Unhealthy Lifestyle Behaviors Research Articles

Postpartum lifestyle behaviour among women with prior gestational diabetes mellitus: evidence from the HUNT study

IntroductionWomen with a history of gestational diabetes mellitus (GDM) are at increased risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Recommendations for postpartum follow-up include targeted lifestyle...

Relationship Between Health Literacy and Unhealthy Lifestyle Behaviours in Older Adults Living in Switzerland: Does Social Connectedness Matter?

Objectives: To investigate the association between health literacy (HL) and unhealthy lifestyle behaviours and to explore the moderating role of social connectedness in this relationship in older adults in Switzerland. Methods: We used data from 1,455 respondents to Wave 8 of the Survey of Health, Ageing, and Retirement in Europe (SHARE). Associations between the number of unhealthy lifestyle behaviours (smoking, risky alcohol consumption, suboptimal daily consumption of fruits/vegetables, lack of vigorous physical activity) and HL were examined using multivariable Poisson regression models, which allowed for interactions between HL and social connectedness to test the moderation hypothesis. Results: Respondents with inadequate HL were significantly more likely to have a higher number of unhealthy lifestyle behaviours than respondents with sufficient HL. We found a stronger positive association between inadequate HL and the number of unhealthy lifestyle behaviours among socially isolated individuals. Conclusion: Greater social connectedness seems to buffer the negative impact of inadequate HL on unhealthy lifestyle behaviours in older adults, highlighting the importance of good HL for healthy lifestyles, especially in individuals with low social reserve.

Translation, adaptation and validation of the Sinhala Version of Weight Efficacy Lifestyle Questionnaire Short Form (WEL-SF) for women

Introduction: The global obesity burden is rising alarmingly due to unhealthy lifestyle behaviours and environmental factors. To date, prevention and treatment efforts to combat obesity mainly focus on lifestyle modifications through diet and physical activity. Eating self-efficacy has been related to weight loss and is considered a significant predictor of weight loss in an individual. The Weight Efficacy Lifestyle Questionnaire Short Form (WEL-SF) is an American instrument used for research and clinical purposes to measure self-efficacy for controlling eating in specific situations.Objectives: Translation, cultural adaptation and validation of the WEL-SFMethods: A sample of 100 women aged ≥ 18 years who were attempting to reduce their weight through self-monitored non-therapeutic diet control in Panadura Medical Officer of Health (MOH) Area, Sri Lanka was recruited using a purposive sampling method. Data were collected using a self-administered questionnaire with socio-demographic information and Sinhala version of the WEL-SF. The construct validity was evaluated by Exploratory Factor Analysis (EFA) using Principal Component Analysis (PCA), while the reliability of the scale was determined by Cronbach's alpha.Results: The eight-item WEL-SF showed a one-factor solution by EFA. All the items on the scale were retained. The model explained a total variance of 59.35%. The internal consistency of WEL-SF was 0.905 using Cronbach’s alpha. The test-retest reliability of the instrument had a high Spearman's correlation of more than 0.7.Conclusions & Recommendations: The Sinhala version of WEL-SF for women to assess self-efficacy levels in overeating appears to be psychometrically valid with high reliability. This instrument can be recommended as a screening tool to assess self-efficacy levels in women striving for a healthy weight.

High prevalence of medical conditions and unhealthy lifestyle behaviours in women with PCOS during preconception: findings from the Australian LongitudinalStudy on Women's Health.

