The association between subjective health perception and lifestyle factors in Shiga prefecture, Japan: a cross-sectional study

Association of meal component combinations with nutrient adequacy in Japanese adults

BACKGROUND AND OBJECTIVES

Consuming a diet that ensures adequate nutrient intake is essential to address all forms of malnutrition. In Japan, a meal combining staple food, main dish, and side dish is considered a balanced diet. This study was conducted to investigate the frequency of meals combining staple food, main dish, and side dish associated with nutrient adequacy.

METHODS AND STUDY DESIGN

This cross-sectional study included 6,264 adults. All data were obtained from the 2015 Health and Nutrition Survey in Shiga prefecture. Staple food, main dish, and side dish were each defined as a dish with primary ingredients of ≥50 g. Regarding the frequency, participants were divided into ≥2 and <2 times/d groups. The nutrient adequacy evaluated using the Dietary Reference Intakes for Japanese 2020 (DRIs-J) score is based on the reference values provided in the DRIs-J. The t-test was used to evaluate nutrient adequacy between the 2 groups.

RESULTS

Of the total participants, only 1,423 (22.7%) were classified into the ≥2 times/d group, and they had significantly higher DRIs-J scores than participants in the <2 times/d group (p < 0.001). The adequacy percentage of all nutrients except saturated fatty acid, particularly dietary fiber and most micronutrients, was > 1.5-fold higher in the ≥2 times/d group than in the <2 times/d group (p < 0.001).

CONCLUSIONS

This study provides important information that meals combining staple food, main dish, and side dish at least twice a day is effective in maintaining a diet with high nutrient adequacy.

Association between behavioral and sociodemographic factors and high subjective health among adolescents: a nationwide representative study in South Korea

The need to understand subjective health has increased during the COVID-19 pandemic, given its substantial impact on lifestyle habits and perceptions. Thus, this study aimed to investigate the trends and association of subjective health with demographic and behavioral factors, primarily focusing on the change when the COVID-19 pandemic emerged. This study used data from the Korea Youth Risk Behavior Web-based Survey, comprising 1,190,468 adolescents aged 12-18 years (female, 48.49%). We investigated the trends and association of subjective health with demographic and behavioral factors from 2006 to 2023. A weighted linear regression and joinpoint regression were conducted to evaluate the trend in adolescent subjective health, while logistic regression was used to assess associated factors. A stratification analysis was performed for subgroups to determine variations across different demographic and behavioral groups. The prevalence of reporting high subjective health increased throughout the years before the COVID-19 pandemic; however, subjective health exhibited a decreasing trend during the pandemic. Regarding demographic factors, female sex (ratio of odds ratio [ROR], 0.85 [95% CI, 0.83-0.87]), low-income households (ROR, 0.67 [95% CI, 0.64-0.69]), and low academic achievement (ROR, 0.83 [95% CI, 0.81-0.85]) were associated with less likelihood of reporting high subjective health. Healthier behavioral factors (ROR, breakfast consumption, 1.13 [95% CI, 1.10-1.16]; sufficient fruit intake, 1.12 [95% CI, 1.09-1.15]; sufficient physical activity, 2.02 [95% CI, 1.95-2.09]) were associated with higher subjective health, and the disparities increased during the COVID-19 pandemic. To address the observed decline in subjective health among adolescents during the COVID-19 pandemic, targeted interventions aimed at promoting healthy behaviors among particularly vulnerable demographics are crucial.

Subjective and objective health according to the characteristics of older adults: Using data from a national survey of older Koreans

As society rapidly ages, older adults are becoming an important national issue. Health is a multidimensional concept and both objective and subjective health must be managed. This study investigated factors that influence the subjective and objective health of older adults. This study analyzed the data of 9391 people aged ≥65 years using raw data from a 2020 survey of senior citizens. The relationships among the characteristics of older adults, such as demographic variables, lifestyle, external activities, environment, physical function, depression, cognition, activities of daily living, satisfaction with life and health, perceived health level, and number of diseases, were investigated. Older adults who drink and do not exercise generally have good objective health but poor subjective health. Older adults who mainly engage in external activities tend to have poor subjective health despite good objective health. The factors affecting subjective health in older adults were depression, cognition, physical factors, activities of daily living, and satisfaction. This study identified the differences between subjective and objective health based on the characteristics of older adults. As many variables affecting the health of older adults have been identified, these basic data will help prepare various programs to promote a healthy life for older adults.

