Unhealthy Lifestyle Behaviors Research Articles

Skipping breakfast, poor sleep quality, and Internet usage and their relation with unhappiness in Japanese adolescents.

Subjective happiness is often regarded as a major life goal. Although Japan is an economically powerful country, the level of subjective well-being reported among Japanese adolescents is lower than in other countries. We aimed to investigate the lifestyle factors related to unhappiness in Japanese adolescents. We collected data through the 2017–2018 Lifestyle Survey of Adolescents, a nationally representative cross-sectional study enrolled in randomly selected junior and senior high schools throughout Japan. We assessed the prevalence of subjective unhappiness in junior and senior high school students according to school life factors and daily lifestyle habits. A multivariable logistic regression analysis was used to examine the associations between these factors and unhappiness. A total of 64,329 students were included in the sample (mean age 15.7 years, 53.9% boys). The average prevalence of unhappiness was 10.2%. The logistic regression analyses indicated that unhappiness was strongly associated with being male and with engaging in unhealthy lifestyle behaviors such as not having breakfast, poor sleep quality, and some problematic Internet usage. Although the prevalence of unhappiness was significantly higher among current smokers and alcohol drinkers, these behaviors were not associated with unhappiness in the multivariable logistic regression analysis. Unhappiness among Japanese adolescents appears to be strongly related to how they spend their daily life. We therefore consider it desirable for school officials to educate students on the importance of happiness and lifestyle factors conducive to happiness.

Association between lifestyle behaviors and frailty in Atlantic Canadian males and females

PurposeThe aim of this study was to identify lifestyle factors in males and females that are associated with a greater degree of frailty in a Canadian cohort. MethodsCross-sectional data analysis from participants aged 30−74 yrs of the Atlantic PATH cohort. Inclusion criteria included completion of mental health questionnaires and ≥1 vital measure (n = 9133, 70% female, mean age 55 yrs). A frailty index was created based on 38 items with higher values indicating increasing frailty. The association between lifestyle factors and frailty was assessed by logistic regression. Results805 participants had a high level of frailty (frailty index ≥0.30). There was a significant interaction among sex, age, and lifestyle factors such as smoking status (P < 0.001), alcohol consumption (P < 0.001), physical activity level (P = 0.005), time spent sitting (P < 0.001) and sleeping (P < 0.001) on frailty. Smoking was harmful whereas sleep was protective for both males and females (<60 yrs). Females (<60yrs) that sat for ≥4 h/day were more likely to be highly frail whereas females (all ages) that consumed alcohol at least occasionally were less likely to be highly frail. Males, but not females, that engaged in a high level of physical activity were less likely to have a high level of frailty. ConclusionsHigher frailty is more prevalent among participants with unhealthy lifestyle behaviors related to smoking, alcohol consumption, sedentary and physical activity level, diet, and sleep. Differences in lifestyle behaviors of males and females of specific ages should be considered for managing frailty levels.

Barriers to healthy lifestyle behaviors in Australian nursing students: A qualitative study.

Studying at university is stressful, which can lead to unhealthy lifestyle behaviors. This study aimed to explore perceived reasons and barriers preventing Australian nursing students from engaging in a healthy lifestyle and strategies to overcome barriers. Fifty-four bachelor of nursing students participated in seven focus groups between July and November 2018. Participants defined healthy lifestyle behaviors as eating well; regular physical activity; regular water consumption; limiting alcohol, caffeine, and nicotine; good sleep quality; stress management and relaxation; and regular social interaction and support. They identified individual (lack of motivation, existing bad habits, lack of knowledge), environmental (time, finances, limited access to healthy food and physical activity resources), and psychosocial (competing priorities, increased learning cognitive load, lack of social interaction and support, compassion fatigue, and shift work) barriers preventing healthy lifestyle. Participants proposed several individual and system-related strategies to overcome barriers. Despite portraying a comprehensive understanding of healthy lifestyle behaviors, students reported finding difficulty in attaining healthy lifestyles. Strategies proposed by students may inform targeted interventions aiming to increase overall health of students, reduce attrition rates, and promote workforce retention post-graduation.

