Sotos-Prieto Mercedes, Bhupathiraju Shilpa N, Falcón Luis M, Gao Xiang, Tucker Katherine L, Mattei Josiemer
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA;
Center for Population Health and Health Disparities, College of Fine Arts, Humanities, and Social Sciences, and.
J Nutr. 2015 Jul;145(7):1531-40. doi: 10.3945/jn.114.206391. Epub 2015 May 6.
Although individual healthy lifestyle behaviors may reduce cardiovascular disease risk, few studies have analyzed the combined effect of multiple lifestyle components as one all-inclusive measure on such outcomes, much less in minority populations.
We aimed to develop a Healthy Lifestyle Score (HLS) that included several lifestyle recommendations and to test its association with metabolic syndrome (MetS) and allostatic load (AL) and their cardiometabolic and neuroendocrine factors in Puerto Ricans.
In a cross-sectional study in 787 Puerto Ricans living in Boston (aged 45-75 y), we developed an HLS that ranged from 0 to 190 (higher score indicative of healthier lifestyle) and included 5 components (diet, physical activity and sedentary behaviors, smoking, social support and network, and sleep). Multivariable-adjusted models were used to test associations between the HLS and biomarkers of dysregulation and odds of MetS and high AL (≥4 out of 10 components).
The HLS showed adequate internal consistency (ρ = 0.31-0.69) and was inversely associated with urinary cortisol (β ± SE = -0.22 ± 0.11; P = 0.042), epinephrine (-0.20 ± 0.09; P = 0.017), and norepinephrine (-0.26 ± 0.11; P = 0.016); waist circumference (-0.014 ± 0.004; P = 0.003); and serum insulin (-0.30 ± 0.13; P = 0.028) and positively associated with plasma HDL cholesterol (0.007 ± 0.003; P = 0.021) after adjustment for potential confounders. For each 20-unit increase in HLS, participants had 19% (95% CI: 2%, 33%) and 25% (11%, 36%) lower odds of MetS or AL, respectively. Healthier scores for social support and network and smoking components were associated with lower odds of high AL (P < 0.005). No significant associations were observed for other individual lifestyle components.
Following an overall healthy lifestyle that comprises a combination of multiple behaviors may provide stronger protection against MetS and AL in Puerto Rican adults than individual components. The HLS may be a useful tool for examining health-related outcomes. This trial was registered at clinicaltrials.gov as NCT01231958.
尽管个体健康的生活方式行为可能会降低心血管疾病风险，但很少有研究分析多种生活方式因素作为一个综合指标对此类结果的综合影响，在少数族裔人群中更是如此。
我们旨在制定一个包含多项生活方式建议的健康生活方式评分（HLS），并测试其与波多黎各人代谢综合征（MetS）、应激负荷（AL）及其心脏代谢和神经内分泌因素之间的关联。
在一项对787名居住在波士顿的波多黎各人（年龄45 - 75岁）的横断面研究中，我们制定了一个范围从0到190分（分数越高表明生活方式越健康）的HLS，它包括5个组成部分（饮食、身体活动和久坐行为、吸烟、社会支持和社交网络以及睡眠）。多变量调整模型用于测试HLS与失调生物标志物、MetS几率和高应激负荷（10项指标中≥4项）之间的关联。
HLS显示出足够的内部一致性（ρ = 0.31 - 0.69），并且在调整潜在混杂因素后，与尿皮质醇（β ± SE = -0.22 ± 0.11；P = 0.042）、肾上腺素（-0.20 ± 0.09；P = 0.017）和去甲肾上腺素（-0.26 ± 0.11；P = 0.016）呈负相关；与腰围（-0.014 ± 0.004；P = 0.003）；以及血清胰岛素（-0.30 ± 0.13；P = 0.028）呈负相关，与血浆高密度脂蛋白胆固醇（0.007 ± 0.003；P = 0.021）呈正相关。HLS每增加20分，参与者患MetS或AL的几率分别降低19%（95%CI：2%，33%）和25%（11%，36%）。社会支持和社交网络以及吸烟部分得分更健康与高应激负荷几率较低相关（P < 0.005）。未观察到其他个体生活方式组成部分有显著关联。
遵循包含多种行为的整体健康生活方式，可能比个体组成部分为波多黎各成年人预防MetS和AL提供更强的保护。HLS可能是检查与健康相关结果的有用工具。该试验在clinicaltrials.gov上注册，注册号为NCT01231958。