Mediterranean diet and a health behavior index in relation to cardiovascular biomarkers: Data from the Health and Retirement Study

BACKGROUND AND AIM

Although lifestyle factors have been repeatedly examined for their role on cardiovascular diseases, their composite effect has not been frequently explored. We aimed to investigate the relation of dietary patterns (DPs) and a health behavior index (HBI) with cardiovascular biomarkers.

METHODS AND RESULTS

A cross-sectional analysis with data from 3461 US residents, participants in the Health and Retirement Study (HRS), was performed. Nutritional data were obtained with a food frequency questionnaire, while adherence to Mediterranean Diet (MD) was determined by the Mediterranean Diet Score. A posteriori DPs were estimated using principal component analysis and the HBI was constructed combining adherence to MD, smoking status, physical activity levels, alcohol consumption and body mass index. Multiple linear regression models were performed to examine the relation between DPs or HBI and levels of C-reactive protein (CRP), glycosylated hemoglobin (HbA1C), cystatin C (Cys C), total cholesterol (TC), high density lipoprotein (HDL) and TC:HDL in blood. Multiple linear regression showed that the "healthy" DP and the MD had a significant negative association with CRP and Cys C (p < 0.05), while the "Western-type" DP had a significant positive association with TC:HDL ratio, CRP and Cys C. Moreover, the HBI was positively associated with HDL (p < 0.05) and negatively associated with TC:HDL ratio, CRP and Cys C (p < 0.05).

CONCLUSIONS

Adherence to MD and to a healthy dietary pattern was negatively associated with biomarkers of inflammation, while the HBI was associated with a better cardiometabolic profile, assessed with blood biomarkers.

Insufficient Workplace Infection Control and Unhealthy Lifestyle Behaviors Are Related to Poor Self-Rated Health During the COVID-19 Pandemic

OBJECTIVE

This study investigated whether workers who practiced unhealthy lifestyles but worked under organizations with insufficient control against coronavirus disease 2019 (COVID-19) would pose a synergistic risk of poor self-rated health (SRH).

METHODS

A total of 22,637 workers (men, 48.5%) were extracted from an online survey during the COVID-19 pandemic in Japan (December 2020). Multiple logistic regression analyses were performed to estimate adjusted odds ratio (AOR) against poor (poor, fair) SRH.

RESULTS

Accumulation of unhealthy lifestyle behaviors (AOR, 1.49 to 4.40; P < 0.05) and insufficient infection control (AOR, 1.80; P < 0.05) were independently related to poor SRH; however, when these factors were combined, SRH was additively worsened (AOR, 2.14 to 7.72; P < 0.05).

CONCLUSIONS

This study highlights that not only unhealthy lifestyle practices but also poor organizational management against infection would worsen workers' SRH during the COVID-19 pandemic.

Domain-specific physical activity, sedentary behavior, subjective health, and health-related quality of life among older adults

PURPOSE

This study aims to investigate the association between domain-specific physical activity (PA), sedentary behavior, subjective health perception, and health-related quality of life (HR-QoL) in Korean adults aged ≥ 65 years.

METHODS

This cross-sectional study analyzed 6,004 older adults from the Korean National Health and Nutrition Examination Survey 2017-2020. PA and sedentary behavior were measured using a global PA questionnaire, and HR-QoL was assessed using the EuroQol-5 Dimension (EQ-5D, three-level version). Multiple logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) after adjusting for confounding parameters.

RESULTS

Older adults who were physically active at work showed a negative association with subjectively good health and HR-QoL, whereas those physically active in transport or leisure time showed a positive association with subjectively good health and HR-QoL. Older adults highly engaged in sedentary behavior showed a worse perception of health and HR-QoL. Compared to high sedentary behavior and physical activity during leisure time or transport, the EQ-5D index was higher than that of their counterparts.

CONCLUSION

Both domain-specific PA and sedentary behavior were significantly associated with older adults' perception of health and HR-QoL. Interventions are needed to improve HR-QoL by reducing sedentary behavior and encouraging physical activity in transportation or leisure time among adults aged 65 years and above.

