Search Results (702)

Non-communicable diseases, particularly cardiovascular diseases (CVD) and metabolic syndrome (MS), remain a major challenge for primary health care (PHC). This study aimed to assess cardiometabolic risk and health behaviours in adult PHC patients using routine preventive screening. This prospective observational study included 506 adults attending routine consultations in an urban PHC centre in Poland. Preventive assessment included anthropometric measurements (body weight, height, BMI, and waist circumference), blood pressure, lipid profile, and fasting glucose levels. Health behaviours were recorded using the standardised NFZ CHUK questionnaire. The 10-year CVD risk was estimated using the SCORE2 algorithm. Multivariable logistic regression was used to identify independent factors associated with high cardiovascular risk (SCORE2 ≥ 5%) and of a composite endpoint defined as the presence of any non-optimal biochemical parameter. Nearly half of the participants had excess body weight (overweight or obesity), and more than half met criteria for central obesity. Borderline or elevated total cholesterol was found in 47% of patients, abnormal LDL in 27%, low HDL-C (<40 mg/dL) in 80% (84% when applying sex-specific cut-offs), and impaired fasting glucose or diabetes in about 12%. High SCORE2 risk (≥5%) was observed in approximately 9% of the cohort. In multivariable models, SCORE2 components (age, sex, and smoking) were, as expected, associated with high SCORE2 risk, and obesity (BMI ≥ 30 kg/m²)—a factor not included in SCORE2—was additionally associated with higher risk. Additionally, age, male sex, and obesity also predicted the presence of at least one non-optimal biochemical marker. The prevalence of high SCORE2 risk increased from 1.2% in patients with 0–1 modifiable risk factor to 25.7% in those with 4–5 factors. Lower educational attainment was associated with a higher proportion of high-risk individuals in univariate analysis. Routine preventive activities in PHC enable the identification of important lipid and glucose abnormalities and the clustering of modifiable risk factors, even in a relatively young, highly educated population. Systematic cardiovascular screening and a focus on patients with accumulated risk factors should remain a priority in PHC to enable early identification of high-risk patients and timely implementation of lifestyle and therapeutic interventions. Full article

Modern lifestyles are increasingly plagued by physical inactivity, social disconnection, digital addiction, and excessive time indoors—factors that negatively impact the health and well-being of both humans and their companion dogs (Canis familiaris). Evidence shows that nature exposure, physical activity, and human–animal bond (HAB) each enhance physical, mental, and social well-being, yet these domains have rarely been examined together as an integrated therapeutic triad. We introduce a new conceptual framework of bonded green exercise, defined as shared physical activity between a bonded human and dog in natural environments. Synthesizing existing evidence across human and canine sciences into a testable conceptual integration, we posit that bonded green exercise may plausibly activate evolutionarily conserved, synergistic mechanisms of physiological, behavioural, and affective co-regulation. Four testable hypotheses are proposed: (H1) triadic synergy: combined domains produce greater benefits than additive effects; (H2) heterospecific benefit: parallel health gains occur in both species; (H3) behavioural amplification: dogs acts as catalysts to drive human participation in nature-based activity; and (H4) scalable health promotion: bonded green exercise represents a low-cost, accessible, One Health approach with population-level potential. This framework highlights how intentional, shared physical activity in nature may potentially offer a novel low-cost and accessible model for enhancing health, lifespan, welfare, and ecological stewardship across species. Full article

Introduction: The COVID-19 pandemic had significant effects on mental health and lifestyle behaviours, especially among university students who experienced academic disruptions, social isolation, and fewer social interactions. Alcohol consumption has long been part of student culture. Still, the influence of post-pandemic academic reintegration on drinking patterns and psychological distress remains relatively unexplored, particularly in countries like Portugal, where student traditions heavily shape consumption habits. This study aimed to describe the prevalence of alcohol consumption, depression, anxiety, and stress in a sample of Portuguese university students during the post-pandemic academic period, and to explore associations with sociodemographic variables. Methods: A cross-sectional study was conducted in November 2021 with 90 students from a private higher education institution in northern Portugal. Data were collected via an online questionnaire including sociodemographic information, the Alcohol Use Disorders Identification Test (AUDIT), and the Depression, Anxiety and Stress Scale (DASS-21). Result: The majority of the participants were not at risk of alcohol addiction (95.3%). In total, 15.1% of students reported anxiety symptoms ranging from severe to extremely severe. A binomial logistic regression was performed to ascertain the effects of being away from home and psychological distress (DASS-42 score), on the likelihood that participants were at risk of alcohol addiction (Level 3 and 4 in the AUDIT scale). The logistic regression model was statistically significant, χ²(2) = 9.20, p = 0.010. Living away from home was associated with a substantially lower likelihood of high-risk status (B = −2.79, p = 0.034), corresponding to an odds ratio of 0.06, indicating a strong protective effect. DASS-42 total score was positively associated with high-risk status (B = 0.04, p = 0.039), such that higher psychological distress increased the odds of being classified as high risk. Conclusions: The findings reveal a low prevalence of alcohol risk but heightened symptoms of anxiety, depression, and stress. Psychological distress notably increases the likelihood of hazardous alcohol use, emphasising the importance of targeted mental health and alcohol-use interventions among university students. Full article

