The Association Between Lifestyle Factors and COVID-19 Among Older Adults in Southern California: The Loma Linda Longevity Study.

Amid a global aging trend, particularly notable in the U.S., there is a growing focus on achieving enhanced longevity and well-being. We evaluated the association between lifestyle factors (sleep, diet, and healthy lifestyle index) and COVID-19 infection in an older adult population in San Bernardino and Riverside counties in Southern California, the United States. A sample of 380 older adults ≥75 years old were surveyed cross-sectionally and self-reported lifestyle behaviors and COVID-19 infection. The results revealed that half the participants reported COVID-19 infection. Participants who slept less than 7 hours or more than 8 hours/night had higher odds of COVID-19 infection than those who slept 7-8 hours/night (OR = 1.62, 95% CI: 1.03, 2.55). Healthy lifestyle behaviors were significantly associated with reduced COVID-19 infection (OR = 0.61, 95% CI: 0.40, 0.92). In conclusion, adequate sleep and healthy lifestyle behaviors may be protective against COVID-19 infection among older adults and should be investigated further.

Exergaming: A Good Exercise Option During the Coronavirus Pandemic.

The purpose of this study was to evaluate Wii sports programs as a potential physical activity solution to increasing inactivity among young adults and potentially improving the immune system. An evaluation was done on five Wii Sports games, including tennis, baseball, bowling, golf, and boxing. Measures included caloric expenditure and metabolic equivalents (MET) expended. A total of 16 subjects participated in two interactive video game sessions that took place over a 14-day period, in which their caloric expenditure (based on metabolic equivalents and rate of perceived exertion [RPE]) was compared with accepted reference values associated with playing the actual sports. Results showed that Wii sports were associated with higher MET values than published norms for other actual sports, and all Wii sports showed caloric expenditure that was four to ten times higher than traditional sedentary gaming. In conclusion, the results justify the integration of interactive video-gaming technologies into future fitness programs targeted toward young adults and, consequently, decrease the risk of metabolic syndrome and obesity.

Why Can't I Stop Smoking: Predictors of Tobacco Use and Quit Rates in the Freedom From Tobacco Program.

Introduction  As the leading cause of preventable chronic diseases in adults 18 years and older, tobacco usage in the U.S. results in over 20 million premature deaths annually. Current smokers might need extra support on the path to successfully quitting.  Aim To evaluate the influence of predictors of smoking-on-smoking cessation in the Freedom From Tobacco Program (FFT) offered by Southern California Permanente Medical Group (SCPMG). Methods This was a quasi-experimental study to evaluate rates of smoking cessation among participants in the FFT program. There were 471 participants in the study. Factors of the Social Ecological Model (SEM) and demographics were examined to determine if they could predict tobacco cessation. The SEM suggests that an individual's behavior is integrated into a network of intrapersonal characteristics, interpersonal processes, institutional factors, community features, and public policy. In particular, the study mainly addressed the institutional factor. It was promoted within a Health Management Organization and the interpersonal process because it was a group intervention.  Findings  After multiple regression analyses with all predictors from the SEM and demographics, the only significant predictor was the number of previous attempts to quit. Smokers who tried to stop four or more times in the past were 2.6 times (p<0.03) more likely to quit than those who tried fewer times. As we are aware, this was the first time this result was found for programs implemented by Health Management Organizations. The general quit rate at 12 months for the FFT program was 43.1%. Conclusion As the only predictor of quitting in this study was the number of previous attempts to quit smoking, the recommendation is to develop longer-term smoking cessation programs or a longer follow-up to facilitate smokers who relapse to go back and try to quit again. Another recommendation is to identify the main reasons for relapse and try to address these factors in further interventions.

Effect of COVID-19 outbreak on the diet, body weight and food security status of students of higher education: a systematic review.

