Explore the vast range of titles available.

Loneliness is a common, emotionally distressing experience and is associated with adverse physical and mental health and an unhealthy lifestyle. Nevertheless, little is known about the prevalence of loneliness in different age groups in Switzerland. Furthermore, the existing evidence about age and gender as potential effect modifiers of the associations between loneliness, physical and mental health and lifestyle characteristics warrants further investigation. Thus, the aim of the study was to examine the prevalence of loneliness among adults in Switzerland and to assess the associations of loneliness with several physical and mental health and behavioral factors, as well as to assess the modifying effect of sex and age. Data from 20,007 participants of the cross-sectional population-based Swiss Health Survey 2012 (SHS) were analyzed. Logistic regression analyses were used to assess associations of loneliness with physical and mental health or lifestyle characteristics (e.g. diabetes, depression, physical activity). Wald tests were used to test for interactions. Loneliness was distributed in a slight U-shaped form from 15 to 75+ year olds, with 64.1% of participants who had never felt lonely. Lonely individuals were more often affected by physical and mental health problems, such as self-reported chronic diseases (Odds ratio [OR] 1.41, 95% confidence interval [CI] 1.30-1.54), high cholesterol levels (OR 1.31, 95% CI 1.18-1.45), diabetes (OR 1.40, 95% CI 1.16-1.67), moderate and high psychological distress (OR 3.74, 95% CI 3.37-4.16), depression (OR 2.78, 95% CI 2.22-3.48) and impaired self-perceived health (OR 1.94, 95% CI 1.74-2.16). Loneliness was significantly associated with most lifestyle factors (e.g. smoking; OR 1.13, 95% 1.05-1.23). Age, but not sex, moderated loneliness' association with several variables. Loneliness is associated with poorer physical and mental health and unhealthy lifestyle, modified by age, but not by sex. Our findings illustrate the importance of considering loneliness for physical and mental health and lifestyle factors, not only in older and younger, but also in middle-aged adults. Longitudinal studies are needed in Switzerland to elucidate the causal relationships of these associations.

Smoking and obesity are major causes of non-communicable diseases. We investigated the associations of heavy smoking, obesity, and underweight with general lifestyle to infer which of these risk groups has the most unfavourable lifestyle. We used data from the population-based cross-sectional Swiss Health Survey (5 rounds 1992-2012), comprising 85,575 individuals aged≥18 years. Height, weight, smoking, diet, alcohol intake and physical activity were self-reported. Multinomial logistic regression was performed to analyse differences in lifestyle between the combinations of body mass index (BMI) category and smoking status. Compared to normal-weight never smokers (reference), individuals who were normal-weight, obese, or underweight and smoked heavily at the same time had a poorer general lifestyle. The lifestyle of obese and underweight never smokers differed less from reference. Regardless of BMI category, in heavy smoking men and women the fruit and vegetable consumption was lower (e.g. obese heavy smoking men: relative risk ratio (RRR) 1.69 [95% confidence interval 1.30;2.21]) and high alcohol intake was more common (e.g. normal-weight heavy smoking women 5.51 [3.71;8.20]). In both sexes, physical inactivity was observed more often in heavy smokers and obese or underweight (e.g. underweight never smoking 1.29 [1.08;1.54] and heavy smoking women 2.02 [1.33;3.08]). A decrease of smoking prevalence was observed over time in normal-weight, but not in obese individuals. Unhealthy general lifestyle was associated with both heavy smoking and BMI extremes, but we observed a stronger association for heavy smoking. Future smoking prevention measures should pay attention to improvement of general lifestyle and co-occurrence with obesity and underweight.

