Healthy Lifestyle Recommendations Research Articles

P.028 Exploring young adult stroke patients’ lived experience, healthy lifestyle habits, and recommendations for designing innovative brain care-related initiatives

Background: Over the past decade, worldwide stroke incidence has been increasing among young adults (≤65years), which has implications during the most dynamic period of their life. There is a dearth of research exploring young adults stroke patients’ experiences, healthy lifestyle habits, preferences, and recommendations for brain care-related initiatives. The study aimed to gain knowledge and a deeper understanding of young adult stroke patients’ experiences, lifestyle habits, and support needs for brain care-related education and interventions. Methods: A descriptive qualitative study was used. Participants who took part in the quantitative phase of a larger mixed methods study (n=103 that expressed an interest in the qualitative phase, were invited to take part in semi-structured focus groups. Simultaneous data collection and analysis are being conducted. Data are being analyzed using inductive thematic analysis outlined by Braun and Clarke (2006). Results: Findings will be available by May 20, 2024. Conclusions: Study findings will be essential to 1) mobilize an understanding of young adult stroke patients’ lived experience; 2) reconceptualize the current model of stroke care and services that is traditionally geared towards older adults; and 3) inform the development of brain care-related education and interventions to meet the unique needs, priorities, and preferences of young adult stroke patients.

P.027 KNOW BRAIN EMBRACE CARE: A study investigating young adult stroke patients’ knowledge and behaviour around lifestyle

Background: Stroke incidence is rising among younger adults (≤65yrs). Modifiable and behavioural risk factors are linked to stroke; however, limited understanding of knowledge and behaviour exists around preventative/lifestyle medicine (LSM) among this patient population. Study aim was to assess younger adult stroke patients’ lifestyle knowledge, habits, and barriers. Methods: A cross-sectional design was employed. Data were collected through an online, self-reported survey following a routine stroke prevention clinic visit and analyzed using descriptive and inferential statistics. Results: Sample included 103 participants (56.3% women, 60% white, mean age 47.6, 54.5% prior stroke). Majority (63%) understood current healthy lifestyle recommendations around blood pressure, sleep, and alcohol use, but fewer (<24.3%) around exercise and diet. Almost 70% ate processed food weekly, with emotions and social/family situations influencing eating habits. Interestingly, despite not understanding the current recommendations, >80% exercised moderately (3.5d/wk) with work and family responsibilities as main barriers. Over 50% slept <7hrs/night, had moderate to high stress levels, and implemented different coping strategies (food, TV, video games, and exercise). Majority (82.4%) reported willingness to change habits. Conclusions: Our findings provide valuable insight on young adult stroke patients’ preventative/LSM-related knowledge, habits, and barriers and provide new opportunities for the development of brain care-related initiatives.

HEBE project: Healthy aging versus inflamm-aging: The role of physical exercise in modulating the biomarkers of age-associated and environmentally determined chronic diseases, study protocol.

Inflamm-aging refers to the chronic low-grade inflammation that occurs with aging and cellular senescence, and it is linked to various diseases. Understanding the markers involved in inflammation and aging, as well as their interaction with environmental factors and bodily control mechanisms, can provide crucial tools for assessing the resilience (i.e. the ability to adapt and improve) of the human body, particularly in the presence of chronic degenerative conditions or vulnerable life stages, that place the individual and the community to which he belongs in a state of potential fragility. HEBE focuses on physical exercise, along with nutritional and lifestyle recommendations, to reduce systemic inflammation and promote healthy aging. HEBE encompasses multiple research lines (LR). In the ongoing LR1 ("proof of concept"), healthy lifestyle recommendations were provided to University of Milan employees, and changes in quality of life and well-being were assessed using a specialized questionnaire. The first 100 eligible subjects, who expressed their willingness to participate, underwent a personalized physical exercise protocol based on clinical and objective assessments. Biomedical samples were collected at baseline (T0) and follow-up (T1) to establish a shared biobank and identify non-invasive biomarkers that monitor the impact of physical exercise on individual characteristics such as cardiovascular and metabolic health. Subsequently (LR2-LR10), the proof of concept findings will be expanded to include various conditions of vulnerability such as obesity, cancer, endocrine disorders, cardiovascular diseases, infertility, functional syndromes, respiratory disorders, neurodegenerative diseases, and autoimmune conditions. The research lines will leverage the expertise of the 94 participating investigators to form a collaborative network that maximizes the potential for investigation and knowledge exchange. This approach fosters a culture of health promotion and disease prevention. ClinicalTrials.gov Identifier: NCT05815732.

