The recurrent stroke presents a high burden, mainly in developing countries, such as Brazil. Secondary prevention guidelines guide the adoption of a healthy lifestyle and having knowledge about ...stroke to control risk factors for recurrent stroke. Therefore, it is important to identify the profile of healthy habits and knowledge to direct the use of related interventions.
To describe the profile of healthy habits and knowledge about stroke among individuals after stroke in a Brazilian metropolis.
Cross-sectional study, which recruited individuals two years after the stroke, aged ≥ 20 years, that received their first attendance in a stroke unit in the metropolis of Belo Horizonte (MG). For data collection, questions from the App “Stroke Riskometer” and from previous studies were used. Data were collected via telephone call and operationalized through absolute and relative frequency.
Seventy-three individuals (63±15 years old, 52% male) were included until now, and 7 (10%) cases of recurrent stroke were identified. As for habits, 64 (88%) reported not smoking, of these, 40 (55%) stopped smoking more than a year ago and 24 (33%) never smoked. Regarding alcohol consumption, 54 (74%) reported do not consume and, of these, 32 (59%) stopped consuming and 22 (41%) never consumed. As for eating, just over half (n=48, 66%) reported have adequate eating and 43 (59%) consume 2-3 fruits or vegetables/day. As for the physical activity practice, 29 (40%) reported practice it and, of these, 15 (52%) practice 2.5 hours/week and 11 (38%) between 1-2 hours/week. Just over half (n=45, 62%) reported to have not experienced significant emotional stress/depression for a year. As for knowledge, just over half reported know what a stroke is (n=42, 58%) and its signs and symptoms: difficulty speaking/understanding/articulating speech (n=48, 66%), loss of strength in arm (n=48, 66%) and smile/crooked mouth/face asymmetry (n=56, 77%). Most said they knew that smoking (n=62, 85%), alcohol consumption (n=55, 75%), inadequate eating (n=57, 78%), not practicing physical activity (n=59, 81%) and mental stress (n=60, 82%) are risk factors for stroke.
The habits that need more attention are healthy eating, alcohol consumption and mainly physical activity. Secondary prevention actions should also promote knowledge about what stroke is and its signs and symptoms. Most claimed to know that unhealthy habits are risk factors for the occurrence of stroke. However, an important amount of subjects (approximately 20%) stated that they did not have this knowledge and lacked this type of information. As the study is ongoing, these results should be interpreted with caution.
The results of this study contribute to the direction of actions for secondary prevention of stroke. Future studies should investigate whether having knowledge about stroke promotes the adoption of a healthy lifestyle.
Unhealthy behaviors, such as physical inactivity, sedentary lifestyle, and unhealthful eating, remain highly prevalent, posing formidable challenges in efforts to improve cardiovascular health. While ...traditional interventions to promote healthy lifestyles are both costly and effective, wearable trackers, especially Fitbit devices, can provide a low-cost alternative that may effectively help large numbers of individuals become more physically fit and thereby maintain a good health status.
The objectives of this meta-analysis are (1) to assess the effectiveness of interventions that incorporate a Fitbit device for healthy lifestyle outcomes (eg, steps, moderate-to-vigorous physical activity, and weight) and (2) to identify which additional intervention components or study characteristics are the most effective at improving healthy lifestyle outcomes.
A systematic review was conducted, searching the following databases from 2007 to 2019: MEDLINE, EMBASE, CINAHL, and CENTRAL (Cochrane). Studies were included if (1) they were randomized controlled trials, (2) the intervention involved the use of a Fitbit device, and (3) the reported outcomes were related to healthy lifestyles. The main outcome measures were related to physical activity, sedentary behavior, and weight. All the studies were assessed for risk of bias using Cochrane criteria. A random-effects meta-analysis was conducted to estimate the treatment effect of interventions that included a Fitbit device compared with a control group. We also conducted subgroup analysis and fuzzy-set qualitative comparative analysis (fsQCA) to further disentangle the effects of intervention components.
