Introduction: Major depressive disorder (MDD), generalized anxiety disorder (GAD), and bipolar disorder (BD) are mental illnesses associated with socio-cognitive functional impairments, reduced quality of life, and increased risk of medical and psychiatric comorbidities. These disorders are also associated with unhealthy patterns in several fundamental lifestyle areas according to the current notions of lifestyle psychiatry, such as diet, physical activity, substance use, sleep, stress management, and social relationships. With the rising prevalence rates of poor mental well-being following the onset of the COVID-19 pandemic, it is essential to understand the relationship between a multifactorial lifestyle and the presence of psychiatric symptoms. Thus, the aim of this thesis was to assess the association between a multidimensional lifestyle and symptoms of MDD and GAD during the COVID-19 pandemic, and lifestyle patterns among symptomatic individuals with BD. We additionally reviewed the literature on lifestyle interventions for improvement of outcomes related to BD. Results: Unhealthy lifestyle behaviours were associated with symptoms of MDD and GAD during the COVID-19 pandemic in Spain, Brazil, and Canada. Machine learning analyses revealed strong predictive power for detecting the presence of these symptoms through lifestyle behaviours and perceptions. Individuals with BD engage in more unhealthy lifestyles than healthy individuals across all the core areas of lifestyle psychiatry, regardless of the polarity of the mood episode. Furthermore, to date, traditional lifestyle domains such as diet, physical activity, and sleep have been the most frequently targeted domains for interventions to improve mood symptoms and functional outcomes of BD, while domains such as substance use, stress management and social relationships have been more neglected. In addition, multidimensional lifestyle interventions have demonstrated a higher efficacy rate of improving outcomes of BD than single-domain interventions, however, there has been a lack of interventions for BD targeting majority of the core lifestyle domains. Conclusion: The findings suggest that multidimensional unhealthy lifestyles are associated with symptoms of MDD, GAD, and BD. These results support the current notions of lifestyle psychiatry, indicating that a multidimensional assessment of lifestyle behaviours and perceptions can be a beneficial approach towards understanding the cumulative impact of various lifestyle patterns on psychiatric symptoms. This work highlights the importance of imposing a holistic approach towards studying the association between lifestyle factors and psychiatric disorders in order to implement effective, personalized preventive and treatment strategies for mental health disorders. / Thesis / Doctor of Philosophy (PhD) / People experiencing symptoms of psychiatric disorders may also engage in more unhealthy routines and behaviours in everyday life. Lifestyle is a construct characterized by behaviours and perceptions in multiple areas of life which are fundamental for the overall well-being of a person. The aim of this thesis was to investigate the relationship between multidimensional lifestyle characteristics and symptoms of depression, anxiety, and bipolar disorder (BD). We examined the association between multidimensional lifestyle and symptoms of depression and anxiety in the general populations of Spain, Brazil, and Canada during the COVID-19 pandemic. We also assessed the relationship between unhealthy behaviours and symptomatic individuals with BD in comparison to healthy individuals, and the importance of lifestyle interventions for improvement of outcomes related to BD. The findings indicated an association between multidimensional unhealthy lifestyles and symptoms of depression and anxiety during COVID-19. Unhealthy lifestyles across all domains were also seen in people with BD currently experiencing a mood episode, while lifestyle interventions for BD have shown promising results so far. A multidimensional approach to evaluating quality of lifestyle can be beneficial for developing preventive and treatment lifestyle strategies for common psychiatric disorders.

Globally, the prevalence of diabetes has seen a significant increase, rising from 211 million in 1990 (3.96% of the global population at that time) to 476 million in 2017 (6.31% of the global population in 2017). Extensive research has been conducted to study the causes of diabetes from a data-driven approach, leading to the development of prospective models for predicting future diabetes risks. These studies have highlighted the strong correlation between diabetes and various biomarker factors, such as BMI, age, and certain blood test measures. However, there is a lack of research that focuses on building prospective models to predict future diabetes risks based on lifestyle factors. Therefore, this thesis aims to employ popular machine learning methods to investigate whether it is possible to predict future diabetes using prospective models that incorporate self-controllable lifestyle factors. Our analysis produced remarkable results, with the biomarker model achieving an average validation AUC score of 0.78, while the lifestyle model reached 0.70. Notably, lifestyle features demonstrate a greater predictive capacity for short-term new-onset diabetes when compared to the long-term endpoint. The biomarker model identified visceral fat as the most significant risk factor, whereas income level and employment emerged as the top risk factors in the lifestyle model. This thesis represents an innovative approach to diabetes prediction by leveraging lifestyle factors, providing valuable data-driven insights into the root causes of diabetes. It addresses a critical research gap by highlighting the significant role of lifestyle factors in predicting the future onset of diabetes, particularly within the context of parametric modeling. / Thesis / Master of Science (MSc)

