Understanding the variables that contribute to low fruit and vegetable (FAV) intake is necessary to create effective strategies to enhance FAV consumption. However, there is a paucity of literature on this issue in Bangladesh. Therefore, we aimed to determine the factors associated with low FAV intake among adults in Bangladesh.
Methods
The World Health Organization's (WHO) 2018 STEPwise approach to surveillance (STEPS) survey dataset was used that covered participants aged 18–69 years. The low FAV intake was the outcome of interest and a daily average consumption of <5 servings of FAVs (nearly 400 grams) was regarded as low FAV intake. Multilevel logistic regression analysis was employed to determine the factors associated with low FAV consumption among Bangladeshi adults.
Results
The prevalence of low FAV intake among Bangladeshi adults was 67.75%. In the regression analysis, factors that were found to be associated with higher odds of having low FAV were as follows: having no knowledge of recommended FAV servings (adjusted odds ratio [AOR]: 6.81, 95% confidence interval [CI]: 5.54–8.38), no intake of daily snacks (AOR: 1.48, 95% CI: 1.19–1.85) or only once a day (AOR: 1.46, 95% CI: 1.18–1.81), absence of abdominal obesity (AOR: 1.36, 95% CI: 1.09–1.70), being from urban areas (AOR: 1.35, 95% CI: 1.07–1.69), and Chittagong and Rangpur division. Conversely, younger individuals showed lower odds of low FAV intake than those aged 60–69.
Conclusion
The findings of this study highlight the importance of increasing knowledge and awareness to have daily recommended servings to promote overall FAV intake.
{"title":"Factors Associated With Inadequate Fruit and Vegetable Consumption Among Adults in Bangladesh: Evidence From a Nationally Representative Cross-Sectional Survey","authors":"Rakhi Dey, Satyajit Kundu, Md. Salauddin Khan","doi":"10.1002/lim2.70015","DOIUrl":"https://doi.org/10.1002/lim2.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Understanding the variables that contribute to low fruit and vegetable (FAV) intake is necessary to create effective strategies to enhance FAV consumption. However, there is a paucity of literature on this issue in Bangladesh. Therefore, we aimed to determine the factors associated with low FAV intake among adults in Bangladesh.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The World Health Organization's (WHO) 2018 STEPwise approach to surveillance (STEPS) survey dataset was used that covered participants aged 18–69 years. The low FAV intake was the outcome of interest and a daily average consumption of <5 servings of FAVs (nearly 400 grams) was regarded as low FAV intake. Multilevel logistic regression analysis was employed to determine the factors associated with low FAV consumption among Bangladeshi adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of low FAV intake among Bangladeshi adults was 67.75%. In the regression analysis, factors that were found to be associated with higher odds of having low FAV were as follows: having no knowledge of recommended FAV servings (adjusted odds ratio [AOR]: 6.81, 95% confidence interval [CI]: 5.54–8.38), no intake of daily snacks (AOR: 1.48, 95% CI: 1.19–1.85) or only once a day (AOR: 1.46, 95% CI: 1.18–1.81), absence of abdominal obesity (AOR: 1.36, 95% CI: 1.09–1.70), being from urban areas (AOR: 1.35, 95% CI: 1.07–1.69), and Chittagong and Rangpur division. Conversely, younger individuals showed lower odds of low FAV intake than those aged 60–69.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings of this study highlight the importance of increasing knowledge and awareness to have daily recommended servings to promote overall FAV intake.</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Derwin K. C. Chan, Alison W. L. Wan, Chun-Qing Zhang, Martin S. Hagger
Background
This two-wave prospective study aims to apply self-determination theory (SDT) to understand how parents are motivated to protect their young children from COVID-19. We hypothesised that psychological need support from society and autonomous motivation from parents were predictive of parent's future engagement in preventive behaviours against COVID-19 for their children.
Methods
Participants were 689 US parents or legal caregivers of 3- to 8-year-old children. They completed an online survey comprising previously validated measures of psychological need support, autonomous motivation from SDT and behavioural adherence to COVID-19 prevention at baseline and a 1-month follow-up. Confirmatory factor analysis and structural equation modelling were employed to test the hypothesised relationships.
