ratio (OR) = 3.70, 95% confidence interval (CI) 1.79–7.63, downsizing OR = 2.41, CI 1.24–4.70, job insecurity OR = 2.77, CI 1.15–6.67). The associations for job loss and insecurity were attenuated by adjustment for personality, although it remained statistically significant for downsizing.ConclusionsThe results suggested a higher risk of suicidal ideation connected with loss of employment and survival of a downsizing, but not a forced reduction in working times/pay during the COVID-19 pandemic. The association for subjective job insecurity was less robust and may be partly explained by personality.

Prevalence of problem drinking in the Swedish workforce: differences between labour market industries based on gender composition and main job activity

BackgroundIdentifying problem drinking patterns across industries is essential for addressing drinking problems in the workforce. Still, it is not well understood how problem drinking differs across industries and whether it is associated with industry gender composition. This study aimed to measure the prevalence of problem drinking (PPD) across Swedish industries and investigate possible associations between gender-typed industries and problem drinking.Methods9,155 current workers were selected from the Swedish Longitudinal Occupational Survey of Health (SLOSH) data collected in 2020. Participants’ work industries were identified through the Swedish Standard Industrial Classification (SNI) codes. Seven gender-typed industry categories were created based on gender composition and main job activity in each industry. Self-reported problem drinking was measured using a slightly modified Cut-down, Annoyed, Guilt, Eye-opener (CAGE) questionnaire and a cut-off score 2 was used to determine problem drinking. Poisson regression with robust standard errors was used to investigate the association between gender-typed industries and problem drinking.ResultsPPD in the workforce was 6.6%. Men (8.5%) had a higher prevalence than women (5.3%). Across industries, PPD varied from 2.3% in Water supply and waste management to 15.4% in Mining and quarrying. The highest prevalence for men was in Mining and quarrying (18.2%), whereas for women it was in Construction (11.1%). Within gender-typed industries, the highest PPD was in male-dominated Goods and Energy Production (7.7%), and the lowest was in female-dominated Health and Social Care (4.7%). In the regression analysis, both Education (aPR: 1.39, p = 0.03) and Labour-intensive Services (aPR: 1.39, p = 0.02) had higher adjusted prevalence ratios (aPR) compared with Health and Social Care. However, there was no significant difference in aPR among gender-typed industries when considering the gender composition of industries only.ConclusionsPPD in the Swedish workforce varied significantly across industries, with differences observed between men and women. Problem drinking differed between industries when categorized by gender composition and main job activity, but not when categorized by gender composition only. Future research should investigate how industry-specific psychosocial factors influence individual alcohol consumption.

Relationship between sleep quality and duration and the incidence rate of arthritis: A prospective cohort study.

Little is known about the relationship between sleep duration and quality and the risk of arthritis in the older adult population of China. The participants were a prospective cohort of adults aged 65 years and over who had not had arthritis at baseline and had participated in follow-up surveys from 2011 to 2018 in the Chinese Longitudinal Health and Longevity Survey (CLHLS). A Cox proportional-hazards regression model was established. The dose-response relationship between sleep duration and the incidence of arthritis was analyzed. The results of a Cox proportional-risk regression model revealed that sleep duration and quality were associated with the risk of arthritis in the participants. Specifically, compared with participants with good sleep quality, those with poor sleep quality had a 38% higher risk of developing arthritis (hazard ratio [HR] = 1.38, 95% confidence interval [CI] = 1.09-1.74), and compared with participants with a sleep duration of 5 to 10 hours, those with a sleep duration shorter than 5 hours had a higher risk of developing arthritis (HR = 1.56, 95% CI = 1.27-1.91). Moreover, the results of a restricted cubic spline Cox proportional-hazards regression model showed that there was an approximately non-linear dose-response relationship between sleep duration and the incidence rate of arthritis (P nonlinear < .0001). Participants with poor sleep quality and a sleep duration shorter than 5 hours had a higher risk of developing arthritis than those with better sleep quality and a longer sleep duration.

