Poor Lifestyle Choices Research Articles

Effect of exercise on cardiac and metabolic outcomes in people living with HIV.

Poorly controlled HIV infection and antiretroviral therapy, especially the use of protease inhibitors, are among the causes that contribute to the development of cardiovascular disease in people living with HIV (PLWH). Poor lifestyle choices (smoking, lack of physical activity, poor diet) and individual factors such as high stress, physical or emotional trauma, depression, and so forth contribute to the overall risk of developing cardiovascular disease. The purpose of this review was to critically evaluate the more recent aerobic and resistance exercise studies and their impact on cardiovascular and metabolic risk factors in PLWH.

The relationship of chronic medical illnesses, poor health-related lifestyle choices, and health care utilization to recovery status in borderline patients over a decade of prospective follow-up

BackgroundThe interaction of borderline personality disorder (BPD) with physical health has not been well characterized. In this longitudinal study, we investigated the long-term relationship of chronic medical illnesses, health-related lifestyle choices, and health services utilization to recovery status in borderline patients over a decade of prospective follow-up. Method264 borderline patients were interviewed concerning their physical health at 6-year follow-up in a longitudinal study of the course of BPD. This sample was then reinterviewed five times at two-year intervals over the next ten years. We defined recovery from BPD based on a Global Assessment of Functioning score of 61 or higher, which required BPD remission, one close relationship, and full-time competent and consistent work or school attendance. We controlled for potentially confounding effects of time-varying major depressive disorder. ResultsNever-recovered borderline patients were significantly more likely than ever-recovered borderline patients to have a medical syndrome, obesity, osteoarthritis, diabetes, urinary incontinence, or multiple medical conditions (p<0.0063). They were also significantly more likely to report pack-per-day smoking, weekly alcohol use, no regular exercise, daily sleep medication use, or pain medication overuse (p<0.0083). In addition, never-recovered borderline patients were significantly more likely than ever-recovered borderline patients to undergo a medical emergency room visit, medical hospitalization, X-ray, CT scan, or MRI scan (p<0.0063). ConclusionsOver a decade of prospective follow-up, failure to recover from BPD seems to be associated with a heightened risk of chronic medical illnesses, poor health-related lifestyle choices, and costly health services utilization.

No effects of short‐term sleep restriction, in a controlled feeding setting, on lipid profiles in normal‐weight adults

Short sleep has been associated with cardiovascular risk. The aim of this study was to determine the impact of short-term sleep restriction on lipid profiles and resting blood pressure factors in young, normal-weight individuals (14 men, 13 women). Participants were randomized to five nights of either habitual (9h) or short (4h) sleep in a cross-over design separated by a 3-week washout period. There was no sleep×day interaction on lipid profile and blood pressure. Short-term sleep restriction does not alter lipid profiles and resting blood pressure in healthy, normal-weight individuals. The association between short sleep and increased cardiovascular risk reported in the epidemiological literature may be the result of long-term sleep restriction and poor lifestyle choices.

Lifestyle Behaviors of African American Breast Cancer Survivors: A Sisters Network, Inc. Study

IntroductionAfrican American breast cancer survivors experience poor cancer outcomes that may, in part, be remedied by healthy lifestyle choices. Few studies have evaluated the health and lifestyle behaviors of this population. The purpose of this study was to characterize the health and lifestyle habits of African American breast cancer survivors and evaluate the socio-demographic and medical correlates of these behaviors.MethodsA total of 470 African American breast cancer survivors (mean age = 54 years) participated in an online survey. All participants completed measures assessing medical and demographic characteristics, physical activity, and sedentary behavior. Chi-square tests for association, nonparametric tests, and logistic regression models were used to assess associations. All statistical tests were two sided.ResultsAlmost half (47%) of the women met the current guidelines for physical activity, almost half (47%) were obese, and many reported having high blood pressure (53%) or diabetes (21%). The prevalence of high blood pressure, diabetes, and high cholesterol increased by age (P<0.001), and obese women had a higher prevalence of high blood pressure (63% vs. 44%) and diabetes (21% vs. 12%) than did non-obese women (all P<0.05). Obese women participated in significantly fewer total minutes of physical activity per week (100 minutes/week) than did non-obese women (150 minutes/week; P<0.05). The number of comorbid conditions was associated with increased odds for physical inactivity (odds ratio = 1.40) and obesity (odds ratio = 2.22).ConclusionMany African American breast cancer survivors had chronic conditions that may be exacerbated by poor lifestyle choices. Our results also provide evidence that healthy lifestyle interventions among obese African American breast cancer survivors are urgently needed.

