Living alone and cardiovascular health status in residents of a rural village of coastal Ecuador (The Atahualpa Project)

Objectives

Knowledge of region-specific factors affecting the cardiovascular health (CVH) is mandatory to reduce the growing burden of stroke and ischemic heart disease in rural areas of Latin American. We conducted a population-based case–control study to assess the CVH status of Atahualpa residents—a rural village representative of Coastal Ecuador—according to their living arrangements.

Methods

All Atahualpa residents aged ≥40 years and free of stroke or ischemic heart disease that lived alone were identified during a door-to-door census, and their CVH status was compared to that of a sample of residents that lived with relatives. Four controls individually matched for age, gender, education, job and alcohol intake, and randomly selected from different households, were selected for each case-person.

Results

A total of 185 persons (37 who lived alone and 148 matched controls) were included. A poor CVH status was found in 89.2 % case-patients and 72.3 % controls (p = 0.03). We found significantly worse levels of physical activity (p < 0.0001) and non-significant trends for worse healthy diet and glucose levels among case-persons than controls.

Conclusions

This study suggests that social isolation is associated with a worse CVH in rural coastal Ecuador. An ongoing community-based intervention may prove effective to improve CVH status in these social isolated persons.     

Status of cardiovascular health in a transition European country: findings from a population-based cross-sectional study

Objectives

Our aim was to assess the prevalence of ideal cardiovascular health (CVH) in the adult population of Republic of Srpska (RS), Bosnia and Herzegovina, and its relationship with socio-demographic characteristics of participants.

Methods

We included 4,170 adults (mean age 50.2 years; 54 % women) from the National Health Survey performed from September to November 2010 in RS. Population prevalence of CVH health metrics (smoking, body mass index, physical activity, diet, cholesterol, blood pressure, and glucose) were estimated according to the American Heart Association criteria for “ideal”, “intermediate”, and “poor” levels.

Results

Only 0.02 % participants had ideal (all 7 health metrics at ideal levels), 7.6 % intermediate, and 92.4 % poor (at least one metric at poor level) CVH. The fasting glucose was the most prevalent (75.9 %), whereas the healthy diet was the least prevalent (4.4 %) ideal CVH metric.

Conclusions

Our study indicates extremely low prevalence of ideal and high prevalence of poor CVH in the adult RS population. Such alarming results require urgent action. Comprehensive public health strategies and interventions must be developed to assist individuals and population in improving their CVH.     

Impact of nocturnal calf cramping on quality of sleep and health-related quality of life

Purpose

To evaluate the impact of nocturnal calf cramping (a condition that affects one in two people over 60 years of age) on quality of sleep and health-related quality of life.

Methods

Eighty adults who experienced nocturnal calf cramp at least once per week and eighty age- and sex-matched controls who never experienced nocturnal cramp were recruited from the Greater Newcastle and Central Coast regions of New South Wales, Australia. All participants completed the SF-36v2 and the Medical Outcomes Study Sleep Survey (MOS-SS).

Results

People who experienced nocturnal muscle cramps reported more sleep disturbance (p < 0.001), less adequate sleep (p = 0.001), less quantity of sleep (p = 0.02) and more snoring (p = 0.03). Both sleep problem summary indices for the MOS-SS identified people who experienced nocturnal muscle cramp as having more sleep problems than the controls. People who experienced nocturnal muscle cramps had lower health-related quality of life for the SF-36 domains role physical (p = 0.007), bodily pain (p = 0.003) and general health (p = 0.02). SF-36 domains that primarily relate to mental health were not significantly different between groups. The impact of nocturnal calf cramps on health-related quality of life was largely explained by their negative impact on quality of sleep.

Conclusions

Nocturnal calf muscle cramps are associated with substantially reduced quality of sleep and reduced physical aspects of health-related quality of life.     

Prevalence of adiposity and its association with sleep duration,quality, and timing among 9–12-year-old children in Guangzhou,China

Background

Short sleep duration has been reported to be associated with obesity in children, but findings are not consistent. Since few studies have examined the relationship between more complex sleep characteristics and obesity, we examined the association between adiposity and self-reported sleep duration, bedtime, and sleep quality in 9–12-year-old Chinese children using multilevel mixed models.

