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13 pages, 622 KB  
Article
Health-Promoting Lifestyle and Psychosocial Correlates in Patients with NAFLD/MASLD and Family Members: A Comparative Cross-Sectional Study of Independent Samples
by Yuhuan Yu and Lili Ji
Healthcare 2026, 14(17), 2686; https://doi.org/10.3390/healthcare14172686 (registering DOI) - 24 Aug 2026
Abstract
Background/Objectives: Lifestyle modification is central to non-alcoholic fatty liver disease, now termed metabolic dysfunction-associated steatotic liver disease (NAFLD/MASLD), yet comparable health-promoting lifestyle (HPL) data for patients and family members are limited. This study compared two independent samples and examined psychosocial correlates. Methods: Two [...] Read more.
Background/Objectives: Lifestyle modification is central to non-alcoholic fatty liver disease, now termed metabolic dysfunction-associated steatotic liver disease (NAFLD/MASLD), yet comparable health-promoting lifestyle (HPL) data for patients and family members are limited. This study compared two independent samples and examined psychosocial correlates. Methods: Two convenience samples recruited at one tertiary hospital were analyzed: 305 adults with NAFLD/MASLD and 299 adult family members of affected patients. A self-administered electronic questionnaire comprised the Health-Promoting Lifestyle Profile II (HPLP-II), the Self-Rated Abilities for Health Practices scale, autonomous-motivation items from the Treatment Self-Regulation Questionnaire, the Medical Outcomes Study Social Support Survey, and sociodemographic items. Group comparisons used parametric and non-parametric tests. HPL correlates were examined using complete-case regression, HC3 inference, and rank-based sensitivity analysis. Cross-sectional indirect-association decompositions used 5000 bootstrap resamples. Results: HPLP-II scores were 102.2 ± 17.5 in patients and 104.2 ± 17.4 in family members (p = 0.171; Mann–Whitney p = 0.166); the adjusted patient-minus-family difference was −1.14 (HC3 95% CI −3.89 to 1.60; p = 0.413). Physical activity was the lowest-scoring dimension. Self-efficacy was the most robust correlate in both samples; social support was associated in the primary models but weakened under rank transformation in family members. Group-by-correlate interactions were not significant. Exploratory indirect associations through self-efficacy were 0.355 (95% bootstrap CI 0.234–0.512) in patients and 0.163 (0.071–0.287) in family members; reverse-order models were also non-zero. Conclusions: The independent unmatched samples reported similar moderate, physically inactive lifestyles. The results identify associations, not shared-household effects or causal mechanisms; objectively characterized, dyad-matched longitudinal studies are needed. Full article
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21 pages, 1056 KB  
Article
Associations Between 24-Hour Movement Behaviors and Anthropometric and Body Composition Indicators in Ecuadorian Preschool Children: SUNRISE Pilot Study
by Emily Cisneros-Vásquez, Estela Jiménez-López, Rodrigo Yáñez-Sepúlveda, Héctor Gutiérrez-Espinoza, Jorge Olivares-Arancibia, Pedro Antonio Sánchez-Miguel, Masoud Rahmati, Dong Keon Yon, Lee Smith and José Francisco López-Gil
Children 2026, 13(9), 1129; https://doi.org/10.3390/children13091129 (registering DOI) - 24 Aug 2026
Abstract
Objective: To analyze associations between 24-hour movement behaviors (and guideline adherence) and anthropometric and body composition indicators in Ecuadorian preschoolers using data from the International Study of Movement Behaviors in the Early Years (SUNRISE) pilot study. Methods: This secondary analysis utilized data from [...] Read more.