The COVID-19 pandemic has impacted college students' lifestyles and placed them at a greater risk of obesity and food insecurity. The purpose of the systematic review was to consolidate evidence for the effect of Covid-19 on students' dietary quality, dietary habits, body weight and food security status. A comprehensive literature search was conducted utilising various databases including Google Scholar, MEDLINE, ScienceDirect, Embase and Scopus to identify relevant studies. To be incorporated in this review, studies had to include higher education students, measure the prevalence of food insecurity and assess the dietary and body weight changes during the COVID-19 pandemic. The studies showed that the diet quality of college students was compromised during the pandemic in many nations due to the decrease in the intake of whole grains, dairy products, legumes, nuts, fruits and vegetables and the increase in consumption of alcohol, confectionery products and refined grains. There was an increase in the frequency of cooking, binge eating, breakfast skipping and unhealthy snacking. These modifications, in return, were associated with body weight changes, with no less than 20 to 30 % of students gaining weight during the pandemic. The pandemic also impacted food security status of students, with over 30% being food insecure worldwide. The COVID-19 outbreak has exacerbated the students' diet quality and dietary habits and placed them under high risk of weight gain and food insecurity. Higher education institutions and governments should improve students' access to nutritious foods and incorporate nutrition education interventions in the curricula.

Effect of COVID-19 outbreak on anxiety among students of higher education; A review of literature.

BACKGROUND AND PURPOSE: The Covid-19 pandemic has impacted the mental health of students and exacerbated the prevalence of anxiety among them. The purpose of the literature review was to consolidate evidence for the prevalence of anxiety among students of higher education during the COVID-19 pandemic and to underscore the effect of various pandemic-related factors on this anxiety. METHODS: A comprehensive literature search was conducted utilizing various databases such as MEDLINE, PsycInfo Google Scholar, ScienceDirect, Scopus, and Embase to identify relevant studies. To be incorporated in this review, studies had to include students of higher education, measure the prevalence of anxiety, and assess anxiety during Covid-19 pandemic. RESULTS: 37 studies met the inclusion criteria and assessed the prevalence of anxiety among students during confinement. Studies showed that more than one-third of the students suffered from anxiety during the early stages of the pandemic. Moreover, being a female, living in rural areas, facing financial hardship, working full-time, spending the quarantine in isolation, worrying about infection for themselves and others, having the uncertainty of the future, having reduced sleep quality, and transitioning to online learning, were factors associated with increased anxiety during the pandemic. CONCLUSION: Anxiety was shown to be highly prevalent among the student population during the Covid-19 pandemic. Higher education institutions and governments should take action to ensure the safety and the physical, social, and mental wellbeing of the students.

Delivering the Same Intervention to Hispanic/Latinos With Pre-diabetes and Diabetes. Early Evidence of Success in a Longitudinal Mixed Method Study.

BACKGROUND: Despite nationwide efforts to address the diabetes epidemic and reduce prevalence disparities, higher rates persist among the poor, especially those with limited literacy. Currently, individuals with abnormal glycemia who have pre-diabetes and diabetes qualify for different programs. However, evidence suggests that, for low-income Hispanic/Latinos, offering a single intervention to all those with abnormal glycemia may provide a more culturally acceptable and effective approach. Our objective was to explore the feasibility of such an intervention led by community health workers (CHWs) among low-income Hispanic/Latinos with diabetes and at risk for diabetes. METHODS: Using a quasi-experimental mixed method design, we assessed weight, glycosylated hemoglobin, diabetes knowledge, and behavior changes of Hispanic/Latinos participants with pre-diabetes and diabetes living in Southern California. Biometric measurements, blood tests, and surveys were collected at baseline and 3 months post-intervention. Interviews and focus group discussions provided qualitative data. RESULTS: Although the program was less costly, results exceeded those reported for low-income H/L attending the National Diabetes Prevention Program and did not differ between pre-diabetes and diabetes groups. Instead, including individuals at different stages of the dysglycemic spectrum seemed to have enhanced the intervention. Physician referral and attendance of family/friends were associated with better outcomes. CONCLUSION: Our findings indicate that a joint prevention/self-management intervention led by CHWs for low-income Hispanic/Latinos with diabetes and with pre-diabetes is feasible and cost-effective, providing results that could help reduce the success gap. Incorporating suggestions and replicating this study on a larger scale could help determine whether or not results are reproducible.