Our final sample comprised 41 articles reporting the results of 37 studies. For Fitbit-based interventions, we found a statistically significant increase in daily step count (mean difference MD 950.54, 95% CI 475.89-1425.18; P<.001) and moderate-to-vigorous physical activity (MD 6.16, 95% CI 2.80-9.51; P<.001), a significant decrease in weight (MD -1.48, 95% CI -2.81 to -0.14; P=.03), and a nonsignificant decrease in objectively assessed and self-reported sedentary behavior (MD -10.62, 95% CI -35.50 to 14.27; P=.40 and standardized MD -0.11, 95% CI -0.48 to 0.26; P=.56, respectively). In general, the included studies were at low risk for bias, except for performance bias. Subgroup analysis and fsQCA demonstrated that, in addition to the effects of the Fitbit devices, setting activity goals was the most important intervention component.
The use of Fitbit devices in interventions has the potential to promote healthy lifestyles in terms of physical activity and weight. Fitbit devices may be useful to health professionals for patient monitoring and support.
PROSPERO International Prospective Register of Systematic Reviews CRD42019145450; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019145450.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Previous studies only focused on the individual social factors, without considering the overall social health patterns. The present study aimed to develop an integrated social health score (SHS) and ...investigate its associations with all-cause, cardiovascular disease (CVD), cancer mortality.
A total of 330,716 participants (mean age 56.3 years; 52.4 % female) from UK Biobank was included between 2006 and 2010, and thereafter followed up to 2021. SHS was calculated by using information on social connections, social engagement and social support. Cox proportional hazards models was used to estimate the hazard ratios and 95 % confidence intervals (CIs) of the association between SHS and all-cause and cause-specific mortality and the 4-way decomposition was used to quantify the mediating effect of lifestyle factors.
During a median follow-up period of 12.4 years, 37,897 death cases were recorded, including 4347 CVD and 10,380 cancer cases. The SHS was inversely associated with the risks of all-cause, CVD and cancer mortality in a dose-dependent manner (P for trend <0.001). The association between SHS with all-cause mortality was mediated by lifestyle factors including diet score, smoking status and alcohol consumption.
Integrated SHS was inversely associated with risks of all-cause, CVD and cancer mortality, and the associations were partially mediated by lifestyle factors. Our study highlights the importance of maintaining high levels of social health by jointly enhancing social involvement, expanding social networks, and cultivating enduring intimate relationships across the life course.
•The social health score was calculated based on information about social connections, engagement, and support, indicting better social health with higher scores.•Social health score was inversely associated with risks of all-cause, CVD and cancer mortality.•The association between social health score with all-cause mortality was mediated by lifestyle factors, including diet score, smoking status, and alcohol consumption.
Objective
To provide guidance for the management of gout, including indications for and optimal use of urate‐lowering therapy (ULT), treatment of gout flares, and lifestyle and other medication ...recommendations.
Methods
Fifty‐seven population, intervention, comparator, and outcomes questions were developed, followed by a systematic literature review, including network meta‐analyses with ratings of the available evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, and patient input. A group consensus process was used to compose the final recommendations and grade their strength as strong or conditional.
Results
Forty‐two recommendations (including 16 strong recommendations) were generated. Strong recommendations included initiation of ULT for all patients with tophaceous gout, radiographic damage due to gout, or frequent gout flares; allopurinol as the preferred first‐line ULT, including for those with moderate‐to‐severe chronic kidney disease (CKD; stage >3); using a low starting dose of allopurinol (≤100 mg/day, and lower in CKD) or febuxostat (<40 mg/day); and a treat‐to‐target management strategy with ULT dose titration guided by serial serum urate (SU) measurements, with an SU target of <6 mg/dl. When initiating ULT, concomitant antiinflammatory prophylaxis therapy for a duration of at least 3–6 months was strongly recommended. For management of gout flares, colchicine, nonsteroidal antiinflammatory drugs, or glucocorticoids (oral, intraarticular, or intramuscular) were strongly recommended.
Conclusion
Using GRADE methodology and informed by a consensus process based on evidence from the current literature and patient preferences, this guideline provides direction for clinicians and patients making decisions on the management of gout.
In two online vignette studies, we investigated the effects of healthy lifestyle nudging and pricing interventions in two different contexts: a supermarket (Study 1) and a train station (Study 2). In ...Study 1 (N = 318) participants were randomly assigned to evaluate one of eight interventions described in a vignette and designed to either encourage healthier food choices or discourage unhealthy food choices in a supermarket setting. Two interventions comprised a small financial incentive to either encourage a healthy food choice or discourage an unhealthy food choice, but the other six interventions were nudges conceived to specifically impact agency, self-constitution or freedom of choice (three different aspects of autonomy). Relative to these nudges, the financial incentive interventions were not found to be less acceptable or more patronising. Overall, the encouragement of healthy food choices was rated as more acceptable and less patronising. The same pattern of results was found in Study 2 (N = 314). We conclude that interventions threatening specific aspects of one's autonomy do not necessarily affect its acceptance. However, the behavioural focus does affect intervention acceptance, that is, interventions focused on encouraging healthy choices are considered more acceptable than interventions that discourage the unhealthy option.
