Search Results (3,331)

Background/Objectives: Oxidative stress and low-grade chronic inflammation are implicated in the early pathogenesis of non-communicable diseases (NCDs). Malondialdehyde (MDA), a biomarker of lipid peroxidation, may reflect subclinical oxidative stress in apparently healthy young adults. This study aimed to establish a population-specific reference interval for plasma MDA in healthy Thai undergraduate students and evaluate associations with lifestyle risk factors. Methods: This cross-sectional study enrolled 141 Thai college students aged 18–27 years. Plasma MDA was measured using the thiobarbituric acid reactive substances (TBARS) assay. A reference interval was determined non-parametrically (P2.5–P97.5) following IFCC recommendations in a reference subgroup (n = 94). The 75th percentile (P75) was used as an exploratory cutoff for elevated MDA. Associations between MDA and lifestyle risk factors were assessed using logistic regression and multiple linear regression. Results: The plasma MDA reference interval was 1.16–9.23 µmol/L, with P75 = 6.07 µmol/L. Using this cutoff, 25.5% of participants had elevated MDA. High sugar intake was associated with elevated MDA in the P75-based model (adjusted OR = 3.42; 95% CI: 1.08–10.87; p = 0.036). In the linear regression model, BMI emerged as independently associated with MDA (p = 0.004). Conclusions: This study established the first population-specific plasma MDA reference interval for Thai young adults. High sugar intake and BMI emerged as complementary exploratory associations with elevated lipid peroxidation across different models. These findings support plasma MDA as a practical, cost-effective candidate biomarker, providing a basis for further early oxidative stress surveillance and NCD prevention in young populations. Full article

Background: Screen-based distractions during meals are increasingly common during adolescence and have been linked to less healthy eating behaviors. Chronotype, an individual’s circadian preference for morningness or eveningness, is associated with differences in alertness, self-regulation, and recreational screen use across the day, which may in turn influence susceptibility to distractions during meals. However, the relationship between chronotype and eating distraction behaviors remains largely unexplored. Therefore, this study examined the association between chronotype and eating distraction behaviors in Spanish adolescents. Methods: A cross-sectional study was carried out in 820 adolescents aged 12–17 years from the Eating Healthy and Daily Life Activities (EHDLA) project. Chronotype was assessed using the Morningness–Eveningness Scale for Children and classified as evening, intermediate, or morning type. Eating distractions were evaluated using a composite score that included eating lunch or dinner while watching television, using mobile devices or social networks during meals, and eating while standing. Associations were examined using ordinal regression models (proportional odds), with eveningness as the reference category; both unadjusted and adjusted models are reported, with adjustment for relevant sociodemographic and lifestyle covariates. Results: In adjusted ordinal regression models with eveningness as reference, morningness was related to lower odds of being in a higher eating distractions category (odds ratio [OR] = 0.53; 95% confidence interval [CI] 0.35–0.82; p = 0.004). Morningness was also associated with lower odds of a higher category of television viewing during meals (OR = 0.59; 95% CI 0.38–0.93; p = 0.024). No significant associations were identified for eating while using a phone or social networks or for eating while standing. Conclusions: Chronotype was independently associated with eating distraction behaviors in Spanish adolescents, with evening types showing a less favorable pattern. These findings suggest that circadian preference may be relevant when addressing mealtime behaviors during adolescence and could help inform future health promotion strategies. Full article

Background: Population aging is intensifying the burden of cognitive decline and dementia, while sustainability is becoming central to how health and care systems respond; yet the research at the intersection of these two agendas has not been mapped. Methods: A bibliometric and thematic analysis was conducted on 1100 documents retrieved from the Web of Science Core Collection and Scopus (2000–2026) and analyzed with the bibliometric package, combining performance analysis, science mapping, and an interpretive labelling of the keyword co-occurrence clusters. Results: The literature grew rapidly (19.9% annual growth) and was concentrated in high-income countries, with the United States and the United Kingdom as the leading collaborators. Four themes were identified: multidomain lifestyle prevention of dementia and mental health; the cognitive health continuum; caregiving and sustainable care delivery for the oldest old; and sustainability as a transversal, foundational dimension. Sustainability appeared as a basic, transversal theme rather than an explicit research focus, and quality of life recurred across the themes. Conclusions: Research on elderly brain care rests on a largely implicit foundation of sustainability. Making sustainability explicit, linking brain health to healthy–longevity and brain–capital frameworks, and broadening participation beyond high-income settings are the field’s main priorities. Full article