The moderating roles of psychological flexibility and inflexibility on the mental health impacts of COVID-19 pandemic and lockdown in Italy

The Moderating Roles of Psychological Flexibility and Inflexibility on the Mental Health Impacts of COVID-19 Pandemic and Lockdown in Italy.Preliminary data suggest the COVID-19 pandemic has adverse effects on mental health in approximately a quarter of the general population. Few prior studies have identified contextual risk factors and no published study has explored factors that might moderate their adverse effects on mental health. Psychological flexibility is the cornerstone of psychological health and resiliency. This study investigated the roles of psychological flexibility and inflexibility in moderating the effects of COVID-19 risk factors on three mental health outcomes: COVID-19 peritraumatic distress, anxiety, depression. We hypothesized that psychological flexibility would mitigate and psychological inflexibility would exacerbate the adverse effects of COVID-19 risk factors on mental health. During the Italian national lockdown (M = 39.29 days, SD = 11.26), 1035 adults (79% female, M = 37.5 years, SD = 12.3) completed an online survey. Twelve COVID-19 risk factors were identified (e.g. lockdown duration, family infected by COVID-19, increase in domestic violence and in unhealthy lifestyle behaviours) and constituted a COVID-19 Lockdown Index. As predicted, results showed that after controlling for sociodemographic variables, global psychological flexibility and four of its sub-processes (self-as context, defusion, values, committed action), mitigated the detrimental impacts of COVID-19 risk factors on mental health. In contrast and as expected, global psychological inflexibility and four of its sub-processes (lack of contact with present moment, fusion, self-as-content, lack of contact with personal values) exacerbated the detrimental impacts of COVID-19 risk factors on mental health. Findings converge with those from the broader psychological flexibility literature providing robust support for the use of ACT-based interventions to promote psychological flexibility and mental health during the COVID-19 pandemic.

Practicability of Implementing a Pilot School Based Obesity Prevention Program

Unhealthy diet and lifestyle behaviours are known to increase the risk of obesity and comorbidities. This article piloted the practicability of a school-based prevention program to control weight among schoolgirls. An eight-week comprehensive program was conducted on 66 adolescent females. Food habits and lifestyle survey was completed. Student health, nutrition, and physical activity knowledge was assessed. Physical education was applied. Subjective assessment of food/beverages at the school's canteen occurred and a sample of a healthy canteen was provided. Results showed students' unhealthy patterns in food habits and lifestyle. Significant changes were noticed in their overall positive responses to pre-and post-questions (P-value=001). Nearly 70% of food/beverage items were categorised as less healthy. School-based obesity prevention programs could support students in improving their eating patterns and weight status. The program could be replicated to improve students' lives in other locations. Benefits could include health and education ministries.

Lifestyle risk score and mortality in Korean adults: a population-based cohort study

Individual lifestyle risk factors have been associated with an increased risk of mortality. However, limited evidence is available on the combined association of lifestyle risk factors with mortality in non-Western populations. The analysis included 37,472 participants (aged ≥19 years) in the Korea National Health and Nutrition Examination Surveys (2007–2014) for whom the data were linked to death certificates/medical records through December 2016. A lifestyle risk score was created using five unhealthy behaviors: current smoking, high-risk alcohol drinking, unhealthy weight, physical inactivity, and insufficient/prolonged sleep. Cox proportional hazards models were used to estimate hazard ratio (HR) and 95% confidence interval (CI). During up to 9 years of follow-up, we documented 1,057 total deaths. Compared to individuals with zero lifestyle risk factor, those with 4–5 lifestyle risk factors had 2.01 times (HR = 2.01, 95% CI = 1.43–2.82) and 2.59 times (HR = 2.59, 95% CI = 1.24–5.40) higher risk of all-cause and cardiovascular mortality, respectively. However, higher lifestyle risk score was not significantly associated with cancer mortality (p-trend >0.05). In stratified analyses, the positive associations tended to be stronger in adults aged <65 years, unemployed, and those with lower levels of education. In conclusion, combined unhealthy lifestyle behaviors were associated with substantially increased risk of total and cardiovascular mortality in Korean adults.

Are Medicare wellness visits improving outcomes?

