OBJECTIVETo quantify the impact of a healthy lifestyle on the risk of Alzheimer dementia.
METHODSUsing data from the Chicago Health and Aging Project (CHAP; n = 1,845) and the Rush Memory and Aging ...Project (MAP; n = 920), we defined a healthy lifestyle score on the basis of nonsmoking, ≥150 min/wk moderate/vigorous-intensity physical activity, light to moderate alcohol consumption, high-quality Mediterranean-DASH Diet Intervention for Neurodegenerative Delay diet (upper 40%), and engagement in late-life cognitive activities (upper 40%), giving an overall score ranging from 0 to 5. Cox proportional hazard models were used for each cohort to estimate the hazard ratio (HR) and 95% confidence interval (CI) of the lifestyle score with Alzheimer dementia, and a random-effect meta-analysis was used to pool the results.
RESULTSDuring a median follow-up of 5.8 years in CHAP and 6.0 years in MAP, 379 and 229 participants, respectively, had incident Alzheimer dementia. In multivariable-adjusted models, the pooled HR (95% CI) of Alzheimer dementia across 2 cohorts was 0.73 (95% CI 0.66–0.80) per each additional healthy lifestyle factor. Compared to participants with 0 to 1 healthy lifestyle factor, the risk of Alzheimer dementia was 37% lower (pooled HR 0.63, 95% CI 0.47–0.84) in those with 2 to 3 healthy lifestyle factors and 60% lower (pooled HR 0.40, 95% CI 0.28–0.56) in those with 4 to 5 healthy lifestyle factors.
CONCLUSIONA healthy lifestyle as a composite score is associated with a substantially lower risk of Alzheimerʼs dementia.
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.
Approximately half of the patients with signs and symptoms of heart failure have a left ventricular ejection fraction that is not markedly abnormal. Despite the historically initial surprise, ...heightened risks for heart failure specific major adverse events occur across the broad range of ejection fraction, including normal. The recognition of the magnitude of the problem of heart failure with preserved ejection fraction in the past 20 years has spurred an explosion of clinical investigation and growing intensity of informative outcome trials. This article addresses the historic development of this component of the heart failure syndrome, including the epidemiology, pathophysiology, and existing and planned therapeutic studies. Looking forward, more specific phenotyping and even genotyping of subpopulations should lead to improvements in outcomes from future trials.
At present, few studies have explored the mediating effect of e-Health literacy and self-efficacy on prevention cognition and healthy lifestyle behaviors during the normalization stage of COVID-19 ...prevention and control. This study aimed to determine the associations among COVID-19-related prevention cognition, self-efficacy, e-Health literacy, and healthy lifestyle behaviors at university students.
By using a stratified cluster random sampling method, 971 students from five universities were recruited between May and August 2021 in Guangzhou, China. We collected participants' demographic characteristics, and assessed self-efficacy, COVID-19-related prevention cognition, e-Health literacy, and healthy lifestyle behaviors. A structural equation model was used for mediation analysis.
The overall mean value of healthy lifestyle behaviors of college students was 0.307 (SD 0.389). Between COVID-19-related prevention cognition, e-Health literacy, self-efficacy, and healthy lifestyle behaviors (r = 0.132–0.505, P < 0.01) were a significant positive correlation. The COVID-19-related prevention cognition had a direct and positive predictive effect on healthy lifestyle behaviors, with a direct effect value of 0.136. e-Health literacy and self-efficacy played both an independent mediating and serial-multiple mediating roles in the association between COVID-19-related prevention cognition and healthy lifestyle behaviors, and the indirect effect values were 0.043, 0.020 and 0.035, respectively.
The results showed that the emphasis on improving college students' prevention cognition, supplemented by improving e-Health literacy and self-efficacy, could improve college students' healthy lifestyle behaviors.
This study was a cross-sectional investigation with no causal relationship between variables.
•The overall mean value of healthy lifestyle behaviors of college students is 0.307(SD 0.389).•COVID-19-related prevention cognition, e-Health literacy, self-efficacy, and healthy lifestyle behaviors are positive correlations.•e-Health literacy and self-efficacy play a mediating role between COVID-19-related prevention cognition and healthy lifestyle behaviors.