What are the pre-existing medical conditions and lifestyle behaviours of women with and without PCOS during the preconception period? During the preconception period, medical conditions of obesity, depression, anxiety, and a history of infertility were more highly prevalent in women with than without PCOS, and more women with than without PCOS were engaged in unhealthylifestyle behaviours. Women with PCOS are predisposed to infertility and pregnancy complications. Optimizing preconception medical health and lifestyle behaviours can improve maternal and pregnancy outcomes but, to the best of our knowledge, no study has examined the preconception medical conditions and lifestyle behaviours of women with PCOS. This is a cross-sectional study on 942 women with PCOS and 7024 women without PCOS, aged 24-30 years from the Australian Longitudinal Study of Women's Health, an ongoing, national survey-based prospective cohort study. The current study analysed self-reported data from Survey 6 collected in 2019 of the cohort of women born between 1989 and 1995. Explored outcomes included BMI, pre-existing medical conditions, and modifiable lifestyle behaviours, including smoking, recreational drug use, alcohol intake, and physical activity level, during the preconception period. Differences between subgroups were tested using Student's t-test, χ2 test, or Fisher's exact test as appropriate. The associations of pregnancy intention with medical conditions and lifestyle behaviours were examined using logistic regression. Obesity, depression, anxiety, and infertility were highly prevalent in women actively planning for pregnancy. Among women with PCOS, the prevalence of obesity was 47.02%, followed by depression at 32.70%, anxiety at 39.62%, and infertility at 47.17%. Conversely among women without PCOS, the corresponding prevalence was lower, at 22.33% for obesity, 18.98% for depression, 23.93% for anxiety, and 16.42% for infertility. In women actively planning for pregnancy, only those without PCOS demonstrated a lower prevalence of unhealthy lifestyle behaviours compared to non-planning women. The prevalence of unhealthy lifestyle behaviours was similar in women with PCOS regardless of their pregnancy intentions. Multivariable logistic regressionrevealed that only moderate/high stress with motherhood/children (adjusted odds ratio (OR) 3.31, 95% CI 1.60-6.85) and history of infertility (adjusted OR 9.67, 95% CI 5.02-18.64) were significantly associated with active pregnancy planning in women with PCOS. The findings were based on self-reported data. The cohort of women surveyed may have a higher level of education than women in the community, therefore our findings may underestimate the true prevalence of pre-existing medical conditions and lifestyle challenges faced by the broader population. A higher proportion of women with than without PCOS had pre-existing medical conditions and engaged in potentially modifiable unhealthy lifestyle behaviours during preconception despite their risk for subfertility and pregnancy complications. Healthcare professionals play a pivotal role in guiding this high-risk group of women during this period, offering counselling, education, and support for the adoption of healthy lifestyles to improve fertility, pregnancy outcomes, and intergenerational health. C.T.T. holds a seed grant from the National Health and Medical Research Council (NHMRC) through the Centre of Research Excellence in Women's Health in Reproductive Life (CRE WHiRL) and Royal Australasian College of Physician Foundation Roger Bartop Research Establishment Fellowship. H.T. holds an NHMRC Medical Research Fellowship. C.L.H. holds an NHMRC CRE Health in Preconconception and Pregnancy Senior Postdoctoral Fellowship. A.E.J. holds a CRE WhiRL Early to Mid-career Fellowship. The authors have no conflicts of interest to declare. N/A.

The nurse-led GILL eHealth intervention for improving physical health and lifestyle behaviours in clients with severe mental illness: design of a cluster-randomised controlled trial

BackgroundClients with severe mental illness (SMI) have overall poor physical health. SMI reduces life expectancy by 5–17 years, primarily due to physical comorbidity linked to cardiometabolic risks that are mainly driven by unhealthy lifestyle behaviours. To improve physical health in clients with SMI, key elements are systematic somatic screening and lifestyle promotion. The nurse-led GILL eHealth was developed for somatic screening and the implementation of lifestyle activities in clients with SMI. Aims of this study are to evaluate the effectiveness of the GILL eHealth intervention in clients with SMI compared to usual care, and to evaluate the implementation process, and the experiences of clients and healthcare providers with GILL eHealth.MethodsThe GILL study encompasses a cluster-randomised controlled trial in approximately 20 mental health care facilities in the Netherlands. The randomisation takes place at the team level, assigning clients to the eHealth intervention or the usual care group. The GILL eHealth intervention consists of two complementary modules for somatic screening and lifestyle promotion, resulting in personalised somatic treatment and lifestyle plans. Trained mental health nurses and nurse practitioners will implement the intervention within the multidisciplinary treatment context, and will guide and support the participants in promoting their physical health, including cardiometabolic risk management. Usual care includes treatment as currently delivered, with national guidelines as frame of reference. We aim to include 258 clients with SMI and a BMI of 27 or higher. Primary outcome is the metabolic syndrome severity score. Secondary outcomes are physical health measurements and participants’ reports on physical activity, perceived lifestyle behaviours, quality of life, recovery, psychosocial functioning, and health-related self-efficacy. Measurements will be completed at baseline and at 6 and 12 months. A qualitative process evaluation will be conducted alongside, to evaluate the process of implementation and the experiences of clients and healthcare professionals with GILL eHealth.DiscussionThe GILL eHealth intervention is expected to be more effective than usual care in improving physical health and lifestyle behaviours among clients with SMI. It will also provide important information on implementation of GILL eHealth in mental health care. If proven effective, GILL eHealth offers a clinically useful tool to improve physical health and lifestyle behaviours.Trial registrationClinical trial registration NCT05533749, registration date: 8 September 2022.