As the largest and unhealthiest population in American history enrolls as Medicare beneficiaries, it is vital for primary care providers to understand how to maximize Medicare wellness provisions. The Baby Boomer population has been documented to have the highest chronic disease prevalence related to preventable lifestyle behaviors. Perpetual unhealthy lifestyle behaviors associated with chronic disease prevalence are detrimental to life quality and the American Medicare resource structure. Since 2011, the Affordable Care Act provisions have included free wellness visits designed to prevent disease for Medicare beneficiaries, who continue to grossly underuse these services. This systematic review was conducted to evaluate the quality, level, and strength of evidence regarding Medicare wellness service efficacy on related health outcomes. The methodology adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for selection of 21 research-based articles included in the analysis. Results from the 21 eligible studies revealed low research quality and vigor; therefore, lacking causality and generalizability of medicare wellness visit (MWV) efficacy on health promotion outcomes. The evidence is focused on how MWVs are affecting preventive care utilization instead of patient health outcomes. In the interest of reducing chronic disease prevalence and the economic burden on our health care system, it is important to understand how these services affect health promotion outcomes. The results of this systematic literature review substantiate the need for primary care providers to study MWV efficacy on health promotion outcomes for the Medicare population.

Use of the prevented fraction for the population to determine deaths averted by existing prevalence of physical activity: a descriptive study

SummaryBackgroundDisease and mortality burdens of unhealthy lifestyle behaviours are often reported. In contrast, the positive narrative around the burdens that an existing behaviour have averted is rarely acknowledged. We aimed to estimate the prevented fraction for the population (PFP) for premature mortality averted by physical activity on a global scale.MethodsIn this descriptive study, we obtained previously published data on physical activity prevalence (2001–16) and relative risks of all-cause mortality for 168 countries. We combined the data in Monte-Carlo simulations to estimate country-specific, mean PFP values, corresponding to percentage of mortality averted, and their 95% CIs. High prevented fractions indicated an increased proportion of deaths averted due to physical activity. Using mortality data for all people in a country aged 40–74 years, we estimated the number of premature deaths averted for all adults and by gender. We present the median and range of the prevented fractions globally, by WHO region, and by World Bank income classification.FindingsThe global median PFP was 15·0% (range 6·6–20·5), conservatively equating to 3·9 million (95% CI 2·5–5·6) premature deaths averted annually. The African region had the highest median prevented fraction (16·6% [range 12·1–20·5]) and the Americas had the lowest (13·1% [10·8–16·6]). Low-income countries tended to have higher prevented fractions (group median 17·9% [12·3–20·5]) than high-income countries (14·1% [6·6–17·8]). Globally, the median prevented fraction was higher for men (16·0% [7·8–20·7] than women (14·1% [5·0–20·4]).InterpretationExisting physical activity prevalence has contributed to averting premature mortality across all countries. PFP has utility as an advocacy tool to promote healthy lifestyle behaviours. By making the case of what has been achieved, the prevented fraction can show the value of current investment and services, which might be conducive to political support.FundingUK Medical Research Council, British Heart Foundation, Cancer Research UK, Economic and Social Research Council, National Institute for Health Research, Wellcome Trust, Heart Foundation Australia.

2243-PUB: Association between Blood Pressure, Adiposity, and Lifestyle Behaviors in Schoolchildren

Background: Childhood blood pressure (BP) is known to be associated with weight status. However, the association between BP and adiposity and lifestyle behaviors in normal-weight (NW) versus overweight/obese (OW/OB) schoolchildren should be further explored. Objective: To determine the association between schoolchildren’s BP with adiposity and lifestyle behaviors. Methods: Data for age, sex, BMI, waist circumference (WC), and BP were recorded. OW/OB was defined as a BMI &amp;gt; 85%ile or &amp;gt; 95%ile respectively. A 5-level index that ranked participants’ daily consumption of vegetables or fruits, milk, sweetened beverages, and TV viewing were performed. Results: Schoolchildren (n = 1249, 554M) aged 9.4 ± 2.1 years from 9 elementary schools in five states of Argentina were examined. The prevalence of OW was 265 (21.2%) o and OB 265 (21.2%). All came from a low socio-economic background; 62% of the parents had an elementary school education or less. Children were divided into NW and OW/OB. Systolic BP was significantly associated with age (r=0.18), WC (r=0.17), and BMI (r=0.34) in NW children. However, systolic BP was significantly associated with age (r=0.37), WC (r=0.42), WC/height (r=0.24), BMI (r=0.19), low fruit intake (r=0.14), and TV watching (r=0.12) in OW/OB children. Diastolic BP was significantly associated with age (r=0.40), WC (r=0.37), WC/height (r=0.18), and BMI (r=0.33) in OW/OB children. Multiple linear regression analyses showed that systolic BP was only significantly associated with age in NW children (R2=0.02); but with age, WC, and TV watching (R2=0.22) in OW/OB children. In addition, diastolic BP was significantly associated with age and WC (R2=0.17) in OW/OB children but no association was found in NW children. Conclusion: These results suggest that BP levels in schoolchildren were associated with adiposity and unhealthy lifestyle behaviors. Future longitudinal studies should be performed to confirm these findings. Disclosure V. Hirschler: None. C. Molinari: None. S. Lapertosa: None. C. Garcia: None.