Objective: To analyze associations between 24-hour movement behaviors (and guideline adherence) and anthropometric and body composition indicators in Ecuadorian preschoolers using data from the International Study of Movement Behaviors in the Early Years (SUNRISE) pilot study. Methods: This secondary analysis utilized data from the primary study conducted in 108 children aged 3–4 years (57.4% girls; 50.9% urban). Anthropometry (weight, height, and body mass index [BMI]) was assessed using standardized protocols during the pilot study, whereas body composition indicators (fat-free mass [FFM], fat mass [FM], and body fat percentage) were estimated using a validated anthropometric prediction equation. Movement behaviors were assessed via triaxial accelerometry (ActiGraph GT3X+ or GT3X-BT, Pensacola, FL, USA) over seven days, complemented by parent-reported questionnaires. Exploratory unadjusted correlation analyses were performed using Spearman’s rho (ρ) for continuous/ordinal variables, and Pearson’s correlations (r), mathematically equivalent to point-biserial correlations (rpb), for dichotomous–continuous associations. Results: In exploratory unadjusted analyses, device-measured longer sleep duration showed small-to-moderate inverse associations with weight (ρ = −0.33, p = 0.001), BMI (ρ = −0.28, p = 0.006), and FFM (ρ = −0.37, p < 0.001). Higher moderate-to-vigorous physical activity showed moderate positive associations with height (ρ = 0.32, p = 0.002), weight (ρ = 0.40, p < 0.001), and FFM (ρ = 0.44, p < 0.001). In complementary multivariable models, the associations between device-measured sleep or moderate-to-vigorous physical activity (MVPA) and the pre-specified anthropometric and body composition outcomes were attenuated after adjustment for age, sex, area of residence, and, where applicable, height, and were generally not statistically significant. Conclusions: In this exploratory secondary analysis of the SUNRISE Pilot Study Ecuador, unadjusted analyses identified associations between specific 24-hour movement behaviors, particularly sleep duration and MVPA, and anthropometric and body composition indicators. However, these associations were attenuated after covariate adjustment. The findings should therefore be interpreted as hypothesis-generating and require confirmation in larger longitudinal studies. Full article
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20 pages, 1352 KB  
Article
Healthy Lifestyle Behaviors and Technostress: A Combined Lifestyle Score Analysis in 104,175 Spanish Workers
by Marta González Rivas, Ángel Arturo López-González, Diego González Carrasco, Carla Busquets-Cortés, Lluis Rodas Cañellas and José Ignacio Ramírez-Manent
Nutrients 2026, 18(17), 2754; https://doi.org/10.3390/nu18172754 (registering DOI) - 23 Aug 2026
Abstract
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 [...] Read more.
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
(This article belongs to the Special Issue Adherence to the Mediterranean Diet and Health Status)
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22 pages, 437 KB  
Article
Lifestyle Characteristics and Dietary Habits in Romanian Patients with Periodontitis: A Cross-Sectional Study
by Ana Maria Hofer, Andrei Picos, Bogdana Adriana Nasui, Alexandra Dădârlat-Pop and Monica Popa
Healthcare 2026, 14(17), 2676; https://doi.org/10.3390/healthcare14172676 (registering DOI) - 22 Aug 2026
Abstract
Background/Objectives: Periodontitis is a multifactorial chronic inflammatory disease influenced by behavioral, metabolic, and lifestyle-related factors. This study aimed to examine the associations of selected dietary habits, body mass index (BMI), physical activity, smoking, and oral hygiene behaviors with clinical periodontal parameters in [...] Read more.
Background/Objectives: Periodontitis is a multifactorial chronic inflammatory disease influenced by behavioral, metabolic, and lifestyle-related factors. This study aimed to examine the associations of selected dietary habits, body mass index (BMI), physical activity, smoking, and oral hygiene behaviors with clinical periodontal parameters in a clinical sample of adults with periodontitis from northwestern Romania. Methods: This cross-sectional study included 204 adults with clinically diagnosed periodontitis. Sociodemographic characteristics, smoking status, physical activity, toothbrushing frequency, tooth mobility, and selected dietary habits were assessed using a structured questionnaire. Periodontal status was clinically evaluated using periodontal probing depth (PPD), clinical attachment loss (CAL), and bleeding on probing (BOP), while BMI was calculated from anthropometric measurements. Descriptive and inferential statistical analyses were performed to evaluate associations between the investigated factors and periodontal parameters. Multivariable linear regression models were constructed separately for PPD, CAL, and BOP, simultaneously including age, sex, BMI, smoking status, physical activity frequency, toothbrushing frequency, tooth mobility, education level, and the assessed dietary habits. Results: In the fully adjusted multivariable analyses, fish consumption 1–3 times/week was independently associated with lower PPD, whereas sweets consumption 1–3 times/week was independently associated with higher PPD. Carbonated beverage and sweets consumption 1–3 times/week were independently associated with higher BOP. Although the multivariable model for CAL was statistically significant overall, none of the individual predictors included in the model reached statistical significance. BMI and physical activity frequency were not independently associated with PPD, CAL, or BOP after simultaneous adjustment for the other variables. Age group was significantly associated with CAL category (χ2(2) = 13.28, p = 0.001, Cramér’s V = 0.255), while educational level was significantly associated with toothbrushing frequency (χ2 = 62.26, p < 0.001, Cramér’s V = 0.39). Conclusions: Selected dietary habits were independently associated with PPD and BOP after adjustment for demographic, anthropometric, lifestyle, and oral hygiene factors, whereas no individual predictor was independently associated with CAL in the fully adjusted model. BMI and physical activity were not independently associated with the periodontal parameters examined. These findings emphasize the multifactorial nature of periodontal status and suggest that specific dietary habits may be associated with different clinical dimensions of periodontal disease. However, causal relationships cannot be established due to the cross-sectional design of the study. Prospective studies using validated dietary assessment methods are needed to confirm these associations. Full article
(This article belongs to the Special Issue Advances in Preventive and Therapeutic Oral Health Care)
31 pages, 1865 KB  
Article
Topical Magnesium Orotate Lipogel in Kidney Transplant Recipients with Persistent Hypomagnesemia: Formulation Development and Pilot Clinical Study
by Corina Moisa, Florin Bănică, Ioana Adela Rațiu, Octavia Gligor, Laura Grațiela Vicaș, Cristian Adrian Rațiu, Mădălin Florin Ganea, Csaba Nagy, Anamaria Ratiu, Edy Hagi Islai and Mariana Ganea
Nutrients 2026, 18(16), 2740; https://doi.org/10.3390/nu18162740 - 21 Aug 2026
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Abstract
Background: In solid-organ transplant recipients, hypomagnesemia is a frequent and persistent complication, predominantly related to long-term use of calcineurin inhibitors. Oral magnesium supplementation is often ineffective due to poor adherence, gastrointestinal adverse effects, and high treatment costs. Objectives: This pilot study [...] Read more.