Lifestyle and the risk of acute coronary event: a retrospective study of patients after myocardial infarction.

Unhealthy lifestyle behaviours that may contribute to the development of disorders leading to MI include consuming foods with a high glycaemic load and excessive supply of saturated fats, especially trans fats. Limiting the consumption of simple and refined carbohydrates, such as sweets, sweet drinks, white bread, or white pasta, has a positive effect on the lipid profile by lowering the concentration of triglycerides. Eliminating simple sugars, especially fructose, prevents the deposition of visceral adipose tissue. The study included 116 patients of the Silesian Centre for Heart Diseases in Zabrze (SCCS; Poland), with their average age being 59.45 ± 11.54 years, staying in the SCCS due to MI, from March to November 2022. The comprehensive assessment of diet quality included 72 patients: 15 women and 57 men. The research tool was the KomPAN questionnaire for examining dietary views and habits, developed by the Committee on Human Nutrition Science of the Polish Academy of Sciences, evaluating the diet in the year preceding the study. The following three indicators were used to assess the diet quality: pro-Healthy Diet Index (pHDI), non-Healthy Diet Index (nHDI) and Diet Quality Index (DQI). Most patients ate white wheat bread several times a day (39.66% of patients, with a higher percentage in men than in women - 42.35% vs. 32.26%), and white rice, fine-ground groats and pasta once a week (40.52% of patients, including 41.17% of men and 38.71% of women). Legume seeds were predominantly eaten 1-3 times a month (51.73% of responses, with comparable percentages of men and women, i.e., 51.76% vs. 51.62%), vegetables several times a week (42.25% of responses, including more women than men, i.e., 54.84% vs. 37.64%), and fruit once a day (40.52% of responses, including more men than women: 45.89% vs. 25.81%). The results of our assessment of individual behaviours of the whole group may indicate errors in the diet. The value of the pro-Healthy Diet Index appears to confirm this fact, while the non-Healthy Diet Index and Diet Quality Index values do not clearly demonstrate its potential adverse impact on health. These limitations of our study may be due to differences in the size of the study population and the size of the population included in the comprehensive diet assessment. Therefore, it seems necessary to conduct further research.

Chronotype, Unhealthy Lifestyle, and Diabetes Risk in Middle-Aged U.S. Women : A Prospective Cohort Study.

Evening chronotype may promote adherence to an unhealthy lifestyle and increase type 2 diabetes risk. To evaluate the role of modifiable lifestyle behaviors in the association between chronotype and diabetes risk. Prospective cohort study. Nurses' Health Study II. 63 676 nurses aged 45 to 62 years with no history of cancer, cardiovascular disease, or diabetes in 2009 were prospectively followed until 2017. Self-reported chronotype using a validated question from the Morningness-Eveningness Questionnaire. The lifestyle behaviors that were measured were diet quality, physical activity, alcohol intake, body mass index (BMI), smoking, and sleep duration. Incident diabetes cases were self-reported and confirmed using a supplementary questionnaire. Participants reporting a "definite evening" chronotype were 54% (95% CI, 49% to 59%) more likely to have an unhealthy lifestyle than participants reporting a "definite morning" chronotype. A total of 1925 diabetes cases were documented over 469 120 person-years of follow-up. Compared with the "definite morning" chronotype, the adjusted hazard ratio (HR) for diabetes was 1.21 (CI, 1.09 to 1.35) for the "intermediate" chronotype and 1.72 (CI, 1.50 to 1.98) for the "definite evening" chronotype after adjustment for sociodemographic factors, shift work, and family history of diabetes. Further adjustment for BMI, physical activity, and diet quality attenuated the association comparing the "definite evening" and "definite morning" chronotypes to 1.31 (CI, 1.13 to 1.50), 1.54 (CI, 1.34 to 1.77), and 1.59 (CI, 1.38 to 1.83), respectively. Accounting for all measured lifestyle and sociodemographic factors resulted in a reduced but still positive association (HR comparing "definite evening" vs. "definite morning" chronotype, 1.19 [CI, 1.03 to 1.37]). Chronotype assessment using a single question, self-reported data, and homogeneity of the study population. Middle-aged nurses with an evening chronotype were more likely to report unhealthy lifestyle behaviors and had increased diabetes risk compared with those with a morning chronotype. Accounting for BMI, physical activity, diet, and other modifiable lifestyle factors attenuated much but not all of the increased diabetes risk. National Institutes of Health.

