Chaves, Inês

Oster, Henrik

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Citation: Oster, H.; Chaves, I. Effectsof Healthy Lifestyles on ChronicDiseases: Diet, Sleep and Exercise.Nutrients 2023, 15, 4627. https://doi.org/10.3390/nu15214627Received: 13 October 2023Revised: 20 October 2023Accepted: 24 October 2023Published: 31 October 2023Copyright: © 2023 by the authors.Licensee MDPI, Basel, Switzerland.This article is an open access articledistributed under the terms andconditions of the Creative CommonsAttribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).nutrientsEditorialEffects of Healthy Lifestyles on Chronic Diseases: Diet,Sleep and ExerciseHenrik Oster 1,* and Inês Chaves 21 Institute of Neurobiology, Center for Brain, Behavior & Metabolism (CBBM), University of Luebeck,23562 Luebeck, Germany2 Department of Molecular Genetics, Erasmus MC Cancer Institute, Erasmus University MedicalCentre Rotterdam, 3015 GD Rotterdam, The Netherlands; i.chaves@erasmusmc.nl* Correspondence: henrik.oster@uni-luebeck.deAmong the many factors affecting general health and resilience to disease, lifestyleis at the same time the most controllable and the most influential factor [1–3]. Non-communicable diseases account for more than 60% of deaths worldwide. Consequently, thecontinuous rise in chronic disease cases is the most pressing challenge to global health [4].In most industrial countries, chronic disorders have become the main cause of poor health,disabilities, and premature death, consequently accounting for a dominant fraction ofexpenditures in the healthcare system [5]. The burden of chronic disease in Westerncountries such as the United States is rooted in three key factors: a high prevalence of riskylifestyles and behaviors [6,7], social and environmental conditions that have an adverseimpact on health state, and an increased life expectancy, which results in more older peoplesuffering from one or more chronic conditions [8].A healthy diet, moderate and regular exercise, and sufficient amounts of high-qualitysleep form the basis of a healthy lifestyle. Healthy diet choices and regular physicalexercise can dramatically delay or prevent the incidence of chronic diseases [9,10]. Sleep isanother important health-promoting factor that is still neglected in modern societies [11–13].People's average sleep times continue to decrease, while the prevalence of sleep disorders ison the rise [14]. Lasting adoption of healthy habits and behaviors can effectively prevent orcontrol chronic diseases. Time of day is an important—albeit too often disregarded—factorwhen studying the health effects of diet, sleep, and exercise. Taking timing into accountfor lifestyle interventions might lead to additional health benefits and at the same timeimprove compliance [15,16]. The studies in this Special Issue shed new light on behavioralrhythms and their effect on metabolic disorders and cancer.With disease progression, most cancer cells develop specific metabolic profiles, makingthem highly sensitive to changes in nutrient supplies and general metabolic state. Theseeffects have brought diet interventions to the attention of oncologists and cancer researchers.The risk of colorectal cancer (CRC), for example, is markedly influenced by dietary patternsand the composition of the gut microbiome. However, so far, the interaction betweenthese two factors has remained unclear. The study by Cai et al. (contribution 1) examinedthis relationship, hypothesizing that different types of dietary nutrient composition maydifferentially affect colorectal cancer risk in individuals, dependent on gut microbiomecomposition. This case–control study involving 410 Han Chinese individuals compared twodietary patterns and three gut microbiota enterotypes to classify 250 colorectal neoplasmcases. It found that a healthy diet based on vegetables, fruits, and dairy products lowersthe CRC risk in subjects with type-I (dominated by Bacteroides and Lachnoclostridium) andtype-II gut microbiota enterotypes, at an adjusted odds ratio of 0.66.Diet composition and microbiome regulation similarly affect specific metabolic dis-eases such as metabolic-associated steatotic liver disease (MASLD, formerly NAFLD),which is currently one of the most prevalent metabolic disorders worldwide. In turn,Nutrients 2023, 15, 4627. https://doi.org/10.3390/nu15214627 https://www.mdpi.com/journal/nutrientsNutrients 2023, 15, 4627 2 of 4lifestyle interventions remain the most effective treatment for MASLD and its sequelae suchas metabolic-associated steato-hepatitis (MASH) and liver cirrhosis to date. Bianco et al.