BACKGROUND: Exposure to air pollution and adherence to a healthy lifestyle have been identified to be related to sarcopenia. However, the interactive effects between these two factors remain insufficiently elucidated. The present study was designed to investigate the potential interaction exposure to air pollution with healthy lifestyle on the risk of developing sarcopenia. METHODS: In the retrospective cohort study, all data was extracted from China Health and Retirement Longitudinal Study. Household air pollution was assessed based on the utilization of solid fuels for cooking and heating. A lifestyle score was constructed comprising information on physical activity, smoking, drinking and sleeping time. Multivariate logistic regression model was used to assess the effects of household air pollution and healthy lifestyle score on sarcopenia, separately. We further explored the additive interaction between household air pollution and healthy lifestyle score to sarcopenia using the interaction table developed by T Anderson. Relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (SI) were used to evaluate the additive interactive effect. RESULTS: 2,114 participants were included in this study. The result indicated that exposed to household air pollution [adjusted relative risk (RR) = 1.80, 95% confidence interval (CI): 1.15-2.94] and unhealthy lifestyle (adjusted RR = 1.46, 95%CI: 1.04-2.03) were both significantly associated with increased risk of sarcopenia. Furthermore, participants exposed to both household air pollution and an unhealthy lifestyle exhibited a significantly higher risk of sarcopenia relative to those without household air pollution exposure and maintaining a healthy lifestyle (adjusted RR = 2.44). But RERI, AP, and SI suggested that there is no statistically significant additive interaction between household air pollution exposure and healthy lifestyle factors in relation to sarcopenia risk. CONCLUSION Household air pollution in conjunction with an unhealthy lifestyle confers a significantly higher risk of sarcopenia compared to either factor in isolation, with no evidence of a significant additive interaction between these two risk factors.
Humans ; China/epidemiology* ; Male ; Sarcopenia/etiology* ; Female ; Longitudinal Studies ; Middle Aged ; Aged ; Air Pollution, Indoor/adverse effects* ; Retrospective Studies ; Healthy Lifestyle ; Risk Factors ; Environmental Exposure/adverse effects* ; Cooking ; Aged, 80 and over

