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Nutritional management of children with severe neurological impairment (SNI) is highly complex, and the profile of this population is changing. The aim of this narrative review was to give the reader a broad description of evolution of the nutritional management of children with SNI in a high resource setting. In the last decade, there has been an emphasis on using multiple anthropometric measures to monitor nutritional status in children with SNI, and several attempts at standardising the approach have been made. Tools such as the Feeding and Nutrition Screening Tool, the Subjective Global Nutrition Assessment, the Eating and Drinking Ability Classification System and the Focus on Early Eating and Drinking Swallowing (FEEDS) toolkit have become available. There has been an increased understanding of how the gut microbiome influences gastrointestinal symptoms common in children with SNI, and the use of fibre in the management of these has received attention. A new diagnosis, 'gastrointestinal dystonia', has been defined. The increased use and acceptance of blended food tube feeds has been a major development in the nutritional management of children with SNI, with reported benefits in managing gastrointestinal symptoms. New interventions to support eating and drinking skill development in children with SNI show promise. In conclusion, as the life expectancy of people with SNI increases due to advances in medical and nutrition care, our approach necessitates a view to long-term health and quality of life. This involves balancing adequate nutrition to support growth, development and well-being while avoiding overnutrition and its associated detrimental long-term effects.
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AIM: The aim of this study was to evaluate the construct validity of the Both Hands Assessment (BoHA) using activity of the upper limbs as detected by accelerometry in children with bilateral cerebral palsy (CP). METHODS: Observational study of children with CP (n = 44, n = 27 boys, aged 9.1 ± 1.6 years; Manual Ability Classification Scale I: n = 15, II: n = 22, III: n = 7) completing a BoHA assessment while wearing a triaxial accelerometer on each wrist. BoHA Each-Hand sub-scores, BoHA percentage difference between hands, BoHA Units, mean activity for each hand, mean activity asymmetry index and total mean activity were calculated. Linear regressions were used to analyze associations between measures. RESULTS: There were significant, positive associations between BoHA Units and total mean activity (B = 0.86, 95%CI: 0.32, 1.40), BoHA Percentage difference between hands and mean activity asymmetry index (B = 0.95, 95%CI: 0.75,1.15), and BoHA Each-Hand sub-score and mean activity for the non-dominant hand (B = 1.71, 95%CI: 1.16, 2.28), but not the dominant hand (B = 0.50, 95%CI: -0.45, 1.45). CONCLUSIONS: This study provides further evidence for the construct validity of the BoHA as a measure of upper limb performance. Wearable wrist sensors such as accelerometers capture and quantify gross upper limb movement in children with CP but cannot measure fine finger movements captured by the BoHA. CLINICAL TRIALS REGISTRATION: Australian New Zealand Clinical Trials Registry (ACTRN12616001488493 and ACTRN12618000164291).
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Paralisia Cerebral , Punho , Criança , Masculino , Humanos , Austrália , Extremidade Superior , Mãos , AcelerometriaRESUMO
The mental health benefits of resistance training (RT) alone or beyond those provided by aerobic physical activity (PA) are unclear. This study aimed to determine the association between meeting recommendations for aerobic PA and/or RT, and symptoms of depression and/or anxiety. Participants were Australian female members of the 10,000 Steps project (nâ¯=â¯5180, 50.0⯱â¯11.5â¯years). Symptoms of depression and anxiety were determined using the Depression Anxiety Stress Score. Participants were grouped as 'depression only', 'anxiety only', 'co-occurring depression and anxiety' or 'neither depression nor anxiety' based on relevant subscale score (cut-points: depression≥14 points, anxiety≥10 points). The International Physical Activity Questionnaire-Long Form questionnaire was used to determine PA with an additional item to specify RT frequency. Participants were classified as adhering to 'aerobic PA only' (≥150â¯min PA/week), 'RT only' (RTâ¯≥â¯2â¯days/week), 'aerobic PAâ¯+â¯RT' (≥150â¯min PA/week+RTâ¯≥â¯2â¯days/week), or 'neither aerobic PA nor RT' (<150â¯min PA/week+RTâ¯<â¯2â¯days/week). Adjusted relative risk ratios (RRR [95%CI]) were estimated using multinomial logistic regression models. Relative to the 'neither PA nor RT' (nâ¯=â¯2215), the probabilities of 'depression only' (nâ¯=â¯317) and 'co-occurring depression and anxiety' (nâ¯=â¯417) were lower for the 'aerobic PA only' (nâ¯=â¯1590) (RRRâ¯=â¯0.74 [0.56-0.97] and RRRâ¯=â¯0.76 [0.59-0.97] respectively), and 'both PAâ¯+â¯RT' (nâ¯=â¯974) groups (RRRâ¯=â¯0.61 [0.43-0.86] and RRRâ¯=â¯0.47 [0.33-0.67] respectively). There were no associations between adhering to one or both recommendations and 'anxiety only' (nâ¯=â¯317), or between 'RT only' (nâ¯=â¯401) and depression and/or anxiety. Prevention and treatment strategies including both aerobic PA and RT may provide additional benefits for depression with or without comorbid anxiety.