ДИСТАНЦИОННОЕ ФАРМАЦЕВТИЧЕСКОЕ КОНСУЛЬТИРОВАНИЕ С ИСПОЛЬЗОВАНИЕМ ЧАТ-БОТА

The article discusses the use of chatbots for a variety of tasks in the medical field – such as scheduling doctor’s appointments, monitoring patients with chronic conditions, and providing healthy lifestyle recommendations – and in pharmacy operations, including verifying pharmacy addresses and hours, searching for and ordering products, and accessing information about delivery and payment, as well as operator consultations. It identifies several challenges faced in pharmaceutical counseling: time constraints, lack of motivation, absence of a dedicated counseling space, and low demand for the service. Chatbots are proposed as a solution to these issues, offering the benefit of pre-determined specific questions to address the time shortage, while the virtual nature of counseling negates the need for a physical space. Pursuant to recommended standards and legal requirements, we have developed a seven-stage model for remote pharmaceutical counseling, tailored for digital implementation. When integrated into a website, mobile app, messenger, or other online pharmacy services as a chatbot, this model enables pharmacists to consider individual client needs and provide comprehensive pharmaceutical care remotely without significantly extending consultation times. Integration with online pharmacy services is suggested to be facilitated through an API (Application Programming Interface). Furthermore, the article describes a mechanism to safeguard user personal data in the application of this algorithm.

Relationship between Health Status and Lifestyle Factors in Patients with Cardiovascular Diseases

Background: The need to study behavioral patterns associated with lifestyle modification is evidenced not only by the high global mortality rate from cardiovascular diseases, but also by the growing burden of cardiovascular risk factors. Our objective was to assess the dynamics of risk factors in people with different health status and the role of healthy lifestyle recommendations in lifestyle changes. Materials and methods: The first stage of the study was conducted in 2016 and included 1,600 respondents while the second was in 2019 involving 991 respondents, which were then divided into three groups by their health status: apparently healthy, those who developed an atherosclerotic cardiovascular disease (CVD) during the observation period, and those already sick (initial CVD cases). The participants were examined and surveyed for the main cardiovascular risk factors, such as blood pressure, cholesterol, including its atherogenic lipoprotein, smoking, body mass index, and past illnesses. Lifestyle modification following the receipt of healthy lifestyle recommendations was assessed by survey. Results: The most pronounced dynamics of risk factors was revealed among those who developed a CVD in the course of observation: cholesterol decreased from 5.7 to 5.2 mmol/L, p = 0.005, its atherogenic lipoprotein – from 4.3 to 3.4 mmol/L, p < 0.001, systolic blood pressure – from 144 to 128 mmHg, p < 0.001, and the body mass index – from 30.8 to 30.7 kg/m2, p = 0.255. Most patients from this group (59.3 %) received healthy lifestyle recommendations and the proportions of those who followed them and modified their lifestyle were higher than in other groups (39.0 % and 54.7 %, respectively; p < 0.001). In the group of apparently healthy individuals, lifestyle recommendations were given to 27.4 % members; yet, this group was noted for a high prevalence of lifestyle self-modification (23.8 %). Among those who already suffered from a CVD at the beginning, the proportion of patients who received healthy lifestyle recommendations was 1.5 times lower (38.3 %) compared to the group of patients who developed the disease, p < 0.001. Conclusion: Those who developed a disease during observation received recommendations for a healthy lifestyle more often and modified it, but the number of such recommendations decreased with disease duration. The decision to modify the lifestyle was more often made by those who were given lifestyle recommendations, while self-modification was less frequent.

AI and semantic ontology for personalized activity eCoaching in healthy lifestyle recommendations: a meta-heuristic approach

