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Background: The increasing prevalence of obesity and overweight among health workers calls for an appraisal of their lifestyle. This study assessed medical practitioners' workhour feeding and lifestyle practices and explored the relationship between these practices and their body mass index (BMI). Methods: The survey involved 321 medical practitioners selected from 9 northern Nigeria hospitals in 2021. Data collected included biodata, medication history, workhour feeding characteristics, lifestyle behaviours, blood pressure, height, and weight measurements. Data were analyzed using Epi info software (version 7). Results: Most respondents were male (70.7%). Their mean age was 38 ± 7.4 years. During their last workhours, 84.1% had lunch, and 46.4% took sugary drinks. Usually, 41.7% source their lunch from the hospital canteen, and 18.7% patronize their canteen at least weekly. Most reported healthy behaviour towards alcohol consumption (99.7%), fruit and vegetable consumption (54.8%) and smoking (98.4%). However, only 22.4% were physically active. Their mean healthy behaviour score and BMI were 2.8 ± 0.7 and 26.1 ± 4.6 kg/m2, respectively. The obesity and overweight rates were 18.4% and 37.7%, respectively. Their source of lunch during workhours, age, sex, years of practice, employment duration, marital status, job category, systolic blood pressure, anti-hypertensive, and antidiabetic medication use were significantly associated with mean BMI. However, only antihypertensive medication use, being married, inadequate fruit/vegetable consumption and workhour sugary drinks consumption predicted obesity. The predictors of overweight/obese were years of practice (< 10 y) and use of antihypertensive medications. Conclusions: Obesity and overweight rates were high. Most were physically inactive. Workhour sugary drink consumption predicted obesity. Effective workplace and community interventions to improve practitioners' lifestyle behaviour and curtail obesity and overweight are needed.

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OBJECTIVES: In this cross-sectional study from Botswana, we investigated knowledge of myocardial infarction (MI) symptoms and risk factors among the general public and outpatients with MI risk factors based on age and lifestyle behaviors, in addition to assessing associations with sociodemographic and MI risk factors. METHOD: Open-ended questionnaires about 8 MI symptoms and 10 risk factors, were administered by research assistants to a representative selection of outpatients (n = 525) and the public (n = 2248). Weight and height were measured in all participants and BMI was calculated. Knowledge scores were compared between the two groups. We examined whether sociodemographic and MI risk factors had impact on the scores. Analyses were further adjusted for lifestyle behavior (smoking status, dietary status and physical activities). RESULTS: The valid response rate was 97.9% comprising 97.8% for the public (n = 2199) and 98.1% for outpatients (n = 515). Public respondents (35.2 ± 12.3 years) were younger than outpatients (38.5 ± 12.6 years). The public comprised 56.9% females while outpatients 54.6%. In general, outpatients had higher knowledge of MI symptoms than the public, with mean scores ± SD of 3.49 ± 2.84 vs 2.80 ± 2.54. Outpatients also had higher knowledge score of MI risk factors than the public, with mean scores, 5.33 ± 3.22 vs 3.82 ± 3.07. For MI symptoms, outpatients were more aware than the public for chest pains among all ages, for arm pain/ numbness, neck/ jaw pain radiating to/ from chest, and feeling sick or looking pallor on the skin among those aged 35-49 years. Among both the public and outpatients, lower knowledge of both MI symptoms and risk factors was associated with primary education, not residing/working together, history of hypertension, no history of heart disease/stroke, and obesity. There were similarities and disparities on MI knowledge among respondents with various numbers of healthy lifestyle behaviours. CONCLUSION: Results call for urgent educational campaigns on awareness and knowledge of MI and using strategies based on age and lifestyle behavior.