Health services use and lifestyle choices of Indigenous and non-Indigenous Australians

In many countries, the health outcomes of Indigenous populations are far worse than those of non-Indigenous populations. Two possible reasons for these differences are poor lifestyle choices and a lack of access to health services when ill. This paper uses Australian data on 17,449 adults, which was collected in the National Health Survey 2004–05 and the National Aboriginal and Torres Strait Islander Health Survey 2004–05, to examine whether Indigenous Australians make different lifestyle choices and health services use than non-Indigenous Australians. After controlling for a range of observable characteristics, it is found that Indigenous Australian are more likely to make poorer lifestyle choices, but are more likely to use health services than non-Indigenous Australians. There is evidence that these results are magnified for Indigenous Australians who live in remote areas. As the lifestyle choices of Indigenous Australians are so different from those of non-Indigenous Australians, the payoff from policies aimed at changing these choices is likely to be large both in terms of the efficient use of the health budget and more importantly in terms of health outcomes for Indigenous Australians.

Ending the epidemic of adolescent obesity

Ending the epidemic of adolescent obesity

Pathological gambling: relationship to obesity, self-reported chronic medical conditions, poor lifestyle choices, and impaired quality of life

BackgroundPathological gambling (PG) is an important public health problem that is prevalent, costly to society, and associated with substance misuse, depression, domestic violence, crime, and suicide. Despite these challenges, little is known about the physical health and medical correlates of PG. The goal of this project was to assess self-reported chronic medical conditions, medication usage, lifestyle choices, health care utilization, quality of life variables, and body mass index (BMI) in persons with and without PG. MethodsSubjects with PG and community controls were systematically assessed for their medical health, lifestyle choices, medication usage, and health care utilization. We administered the Medical Outcome Study Short-Form 36 Health Survey to assess perceived health and quality of life. BMI was calculated for all subjects. Obesity was defined as having a BMI≥30kg/m2. ResultsWe compared 95 subjects with DSM-IV PG (South Oaks Gambling Screen [SOGS] score≥5) and 91 control subjects without PG (SOGS≤2) selected through random digit dialing from the general community. PG subjects and controls were similar in age and gender. Persons with PG had more medical and mental health conditions than controls, and were more likely to avoid regular exercise, smoke≥1 pack/day, drink≥5 servings of caffeine daily, and watch television≥20hours/week. They had more emergency department visits for physical and mental health conditions, were more likely to have been psychiatrically hospitalized in the past year, and were more likely to take psychotropic medication. They were less likely to have had regular dental visits and were more likely to put off medical care due to financial problems. Severity of gambling was positively correlated with number of medical conditions. Persons with PG had poorer self-reported health perceptions on all but one SF-36 subscale. Importantly, persons with PG had a higher BMI than controls and were more likely to be obese. ConclusionsPG is associated with obesity, chronic medical conditions, poor lifestyle choices, worse quality of life, and the use of costly forms of medical care. Pathological gamblers are less likely to receive regular dental care and are more likely to be unable to pay for medical care. The implications of the findings are discussed.

The Obesity Epidemic

The prevalence of obesity is increasing at an alarming rate and with it the occurrence of a number of comorbidities, including cardiovascular disease, type 2 diabetes, stroke, and certain types of cancer. Approximately one third of adults in the US population are currently classified as obese. Globally, >400 × 106 adults are classified as obese, a number that is expected to double by 2015. Consequently, obesity and its associated health problems are placing a large burden on an already overwhelmed healthcare system. The worldwide costs attributable to this disease are estimated to be between 0.7% and 2.8% of total healthcare expenditures. Furthermore, medical costs for obese individuals are substantially higher than for nonobese people. Obesity is a multifactorial disease caused by a chronic energy surplus in which energy intake exceeds energy expenditure, leading to the accumulation of excess adipose tissue. Regulation of energy homeostasis is a complex process, and that fact imparts a considerable challenge in trying to elucidate the pathogenesis of obesity. Although poor lifestyle choices, including inappropriate diets and lack of physical activity, undoubtedly play a large role, genetic susceptibility also puts an individual at increased risk. The majority of obesity therapies have been aimed at behavior modification and pharmacologic intervention, although to date these therapies have led to only modest weight loss. Although less common, bariatric surgery has led to substantial long-term weight loss in morbidly obese patients; this type of treatment, however, is both invasive and costly. Given the growing trend of obesity in both developed and developing countries, considerable importance has been placed on increasing awareness of the problem. In this article, 4 leaders in the field of obesity provide their opinions on obesity and discuss the latest advancements in pathogenesis, therapy, prevention, and the use of novel biomarkers to identify those at risk …