BackgroundAutomated coaches (eCoach) can help people lead a healthy lifestyle (e.g., reduction of sedentary bouts) with continuous health status monitoring and personalized recommendation generation with artificial intelligence (AI). Semantic ontology can play a crucial role in knowledge representation, data integration, and information retrieval.MethodsThis study proposes a semantic ontology model to annotate the AI predictions, forecasting outcomes, and personal preferences to conceptualize a personalized recommendation generation model with a hybrid approach. This study considers a mixed activity projection method that takes individual activity insights from the univariate time-series prediction and ensemble multi-class classification approaches. We have introduced a way to improve the prediction result with a residual error minimization (REM) technique and make it meaningful in recommendation presentation with a Naïve-based interval prediction approach. We have integrated the activity prediction results in an ontology for semantic interpretation. A SPARQL query protocol and RDF Query Language (SPARQL) have generated personalized recommendations in an understandable format. Moreover, we have evaluated the performance of the time-series prediction and classification models against standard metrics on both imbalanced and balanced public PMData and private MOX2-5 activity datasets. We have used Adaptive Synthetic (ADASYN) to generate synthetic data from the minority classes to avoid bias. The activity datasets were collected from healthy adults (n = 16 for public datasets; n = 15 for private datasets). The standard ensemble algorithms have been used to investigate the possibility of classifying daily physical activity levels into the following activity classes: sedentary (0), low active (1), active (2), highly active (3), and rigorous active (4). The daily step count, low physical activity (LPA), medium physical activity (MPA), and vigorous physical activity (VPA) serve as input for the classification models. Subsequently, we re-verify the classifiers on the private MOX2-5 dataset. The performance of the ontology has been assessed with reasoning and SPARQL query execution time. Additionally, we have verified our ontology for effective recommendation generation.ResultsWe have tested several standard AI algorithms and selected the best-performing model with optimized configuration for our use case by empirical testing. We have found that the autoregression model with the REM method outperforms the autoregression model without the REM method for both datasets. Gradient Boost (GB) classifier outperforms other classifiers with a mean accuracy score of 98.00%, and 99.00% for imbalanced PMData and MOX2-5 datasets, respectively, and 98.30%, and 99.80% for balanced PMData and MOX2-5 datasets, respectively. Hermit reasoner performs better than other ontology reasoners under defined settings. Our proposed algorithm shows a direction to combine the AI prediction forecasting results in an ontology to generate personalized activity recommendations in eCoaching.ConclusionThe proposed method combining step-prediction, activity-level classification techniques, and personal preference information with semantic rules is an asset for generating personalized recommendations.

Feasibility of a Text Messaging-Integrated and Chatbot-Interfaced Self-Management Program for Symptom Control in Patients With Gastrointestinal Cancer Undergoing Chemotherapy: Pilot Mixed Methods Study.

Outpatient chemotherapy often leaves patients to grapple with a range of complex side effects at home. Leveraging tailored evidence-based content to monitor and manage these symptoms remains an untapped potential among patients with gastrointestinal (GI) cancer. This study aims to bridge the gap in outpatient chemotherapy care by integrating a cutting-edge text messaging system with a chatbot interface. This approach seeks to enable real-time monitoring and proactive management of side effects in patients with GI cancer undergoing intravenous chemotherapy. Real-Time Chemotherapy-Associated Side Effects Monitoring Supportive System (RT-CAMSS) was developed iteratively, incorporating patient-centered inputs and evidence-based information. It synthesizes chemotherapy knowledge, self-care symptom management skills, emotional support, and healthy lifestyle recommendations. In a single-arm 2-month pilot study, patients with GI cancer undergoing chemotherapy received tailored intervention messages thrice a week and a weekly Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events-based symptom assessment via a chatbot interface. Baseline and postintervention patient surveys and interviews were conducted. Out of 45 eligible patients, 34 were enrolled (76% consent rate). The mean age was 61 (SD 12) years, with 19 (56%) being females and 21 (62%) non-Hispanic White. The most common cancer type was pancreatic (n=18, 53%), followed by colon (n=12, 35%) and stomach (n=4, 12%). In total, 27 (79% retention rate) participants completed the postintervention follow-up. In total, 20 patients texted back at least once to seek additional information, with the keyword "chemo" or "support" texted the most. Among those who used the chatbot system checker, fatigue emerged as the most frequently reported symptom (n=15), followed by neuropathy (n=7). Adjusted for multiple comparisons, patients engaging with the platform exhibited significantly improved Patient Activation Measure (3.70, 95% CI -6.919 to -0.499; P=.02). Postintervention interviews and satisfaction surveys revealed that participants found the intervention was user-friendly and were provided with valuable information. Capitalizing on mobile technology communication holds tremendous scalability for enhancing health care services. This study presents initial evidence of the engagement and acceptability of RT-CAMSS, warranting further evaluation in a controlled clinical trial setting.

