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Health Promotion Begins with Healthy Behaviour and Lifestyle Early in Life

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (31 October 2020) | Viewed by 43992

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Dr. Hellas Cena

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Guest Editor

Dietetics and Clinical Nutrition Laboratory, Department of Public Health, Experimental and Forensic Medicine, University of Pavia; Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, Pavia, Italy.
Interests: lifestyle medicine; dietary and clinical nutrition; Non-Communicable Diseases; obesity; cardiometabolic diseases; public health

Dr. Rachele De Giuseppe

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Guest Editor

Dietetics and Clinical Nutrition Laboratory, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
Interests: lifestyle medicine; dietary and clinical nutrition; Non-Communicable Diseases; obesity; cardiometabolic diseases; public health

Special Issue Information

Dear Colleagues,

Considering the global burden of non-communicable diseases (NCDs), such as obesity, cardiovascular and chronic respiratory diseases, type 2 diabetes, and cancer, prevention strategies should focus on decreasing the exposure to major lifestyle-related risk factors such as unhealthy eating habits, smoking habits, poor sleep quality, and physical inactivity, starting early in life. Indeed, the decline of healthy life expectancy in populations all over the world is of great concern for public health and raises the need for a prompt action firmly and early in life, such as during childhood and/or adolescence.

Regarding dietary habits, low consumption of fruits, vegetables, and fibres, high consumption of fatty and salty foods (fast food, junk food) and of carbonated soft drinks, as well as inappropriate meal times, especially observed in children and adolescents, are the most common habits correlated with increased risk of NCDs. On the contrary, the Mediterranean Diet model has been linked to a number of health benefits, including reduced mortality risk and lower incidence of NCDs.

Adolescence has been indicated as a transition phase of unique opportunities to promote and strengthen health and well-being, with far-reaching consequences in adulthood and the following generation. Therefore, increasing health and nutrition knowledge as well as awareness of the benefits of healthy lifestyle habits is crucial during this period of life and could be a successful strategy to diminish the NCDs’ risk.

Dr. Hellas Cena
Dr. Rachele De Giuseppe
Guest Editors

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Keywords

lifestyle medicine
health promotion
non-communicable diseases (NCDs)
dietary habits
mediterranean model
dietary patterns
adolescence
physical activity

Published Papers (6 papers)

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Research

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17 pages, 320 KiB

Open AccessArticle

How Healthy Are Health-Related Behaviors in University Students: The HOLISTic Study

by Hellas Cena, Debora Porri, Rachele De Giuseppe, Aliki Kalmpourtzidou, Fiorella Pia Salvatore, Marwan El Ghoch, Leila Itani, Dima Kreidieh, Anna Brytek-Matera, Cristina Bianca Pocol, Donaldo Segundo Arteta Arteta, Gözde Utan and Ivana Kolčić

Nutrients 2021, 13(2), 675; https://doi.org/10.3390/nu13020675 - 19 Feb 2021

Cited by 25 | Viewed by 5614

Abstract

The aim of this cross-sectional study was to assess the health-related behaviors among university students, with emphasis on health sciences students from Croatia, Italy, Lebanon, Poland, Romania, Spain and Turkey. We included 6222 students in Medicine, Dentistry, Nursing, Pharmacy, Nutrition and Dietetics, Sports Sciences, Veterinary, and Economics enrolled between April 2018 and March 2020. We assessed dietary patterns, sleeping habits, physical activity and perceived stress among students by means of validated questionnaires. The median age ranged between 19 and 24 years, smoking prevalence between 12.0% and 35.4%, and body mass index (BMI) ranged between 21.1 and 23.2 kg/m². Breakfast was less often and more often consumed daily in Turkey (36.7%), and Italy (75.7%), respectively. The highest Mediterranean diet score was recorded in Spain and Italy, and the lowest in Turkey, followed by students from Croatia, Lebanon, Poland and Romania. Sleep duration, physical activity and stress perception also differed between countries. Multivariable regression analysis revealed a small, but positive association between BMI and several characteristics, including age, female gender, smoking, physical activity, mobile phone use, and perceived stress. A negative association was found between BMI and sleep duration on non-working days. Self-rated health perception was positively associated with female gender, breakfast, physical activity, and time spent studying, and negatively with BMI, smoking and stress. Our results demonstrated diverse habits in students from different countries, some of which were less healthy than anticipated, given their educational background. Greater emphasis needs to be placed on improving the lifestyle of these adolescents and young adults, who will be tomorrow’s healthcare workers. Full article

(This article belongs to the Special Issue Health Promotion Begins with Healthy Behaviour and Lifestyle Early in Life)

