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}
Daniel Wilson, Matthew Driller, Ben Johnston, Nicholas Gill
Background
Lifestyle behaviors including physical activity, sleep, nutrition, smoking, and alcohol consumption are independently associated with health, yet the relationship between these behaviors and mental health has not been explored among airline pilots. The aim of this study was to measure the association between health behaviors and mental health.
Methods
A cross-sectional study was conducted among 502 airline pilots. The primary outcome measure was the mental component score (MCS), derived from the Short Form Health Survey 12v2. We collected information regarding age, sex, ethnicity, height, body mass, alcohol consumption, tobacco smoking status, moderate-to-vigorous physical activity (MVPA), fruit and vegetable intake, and sleep duration.
Results
After controlling for demographic and anthropometric parameters, MVPA, fruit and vegetable intake, and sleep duration were positively correlated with MCS (p ≤ 0.001), and alcohol consumption and tobacco smoking were negatively correlated with MCS (p ≤ 0.001). Multiple linear regression analyses revealed alcohol consumption was the strongest predictor of MCS (β = −0.308, p ≤ 0.001), followed by smoking (β = −0.236, p ≤ 0.001), MVPA (β = 0.233, p ≤ 0.001), sleep (β = 0.148, p ≤ 0.001), and fruit and vegetable intake (β = 0.097, p = 0.003).
Conclusion
The results suggest that greater physical activity, sleep duration, and fruit and vegetable intake are associated with better mental health. Meanwhile, excessive alcohol consumption and tobacco smoking undermine mental health status.
{"title":"Association Between Health Behaviors and Mental Health Among Airline Pilots","authors":"Daniel Wilson, Matthew Driller, Ben Johnston, Nicholas Gill","doi":"10.1002/lim2.70003","DOIUrl":"https://doi.org/10.1002/lim2.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lifestyle behaviors including physical activity, sleep, nutrition, smoking, and alcohol consumption are independently associated with health, yet the relationship between these behaviors and mental health has not been explored among airline pilots. The aim of this study was to measure the association between health behaviors and mental health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted among 502 airline pilots. The primary outcome measure was the mental component score (MCS), derived from the Short Form Health Survey 12v2. We collected information regarding age, sex, ethnicity, height, body mass, alcohol consumption, tobacco smoking status, moderate-to-vigorous physical activity (MVPA), fruit and vegetable intake, and sleep duration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After controlling for demographic and anthropometric parameters, MVPA, fruit and vegetable intake, and sleep duration were positively correlated with MCS (<i>p</i> ≤ 0.001), and alcohol consumption and tobacco smoking were negatively correlated with MCS (<i>p</i> ≤ 0.001). Multiple linear regression analyses revealed alcohol consumption was the strongest predictor of MCS (β = −0.308, <i>p</i> ≤ 0.001), followed by smoking (β = −0.236, <i>p</i> ≤ 0.001), MVPA (β = 0.233, <i>p</i> ≤ 0.001), sleep (β = 0.148, <i>p</i> ≤ 0.001), and fruit and vegetable intake (β = 0.097, <i>p</i> = 0.003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results suggest that greater physical activity, sleep duration, and fruit and vegetable intake are associated with better mental health. Meanwhile, excessive alcohol consumption and tobacco smoking undermine mental health status.</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":"5 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142524810","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}
Angela Li, Amir-Ali Golrokhian-Sani, Maya Morcos, Marc Morcos
Objectives
A physician's work environment varies greatly depending on their medical specialty. As such, it may dictate their stress levels, work-life balance, satisfaction, and, ultimately, expected age of death. This paper aims to determine trends in Canadian physician deaths and determine the median age of death for different specialties.
Methods
We examined physician obituaries from the Canadian Medical Association Journal (CMAJ) published between 2000 and 2023, extracting age at death and medical specialty.
Results
The median age of death for doctors had a steady incline between 1999 and 2023 with a median age of 80 years. Careers in psychiatry (p = 0.020, 95% confidence interval [CI] [1.00, 4.00]) and emergency medicine (p = 0.025, 95% CI [7.00, 26.00]) were associated with decreased average ages of death, while careers in surgery (p < 0.001, 95% CI [−4.00, −2.00]), internal medicine (p = 0.038, 95% CI [−3.00, −1.00]), and public health (p = 0.016. 95% CI [−9.00, −2.00]) correlated with older ages of death. Of the statistically significant specialties, emergency medicine physicians had the lowest median age at death (59 years) while surgery and public health had the highest (81.5 and 83.5, respectively).
Conclusion
Our findings indicate that the median age of death differs across different medical specialties. Moving forward, the CMAJ should report physician obituaries consistently in a standardized format as it holds the most extensive obituary dataset despite missing significant data between 2008 and 2022.
