The power of a healthy lifestyle for cancer prevention:the example of colorectal cancer

Objective:We aimed to directly compare the estimated effects of adherence to a healthy lifestyle with those of risk predisposition according to known genetic variants affecting colorectal cancer(CRC)risk,to support effective risk communication for cancer prevention.Methods:A healthy lifestyle score(HLS)was derived from 5 lifestyle factors:smoking,alcohol consumption,diet,physical activity,and body adiposity.The association of lifestyle and polygenic risk score(PRS)(based on 140 CRC-associated risk loci)with CRC risk was assessed with multiple logistic regression and compared through the genetic risk equivalent(GRE),a novel approach providing an estimate of the effects of adherence to a healthy lifestyle in terms of percentile differences in PRS.Results:A higher HLS was associated with lower CRC risk(4,844 cases,3,964 controls).Those adhering to all 5 healthy lifestyle factors had a 62%(95%CI 54%-68%)lower CRC risk than those adhering to≤2 healthy lifestyle factors.The estimated effect of adherence to all 5 compared with≤2 healthy lifestyle factors was as strong as the effect of having a 79 percentile(GRE 79,95%CI 61-97)lower PRS.The association between a healthy lifestyle and CRC risk was independent of PRS level but was particularly pronounced among those with a family history of CRC in≥1 first-degree relative(P-interaction=0.0013).Conclusions:A healthy lifestyle was strongly inversely associated with CRC risk.The large GRE indicated that CRC risk determined by polygenic risk may be offset to a substantial extent by adherence to a healthy lifestyle.

Environments favorable to healthy lifestyles:A systematic review of initiatives in Canada

Background: In recent years, a number of initiatives aimed at promoting healthy lifestyles in health-friendly environments have been implemented.The purpose of this review is to synthesize initiatives conducted in Canada and documented in publications for the period 1995–2015 in order to gain a better understanding of their objectives and impacts.Methods: A systematic review of Canadian initiatives published over the past 20 years was conducted from multiple databases(i.e., Scopus,SPORTDiscus, Pub Med, Academic search complete, Reseausante.com, Cairn, and Erudit). In total, 264 publications were identified and retained for the final analysis based on 5 criteria:(1) publication between 1995 and 2015,(2) online availability,(3) research conducted in Canada,(4) main topic related to environments favorable to healthy lifestyles(EFHL), and(5) publication in French or English.Results: A sharp increase in the number of studies on EFHL was observed between 2010 and 2015(57%). Two major lifestyle components—physical activity and nutrition—and 2 environmental aspects—neighborhood and built environment—were the elements most frequently examined regarding adults(48%), young people(34%), and seniors(9%), using quantitative(60%) and qualitative(18%) methods. Furthermore, the analysis reveals a greater focus on the municipal(53%) than the national or provincial levels(31%).Conclusion: This work is a first map of Canadian studies related to EFHL. It clarifies the definition of EFHL and classifies its components. As well,it documents the issues raised, the research methods employed, and the role of stakeholders, while outlining a new research agenda that includes dimensions of EFHL formerly neglected by researchers, namely, political and sociocultural spheres of action.? 2018 Production and hosting by Elsevier B.V. on behalf of Shanghai University of Sport. This is an open access article under the CC BY-NC-ND license(http://creativecommons.org/licenses/by-nc-nd/4.0/).

Using Individual, ApoE Genotype-Based Dietary and Physical Activity Advice to Promote Healthy Lifestyles in Finland—Impacts on Cardiovascular Risk Markers

Aim: There is increasing demand for individualized health advice. The aim of this study was to assess the effects on cardiovascular risk markers of receiving personal genetic health information, using apoE genotypes as a tool for promoting lifestyle changes. ApoE was chosen because it had a significant impact on lipid metabolism and cholesterol absorption, all factors for CVD. Methods: This study was a one-year explanatory intervention study for healthy adults, aged between 20 - 67 years old (n = 106). Their clinical markers (serum lipids, blood glucose, blood pressure, Body Mass Index, body fat percentage and waist circumference) were measured three times during the intervention. The clinical effects were assessed for three groups: a high risk group (ε 4+, n = 16);a low-risk group (&#949?4-, n = 35);and a control group (n = 55). Results: The triglyceride values and waist circumference lowered more in &#949?4+ compared with the control group (p < 0.05;alpha value 0.005) during the intervention. Conclusion: The personal genetic information, based on apoE, may have positive effects on cardiovascular risk markers (e.g., improvement in triglyceride values). The individual health information, based on genotyping could be a potential option in the prevention of CVD. More research is required on how to utilize genotype-based health information in the prevention of lifestyle-related diseases.

