This study resituates the twentieth-century origins of lifestyle reform movements by examining the cultural politics of nourishment in the Tokugawa period (1600-1868), when the move toward a shared, authoritative, and seemingly objective system of dietary reform began to take shape, apart from the influence of modern nutritional sciences or the nation-state. A host of popular writers adapted older knowledge on medicine and longevity to communicate rules for dietary conduct that could apply across the spectrum of status and class. The celebration of nourishment in the emerging cultural marketplace of Tokugawa Japan in part represented an attempt to bring society back into alignment through a rhetoric that bundled self-regulation, morality, and individual and collective prosperity into a holistic sense of what the body could become in the world when properly fueled. Surrendering to a desire for the delicious was tantamount to shirking one’s duty, inviting disease, and weakening not only the individual body but the household as well. This tension between self-regulation and an expanded, socially embedded conception of bodily care became the animating logic behind the dispensation and reception of dietary advice in Japan from the eighteenth century on. As the core component in a system of healthy being, nourishing life in late-Tokugawa Japan transcended the personal longevity regimens from which it had once originated to become a perceived cure for social ills. Developments in the Tokugawa and Meiji periods reveal an ongoing tension between a universal healthy diet rooted in human physiology and Japan-specific nutritional standards meant to apply only locally. This study seeks to demonstrate how difficult it can be to isolate and identify a Japanese diet in light of waves of historical change, not only in patterns of eating but in thought and motivation behind competing visions of what to eat and why. Each new iteration of advice represents another attempt to distill and communicate priorities that often extend beyond immediate physiological concerns of bodily care. Following dietary guidance into the past compels us to think of nourishment not as a progression to an increasingly sophisticated and complete understanding of the ways in which food affects how the body performs in the world, but as a contingent struggle between systems of self-care with their own logics, claims to efficacy, and extra-physiological concerns rooted in the historical contexts from which they emerged. Chapter One examines Kaibara Ekiken’s (1630-1714) Precepts on Nourishing Life (Yōjōkun, 1713), a text that marked a turning point at which previously esoteric principles of health migrated from medical systems to an emerging popular culture of nourishment. By the end of the Tokugawa period, Yōjōkun had become both a set of specific principles recorded by Ekiken and a “brand” that others could use to legitimize their own dietary sensibilities. Ekiken carved out a new position from the earlier Chinese and Japanese longevity texts from which he drew inspiration, adapting a model of alimentary choice and personal responsibility to his own historical moment. Chapter Two explores the rise of new knowledge, new knowledge makers, and new knowledge consumers in vernacular dietary guidebooks. These guides changed the implicit structure of authority between ordinary people and those from whom they sought advice on health. Assertions that guidebooks alone could provide all the care one needed altered the terms of the relationship between everyday readers and experts by inserting a new layer of access to knowledge without the need for firsthand consultation. Despite emerging from the realm of medical knowledge, new nourishing life (yōjō) manuals betrayed a growing skepticism of doctors and medicinal healing, subordinating them to preventive nourishment regimens. Chapter Three investigates how the commercial publishing culture of late Tokugawa Japan created a venue for non-specialist authors to comment on the social place of the well-nourished body developed in nourishing life guides. Literary storybooks explored the moral and economic dimensions of health, highlighting excess, gluttony, wealth, and income disparity as themes in who should or could eat what. The chapter focuses on two ‘tales of the stomach,’ which aimed to demystify digestion and the workings of the inner body by personifying foods and bodily responses to them. I argue for a more expansive view of food publications in the Tokugawa period, as well as an understanding of didacticism inclusive enough to account for shared dietary themes across genres. Chapter Four concludes the dissertation by tracing the encounter between Tokugawa dietary health and Western scientific nutrition in the Meiji period (1868-1912), as the fledgling Japanese empire negotiated its new position vis-à-vis the West on political, cultural, and corporeal grounds. The new nutritional sciences were a novel departure from the norms of dietary thinking not only in Japan but in Europe and America, where views on diet had been largely commensurable with those of nourishing life until around the middle of the nineteenth century. Late Meiji doctor Ishizuka Sagen and the civil organizations founded to advance his ideas were among the first to use a “chemical theory of nutrition” to challenge new norms of Western science by evoking a traditionalist vision of a Japanese diet of brown rice, whole grains, miso, and vegetables. Yet vernacular advice persisted as the medium for recording and communicating nourishment to the public, and Tokugawa understandings of yōjō continued to live on in new forms.