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Ansiedade/epidemiologia , Ansiedade/psicologia , Depressão/epidemiologia , Depressão/psicologia , Treinamento Resistido , Adulto , Idoso , Austrália/epidemiologia , Comorbidade , Estudos Transversais , Exercício Físico/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Saúde da MulherRESUMO
Diet quality, physical activity, alcohol use, smoking, sleep and sitting-time are behaviors known to influence health. The aims of this study were to identify how these behaviors co-occur to form distinct health-behavior patterns, and to investigate the relationship between these patterns, and mental and self-rated health. Members of the Australian 10,000 Steps project were invited to participate in an online survey in November-December 2011. The participants self-reported demographic and behavioral characteristics (fruit and vegetable intake, fast food, soft drink and alcohol consumption, smoking, physical activity, sitting-time and sleep), frequency of mental distress and self-rated health. Latent Class Analysis was used to identify health-behavior patterns. Latent class regression was used to examine relationships between behavior patterns, mental and self-rated health, and socio-demographic and economic factors. Data were analyzed in October 2017. Complete datasets were obtained from 10,638 participants. Four latent classes were identified, characterized by 'Low-Risk Behavior', 'Poor Sleep, Low-Risk Daytime Behavior', 'Sound Sleep, High-Risk Daytime Behavior' and 'High-Risk Behavior'. The latter two classes, both characterized by high-risk daytime behaviors, were associated with poor self-rated health. Participants in classes with high-risk daytime behaviors were more likely to be younger, non-partnered, non-university educated, from lower income households and work longer hours. Classes characterized by poor sleep quality were associated with higher frequency of mental distress. Findings suggest that experiencing poor sleep is partly independent of daytime behaviors, demographic and socioeconomic factors, but has a strong association with mental health.
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Autoavaliação Diagnóstica , Comportamentos Relacionados com a Saúde/fisiologia , Estilo de Vida , Saúde Mental , Austrália , Dieta/estatística & dados numéricos , Exercício Físico/fisiologia , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Comportamento Sedentário , Autorrelato , Sono/fisiologia , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
AIM: To investigate longitudinal changes of habitual physical activity (HPA) and sedentary time in children with cerebral palsy (CP) aged 1 year 6 months to 5 years across all functional abilities. METHOD: At study entry, 95 children (62 males, 33 females) were classified using the Gross Motor Function Classification System (GMFCS) at levels I (50), II (9), III (16), IV (6), and V (14). Physical activity was recorded on a total of 159 occasions at four possible time points: 1 year 6 months to 2 years; 2 years 6 months to 3 years; 4 years; and 5 years using ActiGraph for 3 days. Mixed-effects regression models were used for analyses. RESULTS: Participants classified at GMFCS levels I and II had stable HPA as they aged. HPA significantly decreased at 5 years in children classified at GMFCS levels III to V. Sedentary time significantly increased at 4 years and 5 years in all participants. Annual HPA significantly reduced in children classified at GMFCS levels III to V (-123 counts/min, 95% confidence interval [CI] -206 to -40) while annual sedentary time significantly increased in all participants (GMFCS levels I-II: 2.4%, 95% CI 0.7-4.1; GMFCS levels III-V: 6.9%, 95% CI 4.6-9.2). INTERPRETATION: Children with CP at all GMFCS levels should be encouraged to be physically active from early childhood as HPA levels start to decline from 4 years. Breaks in sedentary time are required for all children with CP from the age of 3 years.