Association of secondhand smoke exposure and health-related lifestyle behaviors among male university employees in Japan

Secondhand smoke (SHS) exposure causes various health problems associated with an unhealthy lifestyle. However, the lifestyles of individuals exposed to SHS have not been characterized extensively. Therefore, this cross-sectional study aimed to investigate the association between SHS exposure and lifestyle behaviors. The participants were 2379 healthy male employees at Osaka University who underwent health examinations. Physical and biochemical parameters and lifestyle behavior data were obtained from all the participants. Participants with SHS exposure had significantly higher body mass index, waist circumference, and serum levels of triglycerides and uric acid than that of those without SHS exposure. SHS exposure was significantly correlated with several lifestyle behaviors, including TV time, frequency of breakfast consumption and fried food consumption, vegetable and fruit intake, alcohol consumption frequency and daily alcohol intake, and smoking status. Thus, SHS exposure may be associated with an unhealthy lifestyle. The lifestyle behaviors of the smoke-excluded population were assessed further; however, SHS exposure was still associated with dietary and drinking habits. Since participants with SHS exposure are likely to have an unhealthy life and combined unhealthy lifestyle behaviors, the confounding effect of these factors should be considered when assessing the impact of SHS exposure on health.

The effect of alcohol consumption on all-cause mortality in 70-year-olds in the context of other lifestyle risk factors: results from the Gothenburg H70 birth cohort study

BackgroundIn this study, we examined the effect of alcohol, as well as the combined effect of seven lifestyle factors, on all-cause mortality in older adults (baseline age 70 years).MethodsData was derived from the population-based Gothenburg H70 Birth Cohort study, including 1124 participants from the 2014–16 examination. Risk consumption was defined as > 98 g alcohol per week, and hazardous drinking was based on the Alcohol Use Disorders Identification Test-Consumption questionnaire (AUDIT-C). Cox regression models were used to examine the individual effect of alcohol consumption, as well as the combined effect of seven lifestyle risk factors (high alcohol consumption, lifetime smoking, unhealthy Body Mass Index, insufficient physical activity, sedentary behavior, insufficient/prolonged sleep, unhealthy dietary pattern) on all-cause mortality.ResultsDuring a mean follow-up of 7.7 years, 81 (7.2%) participants died. Neither risk consumption nor hazardous drinking were associated with elevated mortality, but hazardous drinking was associated with an increased risk of mortality in those with insufficient physical activity. Those with at least five lifestyle risk factors had an increased all-cause mortality compared to those fulfilling criteria for a maximum of one lifestyle risk factor. High alcohol consumption showed a relatively minor impact on this risk, while physical activity and unhealthy dietary pattern had an independent effect on mortality.ConclusionsIn this particular sample, there was no independent effect of alcohol on the risk of 8-year all-cause mortality. However, an interaction effect of physical activity was observed. It may be that high alcohol consumption per se is less important for mortality among older adults. However, a combination of several unhealthy lifestyle behaviors was linked to a substantial increase in the risk of mortality in Swedish older adults. Also, it has to be emphasized that high alcohol consumption may have other adverse health effects apart from mortality among older adults.

Lifestyle Risk Behaviours and Nutritional Status Associated with Mental Health Problems among Myanmar Adolescents: Secondary Analysis of a Nationwide 2016 School Survey.

Engaging in unhealthy lifestyles may be considered a risk factor for mental health problems, but there is limited evidence. This study aimed to identify the relationship between unhealthy lifestyles and mental health problems among Myanmar school-going adolescents. Global School Based Student Health Survey (GSHS) data from 2838 school-going adolescents from Myanmar were analysed. Bivariable and multivariable logistic regression analyses were applied. After adjusting for confounding variables, adolescents who were seated for more than three hours per day had higher odds of loneliness, anxiety-induced sleep disturbance, suicide ideation, and suicide attempts compared to others. Moreover, students who ate fruit less than one time per day were more likely to experience anxiety-induced sleep disturbance and suicidal ideation. Being a current drinker was significantly associated with suicidal ideation and attempt. Obese students were more likely to feel lonely compared to normal weight students. Our study indicates there is a strong association between unhealthy lifestyle behaviours and mental health problems among school adolescents in Myanmar.