OPTIMIZATION OF THE PREGNANCY MANAGEMENT SYSTEM IN HEPATITIS B

Purpose. To determine the effectiveness of optimized pregnancy management tactics for hepatitis B. Materials and methods. To determine the risk of obstetric and perinatal risk, it is necessary to determine medical and social indicators, conduct additional examinations to assess the course of hepatitis B, the state of vascular regulation, quality of life, anxiety and depression levels. At an increased risk of complications, depending on the detected changes, organizational and therapeutic measures are recommended: healthy lifestyle recommendations, psychologist consultation and psychocorrection, arginine glutamate, a combination of magnesium with vitamin B6, oral and vaginal probiotics. Results. The verification of the effectiveness of the use of the recommended treatment and prevention complex demonstrated a positive effect on the general condition and well-being of the woman, improvement of microbiocinosis of the vagina and intestines, the state of the hemostasis system and vascular endothelium, improvement of the quality of life of the patients, reduction of the level of anxiety and depression, which collectively made it possible to achieve the set the goal is to reduce the frequency of obstetric and perinatal complications (placental insufficiency, fetal distress and growth retardation, premature birth, blood loss during childbirth, asphyxia and adaptation disorders in the newborn). Conclusion. The obtained results and the absence of side effects allow recommending the proposed treatment-prophylactic complex for wide use in obstetrics and gynecology practice.

Lifestyle Medicine and Foreign Recommendations Aimed at Motivating Medical Staff to Lead a Healthy Lifestyle

The World Health Organization considers the implementation of healthy lifestyle recommendations a basic healthcare service and has already developed the necessary principles and recommendations. Currently, lifestyle medicine is actively developing abroad, and being defined as part of preventive medicine. In relation to the methodology of lifestyle medicine for medical staff, the principles of a healthy lifestyle are of particular importance abroad, as every medical staff, be it a doctor or a nurse, should set a good example for their patients and the general population. The principles of lifestyle medicine dictate that health professionals’ adherence to a healthy lifestyle is crucial since every health worker, whether a doctor or a nurse, should set a positive example for their patients and the general public.

Adherence to lifestyle recommendations among Norwegian cancer survivors and the impact of traditional and complementary medicine use: the Tromsø Study 2015–2016

IntroductionAdherence to healthy lifestyle recommendations has positive effects on cancer outcomes yet adherence is low among cancer survivors. Differences in adherence between women and men, phase of survivorship, and other factors that might increase adherence, like the use of traditional and complementary medicine (T&CM), need to be explored. We aimed to study the adherence to national recommendations for a healthy diet (daily intake of ≥ 5 portions of fruit/vegetables), physical activity (150 min of moderate-intensity or 75 min of high-intensity/week), normal body mass index (BMI) (18.5–24.9 kg/m2), non-smoking, and low-risk alcohol consumption (women ≤ 10 g/day, men ≤ 20 g/day) among Norwegian cancer survivors and their associations with sex, the use of T&CM, and survivorship phase.MethodsWe used logistic regression, independent sample t-test, and chi-square test to study self-reported (diet, physical activity, smoking, alcohol consumption) and measured (BMI) adherence in 1530 cancer survivors (40 years and above, participating in the population-based Tromsø Study conducted in 2015–2016 (65% attendance). We dichotomized all assessed lifestyle recommendations (adherence = 1 point, non-adherence = 0 points), and created a score for every recommendation (0–5 points). Adherence to individual lifestyle recommendations and the use of T&CM as well as the phase of survivorship was adjusted for sex, age, income, and living with a partner.ResultsAdherence to recommendations was 7.5% for diet, 85.3% for physical activity, 30.5% for BMI, 89.3% for non-smoking, and 87.6% for alcohol consumption. In total 2.3% adhered to all five recommendations concurrently (mean score 2.96 [SD = 0.86]). Women adhered to more recommendations concurrently compared to men (3.03 [SD = 0.90] vs. 2.89 [SD = 0.80] points respectively, [p = .012]). In total, 31% reported the use of T&CM and there were no differences in adherence to individual lifestyle recommendations or concurrent adherence in overall T&CM use compared to non-use. Users of self-help techniques were more likely to adhere to the recommendations of diet (aOR 2.69, 95% CI 1.45–4.98) and physical activity (aOR 6.26, 95% CI 1.51–25.92). Users of traditional healers and users of more than one T&CM modality were less likely to adhere to the low-risk alcohol consumption recommendation, (aOR 0.32, 95% CI 0.13–0.77, and aOR 0.53, 95% CI 1.08–2.17, respectively) compared to T&CM non-users. Survivors with cancer previously (1162) had higher odds of adhering to the recommendation of diet (aOR 2.66, 95% CI 1.36–5.19) than survivors with cancer presently (n = 368), but not to other recommendations.ConclusionThe health of cancer survivors can be improved through adherence to lifestyle recommendations, yet our study found partial adherence among survivors in Norway, in accordance with findings from other countries. Although overall T&CM use was not associated with higher adherence to lifestyle recommendations, differences in adherence were seen among individual modalities like the use of self-help techniques and traditional healers. Our results suggest the need for intensified follow-up of lifestyle with attention to male survivors and diet among all survivors throughout the cancer survivorship continuum.

