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1.
BMJ ; 368: l6669, 2020 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-31915124

RESUMO

OBJECTIVE: To examine how a healthy lifestyle is related to life expectancy that is free from major chronic diseases. DESIGN: Prospective cohort study. SETTING AND PARTICIPANTS: The Nurses' Health Study (1980-2014; n=73 196) and the Health Professionals Follow-Up Study (1986-2014; n=38 366). MAIN EXPOSURES: Five low risk lifestyle factors: never smoking, body mass index 18.5-24.9, moderate to vigorous physical activity (≥30 minutes/day), moderate alcohol intake (women: 5-15 g/day; men 5-30 g/day), and a higher diet quality score (upper 40%). MAIN OUTCOME: Life expectancy free of diabetes, cardiovascular diseases, and cancer. RESULTS: The life expectancy free of diabetes, cardiovascular diseases, and cancer at age 50 was 23.7 years (95% confidence interval 22.6 to 24.7) for women who adopted no low risk lifestyle factors, in contrast to 34.4 years (33.1 to 35.5) for women who adopted four or five low risk factors. At age 50, the life expectancy free of any of these chronic diseases was 23.5 (22.3 to 24.7) years among men who adopted no low risk lifestyle factors and 31.1 (29.5 to 32.5) years in men who adopted four or five low risk lifestyle factors. For current male smokers who smoked heavily (≥15 cigarettes/day) or obese men and women (body mass index ≥30), their disease-free life expectancies accounted for the lowest proportion (≤75%) of total life expectancy at age 50. CONCLUSION: Adherence to a healthy lifestyle at mid-life is associated with a longer life expectancy free of major chronic diseases.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Estilo de Vida Saudável/fisiologia , Expectativa de Vida , Neoplasias , Comportamento de Redução do Risco , Adulto , Consumo de Bebidas Alcoólicas , Índice de Massa Corporal , Doenças Cardiovasculares/prevenção & controle , Doenças Cardiovasculares/psicologia , Diabetes Mellitus Tipo 2/prevenção & controle , Diabetes Mellitus Tipo 2/psicologia , Exercício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/prevenção & controle , Neoplasias/psicologia , Pesquisa em Enfermagem , Estudos Prospectivos , Fumar
2.
Diabetes Res Clin Pract ; 155: 107814, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31421138

RESUMO

INTRODUCTION: Emerging evidence suggests us of real-time continuous glucose monitoring systems (RT-CGM), can assist to improve glucose control in Type 2 Diabetes (T2D) treatment, however the impact of these devices on patients' stress levels and behaviour is poorly understood. This study aimed to examine the effects of RT-CGM on tolerance and acceptability of device wear, stress and diabetes management and motivation to change. METHODS: Twenty adults (10 men, 10 women) with T2D (aged 60.6 ±â€¯8.4 years, BMI 34.2 ±â€¯4.7 kg/m2), were randomised to a low-carbohydrate lifestyle plan whilst wearing a RT-CGM or an 'offline-blinded' (Blinded-CGM) monitoring system continuously for 12 weeks. Outcomes were glycaemic control (HbA1c), weight (kg) perceived stress scale (PSS), CGM device intolerance, acceptability, motivation to change and diabetes management behaviour questionnaires. RESULTS: Both groups experienced significant reductions in body weight (RT-CGM -7.4 ±â€¯4.5 kg vs. Blinded-CGM -5.5 ±â€¯4.0 kg) and HbA1c (-0.67 ±â€¯0.82% vs. -0.68 ±â€¯0.74%). There were no differences between groups for perceived stress (P = 0.47) or device intolerance at week 6 or 12 (both P > 0.30). However, there was evidence of greater acceptance of CGM in the RT-CGM group at week 12 (P = 0.03), improved blood glucose monitoring behaviour in the RT-CGM group at week 6 and week 12 (P ≤ 0.01), and a significant time x group interaction (P = 0.03) demonstrating improved diabetes self-management behaviours in RT-CGM. CONCLUSION: This study provides preliminary evidence of improved behaviours that accompany RT-CGM in the context of diabetes management and glucose self-monitoring. RT-CGM may provide an alternative approach to glucose management in individuals with T2D without resulting in increased disease distress.


Assuntos
Automonitorização da Glicemia/métodos , Diabetes Mellitus Tipo 2/sangue , Estilo de Vida Saudável/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto
4.
Cancer Control ; 26(1): 1073274819864666, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31345054

RESUMO

A hospital-based, case-control study was conducted to investigate the association between lifestyle patterns and risk of colorectal cancer (CRC) in the north of Vietnam. Demographic factors employed for the models were age, sex, marital status, occupation, education, income, smoking status, alcohol consumption, vegetable consumption, tea, coffee consumption, and physical activity (PA). Individuals of both groups (n = 154 for the control group and n = 136 for the CRC group) were interviewed using a questionnaire by trained interviewers. The findings showed that moderate PA was inversely associated with CRC risk: odds ratio (OR) = 0.19, 95% confidence interval (CI) = 0.10 to 0.36 with P < .01. The total PA showed that the highest tertile (>2.7 MET-h/d) was associated with the reduced risk of CRC compared with the lowest tertile one after controlling for confounding factors: adjusted OR = 0.25, 95% CI = 0.09 to 0.74, P < .01. Sedentary time was associated with an increased level of CRC risk by 57% as compared between the highest tertile and the lowest one after controlling for confounding factors. Daily consumption of vegetables and 1 to 3 cups of tea per day or more were also associated with decreased risk of CRC. Despite promising findings, a limitation of this research is that it did not establish a temporal relationship between risk factors and CRC due to its retrospective design. However, this is the first analytic study highlighting the role of the active lifestyle pattern associated with reduced CRC risk in Vietnamese adults.


