Cigarette smoking is associated with unhealthy patterns of food consumption, physical activity, sleep impairment, and alcohol drinking in Chinese male adults

Obesity and the accelerated decline in total sleep time increases the self-reported diagnoses of diabetes

Introduction

The aim of this study was to investigate the relationship between obesity and the accelerated decline in Total Sleep Time (TST) and its potential impact on the self-reported diagnoses of diabetes.

Methods

Our study addresses this gap by analyzing trends in a longitudinal cohort study conducted in China, using data from the China Health and Nutrition Survey (CHNS). Employing a joint model, inter-individual variability and intra-individual variability in TST, and its impact on self-reported diagnoses of diabetes were considered.

Results

Our findings reveal that self-reported diagnoses of diabetes prevalence in China rose from 1.10% in 2004 to 3.06% in 2015, accompanied by a decrease in average TST from 8.12 to 7.80. With age, TST decreased by 0.01 per year. Among coffee or tea consumers, it decreased by 0.03, while alcohol users saw a decrease of 0.07. The obese group experienced a decrease of 0.05, the overweight group 0.03, and the normal weight group 0.01. Each 1-hour decrease in TST was associated with a substantial 3.61-fold increase in self-reported diagnoses of diabetes risk (95% CI: 2.92-4.44). Specifically, individuals with a higher baseline TST tend to experience smaller changes over time, whereas those with a lower baseline TST tend to experience larger changes.

Discussion

For the obese, TST decreases at an accelerated rate which contributes to the risk of self-reported diagnoses of diabetes. The findings underscore the role of sleep loss in diabetes risk, with implications for public policy. Future research and interventions should emphasise the impact of sleep management, particularly on obesity and metabolic health, to develop more effective prevention and treatment strategies.

Association between cheese consumption but not other dairy products and lower obesity risk in adults

INTRODUCTION

Some studies have associated dairy consumption with a lower risk of obesity. However, these studies are concentrated in developed countries with high dairy consumption. In developing countries, the evidence is scarce. This study aimed to evaluate the association between the consumption of different types of dairy products and obesity in Chilean adults.

MATERIALS AND METHODS

A cross-sectional study, stratified by sex and age, was carried out using a validated online survey to assess the consumption of dairy products among adults living in Chile. Dairy product consumption was then classified into tertiles. Obesity was determined based on self-reported body mass index (BMI) ≥ 30 kg/m2. Logistic regression models were used to assess the association between dairy consumption and obesity, adjusting for several confounding variables.

RESULTS

In total, 2008 participants were included in the analyses. Forty-seven percent, 39% and 14% belonged to the <35 years, 35-60 years, and ≥60-year groups, respectively. 55% were female, 86% had a low-medium socioeconomic level. Cow-derived cheese, milk, and yogurt were the most commonly consumed dairy products. Obese participants had a lower total consumption of dairy products (17.1%) than normal-weight subjects (25.7%, p<0.05). Higher cheese intake was significantly associated with a lower obesity risk (ORadj: 0.70; 95%CI 0.51-0.96, p<0.05). Other types of dairy products and total consumption of dairy products were not significantly associated.

DISCUSSION AND CONCLUSIONS

Habitual cheese consumption, but not other dairy products, was associated with a lower risk of obesity in this sample of Chilean adults.

The pharmacology of vitamin C

Ascorbic acid, the reduced form of vitamin C, is a ubiquitous small carbohydrate. Despite decades of focused research, new metabolic functions of this universal electron donor are still being discovered and add to the complexity of our view of vitamin C in human health. Although praised as an unsurpassed water-soluble antioxidant in plasma and cells, the most interesting functions of vitamin C seem to be its roles as specific electron donor in numerous biological reactions ranging from the well-known hydroxylation of proline to cofactor for the epigenetic master regulators ten-eleven translocation enzymes and Jumonji domain-containing histone-lysine demethylases. Some of these functions may have important implications for disease prevention and treatment and have spiked renewed interest in, eg, vitamin C's potential in cancer therapy. Moreover, some fundamental pharmacokinetic properties of vitamin C remain to be established including if other mechanisms than passive diffusion governs the efflux of ascorbate anions from the cell. Taken together, there still seems to be much to learn about the pharmacology of vitamin C and its role in health and disease. This review explores new avenues of vitamin C and integrates our present knowledge of its pharmacology. SIGNIFICANCE STATEMENT: Vitamin C is involved in multiple biological reactions of which most are essential to human health. Hundreds of millions of people are considered deficient in vitamin C according to accepted guidelines, but little is known about the long-term consequences. Although the complexity of vitamin C's physiology and pharmacology has been widely disregarded in clinical studies for decades, it seems clear that a deeper understanding of particularly its pharmacology holds the key to unravel and possibly exploit the potential of vitamin C in disease prevention and therapy.

Exploring the prevalence of gout among underrepresented low socioeconomic status type 2 diabetes populations

BACKGROUND

Underserved and underrepresented populations often lack access to affordable, quality healthcare, educational resources, and nutritious foods, all of which contribute to increased risk of Type 2 Diabetes and gout. Type 2 Diabetes is a condition characterized by the denaturation of the insulin receptors, due to chronically high blood glucose levels, leading to impaired regulation of blood sugar. Gout is a chronic inflammatory disease affecting joints in the lower limbs, marked by elevated serum urate levels and the accumulation of uric acid crystals in synovial fluid, causing painful flare-ups that significantly impact quality of life.

METHODS

This multisite cross-sectional study was conducted in three low-income senior residential communities across the mid-Atlantic United States, including Philadelphia and Harrisburg, Pennsylvania, and Clinton, Maryland. A total of 88 consenting participants were surveyed on their health history and tested for hemoglobin A1c (HbA1c), blood glucose, and uric acid levels using finger-stick blood tests and commercially available devices. Inclusion criteria included individuals of any gender, aged 35-92, residing in these communities. Exclusion criteria were a personal history of cancer, organ transplantation, or current pregnancy. Educational materials were provided after discussing each participant's results.