Physical activity, BMI and cancer prevention in urban adults

Background Developing countries are undergoing epidemiological transitions with increasing prevalence of Non-Communicable Diseases (NCD) particularly cancers. In many African countries, poor lifestyle choices including dietary patterns, lack of physical activity and weight gain contribute to the risk factors of many cancers. In this study, we evaluated physical activity, carbohydrate intake and anthropometric measurements in an urbanized Nigerian population. Our objective was to measure the prevalent lifestyle, as well as develop and disseminate adequate educational strategies based on our findings, to alleviate the problem in the population.

Essence of progress in geriatric cardiology.

Essence of progress in geriatric cardiology.

Spectacular anatomy: plastination and salutary dread

In recent years one of the most controversial uses of anatomy for public display has been Gunther von Hagens' Body Worlds exhibitions. Von Hagens also provoked fresh outrage by selling plastinated human and animal body parts online. While some may consider this as an entertainment activity, or a pretext for commercialising the human body, von Hagens has claimed that “The primary goal of Body Worlds is health education”. As stated by the Institute for Plastination, these notorious exhibitions using human remains to deal with the subject of anatomy aim “to educate the public about the inner workings of the human body and show the effects of poor health, good health and lifestyle choices”.

Psychosocial stress and cardiovascular risk - current opinion

Cardiovascular disease (CVD) is a major cause of morbidity and mortality worldwide. Epidemiologic research of the last half-century has clearly shown that psychosocial factors related to the social environment, personality characteristics, and negative affect increase the risk of incident CVD and also impact prognosis of cardiac patients. Several mechanisms may explain this link, including a genetic predisposition, poor lifestyle choices, low adherence to health recommendations, and direct pathophysiologic perturbations. The latter include alteration of the hypothalamic-pituitary adrenal axis and autonomic dysfunction resulting in endothelial dysfunction, inflammation, and a prothrombotic state further downstream. Screening for psychosocial factors seems appropriate as part of the standard history and based on the clinician's knowledge of the patient and the purpose of the visit. Psychological interventions generally alleviate distress in cardiac patients, but whether they reduce the risk of hard cardiovascular endpoints and all-cause mortality is less evident. Cardiac patients with more severe depression may particularly profit from antidepressant medications. Due to their pharmacologic properties, selective serotonin reuptake inhibitors were shown to improve cardiovascular outcome. The most effective psychosocial treatment is multicomponent therapy that combines elements of cognitive behaviour therapy ("stress management") and changes in health behaviours, including the adoption of a regular exercise regimen. Gender-specific issues should probably be considered. The field of behavioural cardiology has accumulated a wealth of epidemiological, mechanistic and clinical knowledge that undoubtedly has furthered our understanding about the important role of psychosocial risk factors in patients with a heart disease.

Functional medicine: how dysfunction leads to disease

Functional medicine is part of integrative medicine. There are three phases in the movement from health to disease. The first phase concerns lifestyle and how poor lifestyle choices move the system into increasing dysfunction. If the changes are rapid and severe then this is called acute disorder, and if slow and persistent then this is called chronic disorder. In the early phase of dysfunction there may be few symptoms and signs but the symptoms and signs rapidly or slowly become more obvious. The symptoms and signs at first are only recording the fact that the system as a whole in under stress and not functioning well. Over time dysfunction may lead to disease. The conventional model of medicine tends to focus its management on treating symptoms or treating the disease if possible. The integrative model pays attention to lifestyle changes, moving the dysfunction back to optimum function and only treating the disease if indicated.

Medication Management, Use and Safety in Non- Communicable Diseases: Any Hope for the Nigerian Patients?