At present, only three risk factors for prostate cancer have been firmly established; these are all nonmodifiable: age, race, and a positive family history of prostate cancer. However, numerous modifiable factors have also been implicated in the development of prostate cancer. In the current review, we summarize the epidemiologic data for age, location, and selected behavioral factors in relation to the onset of prostate cancer. Although the available data are not entirely consistent, possible preventative behavioral factors include increased physical activity, intakes of tomatoes, cruciferous vegetables, and soy. Factors that may enhance prostate cancer risk include frequent consumption of dairy products and, possibly, meat. By comparison, alcohol probably exerts no important influence on prostate cancer development. Similarly, dietary supplements are unlikely to protect against the onset of prostate cancer in healthy men. Several factors, such as smoking and obesity, show a weak association with prostate cancer incidence but a positive relation with prostate cancer mortality. Other factors, such as fish intake, also appear to be unassociated with incident prostate cancer but show an inverse relation with fatal prostate cancer. Such heterogeneity in the relationship between behavioral factors and nonadvanced, advanced, or fatal prostate cancers helps shed light on the carcinogenetic process because it discerns the impact of exposure on early and late stages of prostate cancer development. Inconsistent associations between behavioral factors and prostate cancer risk seen in previous studies may in part be due to uncontrolled detection bias because of current widespread use of prostate-specific antigen testing for prostate cancer, and the possibility that certain behavioral factors are systematically related to the likelihood of undergoing screening examinations. In addition, several genes may modify the study results, but data concerning specific gene-environment interactions are currently sparse. Despite large improvements in our understanding of prostate cancer risk factors in the past two decades, present knowledge does not allow definitive recommendations for specific preventative behavioral interventions.

Individual lifestyle behaviors have been associated with prolonged survival in cancer survivors, but little information is available on the association between combined lifestyle behaviors and mortality in this population. Data from 522 cancer survivors participating in the Third National Health and Nutrition Examination Survey (NHANES III) were analyzed. Behaviors pertaining to lifetime healthy body weight maintenance, physical activity, smoking, diet quality (assessed by the Healthy Eating Index) and moderate alcohol consumption were combined in a lifestyle score (range 0-5). Cox proportional hazards regression models were used to calculate multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI). Both in continuous and categorical models, the lifestyle score was statistically significantly associated with lower mortality in the total study population (HRcontinuous = 0.81, 95% CI: 072, 0.90, per 1 unit increase; HR1-2 vs. 0 total = 0.71, 95% CI: 0.56, 0.92; HR3-5 vs. 0 total = 0.57, 95% CI: 0.38, 0.85, in the fully adjusted model) and in sex-specific analyses. Cancer survivors with high or moderate lifestyle score had lower risk of premature death compared to survivors with zero lifestyle score. Future studies are required in order to verify our findings and to investigate underlying mechanisms of the mortality-adherence association.

Background Little is known about the association of dissatisfaction with body weight - a component of body image - with depression in individuals of different sex, age, and with different body mass index (BMI). Hence, the aim of our study was to evaluate the association of body weight dissatisfaction (BWD) with depression in different sub-groups. Methods We analyzed data of 15,975 individuals from the cross-sectional 2012 Swiss Health Survey. Participants were asked about their body weight satisfaction. The validated Patient Health Questionnaire (PHQ-9) was used to ascertain depression. Age was stratified into three groups (18–29, 30–59, and ≥60 years). The body mass index (BMI) was calculated from self-reported body height and weight and categorized into underweight (BMI <18.5 kg/m 2 ), normal weight (BMI 18.5–24.9 kg/m 2 ), overweight (BMI 25.0–29.9 kg/m 2 ), and obesity (BMI ≥30 kg/m 2 ). The association between body weight dissatisfaction (BWD) and depression was assessed with logistic regression analyses and odds ratios (OR) with 95 % confidence intervals (CI) were computed. Results BWD was associated with depression in the overall group (OR 2.04, 95 % CI 1.66–2.50) as well as in men (OR 1.85, 95 % CI 1.34–2.56) and women (OR 2.25, 95 % CI 1.71–2.96) independent of BMI. The stratification by age groups showed significant associations of BWD with depression in young (OR 1.78, 95 % CI 1.16–2.74), middle-aged (OR 2.10, 95 % CI 1.61–2.74) and old individuals (OR 2.34, 95 % CI 1.30–4.23) independent of BMI. Stratification by BMI categories resulted in statistically significant positive associations of BWD and depression in underweight, normal weight, overweight and obese individuals. Conclusion BWD was associated with depression independent of BMI, sex and age.

