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Healthy lifestyle behaviors among individuals with chronic obstructive pulmonary disease in urban and rural communities in China: a large community-based epidemiological study

Authors Yan R, Wang Y, Bo J, Li W

Received 27 June 2017

Accepted for publication 12 September 2017

Published 13 November 2017 Volume 2017:12 Pages 3311—3321

DOI https://doi.org/10.2147/COPD.S144978

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Charles Downs

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Chunxue Bai


Ruohua Yan, Yang Wang, Jian Bo, Wei Li

On behalf of PURE-China Investigators

State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China

Background: Lifestyle modification is one of the most cost-effective strategies in self-management and secondary prevention of chronic obstructive pulmonary disease (COPD). However, the prevalence of healthy lifestyle behaviors in COPD patients in China remains unclear. The objective of this study was to examine the rates of healthy lifestyle behaviors including smoking cessation, regular exercise, and healthy diet in community population with COPD in China.
Methods: We recruited 46,285 individuals aged 35–70 years from 115 urban and rural communities in 12 provinces of China from 2005 to 2009. We recorded the smoking status, physical activity intensity, and quality of diet for all spirometry-diagnosed COPD patients by standardized questionnaires.
Results: Among 3,690 individuals with COPD, 18.2% (95% confidence interval [CI], 13.0–24.9) quitted smoking, 27.1% (95% CI, 24.7–29.7) exercised often, and 34.8% (95% CI, 31.8–38.0) ate high-quality diet. More than half of the individuals followed one or less key healthy lifestyle, and only 8.4% (95% CI, 7.0–10.0) followed all of the three healthy behaviors. Urban residents had significant higher rates of smoking cessation (23.5% [95% CI, 17.3–31.1] vs 14.4% [95% CI, 9.9–20.5], p=0.0008), regular exercise (45.6% [95% CI, 42.4–48.8] vs 14.0% [95% CI, 12.1–16.2], p<0.0001), and healthy diet (38.5% [95% CI, 35.5–41.6] vs 32.2% [95% CI, 29.2–35.4], p=0.0013) than rural residents. Age, sex, education level, body mass index, respiratory symptoms, and family income were associated with healthy living, and the strength of associations varied between urban and rural areas.
Conclusion: There is a large gap between the anticipated rate and the real participation in healthy lifestyle behaviors in Chinese adults with COPD, especially in rural communities. Simple and effective strategies are warranted to improve patients’ lifestyle in China.

Keywords: COPD, lifestyle, smoking cessation, physical activity, diet

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