Development and evaluation study of FLY-Kids: a new lifestyle screening tool for young children

Evaluating, discussing, and advising on young children’s lifestyles may contribute to timely modification of unhealthy behaviour and prevention of adverse health consequences. We aimed to develop and evaluate a new lifestyle screening tool for children aged 1–3 years. The lifestyle screening tool “FLY-Kids” was developed using data from lifestyle behaviour patterns of Dutch toddlers, age-specific lifestyle recommendations, target group analyses, and a Delphi process. Through 10 items, FLY-Kids generates a dashboard with an overview of the child’s lifestyle that can be used as conversation aid. FLY-Kids was completed by parents of children aged 1–3 years attending a regular youth healthcare appointment. Youth healthcare professionals (YHCP) then used the FLY-Kids dashboard to discuss lifestyle with the parents and provided tailored advice. Parents as well as YHCP evaluated the tool after use. Descriptive and correlation statistics were used to determine the usability, feasibility, and preliminary effect of FLY-Kids. Parents (N = 201) scored an average of 3.2 (out of 9, SD 1.6) unfavourable lifestyle behaviours in their children, while 3.0% complied with all recommendations. Most unfavourable behaviours were reported in unhealthy food intake and electronic screen time behaviour. Parents and YHCP regarded FLY-Kids as usable and feasible. The number of items identified by FLY-Kids as requiring attention was associated with the number of items discussed during the appointment (r = 0.47, p < 0.001). Conclusion: FLY-Kids can be used to identify unhealthy lifestyle behaviour in young children and guide the conversation about lifestyle in preventive healthcare settings. End-users rated FLY-Kids as helpful and user-friendly.What is Known:• A healthy lifestyle is important for optimal growth, development and overall health of young children (1-3 years).• Evaluating, discussing and advising on young children’s lifestyles may contribute to timely modification of unhealthy behaviour and prevention of adverse health consequences.What is New:• The new lifestyle screening tool FLY-Kids generates a dashboard with an overview of young children’s lifestyle that can be used as conversation aid between parents and youth healthcare professionals.• As parents and youth healthcare professionals rated FLY-Kids as helpful and user-friendly, and the number of items identified by FLY-Kids as requiring attention was associated with the number of items discussed during the appointment, FLY-Kids can be considered guiding the lifestyle discussion in preventive healthcare settings.

Insufficient Workplace Infection Control and Unhealthy Lifestyle Behaviors Are Related to Poor Self-Rated Health During the COVID-19 Pandemic.

This study investigated whether workers who practiced unhealthy lifestyles but worked under organizations with insufficient control against coronavirus disease 2019 (COVID-19) would pose a synergistic risk of poor self-rated health (SRH). A total of 22,637 workers (men, 48.5%) were extracted from an online survey during the COVID-19 pandemic in Japan (December 2020). Multiple logistic regression analyses were performed to estimate adjusted odds ratio (AOR) against poor (poor, fair) SRH. Accumulation of unhealthy lifestyle behaviors (AOR, 1.49 to 4.40; P < 0.05) and insufficient infection control (AOR, 1.80; P < 0.05) were independently related to poor SRH; however, when these factors were combined, SRH was additively worsened (AOR, 2.14 to 7.72; P < 0.05). This study highlights that not only unhealthy lifestyle practices but also poor organizational management against infection would worsen workers' SRH during the COVID-19 pandemic.

Clustering of lifestyle behaviors and adiposity in early adolescents in Spain: findings from the SI! Program for Secondary Schools

BackgroundSeveral unhealthy lifestyle behaviors in adolescence are often linked to overweight/obesity. Some of them may be present simultaneously, leading to combined effects on health. Therefore, the clustering of several unhealthy behaviors in adolescents might be associated with adiposity excess.PurposeTo identify lifestyle patterns and analyze their association with adiposity in early adolescents.MethodsA cross-sectional cluster analysis was performed in 1183 adolescents (50.5% girls) with a mean age of 12.5 (0.4) years included in the SI! Program for Secondary Schools in Spain to identify lifestyle patterns based on healthy diet, step counts, sleep time, and leisure screen time. Generalized mixed models were applied to estimate the association between lifestyle patterns and adiposity indices.ResultsFour lifestyle patterns were derived: Cluster 1-higher screen time and poorer diet (n = 213), Cluster 2-lower activity and longer sleepers (n = 388), Cluster 3-active and shorter sleepers (n = 280), and Cluster 4-healthiest (n = 302). Except for the number of steps (12,008 (2357) day), the lifestyle behaviors in our sample presented levels far below the recommendations, especially for sleep duration. Cluster 4 included the largest proportion of adolescents from high socioeconomic status families (47.7%) and the lowest prevalence of overweight/obesity (23.1%). Compared to Cluster 4-healthiest, adolescents in the remaining clusters presented a higher prevalence of overweight/obesity and central obesity, showing Cluster 3 the highest prevalences (PR:1.31 [95%CI: 1.31, 1.31] and PR:1.40 [95%CI: 1.33, 1.47]).ConclusionsClustering of lifestyle patterns in early adolescence allows the identification of individuals with excess adiposity, in whom health promotion strategies should be stressed, especially in socioeconomically disadvantaged groups.Trial registrationClinical Trial Registry, NCT03504059. Registered 20/04/2018—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03504059.