Assuntos
Neoplasias Colorretais/prevenção & controle , Estilo de Vida Saudável/fisiologia , Comportamento de Redução do Risco , Idoso , Estudos de Casos e Controles , Neoplasias Colorretais/epidemiologia , Exercício/fisiologia , Comportamento Alimentar/fisiologia , Feminino , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Vietnã/epidemiologia
5.
Medicine (Baltimore) ; 98(27): e16272, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277151

RESUMO

INTRODUCTION: As aging is associated with functional decline, preventing functional limitations and maintaining independence throughout later life has emerged as an important public health goal. Research indicates that sedentary behavior (prolonged sitting) is associated with functional loss and diminished ability to carry out activities of daily living. Despite many efforts to increase physical activity, which can be effective in countering functional loss, only an estimated 8% of older adults meet national physical activity guidelines. Thus, shifting the focus to reducing sitting time is emerging as a potential new intervention strategy but little research has been conducted in this area. With community support and funding, we developed and pilot tested a 4-week "Stand Up and Move More" intervention and found decreases in sedentary behavior, increases in physical activity, and improvements in mobility and vitality in a small sample of older adults. The purpose of this project is to expand upon these pilot results and examine the effectiveness and feasibility of translating a "Stand Up and Move More" intervention by State Aging Units to older adults in underserved communities. Eighty older adults from 4 counties across Wisconsin predominantly made up of rural older adults and older African American adults are randomly assigned to intervention (n = 40) or wait-list control (n = 40) groups. The intervention consists of 4 weekly sessions plus a refresher session at 8 weeks, and is delivered by community partners in each county. The sessions are designed to elicit ideas from older adults regarding how they can reduce their sitting time, help them set practical goals, develop action plans to reach their goals, and refine their plans across sessions to promote behavior change. Sedentary behavior, physical activity levels, functional performance, and health-related quality of life are assessed before and after the intervention to examine the effectiveness of the program. Feasibility of implementing the program by our community partners is assessed via semi-structured interviews. Strengths of this project include strong community collaborations and a high need given that the older adult population is projected to increase substantially in the next 15 years. CONCLUSION: This project will provide an important step in developing effective strategies for maintaining independence in older adults through determining the feasibility and impact of a community-based intervention to break up sitting time.


Assuntos
Envelhecimento/psicologia , Terapia Comportamental/métodos , Terapia por Exercício/métodos , Exercício/fisiologia , Estilo de Vida Saudável/fisiologia , Qualidade de Vida , Comportamento Sedentário , Idoso , Feminino , Promoção da Saúde/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
7.
Med Sci Sports Exerc ; 51(6): 1252-1261, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31095082

RESUMO

PURPOSE: This article reviews and updates the evidence on the associations between physical activity and risk for cancer, and for mortality in persons with cancer, as presented in the 2018 Physical Activity Guidelines Advisory Committee Scientific Report. METHODS: Systematic reviews of meta-analyses, systematic reviews, and pooled analyses were conducted through December 2016. An updated systematic review of such reports plus original research through February 2018 was conducted. This article also identifies future research needs. RESULTS: In reviewing 45 reports comprising hundreds of epidemiologic studies with several million study participants, the report found strong evidence for an association between highest versus lowest physical activity levels and reduced risks of bladder, breast, colon, endometrial, esophageal adenocarcinoma, renal, and gastric cancers. Relative risk reductions ranged from approximately 10% to 20%. Based on 18 systematic reviews and meta-analyses, the report also found moderate or limited associations between greater amounts of physical activity and decreased all-cause and cancer-specific mortality in individuals with a diagnosis of breast, colorectal, or prostate cancer, with relative risk reductions ranging almost up to 40% to 50%. The updated search, with five meta-analyses and 25 source articles reviewed, confirmed these findings. CONCLUSIONS: Levels of physical activity recommended in the 2018 Guidelines are associated with reduced risk and improved survival for several cancers. More research is needed to determine the associations between physical activity and incidence for less common cancers and associations with survival for other cancers. Future studies of cancer incidence and mortality should consider these associations for population subgroups, to determine dose-response relationships between physical activity and cancer risk and prognosis, and to establish mechanisms to explain these associations.