Results
Structural equation modelling revealed that psychological need support and autonomous motivation at baseline were positively related to parents’ adherence to COVID-19 preventive behaviours at follow-up.
Conclusion
The findings suggest that the provision of autonomy-supportive and need-satisfying social environments may promote greater COVID-19 preventive behaviours in parents for their children and provide formative evidence to inform future interventions.
{"title":"Parent's Motivation and Behaviour to Protect Their Children From COVID-19: A Prospective Test of Self-Determination Theory","authors":"Derwin K. C. Chan, Alison W. L. Wan, Chun-Qing Zhang, Martin S. Hagger","doi":"10.1002/lim2.70013","DOIUrl":"https://doi.org/10.1002/lim2.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This two-wave prospective study aims to apply self-determination theory (SDT) to understand how parents are motivated to protect their young children from COVID-19. We hypothesised that psychological need support from society and autonomous motivation from parents were predictive of parent's future engagement in preventive behaviours against COVID-19 for their children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were 689 US parents or legal caregivers of 3- to 8-year-old children. They completed an online survey comprising previously validated measures of psychological need support, autonomous motivation from SDT and behavioural adherence to COVID-19 prevention at baseline and a 1-month follow-up. Confirmatory factor analysis and structural equation modelling were employed to test the hypothesised relationships.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Structural equation modelling revealed that psychological need support and autonomous motivation at baseline were positively related to parents’ adherence to COVID-19 preventive behaviours at follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings suggest that the provision of autonomy-supportive and need-satisfying social environments may promote greater COVID-19 preventive behaviours in parents for their children and provide formative evidence to inform future interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diabetes mellitus is a global public health challenge. Adherence to self-care management is critical to reducing complications. Evidence on adherence levels and influencing factors among diabetes patients in central Ethiopia is scarce. This study assessed adherence levels and predictors among diabetes patients in Kembata Zone, Central Ethiopia.
Methods
A multicenter cross-sectional study was conducted from May 1 to 30, 2024, involving 414 diabetes patients. Data were collected via interviewer-administered questionnaires and analyzed using Statistical Package for Social Science (SPSS) version 26. Systematic random sampling was employed, and multivariable logistic regression identified adherence predictors. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated, with statistical significance set at p < 0.05.
Results
Overall good adherence to diabetes self-care was 24.4% (95% CI: 20.3–28.5). Adherence by domain was 35.5% for dietary management, 20.5% for exercise, 42.3% for hypoglycemia management, 24.9% for insulin administration, and 29.7% for blood glucose testing. Urban residence (AOR = 1.70, 95% CI: 1.02–2.84) and diabetes duration of 1–5 years (AOR = 2.99, 95% CI: 1.39–6.48) positively predicted adherence, whereas primary education was negatively associated (AOR = 0.33, 95% CI: 0.15–0.74).
Conclusions
Adherence to diabetes self-care management in the study area was low, particularly in exercise and insulin administration. Urban residence and shorter diabetes duration were positive predictors, whereas lower education hindered adherence. Urgent health education tailored to rural and less-educated populations is needed, emphasizing exercise and insulin management to improve outcomes.