Clustering of Lifestyle Factors and Its Association with Low Back Pain: A Cross-Sectional Study of Over 400,000 Japanese Adults.

PurposeAlthough many studies have indicated the association between low back pain (LBP) and lifestyle factors, the combined effect of lifestyle factors on LBP has not been adequately investigated. We aimed to investigate the association between a cluster of unhealthy lifestyle behaviors and LBP using a large cohort of Japanese adults.MethodsWe included 419,003 adults aged over 20 years who underwent an annual health checkup between April 2013 and March 2014 in Japan. Information on the following lifestyle factors was collected using the standardized questionnaire: smoking, alcohol intake, exercise, physical activity, walking speed, weight control, eating habits, and sleep. Each factor was evaluated as a dichotomous variable (1: health risk, 0: no health risk). A lifestyle risk score was calculated by summing the score of each lifestyle factor (range: 0–12) and was categorized into three groups (low, moderate, high). LBP was defined as self-reported LBP under treatment. Logistic regression analysis was conducted to calculate the odds ratio (OR) and 95% confidence interval (CI) for LBP.ResultsIn multivariable logistic regression analysis, the OR for LBP was significantly higher in the moderate-risk score group (adjusted OR: 1.33 [95% CI: 1.23–1.44] in men; 1.40 [95% CI: 1.27–1.54] in women) and the high-risk score group (adjusted OR: 1.54 [95% CI: 1.43–1.67] in men; 1.83 [95% CI: 1.64–2.03] in women) than in the low-risk score group. A trend of higher risk of LBP associated with higher lifestyle risk score was observed in both sexes (p for trend < 0.001). These results were similar even in subgroup analysis by age and body mass index (BMI).ConclusionClustering of unhealthy lifestyles was associated with increased risk of LBP regardless of age and BMI. These results may provide implications for better prevention and management of LBP, considering modifiable lifestyle factors.

Relations between sweetened beverage consumption and individual, interpersonal, and environmental factors: a 6-year longitudinal study in German children and adolescents

ObjectivesThis study aims to characterize the consumption of sweetened beverages (SB) among young people in Germany in terms of individual and interpersonal-environmental correlates.MethodsA representative sample of children and adolescents from Germany was assessed twice, 6 years apart (total longitudinal sample n = 11,691 children and adolescents aged between 0 and 17 years old; weighted). The relations between individual and interpersonal-environmental factors at baseline with SB intake 6 years later were analysed using bivariate and multivariate methods.ResultsThe majority of children and adolescents in Germany consume sweetened beverages weekly, 23% daily. SB consumption is particularly high in boys and often accompanied by other unhealthy lifestyle behaviours including a high level of tobacco and media consumption with a concurrent deficiency in fruit and vegetable consumption. Interpersonal factors associated with higher sweetened beverage consumption include low socio-economic status, tobacco consumption of parents, and older maternal age.ConclusionsResearch on factors that correlate with sweetened beverage consumption is crucial to design effective interventions. Our findings underline the importance of complex, multi-level interventions to target sweetened beverage intake and obesity.