目标 医生的工作环境因其所从事的医疗专业而有很大不同。因此，这可能会决定他们的压力水平、工作与生活的平衡、满意度以及最终的预期死亡年龄。本文旨在确定加拿大医生的死亡趋势，并确定不同专业的中位死亡年龄。 方法 我们研究了《加拿大医学会杂志》（Canadian Medical Association Journal，CMAJ）在 2000 年至 2023 年间发表的医生讣告，提取了死亡年龄和医学专业。 结果 1999年至2023年间，医生死亡年龄的中位数呈稳定上升趋势，中位数年龄为80岁。精神病学（p = 0.020，95% 置信区间 [CI] [1.00, 4.00]）和急诊医学（p = 0.025，95% CI [7.00, 26.00]）职业与平均死亡年龄下降有关，而外科（p < 0.001，95% CI [-4.00，-2.00]）、内科（p = 0.038，95% CI [-3.00，-1.00]）和公共卫生（p = 0.016. 95% CI [-9.00，-2.00]）与较高的死亡年龄相关。在有统计学意义的专科中，急诊科医生的死亡年龄中位数最低（59 岁），而外科和公共卫生科的死亡年龄中位数最高（分别为 81.5 岁和 83.5 岁）。 结论 我们的研究结果表明，不同医学专业的中位死亡年龄是不同的。展望未来，《中国医学杂志》应该以标准化的格式持续报道医生讣告，因为它拥有最广泛的讣告数据集，尽管在 2008 年至 2022 年期间缺失了大量数据。
{"title":"Analysis of Canadian Physician Obituaries Between 2000 and 2023 to Investigate Trends in Death Between Specialties: A Retrospective Cross-Sectional Study","authors":"Angela Li, Amir-Ali Golrokhian-Sani, Maya Morcos, Marc Morcos","doi":"10.1002/lim2.114","DOIUrl":"https://doi.org/10.1002/lim2.114","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>A physician's work environment varies greatly depending on their medical specialty. As such, it may dictate their stress levels, work-life balance, satisfaction, and, ultimately, expected age of death. This paper aims to determine trends in Canadian physician deaths and determine the median age of death for different specialties.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We examined physician obituaries from the <i>Canadian Medical Association Journal</i> (<i>CMAJ</i>) published between 2000 and 2023, extracting age at death and medical specialty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median age of death for doctors had a steady incline between 1999 and 2023 with a median age of 80 years. Careers in psychiatry (<i>p</i> = 0.020, 95% confidence interval [CI] [1.00, 4.00]) and emergency medicine (<i>p</i> = 0.025, 95% CI [7.00, 26.00]) were associated with decreased average ages of death, while careers in surgery (<i>p</i> < 0.001, 95% CI [−4.00, −2.00]), internal medicine (<i>p</i> = 0.038, 95% CI [−3.00, −1.00]), and public health (<i>p</i> = 0.016. 95% CI [−9.00, −2.00]) correlated with older ages of death. Of the statistically significant specialties, emergency medicine physicians had the lowest median age at death (59 years) while surgery and public health had the highest (81.5 and 83.5, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings indicate that the median age of death differs across different medical specialties. Moving forward, the <i>CMAJ</i> should report physician obituaries consistently in a standardized format as it holds the most extensive obituary dataset despite missing significant data between 2008 and 2022.</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":"5 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142007212","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}
Labros S Sidossis, Rob Lawson, Emmanuel Aprilakis, Bernardo C. Barata, Alicja Baska, Anastasia Beneka, Robert Bird, Fraser Birrell, Charistoula Chatzinikola, Maria Chondronikola, George P Chrousos, Russell Conduit, Constantina Constantinou, Barbora de Courten, Jelena Helene Cvejic, Andrew M Davis, Christiana A. Demetriou, Linda Errington, Jack Feehan, Catalina Figueroa, Mary M. Flynn, Beth Frates, Robel Hussen Kabthymer, Leonidas G Karagounis, Leila Karimi, Gerard A. Kennedy, Ourania Kolokotroni, Darinka Korovljev, Antigone Kouris-Blazos, Mehdi Kushkestani, Tassos C. Kyriakides, Emanuela Mercore Hutanu, Maria Cecilia Mosquera, Elena Nikiphorou, Nicola O'Brien, Elena Philippou, Karolina Piątek, Simon Poole, Dana Popescu-Spineni, Sue Radd-Vagenas, Amalia Sidossis, Magdalena Simonis, Helen Soultanakis, Aleksandra Telinga, Audrey Tierney, Anna Tkacz, Dimitris Vlachopoulos, Gulnur Yaman-Dent, Yang Yap, Zoe Zervides, Catherine Itsiopoulos
Introduction
The term “Mediterranean lifestyle” has gained increasing prominence in recent years, yet a specific definition remains elusive. In response, the Mediterranean Lifestyle Medicine Institute Board of Directors convened a multidisciplinary panel comprising international experts and leaders in lifestyle medicine. Their goal was to review existing literature and formulate a consensus definition of the “traditional Mediterranean lifestyle (tMedL),” referring to the historical way of living of the people in the Mediterranean region. This paper presents the agreed consensus statement and a comprehensive holistic definition of the term “traditional Mediterranean lifestyle.”
