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Oral contraceptives use and weight gain in women with a Central European life-style.

OBJECTIVES: The aim of the study was to check and present data on the relation between combined oral contraceptives (COC) use and body weight in young women living in Poland. METHODS: Observational study on the group of young women on COC and the control group of young women who never used COC. Candidates for study (145 women) and control (218 women) groups were recruited in selected gynecological clinics in Poland during the period of 1-31 January 2002 (with the use of randomization). RESULTS: Both groups (study and control) were almost identical in age, anthropometric characteristics, number of pregnancies and deliveries. On the basis of this investigation it was found that there was no relation between use of COC and weight gain. Observed (in both groups) weight gain in young women was most probably related rather to time-passing (patients were getting older). The higher risk for overweight and obesity was found in the group of young women who had already had problems with overweight in their childhood. and in the group of women with high weight gain during the first pregnancy. CONCLUSION: COC use is not associated with weight gain in young women with a Central European life-style.

Adolescent↗

Prevention-oriented life styles and diffusion of cholesterol screening and awareness: Massachusetts behavioral risk factor survey, 1987-1991.

Universal screening of the adult population for detection of elevated serum cholesterol has been recommended. We examined the relation of eight risk factors for morbidity and mortality (hypertension, overweight, inactivity, tobacco use, safety belt nonuse, binge alcohol consumption, driving after alcohol consumption, and chronic alcohol consumption) to adoption of cholesterol screening and to awareness of cholesterol level. Data were collected through the Massachusetts Behavioral Risk Factor Surveillance System between 1987 and 1991 (mean number of respondents interviewed annually, 1240). We compared trends in prevalence of cholesterol screening and awareness within risk groups defined on the basis of the presence or absence of each risk factor. Cholesterol screening prevalence increased from 46.8% in 1987 to 67.9% in 1991. Overweight and hypertensive respondents were more likely to have been screened than nonoverweight or normotensive respondents; for the other six risk factors, individuals at increased risk were less likely to have been screened. The difference in cholesterol screening prevalence between increased-risk and lower-risk respondents increased between 1987-1988 and 1990-1991 for four risk factors. Prevalence of awareness of cholesterol level increased from 7.8% in 1987 to 35.4% in 19991. Trends by risk status were comparable to those observed for cholesterol screening. Individuals already motivated toward a preventive life style appear to be those most likely to avail themselves of a new prevention possibility.

Adult↗

[Life style, family history and personal pathology in relation to arterial hypertension in students of the Medical Faculty of UNAM].

Arterial hypertension (HA) is a public health problem, 15 to 30% of adults in our country suffer it. There are different facts that influence its outcome. Among young people the main factors are: alcoholism, smoking tobacco, overweight, diabetes, family history, sedentarism and psychological aspects. The main object of this study, was to detect the risk factor for the development of HA in the students of the University. For this search 489 sophomore students class at the Medical School of the University of Mexico (UNAM), between 17 and 24 years old, were studied. Our results showed that positive family history was more prevalent among females. Among males life-style factors were more significant, the main factor was sedentarism, whereas lesser factor was overweight. The prevalence of HA was higher for diastolic hypertension than for systolic. We concluded there are many risk factors that influence the development of HA, which are distributed in a different way according to gender preventive measures are recommended.

Adolescent↗

Agricultural life-style: a mortality study among male farmers in South Carolina, 1983-1984.

After reviewing the death certificates of 2,820 South Carolina agricultural workers (including farmers, farm workers, and others in the agricultural industry) aged 35 to 84 during 1983-1984, we calculated proportional mortality ratios (PMRs). Among both white and nonwhite farmers in South Carolina, the PMR was significantly higher for cerebrovascular disease (whites, PMR = 1.20, P less than .05; nonwhites, PMR = 1.43, P less than .001) and lower for all malignant neoplasms (whites, PMR = 0.86, P less than .05; nonwhites, PMR = 0.78, P less than .001). In addition, external causes of death were elevated, attaining statistical significance for white farmers (PMR = 1.51, P less than .001). Significantly lower PMRs for all malignant neoplasms are attributed to fewer deaths from cancers related to smoking (buccal cavity and pharynx, esophagus, lung, and bladder) and colon and rectal cancers among both white and nonwhite farmers. White farmers did not show significantly elevated PMRs for cancers of the lymphatic and hematopoietic systems found in other studies in the Midwest. These data suggest that agricultural life-style can be improved for the prevention of strokes and for external causes of death.

