Content uploaded by Eric M Matheson
Author content
All content in this area was uploaded by Eric M Matheson on Jan 27, 2016
Content may be subject to copyright.
A preview of the PDF is not available
Healthy Lifestyle Habits and Mortality in Overweight and Obese Individuals
Abstract and Figures
Though the benefits of healthy lifestyle choices are well-established among the general population, less is known about how developing and adhering to healthy lifestyle habits benefits obese versus normal weight or overweight individuals. The purpose of this study was to determine the association between healthy lifestyle habits (eating 5 or more fruits and vegetables daily, exercising regularly, consuming alcohol in moderation, and not smoking) and mortality in a large, population-based sample stratified by body mass index (BMI).
We examined the association between healthy lifestyle habits and mortality in a sample of 11,761 men and women from the National Health and Nutrition Examination Survey III; subjects were ages 21 and older and fell at various points along the BMI scale, from normal weight to obese. Subjects were enrolled between October 1988 and October 1994 and were followed for an average of 170 months.
After multivariable adjustment for age, sex, race, education, and marital status, the hazard ratios (95% CIs) for all-cause mortality for individuals who adhered to 0, 1, 2, or 3 healthy habits were 3.27 (2.36-4.54), 2.59 (2.06-3.25), 1.74 (1.51-2.02), and 1.29 (1.09-1.53), respectively, relative to individuals who adhered to all 4 healthy habits. When stratified into normal weight, overweight, and obese groups, all groups benefited from the adoption of healthy habits, with the greatest benefit seen within the obese group.
Healthy lifestyle habits are associated with a significant decrease in mortality regardless of baseline body mass index.
Figures - uploaded by Eric M Matheson
Author content
All figure content in this area was uploaded by Eric M Matheson
Content may be subject to copyright.
... Fiona et al. examined dietary and lifestyle habits among shift workers, uncovering correlated health risks 11 .Specific lifestyle practices linked to reduced Alzheimer's disease risk 12 . Eric et al. demonstrated the mortality-reducing effects of healthy lifestyle habits among overweight and obese individuals 13 . The significance of physical activity in curbing mortality and noncommunicable diseases was substantiated by Marcel Ballin and Peter 14 . ...
... The intricate interplay between lifestyle choices and health outcomes underscores the importance of mindful consideration 4,7 . Embracing a health-driven lifestyle considerably diminishes the propensity for life-threatening ailments and premature mortality 13 . In contrast, unhealthy lifestyles are entwined with metabolic disorders, musculoskeletal issues, cardiovascular diseases, hypertension, obesity, and even violence. ...
This study aims to compare the lifestyles of two groups of individuals in Dhaka City: the sedentary group, consisting of non-participants in gymnastics, and the control group, comprising active participants in gymnastics. The motivation behind this comparison lies in the elevated risk of non-communicable diseases (NCDs) linked to an unhealthy lifestyle. The research involved 384 participants, divided evenly between the two groups, aged 20 to 50 and all residents of Dhaka City. The findings revealed that among those who refrained from exercise, 48% were categorized as normal weight, 20% were underweight, and 32% were overweight. Conversely, among those engaging in gym activities, approximately 78% maintained normal weight, and notably, none were classified as underweight with a BMI below 18.5. Within the gym- engaged group, a significant majority (84%) did not display signs of depression. Furthermore, 82% demonstrated adeptness in decision-making, and 90% reported freedom from anxiety. These favorableoutcomes were attributed to consistent physical activity and healthy habits. In contrast, participants not adopting a healthy lifestyle exhibited different outcomes. Around 48% of this group experienced depressive symptoms due to irregular and unhealthy practices. Moreover, 54% encountered difficulties in decision- making fluency, and 36% reported experiencing anxiety. These issues were likely due to inadequate physical activity and poor dietary choices. This study underscores the importance of motivating individualsto maintain regular exercise routines and adopt nutritious dietary habits. Such strategies are pivotal in promoting overall health and mitigating the risk factors associated with lifestyle-related diseases.