Adherence to 24-h movement guidelines in Spanish schoolchildren and its association with insulin resistance: a cross-sectional study.

Being more active, being less sedentary, and sleeping enough are associated with adequate body weight and adiposity in children. However, few researchers have analyzed these different lifestyle behaviors and the adherence to 24 h movement guidelines with respect to insulin resistance (IR) at school age. Therefore, we aimed to analyse the association between the adherence to 24 h movement guidelines (physical activity, sedentary time, sleep) and IR in Spanish schoolchildren. A cross-sectional study of 839 children (8-13 years, 51.1% girls) were studied. Anthropometric, biochemical, and lifestyle behavioral data were collected. IR was defined as HOMA-IR>3.16. Compliance with the 24 h movement guidelines were defined as ≥60 min/day of moderate and/or vigorous physical activity, < 120 min/day of screen time, and 9-11 h/day of sleep time. Associations between adherence to the 24 h movement guidelines and IR were performed by multivariate logistic regression analyses. The IR in our sample was 5.0%, being higher in girls. Compliance with physical activity or screen time, but not with sleep recommendations, was associated with lower fasting glucose, fasting insulin, and HOMA-IR values. A low adherence to 24 h movement guidelines was associated with a higher risk of IR (odds ratio (95% CI): 2.150 [1.089-4.247]), especially in girls (odds ratio (95% CI): 2.800 [1.180-6.645]). Higher physical activity levels and lower screen times were associated with a lower risk of IR in schoolchildren, underlining the importance of adhering to as many healthy lifestyle recommendations as possible.

Abstract #1401445: Impact of COVID-19 Lockdown on Anthropometric Body Measurements and Nutritional Behaviors in a Colombian Cohort Receiving Online Nutritional Advice

In this study, we aimed to retrospectively assess the change in weight before and after the COVID-19 mandatory lockdown in Colombia among adults who received nutritional and healthy lifestyle recommendations at weight loss and wellness clinics by telehealth. The primary objective was to describe and compare the mean weight reduction measured at the baseline and by the end of the lockdown. Secondary objectives include describing and comparing body fat percentage, muscle mass percentage, and BMI measured at the baseline and by the end of the lockdown. One hundred and seventy-two middle-aged (18-68 years old) women and men received online nutritional and healthy lifestyle advice during the COVID-19 lockdown in Colombia. Weight, fat (%), muscle mass (%), and BMI were assessed before and after the lockdown. We included baseline measurements taken before the lockdown from March 1st to June 20th, 2020, and post-lockdown measurements from August 31st to October 20th, 2020. Exclusion criteria included pregnancy or breastfeeding women, acutely decompensated diabetes, hypertension, CKD, Hypothyroidism or taking any of the obesity treatment medications approved in Colombia, including liraglutide, semaglutide or orlistat. A retrospective analysis was completed to compare the change in mean body anthropometrics. Shapiro Wilk test was used to assess for normality. Paired T Test and Wilcoxon sign test were used to compare the distribution of body anthropometrics before and after the lockdown. IRB approval was obtained before exporting and analyzing the collection of data. Out of 205 subjects and after a review of exclusion criteria, 172 subjects were included in the data analysis. 90.1% (155) were women. 52.3% (135) had overweight or obesity. After the COVID-19 lockdown, the mean weight loss reduction was 8.79 kg (SD ± 5.45, p<0.0001), corresponding to an 11.4% weight loss reduction. The mean fat mass percentage loss was 2.89 % (SD ± 2.64, p<0.0001), and the mean BMI presented a reduction of 3.16 (SD ± 1.96, p <0.0001). The mean muscle percentage loss was 0.10% (SD ± 2.67, p 0.482). Subjects receiving telehealth nutritional advice in Colombia during the COVID-19 lockdown had significant clinical and statistical weight, BMI, and fat loss reduction. Muscle mass was preserved; however, this mean change was not statistically significant. Physical inactivity during the lockdown period was a potential contributor to a nonsignificant mean muscle mass change. The subjects in this study were highly motivated to virtually attend weight loss and wellness clinics and to improve body anthropometrics by optimizing lifestyle changes. Telehealth weight loss strategies should always be considered when in-person patient interaction is not available.