1007 Sociodemographic, Lifestyle and Dietary Correlates of Actigraphy-Measured Irregular Sleep Schedules in the Multi-Ethnic Study of Atherosclerosis

Abstract Introduction Increasing evidence links daily variability in sleep schedules to increased cardiometabolic risk. Little is known, however, regarding sociodemographic and behavioral correlates of irregular sleep schedules that may help identify causes or consequences of irregular sleep. Methods Among 1,946 participants from the Multi-Ethnic Study of Atherosclerosis, we examined the cross-sectional associations of irregular sleep schedules with sociodemographic, lifestyle, dietary factors, and actigraphy-based indices of rest-wake rhythms using multiple linear regression with adjustment for age, sex, race/ethnicity, education, income, marital status and work schedules. Sleep regularity was assessed using standard deviations (SD) in actigraphy-measured sleep duration and sleep onset timing across 7 days. Results Compared to Whites, the 7-day sleep duration SD (95% CI) was 17.4min (12.6, 22.2) higher in African-Americans, 10.4min (4.8, 16.0) higher in Hispanics and 7.9min (1.3, 14.4) higher in Chinese. Shift versus regular work was associated with 11.4min (5.1, 17.7) higher sleep duration SD. Irregular sleep duration was associated with lower income (p=0.006), higher depressive symptoms (p&amp;lt;0.0001), higher BMI (p=0.004) and current smoking (p=0.06). Higher sleep duration variability was associated with lower Alternative Healthy Eating Index (p=0.01), mainly due to suboptimal intakes of fruits, whole grains and nuts/legumes. No associations were observed for age, sex, education, marital status or number of meals per day. While sleep duration variability was not associated with self-reported physical activity level or actigraphy-measured 7-day mean activity count, sleep duration SD was inversely associated with relative amplitude (difference between the most versus the least active period; p&amp;lt;0.0001) and inter-daily stability (synchronization between rest-activity patterns and environmental zeitgebers; p&amp;lt;0.0001) of 24-h rest-activity patterns. Similar results were observed for sleep onset timing SD. Conclusion Substantial differences by sociodemographic factors exist regarding the consistency of day-to-day sleep schedules. Irregular sleep schedules are associated with overall circadian disruption across the day and some unhealthy lifestyle behaviors. Future studies are needed to understand temporal relationships of the observed associations. Support NIH grants K01HL143034, R35HL135818

Adiposity, lifestyle behaviors, and cardiometabolic markers in Argentinean schoolchildren

BackgroundWe determined the association between schoolchildren's OW/OB with age, sex, lifestyle behaviors, and cardiometabolic markers. MethodsAge, sex, anthropometric measures, and BP (blood pressure) were recorded in 1249 (554 M) schoolchildren. OW/OB was defined as BMI > 85%ile and BMI > 95%ile respectively. A validated questionnaire for lifestyle behaviors was performed. We offered free laboratory testing to a subgroup of 168 children. ResultsSchoolchildren aged 8.8 ± 2.1 y from 9 elementary schools in 4 areas of Argentina were examined between April and September 2019. 265 (21.2%) of the children were OW, 265 (21.2%) were OB, and 425 (35%) had central OB. OW/OB was associated with low milk intake (OR = 1.92; 95% CI, 1.1–3.3), skipping breakfast (OR = 2.00; 95% CI, 1.2–3.4), a family history of hypertension (OR = 1.74; 95% CI, 1.1–2.9), and systolic BP (OR = 1.03; 95% CI, 1.01–1.05); adjusted for confounding variables. The subgroup analysis showed that OW/OB children had lower iron (83 vs. 94 ug/dl, respectively) and HDL-C (43 vs. 47 mg/dl) levels, but higher non-HDL-C (107 vs. 99 mg/dl) levels than normal-weight children. Multiple logistic regression analysis showed that OW/OB was inversely associated with iron (OR = 0.99; 95% CI, 0.98–0.998) and HDL-C (OR = 0.94; 95% CI, 0.91–0.97) levels; adjusted for confounding variables. ConclusionAdiposity in schoolchildren was associated with unhealthy lifestyle behaviors, higher atherogenic risk, and lower iron concentrations, suggesting that OW/OB children are at increased risk for anemia and cardiometabolic disease.