Background: In solid-organ transplant recipients, hypomagnesemia is a frequent and persistent complication, predominantly related to long-term use of calcineurin inhibitors. Oral magnesium supplementation is often ineffective due to poor adherence, gastrointestinal adverse effects, and high treatment costs. Objectives: This pilot study aimed to (i) develop a topical magnesium formulation for use in renal transplant recipients with persistent hypomagnesemia; (ii) evaluate the influence of formulation excipients on magnesium release from pharmaceutical preparations; and (iii) preliminarily assess the clinical outcomes, functional parameters, patient satisfaction, and tolerability associated with topical magnesium lipogel use in renal transplant recipients with persistent hypomagnesemia. Materials and Methods: Three lipogel formulations containing magnesium orotate, citrate, or sulfate were prepared and characterized in terms of organoleptic properties, pH, colloidal stability, and rheological behavior. In vitro magnesium release was evaluated using Franz diffusion cells. The formulation demonstrating the most favorable release profile, magnesium orotate lipogel, was administered twice daily for two months to 21 renal transplant recipients with persistent hypomagnesemia who had shown inadequate response, intolerance, or non-adherence to oral magnesium supplementation. Laboratory parameters were assessed at baseline and after treatment. Patient satisfaction was evaluated using the Lübeck questionnaire, while physical activity and exercise capacity were assessed using the International Physical Activity Questionnaire (IPAQ) and metabolic equivalent task (MET) calculations. Results: Franz cell studies demonstrated superior magnesium release from the magnesium orotate lipogel compared with the other formulations. After two months, serum magnesium levels were higher than baseline (1.554 ± 0.124 vs. 1.448 ± 0.111 mg/dL, p < 0.001), although they remained below the normal reference range. No significant changes were observed in eGFR or hsCRP. Moderate-intensity physical activity increased significantly (310.475 ± 92.505 vs. 279.286 ± 89.907 MET-min/week, p < 0.001), while vigorous-intensity activity did not change significantly. No relevant adverse effects were reported. Patient satisfaction was high across all evaluated domains, including practicability (86.6%), efficacy (96.4%), tolerability (97.1%), and trust in medical professionals (97.6%). Conclusions: In this pilot study, topical magnesium orotate lipogel was well tolerated and accepted by renal transplant recipients with persistent hypomagnesemia. Serum magnesium levels and moderate physical activity improved over the two-month observation period, although magnesium levels remained below the normal range. These preliminary findings warrant confirmation in larger, randomized, placebo-controlled studies. Full article
(This article belongs to the Special Issue Magnesium in Aging, Health and Diseases)
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29 pages, 2493 KB  
Article
Hybrid Education Management and Ecological Sustainability in Postgraduate Psychopedagogical Training: Perceptions Regarding the Quality of the Teaching Act and the Reduction in the Carbon Footprint
by Iuliana Roată, Alin Lupașcu, Raluca-Sînziana Zaharia, Florin Andrei Păduraru, Mădălina Maria Popescu-Brezuleanu, Andrei Popescu, Codrin Lupașcu and Carmen-Olguța Brezuleanu
Educ. Sci. 2026, 16(8), 1342; https://doi.org/10.3390/educsci16081342 (registering DOI) - 21 Aug 2026
Viewed by 119
Abstract
This exploratory descriptive-correlational study analyses the perceptions of 257 adult students (doctoral, master’s, and teachers) at DPPD, USV Iași, during the 2025–2026 academic year regarding hybrid education, teaching quality, and environmental sustainability. Using a structured Likert-scale questionnaire, the analysis indicates good-to-excellent internal consistency, [...] Read more.