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Background: Obesity is a multifactorial disease caused by the interplay of environmental and genetic risk factors. With the prevalence of obesity more than doubling since 1980, this disease has become a global epidemic. The objectives of this research were to (1) review the current evidence of gene-environment interactions (GEI) in the field of obesity, (2) investigate novel GEI involving sedentary behaviour, sleep duration and alcohol consumption, (3) assess GEI using a cumulative environmental risk score, and (4) provide an overview of methodological weaknesses in GEI studies and provide suggestions for future directions. Methods: The data for the gene-environment interaction analyses were collected from the EpiDREAM study: a cohort study including participants of six ethnic backgrounds from 17 countries worldwide. A subset of 17 423 participants with complete genotype and phenotype information was included in the analysis. Twenty-three obesity predisposing single nucleotide polymorphisms (SNPs) were analyzed independently and as a genetic risk score (GRS). Linear regression models were used to analyze these interactions. Results: Heritability, monogenic and polygenic obesity studies provide converging evidence that obesity-predisposing genes interact with a variety of environmental exposures including physical activity and diet patterns. In the EpiDREAM cohort, we found that increased sedentary time did not interact with obesity predisposing SNPs or the GRS to modulate BMI. The interaction between sedentary time and physical activity was also not significant. We observed a U-shaped association between sleep duration and BMI and sleep duration did not appear to moderate the impact of the obesity predisposing SNPs or the GRS. However, we did observe an alcohol x FTO rs1421085 interaction, whereby increased alcohol consumption attenuated the impact of FTO rs1421085 variation on BMI. We also found that the combined effect of several environmental risk factors significantly modified the effect of FTO rs3751812 on BMI. Specifically, we found that the effect of the FTO rs3751812 SNP on BMI was over two times greater among those in the highest quartile of environmental risk compared to those in the lowest quartile. The GRS did not interact with any of the exposures tested. Discussion: Our results indicate that sedentary behaviour did not moderate the impact of obesity predisposing genes, while alcohol consumption decreased the impact of variation in FTO rs3751812 on BMI. We also observed that variation in FTO rs3751812 interacted with a cumulative environmental risk score to moderate BMI. The growing body of GEI evidence has provided a deeper understanding of obesity aetiology and may have tremendous applications in the emerging field of personalized medicine and individualized lifestyle recommendations. Although the number of gene-environment interaction analyses has increased rapidly across multiple disciplines, addressing methodological concerns such as statistical modeling, confounding, biological assumptions and measurement precision will be necessary to fully exploit the potential of the GEI field. With the development of new methodological and measurement techniques such as hypothesis-free genome wide interaction studies and deep phenotyping, it may be possible to translate the information from GEI studies into public health policy and personalized medicine for obesity and other complex human diseases. / Thesis / Doctor of Philosophy (PhD)

1 Abstract: Title: The importance of primary and secondary prevention of cardiovascular disease Goals: Develop a theoretical basis for the selected topic. Describe the basic principles of primary and secondary prevention, and thus prepare the groundwork for creating questionnaires. Questionnaire compiled to complement the information obtained from the literature on insight into the practice. Confirm or refute the hypotheses chosen on the basis of a questionnaire. Discuss the most frequently occurring phenomena and compare them with the latest reported information. Draw conclusions and recommendations. Method: For the theoretical treatment of the retrieval method was used. I compared the information and inclined to the best proven. The theoretical part resulted in the goals and tasks of work. For the practical part was conducted by questionnaire survey, which has additional information on the issue of primary and secondary prevention. In the end I obtained data compared with information obtained from studying literature. Results: Lack of information on primary and secondary prevention is mainly for young people aged 10-15 years. This trend is accompanied by the deteriorating health situation and the occasional occurrence of the "diseases of civilization", which can produce complications in adulthood....