The risk of chronic inflammatory diseases has been linked to exposure to polycyclic aromatic hydrocarbons (PAHs). However, limited data are available regarding their impact on periodontitis. This ...study aims to explore the association between PAHs and periodontitis while also evaluating the potential modifying effects of healthy lifestyles. We included 17,031 participants from the US National Health and Nutrition Examination Survey (NHANES, 2001–2004 and 2009–2014). A meta-analysis-based environment-wide association study (EWAS) was adopted to identify environmental chemicals for the mean probing pocket depth (PPD) and the mean attachment loss (AL). PAHs were further evaluated concerning the cross-sectional association with Mod/Sev periodontitis using multivariable logistic regression models. Moreover, healthy lifestyle scores were estimated to assess their modifying effect on the PAH–periodontitis association. EWAS analysis identified several urinary PAH metabolites as significant risk factors for the mean PPD and AL (false discovery rate <0.05, Q > 0.05). Periodontitis severity was positively associated with eight individual and total PAH concentrations. Stratifying the participants in terms of healthy lifestyle scores did not reveal any association in the healthy group. Moreover, the association weakened in never-smokers and individuals with sufficient physical activity and normal weight. PAH exposure was a risk factor for periodontitis. A healthier lifestyle was observed to offset the risk potentials of PAHs for periodontitis. Smoking cessation, physical activity, and weight loss might be recommended as a healthy lifestyle strategy for ameliorating PAH-related periodontitis.
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•Urinary PAH metabolites were positively associated with the risk of periodontitis.•The healthy lifestyle was observed to offset the risk potentials of PAHs for periodontitis.•Smoking cessation, physical activity, and weight control exerted protective effects.
This double-blind study randomly assigned adults with obesity (or overweight and with one or more weight-related coexisting conditions) without diabetes to 68 weeks of once-weekly subcutaneous ...semaglutide (2.4 mg) or placebo, plus lifestyle intervention. Semaglutide therapy was associated with sustained, clinically relevant weight reduction.
Childhood adversity (CA) has a substantial correlation with mental health problems. Keeping a healthy lifestyle is essential for mental health interventions; it is unclear, however, how healthy ...lifestyle affect the relationship between CA and persistent mental health problems.
This longitudinal study (n = 1112, 54.5 % male) collected the data on CA (measured through three dimensions: threat, deprivation and unpredictability), mental health problems, and lifestyle factors. Group-based multi-trajectory modeling (GBMTM) was utilized to estimate trajectories for three mental health problems (i.e., depression, ADHD and overanxiety). Close friendships, regular physical activity, appropriate sleep duration, shorter screen time, and healthy eating were combined to establish a healthy lifestyle score (which ranges from 0 to 5). Higher scores indicated a healthier lifestyle.
Three trajectories of mental health problems were identified: persistently low risk (24.9 %), persistently medium-high risk (50.0 %), and persistently high risk (25.1 %). Multinomial logistic regression showed that high adversity (high-threat: β = 2.01, P < 0.001; high-deprivation: β = 1.03, P < 0.001; high-unpredictability: β = 0.83, P = 0.001; high-overall adversity: β = 1.64, P < 0.001) resulted in a persistently high risk of mental health problems; these outcomes were maintained after robust control for covariates. Further lifestyle stratification, null associations were observed among children with a healthy lifestyle, irrespective of their gender; however, after controlling for covariates, the above associations remained relatively stable only among boys.
The generalizability of our findings is restricted by 1) limited racial diversity and 2) missing data.
This finding underscores the benefits of promoting a healthy lifestyle in children to prevent persistent mental health problems caused by CA.
•We identified three trajectories of multiple mental health problems in children.•Children exposed to high adversity are more likely to be at persistently high risk for mental problems.•A healthy lifestyle can help buffer the risk of a persistently high risk of mental health problems caused by adversity
Youth mental health problems are a public health priority. Multiple healthy lifestyle behaviors may cluster into healthy lifestyle behavioral patterns (HLBPs) that increase mental health risks in ...adolescents and older adults, but little is known regarding young adults. This study aimed to explore the associations between cluster HLBPs and mental health problems in young adults.
We selected 161,744 young adults aged 20–39 as participants from the database of a Chinese general hospital health management center for the years 2015–2020. The latent class analysis was used to identify HLBPs.
A total of 15.0 % of young adults have at least one mental health problem. Five clusters of HLBPs were identified, characterized as low-risk class (1.6 %), moderate-risk class 1 (12.0 %), moderate-risk class 2 (2.1 %), moderate-risk class 3 (56.8 %), and high-risk class (27.4 %). The odds ratios (ORs) for young adults with two mental health problems increased with the risk grade of HLBPs, while the ORs for young adults with one or three mental health problems ranged from high to low according to the risk grade of HLBPs: high-risk class, moderate-risk class 2, moderate-risk class 3, moderate-risk class 1.
Cross-sectional design and no causal conclusions could be drawn.
Young adults demonstrated a cluster phenomenon of healthy lifestyle behaviors and significant associations between HLBPs and mental health problems. Young adults with a higher risk grade for HLBPs were more likely to have mental health problems. Different HLBPs should be taken into account when implementing mental health interventions.