Depressive symptoms and carotid artery intima-media thickness in police officers

Purpose

Police work is a stressful occupation. Depressive symptoms, which may occur as a result of exposure to stressors in police work, have been known to be associated with an increased risk of cardiovascular disease. This cross-sectional study investigated the association between depressive symptoms and carotid artery intima-media thickness (CIMT) among police officers.

Methods

CIMT was measured with B-mode carotid ultrasonography. Depressive symptoms were measured using the Center for Epidemiological Studies Depression (CES-D) scale. Analyses of variance and covariance were utilized to examine the mean values of common CIMT (CCA IMT) and maximum CIMT (MMXIMT) across quintiles of depressive symptoms.

Results

Participants included 412 officers (mean age = 41 years). Hypertension status significantly modified the association between CES-D score and CIMT. The association between CES-D score and CCA IMT was statistically significant (adjusted P = 0.030) but only among officers without hypertension. The associations between CES-D score and MMXIMT were not significant among officers with or without hypertension. Our results also showed that among officers who reported poor sleep quality, mean levels of CCA IMT, and MMXIMT tended to increase as depressive symptoms increased.

Conclusions

Depressive symptoms may be therefore be independently associated with CIMT, yet masked by hypertension. Even though sleep quality did not significantly modify the main association, our results also suggest that poor sleep quality may act synergistically with depressive symptoms to increase CIMT. Future prospective work would help to clarify these associations.     

Ten-year change in self-rated quality of life in a type 1 diabetes population: Wisconsin Epidemiologic Study of Diabetic Retinopathy

Purpose

To investigate a 10-year change of quality of life and associated factors in a population with type 1 diabetes.

Methods

The Medical Outcome Study Short Form-36 (SF-36) was administered in participants (n = 520) at the 1995–1996 and 2005–2007 examination phases of the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR). Physical (PCS) and mental (MCS) component summary scores were calculated. The associations between changes of quality of life and demographic, socioeconomic, and clinical factors were analyzed.

Results

PCS score decreased (p < 0.001) and MCS score increased (p < 0.001) after 10 years. The development of cardiovascular disease and the presence of limb amputation were associated with decrease in the PCS score. Those who were working and retired had increased MCS; those who were working and stopped had a decrease in the MCS score. Change in visual acuity and diabetic retinopathy status did not have a significant impact in health-related quality of life scores.

Conclusions

Our findings reinforce the necessity to make every attempt to decrease complications of diabetes in individuals with long-term type 1 diabetes in order to attenuate the diminished quality of life associated with those complications such as cardiovascular disease. Change in employment status, likely due to development of these complications, was also strongly associated with poorer quality of life and suggests the benefits of preventing or decreasing complications to keep people with type 1 diabetes in the workforce.     

Yeast (1,3)-(1,6)-beta-glucan helps to maintain the body’s defence against pathogens: a double-blind, randomized, placebo-controlled, multicentric study in healthy subjects

Purpose

The effect of brewers’ yeast (1,3)-(1,6)-beta-d-glucan consumption on the number of common cold episodes in healthy subject was investigated.

Methods

In a placebo-controlled, double-blind, randomized, multicentric clinical trial, 162 healthy participants with recurring infections received 900 mg of either placebo (n = 81) or an insoluble yeast (1,3)-(1,6)-beta-d-glucan preparation (n = 81) per day over a course of 16 weeks. Subjects were instructed to document each occurring common cold episode in a diary and to rate ten predefined infection symptoms during an infections period, resulting in a symptom score. The subjects were examined by the investigator during the episode visit on the 5th day of each cold episode.