Assessing the validity, reliability and efficacy of the Cross-Cultural Stress Scale (CCSS) for psychosomatic studies.

OBJECTIVE: The impact of stressful life events (SLEs) on health has been empirically studied with significant correlations documented. We developed a comprehensive stress rating toolkit, the Cross-Cultural Stress Scale (CCSS) from a triangulated qualitative research study. This article describes our pilot test of the scale to explore demographic-specific patterns of SLE scores and evaluate the scale's aptitude in assessing the stress-health correlation. METHODS: The face and content-validated CCSS was shared via a web-based survey to diverse individuals grouped by: (a) gender, (b) age, (c) race and ethnicity, (d) native, foreign-born or first-generation, (e) educational attainment, and (f) income. Participants from the Amazon crowdsourcing marketplace MTurk (N = 216) first indicated perceived stress intensities assuming experiences of all the SLEs in the CCSS. They then selected SLEs they had personally experienced in the last 12 months (N = 176). Multivariable analyses were conducted on perceived intensities. Correlations of experienced SLEs with self-reported health based on the Centers for Disease Control and Prevention (CDC) Health Related Quality of Life (HRQOL) indicators measured by the Behavioral Risk Factors Surveillance System (BRFSS) were analyzed. RESULTS: We validated the CCSS and obtained a high internal reliability (Cronbach's alpha >0.9). We found significant differences in stress rating by and within demographics. We also correlated stress to perceived health using the HRQOL and presence of a chronic disease ascertaining the stress-health hypothesis. LIMITATION: Sampling limitations observed include data drawn from a convenience sample. CONCLUSION: Despite sampling limitations, our research highlights demographic-specific stressors and offers an updated methodology in the stress-health correlation.

Are long-term FAD diets restricting micronutrient intake? A randomized controlled trial.

The micronutrient adequacy of common fad diets is rarely assessed. We compared a high-fiber diet [HF] with a low-carbohydrate diet [LC] to assess their effects on body weight and micronutrient adequacy. One hundred and seventy-three adult males and females with or without diabetes with a mean body mass index of 36 kg/m2 were randomized to either a HF or LC diet. Differences in anthropometrics, blood lipids, glucose, blood pressure, and micronutrient consumption between groups were assessed after 52 weeks. Differences between groups a priori were assessed using independent t tests and chi-squared tests. Post hoc differences in nutrient consumption between groups while controlling for gender were assessed using factorial analysis of variance. After 52 weeks, LC dieters (n = 24) retained weight loss better than their HF counterparts (n = 30) (p = .06). LC dieters consumed more vitamin K (mcg) [HF = 124.0 ± 15.0; LC = 220.0 ± 39.1; p = .025] and vitamin B12 (mcg) [HF = 3.1 ± 0.3; LC = 4.1 ± 0.4; p = .026]. The HF group consumed more folate (mcg) [HF = 479.9 ± 34.0); LC = 333.8 ± 22.1; p < .001], magnesium (mg) [HF = 353.1 ± 17.4; LC = 281.1 ± 18.0; p < .001], and iron (mg) [HF = 14.6 ± 0.8; LC = 10.7 ± 0.6; p < .001. Both groups consumed less than the respective EAR for vitamins D and E and less than the AI for potassium. While a LC diet may be more effective for long-term weight loss, both diets were deficient in micronutrients.

Childhood Obesity: Is the Built Environment More Important Than the Food Environment?