Background: A sedentary lifestyle contributes to chronic disease risk in adults and may predict unfavourable body composition in adolescents. Declining physical activity and rising sedentary behaviour are linked to increasing global obesity rates. Given the scarcity of longitudinal studies examining how participation in organized sports and screen device use relate to body composition in early adolescence, this study aims to address this gap by analyzing temporal trends in both sexes. Methods: A sample of 158 Italian students, 38% of whom were female, was followed longitudinally from ages 11 to 13. Annual anthropometric assessments were conducted, and self-reported data on screen time and organised sports participation were collected. Fat mass (FM), fat-free mass (FFM), fat mass index (FMI), fat-free mass index (FFMI), body mass index (BMI), and waist-to-height ratio (WHtR) were subsequently calculated, along with annual increments. Repeated-measures ANOVA assessed age and sex effects, while multiple regression models evaluated associations between behavioural variables or sex and body composition indices. Results: Significant differences in %F, FM, FFM and its increment, WHtR and its increment, FMI, and FFMI (all p < 0.01) were observed by age and sex interaction. At age 13, weekly sports participation was negatively associated with annual increments in %F (β = −0.204, p = 0.04) and FMI (β = −0.227, p = 0.03). Female sex was associated with greater increments in %F (β = 0.188, p < 0.05) and WHtR (β = 0.323, p < 0.01), and with smaller increments in FFM (β = −0.421, p < 0.01). No significant associations were found for screen time (p > 0.05). Conclusions: Sporting during early adolescence seems to have positive effects on body composition changes, while sex-specific patterns warrant further attention. A deeper understanding of how early adolescent lifestyle factors, such as physical activity and sedentary behaviour, shape body composition is essential for promoting long-term health. Full article

Background/Objectives: The aim of this study was to assess the short-term and long-term effectiveness of group voice therapy in changing vocal behaviour and improving voice quality (VQ) among teachers with hyperfunctional voice disorders (HFVD), using both subjective and objective measures. Methods: Thirty-one teachers participated in a structured group voice therapy programme. Participants underwent videoendostroboscopic evaluation of laryngeal morphology and function, perceptual assessment of voice, acoustic analysis of voice samples, and aerodynamic measurements of phonation. Patients’ self-assessment of VQ and its impact on quality of life were measured using a Visual Analogue Scale (VAS) and the Voice Handicap Index-30 (VHI-30). Evaluations were conducted at four time points: pre-therapy (T0), immediately post-therapy (T1), and at 3-month (T3) and 12-month (T12) follow-up visits. Results: Significant improvement was observed between T0 and T1 in perceptual voice evaluations: grade, roughness, asthenia, strain, loudness, fast speaking rate, as well as in neck muscle tension, shimmer, patients’ most harmful vocal behaviours, VHI-30 scores, patients VQ evaluation, and its impact on quality of life (all p < 0.05). Almost all parameters of subjective and objective voice assessment improved over the 12-month observation period, with the greatest improvement between T0 and T12 (all p < 0.05), indicating lasting reduced laryngeal tension and improved phonatory efficiency. Conclusions: Group voice therapy has been shown to be an effective treatment for teachers with HFVD, leading to significant and long-lasting improvements in perceptual, acoustic, and self-assessment outcomes. Therapy also promoted healthier vocal and lifestyle behaviours, supporting its role as a successful and cost-effective rehabilitation and prevention method for occupational voice disorders. Full article

Background: Low peak bone mass (PBM) is a major contributor to later osteoporosis risk. This study sought to understand young people’s knowledge of factors associated with bone health. Methods: Young people in Aotearoa New Zealand were approached. Eight focus groups (26 participants in total, aged 11 to 17 years) were conducted using a semi-structured approach with open-ended questions and prompts. Transcripts were thematically coded using an inductive content analysis approach. Results: Knowledge of factors associated with good bone health was limited. There was a general awareness of the positive and negative impacts of many lifestyle behaviours on health generally, but not specifically PBM. Dairy intake was commonly mentioned as being beneficial for bone health. Some participants reported potential benefits of sport, but most did not know that weight bearing activity specifically was beneficial. Conclusions: Knowledge of osteoporosis and lifestyle factors that impact PBM was limited. Educational interventions involving promotion of bone health knowledge and supporting weight bearing physical activity in adolescents may be an important contributor to public health strategies. Full article