RESULTS

There is an identifiable prevalence of gout among this population of low-income senior adults living with Type 2 Diabetes. Among the participants, 30.7% had serum urate levels indicative of hyperuricemia, exceeding the national average of 20.1% as reported by the National Health and Nutrition Examination Survey. Participants with high HbA1c had significantly higher uric acid levels compared to those with lower HbA1c levels, with diabetic levels of HbA1c accounting for approximately 40% of the variance in uric acid levels. Additionally, study participants who smoked cigarettes were more likely to have hyperuricemia than non-smokers.

CONCLUSION

Preventive educational efforts focused on diet and lifestyle are critical to reducing the incidence of gout and Type 2 Diabetes in low-income elderly populations. Diabetic individuals are at a higher risk of developing hyperuricemia and gout compared to non-diabetics. Community-based educational health programs are necessary to make a measurable impact on these populations, prevent disease progression, and reduce the burden on healthcare systems.

Network analysis of smoking-related sleep characteristics in Chinese adults

The associations between multiple sleep characteristics and smoking behavior are inconsistent, and it is unclear which sleep characteristics are most crucial for tobacco prevention. This study aimed to explore the associations between smoking status/intensity and multiple sleep characteristics and to identify the potential core domain of smoking-related sleep using network analysis. Data were obtained from a survey of cancer-related risk factors among Chinese adults. Logistic regression models were used to quantify the associations between sleep characteristics and smoking status/intensity. Network analyses were employed to identify the core sleep characteristics. A total of 5,228 participants with a median age of 44 years old were included in the study. Current smoking was significantly positively associated with long nap time, difficulty falling asleep, late bedtime, getting up after 7 am, and waking up earlier than expected. There was significant positive association between current smoking and short sleep duration in young adults under 45 years old. Late bedtime and getting up after 7 am were only associated with current heavy smoking, but not current light smoking. Network analyses showed that multiple smoking-related sleep characteristics were interconnected, with difficulty falling asleep and late bedtime as central characteristics in the network. The study found that the associations between sleep characteristics and smoking varied by age and smoking intensity and highlights the potential benefits of sleep health promotion in smoking cessation, with a particular focus on difficulty falling asleep and late bedtime.

The Interactions between Smoking and Sleep

Smoking a cigarette before bed or first thing in the morning is a common habit. In this review, the relationship between smoking and sleep is investigated based on the existing literature. Out of 6504 unique items that were identified via a PubMed search related to smoking and sleep, 151 were included in this review. Tobacco smoking disrupts sleep architecture by reducing slow wave and rapid eye movement (REM) sleep and undermining sleep quality. Furthermore, smoking affects sleep-related co-morbidities, such as obstructive sleep apnea-hypopnea syndrome (OSAHS), insomnia, parasomnias, arousals, bruxism, and restless legs, as well as non-sleep-related conditions such as cardiovascular, metabolic, respiratory, neurologic, psychiatric, inflammatory, gynecologic and pediatric issues, while poor sleep quality also seems to worsen the chances of successful smoking cessation. In conclusion, the existing literature suggests that there is a wicked relation between smoking and sleep.

Overweight and Obesity Is Associated with Higher Risk of Perceived Stress and Poor Sleep Quality in Young Adults

Background and Objectives: Overweight and obesity are growing public health challenges, particularly concerning young adults. University life presents a unique set of stressors that may influence weight management alongside sleep quality. In this cross-sectional study, we aimed to investigate the association between overweight or obesity, stress, and sleep quality in a large sample of Greek university students. Materials and Methods: The study recruited 2116 active students from across various Greek universities. Participants completed questionnaires on sociodemographics, academic performance, and physical activity levels using the International Physical Activity Questionnaire (IPAQ). Stress and sleep quality were assessed using the Perceived Stress Scale (PSS) and the Pittsburgh Sleep Quality Index (PSQI), respectively. Body weight and height were directly measured to calculate Body Mass Index (BMI). Results: Our analysis of 2116 Greek university students revealed significant associations between various factors and overweight/obesity. Compared to their rural counterparts, young adults in urban areas had an 88% higher prevalence of overweight/obesity (p = 0.0056). Regular smokers were twice as likely to be overweight or obese (p = 0.0012). Notably, those with low physical activity levels displayed a more than two-fold increased risk (p = 0.0008) compared to those with moderate or high activity levels. Similarly, students with moderate or high perceived stress levels had a more than two-fold prevalence of overweight/obesity compared to those with low stress (p = 0.0005). Inadequate sleep quality was also associated with an 86% higher risk of overweight/obesity (p = 0.0007). Interestingly, good academic performance showed a 57% greater prevalence of overweight/obesity compared to very good/excellent performance (p = 0.0103). Conclusions: Our findings reveal that perceived stress and poor sleep quality are significant risk factors for overweight and obesity in this young adult population.

Malnutrition and its associated factors among community-dwelling older men living alone

BACKGROUND/OBJECTIVES

Older men who live alone are more vulnerable to poor nutrition. However, little attention has been paid to malnutrition among this population. This study aimed to examine malnutrition and its associated factors among community-dwelling older men living alone.

SUBJECTS/METHODS

This cross-sectional descriptive study used cohort data of community-dwelling older adults living alone in South Korea. A total of 230 older men aged 65 and over were included in this study. Nutritional status was assessed using the Mini Nutritional Assessment-Short Form. Multidimensional factors (sociodemographic, health-related, psychosocial, and lifestyle characteristics) were evaluated. Hierarchical logistic regression analyses were conducted to identify the malnutrition-related factors.

RESULTS

The prevalence of malnutrition was 32.2% in older men living alone. Low income (odds ratio [OR], 2.44; 95% confidence interval [CI], 1.01-5.90), polypharmacy (OR, 2.23; 95% CI, 1.16-4.28), suicidal ideation (OR, 2.13; 95% CI, 1.02-4.45), meal skipping (OR, 3.26; 95% CI, 1.60-6.64), and smoking (OR, 2.86; 95% CI, 1.43-5.73) were significantly associated with malnutrition.

CONCLUSION

Malnutrition is a severe health problem in older men living alone. This study highlights the importance of comprehensive and tailored interventions to mitigate malnutrition among older men living alone.

