Hiding in plain sight: Cooperative Extension as an underutilized approach to improving cancer survivorship outcomes in underserved populations.

PURPOSE: Explore the potential utility of a Cooperative Extension-specific program to support post-active treatment cancer survivors. METHODS: A user-centered study was conducted to identify barriers to and facilitators of the implementation of a program for adult cancer survivors living post primary cancer treatment ("cancer survivors") via Cooperative Extension ("Extension"), including interviews analyzed using the Consolidated Framework for Implementation Research. Participants included Cooperative Extension Educators and adult cancer survivors in Oklahoma who completed data collection from July 2023 to September 2023. RESULTS: N = 20 participants were enrolled. Cancer survivors indicated poor familiarity with Extension, or a primary association with agriculture. Some voiced surprise Extension was not already providing cancer-related programming. Many expressed poor support in their communities due to issues secondary to rurality, often relying on non-cancer programs. Educators voiced a strong capability to deliver cancer-related programming if intentionally designed, with many already providing education on relevant topics (e.g., finances, nutrition, physical activity). A salient barrier was poor connectivity with the healthcare system. CONCLUSIONS: There is an immense need for improved survivorship care in underserved communities due to poor social connectedness, support structures, and poor mental health. Cooperative Extension is well-poised to deliver cancer survivorship-specific programming. IMPLICATIONS FOR CANCER SURVIVORS: Cooperative Extension provides an extensive network of professionals who can provide support to cancer survivors, particularly those post-active treatment.

The OMNIVEG STUDY: Health outcomes of shifting from a traditional to a vegan Mediterranean diet in healthy men. A controlled crossover trial.

BACKGROUND AND AIM: The Mediterranean diet is a plant-based dietary pattern with well-established health benefits such as the reduced risk of cardiovascular disease. Additionally, incorporating more plant-based foods into a Mediterranean diet may provide further health benefits. The study aimed to assess the effect of shifting from a traditional Mediterranean diet to a vegan Mediterranean diet on cardiorespiratory fitness and lipid profile in physically active and healthy men. METHODS AND RESULTS: Participants underwent a baseline period with adhesion to the general patterns of the Mediterranean diet for three weeks and then they changed to an isocaloric vegan version of the Mediterranean diet for four weeks, with a 7-day washout period between diets. The shift from the traditional Mediterranean diet to the vegan Mediterranean diet required substituting animal-based foods with plant-based foods that contain comparable amounts of protein and fat. Fourteen participants with a mean age of 24.6 ± 7.0 years (range: 18-37 years), completed the study protocol. The change from the traditional to the vegan Mediterranean diet reduced blood concentration of total cholesterol (-22.6 mg/dl, p < 0.01, Effect size [ES] = 1.07) and low-density lipoprotein cholesterol (-12.8 mg/dl, p < 0.01, ES = 0.72). An inverse correlation was observed between the intake of dietary fibre and LDL-C (partial rho = -0.43, p = 0.040). CONCLUSIONS: The adoption of a vegan Mediterranean diet with plant-based proteins and fats instead of the traditional Mediterranean diet improved several cardiometabolic health outcomes in physically active and healthy men. CLINICAL TRIAL REGISTRY: NCT06008886.

Dynamics of indicators of cadets' daily motor activity in different training years.

OBJECTIVE: Aim: The aim is to investigate the dynamics of indicators of daily motor activity of cadets of higher educational institutions with specific learning environment in different training years. PATIENTS AND METHODS: Materials and Methods: The research involved 226 cadets of the National Academy of Internal Affairs in the first (n = 62), second (n = 56), third (n = 60), and fourth (n = 48) training years. We used the Framingham method which involves the calculation of the motor activity index to determine the daily time spent on cadets' motor activity and their daily energy expenditure. RESULTS: Results: The dynamics of motor activity indicators of cadets in different training years have been studied. The best index were found in the third-year cadets (34.12 ± 0.49 points and 2643.9 ± 36.6 kcal), and the worst - in the first (32.68 ± 0.43 points and 2537 ± 33.9 kcal) and fourth (32.85 ± 0.41 points and 2550.9 ± 31.3 kcal). At the same time, a significant difference between the indicators of motor activity per day was found only in the first- and third-year cadets (p < 0.05). In general, the level of daily motor activity of the first- and fourth-year cadets is assessed as insufficient (inadequate), and of the secondand third-year cadets - as proper. CONCLUSION: Conclusions: The results obtained indicate the need to increase the daily level of motor activity of cadets by involving them in sporting and mass participation events and extracurricular physical exercises and increasing the intensity of physical training sessions.