Adult↗

Multistage tumor development in the human esophagus - the first identification of cocarcinogens of the tumor promoter type as principal carcinogenic risk factors in a local life style cancer.

An experimental analysis is described which demonstrates that the epidemiologically established high rate of esophageal cancer among blacks and creoles in Curacao most likely is the result of a multistage process involving initiators and promoters. As part of local lifestyle, the group at risk utilizes for various purposes plant parts of an indigenous bush Croton flavens L. ("Welensali"). Moreover they consume, as an everyday beverage, a "bush tea" made from the leaves of the bush. The roots, leaves and tea are shown to contain a multitude of irritant croton factors which are characterized as diterpene esters of the tigliane type. In mouse skin these exhibit strong promoting activity comparable to that of TPA. As the latter, also the croton factors isolated, show no solitary carcinogenic activity. One cup of Welensali tea contains the equivalent of about 12-times the irritant dose of croton factor F1; in addition, the equivalent of about 1.4-times the irritant dose 50 of the corresponding "cryptic" promoter F1-20-decanoate is present. These amounts are considered sufficient to maintain chronic irritation of the esophagus as an important element of co-carcinogenesis, especially of tumor promotion. Also, persons at risk in Curacao have been exposed at times previously to certain initiators. Mice treated by an initiation/promotion protocol with DMBA (or other initiators) and TPA develop tumors of the forestomach. Therefore, esophageal cancer on Curacao may be considered the first case for cocarcinogens of the tumor promoter type being principal risk factors in a life style cancer.

Animals↗

Life-style: physical activities and activities of daily living. Euronut SENECA investigators.

In 19 towns and cities across Europe, physical activity and activities of daily living were studied in 2586 elderly people born between 1913 and 1918. Data were obtained as part of a standardized questionnaire. Large variations in both levels of physical activity and activities of daily living existed among research towns and cities. Altogether, women spent more hours per day on physically active tasks than men, including more time on housework (2.6-3.9 h/day versus 0.7-2.3 h/day for men) and on leisuretime activities (2.0-4.2 h/day versus 0.9-2.3 h/day for men). According to 16 items of functioning, including both items of personal functioning and more complex tasks, functioning was rated as good in most of the elderly. In all centres good functioning was most prevalent in men, and in the younger elderly born in 1917 or 1918. In further cross-sectional analyses the relationship between physical activity, nutrition and other life-style factors, on the one hand, and anthropometry, health and performance, on the other hand, will be examined.

Activities of Daily Living↗

[Comparison of LDL-C values measured with the automated method and the ultracentrifugation method in severe hypertriglyceridemia, and prevalence and life-style of patients with hypertriglyceridemia].

The correlation between LDL-cholesterol (LDL-C) values assayed by the direct method and the ultra-centrifugation method is reported good in normal to moderate hypertriglyceridemia, but it is not clear in severe hypertriglyceridemia. We examined such a correlation in mild (triglycerides, 150-400 mg/dl; n = 3) and severe (> or = 800 mg/dl, n = 9) hypertriglyceridemia. The bias of LDL-C determined by the direct method in comparison with the ultracentrifugation method was from -1.1% to 3.4% and from -49.5% to 15.7% in mild and severe hypertriglyceridemia, respectively. The prevalence of severe hypertriglyceridemia was only 0.2% both in hospital patients and in company workers. Data analyses of company workers indicated that people with severe hypertriglyceridemia have a higher body-mass index, consume more alcohol, smoke more, and exercise less than those with a normal level of triglycerides. These results suggest that there is not a good correlation between LDL-C values assayed by the direct method and the ultracentrifugation method in severe hypertriglyceridemia; but that the direct method can be used for the clinical examination of LDL-C, because of the very low prevalence of severe hypertriglyceridemia. Patients with severe hypertriglyceridemia should improve their life-style as soon as possible.