Background: Childhood obesity remains a major public health concern. While preventing childhood obesity is important, the effectiveness of existing prevention strategies is indefinite. Important obesity contributors are speculated to be overlooked while the role of well-studied obesity-related factors has been questioned. Objectives: 1) Although the association between lifestyle and obesity is seemingly well-established, how an overlooked dietary factor, breakfast location, associates with obesity was investigated 2) At a time where inconsistencies in findings for the frequently studied association between TV viewing and obesity still exist, this thesis tested for the existence of the said association in the understudied Chinese population 3) The effect of mental health on childhood obesity is understudied. Using self-esteem as a mental health indicator, the effect of self-esteem on childhood obesity was investigated To understand the role of lifestyle factors in the association between self-esteem and obesity, how 4) breakfast habit and 5) TV viewing habit associates with self-esteem was explored Methods: A cohort of 83405 primary 4 (P4) Department of Health Student Health Service participants (49.7% male, mean age 9.9 years) in 1998-2000 were successfully tracked for 2 years into primary 6 (P6). A self-administered health questionnaire collected information on the breakfast and TV habits of participants alongside other lifestyle characteristics. Self-esteem was assessed using the four Culture Free Self-Esteem Inventories for Children (SEI) subscales. Body mass index (BMI) was derived using objectively measured weight and height. Weight status was classified in accordance to International Obesity Task Force standards. Logistic, multinomial logistic and linear regression were used to yield adjusted odds ratios (AOR) and β-coefficients for becoming overweight/obese in P6 (among P4 normal weight children), breakfast skipping/location, TV viewing habit and SEI subscale scores. Breakfast skipping behaviour was tested as a mediator in the association between self-esteem and obesity using standard mediation procedures. Breakfast and TV viewing habits were tested as effect modifiers in the same association by inclusion of interaction terms in models. Results: Among normal weight P4 children, those who skipped breakfast (AOR: 1.24; 95% CI: 1.02 to 1.51) or ate away from home (1.39; 1.20 to 1.60) were more likely to become overweight/obese in P6. Poor self-esteem was also associated with higher AORs for becoming overweight/obese, particularly among girls. While TV viewing in P4 did not predict overweight/obesity in P6, those who increased TV watching hours (≤2h/day to 2h/day) during the two follow-up years were 32% more likely to become overweight/obese in P6 than their counterparts who maintained watching ≤2h/day. Breakfast habit and self-esteem was bi-directionally associated. Although a curvilinear inverted J-shaped relation between P4 TV viewing and P6 self-esteem was observed, self-esteem did not predict TV viewing habit. While neither breakfast nor TV viewing habit significantly interacted with self-esteem to predict obesity, breakfast skipping was found to be a potential partial mediator in the association between self-esteem and obesity. Conclusion: Breakfast location, self-esteem and TV viewing patterns over time are important to consider in relation to childhood obesity. Additionally, the association between self-esteem and obesity could be mediated by lifestyle factors. / published_or_final_version / Community Medicine / Doctoral / Doctor of Philosophy

Despite having the highest life expectancy rate in the world, Hong Kong people do not necessarily lead a healthy life and may suffer from various ailments due to unhealthy lifestyle. For example, more than half of the adult population does not meet the recommended standard of physical activity set by the World Health Organization. Health status of individuals is influenced by different factors such as healthcare input, biological endowment, environment, and lifestyle. Among these factors, only the factor of lifestyle can be managed by an individual. What people can do to improve their health status is to manipulate or change their lifestyle. The present study examines the relationship between lifestyle parameters and self-rated health status of the adult population in Hong Kong. The relationship between physical activity, eating behavior, smoking behavior, and alcohol drinking behavior of individuals on self-rated physical and mental health were analyzed. A total of 1,277 samples were collected among 18 districts in Hong Kong. Structural equation modeling and regression analysis were employed to specify the relationship between lifestyle behavior and individual self-rated health status. Two-way analysis of variance was used to examine the lifestyle behavior across gender and three categorical groups (i.e. age group, education level, marital status). For the physical health, the relationships between eating behavior and physical health, smoking dependence and physical health, alcohol dependence and physical health were negative but statistically insignificant. For the mental health, the relationships between eating behavior and mental health, and smoking dependence and mental health were negative but statistically insignificant. The present study is the pioneer to use latent variables of cigarette dependence and alcohol dependence as a measure of substance use in the empirical tests of Grossman model. Also, this study overcomes the limitations that using one categorical item in measuring self-rated health. The results of the present study provide information on lifestyles and health that can be used by policy-makers, the community, and other stakeholders to promote advocacy and revamp public health policies and practices. It can also provide evidence to guide the development and implementation of public health promotion campaign.