OBJECTIVES: Depressive and anxiety disorders are among the most common mental disorders worldwide and are associated with unhealthy lifestyle behaviors. The Life's Simple 7 (LS7) guideline proposed by the American Heart Association aims to reduce cardiovascular risk by improving behaviors such as diet and physical activity, but its impact on mental health is not yet fully clear. This study examined the association between LS7 scores and symptoms of anxiety and depression in adults undergoing routine health examinations. METHODS: Data were collected from individuals who underwent health examinations from May 2015 to December 2024 at the Health Management Center of the Third Xiangya Hospital. All participants completed the LS7 assessments, the Self-Rating Depression Scale (SDS), and the Self-Rating Anxiety Scale (SAS). Participants were categorized into 4 LS7 score groups: Low (≤7), average (8-9), good (10), and excellent (11-14). Those with SDS or SAS≥50 were classified as having mental disorder symptoms; with this group, SAS≥50 indicated anxiety, SDS≥50 indicated depression, and SDS and SAS≥50 indicated comorbid anxiety-depression. Binary logistic regression was used to assess associations between LS7 score and mental symptoms, calculating odds ratio (OR) and 95% confidence interval (CI). A restricted cubic spline (RCS) regression model was used to analyze the dose-response relationship between LS7 score (continuous variable) and the risk of mental symptoms. Nodes were set at the 5th, 35th, 65th, and 95th percentiles of the LS7 score, with the 5th percentile as the reference point. All models were adjusted for covariates such as gender, age, living alone, drinking status, education level, and sleep quality. Logistic regression framework was used to fit and calculate the adjusted OR (aOR) and 95% CI. Nonlinear relationship tests were also conducted. Subgroup analysis was performed to explore the interaction between gender, age, drinking habits, education level, and other factors and the LS7 score in influencing the risk of mental symptoms. RESULTS: A total of 5 449 participants were included; 1 363 (25.01%) had depressive symptoms, 398 (7.30%) had anxiety symptoms, and 259 (4.75%) had comorbid anxiety-depression. The prevalence of mental symptoms decreased significantly as LS7 scores increased. Univariate and multivariate Logistic regression indicated that LS7 score≥8 was protective against mental symptoms. Multivariate Logistic regression demonstrated moderate discriminative ability (AUC=0.672). Among individuals with anxiety, depression, or comorbid symptoms, LS7 score distributions showed a graded decrease from poor to excellent groups. After adjustment, an excellent LS7 score was associated with a 39% lower risk of depression (aOR=0.61, 95% CI 0.47 to 0.78, P<0.001), a 63% lower risk of anxiety (aOR=0.37, 95% CI 0.22 to 0.59, P<0.001), and a 66% lower risk of comorbid anxiety-depression (aOR=0.34, 95% CI 0.17 to 0.62, P=0.001). The AUC values of the anxiety model, depression model, and comorbid anxiety and depression model were 0.632, 0.672, and 0.619, respectively. All models demonstrated moderate discriminatory ability, which was statistically significant, but their capacity to distinguish cases from non-cases was limited. RCS analysis confirmed a linear inverse relationship between LS7 score and mental symptom risk. Not smoking and regular physical activity were the strongest protective behaviors. Subgroup analysis suggested stronger protective effects in men, younger adults (≤60), non-drinkers, and those with higher education levels, and revealed a significant interaction between alcohol use and LS7 score (P for interaction=0.021), indicating that alcohol consumption may weaken the protective effect of LS7. CONCLUSIONS Ideal healthy lifestyle behaviors, as reflected by higher LS7 scores, are associated with lower risks of anxiety and depression in adults. Promoting LS7-based lifestyle practices may serve as a practical and effective strategy for the prevention and management of anxiety and depression in both clinical and daily life settings.
Humans ; Cross-Sectional Studies ; Depression/epidemiology* ; Anxiety/epidemiology* ; Adult ; Male ; Female ; Middle Aged ; Healthy Lifestyle ; Risk Factors ; Anxiety Disorders/epidemiology* ; Exercise ; Physical Examination ; Aged

INTRODUCTION

According to the World Health Organization (2024), 41 million people are killed each year by Noncommunicable diseases (NCDs) which is equivalent to 74% deaths globally and 68.5% in the Philippines NCDs considered as lifestyle related include cardiovascular conditions (hypertension, stroke), diabetes mellitus, lung/chronic respiratory diseases and a range of cancers. Tobacco use, physical inactivity, harmful use of alcohol and unhealthy diet increase the risk of death from noncommunicable diseases. Early identification of individuals who are at risk using lifestyle assessment tools is important in the prevention of these non-communicable diseases. 

The aim of this study was to determine the lifestyle risk profile of an urban community under a Community Oriented Primary Care program.

This was a cross-sectional survey conducted in an urban community under a Community-Oriented Primary Care program. Using systematic random sampling, one respondent from the included households completed a structured questionnaire on socio-demographic characteristics, physical assessment, and lifestyle behaviors using a validated Lifestyle Medicine Assessment (LMA) tool. The questionnaire was translated into the Hiligaynon dialect and underwent expert review and pilot testing, demonstrating excellent validity and reliability. Data were analyzed using descriptive and inferential statistics, with a significance level set at p < 0.05.

Eighty-seven among 112 households of the community participated in the study. Demographic profiling revealed that most respondents had above-normal waist-hip ratios, and nearly half had above-normal body mass index (BMI). The overall LMA scores indicated a “Very Good” lifestyle profile (scores 31–40). Among demographic factors, only work status showed a statistically significant association with total LMA scores (p = 0.037). Significant associations were found between specific lifestyle domains and socio-demographic factors. The domain of connectedness was significantly associated with age and educational attainment; nutrition showed significant associations with age, marital status, and income; and substance use was significantly associated with sex and work status.