Adult↗

[Life style advice provided by primary health care to prevent cardiovascular diseases].

BACKGROUND: The Working Group on Hypertension of the Norwegian College of General Practitioners reports in this paper on the documentation on behavioural advice in the prevention of cardiovascular disease. Emphasis is given to hypertension. MATERIAL AND METHODS: The recommendations are mainly based on updated metaanalyses and randomised controlled trials. Hypertension is treated to prevent cardiovascular disease; that is why we put emphasis on documentation with significant end points. The validity of the documentation for general practice is assessed. We have also assessed whether certain methods or theories for behavioural change could be helpful to the general practitioner. RESULTS: The value of advice against smoking, dietary advice (increased intake of grain products, vegetables, fruit, poultry and fish), and advice about exercise are well documented and applicable in general practice. Respect for the patient's autonomy and interest in the patients and their health-related habits seem to be important factors for improving doctor's chances of influencing patient behaviour. INTERPRETATION: The value of life-style advice is well documented and should play an important role in clinical strategies to prevent cardiovascular disease in high-risk patients.

Antioxidants↗

Cancer patterns among Koreans in Japan, Koreans in Korea and Japanese in Japan in relation to life style factors.

Cancer incidences for major sites were compared among Koreans in Osaka, Japan, Koreans in Korea and Japanese in Osaka by calculating standardized proportional incidence ratios (SPIR's), in addition to updating the findings on cancer mortality experiences of Koreans and Japanese in Osaka reported before. Compared with Japanese, Koreans in Osaka had significantly higher mortality rates from cancers of the esophagus, liver and lung in males, and liver in females. Mortality rates among Koreans in Osaka were significantly lower for stomach cancer in both sexes and for breast cancer in females. Compared with Korean counterparts in the homeland, Koreans in Osaka had a reduced risk for cancers of the stomach in males and the uterus in females. On the other hand, an elevated risk was observed for cancers of the esophagus, colon, liver and lung among Korean males in Osaka and for cancers of the colon and liver among Korean females in Osaka. The risk for cancer of the breast in females was similar among Koreans in the host and home countries. These different cancer patterns among Koreans in the host and home countries and Japanese are discussed in relation to their life styles, such as smoking, drinking and dietary habits, which have been investigated by means of questionnaire surveys.

Adult↗

[Personality and life style].

The association between personality and various living habits was investigated in a cross-sectional study of 2,892 residents of a town in Saitama prefecture. Living habits including dietary, smoking & drinking habits, degree of mental stress and personality type were surveyed from 1986 to 1988 by use of a self-administered questionnaire together with biochemical & immunological examination of peripheral blood samples. Personality in this study was classified into two types: extraversion which is characterized by persons who are active and emotionally stable; introversion characterized by suppression on emotional and behavioral expression. Our results can be summarized as follows. 1) The introversion type of persons showed higher susceptibility to mental stress, less regularity in meal time, lower intake frequency of animal protein foods (meat, fish and eggs), green & yellow vegetables, fruits, and cruciferous vegetables with statistical significance of p less than 0.05, as compared to the extraversion type. 2) The above association was further examined in each of the sexes and age groups. The association of the introversion type of personality with increased stress and low intake of high animal protein foods was observed for both sexes and all age groups; the association with low intake of eggs and irregularity of meal time was observed for both sexes for groups under 60 years old; that with low intake of fish & shellfish, fruits, cruciferous vegetables and green & yellow vegetables was observed more clearly among males than females. These results indicate that introversion type of personality appears to be associated with a life style that increases the risk for adult diseases such as cancer, ischemic heart disease etc.

Adult↗

[Life styles and blood pressure: the protective effect of apple-eating habits on high blood pressure in a high-salt population].