Healthy lifestyle for people with intellectual disabilities through a health intervention program

There are well known gaps related to health care service and public health interventions for people with Intellectual Disabilities (ID), but there is still lack of research information of what nurses can do to reducing health disparities of persons with ID. The present study aimed at exploring the views of people with ID about a healthy lifestyle, exercise, and to take part in a health promotion program. A qualitative method was an appropriate method for capturing the informants’ points of view. Participants were adults with intellectual disability who would be able to give their consent verbally and in written form. Women (n = 7) and men (n = 6). Data were collected from focus group interviews and analysed according to a qualitative content analysis of the tape-recorded and verbatim transcribed interviews. The participants took part in four workshops about healthy food, and ten physical activities addressing the connection to physical, social and emotional health. The results of the focus group interviews show that participants have knowledge about the importance of a healthy lifestyle for good health including physical activity and healthy food. Participants also describe social interaction and self-determination as important aspects in their life. It could then be concluded that the health promotion program result point at consciousness about a healthy lifestyle. There is still lack of research information of what public health nurses can do to reducing health disparities of persons with ID. Public health nurses work in community-based services and therefore they also might support persons with ID through health intervention programs.

Associations between parental adherence to healthy lifestyles and cognitive performance in offspring:A prospective cohort study in China

Background:Previous studies have reported associations of specific maternal and paternal lifestyle factors with offspring’s cognitive development during early childhood.This study aimed to investigate the prospective associations between overall parental lifestyle and offspring’s cognitive performance during adolescence and young adulthood in China.Methods:We included 2531 adolescents aged 10-15 years at baseline in 2010 from the China Family Panel Studies.A healthy parental lifestyle score(ranged 0-5)was constructed based on the following five modifiable lifestyle factors:Smoking,drinking,exercise,sleep,and diet.Generalized estimating equation models were used to examine the association between baseline parental healthy lifestyle scores and offspring’s fluid and crystallized intelligence in subsequent years(2012,2014,2016,and 2018).Results:Offspring in the top tertile of parental healthy lifestyle scores performed better in overall fluid intelligence(multivariable-adjusted β=0.53,95%confidence interval[CI]:0.29-0.77)and overall crystallized intelligence(multivariable-adjusted β=0.35,95%CI:0.16-0.54)than those in the bottom tertile of parental healthy lifestyle scores.The results were similar after further adjustment for the offspring’s healthy lifestyle scores and persisted across the subgroups of parental socioeconomic status.Additionally,maternal and paternal healthy lifestyle scores were independently associated with better offspring’s cognitive performance,with significant contribution observed for paternal never-smoking,weekly exercise,and diversified diet.When both parents and offspring adhered to a healthier lifestyle,we observed the highest level of the offspring’s overall crystallized intelligence.Conclusions:Our study indicates that parental adherence to a healthier lifestyle is associated with significantly better offspring’s cognitive performance during adolescence and early adulthood,regardless of socioeconomic status.These findings highlight the potential cognitive benefits of promoting healthy lifestyles among parents of adolescents.

Genetic and healthy lifestyle factors in relation to the incidence and prognosis of severe liver disease in the Chinese population