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Paralisia Cerebral/fisiopatologia , Desenvolvimento Infantil/fisiologia , Exercício Físico/fisiologia , Estilo de Vida , Índice de Gravidade de Doença , Actigrafia , Pré-Escolar , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Comportamento SedentárioRESUMO
PURPOSE: To compare ambulatory status in children with cerebral palsy aged 4 to 5 years with their habitual physical activity and time spent sedentary, and to compare their activity with physical activity guidelines. METHODS: Sixty-seven participants-independently ambulant, marginally ambulant, and nonambulant-wore accelerometers for 3 days. Time spent sedentary as a percentage of wear time and activity counts were compared between groups. RESULTS: There were significant differences in time spent sedentary and activity counts between groups. Children who were independently ambulant were more likely to meet physical activity guidelines. CONCLUSION: Children with cerebral palsy spent more than half of their waking hours in sedentary time. Interventions to reduce sedentary behavior and increase habitual physical activity are needed in children with cerebral palsy at age 4 to 5 years.
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Paralisia Cerebral/fisiopatologia , Exercício Físico/fisiologia , Acelerometria , Fatores Etários , Paralisia Cerebral/psicologia , Paralisia Cerebral/reabilitação , Pré-Escolar , Feminino , Marcha , Hábitos , Humanos , Masculino , Atividade Motora , Comportamento SedentárioRESUMO
PURPOSE: To derive and validate triaxial accelerometer cut-points in children with cerebral palsy (CP) and compare these with previously established cut-points in children with typical development. METHODS: Eighty-four children with CP aged 4 to 5 years wore the ActiGraph during a play-based gross motor function measure assessment that was video-taped for direct observation. Receiver operating characteristic and Bland-Altman plots were used for analyses. RESULTS: The ActiGraph had good classification accuracy in Gross Motor Function Classification System (GMFCS) levels III and V and fair classification accuracy in GMFCS levels I, II, and IV. These results support the use of the previously established cut-points for sedentary time of 820 counts per minute in children with CP aged 4 to 5 years across all functional abilities. CONCLUSIONS: The cut-point provides an objective measure of sedentary and active time in children with CP. The cut-point is applicable to group data but not for individual children.
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Acelerometria/métodos , Acelerometria/normas , Paralisia Cerebral/radioterapia , Modalidades de Fisioterapia , Paralisia Cerebral/fisiopatologia , Pré-Escolar , Avaliação da Deficiência , Exercício Físico , Feminino , Humanos , Masculino , Atividade Motora , Reprodutibilidade dos Testes , Comportamento SedentárioRESUMO
OBJECTIVE: To test efficacy of a parent-delivered multidomain early intervention (Learning through Everyday Activities with Parents [LEAP-CP]) for infants with cerebral palsy (CP) compared with equal-dose of health advice (HA), on (1) infant development; and (2) caregiver mental health. It was hypothesized that infants receiving LEAP-CP would have better motor function, and caregivers better mental health. METHODS: This was a multisite single-blind randomized control trial of infants aged 12 to 40 weeks corrected age (CA) at risk for CP (General Movements or Hammersmith Infant Neurologic Examination). Both LEAP-CP and HA groups received 15 fortnightly home-visits by a peer trainer. LEAP-CP is a multidomain active goal-directed intervention. HA is based on Key Family Practices, World Health Organization. Primary outcomes: (1) infants at 18 months CA: Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT mobility); and (2) caregiver: Depression Anxiety and Stress Scale. RESULTS: Of eligible infants, 153 of 165 (92.7%) were recruited (86 males, mean age 7.1±2.7 months CA, Gross Motor Function Classification System at 18 m CA: I = 12, II = 25, III = 9, IV = 18, V = 32). Final data were available for 118 (77.1%). Primary (PEDI-CAT mobility mean difference = 0.8 (95% CI -1.9 to 3.6) P = .54) and secondary outcomes were similar between-groups. Modified-Intention-To-Treat analysis on n = 96 infants with confirmed CP showed Gross Motor Function Classification System I and IIs allocated to LEAP-CP had significantly better scores on PEDI-CAT mobility domain (mean difference 4.0 (95% CI = 1.4 to 6.5), P = .003) compared with HA. CONCLUSIONS: Although there was no overall effect of LEAP-CP compared with dose-matched HA, LEAP-CP lead to superior improvements in motor skills in ambulant children with CP, consistent with what is known about targeted goal-directed training.
