Obesity and alcohol consumption are both important modifiable risk factors for cancer. We examined the joint association of adiposity and alcohol consumption with alcohol- and obesity-related cancer ...incidence. This prospective cohort study included cancer-free UK Biobank participants aged 40–69 years. Alcohol consumption was categorised based on current UK guidelines into four groups. We defined three markers of adiposity: body fat percentage (BF %), waist circumference and BMI and categorised each into three groups. We derived a joint alcohol consumption and adiposity marker variable with twelve mutually exclusive categories. Among 399 575 participants, 17 617 developed alcohol-related cancer and 20 214 developed obesity-related cancer over an average follow-up of 11·8 (SD 0·9) years. We found relatively weak evidence of independent associations of alcohol consumption with cancer outcomes. However, the joint association analyses showed that across all adiposity markers, above guideline drinkers who were in the top two adiposity groups had elevated cancer incidence risk (e.g. HR for alcohol-related cancer was 1·53 (95 % CI (1·24, 1·90)) for within guideline drinkers and 1·61 (95 % CI (1·30, 2·00)) for above guideline drinkers among participants who were in the top tertile BF %. Regardless of alcohol consumption status, the risk of obesity-related cancer increased with higher adiposity in a dose–response manner within alcohol consumption categories. Our study provides guidance for public health priorities aimed at lowering population cancer risk via two key modifiable risk factors.
Background Despite the well-established capacity of physical activity to reduce blood pressure, the associations between physical activity with cardiovascular disease (CVD) incidence and mortality in ...people living with hypertension are not well understood. We examine the dose-response associations of device-assessed physical activity with all-cause and CVD mortality and CVD incidence (total, stroke, and coronary heart disease) in adults with hypertension. Methods and Results This prospective study included data from 39 294 participants with hypertension in the UK Biobank study who had valid accelerometry data and for whom mortality and CVD followed-up data were available. We categorized moderate-to-vigorous physical activity and total physical activity volume into 4 categories based on the 10th, 50th, and 90th percentiles and used Cox regressions to estimate their associations with CVD mortality and incidence outcomes. Splines were used to assess the dose-response associations. During a median follow-up of 6.25 years (241 418 person-years), 1518 deaths (549 attributable to CVD) and 4933 CVD (fatal and nonfatal) incident events were registered. Compared with the lowest category of moderate-to-vigorous physical activity, the relative risks (hazard ratios and 95% CIs) of all-cause mortality for increasing categories were 0.53 (0.46-0.61), 0.41 (0.34-0.49), and 0.36 (0.26-0.49). We found associations of similar magnitude for total CVD incidence, stroke, and coronary heart disease; and for total physical activity volume across all outcomes. For all outcomes, there were linear or nearly linear inverse dose-response relationships with no evidence of harms with high levels of physical activity. Results were robust to removing participants who died within the first 2 years. Conclusions Our findings underscore the importance of physical activity for people living with hypertension and provide novel insights to support the development of physical activity guideline recommendations for this high-risk group.
Although physical activity and sleep may influence each other, little is known about the bidirectional association of these two behaviors. The present analyses included 38,601 UK Biobank participants ...(51% female, 55.7 ± 7.6 years old, 6.9 ± 2.2 years of follow-up). Physical activity was categorized by the weekly metabolic equivalent of task minutes (highly active: ≥ 1200; active: 600 to <1200; inactive: < 600), and sleep patterns were determined using a composite score of healthy sleep characteristics: morning chronotype, adequate sleep duration (7–8 h/d), never or rare insomnia, never or rare snoring, and infrequent daytime sleepiness. We categorized the sleep score into three patterns (healthy: ≥ 4; intermediate: 2–3; poor: ≤ 1). Multiple logistic regressions examined the association of baseline (or the temporal changes in) sleep/physical activity with physical inactivity/poor sleep at follow-up. Participants with an intermediate or poor sleep pattern at baseline had higher odds (adjusted odds ratio: 1.24 1.17, 1.32 and 1.65 1.45, 1.88, respectively) for physical inactivity at follow-up, compared to those with healthy sleep, while shifting to a healthy sleep pattern over time attenuated these adverse associations. Compared to individuals highly active at both time points, being physically inactive at baseline and reducing physical activity over time were both associated with higher odds for poor sleep at follow-up. In conclusion, sleep improvements over time benefitted physical activity at follow-up, while reduced physical activity had a detrimental effect on sleep patterns at follow-up. Our results provide scope for interventions to concurrently target physical activity and sleep.
