The healthy lifestyle intervention reduced the risk of MetS in both genders in short and long term, but with different patterns and improved some of the MetS components.

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Background Following the global upward trend of cardiovascular diseases (CVD/CHD), much attention has been paid to lifestyle behaviors such as physical activity (PA). However, most of previous studies were conducted in developed countries and with just one measurement of physical activity. The aim of the current study is to assess the effect of changes in the PA on the incidence of CVD/CHD in middle-aged and older men and women in an Eastern-Mediterranean population, over a decade follow-up. Methods This study has been conducted within the framework of the Tehran Lipid and Glucose Study (TLGS) including 4073 (57% women) participants without CVD/CHD at baseline. The participants were followed up for an average period of 12 years. The Iranian version of Modified Activity Questionnaire (MAQ) was used to measure PA at baseline and at the closest follow-up to the outcome. Subsequently, participants were categorized as “compliers”, “non-compliers”, “adopters” and “relapsers”, based on their adherence to the PA guideline recommendations. All analysis has been conducted in two separate age groups including middle-aged and elderly in both men and women. The effect of PA patterns on incidence of CVD/CHD was investigated using Cox proportional hazard model. Variables including marital status, job status, education, smoking, and family history of CVD/CHD were adjusted in the models. Results Adherence to guideline recommendation increased from 63.5 to 66.6% between the two measurements. At the second measurement of PA, the percentages of compliers, non-compliers, adopters and relapsers were 48.4, 18.3, 18.2, and 15.1%, respectively. In fully adjusted models, HRs of CVD and CHD for men aged 40–60 years in the complier group were 0.58 (95% CI: 0.38–0.87, P = 0.008) and 0.58 (95% CI: 0.38–0.89, P = 0.01), respectively. HRs of CVD and CHD for men aged 40–60 years in adopter group were 0.61 (95% CI: 0.38–0.96, P = 0.03) and 0.60 (95% CI: 0.37–0.97, P = 0.04) respectively. The corresponding values were not significant in women. Conclusions Adhering to established PA recommendations have a protective effect on the incidence of CVD/CHD among middle-aged men; findings which need to be considered in reducing cardiovascular outcomes in this population.

Introduction Targeting adolescents’ smoking reduces its burden on health systems. We investigated the effects of the first multidisciplinary community-based lifestyle intervention in the Eastern-Mediterranean region, on smoking initiation, continuation and risk of current smoking in Iranian adolescents. Methods The current analyses were conducted on 945 non-smoker adolescents (12-18 years) who participated in Phase II of Tehran Lipid and Glucose Study (TLGS) and were examined four times in 12 years. The lifestyle intervention including school-based and public programs was implemented, focusing on all components of healthy lifestyle. Using two-step cluster analysis families were classified as high- and low-risk, based on parental risk factors of adolescents’ smoking. Participants who failed to complete all the follow-ups (n=99) and those with missing smoking data were excluded. Subsequently, 872 adolescents (538 control, 334 intervention) were included in the Cox model on smoking initiation and 674 adolescents (414 control, 260 intervention) were included in the logistic regression on smoking status. Results Mean age of adolescents was 15.08±1.94 years at baseline. The hazard of the smoking initiation was significantly lower in the intervention (HR=0.71, 95% CI: 0.51-0.99; P=0.044) compared to control group. At the end of the 4 th follow-up, intervention reduced the odds of current cigarette smoking by 29%. Within the intervention group, the high-risk cluster was at a 35% lower risk of initiating smoking and had 37% lower odds of becoming a current smoker. However, the intervention could not make a difference in preventing those who initiated smoking from maintaining it during the follow-ups. Conclusions Our results demonstrate that lifestyle modification programs targeting at-risk populations could reduce risk of smoking initiation and current smoking in adolescents in long-term. Implications Experiencing cigarette smoking at the critical period of adolescence could result in adulthood habitual smoking. Therefore, identifying adolescents who are more at risk of smoking initiation and implementing targeted interventions are of great importance in public health. Our findings highlight the long-term effectiveness of a multidisciplinary community-based behavioral intervention on forming smoking behaviors in adolescents. The current intervention was successful in reducing smoking uptake in adolescents living in high-risk families.