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AIMS AND OBJECTIVES: To identify and synthesise nurses' experiences of competence in lifestyle counselling with adult patients in healthcare settings. BACKGROUND: Modifiable lifestyle risk behaviours contribute to an increased prevalence of chronic diseases worldwide. Lifestyle counselling is part of nurses' role which enables them to make a significant contribution to patients' long-term health in various healthcare contexts, but requires particular competence. DESIGN: Qualitative systematic literature review and meta-aggregation. METHOD: The review was guided by Joanna Briggs Institute's methodology for conducting synthesis of qualitative studies. PRISMA-checklist guided the review process. Relevant original studies were search from databases (CINAHL, PubMed, Scopus, Medic and Psych Articles, Ebscho Open Dissertations and Web of Science). After researcher consensus was reached and quality of the studies evaluated, 20 studies were subjected to meta-aggregation. RESULTS: From 20 studies meeting the inclusion criteria, 75 findings were extracted and categorised into 13 groups based on their meaning, resulting in the identification of 5 synthesised findings for competence description: Supporting healthy lifestyle adherence, creating interactive and patient-centred counselling situations, acquiring competence through clinical experience and continuous self-improvement, collaborating with other professionals and patients, planning lifestyle counselling and managing work across various stages of the patient's disease care path. CONCLUSION: The review provides an evidence base that can be used to support nurses' competence in lifestyle counselling when working with adult patients in healthcare settings. Lifestyle counselling competence is a complex and rather abstract phenomenon. The review identified, analysed and synthesised the evidence derived from nurses' experience which shows that lifestyle counselling competence is a multidimensional entity which relates to many other competencies within nurses' work. IMPLICATIONS FOR THE PROFESSION: Recognising the competencies of nurses in lifestyle counselling for adult patients can stimulate nurses' motivation. The acquisition of these competencies can have a positive impact on patients' lives and their health. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution. IMPACT: The research may enhance nurses' competence in lifestyle counselling, leading to improved health outcomes, better adherence to recommendations and overall well-being. It may also drive the development of interventions, improving healthcare delivery in lifestyle counselling. REPORTING METHOD: The review was undertaken and reported using the PRISMA guidelines. PROTOCOL REGISTRATION: Blinded for the review.

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BACKGROUND: We aimed to assess factors associated with uncontrolled blood pressure (BP) among individuals with hypertension on treatment, by sex. METHODS: We conducted a nested cross-sectional analysis using data from the population-based cohort study CONSTANCES, designed as a randomly selected sample of French adults aged 18-69 years at study inception. We included 11 760 participants previously diagnosed with hypertension and taking antihypertensive medications. Uncontrolled BP was defined as mean systolic BP ≥140 mmHg and/or mean diastolic BP ≥90 mmHg. Sex-specific age-adjusted multivariable analyses were performed using logistic regression models stratified by stages of uncontrolled hypertension. RESULTS: The mean age of participants was 59.4 years. The prevalence of uncontrolled BP was 51.4%, and it was higher in men than in women [adjusted odds ratio (aOR), 1.80; 95% CI, 1.67-1.94]. In both sexes, the lower the age, the lower the prevalence of uncontrolled hypertension. Low level of education and history of cardiovascular events had, respectively, higher and lower odds of uncontrolled BP. In men, additional risk factors included overweight and obesity (aOR, 1.15; 95% CI, 1.00-1.32; and aOR, 1.45; 95% CI, 1.23-1.70, respectively), lack of physical activity (aOR, 1.20; 95% CI, 1.04-1.40), low adherence to a Dietary Approach to Stop Hypertension diet (aOR, 1.21; 95% CI, 1.05-1.40) and heavy alcohol consumption (aOR, 1.33; 95% CI, 1.08-1.63), with the last two factors persisting across different stages of uncontrolled BP. CONCLUSIONS: From a population-based perspective, socio-economic and behavioural characteristics were risk factors for uncontrolled hypertension, but they differed by sex and by stage of uncontrolled hypertension. Modifiable risk factors, such as weight, diet, physical activity and alcohol consumption, have an important role in the control of hypertension.