Background: There is global concern about the impact of lifestyle related diseases which have been on a steady increase in recent years. Poor nutrition, reduced physical activity and cigarette smoking have been documented as the main lifestyle behaviors that result in an increase in prevalence of the three most common occurring chronic diseases of lifestyle namely: diabetes, hypertension and cardiac diseases. Healthcare workers are frontline personnel and are seen as role models by their family, friends and the community they serve. It is therefore important that positive healthy lifestyle behaviors are practiced and encouraged by healthcare workers themselves. Objectives: To develop an initial descriptive profile of hospital employees with regards to their general knowledge, attitudes and practices about healthy lifestyles and to make appropriate recommendations to the hospital management on how the workplace can support the adoption of healthy lifestyles. Methods: The study was conducted at one health institution using the permanently employed staff as the study population. An exploratory descriptive study design was used in context of the precede-proceed planning framework. Self-administered questionnaires and consent forms were distributed in English and isiZulu. Collection boxes were placed in all wards and departments. Data was captured using the SPSS version 13 statistical package. Results: The response rate was 42%. Respondents were classified into the administrative, general staff and health professional categories. There was a significant difference (p=0.03) between the staff body mass index and their weight perception. Knowledge and attitude had mean indices of greater than 70% and the practice indices were lower for all three categories at less than 45%. A significant difference was found between certain staff categories in the knowledge and attitude indices but no significant difference existed in their practices. Conclusion: All categories of staff possessed adequate knowledge and attitudes but this is not transferred into positive health promoting practices. The possibility of workplace health promoting interventions was well supported by staff especially with regards to healthier meal choices at the staff dining room and an onsite gym facility. The main limitations of the study were the non-standardized data collection tool, and the poor response rate, which make the generalization of the study findings difficult. / Thesis (M.PH.)-University of KwaZulu-Natal, 2008.

