Author(s): IMPERIALI, L., BIZZOZERO, S., BANFI, G., GUIDA, S., BRIGUGLIO, M., BARGERI, S., BORGHI, S., Institution: IRCCS ISTITUTO 0RTOPEDICO GALEAZZI, Country: ITALY, Abstract-ID: 1274

INTRODUCTION:
Nutrition, sleep, and physical activity are tightly interconnected health behaviors, but they are often assessed separately. The aim of this study is to deploy a Three Pillars of Health Survey integrating validated components for nutrition, sleep and physical activity to characterize an adult population and to examine age-related differences across these three domains. Data collection is ongoing; therefore, feasibility and preliminary results are presented to guide subsequent behavior-improvement strategies.
METHODS:
We implemented a cross-sectional REDCap survey in an Italian adults population (≥18 years) structured in four sections: (1) demographics/health (anthropometrics, smoking, alcohol frequency, comorbidities/medications, work schedule including night-shift work); (2) nutrition using the Medi-Lite Mediterranean Diet adherence questionnaire; (3) sleep using Pittsburgh Sleep Quality Index (PSQI) plus chronotype and napping questions; (4) physical activity and sedentary time with a Global Physical Activity Questionnaire, and the International Fitness Scale (IFIS) for the subjective self‑assessment of physical fitness. Age-group comparisons (18–30, 31–44, 45–64, and ≥65 years) for all parameters were conducted with GraphPad Prism Software (Graph Pad Software, San Diego, CA). Statistical significance was set at p<0.05.
RESULTS:
A total of 104 participants completed the survey (age: range 21–79 years; 52% female). Regard to nutrition, Mediterranean diet adherence averaged 9.1±2.0 (range 5–13); 62.5% scored >9, a Medi-Lite threshold below which higher odds of abdominal and overall obesity have been reported. Considering sleeping, mean sleep duration was 7.1±1.8 h/night; 38.5% reported < 7 h/night which the National Sleep Foundation considers below the recommended range. Mean PSQI was 4.4±2.8 and 25.2% were classified as poor sleepers (PSQI≥5). Chronotype distribution was 52.9% morning-type, 26.0% intermediate, and 21.2% evening-type. Napping was reported by 20.2% of participants; among nappers (n=21), naps occurred 4.14±1.7 times per week with a duration of 37.0±21.3 minutes. Finally weekly physical activity was 2540±2903 MET-min/week (median 1656.5), with 73.1% achieving the World Health Organization cut-off of ≥600 MET-min/week. Sedentary time averaged 354.5±188.2 min/day (~5.9±3.1 h/day), with 30.8% ≥8 h/day. Significant age-group differences emerged only for IFIS: 18–30 (18.7±3.4) scored higher than 31–44 (16.1±4.2, p=0.034), 45–64 (15.5±4.8, p=0.032), and ≥65 (12.8±3.7, p<0.001), and 31–44 differed from ≥65 (p=0.034); all other comparisons were not significant.
CONCLUSION:
Data collection is ongoing, and these results should be considered preliminary. From these preliminary data, the survey appears feasible and may help identify concurrent lifestyle targets across the three pillars within a single workflow. Integrated monitoring of lifestyle behaviors is essential to improve population health and to inform targeted prevention and health-promotion strategies.