This study investigated the independent and interactive effects of dietary behaviors and physical activity on poor sleep quality among 15,059 Chinese adolescents. Using a cross-sectional design, we assessed sleep quality (Pittsburgh Sleep Quality Index, PSQI), dietary habits, and physical activity. Logistic regression and interaction analysis were performed to examine associations, adjusting for covariates. The prevalence of poor sleep quality (PSQI score ≥ 7) was 9.72%. Seven healthy dietary behaviors were identified as protective (e.g., regular diet, abstaining from alcohol; ORs=0.49–0.56). While physical activity showed no independent association, limiting screen-based sedentary screen time(≤2h/day) reduced poor sleep odds by 31% (OR = 0.69). Two significant interactions emerged: abstaining from alcohol combined with limiting sugary beverages synergistically reduced the odds of poor sleep quality by 42% (OR = 0.58), whereas the combination of healthy dining out and high physical activity was associated with a 181% increased odds of poor sleep quality (OR = 2.81). While healthy dietary patterns are strongly associated with better sleep quality, the interplay between behaviors is complex, demonstrating both synergistic protective association and antagonistic outcomes. Findings highlight the need for integrated lifestyle interventions that account for behavioral interactions in promoting adolescent sleep quality.

Dietary magnesium (Mg) is a potentially modifiable factor in preventing dementia, but current evidence supporting this remains insufficient and inconclusive. This study aimed to determine whether dietary Mg is associated with the risk of dementia among middle-aged and older people. Participants of this 8-year cohort study were 13,032 community-dwelling individuals aged 40–74 years. Dietary data were collected using a validated food frequency questionnaire in 2011–2013. Mg intake was adjusted for energy intake using the residual method. The outcome was newly diagnosed dementia determined using Japan’s long-term care insurance database. Covariates included demographic characteristics, body size, lifestyles, and disease histories. Cox proportional hazard models were used to determine adjusted hazard ratios (HRs). The mean age of participants was 59.0 years. Dementia occurred in 148 males and 138 females. Lower quartiles of energy-adjusted Mg intake were associated with a higher risk of dementia (P for trend = 0.0410) in males, with the lowest quartile (Q1) having an elevated risk of dementia (HR = 1.73, 95% CI:1.07–2.83) compared to the highest quartile (Q4, reference); however, this association was not found in females. In a subgroup analysis by disease history in males, the HR of Q1 was attenuated in both subgroups; HR was 1.52 (95% CI:0.74–3.11) in those with a disease history and 1.40 (95% CI:0.73–2.69) in those without. In conclusion, low dietary Mg intake is associated with increased dementia risk in middle-aged and older Japanese males. However, this association may be partly attributable to underlying disease history.

In the USA and Japan, body mass index (BMI) has increased over the last several decades, whereas energy intake (EI) has decreased. However, self-reported EI data may show systematic errors. Using the calibration approach for attenuating the systematic error of self-reported EI, we aimed to compare trends in BMI and EI with and without calibration in adults from the USA and Japan. This cross-sectional study included 38,370 Americans evaluated in the National Health and Nutrition Examination Survey 2003–2018, and 200,629 Japanese evaluated in national nutrition surveys in Japan 1995–2019. EI was estimated using at least 1 day of 24-h diet recalls for Americans and 1 day of household-based dietary records for Japanese. The calibrated EI was calculated using a previously developed equation based on total energy expenditure (TEE) measured by doubly labelled water method. Using data from a review, uncalibrated EI was −20.2% and calibrated EI was −4.1% compared to the TEE; the calibration approach attenuated EI underestimation. In the USA, uncalibrated EI decreased (annual percentage change [APC]: −0.24%), but calibrated EI and BMI increased (calibrated EI, APC: 0.04%; BMI, APC: 0.32%). In Japan, the decrease was smaller for the calibrated EI than for the uncalibrated EI (uncalibrated EI, APC: −0.23%; calibrated EI, APC: −0.04%). Uncalibrated EI decreased and BMI increased in the USA and Japan, and calibrated EI increased in the USA and decreased slowly in Japan. Calibration may attenuate systematic bias in dietary assessments and facilitate the effective use of dietary data.