This study examines the motivations, socio-demographic profiles, and behavioural orientations of residents in Northern Italy toward mountain and forest visitation, with a focus on their propensity to engage in forest-based health and wellness activities. The analysis draws on a large stratified survey conducted between December 2023 and January 2024, involving 1218 respondents, of whom 976 reported regular forest visitations. Exploratory factor analysis identifies two main attitudinal dimensions: “Health and Wellness-Driven Forest Engagement”, centred on psychophysical restoration, and “Comfort-Oriented Forest Use”, related to accessibility and low physical effort. Regression models show that wellness-oriented engagement is strongly associated with psychological well-being, walking and hiking habits, and gender, while comfort-oriented use reflects seasonal patterns and preferences for easily accessible forests. A small subset of respondents reports discomfort in forest environments, forming a distinct attitudinal barrier. Overall, the results indicate substantial potential for forest-based wellness tourism to support healthier lifestyles and diversify mountain economies. Policy implications highlight the need for accessible infrastructures, targeted communication, and the integration of wellness-oriented services into regional development strategies. Full article

Background & Objectives: Periodontal disease (PD) is a common oral disease that affects the supporting structures of the teeth and is a leading cause of tooth loss worldwide. This study aimed to estimate the prevalence of PD among 9th-grade teachers in the northern West Bank and examine its association with key behavioral and socioeconomic factors. Methods: A cross-sectional study was conducted among 920 teachers selected through proportional stratified random sampling from governmental and private schools. Periodontal health was assessed using the WHO Community Periodontal Index for Treatment Needs (CPITN), and oral hygiene status was measured with the Simplified Oral Hygiene Index (S-OHI). A structured questionnaire was administered to collect data on socioeconomic status, oral hygiene practices, dietary habits, and smoking behaviours. Data was analysed using descriptive statistics, bivariate and multivariate logistic regression. Results: Only 11.8% of participants exhibited completely healthy gingiva, with the mean condition ranging between calculus and shallow pockets. Oral hygiene practices were the strongest predictors of periodontal outcomes: frequent tooth brushing (Adjusted Odds Ratio: AOR = 0.015), morning brushing (AOR = 0.015), and regular toothbrush replacement (AOR = 2.514) were protective. Higher red meat intake was negatively associated with periodontal health (AOR = 0.032), while frequent nut consumption was protective (AOR = 0.227). The number of cigarettes smoked per week was positively associated with PD (AOR = 1.085). Conclusions: PD is highly prevalent among Palestinian adults, with significant behavioural and lifestyle-related determinants. Targeted oral health interventions are urgently needed to improve adults’ oral health. Full article

Background/Objectives: Even with solid proof of its benefits for cardiovascular health and metabolism, adherence to the Mediterranean Diet (MD) in Spain has noticeably declined in recent years. The socioeconomic changes occurring in recent decades have prompted shifts in cooking habits and in how food is socially experienced, particularly among children and adolescents. The MD is more than just food: it is a cultural tradition and a lifestyle, rich in food and cooking skills, and food wisdom passed down over generations. When these practices fade, it affects both health and the environment, making them vital components in strengthening support for food knowledge, cooking abilities, and a healthier lifestyle. Considering these shifting dietary patterns and the growing need for targeted educational strategies, the present study aimed to investigate the association between cooking skills, MD-related health literacy, and adherence to the Mediterranean Diet across different developmental stages: childhood, adolescence, and adulthood in a sample of the Spanish population. Additionally, a secondary objective was to identify potential critical windows for intervention based on the strength of these associations. Methods: This cross-sectional study included 832 Spanish participants grouped by age: children and early adolescents (n = 408), older adolescents (n = 136), and adults (n = 288). Cooking skills were assessed using CooC11 for children and FCSk for older groups. Adults also completed Lit_MEDiet to assess MD-related health literacy. Adherence was measured with KIDMED (children/adolescents) and MEDAS (adults). Spearman correlations and standardized linear regressions were used. All statistical tests were two-sided, and statistical significance was set at p < 0.05. Results: In children, no significant association was found between cooking skills (CooC11) and KIDMED scores (β = 0.008; p = 0.875). Among adolescents, a strong positive association emerged between FCSk and KIDMED (β = 0.313; p < 0.001; ρ = 0.371), indicating a large, standardized effect and suggesting that this stage is particularly sensitive to food skills. In adults (18+), both food and cooking skills (FCSk) (β = 0.189; p = 0.001) and MD-related health literacy (Lit_MEDiet) (β = 0.187; p = 0.004) were moderately associated with MEDAS scores. Conclusions: These findings suggest that mid-adolescence could represent a favourable developmental window where food skills may hold potential to influence positive dietary behaviours. Regarding adults, the results indicate that combining practical and educational components appears to beneficial for dietary quality. Overall, this study supports the relevance of age-tailored public health strategies to potentially enhance long-term adherence to the Mediterranean Diet. Full article