Assuntos
Exercício , Neoplasias/mortalidade , Neoplasias/prevenção & controle , Pesquisa Biomédica , Estilo de Vida Saudável/fisiologia , Humanos , Incidência , Neoplasias/epidemiologia , Guias de Prática Clínica como Assunto , Prevenção Primária , Comportamento de Redução do Risco , Taxa de Sobrevida
8.
Support Care Cancer ; 27(9): 3183-3194, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30993451

RESUMO

PURPOSE: The number of pediatric cancer survivors has increased dramatically over recent decades. Prior studies involving pediatric cancer survivors have reported reduced physical activity and fitness levels. Thus, the aim of this meta-analysis was to synthesize previous findings on physical activity and fitness levels of pediatric cancer survivors, who had completed cancer treatment and are in complete remission compared with age-matched, non-athletic healthy controls with no history of cancer diagnosis. METHODS: Three electronic databases (PubMed, Web of Science, and EBSCO) were searched using a combination of 24 terms. Observational studies examining the post-treatment physical activity and/or fitness levels of pediatric cancer survivors compared with that of non-cancer controls and published in peer-reviewed, English-language journals before August 22, 2018 were eligible. Random-effect models were used in Comprehensive Meta-Analysis software for effect-size estimations of eight studies for physical activity and eight for fitness. RESULTS: The studies included a total sample of 2628; 1413 pediatric cancer survivors and 1215 non-cancer controls. Both physical activity and fitness were significantly lower in childhood cancer survivors than in non-cancer controls (g = - 0.889; 95% confidence interval [CI] = - 1.648 - 0.130; p = 0.022) and (g = - 1.435; 95% CI = - 2.615 - 0.225; p = 0.017), respectively, with high heterogeneity. CONCLUSIONS: Pediatric cancer sequelae and its treatment may limit participation in physical activity and fitness activities by survivors of pediatric cancer. Accentuating the need to incorporate physical activity and fitness into treatment protocols and post-treatment recommendations may improve pediatric cancer survivors' health and well-being.


Assuntos
Sobreviventes de Câncer , Exercício/fisiologia , Aptidão Física/fisiologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Comportamentos Relacionados com a Saúde/fisiologia , Estilo de Vida Saudável/fisiologia , Humanos , Masculino , Neoplasias/terapia , Adulto Jovem
9.
Psychol Aging ; 34(3): 317-329, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30973239

RESUMO

The current study examined how perceptions of change in life satisfaction vary by age and culture. Perceptions of past, present, and future life satisfaction were examined in adults aged 33-79 from the Midlife in the United States Study (N = 4,803) and from the Survey of Midlife in Japan (N = 974). Both cultures exhibited the same age-related pattern of change in perceptions of life satisfaction. Younger adults perceived improvement in life satisfaction from the past to present and from present to the future. The perceived improvement was more modest among middle-aged adults and then shifted to a decline among older adults. Despite the same curvilinear pattern in both cultures, the perceived improvement was not as positive, and the shift toward expecting declines occurred at an earlier age among Japanese adults compared to U.S. adults. Findings support existing theories of life span development but suggest that cultural context may influence both the positive outlook and the timing of these processes across adulthood. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Estilo de Vida Saudável/fisiologia , Satisfação Pessoal , Adulto , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Estados Unidos
10.
JAMA Netw Open ; 2(3): e190355, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30848809

RESUMO

Importance: Although the benefits of leisure-time physical activity (LTPA) in middle age are established, the health effects of long-term participation and changes in LTPA between adolescence and middle age have not been documented. Objective: To determine whether an association exists between LTPA life course patterns and mortality. Design, Setting, and Participants: This prospective cohort study used data from the National Institutes of Health-AARP (formerly American Association of Retired Persons) Diet and Health Study established in 1995 to 1996. Data analysis was conducted from March 2017 through February 2018. Data were analyzed for 315 059 adult AARP members living in 6 states, namely, California, Florida, Louisiana, New Jersey, North Carolina, or Pennsylvania, or 2 metropolitan areas, Atlanta, Georgia, or Detroit, Michigan. Exposures: Self-reported LTPA (hours per week) at the baseline interview for ages grouped as 15 to 18, 19 to 29, 35 to 39, and 40 to 61 years. Main Outcomes and Measures: All-cause, cardiovascular disease (CVD)-related, and cancer-related mortality records available through December 31, 2011. Results: Of 315 059 participants, 183 451 (58.2%) were men, and the participants were 50 to 71 years of age at enrollment. Ten LTPA trajectories (categorized as maintaining, increasing, and decreasing LTPA across time) were identified, and 71 377 deaths due to all causes, 22 219 deaths due to CVD, and 16 388 deaths due to cancer occurred. Compared with participants who were consistently inactive throughout adulthood, participants who maintained the highest amount of LTPA in each age period were at lower risks for all-cause, CVD-related, and cancer-related mortality. For example, compared with participants who were consistently inactive, maintaining higher amounts of LTPA was associated with lower all-cause (hazard ratio [HR], 0.64; 95% CI, 0.60-0.68), CVD-related (HR, 0.58; 95% CI, 0.53-0.64), and cancer-related (HR, 0.86; 95% CI, 0.77-0.97) mortality. Adults who were less active throughout most of the adult life course but increased LTPA in later adulthood (40-61 years of age) also had lower risk for all-cause (HR, 0.65; 95% CI, 0.62-0.68), CVD-related (HR, 0.57; 95% CI, 0.53-0.61), and cancer-related (HR, 0.84; 95% CI, 0.77-0.92) mortality. Conclusions and Relevance: Maintaining higher LTPA levels and increasing LTPA in later adulthood were associated with comparable low risk of mortality, suggesting that midlife is not too late to start physical activity. Inactive adults may be encouraged to be more active, whereas young adults who are already active may strive to maintain their activity level as they get older.