Background:Severe liver disease(SLD),including cirrhosis and liver cancer,constitutes a major disease burden in China.We aimed to examine the association of genetic and healthy lifestyle factors with the incidence and prognosis of SLD.Methods:The study population included 504,009 participants from the prospective China Kadoorie Biobank aged 30-79 years.The individuals were from 10 diverse areas in China without a history of cancer or liver disease at baseline.Cox regression was used to estimate adjusted hazard ratios(HRs)for incident SLD and death after SLD diagnosis associated with healthy lifestyle factors(smoking,alcohol,physical activity,and central adiposity).Additionally,the contribution of genetic risk for hepatitis B virus(HBV,assessed by genetic variants in major histocompatibility complex,class II,DP/DQ[HLA-DP/DQ]genes)was also estimated.Results:Compared with those with 0-1 healthy lifestyle factor,participants with 2,3,and 4 factors had 12%(HR 0.88[95%confidence interval[CI]0.85,0.92]),26%(HR 0.74[95%CI:0.69,0.79]),and 44%(HR 0.56[95%CI:0.48,0.65])lower risks of SLD,respectively.Inverse associations were observed among participants with both low and high genetic risks(HR per 1-point increase 0.83[95%CI:0.74,0.94]and 0.91[95%CI:0.82,1.02],respectively;P_(interaction)=0.51),although with a non-significant trend among those with a high genetic risk.Inverse associations were also observed between healthy lifestyle factors and liver biomarkers regardless of the genetic risk.Despite the limited power,healthy lifestyle factors were associated with a lower risk of death after incident SLD among participants with a low genetic risk(HR 0.59[95%CI:0.37,0.96]).Conclusions:Lifestyle modification may be beneficial in terms of lowering the risk of SLD regardless of the genetic risk.Moreover,it is also important for improving the prognosis of SLD in individuals with a low genetic risk.Future studies are warranted to examine the impact of healthy lifestyles on SLD prognosis,particularly among individuals with a high genetic risk.

The Experience and Impact of a Fitbit-Based Physical Activity and Sleep Hygiene Intervention for Older Adults Experiencing Cognitive Decline

Objectives: This study aimed to understand the experience and impact of a physical activity and sleep wrist-worn tracker (Fitbit)-based healthy lifestyle intervention for older patients attending a memory assessment service, who are experiencing cognitive impairment but do not receive a dementia diagnosis. Methods: A qualitative design was employed. Semi-structured interviews were conducted with a purposeful sample of thirteen participants recruited from a memory assessment service. Thematic analysis, that was data driven and inductive, was undertaken to analyse the data. Results: Two global themes were developed. “Understanding exercise and sleep as part of my lifestyle” was made up of themes representing how participants viewed exercise and sleep as part of their lifestyles in terms of acknowledging the positive impacts and the barriers to exercise and sleep. The second global theme “Understanding my experience of the healthy lifestyle intervention” was made up of themes that identified the positive impact of the intervention regarding improving health and wellbeing, enabling validation of proactive behaviours and motivation to engage in healthy lifestyle behaviours, so promoting positive behaviour change. Conclusion: Patients experiencing age-related cognitive impairment, applied and benefited from a healthy lifestyle Fitbit-based intervention to facilitate and promote physical activity, better sleep hygiene and healthy lifestyles.

The relationships between step count and all-cause mortality and cardiovascular events:A doseresponse meta-analysis

Background:A goal of 10,000 steps per day is widely advocated,but there is little evidence to support that goal.Our purpose was to examine the doseresponse relationships between step count and all-cause mortality and cardiovascular disease risk.Methods:Cochrane Central Register of Controlled Trials,EMBASE,OVID,PubMed,Scopus,and Web of Science databases were systematically searched for studies published before July 9,2021,that evaluated the association between daily steps and at least 1 outcome.Results:Sixteen publications(12 related to all-cause mortality,5 related to cardiovascular disease;and 1 article contained 2 outcomes:both allcause death and cardiovascular events)were eligible for inclusion in the meta-analysis.There was evidence of a nonlinear doseresponse relationship between step count and risk of all-cause mortality or cardiovascular disease(p=0.002 and p=0.014 for nonlinearity,respectively).When we restricted the analyses to accelerometer-based studies,the third quartile had a 40.36%lower risk of all-cause mortality and a 35.05%lower risk of cardiovascular event than the first quartile(all-cause mortality:Q1=4183 steps/day,Q3=8959 steps/day;cardiovascular event:Q1=3500 steps/day,Q3=9500 steps/day;respectively).Conclusion:Our meta-analysis suggests inverse associations between higher step count and risk of premature death and cardiovascular events in middle-aged and older adults,with nonlinear doseresponse patterns.

