Journal of lifestyle medicine最新文献

The 'golden age of medicine' - the first half of the 20th century, reaching its zenith with Jonas Salk's 1955 polio vaccine - was a time of profound advances in surgical techniques, immunization, drug discovery, and the control of infectious disease; however, when the burden of disease shifted to lifestyle-driven, chronic, non-communicable diseases, the golden era slipped away. Although modifiable lifestyle practices now account for some 80% of premature mortality, medicine remains loathe to embrace lifestyle interventions as medicine Here, we argue that a 21st century golden age of medicine can be realized; the path to this era requires a transformation of medical school recruitment and training in ways that prioritize a broad view of lifestyle medicine. Moving beyond the basic principles of modifiable lifestyle practices as therapeutic interventions, each person/community should be viewed as a biological manifestation of accumulated experiences (and choices) made within the dynamic social, political, economic and cultural ecosystems that comprise their total life history. This requires an understanding that powerful forces operate within these ecosystems; marketing and neoliberal forces push an exclusive 'personal responsibility' view of health - blaming the individual, and deflecting from the large-scale influences that maintain health inequalities and threaten planetary health. The latter term denotes the interconnections between the sustainable vitality of person and place at all scales. We emphasize that barriers to planetary health and the clinical application of lifestyle medicine - including authoritarianism and social dominance orientation - are maintaining an unhealthy status quo.

Background: Tobacco use is one of the leading preventable causes of premature death, disease and disability around the world. Medical and Dental graduates have an important role to play in tobacco cessation and prevention. Hence, the present study was undertaken to assess the tobacco use prevalence, practice, attitudes towards policy making and curriculum in medical and dental interns (house surgeons).

Methods: A cross sectional questionnaire based survey was carried out among interns in all the medical and dental colleges of Mangalore city. Global Health Professional Students Survey (GHPSS) questionnaire given by the Center for Disease Control (CDC) was modified and adopted.

Results: In the present study among 512 interns, 263 and 249 interns belonged to dental and medical fraternity respectively The prevalence of current smokers of cigarette was significantly higher among medical interns (32.1%) than the dental interns (20.2%), whereas no significant difference was evident amongst the dental (44.9%) and medical (41.8%) interns under the ever smokers category. A significant difference (p < 0.001) in the attitude of dental and medical college interns was observed towards tobacco use, policy making and their knowledge about the curriculum.

Conclusion: This study shows health professionals lacking specific training in tobacco counseling, all of which indicate a need for including a standardized syllabus to train health professionals in medical and dental schools related to tobacco its ill-effects, cessation and policy making.

Background: Promotion of exclusive breast feeding is known as a savior strategy, to reduce infantile mortality. The theory of planned behavior is an appropriate theory to explain the effect of psychosocial factors on infant feeding behavior. This study aimed to evaluate impact of planned behavior theory-based education on the behavior of pregnant women related to exclusive breast feeding in Arak city, 2016-17.

Methods: This study is an interventional study that was done on 101 pregnant women with gestational age of 32-28 weeks in health centers of Arak city. All individuals were divided into experimental and control groups randomly. Valid and reliable questionnaires were completed before, on and 3 months after intervention. Experimental group received educational intervention in 3 sessions. Date was analyzed using SPSS 16 software (Chi-square, T, R.M.ANOVA Tests).

Results: The results showed that, after implementation of the intervention, mean of scores for attitudes, subjective norms, Perceived behavioral control, intention and exclusive breast feeding behavior has increased significantly in the experimental group compared with the control group.

Conclusion: The findings of this study, showed the efficiency and effectiveness of educational intervention based on the theory of planned behavior on exclusive breast feeding behavior. Designing and implementing educational programs based on the theory of planned behavior is proposed to encourage women to breast-feed exclusively to encourage women to breast-feed exclusively.

Background: Understanding the cardiovascular and psychophysical demands of repetitive lifting tasks is important in job design strategies. This study determined the cardiovascular (oxygen consumption (VO₂) and heart rate (HR) and psychophysical response to repetitive lifting tasks in women.

