Search Results (1,048)

In the original randomised Dietary Intervention to Stop Coronary Atherosclerosis (DISCO-CT) trial, a 12-month Dietary Approaches to Stop Hypertension (DASH) project led by dietitians improved cardiovascular and metabolic risk factors and reduced platelet chemokine levels in patients with coronary artery disease (CAD). It is unclear whether these benefits are sustained. Objective: To determine whether the metabolic, inflammatory, and clinical benefits achieved during the DISCO-CT trial are sustained six years after the structured intervention ended. Methods: Ninety-seven adults with non-obstructive CAD confirmed in coronary computed tomography angiography were randomly assigned to receive optimal medical therapy (control group, n = 41) or the same therapy combined with intensive DASH counselling (DASH group, n = 43). After 301 ± 22 weeks, 84 individuals (87%) who had given consent underwent reassessment of body composition, meal frequency assessment, and biochemical testing (lipids, hs-CRP, CXCL4, RANTES and homocysteine). Major adverse cardiovascular events (MACE) were assessed. Results: During the intervention, the DASH group lost an average of 3.6 ± 4.2 kg and reduced their total body fat by an average of 4.2 ± 4.8 kg, compared to an average loss of 1.1 ± 2.9 kg and a reduction in total body fat of 0.3 ± 4.1 kg in the control group (both p < 0.01). Six years later, most of the lost body weight and fat tissue had been regained, and there was a sharp increase in visceral fat area in both groups (p < 0.0001). CXCL4 decreased by 4.3 ± 3.0 ng/mL during the intervention and remained lower than baseline values; in contrast, in the control group, it initially increased and then decreased (p < 0.001 between groups). LDL cholesterol and hs-CRP levels returned to baseline in both groups but remained below baseline in the DASH group. There was one case of MACE in the DASH group, compared with four cases (including one fatal myocardial infarction) in the control group (p = 0.575). Overall adherence to the DASH project increased by 26 points during counselling and then decreased by only four points, remaining higher than in the control group. Conclusions: A one-year DASH project supported by a physician and dietitian resulted in long-term suppression of the proatherogenic chemokine CXCL4 and fewer MACE over six years, despite a decline in adherence and loss of most anthropometric and lipid benefits. It appears that sustained systemic reinforcement of behaviours is necessary to maintain the benefits of lifestyle intervention in CAD. Full article

Sport volunteering plays an important role in achieving the goals of sustainable development by supporting the social dimension of sustainability, fostering social integration, and promoting a healthy lifestyle. However, there is a lack of systematic research in Poland on the motivations of sport volunteers, particularly in the context of mass endurance events. This study employed a quantitative, cross-sectional design involving 148 sport volunteers engaged in mass endurance events in Poznan, Poland. To measure motivation, the Polish adaptation of the VMS-ISE scale was used. Data analysis was conducted using one-way analysis of variance (ANOVA). The results showed that volunteer motivations were relatively homogeneous regardless of gender and education level, with the exception of passion for sport, which was significantly stronger among men (p = 0.037). Significant differences were found based on place of residence: residents of medium-sized cities demonstrated the highest motivation for personal development (p < 0.001), whereas individuals from rural areas exhibited stronger patriotism, a greater need for interpersonal interaction, and a higher valuation of external rewards (p < 0.05). The motivations of sport volunteers in Poland are complex and sensitive to environmental factors. Understanding these differences allows for better alignment of recruitment and volunteer management strategies, which can enhance both the effectiveness and sustainability of volunteer engagement. It is recommended to develop volunteer programs that take into account the demographic and socio-cultural characteristics of participants. Full article