The changing relationship between health burden and work disability of Australian cancer survivors, 2003\u20132017: evidence from a longitudinal survey

BackgroundThe purpose of this study was to examine the relationship between the cancer health burden and themagnitude of work disability on cancer survivors in Australia from 2003 to 2017.MethodsA longitudinal prospective study design was undertaken among cancer patients using data from the Household, Income and Labour Dynamics in Australia survey. The longitudinal effect was captured using a fixed effect multinomial logistic regression model, which predicted changes in the relationship between cancer burden and work disability level controlling for socio-demographic, lifestyle and life conditions predictors.ResultsThe prevalence of long-term disability among cancer survivors was 50%, with 18% of patients experiencing extreme work disability. The magnitude of disability levels increased significantly with the level of health burden. Cancer survivors who faced a severe health burden were at 5.32 times significantly higher risk of having work disability compared with patients who had no health burden. Other potential predictors, such as older patients (relative risk ratio, RRR = 1.82; 95% CI: 1.57, 5.87), those engaged in lower levels of physical activities (RRR = 1.91; 95% CI: 1.07, 3.40), those who drink alcohol (RRR = 1.29; 95% CI: 1.15, 1.49), and poor socioeconomic status (RRR = 1.28; 95% CI: 1.16, 2.23) were all significantly associated with extreme work disability.ConclusionA substantial proportion of cancer survivors experienced work disability which was more pronounced with the magnitude of the cancer health burden. The different dimensions of disability might be prevented by introducing cancer survivor-specific evidence-based interventions, and incorporating comprehensive social support. Recommendations to improve public health policy aimed at reducing population-level unhealthy lifestyle behaviours include: using these findings to better outline the management of a sequelae course of treatment for cancer survivors; and identifying those who should undergo more intensive physical rehabilitation aimed at reducing their work disability level.

The Mobile Health Multiple Lifestyle Behavior Interventions Across the Lifespan (MoBILE) Research Program: Protocol for Development, Evaluation, and Implementation

BackgroundClustering of multiple lifestyle risk behaviors has been associated with a greater risk of noncommunicable diseases and mortality than one lifestyle risk behavior or no lifestyle risk behaviors. The National Board of Health and Welfare in Sweden reported in 2018 that it is important to provide additional support to individuals with multiple lifestyle risk behaviors, as risks from these behaviors are multiplicative rather than additive. However, the same report emphasized that there is a lack of knowledge regarding interventions that support changes to unhealthy lifestyle behaviors.ObjectiveThe MoBILE (Mobile health Multiple lifestyle Behavior Interventions across the LifEspan) research program has brought together two Swedish research groups supported by international collaborators. Through this collaboration, we aim to design and evaluate a number of novel and tailored mobile health (mHealth) multiple lifestyle behavior interventions across the life span of different health care populations. In addition, the MoBILE research program will extend ongoing research to include mHealth interventions for migrant pregnant women and children.MethodsEach project within the MoBILE program will focus on a specific group: pregnant women, preschool children, high school and university students, and adults in primary and clinical care. All the projects will follow the same 4 phases: requirements, development, evaluation, and implementation. During the requirements phase, implementers and end users will aid the design of content and functionality of the interventions. In the development phase, findings from the first phase will be synthesized with expert domain knowledge and theoretical constructs to create interventions tailored to the target groups. The third phase, evaluation, will comprise randomized controlled trials conducted to estimate the effects of the interventions on multiple lifestyle risk behaviors (eg, alcohol, nutrition, physical activity, and smoking). The final phase will investigate how the interventions, if found effective, can be disseminated into different health care contexts.ResultsThe research program commenced in 2019, and the first results will be available in 2020. Projects involving pregnant women, preschool children, and high school and university students will be completed in the first 3 years, with the remaining projects being planned for the program’s final 3 years.ConclusionsThe development of evidence-based digital tools is complex, as they should be guided by theoretical frameworks, and requires large interdisciplinary teams with competence in technology, behavioral science, and lifestyle-specific areas. Individual researchers or smaller research groups developing their own tools is not the way forward, as it means reinventing the wheel over and over again. The MoBILE research program therefore aims to join forces and learn from the past 10 years of mHealth research to maximize scientific outcomes, as well as the use of financial resources to expand the growing body of evidence for mHealth lifestyle behavior interventions.International Registered Report Identifier (IRRID)PRR1-10.2196/14894

Lifestyle Behaviours and Mental Health Outcomes of Elderly: Modification of Socio-Economic and Physical Health Effects