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AIMS: This review aimed to investigate the effectiveness of nurse-led interventions vs. usual care on hypertension management, lifestyle behaviour, and patients' knowledge of hypertension and associated risk factors. METHODS: A systematic review with meta-analysis was conducted following Joanna Briggs Institute (JBI) guidelines. MEDLINE (Ovid), EmCare (Ovid), CINAHL (EBSCO), Cochrane library, and ProQuest (Ovid) were searched from inception to 15 February 2022. Randomized controlled trials (RCTs) examining the effect of nurse-led interventions on hypertension management were identified. Title and abstract, full text screening, assessment of methodological quality, and data extraction were conducted by two independent reviewers using JBI tools. A statistical meta-analysis was conducted using STATA version 17.0. RESULTS: A total of 37 RCTs and 9731 participants were included. The overall pooled data demonstrated that nurse-led interventions may reduce systolic blood pressure (mean difference -4.66; 95% CI -6.69, -2.64; I2 = 83.32; 31 RCTs; low certainty evidence) and diastolic blood pressure (mean difference -1.91; 95% CI -3.06, -0.76; I2 = 79.35; 29 RCTs; low certainty evidence) compared with usual care. The duration of interventions contributed to the magnitude of blood pressure reduction. Nurse-led interventions had a positive impact on lifestyle behaviour and effectively modified diet and physical activity, but the effect on smoking and alcohol consumption was inconsistent. CONCLUSION: This review revealed the beneficial effects of nurse-led interventions in hypertension management compared with usual care. Integration of nurse-led interventions in routine hypertension treatment and prevention services could play an important role in alleviating the rising global burden of hypertension. REGISTRATION: PROSPERO: CRD42021274900.

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BACKGROUND: Understanding health and developing trends among the older population is essential for countries to tackle the challenges of an ageing population and formulate relevant policies. Facilitating healthy ageing is an essential strategy to address the issues arising among the aged. The concept of healthy ageing is defined as "the process of developing and maintaining the functional ability that enables wellbeing in old age (WHO)," where "functional ability comprises the health-related attributes that enable people to be and to do what they have reason to value." People have different ageing pathways depending on their genetic profile and different life course health risk exposures. Therefore, ageing, more specifically healthy ageing, largely depends on individual lifestyle choices. This study examines the association between lifestyle behaviours and healthy ageing among older adults in India. METHODS: Based on the first round of LASI in 2017-18, we conceptualized healthy ageing within the WHO functional ability framework. We developed a Healthy Ageing Index (HAI), which incorporates physiological health, functional health, cognitive functions, psychological well-being, and social engagement. We used principal component analysis to generate a composite score for HAI. We then used multiple linear regression to demonstrate the association between lifestyle behaviours and HAI. RESULT: The mean HAI was 82.8%, indicating that the study population is healthier. The study findings show that smoking and drinking are more prevalent among males, rural residents, illiterate individuals, those currently employed, and those belonging to the poorest wealth quintile. Engaging in physical activity is associated with better health outcomes (ß = 2.36; 95% CI: 2.16-2.56). CONCLUSION: This study emphasizes the importance of adopting a healthier lifestyle to achieve healthy ageing. Health behaviours are modifiable, so our results highlight the need for policy interventions to promote a healthier lifestyle from an early age.

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Objectives: To investigate associations between multimorbidity, socio-demographic and health behaviour factors, and their interactions (multimorbidity and these factors) with all-cause mortality among Thai adults. Methods: Associations between multimorbidity (coexistence of two + chronic diseases) and mortality between 2005 and 2019 were investigated among Thai Cohort Study (TCS) participants (n = 87,151). Kaplan-Meier survival curves estimated and compared survival times. Multivariate Cox proportional hazards models examined associations between risk factors, and interactions between multimorbidity, these factors, and survival. Results: 1,958 cohort members died between 2005 and 2019. The risk of death was 43% higher for multimorbid people. In multivariate Cox proportional hazard models, multimorbidity/number of chronic conditions, age, long sleep duration, smoking and drinking were all independent factors that increased mortality risk. Women, urbanizers, university education, over 20,000-baht personal monthly income and soybean products consumption lowered risk. The interactions between multimorbidity and these variables (except for female, urbanizers and soybeans intake) also had significant (p < 0.05) impact on all-cause mortality. Conclusion: The results emphasise the importance of healthy lifestyle and reduced intake of alcohol and tobacco, in reducing premature mortality, especially when suffering from multimorbidity.