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Paralisia Cerebral , Criança , Humanos , Lactente , Masculino , Cuidadores , Paralisia Cerebral/terapia , Países em Desenvolvimento , Movimento , Método Simples-CegoRESUMO
BACKGROUND: Physical inactivity and insomnia symptoms are independently associated with increased risk of depression and anxiety; however, few studies jointly examine these risk factors. This study aimed to prospectively examine the joint association of physical activity (PA) and insomnia symptoms with onset of poor mental health in adults. METHODS: Participants from the 2013 to 2018 annual waves of the Household Income and Labour Dynamics in Australia panel study who had good mental health (Mental Health Inventory-5 >54) in 2013, and who completed at least 1 follow-up survey (2014-2018), were included (nâ¯=â¯10,977). Poor mental health (Mental Health Inventory-5 ≤ 54) was assessed annually. Baseline (2013) PA was classified as high/moderate/low, and insomnia symptoms (i.e., trouble sleeping) were classified as no insomnia symptoms/insomnia symptoms, with 6 mutually exclusive PA-insomnia symptom groups derived. Associations of PA-insomnia symptom groups with onset of poor mental health were examined using discrete-time proportional-hazards logit-hazard models. RESULTS: There were 2322 new cases of poor mental health (21.2%). Relative to the high PA/no insomnia symptoms group, there were higher odds (odds ratio and 95% confidence interval (95%CI)) of poor mental health among the high PA/insomnia symptoms (ORâ¯=â¯1.87, 95%CI: 1.57-2.23), moderate PA/insomnia symptoms (ORâ¯=â¯1.93, 95%CI: 1.61-2.31), low PA/insomnia symptoms (ORâ¯=â¯2.33, 95%CI: 1.96-2.78), and low PA/no insomnia symptoms (ORâ¯=â¯1.14, 95%CI: 1.01-1.29) groups. Any level of PA combined with insomnia symptoms was associated with increased odds of poor mental health, with the odds increasing as PA decreased. CONCLUSION: These findings highlight the potential benefit of interventions targeting both PA and insomnia symptoms for promoting mental health.
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Saúde Mental , Distúrbios do Início e da Manutenção do Sono , Adulto , Humanos , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Ansiedade/epidemiologia , Fatores de Risco , Exercício FísicoRESUMO
PURPOSE: To examine the joint associations between meeting guidelines for physical activity (PA) and sleep duration and all-cause mortality risk among adults. METHODS: Participants were adults (nâ¯=â¯282,473) aged 18-84 years who participated in the 2004-2014 U.S. National Health Interview Survey. Mortality status was ascertained using the National Death Index through December 2015. Self-reported PA (Active: meeting both aerobic (AER) and muscle-strengthening (MSA) guidelines, AER only (AER), MSA only (MSA), or not meeting either AER or MSA (Inactive)) and sleep duration (Short, recommended (Rec), or Long) were classified according to guidelines, and 12 PA-sleep categories were derived. Adjusted hazard ratios and 95% confidence intervals (95%CIs) for all-cause mortality risk were estimated using Cox proportional hazards regression models. RESULTS: A total of 282,473 participants (55% females) were included; 18,793 deaths (6.7%) occurred over an average follow-up of 5.4 years. Relative to the Active-Rec group, all other PA-sleep groups were associated with increased mortality risk except for the Active-Short group (hazard ratioâ¯=â¯1.08; 95%CI: 0.92-1.26). The combination of long sleep with either MSA or Inactive appeared to be synergistic. For a given sleep duration, mortality risk progressively increased among participants classified as AER, MSA, and Inactive. Within each activity level, the mortality risk was greatest among adults with long sleep. CONCLUSION: Relative to adults meeting guidelines for both PA and sleep duration, adults who failed to meet guidelines for both AER and muscle strengthening PA and who also failed to meet sleep duration guidelines had elevated all-cause mortality risks. These results support interventions targeting both PA and sleep duration to reduce mortality risk.