Background: Hypertensive disorders of pregnancy (HDP) have significant implications for women’s long-term health, including at least a twofold increased lifetime risk of cardiovascular disease (CVD). The Blood Pressure Postpartum (BP²) Study was a three-arm randomised trial evaluating follow-up and lifestyle behaviour change strategies during the first year after HDP. Methods: This qualitative sub-study, embedded within the BP² Study, explored women’s experiences of life in the first year following HDP. Semi-structured telephone interviews were conducted with 34 women, approximately 10–12 months postpartum. Interviews were transcribed verbatim and a thematic analysis was undertaken. Results: Participants reflected on their experiences post-HDP; three major themes were identified: Navigating life with a newborn, The value of support, and Processing and Moving forward. Some women felt informed and empowered to make positive lifestyle changes; others were still processing their HDP experience and/or feeling overwhelmed by the demands of early motherhood. Responses were influenced by their HDP experience, available support, prior experience with healthy behaviours, and financial stability. Conclusions: The findings highlight that postpartum women who experienced HDP face unique challenges, including physical recovery, emotional processing, and intensive infant care. It often takes time for these women to begin prioritising their own health, as they navigate these challenges. The insights generated from women’s experiences suggest that flexible, accessible, and individually tailored support may facilitate postpartum health, promote lifestyle change, and help reduce long-term CVD risk. Full article

Background: Dementia poses a significant health concern among Australia’s First Nations peoples, who experience higher prevalence and earlier onset compared to non-First Nations populations. Despite growing research attention, the overall scope and characteristics of existing literature on dementia in these communities remain unclear. Objective: This scoping review aimed to map and synthesise existing evidence on the burden of dementia among First Nations peoples, focusing on associated risk factors and culturally responsive approaches to prevention, intervention, and care. Methods: Following the PRISMA Extension for Scoping Reviews guidelines, a comprehensive search was conducted across Scopus, EMBASE, PubMed, PsycINFO, CINAHL, the Indigenous Studies Portal, and Google Scholar for English-language studies published between 2004 and 2025. Search terms combined dementia and cognitive impairment with First Nations, Indigenous peoples, and related concepts, alongside terms for risk factors, intervention, prevention, care strategies, and health disparities. Two reviewers independently screened studies and extracted data using a standardised template. Of the 620 records identified, 324 were screened, 130 were assessed in full, and 75 met the inclusion criteria. Data were narratively synthesised to identify key themes and evidence gaps. Results: The review revealed a disproportionate burden of dementia among First Nations peoples, characterised by earlier onset and higher prevalence than in non-First Nations populations. Major modifiable risk factors included social determinants of health, lifestyle behaviours, and inequitable access to healthcare. Studies emphasised the importance of culturally safe, community-led, and multidisciplinary approaches; however, many interventions remain poorly adapted to the diverse cultural contexts of First Nations communities. The review also identified gaps in diagnostic tools, culturally appropriate care pathways, and the integration of traditional knowledge and digital innovations in dementia management. Conclusions: Addressing dementia inequities among First Nations Australians demands transformative, community-driven action that extends beyond descriptive research. Future work should prioritise co-designed, culturally grounded interventions that embed First Nations knowledge systems, strengthen healthcare capacity, and foster long-term community empowerment. Embedding cultural safety within policy and clinical frameworks, and shifting toward preventive, strengths-based approaches, will advance equity in dementia care and provide valuable insights for First Nations health systems globally. Full article