Socio-demographic correlates of unhealthy lifestyle in Ethiopia: a secondary analysis of a national survey

BackgroundMultiple lifestyle risk factors exhibit a stronger association with non-communicable diseases (NCDs) compared to a single factor, emphasizing the necessity of considering them collectively. By integrating these major lifestyle risk factors, we can identify individuals with an overall unhealthy lifestyle, which facilitates the provision of targeted interventions for those at significant risk of NCDs. The aim of this study was to evaluate the socio-demographic correlates of unhealthy lifestyles among adolescents and adults in Ethiopia.MethodsA national cross-sectional survey, based on the World Health Organization's NCD STEPS instruments, was conducted in Ethiopia. The survey, carried out in 2015, involved a total of 9,800 participants aged between 15 and 69 years. Lifestyle health scores, ranging from 0 (most healthy) to 5 (most unhealthy), were derived considering factors such as daily fruit and vegetable consumption, smoking status, prevalence of overweight/obesity, alcohol intake, and levels of physical activity. An unhealthy lifestyle was defined as the co-occurrence of three or more unhealthy behaviors. To determine the association of socio-demographic factors with unhealthy lifestyles, multivariable logistic regression models were utilized, adjusting for metabolic factors, specifically diabetes and high blood pressure.ResultsApproximately one in eight participants (16.7%) exhibited three or more unhealthy lifestyle behaviors, which included low fruit/vegetable consumption (98.2%), tobacco use (5.4%), excessive alcohol intake (15%), inadequate physical activity (66%), and obesity (2.3%). Factors such as male sex, urban residency, older age, being married or in a common-law relationship, and a higher income were associated with these unhealthy lifestyles. On the other hand, a higher educational status was associated with lower odds of these behaviors.ConclusionIn our analysis, we observed a higher prevalence of concurrent unhealthy lifestyles. Socio-demographic characteristics, such as sex, age, marital status, residence, income, and education, were found to correlate with individuals' lifestyles. Consequently, tailored interventions are imperative to mitigate the burden of unhealthy lifestyles in Ethiopia.

Prevalence and risk factor of diabetes among the elderly people in West Bengal: evidence-based LASI 1st wave

BackgroundThe complication of Diabetes is one of the important health issues among the older adult population in any region. The higher risks of diabetes prevalence among older adult people in the countries was due to social-cultural changes such as increasing urbanization, dietary changes, without physical activity, and unhealthy lifestyle behavior. The present study examines the prevalence and associated risk factors of diabetes among older adults in the state of West Bengal.MethodsThe first wave of the Longitudinal Ageing Study in India 2017-18 was used to achieve the study objectives. Descriptive statistics with multinomial logistic regression models were used to carry out crude and adjusted odds ratios with 95% confidence intervals and examine the associated risk factors of diabetes prevalence among older adults.ResultsThe findings of the study indicate that the overall prevalence of diabetes among the study participants was found to be 12.4% which was significantly higher in urban areas (19%) compare to rural areas (6%). The socio-economic and bio-demographic factors like educational status, richest background family, marital status, obesity, and family history of diabetes were significantly associated with higher risks of diabetes prevalence among the older adult population in West Bengal. The risks of diabetes in the richest adult people were significantly higher than in the poorest adult people (OR = 2.78; 95% CI: 1.974–3.917). The higher risks of diabetes mellitus among the richest wealthy people are because of lifestyle behavior, smoking, and tobacco consumption respectively.ConclusionThe study needs to policy and awareness program to reduce economic inequality and prevention of diabetes care and treatment-seeking behavior, especially for the older adult population in West Bengal.