Endothelial dysfunction is a key mechanism linking obesity, metabolic disturbances, and cardiovascular disease, contributing to the development and progression of atherosclerosis and other vascular complications. This review provides a comprehensive overview of the molecular mechanisms underlying endothelial dysfunction in obesity and discusses current diagnostic approaches and therapeutic strategies aimed at restoring vascular homeostasis. The available evidence indicates that chronic inflammation, oxidative stress, insulin resistance, reduced nitric oxide bioavailability, increased reactive oxygen species production, and dysregulated adipokine signaling play central roles in endothelial impairment. Recent advances in functional vascular assessment, circulating biomarkers, and imaging techniques have improved the early identification of endothelial dysfunction and cardiovascular risk. Current therapeutic strategies include pharmacological agents, such as glucagon-like peptide-1 receptor agonists, sodium-glucose co-transporter 2 inhibitors, metformin, and dipeptidyl peptidase-4 inhibitors, together with lifestyle interventions based on healthy dietary patterns and regular aerobic and resistance exercise. These approaches improve glycemic control, reduce inflammation and oxidative stress, enhance endothelial function, and contribute to cardiovascular protection. Overall, the evidence supports an integrated and personalized management strategy targeting both metabolic and vascular abnormalities to reduce cardiovascular risk and improve long-term clinical outcomes in individuals with obesity. Full article

The perimenopausal phase represents a critical window for early intervention against accelerated bone loss, highlighting an urgent need for safe and accessible non-pharmacological strategies. Although mind–body exercises are widely recommended for healthy aging, their specific structural and metabolic impacts on the perimenopausal skeleton yield conflicting results and remain poorly understood. To address this gap, this systematic review and three-level meta-analysis evaluated the effects of mind–body modalities on bone health in perimenopausal women, utilizing this model to account for statistical dependencies among multiple effect sizes within individual studies. Quantitative synthesis suggested that mind–body exercise may offer modest structural benefits, indicated by positive effects on bone mineral density (SMD = 0.55, p < 0.01) and bone mineral content (SMD = 1.63, p < 0.01); however, these findings must be interpreted with caution as the accompanying certainty of evidence is low to very low. Conversely, these structural adaptations were not accompanied by stable alterations in bone turnover markers, which remained consistently unchanged (SMD = −0.10, p > 0.05). Furthermore, bone mineral metabolism was not statistically significant in the primary analysis, with a confidence interval that included the null (SMD = 0.90, p = 0.079) and demonstrated limited stability across robustness checks. Assessed via the GRADE framework, this overall very low certainty was primarily due to risk-of-bias concerns, inconsistency, imprecision, suspected publication bias, and clinical heterogeneity. Consequently, given the current evidence limitations, mind–body exercise is best conceptualized as a supportive lifestyle component of a healthy aging trajectory rather than a potent osteogenic therapy. It offers a holistic preventative approach that might support bone health while concurrently supporting overall musculoskeletal resilience, though firm clinical recommendations cannot yet be made. Future well-powered trials must adopt rigorous designs with precise endocrine staging to better clarify the underlying mechanisms of skeletal adaptation. Full article