(contribution 2) aimed at estimating the effect of a Mediterranean diet and exercise over aone-year period on the longitudinal trajectories of glucose metabolism in MASLD pa-tients. There was an early onset and steady decline of HbA1c levels in participantswith moderate and severe steatosis, while this effect became apparent only after ninemonths in patients with early-stage MASLD. Effects were persistent over a one-year period.Gu et al. (contribution 3), on the other hand, studied the association of 24-hour behavioralrhythms with MASLD in a cohort of 4502 overweight/obese adults. Comparing the lowestquintile to the highest, participants with higher activity amplitudes had a reduced riskof MASLD. Similarly, individuals in the highest quintile for fasting duration and feedingrhythm score had a decreased MASLD risk. These associations were more pronouncedamong individuals with obesity, underscoring the potential of behavioral interventions forMASLD therapy.Social jetlag (SJL) describes a discrepancy between sleep hours on week-/workdayscompared to weekends/free days [17]. SJL has been linked to decreased metabolic health.Nitta et al. (contribution 4) compared meal patterns in a group of Japanese participantsaged 20–59 years over one month using a food logging mobile app. In participants withan early (morning) chronotype and little SJL, a higher daily intake was seen for fibers,potassium, phosphorus, magnesium, and vitamin K. On the other hand, dinner energyand nutrient intake of carbohydrates, proteins, and total lipids, as well as sodium andsaturated fatty acids, were lower in this group. Utilization of app data may help to establishreferences for dietary intake and informed eating patterns over the 24-hour day.In many Asian countries, eating patterns have adapted to a “Westernized lifestyle”over the last decades, while at the same time, the prevalence of type 2 diabetes (T2DM) hasmarkedly increased. Yang et al. (contribution 5) investigated the hypothesis that healthyeating habits are associated with reduced T2DM risk in adults with sex-specific differences.Their data show that T2DM was more frequently observed in older men of lower educationstate with lower income. In addition, T2DM patients were more often married and lived inrural environments compared to non-T2DM subjects. Blood data showed that non-diabeticwomen had higher intake levels of vitamin C, calcium, fatty acids, retinol, and vitamin B2compared to T2DM subjects, while this effect was not seen in males. In women, but notin men, healthy eating scores were inversely associated with T2DM. These data suggestsex-specific effects of diet habits on T2DM development.A potent and increasingly recognized factor controlling appetite and food choice is sleep.Reduced sleep duration increases hunger, appetite, and food intake [18]. Gangitano et al.(contribution 6) summarize the current evidence on and mechanisms of this interaction,combining findings from animal models and human studies. They conclude that deci-phering the molecular regulatory pathways of sleep and its physiological outputs willhave a major impact on ameliorating metabolic health in vulnerable individuals. Viceversa, weight loss therapies have strong benefits for cardiometabolic health and the qualityof sleep.In a related study, Meyhöfer et al. (contribution 7) describe the impact of sleep phasetiming, as opposed to its duration, on the regulation of parameters of appetite and hunger.In a small-scale laboratory setup (n = 15), participants were tested for neuroendocrinefactors and appetite ratings after 4-hour sleep intervals during the early or late night. Bloodghrelin levels, hunger and appetite rates, and the drive for food consumption