Background/Objectives: Wearable fitness trackers (WFTs) are growing in popularity as tools to motivate physical activity and support healthier lifestyles. Evidence suggests that they can have both positive and negative effects on user behaviour and well-being. However, little is known about their impact in Saudi settings, considering its unique cultural context. This study aims to investigate the perceived positive and negative impacts of WFTs on adults’ health behaviours and well-being in Saudi Arabia. Methods: A cross-sectional survey was conducted among Saudi adults aged 18 years or older who currently use or have previously used WFTs, using an online questionnaire distributed via social media platforms in May 2025. The survey was developed based on evidence from the literature. It included demographic items, five-point Likert-scale questions assessing positive (9 items) and negative (10 items) effects of WFTs, and an open-ended question. Responses were analysed using descriptive statistics, independent samples t-tests, and one-way ANOVA. Results: A total of 154 adults participated. The mean composite score for positive effects was 3.26 (SD = 0.73), indicating general agreement on the benefits of WFTs, while the negative effects score was 2.15 (SD = 0.66), showing low endorsement of adverse outcomes. No significant differences appeared between gender (positive: p = 0.34; negative: p = 0.24) or age groups (positive: p = 0.56; negative: p = 0.19). However, users of over two months had higher positive scores (M = 3.43, SD = 0.66) than newer or former users (p = 0.01). Open responses showed 62% positive experiences; 27% reported stress, guilt, or obsessive monitoring. Conclusions: This study provides initial insights into WFT use and perceptions in Saudi Arabia. However, its cross-sectional nature limits the ability to draw causal conclusions. While most users experienced beneficial health outcomes, a significant proportion reported negative psychological experiences. These findings highlight WFT users’ dual experiences and the need for further longitudinal research and diverse recruitment strategies to better understand sustained engagement and psychological effects. Full article

Background: Midwives, despite their health-promoting role, face factors that may disrupt eating behaviours and weight regulation. Little is known about their body weight perception or disordered eating attitudes (DEAs). This study assessed body weight perception and eating attitudes across BMI categories among Polish midwives. Methods: A cross-sectional survey of 568 midwives was conducted. BMI was calculated from self-reported measures and classified according to WHO criteria. Body weight perception was assessed using discrepancies between actual and ideal body weight and between self-perceived ideal body weight and ideal body weight. Long-term weight variability was additionally evaluated using the difference between maximum and minimum adult body weight. Eating attitudes were examined using the Polish version of the EAT-26. Group differences were analysed with the Kruskal–Wallis and χ² tests. Results: Among the participants, 62.9% had normal weight, 23.4% were overweight, and 13.7% were obese. Perceived ideal body weight increased with BMI (p < 0.001). Midwives with overweight and obesity demonstrated higher EAT-26 scores than those with normal BMI, with EAT-26 > 20 observed in 8.3% of overweight and 14.1% of obese participants (p = 0.010). Overweight and obese midwives also showed larger discrepancies between actual and ideal body weight and greater lifetime weight variability, and these groups simultaneously presented higher levels of disturbed eating attitudes. Emotional eating, binge-type episodes, and dieting behaviours were more common among overweight and obese participants, while calorie awareness remained consistently high across groups. Conclusions: Midwives with excess body weight often misperceive their body size and show an elevated risk of DEA. Weight perception appears more strongly related to maladaptive eating patterns than BMI alone. These findings highlight the need for targeted, non-stigmatising interventions addressing weight perception, eating attitudes, and occupational stressors, which may support both midwives’ well-being and their professional effectiveness in delivering nutrition and lifestyle counselling. Full article

Adequate nutrition and healthy behaviours during pregnancy are essential to maternal and neonatal health. Evidence from Greece on maternal dietary and lifestyle practices remains limited, despite global guidelines promoting supplementation, physical activity (PA) and abstinence from harmful substances. This review evaluates micronutrient intake, supplementation practices, PA and substance exposure among pregnant women in Greece, based on studies from 2010 to 2025. The results reveal widespread use of supplements, but frequent deviations from clinical guidelines. Suboptimal intake of key micronutrients remains common, and unsupervised supplementation raises concerns about excessive intake. Caffeine and tobacco use persist during pregnancy and lactation, while alcohol consumption shows a declining trend. PA is generally below international recommendations, with most pregnant women engaging in sedentary or low-intensity activities. These findings underscore systemic gaps in antenatal care in Greece, including inconsistent counselling, lack of structured screening and the absence of coordinated national strategies. Culturally tailored public health interventions, with a focus on equitable access and behaviour change support, are urgently needed to enhance nutritional adequacy, reduce behavioural risks and promote evidence-based care across the perinatal period. Full article

The scientific evidence on nutrition, lifestyle behaviours, and child and adolescent health highlights a reality increasingly shared at the global level: dietary patterns, physical activity levels, sleep habits, and the use of digital technologies are undergoing rapid and interconnected changes that carry significant implications for the health of children and young people [...] Full article