{"title":"Predictors of Adherence to Diabetes Self-Care Management Among Diabetes Patients in Public Health Facilities of Central Ethiopia: A Multicenter Cross-Sectional Study","authors":"Arega Abebe Lonsako, Bereket Samuel, Abdurehman Ayele, Tsehaynew Kasse, Addisalem Haile","doi":"10.1002/lim2.70014","DOIUrl":"https://doi.org/10.1002/lim2.70014","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diabetes mellitus is a global public health challenge. Adherence to self-care management is critical to reducing complications. Evidence on adherence levels and influencing factors among diabetes patients in central Ethiopia is scarce. This study assessed adherence levels and predictors among diabetes patients in Kembata Zone, Central Ethiopia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multicenter cross-sectional study was conducted from May 1 to 30, 2024, involving 414 diabetes patients. Data were collected via interviewer-administered questionnaires and analyzed using Statistical Package for Social Science (SPSS) version 26. Systematic random sampling was employed, and multivariable logistic regression identified adherence predictors. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated, with statistical significance set at <i>p</i> < 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall good adherence to diabetes self-care was 24.4% (95% CI: 20.3–28.5). Adherence by domain was 35.5% for dietary management, 20.5% for exercise, 42.3% for hypoglycemia management, 24.9% for insulin administration, and 29.7% for blood glucose testing. Urban residence (AOR = 1.70, 95% CI: 1.02–2.84) and diabetes duration of 1–5 years (AOR = 2.99, 95% CI: 1.39–6.48) positively predicted adherence, whereas primary education was negatively associated (AOR = 0.33, 95% CI: 0.15–0.74).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Adherence to diabetes self-care management in the study area was low, particularly in exercise and insulin administration. Urban residence and shorter diabetes duration were positive predictors, whereas lower education hindered adherence. Urgent health education tailored to rural and less-educated populations is needed, emphasizing exercise and insulin management to improve outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.70014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143404495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Shawe, M. Felton, J. Harper, et al., “Cold Water Swimming and Pregnancy: A Scoping Review and Consensus Recommendations,” Lifestyle Medicine 6 (2025): e70009, https://doi.org/10.1002/lim2.70009.
In the abstract, the article mistakenly states that four studies were identified, however six were identified. The information in the rest of the article and PRISMA diagram are correct.
We apologize for this error.
{"title":"Correction to Cold Water Swimming and Pregnancy: A Scoping Review and Consensus Recommendations","authors":"","doi":"10.1002/lim2.70011","DOIUrl":"https://doi.org/10.1002/lim2.70011","url":null,"abstract":"<p>J. Shawe, M. Felton, J. Harper, et al., “Cold Water Swimming and Pregnancy: A Scoping Review and Consensus Recommendations,” <i>Lifestyle Medicine</i> 6 (2025): e70009, https://doi.org/10.1002/lim2.70009.</p><p>In the abstract, the article mistakenly states that four studies were identified, however six were identified. The information in the rest of the article and PRISMA diagram are correct.</p><p>We apologize for this error.</p>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Uzoamaka Nwakaego Akobundu, Sochima Johnmark Obiekwe, Ginika Lovelyn Okonkwo, Uchenna Prosper Okonkwo, Ifeoma Adaigwe Amaechi, Ebere Yvonne Ihegihu, Nnaemeka Charles Ani, Joseph Onuwa Umunnah
Background
Low back pain (LBP) is one of the most common complications of pregnancy, especially during the third trimester, and can occur as a result of different pregnancy-related physiological changes.
Objectives
To examine the social impact of LBP during the third trimester among pregnant women in selected hospitals in Nnewi North, Anambra State, Nigeria.
Design
A cross-sectional study.
Methods
Pregnant women in their third trimester and attending antenatal care in some selected hospitals in Nnewi were selected conveniently. The participants completed a self-administered Oswestry Disability Index (ODI), from which their data were obtained, summarized and analysed using descriptive statistics and inferential statistics of chi-square (χ2), respectively. The alpha level was set at 0.05.
Results
A total of 104 women with a mean age and number of pregnancies of 33.89 ± 9.37 and 3.53 ± 1.66, respectively. The mean ODI score was 30.06 ± 17.85, respectively. All the participants revealed that they had LBP, and 39.4% reported pain of moderate intensity. The pain impacted their physical function, social activities and work; 35.6% were unable to walk more than 2 km, and 42.3% experienced increased pain during travel. The numbers of pregnancies, maternal age, occupations and educational level during the third trimester of pregnancy were not significantly associated (p > 0.05) with the severity of LBP.
Conclusion
LBP has a significant social impact on pregnant women during their third trimester of pregnancy as normal activities such as basic activities of daily living, travelling, sex life, social life and work result in exacerbation of pain. It is necessary to carry out thorough assessments and counselling, provide education on proper ergonomics and incorporate thorough pain management techniques into standard prenatal treatment.