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Terapia por Exercício , Duração do Sono , Feminino , Humanos , Adulto , Masculino , Estudos Prospectivos , Terapia por Exercício/métodos , Exercício Físico/fisiologia , MúsculosRESUMO
Objective: To explore young adult's experiences of how starting university influenced their physical activity, diet, sleep, and mental well-being, and barriers and enablers to health behavior change. Participants: University students aged 18-25 years. Methods: Three focus groups were conducted in November 2019. Inductive thematic approach was utilized to identify themes. Results: Students (female: n = 13, male: n = 2, other gender identity: n = 1, 21.2 (1.6) years) reported mental well-being, physical activity levels, diet quality and sleep health were negatively affected. Stress, study demands, university timetabling, not prioritizing physical activity, cost and availability of healthy foods, and difficulty falling asleep were key barriers. Health behavior change interventions aiming to support mental well-being need to include both information and support features. Conclusions: There is a significant opportunity to improve the transition to university for young adults. Findings highlight areas to target in future interventions to improve physical activity, diet, and sleep of university students.
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INTRODUCTION: School readiness includes cognitive, socio-emotional, language and physical growth and development domains which share strong associations with life-course opportunities. Children with cerebral palsy (CP) are at increased risk of poor school readiness compared with their typically developing peers. Recently, earlier diagnosis of CP has allowed interventions to commence sooner, harnessing neuroplasticity. First, we hypothesise that early referral to intervention for children at-risk of CP will lead to improved school readiness at 4-6 years relative to placebo or care as usual. Second, we hypothesise that receipt of early diagnosis and early intervention will lead to cost-savings in the form of reduced healthcare utilisation. METHODS AND ANALYSIS: Infants identified as at-risk of CP ≤6 months corrected age (n=425) recruited to four randomised trials of neuroprotectants (n=1), early neurorehabilitation (n=2) or early parenting support (n=1) will be re-recruited to one overarching follow-up study at age 4-6 years 3 months. A comprehensive battery of standardised assessments and questionnaires will be administered to assess all domains of school readiness and associated risk factors. Participants will be compared with a historical control group of children (n=245) who were diagnosed with CP in their second year of life. Mixed-effects regression models will be used to compare school readiness outcomes between those referred for early intervention versus placebo/care-as-usual. We will also compare health-resource use associated with early diagnosis and intervention versus later diagnosis and intervention. ETHICS AND DISSEMINATION: The Children's Health Queensland Hospital and Health Service, The University of Queensland, University of Sydney, Monash University and Curtin University Human Research Ethics Committees have approved this study. Informed consent will be sought from the parent or legal guardian of every child invited to participate. Results will be disseminated in peer-reviewed journals, scientific conferences and professional organisations, and to people with lived experience of CP and their families. TRIAL REGISTRATION NUMBER: ACTRN12621001253897.
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Paralisia Cerebral , Neuroproteção , Lactente , Humanos , Criança , Pré-Escolar , Seguimentos , Hospitais Pediátricos , Instituições Acadêmicas , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
OBJECTIVES: To investigate the joint, prospective associations of physical inactivity and insomnia symptoms and productivity using the 2013 and 2014 household income and labor dynamics in Australia Survey panel data. METHODS: The association between (i) presenteeism (yes/no, nâ=â5864) and (ii) absenteeism (sick leave days, nâ=â4324) and the mutually exclusive groups "active without insomnia," "active with insomnia," "inactive without insomnia," and "inactive with insomnia" was assessed. RESULTS: Participants "active with insomnia" or "inactive with insomnia" had greater odds of presenteeism than those "active without insomnia" (odds ratio [OR]â=â1.41, 95% confidence interval [CI]: 1.07 to 1.85 and ORâ=â1.44, 95% CI: 1.14 to 1.83, respectively). Participants "inactive with insomnia" had a greater incidence of absenteeism than participants "active without insomnia" (incidence rate ratio [IRR]â=â1.28, 95% CI: 1.07 to 1.54). CONCLUSIONS: Findings suggest improving physical activity levels and insomnia symptoms concurrently may improve productivity by reducing presenteeism and sick leave.
