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The impact of diet, exercise, and sleep on Helicobacter pylori infection with different occupations: a cross-sectional study

BMC Infectious Diseases volume 24, Article number: 692 (2024) Cite this article

Abstract

Background

Associations between Helicobacter pylori infection and lifestyle factors vary greatly by geographic location. This study aims to evaluate the prevalence of Helicobacter pylori infection in the Hunan cohort of central China and analyze the associations between Helicobacter pylori infection and lifestyle factors in different occupations.

Methods

This was a cross-sectional study. Participants who received an annual physical examination were invited. Helicobacter pylori infection was detected by the 13 C-urea breath test. Self-reported physical examination questionnaires were used to analyze participants’ demographic information, diet, exercise status, and sleep situations.

Results

23254 participants finished this study. The Helicobacter pylori infection rate in the Hunan area was 25.8%, with the lowest prevalence in students (8.5%) and the highest prevalence in business managers (29.9%). The risk factors for Helicobacter pylori infection were marital status (divorced or married) (OR:1.16, 95%CI:1.090–1.234), overeating (OR:1.105, 95%CI: 1.001–1.220), and consumption of eggs (OR:1.047, 95%CI:1.004–1.092), animal viscera (OR: 1.077, 95%CI:1.014–1.144) and coffee (OR:1.074, 95%CI:1.019–1.132). Participants’ education level (OR:0.911, 95%CI:0.881-0942), consumption of midnight snack (OR:0.926, 95%CI:0.877–0.977), and vegetable (OR:0.927, 95%CI: 0.884–0.972) were protective factors against Helicobacter pylori infection. Whether participants exercised regularly or had sleep problems had no significant effect on Helicobacter pylori infection. Different professionals showed significant differences in the rates of overeating, eating three meals on time, midnight snack, and consuming coffee, eggs, animal viscera, and vegetables > 3 times/week (P values < 0.05).

Conclusions

Helicobacter pylori infection showed a significant relationship with dietary factors, but not significantly with sleep and exercise factors. Different occupations showed different dietary tendencies related to Helicobacter pylori infection. The design of an occupation-based Helicobacter pylori screening and prevention program is supported.

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Background

The WHO reported that malignancies caused by infectious agents (including Helicobacter pylori, H. pylori) accounted for 20% of malignancies in developing countries [1]. H. pylori has been identified as a Class I carcinogen and as a major etiologic agent of infection-associated cancers, responsible for approximately 90% of gastric cancer cases [2]. H. pylori can lead to chronic gastritis, peptic ulcer, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma and is associated with idiopathic thrombocytopenic purpura [3]. In addition, H. pylori may be associated with hepatobiliary, cardiovascular, and allergic diseases, and people with a medical history of cholecystitis/cholecystolithiasis, hypertension, and asthma had a significant negative association with H. pylori infection [4]. Thus, preventing H. pylori infection is important for preventing gastrointestinal-related diseases and extra gastric diseases.

H. pylori infection is highly prevalent worldwide, with a global prevalence of 44.3% in 2015–2022 [5]. H. pylori infection varied by location and sanitation standards [6], prevalence of H. pylori infection was 41% in the United Arab Emirates, 41.5% in Korea, 87.2% in Spain, and 84% in Portugal and Poland [7, 8]. According to a meta-analysis, the worldwide prevalence of H. pylori infection (50.8%) in developing countries are higher than in developed countries(34.7%) [9]. In China, the prevalence decreased from 58.3% in 1983–1994 to 40.0% in 2015–2019. The prevalence of H. pylori infection was high in the northwest (51.8%), east (47.7%), and southwest (46.6%) of China and low in the central region [10, 11]. Changsha city is in the central region of China, and the previous study focused on the Changsha population was limited to children [12], large sample size cross-sectional surveys are still needed.