... Fiona et al. examined dietary and lifestyle habits among shift workers, uncovering correlated health risks 11 .Specific lifestyle practices linked to reduced Alzheimer's disease risk 12 . Eric et al. demonstrated the mortality-reducing effects of healthy lifestyle habits among overweight and obese individuals 13 . The significance of physical activity in curbing mortality and noncommunicable diseases was substantiated by Marcel Ballin and Peter 14 . ...
... The intricate interplay between lifestyle choices and health outcomes underscores the importance of mindful consideration 4,7 . Embracing a health-driven lifestyle considerably diminishes the propensity for life-threatening ailments and premature mortality 13 . In contrast, unhealthy lifestyles are entwined with metabolic disorders, musculoskeletal issues, cardiovascular diseases, hypertension, obesity, and even violence. ...
This study aims to compare the lifestyles of two groups of individuals in Dhaka City: the sedentary group, consisting of non-participants in gymnastics, and the control group, comprising active participants in gymnastics. The motivation behind this comparison lies in the elevated risk of non-communicable diseases (NCDs) linked to an unhealthy lifestyle. The research involved 384 participants, divided evenly between the two groups, aged 20 to 50 and all residents of Dhaka City. The findings revealed that among those who refrained from exercise, 48% were categorized as normal weight, 20% were underweight, and 32% were overweight. Conversely, among those engaging in gym activities, approximately 78% maintained normal weight, and notably, none were classified as underweight with a BMI below 18.5. Within the gym- engaged group, a significant majority (84%) did not display signs of depression. Furthermore, 82% demonstrated adeptness in decision-making, and 90% reported freedom from anxiety. These favorableoutcomes were attributed to consistent physical activity and healthy habits. In contrast, participants not adopting a healthy lifestyle exhibited different outcomes. Around 48% of this group experienced depressive symptoms due to irregular and unhealthy practices. Moreover, 54% encountered difficulties in decision- making fluency, and 36% reported experiencing anxiety. These issues were likely due to inadequate physical activity and poor dietary choices. This study underscores the importance of motivating individualsto maintain regular exercise routines and adopt nutritious dietary habits. Such strategies are pivotal in promoting overall health and mitigating the risk factors associated with lifestyle-related diseases.
... In line with previous research [46], we found that pre-obese and obese individuals were less likely to have a healthy lifestyle compared to individuals with physiological BMI. While healthy living is usually discussed in terms of obesity prevention, maintaining a healthy diet, exercising regularly, and refraining from alcohol and smoking are associated with improved health outcomes for obese individuals, including a decreased risk of cardiovascular disease, kidney failure, gout, sleep disorders, and mood disorders [47,48]. Thus, there is a need for a broader discussion of the barriers to a healthier lifestyle for overweight and obese individuals in Bulgaria. ...
(1) Background: Non-communicable diseases (NCDs) are a global health issue causing millions of deaths annually. Bulgaria has one of the highest rates of premature mortality due to NCDs in the European Union, mostly attributed to poor lifestyle habits. While adopting a healthy lifestyle is beneficial to preventing NCDs and managing existing conditions, research on health-promoting behaviors among individuals with NCDs remains limited. (2) Methods: This study investigates lifestyle disparities between individuals diagnosed with common NCDs and healthy individuals, and the sociodemographic determinants of healthy lifestyles among a nationally representative sample of 2017 adult Bulgarian citizens. We analyzed sociodemographic characteristics, health status (weight, height, existing diagnoses—diabetes, cardiovascular disease, insulin resistance, hypertension, and depression), and lifestyle data. (3) Results: Only 18.8% of the participants maintained a healthy lifestyle and 65% had a moderately healthy lifestyle. Over one-third of the respondents were pre-obese, and many reported having at least one chronic condition. Multinomial logistic regression revealed individuals with chronic conditions were less likely to have healthy or moderately healthy lifestyles compared to healthy participants, except those diagnosed with cardiovascular disease or depression, who were more likely to maintain healthy habits. (4) Conclusions: Considering the discovered discrepancies in lifestyle quality, more research should be directed toward identifying the barriers to healthy living for individuals diagnosed with NCDs.