Results

In the per protocol population, supplementation with insoluble yeast (1,3)-(1,6)-beta-glucan reduced the number of symptomatic common cold infections by 25 % as compared to placebo (p = 0.041). The mean symptom score was 15 % lower in the beta-glucan as opposed to the placebo group (p = 0.125). Beta-glucan significantly reduced sleep difficulties caused by cold episode as compared to placebo (p = 0.028). Efficacy of yeast beta-glucan was rated better than the placebo both by physicians (p = 0.004) participants (p = 0.012).

Conclusion

The present study demonstrated that yeast beta-glucan preparation increased the body’s potential to defend against invading pathogens.     

How do life-course trajectories of socioeconomic position affect quality of life in patients with diabetes mellitus?

Purpose

This study evaluated the association of life-course economic trajectory with health-related quality of life in patients with diabetes mellitus.

Methods

The study subjects were 183 outpatients over 20 years of age with diabetes mellitus. A questionnaire was administered to collect information about current and childhood economic status, and health-related quality of life was assessed through the 12-item short-form health survey (SF-12). Economic trajectory was categorized into five groups according to the change between current and childhood economic status. The mental component summary score and physical component summary score of the SF-12 were compared with average scores for the US population due to lack of domestic data.

Results

Physical health-related quality of life was more likely to be affected by current economic status than by economic position in childhood. On the other hand, mental health-related quality of life was associated not only with the self-rated economic status (p = 0.01) but also socioeconomic trajectory (p = 0.04), even after controlling for potential confounding factors. These results suggest that early economic status may affect mental health throughout one’s lifetime.

Conclusions

Economic status and trajectory throughout life may influence health-related quality of life in patients with diabetes mellitus.     

Role of global stress in the health-related quality of life of caregivers: evidence from the Survey of the Health of Wisconsin

Purpose

Informal caregivers play a critical role in the care of individuals who are aging or have disabilities and are at increased risk for poor health outcomes. This study sought to determine whether and to what extent: (1) global stress and health-related quality of life (HRQoL) differed between caregivers and non-caregivers; (2) global stress mediated the relationship between caregiving status and HRQoL; and (3) caregiver strain (i.e., stress attributable to caregiving) was associated with worse HRQoL after accounting for global stress.

Methods

Cross-sectional data were from the 2008–2010 Survey of the Health of Wisconsin, a representative sample of adults aged 21–74 years. Participants (n = 1,364) completed questionnaires about caregiving status, sociodemographics, global stress, and HRQoL. Staged generalized additive models assessed the impact of caregiving on HRQoL and the role of caregiver strain and global stress in this relationship.

Results

In the last 12 months, 17.2 % of the sample reported caregiving. Caregivers reported worse mental HRQoL than non-caregivers (β ?1.88, p = 0.02); global stress mediated this relationship (p < 0.01). Caregivers with the highest levels of strain reported worse mental and physical HRQoL (β ?7.12, p < 0.01), and caregivers with the lowest levels of strain reported better mental HRQoL (β 2.06, p = 0.01) than non-caregivers; these associations were attenuated by global stress (p < 0.01).

Conclusion

Global stress, rather than caregiving per se, contributes to poor HRQoL among caregivers, above and beyond the effect of caregiving strain. Screening, monitoring, and reducing stress in multiple life domains presents an opportunity to improve HRQoL outcomes for caregivers.     

Nutritional intake and status in persons with alcohol dependency: data from an outpatient treatment programme

Purpose

Malnutrition increases the risk of developing alcohol-related complications. The aim of this study was to describe nutrient intake, nutritional status and nutrition-related complications in a Danish population of outpatients with alcohol dependency.

Methods

This was a cross-sectional study with a 6-month follow-up enrolling persons with alcohol dependency (n = 80) admitted to a hospital-based outpatient clinic. Body mass index, the waist-to-hip ratio and handgrip strength (HGS) were measured, a 7-day food diary was collected, and biochemical testing was conducted. Dual-energy X-ray absorptiometry was performed to determine body composition and bone mineral density (BMD).