Obesity continues to be a health burden to society and new efforts may be needed to combat this epidemic. This study aims to investigate the contribution of parents education and level of income, food environment (grocery stores and fast food restaurants), and built environment (perceived safety, availability/quantity of parks) on childhood obesity. This cross-sectional observational study explored whether parents education and income level, built environment, and food environment can affect children with obesity. Participants were selected from 3 separate elementary schools located in an urban community with higher risk to have children with obesity in Montclair, California. Children living in families with low incomes have 2.31 times greater odds to be affected by obesity than children living in higher income homes. Children whose parents did not feel safe in their neighborhoods had odds of obesity 2.23 times greater than those who reported their neighborhoods as safe. Age also appeared to be a risk factor, and the odds of children affected by obesity among children 8 to 9 years was 0.79, and the odds of being affected by obesity among children 10 to 11 years of age was 0.36, when compared to children 6 to 7 years old. Findings suggest that low family income, perceptions of neighborhoods as unsafe, and young age are associated with higher body mass index (BMI) percentiles among children living in poor neighborhoods in Montclair, California.

A Qualitative Study on the Perspectives of Latinas Enrolled in a Diabetes Prevention Program: Is the Cost of Prevention Too High?

Introduction: Latinas are among the groups most affected by diabetes health disparities, yet they often benefit less from diabetes interventions even when these are culturally adapted. The purpose of this qualitative study was to explore readiness of Latinas enrolled in a diabetes prevention program to adopt recommended preventive behaviors, and to identify factors associated with the adoption and maintenance of these recommended lifestyle changes. Insights gained will be used to inform future efforts at reducing diabetes disparities and the burden of chronic diseases among Latinas. Methods: Nine focus group discussions (FGDs) and 3 key informant interviews (KIIs) were conducted after the completion of a culturally adapted diabetes prevention program led by Latino community health workers. A grounded theory approach by Charmaz informed by the transtheoretical model guided the questions. Discussions and interviews were audio-taped with participants' permission, transcribed, coded, and themed. Results: Forty low-income Latinas contributed to FGDs and KIIs. Baseline readiness to engage in new behaviors varied. Negative personal and family health events and physician referral impacted most readiness to enroll and to adopt preventive behaviors. Built environment, financial constraints, and threat of social alienation constituted major barriers to behavior adoption and maintenance, while physician involvement, awareness of diabetes complications, and social support partially mitigated these impediments. Conclusions: Our results suggest that timing of enrollment, physician-patient dynamics, and the emotional personal/family cost of behavior modification should all be considered when planning diabetes prevention programs for low-income Latinas. Besides appropriately timing referrals to accessible culturally informed prevention programs, health educators and health care providers should be aware of the potentially negative impact of behavior modification on family dynamics and be prepared to address resulting repercussions. Future research on Latinas should also include and report data on physician involvement, family context, and social determinants of health for more consistent program comparisons.

Stressful life events and social capital during the early phase of COVID-19 in the U.S.

BACKGROUND: A novel coronavirus disease (COVID-19) was reported in Wuhan, China late December 2019. The disease has as of the end of March 2020, affected over 35 countries (with over 570,000 cases and 26,000 deaths) worldwide. This includes the U.S., where cases are increasing by the thousands every day (100,000 cases with 1500 deaths as of April 2020). We set out to investigate new or increased stressful life events (SLEs) as a result of this pandemic in the U.S. METHODS: In this exploratory qualitative study, we examined new or heightened SLEs during an active phase of this outbreak. We used a list of SLEs acquired from the first phase of our study, whereby we conducted open-ended surveys and performed an in-depth focus group. We applied Lazarus and Folkman's transactional model of stress and coping to understand diverse focus-group participants' appraisal of events. We coded survey data and applied sentiment analysis. RESULTS: Participants varied in perceived threat and challenge appraisals of COVID-19, indicating both calm and fear. From 267 coded and sentiment analyzed events from survey text, 95% were predominantly negative; 112 (42%) very negative and 142 (53%) moderately negative. Social capital was unanimously emphasized upon as monumental for example: family, friends or technology mediated. We additionally identified seven major themes of SLEs due to the pandemic. LIMITATIONS: Our sample profile is not inclusive of all subsets of the population. CONCLUSIONS: Participants mostly shared similar frustrations and a variety of SLEs such as fear of the unknown and concern for loved ones as a result of COVID-19.

Dietary Factors Associated with Asthma Prevalence Among Children in California.