Cancer-related fatigue is a common problem among colorectal cancer (CRC) survivors even after completion of treatment. In a randomised trial, we assessed the effect of a person-centred lifestyle programme on cancer-related fatigue among CRC survivors who completed treatment. Survivors who completed treatment at least 6 months but no longer than 5 years ago and who were experiencing cancer-related fatigue were randomised to intervention or control group. The intervention group worked with a lifestyle coach for 6 months during twelve sessions to stepwise increase adherence to the World Cancer Research Fund/American Institute of Cancer Research cancer prevention guidelines on healthy diet and physical activity. The control group did not receive lifestyle coaching. Changes in cancer-related fatigue from baseline to 6 months were assessed with the FACIT (Functional Assessment of Chronic Illness Therapy) – Fatigue Scale. As a secondary outcome, we assessed changes in health-related quality of life (HRQoL). Higher scores indicate less fatigue and better HRQoL. Eighty participants were randomised to the intervention group; eighty-one to the control group. Baseline characteristics were similar: mean age 64·1 (sd 10·9) years; 55·3 % were women; and 72 % had colon cancer. There were favourable changes in dietary behaviours and physical activity in the intervention group; the control group did not show changes to the same extent. The programme did not result in statistically significant differential changes over time between intervention and control group in cancer-related fatigue (0·8; 95 % CI −1·6, 3·2) or HRQoL (1·3; 95 % CI −2·2, 4·8). A person-centred lifestyle programme improved the lifestyle of CRC survivors, but the programme was not effective in reducing cancer-related fatigue or in improving HRQoL.

In recent years, there has been growing interest regarding the impact of human movement quality on health. However, assessing movement quality outside of laboratories or clinics remains challenging. This study aimed to evaluate the capabilities of consumer-grade wearables to assess movement quality and to consider optimal sensor locations. Twenty-two participants wore Polar Verity Sense magnetic, angular rate, and gravity (MARG) sensors on their chest and both wrists, thighs, and ankles, while performing repeated bodyweight movements. The Madgwick sensor-fusion algorithm was utilized to obtain three-dimensional orientations. Concurrent validity, quantified using the root-mean-square-error (RMSE), was established against a Vicon optical motion capture system following time-synchronization and coordinate-system alignment. The chest sensors demonstrated the highest accuracies overall, with mean RMSE ($ {\mathrm{RMSE}}_{\mathrm{mean}} $) less than 9.0° across all movements. In contrast, the wrist sensors varied considerably ($ 5.5\hskip-2pt {}^{\circ}\le {\mathrm{RMSE}}_{\mathrm{mean}}\le 139.1\hskip-2pt {}^{\circ} $). Ankle and thigh sensors yielded mixed results, with the $ {\mathrm{RMSE}}_{\mathrm{mean}} $ ranging from 2.0° to 40.0°. Notably, yaw angles consistently demonstrated higher discrepancies overall, while pitch and roll were relatively more stable. This study highlights the potential of consumer-grade MARG sensors to increase the real-world applicability and accessibility of complex biomechanical models. It also accentuates the requirement for strategic sensor placement and refined calibration and postprocessing methods to ensure accuracy.

There is growing evidence that optimising dietary quality and engaging in physical activity (PA) can reduce dementia and cognitive decline risk and improve psychosocial health and quality of life (QoL). Multimodal interventions focusing on diet and PA are recognised as significant strategies to tackle these behavioural risk factors; however, the cost-effectiveness of such interventions is seldom reported. A limited cost consequence based on a 12-month cluster-randomised Mediterranean diet (MedDiet) and walking controlled trial (MedWalk) was undertaken. In addition, QoL data were analysed. Programme costs ($AUD2024) covered staff to deliver the MedWalk programme and foods to support dietary behaviour change. The primary outcome measure of this study was change in QoL utility score, measured using the Assessment of Quality of Life (AQoL-8D). Change scores were compared for the groups using general linear models while controlling for demographic factors associated with baseline group differences and attrition. Change in QoL (decreased, maintained or improved) was determined using a cross-tabulation test. MedWalk programme costs were estimated at $2695 AUD per participant and control group cost at $165 per person – a differential cost of $2530. Mean change in utility scores from baseline to 12 months was not statistically significant between groups. Nevertheless, the MedWalk group was significantly less likely to experience a reduction in their QoL (20·3 % MedWalk v. 42·6 % control group) (P = 0·020). A MedDiet and walking intervention may have a role in preventing decline in QoL of older Australians; however, longer-term follow-up would be beneficial to see if this is maintained.

Regular physical activity for adults is associated with optimal appetite regulation, though little work has been performed in adolescents. To address this gap in the literature, we conducted a study examining appetite across a range of physical activity and adiposity levels in adolescent males. Healthy males (n 46, 14–18 years old) were recruited across four body weight and activity categories: normal weight/high active (n 11), normal weight/low active (n 13), overweight, obese/high active (n 14), overweight and obese/low active (n 8). Participants from each group completed a 6-h appetite assessment session on Day 0, followed immediately by a 14-day free-living physical activity and dietary assessment period on Days 1–14, and a fitness test session occurring between Days 15–18. Subjective and objective assessment of appetite, resting energy expenditure, body composition using dual energy absorptiometry and thermic effect of feeding (TEF) was conducted on Day 0. Physiological variables in the normal weight low active group that were different than their peers included lower fat-free mass, cardiorespiratory fitness, glucose/fullness response to a standardised meal, TEF in response to a standardised meal, lower self-rated fullness and satiety and higher self-rated hunger to a standardised meal. Conversely, the overweight, obese high active group displayed better subjective appetite responses, but higher insulin responses to a standardised meal. Taken together, these results suggest that physical inactivity during adolescence has a negative impact on metabolic health and appetite control, which may contribute to future weight gain.