Comparison of perinatal outcomes of women with gestational diabetes mellitus according to type of treatment for glycemic control.

OBJECTIVE: To compare the perinatal outcomes of women with Gestational Diabetes Mellitus (GDM), between pregnant treated only with lifestyle changes and pregnant treated with insulin and lifestyle changes. METHODS: Prospective cohort study with follow-up of 64 women with GDM during the prenatal care and postpartum period until hospital discharge, divided into a control group (43) and an insulin group (21), with collection of sociodemographic, clinical, glycemic control and perinatal outcome data. Fetal macrosomia (≥ 4 Kg), or large-for-gestational-age newborns were considered the primary outcome of the research. RESULTS: Pre-pregnancy BMI (31.2 ± 3.9 versus 28.8 ± 5.5), diastolic blood pressure (75 ± 8.7 versus 69 ± 6.9) and postprandial blood glucose (136.6 versus 115.4) ​​were higher in the insulin group, respectively. The control group had an average birth weight of 3058 g and an incidence of preterm birth of 11.6 %, while the insulin group had an average birth weight of 3203 g, with an incidence of preterm birth of 4.8 %. The majority of newborns had an adequate weight for their gestational age. Even all participants met glycemic goals, in the insulin group the Apgar score at the 5th minute and exclusive breastfeeding was lower, had 100 % of resuscitation cases, and a longer inpatient period. CONCLUSION: These data reinforce that even during prenatal care with lifestyle changes, newborns of women with GDM treated with insulin had worse outcomes, including clinical complications and less exclusive breastfeeding. It is important in prenatal care to identify neonates with risk for prevention and health promotion measures.

Antioxidant activity, physico-chemical properties, and bioactive compounds of Nigella sativa seeds and oil impacted by microwave processing technique.

Strongly anti-oxidant and medicinal, Nigella sativa L (NS) is utilized in conventional medicine to address a range of illnesses, including gastrointestinal, inflammatory and rheumatic illnesses. This study was carried out to investigate the effects of microwave processing on the physico-chemical properties of Moroccan-grown Nigella sativa seeds and oils, as well as to investigate the antioxidant qualities of black cumin oils under conditions of accelerated oxidation. The study's specific goal was to ascertain the effects of varying microwave power levels (500 and 750 W) and roasting times (5, 10, and 15 min) on the black cumin oils' quality indices, fatty acid and sterol content, carotenoid and chlorophyll levels, mineral profile, tocopherol amount, and overall antioxidant activity. To this end, the seeds of black cumin were roasted at two power levels (500 and 750 W) and for three different periods (5, 10, and 15 min) in a microwave oven. The obtained results show that the duration and the processing power did not significantly influence the amount of sterols and fatty acids. In contrast, the quality indices, physico-chemical properties, carotenoid and chlorophyll contents, mineral profile, and tocopherol amount were influenced by the microwave processing. A significant decline in the antioxidant activity was recorded from 45.01 ± 0.81 % (unroasted cumin seeds) to 4.32 ± 0.91 % (750 W/5 min). Based on these findings, the black cumin oil preparations should be handled carefully and the oil must be protected once extracted. The stability and preservation of antioxidants are crucial steps against pro-oxidant and inflammatory conditions that could favour cellular senescence and accelerate aging processes.

LEAP! Rx: A randomized trial of a pragmatic approach to lifestyle medicine.