Environmental factors is one of the three parts of main pathophysiology of H. pylori infection [6]. Previous studies have revealed that lifestyle, mostly diet, was associated with H. pylori infection, such as binge drinking, coffee, dairy food, vegetables, and fruit [13,14,15,16]. Exercise and sleep had some impact on H. pylori-related gastric disease [17,18,19]. The pathological mechanism may involve metabolic disorders associated with H. pylori infection, as conventional H. pylori eradication therapy promoted positive changes in glucose and lipid profiles [20]. Differently, Habbash and colleagues [15] reported that exercise and sleep had no significant impact on Helicobacter pylori infection in 200 Bahraini adults. Thus, the association between lifestyle (diet, exercise, and sleep) and H. pylori infection needs more evidence.

Lifestyle-associated variables (including exercise and diet) mediated the association between occupations and chronic diseases, such as cardiovascular disease and metabolic syndrome [21, 22]. People with different occupations had reported significant differences in Helicobacter pylori infection [4, 11]. The associations of H. pylori infection with lifestyle, diet, exercise, and sleep in different occupations were less reported, and the benefit of eradication at the occupational level has not yet been adequately studied [23]. Therefore, this study aimed to indicate the prevalence of H. pylori infection in the Hunan cohort of central China and analyze the associations of H. pylori infection with lifestyle, diet, exercise, and sleep in different occupations.

Methods

Study design and implementation

A cross-sectional study was carried out at the health management center of a general tertiary hospital located in the Hunan area in central China between January 1, 2015, and December 31, 2020. The health management center is one of the first health management flagship units in China (the only one in Changsha, Hunan area), which can receive over 800 people for physical examinations every day and has signed the health management services with tens of thousands of people from more than 20 communities and rural residential villages. Participants who received annual physical examinations were invited. For participants who were under the age of 18, consent from the guardian was needed. The exclusion criteria were as follows: (1) did not sign the consent form; (2) pregnancy preparation, pregnancy status, and breast-feeding status; and 3)undertaking proton pump inhibitors(PPI)/antibiotics/bismuth-containing compounds/anti-inflammatory drug within the past month (diseases such as bleeding from peptic ulcers, stomach surgery, gastric MALT lymphoma, severe atrophy of gastric mucosa).

Written informed consent was obtained from the two health management centers. With the help of the directors of health management centers, three trained study members (post-graduate students) recruited participants at the physical examination registration points and explained the aims, procedures, and risks of this study to participants. After participants agreed and signed the informed consent, one of the study members would send the questionnaire link to the participants’ mobile phones and guide them to complete the filling out. Participants were requested to fill out electronic questionnaires within 24 h. The questionnaire links were formed by the Self-rated Physical Examination Questionnaire System (website: https://new.selfhealth.cn, patent number CN201710710888.1). Then, participants received physical examinations and H. pylori infection tests. 23,254 participants finished the study, and the response rate was 74.3%.

Measurements

H. pylori was detected by 13 C-UBT detection. The demographic information, diet, exercise, and sleep situations of participants were investigated by Self-rated Physical Examination Questionnaires.

13 C-UBT detection

13 C-UBT detection is one of the general methods to detect Helicobacter pylori in the stomach. 13 C-UBT detection was regarded as positive when the 13 C radioactive signal values (delta-over-baseline, DOB) were greater than or equal to 4. Before detection, participants fasted for at least 2 h and exhaled CO2 was collected using a special gas cylinder. Then, participants consumed the 13 C capsule with cold drinking water. After 20 min, the exhaled CO2 was collected using a special gas cylinder and measured by an H. pylori detector. Drugs such as PPIs, antibiotics, bismuth agents, and gastric mucosa protectors will affect the activity of urease, so patients are required to stop using antibiotics, bismuth compounds, and other drugs for at least 4 weeks and PPI and sucralfate for at least 2 weeks before testing [24].