Association of dietary diversity and weight change with cognitive impairment among Chinese elderly: A prospective national cohort study

BackgroundDietary diversity is reported to be beneficial for cognitive function, while the effect may be offset by weight change status. We aimed to examine the association of dietary diversity and weight change with cognitive impairment among older adults. MethodsWe used three waves from 2008 to 2014 of the Chinese Longitudinal Survey of Health and Longevity, which included 16,954 participants for the subsequent screening and analysis. Dietary diversity information was collected from the food frequency questionnaire. Cognitive function was assessed using the Mini Mental State Examination. The relation of dietary diversity and weight change with cognitive impairment was investigated using Cox proportional hazards models and cubic spline regression. ResultsCompared with those reported poor dietary diversity at baseline, participants with good dietary diversity had a 16 % (hazard ratio [HR] = 0.84, 95 % confidence interval [CI]: 0.71–0.99) lower risk of cognitive impairment. The HR and 95 % CI of participants with consistently good dietary diversity from 2008 to 2011 was 0.71 (0.57–0.89) for cognitive impairment compared to those with consistently poor dietary diversity. Compared with the weight stable group, the HRs and 95 % CI for cognitive impairment were 1.34 (1.10–1.64) in weight loss group, and 1.08 (0.88–1.33) in weight gain group. Restricted cubic splines showed the risk of cognitive impairment decreased with higher dietary diversity score or less weight change, though no significant interaction between dietary diversity and weight change was found. LimitationGiven the observational nature of this study, there might be a reverse causation for the observed association. ConclusionEstablishing and maintaining good dietary diversity were associated with a lower risk of cognitive impairment regardless of weight change status, whereas weight loss was associated with increased cognitive impairment risk independently among older Chinese adults.

Association between cMIND diet and hypertension among older adults in China: a nationwide survey

BackgroundExisting research indicates that the Mediterranean diet has a positive impact on preventing and treating hypertension. However, its specific effect on hypertension among elderly Chinese individuals is unclear.AimsThe objective of this research was to explore the association between the Chinese version of the Mediterranean-DASH Intervention for Neurodegenerative Delay (cMIND) diet and hypertension among elderly Chinese individuals, aiming to offer novel strategies for alleviating the burden of hypertension in this demographic.MethodsIn this study, we used cross-sectional data published in 2018 by the China Longitudinal Health and Longevity Survey (CLHLS) to develop a binary logistic regression model to investigate the correlation between cMIND diet and hypertension in a Chinese elderly population. Restricted cubic spline was used to test for linear associations, and further subgroup analyses were performed to test for interactions.ResultsIn total, 7,103 older adults were included in the study, with a prevalence of hypertension of 39.0%. When the cMIND diet score was used as a continuous variable, a significant protective effect against hypertension was present (OR = 0.955, 95% CI:0.923–0.988, p = 0.008); when used as a categorical variable, this protective effect was still present at higher levels (compared to lower levels) of the cMIND diet (OR = 0.869, 95% CI: 0.760–0.995, p = 0.042).DiscussionAlthough the Mediterranean diet has great potential to reduce the chance of hypertension, it should also consider the effect on the Chinese population. The results of this study provide new ways to reduce the disease burden of hypertension in Chinese older adults and improve quality of life in later life.ConclusionThe cMIND diet can considerably reduce the risk of hypertension among older adults in China.

Impact of work-life interference on burnout and job discontent: A one-year follow-up study of physicians in Sweden.

In recent years, increased physician workload has led to higher levels of interference between work and private life with increasing stress and job discontent. The objective of this paper was to study if the experience of work-life interference (WLI) is associated with a high risk of burnout and discontent with work (turnover intention and job dissatisfaction) the following year among physicians in Sweden. The study applied data for 2021 and 2022 from the Longitudinal Occupational Health survey for Health Care professionals in Sweden study. The data comprised a representative sample of physicians (N=1575) working in Sweden. Descriptive analyses included frequencies and estimates of prevalence with Chi-square and McNemar tests. Analyses of association were assessed through logistic regression reporting odds ratios (OR) and 95% confidence intervals (CI) adjusting for demographics and work-related factors. Higher levels of WLI in 2021 were associated with 1.53 (95% CI 1.05-2.25) times higher odds of reporting a high risk of burnout, 2.06 (95% CI 1.68-2.54) times higher odds of reporting job dissatisfaction, and 1.72 (95% CI 1.47-2.00) times higher odds of reporting turnover intention in 2022. Experiencing WLI negatively affects mental well-being and work satisfaction among physicians in Sweden. This could ultimately impact the quality of care and necessitates further research to clarify the role of WLI among healthcare workers in Sweden.

