Caffeine Intake among Undergraduate Students: Sex Differences, Sources, Motivations, and Associations with Smoking Status and Self-Reported Sleep Quality.

Due to its stimulatory effects, caffeine is one of the most frequently consumed mood and behavior altering drugs. University students report using caffeine-containing products to enhance mood and performance or for a desire of alertness. The current study investigated caffeine consumption in university undergraduate students, and associations with smoking status, alcohol and cannabis consumption, fruit and vegetable consumption, and sleep quality. Motivations for caffeine intake were also ascertained. A total of 886 undergraduates aged 18−25 years from the University of the Balearic Islands participated in a cross-sectional survey. Caffeine was consumed by 91.1% of participants. Caffeine consumers were more likely to be female, smokers, and alcohol and cannabis consumers. Coffee was found to be the main source of caffeine intake in both men and women (48.9% of total caffeine intake). Higher percentages of women consumed coffee (56.4 vs. 42.1%, p = 0.01) and tea (40.3 vs. 19.8%, p < 0.001), whereas a higher percentage of men consumed energy drinks (18.0 vs. 7.4%, p < 0.001). Main motivations for caffeine intake were those related to cognitive enhancement. Caffeine intake was associated with poorer subjective sleep quality (p < 0.001). In conclusion, undergraduate students that were female and smokers reported higher caffeine intakes. Coffee was found as the main caffeine contributor, with higher contributions of tea in women and energy drinks in men. Universities should consider the implementation of health campaigns and educational programs to educate students of the risks of high caffeine consumption together with associated behaviors such as smoking, alcohol consumption and poor sleep quality to physical health and academic performance.

Analysis of the psychometric properties of the Sense of Coherence scale (SOC-13) in patients with cardiovascular risk factors: a study of the method effects associated with negatively worded items.

PURPOSE: The objectives of this study were to analyze the psychometric properties of the Sense of Coherence scale (SOC-13), determine the role of the method effect in the performance of the instrument, and identify the relationship with health perception, quality of life, and sleep quality in patients at cardiovascular risk. METHODS: The final sample consisted of 293 patients at cardiovascular risk, with a mean age of 61.9 years (SD = 8.8), 49.8% of whom were women. The SOC-13, the Patient Health Questionnaire (PHQ-9), and the Medical Outcomes Study-Sleep Scale (MOS-Sleep) were administered. In addition, the participant's self-perceived health and quality of life were also evaluated. All analyses were carried out with SPSS 26.0 and EQS 6.1 statistical software. RESULTS: The results showed adequate reliability for the SOC-13, with a Cronbach's alpha of .789. The fit of the structures was not adequate in any of the cases (.26 to .62 for one factor, .26 to.73 for three factors, .20 to .54 for one second-order factor, and .25, .42, and .54 for three first-order factors). The three structure models showed an improved fit when adding a latent factor resulting from the method effect (.6 to .85 for one factor, .11 to.90 for three factors, and .11 to .96 for one second-order factor). Moreover, positive correlations were found with health perception, perceived quality of life, and perceived sleep quality. CONCLUSION: The SOC-13 is a suitable instrument for patients with cardiovascular risk in Spain, and it is also an indicator of health perception, quality of life, and perceived quality of sleep. Control of the method effect improves the fit of the instrument's structure. As a future direction, it is recommended to conduct new studies in this and other samples and using different versions of the SOC. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number: ISRCTN76069254, 08/04/2015 retrospectively registered.

Association between Depression, Lifestyles, Sleep Quality and Sense of Coherence in a Population with Cardiovascular Risk.

