Search Results (713)

Background/Objectives: The aim of this study was to evaluate baseline health measurements among transitional housing residents (n = 29) participating in an 8-week pilot wellness intervention. Methods: Researchers measured anthropometrics, body composition, muscular strength, cardiovascular indicators, physical activity, diet quality, and health-related perceptions. Researchers analyzed data using descriptive statistics and conventional content analysis. Results: Most participants were male, White, and food insecure. Mean BMI (31.8 ± 8.6 kg/m²), waist-to-hip ratio (1.0 ± 0.1 males, 0.9 ± 0.1 females), body fat percentage (25.8 ± 6.1% males, 40.5 ± 9.4% females), blood pressure (131.8 ± 17.9/85.2 ± 13.3 mmHg), and daily step counts exceeded recommended levels. Absolute grip strength (77.1 ± 19.4 kg males, 53.0 ± 15.7 kg females) and perceived general health were below reference standards. The Healthy Eating Index-2020 score (39.7/100) indicated low diet quality. Common barriers to healthy eating were financial constraints (29.6%) and limited cooking/storage facilities (29.6%), as well as to exercise, physical impediments (14.8%). Conclusions: Residents living in transitional housing have less favorable body composition, diet, and grip strength measures, putting them at risk for negative health outcomes. Wellness interventions aimed at promoting improved health-related outcomes while addressing common barriers to proper diet and exercise among transitional housing residents are warranted. Full article

Background/Introduction: Psychological inflexibility, which includes experiential avoidance, is a transdiagnostic process associated with multiple mental health issues in adolescence. Physical fitness (PF) has shown benefits for mental well-being, yet its specific relationship with psychological inflexibility remains understudied, particularly among youth. Objectives: To examine the association between components of PF and psychological inflexibility, measured by the Acceptance and Action Questionnaire-II (AAQ-II), in a representative sample of Spanish adolescents. Methods: A cross-sectional analysis was conducted using data from 631 adolescents (aged 12–17) participating in the Eating Healthy and Daily Life Activities (EHDLA) study. PF was assessed by the Assessing the Levels of PHysical Activity and Fitness (ALPHA-Fit) Test Battery (cardiorespiratory fitness, muscular strength, agility, and flexibility). Psychological inflexibility was measured using the AAQ-II. Generalized linear models (GLMs) were used to evaluate associations, adjusting for age, sex, body mass index, socioeconomic status, physical activity, sedentary behavior, sleep duration, and energy intake. Results: Unadjusted analyses showed weak but significant associations between psychological inflexibility and performance in the 20 m shuttle run test (p = 0.002), the 4 × 10 shuttle run test (p = 0.005), and the sit-and-reach test (p < 0.001). However, after adjusting for covariates, none of the PF components maintained a statistically significant association with the AAQ-II scores. Conclusions: In this adolescent sample, PF components were not independently associated with psychological inflexibility after adjustment for key confounders. These findings suggest that, while PF may contribute to general well-being, it is not a primary determinant of psychological inflexibility. Further longitudinal and intervention studies are needed to clarify the mechanisms linking physical and psychological health in youth. Full article

Background/Objectives: Acrylamide is a probably carcinogenic to humans that naturally forms during the thermal processing of foods. An individual’s lifestyle—especially dietary habits and physical activity—may influence the severity of acrylamide’s adverse health effects. This study aimed to examine the relationship between adolescents’ dietary and exercise behaviors and their dietary acrylamide exposure and associated health risks. Methods: This descriptive and cross-sectional study was conducted with 370 high school students in Türkiye. Data were collected using the Nutrition Exercise Behavior Scale (NEBS) and a retrospective 24-h dietary recall questionnaire. Acrylamide exposure was calculated based on food intake to estimate carcinogenic (CR) and non-corcinogenic (target hazard quotient: THQ) health risks and analyzed in relation to NEBS scores. Results: Findings indicated that while adolescents are beginning to adopt healthy eating and exercise habits, these behaviors are not yet consistent. Emotional eating and unhealthy food choices still occur. Higher acrylamide exposure and risk values were observed in boys and underweight individuals. This can be explained mainly by the fact that boys consume more of certain foods—especially bread, which contains relatively higher levels of acrylamide—than girls do, and that underweight individuals have lower body weights despite consuming similar amounts of food as other groups. Bread products emerged as the primary source of daily acrylamide intake. Positive correlations were found between NEBS total and subscale scores and acrylamide exposure and health risk values. Conclusions: The study demonstrates a significant association between adolescents’ health behaviors and acrylamide exposure. These results underscore potential public health concerns regarding acrylamide intake during adolescence and emphasize the need for targeted nutritional interventions to reduce risk and promote sustainable healthy behaviors. Full article