... Among a general population cohort in Ireland, clusters of healthy lifestyle behavior patterns including smoking and alcohol avoidance, achievement of physical activity guidelines, and strong adherence to the Dietary Approaches to Stop Hypertension dietary pattern reported the highest levels of energy vitality, lowest levels of psychological stress, and the highest self-rated quality of life [24]. Within a United States-based prospective cohort analysis, all-cause mortality risk was over three times higher in those who adhered to 0 health behavior guidelines (i.e., smoking, alcohol, physical activity, and fruit and vegetable intake) compared with those who achieved all four guidelines [37]. Interestingly, in the present study, we also included sleep, and those who achieved all five health behavior guidelines had an approximate 1.75 times greater average mental health score compared with those who achieved no guidelines. ...
Background
Lifestyle behaviors including physical activity, sleep, nutrition, smoking, and alcohol consumption are independently associated with health, yet the relationship between these behaviors and mental health has not been explored among airline pilots. The aim of this study was to measure the association between health behaviors and mental health.
Methods
A cross‐sectional study was conducted among 502 airline pilots. The primary outcome measure was the mental component score (MCS), derived from the Short Form Health Survey 12v2. We collected information regarding age, sex, ethnicity, height, body mass, alcohol consumption, tobacco smoking status, moderate‐to‐vigorous physical activity (MVPA), fruit and vegetable intake, and sleep duration.
Results
After controlling for demographic and anthropometric parameters, MVPA, fruit and vegetable intake, and sleep duration were positively correlated with MCS (p ≤ 0.001), and alcohol consumption and tobacco smoking were negatively correlated with MCS (p ≤ 0.001). Multiple linear regression analyses revealed alcohol consumption was the strongest predictor of MCS (β = −0.308, p ≤ 0.001), followed by smoking (β = −0.236, p ≤ 0.001), MVPA (β = 0.233, p ≤ 0.001), sleep (β = 0.148, p ≤ 0.001), and fruit and vegetable intake (β = 0.097, p = 0.003).
Conclusion
The results suggest that greater physical activity, sleep duration, and fruit and vegetable intake are associated with better mental health. Meanwhile, excessive alcohol consumption and tobacco smoking undermine mental health status.
... These behaviors are critical for reducing morbidity and mortality, particularly in individuals with obesity. Matheson, King, and Everett [14] demonstrated that adopting healthy behaviors significantly reduces mortality risk, underscoring the importance of lifestyle modifications for extending lifespan and mitigating health risks. This connects to the present study's focus on how emotional food cravings disrupt otherwise healthy lifestyle choices, potentially exacerbating unhealthy dieting behaviors. ...
Background/Objectives: This study investigates the relationship between food attitudes and the management of eating behavior from a psycho-nutritional perspective, with a focus on the Health Belief Model (HBM). The objective was to explore how emotional food cravings influence different aspects of eating behavior and dietary attitudes, and to identify indirect pathways through which these cravings affect attitudes toward dieting behaviors. Methods: Data were collected from 659 participants using validated scales that assessed dieting tendencies, bulimia and food preoccupation, culinary behaviors, food preoccupation, expectations of positive outcomes, and emotional food cravings. Descriptive statistics, Pearson’s correlations, and network analysis were employed to uncover significant associations among these variables. A sequential mediation analysis was conducted using SPSS PROCESS Macro Model 6 to identify indirect pathways. Results: The analysis revealed significant associations among the variables. Emotional food craving had a negative indirect effect on dieting attitudes through bulimia tendencies (effect size: −0.523) and a positive indirect effect through food preoccupation (effect size: 0.1006). These results highlight the complex interplay between emotional food cravings, bulimia tendencies, and food preoccupation in shaping dieting attitudes. Conclusions: The findings emphasize the complex dynamic between emotional food cravings, bulimia tendencies, and food preoccupation, and their collective impact on dieting attitudes. This study provides insights into potential intervention strategies aimed at improving eating habits by addressing emotional food cravings and their indirect effects on dietary behavior.