Background: Technostress has emerged as a major occupational health concern in increasingly digitalized workplaces. Although organizational and technological determinants of technostress have been widely investigated, the potential influence of healthy lifestyle behaviors remains poorly understood. This study aimed to evaluate the association between a combined Healthy Lifestyle Score (HLS) and technostress in a large cross-sectional sample of Spanish workers. Methods: A cross-sectional study was conducted among 104,175 workers who underwent routine occupational health examinations between January 2021 and December 2024. The Healthy Lifestyle Score was constructed by assigning one point each for regular physical activity, high adherence to the Mediterranean diet, and non-smoking status, resulting in scores ranging from 0 to 3. Technostress was assessed using the Technostress Short Questionnaire (TCS-Short) and categorized as low, moderate, high, or very high. Logistic regression models were used to estimate crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for high-to-very high technostress according to HLS categories. Results: Significant differences in technostress levels were observed across HLS categories (p < 0.001). The prevalence of high-to-very high technostress was 50.8% among workers with HLS = 0 and 50.7% among those with HLS = 1, decreasing markedly to 7.5% and 7.2% among workers with HLS = 2 and HLS = 3, respectively. After adjustment for sex, age, educational level, and social class, participants with HLS = 2 and HLS = 3 exhibited substantially lower odds of high technostress (OR = 0.073, 95% CI 0.068–0.078 and OR = 0.074, 95% CI 0.069–0.079, respectively) compared with those with HLS = 0. The categorical analysis suggested a threshold-like rather than progressive association, with substantially lower odds of high-to-very high technostress observed among workers with HLS = 2 and HLS = 3, whereas HLS = 1 did not show lower odds compared with HLS = 0. The final model demonstrated excellent discrimination (AUC = 0.902). Conclusions: Healthy lifestyle profiles were strongly associated with technostress in this large cross-sectional occupational sample. Workers with HLS = 2 and HLS = 3 showed markedly lower odds of high-to-very high technostress than those with HLS = 0, whereas HLS = 1 did not show lower odds. Component-specific analyses indicated that the associations differed substantially across the behaviors comprising the score, supporting interpretation of the HLS as an unweighted behavioral count rather than as a measure of equivalent contributions from each component. Full article

Background: Depressive symptoms have become a significant public health issue faced by middle-aged and older adults in China. Although previous studies have primarily focused on demographic and socioeconomic factors, the association between modifiable lifestyle behaviors and depressive symptoms still requires further investigation. Objective: To examine the associations between sleep duration, physical activity, digital participation, social participation, and depressive symptoms as well as life satisfaction among middle-aged and older adults in China. Methods: A cross-sectional analysis was conducted using data from the 2020 China Health and Retirement Longitudinal Survey (CHARLS). Depressive symptoms were defined as CES-D-10 scores ≥10, with 13,576 individuals included in the analysis sample. Adjusted prevalence ratios (aPRs) were estimated using modified Poisson regression, while ordinal logistic regression was employed to analyze life satisfaction. The analysis controlled for covariates such as demographics, socioeconomic status, and health status, and accounted for the complex sampling design. Results: The weighted prevalence of depressive symptoms was 44.5%. Sleep deprivation (<7 h/day) was significantly associated with elevated depressive symptoms (aPR = 1.49, 95% CI: 1.33–1.68); participation in recreational activities was significantly associated with reduced depressive symptoms (aPR = 0.86, 95% CI: 0.77–0.96); adequate physical activity was associated with a higher prevalence of elevated depressive symptoms (aPR = 1.17, 95% CI: 1.04–1.32); watching videos (aPR = 0.87, 95% CI: 0.76–0.99) and playing online games (aPR = 0.65, 95% CI: 0.50–0.83) were significantly associated with reduced depressive symptoms; and overall internet use was correlated with lower life satisfaction (OR = 0.90, 95% CI: 0.81–1.00). Women, rural residents, and low-income groups exhibited higher prevalence of elevated depressive symptoms. Conclusion: Sleep deprivation, as well as different types of social engagement, physical activity, and digital behavior, exhibit distinct associations with depressive symptoms in middle-aged and older adults. Behavioral intervention strategies targeting sleep hygiene, leisure activities, and tailored digital behaviors warrant further attention. Full article