Background: Asthma continues to be the leading chronic disease affecting children in the United States. With mounting evidence of how diet plays a role in both chronic and allergic diseases, it is important to identify types of foods that may potentially promote a pro-inflammatory state. The study aims to examine the association between current asthma prevalence and intake of specific foods among children in California. Methods: Cross-sectional study conducting secondary analysis of data from the 2001 to 2015 California Health Interview Survey (CHIS) child surveys. A total of 65,565 completed surveys met the eligibility criteria (children ages 2-11) between the years 2001 and 2015. After excluding children with less than 2 years of age (for whom diet questions were not asked), analysis was conducted using 56,312 surveys. Multivariable logistic regression models estimated the adjusted odds ratios (ORs) and 95% CIs for the association of dietary intake with current asthma, controlling for confounding variables: gender, age, race, weight status, parent's education, English language proficiency of parent, household income, and location of residence. Analyses were survey weighted using raking variables to adjust for the oversampling and nonresponse surveys to reflect California Department of Finance Population Estimates for each survey period. Results: Approximately 13.4% of children in California currently have asthma. Consuming three or more sodas per day (adjusted OR = 1.83, 95% CI: 1.22-2.76, P = 0.004), two or more servings of French fries per day (adjusted odds ratio = 1.89, 95% CI: 1.08-3.21, P = 0.026), and fast food two or more times per week (adjusted odds ratio = 1.21, 95% CI: 1.02-1.45, P = 0.031) were positively associated with the prevalence for asthma. Conclusion: Analysis showed that children consuming energy dense foods were significantly associated with greater odds for current asthma after controlling for potential confounders.

The Association between Affect and Biomarkers of Stress and Inflammation in Healthy Seventh-Day Adventists.

OBJECTIVE: To evaluate the association between positive and negative affective states with stress biomarkers, biomarkers of inflammation and blood pressure in a population of healthy Seventh-day Adventists. DESIGN: In a cross-sectional study, biomarkers were regressed on positive and negative affect and control variables among reportedly healthy 133 females and 100 males (35% Black and 65% White) who provided blood and urine samples following completion of a questionnaire and measurement of anthropometrics and vital signs. SETTING/LOCATION: Data were extracted from the Biological Manifestations of Religion Study, an NIA-funded study conducted in members of the entity who lived within driving distance of two clinic sites. OUTCOME MEASURES: The stress biomarkers, epinephrine, and norepinephrine, were measured in 12-hour overnight urine samples analyzed by high-performance liquid chromatography. Urinary cortisol was evaluated by enzyme-linked immunosorbent assay (ELISA) and normalized for urinary output (reported in µg/g creatinine). Serum DHEA-S (reported in µg/ml) was measured by ELISA. Inflammatory markers included CRP (ng/ml), IL-6, IL-10, and TNF-α, all analyzed in serum by ELISA, and the data expressed in pg/ml. RESULTS: Multiple linear regression analyses showed after controlling for age, gender, ethnicity, body mass index (BMI), education, socioeconomic status, exercise, and use of blood pressure medication, that negative affect was associated with higher levels of epinephrine (ß = .143; P = .030). Positive affect was not associated with the biomarkers. CONCLUSIONS: While negative affect was associated with a biomarker of sympathetic stimulation, positive affect was not protective against such stimulation.

The Effect of a Tobacco Dependence Treatment Program With Stress Management Through Mindfulness Technique Training in US Veterans.

OBJECTIVE: The purpose of this study was to examine whether the Life-Change Stop Smoking Program (tobacco dependence treatment program with Stress Management/Mindfulness Training) was more effective in achieving 6 mo of smoking abstinence among a high-risk group, such as US veterans at the Loma Linda Veterans Affairs (VA) Medical Center, compared with the VA's conventional stop smoking program. The effects of participants' initial stress level and depression risk on achieving abstinence were also assessed. METHODS: Through examination of medical records and confirmation of exhaled air carbon monoxide level, abstinence status from smoking was determined at the 6-mo follow-up of the Life-Change Stop Smoking program (study group) participants and the Break the Chains program (comparison group, age and gender matched) participants. The 6-mo abstinence rates of the study group and comparison group were analzyed. RESULTS: The statistically significant level of difference (χ2 [P < .001], regression [P = .0000]) in 6-mo abstinence rates between groups was observed. CONCLUSION: The stop smoking program with Stress Management/Mindfulness Training was effective (64.6% in study group, 40.1% in comparison group, P < .001) in achieving 6 mo of smoking abstinence for the high-risk group.