... Despite massive advancements in antidiabetics over the past decade, achieving desirable HbA1c levels remains challenging [4]. While adherence to antidiabetic medications is the cornerstone of present-day diabetes treatment, adherence to diet and physical activity interventions is essential in diabetes management due to the documented effects on HbA1c and BMI [8][9][10][11][12][13][14][15][16][17] as well as the health benefits beyond HbA1c reduction and weight loss [18,19]. Still, several studies have documented that adherence to these treatment initiatives can be challenging [17,[20][21][22]. ...
There is a growing focus on person-centered care, emphasizing the importance of respecting inter-individual differences and implementing individualized treatment initiatives. Prior research has established an association between personality traits, body mass index, and health-related behaviors. The aim of this study was to explore the potential of personality trait assessments in identifying individuals at risk of glycemic dysregulation and increasing BMI. This cross-sectional study used a dataset comprising 140 participants with diabetes who completed the Big Five personality trait questionnaire from the Lolland-Falster Health Study. Logistic regression was used to investigate associations between personality traits, glycemic control, and BMI ≥ 25. No significant associations between personality traits and glycemic control were found. There was a significant association between agreeableness and lower odds of BMI ≥ 25 in the unadjusted analysis (OR 0.54 (0.34–0.86)), which persisted after adjusting for sex, age, and education (OR 0.54 (0.33–0.89)). No significant association between glycemic control and personality traits was observed in this small sample study. However, higher levels of agreeableness were associated with a lower likelihood of having a BMI of ≥25. This preliminary study suggests that integrating personality assessments could help identify individuals at risk of increasing BMI. These findings highlight the potential of using personality traits to guide targeted interventions, offering a direction for future research.
... Additionally, other studies that focused on lifestyle changes to this population were able to improve their biological parameters, physical function, body image, and depressive symptoms. Moreover, these interventions were able to improve these participants' anthropometric parameters, emotional eating, and promote healthy eating habits (Galani and Schneider, 2005;Matheson et al., 2012;Carels, 2014;Ulian et al., 2018). These results indicate that bariatric surgery and losing weight are not the only possibilities to overcome body-related limitations. ...
The literature suggests that obesity mirrors some aspects of aging, but little is known whether body weight can contribute to one’s self-perception of aging. We aimed to qualitatively understand the self-perception of aging of adult and older adult women who underwent bariatric surgery, both at the present time and at the time of the procedure. We conducted individual, semi-structured interviews with 15 adult and 15 older adult women. Data were analyzed identifying the regular, expressive, and meaningful significance units collected through the interviews. Three major aspects influenced the participants’ aging perceptions: 1) The process of undergoing bariatric surgery; 2) the way they presented themselves and acted in the world (feeling a sense of independence, capacity, youthfulness, and having a certain attitude) and 3) their excessive weight before the bariatric surgery. Ageism and weight stigma were intricated in our participants’ experiences, leading them to wish distance from negative labels about aging and fatness. It is high time that the public sphere proposes public politics to the population with obesity that is algo getting older. Thus, our data can help policymakers to consider interactions between age and obesity.
... This pattern suggests a nonlinear association between BMI and mortality risk, in which risk is elevated primarily at the lower and higher ends of the BMI distribution. Moreover, Matheson et al 16 found that positive health behaviors are more strongly related to mortality rates than BMI. Clearly, BMI and weight are imprecise indicators of health, and a system built on these variables can be explicitly harmful by stigmatizing patients with higher weight, subsequently leading to poorer health outcomes for these individuals. ...
Increasing rates of overweight and obesity in the United States have resulted in increasing calls for weight loss. However, weight cycling—repeated weight gain after attempts at weight loss—has been associated with an increased risk of obesity, cardiovascular disease, type 2 diabetes, and all-cause mortality. Clinicians should be aware of the risks associated with weight cycling when recommending weight loss. Lifestyle modifications can reduce risks associated with obesity and are more readily measured.
