American Journal of Lifestyle Medicine最新文献

Obesity is a significant global public health concern, and health care providers play a crucial role in addressing it by offering healthy lifestyle counseling and weight management support. Evidence demonstrates that even brief counseling on healthy behaviors can lead to meaningful changes and sustained weight management. However, weight consultations are often underutilized in primary care due to various barriers, including biases against patients with obesity, misconception of physicians with obesity, or concerns about stigmatizing them by initiating discussions about weight. This paper explores the impact of biases, misconceptions, and stigma on the communication and treatment of patients with obesity and proposes strategies to overcome these challenges. Practical solutions include fostering inclusive health care environments for individuals of all body sizes and utilizing the 5A model (Ask, Assess, Advise, Agree, Assist) to guide respectful and effective weight management conversations.

First Nations women in Australia diagnosed with type 2 diabetes, co-designed and attended a programmed shared medical appointment that included continuous glucose monitors and culturally responsive food appreciation activities over 8 weekly sessions to improve glycaemic control. The project was a single site, longitudinal change from baseline, mixed methods, feasibility study using HbA1c as the primary outcome measure. Secondary outcome measures included, weight, metabolic health-related blood panels, CGM, Blood Glucose Levels (BGL) time-in-range percentage, Patient Activation Measure (PAM) and Problem Areas In Diabetes (PAID) tools and client satisfaction survey and semi focussed interviews. Forty participants commenced and twenty-five participants completed the program (62,5%). Of the completing participants the mean HbA1c had an absolute reduction of 0.7 percentage points ( from baseline to program completion, P = .013). Eighteen (75%) reduced HbA1c and maintained some reduction for 12 months. Seven (28%) achieved remission, HbA1c <6.4% (46 mmol/l) maintained for 12 months. There were statistically significant improvements in weight, systolic blood pressure, liver enzymes, BGL time-in-range, PAM and PAID scores. It is feasible to use programmed shared medical appointments incorporating CGM aiming to improve glycaemic control and other metabolic measures of health among First Nations women in Australia. Trial Registration: The project was registered with the Australian and New Zealand Clinical Trial Registry ACTRN12622000650796. The trial web page = https://www.anzctr.org.au/ACTRN12622000650796.aspx.

Cardiovascular disease (CVD) remains a significant global health concern for women, influenced by a complex interplay of social, economic, and environmental factors. This article examines cardiovascular risk through the lens of the exposome, which encompasses all environmental exposures from conception onward, including pollution, diet, and chronic stress. Social determinants such as socioeconomic status (SES), education, and stress management play crucial roles in shaping women's cardiovascular health. Lower SES and education are associated with greater exposure to adverse living conditions, poor nutrition, and limited access to healthcare, increasing the risk of CVD. Environmental pollution, particularly air pollution and climate-related changes, further exacerbates cardiovascular risk by promoting oxidative stress and inflammation. Additionally, gender-specific factors, such as pregnancy and menopause, interact with the exposome, heightening the vulnerability of women to cardiovascular risks over their lifetime. Addressing these risk factors requires a comprehensive approach, incorporating public health strategies that focus on reducing pollution, improving food security, and mitigating social inequalities. By addressing the cumulative and interacting exposures that contribute to cardiovascular disease, especially in women, more effective prevention strategies can be developed to improve long-term health outcomes.

Acute exercise is linked to memory improvement. Several mediators may influence the effect of exercise such as the type of exercise (aerobic exercise, muscle stretching). Purpose: The primary aim was to analyze memory outcomes after a 20-min bout of aerobic exercise or muscle stretching. Methods: 42 healthy participants ages 18-35 were randomized to perform 20 min of either moderate-intensity aerobic exercise (AE) on a treadmill or muscle stretching exercise (SE). After exercise, memory was assessed using the Rey Auditory Verbal Learning Test (RAVLT). The relationship between exercise heart rate and memory outcomes were evaluated within each group. Results: Immediate learning as well as delayed recall was higher after AE compared to SE. Heart rate during exercise correlated with immediate learning in the AE group only. Conclusion: Acute exercise that elicits a heart rate response may be important for improving memory.

Purpose: Physical activity and sedentary behavior have significant prognostic importance in survivors of breast cancer. However, not much is known about physical activity and sedentary behavior in the midwestern United States for patients who have breast cancer. This study provides patient-reported physical activity and sedentary behavior from a cohort of patients from the midwestern United States. Methods: A survey assessed physical activity and sedentary behavior from patients with all types of local or invasive breast cancer and ductal carcinoma in situ (DCIS). Demographic information and characteristics of participants' breast cancer, including time since diagnosis, type of cancer, and remission status were gathered. Results: Data from 108 patients reveal diverse physical activity and sedentary behavior patterns. Seventeen individuals (15.9%) report not engaging in any form of physical activity and only 15.9% report meeting national guideline recommendations of greater than 150 minutes of moderate intensity-equivalent physical activity per week. A wide range of physical activity in minutes was reported across age, time since diagnosis, type of cancer and remission status, none of which was statistically significant. Participants report sitting or reclining an average of 6.1 hours (SD = 3.9) per day during a typical workday and 5.8 hours (SD = 3.8) on a typical non-workday. Conclusions: Our study provides information about physical activity and sedentary behavior in a cohort of midwestern patients with breast cancer and indicates that the majority of the patients could be at high risk for long-term adverse prognosis. Tailored lifestyle programs to enhance physical activity and decrease sedentary behavior are critical to improve outcomes. Our results indicate that clinicians should incorporate healthy lifestyle medicine recommendations for all patients living with breast cancer at any age or time since diagnosis, independent of cancer type or remission status.