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18 pages, 516 KiB

Open AccessArticle

Have Lifestyle Habits and Psychological Well-Being Changed among Adolescents and Medical Students Due to COVID-19 Lockdown in Croatia?

by Ružica Dragun, Nikolina Nika Veček, Mario Marendić, Ajka Pribisalić, Gabrijela Đivić, Hellas Cena, Ozren Polašek and Ivana Kolčić

Nutrients 2021, 13(1), 97; https://doi.org/10.3390/nu13010097 - 30 Dec 2020

Cited by 100 | Viewed by 16825

Abstract

Objective: To investigate dietary habits, sleep and psychological well-being of adolescents and medical students during COVID-19 lockdown in Split, Croatia. Methods: We surveyed 1326 students during 2018 and 2019, and compared their responses with 531 students enrolled in May 2020. Perceived stress, quality of life (QoL), happiness, anxiety, and optimism were assessed as proxies of psychological well-being, using general linear modelling. Results: We found no substantial differences in dietary pattern between pre-lockdown and lockdown periods, including the overall Mediterranean diet (MD) adherence. However, the MD pattern changed, showing increased adherence to the MD pyramid for fruit, legumes, fish, and sweets, while cereals, nuts, and dairy intake decreased during COVID-19 lockdown. A third of students reported weight loss during lockdown, 19% reported weight gain, while physical activity remained rather stable. The most prominent change was feeling refreshed after a night’s sleep, reported by 31.5% of students during lockdown vs. 8.5% before; median length of sleep duration increased by 1.5 h. Lockdown significantly affected QoL, happiness, optimism (all p < 0.001), and perceived stress in students (p = 0.005). MD adherence was positively correlated with QoL and study time, and negatively with TV and mobile phone use in pre-lockdown period (all p < 0.001). Interestingly, higher MD adherence was correlated with less perceived hardship and greater happiness and QoL during lockdown. Conclusion: These insights provide valuable information for tailored interventions aimed at maintaining healthy lifestyle in young population. Given the numerous beneficial effects associated with MD adherence, modification of lifestyle through application of lifestyle medicine deserves a priority approach. Full article

(This article belongs to the Special Issue Health Promotion Begins with Healthy Behaviour and Lifestyle Early in Life)

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15 pages, 630 KiB

Open AccessArticle

Assessing Orthorexia Nervosa: Validation of the Polish Version of the Eating Habits Questionnaire in a General Population Sample

by Anna Brytek-Matera, Natalija Plasonja and Greg Décamps

Nutrients 2020, 12(12), 3820; https://doi.org/10.3390/nu12123820 - 14 Dec 2020

Cited by 13 | Viewed by 3821

Abstract

Extreme focus on healthy eating, called orthorexia nervosa (ON), was assessed using a 21-item Eating Habits Questionnaire (EHQ). The present study aimed to validate the Polish version of the EHQ in a general population sample. Nine hundred sixty-seven women (59%) and men participated in the present study. Data was obtained from an internet-administered survey. Exploratory factor analysis with the first split sample (n = 502) produced a three-factor solution accounting for 47% of the variance. In confirmatory factor analysis with the second split sample (n = 465), the three-factor structure showed satisfactory goodness-of-fit (comparative fit index (CFI) = 0.99, root mean square error of approximation (RMSEA) = 0.008). Reliability analysis for the Polish version of the EHQ across the whole questionnaire showed strong internal consistency (α = 0.88, intraclass correlation coefficient (ICC) = 0.86). The internal consistency, measured by Cronbach’s alpha coefficients, for the EHQ subscales were 0.85 (knowledge), 0.81 (problems), and 0.81 (feelings and behaviors). Total EHQ score was positively correlated with its three subscales, cognitive restraint, uncontrolled eating, and emotional eating, and was negatively correlated with body mass index (BMI). The Polish version of the EHQ is a reliable questionnaire that can be used with confidence to better assess ON in a general population sample. Full article

(This article belongs to the Special Issue Health Promotion Begins with Healthy Behaviour and Lifestyle Early in Life)

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14 pages, 427 KiB

Open AccessArticle

Impact of a Three-Year Obesity Prevention Study on Healthy Behaviors and BMI among Lebanese Schoolchildren: Findings from Ajyal Salima Program

by Carla Habib-Mourad, Lilian A. Ghandour, Carla Maliha, Michèle Dagher, Samer Kharroubi and Nahla Hwalla