Methods
Major medical and social sciences electronic databases from inception to February 2023 were searched, employing keywords relevant to the Mediterranean lifestyle and its constituent elements (diet, physical activity, sleep, stress, socialization). Subsequently, definitions for each pillar were created and synthesized to derive a comprehensive definition of the “traditional Mediterranean lifestyle.”
Results
This proposed definition received ratification from the Mediterranean Lifestyle Medicine Institute's expert working group during the First International Mediterranean Lifestyle Medicine Conference held in June 2023 on the island of Leros, Greece. “The traditional Mediterranean lifestyle is characterized by its diverse and adaptable nature. Key facets encompass conviviality, lifelong social connectedness, purposeful living, strong community and familial bonds, harmony with nature and the environment, profound spirituality, adherence to religious practices, preservation of local customs, resilience cultivated through adversity, and a commitment to moderation across all spheres of life.”
Conclusions
This definition comprehensively outlines the primary lifestyle factors ingrained in Mediterranean inhabitants across generations. Its holistic nature furnishes a crucial conceptual framework for directing lifestyle medicine practitioners in assisting patients to mitigate diseases, promote overall well-being, devise research initiatives to investigate the health ramifications of this lifestyle, and inform curriculum development.
{"title":"Defining the Traditional Mediterranean Lifestyle: Joint International Consensus Statement","authors":"Labros S Sidossis, Rob Lawson, Emmanuel Aprilakis, Bernardo C. Barata, Alicja Baska, Anastasia Beneka, Robert Bird, Fraser Birrell, Charistoula Chatzinikola, Maria Chondronikola, George P Chrousos, Russell Conduit, Constantina Constantinou, Barbora de Courten, Jelena Helene Cvejic, Andrew M Davis, Christiana A. Demetriou, Linda Errington, Jack Feehan, Catalina Figueroa, Mary M. Flynn, Beth Frates, Robel Hussen Kabthymer, Leonidas G Karagounis, Leila Karimi, Gerard A. Kennedy, Ourania Kolokotroni, Darinka Korovljev, Antigone Kouris-Blazos, Mehdi Kushkestani, Tassos C. Kyriakides, Emanuela Mercore Hutanu, Maria Cecilia Mosquera, Elena Nikiphorou, Nicola O'Brien, Elena Philippou, Karolina Piątek, Simon Poole, Dana Popescu-Spineni, Sue Radd-Vagenas, Amalia Sidossis, Magdalena Simonis, Helen Soultanakis, Aleksandra Telinga, Audrey Tierney, Anna Tkacz, Dimitris Vlachopoulos, Gulnur Yaman-Dent, Yang Yap, Zoe Zervides, Catherine Itsiopoulos","doi":"10.1002/lim2.115","DOIUrl":"https://doi.org/10.1002/lim2.115","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The term “Mediterranean lifestyle” has gained increasing prominence in recent years, yet a specific definition remains elusive. In response, the Mediterranean Lifestyle Medicine Institute Board of Directors convened a multidisciplinary panel comprising international experts and leaders in lifestyle medicine. Their goal was to review existing literature and formulate a consensus definition of the “traditional Mediterranean lifestyle (tMedL),” referring to the historical way of living of the people in the Mediterranean region. This paper presents the agreed consensus statement and a comprehensive holistic definition of the term “traditional Mediterranean lifestyle.”</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Major medical and social sciences electronic databases from inception to February 2023 were searched, employing keywords relevant to the Mediterranean lifestyle and its constituent elements (diet, physical activity, sleep, stress, socialization). Subsequently, definitions for each pillar were created and synthesized to derive a comprehensive definition of the “traditional Mediterranean lifestyle.”</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This proposed definition received ratification from the Mediterranean Lifestyle Medicine Institute's expert working group during the First International Mediterranean Lifestyle Medicine Conference held in June 2023 on the island of Leros, Greece. “The traditional Mediterranean lifestyle is characterized by its diverse and adaptable nature. Key facets encompass conviviality, lifelong social connectedness, purposeful living, strong community and familial bonds, harmony with nature and the environment, profound spirituality, adherence to religious practices, preservation of local customs, resilience cultivated through adversity, and a commitment to moderation across all spheres of life.”</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This definition comprehensively outlines the primary lifestyle factors ingrained in Mediterranean inhabitants across generations. Its holistic nature furnishes a crucial conceptual framework for directing lifestyle medicine practitioners in assisting patients to mitigate diseases, promote overall well-being, devise research initiatives to investigate the health ramifications of this lifestyle, and inform curriculum development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":"5 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141994183","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}
Ahmed H. Mujamammi, Essa M. Sabi, Faisal M. Alsaawi, Naif A. Alfahed, Omar A. Alrajhi, Hamad A. Alshaalan, Mohamed F. Alqahtani, Mohammed A. Alamer
Aims
Lack of obstructive sleep apnea (OSA) awareness both directly and indirectly causes a medical and financial burden worldwide. The objective of this study is to provide new insights, focusing on type 2 diabetics and their knowledge levels about OSA in King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia, and to recognize obesity as a common risk factor contributing to OSA in type 2 diabetes mellitus (T2DM) participants.