This exploratory descriptive-correlational study analyses the perceptions of 257 adult students (doctoral, master’s, and teachers) at DPPD, USV Iași, during the 2025–2026 academic year regarding hybrid education, teaching quality, and environmental sustainability. Using a structured Likert-scale questionnaire, the analysis indicates good-to-excellent internal consistency, with Cronbach’s alpha values ranging between 0.886 and 0.901, and a high overall global average score of 4.64. The findings reveal strong support for the hybrid model. Perceived teaching quality received the highest subscale rating (M = 4.80), closely followed by the perceived ecological impact (M = 4.65). The analysis indicates strong Pearson correlations, specifically between the hybrid learning experience and perceived teaching quality (r = 0.818), as well as between the perceived ecological impact and pro-sustainability attitudes (r = 0.809). Regarding academic mobility, the estimate indicates 81,283 km of avoided commuting travel and approximately 12,295 kg of avoided commuting-related CO2 emissions, based on self-reported distance, means of transport, and number of physical attendances replaced by online activities. These findings suggest that hybrid learning may represent a relevant managerial option for university sustainability policies. The model appears well suited to postgraduate programmes addressed to employed adults, although the ecological benefits should be read as partial and do not displace perceived teaching quality as the central factor. Full article
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19 pages, 1398 KB  
Article
Leisure-Time Physical Activity, Sleep, and Self-Perception of Health During the COVID-19 Lockdown in Québec
by Adrien Murphy-Després, Natalie Alméras, Dominic J. Chartrand, Isabelle Lemieux, Serge Simard, Laura Jalbert, Annie LeBlanc and Jean-Pierre Després
Epidemiologia 2026, 7(4), 117; https://doi.org/10.3390/epidemiologia7040117 - 20 Aug 2026
Viewed by 174
Abstract
Background and Objectives: The lockdown imposed by public health authorities during the COVID-19 pandemic has disrupted many behaviours, including physical activity (PA). This study aimed to assess changes in selected components of the 24 h movement behaviours during the COVID-19 lockdown and [...] Read more.
Background and Objectives: The lockdown imposed by public health authorities during the COVID-19 pandemic has disrupted many behaviours, including physical activity (PA). This study aimed to assess changes in selected components of the 24 h movement behaviours during the COVID-19 lockdown and to examine whether changes in these components were associated with changes in self-perceived physical health, mental health and sleep quality. Materials and Methods: The sample was drawn from the MAVIPAN study, a mixed-methods based, prospective, observational, longitudinal cohort study. In the present analyses, we used cross-sectional self-reported data collected through online questionnaires. Participants in the present analyses had to be 18 years of age and have complete gender and PA data (n = 2268). Results: During the lockdown, reductions in total PA (effect size: −8.4%; 95% CI: −11.9%, −4.7%; p < 0.0001) and moderate-to-vigorous-intensity PA (MVPA) (effect size: −8.7%; 95% CI: −13.1%, −4.1%; p < 0.0001) were observed. Total PA increased during the lockdown among participants who self-perceived their physical health, mental health, and sleep quality as better compared to those who reported worse outcomes (p < 0.0001). After adjusting for several confounding variables, an increase in MVPA of 30 min per week was associated with higher odds of reporting better physical health (1.65; 95% CI: 1.51, 1.81; p < 0.0001). Conclusions: Although our study design does not allow causal inference, these findings are concordant with public health strategies considering PA to help enhance and maintain physical and mental health, including sleep quality, in both constrained and everyday conditions. Full article
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19 pages, 1206 KB  
Article
Exercise Participation and Clinical Characteristics of Desk-Based Workers with Chronic Non-Specific Neck Pain Exposed to Increased Ergonomic Risk: A Cross-Sectional Study
by Eda Acikalin, Aynur Demirel and Songul Atasavun Uysal
Medicina 2026, 62(8), 1602; https://doi.org/10.3390/medicina62081602 - 20 Aug 2026
Viewed by 148
Abstract
Background and Objectives: Chronic non-specific neck pain (CNNP) is common among desk-based workers exposed to increased ergonomic risk and is accompanied by functional impairments. This study examined associations between exercise participation and pain intensity, upper-extremity disability, body awareness, and perceived sagittal trunk appearance [...] Read more.