Do tougher drinking policies affect men's smoking behavior - Evidence from China

In 2011, China implemented tougher driving-under-the-influence laws, which criminalized driving under the influence of alcohol for the first time and increased penalties. This paper provides the first comprehensive analysis of the effects of stricter drinking policies on men's smoking behavior by using data from the 2010 and 2012 waves of the China Family Panel Studies. The results show that stricter drinking policies reduced smoking initiation and the number of cigarettes smoked per day among men by reducing the frequency and quantity of alcohol consumption. Heterogeneity analyses show that the impact of the policy is more pronounced not only for men aged 41-55, but also for men who have higher educational qualifications, who are employed, or who are not members of the Communist Party.

Trends in sleep duration in the U.S. from 2004 to 2018: A decomposition analysis

Average sleep duration in the United States declined in recent years, and the decline may be linked with many biopsychosocial factors. We examine how a set of biopsychosocial factors have differentially contributed to the temporal trends in self-reported sleep duration across racial groups between 2004-2005 and 2017-2018. Using repeated nationally representative cross-sections from the National Health Interview Survey, we decompose the influence of biopsychosocial factors on sleep duration trends into two components. One component corresponds to coefficient changes (i.e., changes in the associations between behaviors or exposures and sleep duration) of key biopsychosocial factors, and the other part accounts for the compositional changes (i.e., changes in the distributions of exposures) in these biopsychosocial factors during the study period. We reveal that changes in the coefficients of some biopsychosocial factors are more important than compositional changes in explaining the decline in sleep duration within each racial/ethnic group. Our findings highlight racial differences manifest across multiple biopsychosocial domains that are shifting in terms of association and composition. Methodologically, we note that the standard regression approach for analyzing temporal trends neglects the role of coefficient changes over time and is thus insufficient for fully capturing how biopsychosocial factors may have influenced the temporal patterns in sleep duration and related health outcomes.

Plasma metabolite profiles associated with the World Cancer Research Fund/American Institute for Cancer Research lifestyle score and future risk of cardiovascular disease and type 2 diabetes

BACKGROUND

A healthy lifestyle (HL) has been inversely related to type 2 diabetes (T2D) and cardiovascular disease (CVD). However, few studies have identified a metabolite profile associated with HL. The present study aims to identify a metabolite profile of a HL score and assess its association with the incidence of T2D and CVD in individuals at high cardiovascular risk.

METHODS

In a subset of 1833 participants (age 55-80y) of the PREDIMED study, we estimated adherence to a HL using a composite score based on the 2018 Word Cancer Research Fund/American Institute for Cancer Research recommendations. Plasma metabolites were analyzed using LC-MS/MS methods at baseline (discovery sample) and 1-year of follow-up (validation sample). Cross-sectional associations between 385 known metabolites and the HL score were assessed using elastic net regression. A 10-cross-validation procedure was used, and correlation coefficients or AUC were assessed between the identified metabolite profiles and the self-reported HL score. We estimated the associations between the identified metabolite profiles and T2D and CVD using multivariable Cox regression models.

RESULTS

The metabolite profiles that identified HL as a dichotomous or continuous variable included 24 and 58 metabolites, respectively. These are amino acids or derivatives, lipids, and energy intermediates or xenobiotic compounds. After adjustment for potential confounders, baseline metabolite profiles were associated with a lower risk of T2D (hazard ratio [HR] and 95% confidence interval (CI): 0.54, 0.38-0.77 for dichotomous HL, and 0.22, 0.11-0.43 for continuous HL). Similar results were observed with CVD (HR, 95% CI: 0.59, 0.42-0.83 for dichotomous HF and HR, 95%CI: 0.58, 0.31-1.07 for continuous HL). The reduction in the risk of T2D and CVD was maintained or attenuated, respectively, for the 1-year metabolomic profile.

CONCLUSIONS

In an elderly population at high risk of CVD, a set of metabolites was selected as potential metabolites associated with the HL pattern predicting the risk of T2D and, to a lesser extent, CVD. These results support previous findings that some of these metabolites are inversely associated with the risk of T2D and CVD.

TRIAL REGISTRATION

The PREDIMED trial was registered at ISRCTN ( http://www.isrctn.com/ , ISRCTN35739639).

Factors Associated with Adherence to the Brazilian Food Guide in Food Service Workers

The present study aimed to evaluate factors associated with adherence to the Food Guide for the Brazilian Population (GAPB) among food service workers. A cross-sectional study was conducted with 421 employees from 43 food service establishments located in a capital of Brazil. Health and lifestyle data were collected, including the continuous use of medication, smoking, physical activity, and alcohol consumption. An instrument based on the GAPB was utilized, covering the domains of planning, household organization, eating habits, and food choices, according to GAPB recommendations. The findings revealed a direct association between the quality of life scores and the total GAPB adherence score (β = 1.17; p < 0.001), as well as the domains of planning (β = 0.53; p < 0.001), household organization (β = 0.22; p = 0.001), and eating habits (β = 0.38; p < 0.001). Adherence to the GAPB among food service workers was strongly linked to their perception of quality of life, in addition to other factors such as gender, age, education, type of work activity, and variables of lifestyle. Therefore, the eating practices of these employees need to be assessed comprehensively, and enhancing their quality of life can encourage proper and healthy eating.

Plant-Based Diets and the Incidence of Asthma Symptoms among Elderly Women, and the Mediating Role of Body Mass Index

We aimed to test the hypothesis that adherence to a healthful plant-based diet (hPDI) is associated with a subsequent decrease in the incidence of asthma symptoms, with an opposite association with adherence to an unhealthful plant-based diet (uPDI). In addition, we evaluated a potential mediating role of body mass index (BMI) and the modifying effect of smoking. Among 5700 elderly women from the French Asthma-E3N study with dietary data in 1993 and 2005, we assessed the incidence of asthma symptoms in 2018 among women with no asthma symptoms in 2011. BMI was evaluated in 2008. Mediation analyses in the counterfactual framework were used to disentangle total, direct, and indirect effects mediated by BMI. We found that both healthful and unhealthful plant-based diets were associated with a lower incidence of asthma symptoms over time, mediated by BMI (OR (95%CI) for the indirect effect: 0.94 (0.89-1.00) for hPDI and 0.92 (0.70-1.00) for uPDI)). Associations with both healthful and unhealthful PDIs were mediated by changes in BMI by 33% and 89%, respectively. Plant-based diets (healthful and unhealthful) were associated with subsequently reduced incidences of asthma symptoms over time, partly or almost totally mediated by BMI according to their nutritional quality.