Background: Type 2 diabetes (T2D) is a growing public health concern, particularly in low- and middle-income countries. Although prediabetes is a major risk factor for T2D, it remains largely underdiagnosed and untreated. Structured lifestyle interventions have proven effective in preventing diabetes, but their feasibility within the Brazilian public health system remains unclear. Methods: This multicenter pilot randomized controlled trial assessed the feasibility of a culturally adapted lifestyle intervention (PROVEN-DIA) across the five regions of Brazil. A total of 220 adults at high risk for T2D were randomized to an intervention group or a control group (usual care) and followed for three months. Both groups received similar educational content on healthy eating and physical activity, but the intervention group participated in a structured and personalized lifestyle program with regular follow-up sessions. The primary outcome was adherence to dietary recommendations, assessed using the BALANCE Index—a validated dietary score (range: 0–40) based on the Brazilian Cardioprotective Diet that classifies foods into color-coded groups according to nutritional quality—along with engagement in moderate-to-vigorous physical activity (MVPA). Secondary outcomes included diet quality (DQIR), anthropometric and metabolic parameters. Results: Feasibility was demonstrated by a 93.2% retention rate (n = 205). There was no significant difference in the primary outcome (simultaneous improvement in diet and MVPA). However, the PROVEN-DIA group exhibited significantly greater improvements in diet quality, with a 2.8-point increase in the BALANCE Index (vs. 0.5 in the control, p = 0.03), and a significant improvement in the DQIR (p < 0.001). No significant differences between groups were observed in MVPA, HbA1C, glycaemia, or body weight. Conclusions: The PROVEN-DIA intervention proved feasible within the Brazilian public health context, resulting in significant improvements in dietary quality among individuals at high risk for T2D. A larger trial with longer follow-up is warranted to evaluate its effectiveness in preventing the progression to diabetes. However, to enhance physical activity outcomes, specific adaptations and targeted strategies may be required to better support participant engagement in exercise. Full article

Background/Objectives: Job stress negatively affects physical and psychological health and can lead to behavioral changes such as unhealthy eating. This study aimed to evaluate the relationship between job stress levels, adherence to the Mediterranean diet, and the phytochemical index (PI). Methods: The study included 200 healthy individuals aged 18–50 working at the Tuzla Gum Factory. Data were collected through demographic and dietary questionnaires, two-day 24-h food records, PI values, and anthropometric measurements. Job stress was assessed using the Job Stress Scale, and Mediterranean diet adherence was assessed with the Mediterranean Diet Adherence Questionnaire. Results: Waist and hip circumference, waist/hip ratio, and BMI were significantly higher in individuals with high levels of job stress (p < 0.01). Unskilled workers reported higher stress than professionals (p < 0.01). Significant differences were found in carbohydrate and fiber intake among males and in energy, protein, carbohydrate, and vitamin A intake among females with varying stress levels (p < 0.01). No significant difference in Mediterranean diet adherence was observed between medium and high stress groups. However, women had higher adherence and PI scores than men (p < 0.01). Diet adherence was better among managers than service-sales and technical staff (p < 0.01). PI scores were higher in medium stress than high stress individuals (p < 0.05) and in those with a higher BMI compared to a normal BMI (p < 0.01). Conclusions: Job stress influences both anthropometric parameters and dietary habits. Effective stress management may improve adherence to the Mediterranean diet and phytochemical intake. Workplace strategies supporting healthy eating behaviors are recommended. Full article