Background and Objectives: Chronic non-specific neck pain (CNNP) is common among desk-based workers exposed to increased ergonomic risk and is accompanied by functional impairments. This study examined associations between exercise participation and pain intensity, upper-extremity disability, body awareness, and perceived sagittal trunk appearance in this population. Materials and Methods: This cross-sectional study included 250 of 512 screened desk-based workers with CNNP, pain severity ≥4/10, and a Rapid Upper Limb Assessment (RULA) score ≥ 3/7. Physical activity, upper-extremity disability, body awareness, perceived sagittal trunk appearance, and ergonomic risk were assessed using the IPAQ-SF, QuickDASH, Body Awareness Rating Questionnaire (BARQ), KyphoTAPS, and a video-call-based RULA. Results: Participants reporting exercise participation had lower QuickDASH scores (p = 0.003, d = −0.42) and higher BARQ total scores (p = 0.023, d = 0.33) than non-exercisers. BARQ function and awareness scores were higher in this group (p = 0.004 and p = 0.033), while pain severity, perceived sagittal trunk appearance, and ergonomic risk were similar between groups. QuickDASH scores were positively correlated with pain severity (rho = 0.636–0.727) and negatively correlated with BARQ total scores (rho = −0.477). RULA scores showed a weak positive correlation with general neck pain (rho = 0.288) (FDR-adjusted p < 0.002). Exploratory adjusted analyses showed that participants reporting regular exercise participation had lower QuickDASH and higher BARQ total scores than non-exercisers in all models. Participants reporting low-frequency exercise participation had lower QuickDASH scores than non-exercisers only in Model 4. Conclusions: Self-reported exercise participation may be associated with lower QuickDASH scores and higher BARQ total scores in desk-based workers with CNNP and increased ergonomic risk. Because maintaining consistent exercise participation can be challenging in occupational settings, future studies should investigate feasible exercise strategies to address pain-related, functional, and perceptual outcomes among occupational populations exposed to prolonged ergonomic loading. Full article
(This article belongs to the Section Epidemiology & Public Health)
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17 pages, 298 KB  
Article
Factors Associated with Meeting Physical Activity Guideline Recommendations in a Single Community Rehabilitation Center in Singapore: An Exploratory Study
by Llewelyn Yi Chang Tan, Lisa Wu, Chin Jung Wong, Jia Qian Goh and Matthew Rong Jie Tay
Healthcare 2026, 14(16), 2648; https://doi.org/10.3390/healthcare14162648 - 20 Aug 2026
Viewed by 169
Abstract
Background: Physical exercise is a vital component of cancer rehabilitation, with demonstrated improvements in cancer health-related outcomes, relapse rates, mortality and overall survival, yet global participation remains low. In Singapore, uptake of community cancer rehabilitation is limited despite high prevalence of treatment-related impairments. [...] Read more.
Background: Physical exercise is a vital component of cancer rehabilitation, with demonstrated improvements in cancer health-related outcomes, relapse rates, mortality and overall survival, yet global participation remains low. In Singapore, uptake of community cancer rehabilitation is limited despite high prevalence of treatment-related impairments. Methods: A cross-sectional study was conducted among adults (≥21 years) enrolled in the Singapore Cancer Society Rehabilitation Center between December 2021 and March 2023. Clinical data was collected from medical records and assessments included the Distress Thermometer (DT), Brief Illness Perception Questionnaire (Brief IPQ), and modified Bandura’s Exercise Self-Efficacy (ESE) scale. Adequate exercise was defined as ≥150 min/week of moderate intensity aerobic exercise and ≥2 days/week of resistance training. Regression analyses were performed to identify factors associated with meeting recommended moderate-intensity aerobic exercise levels. Results: The median age of our study cohort was 60.0 (IQR: 51.0–66.3) years. Of 132 analyzed participants, only 29.5% met recommended aerobic exercise levels and 9.1% met resistance training level recommendations. The median duration of moderate intensity aerobic exercise per week was 85.0 (30.0–180.0) minutes. The three most common cancer diagnoses amongst the participants were breast (53.8%), gastrointestinal (11.4%) and gynecological (7.6%) cancers. Clinically significant distress (DT ≥ 5) was present in 40.9% of patients. Multivariate regression analyses revealed that having lower ESE was the only significant psychosocial factor associated with a lower likelihood of meeting recommended aerobic exercise activity levels (OR = 0.856; 95% CI = 0.787–0.931; p < 0.001). Conclusions: Our study found a low prevalence of meeting recommended physical activity levels amongst our cohort of Asian cancer survivors enrolled in a community rehabilitation program in Singapore. Reinforcing the need for future longitudinal studies involving Asian cancer survivors to explore additional factors associated with physical inactivity and whether behavioral interventions targeting ESE will improve physical activity participation. Full article
28 pages, 681 KB  
Article
Life Satisfaction and Psychological Distress in Relation to Mediterranean Lifestyle Adherence and Behavioural Correlates: Findings from the MEDIET4ALL International Survey
by Achraf Ammar, Atef Salem, Khaled Trabelsi, Martha Montalvan, Bassem Bouaziz, Mohamed Ali Boujelbane, Mohamed Kerkeni, Liwa Masmoudi, Hadeel Ali Ghazzawi, Adam Tawfiq Amawi, Bekir Erhan Orhan, Raynier Zambrano-Villacres, Juliane Heydenreich, Christiana Schallhorn, Tarak Driss, Evelyn Frias-Toral, Piotr Zmijewski, Haitham Jahrami, Waqar Husain, Giuseppe Grosso, Hamdi Chtourou and Wolfgang I. Schöllhornadd Show full author list remove Hide full author list
Nutrients 2026, 18(16), 2708; https://doi.org/10.3390/nu18162708 - 19 Aug 2026
Viewed by 241
Abstract
Background: Life satisfaction and psychological distress are associated with multiple lifestyle, sleep-related, psychosocial, and sociodemographic factors. However, multinational evidence simultaneously examining these positive and negative psychological dimensions within a comprehensive Mediterranean lifestyle framework remains limited. This study examined correlates of life satisfaction and [...] Read more.