•Young adults demonstrated a cluster phenomenon of healthy lifestyle behaviors.•Young adults displayed five clusters of HLBPs different from those of adolescents and older adults.•Young adults with a higher risk grade for HLBPs were more likely to have mental health problems.•The dose-response association between the risk grade for HLBPs and mental health risks does not hold exactly.
BACKGROUND:Americans have a shorter life expectancy compared with residents of almost all other high-income countries. We aim to estimate the impact of lifestyle factors on premature mortality and ...life expectancy in the US population.
METHODS:Using data from the Nurses’ Health Study (1980–2014; n=78 865) and the Health Professionals Follow-up Study (1986–2014, n=44 354), we defined 5 low-risk lifestyle factors as never smoking, body mass index of 18.5 to 24.9 kg/m, ≥30 min/d of moderate to vigorous physical activity, moderate alcohol intake, and a high diet quality score (upper 40%), and estimated hazard ratios for the association of total lifestyle score (0–5 scale) with mortality. We used data from the NHANES (National Health and Nutrition Examination Surveys; 2013–2014) to estimate the distribution of the lifestyle score and the US Centers for Disease Control and Prevention WONDER database to derive the age-specific death rates of Americans. We applied the life table method to estimate life expectancy by levels of the lifestyle score.
RESULTS:During up to 34 years of follow-up, we documented 42 167 deaths. The multivariable-adjusted hazard ratios for mortality in adults with 5 compared with zero low-risk factors were 0.26 (95% confidence interval CI, 0.22–0.31) for all-cause mortality, 0.35 (95% CI, 0.27–0.45) for cancer mortality, and 0.18 (95% CI, 0.12–0.26) for cardiovascular disease mortality. The population-attributable risk of nonadherence to 5 low-risk factors was 60.7% (95% CI, 53.6–66.7) for all-cause mortality, 51.7% (95% CI, 37.1–62.9) for cancer mortality, and 71.7% (95% CI, 58.1–81.0) for cardiovascular disease mortality. We estimated that the life expectancy at age 50 years was 29.0 years (95% CI, 28.3–29.8) for women and 25.5 years (95% CI, 24.7–26.2) for men who adopted zero low-risk lifestyle factors. In contrast, for those who adopted all 5 low-risk factors, we projected a life expectancy at age 50 years of 43.1 years (95% CI, 41.3–44.9) for women and 37.6 years (95% CI, 35.8–39.4) for men. The projected life expectancy at age 50 years was on average 14.0 years (95% CI, 11.8–16.2) longer among female Americans with 5 low-risk factors compared with those with zero low-risk factors; for men, the difference was 12.2 years (95% CI, 10.1–14.2).
CONCLUSIONS:Adopting a healthy lifestyle could substantially reduce premature mortality and prolong life expectancy in US adults.
Healthy lifestyle behaviours are effective means to reduce the burden of diseases. This study was aimed to fill the knowledge gaps on the distribution, associated factors, and potential health ...benefits on mortality of four healthy lifestyle behaviours in China.
During 2015-2019, participants aged 35-75 years from 31 provinces were recruited by the China PEACE Million Persons Project. Four healthy lifestyle behaviours were investigated in our study, including non-smoking, none or moderate alcohol use, sufficient leisure time physical activity (LTPA), and healthy diet.
Among 903,499 participants, 74.1% were non-smokers, 96.0% had none or moderate alcohol use, 23.6% had sufficient LTPA, 11.1% had healthy diet, and only 2.8% had all the four healthy lifestyle behaviours. The adherence varied across seven regions; the highest median of county-level adherence to all the four healthy lifestyle behaviours was in North China (3.3%) while the lowest in the Southwest (0.8%) (p < 0.05). Participants who were female, elder, non-farmers, urban residents, with higher income or education, hypertensive or diabetic, or with a cardiovascular disease (CVD) history were more likely to adhere to all the four healthy lifestyle behaviours (p < 0.001). County-level per capital Gross Domestic Product (GDP) was positively associated with sufficient LTPA (p < 0.05 for both rural and urban areas) and healthy diet (p < 0.01 for urban areas), while negatively associated with none or moderate alcohol use (p < 0.01 for rural areas). Average annual temperature was negatively associated with none or moderate alcohol use (p < 0.05 for rural areas) and healthy diet (p < 0.001 for rural areas). Those adhering to all the four healthy lifestyle behaviours had lower risks of all-cause mortality (HR 0.64 95% CI: 0.52, 0.79) and cardiovascular mortality (HR 0.53 0.37, 0.76) after a median follow-up of 2.4 years.
Adherence to healthy lifestyle behaviours in China was far from ideal. Targeted health promotion strategies were urgently needed.
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