INTRODUCTION: Clinicians lack the tools to incorporate physical activity into clinical care for Alzheimer's disease prevention. We tested a 52-week exercise and health education program (Lifestyle Empowerment for Alzheimer's Prevention [LEAP! Rx]) that integrates clinician referrals and community-based fitness resources. METHODS: We randomized 219 participants to the LEAP! Rx (ie, exercise and monthly brain health education) or a standard-of-care control group and tested the effects on cardiorespiratory fitness, insulin resistance, body composition, lipids, and cognitive performance. RESULTS: Physicians were able to connect their patients to a community lifestyle intervention. The intervention group increased in cardiorespiratory fitness at 12 and 52 weeks (p = 0.005). We observed no effects on secondary measures. Participants meeting 80% of weekly goals (150 min, moderate to vigorous activity) saw greater fitness improvements than those with less than 80% (p < 0.001). DISCUSSION: These results hold promise for broad implementation of exercise interventions into larger healthcare systems and have implications for improved research recruitment strategies. TRIAL REGISTRATION: NCT No. NCT03253341. HIGHLIGHTS: Our community-based exercise program increased cardiorespiratory fitness. Our digital physician referral method increased the diversity of the participant sample. Our findings have implications for personalized dementia risk reduction strategies.

Plasma metabolites, systolic blood pressure, lifestyle and stroke risk: a UK Biobank based cohort study.

Background To estimate the associations of stroke risk with plasma metabolites, metabolic risk score (MRS), the combinations of MRS with hypertension or lifestyle, and lifestyle-related metabolic signature. To assess the improvement of the stroke risk prediction model through the incorporation of MRS. Methods A total of 77,315 participants from the UK Biobank were included in this study. Xgboost and LASSO-COX regression were used to select metabolites and construct MRS. Elastic net regression was utilized to construct the lifestyle-related metabolic signature. Multivariate Cox regression was used to estimate the associations between metabolites, MRS, the combinations of MRS with hypertension or lifestyle, lifestyle-related metabolic signature and stroke risk. Results We identified 48, 63, 39, and 4 metabolites associated with the risk of stroke, ischemic stroke (IS), subarachnoid hemorrhage (SAH), and intracerebral hemorrhage (ICH), respectively. High MRS significantly increased the risk of stroke (HR= 2.65 [95%CI 2.09-3.35]), IS (HR= 2.45 [95%CI 1.89-3.17]), ICH (HR= 2.74 [95%CI 1.55-4.85]), and SAH (HR= 4.64 [95%CI 2.25-9.56]). In the combination analyses, compared with normal SBP and low MRS, normal/high SBP and high MRS significantly increased stroke risk (HR= 5.80 [95% CI: 2.75-12.27]/6.37 [95% CI 3.22-12.62]). A favorable/unfavorable lifestyle and high MRS also significantly increased stroke risk (HR= 2.38 [95% CI: 1.73-3.28]/3.86 [95% CI 2.63-5.67]) compared with a favorable lifestyle and low MRS. Incorporating MRS into the 15-year stroke and IS risk prediction model increased the AUCs from 0.746 to 0.766 and from 0.771 to 0.811, respectively. The metabolic signature was correlated with adherence to a healthy lifestyle (r = 0.414; P = 2.22e-16) and inversely associated with stroke risk (HR= 0.80 [95% CI 0.73-0.86]). Conclusions Various metabolites and MRS were significantly associated with the risk of stroke, IS, ICH and SAH. Individuals with a high MRS may face an elevated stroke risk among populations with high SBP or unhealthy lifestyle, even those with normal SBP or healthy lifestyle. MRS provided modest improvement to the stroke risk prediction model. The lifestyle-related metabolic signature could reduce 20% stroke risk.

Uncovering the key working mechanisms of a complex community-based obesity prevention programme in the Netherlands using ripple effects mapping.