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

Background: It is well-established that, for adolescents to adopt sustainable healthy lifestyle behaviors, not only access to information but also the skills required to translate that information into action are critical. In this field, research that examines the relationship between e-health literacy and sustainable healthy lifestyle behaviors within the context of physical literacy is notably scarce. In this context, the aim of this study is to examine the effect of e-health literacy on a sustainable healthy lifestyle and to evaluate the mediating role of physical literacy in this relationship. Methods: A total of 835 adolescents from high schools across Türkiye voluntarily participated in this study. During the data collection process, the e-Health Literacy Scale, the Perceived Physical Literacy Scale, and the Healthy and Sustainable Lifestyle Scale were utilized. Data were analyzed using the JASP (version 0.18.3.0) software. Correlation analysis and structural equation modeling were conducted, and the bootstrap method (n = 5000) was employed for mediation analysis. Results: The effect of e-health literacy on a sustainable healthy lifestyle was found to be positive and statistically significant (β = 0.452, p < 0.001). Similarly, e-health literacy significantly predicted physical literacy (β = 0.755, p < 0.001), and physical literacy significantly predicted a sustainable healthy lifestyle (β = 0.310, p < 0.001). The mediating effect was also statistically significant (β = 0.234, p < 0.001). The model explained 32% of the variance in healthy lifestyle behaviors. Conclusions: The findings indicate that evaluating e-health literacy and physical literacy together provides a holistic approach to fostering sustainable healthy lifestyle habits among adolescents. It is recommended that intervention programs be structured to encompass both areas of competence. Full article

Background/Objectives: Endometriosis is a chronic, estrogen-driven gynecological disorder affecting approximately 10% of reproductive-aged women worldwide, with significant physical, psychosocial, and socioeconomic impacts. Recent research suggests a possible involvement of the gut microbiome in endometriosis disease mechanisms through immune manipulation, estrogen metabolism, and inflammatory networks. This narrative review aims to summarize current evidence on gut microbiota changes in endometriosis patients, explore the mechanisms by which gut dysbiosis contributes to disease progression, and examine epidemiological links between gastrointestinal health and endometriosis risk. Methods: A narrative review was conducted to synthesize available literature on the compositional changes in gut microbiota associated with endometriosis. The review also evaluated studies investigating potential mechanisms and epidemiological patterns connecting gut health with endometriosis development and severity. Results: Alterations in gut microbiota composition were observed in endometriosis patients, suggesting roles in immune dysregulation, estrogen metabolism, and inflammation. Potential gut-oriented interventions, including dietary changes, probiotics, and lifestyle modifications, emerged as promising management options. However, methodological variability and research gaps remain barriers to clinical translation. Conclusions: Integrating gut microbiome research into endometriosis management holds potential for improving early diagnosis, patient outcomes, and healthcare system sustainability. The study emphasizes the need for further research to address existing challenges and to develop public health strategies that incorporate microbiome-based interventions in population-level endometriosis care. Full article

Ensuring a sustainable and healthy human environment in university dormitories is essential for students’ learning, living, and overall health and well-being. To address this need, we carried out a series of systematic field measurements of the noise levels at 30 dormitories in three representative major urban universities in a major provincial capital city in China and designed and implemented a comprehensive questionnaire and surveyed 1005 students about their perceptions of their acoustic environment. We proposed and applied a sustainability–health-oriented, multidimensional assessment framework to assess the acoustic environment of the dormitories and student responses to natural sound, technological sounds, and human-made sounds. Using the Structural Equation Modeling (SEM) approach combined with the field measurements and student surveys, we identified three categories and six factors on student health and well-being for assessing the acoustic environment of university dormitories. The field data indicated that noise levels at most of the measurement points exceeded the recommended or regulatory thresholds. Higher noise impacts were observed in early mornings and evenings, primarily due to traffic noise and indoor activities. Natural sounds (e.g., wind, birdsong, water flow) were highly valued by students for their positive effect on the students’ pleasantness and satisfaction. Conversely, human and technological sounds (traffic noise, construction noise, and indoor noise from student activities) were deemed highly disturbing. Gender differences were evident in the assessment of the acoustic environment, with male students generally reporting higher levels of the pleasantness and preference for natural sounds compared to female students. Educational backgrounds showed no significant influence on sound perceptions. The findings highlight the need for providing actionable guidelines for dormitory ecological design, such as integrating vertical greening in dormitory design, water features, and biodiversity planting to introduce natural soundscapes, in parallel with developing campus activity standards and lifestyle during noise-sensitive periods. The multidimensional assessment framework will drive a sustainable human–ecology–sound symbiosis in university dormitories, and the category and factor scales to be employed and actions to improve the level of student health and well-being, thus, providing a reference for both research and practice for sustainable cities and communities. Full article