Simple Prediction Model for Colorectal Serrated Polyps: Development and External Validation Study in U.S. Prospective Cohorts.

On the basis of four prospective studies in the United States, we developed and externally validated a simple risk prediction model for high-risk SPs in the setting of colonoscopy screening. Our model showed moderate discriminatory accuracy and has potential utility for individualized risk assessment, healthy lifestyle recommendations, and tailored colorectal cancer prevention.

Psychosocial Determinants of Recommended Lifestyle Behaviors among Hypertensive Patients: An Integrative Literature Review.

Healthy lifestyle levels are low among adults with hypertension (HTN). Unfortunately, psychosocial factors contributing to patients' inability to meet healthy lifestyle recommendations are not well-understood. This integrative review examined the relationships of three psychosocial factors (self-efficacy, outcome expectancy, and social support) with dietary adherence (DA) and physical activity (PA) among adults with HTN. In total, 24 peer-reviewed studies were assessed. Results showed self-efficacy had small-to-large relationships with PA (r = 0.02-0.46) and DA (r = 0.06-0.79), with the strength of the associations varying by the assessed domain and country of origin. However, few studies reported a small relationship between the remaining factors (outcome expectancy and social support) and PA and DA. Thus, more efforts are needed to delineate the contributions of social support and outcome expectancies on DA or PA. When designing an intervention that focuses on improving PA or DA among adults with HTN, these psychosocial factors should be targeted.

Lifestyle factors for the prevention of inflammatory bowel disease

ObjectiveTo estimate the proportion of cases of Crohn’s disease (CD) and ulcerative colitis (UC) that could be prevented by modifiable lifestyle factors.DesignIn a prospective cohort study of US adults from...

Practice-relevant dietary recommendations in uro-oncology

Ahealthy lifestyle is recommended for prevention, during therapy and in the survivorship of various medical conditions. This article aims to give an overview of the current dietary recommendations and currently discussed topics which are useful for patient counseling. The literature with afocus on uro-oncology, on prevention, during cancer therapy and survivorship was reviewed for healthy lifestyle recommendations. In addition, issues perceived in practice were researched, discussed with examples, and critically evaluated. The current recommendations of the professional associations are intended to encourage all healthy or already ill patients to adopt ahealthy lifestyle that includes abalanced diet, physical activity and healthy body weight. Consistent with current evidence, neither general supplementation of dietary supplements nor avoidance of entire food groups (such as meat or dairy products) is recommended. In the counseling situation, patients should be encouraged in ahealthy lifestyle or supported in an appropriate change of behavior. Any perceived uncertainty or questions from patient's perspective should be clarified and, if necessary, referred to adietician, oecotrophologist or nutritionist.

MUSCLE DEPLETED OBESITY IN INDIVIDUALS SCREENED FOR COLORECTAL CÂNCER.

Colorectal cancer (CRC) is the third most incident cancer in the world and the second leading cause of cancer death. Significant decreases in incidence and mortality can be achieved by reducing risk factors and adhering to healthy lifestyle recommendations, as well as screening for the disease. To evaluate the clinical nutritional profile of individuals at medium risk screened for CRC residing in the city of Piranhas/Alagoas. Cross-sectional study conducted from September to October 2020, with individuals at medium risk for CRC, of both sexes and aged between 50 and 70 years old. Participants were screened for CRC with fecal immunochemical testing (FIT) and colonoscopy. Personal, socioeconomic, clinical, lifestyle and nutritional assessment data were collected. The latter was performed using anthropometric data (weight, height, arm circumference and triceps skinfold thickness), body composition (bioimpedance) and physical examination. Descriptive analysis of data frequencies and dichotomization according to the presence or absence of overweight was performed, followed by comparison of means and medians and frequencies by chi-square or Fisher's exact test. In total, 82 people agreed to undergo the clinical nutritional assessment, most of them female (56.1%; n=46), adults (56.1%; n=46), with a mean age of 59.02 years (±6.30 SD). Pre-cancerous lesions were identified in 54.5% (n=42) of those screened, 52.4% (n=43) were smokers or former smokers, and 65.9% (n=54) did not practice scheduled physical activity. Nutritional assessment showed that 64.6% (n=53) were overweight according to body mass index. On the other hand, the muscle mass, % arm muscle circumference adequacy and body muscle mass (kg) markers showed that 32.9% (n=27) and 47.6% (n=39) of the subjects were muscle depleted, respectively. Above all, overweight participants had, in parallel, lower muscle mass (P<0.05), suggesting sarcopenic obesity in this population. Obesity is one of the main risk factors for CRC; when concomitant with sarcopenia, it favors worse health outcomes. In this context, evidence shows the need to assess muscle composition in people with obesity, especially through other methods of assessing body composition. Our results add to the evidence on the importance of the population being guided about screening and adherence to healthy lifestyle recommendations, especially strategies aimed at weight control and the practice of physical activity.