Lifestyle behaviours and its mediating relationships between socio-economic characteristics and physical health effects have been widely discussed in epidemiological study. Considering a proper study framework, the relationship between lifestyle and mental health has not been rigorously established. Utilizing population based elderly data from Building a Knowledge Base on Population Ageing in India (BKPAI), present study has made an attempt to understand the direct and indirect effects of lifestyle behaviours on the mental health outcomes of elderly through statistical path. Six lifestyle behaviours were examined: physical activity, smoking, alcohol consumption, diet, family relation and social activity. In order to measure mental health, two common symptoms of general psychological stress including anxiety and depression were identified by examining factor structure of twelve item General Health Questionnaire (GHQ-12) in Indian elderly. The result shows that anxiety and depression were more common among the elderly with unhealthy lifestyle such as physical inactivity, regular smoking, social isolation and poor family relation. Multivariate analysis also shows, poor physical health, characterised by functional limitation, presence of NCDs, and disability has a stronger influence on anxiety and depression. Moderation analysis suggests that both physical activity and social activity have a moderation effect on anxiety and depression over socio-economic risk factors. This study evidently concludes that unhealthy lifestyle behaviours of older adults such as regular smoking, low level of physical activity are directly vis-a-vis indirectly associated with bad mental health. Therefore, modification of these unhealthy lifestyle behaviours will effectively reduce the burden of psychological distress among older adults in India.

Prevalence and Associated Lifestyle Factors of Suboptimal Health Status among Chinese Children Using a Multi-Level Model.

Chinese children are facing health challenges brought by chronic non-communicable diseases, such as physical problems and psychological related health problems. Childhood represents a critical life period when the long-term dietary and lifestyle behaviors are formed. It is necessary to survey the prevalence of suboptimal health status (SHS) among Chinese children and to research the relationship between SHS and lifestyles. This study aimed to examine the prevalence of SHS among Chinese children using a large-scale population survey sample covering school students and nonstudent children, and clarified the relationships between SHS and lifestyle factors using multi-level models controlled for the cluster effect of location and the confounding effect of demographics. Multi-level generalized estimating equation models were used to examine the relationships between SHS and lifestyle factors. Prevalence ratios (PR) and 95% confidence intervals (CI) were used to assess the strength of these relationships. Of the 29,560 children, 14,393 reported one or more SHS symptoms, giving a SHS prevalence of 48.69%. The prevalence of SHS for boys (46.07%) was lower than that for girls (51.05%). After controlling for the cluster effect of living areas and confounding effect of demographic characteristics, lifestyle factors associated with SHS were: less sleep duration, current smokers (PR = 1.085, 95%CI: 1.027–1.147), current drinkers (PR = 1.072, 95%CI: 1.016–1.131), children’ parents suffering from chronic diseases (PR = 1.294, 95%CI: 1.179–1.421), poor sleep quality (PR = 1.470, 95%CI: 1.394–1.550), stress (PR = 1.545, 95%CI: 1.398–1.707), negative life events (PR = 1.237, 95%CI: 1.088–1.406), hypertension (PR = 1.046, 95%CI: 1.009–1.084), unhealthy diet choice (PR = 1.091, 95%CI: 1.051–1.133) and irregular meal time (PR = 1.210, 95%CI: 1.163–1.259). Children who could exercise regularly (PR = 0.897, 95%CI: 0.868–0.927) and those with regular medical checkup (PR = 0.891, 95%CI: 0.854–0.929) were associated with lower prevalence probability of SHS. SHS has become a serious public health challenge for Chinese children. Unhealthy lifestyles were closely associated with SHS. Implementation of preventative strategies are needed to reduce the potential SHS burden associated with these widespread high-risk unhealthy lifestyle behaviors.

Utility of a Specific Health Checkup Database Containing Lifestyle Behaviors and Lifestyle Diseases for Employee Health Insurance in Japan.