Prospective epidemiological studies of blood pressure in a high-salt population in northeastern Japan were investigated along with dietary habits such as miso soup, rice, apple, fish, milk and sake consumption as well as smoking habits. Blood pressures of the populations in 3 villages were determined once or twice a year by mass surveys from 1954, 1957 or 1958 through 1975. The means and transitions of the personal blood pressure were calculated by regression analysis of the data obtained during each entire period. The number of persons was 1127 males and 1369 females and the response rate was 98.7 percent. The average number of times of determination of blood pressure for a person was 12.9. Stepwise multiple regression analyses were run with the means and transitions of systolic and diastolic blood pressure as the dependent variables and the life styles of the population in 1958 as an independent variable based on data of persons whose blood pressures were determined 5 or more times during the entire period. According to the backward stepwise method this study confirmed the positive relationship of age and sake drinking and the negative relationship of apple eating habits to blood pressure.

Aged↗

Cause-specific mortality among physicians with differing life-styles.

We compare the mortality experience of medical school graduates from Loma Linda University (LLU [n = 4342]) and the University of Southern California (USC [n = 2832]) with each other and with that of contemporaneous, white, American men. When compared with US white men from the general population, both USC and LLU graduates had below expected deaths for all causes (USC, standardized mortality ratio [SMR] = 76; LLU, SMR = 56), although deaths due to cerebrovascular disease, airplane accidents, and suicides were elevated for USC (SMRs = 132, 360, and 218, respectively). The LLU graduates had a risk similar to that of the USC graduates for fatal cancer, with a mortality ratio (MR) of 0.92 (95% confidence interval, 0.67 to 1.26); but half the risk of fatal atherosclerotic disease, with MRs of 0.58 (0.46 to 0.73) and 0.66 (0.43 to 0.99) for coronary and cerebrovascular disease, respectively; and three times the risk of fatal airplane accidents. The overall mortality rate of LLU physicians was only 75% as high as that of the USC physicians and only 56% as high as that of the US male population at large. We attribute this reduced mortality mainly to the low cardiovascular mortality rates, which may be accounted for by the life-style of the substantial proportion of Seventh-day Adventists among LLU graduates.

Accidents↗

Environmental and life-style risk factors for Lyme disease in children.

Risk factors for Lyme disease and/or infection with Borrelia burgdorferi in children are not defined. A case-control study was performed using Lyme disease patients from our Lyme Clinic population. Age- and sex-matched controls from the same neighborhood were identified by the Lyme patients' families. A site visit was made to each case/control neighborhood. Twenty-four environmental variables, especially the ecologic characteristics of the home environment were examined. Forty-five items were surveyed by parent questionnaire, including certain "high-risk" activities and behaviors, whether ticks or certain animals were present on the property, and whether antitick measures were used. Control subjects had serologic assays for antibodies to B. burgdorferi. Forty-four Lyme disease patients and 44 well-matched control subjects participated; 2 controls were seropositive. Significant associations with Lyme disease were found for deer ticks in the home environment, ground cover containing moist humus, and leaf litter in the yard. Among the 45 items related to life-style, there was no correlation with Lyme disease for the use of any antitick measures or for any childhood activities; in fact, an inverse correlation was observed for camping and fishing. We conclude that conditions in the immediate home environment, including certain ecologic factors that favor the presence of Ixodes ticks, are associated with an increased risk for Lyme disease in children.

Adolescent↗

[Significance of life style factors for the blood lipids profile in bank employees].