Results

In total, 64 % of the patients with alcohol dependency had vitamin D insufficiency (25-OH-vit D <50 nmol/l). Compared with surveys of the general population, the patients with alcohol dependency had lower energy intake (p = 0.008), s-zinc levels (p < 0.001), s-magnesium levels (p = 0.02), Z-scores for BMD (lumbar spine, p = 0.03; total hip, p = 0.009) and HGS (p < 0.001). Osteopenia was observed in 52 % of individuals, and overt osteoporosis was noted in 7 %. Comparing baseline data with data from the follow-up (n = 30), we found a decrease in s-CRP (p = 0.002) and s-alanine amino transferase (p = 0.01) levels and an increase in s-parathyroid hormone levels (p = 0.02).

Conclusions

Patients with alcohol dependency have an altered nutritional status and risk of complications, as evidenced by osteopenia/osteoporosis and reduced muscle strength. Treatment at an outpatient clinic improved the variables related to liver function, but no change was observed in nutritional status over time. These findings suggest that specific screening and targeted treatment regimens for nutritional deficits could be beneficial.     

Sleep disturbances in adult survivors of childhood brain tumors

Purpose

The aims of this study are to compare self-reported sleep quality in adult survivors of childhood brain tumors and a population-based comparison group, to identify treatment-related factors associated with sleep disturbances, and to identify the impact of post-treatment obesity and depression on sleep scores in adult survivors of childhood brain tumors.

Methods

Randomly selected adult survivors of childhood brain tumors (n = 78) and age-, sex-, and zip code-matched population-group members (n = 78) completed the Pittsburgh Sleep Quality Index and the Brief Symptom Inventory. Sleep quality and the effect of demographic, treatment, and post-treatment characteristics were evaluated with linear and logistic regression analyses.

Results

Brain tumor survivors were 2.7 (95 % CI, 1.1, 6.5) times more likely than the comparison group to take greater than 30 min to fall asleep. Females in both groups reported worse sleep quality and impaired daytime functioning. Among survivors, post-treatment obesity was associated with daytime dysfunction.

Conclusions

These results agree with previous studies associating sleep, sex, and obesity and identified longer sleep latency as being a problem among childhood brain tumor survivors. Further study identifying factors contributing to sleep latency, and its impact on quality of life among adult survivors of childhood brain tumors is needed.     

Effects of an HIV-Care-Program on immunological parameters in HIV-positive patients in Yaoundé, Cameroon: a cluster-randomized trial

Objectives

To measure the effects of an HIV-Care-Program, focusing on nutrition and lifestyle, which can be provided at scale to HIV-infected patients, on clinical and anthropometrical parameters, and health status.

Methods

A cluster-randomized trial, including 5 health facilities randomized to intervention n = 100 (HIV-Care-Program) or control n = 101 (Usual-Care). The HIV-Care-Program consisted of counseling lessons for 6 months, on: nutrition, hygiene, coping with stigma and discrimination, embedded in practical activities. Outcome variables were CD4 count after 6 months and time to antiretroviral therapy (ARV) initiation, using analysis of covariance and Kaplan–Meier method, respectively.

Results

After 6 months, CD4 count dropped by 46.3 cells (7.7 %) (intervention) and 129 (23 %) (control) (p = 0.003). Mean time to ARV; 5.9 months 95 % CI (5.9, 6.0) (intervention); 4.9 months 95 % CI (4.7, 5.2) (control) (p < 0.004). There was a partial correlation between CD4 count and initial viral load (r = ?0.190, p = 0.017).

Conclusions

The intervention provides a low-cost alternative improving health status, slowing down CD4 cell decline, delaying initiation of ARV and thus freeing local ARV capacities for patients in urgent need.     

Correlations between physician-perceived functional status, patient-perceived health status, and cardiopulmonary exercise results in hypertrophic cardiomyopathy

Background

Dyspnea and the resulting functional impairment are a common complication in hypertrophic cardiomyopathy (HCM). The relationship between physician-perceived functional status, patient-perceived health status, and objective exercise test results has not been evaluated in this condition.

Purpose

To evaluate the correlation between the Kansas City Cardiomyopathy Questionnaire (KCCQ) and (1) physician’s perceived (NYHA class) and (2) objective measurement (cardiopulmonary exercise test) of functional capacity in patients with HCM.