Background: Life satisfaction and psychological distress are associated with multiple lifestyle, sleep-related, psychosocial, and sociodemographic factors. However, multinational evidence simultaneously examining these positive and negative psychological dimensions within a comprehensive Mediterranean lifestyle framework remains limited. This study examined correlates of life satisfaction and psychological distress among adults from Mediterranean and neighbouring countries participating in the MEDIET4ALL survey. Methods: Data were collected from 4010 adults (59.5% female) across 10 Mediterranean and neighbouring countries using a standardized multilingual e-survey. Life satisfaction was assessed as the primary outcome using the Short Life Satisfaction Questionnaire (SLSQ), whereas psychological distress (depression, anxiety, and stress) was assessed as the secondary outcomes using the Depression Anxiety Stress Scales (DASS-21). Mediterranean lifestyle adherence was assessed using the validated MEDLIFE index, integrating dietary habits with brief indicators of physical activity, rest, and social/convivial habits, while complementary validated measures provided more detailed assessments of physical activity, sedentarily, sleep, insomnia and social participation. Hierarchical multiple linear regression analyses were conducted to identify correlates of the primary and secondary outcomes. Bootstrapped exploratory cross-sectional indirect-association analyses were conducted to examine selected indirect statistical associations involving Mediterranean lifestyle adherence, physical activity, social participation, insomnia severity, life satisfaction, and psychological outcomes. Results: Higher life satisfaction was associated with greater Mediterranean lifestyle adherence, better subjective sleep quality, higher social participation, higher education, marital or cohabiting status, and better self-reported health status (β ≈ 0.06–0.18). Conversely, lower life satisfaction was associated with higher body mass index, greater physical activity expenditure, higher insomnia severity, and regional differences between Mediterranean and neighbouring/non-Mediterranean countries (β ≈ −0.05 to −0.19). Insomnia severity showed the strongest negative association with life satisfaction (β = −0.19). Across psychological distress outcomes, insomnia severity emerged as the strongest positive correlate of depression, anxiety, and stress (β ≈ 0.43–0.47), followed by alcohol consumption (β ≈ 0.12–0.15) and residence in Mediterranean countries (β ≈ 0.05–0.08). Older age, analysed as a continuous variable, better self-reported health status, and higher physical activity levels were consistently associated with lower distress levels (β ≈ −0.03 to −0.14). Exploratory cross-sectional indirect-association analyses identified statistically significant indirect associations involving insomnia severity among Mediterranean lifestyle adherence, life satisfaction, and psychological distress. Additional indirect statistical associations involving life satisfaction were observed among physical activity, social participation, and psychological distress outcomes, although their magnitudes were small. Conclusions: Mediterranean lifestyle adherence, social participation, physical activity, sleep-related characteristics, and sociodemographic and health-related factors were associated with life satisfaction and psychological distress. Sleep-related variables, particularly insomnia severity and subjective sleep quality, emerged as the most consistent correlates across the psychological outcomes. These cross-sectional findings, including the exploratory indirect statistical associations, should be interpreted as hypothesis-generating and not as evidence of temporal ordering, causal mediation, or behavioural mechanisms. Full article
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18 pages, 301 KB  
Article
Factors Associated with Smoking Status and Self-Reported Physical Activity Among Spanish Nursing Professionals: A Cross-Sectional Study
by Jose-Manuel Cuervo-Menéndez, Marta Sánchez-Zaballos, María-Carmen Migoya-Méndez, Sara Franco-Correia, Aida Gámez-Fernández and Maria-Pilar Mosteiro-Diaz
Nurs. Rep. 2026, 16(8), 287; https://doi.org/10.3390/nursrep16080287 - 18 Aug 2026
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Abstract
Background: Modifiable lifestyle behaviours, including physical activity and smoking, are important determinants of health and may influence the mental well-being of nursing professionals. However, evidence simultaneously examining these factors and their associations with sociodemographic, occupational, and mental health factors remains limited. Objectives [...] Read more.