Self-rated physical examination questionnaire

The self-rated Physical Examination Questionnaire was published by the Chinese Medical Association in 2014, aiming to screen chronic diseases and related risk factors [25], and formed into an electronic system (the Self-Rated Physical Examination Questionnaire System) in 2017. The self-rated physical examination questionnaire collected six dimensions of subjective health information (health-related history, physical symptoms, lifestyle and environment, mental health and mental stress, sleep health, and health literacy) [25], with the coefficient of Cronbach α ranged from 0.669 to 0.917, the split-half reliability ranged from 0.572 to 0.877, and the test-retest reliability ranged from 0.693 to 0.896 [26]. The questionnaire was widely used and can improve the detection rate of risk stratification of patients with chronic diseases (such as hypertension) [27]. This study analyzed the data on participants’ demographic information, lifestyle, and sleep health. The content is as follows:

Demographic information

Participants’ demographic information was collected, including age, gender, body mass index (BMI), marital status, education level, medical insurance, chronic disease, long-term medication, and occupation.

Lifestyle

Dietary habits were assessed: (1) eating patterns, including staple food, food taste preference, eating three meals on time, midnight snacks, and overeating. Eating three meals on time was defined as having breakfast between 7:00–9:00, lunch between 11:00–13:00, and dinner between 17:00–19:00. Midnight snacks were defined as snacks between 22:00 and 04:00. Overeating was defined as binge eating and drinking without restraint or regularity occurring at least 3 times within 6 months. The frequency of eating three meals on time and midnight snacks was valued by “<2 times/week”, “2 ~ 3 times/week” and “>3 times/week”. (2) Food categories: sugar-sweetened beverages, coffee, and alcohol; milk and dairy products, eggs, beans, or beans products (beans, nuts, and seeds), fruit, vegetables, livestock meat (pork, poultry, beef, and organs), oil and fat, animal viscera, fish and shrimp (seafood, freshwater fish and aquatic products). The frequency of drinking and food intake categories were valued by “never”, “seldom (1 ~ 2 times/week)”, “sometimes (3 ~ 5 times/week)” and “often (> 5 times/week)”.

The exercise was assessed. Regular exercise was defined as exercising during leisure time at least once per week. Years of exercising regularly, frequency of exercising, and sustained exercise time per day were evaluated.

Sleep health

Night sleeping time and sleep problems were evaluated. Sleep problems were defined as having had sleep problems at least 3 times per week. The four types of sleep problems included difficulty falling asleep (cannot fall asleep within 30 min), early waking, excessive dreaming or waking from a nightmare, and nighttime awakening (waking up more than twice after falling asleep).

Sample size estimation

According to previous data [11], it is found that the pooled prevalence of H. pylori infection in chinese mainland was 43.7%. We required that with 95% conffdence, the results need to fall within 10% of the overall truth rate. According to the calculation formula N = Z21−α/2(1 − p)/ε2γ, it is calculated that N = 495. Considering the 10% of attrition rate and the design efffciency, the questionnaires required for this cross-sectional study were at least 1089 in total.

Statistical analysis

SPSS 19.0 for Windows (IBM Corp, Armonk, NY, USA) was used for all statistical analyses. Participants’ age and BMI index were expressed as the mean ± standard deviation (SD), and categorical data such as sex, marital status, and education level were expressed as frequencies and percentages. Independent samples t-tests and χ2 tests were used to analyze the differences in H. pylori infection rates among populations with different diet, sleep, and exercise characteristics. Logistic regression models (stepwise, with the criteria for inclusion being 0.10 and for exclusion being 0.15) were used to select the optimal subset of independent variables in all participants. A P value < 0.05 was considered to indicate a significant association with H. pylori infection.

Results

Demographic characteristics of the participants

A total of 31,300 participants were invited to participate in this study. 8046 participants were excluded because of not signing the consent form, unfinished 13 C-UBT detection, and incomplete questionnaires. Finally, 23,254 participants were enrolled in this study.

The overall H. pylori infection rate in the Hunan area was 25.8%. Participants with H. pylori infection were 44.52 ± 10.865 years old and had a BMI of 25.07 ± 3.17. Participants who were female, married or divorced, had a lower educational background, and had a chronic disease, long-term medication use, and medical insurance showed a higher prevalence of H. pylori infection (details in Table 1).

Table 1 Correlation between the prevalence of Helicobacter pylori infection and demographic information
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As shown in Fig. 1, the three occupations with the highest H. pylori infection prevalence were business managers, farmers, and unemployed individuals. Students and professional and technical personnel showed a relatively low prevalence of H. pylori infection.