{"title":"Low Back Pain in the Third Trimester: Social Implications for Pregnant Women in Nigerian Suburban Hospitals","authors":"Uzoamaka Nwakaego Akobundu, Sochima Johnmark Obiekwe, Ginika Lovelyn Okonkwo, Uchenna Prosper Okonkwo, Ifeoma Adaigwe Amaechi, Ebere Yvonne Ihegihu, Nnaemeka Charles Ani, Joseph Onuwa Umunnah","doi":"10.1002/lim2.70010","DOIUrl":"https://doi.org/10.1002/lim2.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Low back pain (LBP) is one of the most common complications of pregnancy, especially during the third trimester, and can occur as a result of different pregnancy-related physiological changes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine the social impact of LBP during the third trimester among pregnant women in selected hospitals in Nnewi North, Anambra State, Nigeria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A cross-sectional study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Pregnant women in their third trimester and attending antenatal care in some selected hospitals in Nnewi were selected conveniently. The participants completed a self-administered Oswestry Disability Index (ODI), from which their data were obtained, summarized and analysed using descriptive statistics and inferential statistics of chi-square (<i>χ</i><sup>2</sup>), respectively. The alpha level was set at 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 104 women with a mean age and number of pregnancies of 33.89 ± 9.37 and 3.53 ± 1.66, respectively. The mean ODI score was 30.06 ± 17.85, respectively. All the participants revealed that they had LBP, and 39.4% reported pain of moderate intensity. The pain impacted their physical function, social activities and work; 35.6% were unable to walk more than 2 km, and 42.3% experienced increased pain during travel. The numbers of pregnancies, maternal age, occupations and educational level during the third trimester of pregnancy were not significantly associated (<i>p</i> > 0.05) with the severity of LBP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LBP has a significant social impact on pregnant women during their third trimester of pregnancy as normal activities such as basic activities of daily living, travelling, sex life, social life and work result in exacerbation of pain. It is necessary to carry out thorough assessments and counselling, provide education on proper ergonomics and incorporate thorough pain management techniques into standard prenatal treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.70010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J Shawe, M Felton, JC Harper, C Mark Harper, R Stidson, M Tipton, S Blowers, K Fraser, S Hingley, E McGrath, G Bainbridge, Massey Heather
Introduction
Cold water swimming has increased in popularity and women wish to swim throughout pregnancy. There is a lack of evidenced-based guidance to make decisions about the safety of immersion in cold water during pregnancy.
Methods
Closed social media groups were asked for specific questions in relation to cold water swimming and pregnancy. This highlighted concerns including water temperature, risks to the mother and fetus, and water quality. To find evidence-based answers, a series of meetings brought together clinicians and researchers with expertise in cold water physiology, exercise physiology, fertility, obstetrics, neonatology, midwifery, water epidemiology, public health and representatives from the Open Water Swimming Society and an Open Water swimming social enterprise.
Results
Published data were examined via a scoping review process and four studies and eight reports were identified. Recommendations were made with evidence graded (mostly grade 4 expert opinion).
Conclusion
Research gaps highlight the need for research to enable accurate advice to determine whether it is safe for pregnant women to swim outdoors in cold water.
