Abstract
BACKGROUND: Lifestyle factors - such as dietary habits, physical activity, smoking, and sleep quality - are modifiable determinants that not only directly affect cardiovascular risk but also shape an individual's self-rated health and mental wellbeing. However, the interrelationships among these domains remain inadequately understood. The aim of this study is a comprehensive assessment of complex factors - self-rated health, mental wellbeing, and lifestyle factors and their association with morbidity of ischemic heart disease (IHD). MATERIALS AND METHODS: This epidemiological health survey of the study "Chronic diseases and their risk factors in the adult population" was performed during 2023-2024 in Kaunas city (Lithuania) following the methodology of the WHO MONICA study. A random sample of Kaunas inhabitants aged 25-69 years, stratified by sex and age, was randomly selected from the Lithuanian population register. The 3,426 individuals were screened. The associations of self-rated health, mental wellbeing status, and lifestyle habits with the IHD were investigated using binary logistic regression analysis. An exploratory factor analysis with orthogonal varimax rotation was conducted to examine the factor structure of the food intake data. RESULTS: This study highlights the significant association of good self-rated health and mental wellbeing status with a lower odds of IHD, even after adjusting for main covariates (sex, age, education, marital status, metabolic syndrome, and its components) (OR = 0.692, 95% CI: 0.22-0.93, p = 0.013). Furthermore, specific lifestyle habits - including regular physical activity (OR = 1.661, 95% CI: 1.35-2.04, p < 0.001), sufficient sleep (OR = 1.115, 95% CI: 1.03-1.21, p = 0.006), and healthy nutrition habits rich in fruits, vegetables, and fish (OR = 1.463, 95% CI: 1.24-1.73, p < 0.001) - were positively associated with better self-rated health and mental wellbeing. However, more frequent consumption of meat products and potatoes reduced the odds of good self-rated health and mental wellbeing (OR = 0.831, 95% CI: 0.70-0.99, p = 0.04). CONCLUSION: These findings underscore the importance of promoting healthy lifestyle behaviours and mental wellbeing as part of comprehensive cardiovascular disease prevention strategies.