Considering the influence of Lifestyle Behavior on health, especially that of acquiring non-communicable diseases, using lifestyle assessment tools may aid in the formulation of campaigns, projects targeted on the community’s problem. Like in every Family and Community Medicine Residency Programs, COPC programs is one way of using the data gathered on lifestyle behavior in the community. 

Humans ; Obesity/prevention & control* ; Healthy Lifestyle

Humans ; Obesity/prevention & control* ; Healthy Lifestyle

Humans ; Blood Pressure/physiology* ; Hypertension/prevention & control* ; Body Mass Index ; Healthy Lifestyle

Objective: To investigate the associations between the numbers of healthy lifestyles and overweight/obesity and abdominal obesity in adult twins in Shanghai. Methods: Based on the Shanghai Twin Registry System Phase Ⅱ survey data in 2017-2018, a case-control study was conducted to analyze the association between healthy lifestyles and obesity and further adjusted for confounders by a co-twin control study. Results: A total of 7 864 adult twins (3 932 pairs) were included. In the co-twin case-control analysis for monozygotic twins, compared with participants with 0 to 2 healthy lifestyles, those with 3 and 4 to 5 healthy lifestyles had a 49% (OR=0.51, 95%CI: 0.28-0.93) and 70% (OR=0.30, 95%CI: 0.13-0.69) lower risk of overweight/obesity, respectively, and a 17% (OR=0.83, 95%CI: 0.44-1.57) and 66% (OR=0.34, 95%CI: 0.14-0.80) lower risk of abdominal obesity, respectively. For each additional healthy lifestyle, the risk of developing overweight/obesity was reduced by 41% (OR=0.59, 95%CI: 0.42-0.85), and the risk of developing abdominal obesity was reduced by 37% (OR=0.63, 95%CI: 0.44-0.90). Conclusion: An increasing number of healthy lifestyles was associated with a marked decreased risk for both overweight/obesity and abdominal obesity.
Adult ; Humans ; Case-Control Studies ; China/epidemiology* ; Healthy Lifestyle ; Obesity/epidemiology* ; Obesity, Abdominal/epidemiology* ; Overweight/epidemiology* ; Twins, Monozygotic

Background: Cardiovascular disease (CVD) is a leading cause of death around the world including the Philippines. Dyslipidemia and lifestyle have been considered as important modifiable risk factors. Experts in the Philippines have recommended that among individuals with dyslipidemia, lifestyle modification should be advised regardless of their present condition or risk profile. However, a key limitation of the most recent guidelines is the lack of studies on lifestyle interventions involving Filipinos. Objective: This study aimed to provide preliminary evidence for the use of a lifestyle medicine intervention program in the management of dyslipidemia as risk factor for cardiovascular disease. Methods: This study employed a mixed method of quantitative and qualitative research designs. The tools used were selfadministered questionnaires, collecting and examining documents. Measures to improve validity in qualitative studies have also been employed such as respondent validation and rival explanation. Triangulation with the findings from the other qualitative methodologies was also employed. Ethical approval was granted. Results: The first part of the study has a total of 66 participants who underwent a lifestyle intervention program in a single clinic, comprising of 26 male and 40 female subjects were selected through convenient sampling method. Around 50% of the participants were 40-59 years old, 42.4% were 30-39 years old, and only 7.6% were 60-89 years old. The knowledge of the respondents had an overall mean of 7.73 (SD=1.16) which is interpreted as high knowledge. The attitude of the respondents had a mean of 3.58 (SD=0.50) which is interpreted as very positive. The respondents also had a good lifestyle practice with overall mean of 2.76 (SD=0.49). The second part of the study consisted of eight participants with 3 males and 5 females who were chosen through purposive sampling. All participants experienced reduction of their LDL-C and total cholesterol levels after the 12-week lifestyle intervention. Two participants had increased triglyceride levels. The select group also showed reduction in the blood glucose levels and body mass index. Conclusion This study revealed that participants had good knowledge and attitude regarding cardiovascular diseases and its risk factors. Yet, there is still a high number of those who do not efficiently practice healthy lifestyle and diet. Additional information should be extracted to establish the dietary intake of participants which contributed to the increase in triglyceride levels of some select participants.
lifestyle ; ischemic heart disease ; dyslipidemia