Mediterranean Diet Adherence in Community-Dwelling Older Adults in Spain: Social Determinants Related to the Family

The Mediterranean diet (MD), a well-established quality diet model, and regular physical activity are associated with reducing the appearance or progression of several chronic diseases and reducing morbidity and mortality. However, reduction of these goals, adherence to the MD, and regular physical activity occur at all ages, including older individuals in Mediterranean countries such as Spain, where at least adherence to the MD is culturally rooted. Objective: To evaluate the degree of adherence to the MD and physical activity in older individuals. Methods: The sample comprises 679 older adults aged 60 and over who attended activities in municipal centers for older adults in Valencia. Adherence to the Mediterranean diet, frequency of physical activity, and anthropometric assessment were used. Results: High adherence (score ≥ 9) to MD was observed only in 23.7% of the study sample. Smoking habits or having meals in fast-food restaurants on a weekly basis were significantly (p < 0.05) associated with lower MD adherence. Age, BMI, marital status, and physical activity were not significantly associated with MD adherence. Physical activity was significantly (p < 0.05) lower in individuals who were divorced or widow/ers and in those taking care of their grandchildren several times a week. Conclusions: Adherence to the MD in a big Spanish city is low among older individuals. Socio-family factors seem to play a role. Public health and governmental strategies should reinforce adherence to the MD among older individuals as a gold standard for nutrition.

Plasma Metabolite Profiles Associated with the Amount and Source of Meat and Fish Consumption and the Risk of Type 2 Diabetes

SCOPE

Consumption of meat has been associated with a higher risk of type 2 diabetes (T2D), but if plasma metabolite profiles associated with these foods reflect this relationship is unknown. The objective is to identify a metabolite signature of consumption of total meat (TM), red meat (RM), processed red meat (PRM), and fish and examine if they are associated with T2D risk.

METHODS AND RESULTS

The discovery population includes 1833 participants from the PREDIMED trial. The internal validation sample includes 1522 participants with available 1-year follow-up metabolomic data. Associations between metabolites and TM, RM, PRM, and fish are evaluated with elastic net regression. Associations between the profiles and incident T2D are estimated using Cox regressions. The profiles included 72 metabolites for TM, 69 for RM, 74 for PRM, and 66 for fish. After adjusting for T2D risk factors, only profiles of TM (Hazard Ratio (HR): 1.25, 95% CI: 1.06-1.49), RM (HR: 1.27, 95% CI: 1.07-1.52), and PRM (HR: 1.27, 95% CI: 1.07-1.51) are associated with T2D.

CONCLUSIONS

The consumption of TM, its subtypes, and fish is associated with different metabolites, some of which have been previously associated with T2D. Scores based on the identified metabolites for TM, RM, and PRM show a significant association with T2D risk.

Epidemiology of tobacco use and nicotine dependence in truck drivers

OBJECTIVE

To investigate the epidemiology of tobacco use and nicotine dependence in a sample of truck drivers in Brazil.

METHODS

Between 2015 and 2016, a cross-sectional study was conducted on 624 truck drivers who operate on the BR-050 highway in Brazil. Participants were interviewed about sociodemographic data, occupational characteristics, mental health, behavioral data, and tobacco use. Then, the Fagerstrom test for nicotine dependence (FTND) was used to verify nicotine dependence in smoking truck drivers. Logistic regression and linear regression were also used to verify factors associated with tobacco use in the previous 30 days and nicotine dependence scores, respectively.

RESULTS

The prevalence of tobacco use among truck drivers was 21.1% (n = 132;95%CI: 18.1-24.5). Of the total number of smokers who responded to the FTND (n = 118; 89.4%), most had high/very high nicotinic dependence (68.6%; 95%CI: 59.8-76.3). Tobacco use was associated with absence of religion (adjusted odds ratio [AOR]: 2.60; 95%CI: 1.35-5.01), employment relationship of the contract (AOR = 1.98; 95%CI: 1.26-3.13); > 12 hours daily working time (AOR = 1.80; 95%CI: 1.09-2.98) and alcohol use in the previous 30 days (AOR = 2.92; 95%CI: 1.86-4.57). Irregular physical activity was associated with higher scores of nicotine dependence (β = 1.87; 95%CI: 0.55-3.19).

CONCLUSION

The results showed a high prevalence of tobacco use and high/very high nicotine dependence among the truck drivers.

Short-term exposure to JUUL electronic cigarettes can worsen ischemic stroke outcome

BACKGROUND

The short and long-term health effects of JUUL electronic cigarette (e-Cig) are largely unknown and warrant extensive research. We hypothesized that JUUL exposure could cause cerebrovascular toxicities impacting the progression and outcome of ischemic stroke comparable to tobacco smoke (TS) exposure.

METHODS

We exposed male C57 mice to TS/JUUL vapor for 14 days. LCMS/MS was used to measure brain and plasma nicotine and cotinine level. Transient middle cerebral artery occlusion (tMCAO) followed by reperfusion was used to mimic ischemic stroke. Plasma levels of IL-6 and thrombomodulin were assessed by enzyme-linked immunosorbent assay. At the same time, western blotting was used to study blood-brain barrier (BBB) tight junction (TJ) proteins expression and key inflammatory and oxidative stress markers.

RESULTS

tMCAO upregulated IL-6 and decreased plasma thrombomodulin levels. Post-ischemic brain injury following tMCAO was significantly worsened by JUUL/TS pre-exposure. TJ proteins expression was also downregulated by JUUL/TS pre-exposure after tMCAO. Like TS, exposure to JUUL downregulated the expression of the antioxidant Nrf2. ICAM-1 was upregulated in mice subjected to tMCAO following pre-exposure to TS or JUUL, with a greater effect of TS than JUUL.

CONCLUSIONS

These results suggest that JUUL exposure could negatively impact the cerebrovascular system, although to a lesser extent than TS exposure.