People with cardiovascular risk have more depression than the general population. Depression and cardiovascular risk have been commonly linked to lower sense of coherence (SOC) values, unhealthy lifestyles, and poor sleep quality. The aim of this study was to analyze the association between depression, health-related lifestyles, sleep quality, and SOC in a population with cardiovascular risk. A cross-sectional study was conducted in 310 participants (aged 35-75 years) with cardiovascular risk. Sociodemographic and anthropometric characteristics, cardiovascular risk, SOC score, depression levels, sleep quality, and lifestyles (physical activity, diet quality (measured as the adherence to the Mediterranean diet), and tobacco and alcohol consumption) were determined. The regression analysis showed significant associations between depression levels and sex (odds ratio (OR): 2.29; 95% CI: 1.29, 4.07), diet (OR: 0.85; 95% CI: 0.73, 0.99), body mass index (BMI) (OR: 1.06; 95% CI: 1.01, 1.12), cardiovascular disease (CVD) (OR: 2.55; 95% CI: 1.18, 5.48), sleep quality (OR: 0.26; 95% CI: 0.15, 0.46), and SOC (OR: 0.96; 95% CI: 0.94, 0.98). Protective effects of male sex, a lower BMI, no CVD, a higher adherence to the Mediterranean diet, a high sleep quality, and a higher SOC were found. In conclusion, among lifestyles determined, only diet was associated with depression levels. SOC and sleep quality were also found as significant predictors for depression levels.

Blood Cell In Vitro Cytokine Production in Response to Lipopolysaccharide Stimulation in a Healthy Population: Effects of Age, Sex, and Smoking.

Immune system functionality has been commonly assessed by a whole-blood or isolated-cell stimulation assay. The aim of this study was to determine whether cytokine production in whole-blood-stimulated samples is influenced by age, sex, and smoking. A descriptive cross-sectional study in 253 healthy participants aged 18-55 years was conducted. Whole blood samples were stimulated for 24 h with LPS and concentrations of IL-6, IL-10, and TNF-α were determined in the culture media. Among parameters considered, statistical regression analysis indicated that smoking (change in R2 = 0.064, p < 0.001) and sex (change in R2 = 0.070, p < 0.001) were the main predictors for IL-10 production, with higher values for women and non-smokers. Age was also found to be a significant predictor (change in R2 = 0.021, p < 0.001), with higher values for younger ages. Age (change in R2 = 0.089, p = 0.013) and smoking (change in R2 = 0.037, p = 0.002) were found to be negative predictors for IL-6 production. Regarding TNF-α-stimulated production, age (change in R2 = 0.029, p = 0.009) and smoking (change in R2 = 0.022, p = 0.022) were found to be negative predictors. Furthermore, sex (change in R2 = 0.016, p = 0.045) was found to be a significant predictor, with lower values for women. In conclusion, sex, age, and smoking were found to be independent determinants of stimulated cytokine production. While female sex is associated with higher IL-10 and lower TNF-α production, aging and smoking are associated with lower IL-6, IL-10, and TNF-α production.

Effectiveness of physical activity prescription by primary care nurses using health assets: A randomized controlled trial.

AIM: To evaluate the effectiveness of a 12-month multifactorial intervention by primary care nurses using health assets in increasing adherence to physical activity prescription (150 min/week) in patients with two or more cardiovascular risk factors. BACKGROUND: Physical activity promotion is a priority and helps to decrease mortality risk due to cardiovascular diseases. However, adherence to the habitual physical activity prescription in primary healthcare settings is low. DESIGN: Multicentre, single-blind, parallel randomized (in two different branches) clinical trial. METHODS: In total, 263 participants from 20 primary healthcare centres in Mallorca completed the randomized controlled trial study (intervention group N = 128, control group N = 135). The intervention consisted in four visits and included a motivational interview and an individualized prescription of physical activity using health assets. Primary outcome measure was the number of participants performing at least 150 min of weekly physical activity. Secondary outcomes included physical activity level and physical fitness, Sense of Coherence, cardiovascular risk, sociodemographic data, trans-theoretical stage of change, sleep quality, and depression. RESULTS: Adherence to the recommendation of at least 150 min of physical activity was higher in the intervention than in the control group (χ2  = 3.951, p = .047). However, this higher adherence did not suppose higher physical activity levels because no differences between groups were found in the total physical activity performed after intervention (t=-0.915, p = .361). At the end of the intervention participants randomized to the intervention group spent more time walking than participants in the control group (t = 2.260, p = .025). CONCLUSION: The multifactorial intervention performed by primary care nurses induced a higher adherence to the 150-min of weekly physical activity recommendation. IMPACT: Adherence to the usual physical activity prescription in primary care is low. Physical activity prescription performed by primary care nurses and based on health assets and motivational interview can help to increase physical activity levels of patients. The main finding of the present study was that prescription using this approach was shown to be effective, leading to a higher adherence in the intervention group. This intervention is feasible in the nurse's primary healthcare setting, thus it could be implemented as the main tool when exercise is prescribed. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number: ISRCTN76069254.