Pharmacist intervention in cardiovascular disease prevention: lipid modifying treatment optimisation in type 2 diabetes within hastings primary care network

Abstract Introduction Cardiovascular disease (CVD) leads to 1 in 4 premature deaths with higher likelihood in the most deprived population1. Consistent data demonstrated efficacy of statins in CVD prevention and mortality reduction through modifying lipid profile1,2. NICE:CG181 recommends high-intensity statin, namely atorvastatin 20mg daily in type 2 diabetes (T2DM) with high risk of developing CVD1, whilst the European Society of Cardiology suggests LDL-C target below 1.4mmol/L, the lower the better 2. In contrast, 30% of patients in Hastings Primary Care Network (PCN) are prescribed sub-optimal statin therapy3 with scope to promote medicine optimisation through modification of CVD risk factor in one of the England’s most deprived areas. Aim Lowering patient’s CVD risk through optimising statin therapy and improving practice’s compliance with NICE:CG181. Methods NHS Health Research Authority Decision tool was followed, ethics approval was not required. Statin prescribing data were obtained through OpenPrescribing database. This pilot study focused on the prescribing of simvastatin at one surgery within the PCN where patients were identified using the surgery medical information system with the inclusion clinical codes of: “T2DM”, “QRISK2&amp;gt;10%”, “latest LDL-C&amp;gt;1.4mmol/L” and “current simvastatin 10/20/40mg prescription”. Systematic review of patient medical records was followed, including medical history, latest lipid profile and liver function, allergies, history of statin intolerance, previous lipid therapy and frailty status determined using the electronic frailty index, Rockwood score and medical notes. Patients with heterozygous familial hypercholesterolaemia diagnosis, confirmed statin intolerance and moderately-to-severely frail were excluded. Patients were contacted to exercise shared decision-making. Once intervention agreed, prescription was initiated for prescriber authorisation. Blood test 3 months post-intervention monitored for liver function and lipid profile. Results Search in February 2022 identified 44 patients with 39 suitable for intervention after exclusion. Thirty-six contactable patients were all switched to high-intensity statin. Thirty-four were switched to atorvastatin 20 mg whilst two with prior atorvastatin intolerance were switched to rosuvastatin 10 mg. At baseline, 32 patients (88%) had cholesterol profile done within a year as per NICE:CG181. Three-month post-intervention blood tests were completed for 21, with 15 pending; 33% (7/21) had a reduction of LDL-C. In February 2022, 28.9% of the practice’s statin prescriptions were of low and medium intensity and was reduced to 25.6% post intervention. Discussion/Conclusion All contactable patients had statin therapy optimised after exercising shared decision-making with improvement of prescribing compliance to NICE:CG181 demonstrated in this practice. Findings were inconclusive whether the intensification of statin therapy demonstrated cholesterol lowering effect in this cohort. Study limitations due to small sample size, currency of baseline profile at time of intervention and patient compliance not measured. Raised LDL-C observed could have been influenced by lifestyle changes such as poor diet and lack of exercise1. The limitations of this study will be reviewed for future roll out across Hastings PCN. Further exploration of therapy compliance, lifestyle education and the barriers to regular blood test would facilitate such medicine optimisation intervention. In conclusion, patients prescribed with sub-optimal lipid therapy should be reviewed and managed through healthy lifestyle recommendations and aggressive pharmacological intervention.