: According to the World Health Organization, in 2019, an estimated 38.2 million children under the age of 5 years were overweight or obese. With this increased prevalence along came the rise of its comorbidities such as non-alcoholic fatty liver disease (NAFLD) at early ages. The general objective of this case study is to bring awareness of NAFLD in the young. The specific objective is to present a case of a ten year old boy with non alcoholic liver disease and the challenge in the management. The case study is a 10 year old boy diagnosed to be overweight, hypertriglyceridemia and non-alcoholic fatty liver disease. Baseline weight and body mass index were taken on his first visit and follow up. CBC, Na+, K+, Creatinine, SGPT, FBS, Uric Acid, Total cholesterol, triglycerides, high density lipoprotein, Low density lipoprotein, HBsAg, Anti-HBs, ultrasound of the abdomen and fibroscan of the liver were done. Nutritional counselling was given but not followed. Physical activity prescription of at least 30 minutes/day moderate intensity exercise five times/week. This was done for 1 hour/day five times/week. He was also prescribed N acetylcysteine, Fish oil and Vitamin D. After six and a half months, triglycerides became normal however weight and BMI remain the same. Non-alcoholic liver disease was still present on repeat abdominal ultrasound. Conclusion 1. By engaging in exercise for 6 1/2 months, patient NP was able to normalize the elevated triglyceride level. 2. Without dietary modification, patient wasn’t able to improve his body mass index. His ultrasound still showed the presence of fatty liver. 3. Physicians have the power to influence patients on developing healthy behaviors. They need to take time to engage and listen and help patient discover by themselves lifestyle behaviors that can impact their health. 4. There is a great challenge in instituting this therapeutic intervention for a teenager especially when he is asymptomatic and do not see the need for it. To elicit a better outcome of this patient, it will entail the adoption of the lifestyle modification by the entire family. To set clear and achievable goals and a collaborative management to include a dietician, a health coach and a behavioral therapist may aid compliance.
Pediatric ; non-alcoholic fatty liver disease (NAFLD) ; hypertriglyceridemia ; lifestyle

Background: The close association of lifestyle with the pathogenesis of chronic diseases has been established since early times. Lifestyle medicine provides an evidence-based solution to the Non-communicable disease epidemic. However, physicians do not receive adequate training on lifestyle counseling and intervention in both undergraduate education and graduate medical training. Objective: The aim of this study was to examine whether knowledge and attitude regarding lifestyle medicine and the Physicians’ personal lifestyle practices will determine the presence or absence of lifestyle counseling in their medical practice. Methods: An online survey questionnaire was formed and spread through the internet. The questionnaire consisted of four parts- demographics, physicians’ personal lifestyle practices, their attitudes, and knowledge about Lifestyle Medicine. Ethical approval was granted. Results: Out of 188 respondents, 81.4% were females with mean age ranging between 40-49 years. 49 (26.1%) were residents, 84 (44.7%) were Fellows and the remaining participants were Diplomates. 71.3% and 48.4% of respondents said that they include animal and plant food in their diet. The results regarding attitude and knowledge of the doctors of Lifestyle Medicine were mostly insignificant. Conclusion The study doesn’t only provide information about the knowledge gap and lack of counseling skills but also highlights the urgent need for lifestyle medicine education programs for the new trainees as well as practicing physicians.
lifestyle ; continuing education ; nutrition ; medical education