Background/Objectives: Occupational stress is a common issue among academics. This study aims to determine the level of work stress experienced by academics depending on their titles and the relationship between this stress and eating behaviors. Methods: The data for the study were collected through an online survey from 649 academicians working in universities in Türkiye between January and February 2025. This is a cross-sectional study, and the snowball sampling method was used to facilitate high participation rates. Data were collected using a demographic questionnaire, the General Work Stress Scale (GWSS) to assess work stress levels, and the Turkish version of the Adult Eating Behavior Questionnaire (AEBQ-TR) to evaluate eating behaviors. Results: Among the participants, 47.6% were of normal weight, with an average BMI of 25.85 ± 4.56 kg/m². The median work stress score of male academicians (17.00) was significantly lower than that of female academicians (21.00) (p < 0.001). Similarly, the median eating behavior score was lower in male academicians (18.55) compared to females (19.78) (p < 0.001). Work stress levels decreased with increasing academic title, with professors reporting the lowest levels of stress (p < 0.001). Conclusions: The findings indicate that female academics are more likely to engage in emotional eating under stress, whereas male academics tend to alter their dietary preferences by avoiding certain foods. These results underscore the importance of stress management and the promotion of healthy eating habits among academics. Full article

Background/Objectives: Dietary quality plays a crucial role in maintaining liver function. In this study, we examined sex differences in the association between dietary quality and elevated liver enzyme levels in Korean adults. Methods: This study included a nationwide sample of 15,997 males and 22,300 females in South Korea. Dietary assessment was performed using the Korean Healthy Eating Index (KHEI), an evidence-based dietary quality index that quantitatively reflects adherence to Korean dietary guidelines (range 0–100). Serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were measured, with individuals classified as having elevated AST or ALT levels when values were ≥40 IU/L or ≥35 IU/L, respectively. Logistic regression analysis was performed to examine the association between the KHEI and elevated AST or ALT levels stratified by sex. Odds ratios (ORs) and 95% confidence intervals (CIs) were determined. Results: Among the males, a 10-point increase in the KHEI score was inversely associated with the likelihood of having elevated AST (OR: 0.90; 95% CI: 0.85–0.96) and ALT (OR: 0.96; 95% CI: 0.92–1.00) levels, respectively. Among the females, there was no clear association between the KHEI and elevated AST (OR: 0.98; 95% CI: 0.91–1.05) or ALT (OR: 1.00; 95% CI: 0.95–1.05) levels. Conclusion: Further research is warranted to elucidate the underlying mechanisms of the observed sex-specific associations and guide the development of targeted dietary interventions for liver health in males and females. Full article

Background: Female collegiate runners may be at high risk for disordered eating and poor bone health, which are characteristics of the female athlete triad. Intuitive eating can promote healthy eating behavior and adequate calorie intake, central variables in calculating energy availability, an underlying cause of low bone mass in athletes. Poor bone health can contribute to injury, preventing optimal performance for athletes. The purpose of this study was to assess intuitive eating, energy availability, and bone mineral density in female college runners with comparison to non-athletes. Methods: Female college athletes (n = 13, 19.5 ± 1.4 yrs) and non-athletes (n = 12, 19.9 ± 1.3 yrs) completed the Intuitive Eating Scale, Eating Disorder Examination Questionnaire, and menstrual history survey. Bone mineral density and body composition were measured using a dual-energy X-ray absorptiometer (DEXA). A 3-day diet record and exercise log were used to assess dietary intake, estimate energy expenditure, and calculate energy availability. Results: Intuitive eating was inversely correlated with disordered eating (r = −0.596, p = 0.002). Intuitive eating scores were not correlated to calorie intake, energy availability, bone mass, or percent body fat. Runners consumed significantly more calories, calcium, magnesium, phosphorus, and protein (g/kg) than non-athletes. Energy availability and bone mineral density were not significantly different between runners and non-athletes. Conclusions: Intuitive eating is associated with healthy eating behaviors in college-age females and was not related to energy availability, bone density, or body composition in this population. Future research could explore the use of intuitive eating principles in reducing disordered eating and addressing low energy availability in female runners and non-athletes. Full article