Globally, the recognition of non-communicable diseases (NCDs) as a major cause of morbidity and mortality is increasing. The link between poor lifestyle choices such as drug use, alcohol and tobacco use, diet, lack of exercise or stress management provides a major challenge in medication use in the management of NCDs. In NCDs, the management and use of medications is associated with many challenges in the Nigerian health care system including access to medicine, infrastructural decay, quality of health professional, poor adherence to therapy, and poor knowledge of patients, among others. Despite these challenges, there is hope for Nigerian patients suffering from NCDs as the existing global approaches aimed at improving access to drugs, and medication management and use can be a live saver for them. Irrespective of poverty problems in the country, the threat from increasing prevalence of NCDs can be overcome with a combination of the efforts from government, health professionals and the individual patients. Adequate education of the patients and the public can lead to behavioral change and reduction in NCDs while at the same time improving medication use behaviours.Keywords: NCDs, Drug management, Drug safety, Drug Use, Nigerian population.

Framing obesity: the framing contest between industry and public health at the New Zealand inquiry into obesity

Drawing on submissions to the 2006-2007 New Zealand Inquiry into Obesity and Type 2 Diabetes, this article outlines how the food and marketing industries (industry) and the public health sector framed the issue of obesity. The analysis revealed that industry framed obesity as a consequence of poor lifestyle choices attributed largely to knowledge, cultural or other character deficits. Industry argued that lack of physical activity rather than increased food consumption was the dominant cause of obesity. In contrast, public health groups positioned obesity as a normal response to an obesogenic environment, characterized by the ubiquitous marketing and availability of low-cost, energy-dense/nutrient-poor foods. For public health groups, increased consumption of energy-dense/nutrient-poor foods was positioned as the dominant cause of obesity. Many public health submitters also suggested that social inequalities contributed to obesity. Industry emphasized education as the key solution to obesity, while public health groups argued for regulation of the activities of the food and marketing industries, and policies to address wider determinants of health and social inequalities. Identifying and documenting these frames, by making transparent the interests of the frame's sponsors, contributes to greater understanding of the wider policy context around obesity and provides useful information for public health advocacy.

Dealing with Complexity through More Robust Approaches to the Evidence-Based Design of Healthcare Facilities

IntroductionHealthcare systems and facilities provide settings for a wide range of activities and accommodate patients with everincreasing expectations regarding the quality of service provided. The planning and design of healthcare systems and facilities are often complex processes that have to provide flexible, adaptable, and multifunctional solutions to meet rapidly changing demands, and use effective stakeholder engagement processes to ensure that a wide range of current and future patients' needs are taken into account. Thus, new approaches to the planning and design of healthcare facilities have emerged, such as scenario planning, user-centered design, building information modeling, physical and virtual mock-ups, and simulation and visualization. These new approaches rely heavily on research evidence, thus increasing the need for robust evidencebased planning and design, especially in relation to the health-promoting aspects of built healthcare environments. To improve, innovation and new solutions are needed, though some may fail.Evidence-based design (EBD) provides an excellent process for the diffusion of innovation and learning from previous experience to lessen the impact of innovation failure. However, in some situations, EBD can encourage the status quo or it may not be suitable because of the context-specific nature of the evidence. Given the complex and parametric nature of many planning and design processes, new (enhanced) approaches to EBD must emerge. Such approaches should take into account current and anticipated trends, such as the increased need for flexibility; include robust methods of data (evidence) collection and analysis; provide mechanisms for effective stakeholder engagement; and be based on theory relevant to the complex nature of the problem.This issue of HERD includes seven articles:* Two articles capture current trends, especially in relation to the need for flexibility and adaptability to accommodate changing needs over time.* Two articles highlight the importance of robust data collection and different users' needs (focusing on patients' and parents' satisfaction regarding children's healthcare facilities).* Three articles provide some excellent ideas regarding the development of more robust and advanced approaches to EBD through the application of new concepts, undergirding theories, and principles.Current and Future Trends: Flexibility and AdaptabilityHealthcare provision in many countries is experiencing profound change, the main drivers being aging populations, increased public expectations about the quality of care, rapid advances in medical technologies and clinical practices, poor lifestyle choices resulting in increased obesity, and increased economic pressures. Healthcare systems and facilities must be sufficiently flexible and adaptable to accommodate different operational models over the lifetime of a facility. The articles by Carthey et al. and Kendall report on different and interesting aspects related to current trends. They consider* terminology and design-related strategies for flexible healthcare facilities; and* current trends in practice and the potential implications for architectural education.Carthey and colleagues report on different terms and strategies associated with healthcare facilities. The main goal was to identify practical, cost-effective, design-related strategies for making healthcare assets flexible. Initially, the authors systematically reviewed the literature from a wide range of sources to assemble and compile various definitions and terms used to describe flexibility and adaptability. Interestingly, they also identified varied applications of related terms such as convertibility and expandability. They suggest that there is a need to define flexibility and adaptability and associated terms more rigorously if future-proofing strategies that have been implemented are to be assessed appropriately. …