The purpose of this study is to analyze how future landscape paintings using paints and binders made from the waste materials of a particular region and the background information of these artworks affect viewers’ behavioral intentions regarding social and environmental issues. First, 30 beauty evaluation items were extracted by a repertory grid analysis. Then, we asked participants to view the artworks at an exhibition in order to determine the impact of the background information behind the painting and the painting itself on participants’ imagination of the future, reconsidering themselves, social and environmental issues, and their behavioral intentions. The results showed that viewing paintings with their background information and using paints made of waste materials from a particular region improved participants’ behavioral intentions to imagine the future, to reconsider themselves, and to reconsider social and environmental issues. The elements of beauty of the paintings were found to have the potential to trigger the first step toward lifestyle change for sustainability. Full article

This study presents a systematic review regarding the use of augmented reality and virtual reality in exergaming by analyzing studies published during 2010–2025. This study focuses on providing an overview of the field and on examining and synthesizing the findings of related studies to identify the contexts, applications, and domains in which extended reality exergames are being used and the related implications, benefits, and challenges. Based on the results, augmented reality and virtual reality exergames offer immersive, enjoyable, engaging, and personalized experiences that support physical, cognitive, and emotional well-being, while enhancing physical performance, cognitive functioning, psychological outcomes, and mental health. They promote motivation, active lifestyles, and sustainable health behaviors across diverse populations, including older adults, individuals with disabilities, and neurological groups, as well as the general adult and youth populations. Although emphasis is placed on their use in physical and cognitive rehabilitation and treatment, they also show great potential to be effectively used in different domains, including education. Among the technologies examined, the significant majority of studies focused on virtual reality exergames, a limited number of studies involved augmented reality, and only a few studies examined mixed reality, extended reality, and the metaverse. Finally, nine main topics were identified through topic modeling, providing a clear representation of the core themes within the literature. Full article

Promoting sustainable lifestyles through early interventions in schools is increasingly recognized as a critical component of public health and educational policy. Sustainable development, as outlined by the United Nations Sustainable Development Goals (SDGs), particularly Goal 3 (Good Health and Well-being) and Goal 4 (Quality Education), calls for integrating health-promoting behaviors into all aspects of life, including school settings. Active breaks (ABs) could represent a promising strategy to counteract these effects. This study assessed the impact of ABs on the attention of fifth-grade children, aiming to promote both immediate cognitive benefits and long-term health. A total of 32 primary children (age, 9.34 ± 0.77 years old), divided into an experimental group (AB sessions) and a control group, participated in this study. Attention and concentration were measured using the D2-R Test, while processing speed and distraction-related behaviors were tracked. Additionally, questionnaires assessed children’s and teachers’ perceptions. After five weeks, the experimental group demonstrated significant improvements in attention (p < 0.05), especially after high intensity ABs at 12:00. This study suggested the effectiveness of ABs as a tool for improving children’s attention and behavior in primary schools. The findings suggest that integrating physical activity breaks not only enhances cognitive function but also contributes to sustainable educational practices by fostering better learning environments and supporting children’s health and well-being. Full article

Lifestyle blocks (LBs) are small rural holdings primarily used for residential and recreational purposes rather than commercial farming. Despite the rapid expansion of LBs over the last 25 years, which has been driven by lifestyle amenity preference and land subdivision incentives, their environmental performance remains understudied. This is the case even though their proliferation is leading to an irreversible loss of highly productive soils and accelerating land fragmentation in peri-urban areas. Through undertaking a systematic literature review of relevant studies on LBs in New Zealand and comparable international contexts, this paper aims to quantify existing knowledge and suggest future research needs and management strategies. It focuses on the environmental implications of LB activities in relation to water consumption, food production, energy use, and biodiversity protection. The results indicate that variation in land use practices and environmental awareness among LB owners leads to differing environmental outcomes. LBs offer opportunities for biodiversity conservation and small-scale food production through sustainable practices, while also presenting environmental challenges related to resource consumption, greenhouse gas (GHG) emissions, and loss of productive land for commercial agriculture. Targeted landscape design could help mitigate the environmental pressures associated with these properties while enhancing their potential to deliver ecological and sustainability benefits. The review highlights the need for further evaluation of the environmental sustainability of LBs and emphasises the importance of property design and adaptable planning policies and strategies that balance environmental sustainability, land productivity, and lifestyle owners’ aspirations. It underscores the potential for LBs to contribute positively to environmental management while addressing associated challenges, providing valuable insights for ecological conservation and sustainable land use planning. Full article