Background/Objectives: More than half of Swiss adults exceed the World Health Organization’s recommended limit for free sugar intake, with sugar-sweetened beverage (SSB) as a major contributor. SSB intake may be associated with other dietary risk factors, but little is known about diet quality excluding SSB intake. Therefore, the objective of this study was to investigate the association of SSB intake with the non-SSB diet quality in Swiss adults. Methods: Data from the cross-sectional, national nutrition survey menuCH (2014–2015, n = 2057, 18–75 years) were analyzed. Dietary intake was assessed via two 24 h dietary recalls. Participants were categorized as non-, low-, or high-SSB consumers based on the Swiss dietary guideline for free sugar intake. Diet quality excluding SSB was evaluated using the Alternative Healthy Eating Index (AHEI) scoring system (non-SSB AHEI). Results: Non-SSB consumers had higher non-SSB AHEI scores compared to low-SSB consumers, indicating healthier food choices beyond SSB intake, while high-SSB consumers had substantially poorer non-SSB diet quality. Despite these differences, non-SSB AHEI scores were only moderate across all SSB consumer types, suggesting that reducing SSB alone may not suffice to achieve optimal diet quality. Conclusions: In addition to population-based strategies to reduce SSB intake, future policies should aim to improve overall diet quality, including higher consumption of vegetables, fruits, whole grains and unsaturated fats. Prospective studies are needed to clarify which alternative food choices individuals make when reducing SSB intake.

Purpose of ReviewThis systematic review aimed to determine the effects of interdisciplinary/multidisciplinary outpatient rehabilitation programmes by looking at physical, psychosocial and return to work status of adult cancer patients.Recent FindingsThere is growing evidence that emphasizes the importance of interdisciplinary/multidisciplinary rehabilitation especially in outpatient care, which addresses the complex and individual needs of cancer patients. Many studies focus on measuring the effect of individual rehabilitation interventions.SummaryRandomized controlled trials (RCTs) and before-after studies examining the effects of interdisciplinary/multidisciplinary outpatient rehabilitation programmes were included in this systematic review. The electronic literature search was conducted in MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials and PEDro. The PICO statement was used for selection of the studies. Six randomized controlled trials and six before-after studies were included. Interdisciplinary/multidisciplinary outpatient cancer rehabilitation programmes improved physical and/or psychosocial status of cancer patients. However, non-significant changes in a variety of single physical and psychosocial measures were also common.The findings of the systematic review indicate that interdisciplinary/multidisciplinary outpatient cancer rehabilitation can improve cancer patients’ physical and psychosocial status. This review is limited by the narrative approach due to the heterogeneity of outcome measures. To evaluate effects of rehabilitation, better comparable studies are necessary. Further research is needed in regard to long-term outcomes, effects on return to work status and on the associations depending on cancer type.

Purpose Swiss healthcare institutions conducted only urgent procedures during the COVID-19 lockdown, potentially leading to a lack of care for other severe diseases, such as cancer. We examined the effects of the pandemic on cancer stage distribution and time between cancer diagnosis and treatment initiation using population-based cancer registry data. Methods The study was based on data of the cancer registry of the cantons of Zurich and Zug from 2018 to 2021. Cancer stage distribution was analysed descriptively and with a Pearson’s Chi-squared test. Time between cancer diagnosis and treatment initiation was determined in days and analysed descriptively and by fitting Quasipoisson regression models. Results For all-cancer and colorectal, lung, and prostate cancer statistically significant evidence for a difference in cancer stages distribution among the incidence years was observed. Based on the all-cancer regression models, longer time to treatment initiation (TTI) was observed for patients diagnosed in 2021 and receiving surgery (Rate Ratio = 1.08 [95% confidence interval 1.03, 1.14]) or hormone therapy (1.20 [1.03, 1.40]) compared to those diagnosed in 2018/19 receiving those therapies. We observed no difference in TTI between cancer patients diagnosed in 2020 compared to 2018/19 for any of the therapies investigated, except for chemotherapy with shorter TTI (0.92 [0.86, 0.98]). Conclusion The observed effects on cancer outcomes in 2020 and 2021 compared to 2018/19 coincided with the beginning of the COVID-19 pandemic in Switzerland in 2020 onwards. Short- and long-term effects of the pandemic on cancer outcomes and the public healthcare system were observed. However, we cannot exclude that the implementation of the new Swiss law on cancer registration in 2020 explains part of our observations.