Assuntos
Doenças Cardiovasculares/mortalidade , Exercício , Estilo de Vida Saudável/fisiologia , Atividades de Lazer/psicologia , Neoplasias/mortalidade , Adolescente , Adulto , Idoso , Causas de Morte , Estudos de Coortes , Exercício/fisiologia , Exercício/psicologia , Comportamentos Relacionados com a Saúde/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade , Estudos Prospectivos , Estados Unidos/epidemiologia
11.
Rev. andal. med. deporte ; 12(1): 62-66, ene.-mar. 2019. tab, graf
Artigo em Português | IBECS | ID: ibc-184499

RESUMO

Objetivo: Propor um protocolo de estudo para perda de peso saudável baseado em dieta com restrição de carboidratos e exercício intermitente de alta intensidade. Método: O protocolo foi gerado para um estudo clínico randomizado e controlado, visando a perda de peso baseada na adoção de dieta com ou sem restrição de carboidratos, e exercício contínuo (caminhada e corrida) ou intermitente de alta intensidade (circuito com exercícios funcionais). Participarão do estudo, adultos sobrepesados e sedentários, integrantes da comunidade universitária. Os participantes serão avaliados antes e após as 12 semanas de intervenção quanto aos aspectos nutricionais (avaliação antropométrica e da ingestão alimentar), físicos (força, agilidade, velocidade e resistência cardiorrespiratória), bioquímicos (hemograma, hormonal e lipidograma), estados de humor, além de sua percepção qualitativa da intervenção, identificando as barreiras e facilitadores do processo de perda ponderal. Discussão: Tendo em vista a importância da alimentação e do exercício físico para saúde, a presente proposta poderá auxiliar no melhor entendimento sobre os efeitos da restrição em níveis recomendados dos carboidratos da dieta e do exercício físico contínuo ou intermitente sobre o emagrecimento e performance funcional em indivíduos com excesso de peso. Os métodos descritos são facilmente aplicáveis e de baixo custo, podendo ser útil como ferramenta para o tratamento da obesidade em âmbito ambulatorial. Número de registro: RBR-5n9g5f (Ensaios Clínicos Governo do Brasil, data de registro: 17 de maio de 2017)


Objetivo: Proponer un protocolo de estudio para pérdida de peso saludable basado en la restricción de carbohidratos y ejercicio interválico de alta intensidad. Método: El protocolo se ha generado para un estudio clínico aleatorizado, controlado, dirigido a la pérdida de peso basado en una dieta con o sin la restricción de carbohidratos, y ejercicio continuo (caminar y correr) o interválico (ejercicios funcionales de circuito) de alta intensidad. La muestra será formada por adultos sedentarios con sobrepeso. Los participantes serán evaluados antes y después de 12 semanas de intervención en relación con aspectos nutricionales (antropometría y evaluación de la ingesta de alimentos), físicos (fuerza, agilidad, velocidad y resistencia cardiorrespiratoria), bioquímicos (hemograma, hormonas y perfil lipídico), estado de ánimo, así como su percepción cualitativa de la intervención, la identificación de las barreras y facilitadores del proceso de pérdida de peso. Discusión: En vista de la importancia de la nutrición y la actividad física para la salud, esta propuesta puede contribuir a una mejor comprensión de los efectos de la restricción de carbohidratos de la dieta y el ejercicio continuo o interválico sobre la pérdida de peso y capacidad funcional de personas con sobrepeso. Los métodos descritos son fácilmente aplicables y económicos, y pueden ser útiles como una herramienta para el tratamiento de la obesidad en un paciente ambulatorio. Número de registro: RBR-5n9g5f (Ensaios Clínicos Governo do Brasil, fecha de registro: 17 de marzo de 2017)