Background: Healthy lifestyle guidance is an important component of outpatient preventive care, yet evidence is limited on whether outpatients receive satisfactory guidance across multiple lifestyle domains. This study examined receipt of satisfactory healthy lifestyle guidance and its associated factors among outpatients in China. Methods: This national multicenter cross-sectional study used data from the outpatient component of the fifth National Third-Party Evaluation of the Action Plan for Further Improving Healthcare Services. A total of 31,599 outpatients from 143 tertiary public hospitals across all 31 provincial-level administrative regions of mainland China were included. The primary outcome was receipt of satisfactory healthy lifestyle guidance, defined as receiving at least one type of guidance and reporting satisfaction or high satisfaction. Mixed-effects logistic regression models with hospital-level random intercepts were used to identify associated factors. Results: Dietary guidance was the most frequently reported domain, followed by physical activity, weight management, and smoking cessation and alcohol reduction guidance. Overall, most outpatients were classified as having received satisfactory healthy lifestyle guidance. In the fully adjusted model, male sex and hypertension were associated with higher odds of satisfactory guidance, whereas a greater number of chronic conditions and unclear physician type were associated with lower odds. Satisfaction with history taking and disease communication and perceived respect and comfort from healthcare professionals were strongly associated with satisfactory healthy lifestyle guidance. However, these contemporaneously measured patient-reported indicators may reflect overlapping dimensions of patients’ overall outpatient care experience. Sensitivity analyses yielded broadly consistent findings. Conclusions: Satisfactory healthy lifestyle guidance was common among outpatients in China’s tertiary public hospitals, but guidance was unevenly distributed across lifestyle domains. Patients’ evaluations of satisfactory healthy lifestyle guidance were closely associated with their broader communication and interpersonal care experiences. However, because these measures were self-reported and assessed contemporaneously, the observed associations should not be interpreted causally. Full article

Background: Population aging is driving a convergent rise in three disorders historically managed in isolation: cardiovascular disease, neurocognitive decline, and osteoporotic bone loss. Mechanistic data indicate that these systems are coupled through shared regulators of calcium trafficking, inflammation resolution, vascular integrity, and inflammaging. On this basis, a “Heart–Brain–Bone” axis has been proposed; it should be understood as an integrative conceptual framework that organizes evidence drawn from three separate studies, not as a validated physiological entity with agreed diagnostic criteria or demonstrated modifiability. Three lipid-soluble nutrients—long-chain omega-3 polyunsaturated fatty acids (EPA/DHA), vitamin D3 (cholecalciferol), and vitamin K2 (menaquinone-7 [MK-7])—act on overlapping nodes of this network. Methods: We performed a structured narrative review. PubMed/MEDLINE, Embase, the Cochrane Library, and Web of Science were searched from database inception to 25 June 2026 using predefined term blocks for each nutrient, each organ domain, and each candidate mechanism, and the search was updated on 7 August 2026. Records were screened against prespecified inclusion and exclusion criteria by two authors independently, with disagreements resolved by a third. The strength of evidence for each nutrient–organ relationship was graded with an explicitly defined four-level scheme ((−) to (+++)) applied separately to preclinical, observational, randomized and meta-analytic evidence. Results: Vitamin K2-dependent gamma-carboxylation of matrix Gla protein (MGP) and osteocalcin has been proposed to influence whether calcium is incorporated into the bone matrix or deposited in the arterial wall, offering a candidate mechanistic account of the “calcium paradox” associated with isolated vitamin D3 supplementation; EPA/DHA-derived specialized pro-resolving mediators may support resolution of endothelial and neuronal inflammation; and bone-, vascular- and brain-derived signals (osteocalcin, FGF23, the neurovascular unit) interconnect the three organs. These mechanisms are biologically plausible but remain insufficiently confirmed in humans. The clinical evidence is heterogeneous, formulation- and population-dependent, and comprises positive, neutral and null results: cardiovascular omega-3 trials are discordant (REDUCE-IT, which used icosapent ethyl [an EPA ethyl ester], positive; VITAL/STRENGTH/ASCEND null, predominantly in lower-risk or replete cohorts); cognitive trials are largely null or subgroup-dependent (MAPT, DO-HEALTH, VITAL); and MK-7 improves surrogate bone and calcification biomarkers and slowed coronary artery calcification in one recent randomized imaging trial (VitaK-CAC), whereas combined MK-7 plus vitamin D3 did not slow aortic valve or coronary calcification in AVADEC and MK-7 did not reduce bone loss in early menopausal women. Recognized safety signals include a dose-dependent increase in atrial fibrillation with high-dose omega-3, adverse skeletal effects of high-dose or bolus vitamin D, and clinically relevant interference of even low-dose MK-7 with vitamin K antagonist therapy. Conclusions: No adequately powered randomized trial has demonstrated that the combination of long-chain omega-3, vitamin D3 and MK-7 is superior to its individual components or to placebo for any clinical endpoint. The combined regimen is therefore mechanistically rational and hypothesis-generating rather than clinically established; benefit appears most plausible in individuals with elevated risk or demonstrable nutritional insufficiency, and least in replete, low-risk populations. Findings should be interpreted within a broader healthy-aging context that includes lifestyle and psychosocial factors. Adequately powered factorial randomized controlled trials stratified by baseline Omega-3 index, 25(OH)D and vitamin K status, with prespecified mechanistic biomarkers and hard endpoints, are required. Full article