Methods: Ten female (age 27 ± 5 yrs) participants transferred 11.4, 15.9, and 20.5 kg weights back and forth from a rung 40.6 cm high to a rung 156.2 cm high. Rungs were 195.6 cm apart horizontally. Three, 10 minute bouts (1 = 11.4 kg; 2 = 15.9 kg; 3 = 20.5 kg) were performed at 6 lifts per minute. Cardiovascular and psychophysical (rating of perceived exertion, RPE) parameters were monitored throughout the bouts. VO₂max and HRmax were determined via a maximal treadmill test.

Results: VO₂, HR, and RPE were significantly different between each work bout (p < 0.01), with each outcome variable increasing as load increased. VO₂max and HRmax equaled 46.5 ± 7.5 mL·kg^-1·min^-1 and 191 ± 11 bpm, respectively. Work at 11.4 kg was performed at 38% VO₂max and 63% HRmax; at 15.9 kg at 41% VO₂max and 72% HRmax; and at 20.5 kg at 49% VO₂max and 81% HRmax. RPE at 11.4, 15.9, and 20.5 kgs were: 8.4 ± 1.6, 11.4 ± 1.9, and 15.0 ± 2.2.

Conclusion: During these repetitive lifting tasks, metabolic cost and perceived exertion increased with weight lifted; average work intensity ranged from 63 to 81% of HRmax and 38 to 49% of VO₂max. Results have important implications in relation to job pacing and design, and worksite health promotion strategies aimed at reducing work place injury.

Breast cancer patients have various physical, psychological health risks, among which are the effects on general health. Lifestyle intervention involving nutrition education, physical activity, and stress management, and has been shown to be effective in improving the health of breast cancer patients. Therefore, it is necessary to develop and apply a lifestyle intervention program to promote health in breast cancer patients.

Background: The purpose of this study was to comprehensively examine the association of a multitude of individual medical conditions, as well as multimorbidity, on work status among a national sample of U.S. adults.

Methods: The present study included 7 cycles (1999-2012) from the National Health and Nutrition Examination Survey (N = 28,119).

Results: In total, 26 medical conditions increased the odds of not working. Multimorbidity as well as having prevalent medical condition(s) within each of the Cumulative Index Rating Scale Morbidity Classes were associated with increased odds of not working. Few medical conditions were associated with higher odds of working part-time (vs. full-time) or unemployment (vs. working).

Conclusion: These findings underscore the importance of instating comprehensive worksite wellness health promotion policies, as well as providing individuals with resources to preserve and enhance personal health.

Background: The purpose of this study was to examine the prospective association of personality typology on changes in sitting (sedentary) time.

Methods: Young adults (N = 126; M_age = 21.6 yrs) completed self-report assessments of personality and sitting time at baseline and at an approximate 5-month follow-up. At baseline, personality was assessed via the Neuroticism-Extraversion-Openness Five Factor Inventory (NEO-FFI) questionnaire. At both baseline and the follow- up period, sitting time was self-reported using the International Physical Activity Questionnaire (IPAQ) short form.

Results: Both extraversion (β = -5.8; 95% CI: -11.7, 0.21; p = 0.05) and conscientiousness (β = -5.7; 95% CI: -11.3, -0.2; p = 0.04) were inversely associated with baseline sitting time. Regarding the prospective results, the only personality trait associated with changes in sitting time was openness to experience. Independent of changes in physical activity as well as other potential confounders, for every 1 unit increase in openness to experience, there was an associated 6.6 min/day increased change score in sitting time over the 5-month follow-up period (β = 6.6; 95% CI: 0.13, 13.0; p = 0.04).

Conclusion: Personality was differentially associated with sitting time based on the study design, with the personality trait of openness to experience being prospectively associated with increases in sitting time.

Background: Clinical studies have reported hydrogen-rich water (HRW) to have therapeutic and ergogenic effects. The aim of this study was to determine the effect of acute supplementation with HRW on exercise performance as measured by VO₂, respiratory exchange ratio (RER), heart rate (HR), and respiratory rate (RR).