Methods

In 24 outpatients with HCM at a single, referral center, the KCCQ instrument was administered and cardiopulmonary exercise testing (CPX) was performed. Severity of symptoms as determined by physician (NYHA classification) and patient (KCCQ instrument) was obtained before exercise test results were known. Pearson correlation was used to assess the independent correlation between KCCQ score and the various exercise parameters; Spearman correlation was used to assess correlation between KCCQ score and NYHA class.

Results

KCCQ results demonstrated moderate reductions in all domains, with greatest reduction in quality-of-life domain. CPX testing showed reduction in peak oxygen consumption (mean absolute VO2 20.5 ± 7.8 ml/kg/min and percent predicted VO2 76.8 ± 4.1 %). There were negative correlations between NYHA class and all KCCQ components except the self-efficacy score. The strongest correlations were between NYHA class and the overall summary score (r = ?0.623, p = 0.001) as well as the physical limitation score (r = ?0.604, p = 0.002). Similarly, there were statistically significant positive correlations between the KCCQ components and percent predicted peak VO2. The strongest correlation was between percent predicted peak VO2 and the physical limitation score (r = 0.474, p = 0.019), but there was also correlation between percent predicted peak VO2 and the quality-of-life score (r = 0.456, p = 0.025), the functional status score (r = 0.455, p = 0.025), and the clinical summary score (r = 0.444, p = 0.030).

Conclusions

The multiple domains of the KCCQ provide data on patient-perceived health status, which correlate with physician-perceived and objective measurement of functional capacity in HCM. Additional studies are needed to evaluate the sensitivity of the KCCQ to changes in functional capacity over time or in response to therapies for this condition.     

Different healthy habits between northern and southern Spanish school children

Aim

Healthy habits are influenced by several factors such as geographical location. The aims of this study were to describe and compare healthy habits within two populations of sixth-grade primary school children (aged 11–12 years) from northern and southern Spain.

Subjects and methods

A cross-sectional study using two representative samples of school children was conducted. Participants came from Logroño (n = 329) in the north and Granada (n = 284) in the south of Spain. Socio-demographic and anthropometric variables, adherence to the Mediterranean diet, aerobic fitness, and healthy lifestyles were recorded.

Results

Boys reported a higher level of physical activity and aerobic fitness than girls (p = 0.000). Southern school children reported significantly higher adherence to the Mediterranean diet (♀: p = 0.041; ♂: p = 0.008), lower aerobic fitness (♀: p = 0.000; ♂: p = 0.042) and hours of nightly sleep (♀: p = 0.008, ♂: p = 0.007) than northern school children. Southern boys also reported lower levels of physical activity (p = 0.013). There were slight or moderate correlations among all habits measured (physical activity, diet, screen and sleep time). Additionally, the physical activity level was inversely related to weight status. Overweight and obese northern boys reported less physical activity than healthy-weight northern boys (p = 0.020) and overweight and obese southern girls reported less physical activity than healthy-weight southern girls (p = 0.024).

Conclusions

Results showed differences in physical activity, eating and sleep habits, and aerobic fitness according to geographical location. The relationships found among lifestyle habits indicate the need for health promotion interventions nationally and considering the differences discussed here.

     

The impact of severe preeclampsia on maternal quality of life

Purpose

Preeclampsia (PE) is a serious life event that can change women’s psychological profile. The aim of this study was to evaluate the physical and mental health-related quality of life (HR-QoL) in women after PE and the impact of contributing factors.

Methods

Ninety-five women who had suffered from PE answered the Short-Form-12 Health Survey on general state of health. Comparison was made with the reference values and among the study cohorts, namely mild (14.7 %), severe (74.7 %) and superimposed PE (10.5 %). Medical parameters were evaluated as additional factors, and age served as covariate.