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Background: The COVID-19 pandemic caused by the coronavirus was accompanied by the emergence of various adverse conditions, as well as the deterioration of health from the point of view of chronic diseases, as well as lifestyle changes related to the preference of certain foods and changes in body weight due to the restriction of free movement. Objective: The objective of our survey was to assess the impact of the pandemic and lockdown on selected key lifestyle elements affecting the overall health status of the Slovak population and subsequently to evaluate subjectively assessed changes in the respondents' eating habits, daily routine, physical activity and body weight. Material and Methods: The research group consisted of 528 participants who took part in an online distributed questionnaire survey. Results: Respondents subjectively evaluated the change in lifestyle rather negatively. Up to 48.37% of men and 38.93% of women reported a change for the worse. Almost 59% of participants reported no change in their health, while almost a quarter reported a slight deterioration in their health. A change in eating habits for the worse was reported by 22.88% of men and 28.26% of women (p<0.05). Increased appetite during the lockdown was reported by 24.18% of men and 35.47% of women (p<0.05), more frequent overeating during the pandemic occurred in 30.07% of men and 38.13% of women. When evaluating the consumption of individual food commodities, the increased consumption of fresh fruit, fresh vegetables (p<0.01), homemade bread (p<0.05), homemade pastries (p<0.05) and dairy products (p<0.05) is very favourable. We also found a significant increase in the consumption of sweets (p<0.01) and coffee (p<0.001). When evaluating the sleep pattern, we noted an increase in sleep during the pandemic, as well as more time spent sitting. Over half of the respondents reported a change in body weight, in most cases it was an increase in both sexes. Conclusions: The results show that the pandemic and the restrictions during it caused changes not only in diet, but also in physical activity, daily routine and overall lifestyle. However, this is a very specific issue that needs to be assessed in a comprehensive and strictly personalized manner. The positive or negative impact of the pandemic on the health of the population will be the subject of research in the near future.

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BACKGROUND: Despite the increasing interest in text-messaging interventions to support healthcare delivery, the available evidence about their effectiveness is still limited. OBJECTIVES: 1) to develop DiabeText, an intervention delivering automated, tailored brief text messages to support diabetes self-management; 2) to explore the potential impact of DiabeText on self-management behavior and glycaemic control, and; 3) to examine the feasibility of conducting a future phase III randomized clinical trial to evaluate the effectiveness of DiabeText. METHODS: 3-month, two-arm, randomized feasibility trial (ClinicalTrials.gov: NCT04738591) with patients with type 2 diabetes (HbA1c > 8%). Participants were allocated to the control (usual care) or DiabeText group (usual care + five text messages per week). Outcomes were: recruitment rate; follow-up rate, missing data; medication adherence; adherence to Mediterranean diet; physical activity; and HbA1c. In addition, after delivering the intervention, we conducted a qualitative study involving 14 semi-structured interviews with participants allocated to the DiabeText group, to understand their views about the intervention. RESULTS: From 444 screened people, we recruited 207 participants (recruitment rate = 47%), of which 179 completed the post-intervention interview (follow-up rate = 86%). We sent 7,355 SMS during the intervention period, of which 99% successfully reached the participants. At post-intervention, DiabeText was associated with non-statistically significant (p > 0.05) improvements in adherence to medication (OR = 2.0; 95%CI 1.0 to 4.2), Mediterranean diet (1.7; 0.9 to 3.2), and physical activity (1.7; 0.9 to 3.1). No between-group differences were observed in mean HbA1c (p = 0.670). The qualitative study indicated that participants perceived DiabeText as a helpful resource because it increased their awareness about the importance of adequate self-management and the sense of being cared for. CONCLUSIONS: DiabeText is the first system in Spain to integrate patient-generated and routinely collected clinical data to deliver tailored text messages to support diabetes self-management. More robust trials are needed to determine its effectiveness and cost-efficacy.

