Pub Date : 2017-03-01DOI: 10.1097/pp9.0000000000000002
M. Sagner, Amy McNeil, P. Puska, C. Auffray, N. Price, L. Hood, C. Lavie, Ze-Guang Han, Zhu Chen, S. Brahmachari, B. McEwen, M. Soares, R. Balling, E. Epel, R. Arena
Chronic diseases (i.e., noncommunicable diseases), mainly cardiovascular disease, cancer, respiratory diseases and type-2-diabetes, are now the leading cause of death, disability and diminished quality of life on the planet. Moreover, these diseases are also a major financial burden worldwide, significantly impacting the economy of many countries. Healthcare systems and medicine have progressively improved upon the ability to address infectious diseases and react to adverse health events through both surgical interventions and pharmacology; we have become efficient in delivering reactive care (i.e., initiating interventions once an individual is on the verge of or has actually suffered a negative health event). However, with slowly progressing and often ‘silent’ chronic diseases now being the main cause of illness, healthcare and medicine must evolve into a proactive system, moving away from a merely reactive approach to care. Minimal interactions among the specialists and limited information to the general practitioner and to the individual receiving care lead to a fragmented health approach, non-concerted prescriptions, a scattered follow-up and a suboptimal cost-effectiveness ratio. A new approach in medicine that is predictive, preventive, personalized and participatory, which we label here as “P4” holds great promise to reduce the burden of chronic diseases by harnessing technology and an increasingly better understanding of environment-biology interactions, evidence-based interventions and the underlying mechanisms of chronic diseases. In this concept paper, we propose a ‘P4 Health Continuum’ model as a framework to promote and facilitate multi-stakeholder collaboration with an orchestrated common language and an integrated care model to increase the healthspan.
{"title":"The P4 Health Spectrum – A Predictive, Preventive, Personalized and Participatory Continuum for Promoting Healthspan","authors":"M. Sagner, Amy McNeil, P. Puska, C. Auffray, N. Price, L. Hood, C. Lavie, Ze-Guang Han, Zhu Chen, S. Brahmachari, B. McEwen, M. Soares, R. Balling, E. Epel, R. Arena","doi":"10.1097/pp9.0000000000000002","DOIUrl":"https://doi.org/10.1097/pp9.0000000000000002","url":null,"abstract":"Chronic diseases (i.e., noncommunicable diseases), mainly cardiovascular disease, cancer, respiratory diseases and type-2-diabetes, are now the leading cause of death, disability and diminished quality of life on the planet. Moreover, these diseases are also a major financial burden worldwide, significantly impacting the economy of many countries. Healthcare systems and medicine have progressively improved upon the ability to address infectious diseases and react to adverse health events through both surgical interventions and pharmacology; we have become efficient in delivering reactive care (i.e., initiating interventions once an individual is on the verge of or has actually suffered a negative health event). However, with slowly progressing and often ‘silent’ chronic diseases now being the main cause of illness, healthcare and medicine must evolve into a proactive system, moving away from a merely reactive approach to care. Minimal interactions among the specialists and limited information to the general practitioner and to the individual receiving care lead to a fragmented health approach, non-concerted prescriptions, a scattered follow-up and a suboptimal cost-effectiveness ratio. A new approach in medicine that is predictive, preventive, personalized and participatory, which we label here as “P4” holds great promise to reduce the burden of chronic diseases by harnessing technology and an increasingly better understanding of environment-biology interactions, evidence-based interventions and the underlying mechanisms of chronic diseases. In this concept paper, we propose a ‘P4 Health Continuum’ model as a framework to promote and facilitate multi-stakeholder collaboration with an orchestrated common language and an integrated care model to increase the healthspan.","PeriodicalId":92284,"journal":{"name":"Progress in preventive medicine (New York, N.Y.)","volume":"2 1","pages":"e0002"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/pp9.0000000000000002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48837043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-02-01DOI: 10.1097/pp9.0000000000000004
Keith Brazendale, C. Drenowatz, R. Falck, A. Randel, Jared D. Hoffmeyer, G. Hand, S. Burgess, S. Blair
Introduction: Sedentary time and depressive symptoms are positively associated in elderly adults and adults with chronic disease; however, little is known about this relationship in generally healthy young adults. The purpose of this study was to investigate the association between objectively measured sedentary time and depressive symptoms in a large sample of healthy young adults. Methods: Time spent sedentary and in moderate-to-vigorous physical activity (MVPA) was measured in 430 participants (49% men; 28 ± 4 years; 25.5 ± 3.3 kg/m2) using the SenseWear Mini Armband over a 10-day period. The Profile of Mood States depression scale was administered to assess depressive symptoms. Independent samples t tests investigated differences in MVPA, time spent sedentary, and Profile of Mood States scores between males and females. Linear regression analyses, adjusting for MVPA, sex, and body mass index, were employed to examine associations between sedentary time and depressive symptoms. Results: Mean time spent sedentary while awake was 681 ± 94 min/d. Holding MVPA constant, depressive symptoms were positively associated with sedentary time (&bgr; = 1.80; P < 0.01; R2 = 0.54). This association was statistically significant in males (&bgr; = 2.06; P < 0.01; R2 = 0.59) but not females (P = 0.10). Conclusions: Depressive symptoms are positively associated with time spent sedentary in healthy young US adults, independent of MVPA, particularly in men. A reduction in sedentary time may provide a valuable, low cost, option in the prevention of depressive symptoms.
{"title":"Depressive Symptoms Are Positively Associated with Time Spent Sedentary in Healthy Young US Adults","authors":"Keith Brazendale, C. Drenowatz, R. Falck, A. Randel, Jared D. Hoffmeyer, G. Hand, S. Burgess, S. Blair","doi":"10.1097/pp9.0000000000000004","DOIUrl":"https://doi.org/10.1097/pp9.0000000000000004","url":null,"abstract":"Introduction: Sedentary time and depressive symptoms are positively associated in elderly adults and adults with chronic disease; however, little is known about this relationship in generally healthy young adults. The purpose of this study was to investigate the association between objectively measured sedentary time and depressive symptoms in a large sample of healthy young adults. Methods: Time spent sedentary and in moderate-to-vigorous physical activity (MVPA) was measured in 430 participants (49% men; 28 ± 4 years; 25.5 ± 3.3 kg/m2) using the SenseWear Mini Armband over a 10-day period. The Profile of Mood States depression scale was administered to assess depressive symptoms. Independent samples t tests investigated differences in MVPA, time spent sedentary, and Profile of Mood States scores between males and females. Linear regression analyses, adjusting for MVPA, sex, and body mass index, were employed to examine associations between sedentary time and depressive symptoms. Results: Mean time spent sedentary while awake was 681 ± 94 min/d. Holding MVPA constant, depressive symptoms were positively associated with sedentary time (&bgr; = 1.80; P < 0.01; R2 = 0.54). This association was statistically significant in males (&bgr; = 2.06; P < 0.01; R2 = 0.59) but not females (P = 0.10). Conclusions: Depressive symptoms are positively associated with time spent sedentary in healthy young US adults, independent of MVPA, particularly in men. A reduction in sedentary time may provide a valuable, low cost, option in the prevention of depressive symptoms.","PeriodicalId":92284,"journal":{"name":"Progress in preventive medicine (New York, N.Y.)","volume":"2 1","pages":"e0004"},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/pp9.0000000000000004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43580898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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