BACKGROUND: Much remains unknown about how complex community-based programmes can successfully achieve long-term impact. More insight is needed to understand the key mechanisms through which these programmes work. Therefore, we conducted an in-depth study in five communities that implemented the Healthy Youth, Healthy Future (JOGG) approach, a Dutch community-based obesity prevention programme. We aimed to identify perceived outcomes and long-term impacts among local stakeholders and explore potential causal pathways and working mechanisms. METHODS: We used ripple effects mapping (REM), a qualitative participatory method to map outcomes and identify causal pathways, in five communities. We involved 26 stakeholders, professionals and policy-makers affiliated with the local JOGG approach, spread over eight REM sessions and conducted individual interviews with 24 additional stakeholders. To uncover working mechanisms, we compared outcomes and causal pathways across communities. RESULTS: Over 5-9 years of implementation, participants perceived that JOGG had improved ownership of local stakeholders, health policies, intersectoral collaboration and social norms towards promoting healthy lifestyles. Causal pathways comprised small initial outcomes that created the preconditions to enable the achievement of long-term impact. Although exact JOGG actions varied widely between communities, we identified five common working mechanisms through which the JOGG approach contributed to causal pathways: (1) creating a positive connotation with JOGG, (2) mobilizing stakeholders to participate in the JOGG approach, (3) facilitating projects to promote knowledge and awareness among stakeholders while creating successful experiences with promoting healthy lifestyles, (4) connecting stakeholders, thereby stimulating intersectoral collaboration and (5) sharing stakeholder successes that promote healthy lifestyles, which gradually created a social norm of participation. CONCLUSIONS: The JOGG approach seems to work through activating initial stakeholder participation and bolstering the process towards ownership, policy change, and intersectoral collaboration to promote healthy lifestyles. Key working mechanisms can inform further development of JOGG as well as other complex community-based prevention programmes.

Barriers to a Healthy Lifestyle Among Obese Patients Attending Primary Care Clinics in Al-Ahsa, Saudi Arabia.

Obesity is a significant public health issue in Saudi Arabia, contributing to high morbidity and mortality rates. This study aimed to identify the barriers preventing obese patients from adhering to healthy diets and regular exercise while following a health coach in primary healthcare centers in Al-Ahsa. A cross-sectional study of 283 obese adults revealed that major barriers included lack of energy, willpower, and time for exercise, as well as lack of willpower, social influence, and time for maintaining a healthy diet. These barriers were significantly associated with demographic factors such as obesity grade, comorbidities, and educational level. Addressing these barriers is essential for developing effective interventions to support lifestyle changes in obese patients.

Association between healthy lifestyle and frailty in adults and mediating role of weight-adjusted waist index: results from NHANES.

BACKGROUND: The relationship between healthy lifestyle and frailty remains unclear. Healthy weight is crucial for overall well-being, but using body mass index (BMI) to evaluate weight management is inefficient. This study clarifies the association between healthy lifestyle or its factors (non-smoking, moderate drinking, healthy weight, healthy diet, sufficeint physical activity, and non-sedentary) and frailty, and the feasibility of using the weight-adjusted waist index (WWI) reflecting central obesity as an intermediate indicator. METHODS: This study included 4,473 participants from the 2007-2018 National Health and Nutrition Examination Survey (NHANES). Healthy lifestyle quality was assessed by summing the scores of each healthy lifestyle factor. Frailty was assessed using a 49-item frailty index (FI), categorizing participants into robust, pre-frail, and frail. Logistic regression to investigate the association between healthy lifestyle or its factors, WWI, and frailty. Smooth curve fitting and threshold effect analyses were used to elucidate the nonlinear association. Subgroup and two other sensitivity analyses were conducted to confirm the stability of the results. A causal mediation model examined the proportion of frailty mediated by WWI. RESULTS: The study identified 13.98% of the participants as frail. Optimal healthy lifestyle and frailty were negatively associated (OR: 0.39, 95%CI: 0.27-0.58). Five healthy lifestyle factors (non-smoking, healthy weight, healthy diet, sufficient physical activity, and non-sedentary) were associated with a lower prevalence of frailty, with odds ratios (OR) ranging from 0.48 to 0.61. We also analyzed the association between a healthy lifestyle and WWI (OR: 0.32, 95%CI: 0.27-0.37), WWI and frailty (OR: 1.85, 95%CI: 1.59-2.16). A positive association between WWI and FI was observed beyond the inflection point (9.99) (OR: 0.03, 95%CI: 0.02-0.03). Subgroup and sensitivity analyses confirmed stable associations between healthy lifestyle, WWI, and frailty. WWI partially mediated the association between a healthy lifestyle and frailty (mediating ratio = 20.50-20.65%). CONCLUSIONS: An optimal healthy lifestyle and positive healthy lifestyle factors are associated with a lower incidence of frailty. WWI may mediate the relationship between a healthy lifestyle and frailty.

Developing an assessment tool for the healthy lifestyles of the occupational population in China: a modified Delphi-analytic hierarchy process study.