•Nudge interventions that encourage healthy choices are considered more acceptable.•Potential threats to autonomy are not necessarily linked to nudge acceptance.•Financial incentives are not considered less acceptable than nudges.•Financial incentives are not considered more patronising than nudges.
Some healthy lifestyle components have been linked with sleep disordered breathing (SDB), yet little is known about the relationship between comprehensive lifestyle factors and SDB. This study aimed ...to examine the healthy lifestyle with SDB in community-dwelling adults. We conducted a cross-sectional analysis of the Suzhou Food Consumption and Health Survey in China between 2018 and 2020. The healthy lifestyle index (HLI) was created by combining smoking, alcohol drinking, diet, physical activity, and body mass index (BMI). Its association with SDB was assessed by multiple logistic regression analysis. Subgroup analysis and sensitivity analysis were conducted to assess the robustness of our results. The final analysis included 3788 participants (2859 without SDB and 929 with SDB). In multivariable-adjusted analyses, non-smoking (OR: 0.58, 95 % CI: 0.47–0.71), non-drinking (OR: 0.55, 95 % CI: 0.45–0.68), healthy diet (OR: 0.79, 95 % CI: 0.65–0.95), and healthy BMI (OR: 0.72, 95 % CI: 0.6–0.86) were associated with SDB. Compared with participants with HLI score of 0–1, participants with HLI score of 2, 3, 4, and 5 had OR of 0.68 (95 % CI: 0.51–0.91), 0.49 (95 % CI: 0.37–0.64), 0.29 (95 % CI: 0.21–0.38), and 0.22 (95 % CI: 0.15–0.33), respectively, after adjustment for confounding factors (P-trend<0.001). An inverse dose-response relationship between HLI and SDB was also observed. The association was similar in subgroups stratified by sex, marital status, diabetes and dyslipidemia. A higher score of HLI was associated with reduced odds of SDB in Chinese adults. Our findings suggest the potential of addressing five modifiable lifestyle factors for the prevention of SDB.
•There was an inverse dose-response association between healthy lifestyle index (HLI) and sleep disordered breathing (SDB).•No smoking, no alcohol consumption, healthy diet, and healthy BMI were protective factors for SDB.•The inverse association between HLI and SDB was independent of multiple confounders.
Both genetic and lifestyle factors play an etiologic role in colorectal cancer (CRC).
We evaluated potential gene–environment interactions in CRC risk.
We used data from 346,297 participants in the ...UK Biobank cohort. Healthy lifestyle scores (HLSs) were constructed using 8 lifestyle factors, primarily according to the American Cancer Society guidelines, and were categorized into unhealthy, intermediate, and healthy groups. A polygenic risk score (PRS) was created using 95 genetic risk variants identified by genome-wide association studies of CRC and was categorized by tertile. Cox models were used to estimate the HRs and 95% CIs of CRC risk associated with the HLS and PRS.
During a median follow-up of 5.8 y, 2066 incident cases of CRC were identified. Healthier HLSs were associated with reduced risk of CRC in a dose–response manner. The risk reduction was more apparent among those with high PRS (HRhealthy vs. unhealthy HLS1: 0.58; 95% CI: 0.43, 0.79 for men and 0.71; 0.58, 0.85 for men and women combined) than those with low PRS. Although no multiplicative interactions were identified, the HLS1 and PRS showed a significant additive interaction (P = 0.02 for all participants combined, 0.04 for men). In analyses including all participants, the adjusted CRC cumulative risk from age 40 to 75 y was 6.40% for those with high PRS/unhealthy HLS1, with a relative excess risk due to interaction of 0.58 (95% CI: 0.06, 1.10), compared with 2.09% among those with low PRS/healthy HLS1. This pattern was more apparent among those who reported not having received any bowel screening before baseline.
Although the observational nature of the study precludes proof of causality, our findings suggest that individuals with a high genetic susceptibility could benefit more substantially than those with a low genetic risk from lifestyle modification in reducing CRC risk.
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