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Distúrbios do Início e da Manutenção do Sono , Absenteísmo , Austrália/epidemiologia , Eficiência , Exercício Físico , Humanos , Presenteísmo , Licença Médica , Distúrbios do Início e da Manutenção do Sono/epidemiologiaRESUMO
BACKGROUND: Physical activity (PA) and sleep duration have established associations with health outcomes individually but tend to co-occur and may be better targeted jointly. This study aimed to describe the cross-sectional prevalence, trends, and population characteristic correlates of activity-sleep patterns in a population-representative sample of US adults from the National Health Interview Survey (2004-2018). METHODS: Participants (N = 359,019) self-reported aerobic and muscle-strengthening activity and sleep duration. They were categorized as "meeting both"/"meeting PA only"/"meeting sleep only"/"meeting neither" of the 2018 US PA guidelines and age-based sleep duration recommendations. Trends in activity-sleep patterns were analyzed using weighted multinomial logistic regression, and correlates were identified using weighted binary Poisson regressions, with P ≤ .001 considered significant. RESULTS: "Meet sleep only" was most prevalent (46.4%) by 2018, followed by "meet neither" (30.3%), "meet both" (15.6%), and "meet PA only" (7.7%). Many significant sociodemographic, biological, and health-behavior correlates of the activity-sleep groups were identified, and the direction and magnitude of these associations differed between groups. CONCLUSIONS: Public health campaigns should emphasize the importance of both sufficient PA and sleep; target women and older adults, current smokers, and those with lower education and poorer physical and mental health; and consider specific barriers experienced by minority ethnic groups.
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Exercício Físico , Sono , Idoso , Estudos Transversais , Feminino , Humanos , Músculos , PrevalênciaRESUMO
The study aimed to investigate the association between clustered cardiometabolic risk (CCMR) and health-behavior indices comprising 3 different measures of physical activity, screen time, diet and sleep in NHANES 2005-2006. CCMR was calculated by standardizing and summarizing measures of blood pressure, fasting glucose, triglycerides, insulin, high-density lipoprotein and waist circumference to create a z score. Three health behavior indices were constructed with a single point allocated to each of the following lower risk behaviors: muscle strengthening activity, healthy eating score, sleep disorder/disruption, sleep duration, screen time and physical activity (self-reported moderate-to-vigorous physical activity [MVPA] (Index Score-SR), accelerometer-measured MVPA (Index Score-MVPA) or accelerometer-measured steps Index Score-Steps). Linear regression models explored associations between index scores and CCMR. In the sample (n = 1537, 52% male, aged 45.5 [SE: 0.9] years), reporting 0-5 vs. 6 health behaviors using Index Score-SR and Index Score-MVPA, and 0-4 vs. 6 health behaviors using Index Score-Steps, were associated with a significantly higher CCMR. The beta (ß [95% CI]) for zero vs. 6 behaviors were Index Score-SR (2.86 [2.02, 3.69], Index Score-MVPA (2.41 [1.49, 3.33] and Index Score-Steps (2.41 [1.68, 3.15]). Irrespective of the measure of physical activity, engaging in fewer positive health behaviors was associated with greater CCMR. Novelty: Physical activity, screen time, diet and sleep may exert synergistic/cumulative effects on clustered cardiometabolic risk. A greater number of positive health behaviors was associated with a lower clustered cardiometabolic risk factor score. The reduction in cardiometabolic risk was similar irrespective of which physical activity measure was used.