The purpose of this study was to describe the relationship between mental, physical, and social activity, and episodic memory (EM) of cognitively intact older persons. The specific aims were (a) to describe the relationship between EM and mental, physical, and social activity, (b) to describe the role of gender, marital status, and race on EM, (c) to describe the moderating effects of each activity on the relationship between each of the remaining two activities and EM, and (d) to describe the moderating effects of gender, marital status, and race on the relationship between each activity and EM. Two theoretical frameworks: Cognitive Reserve Theory (Stern, 2002) and Theory of Nursing as Caring (Boykin & Schoenhofer, 1993) guided the study. This study was designed as a correlational and retrospective secondary analysis of data sets from the Health and Retirement Study. The sample consisted of 3,903 cognitively intact persons who were 50 years and older and completed immediate and delayed recall tests in the 2016 HRS and the 2015 Consumptions and Activities Mail Survey. Descriptive statistics included the means for age: 67 (SD 9.54), education:13.85 (SD 5.89), and total cognition 16.86 (SD 3.11). The sample was predominantly Caucasian (78.3%), female (59.8%), and married (60.9%). / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2020. / FAU Electronic Theses and Dissertations Collection

Thesis (PhD)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: Unhealthy behaviour is a key modifiable factor that underlies much of the South African (SA) burden of disease and primary care morbidity. Chronic diseases such as heart disease, type 2 diabetes, lung diseases and some cancers are linked to underlying behavioural issues such as tobacco smoking, alcohol abuse, physical inactivity and unhealthy eating. Evidence shows that brief behaviour change counselling by primary care providers can be effective in helping patients to change risky lifestyle behaviours. However, the capacity of South African primary care providers to educate and counsel patients on lifestyle modification is generally poor. The need for primary care provider training in lifestyle counselling, is stated as a critical objective in ‘re-orientating’ the primary health care system to effectively address NCDs in the National Strategic Plan for the Prevention and Control of NCDs and their risk factors in SA. The overall aim of this research was to develop, implement and evaluate the effectiveness of a training intervention for primary care providers in the South African setting, which is based on teaching best practice, behaviour change counselling (BBCC) methods that can be used for patients with risky lifestyle behaviours associated with non-communicable diseases (NCDs). “Effectiveness” relates to the effect of the training on PCPs adoption of a patient centred approach, and skills acquisition after the training, and not the effectiveness in changing, or improving patient outcomes. The sequence of the abstracts of the four articles that were published from this research, gives an overview of the process. / AFRIKAANSE OPSOMMING: Ongesonde lewenstyl kan gekoppel word aan die meeste chroniese siektes wereldwyd, en dra grootliks by tot die las van primere sorg morbiditeit, asook in Suid Afrika. Rook, ongesonde dieet, fisiese onaktiwiteit, en alkohol misbruik word beskou as die onderliggende risiko faktore wat verantwoordelik is vir die ontwikkeling van kardiovaskulere siektes, tipe 2 diabetes, respiratoriese siektes, sowel as sommige kankers. Navorsing het bewys dat primere gesondheidsorg werkers effektief kan wees om pasiente te help om hierdie gewoontes te bekamp. Nieteenstaande hierdie bewyse, is die huidige kapasiteit van primere sorg dokters en verpleegsters in Suid-Afrika nie voldoende om sodanige diens te verskaf nie. In die Nationale Strategiese Plan vir die beheer van chroniese siektes, word opleiding vir primere gesondheidsorg werkers geprioritiseer as n kritiese uitkomste vir die beheer van chroniese siektes, en die onderliggende risiko faktore. Dit is dus duidelik dat daar n behoefte is om sodanige opleidingprogramme te ontwikkel. Die doel van hierdie navorsing was om n bewysgebaseerde opleidingsprogram te ontwikkel, te implementeer, en die effektiwiteit daarvan te evalueer in ons unieke primere gesondheidsorg sisteem in Suid-Afrika. Die opleidingsprogram moes ontwikkel word, vir beide primere sorg dokters en verpleegsters, sodat dit hulle in staat kan stel om pasiente te beraad oor enige van die vier risiko faktore.