As global aging accelerates, identifying age- and lifestyle-associated gut microbiota alterations has become critical for understanding healthy aging and microbiota-targeted interventions. To explore the associations of age and lifestyle factors with gut microbiota profiles in community-dwelling adults, 159 Chongqing residents were divided into young (18–39, n = 44), middle-aged (40–59, n = 71) and elderly (60–89, n = 44) groups. Fecal samples were analyzed by 16S rRNA gene sequencing, and lifestyle factors were assessed using a study-specific structured questionnaire. The Shannon index differed significantly between the young and middle-aged groups (p < 0.05), whereas other α-diversity and β-diversity analyses showed no significant differences. Age-related shift trends included decreased Bacillota and increased abundance of Bacteroidota. Young adults were enriched in Parasutterella, the [Eubacterium] ventriosum group and Anaerostipes; middle-aged adults were enriched in Clostridium sensu stricto 4, Clostridium sensu stricto 1 and Holdemanella; and elderly adults were enriched in Prevotellaceae UCG-004, Helicobacter, Lactobacillus, Streptococcus and Fusobacterium. Lifestyle factors were independently associated with specific microbial signatures, including tea-related enrichment of Catenibacterium and Escherichia–Shigella, exercise-related enrichment of Dialister and Bavariicoccus, and milk-related enrichment of Bacillus and Klebsiella (formerly Raoultella). Overall, these findings provide population-based evidence linking age and lifestyle factors with gut microbial profiles and may inform microbiota-targeted strategies for healthy aging. Full article

Background: Coronary artery disease (CAD) remains a leading global health burden largely driven by modifiable risk factors, and public awareness plays a critical role in its prevention and early risk reduction. However, gaps in knowledge and behavioral practice persist. Objective: This study aims to assess awareness of CAD risk factors and examine its relationship with the socio-demographic characteristics, lifestyle behaviors, personal medical history, and family history among residents of the Jazan Region, Saudi Arabia. Methods: A cross-sectional study was conducted among 559 participants between April and May of 2026. Data were collected using a structured questionnaire assessing awareness of behavioral, clinical, and non-modifiable risk factors. Awareness was scored out of 12 and categorized as poor (<50%), moderate (50–75%), or high (>75%). Chi-square tests were applied to analyze associations, and binary logistic regression analysis was performed to determine independent factors associated with high awareness. The results are expressed as adjusted odds ratios (aORs) with 95% confidence intervals. Statistical significance was set at p < 0.05, and data were analyzed using IBM SPSS Statistics v.29. Results: Among the 559 participants, 67.3% demonstrated high awareness, 29.9% moderate awareness, and 2.9% poor awareness of CAD risk factors. Awareness of modifiable factors was high, including smoking (96.8%), obesity (95.5%), hypertension (94.6%), and high cholesterol (93.4%), while non-modifiable factors such as family history (54.6%) and sex (60.3%) were less recognized. In the bivariate analysis, significant associations with awareness were found for age, body mass index (BMI), education, marital status, and employment status. Exercise was significantly associated with awareness (p = 0.020), with higher awareness levels observed in individuals with greater activity. High awareness was independently linked to a higher educational level (aOR = 1.76, p = 0.009) and a previous diagnosis of CAD (aOR = 6.28, p = 0.014). Conclusions: This study found moderate to high CAD risk factor knowledge among adult residents in the Jazan Region. Self-reported preventative practices differed among health behaviors, demonstrating that awareness alone may not always lead to healthy lifestyles. As the cross-sectional nature of the study precludes causal conclusions, more longitudinal, qualitative, or theory-informed research is needed to understand the drivers of healthy behavior adoption. Full article