Objective: This study aims to propose a study protocol for healthy weight loss based on diet with carbohydrate restriction and High Intensity Intermittent Exercise. Method: The protocol was generated for a randomized controlled clinical trial; which aims to provide weight loss based on diet with or without carbohydrate restriction and continuous exercise (walking or running) or High Intensity Intermittent Exercise (circuit with functional exercise). The sample will be composed by sedentary overweight adults from the university community. The volunteers will be evaluated before and after 12 weeks of intervention in relation to the nutritional (anthropometric and dietary intake), physical (strength, agility, speed and cardiorespiratory resistance), biochemical (complete blood count, hormone test and lipid profile test) and mood aspects, besides their qualitative perception of the intervention, identifying the barriers and facilitators of the weight loss process. Discussion: Considering the relevance of diet and physical exercise for health, the present proposal may help to understand the effects of moderated restriction of dietary carbohydrates and continuous or intermittent physical exercise on weight loss and functional performance in overweight individuals. The described methods are easily applicable and inexpensive, and can be useful as a tool for the treatment of obesity in an outpatient setting. Registration number: RBR-5n9g5f (Ensaios Clínicos Governo do Brasil, registration date: May 17, 2017)


Assuntos
Humanos , Masculino , Feminino , Adulto , Obesidade/terapia , Treinamento Intervalado de Alta Intensidade/métodos , Dieta com Restrição de Carboidratos/métodos , Perda de Peso/fisiologia , Qualidade de Vida , Estilo de Vida Saudável/fisiologia , Avaliação de Resultado de Intervenções Terapêuticas , Resultado do Tratamento
12.
Pediatrics ; 143(3)2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30718380

RESUMO

BACKGROUND: Research shows that the development of cardiometabolic disease can begin early in life with risk factors accumulating over time, but less is known about protective pathways to positive health. In this study, we use prospective data to test whether childhood assets predict a greater likelihood of being in optimal cardiometabolic health by age 17. METHODS: Data are from 3074 participants in the Avon Longitudinal Study of Parents and Children (mean age = 17.8). Four childhood assets were prospectively assessed via cognitive tests and parent report when children were between ages 8 and 10: strong executive functioning skills, prosocial behaviors, and low levels of internalizing and externalizing problems. Cardiometabolic health was assessed at ages 9 and 17 by using a composite dysregulation score derived from multiple biological parameters, including cholesterol, blood pressure, C-reactive protein, insulin resistance, and BMI. Associations between assets and optimal health at age 17 (ie, a dysregulation score of ≤1) were evaluated with Poisson regression models with robust error variances. RESULTS: After controlling for covariates (including sociodemographics, correlates of cardiometabolic health, and dysregulation scores at age 9), participants with multiple assets were 1.08 to 1.27 times more likely to be in optimal cardiometabolic health at age 17 compared with those with 0 or 1 asset. Each additional asset conferred a 6% greater likelihood of optimal health over time (relative risk = 1.06 [95% confidence interval: 1.01 to 1.11]). CONCLUSIONS: Childhood assets predicted cardiometabolic health with seemingly cumulative impacts. Identifying early assets may provide novel targets for prevention and elucidate pathways to positive adult health.


Assuntos
Função Executiva/fisiologia , Comportamentos Relacionados com a Saúde/fisiologia , Nível de Saúde , Cardiopatias/prevenção & controle , Doenças Metabólicas/prevenção & controle , Comportamento Social , Adolescente , Criança , Inglaterra/epidemiologia , Feminino , Estilo de Vida Saudável/fisiologia , Cardiopatias/epidemiologia , Cardiopatias/psicologia , Humanos , Estudos Longitudinais , Masculino , Doenças Metabólicas/epidemiologia , Doenças Metabólicas/psicologia , Estudos Prospectivos
13.
J Med Internet Res ; 21(1): e11454, 2019 01 23.
Artigo em Inglês | MEDLINE | ID: mdl-30674450

RESUMO

BACKGROUND: In early life, both mothers and fathers are important influences on their children's diet, active play, and obesity risk. Parents are increasingly relying on the internet and social media as a source of information on all aspects of parenting. However, little is known about the use of Web-based sources of information relevant to family lifestyle behaviors and, in particular, differences between mothers' and fathers' use and sociodemographic predictors. OBJECTIVE: The objective of this study was to examine if mothers and fathers differ in their use of the internet for information on their own health and their child's health, feeding, and playing and to examine sociodemographic predictors of the use of the internet for information on these topics. METHODS: We conducted a secondary analysis on data collected from mothers (n=297) and fathers (n=207) participating in the extended Infant Feeding, Activity and Nutrition Trial (InFANT Extend) when their children were 36 months of age. The main outcome variables were the use of the internet for information gathering for parents' own health and child health, feeding, and playing. Binary logistic regression was used to examine the sociodemographic predictors of outcomes. RESULTS: Compared with fathers (n=296), a higher proportion of mothers (n=198) used the internet for information on their own health (230, 78.5% vs 93, 46.5%), child health (226, 77.1% vs 84, 42.4%), child feeding (136, 46.3% vs 35, 17.5%), and child play (123, 42.1% vs 28, 14.0%) and intended to use Facebook to connect with other parents (200, 74.9% vs 43, 30.5%). Despite the high use of the internet to support family health behaviors, only 15.9% (47/296) of mothers reported consulting health practitioners for advice and help for their own or their child's weight, diet, or physical activity. Sociodemographic predictors of internet use differed between mothers and fathers and explained only a small proportion of the variance in internet use to support healthy family lifestyle behaviors. CONCLUSIONS: Our findings support the use of the internet and Facebook as an important potential avenue for reaching mothers with information relevant to their own health, child health, child diet, and active play. However, further research is required to understand the best avenues for engaging fathers with information on healthy family lifestyle behaviors to support this important role in their child's life. TRIAL REGISTRATION: ISRCTN Registry ISRCTN81847050; http://www.isrctn.com/ISRCTN81847050.