Results

Quality of mental life was significantly worse in all patients (p < 0.01), especially in those after severe PE (p < 0.01) compared to the reference range. These women demonstrated significantly worse results than those affected by the mild form (p = 0.03). Women who had had superimposed PE were neither physically nor mentally impaired compared to the standard population values (p = 0.94 and p = 0.90, respectively). After controlling for medical parameters and age, differences remained statistically significant. Multiparous women scored significantly worse on the mental scale than primiparous (p = 0.02), and pregnant women scored significantly worse than non-pregnant women on the physical level (p = 0.04).

Conclusions

This study shows that women who have suffered from severe PE are substantially reduced in their mental quality of life. An extensive medical care including HR-QoL parameters might improve pregnancy outcome.     

Prevention of quality-of-life deterioration with light therapy is associated with changes in fatigue in women with breast cancer undergoing chemotherapy

Purpose

During chemotherapy, women with breast cancer not only experience poor quality of life (QOL), they also have little exposure to bright light, which has been shown to be associated with depression, fatigue, and poor sleep in other chronic illnesses. This study examined whether increased light exposure would have a positive effect on QOL.

Methods

Thirty-nine women with stage I–III breast cancer scheduled to receive ≥4 cycles of chemotherapy were randomized to a bright white light (BWL, n = 23) or dim red light (DRL, n = 16) treatment group. Data were collected before (baseline) and during cycles 1 and 4 of chemotherapy. Light was administered via a light box (Litebook^®, Ltd.). QOL was assessed with the Functional Assessment of Cancer Therapy-Breast (FACT-B) and the Functional Outcomes of Sleep Questionnaire (FOSQ).

Results

Compared with baseline, the DRL group demonstrated significant decline in QOL during the treatment weeks of both cycles (all ps < 0.02), whereas the BWL group had no significant decline (all ps > 0.05). Mixed model analyses revealed that there was a group-by-time interaction for FOSQ at the treatment week of cycle 4, and this interaction was mediated by fatigue.

Conclusion

The data suggest that increased exposure to bright light during chemotherapy may prevent the decline in QOL via preventing the increase in fatigue.     

Sleep behavior of underrepresented youth

Aim

In a disadvantageous socioeconomic context, minority children’s sleep ecology and hygiene may promote poor sleep.

Subjects and methods

A de-identified questionnaire was randomly distributed in local community centers. Subjects were a posteriori stratified into lower class (59.5 %), middle class (22.2 %) and upper class (18.4 %), and into the age categories used in the National Sleep Foundation Polls.

Results

The sample (n?=?221) comprised 85.4 % African Americans, 9.1 % Hispanics and 5.6 % Mixed Ethnicities, which were equally distributed across classes. The respondent was primarily the mother (64.4 %), and the questionnaire information reflected the sleep of 7.0?±?4.5 year olds, 49.5 % of which were girls. Co-sleeping was done by 43.5 %, and 76.8 % had a television in the room. Almost 45 % of the children went to bed on their own. Given the age range, the already insufficient amount of nighttime sleep was further reduced by poor sleep hygiene or ecology by about an hour. Sleep problems reported indicated difficulties with initiating and maintaining sleep.

Conclusion

Underrepresented youth have problematic sleep, which is characterized by difficulties initiating and maintaining sleep, or sleep-impeding circumstances. Sleep interventions in the underprivileged aiming at improving sleep hygiene and ecology should be developed.     

TNFα blockade for inflammatory rheumatic diseases is associated with a significant gain in android fat mass and has varying effects on adipokines: a 2-year prospective study

Purpose

To evaluate the long-term consequences of TNFα inhibitors on body composition and fat distribution, as well as changes in serum adipokines in patients with rheumatoid arthritis (RA) or ankylosing spondylitis (AS).

Methods

Eight patients with RA and twelve with AS requiring a TNFα inhibitor were prospectively followed for 2 years. Body composition was evaluated by dual X-ray absorptiometry and included measurements of total fat mass, lean mass, fat in the gynoid and android regions, and visceral fat. Serum leptin, total and high molecular weight (HMW) adiponectin, resistin, and ghrelin were also assessed.