Noise Exposure and Quality of Life Among Nurses

BACKGROUND

The purpose of this study was to describe the relationship between noise exposure, selected health conditions, and well-being among nurses.

METHODS

A secondary analysis was performed on data obtained from 3,818 U.S. nurses who responded to a survey regarding noise exposure, health conditions, stress, professional quality of life, and workplace support.

FINDINGS

Those who reported high noise exposure reported more health conditions, higher stress and burnout scores, and lower supportive environments. High noise exposure was significantly associated with lower professional quality of life.

CONCLUSION/APPLICATION TO PRACTICE

Noise may impact the health and quality of professional life of nurses. Occupational health nurses should advocate for the regular monitoring of nurses' exposure to hazardous noise at work, compare it to OSHA permissible levels, and collaborate with the occupational health team to ensure safe noise levels are maintained. Occupational health nurses should advocate for expanded research on effects of noise on health.

[Nutritional problems in smokers and passive smokers]

OBJECTIVE

active or passive tobacco use affects a high percentage of individuals and is associated with various health risks. The aim of this review was to look more closely at the nutritional problems that are specific of smokers, which may harm their health.

METHODS

a bibliographic search related to the topic.

RESULTS

smokers consume lower amounts of various foods, especially fruits, vegetables, cereals and dairy. As a result, their intake of vitamins, minerals, and phytochemicals is lower than that observed in non-smokers. Their consumption of meat, caffeine and alcohol is usually higher, and their activity lower than those of non-smokers, coexisting in smokers unhealthy behaviors that contribute to harming their health and quality of life. Oxidative stress and metabolic changes render the needs for some nutrients higher in smokers to achieve the same biochemical situation as in non-smokers. Recommended intakes of vitamin C have increased, but it will probably be necessary to also increase the intakes of other nutrients. In general, smokers suffer from deficiencies more frequently (vitamins C, E, β-carotene, B1, B2, B12, folic acid, calcium, magnesium, iron, iodine, etc.) than non-smokers. Passive smokers are also affected in their eating habits and nutritional status.

CONCLUSIONS

the worse nutritional status of smokers can contribute to the appearance/worsening of various diseases associated with smoking (cardiovascular, cancer, cataracts, osteoporosis, etc.); therefore, nutritional surveillance and correction of nutritional deficiencies could represents health benefits for smokers and passive smokers, which should be considered in the future.

Sleep Quality Associated with Habitual Physical Activity Level and Autonomic Nervous System of Smokers

BACKGROUND

Few studies have examined the relationship of one's habitual physical activity level and autonomic nervous system (ANS) modulation on sleep quality in smokers.

OBJECTIVE

The aim of this study was to identify changes in the sleep quality of smokers and its relation with their habitual physical activity level and ANS modulation.

METHODS

Forty-two smokers were divided into two groups according to the 50th percentile of the moderate-to-vigorous physical activity (MVPA). Sleep quality was assessed using the Mini-sleep Questionnaire, and ANS modulation was assessed by indices of heart rate variability (HRV). To examine the possible mean differences, the analysis of covariance (ANCOVA) was used, adjusted for age, sex, body composition, pack-years, beta-blockers, anxiety, and depression in log base 10, not including qualitative data, such as sex and beta-blockers. Correlations were made by using the Spearman rank correlation. The statistical significance was set at 5.

RESULTS

The smokers who were less active showed poor sleep quality (p=0.048) and insomnia (p=0.045). Furthermore, the less active group presented decreased parasympathetic modulation [HF (un; p=0.049); RMSSD (ms; p=0.047) and SD1 (ms; p=0.047)] and an increased LF (un) index (p=0.033) and LF/HF ratio (p=0.040). A positive correlation between the total Mini-sleep score with LF (un) index (r=0.317, p=0.041) and LF/HF ratio (r=0.318, p=0.040) and negative correlation with HF (un) index (r= -0.322, p=0.038).

CONCLUSIONS

Smokers with lower levels of habitual physical activity showed poor sleep quality and alterations in autonomic nervous system modulation; (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0).

Social Smoking Environment and Associations With Cardiac Rehabilitation Attendance

PURPOSE

Continued cigarette smoking after a major cardiac event predicts worse health outcomes and leads to reduced participation in cardiac rehabilitation (CR). Understanding which characteristics of current smokers are associated with CR attendance and smoking cessation will help improve care for these high-risk patients. We examined whether smoking among social connections was associated with CR participation and continued smoking in cardiac patients.

METHODS

Participants included 149 patients hospitalized with an acute cardiac event who self-reported smoking prior to the hospitalization and were eligible for outpatient CR. Participants completed a survey on their smoking habits prior to hospitalization and 3 mo later. Participants were dichotomized into two groups by the proportion of friends or family currently smoking ("None-Few" vs "Some-Most"). Sociodemographic, health, secondhand smoke exposure, and smoking measures were compared using t tests and χ2 tests (P < .05). ORs were calculated to compare self-reported rates of CR attendance and smoking cessation at 3-mo follow-up.

RESULTS

Compared with the "None-Few" group, participants in the "Some-Most" group experienced more secondhand smoke exposure (P < .01) and were less likely to attend CR at follow-up (OR = 0.40; 95% CI, 0.17-0.93). Participants in the "Some-Most" group tended to be less likely to quit smoking, but this difference was not statistically significant.

CONCLUSION

Social environments with more smokers predicted worse outpatient CR attendance. Clinicians should consider smoking within the social network of the patient as an important potential barrier to pro-health behavior change.

Associations of dietary habits and sleep in older adults: a 9-year follow-up cohort study

PURPOSE

China has faced rapid growth of its older adult population, shifting dietary landscape, and sleep-related problems. However, knowledge regarding the associations of dietary behavior on sleep-related outcomes with longitudinal data remains limited. This study investigates the relationships of dietary habits with sleep quality and duration.

METHODS

Using data from the Chinese Longitudinal Health Longevity Survey (CLHLS), older adults were included in the 9-year span between 2005 and 2014 (age ≥ 60; n = 62,552). Self-reported dietary habits, sleep quality, and sleep duration (hours) were assessed. Four types of dietary behaviors were identified: vegetables, fruits, egg, and meat. Cox proportional hazard models were used to explore the potential association between dietary habits and sleep status. The outcomes were self-reported sleep quality and sufficient sleep duration (7-8 h daily).