The primary purpose of this study was to investigate the effect of acute high-intensity interval exercise (HIIE) vs. continuous moderate-intensity exercise (CME) on serum CTRP9 and brachial FMD responses in obese and normal-weight subjects. Sixteen participants (9 obese and 7 normal-weight) completed HIIE and CME in a randomized fashion. Our results showed a significant time effect for CTRP9 immediately following acute HIIE and CME in both groups. Furthermore, both significant treatment by time and group by time interactions for FMD were observed following both exercise protocols, with greater CME-induced FMD response in obese subjects than normal-weight subjects. Additionally, a positive correlation in percent change (baseline to peak) between CTRP9 and FMD was observed following acute CME. These findings support acute CME for improvement of endothelial function in obesity. Furthermore, the novel results from this study provide a foundation for additional examination of the mechanisms of exercise-mediated CTRP9 on endothelial function. / Includes bibliography. / Thesis (M.S.)--Florida Atlantic University, 2017. / FAU Electronic Theses and Dissertations Collection

Various studies on compliance with anti-hypertensive medications and appropriate lifestyle modifications have been conducted worldwide but studies specific to the Island of Praslin are lacking. The purpose of this quantitative, descriptive-correlational study was to describe factors that affected compliance with hypertension medications and lifestyle modification strategies in a sample of 102 hypertensive persons. The comprehensive version of the Health Belief Model served as the conceptual framework directing the study. The researcher investigated whether there were any significant relationships between compliance and the Health Belief Model variables. Data was collected by means of structured interviews and document analysis, involving an interview schedule and a checklist. All respondents were diagnosed hypertension patients registered at either of the two public health centres on the Island of Praslin. Individual perception of the benefits and risks of hypertension treatment as well as cues to action were found to be significant determinants of compliance behaviour. The study highlighted the need for improved health education and follow-up measures to strengthen patients’ perceptions about the benefits of treatment and compliance. / Public Health / M.A. (Public Health)

Thesis (M Sport Sc (Sport Science))--Stellenbosch University, 2011. / ENGLISH ABSTRACT: Adolescence is the period between childhood and adulthood. This phase starts between the ages of 11 and 13 years and ends between 17 and 21 years. Adolescence was seen as a phase of development, growth and excellent health in the past, but that is not the case in the 21st century. The health of adolescent are being influenced by technology such as computers and televisions, crime, poor eating habits, the absence of Physical Education at schools, urbanization, overpopulation and less available space for children to play. These aspects lead to a sedentary lifestyle which may impact their health in the form of hypokinetic diseases. The primary aim of this study was to determine the lifestyle patterns of adolescents in selected Western Cape high schools. The secondary aims of this study were to determine the lifestyle patterns of different ethnic groups; those of boys and girls; and to compare these lifestyle patterns with those of adolescents 10 years ago. In this study, two questionnaires were used for data collection: a questionnaire for the adolescents; and one for the Life Orientation teachers. The high schools (N=30) were randomly selected to partake in the study. Out of each school learners (N=60) were also randomly selected to partake in the study. The 60 learners consisted of [n=15] boys and [n=15] girls in Grade 9 and [n=15] boys and [n=15] girls in Grade 11 between the ages of 15 and 17 years. One Life Orientation teacher was also randomly selected from each school. Data from the two questionnaires were coded in computer format and statistically analysed with the computer program Stasoft Statistica Version 10. From the results of the study it can be concluded that neither White nor Coloured adolescents found school sport important nor they did not partake in sporting activities on a regular basis. Adolescent boys, on the other hand, were found to be much more active than adolescent girls. Adolescent girls preferred sedentary activities like listening to music and reading books. Both White and Coloured adolescents, and boys and girls, found their health to be excellent despite the fact that research showed the opposite to be true. White adolescents also found socialising more important than Coloured adolescents. Coloured adolescent on the other hand found household chores more important. Boys and Coloured adolescents attended self defence classes on a regular basis. This study is a follow-up study on one conducted by Van Deventer in 1999. It serves as a basis for further research and it is recommended that a new study should be conducted every 10 years to determine changes in