Lifestyle is an important factor affecting people's health. Evaluating and promoting healthy lifestyles among occupational population can not only improve work ability and efficiency, but also contribute to the prevention a variety of potential diseases. This study developed a preliminary index system based on literature review and group discussion. Two rounds of expert consultation were conducted on 12 experts using Delphi method. The questionnaire recovery rate of the two rounds of Delphi survey was over 85%, the expert authority coefficient was over 0.70, and Kendall W was 0.450 and 0.446, which were significant (P < 0.001). The weighting coefficient of each indicator was calculated using the hierarchical analysis method. Among them, the weighting coefficients of physical health lifestyle, mental health lifestyle, social adaptation lifestyle and occupational health lifestyle were 0.4133, 0.2922, 0.1078 and 0.1867, respectively. The consistency index CI = 0.024 and the consistency ratio CR = 0.027 of the first-level index judgment matrix. The weighting coefficient is acceptable and the indicators do not cause logical confusion. The healthy lifestyle assessment tool of the occupational population constructed in this study consists of 4 primary indicators, 13 secondary indicators and 45 tertiary indicators, which can provide a standardized and operable assessment tool for monitoring and evaluating the healthy lifestyle of the Chinese occupational population. At the same time, the weight analysis of various indicators through the analytic hierarchy process can also provide reference for the key areas of occupational health intervention.

Sleep and periodontal health.

Sleep is fundamental for health and well-being. An adequate amount and quality of sleep is a cardinal component of a healthy lifestyle at the basis of the prevention of many non-communicable chronic diseases. Recent evidence suggests that sleep disorders, particularly obstructive sleep apnea, represent an emerging risk factor for periodontal health. This review article provides a critical appraisal of the existing literature concerning the association between sleep duration, sleep quality, sleep disorders in general, and obstructive sleep apnea with periodontal diseases, including gingivitis and periodontitis. The putative mechanisms underlying these associations are described as well as the potential clinical implications for diagnosis and treatment.

Healthy Lifestyle and Cardiac Rehabilitation for Weight Loss.

PURPOSE OF REVIEW: Considerable current interest is directed at pharmacological agents for producing significant weight loss. However, healthy lifestyle choices can also lead to clinically meaningful weight loss and improvements in cardiovascular disease (CVD) risk factors. RECENT FINDINGS: In this review, we summarize the recent research from our PROmoting Successful Weight Loss in Primary CarE in Louisiana (PROPEL) randomized controlled trial and review previous data on the potential benefits of cardiac rehabilitation and exercise training (CRET) programs to produce weight loss and improvements in CVD risk factors. Although obesity medications are becoming extremely attractive for secondary and even primary CVD prevention, high-intensity non-pharmacological therapies with healthy lifestyle choices reviewed herein can also lead to substantial health improvements in patients with obesity, including improvements in body weight and other body composition parameters as well as overall CVD risk.

A Qualitative Study of the Knowledge of Metabolic Syndrome, Attitudes about Lifestyle Modifications, and Preferences for Lifestyle Interventions among Patients with Cancer and Metabolic Syndrome.

Metabolic syndrome is a group of disorders-hypertension, dyslipidemia, obesity, and insulin resistance-that together increase the risk of coronary heart disease, stroke, and diabetes. Although ~60% of cancer patients have metabolic syndrome, which increases their risk of mortality, oncology providers lack clear guidance about its management. The development of metabolic syndrome lifestyle interventions requires a better understanding of these patients' knowledge, attitudes, and intervention preferences in order to inform management. During 2022-2023, 19 adult cancer patients with metabolic syndrome engaged in semistructured interviews focused on metabolic syndrome and lifestyle interventions. Interviews were analyzed using hybrid thematic analysis involving deductive and inductive coding. The findings indicated that patients lack knowledge about metabolic syndrome, were motivated to prioritize lifestyle modifications, and expressed strong interest in personalized care plans focused on healthy lifestyle rather than simply on weight loss. As part of their tailored intervention plans, participants desired clear communication with, and coordination of care among, their medical team and shared decision-making with providers about treatment decisions. The findings indicate that patients with metabolic syndrome want collaborative, patient-centered care, tailored interventions, and practical implementation strategies. This research will be used to inform the development of future lifestyle interventions for patients diagnosed with metabolic syndrome based on their identified needs and preferences.