In a study sample of 75 sedentary, non-smoking male bank employees (mean age 41.2 +/- 7.8 years) the relationship between lifestyle characteristics and serum lipid concentrations were examined. According to the mortality statistics of the canton of Zurich, this population is at increased risk for coronary heart disease. Statistical analyses confirmed the predictive character of physical activity for serum lipid levels. A low level of physical activity was associated with significantly higher concentrations of apolipoprotein B and LDL-C (Pearson coefficient of correlation r = -0.38, p < 0.001 and r = -0.35, p < 0.01, respectively). Accumulation of upper body fat (estimated by the waist to hip ratio) revealed to be a better predictor of lipid levels than body mass index and showed highly significant positive correlations with atherogenic lipid fractions. The most pronounced differences were seen for triglyceride levels, where the subgroup of subjects in the lowest tertile of waist-hip ratio showed about 40% lower triglyceride values compared to the highest waist-hip ratio tertile. In a study population of self-selected, non-smoking men, high levels of LDL-C and apolipoprotein B could partially be explained by unfavourable life style characteristics, particularly physical inactivity. The waist-hip ratio, characterizing abdominal fat accumulation, proved to be a good indicator of an atherogenic lipid profile. Measuring waist-hip ratio in medical routine examinations should thus be considered.

Adult↗

Life style and urinary 8-hydroxydeoxyguanosine, a marker of oxidative dna damage: effects of exercise, working conditions, meat intake, body mass index, and smoking.

The urinary levels of 8-hydroxydeoxyguanosine (8-OH-dG), a marker of oxidative DNA damage, of 318 healthy men aged 18 - 58 were measured with high resolution by a newly developed automated high-pressure liquid chromatography (HPLC) system coupled to an electrochemical detector (ECD). The mean 8-OH-dG level (mg / g creatinine) was 4.12 +/- 1.73 (SD). An eleven-fold inter-individual variation was observed. The accuracy of the measurement estimated from the recovery of an added 8-OH-dG standard was 90 - 98%. By univariate analysis, it was found that moderate physical exercise (P = 0.0023) and high body mass index (BMI) (P = 0.0032) reduced the 8-OH-dG level, while physical labor (P = 0.0097), smoking (P = 0.032), and low meat intake (less than once / week) (P = 0.041) increased its level. Based on a multi-regression analysis of the log-transformed values, moderate physical exercise (P = 0.0039), high BMI (P = 0.0099), and age (P = 0.021) showed significant reducing effects on the 8-OH-dG level, while low meat intake (P = 0.010), smoking (P = 0.013), and day-night shift work (P = 0.044) increased its level. These results suggest that many types of life-style factors that either generate or scavenge oxygen radicals may affect the level of oxidative DNA damage of each individual.

8-Hydroxy-2'-Deoxyguanosine↗

Polycystic ovary syndrome and insulin resistance: thrifty genes struggling with over-feeding and sedentary life style?

Almost two decades of research have greatly increased our knowledge in the complex field of metabolic aberrations in polycystic ovary syndrome, but still many problems remain unsolved. The statistical association between insulin levels and androgens originally put the focus on possible direct cause-and-effect relationships between these factors. Indeed there is evidence that insulin may affect ovarian functions in multiple ways, presumably in some cases causing anovulation and hyperandrogenism. Clearly, insulin may increase biologically active testosterone through reducing SHBG levels. Conversely, major increases in androgen levels may induce muscular changes leading to reduced insulin-mediated glucose uptake. There are suggestions of increased steroidogenesis in both ovarian and adrenal pathways, with the net result of increased androgen production. There are also findings supporting increased corticosteroid production, which could contribute to insulin resistance directly or through promoting accumulation of abdominal fat, a typical feature of over-weight women with PCOS. Free fatty acids, released in great amounts from abdominal fat, may induce insulin resistance. Insulin resistance may also be due to a primary aberration in the insulin receptor. Putatively increased serine phosphorylation may cause both impairment of the insulin signal and increased 17,20 lyase activity, thus suggesting a common cause for insulin resistance and increased androgen production. There are also findings supporting a high prevalence of beta-cell dysfunction in PCOS, ranging from increased insulin secretion, not explained by insulin resistance or BMI, to failing beta-cell function, mainly in obese women during progress to glucose intolerance and NIDDM. Recent genetic findings also support a multifactorial genesis to PCOS, notably with positive findings both in genes regulating steroidogenesis and insulin secretion. It is suggested that PCOS is the result of "thrifty" genes, providing advantages in times of shortage of nutrition such as muscular strength, moderate abdominal fatness and decreased insulin sensitivity, i.e. an anabolic, energy saving constitution. However, when this constitution is exposed to unlimited food supplies and modern sedentary life style a full-blown PCOS with insulin resistance and infertility is triggered, presumably via several mechanisms, which follow a logical amplification system between two basic anabolic hormones, insulin and testosterone.