A cluster randomized trial of a comprehensive intervention nesting family and clinic into school centered implementation to reduce myopia and obesity among children and adolescents in Beijing, China: study protocol

BackgroundMyopia and obesity in children and adolescents have become serious public health problems that endanger public health, especially in China. Unhealthy lifestyle behaviors are environmental drivers of both myopia and obesity. This protocol describes a study to evaluate the effectiveness of “22510SS”, that is 2 h of daytime outdoor activities (‘2’); Limit screen time to no more than 2 h per day (‘2’); Consume at least 5 servings of fruits and vegetables daily (‘5’); Attain 1 h of physical activity daily (‘1’); Consume 0 sugar-sweetened beverages (‘0’); Reasonable sleep duration (‘S’); Regular supervision (‘S’). A school-based, multifaceted intervention strategy for myopia and obesity prevention, and to assess and explore the implementation of “22510SS” with regards to acceptability, feasibility, adoption, usage and maintenance.Methods and analysisThis study aims to develop a comprehensive intervention strategy "22510SS" based on the socio-ecological model, and A two-arm cluster randomized trial with a parallel-group of a 1:1 allocation ratio in 36 primary and secondary schools to test its evidence-based intervention programs on the effects and implementation of myopia and obesity epidemics in children and adolescents in grades 4 and 7. The primary outcomes will include differences in visual acuity, body mass index, outdoor activity indicators, screen time, fruit and vegetable intake, high-quality protein intake, sugar-sweetened beverage intake, sleep duration, and level of monitoring among children and adolescents. Secondary outcomes will assess the acceptability, feasibility, uptake, use, and maintenance of the intervention. Effects on the primary and secondary outcomes will be analyzed using linear and logistic regression analyses, as well as difference-in-difference analysis, taking into account cluster effects and possible confounding factors. Process assessments will also be conducted through quantitative and qualitative analyses, including acceptability, feasibility, gender, adoption, implementation, and sustainability.DiscussionThis study will evaluate the effectiveness of “22510SS” and examine its implementation in the school-based network nesting family and clinic. Following this intervention study, the integrated intervention program focused on myopia and obesity among children and adolescents have great potential to be implemented in China to promote and support healthy lifestyle behavior change and reduce the risk of myopia and obesity in children and adolescents.Trial registrationNCT05275959. Registered 23 Mach 2022.

An intervention based on Well-Being Therapy to prevent alcohol use and other unhealthy lifestyle behaviors among students: a three-arm cluster randomized controlled trial

ABSTRACT Unhealthy lifestyle, such as alcohol use, and negative health outcomes have been associated with impairments in psychological well-being. The primary objective of the study was to test the efficacy of an intervention based on Well-Being Therapy to prevent or stem alcohol use, binge drinking and other unhealthy lifestyle among Italian adolescents in school settings. A three-arm cluster randomized controlled trial including three test periods (baseline, post-test, six-month follow-up) was implemented. Seven classes (144 students) were randomly assigned to receive well-being intervention (WBI), lifestyle intervention (LI), or no intervention (NI). Primary outcomes were alcohol use (AUDIT-C), binge drinking and other unhealthy lifestyle behaviors (i.e. unhealthy diet, physical inactivity, tobacco and cannabis smoking, poor sleep and Internet addiction). Linear mixed models and mixed-effects logistic regression were used to test the efficacy of WBI in comparison with LI and NI. At six-month follow-up, AUDIT-C total score increased more in NI in comparison with WBI (p = 0.044) and LI (p = 0.016), whereas the odds of being classified as at-risk drinker were lower in WBI (p = 0.038) and LI (p = 0.002), than NI. Only WBI showed a protective effect for cannabis use at post-test in comparison with NI (p = 0.003) and LI (p = 0.014). Sleep hours at night decreased more in NI than in LI (p = 0.027) at six months. Internet addiction decreased more in WBI (p = 0.002) and LI (p = 0.005) at post-test in comparison with NI. Although both interventions showed a positive impact on adolescent lifestyle, the positive effect of WBI on cannabis use underlines how this approach might be promising to stem adolescents’ substance use.

The clustering of multiple health and lifestyle behaviors among Swedish adolescents: a person-oriented analysis.

Knowledge of the distribution, prevalence, and clustering of multiple health and lifestyle related behaviors (HLBs) among adolescents can inform the development of effective health-promoting policies and interventions. We assessed the clustering of multiple HLBs among 11, 13 and 15-year-old Swedish adolescents and examined the socioeconomic and demographic correlates for the identified clusters. We used data from the 2017/2018 Swedish Health Behaviour in School-aged children (HBSC) study to conduct sex and age-stratified latent class analysis (LCA). The LCA was based on five HLBs: eating behavior and habits (EBH), physical activity (PA), tobacco usage (TU), alcohol consumption (AC) and sleeping habits and patterns (SHPs). Multinomial logistic regression models were used to assess the associations between the identified clusters and the socioeconomic and demographic characteristics of adolescents and their parents. Health behaviors varied by sex and age. Four distinct clusters were identified based on sex: cluster 1 (Mixed eating behaviors and habits, physical activity and low alcohol consumption), cluster 2 (Healthy lifestyle behaviors), cluster 3 (Unhealthy lifestyle behaviors), and cluster 4 (Breakfast, low alcohol consumption and tobacco usage). In the age-stratified analyzes, three clusters were identified: cluster 1 (Unhealthy lifestyle behaviors), cluster 2 (Moderately healthy lifestyle behaviors) and cluster 3 (Healthy lifestyle behaviors). The multinomial analysis showed that sex, age, family situation and perceived family wealth were strong predictors of health behaviors. Unhealthy behaviors were most commonly associated with socioeconomic disadvantage, having a migrant background, and living in reconstructed families or single-parent households. Health behaviors vary significantly based on socioeconomic and demographic circumstances. Targeted policies and intervention programs are necessary to improve HLBs among vulnerable and at-risk adolescents.