Community-based health programme for nurses and midwives: A mixed methods evaluation.

To evaluate a community-based psychological health and well-being programme for nurses and midwives. Mixed methods programme evaluation. Four studies were included: observational descriptive study (cross-sectional survey) of the health, well-being and experiences of previous programme participants (Study 1); observational exploratory prospective cohort study (longitudinal survey) of health, well-being and experiences of participants who engaged in the programme from 2020 to 2023 (Study 2); qualitative descriptive study (interviews) of experiences and perceptions of nurses and midwives who have engaged with the programme as participants or clinicians (Study 3); observational descriptive study (cross-sectional survey) of experiences and perceptions of programme stakeholders (Study 4). Surveys included validated measures. Data were collected online. Descriptive, repeated measures and thematic analyses were conducted. One-hundred and fifteen participants completed Study 1: 20% (n = 23) reported stress in the severe-to-extremely severe category; 22% (n = 25) reported psychological distress in the moderate-to-severe category. Thirty-one programme participants were followed in Study 2: the effect of the programme on participant well-being over time was not significant. Sixteen programme participants and eight programme clinicians were interviewed (Study 3). Experiences of nurses and midwives engaging with the programme were highly positive and strong attributes of the programme included (1) shared professional experience of clinicians and participants which supported a common language and facilitated understanding, and (2) effective programme leadership, and autonomy and flexibility in the clinicians' role which enabled and supported a positive working experience. Thirty-nine broader stakeholders participated in a cross-sectional survey (Study 4). All stakeholders reported high satisfaction with the programme. Participants considered the programme being 'by nurses and midwives, for nurses and midwives' critical to the programme's success and value. The community-based psychological health and well-being programme developed, led and delivered by nurses and midwives, for nurses and midwives, was a highly valued resource. Levels of stress and burnout in the health workforce are high. A community-based psychological health and well-being programme for nurses and midwives was found to be an important and highly valued resource for nurses and midwives. A programme delivered by nurses and midwives, for nurses and midwives, was considered critical to programme success. Programme leadership, and autonomy and flexibility in the programme clinicians' roles, facilitated and supported a positive working experience for programme clinicians. Quality and safety in patient care is directly impacted by the well-being of nurse and midwives. A community-based psychological health and well-being programme for nurses and midwives was found to be an important and highly valued resource for nurses and midwives. Survey findings were reported according to STROBE (von Elm etal. in Lancet, 370:1453-1457, 2007) and qualitative findings according to COREQ (Tong etal. in International Journal for Quality in Health Care, 19(6):349-357, 2007). No patient or public contribution.

Social Exclusion Among Older Adults: A Multilevel Analysis for 10 European Countries

Demographic ageing has influenced the well-being of the population. Issues that need to be addressed in terms of generating vulnerability in older adults (aged 60+) include social exclusion. Using the longitudinal Survey of Health, Ageing and Retirement in Europe (SHARE), this study proposes a measure of social exclusion among older adults represented by five underlying dimensions: exclusion from material resources, from social relationships, from basic services, from participation in civic activities and from neighbourhoods. This measure is then associated with individual and collective factors using a multilevel linear regression model, which captures differences between countries and individuals over three years. The main results indicate that being female, having a high level of education, and living in an urban area are significant factors in the risk of social exclusion. Additionally, trust in government has a negative association while the Gini coefficient variable and belonging to Southern and Eastern European countries have positive associations. These regions are characterised by a more family-based, dependent culture, but exclusion in old age is also reflected in different political, historical, and socio-cultural contexts over time, which makes older people less likely to be socially excluded today.