Background: In rapidly aging societies like Japan, socioeconomic status (SES) plays a critical role in shaping older adults’ health behaviors. Disparities in SES influence access to healthcare, engagement in health-promoting activities, and the adoption of digital health technologies. This narrative review synthesizes current evidence on how SES affects health behaviors among older adults and highlights challenges in promoting equitable and sustainable healthcare in aging populations. Methods: A PubMed search was conducted for English-language articles published up to May 2025 using the keywords “socioeconomic status”, “older adults”, and terms related to health behaviors. Studies were included if they focused on individuals aged 65 or older and examined associations between SES and healthcare use, digital health, complementary and alternative medicine (CAM), supplements, or lifestyle behaviors. Results: A total of 24 articles were identified. Higher SES—typically measured by income, education, and occupation—was consistently associated with an increased use of preventive services, digital health tools, CAM, and healthier lifestyle behaviors such as diet, physical activity, and sleep. In contrast, lower SES was linked to healthcare underuse or overuse, digital exclusion, and less healthy behaviors. Structural and regional disparities often reinforce individual-level SES effects. Comorbidity burden and shifting health perceptions with age may also modify these associations. Conclusions: SES is a key determinant of health behavior in older adults. Policies should focus on redistributive support, digital inclusion, and SES-sensitive health system strategies to reduce disparities and promote healthy aging in super-aged societies. Full article

Background/Objectives: Despite its well-established health benefits, adherence to the Mediterranean lifestyle (MedLife) has declined globally, including in its region of origin, alongside a significant shift toward ultra-processed food consumption. Understanding the factors associated with MedLife adherence is essential for developing targeted interventions and tailored policy recommendations. As part of the MEDIET4ALL PRIMA project, this cross-sectional study aimed to comprehensively examine geo-demographic, socio-economic, psychological, behavioral, and barrier-related factors associated with and potentially contributing to MedLife adherence. Methods: Data were collected from 4010 participants aged 18 years and above across ten Mediterranean and neighboring countries using the multinational MEDIET4ALL e-survey, which included the validated MedLife index, along with various other questionnaires. Results: Results indicate that only 22% of respondents demonstrated high adherence to the Mediterranean lifestyle (MedLife), with significant variability observed across countries, age groups, education levels, and health statuses. Spain had the highest proportion of participants with high adherence (38%). Factors associated with significantly higher adherence rates include older age, living in the Mediterranean region, higher education levels, a greater awareness of MedLife principles, lower perceived barriers, normal BMI, better health status, and stable economic and marital conditions (p-values ranging from 0.04 to <0.001). Additionally, individuals with high MedLife adherence exhibited more socially and physically active lifestyles and experienced less psychological strain (p < 0.001). Regression analyses identified MedLife awareness as the strongest positive predictor of adherence (β = 0.206), followed by social participation (β = 0.194) and physical activity (β = 0.096). Additional positive contributors include life satisfaction, sleep quality, living in the Mediterranean region, age, and education (β ranging from 0.049 to 0.093). Conversely, factors that are negatively associated with adherence include sedentary behavior, living environment, and barriers such as low motivation, taste dislike, price unaffordability, limited availability, and the time-consuming nature of preparing Mediterranean food (MedFood; β ranging from −0.036 to −0.067). Conclusions: These findings indicate that fewer than one in four adults across Mediterranean and neighboring countries demonstrate high adherence to MedLife, supporting prior evidence of suboptimal adherence even within Mediterranean regions. This study identified a range of behavioral, socio-demographic, and environmental factors—both positive and negative predictors—that can help guide the design of targeted, culturally adapted interventions to promote MedLife behavior. Future research should incorporate objective measurements and longitudinal monitoring to better understand underlying mechanisms, establish causality, and develop sustainable strategies for enhancing MedLife adherence in diverse populations. Full article