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OBJECTIVE: Polycystic ovarian syndrome (PCOS) is a prevalent endocrinological disorder in reproductive-age women. Due to varied presentations, it's often difficult to diagnose and manage women with PCOS. Management usually focuses on treating the symptoms and preventing long-term sequelae of the disease. This study was planned to assess the knowledge among reproductive-age women (15-44 years) regarding the risk factors, symptoms, complications, and management of PCOS. MATERIAL AND METHODS: This is a hospital-based descriptive cross-sectional study. A pre-validated well-structured questionnaire which included basic demographic data, menstrual history, knowledge about PCOS symptoms, risk factors, complications, prevention, and treatment, was administered. Completed questionnaires were analyzed to calculate the knowledge score of the participants and its association with their education level and occupation was seen. RESULTS: A total of 350 women participated but only 334 completed questionnaires were included for final evaluation. The mean age of the study population was 28.70±6.29 years. Around 9.3% of the participants were already diagnosed with PCOS. Most of the women (43.4%) had heard about PCOS. The source of information was doctors (26.6%), the internet (6.28%), teachers (5.6%), and friends (4.7%). Obesity (33.5%), unhealthy dietary habits (35%), and genetic predisposition (40.7%) were thought as risk factors for PCOS. Most of the participants were aware that subfertility (40.1%), abortions (34.4%), diabetes (28.7%), hypertension (31.7%), cardiovascular disease (33.5%), endometrial carcinoma (35.9%), and psychological disturbances (37.1%) are among the known PCOS related complications. Eating a healthy diet (37.1%) and weight reduction (41%) can help in the management of PCOS. Around 60.5% of women showed poor knowledge, 14.7% fair knowledge, and 24.9% good knowledge regarding PCOS. Education level and occupation status were found to be significantly related to the knowledge score (P≤0.001). CONCLUSION: PCOS is a prevalent condition with varied presentations which significantly affects one's quality of life. Since there is no definitive treatment for PCOS the management generally aims at managing symptoms and reducing the risk of long-term complications. To reduce the burden of PCOS-related long-term complications behavioral changes in terms of regular exercise and healthy dietary habits need to be incorporated from childhood.

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OBJECTIVE: This study investigates laughter by General Practitioners (GPs) in response to patient laughter in lifestyle behaviour consultations. METHOD: We examined video-recorded consultations involving 44 patients of four GPs in Australia. After identifying 33 cases of patient laughter, we examined whether GPs laughed in response. We used Conversation Analysis to explore the appropriateness of GP laughter and non-laughter by investigating the talk before and after the occurrence of patient laughter. RESULTS: GP reciprocal laughter was found in thirteen occasions when patients unsolicitedly mentioned their behaviours, laughed and displayed their evaluative stances (whether the behaviours were positive or negative). On twenty occasions, patients laughed in response to GP enquiries, which worked to problematise particular behaviours. In this context, patient laughter was not usually reciprocated (19/20 cases) because reciprocal laughter may risk being interpreted as laughing at the patient, as evidenced by one deviant case. CONCLUSION: GP reciprocal laughter may be problematic when the behaviour issues are raised by GPs and patients' evaluative stances regarding their behaviour have not yet been revealed. PRACTICE IMPLICATIONS: To decide when it is appropriate to reciprocate laughter, GPs should consider the contexts that lead to patient laughter and patients' evaluative stances.

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The COVID-19 pandemic and containment measures will likely have a detrimental impact on immunosuppressed individuals' lifestyle behaviours. Increasing evidence suggests that pet ownership is positively associated with healthier lifestyle. Yet, no study has investigated the potential benefits of pet ownership on lifestyle behaviours of immunosuppressed individuals, a population at increased risk of COVID-19 complications. This study aims to examine 1) changes in light, moderate and vigorous intensity physical activity (LPA, MPA, VPA), sedentary time (SED), and sleep duration, assessed by comparing "before COVID-19 pandemic" and "past 7 days" (i.e., current, during pandemic) self-reported behaviours in immunosuppressed individuals and their relatives; 2) to assess if changes in lifestyle behaviours are associated with pet ownership status and whether age is a moderator of these associations. A convenience sample of 132 participants (65.2% female, 41.3% ≥55 years of age) provided self-reported LPA, MPA, VPA (days/week), SED and sleep (min/day) and pet ownership status using an online questionnaire (May-August 2020). Descriptive analyses, paired T-tests, Cohen's d effect size and linear regressions were conducted. Results show that participants reported a decrease in VPA (-0.56 days/week, d = 0.34; p < 0.01) and an increase in SED (106.79 min/day, d = -0.81; p < 0.01). Stratified analysis revealed that having at least one dog, compared to not owning pets, is associated with a reduced decline in LPA, MPA and VPA and an increase in sleep in participants aged < 55 years old only. Having a dog appears to be positively associated with healthy lifestyle behaviours in younger and middle age immunosuppressed individuals.