RESULTS

In the study sample, the median age was 87 years old, and approximately 57.2% of the study participants were female. More than 60% of the older adult population had good quality sleep, and almost 40% of participants slept 7-8 h a day. In the fully adjusted Cox models, daily fruits, meat, and egg consumption were positively associated with sleep quality (all p < 0.05). Compared with participants who rarely consumed or did not consume vegetables, more frequent consumption was positively associated with sufficient sleep duration (all p < 0.0001) but was not associated with sleep quality.

CONCLUSION

Older adults should be aware that sleep quality and duration might be related to their dietary habits.

Uso de Álcool e outras Substâncias Psicoativas por Estudantes Universitários de Psicologia

Resumo O consumo de substâncias psicoativas (SPAs) cresce em escala global, especialmente entre universitários. Este estudo tem como objetivo avaliar o padrão de uso de álcool e outras SPAs em estudantes universitários. A amostra foi composta por 180 graduandos de Psicologia que preencheram um questionário sociodemográfico e instrumentos de rastreamento do uso de SPAs validados para o contexto brasileiro. Os resultados evidenciaram maior prevalência do uso de álcool: 81,7% na vida, 67,6% nos últimos três meses e 55% no padrão binge. Dentre os motivos endossados para o consumo destaca-se o convívio universitário, porém o fator mais valorizado foi o álcool como potencializador do desejo de fumar, seguido de sua percepção como fator gregário em festas/reuniões sociais e como facilitador do enfrentamento de estresse. As pressões da vida universitária geram insegurança e instabilidade que deixam os jovens universitários mais suscetíveis à influência dos pares e à busca de diversão e descontração em ambientes de festas, nas quais o consumo é estimulado e facilitado, o que pode favorecer o beber em quantidade excessiva. Esse padrão de consumo pode se associar a outros comportamentos de risco, como dirigir sob efeito do álcool, manter relações sexuais sem proteção ou envolver-se em distúrbios da ordem pública e infrações à lei. Considerando que os jovens fazem uso em excesso de SPAs sem um suporte social comunitário adequado, é necessário investir em programas de prevenção e políticas públicas guiadas pelas noções de autocuidado, protagonismo e participação ativa na própria reabilitação.

[Physical activity and health-related lifestyle in the Spanish population living with musculoskeletal disease]

Introduction

Background: physical activity is a health-related behavior that is associated with increased well-being in people living with musculoskeletal disease. Objective: we assessed the association of different health and lifestyle factors with physical activity in the Spanish population living with musculoskeletal disease. Method: we used data from the 2014 European Health Survey for Spain. The population was classified according to their musculoskeletal disease (including osteoarthritis, back pain, osteoporosis, or several of these diseases) diagnostic status. The survey collected data on habitual physical activity and other health-related behaviors (diet, alcohol and tobacco consumption, among others) and other health indicators (self-perceived health status, perceived pain, mental health, physical limitations, among others). We used multivariate logistic regression models to analyze the relationship between the different variables studied in the population living with musculoskeletal disease. Results: physical activity is associated with daily fruit and vegetable intake, regardless of age and sex, and with daily fish consumption in women aged 45 years and older. Tobacco smoking is higher in inactive women and men, while weekly consumption of alcohol is associated with more physical activity (except in women aged 15-44 years). Conclusions: physical activity is a behavior associated with a better health status and healthier lifestyle in the Spanish population living with musculoskeletal disease.

The impact of tobacco smoking on physical activity and metabolism in mice

Cigarette smoking can increase the risk of many respiratory and chronic systemic diseases. Particularly, cigarette smoke produces toxic particulate matter (PM), which is harmful to the smokers. Although previous studies have demonstrated the toxicity of cigarette smoke PM and its relationship with disease pathogenesis, systematic data for the impact of cigarette smoke PM on physical activity and metabolism in animals are still lacking. In this report, the C57/B6 mice were exposed to cigarette smoke PM in a smoking chamber coupled with the analysis of metabolic changes and physical activity in metabolic cages at indicated time, for a period up to 12-month-old of age. The mice became excited following short period (e.g., 3 months) but listless after long-term cigarette smoke PM exposures (e.g., 9 or 10 months), as manifested by the changes of drink/food intake and daily activities along with increased oxygen consumption and CO₂ accumulation. Our data suggest that particulate matter originated from cigarette smoke impairs metabolism and physical activities.

The Relationship between the Number of Daily Health-Related Behavioral Risk Factors and Sleep Health of the Elderly in China

This study examined the cross-sectional association among a number of daily health-related behavioral risk factors and sleep among Chinese elderly. A sample of 4993 adults, aged 60 years and older, from the China’s Health-Related Quality of Life Survey for Older Adults 2018 was included in this study. Five daily health-related behaviors, which included smoking, drinking, unhealthy eating habits, insufficient leisure activities, and physical inactivity were measured. Sleep disturbances and sleep quality were used to represent the respondents’ sleep status. Multiple logistic regression models and multiple linear regression models were established. The odds ratios (ORs) of sleep disturbances for those with one to five health-related risk behaviors were 1.41 (95% CI = 1.11 to 1.78), 2.09 (95% CI = 1.66 to 2.63), 2.54 (95% CI = 1.99 to 3.25), 2.12 (95% CI = 1.60 to 2.80), and 2.49 (95% CI = 1.70 to 3.65), respectively. Individuals with one health-related risk behavior (B = 0.14, 95% CI = −0.23 to −0.06), two health-related risk behaviors (B = 0.21, 95% CI = −0.30 to −0.13), three health-related risk behaviors (B = 0.46, 95% CI = −0.55 to −0.37), four health-related risk behaviors (B = 0.50, 95% CI = −0.62 to −0.39), and five health-related risk behaviors (B = 0.83, 95% CI = −1.00 to −0.66) showed lower scores of self-perceived sleep quality. Having multiple health-risk behaviors was positively correlated with a higher risk of sleep disturbances among Chinese elderly. Moreover, elderly individuals with multiple health-related risk behaviors were significantly associated with poorer sleep quality.