Fig. 1
figure 1

Percentage of H. pylori infection in different occupations

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Prevalence of Helicobacter pylori infection and dietary habits

Participants who ate midnight snacks rarely (P = 0.004), overeat (P = 0.034), and drink coffee rarely or occasionally (P = 0.046) revealed a higher prevalence of H. pylori infection. Participants who had a low frequency of fruit (P = 0.031) and vegetable (P = 0.050) consumption and a high frequency of animal viscera consumption (P = 0.009) showed a significantly higher prevalence of H. pylori infection. Details are shown in Table 2.

Table 2 Correlation between the prevalence of Helicobacter pylori infection and dietary habit
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Prevalence of Helicobacter pylori infection, exercise, and sleep

Table 3 showed that whether participants exercised regularly or had any one of the four sleeping problems had no significant effect on H. pylori infection (all P values > 0.05). There was no significant difference in H. pylori infection among participants with different nighttime sleep durations (P = 0.093). Among regularly exercising people, exercising 3 ~ 5 times/week showed the lowest rate of H. pylori infection (p = 0.039).

Table 3 Correlation between the prevalence of Helicobacter pylori infection, exercise, and sleep
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Multivariate analysis of the correlation between risk factors and H. pylori infection

The total test of model coefficients χ2 = 223.695, p < 0.001, and the logistic regression equation had statistical significance. Participants’ education level (OR: 0.911; 95%CI: 0.881-0942) was a protective factor against H. pylori infection. Participants’ marital status (divorced or married) (OR: 1.16; 95%CI: 1.090–1.234) was a risk factor for H. pylori infection. In lifestyle factors, exercise and sleep showed no significant relationship with H. pylori infection. Participants’ diet patterns showed a significant relationship with H.pylori infection. Overeating (OR: 1.105; 95%CI: 1.001–1.220) and egg (OR: 1.047; 95%CI: 1.004–1.092), animal viscera (OR: 1.077; 95%CI: 1.014–1.144), and coffee consumption (OR: 1.074; 95%CI: 1.019–1.132) were risk factors for H. pylori infection. Consumption of midnight snacks (OR: 0.926; 95%CI: 0.877–0.977) and vegetables (OR: 0.927; 95%CI: 0.884–0.972) was a protective factor for H. pylori infection. Details are in Table 4.

Table 4 Risk factors associated with the prevalence of Helicobacter pylori
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Diet pattern related to H. pylori infection in different occupations

According to the results of multivariate analysis, diet patterns related to H. pylori infection in different occupations are shown in Fig. 2. Figure 2 revealed that more than 30% of participants reported eating three meals on time > 3 times/week, and less than 15% of participants reported overeating and taking midnight snacks > 3 times/week. Participants from different professions showed significant differences in the rates of overeating, eating three meals on time, and midnight snack consumption > 3 times/week (P values < 0.05). Students had the highest high-frequency (> 3 times/week) midnight snacking and overeating per week, and retired people had the lowest proportion.

Fig. 2
figure 2

The percentage of eating meals on time, midnight snacks, and overeating more than 3 times/week ▲: risk factor for H. pylori infection △: protective factor for H. pylori infection *: P values < 0.05, comparison between occupations

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Figure 3 revealed that more than 30% of participants reported egg consumption > 3 times/week, and less than 30% of participants reported vegetable consumption > 3 times/week. Participants with different professions showed significant differences in the rates of consuming coffee, eggs, animal viscera, and vegetables > 3 times/week (P values < 0.05). Students had the highest proportion of high-frequency risk foods related to H. pylori infection, and farmers had the lowest proportion.