Blood 25-hydroxyvitamin D (25(OH)D) concentrations vary considerably by season and sex. The present study aimed to determine associations between vitamin D deficiency and mortality in Japanese adults and identify risk thresholds according to 25(OH)D concentrations. This was a cohort study with an 11-year follow-up. Participants were 8285 community-dwelling Japanese adults aged 40–74 years. Plasma 25(OH)D concentrations were measured by chemiluminescent immunoassay at baseline and divided into quintiles for each of the subgroups stratified by season and sex (denoted as season- and sex-stratified quintiles). The main outcome was all-cause mortality. Hazard ratios (HR) were calculated using a Cox proportional hazards model. Mean age and 25(OH)D concentration were 59·9 years (sd = 9·1) and 50·1 nmol/l (sd = 18·1), respectively. Lower season- and sex-stratified quintiles were associated with higher hazards of all-cause mortality (Pfor trend = 0·0015), with the first quintile (median = 28·2 nmol/l) having a higher HR (HR = 1·46, 95 % CI, 1·13, 1·88) than the highest quintile (reference). When crude quintiles were used, the overall association was similar (Pfor trend = 0·0027), with the first (median = 28·0 nmol/l) and second (median = 39·7 nmol/l) quintiles having higher HR (HR = 1·40, 95 % CI, 1·06, 1·85 and 1·38, 95 % CI, 1·07, 1·77, respectively) than the reference. The risk threshold difference was estimated to be approximately 10 nmol/l. In conclusion, low blood 25(OH)D concentrations are associated with high mortality risk. Crude blood 25(OH)D concentration may modulate the estimated risk threshold for vitamin D deficiency associated with mortality.

Few studies have examined the effects of early-life nutrition interventions on adolescent physical activity (PA). We aimed to examine the long-term effects of small-quantity lipid-based nutrient supplements (SQ-LNS) on adolescent PA and sedentary behaviour (SB) and to describe current adolescent PA and SB levels in this cohort. In the International Lipid-Based Nutrient Supplements (iLiNS)-DYAD-Ghana trial, 1320 mothers were enrolled and randomly assigned to one of three conditions: (1) daily iron and folic acid during pregnancy and placebo (calcium) from birth to 6 months postpartum (IFA), (2) multiple micronutrient supplements during pregnancy to 6 months postpartum (MMN) or (3) SQ-LNS during pregnancy to 6 months postpartum (LNS). Infants from mothers in the LNS group received SQ-LNS designed for children from 6 to 18 months. We recruited 11–13-year-old adolescents of mothers enrolled in the iLiNS-DYAD-G trial for a 7-d PA and SB assessment using accelerometers (n 305) and self-reported PA and SB (n 508). We compared the LNS with non-LNS (IFA+MMN) groups using ANCOVA models for the following outcomes: mean vector magnitude counts per minute, PAQ-C score and percentage of time in SB, light PA and moderate-to-vigorous PA (MVPA). There were no significant differences between the LNS and non-LNS groups in any PA outcome in minimally or fully adjusted models. Only approximately 50 % of adolescents met the PA recommendation of 60 min/d MVPA, with males more active than females; however, there is room for improvement. SQ-LNS in early life does not appear to have a sustained impact on PA or SB.

This study compared red meat, white meat and vegetable consumption before, during and after COVID-19 pandemic among older adults in regional China. Data were collected from urban individuals aged 60+ years in Nanjing municipality in 2018, 2021 and 2023. Differences in food intake frequencies between participants and survey years were examined. Logistic regression models were employed to identify influencing factors of meat, and vegetable consumption. Totally, 13 792 participants were analysed, with 4355, 4622 and 4815 from 2018, 2021 and 2023 surveys, respectively. The mean weekly intake frequency (sd) in 2018, 2021 and 2023 was, separately, 3·85 (sd 2·83), 3·21 (sd 2·90) and 4·71 (sd 3·94) for red meat; 1·38 (sd 1·21), 2·08 (sd 1·90) and 2·73 (sd 2·55) for white meat; and 10·98 (sd 4·84), 10·00 (sd 5·04) and 10·34 (sd 5·04) for vegetable. Moreover, 23·2, 32·6 and 52·3 % of participants met the recommendation for meat intake, while 53·7, 46·8 and 49·6 % reached vegetable intake recommendation before, during and after COVID-19 pandemic, respectively. Meat intake was positively associated with education, marital status and drinking, but negatively associated with age. Additionally, education and marital status were in negative relation to vegetable consumption, while smoking and drinking were positively associated with vegetable intake. The older residents consumed less red meat and vegetable but more white meat during COVID-19 pandemic, and their consumption levels of meat and vegetable went up after the pandemic. These findings highlight the need for targeted interventions to support older adults’ dietary habits during emergency events.