This study was conducted to determine the effects of nurses' emotional eating behaviour and burnout levels on job performance. The population of this descriptive and cross-sectional study covered 750 nurses working in İstanbul Haseki Training and Research Hospital, and the sample included 255 nurses. The data were collected between 15.08.2023 and 15.11.2023 using the 'Personal Information Form', 'Maslach Burnout Inventory', 'Emotional Eater Questionnaire', and 'Job Performance Scale'. The mean scores of the Maslach Burnout Inventory and Emotional Eater Questionnaire of the participant nurses who had been working for 1-5 years, who were dissatisfied with their work and who worked in intensive care were found significantly higher. A positive relationship was found between the Job Performance Scale, the Maslach Burnout Inventory and the Emotional Eater Questionnaire. Based on the obtained data, it was concluded that nurses experience burnout and exhibit emotional eating behaviour. Therefore, it is recommended to support nurses in managing burnout and stress, plan training sessions, and, if necessary, provide psychiatric support. Processes in the work environment can negatively affect nurses emotionally and physically, which is reflected in job performance and patient care. Burnout affects not only job performance but also emotional eating.

The 5A's Framework (Assess, Advise, Assist, Agree, and Arrange) has been recommended as a practice guide for obesity counseling. Its integration in research, however, is not well known. This systematic review was to find how the 5A's Framework was integrated in research on obesity and weight counseling. Methods: A systematic search of four databases was conducted combining two concepts: "5 A's Framework" and "obesity, body size, dieting/eating, exercise, weight loss." Inclusion criteria were quantitative studies with the 5A's Framework as a singular intervention or combined with others to influence patients' healthy eating, physical activity, and weight outcomes or care providers' counseling behaviors. Twenty-two studies were included in the final analysis. Results: Most studies were conducted in the primary care setting. The 5A's Framework was (1) integrated in training interventions as formal medical curricular and on-the-job education workshops to influence obesity/weight counseling skills, (2) utilized to develop assessment tools to evaluate counseling behaviors, and (3) combined with behavior change strategies to impact the patient's weight management behaviors and outcomes. Conclusion: The integration of the 5A's Framework in obesity and weight counseling research is wide-ranging. The findings have implications for clinicians to use the framework to better obesity/weight counseling.

Group health coaching (GHC) may be a suitable method for supporting healthy lifestyle behaviors in cancer patients and survivors. The aim of this scoping review was to explore GHC interventions targeting this population, specifically examining program composition and measured outcomes. A systematic search strategy was used to identify intervention studies focused on GHC with cancer patients and survivors. Seven studies met the criteria. Studies focused on physical activity, diet, weight loss, or some combination thereof utilizing GHC by itself or as one component of an exercise and/or diet intervention. There was a wide range of measured outcomes, grouped into: feasibility/acceptability; physical activity/exercise; body composition and biomarkers; diet; distress, quality of life, fatigue; and other. Overall, studies were found to be feasible and showed positive results for weight loss, diet, and quality of life. Findings for changes in physical activity, distress, and fatigue were mixed. Additionally, variability was found in many of the GHC components. This review suggests GHC for cancer patients and survivors is still in the nascent stages. However, these studies were deemed feasible and satisfactory to participants, with positive outcomes noted. While still in the early stages, GHC appears promising for supporting positive lifestyle behaviors in this population.

Stress is ubiquitous in our modern society and contributes to many disease states. This narrative review describes the effect of stress/distress on cancer development and progression. Seminal randomized controlled trials, systematic reviews/meta-analyses, and distress management guidelines from the National Comprehensive Cancer Network (NCCN), the American Society of Clinical Oncology (ASCO), and the Society for Integrative LinearOncology (SIO) are highlighted. We describe the physiological effects of distress, distress assessment, and management. Psychological treatments are summarized. Evidence-based lifestyle modifications and integrative therapies are reviewed in detail, including mindfulness-based techniques, yoga, guided imagery, breathing techniques, hypnosis, exercise, music therapy, qigong/Tai Chi, eye movement desensitization and reprocessing, and improving sleep and heart rate variability. Recognition and treatment of distress can improve quality of life. More research is needed to determine the effects of managing distress on cancer outcomes, as well as the best type and duration of intervention, noting that the benefits of interventions may be specific for patients with different cancer types.