Fig. 3
figure 3

The percentage of intaking coffee, eggs, animal’s viscera and vegetables more than 3 times/week Notes: ▲: risk factor for H. pylori infection △: protective factor for H. pylori infection *: P values < 0.05, comparison between occupations

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Discussion

This study showed that the overall H. pylori infection rate in the Hunan cohort of central China was 25.8%, which is similar to that in the Chongqing cohort of central China (24.58%) [28] and lower than that in the Zhengzhou cohort of central China (54.27%) [29]. This reflected that the prevention and control of H. pylori infection in Hunan areas has a good effect. With efforts to prevent and control H. pylori, such as a family-based H. pylori prevention and eradication strategy (2021 edition), the infection rate has decreased over the past decades [10, 30]. On the other hand, the difference in the monitoring methods of H. pylori in different regions may cause conflicting results regarding the H. pylori infection rate.

This study reported that marital status was significantly correlated with H. pylori, but gender, chronic disease, and medical insurance were not. These results were consistent with those of previous studies [4, 31]. The higher the education and socioeconomic level of the people, the stronger their awareness of preventing H. pylori infection [4, 15, 16]. Previous studies showed that the H. pylori infection rate was higher in married couples than in single individuals [31] and increased with the duration of marriage [29]. Both partners could be infected (34.84%) and share the same strains (34.55%) [16, 29].

A regular meal pattern includes meal frequency and meal time, and “eating three meals per day” is the typical practice [32]. This study reported that eating three meals on time had no significant effect on H. pylori infection. Still, overeating was a risk factor for H. pylori infection. Regular fasting periods could reduce inflammation and modulate the gut microbiota related to H. pylori infection [32]. People who deviated from their meals by 2 h or more, twice or more per week, were six times more likely to have H. pylori infection with gastritis [33]. Overeating and midnight snacks break the regular meal pattern. Overeating and snacking were risk factors for H. pylori infection, and they changed gut microflora, resulting in dysbiosis, increased intestinal permeability, and leakage of toxic bacterial metabolites into the circulation, all of which contribute to the development of low-grade systemic inflammation [34, 35].

Differently, participants who consumed midnight snacks > 3 times/week showed a lower rate of H. pylori infection in this study. One of the reasons may be that people with a high frequency of midnight snacks had a higher percentage of insufficient dietary diversity [36], which means that people have a lower chance of consuming food susceptible to Helicobacter pylori infections, such as milk, vegetables, foods of animal origin, and ready-to-eat foods [37]. Besides, this cross-sectional study may lead to a contrary relationship to our traditional belief that restricting late-night snacks is more beneficial for health. Anyway, meal patterns had some effect on H. pylori infection.

This study indicated that coffee was a risk factor for H. pylori infection, and sugar-sweetened beverages and alcohol showed no significant correlation with H. pylori infection, corresponding to previous studies [8, 16, 38]. In contrast, Habbash and colleagues indicated that green tea, honey, and coffee were independent protectors against H. pylori infection [15]. This may be because coffee and tea contributed the most to the dietary total antioxidant capacity, which was associated with a reduced risk of H. pylori infection in adults [39, 40]. For people with active H. pylori infection, coffee was positively related to upper gastrointestinal symptoms [41], and coffee drinkers had worse symptom improvement after eradication therapy [42, 43]. For alcohol drinkers, some studies have shown that alcohol consumption is a risk factor for H. pylori infection, and binge drinking is positively associated with H. pylori infection [13, 43]. An intake of 10, 15, 30, 60, and 96 g/day alcohol could reduce H. pylori infection by approximately 22% and may facilitate the elimination of H. pylori [44]. Therefore, more research is needed on the relationship between coffee and alcohol and H. pylori infections, especially in frequency and amount of consumption.

Vegetables were a protective factor against H. pylori infection [8, 45], while animal viscera and eggs could increase the risk of H. pylori infection in this study. H. pylori infection is associated with metabolic disorders, and H. pylori infection may exacerbate the dysbiosis of the gut microenvironment induced by a high-fat diet, including alterations in the microbiota and metabolites [46]. Vegetable extracts (Broccoli sprouts, curcumin, Burdock complex, and Nigella sativa) and micronutrients (vitamins C and E) synergized with pharmacological therapies to eradicate H. pylori but showed a slight effect on clearing H. pylori as single agents [47]. Thus, vegetable consumption was encouraged to decrease the risk of H.pylori infection.