The incidence of both non-alcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease (ALD) are expected to grow as a consequence of the ongoing obesity and alcohol consumption trends.
We ...examined the joint associations of adiposity (body mass index (BMI) and waist circumference (WC)) and alcohol consumption on ALD, NAFLD and liver disease incidence and mortality (n = 465,437).
Alcohol consumption was categorised based on current UK guidelines (14 units/week). Data were analysed using Cox proportional hazard models. A total of 1090 liver disease deaths, 230 ALD deaths and 192 NAFLD deaths occurred over an average follow-up length of 10.5 ± 1.7 years.
In multivariate models, we observed greater point estimates for risk of ALD, NAFLD and liver disease incidence and mortality among overweight/obese participants who consumed alcohol at the same level as normal weight participants. We found that overweight/obese participants who reported alcohol consumption above the guidelines had a greater HR for liver disease incidence and mortality (HR 1.52, 95% CI 1.32, 1.75 and HR 2.20, 95% CI 1.41, 3.44, respectively) than normal weight individuals (HR 0.95, 95% CI 0.83, 1.09 and HR 1.24, 95% CI 0.8, 1.93, respectively). The results for the associations of alcohol consumption and WC with ALD, NAFLD and liver disease mortality were similar. Participants with high WC who reported alcohol consumption above the guidelines had a greater HR for liver disease incidence (HR 1.59, 95% CI 1.35, 1.87) than normal WC individuals (HR 0.85, 95% CI 0.72, 1.01).
We found evidence that being overweight/obese amplified the harmful effect of alcohol on the liver incidence and mortality.
•There was a dose–response of healthy lifestyle behaviour combinations against infection mortality.•Associations were independent of multiple markers of overall health status.•Mortality risk was ...reduced among both the low and high-risk segments of the population.
In this community-based cohort study, we investigated the relationship between combinations of modifiable lifestyle risk factors and infectious disease mortality. Participants were 468,569 men and women (56.5 ± 8.1, 54.6% women) residing in the United Kingdom. Lifestyle indexes included traditional and emerging lifestyle risk factors based on health guidelines and best practice recommendations for: physical activity, sedentary behaviour, sleep quality, diet quality, alcohol consumption, and smoking status. The main outcome was mortality from infectious diseases, including pneumonia, and coronavirus disease 2019 (COVID-19). Meeting public health guidelines or best practice recommendations among combinations of lifestyle risk factors was inversely associated with mortality. Hazard ratios ranged between 0.26 (0.23–0.30) to 0.69 (0.60–0.79) for infectious disease and pneumonia. Among participants with pre-existing cardiovascular disease or cancer, hazard ratios ranged between 0.30 (0.25–0.34) to 0.73 (0.60–0.89). COVID-19 mortality risk ranged between 0.42 (0.28–0.63) to 0.75 (0.49–1.13). We found a beneficial dose–response association with a higher lifestyle index against mortality that was consistent across sex, age, BMI, and socioeconomic status. There was limited evidence of synergistic interactions between most lifestyle behaviour pairs, suggesting that the dose–response relationship among different lifestyle behaviours is not greater than the sum of the risk induced by each behaviour. Improvements in lifestyle risk factors and meeting public health guidelines or best practice recommendations could be used as an ancillary measure to ameliorate infectious disease mortality.
The complexity of sleep hinders the formulation of sleep guidelines. Recent studies suggest that different unhealthy sleep characteristics jointly increase the risks for cardiovascular disease (CVD). ...This study aimed to estimate the differences in CVD-free life expectancy between people with different sleep profiles.
We included 308,683 middle-aged adults from the UK Biobank among whom 140,181 had primary care data linkage. We used an established composite sleep score comprising self-reported chronotype, duration, insomnia complaints, snoring, and daytime sleepiness to derive three sleep categories: poor, intermediate, and healthy. We also identified three clinical sleep disorders captured by primary care and inpatient records within 2 years before enrollment in the cohort: insomnia, sleep-related breathing disorders, and other sleep disorders. We estimated sex-specific CVD-free life expectancy with three-state Markov models conditioning on survival at age 40 across different sleep profiles and clinical disorders.