{"title":"Cold Water Swimming and Pregnancy: A Scoping Review and Consensus Recommendations","authors":"J Shawe, M Felton, JC Harper, C Mark Harper, R Stidson, M Tipton, S Blowers, K Fraser, S Hingley, E McGrath, G Bainbridge, Massey Heather","doi":"10.1002/lim2.70009","DOIUrl":"https://doi.org/10.1002/lim2.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Cold water swimming has increased in popularity and women wish to swim throughout pregnancy. There is a lack of evidenced-based guidance to make decisions about the safety of immersion in cold water during pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Closed social media groups were asked for specific questions in relation to cold water swimming and pregnancy. This highlighted concerns including water temperature, risks to the mother and fetus, and water quality. To find evidence-based answers, a series of meetings brought together clinicians and researchers with expertise in cold water physiology, exercise physiology, fertility, obstetrics, neonatology, midwifery, water epidemiology, public health and representatives from the Open Water Swimming Society and an Open Water swimming social enterprise.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Published data were examined via a scoping review process and four studies and eight reports were identified. Recommendations were made with evidence graded (mostly grade 4 expert opinion).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Research gaps highlight the need for research to enable accurate advice to determine whether it is safe for pregnant women to swim outdoors in cold water.</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143114801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>One of the American Heart Association (AHA) founders, Paul Dudley White (June 6, 1886–October 31, 1973), a renowned cardiologist in the 20th century, emphasized the importance of a balanced lifestyle to maintain heart health. In keeping with his beliefs, he was a vigorous walker and bicycle rider. He was appointed as President Dwight D. Eisenhower's cardiologist following his heart attack in 1955 and played an important role in his recovery and his subsequent running for a second presidential term of office [<span>1</span>]. Dr. White's key recommendations were to “<i>walk more, eat less, and sleep more</i>”; coincidently, he is the father of prevention cardiology. White advocated for exercise, diet, and weight control in preventing heart disease, prescribing cycling for the president. Furthermore, Dr. White played a key role in establishing the National Institutes of Health and the Framingham Heart Study, which identified major risk factors for heart disease [<span>1, 2</span>]. Over the last 100 years, advancements in technology, research, and development have led to numerous groundbreaking discoveries in cardiology, revolutionizing the diagnosis and treatment of cardiac diseases. These include electrocardiography (ECG), cardiac catheterization and coronary angiography, open-heart surgery, cardiopulmonary resuscitation, percutaneous coronary intervention, the use of defibrillators, thrombolytic therapy, genetic insights into heart disease, high-resolution imaging (such as echocardiography, cardiac CT, and MRI), and an enhanced understanding of leukocyte biology [<span>3, 4</span>]. Today, the application of artificial intelligence is accelerating ECG and imaging analysis, enabling personalized risk assessments, diagnostics, and long-term treatment plans. Despite these revolutionary and timely advances, the “Life's Essential 8” with primary diet, sleep, and exercise—remain foundational elements of lifestyle medicine. These three lifestyle components regulate body weight, blood pressure, lipids, and glucose, playing a decisive role in the prevention and management of cardiovascular diseases.</p><p>Acute inflammation directed by 1% leukocytes (innate immune cells) is necessary for host defense that coincides with the safe clearance of inflammation termed resolution; however, the chronic or unresolved infiltration of leukocytes leads to chronic inflammation which is the prime basis of multiple cardiovascular and cardiometabolic disorders [<span>4, 10</span>]. At the immunological, cellular, and molecular levels, an imbalance in diet, sleep, and exercise can trigger weight gain, obesity, low-grade chronic inflammation (residual inflammation), and cardiometabolic syndrome [<span>11-13</span>]. Heart failure is broadly classified into two types: heart failure with reduced (HFrEF) and preserved (HFpEF) ejection fraction with multiple signs of chronic inflammation in obesity. Outcomes from UK biobank participants indicate that adherence to a healthy