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Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Exercício Físico , Comportamentos Relacionados com a Saúde , Acelerometria , Adulto , Idoso , Biomarcadores/análise , Estudos Transversais , Dieta , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Tempo de Tela , SonoRESUMO
OBJECTIVE: The prospective relationships between poor sleep health, poor diet quality, and physical inactivity with self-rated health (SRH) are not well described. The aim of this study was to assess individual and joint associations between high-risk health behaviors and incident poor SRH. METHOD: Participants from the Household Income and Labor Dynamics in Australia longitudinal cohort reporting "good" SRH in 2013 were included (n = 8,853) in 2020 data analysis. Logistic regression was used to assess odds of poor SRH in 2017 associated with (a) individual, (b) count, and (c) unique combinations of high-risk behaviors reported in 2013. RESULTS: In the sample (48% female, Mage = 45.2 years, SD = 16.8), poor sleep health (OR = 1.66, 95% CI [1.38, 2.01]), physical inactivity (OR = 1.18, [1.01, 1.38]), and poor diet quality (OR = 1.38, [1.16, 1.65]) were associated with increased odds of poor SRH. Reporting one (OR = 1.76, [1.27, 2.43]), two (OR = 2.16, [1.57, 2.98]), and three (OR = 2.99, [2.02, 4.41]) high-risk behaviors was associated with increased odds of poor SRH. All unique combinations of high-risk behaviors were significantly associated with greater odds of poor SRH, except "poor sleep health only" (prevalence = 1.3%). Odds of poor SRH associated with high-risk behavior combinations ranged from 1.73 (95% CI [1.21, 2.47]) for "physical inactivity only" to 4.11 ([2.66, 6.35]) for "poor sleep health + poor diet quality." CONCLUSIONS: Reporting ≥ 1 high-risk behavior was associated with increased odds of poor SRH. The combination of poor sleep health with poor diet quality was associated with the greatest odds of poor SRH. Improving multiple high-risk behaviors in combination may be more effective in preventing decline in SRH than improving any behavior alone. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Dieta/psicologia , Nível de Saúde , Transtornos do Sono-Vigília/psicologia , Estudos de Coortes , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
INTRODUCTION: Little is known about the joint effects of physical activity and sleep difficulties on hypertension. The aim of this study was to examine the joint associations of physical activity and sleep difficulties with the incidence of hypertension in mid-aged women. STUDY DESIGN: Prospective cohort study. MAIN OUTCOME MEASURES: Mid-aged participants (n = 5,300) in the Australian Longitudinal Study on Women's Health completed four triennial surveys starting in 2004, when they had a mean age of 55 years. The presence of hypertension, physical activity and the number of sleep difficulties (range 0-4) were reported at each survey. Total MET.min/week of physical activity was assessed, and dichotomised as inactive (<500 MET.min/wk) or active (≥500 MET.min/wk). Joint categories of physical activity and sleep difficulties were created using six mutually exclusive groups. Associations of joint physical activity and sleep difficulty groups with incident hypertension were examined via discrete-time survival analysis using logit-hazard models. RESULTS: There were 1,175 cases of incident hypertension (22.2%). Compared with the Active and No Difficulties group, women in the Inactive and 1 Difficulty (Odds Ratio (95% confidence interval) (1.31 (1.06, 1.62)) and Inactive and 2-4 Difficulties (1.44 (1.16, 1.78)) groups were more likely to develop hypertension. Sleep difficulties were not associated with hypertension among active women. CONCLUSIONS: Mid-aged inactive women with sleep difficulties were more likely to develop hypertension. Physical activity appeared to protect against the increased risk of hypertension in women with sleeping difficulties.
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Exercício Físico , Hipertensão/epidemiologia , Comportamento Sedentário , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Austrália/epidemiologia , Feminino , Humanos , Incidência , Estudos Longitudinais , Pessoa de Meia-Idade , Estudos Prospectivos , Inquéritos e Questionários , Saúde da MulherRESUMO
University students have high rates of health risk behaviors and psychological distress. This study explores patterns of health behaviors among a sample of Australian university students, and determines whether patterns of health behaviors are associated with psychological distress and demographic characteristics. Cross-sectional data from the University of Newcastle Student Healthy Lifestyle Survey 2019 were analyzed. Fruit and vegetable intake, sugar-sweetened beverage intake, physical activity, sitting time, smoking, alcohol intake, drug use, sleep and psychological distress were assessed. Latent class analysis (LCA) was used to identify patterns of health risk behaviors, and latent class regression to explore associations between psychological distress and demographic characteristics with health behavior classes. Analysis included 1965 students (mean age 25.8 ± 8.6 years, 70.7% female). Three patterns of health behaviors were identified: healthier (48.6%), moderate (40.2%) and unhealthy (11.2%) lifestyle classes. Students in the moderate and unhealthy lifestyle classes had higher odds of moderate (OR 1.43 and 2.37) and high/very high psychological distress risk (OR 2.71 and 11.69). Students in the unhealthy and moderate lifestyle classes had a higher odds of being male, younger, enrolled in transition to university and English language courses, Aboriginal or Torres Strait Islander descent and to report some financial difficulty. Study findings may be used to inform the design of mental health interventions for university students that target key health risk behaviors.