Methods
An analytical cross-sectional study was conducted from July 2022 to December 2022 with a convenience sampling method of 386 participants (18 years old and above). The study was done face-to-face using an electronic questionnaire. The inclusion criterion was all T2DM patients at the waiting area of KKUH Diabetes Center in Riyadh, excluding participants with other metabolic disorders.
Results
Overall knowledge levels were poor, with 70.2% of participants not knowledgeable about the disease and 81.3% of participants having no knowledge concerning the bidirectional relationship between T2DM and OSA. Statistical significance was found between the risk of developing OSA symptoms and body mass index ≥30 (p ≤ 0.001).
Conclusion
The majority have very little to no knowledge regarding OSA and its bidirectional relationship with T2DM, indicating the need to put more effort into improving participant's awareness in this regard. Moreover, obesity should be considered as a common risk factor, recommending patients to practice healthier habits to minimize the risks and decrease mortality.
目的 缺乏对阻塞性睡眠呼吸暂停（OSA）的认识直接或间接地给全世界造成了医疗和经济负担。本研究旨在提供新的见解，重点关注沙特阿拉伯利雅得哈立德国王大学医院（KKUH）的 2 型糖尿病患者及其对 OSA 的认知水平，并认识到肥胖是导致 2 型糖尿病（T2DM）患者发生 OSA 的常见风险因素。 方法 一项分析性横断面研究于 2022 年 7 月至 2022 年 12 月进行，采用方便抽样法，共抽取了 386 名参与者（18 岁及以上）。研究使用电子问卷进行面对面调查。纳入标准为利雅得 KKUH 糖尿病中心候诊区的所有 T2DM 患者，不包括患有其他代谢疾病的参与者。 结果 总体知识水平较低，70.2%的参与者不了解该疾病，81.3%的参与者不了解 T2DM 与 OSA 之间的双向关系。出现 OSA 症状的风险与体重指数≥30 之间存在统计学意义（P ≤ 0.001）。 结论 大多数人对 OSA 及其与 T2DM 的双向关系知之甚少甚至一无所知，这表明有必要加大力度提高参与者在这方面的认识。此外，肥胖也应被视为一种常见的风险因素，建议患者养成更健康的生活习惯，以最大限度地降低风险和死亡率。
{"title":"Type 2 Diabetic Patients and Their Awareness About Obstructive Sleep Apnea in Diabetic Centers of Riyadh City","authors":"Ahmed H. Mujamammi, Essa M. Sabi, Faisal M. Alsaawi, Naif A. Alfahed, Omar A. Alrajhi, Hamad A. Alshaalan, Mohamed F. Alqahtani, Mohammed A. Alamer","doi":"10.1002/lim2.116","DOIUrl":"https://doi.org/10.1002/lim2.116","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Lack of obstructive sleep apnea (OSA) awareness both directly and indirectly causes a medical and financial burden worldwide. The objective of this study is to provide new insights, focusing on type 2 diabetics and their knowledge levels about OSA in King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia, and to recognize obesity as a common risk factor contributing to OSA in type 2 diabetes mellitus (T2DM) participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An analytical cross-sectional study was conducted from July 2022 to December 2022 with a convenience sampling method of 386 participants (18 years old and above). The study was done face-to-face using an electronic questionnaire. The inclusion criterion was all T2DM patients at the waiting area of KKUH Diabetes Center in Riyadh, excluding participants with other metabolic disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall knowledge levels were poor, with 70.2% of participants not knowledgeable about the disease and 81.3% of participants having no knowledge concerning the bidirectional relationship between T2DM and OSA. Statistical significance was found between the risk of developing OSA symptoms and body mass index ≥30 (<i>p</i> ≤ 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The majority have very little to no knowledge regarding OSA and its bidirectional relationship with T2DM, indicating the need to put more effort into improving participant's awareness in this regard. Moreover, obesity should be considered as a common risk factor, recommending patients to practice healthier habits to minimize the risks and decrease mortality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":"5 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141980290","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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