生活历程中的应激事件与生活方式行为簇之间的前瞻性关联。

Prospective associations between stressful life course events and clusters of lifestyle behaviours.

作者信息

Siew Raymond Vooi Khong, Torres Susan J, Nilsson Charlotte Juul, Abbott Gavin, Hansen Åse Marie, Cherbuin Nicolas, Leach Liana, Butterworth Peter, Turner Anne I

机构信息

School of Health and Social Development, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia.

Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

出版信息

BMC Public Health. 2025 Sep 24;25(1):3068. doi: 10.1186/s12889-025-24110-3.

DOI:10.1186/s12889-025-24110-3

PMID:40993614

Abstract

BACKGROUND

The adoption of health-damaging lifestyle behaviours may be a coping mechanism stemming from maladaptive behavioural stress response to stress exposure, but little is known about the influence of stressors on health-damaging lifestyle behaviour clusters. This study aimed to identify clusters of lifestyle behaviours based on six lifestyle-related behaviours and to examine the associations between childhood adversity, stressful and traumatic life events, and the clusters of lifestyle behaviours in community-dwelling Australian adults.

METHODS

This prospective study comprises 1773 adults aged 40-44 years at baseline from the Personality and Total Health (PATH) Through Life Study. Data on childhood adversity, stressful life events, traumatic life events were obtained from Wave 1 in 2000/2001 to Wave 3 in 2008/2009 and lifestyle behaviours were obtained at Wave 4 in 2012/2013 using self-reported surveys. Latent class analysis was conducted to identify distinct clusters of lifestyle behaviours using data from physical activity, alcohol consumption, insomnia, fruit and vegetable intake, and smoking status. Multinomial logistic regression analysis examined the associations between stressors and lifestyle behaviour clusters.

RESULTS

Three clusters of lifestyle behaviours labelled 'Poor sleep quality, low vegetable intake' (58.8%), 'Inactive, risky alcohol use, smoker' (3.3%), and 'Inactive, low fruit and vegetable intake, poor sleep quality, smoker' (35.9%) were identified. Exposure to stressful life events was associated with higher likelihood of belonging to the 'inactive, low fruit and vegetable intakes, poor sleep quality, smoker' cluster as opposed to the 'poor sleep quality, low vegetable intake's cluster (RRR = 1.42, 95% CI=[1.12, 1.81]) after adjusting for age, sex, educational level and income.

CONCLUSIONS

Our findings revealed an association between exposure to stressful life events and clustering of being physically inactive, low fruit and vegetable intake, poor sleep quality and smoking. Consequently, implementing health promotion strategies to target multiple lifestyle behaviours may be beneficial in reducing the cumulative impact of stress on health.

摘要

背景

采取有害健康的生活方式行为可能是对应激暴露的适应不良行为应激反应所产生的一种应对机制，但对于应激源对有害健康的生活方式行为群组的影响知之甚少。本研究旨在基于六种与生活方式相关的行为确定生活方式行为群组，并探讨童年逆境、应激性和创伤性生活事件与澳大利亚社区居住成年人的生活方式行为群组之间的关联。

方法

这项前瞻性研究包括来自“人格与终生健康（PATH）”研究中1773名基线年龄为40 - 44岁的成年人。关于童年逆境、应激性生活事件、创伤性生活事件的数据是从2000/2001年的第1波到2008/2009年的第3波获取的，而生活方式行为是在2012/2013年的第4波通过自我报告调查获取的。使用来自身体活动、饮酒、失眠、水果和蔬菜摄入量以及吸烟状况的数据进行潜在类别分析，以确定不同的生活方式行为群组。多项逻辑回归分析检验了应激源与生活方式行为群组之间的关联。

结果

确定了三个生活方式行为群组，分别标记为“睡眠质量差、蔬菜摄入量低”（58.8%）、“不活动、危险饮酒、吸烟者”（3.3%）和“不活动、水果和蔬菜摄入量低、睡眠质量差、吸烟者”（35.9%）。在调整年龄、性别、教育水平和收入后，暴露于应激性生活事件与属于“不活动、水果和蔬菜摄入量低、睡眠质量差、吸烟者”群组而非“睡眠质量差、蔬菜摄入量低”群组的可能性更高相关（相对风险比 = 1.42，95%置信区间 = [1.12, 1.81]）。