Relationships between modifiable lifestyle factors and indicators of cardiovascular risk

The global demographic, socio-economic and technological changes linked with lifestyle modifications are widely considered to be the underlying cause of the increased prevalence of CVD and other non-communicable disease worldwide. Understanding the role of the lifestyle factors in associations with these problems is important for treatment and prevention. The aims of the present thesis were: 1) To evaluate the associations between some lifestyle factors, body weight and shape, and CVD risk factors. 2) To determine the combination association between lifestyle factors and body weight and CVD risk factors. 3) To evaluate the effects of a smoking cessation program on energy balance. To achieve these aims a secondary analysis of Scottish Health Survey (SHS) 1998 and an observational study have been carried out. The relationships between smoking status and body size and shape have been examined using the SHS data from those aged 16-74 years. After adjustment for some confounding factors, BMI was lower in current smokers and higher in ex-smokers (p<0.001) when compared to non-smokers in the survey population as a whole. Smoking was associated with a lower BMI in the sample as a whole, but not for the youngest age group. Smoking cessation was associated with weight gain. Smoking and obesity were the two major risk factors, which showed the strongest associations with the CVD risk factors, and their combination exaggerated CVD risk factors. Achievement of currently recommended physical activity levels were associated with lower BMI and prevalence of obesity, and a smaller WC and WHR. However, approximately 50% of active subjects were overweight and obese. These levels of activity were associated with lower CVD risk factors, however the joint associations of physical activity and BMI showed that obese active people still had higher CVD risk factors than inactive people with BMI < 25 kg/m2. Smoking and inactivity were two major modifiable behaviours that showed the strongest associations with unhealthy dietary habits. Smoking cessation was associated with increased body weight and WC within weeks of cessation, particularly in females with NRT. Attrition rates were high and effective weight maintenance strategies may improve this