Assuntos
Comportamentos de Risco à Saúde , Análise de Classes Latentes , Angústia Psicológica , Estudantes/psicologia , Universidades , Adolescente , Adulto , Austrália , Feminino , Humanos , Masculino , Probabilidade , Fatores de Risco , Adulto JovemRESUMO
BACKGROUND: Emerging evidence links a poor diet with mental ill-health although the direction of this association is unclear. The aim was to examine the bidirectional prospective relationships between core (and non-core food consumption, and symptoms of depression. METHODS: Depressive symptoms (Mental Health Index-5, MHI-5), current/prior depression and consumption of core (recommended food groups) and non-core (discretionary) foods were assessed in the population-based 2013 and 2017 Household Income and Labour Dynamics in Australia cohort study. Three cross-lagged linear models assessed associations between all three baseline variables in 2013, alternating 2017 variables as outcomes. RESULTS: In the population (n = 10,003; 48.3% women; 48.5[15.7] years), core food score in 2013 was associated with MHI-5 (ß:0.102, 95%CI: 0.010,0.193) in 2017, while the non-core food score was not (ß:-0.030, 95%CI:-0.099,0.160). Depressive symptom score in 2013 was not associated with either food score in 2017. Current/prior diagnosis of depression in 2013 was associated with core (ß:-0.198, 95%CI:-0.329,-0.067) but not non-core (ß:-0.036, 95%CI: -0.151,0.080) food score in 2017. LIMITATIONS: Results may not be generalizable to the whole population due to some selection bias, self-report depression diagnosis may have led to misclassification of previous mental illness, and core and non-core food scores are not validated measures of diet quality. CONCLUSIONS: There is a prospective association between core food consumption and depressive symptoms. This association is of small magnitude and we cannot discount insufficient core food consumption reflecting an effect of prior mental illness. Our results suggest that, for depression, public health focus should be on improving core food intake.
Assuntos
Depressão , Dieta , Austrália/epidemiologia , Estudos de Coortes , Depressão/epidemiologia , Feminino , Humanos , Masculino , Estudos ProspectivosRESUMO
OBJECTIVE: To identify the patterns of activity, sitting and sleep that adults engage in, the demographic and biological correlates of activity-sleep patterns and the relationship between identified patterns and self-rated health. DESIGN AND SETTING: Online panel of randomly selected Australian adults (n = 2034) completing a cross-sectional survey in October-November 2013. PARTICIPANTS: Panel members who provided complete data on all variables were included (n = 1532). MEASUREMENTS: Participants self-reported their demographic characteristics, height, weight, self-rated health, duration of physical activity, frequency of resistance training, sitting time, sleep duration, sleep quality, and variability in bed and wake times. Activity-sleep patterns were determined using latent class analysis. Latent class regression was used to examine the relationships between identified patterns, demographic and biological characteristics, and self-rated health. RESULTS: A 4-class model fit the data best, characterized by very active good sleepers, inactive good sleepers, inactive poor sleepers, moderately active good sleepers, representing 38.2%, 22.2%, 21.2%, and 18.4% of the sample, respectively. Relative to the very active good sleepers, the inactive poor sleepers, and inactive good sleepers were more likely to report being female, lower education, higher body mass index, and lower self-rated health, the moderately active good sleepers were more likely to be older, report lower education, higher body mass index and lower self-rated health. Associations between activity-sleep pattern and self-rated health were the largest in the inactive poor sleepers. CONCLUSIONS: The 4 activity-sleep patterns identified had distinct behavioral profiles, sociodemographic correlates, and relationships with self-rated health. Many adults could benefit from behavioral interventions targeting improvements in physical activity and sleep.