Background: Modifiable lifestyle behaviours, including physical activity and smoking, are important determinants of health and may influence the mental well-being of nursing professionals. However, evidence simultaneously examining these factors and their associations with sociodemographic, occupational, and mental health factors remains limited. Objectives: The aim of this study was to analyse the sociodemographic and occupational factors, as well as anxiety and depressive symptoms, associated with smoking status and physical activity among Spanish nursing professionals. Methods: A cross-sectional study was conducted between June and August 2021, including 1216 Spanish nursing professionals. Participants completed an online questionnaire assessing sociodemographic and occupational characteristics, smoking status, physical activity, and symptoms of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS). Bivariate analyses and multivariable logistic regression models identified factors associated with smoking status and physical activity. Results: Overall, 19.0% of participants were current smokers and 49.2% reported physical activity. Self-reported physical activity was positively associated with being a registered nurse, being male, being separated or widowed, living alone, and longer time working in the current service, whereas having children and current smoking were associated with lower odds of being physically active. Current smoking was less likely among older professionals, registered nurses, participants reporting physical activity, and those with anxiety symptoms. Conclusions: Physical activity and smoking showed an inverse association and were related to different sociodemographic and occupational characteristics among Spanish nursing professionals. The inverse association between anxiety symptoms and current smoking was unexpected and should be interpreted with caution. These findings may inform workplace health promotion strategies addressing physical activity and tobacco use together, while considering the specific needs of different professional groups within the nursing workforce. Full article
38 pages, 19167 KB  
Article
Inclusive Urban Park Design and Women’s Well-Being: The Mediating Role of Place Attachment in Sustainable and Resilient Communities
by Gege Zhu, Furong Qu and Qiongying Xiang
Sustainability 2026, 18(16), 8447; https://doi.org/10.3390/su18168447 - 18 Aug 2026
Viewed by 273
Abstract
Urban parks are essential components of green infrastructure that support residents’ physical health and well-being. However, less attention has been paid to how women can secure such benefits under equitable, safe, and sustainable park-use conditions. Using Xi’an Expo Park as a case study, [...] Read more.
Urban parks are essential components of green infrastructure that support residents’ physical health and well-being. However, less attention has been paid to how women can secure such benefits under equitable, safe, and sustainable park-use conditions. Using Xi’an Expo Park as a case study, this study examined the associations among Inclusive Urban Park Design (IUPD), Place Attachment (PA), Environmental Experience (EE), and Women’s Well-Being (WWB), with a focus on whether PA showed an indirect association between IUPD and WWB. This study adopted a quantitative-dominant mixed-methods design, combining 220 valid questionnaires (115 female and 105 male participants) with field observations and semi-structured interviews. Data were analyzed using correlation analysis, gender-comparison tests, mediation models, and robustness checks. Among female participants, the baseline model showed a statistically significant indirect association between IUPD and WWB through PA; however, this association was not retained after controlling for EE, nor in the fully adjusted model including EE, age, and visit frequency. The gender-comparison and qualitative findings suggested that similar levels of PA and WWB did not necessarily reflect equal conditions of park use. Qualitative evidence further indicated that some women’s park use was shaped by childcare, family activities, and other task-oriented responsibilities, which may involve hidden time, physical, and psychological costs. The subdimension-level findings suggested that perceived safety, accessibility and spatial legibility, and facility support and maintenance should be understood as interrelated use conditions rather than distinct independent effects. This study extends urban park equity research beyond spatial provision by emphasizing actual conditions of use and the equitable realization of well-being benefits. The findings provide implications for gender-responsive park design and social sustainability, while their relevance to everyday resilience should be understood as a conceptual extension rather than as direct evidence of community resilience. Full article
(This article belongs to the Special Issue Sustainable Urban Design and Resilient Communities)
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16 pages, 283 KB  
Article
Muscle Strength and Physical Performance in Relation to Dietary Intake Among Older Men and Women
by Małgorzata Kamila Pigłowska, Bartłomiej Konrad Sołtysik, Joanna Kostka, Tomasz Kostka and Agnieszka Guligowska
Nutrients 2026, 18(16), 2684; https://doi.org/10.3390/nu18162684 - 17 Aug 2026
Viewed by 352
Abstract
Background: The aim of this study was to examine the relationships between dietary intake and two key components of sarcopenia in older, sex- and age-matched men and women: muscle strength and physical performance. Methods: The study included 620 carefully selected community-dwelling adults aged [...] Read more.