Des milliers d’articles scientifiques sur la nutrition sont publiés chaque
année et les professionnels de la santé ont peine à suivre devant ce raz-
de-marée d’information. Mais qui dit publication scientifique ne dit pas
systématiquement information de qualité. Il est donc essentiel pour les diététistes-
nutritionnistes d’être en mesure de juger globalement et rapidement de la qualité
des publications consultées. Cet article présente certains repères à considérer pour
reconnaître une étude de qualité en nutrition.
A systematic review and meta-analysis was conducted to evaluate evidence-based strategies for increasing the delivery of smoking cessation treatments in primary care clinics.
The review included studies published before January 1, 2009. The pooled odds-ratio (OR) was calculated for intervention group versus control group for practitioner performance for "5As" (Ask, Advise, Assess, Assist and Arrange) delivery and smoking abstinence. Multi-component interventions were defined as interventions which combined two or more intervention strategies.
Thirty-seven trials met eligibility criteria. Evidence from multiple large-scale trials was found to support the efficacy of multi-component interventions in increasing "5As" delivery. The pooled OR for multi-component interventions compared to control was 1.79 [95% CI 1.6-2.1] for "ask", 1.6 [95% CI 1.4-1.8] for "advice", 9.3 [95% CI 6.8-12.8] for "assist" (quit date) and 3.5 [95% CI 2.8-4.2] for "assist" (prescribe medications). Evidence was also found to support the value of practice-level interventions in increasing 5As delivery. Adjunct counseling [OR 1.7; 95% CI 1.5-2.0] and multi-component interventions [OR 2.2; 95% CI 1.7-2.8] were found to significantly increase smoking abstinence.
Multi-component interventions improve smoking outcomes in primary care settings. Future trials should attempt to isolate which components of multi-component interventions are required to optimize cost-effectiveness.
Background: Exercise is widely promoted as a method of weight management, while the other health benefits are often ignored. The purpose of this study was to examine whether exercise-induced improvements in health are influenced by changes in body weight.
Methods: Fifty-eight sedentary overweight/obese men and women (BMI 31.8 (SD 4.5) kg/m2) participated in a 12-week supervised aerobic exercise intervention (70% heart rate max, five times a week, 500 kcal per session). Body composition, anthropometric parameters, aerobic capacity, blood pressure and acute psychological response to exercise were measured at weeks 0 and 12.
Results: The mean reduction in body weight was −3.3 (3.63) kg (p<0.01). However, 26 of the 58 participants failed to attain the predicted weight loss estimated from individuals’ exercise-induced energy expenditure. Their mean weight loss was only −0.9 (1.8) kg (p<0.01). Despite attaining a lower-than-predicted weight reduction, these individuals experienced significant increases in aerobic capacity (6.3 (6.0) ml/kg/min; p<0.01), and a decreased systolic (−6.00 (11.5) mm Hg; p<0.05) and diastolic blood pressure (−3.9 (5.8) mm Hg; p<0.01), waist circumference (−3.7 (2.7) cm; p<0.01) and resting heart rate (−4.8 (8.9) bpm, p<0.001). In addition, these individuals experienced an acute exercise-induced increase in positive mood.
Conclusions: These data demonstrate that significant and meaningful health benefits can be achieved even in the presence of lower-than-expected exercise-induced weight loss. A less successful reduction in body weight does not undermine the beneficial effects of aerobic exercise. From a public health perspective, exercise should be encouraged and the emphasis on weight loss reduced.
There is a general perception that almost no one succeeds in long-term maintenance of weight loss. However, research has shown that approximately 20% of overweight individuals are successful at long-term weight loss when defined as losing at least 10% of initial body weight and maintaining the loss for at least 1 y. The National Weight Control Registry provides information about the strategies used by successful weight loss maintainers to achieve and maintain long-term weight loss. National Weight Control Registry members have lost an average of 33 kg and maintained the loss for more than 5 y. To maintain their weight loss, members report engaging in high levels of physical activity ( approximately 1 h/d), eating a low-calorie, low-fat diet, eating breakfast regularly, self-monitoring weight, and maintaining a consistent eating pattern across weekdays and weekends. Moreover, weight loss maintenance may get easier over time; after individuals have successfully maintained their weight loss for 2-5 y, the chance of longer-term success greatly increases. Continued adherence to diet and exercise strategies, low levels of depression and disinhibition, and medical triggers for weight loss are also associated with long-term success. National Weight Control Registry members provide evidence that long-term weight loss maintenance is possible and help identify the specific approaches associated with long-term success.