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease involving complex interactions between inflammatory and metabolic pathways. Asprosin is a glucogenic adipokine involved in glucose homeostasis, which has been investigated in relation to obesity, insulin resistance, and inflammatory processes. This study aimed to evaluate serum asprosin levels in patients with HS and to investigate their associations with disease severity and selected metabolic and inflammatory characteristics. Methods: This single-center, case–control study included 44 patients with HS and 44 age- and sex-matched healthy controls. Sociodemographic, clinical, anthropometric, metabolic, and inflammatory parameters were recorded. Serum asprosin levels were measured using an enzyme-linked immunosorbent assay, while disease severity was assessed using Hurley staging and the International Hidradenitis Suppurativa Severity Score System (IHS4). Multivariable regression analyses were performed using log-transformed asprosin concentrations to evaluate the independent association between HS status and serum asprosin after adjustment for relevant metabolic and lifestyle-related factors. Results: Serum asprosin levels were significantly lower in patients with HS than in healthy controls in the unadjusted analysis (30.07 ± 28.15 vs. 40.94 ± 33.11 ng/mL, respectively; p = 0.028). However, HS status was not independently associated with serum asprosin levels after adjustment for BMI, smoking status, metabolic syndrome, age, and sex or after adjustment for BMI, smoking status, fasting glucose, triglycerides, and HDL cholesterol. Additionally, BMI showed a consistent negative association with serum asprosin levels across all three models. Serum asprosin was not significantly associated with Hurley stage, IHS4 score, or metabolic syndrome, and ROC analysis demonstrated poor discriminatory performance of serum asprosin, with an area under the curve of 0.364, a sensitivity of 43.2%, and a specificity of 38.6%. Conclusions: Serum asprosin levels were lower in patients with HS than in healthy controls in the unadjusted analysis; however, this difference was not independently associated with HS after adjustment for relevant confounding factors. The absence of associations with disease severity and the poor discriminatory performance in ROC analysis do not support serum asprosin as a diagnostic or disease severity biomarker for HS. Thus, further prospective and mechanistic studies are required to clarify the biological significance of altered asprosin levels in HS. Full article

To advance technological applications in animal welfare assessment, this study evaluated resting activity as a component of total locomotor activity (TLA) in horses using two different accelerometer devices: a collar-mounted device containing a single-axis accelerometer that records physical movement, and a three axes accelerometer that classifies the measured physical activity into nine different activities. Ten clinically healthy Italian saddle horses were enrolled in the study and divided into two groups on the basis of their lifestyle. Group A consisted of regularly trained horses housed continuously in boxes, Group B comprised retired horses turned out in paddocks during the day and stabled in boxes at night. TLA was simultaneously monitored for 48 consecutive hours using both devices, in each horse. Two-way ANOVA applied to the one-axis and three-axis data showed a significant effect of group (p < 0.0001) and day in group A (p < 0.0001), with higher intensity values during day 1 compared to day 2 (p < 0.0001). A significantly greater amount of time spent in the “Lying/sitting rest” (recumbency) position was observed in group A (3.37 h ± 1.19 h) compared to group B (1.88 h ± 0.06 h), in both days of monitoring (p < 0.0001). A greater amount of time spent in the “Lying/sitting rest” (recumbency) position was observed during day 1 (4.16 h) compared to day 2 (2.58 h), in group A (p < 0.0001). Both devices detect the same qualitative pattern of group and day differences. Different amounts of activity were observed in trained and retired horses, with more rest periods in trained than in retired horses. Full article

