Healthy lifestyle behaviors and all-cause mortality among adults in the United States

This study examined individual-level determinants of self-reported changes in healthy (diet and physical activity) and addictive (alcohol use, smoking, and vaping) lifestyle behaviors during the initial COVID-19 lockdown period in the USA. A national online survey was administered between May and June 2020 that targeted a representative U.S. sample and yielded data from 1276 respondents, including 58% male and 50% racial/ethnic minorities. We used univariate and multivariable linear regression models to examine the associations of sociodemographic, mental health, and behavioral determinants with self-reported changes in lifestyle behaviors. Some study participants reported increases in healthy lifestyle behaviors since the pandemic (i.e., 36% increased healthy eating behaviors, and 33% increased physical activity). However, they also reported increases in addictive lifestyle behaviors including alcohol use (40%), tobacco use (41%), and vaping (46%). With regard to individual-level determinants, individuals who reported adhering to social distancing guidelines were also more likely to report increases in healthy lifestyle behaviors (β = 0.12, 95% CI 0.04 to 0.21). Conversely, women (β = −0.37, 95% CI −0.62 to −0.12), and unemployed individuals (β = −0.33, 95% CI −0.64 to −0.02) were less likely to report increases in healthy lifestyle behaviors. In addition, individuals reporting anxiety were more likely to report increases in addictive behaviors (β = 0.26, 95% CI 0.09 to 0.43). Taken together, these findings suggest that women and unemployed individuals may benefit from interventions targeting diet and physical activity, and that individuals reporting anxiety may benefit from interventions targeting smoking and alcohol cessation to address lifestyle changes during the pandemic.

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Nurse-Led Intervention Promoting Healthy Lifestyle Behaviors in a Yazidi Community

Journal of Transcultural Nursing ◽

10.1177/1043659620941580 ◽

2020 ◽

pp. 104365962094158

Author(s):

Michelle L. Johnson ◽

Tiffany Hunt ◽

Jessica P. Johnson

Keyword(s):

Cultural Sensitivity ◽

Healthy Lifestyle ◽

The United States ◽

Lifestyle Behaviors ◽

Community Members ◽

Northern Iraq ◽

Seeking Safety ◽

Age Related ◽

Healthy Lifestyle Behaviors ◽

Health Promoting

Introduction: Immigrating to a new country poses many challenges, including managing daily health care in a new environment. Yazidis experiencing long-standing ethnoreligious persecution in Northern Iraq, fled their homeland seeking safety and refuge in the United States, where approximately 10,000 Yazidi immigrants reside. Method: The researchers collaborated with Yazidi community members to design the healthy lifestyle intervention and ensure cultural sensitivity. Six weekly classes addressed healthy lifestyle behaviors. Data were collected on health promoting activities, biomarkers, and participants’ experiences with the intervention. Results: Participants reported doing slightly more health promoting activities postintervention. Age-related health promoting activities were significantly different at baseline, χ2(2) = 6.093, p = .048, but not postintervention, χ2(2) = 0.212, p = .899. Median loss in biomarkers trended toward clinically significant findings. Participants recommended more strategies to manage stress. Discussion: The pilot study provided an empowering example of nurses collaborating with community members to design a culturally sensitive intervention.

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The combined effects of healthy lifestyle behaviors on all cause mortality: A systematic review and meta-analysis

Preventive Medicine ◽

10.1016/j.ypmed.2012.06.017 ◽

2012 ◽

Vol 55 (3) ◽

pp. 163-170 ◽

Cited By ~ 266

Author(s):

Martin Loef ◽

Harald Walach

Keyword(s):

Systematic Review ◽

Healthy Lifestyle ◽

Meta Analysis ◽

Combined Effects ◽

Lifestyle Behaviors ◽

Healthy Lifestyle Behaviors ◽

All Cause Mortality

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Sex disparity in long-term stroke recurrence and mortality in a rural population in the United States

Therapeutic Advances in Neurological Disorders ◽

10.1177/1756286420971895 ◽

2020 ◽

Vol 13 ◽

pp. 175628642097189

Author(s):

Clare Lambert ◽

Durgesh Chaudhary ◽

Oluwaseyi Olulana ◽

Shima Shahjouei ◽

Venkatesh Avula ◽

...

Keyword(s):