{"title":"Lifestyle Medicine Essentials: “Walk More, Eat Less, Sleep More”—White's Early Inspiration","authors":"Ganesh V. Halade, Ankur Kalra","doi":"10.1002/lim2.70008","DOIUrl":"https://doi.org/10.1002/lim2.70008","url":null,"abstract":"<p>One of the American Heart Association (AHA) founders, Paul Dudley White (June 6, 1886–October 31, 1973), a renowned cardiologist in the 20th century, emphasized the importance of a balanced lifestyle to maintain heart health. In keeping with his beliefs, he was a vigorous walker and bicycle rider. He was appointed as President Dwight D. Eisenhower's cardiologist following his heart attack in 1955 and played an important role in his recovery and his subsequent running for a second presidential term of office [<span>1</span>]. Dr. White's key recommendations were to “<i>walk more, eat less, and sleep more</i>”; coincidently, he is the father of prevention cardiology. White advocated for exercise, diet, and weight control in preventing heart disease, prescribing cycling for the president. Furthermore, Dr. White played a key role in establishing the National Institutes of Health and the Framingham Heart Study, which identified major risk factors for heart disease [<span>1, 2</span>]. Over the last 100 years, advancements in technology, research, and development have led to numerous groundbreaking discoveries in cardiology, revolutionizing the diagnosis and treatment of cardiac diseases. These include electrocardiography (ECG), cardiac catheterization and coronary angiography, open-heart surgery, cardiopulmonary resuscitation, percutaneous coronary intervention, the use of defibrillators, thrombolytic therapy, genetic insights into heart disease, high-resolution imaging (such as echocardiography, cardiac CT, and MRI), and an enhanced understanding of leukocyte biology [<span>3, 4</span>]. Today, the application of artificial intelligence is accelerating ECG and imaging analysis, enabling personalized risk assessments, diagnostics, and long-term treatment plans. Despite these revolutionary and timely advances, the “Life's Essential 8” with primary diet, sleep, and exercise—remain foundational elements of lifestyle medicine. These three lifestyle components regulate body weight, blood pressure, lipids, and glucose, playing a decisive role in the prevention and management of cardiovascular diseases.</p><p>Acute inflammation directed by 1% leukocytes (innate immune cells) is necessary for host defense that coincides with the safe clearance of inflammation termed resolution; however, the chronic or unresolved infiltration of leukocytes leads to chronic inflammation which is the prime basis of multiple cardiovascular and cardiometabolic disorders [<span>4, 10</span>]. At the immunological, cellular, and molecular levels, an imbalance in diet, sleep, and exercise can trigger weight gain, obesity, low-grade chronic inflammation (residual inflammation), and cardiometabolic syndrome [<span>11-13</span>]. Heart failure is broadly classified into two types: heart failure with reduced (HFrEF) and preserved (HFpEF) ejection fraction with multiple signs of chronic inflammation in obesity. Outcomes from UK biobank participants indicate that adherence to a healthy ","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.70008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142861212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniel Crabtree, Sara Bradley, Jenni Connelly, Lynn Bauermeister, Trish Gorely, Sandra MacRury
Background
Physical activity is an important aspect of lifestyle management and type 2 diabetes, although the percentage of people with type 2 diabetes achieving recommended guidelines is low. Supported self-management underpinned by group educational programmes may be helpful but difficult to implement in remote and rural areas. We aimed to test the feasibility of an approach based on education delivered individually by community-based exercise advisors to people with type 2 diabetes.
Methods
Following the development of an online educational toolkit a mixture of exercise advisors and people with type 2 diabetes were recruited. People with diabetes had a face-to-face consultation with an exercise advisor with mutually agreed follow-up over 6 months. To track physical activity, people with diabetes aimed to wear an accelerometer device for 7 days at baseline, 3 months and 6 months. Post-intervention semi-structured interviews were undertaken with both groups of participants to gauge perspectives of the initiative.
Results
There was a 56% total attrition rate from baseline to 3 months due to COVID-19 and its impact on clinical research. Around 50% of participants achieved minimum physical activity recommendations at each time point and 22% of participants had accelerometer data at 3 time points. People with diabetes valued interaction with exercise advisors and felt that the programme would be of greatest benefit to less active individuals. Exercise advisors felt that the programme provided more opportunities and increased confidence and that training in working with older less active individuals would be useful for them.
Conclusion
It is feasible to develop a physical activity programme delivered by non-healthcare practitioners underpinned by diabetes-specific education tailored to people with type 2 diabetes. Several project adaptions should be considered for progress to a pilot study to assess an integrated physical activity programme delivered by community exercise advisors.