the lifestyle patterns of adolescents so that it can be addressed. Further research is recommended because of the low feedback of Life Orientation teachers to determine and address the status of Life Orientation presently in schools, the attitudes of teachers and learners toward Life Orientation, Education and training of Life Orientation teachers, apparatus and facilities needs and time allocation towards the movement component in Life Orientation. Further research is also recommended because of the insufficient feedback received from Black learners. It is also important to determine their lifestyle patterns so that recommendations in this regard can be made. / AFRIKAANSE OPSOMMING: Adolessensie is die periode tussen die kinderjare en volwassenheid. Die fase begin tussen die ouderdomme van 11 en 13 jaar en eindig tussen 17 en 21 jaar. Adolessensie is vroeër as 'n fase van groei, ontwikkeling en goeie gesondheid beskou maar dit is nie meer die geval nie. Adolessente se gesondheid word huidig deur beskikbare tegnologie soos televisie en rekenaars, vervoer, misdaad, verstedeliking, minder sportgronde as gevolg van oorbevolking, gebrekkige Liggaamlike Opvoeding by skole en ongesonde eetgewoontes belemmer. Dit kan tot sedentêre leefstylpatrone aanleiding gee wat hipokinetiese siektes kan meebring. Die hoofdoel van die studie was om die leefstylpatrone van adolessente in geselekteerde hoërskole van die Wes-Kaapse Onderwysdepartement te bepaal. Daar was ook op die volgende subprobleme gefokus: die vergelyking van die leefstylpatrone van verskillende etniese groepe, die vergelyking van die leefstylpatrone van seuns en meisies en die vergelyking van die leefstylpatrone van huidige adolessente met dié van 10 jaar gelede. Twee vraelyste was vir die insameling van die data gebruik. Een wat leerders en die ander die Lewensoriëntering-onderwyser voltooi het. Die hoërskole (N=30) was ewekansig geselekteer. Uit elke hoërskool was leerders (N=60) ewekansig: uit Graad 9 [n=15] seuns en [n=15] meisies en uit Graad 11 [n=15] seuns en [n=15] meisies tussen die ouderdomme van 15 en 17 geselekteer. Een Lewensoriëntering-onderwyser per skool was ook ewekansig geselekteer. Die data wat vanaf die vraelyste verkry was, is in rekenaarformaat gekodeer en statisties verwerk. Stasoft Statistica Weergawe 10 is vir verdere dataverwerking gebruik. Daar is tot die gevolgtrekking gekom dat beide Wit en Bruin adolessente sport as onbelangrik geag het en ongereeld daaraan deelneem het. Adolessente seuns het sport belangriker geag en ook meer gereeld as adolessente meisies daaraan deelgeneem. Adolessente meisies het sedentêre aktiwiteite, soos om te lees en na musiek te luister, belangriker as adolessente seuns geag. Wit en Bruin adolessente, en die seuns en meisies, het hul gesondheid goed geag al bewys navorsing die teendeel. Wit adolessente het meer as Bruin adolessente gesosialiseer, terwyl Bruin adolessente huishoudelike take belangriker as Wit adolessente geag het. Adolessente seuns en Bruin adolessente het gereeld selfverdedigingsklasse bygewoon. Die onderhawige studie is 'n opvolgstudie wat deur Van Deventer in 1999 uitgevoer is en dien as rigtingwyser vir verdere navorsing. 'n Opvolgstudie elke 10 jaar is ideaal sodat die veranderinge in leefstylpatrone onder adolessente gemonitor en aangespreek kan word. Verdere navorsing word as gevolg van die lae terugvoersyfer van Lewensoriënteringonderwysers aanbeveel sodat die volgende aangespreek kan word: die status wat Lewensoriëntering huidig geniet; die gesindheid van onderwysers en leerders teenoor Lewensoriëntering; onderwyseropleiding; apparaat en fasiliteit behoeftes; en die tydstoekenning vir die bewegingskomponent van Lewensoriëntering. Verdere navorsing word as gevolg van die lae terugvoersyfer van Swart adolessente aanbeveel sodat hul leefstylpatrone ook bepaal en aanbevelings daarvolgens gemaak kan word.

Various studies on compliance with anti-hypertensive medications and appropriate lifestyle modifications have been conducted worldwide but studies specific to the Island of Praslin are lacking. The purpose of this quantitative, descriptive-correlational study was to describe factors that affected compliance with hypertension medications and lifestyle modification strategies in a sample of 102 hypertensive persons. The comprehensive version of the Health Belief Model served as the conceptual framework directing the study. The researcher investigated whether there were any significant relationships between compliance and the Health Belief Model variables. Data was collected by means of structured interviews and document analysis, involving an interview schedule and a checklist. All respondents were diagnosed hypertension patients registered at either of the two public health centres on the Island of Praslin. Individual perception of the benefits and risks of hypertension treatment as well as cues to action were found to be significant determinants of compliance behaviour. The study highlighted the need for improved health education and follow-up measures to strengthen patients’ perceptions about the benefits of treatment and compliance. / Public Health / M.A. (Public Health)