Assuntos
Pai/psicologia , Estilo de Vida Saudável/fisiologia , Mães/psicologia , Obesidade/prevenção & controle , Poder Familiar/psicologia , Adulto , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Adulto Jovem
14.
J Med Internet Res ; 21(1): e11935, 2019 01 16.
Artigo em Inglês | MEDLINE | ID: mdl-30664460

RESUMO

BACKGROUND: Approximately 80% of internet users access health information online and patients with chronic illnesses especially rely on internet-based resources. YouTube ranks second among the most accessed websites worldwide and hosts an increasing number of videos with medical information. However, their quality is sometimes unscientific, misleading, or even harmful. OBJECTIVE: As little is known about YouTube as a source of information on psoriasis, we aimed to investigate the quality of psoriasis-related videos and, if necessary, point out strategies for their improvement. METHODS: The quality of the 100 most viewed psoriasis-related videos was assessed using the DISCERN instrument and the Global Quality Scale (GQS) by categorizing the videos into useful, misleading, and dangerous and by evaluating the reception of the videos by users. RESULTS: Evaluation of the videos exhibited a total of 117,221,391 views and a total duration of 10:28 hour. The majority of clips contained anecdotal personal experiences with complementary and alternative psoriasis treatments, topical treatments, and nutrition and diets being the most frequently addressed topics. While advertisements accounted for 26.0% (26/100) of the videos, evidence-based health information amounted to only 20.0% (20/100); 32.0% (32/100) of the videos were classified as useful, 52.0% (52/100) as misleading, and 11.0% (11/100) as even dangerous. The quality of the videos evaluated by DISCERN and GQS was generally low (1.87 and 1.95, respectively, on a 1 to 5 scale with 5 being the maximum). Moreover, we found that viewers rated poor-quality videos better than higher quality videos. CONCLUSIONS: Our in-depth study demonstrates that nearly two-thirds of the psoriasis-related videos we analyzed disseminate misleading or even dangerous content. Subjective anecdotal and unscientific content is disproportionately overrepresented and poor-quality videos are predominantly rated positively by users, while higher quality video clips receive less positive ratings. Strategies by professional dermatological organizations are urgently needed to improve the quality of information on psoriasis on YouTube and other social media.


Assuntos
Coleta de Dados/métodos , Estilo de Vida Saudável/fisiologia , Psoríase/epidemiologia , Mídias Sociais/normas , Gravação em Vídeo/métodos , Estudos Transversais , Humanos , Internet
15.
Complement Ther Med ; 42: 19-26, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30670242

RESUMO

BACKGROUND: While yoga can improve health-related variables and health behavior, different yoga styles and practice components appear to be associated with specific health outcomes. The aim of this study was to explore the connection between yoga use, health, and health behaviors across different yoga styles. METHODS: A cross-sectional anonymous online survey (n = 1,702; 88.9% female; 93.3% German nationality; mean age 47.2 ± 10.8 years; 58.2% yoga teachers) assessed yoga practice characteristics, health-related variables and health behavior. The survey was distributed in Germany only but not limited to German participants. RESULTS: Ashtanga yoga (15.7%), Hatha yoga (14.2%), and Sivananda yoga (22.4%) were the most commonly practiced yoga styles; participants practiced for a mean of 12.7 ± 10.0 years. Most participants had good to excellent (96.1%) overall health; 87.7% reported improved health since starting yoga. Controlling for sociodemographic and clinical factors, health-related variables were mainly associated with frequency of yoga postures practice (p < 0.05), health behaviors also with yoga philosophy study (p < 0.05). The various yoga styles were associated with specific health-related variables (p < 0.05). CONCLUSION: Yoga practitioners generally have a good overall health and a healthy lifestyle. While health variables are mainly associated with practice of yoga postures, health behaviors are also associated with the study of yoga philosophy. Yoga interventions targeting prevention or health promotion should include yoga philosophy to modify health behaviors. The specific yoga style employed may also influence health outcomes.