Socioeconomic position, perceived weight, lifestyle risk, and multimorbidity in young adults aged 18 to 35 years: a Multi-country Study

BackgroundMultimorbidity-risk is established early in life, therefore reducing modifiable risk factors such as overweight or obesity may, in part, tackle the burden of multimorbidity in later life.MethodsWe made use of a cross-sectional online survey that included young adults (18-35yrs old) from three countries – Kenya, South Africa, and the United Kingdom (n = 3000). Information pertaining to socio-demographic, health, lifestyle, and perceived weight was collected. Additionally, the sum of affirmed morbidities was used to determine a morbidity score. Likewise, a lifestyle risk score was calculated based on information obtained from questions surrounding four unhealthy lifestyle behaviours, namely current smoking, alcohol consumption, physical inactivity, and overweight/obese weight status as a confirmed clinic condition. We further explored differences in socioeconomic position, and the prevalence of perceived weight, multimorbidity, and lifestyle risk factors between the three countries. We also determined the odds ratio of multimorbidity with perceived weight as a main predictor variable. We furthermore performed a generalised structural equation model to determine whether the association between socioeconomic position and multimorbidity was mediated via perceived weight and/or lifestyle risk.ResultsSocioeconomic position, weight perceptions, lifestyle risk, and multimorbidity varied significantly across the different economic countries. Higher morbidity (by > 11.9%) and lifestyle risk (by > 20.7%) scores were observed in those who reported an overweight weight perception when compared to those with an underweight or normal weight perception. In pooled analyses, the odds ratio in developing 2 or more morbidities increased multiple times in those who perceived themselves as overweight (all models: OR ≥ 2.241 [95% CI ≥ 1.693; ≥ 2.966] p < 0.001), showing a larger odds ratio with high significance in those who reported 3 or more morbidities (all models: OR ≥ 3.656 [95% CI ≥ 2.528; ≥ 5.286] p < 0.001). Furthermore, this study showed that an overweight weight perception partially mediated (p ≤ 0.001) the association between socioeconomic position and multimorbidity.ConclusionsThis study confirmed poorer health outcomes in those who perceived themselves as overweight. The findings from this study further emphasise the importance of targeted intervention strategies directed at raising weight-related awareness and potentiating risk factors, specifically in those who reside in lower economic developed countries.

한국 청소년의 인터넷 사용 수준이 건강상태(BMI)에 미치는 영향

Objectives The purposes of this study were to investigate the socio-demographics, health and dietary factors, and health status (BMI) of Korean adolescents according to their internet usage level, using data from the 2019 Korea Youth Risk Behavior Web-Based Survey. Additionally, the study aimed to examine the relationship between internet usage level and the risk of obesity.&#x0D; Methods For this purpose, the raw data from the 2019 KYRBS was analyzed, and a total of 57,302 individuals were selected as the study subjects. To analyze the differences in socio-demographics, health and dietary factors, and health status (BMI) according to the level of internet usage, Rao-Scott χ2 test was used, and logistic regression analysis was used to calculate the odds ratios (OR) and 95% confidence intervals (95% CI) for the risk of obesity according to internet usage level.&#x0D; Results This study found that adolescents who overused the internet were more likely to be female, middle school students, and have lower parental education and economic status. They also showed unhealthy dietary and lifestyle behaviors, including high alcohol consumption, low physical activity, irregular breakfast, inadequate fruit and vegetable intake, inadequate milk and water intake, excessive consumption of sugary drinks and fast food, and rely on convenience food instead of regular meals. They had a higher risk of obesity compared to non-internet users.&#x0D; Conclusions This study was able to explain the association between internet usage level and obesity, and found that the group that overused the internet had a higher risk of obesity compared to the group that non-internet users.