The use of planned behavior theory in predicting cigarette smoking among Waterpipe smokers.

BACKGROUND: Waterpipe and cigarette smoking have been found to be associated with each other as cigarette smokers were more likely to be waterpipe users than non-cigarette smokers. Also, waterpipe smokers were likely to be former daily cigarette users. The aim of this study is to examine the likelihood of waterpipe use leading to cigarette use among current waterpipe users using theory of planned behavior. METHODS: Four hundred six current waterpipe smokers who initially had started tobacco use with the waterpipe were recruited from 15 waterpipe lounges in 2015. From a total of 70 waterpipe lounges in Riyadh, the 15 waterpipe lounges were selected randomly and participants were also selected randomly inside each waterpipe lounge based on the table or section number. The survey was developed using the Qualtrics Online Survey Software and participants completed a survey using iPad tablets. RESULTS: Cigarette smoking and intention to smoke cigarettes were predicted by attitude and perceived behavioral control. There was no direct effect of subjective norm on the cigarette use behavior, yet subjective norm had a statistically significant indirect effect on intentions through attitude and perceived behavioral control. CONCLUSIONS: The findings of this study could be useful in prevention/intervention programs aimed at reducing tobacco smoking behaviors among waterpipe users. Intervention programs might be directed at the attitude and perceived behavioral control by targeting underlying behavioral and control beliefs. The theory of planned behavior provided solid explanations of intention to use cigarettes among waterpipe smokers.

An examination of ecological predictors of health literacy in black college students.

OBJECTIVE: Health literacy is a determinant of health, but disparities in health literacy persist. This study examined the influence of ecological factors on college students' health literacy. PARTICIPANTS: During January 2016 a nonrandom sample of black undergraduate students (n = 298) aged 18-24 were recruited from enrollment lists at two urban universities in the Southeastern United States. METHODS: Information on health literacy as well as numerous intrapersonal, social, and cultural-environment factors was obtained using an electronic questionnaire and then statistically modeled. RESULTS: Ecological factors accounted for 28.7% of the variance in health literacy. In particular, reappraisal (B = 0.323, p < .001), suppression (B = -0.289, p < .001), campus health education (B = 0.192, p < .05), campus tobacco culture (B = -0.174, p < .05), and perceived norms (B = -0.153, p < .05) directly predicted health literacy. CONCLUSIONS: Although intrapersonal factors influence health literacy, the sociocultural environment of college can also foster or hinder college students' health literacy.

Exercise Video Games and Exercise Self-Efficacy in Children.

The aim of this article was to investigate the use of exergaming in promoting exercise behavior among children and to examine the impact of the intervention on participants' exercise self-efficacy, in addition to assessing physiological changes. A sample of 55 children enrolled in the Family Fit program, where participants were categorized into 2 groups: healthy weight and overweight. Measures were taken at baseline, after the 7-week program, at the 12-week follow-up, and at the 24-month follow-up. Positive changes in exercise self-efficacy were significant for the overweight group, while the healthy weight group maintained their exercise self-efficacy. At the 24-month follow-up, 97% children reported being interested in participating in a future fitness program, and 96% children who did not play sports before the intervention started practicing sports. Exercise self-efficacy is a predictor of physical activity, and incorporating exergaming in a structured program may lead to increased self-efficacy in participants.

Exploring Demographic and Substance Use Correlates of Hookah Use in a Sample of Southern California Community College Students.