Assuntos
Comportamentos Relacionados com a Saúde/fisiologia , Ioga/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Alemanha , Promoção da Saúde/métodos , Nível de Saúde , Estilo de Vida Saudável/fisiologia , Humanos , Masculino , Meditação/psicologia , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
16.
BMC Psychiatry ; 19(1): 10, 2019 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-30621644

RESUMO

BACKGROUND: As the elderly population and prevalence of dementia is increasing, it is necessary to have a better comprehension of the influence of specific factors on cognitive function. Dementia is not an inevitable consequence of ageing. Lifestyle factors might either increase or decrease the risk. Even though different studies have focused on individual factors, only a few studies are available which assess all these factors as a whole. Available evidence on these factors is mainly from high income countries and much less evidence is available from low and middle income countries. As cognition is critical for elderly people to engage in a physically independent life, we aimed to identify the associated factors of cognition. METHODS: This was a descriptive cross sectional study performed with 421 elderly people dwelling in residential care facilities for the aged in two selected districts in the Southern Province of Sri Lanka. Cognition was assessed using the Mini Mental State Examination (MMSE). Independent sample t test, ANOVA and regression analyses were used to explore associated factors for cognition. The statistical significance was kept at bonferroni adjusted p < 0.004. RESULTS: The study included elderly people with a mean age of 71.9 ± 6.7 years and of them 65.8% were females. Factors affecting higher level of cognition were, having upper secondary, advanced and higher education; being married; arriving at the facility on one's own accord; being visited by family members; higher physical activity levels and engaging in social and leisure activities (p < 0.004). The factors, namely physical activity level, educational status, visits by family members and engaging in leisure activities were the predictors of cognition in the regression model. CONCLUSION: Though there were several factors that associated with the level of cognition such as educational status, marital status, reason for attending the facility, visits by family members, physical activity levels and participation in social and leisure activities, only the factors, such as physical activity levels, visits by family members, educational status and engaging in leisure activities were the predictors of cognition.


Assuntos
Cognição/fisiologia , Exercício/fisiologia , Exercício/psicologia , Estilo de Vida Saudável/fisiologia , Instituição de Longa Permanência para Idosos/tendências , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Demência/epidemiologia , Demência/psicologia , Família/psicologia , Feminino , Humanos , Masculino , Prevalência , Distribuição Aleatória , Sri Lanka/epidemiologia
17.
BMC Geriatr ; 19(1): 11, 2019 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-30634923

RESUMO

BACKGROUND: Physical activity (PA) has health benefits for people with type 2 diabetes (T2D). Indeed, regular PA is considered an important part of any T2D management plan, yet most patients adopt a sedentary lifestyle. Exercise referral schemes (ERS) have the potential to effectively promote physical activity among T2D patients, and their effectiveness may be enhanced when they are supported by computer-based technologies. The 'TRIPL-A' study (i.e., a TRIal to promote PhysicaL Activity among patients in the young-old age affected by T2D) aims to assess if realizing an innovative ERS, based on a strong partnership among general practitioners, specialist physicians, exercise specialists, and patients, and supported by a web-based application (WBA), can effectively lead sedentary older T2D patients to adopt an active lifestyle. METHODS: A randomized controlled design will be used, and an ERS, supported by a WBA, will be implemented. 300 physically inactive T2D patients (aged 65-74 years) will be assigned to either an intervention or control arm. Control arm patients will only receive behavioral counseling on physical activity and diet, while intervention arm patients will also undergo an 18-month (3 day/week), discontinuously supervised aerobic exercise training program. The trial will be divided into six three-month periods: during first, third and fifth period, an exercise specialist will supervise the training sessions and, using the WBA, prescribe exercise progression and monitor exercise adherence. Patients will exercise on their own in the other periods. Patients' sedentary behaviors (primary outcome), PA level, fitness status, metabolic profile, psychological well-being, quality of life, and use of health care services (secondary outcomes) will be assessed at baseline and at 6, 12, and 18 months from baseline. Repeated measure ANCOVAs will be used to compare the intervention and control arm with respect to each study outcome measure. DISCUSSION: Primary and secondary outcome results will allow us to evaluate the effectiveness of an ERS, specifically designed for the management of T2D clinical conditions and supported by a WBA, in promoting PA within Italian primary care settings. TRIAL REGISTRATION: This trial is retrospectively registered under the Australian New Zealand Clinical Trials Registry (reference number: ACTRN12618001164280 ; registered 13 July 2018).


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/terapia , Exercício/fisiologia , Estilo de Vida Saudável/fisiologia , Autogestão/métodos , Idoso , Diabetes Mellitus Tipo 2/psicologia , Feminino , Humanos , Itália/epidemiologia , Masculino , Atenção Primária à Saúde/métodos , Qualidade de Vida/psicologia , Estudos Retrospectivos , Comportamento Sedentário , Autogestão/psicologia
18.
Biol Res Nurs ; 21(2): 173-181, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30522333

RESUMO

OBJECTIVE: Unhealthy lifestyle behaviors, such as smoking, drinking, betel-quid chewing, insufficient exercise, and inadequate sleep are significantly correlated with metabolic syndrome (MetS). To further understand this relationship, this study examined the main effect of unhealthy lifestyle behaviors and their interaction on MetS by gender in young adults. METHOD: A cross-sectional study involving 694 young adults from a national survey was performed in which demographic characteristics, unhealthy lifestyle behaviors, anthropometric measurements, and blood chemistry panels were collected during face-to-face interviews. RESULTS: The prevalence of MetS among young adults was 17.4% and was greater in males than females (19.0% vs. 7.8%). The unhealthy lifestyle-behavior risk factors associated with MetS included smoking (odds ratio [ OR] = 4.53) and physical activity ( OR = 0.51) among males and betel-quid chewing ( OR = 8.90) and less sleep ( OR = 0.08) among females. Significant interaction effects were observed between the abovementioned behaviors and gender for the risk of developing MetS. CONCLUSION: These results can guide health-care providers in reducing MetS risk by encouraging young adult males to reduce or quit cigarette smoking and maintain optimum levels of physical activity and young adult females to quit chewing betel quid and obtain appropriate amounts of sleep.