Background: Gut microbiota plays a key role in the aging process, with age-related microbial shifts contributing to chronic inflammation, metabolic dysfunction, frailty, and cognitive decline. Despite growing interest, an integrated synthesis of how diet and lifestyle modifications influence gut microbiota remains limited. This overview of reviews summarizes the current evidence on how dietary and lifestyle interventions shape microbial composition and affect aging outcomes. Methods: Following the PRISMA guidelines, we searched PubMed and Scopus for English-language reviews (January 2023–October 2025) including human adults aged ≥ 18 years, evaluating dietary or lifestyle interventions, and reporting gut microbiota with healthy-aging outcomes. Quality of the reviews was appraised using the SANRA tool. Results: Mediterranean and plant-based diets, calorie restriction, and microbiota-targeted approaches such as probiotics, prebiotics, symbiotics, and fecal microbiota transplantation were associated with increases in short-chain fatty acid-producing bacteria, including Faecalibacterium, Bifidobacterium, Lactobacillus, and Akkermansia muciniphila, while reducing pro-inflammatory taxa. These changes were linked to improved metabolic and immune function, reduced inflammaging, lower frailty, and greater physical resilience. Cognitive benefits included decreased neuroinflammation and a lower risk of Alzheimer’s and Parkinson’s diseases. Conclusions: Maintaining microbial balance through targeted dietary strategies may support healthier, more resilient aging, offering practical insights for public health and clinical nutrition planning. Full article

Background: Quality of life (QoL) among university students is an important indicator of overall health and academic success. Although these factors are interrelated, few studies have simultaneously examined their structural associations with QoL among university students in Saudi Arabia. This study investigated the associations among demographic characteristics, lifestyle behaviors, psychological distress, and quality of life using structural equation modeling (SEM). Methods: We conducted a cross-sectional study among undergraduate students enrolled in public universities in Riyadh, Saudi Arabia. The survey included demographic characteristics, the Depression Anxiety Stress Scale-21 (DASS-21), the World Health Organization Quality of Life-BREF (WHOQOL-BREF), and measures of sleep quality, sleep duration, and physical activity. Confirmatory factor analysis was performed to evaluate the measurement model. We fitted SEM to examine associations among demographic characteristics, lifestyle behaviors, health status, and quality of life. Results: A total of 198 undergraduate students were included in the analysis. The measurement model demonstrated satisfactory psychometric properties. The SEM demonstrated acceptable model fit (χ²/df = 2.00, Comparative Fit Index = 0.937, Tucker–Lewis Index = 0.914, Root Mean Square Error of Approximation = 0.071, Standardized Root Mean Square Residual = 0.070). Male students reported poorer sleep quality (β = −0.405, p < 0.001), shorter sleep duration (β = −0.208, p = 0.019), and lower physical activity (β = −0.299, p < 0.001) than female students. Students with a GPA of 4.50 or above reported higher physical activity than those with lower GPAs (β = 0.182, p = 0.027). Better sleep quality (β = 0.169, p = 0.024) and very good or excellent self-rated health (β = 0.492, p < 0.001) were positively associated with quality of life, whereas sleep duration was not significantly associated with quality of life (p = 0.225). Conclusions: Quality of life among undergraduate students was associated with multiple interconnected demographic and lifestyle factors. Our findings highlight the importance of integrated university health-promotion strategies that simultaneously address sleep health, healthy lifestyle behaviors, and psychological well-being to improve students’ overall quality of life. Longitudinal studies should be conducted to clarify the temporal relationships among these factors. Full article