Background: The aim of this study was to examine the relationships between dietary intake and two key components of sarcopenia in older, sex- and age-matched men and women: muscle strength and physical performance. Methods: The study included 620 carefully selected community-dwelling adults aged 60 years and more (310 men and 310 women) matched by sex and age (±1 year; median age: 66 years). Body mass and body mass index were assessed. Dietary intake was evaluated using 24 h dietary recall questionnaire and analyzed with Dieta 5.0 software. Handgrip strength (HGS) was measured using a hydraulic hand dynamometer, while physical performance using the Timed Up and Go test (TUG). Results: In men, but not in women, higher intakes of multiple dietary components, especially proteins, were associated with greater HGS. TUG was inversely related to animal protein, some amino acids, folate and vitamin C in men, whereas in women to copper, magnesium, vitamins C and E, riboflavin, and PUFA intakes. After multivariable adjustment, no nutrient remained associated with HGS in both sexes. In women, vitamin C intake remained inversely associated with TUG. Age was the strongest predictor of HGS, while age, physical activity (PA) and chronic diseases were significant factors associated with TUG in both sexes. Conclusions: Our findings show multifactorial nature of muscle physiology, suggesting that in preventive strategies adequate dietary intake integrated with PA and effective management of chronic diseases is required, as nutrition alone appears insufficient to preserve muscle function. The sex-stratified associations suggest that personalized dietary recommendations may be beneficial. Full article
16 pages, 639 KB  
Article
Entertainment Sedentary Time and Subjective Well-Being in College Students: A Moderation Model of Perceived Time Poverty
by Lin-Ming Li, Shi-Yao Wang, Zhi-Lin Jia, Qian Qiu, Feng-Bo Liu, Wei-Wei Sheng, Jing-Jing Ge, Xuan-Yu Zhao, Ruo-Fei Du and Ming Wu
Behav. Sci. 2026, 16(8), 1408; https://doi.org/10.3390/bs16081408 - 17 Aug 2026
Viewed by 208
Abstract
This study examined the association between entertainment sedentary time (EST) and subjective well-being (SWB) among Chinese college students and further explored the moderating role of perceived time poverty (PTP). A total of 1582 college students completed questionnaires assessing EST, PTP, SWB, and moderate-to-vigorous [...] Read more.
This study examined the association between entertainment sedentary time (EST) and subjective well-being (SWB) among Chinese college students and further explored the moderating role of perceived time poverty (PTP). A total of 1582 college students completed questionnaires assessing EST, PTP, SWB, and moderate-to-vigorous physical activity (MVPA). Descriptive statistics, correlation analyses, multiple linear regression analysis, and moderation analysis using Model 1 of the PROCESS macro for SPSS (Version 4.2) were conducted. After adjustment for gender, grade, and MVPA, EST was significantly and negatively associated with SWB, although the association was weak. PTP was also significantly and negatively associated with SWB. The interaction between EST and PTP was statistically significant, indicating that PTP moderated the association between EST and SWB. Specifically, the negative association between EST and SWB was stronger among students with lower levels of PTP and weakened as PTP increased. Johnson–Neyman analysis further identified the ranges of PTP within which the conditional association between EST and SWB was statistically significant. These findings suggest that PTP may function as a contextual boundary condition of the association between EST and SWB and should be considered when interpreting this association. Full article
(This article belongs to the Section Health Psychology)
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22 pages, 580 KB  
Article
Motivation and Perceived Barriers to Physical Activity Among Lithuanian Students: A Cross-Sectional Study
by Dominykas Radišauskas and Aušra Beržanskytė
Medicina 2026, 62(8), 1556; https://doi.org/10.3390/medicina62081556 - 13 Aug 2026
Viewed by 250
Abstract
Background and Objectives: Regular physical activity is important for students’ health and well-being, but participation may be influenced by motivation and perceived barriers. This study assessed physical activity levels, motivational regulation, perceived barriers, and their associations among students enrolled in Lithuanian higher [...] Read more.
Background and Objectives: Regular physical activity is important for students’ health and well-being, but participation may be influenced by motivation and perceived barriers. This study assessed physical activity levels, motivational regulation, perceived barriers, and their associations among students enrolled in Lithuanian higher education institutions. Materials and Methods: A cross-sectional survey was conducted among 370 students. The questionnaire assessed weekly physical activity, motivational regulation, perceived barriers, and sociodemographic characteristics. Group comparisons and exploratory hierarchical multivariable logistic regression were performed. Results: Overall, 74.6% of the participants met the World Health Organization physical activity recommendations. In separate analyses, male participants and those from major cities were more likely to meet the World Health Organization physical activity recommendations. Intrinsic and identified regulation were the most prominent motivational factors, whereas lack of energy, lack of willpower, and lack of time were the most frequently reported barriers. In the final model, higher intrinsic regulation was associated with greater odds of meeting the recommendations (odds ratio 1.64, 95% confidence interval 1.10–2.44), while lack of willpower (odds ratio 0.34, 95% confidence interval 0.19–0.60) and lack of time (odds ratio 0.35, 95% confidence interval 0.18–0.68) were associated with lower odds. Sociodemographic characteristics were not statistically significant in the final model. Conclusions: Most participants in this sample met the World Health Organization physical activity recommendations. The findings highlight the relevance of intrinsic regulation and selected perceived barriers to physical activity participation. These exploratory associations may help guide future longitudinal and intervention research on context-specific physical activity promotion in higher education. Full article
(This article belongs to the Section Epidemiology & Public Health)
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