Methods: Baseline levels of all exercise indices were determined in nineteen (4 female, 23.4 ± 9.1 yr; 15 male, 30.5 ± 6.8 yr) healthy subjects using a graded treadmill exercise test to exhaustion. Each subject was examined two additional times in a randomized double-blinded, placebo-controlled crossover fashion. Subjects received either HRW or placebo, which was consumed the day before and the day of the testing. HRW was delivered using the hydrogen-producing tablets, DrinkHRW (5 mg of H₂). All data was analyzed with SPSS using pairwise comparisons with Bonferroni adjustment.

Results: HRW supplementation did not influence maximal or minimal indices of exercise performance (VO₂, RER, HR and RR) (p < 0.05). However, HRW significantly decreased average exercising RR and HR (p < 0.05). HRW decreased exercising HR during minutes 1-9 of the graded exercise test (121 ± 26 bpm) compared to placebo (126 ± 26 bpm) and baseline (124 ± 27 bpm) (p < 0.001) without substantially influencing VO₂.

Conclusion: Acute supplementation of DrinkHRW tablets may benefit submaximal aerobic exercise performance by lowering exercising HR. Further studies are needed to determine the influence and practical significance of HRW on varying exercise intensities as well as optimal dosing protocols and the effects of chronic use.

The Nobel Prize for Medicine in 2017 was awarded to Michael Young, Michael Rosbash and Jeffrey Hall for their discoveries into the molecular mechanisms controlling circadian rhythms (CR). The aims of this paper were to present the mechanisms behind the CRs and discuss the impact this could have on human health. We argued that further research in this field has the potential to revolutionise healthcare through understanding the influence on the pathogenesis of disease, including in cardiovascular, mental and neurological health, as well as influence on cognitive function. The research has shown that intrinsic CRs have physiological and biochemical influences on the body, which may affect the efficiency of drug absorption due to the altered activity of enzymes. There is strong data to suggest CR disturbances, due to either shift work, sleep disorders or frequent travel between time zones, has negative impact on health. This article aims to summarise the extent of this impact and analyse CRs as a potential therapeutic target, as well as describing the pathophysiology and mechanisms driving the course of disease among people with CR disorders. These new discoveries may revolutionise the way in which treatment is provided in the future with more focus on lifestyle changes to provide treatment and more optimal precision medicine. Pharmaceutical companies and healthcare staff must consider the significant message provided from this data and use the information to optimise drug delivery and treatment provision. The facts of CRs role in healthcare can no longer be ignored.

Background: To date, there is no country-representative study on tobacco and alcohol use in Zambia and Zimbabwe despite the fact that these two countries rank among the top producers of tobacco worldwide. To fill this research gap, we conducted this study to measure the prevalence of tobacco and alcohol consumption among adolescent and adult men in Zambia and Zimbabwe. Special attention was given to the age differential in the prevalence of smoking and drinking.

Methods: Country-representative data on alcohol and tobacco use along with relevant sociodemographic parameters were collected from Demographic and Health Surveys. Sample population were 23,169 men (14,773 from Zambia and 8,396 from Zimbabwe) aged 15-54 years. Data were analysed using multivariate regression techniques.

Results: Prevalence of tobacco use was 19.9% (19.0-20.9) in Zambia and 18.4% (17.4-19.5) in Zimbabwe, and that of alcohol was 37.6% (36.4-38.9) in Zambia and 50.5 (48.9-52.1) in Zimbabwe. In both of the countries, the majority of the tobacco and alcohol users were aged between 24-39 years. Results of multivariate regression analysis showed a significant positive association between tobacco and alcohol use with age, place of residence, religious affiliation, marital status, education and wealth quintile.

Conclusion: Nearly one-fifth of all men in the age group of 15-54 years smoke tobacco in Zambia and Zimbabwe, with the prevalence being most pronounced among those aged between 25-39 years. The predominantly young age structure of alcohol and tobacco users warrant demographically tailored anti-tobacco and alcohol controlling programmes.