Background/Objectives: Recent research indicates a global transition from healthy and balanced diets to unhealthy Westernized dietary patterns (WDPs). This transition is linked to increased rates of non-communicable diseases (NCDs), e.g., obesity, type 2 diabetes, and cardiovascular diseases, often preceded by metabolic syndrome (MetS). Therefore, the objective of this study was to develop a diet quality index, termed Westernized Diet Index (WDI), to assess adherence to WDPs and its association with main cardiometabolic health issues, for which MetS and its components were chosen as representatives of NCDs. Methods: The development of the WDI was driven by a semi-systematic and comprehensive examination of the literature (n = 491 articles) that evaluated the influence of WDP components on health outcomes. The scoring algorithm involved multiple steps, assigning scores based on study design, sample size, and the direction of food effects on health outcomes. Results: The final developed index encompassed 30 food groups/items. It was revealed that soft drinks, processed foods, red meat, sodium, and hydrogenated fats had the most detrimental effects on health, significantly influencing the index’s coefficients. In contrast, dietary fiber, plant-based metabolites, vitamins, minerals, nuts/seeds, and fish had the most substantial beneficial impacts. Conclusions: The WDI aligns with the existing literature on the importance of specific food items and with other validated diet quality indices, e.g., the Dietary Inflammatory Index (DII) and Alternate Healthy Eating Index (AHEI). Thus, the WDI can provide evidence for clinicians and researchers in formulating evidence-based dietary guidelines as well as strategies for the prevention and treatment of diet-related health issues. However, further validation is proposed to verify the WDI’s capability across different contexts. Full article

Body image and mental health outcomes are influenced by both sex and body weight. This study investigated how sex and BMI category (participants classified with healthy weight, overweight, or with obesity) relate to body image, disordered eating, weight bias, global self-esteem and depression. Participants (N = 642; 278 (43.3%) males; 364 females (56,7%)) provided self-report measures of appearance satisfaction, body appreciation, overweight preoccupation, disordered eating scores, weight bias, depression, and self-esteem. The results indicated that women and participants classified with overweight and obesity based on BMI categories reported lower appearance satisfaction and body appreciation and a higher preoccupation with overweight and depression. Interaction effects showed that women participants with overweight and obesity reported particularly low appearance satisfaction and body appreciation. Individuals classified with healthy BMI category reported higher disordered eating scores than those classified with overweight. No significant effects were found for global self-esteem. These findings suggest that sex and BMI contribute to the study’s variables of interest, with some effects more pronounced in women with a higher BMI. The results align with sociocultural theories of appearance pressure but indicate complexity in disordered eating patterns. The findings underscore the importance of adopting intersectional, weight-inclusive, and sex-responsive approaches in both research and clinical practice. Full article

Background: While some evidence supports the benefits of food-related tasks, research examining their association with psychosocial health in adolescents remains scarce. The aim of this study was to examine the association between Spanish adolescents’ involvement in food-related household tasks and their psychosocial health. Methods: This cross-sectional study used secondary data from the original Eating Healthy and Daily Life Activities (EHDLA) study. The final sample comprised 273 boys (43.0%) and 361 girls (57.0%). Adolescents self-reported their weekly frequency of involvement in two food-related tasks: meal preparation and grocery shopping, with responses ranging from ‘never’ to ‘seven times’. Psychosocial health was assessed using the 25-item self-report version of the Strengths and Difficulties Questionnaire (SDQ), comprising five subscales: emotional problems, conduct problems, hyperactivity, peer problems, and prosocial behavior. A total difficulties score was calculated by summing the first four subscales. Generalized linear models were used to evaluate associations between the frequency of food task involvement (categorized into five levels) and SDQ outcomes. All models were adjusted for age, sex, socioeconomic status, body mass index, sleep duration, physical activity, sedentary behavior, and energy intake. Results: Concerning to the frequency of helping to prepare food for dinner, an inverse association was observed between food preparation involvement and several psychosocial problems. Adolescents who helped seven times per week reported significantly lower scores in conduct problems (B = −2.00; 95% CI −3.30 to −0.69; p = 0.003), peer problems (B = −2.83; 95% CI −4.29 to −1.38; p < 0.001), internalizing problems (B = −3.90; 95% CI −7.03 to −0.77; p = 0.015), and total psychosocial difficulties (B = −5.74; 95% CI −10.68 to −0.80; p = 0.023), compared to those who never helped. Conversely, those who helped seven times per week had higher prosocial behavior than their counterparts who never helped (B = 1.69; 95% CI: 0.14 to 3.24; p = 0.033). Regarding the frequency of helping to shop for food, similar patterns were found, with lower conduct problems (B = −2.11; 95% CI −3.42 to −0.81; p = 0.002), peer problems (B = −2.88; 95% CI −4.34 to −1.42; p < 0.001), internalizing problems (B = −4.16; 95% CI −7.28 to −1.04; p = 0.009), and total psychosocial difficulties (B = −6.31; 95% CI −11.24 to −1.39; p = 0.012) associated with more frequent involvement, especially among those who helped five or more times per week. Conversely, adolescents who helped seven times per week had higher prosocial behavior than their peers who never helped (B = 1.56; 95% CI: 0.01 to 3.11; p = 0.049). Conclusions: Although adolescent psychosocial health is influenced by multiple factors, our findings suggest that regular involvement in food-related household tasks may serve as a protective factor against conduct problems, peer problems, internalizing problems, and total difficulties, while also enhancing prosocial behavior. However, given the cross-sectional design, conclusions regarding causality should be made cautiously, and further longitudinal research is needed to confirm these associations and assess their long-term impact. These results highlight the relevance of daily structured routines, such as meal preparation and grocery shopping, as potential support for mental well-being during adolescence. Full article