{"title":"Promoting Physical Activity in the Management of Type 2 Diabetes: A Feasibility Study to Develop Intervention Tools for Delivery of Diabetes-Specific Education","authors":"Daniel Crabtree, Sara Bradley, Jenni Connelly, Lynn Bauermeister, Trish Gorely, Sandra MacRury","doi":"10.1002/lim2.70006","DOIUrl":"https://doi.org/10.1002/lim2.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Physical activity is an important aspect of lifestyle management and type 2 diabetes, although the percentage of people with type 2 diabetes achieving recommended guidelines is low. Supported self-management underpinned by group educational programmes may be helpful but difficult to implement in remote and rural areas. We aimed to test the feasibility of an approach based on education delivered individually by community-based exercise advisors to people with type 2 diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following the development of an online educational toolkit a mixture of exercise advisors and people with type 2 diabetes were recruited. People with diabetes had a face-to-face consultation with an exercise advisor with mutually agreed follow-up over 6 months. To track physical activity, people with diabetes aimed to wear an accelerometer device for 7 days at baseline, 3 months and 6 months. Post-intervention semi-structured interviews were undertaken with both groups of participants to gauge perspectives of the initiative.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was a 56% total attrition rate from baseline to 3 months due to COVID-19 and its impact on clinical research. Around 50% of participants achieved minimum physical activity recommendations at each time point and 22% of participants had accelerometer data at 3 time points. People with diabetes valued interaction with exercise advisors and felt that the programme would be of greatest benefit to less active individuals. Exercise advisors felt that the programme provided more opportunities and increased confidence and that training in working with older less active individuals would be useful for them.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>It is feasible to develop a physical activity programme delivered by non-healthcare practitioners underpinned by diabetes-specific education tailored to people with type 2 diabetes. Several project adaptions should be considered for progress to a pilot study to assess an integrated physical activity programme delivered by community exercise advisors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142860686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stephanie Tierney, Jordan Gorenberg, Marta Santillo, Debra Westlake, Geoffrey Wong, Kerryn Husk, Sofia Vougioukalou, Ruthanne Baxter, Shoba Dawson, Nia Roberts, Caroline Potter, Harriet Warburton, Beth McDougall, Johannah Latchem, Kamal R Mahtani
Introduction
Social prescribing addresses non-medical issues (e.g., loneliness, financial worries, housing problems) affecting physical and/or mental health. It involves connecting people to external support or services, including ‘cultural offers’–events, groups and activities run within or by cultural organisations. Such offers need to be acceptable and accessible to diverse populations if forming part of a social prescription.
Methods
A scoping review was conducted to identify what existing literature, conducted in the United Kingdom, tells us about tailoring cultural offers for older people (aged 60+ years) from ethnic minority groups. Relevant literature was searched for on electronic databases, through Google, via a questionnaire to cultural organisations and by contacting the study's advisory group.
Results
Screening of 906 references–59 of which were read as full documents–resulted in six sources being included in the review. Some cultural activities described within them were run in traditional cultural spaces (e.g., museums, art galleries). Others were held in community centres. Data suggested that attending with others could reduce concerns about belonging. Barriers to engagement included low energy, language, poor confidence, accessing transport and unfamiliarity with a setting and/or activities. Provision of familiar food could help make people feel welcomed.
Conclusions
Reviewed papers showed that consulting with target groups is important to ensure that activities are inclusive and sympathetically delivered. The review also highlighted a paucity of published research on the topic; this means that cultural providers have little evidence to draw on when developing cultural offers for older people from ethnic minority groups.
{"title":"Digging for Literature on Tailoring Cultural Offers With and for Older People From Ethnic Minority Groups: A Scoping Review","authors":"Stephanie Tierney, Jordan Gorenberg, Marta Santillo, Debra Westlake, Geoffrey Wong, Kerryn Husk, Sofia Vougioukalou, Ruthanne Baxter, Shoba Dawson, Nia Roberts, Caroline Potter, Harriet Warburton, Beth McDougall, Johannah Latchem, Kamal R Mahtani","doi":"10.1002/lim2.70004","DOIUrl":"https://doi.org/10.1002/lim2.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Social prescribing addresses non-medical issues (e.g., loneliness, financial worries, housing problems) affecting physical and/or mental health. It involves connecting people to external support or services, including ‘cultural offers’–events, groups and activities run within or by cultural organisations. Such offers need to be acceptable and accessible to diverse populations if forming part of a social prescription.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A scoping review was conducted to identify what existing literature, conducted in the United Kingdom, tells us about tailoring cultural offers for older people (aged 60+ years) from ethnic minority groups. Relevant literature was searched for on electronic databases, through Google, via a questionnaire to cultural organisations and by contacting the study's advisory group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Screening of 906 references–59 of which were read as full documents–resulted in six sources being included in the review. Some cultural activities described within them were run in traditional cultural spaces (e.g., museums, art galleries). Others were held in community centres. Data suggested that attending with others could reduce concerns about belonging. Barriers to engagement included low energy, language, poor confidence, accessing transport and unfamiliarity with a setting and/or activities. Provision of familiar food could help make people feel welcomed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Reviewed papers showed that consulting with target groups is important to ensure that activities are inclusive and sympathetically delivered. The review also highlighted a paucity of published research on the topic; this means that cultural providers have little evidence to draw on when developing cultural offers for older people from ethnic minority groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142749297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cigarette smoking is the leading cause of preventable death in the United States. Although smoking rates have been declining, it is unclear how the COVID-19 pandemic impacted smoking behaviors.