United States ◽

Ischemic Stroke ◽

Rural Population ◽

The United States ◽

Competing Risk ◽

Stroke Recurrence ◽

Composite Outcome ◽

Stroke Patients ◽

Central Pennsylvania ◽

All Cause Mortality

Background: Several studies suggest women may be disproportionately affected by poorer stroke outcomes than men. This study aims to investigate whether women have a higher risk of all-cause mortality and recurrence after an ischemic stroke than men in a rural population in central Pennsylvania, United States. Methods: We analyzed consecutive ischemic stroke patients captured in the Geisinger NeuroScience Ischemic Stroke research database from 2004 to 2019. Kaplan–Meier (KM) estimator curves stratified by gender and age were used to plot survival probabilities and Cox Proportional Hazards Ratios were used to analyze outcomes of all-cause mortality and the composite outcome of ischemic stroke recurrence or death. Fine–Gray Competing Risk models were used for the outcome of recurrent ischemic stroke, with death as the competing risk. Two models were generated; Model 1 was adjusted by data-driven associated health factors, and Model 2 was adjusted by traditional vascular risk factors. Results: Among 8900 adult ischemic stroke patients [median age of 71.6 (interquartile range: 61.1–81.2) years and 48% women], women had a higher crude all-cause mortality. The KM curves demonstrated a 63.3% survival in women compared with a 65.7% survival in men ( p = 0.003) at 5 years; however, the survival difference was not present after controlling for covariates, including age, atrial fibrillation or flutter, myocardial infarction, diabetes mellitus, dyslipidemia, heart failure, chronic lung diseases, rheumatic disease, chronic kidney disease, neoplasm, peripheral vascular disease, past ischemic stroke, past hemorrhagic stroke, and depression. There was no adjusted or unadjusted sex difference in terms of recurrent ischemic stroke or composite outcome. Conclusion: Sex was not an independent risk factor for all-cause mortality and ischemic stroke recurrence in the rural population in central Pennsylvania.

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Workplace Healthy Lifestyle Determinants and Wellbeing Needs across the Preconception and Pregnancy Periods: A Qualitative Study Informed by the COM-B Model

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084154 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4154

Author(s):

Seonad K. Madden ◽

Claire A. Blewitt ◽

Kiran D. K. Ahuja ◽

Helen Skouteris ◽

Cate M. Bailey ◽

...

Keyword(s):

Healthy Lifestyle ◽

Intervention Development ◽

Health Behavior Change ◽

Overweight And Obesity ◽

Specific Reference ◽

Lifestyle Behaviors ◽

Policy Makers ◽

Health And Wellbeing ◽

Healthy Lifestyle Behaviors ◽

And Control

Overweight and obesity present health risks for mothers and their children. Reaching women during the key life stages of preconception and pregnancy in community settings, such as workplaces, is an ideal opportunity to enable health behavior change. We conducted five focus groups with 25 women aged between 25 and 62 years in order to investigate the determinants of healthy lifestyle behaviors, weight management, and wellbeing needs during the preconception and pregnancy periods in an Australian university workplace. Discussions explored women’s health and wellbeing needs with specific reference to workplace impact. An abductive analytical approach incorporated the capability, opportunity, and motivation of behavior (COM-B) model, and four themes were identified: hierarchy of needs and values, social interactions, a support scaffold, and control. Findings highlight the requirement for greater organization-level support, including top-down coordination of wellbeing opportunities and facilitation of education and support for preconception healthy lifestyle behaviors in the workplace. Interventionists and organizational policy makers could incorporate these higher-level changes into workplace processes and intervention development, which may increase intervention capacity for success.

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Dietary patterns related to total mortality and cancer mortality in the United States

Cancer Causes & Control ◽

10.1007/s10552-021-01478-2 ◽

2021 ◽

Author(s):

Marcela R. Entwistle ◽

Donald Schweizer ◽

Ricardo Cisneros

Keyword(s):

United States ◽

Dietary Patterns ◽

Cancer Mortality ◽

Cox Regression ◽

Total Mortality ◽

Principal Component ◽

The United States ◽

Red Meat ◽

Increased Risk ◽

All Cause Mortality

Abstract Purpose This study investigated the association between dietary patterns, total mortality, and cancer mortality in the United States. Methods We identified the four major dietary patterns at baseline from 13,466 participants of the NHANES III cohort using principal component analysis (PCA). Dietary patterns were categorized into ‘prudent’ (fruits and vegetables), ‘western’ (red meat, sweets, pastries, oils), ‘traditional’ (red meat, legumes, potatoes, bread), and ‘fish and alcohol’. We estimated hazard ratios for total mortality, and cancer mortality using Cox regression models. Results A total of 4,963 deaths were documented after a mean follow-up of 19.59 years. Higher adherence to the ‘prudent’ pattern was associated with the lowest risk of total mortality (5th vs. 1st quintile HR 0.90, 95% CI 0.82–0.98), with evidence that all-cause mortality decreased as consumption of the pattern increased. No evidence was found that the ‘prudent’ pattern reduced cancer mortality. The ‘western’ and the ‘traditional’ patterns were associated with up to 22% and 16% increased risk for total mortality (5th vs. 1st quintile HR 1.22, 95% CI 1.11–1.34; and 5th vs. 1st quintile HR 1.16, 95% CI 1.06–1.27, respectively), and up to 33% and 15% increased risk for cancer mortality (5th vs. 1st quintile HR 1.33, 95% CI 1.10–1.62; and 5th vs. 1st quintile HR 1.15, 95% CI 1.06–1.24, respectively). The associations between adherence to the ‘fish and alcohol’ pattern and total mortality, and cancer mortality were not statistically significant. Conclusion Higher adherence to the ‘prudent’ diet decreased the risk of all-cause mortality but did not affect cancer mortality. Greater adherence to the ‘western’ and ‘traditional’ diet increased the risk of total mortality and mortality due to cancer.

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