Context The increase in sedentary lifestyle may contribute to the rise in obesity
nationally. Although guidelines suggest that physicians counsel all patients
about exercise, physicians counsel only a minority of their patients. Whether
patient factors influence physician counseling is not well established.Objectives To examine and to identify factors associated with exercise counseling
by US physicians.Design and Setting National population-based supplemental (Year 2000) survey to the 1995
National Health Interview Survey.Participants Of the 17,317 respondents to the Year 2000 supplemental survey, 9711
adults had seen a physician in the previous year, and 9299 responded when
asked about physician counseling on exercise.Main Outcome Measure Physician counseling to begin or to continue to exercise.Results Of 9299 respondents, 34% reported being counseled about exercise at
their last visit. After adjustment for other sociodemographic and clinical
factors, women were slightly more likely to be counseled, with an adjusted
odds ratio (AOR) of 1.15 (95% confidence interval [CI], 1.02-1.29). Physicians
counseled older patients (>30 years) more often than younger patients; those
aged 40 to 49 years were counseled most often (AOR, 1.71 [95% CI, 1.34-2.20]).
Patients with incomes above $50,000, those with higher levels of physical
activity, college graduates, and patients who were overweight to obese (body
mass index: 25 to ≥30 kg/m2) were more likely to be counseled,
as were patients with cardiac disease (AOR, 1.81 [95% CI, 1.52-2.14]) and
diabetes (AOR, 1.87 [95% CI, 1.46-2.38]). Counseling did not vary by physician
specialty or patient race.Conclusion The rate of physician counseling about exercise is low nationally. Physicians
appear to counsel as secondary prevention and are less likely to counsel patients
at risk for obesity. The failure to counsel younger, disease-free adults and
those from lower socioeconomic groups may represent important missed opportunities
for primary prevention.
About 97 million adults in the United States are overweight or obese. Obesity and overweight substantially increase the risk of morbidity from hypertension; dyslipidemia; type 2 diabetes; coronary heart disease; stroke; gallbladder disease; osteoarthritis; sleep apnea and respiratory problems; and endometrial, breast, prostate, and colon cancers. Higher body weights are also associated with increases in all-cause mortality. The aim of this guideline is to provide useful advice on how to achieve weight reduction and maintenance of a lower body weight. It is also important to note that prevention of further weight gain can be a goal for some patients. Obesity is a chronic disease, and both the patient and the practitioner need to understand that successful treatment requires a life-long effort. Assessment of Weight and Body Fat Two measures important for assessing overweight and total body fat content are; determining body mass index (BMI) and measuring waist circumference. 1. Body Mass Index: The BMI, which describes relative weight for height, is significantly correlated with total body fat content. The BMI should be used to assess overweight and obesity and to monitor changes in body weight. Measurements of body weight alone can be used to determine efficacy of weight loss therapy. BMI is calculated as weight (kg)/height squared (m 2). To estimate BMI using pounds and inches, use: [weight (pounds)/height (inches) 2 ] x 703. Weight classifications by BMI, selected for use in this report, are shown in the table below. • Pregnant women who, on the basis of their pre-pregnant weight, would be classified as obese may encounter certain obstetrical risks. However, the inappropriateness of weight reduction during pregnancy is well recognized (Thomas, 1995). Hence, this guideline specifically excludes pregnant women. Source (adapted from): Preventing and Managing the Global Epidemic of Obesity. Report of the World Health Organization Consultation of Obesity. WHO, Geneva, June 1997.
An abstract is unavailable. This article is available as HTML full text and PDF.