Methods
Following a preregistered plan, we accessed population-based data from the Behavioral Risk Factor Surveillance System (2010–2023) to analyze three primary outcomes: (1) currently smoking, (2) number of cigarettes per day, and (3) quit smoking in the past year. Two-way fixed effect linear regression models accounted for state-level factors and temporal trends. Splitting each survey into an early and late wave, we identified the effect of exposure to the COVID-19 pandemic by comparing changes in an unexposed reference group (interviewed January 1–March 20, early wave) with the changes in an exposed group (interviewed January 1–March 31, late wave).
Results
The sample included 1,449,112 responses, among which 12.8% were in the late wave. Baseline smoking prevalence was 15.9% in the late wave, with an average of 12.5 cigarettes smoked per day among smokers. 8.6% of the late-wave respondents attempted to quit smoking in the past year. Overall, we found a negative 1.7% point association between the pandemic and smoking prevalence. However, among smokers, we found that the pandemic was associated with 5.1 more cigarettes smoked per day. The pandemic was also associated with a 6.3% point decline in the probability of attempting to quit smoking in the past year. While these results did not vary significantly over time, we did observe heterogeneous associations between the pandemic and smoking outcomes by socioeconomic subgroups.
Conclusions
Smoking prevalence continues to decline in the United States, and the pandemic appeared to have been associated with lower smoking rates. However, our results suggest that the pandemic was also associated with greater intensity and fewer quit attempts among smokers warranting greater attention from policymakers and researchers.
{"title":"How Did the COVID-19 Pandemic Change Cigarette Smoking Behavior?","authors":"Jason Semprini","doi":"10.1002/lim2.70005","DOIUrl":"https://doi.org/10.1002/lim2.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cigarette smoking is the leading cause of preventable death in the United States. Although smoking rates have been declining, it is unclear how the COVID-19 pandemic impacted smoking behaviors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following a <i>preregistered</i> plan, we accessed population-based data from the Behavioral Risk Factor Surveillance System (2010–2023) to analyze three primary outcomes: (1) currently smoking, (2) number of cigarettes per day, and (3) quit smoking in the past year. Two-way fixed effect linear regression models accounted for state-level factors and temporal trends. Splitting each survey into an early and late wave, we identified the effect of exposure to the COVID-19 pandemic by comparing changes in an unexposed reference group (interviewed January 1–March 20, early wave) with the changes in an exposed group (interviewed January 1–March 31, late wave).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The sample included 1,449,112 responses, among which 12.8% were in the late wave. Baseline smoking prevalence was 15.9% in the late wave, with an average of 12.5 cigarettes smoked per day among smokers. 8.6% of the late-wave respondents attempted to quit smoking in the past year. Overall, we found a negative 1.7% point association between the pandemic and smoking prevalence. However, among smokers, we found that the pandemic was associated with 5.1 more cigarettes smoked per day. The pandemic was also associated with a 6.3% point decline in the probability of attempting to quit smoking in the past year. While these results did not vary significantly over time, we did observe heterogeneous associations between the pandemic and smoking outcomes by socioeconomic subgroups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Smoking prevalence continues to decline in the United States, and the pandemic appeared to have been associated with lower smoking rates. However, our results suggest that the pandemic was also associated with greater intensity and fewer quit attempts among smokers warranting greater attention from policymakers and researchers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.70005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142749296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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