BackgroundThe Japanese Ministry of Health, Labour and Welfare introduced Specific Health Checkups (SHC) to identify individuals at risk of metabolic syndrome (MS). This study aimed to describe the SHC database developed by the Japan Medical Data Center Co., Ltd. (JMDC) as a means of exploring lifestyle behaviors and lifestyle diseases among working generations.MethodsWe conducted a retrospective, cross-sectional study of employees and their families using the JMDC-SHC database to describe the prevalence of lifestyle behaviors (smoking, exercise, dietary habits, drinking habits, and sleeping) and lifestyle diseases (MS, hypertension, dyslipidemia, and diabetes mellitus). Results were compared with data from the 2015 National Health and Nutrition Survey (NHNS) in Japan as a benchmark.ResultsAll 646,869 enrollees in the JMDC-SHC database were included, of whom 66.5% were men. Age ranged from 40–74 years. Compared with the results of the NHNS, the JMDC-SHC subjects were younger and had fewer MS components and a lower prevalence of diabetes and hypertension. Subjects in their 40s were most likely to have unhealthy lifestyle behaviors in all age groups (eg, smoking: 41.0% in men and 10.2% in women). The SHC group had more favorable behaviors overall, but underweight was more prevalent in the SHC females.ConclusionsThe JMDC-SHC population showed different lifestyle and lifestyle disease profiles to the NHNS population, probably due to its different age, gender, and employment distributions. Development of healthcare policies and plans for working generations would benefit from the selection of an age- and employment-appropriate database.

The effects of unhealthy lifestyle behaviours on risky riding behaviours – A study on app-based motorcycle taxi riders in Vietnam

IntroductionIn developing countries, traditional motorcycle taxis are operated as a type of public transport mode. Recently, the development of mobile technology has enabled this transport mode to become an app-based motorcycle taxi service, leading to a rapid increase in travel demand. However, the emergence of app-based motorcycle taxi riders is considered to contribute directly and indirectly to the high proportion of road traffic crashes through their risky riding behaviours. The associations between unhealthy habits such as smoking, drink riding and other risky behaviours among motorcyclists have received less attention. Therefore, the aim of this study is to explore the effect of unhealthy lifestyle behaviours on risky riding behaviours among app-based motorcycle taxi riders. This study also explores the prevalence of risky riding behaviours and their associations. MethodsAn online survey and field surveys were carried out to obtain information about app-based motorcycle taxi riders’ demographics, work patterns and risky riding behaviours. More than 600 riders (mean age = 25.74 years, SD = 7.3), who were working in the three largest cities in Vietnam, completed a structured questionnaire. ResultsBinary logistic regression modelling showed that riders who regularly smoked and drunk alcohol were more likely to engage in the risky behaviours of smoking while riding and drink riding (Adj. OR = 18.61, 95%CI, p < 0.001 and Adj. OR = 9.02, 95%CI, p < 0.01 respectively). The results also indicated that those who sometimes smoked cigarettes were more likely not to wear helmets when riding (Adj. OR = 2.55, p < 0.01). While smoking habits were associated with smoking while riding and not wearing a helmet, most surveyed risky riding behaviours were associated with drinking habits. Significant associations between smoke/drink riding and all other risky riding behaviours were also found in this study. ConclusionA better understanding of these relationships will help authorities and ride-hailing firms to improve safe riding behaviours among app-based motorcycle taxi riders.

MINOR DISCOMFORTS AMONG PREGNANT WOMEN ATTENDING IN BENI- SWEIF UNIVERSITY HOSPITAL

Most pregnant women suffer from minor discomforts during their pregnancy period. These minor discomforts are due to hormonal change. The common of minor discomforts are nausea and vomiting ,fatigue ,constipation ,heart burn, backache ,Dyspnea, leg cramps varicose vein, insomnia, urerinary frequency, and leucorrhea.Aim: The present study aimed to explore the magnitude and types of minor discomforts among pregnant women attending Beni-Sweif University Hospital. A sample of 90 pregnant women selected from those attending in the antenatal clinic of Beni-Sweif University Hospital. Asructureit interview questionnaire was developed and used for data collection to assess women's socio-demographic and obstetric characteristics, and pregnancy related to problems .Based of data collection of the current study It can be concluded that the majority of the pregnant women complained from minor discomfort during pregnancy period these were; vaginal discharge,,frequenancy of urinantion, back ache ,nausea ,heart burn ,drowsiness difficult of breathing ,constipation heavy breast and muscles spasm. Recommendations Awareness raising programs must be conducted regarding importance of antenatal care to improve mothers' knowledge regarding minor discomfort . In- services training to all nurses and health care provider at maternal health services to up date their knowledge,increase their ability to care for pregnant mother with discomfort and instruct them to avoid their unhealthy lifestyle behaviors.