BACKGROUND AND PURPOSE: Hookah smoking is a growing young adult phenomenon, particularly among college students. Many users feel that it is safer than other tobacco products, although its health threats are well documented. Little is known about hookah use rates in community colleges that are attended by nearly half of all US college students. This study examined hookah use in a diverse convenience sample of students attending two southern California community colleges. METHODS: In fall 2011, a cross-sectional, in-classroom survey was administered to 1,207 students. A series of fully adjusted multivariate logistic regressions were conducted to explore demographic, other substance use, and attitudinal correlates of lifetime and current hookah use. RESULTS: Lifetime hookah use (56%) was higher than lifetime cigarette use (49%). Gender and personal socioeconomic status were not related to hookah use. Current use (10.8%) was associated with current use of alcohol, cigars, and cigarettes. Compared to African-Americans, Whites were 2.9 times more likely to be current users, and students who perceive hookah to be more socially acceptable were 21 times more likely to currently use. CONCLUSION: Since hookah use rates are high, colleges should offer health education programs to inform incoming students about the health risks of hookah and cessation programs.

Determinants of vitamin D levels in men receiving androgen deprivation therapy for prostate cancer.

PURPOSE: Studies found an association between decreased 25-OH vitamin D blood level and prostate cancer progression. Vitamin D supplementation is controversial and dosage recommendations inconsistent. This study identified factors associated with 25-OH vitamin D levels and whether vitamin D supplementation with 800 IU/day raised vitamin D levels in prostate cancer patients receiving androgen deprivation therapy (ADT). DATA SOURCES: We recruited 108 men treated with ADT for ≥9 months from eight cancer and urology practices. Sections of the NHANES 2005-2006 questionnaire and Canadian Fitness Survey were completed identifying age, ethnicity, length of ADT use, calcium supplementation ≥1000 IU mg/day, body mass index, exercise, alcohol and tobacco use, and vitamin D supplementation ≥800 IU/daily. Blood was collected for 25-OH vitamin D analysis. CONCLUSIONS: The majority of men (66%) had blood levels of 25-OH vitamin D <32 ng/mL. Regression analysis showed vitamin D supplementation (ß = 6.556, CI 1.463, 11.650; p = .012) and African American ethnicity (ß = -7.816, CI -12.996, -2.635; p = .003) is associated with 25-OH vitamin D level after controlling age and tobacco use. PRACTICE IMPLICATIONS: Findings support current recommendations for supplementation with ≥800 IU vitamin D/day for men receiving ADT. Nurse practitioners caring for prostate cancer patients receiving ADT should include vitamin D monitoring and supplementation.

Body mass index gain between ages 20 and 40 years and lifestyle characteristics of men at ages 40-60 years: the Adventist Health Study-2.

BACKGROUND: Obesity increases risk of premature disease, and may be associated with unfavorable lifestyle changes that add to risk. This study analyzed the association of midlife BMI change with current lifestyle patterns among multiethnic men. METHODS: Men aged 40-60 years (n=9864) retrospectively reported body weight between ages 20-40 years and current dietary, TV, physical activity and sleep practices in the Adventist Health Study II, a study of church-goers in the US and Canada. In multivariate logistic regression analysis, odds ratios for BMI gain were calculated for each lifestyle practice controlling for sociodemographic and other lifestyle factors and current BMI. RESULTS: Men with median or higher BMI gain (2.79 kg/m(2)) between ages 20-40 years were more likely to consume a non-vegetarian diet, and engage in excessive TV watching and little physical activity and had a shorter sleep duration compared to men with BMI gain below the median (all p<0.001). In multivariate logistic analysis current BMI was significantly associated with all lifestyle factors (all p≤0.005). BMI gain was associated with lower odds of vegetarian diet (odds ratio [OR] 0.939; 95% confidence interval [CI] 0.921-0.957) and of physical activity ≥150 min/week (OR 0.979, 95% CI 0.960-0.999). CONCLUSIONS: These findings imply that diet and less physical activity are associated with both gained and attained BMI, while inactivity (TV watching) and short sleep duration correlated only with attained BMI. Unhealthy lifestyle may add risk to that associated with BMI. Longitudinal and intervention studies are needed to infer causal relationships.