In a recent study published within the Journal of Activity, Sedentary and Sleep Behaviors, researchers investigated the prioritization of health behaviors amongst Australians. They used phone and online surveys to judge sleep, physical activity, and weight loss program prioritization patterns amongst 1,684 Australian adults between the ages of 18 and 72. Their findings revealed that 49% of all Australian adults prioritize weight loss program, however the shiftwork-only subset of participants prioritized sleep. Their analyses found associations between shiftwork experience (variety of years) and sleep prioritization, suggesting that occupation plays a fundamental role in health behavior resource allocation. Hence, this study highlights how occupation and capability modify the prioritization between these ‘three pillars of health.’
Study: Exploring the prioritisation of sleep, weight loss program, and physical activity as pillars of health: correlates and associations with health behaviours in Australian adults. Illustration created with the help of DALL·E 3
Modifiable health behaviors and the hazards of chronic diseases
Chronic or lifelong diseases are (predominantly) non-communicable diseases comparable to type 2 diabetes (T2D), cardiovascular diseases (CVDs), and cancers, which collectively form the leading mortality cause globally. Research has identified that the most effective deterrent against these conditions is modifiable health behaviors, of which weight loss program, sleep, and physical activity are crucial.
These three behaviors play such a profound role in stopping chronic diseases that scientists and clinicians have christened weight loss program, exercise, and sleep patterns because the “Three Pillars of Health.” These pillars have been hypothesized to be especially essential for populations and occupations (comparable to shift employees) with high poor health risks. Shift employees have work schedules significantly different from conventional work hours, leading to severe disruptions to circadian rhythms. These disruptions, in turn, are related to poor and inadequate sleep and will end in altered food intake patterns.
“Inadequate sleep, insufficient physical activity, and an unhealthy weight loss program are each independently related to an increased risk of chronic disease and subsequently independently contribute to a big burden on the healthcare system.”
Despite a growing body of literature on the advantages of excellent health behaviors, studies geared toward understanding behavior prioritization in adults remain lacking, with no studies having yet investigated the subject from the Australian context. The association between prioritization and behavioral outcomes similarly stays unexplored.
Concerning the study
In the current study, researchers aimed to elucidate the health behavior differences between general and shift employee cohorts and the way these prioritisations translate to actual behavioral outcomes. They further investigate the sociodemographic aspects that influence each behavioral prioritization and outcomes.
Data for this study was derived from two cross-sectional studies, each of which were guided by the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The primary study included 1,151 Australian adults aged 18-65 years (54% female). This ‘general’ cohort represented all sociodemographic and employment classes (including unemployed and retired) and was conducted using a phone interview.
The second study included 533 Australians between the ages of 18 and 72, all of whom were currently employed as shift employees. Data generation herein comprised a web-based questionnaire survey that measured respondents’ prioritization of sleep, weight loss program, and physical activity and the way these prioritisations influenced respondents’ actions. Outcomes were measured using previously established metrics of sleep duration, physical activity intensity and frequency, and dietary behaviors (healthy or unhealthy).
Statistical evaluation consisted of within-cohort multinomial logistic regressions to judge the associations between participants’ priority list and their behavioral correlates.
The current study revealed that Australians generally prioritize weight loss program as their most significant health behavior (49.3%), followed by sleep (29.2%) and physical activity (21.5%). Surprisingly, 62.3% of respondents presented body mass indexes (BMIs) within the overweight-obese category (BMI > 25kgm2). Encouragingly, 69.8% of respondents didn’t present sleep problem symptoms.
Substantial changes in health behavior were noted when moving from the final to the shift working cohort, with sleep prioritized by an awesome 67.7% of respondents. Compared, only 20.2% and 12.0% of respondents considered sleep and physical activity, respectively, as priorities. Demographic analyses revealed that sleep received the very best priority amongst shift employees no matter the precise shift employee occupation – Participants involved in retail trade, information media, and telecommunications regarded sleep as their most significant health behavior without exception.
Unfortunately, behavior prioritization didn’t translate adequately to health outcomes – 54.0% of respondents failed to satisfy the minimum really useful sleep frequency and duration guidelines. Interestingly, the duration of shiftwork experience was found to be positively related to sleep prioritization, with participants presenting 16 or more years of experience being almost 100% likely to think about sleep their first priority despite most not receiving adequate sleep.
The current study explores the final and shift employees’ prioritization of health behaviors in Australia and the way these priorities correspond to behavioral actions and health outcomes throughout the Australian context. Findings reveal that while most Australians consider weight loss program their first priority, shift employees as a substitute feel that sleep is crucial actionable health behavior among the many Three Pillars of Health.
Unfortunately, this study revealed that prioritization doesn’t translate to positive health outcomes – a lot of the general cohort that reported weight loss program prioritization were found to be chubby or obese. A lot of the shift employee respondents who reported sleep were found to be sleep-deprived.
Notably, each general and shift employee cohorts paid the least attention to physical activity, which could explain the high BMI of the previous cohort and be as a result of insufficient time within the latter.
“These findings suggest that behavior prioritization is just a part of the story of behavior change, and future research should give attention to comprehensive approaches to behavior change promotion that focus on the barriers to specific behaviors.”
- Gupta, C.C., Duncan, M.J., Ferguson, S.A. et al. Exploring the prioritisation of sleep, weight loss program, and physical activity as pillars of health: correlates and associations with health behaviours in Australian adults. JASSB 2, 26 (2023), DOI – https://doi.org/10.1186/s44167-023-00035-3, https://jassb.biomedcentral.com/articles/10.1186/s44167-023-00035-3