Background/Objectives: This cross-sectional study examined the association between diet quality, measured by the Korean Healthy Eating Index (KHEI), and medical expenditures among Korean adults. Methods: We used data from the Korea National Health and Nutrition Examination Survey (2016–2021). Adults aged ≥20 years with complete data on diet, sociodemographics, and healthcare use were included. Medical costs were estimated from self-reported service use and converted to USD. KHEI scores were categorized into quartiles. Multivariable linear regression was used to assess the association between KHEI quartiles and log-transformed costs. Subgroup analyses were conducted by age (<57 vs. ≥57 years), and sensitivity analyses treated KHEI as a continuous variable. A two-part model addressed skewed, zero-inflated cost data. Results: Compared to Q1, participants in Q4 had significantly lower inpatient (β = −0.080; 95% CI: −0.139 to −0.020) and total costs (β = −0.086; 95% CI: −0.144 to −0.027). In the younger group, Q4 was associated with lower total costs (β = −0.115; 95% CI: −0.198 to −0.031). Higher continuous KHEI scores were also linked to lower costs. In the two-part model, Q4 participants had a higher probability of incurring any cost but lower conditional costs (Q3 vs. Q1: β = −0.173; Q4 vs. Q1: β = −0.160; both p < 0.05). Conclusions: Higher diet quality was associated with reduced healthcare costs in Korean adults, especially among younger individuals. Promoting healthy eating may help lower economic burdens in aging societies. Full article

Background: Childhood obesity disproportionately affects Hispanic families in the U.S. Although parenting practices and interventions appear to be viable approaches to lower the risk of childhood obesity, there is limited information on which parenting practices would be relevant and culturally appropriate for Hispanic families. This study aimed to document the health-related factors that impact Hispanic parenting practices to inform evidence-based parenting interventions to improve child health outcomes and reduce the risk of childhood obesity. Methods: We conducted cross-sectional, formative research guided by the COREQ checklist. Hispanic parents of elementary school-aged children were recruited using purposive and snowball sampling. Eligible parents completed a brief sociodemographic survey, the Comprehensive Feeding Practices Questionnaire (CFPQ), and an individual semi-structured interview. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed using a coding-based thematic approach. Results: Seventeen parents (88.2% female) participated in the study, and the majority reported Spanish as their preferred language (70.6%). According to parent-reported data, the children’s (52.9% female) mean age was 8.4 ± 1.5 years, and over half were classified as having overweight or obesity. The CFPQ analysis indicated that parents scored highest on subscales related to encouraging healthy eating and eating variety, a finding that was reinforced by interview data. Qualitative analysis identified four key themes: 1. parenting roles, routines, and strategies for promoting culturally appropriate and healthy meals; 2. beliefs of children’s health and weight; 3. beliefs on physical activity and screen time; and 4. environmental and social factors affecting access to healthy food and physical activity. Conclusions: Both quantitative and qualitative results emphasize that parents engage in healthy eating guidance and eating variety and are aware of the factors that impact parenting practices and their children’s health. To improve child health outcomes and reduce the risk of childhood obesity among Hispanic families, parenting interventions need to be culturally responsive and address the factors that influence parenting practices. The findings from this study highlight four key areas to prioritize when designing or adapting parenting interventions to lower the risk of childhood obesity among Hispanic families. Full article