Daily Limited Future Time Perspective Is Associated with More Health Behavior Within Older Adults.

OBJECTIVE: Cross-sectional studies suggest that individuals who perceive a broader future horizon may be more likely to consider the future consequences of their actions and, as a result, engage in healthy lifestyle behaviors. However, research has yet to consider how this association plays out on the daily level. METHOD: The present study used daily diary data from a sample of 198 older adults aged 60 years and older (M = 63.34, SD = 3.29) to investigate the relationship between daily future time perspective (FTP) and daily health behavior. Participants reported on sociodemographic characteristics during baseline surveys and completed daily diary measures of FTP and health behavior (e.g., nutrition, exercise, social/leisure activity) across 14 days. Multilevel modeling was used to examine within- and between-person associations between daily FTP and health behavior. RESULTS: Daily FTP was significantly associated with daily health behavior at the within- but not at the between-person level. Counter to past cross-sectional work, results revealed that individuals showed increased engagement in health behavior on days when they reported a more limited FTP. DISCUSSION: Findings highlight the importance of moving beyond the between-person level to consider how FTP fluctuates from day-to-day and relates to health behavior in everyday life. Older adults who view a more limited time horizon may be motivated to increase that future through healthier activities.

Plasma metabolomic signature of healthy lifestyle, structural brain reserve and risk of dementia.

Although the association between healthy lifestyle and dementia risk has been documented, the relationship between a metabolic signature indicative of healthy lifestyle and dementia risk and the mediating role of structural brain impairment remain unknown. We retrieved 136 628 dementia-free participants from UK Biobank. Elastic net regression was used to obtain a metabolic signature that represented lifestyle behaviours. Cox proportional hazard models were fitted to explore the associations of lifestyle-associated metabolic signature with incident dementia. Causal associations between identified metabolites and dementia were investigated using Mendelian randomization. Mediation analysis was also conducted to uncover the potential mechanisms involving 19 imaging-derived phenotypes (brain volume, grey matter volume, white matter volume and regional grey matter volumes). During a follow-up of 12.55 years, 1783 incident cases of all-cause dementia were identified, including 725 cases of Alzheimer's dementia and 418 cases of vascular dementia. We identified 83 metabolites that could represent healthy lifestyle behaviours using elastic net regression. The metabolic signature was associated with a lower dementia risk, and for each standard deviation increment in metabolic signature, the hazard ratio was 0.89 [95% confidence interval (CI): 0.85, 0.93] for all-cause dementia, 0.95 (95% CI: 0.88, 1.03) for Alzheimer's dementia and 0.84 (95% CI: 0.77, 0.91) for vascular dementia. Mendelian randomization revealed potential causal associations between the identified metabolites and risk of dementia. In addition, the specific structural brain reserve, including the hippocampus, grey matter in the hippocampus, parahippocampal gyrus and middle temporal gyrus, were detected to mediate the effects of metabolic signature on dementia risk (mediated proportion ranging from 6.21% to 11.98%). The metabolic signature associated with a healthy lifestyle is inversely associated with dementia risk, and greater structural brain reserve plays an important role in mediating this relationship. These findings have significant implications for understanding the intricate connections between lifestyle, metabolism and brain health.

Exploring the Relationships between Lifestyle Patterns and Epigenetic Biological Age Measures in Men.

DNA methylation, validated as a surrogate for biological age, is a potential tool for predicting future morbidity and mortality outcomes. This study aims to explore how lifestyle patterns are associated with epigenetic changes in British men. Five biological age clocks were utilised to investigate the relationship between these epigenetic markers and lifestyle-related factors in a prospective study involving 221 participants. Spearman's correlation test, Pearson's correlation test, and univariate linear regression were employed for analysis. The results indicate that higher consumption of saturated fat and total daily calories, and a higher body mass index (BMI) are associated with accelerated biological aging. Conversely, higher vitamin D intake and a higher healthy lifestyle index (HLI) are linked to decelerated biological aging. These findings highlight the potential impact of specific lifestyle-related factors on biological aging and can serve as a reference for applying healthy lifestyle improvements in future disease prevention studies.

Nut consumption is associated with a lower risk of all-cause dementia in adults: a community-based cohort study from the UK Biobank.