Illegitimate work tasks: an investigation of psychometric properties of the Swedish version of the BITS instrument and its suitability in human versus ‘non-human’ service occupations

BackgroundIllegitimate tasks, i.e. working tasks that are perceived as unnecessary or unreasonable, are commonly measured by the Bern Illegitimate Tasks Scale (BITS). Despite a growing research attention paid to illegitimate tasks, the Swedish version of BITS needs yet to be properly evaluated. Moreover, previous multiorganizational studies in this field have taken for granted, without really testing it, that the instrument functions invariantly in different contexts; a prerequisite for meaningful comparisons.MethodsTwo occupational groups that differs hugely—966 human services workers (teachers and registered nurses) and 750 non-’human service’ workers (construction and IT-workers) were targeted utilizing questionnaires data collected 2018 within the Swedish Longitudinal Occupational Survey of Health (SLOSH) study. Psychometric properties, i.e., reliability, dimensionality, and measurement invariance between the occupations were examined using confirmatory factor analyses and structural equation models. Also, the associations between the two dimensions of illegitimate tasks and job satisfaction and emotional exhaustion, respectively, were tested.ResultsGood reliability was supported and two- versus one-dimensionality showed better psychometric properties. Partial scalar measurement invariance was satisfactory supported with only 25% relaxed constraints of equal intercepts between groups. Examining the two subdimensions revealed different associations with emotional exhaustion, where the associations was more substantial for unreasonable tasks. Nevertheless, the findings point to potential improvements for future investigation.ConclusionsThis study shows that the Swedish version of BITS is working satisfactory and allows for meaningful comparisons of occupational groups. Furthermore, construct validity of the two dimensions was corroborated.

Excess deaths and loss of life expectancy attributed to long-term NO2 exposure in the Chinese elderly

BackgroundEvidence linking nitrogen dioxide (NO2) air pollution to life span of high-vulnerability older adults is extensively scarce in low- and middle-income countries. This study seeks to quantify mortality risk, excess deaths, and loss of life expectancy (LLE) associated with long-term exposure to NO2 among elderly individuals in China. MethodsA nationwide dynamic cohort of 20352 respondents ≥65 years old were enrolled from the China Longitudinal Health and Longevity Survey during 2005–2018. Residential exposures to NO2 and co-pollutants were assessed by well-validated spatiotemporal prediction models. A Cox regression model with time-dependent covariates was utilized to quantify the association of all-cause mortality with NO2 exposure, controlling for confounders such as demographics, lifestyle, health status, and ambient temperature. NO2-attributable deaths and LLE were evaluated for the years 2010 and 2020 based on the pooled NO2-mortality relation derived from multi-national cohort investigations. Decomposition analyses were conducted to dissociate net shift in NO2-related deaths between 2010 and 2020 into four primary contributing factors. ResultsA total of 14313 deaths were recorded during follow-up of approximately 100 hundred person-years (median 3.6 years). We observed an approximately linear relationship (nonlinear P = 0.882) of NO2 exposure with all-cause death across a broad range from 6.6 to 95.7 μg/m3. Every 10-μg/m3 rise in yearly average NO2 concentration was linked to a hazard ratio (HR) of 1.045 (95% confidence interval [CI]: 1.031–1.059). In the updated meta-analysis of this study and 9 existing cohorts, we estimated a pooled HR of 1.043 (95% CI: 1.023–1.063) for each 10-μg/m3 growth in NO2. Reaching a 10-μg/m3 counterfactual target of NO2 concentration in China could avoid 0.33 (95% empirical CI: 0.19–0.49) million premature deaths and an LLE of 0.40 (95% empirical CI: 0.23–0.59) years in 2010, which greatly dropped to 0.24 (95% empirical CI: 0.14–0.36) million deaths and 0.21 (95% empirical CI: 0.12–0.31) years of LLE in 2020. The net fall in NO2-attributable deaths (–26.8%) between 2010 and 2020 was primarily driven by the declines in both NO2 concentration (–41.6%) and mortality rate (–27.1%) under population growth (+41.0%) and age structure transition (+0.9%). ConclusionsOur findings provide national evidence for increased risk of premature death and loss of life expectancy attributed to later-life NO2 exposure among the elderly in China. In an accelerated aging society, strengthened clean air actions should be formulated to minimize the health burden and regional inequality in NO2-attributable mortality.

