Niacin, lutein and zeaxanthin and physical activity have an impact on Charlson comorbidity index using zero-inflated negative binomial regression model: National Health and Nutrition Examination Survey 2013–2014

Abstract

Background: Combined with the increasing life expectancy, chronic medical conditions have gradually become the dominant cause of death and disability, and multimorbidity became an increasingly serious public health challenge. However, most existing studies have focused on the coexistence of specific diseases or relatively few diseases. Given one person may have multiple diseases at the same time, we applied Charlson Comorbidity Index (CCI) to systematically evaluate one's 10-year mortality. In this study, we explored the effects of nutrients and physical activity on CCI using National Health and Nutrition Examination Survey (NHANES) 2013-2014 data. Methods: The study sample consists of one continuous cycle (2013-2014) of NHANES, and 4386 subjects were included in the study. Nutrients intake was measured by dietary recall, and physical activity was evaluated by the Global Physical Activity Questionnaire respectively. Besides, CCI was the sum of the scores assigned for each medical condition. We utilized zero-inflated negative binomial (ZINB) model to investigate the effects in nutrients intake and physical activity on CCI by adjusting for seven sociodemographic characteristics, smoking and drinking. Results: Among the 4386 participants, 2018 (68.7%) are Non-Hispanic White, over half participants (78.6%) drink. In count part (CCI ≥ 0), holding other variables constant, the expected change in CCI for a one-unit increase in niacin is 1.621(RR = 1.621, p = 0.016), in lutein + zeaxanthin is 0.974 (RR = 0.974, p = 0.031), and in sedentary time is 1.035 (RR = 1.035, p = 0.005). Moreover, those who do not have vigorous work activity would be more likely to have higher CCI than those who have (RR = 1.275, P = 0.045). In logit part (CCI = 0), the log odds of having CCI equals zero would increase by 0.541 and 0.708 for every additional vigorous recreational activity (OR = 0.541, p = 0.004) and moderate recreational activity (OR = 0.708, p = 0.017) respectively. Conclusions: Lutein and zeaxanthin intake, vigorous work activity, vigorous recreational activity and moderate recreational activity may be good for one's health. Rather, increasing niacin intake and sedentary activity may be likely to raise 10-year mortality. Our findings may be significant for preventing diseases and improving health, furthermore, reducing people's financial burden on healthcare.

The association of work physical activity and recreational physical activity with periodontitis in the NHANES (2009–2014)

“…A large‐scale study concluded that nonrecreational PA might be related to reduced invasive breast cancer risk 62 . Similarly, another observational study supported the idea that both work and recreational activity were beneficial to overall health 63 . Notably, a reversed symmetrical effect of work and recreational activity was observed in a study concerning the risk of uterine artery notching 64 .…”

“…62 Similarly, another observational study supported the idea that both work and recreational activity were beneficial to overall health. 63 Notably, a reversed symmetrical effect of work and recreational activity was observed in a study concerning the risk of uterine artery notching. 64 Reports about the correlation of PA and periodontitis are comparatively scarce, not to mention the discrepancy of different PA types.…”

“…Contrary to the recreational ones, work activities serve as an aggravating factor in many diseases, including Barrett's esophagus, gastroesophageal reflux, and breast cancer 59–61 . Nevertheless, there are studies reporting the opposite conclusion 62–64 . A large‐scale study concluded that nonrecreational PA might be related to reduced invasive breast cancer risk 62 .…”

“…[59][60][61] Nevertheless, there are studies reporting the opposite conclusion. [62][63][64] A large-scale study concluded that nonrecreational PA might be related to reduced invasive breast cancer risk. 62 Similarly, another observational study supported the idea that both work and recreational activity were beneficial to overall health.…”