Content related with preschool children's health on Facebook: a study of parental informational needs

Abstract Background Little is known how Lithuanian mothers use social networks to seek information about preschool children's health. This study aimed to identify health topics of the posts, characteristics of the most engaging posts, and practices shared in the comments. Methods This study included all accessible posts published in 2021 on one Facebook group with more than 21 000 Lithuanian mothers. In total, 1674 posts and 3192 comments on the most engaged group of posts (gastrointestinal disorders) were analysed. Number and type of reactions to posts, categories of health topics, aim, form, tone, and structure of the posts, also practice type on comment were registered. Results Among all posts, 72.9% were related to children's health. The most common health topics included injuries (17.1%), healthcare (15.1%), gastrointestinal disorders (9.7%), allergies and skin diseases (9.7%), nutrition, physical activity and health promotion (9.3%), nurture (8.9%). The most common form was text only (48.7%), repetitive aim was to ask about personal experience (47.5%), and recommendations (35.5%). Larger numbers of reactions achieved posts with sensitive tone, including appeal, child's health description, gratitude in advance, and written in Lithuanian (p &amp;lt; 0.05). Comments with healthy lifestyle recommendations, recommendations for medication, also recommendations to treat children by themselves, to visit physicians accounted for 73.6%, 26.4%, 36.0% and 10.8% respectively. Conclusions Main topics of children's health on Facebook for Lithuanian mothers are injuries, healthcare, gastrointestinal disorders, allergies, skin diseases, nutrition, physical activity, health promotion, nurture. Posts with sensitive tone, appeal, situation description, gratitude, written in Lithuanian achieve the largest number of reactions. Comments most frequently include advices to treat children at home, also healthy lifestyle recommendations. Key messages • Lithuanian mothers most frequently seek advices regarding preschool children’s injuries, healthcare, gastrointestinal issues, allergies and skin diseases, and nurture. • Publication of posts including text only, sensitive tone, greetings, situation description, and gratitude might help to promote health more effectively.

Association of Adherence to Healthy Lifestyle Recommendations With All-Cause and Cause-Specific Mortality Among Former Smokers

The benefits of smoking cessation are well known, but former smokers have a higher health risk than never smokers. The impact of former smokers' engaging in other aspects of a healthy lifestyle is unclear. To assess the association between adherence to evidence-based lifestyle recommendations and mortality among former smokers. This prospective cohort study included 159 937 participants in the National Institutes of Health-AARP Diet and Health Study of older US adults who completed the baseline and risk factor questionnaires and self-identified as former smokers. Baseline questionnaires were mailed from 1995 to 1996. Data analysis was performed from November 2020 to November 2021. Adherence to evidence-based lifestyle recommendations was scored for body weight (scores, 0-2), diet (scores, 0-3), physical activity (scores, 0-2), and alcohol intake (scores, 0-1) recommendations, with higher scores indicating better adherence. Individual lifestyle adherence scores were summed to make a total adherence score (scores, 0-8). The primary outcomes were all-cause and cause-specific mortality through December 31, 2019, with a mean (SD) follow-up of 18.9 (6.3) years. Hazard ratios (HRs) and 95% CIs were computed using a multivariable Cox proportional hazards regression model. Among 159 937 former smokers (mean [SD] age, 62.6 [5.2] years; 106 912 [66.9%] male; 149 742 [93.6%] White), 86 127 deaths occurred. A higher total adherence score was associated with lower all-cause mortality (HR per unit increase, 0.95; 95% CI, 0.94-0.95). Compared with the lowest total adherence score category (scores, 0-2), the HRs for all-cause mortality were 0.88 (95% CI, 0.86-0.90) for scores of 3 to 4, 0.80 (95% CI, 0.79-0.82) for scores of 5 to 6, and 0.73 (95% CI, 0.71-0.75) for scores of 7 to 8. Associations were observed regardless of health status, comorbid conditions, the number of cigarettes participants used to smoke per day, years since cessation, and age at smoking initiation. When examined individually, the HRs for highest vs lowest adherence score were 0.86 (95% CI, 0.84-0.88) for body weight, 0.91 (95% CI, 0.90-0.93) for diet, 0.83 (95% CI, 0.81-0.85) for physical activity, and 0.96 (95% CI, 0.94-0.97) for alcohol intake recommendations. Participants with a higher total adherence score also had a lower risk of mortality from cancer, cardiovascular disease, and respiratory disease. In a large US cohort of former smokers, better adherence to healthy lifestyle recommendations was associated with lower mortality risk. These results provide evidence that former smokers may benefit from adhering to lifestyle recommendations, as do other groups.