The influence of residential Environment and residential experience on psychological depression in older adults: Evidence from China and Europe

This cross-national study examined the influence of residential environment and experience on depression in older adults in China and Europe to address existing research gaps. Using data from the China Health and Retirement Longitudinal Study (CHARLS) and Survey of Health, Ageing, and Retirement in Europe (SHARE) and employing ridge regression, it was found that residential environment and experience have a significant influence on older adults' depression. The influence of residential experience aligns with the sensitivity period hypothesis. The environment in which older adults live during specific age periods leaves an imprint on their psyche. This imprint is activated when specific environments are encountered in old age, thereby influencing the level of depression. This study examined how their influence on depression contributes to understanding older adults’ housing preferences and can guide housing-related policies.

Is Transition to Retirement Associated With Volunteering? Longitudinal Evidence from Europe.

Studies have shown that retired older adults are more likely to volunteer than their working counterparts. However, whether the transition to retirement is associated with increased volunteering frequency and whether this varies according to material and time resources of participants is unclear. We used four waves of data from the longitudinal Survey of Health, Ageing and Retirement in Europe, collected between 2011-2018 across 19 countries (n = 12,400 person-observations from 6200 individuals over 50). Within-person (or panel fixed-effect) regression analyses revealed that transition to retirement was associated with an increased volunteering frequency over time. This association was stronger among individuals with better health, higher education, improved financial situation and in countries with higher gross domestic product per capita. Overall, transition to retirement tends to open new ways of organizing everyday life and is associated with increased frequency of volunteering.

Social support and negative emotions of Chinese older adults: Comparison of those who had been widowed to those with a spouse

We investigated the association between social support and negative emotions in Chinese people aged 65 years and over, by comparing those who still had a spouse with those who had been widowed. Data were drawn from the 2018 Chinese Longitudinal Health and Longevity Survey of Elders. The results showed that there were significant differences between those who were widowed and those whose spouse was still alive in terms of the negative emotions of uselessness and loneliness, but not anxiety. The more informal and formal social support (excluding economic support and medical insurance) these older adults had, the fewer negative emotions they felt. These findings provide theoretical and practical insights for scholars who are researching the topic of old age, and also offer practical insights for older adults to maintain their health.

Ultraprocessed Food Intake during the Transition to Adulthood Varies According to Sociodemographic Characteristics and Maternal Intake in Cebu, Philippines

BackgroundUltraprocessed foods (UPFs) are associated with elevated risk of noncommunicable disease, but little is known about UPF intake and the individual-, household-, and community-level factors associated with it among adolescents in low- or middle-income countries. ObjectivesWe estimated the association of UPF intake across adolescence with sociodemographic characteristics and maternal UPF intake in a Filipino cohort. MethodsData were from 4 waves (1994–2005) of the Cebu Longitudinal Health and Nutrition Survey (n = 2068); participants were aged 11, 15, 18, and 21 y. Foods from 24-h recalls were classified using NOVA. We used two-part multilevel models to estimate time-varying associations of the odds and amount (percentage daily kilocalories) of UPF intake with sociodemographic characteristics and maternal UPF intake (none, below median among UPF-consuming mothers [“low”], at or above median [“high”]). ResultsMedian UPF intake (interquartile range [IQR]) among adolescents was 7.3% (IQR: 0, 17.2%) of daily kilocalories at age 11 y and 10.6% (IQR: 3.6, 19.6%) at 21 y. The odds and amount of adolescent UPF intake were positively associated with female sex, years of schooling, and household wealth and inversely associated with household size. The odds—but not amount—of adolescent UPF intake was positively associated with maternal education and urbanicity and inversely associated with the distance from a household’s primary store/market. The association between odds of adolescent UPF intake and school enrollment was positive in adolescence but disappeared in early adulthood. Compared with offspring whose mothers did not consume UPFs, the odds of UPF intake among those whose mothers had low or high UPF intake was greater in adolescence, but there was no association once offspring became adults. At all ages, maternal UPF intake was positively associated with the amount of offspring intake. ConclusionsAdolescent UPF intake varied across sociodemographic characteristics and was positively associated with maternal UPF intake, but not after adolescents entered adulthood.