Milk or dairy products, beans or bean products, livestock meat, oil and fat, and seafood had no significant correlation with H. pylori infection in this study, same as previous studies [32, 45]. A meta-analysis showed that intake of these foods could reduce the incidence of H. pylori infection [11]. Chicken egg yolk, which contains immunoglobulin Y (IgY), could minimize harm from animal sources without inducing specific resistance, and thus it has been an alternative treatment for H. pylori infection [48]. Bovine milk could resist H. pylori by turning caseins into cascading 17 and β-casein 207–224 under pepsin [49]. However, H. pylori exist in food: raw milk from bovines (7.5%), ovines (17.27%), caprines (13.84%), buffaloes (10.76%), camels (5%), and 12% of shellfish [50, 51]. Quaglia and colleagues thought that the intake of seawater, milk, foods of animal origin, and ready-to-eat foods could increase the chance of H. pylori infection [37]. Therefore, future studies should control for cooking methods, food quality, and hygiene factors when analyzing the correlation between food and H. pylori infection.

Few studies reported the correlation between physical activity, sleep, and H. pylori infection. Like previous study [15], physical activity and sleep showed no significant correlation with H. pylori infection. Most studies revealed the correlation between exercise, sleep disorders, and gastric disease caused by H. pylori infection. Regular exercise reduces the risk of gastric cancer related to H. pylori infection [8, 17]. Moderate physical activity could reduce gastric secretions, enhance immune function, reduce anxiety, and encourage the adoption of a healthy lifestyle. Prolonged endurance exercise might suppress immune function and mucosal blood flow [51]. Sleep disorders could increase the risk of ulcers caused by H. pylori infection. Poor sleepers were more likely to have peptic ulcer disease or peptic ulcer disease recurrence, especially sleepers who experienced longer sleep onset latency and more nighttime awakenings [19, 52, 53]. During deeper sleep stages, the human body increases defensive factors (gastric bicarbonate efflux, gastric mucosal blood flow, and melatonin secretion) and decreases aggressive mediators (gastrin secretion) against gastrointestinal diseases [18, 19]. Therefore, physical activity and sleep seem to have a minor effect on H. pylori infection and more evidence was needed.

This study revealed that business managers, farmers, and the unemployed had the highest infection rates, while students, professional and technical personnel, and militaries reported the lowest. Business managers were more likely to be infected with H. pylori through face-to-face communication or close physical proximity when conducting business activities, such as producing or servicing [54]. Farmers showed a significantly higher H. pylori infection rate than nonfarmers and had the highest H. pylori prevalence among agricultural, forestry, and fishery workers [4, 55]. Farm animals increase the Helicobacter pylori infection in farmers, with pets and farm animals could transmit H. pylori infection to humans [56]. Elhariri and colleagues also reported that the milk and feces from healthy cattle, buffaloes, and sheep were the shedding site of H. pylori (especially the virulent H. pylori strains), and feces showed as a possible source of milk contamination [57]. Students and professional and technical personnel had more knowledge about H. pylori, which may lead to a lower H. pylori infection rate [43]. A lower prevalence of infection in the military may be because most soldiers are young males and are typically healthier than the general population [55]. The three meals provided to students and militaries had strict requirements, which may also be a related factor. As a result, business managers, farmers, and unemployed people need to improve the prevention of H. pylori infection.

Occupational status was one of the factors associated with H. pylori infection [58], but the benefit of eradication at the occupational level has not yet been adequately studied [23]. This study supported that the prevalence of H. pylori infection between different occupations was significantly different, and different occupations showed different dietary patterns. The prevalence of H. pylori infection has greatly decreased in adults, but not children and adolescents in any World Health Organization regions during the last three decades [5]. This study showed that dietary patterns in children showed a high risk of H. pylori infection, and the H. pylori infection rate will increase with students’ graduation and joining the workforce if their dietary patterns are not changed. Decreasing the frequency of overeating and midnight snacks, reducing the consumption of eggs, animal viscera, and coffee, and increasing vegetable consumption was urgent for students. For farmers, factory workers, and unemployed people, although their high frequency (> 3 times/week) of coffee and egg consumption was relatively low, reducing the frequency of animal viscera consumption and overeating was supported. Retired people, militaries, and professional and technical personnel showed good control of animal viscera and coffee consumption, but not egg consumption. Business managers should limit the consumption of coffee and animal viscera.