Effects of Habitual Caffeine Intake, Physical Activity Levels, and Sedentary Behavior on the Inflammatory Status in a Healthy Population.

Low-grade chronic inflammation is associated with many chronic diseases and pathological conditions. The aim of the present study was to determine the effect of regular caffeine intake, physical activity levels, and sedentary behavior on the inflammatory status in healthy participants. In total, 112 men and 132 women aged 18 to 55 years and belonging to the staff and student population of the University of the Balearic Islands volunteered to participate in this descriptive cross-sectional study. Plasma concentrations of pro-inflammatory and anti-inflammatory markers were measured. Weight, height, and body composition (bioelectrical impedance) were determined. Caffeine intake, physical activity levels and sitting time, and diet quality were determined using questionnaires. Statistical regression analysis showed that caffeine intake was a negative predictor of C-reactive protein (CRP) (p = 0.001). Body fat percentage was positively associated with CRP (p < 0.001) and inversely associated with adiponectin (p = 0.032) and interleukin (IL)-10 levels (p = 0.001). Visceral fat was the main predictor for IL-6 (p < 0.001) and tumor necrosis factor (TNF)-α (p < 0.001). Sitting time was found to be the main, inverse, predictor for IL-10 (p < 0.001), and a positive predictor for TNF-α (p < 0.001). In conclusion, regular caffeine consumption induced very limited anti-inflammatory effects. Sedentary behavior and body fat accumulation induced significant pro-inflammatory effects.

Physical activity prescription by primary care nurses using health assets: Study design of a randomized controlled trial in patients with cardiovascular risk factors.

AIM: To analyse the efficacy of a 12-month multifactorial intervention by primary care nurses in increasing adherence to physical activity prescription (150 min/week) in patients with two or more cardiovascular risk factors and with cardiovascular risk up to 15% determined by the REGICOR equation. BACKGROUND: In Spain, cardiovascular diseases are responsible for 30.5% of deaths. Regular physical activity decreases mortality risk due to cardiovascular diseases but the effectiveness of physical activity prescription in routine in primary care settings has been shown to be low. DESIGN: Multicentre, single-blind, parallel randomized (in two different branches) clinical trial. METHODS: At least 368 participants will be recruited (184 control and 184 intervention), to show an 8% increase in adherence to the physical activity prescription (1.2% control group and 9.2% intervention group). Participants will be patients aged 35-75 years with at least two cardiovascular risk factors and with a cardiovascular risk of up to 15% measured using the Framingham-REGICOR equation. Intervention will be performed throughout baseline and three follow-up visits. A motivational interview, the trans-theoretical stages of changes of Prochaska and DiClemente and an individualized prescription of physical exercise using physical activity assets will be used in the intervention. Data will be collected at baseline and after the 1-year intervention. DISCUSSION: The present study will allow us to find out whether this brief multifactorial intervention induces greater adherence to physical activity prescription than usual practice, improving the quality of patient care. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN): ISRCTN76069254. Protocol version 1.1, 6 July 2015.