Anti-Inflammatory Diet and Protein-Enriched Diet Can Reduce the Risk of Cognitive Impairment among Older Adults: A Nationwide Cross-Sectional Research.

Cognitive impairment (CI) is a common mental health disorder among older adults, and dietary patterns have an impact on cognitive function. However, no systematic researches have constructed anti-inflammatory diet (AID) and protein-enriched diet (PED) to explore their association with CI among older adults in China. The data used in this study were obtained from the 2018 waves of the China Longitudinal Health and Longevity Survey (CLHLS). We construct AID, PED, and calculate scores for CI. We use binary logistic regression to explore the relationship between them, and use restrictive cubic splines to determine whether the relationships are non-linear. Subgroup analysis and sensitivity analysis were used to demonstrate the robustness of the results. A total of 8692 participants (mean age is 83.53 years) were included in the analysis. We found that participants with a higher AID (OR = 0.789, 95% confidence interval: 0.740-0.842, p < 0.001) and PED (OR = 0.910, 95% confidence interval: 0.866-0.956, p < 0.001) score showed lower odds of suffering from CI. Besides, the relationship between the two dietary patterns and CI is linear, and the results of subgroup analysis and sensitivity analysis are also significant. Higher intakes of AID and PED are associated with a lower risk of CI among older adults, which has important implications for future prevention and control of CI from a dietary and nutritional perspective.

Pregnancy is linked to faster epigenetic aging in young women

A central prediction of evolutionary theory is that energy invested into reproduction comes at the expense of somatic maintenance and repair, accelerating biological aging. Supporting this prediction are findings that high fertility among women predicts shorter lifespan and poorer health later in life. However, biological aging is thought to begin before age-related health declines, limiting the applicability of morbidity and mortality for studying the aging process earlier in life. Here, we examine the relationship between reproductive history and biological aging in a sample of young (20 to 22yo) men and women from the Cebu Longitudinal Health and Nutrition Survey, located in the Philippines (n = 1,735). We quantify biological aging using six measures, collectively known as epigenetic clocks, reflecting various facets of cellular aging, health, and mortality risk. In a subset of women, we test whether longitudinal changes in gravidity between young and early-middle adulthood (25 to 31yo) are associated with changes in epigenetic aging during that time. Cross-sectionally, gravidity was associated with all six measures of accelerated epigenetic aging in women (n = 825). Furthermore, longitudinal increases in gravidity were linked to accelerated epigenetic aging in two epigenetic clocks (n = 331). In contrast, the number of pregnancies a man reported fathering was not associated with epigenetic aging among same-aged cohort men (n = 910). These effects were robust to socioecological, environmental, and immunological factors, consistent with the hypothesis that pregnancy accelerates biological aging and that these effects can be detected in young women in a high-fertility context.

Development of nature-related habits and their relation to mental health outcomes during two years of the COVID-19 pandemic: a population-based study in Sweden