Introdução: Recentes estudos apontam inatividade física e comportamento sedentário como dois fatores de risco distintos para desfechos em saúde. Avaliar fatores associados a este comportamento numa população é importante na identificação dos segmentos mais vulneráveis. Objetivo: Identificar a prevalência e características associadas a exposição à CS em adultos. Métodos: Estudo transversal, envolvendo 2.512 participantes do Inquérito de Saúde no município de São Paulo (ISA-Capital) 2015, com idade entre 20 e 65 anos. Variáveis socioeconômicas, ambientais e de condições de saúde foram consideradas neste estudo. Utilizou-se o Questionário Internacional de Atividade Física, (IPAQ) para coletar dados referentes à variável dependente que foram inicialmente analisados na sua forma contínua. Estimou-se a prevalência de CS dicotomizando-se o tempo sentado total pela mediana. Resultado: A mediana de tempo sentado total para amostra foi de 180 min/dia. As variáveis que após ajuste permaneceram associadas com exposição a CS foram: escolaridade (RP=1,41; IC95% 1,35-1,48); estado conjugal (RP= 1,05; IC95% 1,02-1,08); segurança no bairro ( RP= 0,96; IC95% 0,93-0,99); faixa etária ( RP=0,91; IC95% 0,87-0,95); renda ( RP=1,07 ; IC95% 1,00-1,15); auto percepção de saúde (RP= 1,03 IC 95% 1,01-1,07) e sexo masculino (RP=0,96; IC95% 0,94-0,99) Conclusão: Indivíduos mais jovens, homens, com maior escolaridade, maior renda, que residem em bairros considerados seguros, não casados e que tem auto percepção negativa de sua saúde, estão entre os mais vulneráveis a CS nesta população. Considerando o emergente desafio de lidar com o comportamento sedentário como um fator de risco diferente e independente da prática de atividade física ressalta-se a importância de investimentos voltados não apenas para o aumento do nível de AF, como também para a redução do tempo sentado / Introduction: Recent studies have pointed to physical inactivity and sedentary behavior (SB) as two separate risk factors for health outcomes. Evaluating factors associated with this behavior in a population is important to help identify the most vulnerable sub-groups. Objective: To identify the prevalence and characteristics associated with exposure to SB in adults. Methods: This was a cross-sectional study that involved 2,512 participants aged between 20 and 65 from the municipality of Sao Paulo Health Survey (ISA-Capital) 2015. Socioeconomic, environmental and health conditions variables were considered in this study. The International Physical Activity Questionnaire (IPAQ) was used to collect data relating to the dependent variable that were firstly analyzed in their continuous form. The prevalence of SB was estimated by splitting the total sitting time (TST), as being above the median. Result: The median of total sitting time in the sample was 180 minutes per day. The variables that remained associated with exposure to SB after adjustment were: scholarity (PR=1.41; IC95% 1.35-1.48); marital status (PR= 1.05; CI95% 1.02-1.08); security in the neighborhood (PR= 0.96; CI95% 0.93-0.99); age (PR=0.91; IC95% 0.87-0.95); income (PR=1.07 ; CI95% 1.00-1.15); self-perception of health (PR= 1.03 CI 95% 1.01-1.07) and gender (PR=0.96; CI95% 0.94-0.99). Conclusion: Individuals who were younger, men, with higher scholarity, higher income, residents in neighborhoods that are considered to be safe, not married and who have a negative self-perception of health are among the most vulnerable to SB in this population. Dealing with sedentary behavior as a risk factor independent of physical activity is considered to be an emergent challenge. As such it is important that investments are made not only in increasing physical activity but also in reducing sitting time

This study sought for the importance and influence of visual text in Lifestyle magazines. The aim was to see the importance of visual text for middle-aged women as well as for the magazines. It also aimed to understand how the reading of these magazines can affect women´s daily life. In the search for these six lifestyle magazines; three Swedish, two Finnish and one Danish, were analysed. There were further six interviews conducted were the Swedish magazines also were shown. What is found is the similarities the magazines pose even though being from different countries. There are some patterns in the visuality that consists. What seemed to be most differently between the magazines was the depiction of women. In the Swedish magazines all women were smiling but for men it seemed optional. The Danish magazine followed this pattern to some extent while the Finnish magazines had full segments of women without even a trace of smile. The six women interviewed all had their reasons for reading lifestyle magazines. Mostly it was to pass time when needed. Although, when reading for fun there had to be some sort of interest in the text or subject to be read. Most important though was that there had to exist recognizability. The women wanted to relate and recognize themselves in the text. This way a meaning was ascribed to the reading. Furthermore, most of them did not reflect on how women were depicted. Still though, when asked all women could give an opinion on how the women in the magazines looked. What was interesting then was that they gave the same description only with different words.