Prevalence and Risk Factors Associated with Prehypertension among Young and Middle-Aged Health Check-Up Population in Guangzhou

Objective:To provide basic information and theories for prehypertension early intervention,a systematic analysis of the epidemic status and risk factors among young and middle-aged was carried out here.Methods:This study relied on the data bank of a health check-up population of a class a tertiary general hospital in Guangdong province in 2015.Total 9540 young and middle-aged adults were enrolled,and 733 people were included to find out the effect with lifestyle in these crowd.Principal Components Analysis(PCA)of Factor(FA)was used to identify dietary patterns.The logistic regression model was used to find the risk factors of prehypertension.Results:Among 9540 young and middle-aged cases,the incidence of prehypertension was 36.6%.Moreover,the average age,proportion of male gender,overweight,FBG(fasting blood glucose),dyslipidemia,and hyperuricemia were significantly higher in the prehypertension group than in the optimal BP group.Multivariate logistic regression analysis indicated that age,total cholesterol,triglycerides,uric acid,body mass index and HR(heart rate)were risk factors,and female was a protective factor for prehypertension.Among 733 cases,the incidence of prehypertension was 35.1%.The proportion of smoking,drinking,physical workers,moderate and severe physical activity,and the intake of meat,dietary energy were significantly higher in the prehypertension group than in the optimal BP group.Dietary patterns included“meat model”,“spice model”,“main vegeTables model”and“high protein model”.Multivariate logistic regression analysis indicated that age,drinking were risk factors for prehypertension,while dietary milk intake,dietary magnesium intake were protective factors.Conclusions:Prehypertension is highly prevalent in Guangzhou.However,education about effective lifestyle modifications as an alcohol limit,increasing the intake of dairy products,and magnesium may intervene in the development of prehypertension.But how to develop targeted interventions for such groups need to be further explored.The present study would lay the theoretical foundation and basic data for the next step.

Associations of socioeconomic status with infectious diseases mediated by lifestyle, environmental pollution and chronic comorbidities: a comprehensive evaluation based on UK Biobank

Background Socioeconomic status(SES)inequity was recognized as a driver of some certain infectious diseases.However,few studies evaluated the association between SES and the burden of overall infections,and even fewer identified preventable mediators.This study aimed to assess the association between SES and overall infectious diseases burden,and the potential roles of factors including lifestyle,environmental pollution,chronic disease history.Methods We included 401,009 participants from the UK Biobank(UKB)and defined the infection status for each participant according to their diagnosis records.Latent class analysis(LCA)was used to define SES for each participant.We further defined healthy lifestyle score,environment pollution score(EPS)and four types of chronic comorbidities.We used multivariate logistic regression to test the associations between the four above covariates and infectious diseases.Then,we performed the mediation and interaction analysis to explain the relationships between SES and other variables on infectious diseases.Finally,we employed seven types of sensitivity analyses,including considering the Townsend deprivation index as an area level SES variable,repeating our main analysis for some individual or composite factors and in some subgroups,as well as in an external data from the US National Health and Nutrition Examination Survey,to verify the main results.Results In UKB,60,771(15.2%)participants were diagnosed with infectious diseases during follow-up.Lower SES[odds ratio(OR)=1.5570]were associated with higher risk of overall infections.Lifestyle score mediated 2.9%of effects from SES,which ranged from 2.9 to 4.0%in different infection subtypes,while cardiovascular disease(CVD)mediated a proportion of 6.2%with a range from 2.1 to 6.8%.In addition,SES showed significant negative interaction with lifestyle score(OR=0.8650)and a history of cancer(OR=0.9096),while a significant synergy interaction was observed between SES and EPS(OR=1.0024).In subgroup analysis,we found that males and African(AFR)with lower SES showed much higher infection risk.Results from sensitivity and validation analyses showed relative consistent with the main analysis.Conclusions Low SES is shown to be an important risk factor for infectious disease,part of which may be mediated by poor lifestyle and chronic comorbidities.Efforts to enhance health education and improve the quality of living environment may help reduce burden of infectious disease,especially for people with low SES.

Life’s Essential 8 and risk of non-communicable chronic diseases:Outcome-wide analyses