Above all, this article reveals that different occupational practitioners have different dietary patterns, and dietary patterns have a certain correlation with Helicobacter pylori infection. This may be related to the nutritional elements in the food, the number of Helicobacter pylori infections in the food, and the cooking method of the food. Therefore, studying and setting up occupation-related measures for Helicobacter pylori prevention should be noticed in the future.

Strengths and limitations

As we know, this is the first study to combine diet, exercise, and sleep factors to analyze the impact of lifestyle on H. pylori infection in different occupations. This study provided a preliminary H. pylori infection prevention at the occupational level. On the side of lifestyle, this study explained the poor control of Helicobacter pylori infection in adolescents and children to a certain degree. There were some limitations in this study. First, this study included participants undergoing a physical examination, which has to some extent overlooked the portion of the population with poor awareness of self-health management. Second, a cross-sectional study cannot reflect the time trend of H. pylori infection. Finally, selection bias needs to be considered. The samples for this study mainly come from the physical examination population in Hunan areas, which may cause the samples to be homogeneous. Finally, living in the same house with H. pylori-positive relatives was more likely to result in an H. pylori infection [14]. It is necessary to analyze the relationship between eating habits and H. pylori infection after controlling for residents in the same house in future research.

Conclusions

This study indicated that the overall H. pylori infection rate in the Hunan area was 25.8%. People who were business managers, farmers, or unemployed showed the highest rate of H. pylori infection. Although this study reveals that independent eating habits, frequency of food consumption, exercise, and sleep have almost no effect on H. pylori infection, after combining the occupational and social background, the diet pattern affects H. pylori infection significantly. Thus, people need to avoid overeating (especially for students and business managers), coffee (especially for students and professional and technical personnel), and animal viscera (especially for students and farmers), increase the intake of vegetables (especially for students and unemployed people). These findings provide new insights into public preventive measures for H. pylori infection and outline the areas of potential focus.

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We are grateful to the directors of health management centers for providing room to investigation. We are also grateful to all the participants in the study.

Funding

This study was supported by the Clinical Medical Technology Innovation Guide Project of Hunan Provimce (NO.2020SK53609).

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Author notes

  1. Xue He and Shiwen He share first authorship.

Authors and Affiliations

  1. Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China

    Shiwen He, Xue He, Ying Li, Pingting Yang & Yaqin Wang

  2. Nursing Department, The Third Xiangya Hospital, Central South University, No. 138, Tongzipo Road, PO Box 410013, Changsha, Hunan, China

    Shiwen He, Yinglong Duan, Yating Luo, Yuxuan Li, Jing Li, Jianfei Xie & Min Liu

  3. School of Health Sciences, Western Sydney University, Sydney, Australia

    Andy SK Cheng

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  1. Shiwen He
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Contributions

He SW and He X draft the manuscript. Luo YT, Li YX, Li J and Li Y collected the data. Duan YL and He X analyzed the data. Yang PT, Wang YQ and Cheng ASK participated in the design of the study and contributed to resources and supervision. Liu M and Xie JF conceived of the study, and participated in its design and coordination and helped to draft the manuscript. All authors reviewed the manuscript.

Corresponding author

Correspondence to Min Liu.

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Ethics approval and consent to participate

All included participants gave their oral and written informed consent. This study was approved by the IRB of Third Xiangya Hospital, Central South University (NO.2020-S587).

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The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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He, S., He, X., Duan, Y. et al. The impact of diet, exercise, and sleep on Helicobacter pylori infection with different occupations: a cross-sectional study. BMC Infect Dis 24, 692 (2024). https://doi.org/10.1186/s12879-024-09505-8

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Keywords

BMC Infectious Diseases

ISSN: 1471-2334

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