Abstract Aims Spending time in natural environments has been linked to mental health benefits, and may have been an important resilience factor during the COVID-19 pandemic, but longitudinal studies are limited. This longitudinal study aimed to investigate the development of nature-related habits and their relationship to different mental health outcomes before and during early and later phases of COVID-19 (2019–2022). Furthermore, the buffering potential of nature-related habits on effects of major life events on mental health outcomes was investigated. Subject and methods A subsample of the Swedish Longitudinal Occupational Survey of Health (SLOSH) was studied during 2018–2022, including follow-ups in early 2021 (n = 1902) and 2022 (n = 1580). Visits to various types of nature, mental health outcomes (symptoms of depression, anxiety, loneliness, sleep difficulties), and major life events were analyzed across the study period while controlling for confounders. Results Greater overall engagement in nature visits, particularly visiting forests or using one’s garden, was associated with lower levels of depression, anxiety, loneliness, and sleep problems in early 2021 and 2022. Importantly, changes in nature visits were consistently negatively associated with investigated mental health outcomes across the study period. All nature visits, except for garden time, increased in the long term (2019–2022). Visiting forests also increased in the short term, while overall nature visits initially decreased (2019–2020). Conclusion Generally, nature visits increased longitudinally and were associated with better mental health outcomes during the COVID-19 pandemic. This underscores the importance of green- and blue-space accessibility for facilitating outdoor recreation in natural environments, to support resilience and public health during pandemics.

Abstract P191: Changes in Ultra-Processed Food Intake During the Transition to Adulthood Are Associated With Blood Pressure in Early Adulthood Among a Filipino Birth Cohort

Ultra-processed food (UPF) intake in adulthood is positively associated with risk of high blood pressure (BP), but little is known about the implications of UPF intake in adolescence on later BP. The objective of this study was to estimate the association between the change in UPF intake during the transition from adolescence to adulthood and BP in early adulthood. We hypothesized a positive association. Data were from the 2002, 2005, 2009, and 2018 waves of the Cebu Longitudinal Health and Nutrition Survey, a birth cohort established in 1983 in metropolitan Cebu, Philippines. Participants in the analysis sample were approximately 18 (n=2,012), 21 (n=1,853), 25 (n=1,680), and 35 (n=1,305) years old at the time of the surveys. Foods and beverages from two 24-hour recalls collected at ages 18 and 21 were classified according to NOVA. UPF intake was estimated as the percentage of daily kilocalories (kcals) from UPFs. The outcomes, systolic and diastolic BP (SBP and DBP) at ages 21, 25, and 35, were estimated as the average of three measures collected each wave. The exposure was change in UPF intake from age 18 to 21, modeled as a three-level categorical variable: 1) “decreasing” if the absolute change was &lt;-2.5% of daily kcals, 2) “no change” if the absolute change was ≥-2.5% and ≤2.5%, and 3) “increasing” if the absolute change was &gt;2.5%. We used multivariable linear regression models to estimate associations of SBP and DBP at ages 21, 25, and 35 with the change in UPF intake from age 18 to 21, adjusting for physical activity, smoking status, household wealth, urbanicity, UPF intake, and BP at age 18. We stratified all analyses by sex. Mean UPF intake at ages 18 and 21, respectively, was 15% and 16% of daily kcals among females and 11% and 10% among males. Mean SBP rose from 99 mmHg at age 18 to 110 mmHg at age 35 among females and from 106 to 121 mmHg among males. Compared to females with no change in UPF intake from age 18 to 21, females with decreasing UPF intake had, on average, SBP that was 2.9 mmHg lower (95% CI: -5.1, -0.7) at age 25 and DBP that was 2.6 mmHg lower (95% CI: -4.4, -0.6) at age 21 and 2.5 mmHg lower (95% CI: -4.4, -0.6) at age 25. There were no differences at age 35. For males, compared to those with no change in UPF intake from age 18 to 21, those with decreasing UPF intake had SBP and DBP that were, on average, 3.4 mmHg lower (95% CI: -6.4, -0.3) and 2.8 mmHg lower (95% CI: -5.3, -0.2) at age 35, though there were no differences earlier in adulthood. We did not observe differences in BP comparing participants with increasing UPF intake versus no change, except among females at age 25, when, contrary to our hypothesis, SBP and DBP were lower among females with increasing intake. In conclusion, we observed lower BP in early adulthood among participants with decreasing UPF intake during the transition to adulthood. Efforts to prevent hypertension in low- and middle-income countries should aim to reduce UPF intake during this transitional period.