Syfte: Att undersöka hur läkare och sjuksköterskor arbetar med livsstilsfrågor och livsstilsfor-muläret vid lasarettet i Enköping. Dessutom undersöka vad personalen har för åsikt omlivsstilsformuläret samt om de behöver mer kunskap om livsstilsfrågorna och motiverandesamtal. Metod: En enkät skickades ut till 79 sjuksköterskor och läkare, svarsfrekvens 52 %.Huvudresultat: Alla deltagare tyckte att det var mycket viktigt eller ganska viktigt att frågapatienter om livsstilsfrågor och de områden man frågade mest om var tobak och alkohol.Bland svaren framkom det att de flesta samtalade med en patient som hade ett riskbeteende.De områden deltagarna ville ha mest kunskap i var motiverande samtal och stress. Positivaåsikter som framkom om livsstilsformuläret var att personalen fick en bra överblick av patien-tens levnadsvanor och hade ett bra underlag att samtala om vid mötet med patienten. De nega-tiva aspekterna som framkom var formulärets utformning och svarsalternativ som ansågs varaför komplicerat. Slutsats: Det hälsofrämjande arbetet anses viktigt och det behövs kontin-uerlig utbildning till personalen för att kunna arbeta med dessa frågor med patienterna. Detbehövs även klarare riktlinjer i uppföljningen av patienter med riskbeteende. Livsstilsfor-muläret är ett bra verktyg men det behöver förbättras. / Aim: To study how physicians and nurses work with health promotion at the hospital inEnköping, Sweden. And investigate the staffs’ opinion about the lifestyle questionnaire and ifthey need more education in health promotion or motivational interviewing. Method: Aninquiry was sent to 79 nurses and doctors, with a response rate of 52 %. Primary results:Everyone thought it was important or very important to ask about lifestyle questions werealcohol and tobacco was the most frequently asked questions. Among the answers most ofthem had a conversation with patients who had a risk behavior. The subjects that the staffwanted more knowledge of was motivational interviewing and stress. The positive aspects ofthe questionnaire were that the employees got an overview of the patient ́s health and couldhave a conversation around it. The negative aspect of the questionnaire was the formattingand the complicated answers to choose from. Conclusion: The work with health promotion isimportant and the employees need a continuously updated education to work in a professionalway with the patients. There is also a need to have stricter routines to evaluate the patientswith a risk behavior. The questionnaire is a good tool to work with but it needs improvement.Keywords: Health promoting hospitals (HPH), employees, lifestyle questions, questionnaireof lifestyle.

Actuality. Lifestyle of people depends on many social, economical and cultural factors (Grabauskas and other, 2004). According World Health Organization, main reason of 70% of early, or possible to avoid, deaths of grown-ups is wrong behavior since teenage, for example, smoking, usage of drugs or alcohol, unsafe sexual behavior and unhealthy nourishment (Žekas, Zaborskis, Goštautas and other, 2005). That’s why society health and lifestyle research, especially of children and youth, is an actual problem, because only knowing their attitude to their health and attitude to lifestyle, it is possible to correct this process. Research of students’ lifestyle is important preparing health strengthening and health teaching programs. Our research object was lifestyle of students of upper grades. Aim of research – determine subjective attitude towards their lifestyle of upper grade students. Tasks: 1. Determine subjective attitude of 11-12 grade boys and girls towards their personal health habits. 2. Determine subjective attitude of 11-12 grade boys and girls towards health keeping activity, influenced by family and school. 3. Determine health risk factors of 11-12 grade boys and girls. 4. Determine lifestyle differences according sex of upper grade students. After comparing subjective attitude towards their personal health habits of boys and girls, we have determined, that boys are more physically active and exercises more often than girls (p<0,05), but girls care more about... [to full text]

It has often been claimed that contemporary societies are shaped by globalization; the rapid interconnections of societies, economies, markets, flows and information potentially linking all places in the world to each other. In search for experiences, variation, escape or comfort, individuals are travelling, circulating, and migrating between places, challenging the notions of ‘home’ and ‘away’, ‘everyday’ and ‘extraordinary’. This thesis addresses the ways lifestyle-led mobilities are produced and performed, by studying the mobility trajectories and experiences of Swedes dividing their time seasonally between Sweden and Malta. It explores how movers are faced with a structural framework that both facilitates and directs their choices concerning mobility, and how they interpret and respond to these structures. It also explores the imaginaries, meanings, and feelings for place, identity, and lifestyle that the movers negotiate through their mobility practices and through the links they create and sustain in places. Thus, this thesis is situated in an evolving field of research on lifestyle mobilities. Lifestyle mobilities are here defined as those mobility practices undertaken by individuals based on their freedom of choice, of a temporal or more permanent duration, with or without any significant ‘home base(s)’, that are primarily driven by aspirations to increase ‘quality of life’, and that are primarily related to the individuals’ lifestyle values. The thesis is based on four individual papers exploring different aspects lifestyle mobility. The aim is to understand how production and performance aspects of lifestyle mobilities are related, and how notions of identity and belonging are negotiated in relation to lifestyle mobility practices. The production aspect relates to those structures and frameworks that create, facilitate, or sometimes delimit opportunities for lifestyle mobility while the performance aspect focuses on individual agency and meaning of lifestyle mobility practices. The studies are based on in-depth interviews with Swedish movers in Malta, and focus on how structural frameworks and mediations influence the ways that movers manoeuvre, manipulate or adapt to structures and influences in order to arrange their life context to achieve ‘quality of life’. A second aim focuses on the ways that movers reflect upon their identities and belongings as they travel routinely between two (or more) significant places, and how this may influence mobility practices. It is concluded that structures and mediations are both facilitating and delimiting movers’ space of choice regarding mobility decisions. Through their agency, movers negotiate their space of choice by allocating resources and experience, accessing supportive networks and tailoring their access to entitlements. The production and performance aspects of lifestyle mobility practices are interlinked in complex ways.