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BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) represents a spectrum of disease ranging from simple fatty liver to non-alcoholic steatohepatitis, cirrhosis, liver cancer and liver failure. NAFLD affects up to 30-40% of adults in Western countries and is directly linked to overweight and obesity. There are no approved drugs to specifically target NAFLD, therefore weight loss achieved through changes in dietary and physical activity behaviours is the recommended management approach. However, achieving and sustaining weight loss is challenging for patients with NAFLD. We developed a NAFLD-specific digital lifestyle intervention (VITALISE) to target changes in dietary and physical activity behaviours of patients with NAFLD to initiate weight loss and weight loss maintenance. This study aims to evaluate the feasibility and acceptability of VITALISE in a secondary care clinical setting. METHODS: A single-centre, one-arm, prospective design will be used to assess the feasibility and acceptability of recruitment, uptake, engagement and completion of VITALISE. Health-related outcomes will be assessed at baseline and 6-months. An interim measure of self-reported weight, physical activity and self-efficacy will be recorded at 12-weeks. Qualitative semi-structured interviews conducted at 6 months follow up will further explore acceptability and feasibility and fidelity of receipt and enactment. The study aims to recruit 35 patients with newly diagnosed NAFLD over a 6-month time period. Eligible patients will have continuous access to VITALISE and monthly tele-coaching support for 6 months prior to follow-up with a hepatologist. DISCUSSION: VITALISE offers access to evidence and theory-informed tailored dietary and physical activity support for patients with NAFLD. The intervention is designed for use by patients in their own time, outside of the hospital setting to overcome well documented challenges including attending additional appointments, and lack of time during routine appointments to adequately address lifestyle behaviour change. This feasibility study will determine the feasibility of VITALISE to support clinical care delivery. TRIAL REGISTRATION: ISRCTN12893503.

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PURPOSE: This study aimed to identify clusters of lifestyle behaviours in toddlers and assess associations with socio-demographic characteristics. METHODS: We used data from the Dutch National Food Consumption Survey 2012-2016 and included 646 children aged 1-3 years. Based on 24-h dietary recalls and a questionnaire, a two-step cluster analysis was conducted to identify clusters in the intake of fruit, vegetables, sugar-sweetened beverages and unhealthy snacks, physical activity and screen time. Logistic regression models assessed associations between socio-demographic characteristics and cluster allocation. RESULTS: Three clusters emerged from the data. The 'relatively healthy cluster' demonstrated a high intake of fruit and vegetables, low sugar-sweetened beverage and unhealthy snack intake and low screen time. The 'active snacking cluster' was characterised by high unhealthy snack intake and high physical activity, and the 'sedentary sweet beverage cluster' by high intake of sugar-sweetened beverages and high screen time. Children aged 1 year were most likely to be allocated to the 'relatively healthy cluster'. Compared to children of parents with a high education level, children of parents with a low or middle education level were less likely to be in the 'relatively healthy cluster', but more likely to be in the 'sedentary sweet beverage cluster'. CONCLUSION: Clusters of lifestyle behaviours can be distinguished already in children aged 1-3 years. To promote healthy lifestyle behaviour, efforts may focus on maintaining healthy behaviour in 1-year-olds and more on switching towards healthy behaviour in 2- and 3-year-olds.

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The prevalence of Major Depressive Disorder in men is half that of women, yet depression affects approximately 109 million men worldwide. Alarmingly, men account for three quarters of suicides in Western countries but are unlikely to seek help for mental health concerns. It is possible that existing mental health treatments are not engaging or accessible to men. The aim of this review was to quantify the number of men involved in randomised trials of psychotherapy or lifestyle behaviour change targeting depression. Results found men represented 26% of participants in 110 eligible articles compared to 73% women. Men's representation was low across all intervention characteristics (e.g., delivery mode). No studies used a completely male sample, compared to 19 studies targeting women only. Men are substantially underrepresented in research trials targeting depression. Supplementary information: The online version contains supplementary material available at 10.1007/s12144-022-04017-7.