We observed a gradual loss in CVD-free life expectancy toward poor sleep such as, compared with healthy sleepers, poor sleepers lost 1.80 95% CI 0.96-2.75 and 2.31 1.46-3.29 CVD-free years in females and males, respectively, while intermediate sleepers lost 0.48 0.41-0.55 and 0.55 0.49-0.61 years. Among men, those with clinical insomnia or sleep-related breathing disorders lost CVD-free life by 3.84 0.61-8.59 or 6.73 5.31-8.48 years, respectively. Among women, sleep-related breathing disorders or other sleep disorders were associated with 7.32 5.33-10.34 or 1.43 0.20-3.29 years lost, respectively.
Both self-reported and doctor-diagnosed poor sleep are negatively associated with CVD-free life, especially pronounced in participants with sleep-related breathing disorders.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
We conducted a systematic review to evaluate combinations of physical activity, sedentary behavior, and sleep duration (defined as “movement behaviors”) and their associations with physical, ...psychological, and educational outcomes in children and adolescents. MEDLINE, CINAHL, PsychInfo, SPORTDiscus, PubMed, EMBASE, and ERIC were searched in June 2020. Included studies needed to 1) quantitatively analyze the association of 2 or more movement behaviors with an outcome, 2) analyze a population between 5 and 17 years of age, and 3) include at least an English abstract. We included 141 studies. Most studies included the combination of physical activity and sedentary behavior in their analyses. Sleep was studied less frequently. In combination, a high level of physical activity and a low level of sedentary behavior were associated with the best physical health, psychological health, and education-related outcomes. Sleep was often included in the combination that was associated with the most favorable outcomes. Sedentary behavior had a stronger influence in adolescents than in children and tended to be associated more negatively with outcomes when it was defined as screen time than when defined as overall time spent being sedentary. More initiatives and guidelines combining all 3 movement behaviors will provide benefit with regard to adiposity, cardiometabolic risk factors, cardiorespiratory fitness, muscular physical fitness, well-being, health-related quality of life, mental health, academic performance, and cognitive/executive function.
Tasmania, the smallest state by population in Australia, has a comprehensive tobacco control mass media campaign program that includes traditional (eg, television) and "new" channels (eg, social ...media), run by Quit Tasmania. The campaign targets adult smokers, in particular men aged 18-44 years, and people from low socioeconomic areas.
This study assesses the impact of the 2019-2021 campaign program on smokers' awareness of the campaign program, use of Quitline, and smoking-related intentions and behaviors.
We used a tracking survey (conducted 8 times per year, immediately following a burst of campaign activity) to assess campaign recall and recognition, intentions to quit, and behavioral actions taken in response to the campaigns. The sample size was approximately 125 participants at each survey wave, giving a total sample size of 2000 participants over the 2 years. We merged these data with metrics including television target audience rating points, digital and Facebook (Meta) analytics, and Quitline activity data, and conducted regression and time-series modeling.
Over the evaluation period, unprompted recall of any Quit Tasmania campaign was 18%, while prompted recognition of the most recent campaign was 50%. Over half (52%) of those who recognized a Quit Tasmania campaign reported that they had performed or considered a quitting-related behavioral action in response to the campaign. In the regression analyses, we found having different creatives within a single campaign burst was associated with higher campaign recall and recognition and an increase in the strength of behavioral actions taken. Higher target audience rating points were associated with higher campaign recall (but not recognition) and an increase in quit intentions, but not an increase in behavioral actions taken. Higher Facebook advertisement reach was associated with lower recall among survey participants, but recognition was higher when digital channels were used. The time-series analyses showed no systematic trends in Quitline activity over the evaluation period, but Quitline activity was higher when Facebook reach and advertisement spending were higher.
Our evaluation suggests that a variety of creatives should be used simultaneously and supports the continued use of traditional broadcast channels, including television. However, the impact of television on awareness and behavior may be weakening. Future campaign evaluations should closely monitor the effectiveness of television as a result. We are also one of the first studies to explicitly examine the impact of digital and social media, finding some evidence that they influence quitting-related outcomes. While this evidence is promising for campaign implementation, future evaluations should consider adopting rigorous methods to further investigate this relationship.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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