Adherence to Healthy Lifestyle Habits in US Adults, 1988-2006
ABSTRACT Lifestyle choices are associated with cardiovascular disease and mortality. The purpose of this study was to compare adherence to healthy lifestyle habits in adults between 1988 and 2006.
Analysis of adherence to 5 healthy lifestyle trends (>or=5 fruits and vegetables/day, regular exercise >12 times/month, maintaining healthy weight [body mass index 18.5-29.9 kg/m(2)], moderate alcohol consumption [up to 1 drink/day for women, 2/day for men] and not smoking) in the National Health and Nutrition Examination Survey 1988-1994 were compared with results from the National Health and Nutrition Examination Survey 2001-2006 among adults aged 40-74 years.
Over the last 18 years, the percent of adults aged 40-74 years with a body mass index >or=30 kg/m(2) has increased from 28% to 36% (P <.05); physical activity 12 times a month or more has decreased from 53% to 43% (P <.05); smoking rates have not changed (26.9% to 26.1%); eating 5 or more fruits and vegetables a day has decreased from 42% to 26% (P <.05), and moderate alcohol use has increased from 40% to 51% (P <.05). Adherence to all 5 healthy habits has gone from 15% to 8% (P <.05). Although adherence to a healthy lifestyle was lower among minorities, adherence decreased more among non-Hispanic Whites over the period. Individuals with a history of hypertension/diabetes/cardiovascular disease were no more likely to be adherent to a healthy lifestyle than people without these conditions.
Generally, adherence to a healthy lifestyle pattern has decreased during the last 18 years, with decreases documented in 3 of 5 healthy lifestyle habits. These findings have broad implications for the future risk of cardiovascular disease in adults.
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ABSTRACT: The 40-Something RCT aimed to determine if a 12-month health professional-led intervention could modify diet and physical activity behaviour for obesity prevention, in 44-50 year old, non-obese (BMI=18.5-29.9kg/m(2)) premenopausal women. Women were monitored for an additional 12 months to determine if effects could be maintained. This paper aimed to explore dietary and physical activity behavioural mediators hypothesized to be causally associated with weight change. Fifty-four women were randomised to a Motivational Interviewing Intervention (MI) (n=28; five health professional consultations) or a Self-Directed Intervention (n=26; written advice). Compliance to 10 study recommendations was measured at three months by a four-day weighed food and physical activity record including pedometer-measured step counts, self-reported exercise minutes and sitting time. The 10 compliance scores were independently assessed in mediation models for 12- and 24-month weight change. The MI effect on step count was an increase of 0.99 points on the 10-point compliance scale (p≤0.01). This MI effect on step count significantly mediated the 12 and 24 month effect on weight (12 months AB=-0.74, 95%CI=-1.95, -0.14; 24 months AB=-1.06, 95%CI=-2.56, -0.36), accounting for 37.23% and 53.79% of the effect, respectively. The MI effect on vegetable serves was an increase of 1.50 points on the compliance scale (p=0.02). The MI effect on vegetable compliance significantly mediated the effect on weight at 24 months (AB=-0.54, 95%CI=-1.50, -0.04), accounting for 24.92% of the effect. The remaining eight dietary and physical activity compliance scores did not significantly mediate weight loss. Encouraging women to take 10,000 steps and eat five vegetable serves per day may be a promising strategy to achieve long-term weight control at mid-life.Appetite 07/2014; DOI:10.1016/j.appet.2014.07.020 · 2.52 Impact Factor
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ABSTRACT: Background Insight into the effects of ethnic disparities on patients' perioperative safety is necessary for the development of tailored improvement strategies. The aim of this study was to review the literature on safety differences between patients from minority ethnic groups and those from the ethnic majority undergoing surgery.Methods PubMed, CINAHL, the Cochrane Library and Embase were searched using predefined inclusion criteria for available studies from January 1990 to January 2013. After quality assessment, the study data were organized on the basis of outcome, statistical significance and the direction of the observed effects. Relative risks for mortality were calculated.ResultsAfter screening 3105 studies, 26 studies were identified. Nine of these 26 studies showed statistically significant higher mortality rates for patients from minority ethnic groups. Meta-analysis demonstrated a greater risk of mortality for these patients compared with patients from the Caucasian majority in studies performed both in North America (risk ratio 1·22, 95 per cent confidence interval 1·05 to 1·42) and outside (risk ratio 2·25, 1·40 to 3·62). For patients from minority groups, the length of hospital or intensive care unit stay was significantly longer in five studies, and complication rates were significantly higher in ten. Methods used to identify patient ethnicity were not described in 14 studies.Conclusion Patients from minority ethnic groups, in North America and elsewhere, have an increased risk of perioperative death and complications. More insight is needed into the causes of ethnic disparities to pursue safer perioperative care for patients of minority ethnicity.British Journal of Surgery 08/2014; 101(11). DOI:10.1002/bjs.9609 · 4.84 Impact Factor
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ABSTRACT: OBJECTIVE: The aim of this study was to evaluate the adherence to a physical activity (PA) in an annual inter-ventional programme of domiciliary rehabilitation designed for patients with coronary artery disease. METHODS: The fi nal group consisted of 20 patients (4 women and 16 men) from the 1st Internal Department – University Hospital of Olomouc. The mean age of patients was 61.95 ± 11.02 years. They were split into three groups in accordance with the method of monitoring PA. Group 1 (G1) used a pedometer, group 2 (G2) used a heart rate monitor and group 3 (G3) used both types of equipment simultaneously. Patients recorded the number of steps, the duration of the exercise (G1 and G3) or the average heart rate (G2 and G3), entering this information into the archive system. The checking of monitored indicators took place after 3, 6 and 12 months. RESULTS: The adherence to the programme varied a lot (60–360 days). The results showed that the lowest one was in the case of patients from G1 and the highest one was in the third group of patients. Only 2 patients from group G3 managed to fi nish the programme (10% of the total number). We found no statistically signifi cant diff erence between the groups in any of the quality indicators of a physical activity (number of steps, duration of the exercise, estimate of the weekly caloric output and total caloric output during exercise). CONCLUSIONS: Using a pedometer has seemed to be an easy way to monitor the amount of a physical activity. Low adherence to the programme results from a fi xation on a sedentary lifestyle, as well as from psychological and social causes.