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Research has documented relationships between individual health behaviours and mental health, but few studies have examined patterns of health behaviours (i.e., health lifestyles) and mental health outcomes. This study investigated the relationship between health lifestyles and mental health and psychological wellbeing in adolescents. Data from the My World Survey 2 - Second Level (MWS2-SL), a random national sample of 9493 adolescents (44.2% male) aged 12-18 years (M = 14.8, SD = 1.66) in second level education in Ireland were used. TwoStep cluster analysis identified clustering of health behaviours (sleep, alcohol use, cannabis use, social media use, sport and hobby participation). ANOVA and Chi Square tests identified potential differences in demographic characteristics (age, gender, socioeconomic status, ethnicity) and psychological outcomes (anxiety, depression, life satisfaction, daily functioning) across clusters. Three clusters were identified; 1. Low (22.0%), 2. Moderate-high (41.5%) and 3. High (36.5%), health promoting. The 'Low' health-promoting cluster, characterised by high alcohol, cannabis and social media use, moderate sport and hobby participation, and low sleep duration, demonstrated the highest levels of anxiety and depression and the lowest levels of life satisfaction, self-esteem and daily functioning. The 'High' health-promoting cluster reported the most favourable psychological outcomes. Cluster 1 were more likely to be older and male, Cluster 3 were more likely to be younger and female. Findings demonstrate the potential for health promotive lifestyles to mitigate mental health difficulties and promote life satisfaction and daily functioning in adolescents. Health lifestyles represent important indicators of mental health and targets for prevention/promotion efforts.

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BACKGROUND: The preconception period provides a window of opportunity for interventions aiming to reduce unhealthy lifestyle behaviours and their negative effect on pregnancy outcomes. This study aimed to assess the effectiveness of a locally tailored preconception care (PCC) intervention in a hybrid-II effectiveness implementation design. METHODS: A stepped-wedge cluster randomized controlled trial was performed in four Dutch municipalities. The intervention contained a social marketing strategy aiming to improve the uptake (prospective parents) and the provision (healthcare providers) of PCC. Prospective parents participated by administering a questionnaire in early pregnancy recalling their preconceptional behaviours. Experiences of healthcare providers were also evaluated through questionnaires. The composite primary outcome was adherence to at least three out of four preconceptional lifestyle recommendations (early initiation of folic acid supplements, healthy nutrition, no smoking or alcohol use). Secondary outcomes were preconceptional lifestyle behaviour change, (online) reach of the intervention and improved knowledge among healthcare providers. RESULTS: A total of 850 women and 154 men participated in the control phase and 213 women and 39 men in the intervention phase. The composite primary outcome significantly improved among women participating in the municipality where the reach of the intervention was highest (Relative Risk (RR) 1.57 (95% Confidence Interval (CI) 1.11-2.22). Among women, vegetable intake had significantly improved in the intervention phase (RR 1.82 (95%CI 1.14-2.91)). The aimed online reach- and engagement rate of the intervention was achieved most of the time. Also, after the intervention, more healthcare providers were aware of PCC-risk factors (54.5% vs. 47.7%; p = 0.040) and more healthcare providers considered it easier to start a conversation about PCC (75.0% vs. 47.9%; p = 0.030). CONCLUSION: The intervention showed some tentative positive effects on lifestyle behaviours among prospective parents. Primarily on vegetable intake and the knowledge and competence of healthcare providers. The results of this study contribute to the evidence regarding successfully implementing PCC-interventions to optimize the health of prospective parents and future generations. TRIAL REGISTRATION: Dutch Trial Register: NL7784 (Registered 06/06/2019).

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Introduction Youth is a period where a number of healthy and unhealthy habits get acquired that last throughout a person's life. Youth health promotion has become a key study focus around the world. Thus this study is undertaken to understand health-related lifestyles affecting college-going youth. Methods A cross-sectional survey was done in the junior colleges in Bhubaneswar, India, which included college-going youth. The sample size was 636. The sampling technique was a two-stage stratified sampling method. Firstly, one college was selected from each of five administrative regions (east, west, north, south, and central zone) in Bhubaneswar randomly by lottery method to provide a representative sample. From each college, 128 students were selected randomly from the list of students. Results In this study, 237 (37.3%) of the participants ate green leafy vegetables on a daily basis, with 39.3% of females and just 31.2% of males. This difference in preference of green leafy vegetables among males and females was found to be statistically significant with a p-value of 0.019. Out of 180 (28.3%) of the participants who consumed milk products daily, 25% were females, while 38.1% were males (p-value of 0.004). In the present study, out of 247 (38.8%) participants who preferred eating fast food, 37.6% were females, while 42.5% were males. Out of 213 (33.5%) of them who preferred sweets (candy/chocolate), 37.2% were females, while only 22.5% were males. This difference in gender in regards to junk food preference was found to be statistically significant with a p-value of 0.001. In the current study, out of 243 (42%) of the participants who spent 30 minutes to one hour on exercise per day, 43.4% were females, while 37.4% were males. Out of 133 (23%) of them who spent one to two hours on exercise per day, 23.6% were females, while only 20.9% were males (p-value of 0.003). Out of 208 (35.9%) of the participants who preferred walking as the main mode of exercise, 40.2% were females, while 22.3% were males (p-value <0.0001). Conclusion The main findings of this study demonstrated that the majority of the youth followed proper meal routines and engaged in regular physical exercise. However, when compared to junk food consumption, participants consumed far fewer green leafy vegetables. This would prove to be harmful to their health. Since the youth of today are the future of tomorrow, they should be provided with proper health education regarding the harmful effects of regular intake of junk food.