Physical Activity, HIV, And Cardiovascular Disease Risk

The life expectancy for people living with HIV/AIDS (PLWHA) has increased due predominantly to advances in antiretroviral therapy (ART). However, these drugs in conjunction with the HIV infection and poor lifestyle choices have increased the prevalence of metabolic and anthropomorphic abnormalities that accelerates the progression of atherosclerosis and increases the risk of cardiovascular disease (CVD). PURPOSE: The purpose of this study was to determine the effects of moderate physical activity on CVD risk factors in a group of HIV-infected individuals. METHODS: 114 individuals were randomized to a physical activity group (PA) or non-exercise control group (CON). PA participated in a 6-week program consisting of two weekly 30 minute bouts of moderate intensity physical activity and 30 minute bouts of resistance training. CON attended the research center for the equivalent amount of time and were allowed to read or watch television. A graded exercise stress test and blood analysis was performed before and after the physical activity program for each participant. Repeated measures ANOVA was used to compare variables within groups, with between group analysis using ANOVA/Tukey post-hoc analysis. RESULTS: Baseline aerobic capacity across groups was approximately 25% below age and gender predicted levels. PA participants showed a 21% increase in aerobic capacity. Baseline blood analysis placed the average triglyceride level in the borderline high range. PA showed a significant reduction in triglycerides (155±70 to 110±30 mg/dl) with no change in the CON participants. CONCLUSION: The results indicate that even moderate doses of physical activity can increase aerobic capacity and reduce serum triglyceride levels. These findings suggest that physical activity can significantly affect important risk factors for CVD in people living with HIV/AIDS.

Mitochondria and Redox Signaling in Steatohepatitis

Alcoholic and nonalcoholic fatty liver diseases are potentially pathological conditions that can progress to steatohepatitis, fibrosis, and cirrhosis. These conditions affect millions of people throughout the world in part through poor lifestyle choices of excess alcohol consumption, overnutrition, and lack of regular physical activity. Abnormal mitochondrial and cellular redox homeostasis has been documented in steatohepatitis and results in alterations of multiple redox-sensitive signaling cascades. Ultimately, these changes in signaling lead to altered enzyme function and transcriptional activities of proteins critical to mitochondrial and cellular function. In this article, we review the current hypotheses linking mitochondrial redox state to the overall pathophysiology of alcoholic and nonalcoholic steatohepatitis and briefly discuss the current therapeutic options under investigation.

A Partnership Evaluation: Public Mental Health and Dental Services

This study evaluates the partnership between a mental health service and a public dental hospital in providing timely and efficient access to dentistry to patients with a mental illness. In addition, the factors that contributed to the sustainability of the partnership were examined. The partnership was appraised using a survey-based evaluation with 20 patients, 43 community mental health staff and 14 dental staff, and focus groups with mental health and dental staff. The partnership between the services is the key element to the success of improving access to dental services for patients. Overall feedback received from mental health staff highlighted the importance of the partnership and its role in meeting the oral health needs of patients. Generally, patients were satisfied with the treatment they received and valued the dental service. Results highlighted an ongoing problem of poor dietary and lifestyle choices. Dental staff felt that mental health patients were less likely to take care of their teeth and were more likely to cancel appointments. Dental staff also acknowledged frustration with patients with a mental illness not attending appointments or following through with a recommended course of treatment. The partnership with the local dental hospital has created a sustainable way to ensure improved dental health outcomes for patients of mental health services. This partnership has led to increased access to dental services and improved follow-up.

Physical Activity and Medications: Important Considerations for Fitness and Exercise Professionals

The development of chronic disease conditions (CDCs) is linked to poor lifestyle choices and, consequently, the management of disease is shifting toward therapeutic lifestyle intervention concurrent to drug therapy. Fitness professionals are now commonly working with clients who have various chronic diseases and who may be managing both their disease and associated co-morbidities with pharmacotherapy. Common medications such as non-steroid anti-inflammatory drugs, HMG-CoA reductase inhibitors/statins, ACE inhibitors, calcium channel blockers, ?-blockers, and oral hypoglycaemic agents