Contextualization: Lifestyle changes, such as smoking cessation, physical activity, and healthy eating, are essential for the treatment and prevention of cardiovascular diseases. The 2021 update of the European Society of Cardiology (ESC) guidelines highlights the need to investigate the adherence to the Mediterranean diet in patients who have suffered acute myocardial infarction (AMI). Objective: The aim of this study was to investigate the adherence to the Mediterranean diet and dietary 2021 ESC guidelines of individuals who have suffered AMI and to evaluate the sociodemographic and lifestyle factors associated with the adherence. Methods: A cross-sectional study was conducted using baseline data from participants prior to enrollment in the DICA-NUTS multicenter clinical trial. The dietary intake was assessed using a food frequency questionnaire and 24 h dietary recall. The nutrient intake was compared with the nutritional recommendations of the 2021 ESC guidelines, and the adherence to the Mediterranean diet was analyzed using a Mediterranean diet score. Furthermore, the analyses of the factors associated with the Mediterranean diet score and 2021 ESC were performed. Analyses were conducted using Stata Data Analysis and Statistical Software version 15.0. Values were considered statistically significant when the p-value < 0.05. Results: Among 488 participants aged ≥ 40 years, moderate adherence to the Mediterranean diet was observed obtaining an average of nine points, with a low intake of vegetables, fish, and cereals. The protein intake was adequate with 18% (interquartile range [IQR] 15.0–23.1) of the total energy value, and the saturated fat intake was high with 9.7% (IQR 7.3–12.7) of the total energy value, while the carbohydrate and total fat intake was adequate. According to the 2021 ESC guidelines, the fiber intake was low with more than 79% of the sample consuming less than 30 g per day. The multivariate analysis using the 2021 ESC dietary recommendations showed that older age (≥60 years) [odds ratio (OR) = 1.63; 95% confidential interval (CI) = 1.44–1.91], never smoking (OR = 1.34; 95% CI = 1.17–1.65), and higher education (OR = 1.37; 95% CI = 1.17–1.77) were correlated with an increased fruit and vegetable intake. Non-white, never-smokers, and former smokers were more likely to consume fish. The alcohol scores were higher in older age participants and women. The dairy scores increased with older age, while the cereal scores decreased. No significant association was found for legumes. Conclusions: According to the scores used, the diet of these individuals moderately reflects the Mediterranean characteristics. Analyzing the 2021 ESC dietary recommendations, the studied population was inadequate. This study found different factors associated with an adequate food intake in post-AMI patients. The highlight of this study was that older age is more likely to increase fruit, vegetable, and dairy intake. Full article

Background/Objective: The impact that lifestyle has on someone’s health has been widely proven. And the lifestyle can also be highly influenced by the sociodemographic background; however, there is less literature that focuses on this matter. Hence, the objective of the present study is to analyze the influence of sociodemographic variables on the lifestyle of the adult population. Methods: A cross-sectional multicenter study was conducted in 20 health centers of the Community of Madrid (Spain). A total of 365 participants were scheduled for nursing consultations and recruited through systematic probabilistic sampling. Lifestyle was assessed using the “Ponte a 100” questionnaire; based on the total score achieved by the participants, these were categorized into four groups depending on their need to adopt healthier lifestyle habits: minimal need (80–100 points), mild need (60–79 points), moderate need (40–59 points), and high need (<39 points). Results: Values ranged from 23 to 98 points in the Lifestyle Index (ISEV), with an average of 71.8 (SD = 14.6 points). Older individuals had better eating habits (β = −1.982), while younger individuals had better physical activity habits and a higher consumption of toxic substances. Men consumed more alcohol (β = −2.307) and felt happier with their lives, while women took more active breaks. Being a student was associated with higher levels of stress and anxiety, lower physical activity and leisure time, and higher alcohol consumption. Retirees had better emotional well-being indices (β = 0.999). Lower income levels were associated with occasional drug use and poorer emotional well-being. People with university degrees had better emotional states (β = 0.861) and better eating habits (β = 1.652) and engaged in more intense physical activity. Having no chronic diseases was related to being more physically active (β = 1.789). Conclusions: The study population generally presents a healthy lifestyle. The dimension of emotional well-being was the most influenced by sociodemographic factors. This study contributes to understanding the impact of socioeconomic variables on lifestyle. Full article