Body Composition↗

Design of a multicenter trial to evaluate long-term life-style intervention in adults with high-normal blood pressure levels. Trials of Hypertension Prevention (phase II). Trials of Hypertension Prevention (TOHP) Collaborative Research Group.

Phase II of the Trials of Hypertension Prevention (TOHP) is a multicenter, randomized trial sponsored by the National Heart, Lung, and Blood Institute designed to test whether weight loss alone, sodium reduction alone, or the combination of weight loss and sodium reduction will decrease diastolic (DBP) and systolic blood pressure (SBP) as well as the incidence of hypertension (DBP > or = 90 mm Hg, SBP > or = 140 mm Hg, and/or use of antihypertensive medications) in subjects with high-normal DBP (83 to 89 mm Hg) and SBP less than 140 mm Hg at entry. These interventions were chosen for longer-term testing with end points including hypertension prevention as well as blood pressure (BP) change based on their demonstrated short-term efficacy in reducing BP in phase I of TOHP. The phase II study population is comprised of 2382 participants (1566 men and 816 women) who are 110 to 165% of desirable body weight, allocated at random to the four treatment arms using a 2 x 2 factorial design. The trial has 80% power to detect an overall treatment effect on DBP of 1.2 mm Hg for weight loss or sodium reduction and a difference of 1.6 mm Hg between the combined intervention and placebo groups. BP observers are blinded to participant treatment assignments. Participants will be followed for 3 to 4 years. This trial may have important public policy implications concerning the ability of life-style modifications to reduce BP and prevent the development of hypertension over the long term, thereby avoiding the need for drug therapy which while effective is costly and may have side effects.

Adult↗

Current health behaviors and readiness to pursue life-style changes among men and women diagnosed with early stage prostate and breast carcinomas.

BACKGROUND: Cancer survivors are at increased risk for developing secondary tumors, diabetes, osteoporosis, and cardiovascular disease, thus making them an important target population for health-related interventions. However, little is known regarding cancer survivors' behaviors and their interest in pursuing healthier diets, exercise, and smoking cessation. METHODS: A 65-item survey was mailed to 1667 patients diagnosed with early stage carcinoma of the breast or prostate that requested data regarding demographics, health behaviors, stage of readiness for smoking cessation, exercise, increased fruit and vegetable (F&V) consumption, and decreased fat intake, as well as interest in specific health programs and when, relative to diagnosis, these programs should be offered. RESULTS: Responses from 978 cancer survivors suggested that the overwhelming majority (85%) reported their health as good to excellent. The majority of respondents (55%) ate fewer than 5 daily servings of F&Vs, with prostate carcinoma patients reporting eating significantly fewer servings than patients with breast carcinoma (P < 0.001). In contrast, 69% of respondents reported adherence to a low fat diet, again with lower practice rates among prostate carcinoma patients than patients with breast carcinoma (P = 0.006). The majority of respondents (58%) reported routine exercise and 8% were current smokers. Significantly more breast carcinoma patients than prostate carcinoma patients were current smokers (P = 0.03). There was strong interest in health promotion programs across behaviors, and a fair amount of concordance between low fat dietary behaviors and exercise, as well as consumption of five daily servings of F&Vs. The majority of patients expressed a preference for programs that could be delivered via mailed brochure, with 57% of respondents indicating that programs should be initiated at the time of diagnosis or soon after (within 6 months). CONCLUSIONS: The results of the current study suggest that although many cancer survivors already practice healthy life-style behaviors, there is a substantial proportion who do not. Interventions especially are needed to increase daily F&V intake; however, given the fair degree of clustering between dietary and exercise behaviors, multiple risk factor interventions also may be warranted. Among cancer survivors, receptivity is high for health promotion programs, especially those that can be delivered by mail and soon after diagnosis.

Adult↗