Self-assessment of the health status and leisure activities of individuals on haemodialysis

Self-assessment of health status is an important marker of social and health aspects. Haemodialysis is an option for renal replacement therapy that alters daily life and impacts social participation and the performance of tasks that give the subject a socially accepted role. In this scenario, leisure activities have the potential to generate well-being and are associated with several aspects of daily life, but few studies have analysed their relationship with the self-assessment of health status. This is a cross-sectional, census study with 1024 individuals from haemodialysis units of a Southeast Brazilian region, with the application of a questionnaire in 2019. We calculated the difference between the proportions of self-assessment of health status (positive and negative) and the two logistic regression models. The chances of individuals on haemodialysis negatively evaluating their health increase when they do not perform artistic leisure activities (OR 2.15; 95% CI 1.35-3.43), physical and sports activities (OR 3.20; 95% CI 1.86-5.52), intellectual (OR 2.21; 95% CI 1.44-3.41), manuals (OR 1.82; 95% CI 1.22-2.72), social (OR 2.74; 95% CI 1.74-4.31), tourist (OR 2.08; 95% CI 1.37-3.17) and idleness and contemplative (OR 1.92; 95% CI 1.29-2.85). Negative health self-assessment is associated with not practicing artistic, manual, physical and sporting, social, intellectual, tourist, and contemplative leisure activities, which have the function of providing social participation and giving meaning to life.

The health status: the ignored risk factor in dementia incidence. NEDICES cohort

BACKGROUND

The causes of the dementia decrease in affluent countries are not well known but health amelioration could probably play a major role. Nevertheless, although many vascular and systemic disorders in adult life are well-known risk factors (RF) for dementia and Alzheimer disease (AD), health status is rarely considered as a single RF.

AIM

To analyse whether the health status and the self-perceived health (SPH) could be RF for dementia and AD and to discuss its biological basis.

METHODS

We analysed different objective health measures and SPH as RF for dementia and AD incidence in 4569 participants of the NEDICES cohort by means of Cox-regression models. The mean follow-up period was 3.2 (range: 0.03-6.6) years.

RESULTS

Ageing, low education, history of stroke, and "poor" SPH were the main RF for dementia and AD incidence, whereas physical activity was protective. "Poor" SPH had a hazard ratio = 1.66 (95% CI 1.17-2.46; p = 0.012) after controlling for different confounders.

DISCUSSION

According to data from NEDICES cohort, SPH is a better predictor of dementia and AD than other more objective health status proxies. SPH should be considered a holistic and biologically rooted indicator of health status, which can predict future development of dementia and AD in older adults.

CONCLUSIONS

Our data indicate that it is worthwhile to include the SPH status as a RF in the studies of dementia and AD incidence and to explore the effect of its improvement in the evolution of this incidence.

Clustering of health behaviors among Japanese adults and their association with socio-demographics and happiness

Background

Scholars have associated happiness with health behaviors, which co-occur and exert synergistic effects. Therefore, identifying clusters of health behaviors and their effect on happiness can contribute to the development of strategies for promoting happiness and improving health behaviors.

Aim

This study aimed to examine clusters of health behaviors and their associations with socio-demographics and with happiness among Japanese adults.

Methods

This study used data from the Japanese Household Panel Survey and the Keio Household Panel Survey. Questionnaires were distributed to 4,993 households out of which 1,554 responses were analyzed (participants aged 27−65 years). The survey included health behaviors (alcohol consumption, smoking, vegetable and fruit consumption, breakfast-eating habits, and physical activities), happiness, and socio-demographics. Latent class analysis was conducted to identify the clusters, whereas latent regression was employed to investigate socio-demographics related to the clusters. Logistic regression analysis was conducted to examine the relation between happiness and the clusters.

Results

Two health behavior clusters were identified: Cluster 1 (low substance use and good dietary habit; n = 817; 52.3%) and Cluster 2 (high alcohol, poor nutrition, and inactive; n = 737; 47.7%). Latent regression analysis indicated that all socio-demographics, barring socioeconomic status, were significantly associated with the clusters. The “low substance use and good dietary habit” cluster was significantly related with higher odds of happiness (odds ratio = 1.425, 95% confidence interval = 1.146−1.772, p = 0.001).

Conclusions

This study identified health behavior clusters among Japanese adults and established the association between the “low substance use and good dietary habit” cluster and high levels of happiness. However, the causality of the relationship between health behavior and happiness remains unclear, which highlights the need for further research to elucidate the underlying mechanisms.