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BACKGROUND: Healthy lifestyle behaviours have been consistently associated with reduced non-communicable disease related morbidity, mortality and wellbeing. Unhealthy behaviours are major contributors to the global burden of disease. The main aim of this study is to access lifestyle behaviours in adults during the corona virus disease-19 pandemic. METHODS: Cross sectional study was conducted among general population residing in Nepal. Online questionnaire was developed using Google Forms. Questionnaire comprised of three validated tools regarding the following lifestyle behaviours: Physical activity, Nutrition, Sleep. The collected data was analysed using SPSS version 20. To test the differences between changes in dietary and physical activity behaviours in relation to changes in body weight a Chi-square test was used. RESULTS: During Covid -19 lockdown, 124(42%) participants performed moderate level of physical activity. Of those participated, 127(43.1%) and 44(14.9%) reported an increase and decrease of weight, respectively. Among 110(37.3%) who reported snacking in lockdown led to weight gain in 68(61.8%). Availability of more time for meal preparation (24.1%) and feelings of boredom (17.4%) were the main reasons for changing dietary habits. The subjective sleep quality of participants was as follows: very good-40.3%; fairly good-45.4 %; fairly bad-11.2%; very bad 3.1%. There was significant positive correlation between sleep quality and sleep duration (R=0.261; P<0.001), sleep latency (R=0.362; P<0.001), sleeping medications (R=0.174; P<0.003) and daytime dysfunction (R=0.308; P<0.001). CONCLUSIONS: Life style behaviours were affected during lockdown period. Higher amounts of food intake and snaking were increased. Physical activity was at a moderate level, increased sedentary behaviour was reported by most participants during lockdown. However, sleep quality was not negatively affected.

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BACKGROUND: Several lifestyle behaviours, including physical activity, smoking, alcohol consumption, nutrition habits, and social activity have been associated with psychological well-being (PWB). However, their effect on PWB prospectively has been less studied. The aim of the present study was to evaluate the influence of lifestyle factors on higher future PWB during the 10-year follow-up of middle-aged and elderly urban population. METHODS: In the baseline survey (2006 to 2008), 7115 men and women 45-72 years of age were examined within the framework of the international study Health, Alcohol and Psychosocial Factors in the Eastern Europe (HAPIEE). In the follow-up survey (in 2016), which was performed among all 6210 participants who survived till that year, 4266 individuals participated responding to postal questionnaires. PWB was assessed by a CASP-12 questionnaire. The lifestyle behaviours, including smoking and nutrition habits, alcohol consumption, social and physical activity, were evaluated by the questionnaire. Multivariable logistic regression models were applied for statistical data analysis. RESULTS: After accounting for several potential confounders, healthy levels of lifestyle behaviours were associated with higher PWB after 10-year follow-up. Never-smokers in men and former smokers in women had higher PWB by 43 and 67% odds respectively in comparison with smokers. Physical activity in women and high social activity both in men in women was positively related to higher PWB. More frequent fresh vegetable and fruit consumption was associated with higher odds of higher PWB (odds ratio 1.57 in men and 1.36 in women, p < 0.05) compared to less frequent consumption of such food groups. Dose-response relationship between increasing number of healthy lifestyle factors and higher PWB was determined both in men and women. CONCLUSIONS: Lifestyle factors such as never smoking and former smoking, high social activity, and more frequent fresh vegetable and fruit consumption increased the odds of higher PWB over 10 years of follow-up in men and women groups. The increase of the protective health behaviour score was directly associated with the odds of higher PWB.

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