Division of Cardiology, Mount Sinai Morningside Hospital, Mount Sinai Heart, and the Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
Division of Cardiology, Mount Sinai Morningside Hospital, Mount Sinai Heart, and the Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
Prog Cardiovasc Dis. 2023 Mar-Apr;77:107-118. doi: 10.1016/j.pcad.2023.02.002. Epub 2023 Feb 26.
Unhealthy lifestyles, such as maintenance of poor diets and physical inactivity, are a powerful driver of disease-producing risk factors and chronic illnesses. This has led to an increasing call to assess adverse lifestyle factors in healthcare settings. This approach could be aided by designating health-related lifestyle factors as "vital signs" that can be recorded during patient visits. Just such an approach has been used for assessing patients' smoking habits since the 1990s. In this review, we assess the rationale for addressing six other health-related lifestyle factors, beyond smoking, in patient care settings: physical activity (PA), sedentary behavior (SB), participation in muscle strengthening exercises, mobility limitations, diet, and sleep quality. For each domain, we evaluate the evidence that supports currently proposed ultra-short screening tools. Our analysis indicates strong medical evidence to support the use of one to two-item screening questions for assessing patients' PA, SB, muscle strengthening activities, and presence of "pre-clinical" mobility limitations. We also present a theoretical basis for measuring patients' diet quality through use of an ultrashort dietary screen, based on evaluation of healthy food intake (fruits/vegetables) and unhealthy food intake (high consumption of highly processed meats and/or consumption of sugary foods and beverages) and a proposed evaluation of sleep quality using a single-item screener. The result is a 10-item lifestyle questionnaire that is based on patient self-report. As such, this questionnaire has the potential to be employed as a practical tool for assessing health behaviors in clinical care settings without impairing the normal workflow of healthcare providers.
不健康的生活方式，如不良饮食和缺乏身体活动的维持，是产生致病风险因素和慢性疾病的强大驱动因素。这导致越来越多的人呼吁在医疗保健环境中评估不良生活方式因素。这种方法可以通过将与健康相关的生活方式因素指定为“生命体征”来实现，这些因素可以在患者就诊期间记录下来。自 20 世纪 90 年代以来，这种方法一直被用于评估患者的吸烟习惯。在这篇综述中，我们评估了在患者护理环境中评估除吸烟以外的另外六个与健康相关的生活方式因素的基本原理：身体活动 (PA)、久坐行为 (SB)、参与肌肉强化运动、活动能力受限、饮食和睡眠质量。对于每个领域，我们评估了支持目前提出的超短筛查工具的证据。我们的分析表明，有强有力的医学证据支持使用一到两个项目来筛查患者的 PA、SB、肌肉强化活动以及是否存在“临床前”活动能力受限。我们还通过评估健康食物摄入（水果/蔬菜）和不健康食物摄入（高度加工肉类的大量摄入和/或含糖食物和饮料的摄入）以及通过单一项目筛查器评估睡眠质量，为通过使用超短饮食筛查器来衡量患者的饮食质量提供了理论依据。结果是一个基于患者自我报告的 10 项生活方式问卷。因此，该问卷有可能作为一种实用工具，在不影响医疗保健提供者正常工作流程的情况下，在临床护理环境中评估健康行为。