Smoking and Physical Activity Trajectories from Childhood to Midlife

Introduction: Despite substantial interest in the development of health behaviors, there is limited research that has examined the longitudinal relationship between physical activity (PA) and smoking trajectories from youth to adulthood in a Finnish population. This study aimed to identify trajectories of smoking and PA for males and females, and study the relationship between these trajectories from youth to adulthood. Methods: Latent profile analysis (LPA) was used to identify trajectories of smoking and PA separately for males and females among 3355 Finnish adults (52.1% females). Participants' smoking and PA were assessed five to eight times over a 31-year period (3⁻18 years old at the baseline, 34⁻49 years at last follow-up). Multinomial logistic regression analysis was used to study the relationship between the trajectories of smoking and PA. Results: Five smoking trajectories and four to five PA trajectories were identified for males and females. Of the PA trajectory groups, the persistently active group were least likely to follow the trajectories of regular smoking and the inactive and low active groups were least likely to follow non-smoking trajectory group. Likewise, inactive (women only) and low active groups were less likely to belong to the non-smokers group. Conclusions: The study suggests that those who are persistently active or increasingly active have substantially reduced probabilities of being in the highest-risk smoking categories.

Combined interventions for physical activity, sleep, and diet using smartphone apps: A scoping literature review

BACKGROUND

The use of smartphone apps to track and manage physical activity (PA), diet, and sleep is growing rapidly. Many apps aim to change individual behavior on these three key health dimensions (PA, sleep, diet) by using various interventions. Earlier reviews have examined interventions using smartphone apps for one or two of these dimensions. However, there is lack of reviews focusing on interventions for all three of these dimensions in combination with each other. This is important since the dimensions are often inter-related, and all are required for a healthy lifestyle.

OBJECTIVE

The objective of this study is to conduct a review to: (1) map out the research done using smartphone app interventions targeting all three or any two of the three dimensions (PA, sleep, and diet), (2) examine if the studies consider the inter-relationships among the dimensions, and (3) identify the personalization methods implemented by the studies.

METHODS

A literature search was conducted in electronic databases and libraries related to medical and informatics literature - PubMed, ScienceDirect, PsycINFO (ProQuest, Ovid) - using relevant selected keywords. Article selection and inclusion were done by removing duplicates, analyzing titles and abstracts, and then reviewing the full text of the articles.

RESULTS

In the final analysis, 14 articles were selected - 2 articles focusing on PA and sleep, 8 on PA and diet, and 4 that examine or (at least) collect data of all three dimensions (PA, sleep, and diet). No research was found that focused on sleep and diet together. Of the 14 articles, only 4 build user profiles. Further, 3 of these 4 studies deliver personalized feedback based on the user's profile, with only 1 study providing automated, personalized recommendations for behavior change. Additionally, 6 of the included studies report all positive outcomes, while for 3 studies the primary outcomes are awaited. The remaining 5 studies do not report significant changes in all outcomes. In all, only 1 study examines the relationship between two (PA and diet) dimensions. No study was found to assess the relationships among the 3 dimensions.

Does delay discounting predict maladaptive health and financial behaviors in smokers?

OBJECTIVE

Excessive delay discounting, the rapid devaluation of future rewards, is often demonstrated by individuals suffering from substance use disorders, including chronic cigarette smokers. This constricted temporal window not only produces increased valuation of immediate unhealthy rewards (e.g., cigarettes) but also a decreased valuation of both future healthy rewards (e.g., increased energy) and future consequences (e.g., lung cancer). Moreover, in addition to cigarettes, smokers tend to engage in other behaviors that elicit immediate rewards and negative future consequences such as overconsuming alcohol, unhealthy eating, physical inactivity, and/or irresponsible spending. The present study sought to determine whether smokers' discounting rate would predict the frequency of engagement in other poor health and financial behaviors, independent of cigarette smoking.

METHOD

A total of 303 daily smokers were asked to complete a delay discounting task and then answer how frequently they typically engaged in health and finance related behaviors.

RESULTS

A structural equation model was used to group the questions into highly significantly latent factors of "Drug Use," "Finances," "Fitness," "Food," "Health," "Household Savings," "Personal Development," and "Safe Driving." When regressed on the model, delay discounting significantly predicted engagement all of the factors, except "Safe Driving," independent of smoking status.

CONCLUSION

In sum, these findings highlight delay discounting as a useful metric for predicting whether individuals' engagement in variety of healthy physical and financial behaviors, as a function of their temporal window. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Tobacco exposure and sleep disturbance in 498 208 UK Biobank participants

Background

The prevalence of sleep disturbance is high and increasing. The study investigated whether active, former and passive smoking were associated with sleep disturbance.

Methods

This cross-sectional study used data from the UK Biobank: a cohort study of 502 655 participants, of whom 498 208 provided self-reported data on smoking and sleep characteristics. Multivariable multinomial and logistic regression models were used to examine the associations between smoking and sleep disturbance.

Results

Long-sleep duration (>9 h) was more common among current smokers [odds ratio (OR): 1.47; 95% confidence interval (CI): 1.17-1.85; probability value (P) = 0.001] than never smokers, especially heavy (>20/day) smokers (OR: 2.85; 95% CI: 1.66-4.89; P < 0.001). Former heavy (>20/day) smokers were also more likely to report short (<6 h) sleep duration (OR: 1.41; 95% CI: 1.25-1.60; P < 0.001), long-sleep duration (OR: 1.99; 95% CI: 1.47-2.71; P < 0.001) and sleeplessness (OR: 1.47; 95% CI: 1.38-1.57; P < 0.001) than never smokers. Among never smokers, those who lived with more than one smoker had higher odds of long-sleep duration than those not cohabitating with a smoker (OR: 2.71; 95% CI: 1.26-5.82; P = 0.011).

Conclusions

Active and passive exposure to high levels of tobacco smoke are associated with sleep disturbance. Existing global tobacco control interventions need to be enforced.

Associations between fruit and vegetable, and antioxidant nutrient intake and age-related macular degeneration by smoking status in elderly Korean men

Background

Age-related macular degeneration (AMD) is one of the major causes of irreversible blindness. The objective of this study was to determine whether there is any relationship between dietary intake of fruits and vegetables (F&V) and antioxidant nutrients including carotenoids and AMD according to smoking status in elderly men.