Obesity, underweight, and smoking are associated with an increased mortality. We investigated the joint effects of body mass index and smoking on all-cause and cause-specific mortality. Data of the Third National Health and Nutrition Examination Survey (1988–1994) including mortality follow-up until 2011 were used (n = 17,483). Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause, cardiovascular disease (CVD), and cancer mortality with BMI, smoking, and their combinations as exposure, stratified by sex. Normal weight never smokers were considered as reference group. Compared to normal weight never smokers, obese and underweight current smokers were the two combinations with the highest mortality from all-causes, CVD, and cancer. Among underweight current smokers, the HR of death from all-causes was 3.49 (95% CI 2.42–5.02) and for obese current smokers 2.76 (2.12–3.58). All-cause mortality was particularly high in women who were underweight and current smoker (3.88 [2.47–6.09]). CVD mortality risk was the highest among obese current smokers (3.33 [2.98–5.33]). Cancer mortality risk was the highest among underweight current smokers (5.28 [2.68–10.38]). Obese current smokers in the middle age group (between 40 and 59 years old) had the highest risk of all-cause mortality (4.48 [2.94–7.97]). No statistically significant interaction between BMI and smoking on all-cause and cause-specific mortality was found. The current study indicates that obesity and underweight in combination with smoking may emerge as a serious public health problem. Hence, public health messages should stress the increased mortality risk for smokers who are underweight or obese. Also, health messages regarding healthy lifestyle are aimed at maintaining a healthy body weight rather than just “losing weight” and at not starting smoking at all.

Background More people than ever before are currently living with a diagnosis of cancer and the number of people concerned is likely to continue to rise. Cancer survivors are at risk of developing a second primary cancer (SPC). This study aims to investigate the risk of SPC in Switzerland. Methods The study cohort included all patients with a first primary cancer recorded in 9 Swiss population-based cancer registries 1981–2009 who had a minimum survival of 6 months, and a potential follow-up until the end of 2014. We calculated standardized incidence ratios (SIR) to estimate relative risks (RR) of SPC in cancer survivors compared with the cancer risk of the general population. SIR were stratified by type of first cancer, sex, age and period of first diagnosis, survival period and site of SPC. Results A total of 33,793 SPC were observed in 310,113 cancer patients. Both male (SIR 1.18, 95%CI 1.16–1.19) and female (SIR 1.20, 95%CI 1.18–1.22) cancer survivors had an elevated risk of developing a SPC. Risk estimates varied substantially according to type of first cancer and were highest in patients initially diagnosed with cancer of the oral cavity and pharynx, Hodgkin lymphoma, laryngeal, oesophageal, or lung cancer. Age-stratified analyses revealed a tendency towards higher RR in patients first diagnosed at younger ages. Stratified by survival period, risk estimates showed a rising trend with increasing time from the initial diagnosis. We observed strong associations between particular types of first and SPC, i.e. cancer types sharing common risk factors such as smoking or alcohol consumption (e.g. repeated cancer of the oral cavity and pharynx (SIR males 20.12, 95%CI 17.91–22.33; SIR females 37.87, 95%CI 30.27–45.48). Conclusion Swiss cancer survivors have an increased risk of developing a SPC compared to the general population, particularly patients first diagnosed before age 50 and those surviving more than 10 years. Cancer patients should remain under continued surveillance not only for recurrent cancers but also for new cancers. Some first and SPCs share lifestyle associated risk factors making it important to promote healthier lifestyles in both the general population and cancer survivors.