This cohort study aimed to analyze the relationship between nut consumption and the risk of all-cause dementia in adults from the United Kingdom (UK). Data from participants in the UK Biobank cohort between 2007-2012 (baseline) and 2013-2023 (follow-up) were analyzed. Baseline information on nut consumption was obtained using the Oxford WebQ 24-h questionnaire. All-cause dementia (i.e. Alzheimer's disease, frontotemporal dementia, or vascular dementia) was assessed at baseline and follow-up through self-reported medical diagnosis, hospitalization, or death records. Hazard regression models were used to estimate the association between nut consumption and the risk of developing all-cause dementia, with adjustments made for sociodemographic, lifestyle, hearing problems, self-rated health, and the number of chronic diseases. Participants with all-cause dementia at baseline were excluded. A total of 50,386 participants (mean age 56.5 ± 7.7 years, 49.2% women) were included in the prospective analyses. The incidence of all-cause dementia was 2.8% (n = 1422 cases). Compared with no consumption, daily nut consumption (> 0 to 3 or more handfuls) was significantly associated with a 12% lower risk of all-cause dementia (hazard ratio = 0.88; 95% confidence interval, 0.77-0.99) after 7.1 mean years of follow-up, regardless of the potential confounders considered. No statistically significant interactions were observed between nut consumption and any of the covariates included in the hazard regression models. Stratified analyses revealed that nut consumption of up to 1 handful of 30 g/day and consumption of unsalted nuts were associated with the greatest protective benefits. The daily consumption of nuts may play a protective role in the prevention of dementia.

The healthy habits questionnaire (HHQ): Validation of a measure designed to assess problematic influential behaviours amongst families of children living with obesity or a risk of developing obesity.

The 48-item Healthy Habits Questionnaire (HHQ-48) was developed to (1) monitor positive changes in family lifestyles following engagement in the Parents Plus Healthy Families (PP-HF) parent training programme and (2) be utilised as a standalone measure in clinical settings to identify and track problematic influential behaviours amongst families of children in weight-management services. This study aimed to develop and validate a brief version of the HHQ-48. The scale was administered to a cross-sectional community sample (n = 480), and on two occasions to a control sample (n = 50) and an experimental sample (n = 40) from a randomised controlled trial (RCT) of the PP-HF programme to assess test-retest reliability and sensitivity to change respectively. Exploratory and confirmatory factor analysis showed that a 23-item, 4-factor version of the HHQ (i.e., the HHQ-23) best fit the data. The scale and factor subscales had good internal consistency and test-retest reliability. They also had good concurrent and construct validity shown by significant correlations with another scale that assessed lifestyle issues, and scales that assessed parenting satisfaction, family functioning, and children's strengths and difficulties. The HHQ-23 was sensitive to change following parents completing the PP-HF programme. The HHQ-23 may, therefore, be used to monitor positive changes in family lifestyles following engagement in the PP-HF parent training programme. The HHQ-23 also shows promising potential as a standalone screening measure or as part of a larger battery of screening assessments in paediatric weight-management services.

This study aimed to develop a brief version of the 48-item Healthy Habits Questionnaire (HHQ-48), which assesses how parents encourage healthy lifestyles in their children and evaluates the effectiveness of the 8-session Parents Plus ­ Healthy Families (PP-HF) program aimed at preventing childhood obesity. The HHQ-48 items are grouped into eight categories reflecting the PP-HF sessions: empowering parents, family connection, healthy food routines, healthy meals, active play, managing technology, restful sleep, and a happy, healthy mind. To create a shorter version of the HHQ, 480 parents completed the HHQ-48 and additional family life questionnaires online. Factor analysis identified 23 items grouped into four clusters: Screens and Routines, Activity, Parent-Child Connection, and Healthy Food & Good Example, forming the HHQ-23.The HHQ-23 showed strong correlations with the HHQ-48 and moderate correlations with other established questionnaires on children's lifestyles, parenting satisfaction, family functioning, and children's strengths and difficulties. In a test with 50 parents over eight weeks, HHQ-23 scores were stable. Scores increased for 41 parents who completed the HHQ-23 before and after the PP-HF program, demonstrating the HHQ-23's sensitivity to change.