were elevatedafter sleep loss during the late but not the early part of the night. Leptin levels, on the otherhand, were not affected by sleep timing. These data emphasize the metabolic relevance ofcircadian sleep regulation.To summarize, behavioral interventions promote metabolic health through lifestylechanges, including diet improvements, increased physical activity, stress management,and sustainable behavioral changes [19]. These interventions help individuals maintain ahealthy metabolic state with high insulin sensitivity and low vulnerability for metabolicNutrients 2023, 15, 4627 3 of 4conditions like obesity and T2DM. This Special Issue highlights the role of timing in thiscontext. Discriminating parameters such as chronotype are assessed and strategies aredevised to implement chronomedical approaches in lifestyle therapies.Author Contributions: Conceptualization, I.C. and H.O.; writing—original draft preparation, H.O.;writing—review and editing, I.C. and H.O. All authors have read and agreed to the published versionof the manuscript.Funding: H.O. is funded by the German Research Foundation (DFG; OS353-10/1 and OS353-11/1).Conflicts of Interest: The authors declare no conflict of interest.List of Contributions:1. Cai, J.-A.; Zhang, Y.-Z.; Yu, E.-D.; Ding, W.-Q.; Jiang, Q.-W.; Cai, Q.-C.; Zhong, L. Gut MicrobiotaEnterotypes Mediate the Effects of Dietary Patterns on Colorectal Neoplasm Risk in a ChinesePopulation. Nutrients 2023, 15, 2940. https://doi.org/10.3390/nu15132940.2. Bianco, A.; Franco, I.; Curci, R.; Bonfiglio, C.; Campanella, A.; Mirizzi, A.; Fucilli, F.; Di Giovanni,G.; Giampaolo, N.; Pesole, P.L.; et al. Diet and Exercise Exert a Differential Effect on GlucoseMetabolism Markers According to the Degree of NAFLD Severity. Nutrients 2023, 15, 2252.https://doi.org/10.3390/nu15102252.3. Gu, W.; Han, T.; Sun, C. Association of 24 h Behavior Rhythm with Non-Alcoholic FattyLiver Disease among American Adults with Overweight/Obesity. Nutrients 2023, 15, 2101.https://doi.org/10.3390/nu15092101.4. Nitta, L.; Tahara, Y.; Shinto, T.; Makino, S.; Kuwahara, M.; Tada, A.; Abe, N.; Michie, M.; Shibata,S. Association of Eating Pattern, Chronotype, and Social Jetlag: A Cross-Sectional Study UsingData Accumulated in a Japanese Food-Logging Mobile Health Application. Nutrients 2023, 15,2165. https://doi.org/10.3390/nu15092165.5. Yang, H.-J.; Kim, M.-J.; Hur, H.-J.; Jang, D.-J.; Lee, B.-K.; Kim, M.-S.; Park, S. Inverse Associationof the Adequacy and Balance Scores in the Modified Healthy Eating Index with Type 2 Diabetesin Women. Nutrients 2023, 15, 1741. https://doi.org/10.3390/nu15071741.6. Gangitano, E.; Martinez-Sanchez, N.; Bellini, M.I.; Urciuoli, I.; Monterisi, S.; Mariani, S.; Ray, D.;Gnessi, L. Weight Loss and Sleep, Current Evidence in Animal Models and Humans. Nutrients2023, 15, 3431. https://doi.org/10.3390/nu15153431.7. Meyhöfer, S.; Chamorro, R.; Hallschmid, M.; Spyra, D.; Klinsmann, N.; Schultes, B.; Lehnert, H.;Meyhöfer, S.M.; Wilms, B. Late, but Not Early, Night Sleep Loss Compromises Neuroendocrine AppetiteRegulation and the Desire for Food. Nutrients 2023, 15, 2035. https://doi.org/10.3390/nu15092035.References1. Swaby, A.; Atallah, A.; Varol, O.; Cristea, A.; Quail, D.F. Lifestyle and Host Determinants of Antitumor Immunity and CancerHealth Disparities. Trends Cancer 2023, 9, 167–170. [CrossRef]2. Younossi, Z.M.; Zelber-Sagi, S.; Henry, L.; Gerber, L.H. Lifestyle Interventions in Nonalcoholic Fatty Liver Disease. Nat. Rev.Gastroenterol. Hepatol. 2023, 20, 708–722. [CrossRef]3. Khan, T.A.; Field, D.; Chen, V.; Ahmad, S.; Mejia, S.B.; Kahleová, H.; Rahelić, D.; Salas-Salvadó, J.; Leiter, L.A.; Uusitupa, M.; et al.Combination of Multiple Low-Risk Lifestyle Behaviors and Incident Type 2 Diabetes: A Systematic Review and Dose-ResponseMeta-Analysis of Prospective Cohort Studies. 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Effects of Healthy Lifestyles on Chronic Diseases:Diet, Sleep and Exercise

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Effects of Healthy Lifestyles on Chronic Diseases:Diet, Sleep and Exercise

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