Background: It is well established that healthy lifestyle behaviors have significant effects not only on physical health but also on psychological well-being; however, the underlying mechanisms of these effects have yet to be fully elucidated. In this context, the aim of this study is to examine the relationships between a sustainable healthy lifestyle and levels of depression, stress, and anxiety, and to test the mediating role of physical literacy in these associations. Methods: This cross-sectional study was conducted among university students in Malatya, Türkiye, and a total of 652 voluntary participants were included. In the theoretical model of the study, a sustainable healthy lifestyle was positioned as the independent variable, depression, stress, and anxiety as dependent variables, and physical literacy as the mediating variable. Data were analyzed using structural equation modeling with bootstrapping to assess mediation effects. Results: Results obtained from the structural equation modeling indicate that a sustainable healthy lifestyle has significant and protective relationships with psychological well-being. Negative and significant relationships were identified between a sustainable healthy lifestyle and levels of depression, stress, and anxiety. Furthermore, higher levels of physical literacy were associated with lower levels of these psychological symptoms, with physical literacy playing a strong mediating role in these relationships. The model results revealed that lifestyle components such as regular physical activity, balanced nutrition, and sufficient sleep enhance individuals’ physical competence and awareness. Physical literacy was also found to have a significant negative relationship with depression, stress, and anxiety. Conclusions: These results indicate that physical literacy is a key variable not only for physical functioning but also for psychological resilience and well-being. Moreover, the impact of a sustainable healthy lifestyle on psychological symptoms appears to be largely mediated through physical literacy. Full article

Physical and mental health show strong associations with health-related behavior. University students are one of the at-risk groups who are in a vulnerable transition phase from adolescence to adulthood, significantly affecting their health-related lifestyle. This study aims to identify different groups of university students with homogeneous health-related behavior, considering their dietary habits, physical activity, alcohol and tobacco consumption, mental well-being and lifestyle change motives. For data collection, an anonymous, closed-ended paper-and-pencil questionnaire was administered to a sample of 171 university students. Data analysis was performed using descriptive statistics, a t-test for independent samples, a chi-square test, Spearman correlation and hierarchical cluster analyses (Ward’s method, Dendrogram). On average, students reported good health (M = 4.84), including daily physical activity (M = 31.35 min) and regular consumption of fruits (M = 4.02) and vegetables (M = 4.19). The hierarchical cluster analysis revealed two distinct patterns among the students: “Caring for a healthy lifestyle” (N = 69) and “Physically inactive with poor mental well-being” (N = 62). Better health-related behavior was found among male students enrolled in higher study years (p ≤ 0.01). These findings provide new insights into the different patterns of health-related behavior among university students that require targeted health promotion actions. Universities should develop and implement courses in healthy lifestyles and sustain them in the curricula. Full article

Background/Objectives: The adoption of sustainable eating behaviors is not only crucial for environmental health but also has significant implications for individual health outcomes. A deeper understanding of the psychological determinants underlying such changes is needed. The Theory of Planned Behavior (TPB) has been widely used to understand the psychological factors influencing health behaviors, including dietary choices. Recent advances suggest integrating additional psychological constructs, such as personal values, to enhance TPB’s predictive power and the effectiveness of related behavioral interventions. Methods: A novel Food-Related Personal Values Questionnaire (FRPV-Q) was developed based on Schwartz’s circumplex model of basic values, and the role of these food-related personal values within an enhanced TPB framework was tested. Statistical analyses were conducted to explore the structure of the questionnaire. Results: Three components were identified within the FRPV-Q: Openness, Health and Security, and Autonomy (Kaiser–Meyer–Olkin test = 0.576). The regression analyses highlighted the potential role of personal values in predicting sustainable eating behaviors (adjusted R² = 0.318). Specifically, an orientation toward autonomy, hedonism, and self-directionality appeared to hinder the adoption of sustainable food choices, while an orientation toward health, security, and openness to novelty was found to promote more sustainable dietary choices. Conclusions: The results offer preliminary insights into the role of personal values in food-related behaviors. Future research aimed at understanding and promoting pro-environmental food-related behaviors should rigorously investigate the topic. Carefully tailored value-based psychological interventions may prove beneficial for the general population in the promotion of sustainable dietary lifestyles. Full article