American Journal of Lifestyle Medicine最新文献

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.

Interest in Food is Medicine (FIM) interventions has surged nationwide, reflecting a growing commitment to integrating nutrition into health care. FIM approaches typically combine medically tailored or supportive food with nutrition and culinary education, aiming to improve clinical outcomes and health equity. As the field expands, it draws together diverse public and private actors from across health care, food systems, and agriculture, including clinicians, farmers, policymakers, retailers, and community advocates, alongside the individuals and families these programs serve. While existing research largely emphasizes program design and quantitative outcomes, qualitative inquiry offers an important complementary lens by describing provider and patient experiences. However, personal narratives of those shaping FIM remain underrepresented. This work elevates nine distinct voices from across the movement, including program founders, participants, health care leaders, clinicians, and food producers. Their stories reveal shared priorities of health improvement, equity, and scalability, while underscoring the passion driving this work. Ultimately, these accounts illuminate the human dimension behind the promise of FIM: food is medicine, and so much more than medicine too.

Food insecurity is a persistent public health issue linked to poor diet quality and increased risk for chronic conditions. Food-as-medicine programs, such as produce prescriptions and food pharmacies, aim to mitigate these risks by integrating nutrition into clinical care. However, traditional approaches often lack personalization, limiting their effectiveness. This formative research study explored user needs, preferences, and contextual factors to inform the continued development of MyFoodRx, a personalized, AI-driven food-as-medicine smartphone application. Guided by the Information-Motivation-Behavioral Skills (IMB) Model, semi-structured interviews were conducted with 16 participants enrolled in a clinic-based food pharmacy program. Thematic analysis revealed key informational needs (e.g., tailored education, recipes, and eating plans), motivational ifactors (e.g., health improvement, goal tracking, and reducing food waste), and behavioral skill gaps (e.g., portion control, food preparation, and grocery planning). Participants emphasized the importance of personalization based on health conditions, family history, medication use, and available kitchen resources. Findings support the integration of adaptive, real-time personalization features to enhance usability and relevance. This study provides critical insights for the continued development of MyFoodRx, contributing to scalable, equitable, and patient-centered digital food-as-medicine interventions.

Objective: To determine the usability of National Electronic Injury Surveillance System All Injury Program (NEISS-AIP) narrative data in identifying drowning circumstances, and to describe drowning-related emergency department (ED) visits in the U.S. from 2013 to 2022. Methods: We identified non-fatal unintentional drowning incidents using an expanded version of the definition used by CDC WISQARS. It includes a separate search of visits using the diagnosis of the incident and text analysis of the narratives using key words to describe drowning incidents and circumstances. Descriptive statistics of non-fatal drowning incidents and their circumstances were calculated. Results: There were 2423 ED visits representing 94 000 non-fatal drowning ED visits identified (2.90 per 100 000 persons) from 2013 to 2022. The majority of non-fatal drowning ED visits occurred among children aged 1-4 (25.78 per 100 000 children). We found over 55% of non-fatal drowning visits happened in a pool and among children 14 and younger, 28.5% were alone without an adult when the non-fatal drowning occurred. Conclusion: NEISS-AIP narrative data is unique in identifying certain characteristics of non-fatal drowning such as specific bodies of water that may not be included in other data sources. Fatal and non-fatal drowning incidents are preventable, and these data can inform implementation of effective intervention strategies.

Background: Individuals with intellectual and developmental disabilities (IDD) are understudied in the field of health promotion. Additionally, health promotion programs need tailoring to meet the needs of this population to enhance participation and usability. This study explores coach reflections from an Integrative Health and Wellness Coaching (IHWC) program for individuals with IDD, emphasizing the demands of individualized, client-led work. Methods: Qualitative data were collected through coach debriefs and written reflections during the IHWC program and analyzed thematically. Results: Four themes were developed: coach perspectives and preparedness for working with individuals with IDD; recognizing and responding to client differences in IDD coaching; holding the frame: balancing coaching structure with individual adaptations; and coaching in practice: adapting, reflecting, and looking ahead. Discussion: Coach reflections revealed the need for flexibility, ongoing learning, and preparation to support neurodivergent clients. Direct experience helped coaches grow more confident in adapting IHWC to individual needs. Conclusion: IHWC for individuals with IDD requires reflective training and adaptable approaches that affirm neurodiversity and move beyond standardized models.

As health care costs rise, employers are looking to reduce expenditures and promote employee well-being. Leveraging lifestyle medicine (LM), an evidence-based intervention, and the expertise of non-physician health professionals, like registered dietitian nutritionists (RDNs), can support these goals. In 2024, Trinity Health (TH) partnered with implementation science experts on a quality improvement (QI) project to evaluate the efficacy of an RDN-led LM program in facilitating healthy lifestyle behavior adoption among employees. Fifty TH employees enrolled in a virtual program that included 12 weeks of virtual classes, individual RDN sessions, access to fitness professionals, and culinary demonstrations. Participants completed LM behavior assessments and provided anthropometric and laboratory data pre- and post-program. Program completers (n = 34) saw significant reductions in weight (P = 0.008), BMI (P = 0.011), waist circumference (P = 0.018), systolic blood pressure (P = 0.019), and diastolic blood pressure (P = 0.015). All completers reported enhanced LM knowledge and indicated acquisition of skills to support behavior change. No significant changes were observed in cholesterol, HbA1c, or inflammatory markers. Similar LM-based workplace programs are emerging, and this QI project contributes to the growing evidence base supporting their effectiveness. Additional research is needed to determine replicability, scalability, and long-term impact.