Background:Life’s Simple 7,the former construct of cardiovascular health(CVH)has been used to evaluate adverse non-communicable chronic diseases(NCDs).However,some flaws have been recognized in recent years and Life’s Essential 8 has been established.In this study,we aimed to analyze the association between CVH defined by Life’s Essential 8 and risk of 44 common NCDs and further estimate the population attributable fractions(PAFs)of low-moderate CVH scores in the 44 NCDs.Methods:In the UK Biobank,170,726 participants free of 44 common NCDs at baseline were included.The Life’s Essential 8 composite measure consists of four health behaviours(diet,physical activity,nicotine exposure,and sleep)and four health factors(body mass index,non-high density lipoprotein cholesterol,blood glucose,and blood pressure),and the maximum CVH score was 100 points.CVH score was categorized into low,moderate,and high groups.Participants were followed up for 44 NCDs diagnosis across 10 human system disorders according to the International Classification of Diseases 10th edition(ICD-10)code using linkage to national health records until 2022.Cox proportional hazard models were used in this study.The hazard ratios(HRs)and PAFs of 44 NCDs associated with CVH score were examined.Results:During the median follow-up of 10.85 years,58,889 incident NCD cases were documented.Significant linear dose-response associations were found between higher CVH score and lower risk of 25(56.8%)of 44 NCDs.Low-moderate CVH(<80 points)score accounted for the largest proportion of incident cases in diabetes(PAF:80.3%),followed by gout(59.6%),sleep disorder(55.6%),chronic liver disease(45.9%),chronic kidney disease(40.9%),ischemic heart disease(40.8%),chronic obstructive pulmonary disease(40.0%),endometrium cancer(35.8%),lung cancer(34.0%),and heart failure(34.0%)as the top 10.Among the eight modifiable factors,overweight/obesity explained the largest number of cases of incident NCDs in endocrine,nutritional,and metabolic diseases(35.4%),digestive system disorders(21.4%),mental and behavioral disorders(12.6%),and cancer(10.3%);however,the PAF of ideal sleep duration ranked first in nervous system(27.5%)and neuropsychiatric disorders(9.9%).Conclusions:Improving CVH score based on Life’s Essential 8 may lower risk of 25 common NCDs.Among CVH metrics,avoiding overweight/obesity may be especially important to prevent new cases of metabolic diseases,NCDs in digestive system,mental and behavioral disorders,and cancer.

Caloric restriction,Sirtuins,and cardiovascular diseases

Caloric restriction(CR)is a well-established dietary intervention known to extend healthy lifespan and exert positive effects on aging-related diseases,including cardiovascular conditions.Sirtuins,a family of nicotinamide adenine dinucleotide(NAD^(+))-dependent histone deacetylases,have emerged as key regulators of cellular metabolism,stress responses,and the aging process,serving as energy status sensors in response to CR.However,the mechanism through which CR regulates Sirtuin function to ameliorate cardiovascular disease remains unclear.This review not only provided an overview of recent research investigating the interplay between Sirtuins and CR,specifically focusing on their potential implications for cardiovascular health,but also provided a comprehensive summary of the benefits of CR for the cardiovascular system mediated directly via Sirtuins.CR has also been shown to have considerable impact on specific metabolic organs,leading to the production of small molecules that enter systemic circulation and subsequently regulate Sirtuin activity within the cardiovascular system.The direct and indirect effects of CR offer a potential mechanism for Sirtuin modulation and subsequent cardiovascular protection.Understanding the interplay between CR and Sirtuins will provide new insights for the development of interventions to prevent and treat cardiovascular diseases.

Cognitive function and mental health of elderly people in China: findings from 2018 CLHLS survey

This paper uses the latest data from the Chinese Longitudinal Healthy Longevity Survey(CLHLS)of 2018 to report that the cognitive function and mental health sta-tus of elderly people in China.Elderly women and the oldest-old(age over 80 years)tended to have higher risks of cognitive impairment and depressive symptoms than elderly men and younger elderly people.Respondents who continued to live at home in their communities(i.e.were not institutionalized in elderly care facilities,and were educated,married,without ADL disability and engaged in physical activities regularly appeared to have better cognitive function and mental health.Therefore,healthy lifestyles should be advocated and healthy interventions should focus more on the vulnerable elderly such as the oldest-old and women.

Joy of gardening: a hospital-based cooking and gardening program

Background Nutrition interventions aid in implementing healthy eating.Garden-enhanced nutrition intervention programs have been conducted in schools.We sought to assess feasibility of a hospital-based cooking and gardening program.Methods The cohort study implemented a 3-week integrated cooking and gardening program in the United States(Seattle,WA).We recruited participants with ages 8-15 years from ambulatory clinics.We conducted three 3-week series hospitalbased cooking and gardening program.Children and parents were given pre-and post-program(1 year)surveys.The surveys assessed child participation in food preparation and gardening,strengths and weaknesses of the program,and identified parents'opinions towards sustaining healthy behaviors.Results Eighteen children participated in the hospital-based cooking and gardening program.At l-year follow-up,78%of participants were gardening at home and 100%of participants were cooking at home.Conclusions Novel approaches to combat obesity are needed.A hospital-based cooking and gardening program is a novel intervention to consider for nutrition education.