Nutrients 2020, 12(9), 2687; https://doi.org/10.3390/nu12092687 - 03 Sep 2020

Cited by 12 | Viewed by 3916

Abstract

Most school-based obesity prevention programs in low- to middle-income countries are of short duration, and few undertake follow-up analyses after the termination of the project. The aims of the current study are to investigate (1) the long-term effects of a school-based intervention program when implemented over two years on body mass index (BMI), healthy dietary behaviors, and physical activity (PA); and (2) whether the effects are sustained after one-year washout. The study is a cluster-randomized trial; 36 public and private schools were randomized into either intervention or control groups. Students (8–12 years) completed pre-and post-assessment anthropometric measurements and questionnaires about their eating and physical activity habits. Students in the intervention groups received the program components for two consecutive years. Multiple logistic regression models were used to examine the effect of the intervention on BMI and healthy behaviors. Students in the intervention groups were less likely to be overweight at washout, only in public schools. The number of children reporting change in dietary behaviors significantly increased in intervention groups, with a sustained effect only in public schools. Policies aiming at securing a positive nutrition environment in schools, and adoption of nutrition programs, are needed for achieving sustained behavior and prompting BMI changes in children. Full article

(This article belongs to the Special Issue Health Promotion Begins with Healthy Behaviour and Lifestyle Early in Life)

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16 pages, 282 KiB

Open AccessArticle

Restrained Eating and Vegan, Vegetarian and Omnivore Dietary Intakes

by Anna Brytek-Matera

Nutrients 2020, 12(7), 2133; https://doi.org/10.3390/nu12072133 - 17 Jul 2020

Cited by 20 | Viewed by 7382

Abstract

There are a significant number of studies on cognitive restraint among individuals with varying dietary patterns. Although most research has found that vegetarians report higher levels of cognitive restraint compared to non-vegetarians, many studies have contributed inconsistent results. The aim of the current study, therefore, was to assess any differences between groups with varying dietary patterns on cognitive restraint and other disordered eating pattern. The second objective was to examine determinants of cognitive restraint in individuals adhering to a vegan diet, a vegetarian diet and an omnivore diet. Two-hundred and fifty-four participants with varying dietary patterns completed the Three-Factor Eating Questionnaire, the Perseverative Thinking Questionnaire and the Eating Habits Questionnaire. Our results indicated that both vegetarian and vegan groups showed a significantly lower cognitive restraint, lower emotional eating and lower uncontrolled eating than those who followed an omnivorous diet. In addition, these both groups following a plant-based diet have shown more cognitions, behaviours and feelings related to an extreme focus on healthy eating (orthorexia nervosa) than group following an omnivorous diet. There were no significant differences between the groups in perseverative thinking. Core characteristics of repetitive negative thinking was a significant predictor of cognitive restraint in vegans. Feeling positively about healthy eating predicted cognitive restraint among vegetarians. Problems associated with healthy eating and feeling positively about healthy eating predicted cognitive restraint among individuals following an omnivorous diet. Knowledge of predictors of cognitive restraint may serve as a psychological intervention goal or psychoeducation goal among individuals with varying dietary patterns. Full article

(This article belongs to the Special Issue Health Promotion Begins with Healthy Behaviour and Lifestyle Early in Life)

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15 pages, 777 KiB

Open AccessReview

The Role of Fetal, Infant, and Childhood Nutrition in the Timing of Sexual Maturation

by Valeria Calcaterra, Hellas Cena, Corrado Regalbuto, Federica Vinci, Debora Porri, Elvira Verduci, Chiara Mameli and Gian Vincenzo Zuccotti

Nutrients 2021, 13(2), 419; https://doi.org/10.3390/nu13020419 - 28 Jan 2021

Cited by 17 | Viewed by 5720

Abstract

Puberty is a crucial developmental stage in the life span, necessary to achieve reproductive and somatic maturity. Timing of puberty is modulated by and responds to central neurotransmitters, hormones, and environmental factors leading to hypothalamic-pituitary-gonadal axis maturation. The connection between hormones and nutrition during critical periods of growth, like fetal life or infancy, is fundamental for metabolic adaptation response and pubertal development control and prediction. Since birth weight is an important indicator of growth estimation during fetal life, restricted prenatal growth, such as intrauterine growth restriction (IUGR) and small for gestational age (SGA), may impact endocrine system, affecting pubertal development. Successively, lactation along with early life optimal nutrition during infancy and childhood may be important in order to set up timing of sexual maturation and provide successful reproduction at a later time. Sexual maturation and healthy growth are also influenced by nutrition requirements and diet composition. Early nutritional surveillance and monitoring of pubertal development is recommended in all children, particularly in those at risk, such as the ones born SGA and/or IUGR, as well as in the case of sudden weight gain during infancy. Adequate macro and micronutrient intake is essential for healthy growth and sexual maturity. Full article

(This article belongs to the Special Issue Health Promotion Begins with Healthy Behaviour and Lifestyle Early in Life)

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