American Journal of Lifestyle Medicine最新文献

Stroke is a leading cause of mortality and disability, affecting approximately 13.7 million individuals globally each year. It is broadly classified as ischemic or hemorrhagic and often results in cognitive, motor, and emotional impairments. Lifestyle interventions are associated with lower stroke risk and recurrent events, and are core to guideline-based prevention; effect sizes vary by risk factor, adherence, and setting. This review begins with the pathophysiology of stroke, focusing on the roles of sex hormones, genetics, environment, and lifestyle. We then outline how lifestyle interventions can aid in primary and secondary prevention of stroke by targeting modifiable risk factors responsible for approximately 90% of stroke risk, including hypertension, diabetes, high cholesterol, poor diet, sedentary behavior, abdominal obesity, psychological stress, smoking, cardiac causes, and alcohol use. We also discuss clinical implementation, policy strategies, health equity, cost-effectiveness, and future directions. These insights highlight the critical role of lifestyle medicine in stroke prevention, aimed at reducing the global stroke burden.

Dietary interventions for disease prevention have been well studied, yet standard American diets often fall short. Limited culinary skills and nutritional literacy are key contributors. Shared medical appointments (SMAs) with culinary education offer one solution to enhance culinary and nutrition literacy. In our model, patients were recruited from the University of Texas Southwestern Culinary Medicine Clinic to participate in a culinary medicine-focused SMA program located in local church kitchens in Dallas, TX including 6 classes over 2 months. Classes, led by a physician and culinary dietitian, included goal-setting, culinary skill demonstration, and supervised cooking. Classes were billed as primary care visits through patients' insurance. Health records and patient reported data were collected to assess feasibility. Sixty patients from four cohorts of SMAs had a 75% average attendance. Patients were predominantly Black (55%) and female (87%). Hypertension, diabetes, and obesity were the most common referral diagnoses. Qualitative telephone interviews (n = 18) reveal that co-learning new skills with peers is an important contributor to patient engagement. In conclusion, culinary medicine-focused SMAs are a feasible approach to deliver culinary nutrition education, demonstrate high levels of engagement and retention, and lay the foundation for a financially sustainable model.

This transdisciplinary, evidence-based viewpoint draws attention to literature suggesting that formalized plant-based lifestyle interventions have the potential to reduce the risk of COVID-19 and non-communicable diseases. Such interventions also offer the health sector a way to contribute to mitigating the risk of new zoonotic diseases and reducing carbon emissions (and, consequently, climate-change-induced diseases), all of which would help lower the overall disease burden. However, several challenges must be addressed to incorporate plant-based lifestyle interventions into clinical medicine. These include generating more methodologically robust and convincing evidence on the COVID-19-diet link, enhancing physicians' understanding of plant-based diets, and ensuring equitable access to affordable, culturally inclusive, nutritionally adequate, and appealing plant-based foods. Contextual barriers, such as counteraction from profit-driven industries, and personal barriers, such as psychological resistance, must also be acknowledged and mitigated. While not without obstacles, plant-based lifestyle interventions merit consideration given their multifaceted potential to enhance both human and planetary health.

Background. Hypertension is a major cause of cardiovascular disease and mortality in the US among middle-age and older adults. Physical activity and sleep are key modifiable factors, yet their age-specific association to hypertension remain unclear. Methods. We conducted a cross-sectional analysis of 9133 adults aged 40-80 years using data from National Health and Nutrition Examination Survey (NHANES) 2013-2018. Logistic regression models estimated odds ratios and 95% confidence intervals for associations between physical activity, sleep duration, and hypertension, adjusting for sociodemographic and health covariates. Analyses were stratified by age. Results. Overall, 61.2% of participants had hypertension, with prevalence higher among older adults (76.9%) than middle-aged adults (54.2%). In the overall sample, not meeting physical activity guidelines was associated with higher odds of hypertension (OR = 1.51, 95% CI: 1.18-1.92). Among middle-aged adults, both insufficient physical activity (OR = 1.63, 95% CI: 1.20-2.22) and long sleep duration (>9 hours/night) (OR = 1.45, 95% CI: 1.04-2.03) were linked to higher odds of hypertension. No significant associations were observed among older adults. Conclusion. Middle-age is critical for lifestyle-based hypertension prevention. Promoting physical activity and monitoring sleep during this period may reduce the likelihood of hypertension and improve cardiovascular health.

This study aimed to assess rates of death of elite and professional young adult athletes in different US sports, comparing to the general population. Male and female athletes' birth and death dates were analyzed to compare rates of death from ages 21-40 years inclusive between the athlete groups and the general population. Data were downloaded from Wikidata for notable US athletes, and Standardized Mortality Ratios (SMRs) were calculated against mortality rates by year (1950-2022 inclusive) for the USA general population by age and sex. Sports were included based on sufficient cohort size for analysis. Results were obtained for 54 648 male and 6280 female notable athletes from 17 sports. Overall SMRs (95% confidence intervals) for athletes were 0.49 (0.46-0.53) for males and 0.38 (0.26-0.55) for females. The majority of sports, including football, baseball, basketball, hockey, tennis, and golf in males, and track and field, soccer, and rowing in both males and females, had significantly lower mortality rates in athletes than the general population. The only sports with significantly higher mortality rates in male athletes were auto racing, mountaineering, and professional wrestling. For the majority of major sports, professional and elite athletes have lower death rates than the general population in early adulthood.

Background: Unintentional falls are a leading cause of injury, disability, and healthcare utilization among older adults (65+). Methods: Using the 2016-2021 Medicare Current Beneficiary Survey data, we examined the relationship between falls and nursing facility placement. Data from a cohort of 31 517 community-dwelling older adults were analyzed to assess fall prevalence at baseline and its association with nursing home placement in the following year. Multivariate regression models adjusted for demographic, health status, and functional limitations. Results: Falls were reported by 22.6% of participants at baseline and were higher among older females, white people, and those with poor health status, multiple chronic conditions, and existing functional limitations. Falls significantly increased risk of nursing home placement in the following year with an adjusted risk ratio (aRR) = 1.24 for any nursing facility, aRR = 1.51 for nursing home, and aRR = 1.18 for skilled nursing facilities. Conclusion: These findings underscore the strong association between falls and nursing facility placement, particularly among older adults with poorer health and multimorbidity. Preventative strategies targeting modifiable fall risk factors, such as strength and balance training, chronic disease management, and home safety intervention, could reduce fall incidence and the need for placement in nursing facilities.

Lifestyle Medicine (LM) is an increasingly important aspect of modern medical practice. LM focuses on sleep, healthy eating, physical activity, mental wellbeing, and the socioeconomic determinants of health. In 2019, Imperial College London introduced the 'Lifestyle Medicine and Prevention' (LMAP) module to educate medical students on these areas within a broader framework of public health ethics and practice. We hypothesised that early LM education may enhance students' insight into their own health and wellbeing. Of 364 first-year medical students invited to complete an end-of-module survey, 278 consented to share their data and 239 responded to the open-ended question analysed: 'Has your LMAP learning encouraged you to change any of your health behaviours? Please explain how'. Responses were analysed thematically. Of 239 responses, 155 students (66%) reported changes in their health behaviours after the LMAP module, 57 (24%) reported no change, and 27 (10%) described early contemplation of change. Lifestyle Medicine education may encourage reflection and positive health behaviour change amongst medical students.