Assuntos
Exercício/fisiologia , Estilo de Vida Saudável/fisiologia , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/fisiopatologia , Sono/fisiologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Razão de Chances , Prevalência , Fatores de Risco , Fatores Sexuais , Adulto Jovem
19.
Int J Cancer ; 144(9): 2135-2143, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30468245

RESUMO

The risk of developing colorectal cancer (CRC) is associated with a wide range of dietary and lifestyle factors. The individual contribution of single modifiable factors, such as alcohol consumption, physical activity, smoking, body mass index (BMI) or dietary components, to the development of CRC has been investigated extensively, but evidence on their combined effect at various stages of colorectal carcinogenesis is sparse. The aim of our study was to analyze the association of a healthy lifestyle pattern with prevalence of early and advanced colorectal neoplasms. A total of 13,600 participants of screening colonoscopy in Saarland/Germany (mean age 62.9 years) who were enrolled in the KolosSal study (Effektivität der Früherkennungs-Koloskopie: eine Saarland-weite Studie) from 2005 until 2013 were included in this cross-sectional analysis. Dietary and lifestyle data were collected and colonoscopy results were extracted from physicians' reports. The association of an a priori defined healthy lifestyle score-including dietary intake, alcohol consumption, physical activity, smoking and BMI-with early and advanced colorectal neoplasms was assessed by multiple logistic regression analyses with comprehensive adjustment for potential confounders. Strong inverse dose-response relationships were observed between an overall healthier lifestyle pattern and presence of advanced colorectal neoplasms, nonadvanced adenomas and hyperplastic polyps (p value <0.0001 in all cases), with adjusted odds ratios (95% CI) for the highest compared to the lowest category of the healthy lifestyle score of 0.41 (0.30-0.56), 0.42 (0.33-0.54) and 0.39 (0.29-0.54) respectively. A healthy lifestyle is strongly associated with lower risk of all stages of colorectal neoplasms.


Assuntos
Neoplasias Colorretais/epidemiologia , Estilo de Vida Saudável/fisiologia , Programas de Rastreamento/estatística & dados numéricos , Idoso , Consumo de Bebidas Alcoólicas , Índice de Massa Corporal , Carcinogênese/patologia , Colonoscopia/estatística & dados numéricos , Estudos Transversais , Dieta , Exercício , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Risco , Fumar
20.
Drug Alcohol Depend ; 194: 197-204, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30447512

RESUMO

BACKGROUND: The prevalence of smoking varies across ethnic groups in developed countries, but little is known about ethnic variations in specific aspects of nicotine dependence (ND). We conducted item-response analyses in current smokers to compare ND factors across five ethnic groups. METHODS: Data were obtained from a population-based, multi-ethnic cohort study conducted in the Netherlands. The Fagerström Test for Nicotine Dependence (FTND) was assessed in 1147 Dutch, 991 South-Asian Surinamese, 1408 African Surinamese, 1396 Turkish, and 584 Moroccan smokers (N = 5526). We tested whether the factorial structure of the FTND was invariant across ethnic groups using a multi-group confirmatory factor analysis. FTND item and total scores and factor means were compared across groups. RESULTS: The two-factor model representing "morning smoking" and "smoking patterns" provided an adequate fit. The items "Cigarettes smoked daily" and "Time until first cigarette" showed differential item functioning (DIF) as a function of ethnicity. Three out of four ethnic minority groups scored significantly higher on both factors compared to the Dutch origin group (all p < 0.001) before and after taking DIF into account, while the African Surinamese scored higher only on "morning smoking" when DIF was accounted for. DISCUSSION: The factor structure of the FTND is not measurement invariant across ethnic groups in this population-based sample. Accounting for DIF affecting the nicotine dependence factor scores, although South-Asian Surinamese, Turkish, and Moroccan groups showed higher levels of dependence than the Dutch origin group, genetic as well as environmental factors may account for the observed differences.


Assuntos
Grupos Étnicos/psicologia , Estilo de Vida Saudável , Fumantes/psicologia , Tabagismo/etnologia , Tabagismo/psicologia , População Urbana/tendências , Adulto , Grupo com Ancestrais do Continente Asiático/etnologia , Grupo com Ancestrais do Continente Asiático/psicologia , Estudos de Coortes , Feminino , Estilo de Vida Saudável/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos/etnologia , Países Baixos/etnologia , Estudos Prospectivos , Abandono do Hábito de Fumar/etnologia , Abandono do Hábito de Fumar/psicologia , Suriname/etnologia , Tabagismo/diagnóstico , Turquia/etnologia
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