Methods

We performed a cross-sectional analysis using nationally representative samples of elderly aged ≥ 65 years (n = 1414) from the Korea National Health and Nutrition Examination Survey (KNHANES, 2010–2012).

Results

The current smokers consumed less food in total, and, in particular, less cereals/potatoes/sugar products, fruits and vegetables than the nonsmokers and former smokers (p < 0.05). Intake of energy, thiamin, vitamin C, vitamin A, and β-carotene were significantly lower in the current smokers than in the nonsmokers and the former smokers. For current smokers, the ORs of the highest tertile compared with the lowest tertile were 0.36 (95% CI: 0.14–0.96, p for trend = 0.0576) for F&V, 0.32 (95% CI: 0.12–0.85, p for trend = 0.0561) for vitamin C, 0.23 (95% CI: 0.08–0.67, p for trend = 0.0038) for α-carotene, 0.13 (95% CI: 0.04–0.46, p for trend = 0.0003) for β-carotene after adjusting for confounding factors. In contrast, there was no association between antioxidant nutrient intake and AMD among the nonsmokers and former smokers.

Conclusions

These results suggest that increased consumption of fruits and vegetables containing antioxidant components such as vitamin C, α-carotene, and β-carotene may have a protective effect on AMD. These effects may be more evident among current smokers.

The Prognostic Value of Combined Smoking and Alcohol Consumption Habits for the Estimation of Cause-Specific Mortality in Middle-Age and Elderly Population: Results from a Long-Term Cohort Study in Lithuania

Aim

To evaluate the prognostic value of combined smoking and alcohol consumption habits for the estimation of cause-specific mortality risk in middle-age and elderly population.

Methods

The study presents data from the four surveys. A random sample of 6,729 subjects aged 35-64 years was selected for statistical analysis. During the follow-up of 31 years (1983-2014), there were 2,158 deaths from any cause. Multivariate Cox's proportional hazards models were used to estimate hazard ratios (HR) for all-cause mortality and Competing Risk Regression analysis was used to estimate subdistribution hazard risk (SHR) for cause-specific mortality.

Results

Smoking clearly increased the risk of all-cause mortality and mortality from cancer and cardiovascular disease (CVD), but alcohol use had little effect in men aged 35-64 years. However, heavy alcohol consumption (>14 units/week) increased the risk of all-cause mortality and mortality from external causes in the never-smokers men group who drank alcohol of 1-14 units/week (HR 2 = 1.57 and SHR 2 = 2.40, resp.).

Conclusions

The smoking habits and alcohol consumption are modifiable risk factors, and thus efforts to support abstinence from alcohol and smoking use should be a public health priority.

Relationship between healthy lifestyle behaviors and cardiovascular risk factors in Chinese patients with type 2 diabetes mellitus: a subanalysis of the CCMR-3B STUDY

AIMS

This subanalysis of a cross-sectional, nationwide study was undertaken to assess the relationship between healthy lifestyle behaviors and multiple cardiovascular risk factors among people with type 2 diabetes mellitus (T2DM).

METHODS

Data collected from 25,454 participants, including demographics, lifestyle behaviors and cardiovascular risk profiles, were analyzed. Blood pressure control as well as blood glucose and blood lipid (3Bs) levels were measured as multi-risk factors for cardiovascular disease. Healthy lifestyle behaviors included regular exercise, nonsmoking status and no alcohol consumption. The relationship between the healthy lifestyle behavior(s) and control of 3B(s) was calculated.

RESULTS

Of the 25,454 eligible participants, 4171 (16.4%) were current smokers, 2011 (7.9%) currently consumed alcohol, and 11,174 (43.9%) did not exercise. In total, 654 (2.6%) reported all three unhealthy lifestyle behaviors. Most participants (71.1%) had received at least a high school education and were more likely to smoke and drink as compared to those with lower education. Unhealthy lifestyle behaviors were commonly found in participants with low atherosclerosis risk, such as non-elderly people and those with an above-college education level. Unhealthy lifestyle is associated with poor 3B control and worse medication adherence.

CONCLUSIONS

Unhealthy lifestyles are common in Chinese people with T2DM, especially in people who are non-elderly and above-college educated. Interventions aimed at changing risky lifestyle behaviors are required for improved outcomes for Chinese patients with T2DM.

Physical activity, smoking, and the incidence of clinically diagnosed insomnia

OBJECTIVE

This study was designed to examine the independent and combined associations of physical activity and smoking on the incidence of doctor-diagnosed insomnia using a nationally representative sample over seven years, taking into account other relevant covariates.

METHODS

Participants aged 18 years or older in the 2005 Taiwan National Health Interview Survey (NHIS) with links to National Health Insurance (NHI) claim data between 2005 and 2012 and without diagnosed insomnia before 2005, were selected into this study (n = 12,728). Participants were classified as having insomnia with International Classification of Diseases, Ninth Revision (ICD-9) CM codes 307.41, 307.42, or 780.52. Self-reported smoking status and frequency, duration, and types of leisure-time and non-leisure-time physical activities were collected. Metabolic equivalent (MET) intensity levels for each activity were assigned, and weekly energy expenditure of each activity was calculated and summed.

RESULTS

Inactive participants had a higher risk of incident insomnia [hazard ratio (HR) = 1.22, 95% confidence interval (CI) = 1.06-1.42, p = 0.007] than the active group, and ever-smokers were more likely to have incident insomnia than never smokers (HR = 1.45, 95% CI = 1.20-1.76, p < 0.001). Compared with the nonsmoker/active group, the ever-smoker/inactive group had a higher risk of incident insomnia (HR = 1.78, 95% CI = 1.41-2.25, p < 0.001). Sensitivity analyses excluding individuals diagnosed with other sleep disorders or mental disorders yielded similar results, with the ever-smoker/inactive group having the highest risk of insomnia.

CONCLUSIONS

Inactive adults and smokers are at higher risk for incident insomnia, highlighting the importance of a healthy lifestyle and pointing to strategies such as encouraging smoking cessation and physical activity to avoid insomnia among adults.