Physical inactivity is a leading cause globally of noncommunicable diseases such as diabetes, heart attacks, and strokes. Here, we present the results from a 4-week-long experimental test of a nudge designed to promote physical activity among 206 seniors in Abu Dhabi, United Arab Emirates—a population with one of the highest rates of physical inactivity in the world. We find that the “Forever Fit” nudge—a booklet containing a simple exercise program and information about the health benefits of physical activity—has a large positive effect on 93 previously inactive seniors. The nudge increases the time previously inactive participants spend being physically active from about 5 to about 15 minutes per day.

The Tohu Manawa Ora | Healthy Heart Award programme helps early learning services across Aotearoa create an environment that promotes nutritional health and physical activity. It achieves a sustainable change to the environment by using a ‘whole-service’ approach, through governance and management, learning and teaching, collaboration and professional development. The programme aims to foster happy tamariki with awareness of how to have hearts fit for life, ensuring healthier futures for whānau across Aotearoa New Zealand. To evaluate and understand the impact and social value of the Tohu Manawa Ora | Healthy Heart Award programme on fostering healthy habits and creating supportive environments in early learning settings across Aotearoa New Zealand the Heart Foundation undertook this evaluation with ImpactLab. Two hundred and fifteen early learning services and 33,717 tamariki across Aotearoa New Zealand, who were enrolled in or had achieved a Tohu Manawa Ora | Healthy Heart Award, were used to determine the impact and social value of the programme. This was achieved through using a social value calculation which integrates multiple data sources and analytical methods. Firstly, impact values derived from the programme were combined with evidence from global literature on the effectiveness of similar health promotion programmes. Secondly, the size of the opportunity for participants—early learning services across Aotearoa New Zealand—to achieve more positive health outcomes was assessed. Thirdly, the number of people supported by the programme was considered. Every year, the Tohu Manawa Ora | Healthy Heart Award programme delivers $6,163,581 of measurable good to society in New Zealand. Outcomes for tamariki of improved oral health, physical activity and reduced diabetes and improved physical activity for whānau directly contribute to the social value. Improved health equity, nutrition, increased food exposure and physical activity, promotion of lifelong wellbeing and positive health behaviours, reduced cardiovascular disease and sugar consumption indirectly contributed to the social value. This means that every dollar invested in the Tohu Manawa Ora | Healthy Heart Award programme delivers $4.50 of measurable good to New Zealand. The Tohu Manawa Ora | Healthy Heart Award programme delivers significant measurable social value to Aotearoa New Zealand. Growth, development and continued funding of the programme should continue to further positively impact the future of tamariki and their whānau in Aotearoa New Zealand.

Our daily lives are shaped by the digital platforms we engage with, presenting both challenges and opportunities in the pursuit of health and social well-being. Despite extensive public efforts to increase physical activity, sedentary lifestyles and car-dependence persist; often exacerbated by digital apps functioning at odds with these initiatives. With growing urbanization, walking for transportation becomes a feasible way for many Americans to achieve daily activity goals. This work explores the potential of leveraging nudges within digital apps, specifically Google Maps, to encourage walking. I found that displaying walking directions as the default in Google Maps, instead of driving, and complemented by graphics depicting social norms, significantly increased the hypothetical choice to walk — particularly among less active individuals. This underscores the power of digital environments in shaping our choices and outcomes; and highlights the need for us to critically assess digital app design. I advocate for collaboration between ‘big tech’, policymakers, and the public to create digital tools that balance our immediate convenience with long-term health and environmental sustainability goals. Re-envisioning technology’s role in daily life, we can potentially harness its vast influence to foster choices that contribute to both personal well-being and the collective good.

In an era marked by mounting global challenges, education is often envisioned as an agent of transformative action towards a more sustainable future. This research seeks to delve into the students’ perceptions concerning competencies for sustainability in Physical Education Teacher Education. Adopting a qualitative approach, a non-probabilistic purposive sample of 57 students (35 males, 22 females, mean age: 21.2 ± 3.2 years) was recruited. Data collection comprised semi-structured interviews. Analysis was facilitated through Atlas.ti v.7.5.18, abiding by established qualitative research paradigms. Participants emphasised the intrinsic value of an interdisciplinary approach. The study discerned a strong inclination towards cooperative and introspective tasks. Moreover, this exploration offers valuable insights for academic institutions, suggesting integrative strategies for environmental education. Therefore, these findings invite to adapt curricular designs, ensuring that educators are aptly prepared to respond the multifaceted challenges of the 21st century, driving our collective stride towards a sustainable, equitable future.