Results

There was a significant gain in body mass index (p = 0.05) and a tendency for weight (p = 0.07), android fat (p = 0.07), and visceral fat (p = 0.059) increase in patients with RA, while in AS, total fat mass significantly increased (p = 0.02) with a parallel weight gain (p = 0.07). When examining the whole population of patients, we observed after 2 years a significant increase in body weight (+1.9 %; p = 0.003), body mass index (+2.5 %; p = 0.004), total fat mass (+11.1 %; p = 0.007), and fat in the android region (+18.3 %; p = 0.02). There was a substantial, albeit nonsignificant gain in visceral fat (+24.3 %; p = 0.088). Lean mass and gynoid fat were not modified. No major changes were observed for serum leptin, total adiponectin, and ghrelin, while HMW adiponectin and the HMW/total adiponectin ratio tended to decrease (?15.2 %, p = 0.057 and ?9.3 %, p = 0.067, respectively). Resistin decreased significantly (?22.4 %, p = 0.01).

Conclusions

Long-term TNFα inhibition in RA and AS is associated with a significant gain in fat mass, with a shift to the android (visceral) region. This fat redistribution raises questions about its influence on the cardiovascular profile of patients receiving these treatments.     

Patient-reported outcomes in the practice-based opportunities for weight reduction (POWER) trial

Purpose

To evaluate effects of two behavioral weight-loss interventions (in-person, remote) on health-related quality of life (HRQOL) compared to a control intervention.

Methods

Four hundred and fifty-one obese US adults with at least one cardiovascular risk factor completed five measures of HRQOL and depression: MOS SF-12 physical component summary (PCS) and mental component summary; EuroQoL-5 dimensions single index and visual analog scale; PHQ-8 depression symptoms; and PSQI sleep quality scores at baseline and 6 and 24 months after randomization. Change in each outcome was analyzed using outcome-specific mixed-effects models controlling for participant demographic characteristics.

Results

PCS-12 scores over 24 months improved more among participants in the in-person active intervention arm than among control arm participants (P < 0.05, ES = 0.21); there were no other statistically significant treatment arm differences in HRQOL change. Greater weight loss was associated with improvements in most outcomes (P < 0.05 to < 0.0001).

Conclusions

Participants in the in-person active intervention improved more in physical function HRQOL than participants in the control arm did. Greater weight loss during the study was associated with greater improvement in all PRO except for sleep quality, suggesting that weight loss is a key factor in improving HRQOL.     

Leisure-time physical activity does not fully explain the higher body mass index in irregular-shift workers

Purpose

To elucidate the influence of leisure-time physical activity on body mass index (BMI), appetite-related hormones, and sleep when working irregular shifts.

Methods

A cross-sectional study was undertaken of 57 male truck drivers, 31 irregular-shift workers and 26 day-shift workers. Participants completed the International Physical Activity Questionnaire and were assessed for BMI. Subjects also provided a fasting blood sample for analysis of appetite-related hormones and wore an actigraphy device for seven consecutive days.

Results

Although leisure-time physical activity (LTPA) was generally low (<150 min/week) in both groups, the irregular-shift workers were more physically active than day-shift workers (99 ± 166 vs. 23 ± 76 min/week, p < 0.01). In spite of this, mean BMI of irregular-shift workers was 2 kg/m² greater than day-shift workers (28.4 ± 3.8 vs. 26.4 ± 3.6 kg/m², p = 0.04). Mean leptin concentration was 61 % higher in irregular-shift workers (5,205 ± 4,181 vs. 3,179 ± 2,413 pg/ml, p = 0.04). Among obese individuals, irregular-shift workers had higher leptin concentration (p < 0.01) and shorter sleep duration (p = 0.01) than obese day-shift workers.

Conclusion

Elevated BMI was associated with high leptin and low ghrelin levels in this population of irregular-shift workers. No influence of LTPA on appetite-related hormones or sleep duration was found. We conclude that moderate LTPA is insufficient to attenuate the higher BMI associated with this type of irregular-shift work in truck drivers.