Nielsen, Jesper Bo; Leppin, Anja; Gyrd-Hansen, Dorte
BACKGROUND: Elimination of modifiable risk factors including unhealthy lifestyle has the potential for prevention of 80% of cardiovascular disease cases. The present study focuses on disclosing barriers for maintaining specific lifestyle changes by exploring associations between perceiving...... inequality even in populations with equal and cost-free access to health care. Our study suggests supplementing traditional public campaigns to counter cardiovascular disease by using individualized and targeted initiatives....... these barriers and various sociodemographic and health-related characteristics. METHODS: Data were collected through a web-based questionnaire survey and included 962 respondents who initially accepted treatment for a hypothetical cardiovascular risk, and who subsequently stated that they preferred lifestyle...
J.O. Younge (John)
markdownabstract__Abstract__ Globally, the burden of cardiovascular disease (CVD) is still increasing. However, in recent decades, better treatment modalities have led to less cardiovascular related deaths. After years of research, we now generally accept that lifestyle factors are the most
Full Text Available Abstract Background Healthy lifestyles are an important facet of cardiovascular risk management. Unfortunately many individuals fail to engage with lifestyle change programmes. There are many factors that patients report as influencing their decisions about initiating lifestyle change. This is challenging for health care professionals who may lack the skills and time to address a broad range of barriers to lifestyle behaviour. Guidance on which factors to focus on during lifestyle consultations may assist healthcare professionals to hone their skills and knowledge leading to more productive patient interactions with ultimately better uptake of lifestyle behaviour change support. The aim of our study was to clarify which influences reported by patients predict uptake and completion of formal lifestyle change programmes. Methods A systematic narrative review of quantitative observational studies reporting factors (influences associated with uptake and completion of lifestyle behaviour change programmes. Quantitative observational studies involving patients at high risk of cardiovascular events were identified through electronic searching and screened against pre-defined selection criteria. Factors were extracted and organised into an existing qualitative framework. Results 374 factors were extracted from 32 studies. Factors most consistently associated with uptake of lifestyle change related to support from family and friends, transport and other costs, and beliefs about the causes of illness and lifestyle change. Depression and anxiety also appear to influence uptake as well as completion. Many factors show inconsistent patterns with respect to uptake and completion of lifestyle change programmes. Conclusion There are a small number of factors that consistently appear to influence uptake and completion of cardiovascular lifestyle behaviour change. These factors could be considered during patient consultations to promote a tailored approach to
Nielsen, Jesper Bo; Leppin, Anja; Gyrd-Hansen, Dort E; Jarbøl, Dorte Ejg; Søndergaard, Jens; Larsen, Pia Veldt
Elimination of modifiable risk factors including unhealthy lifestyle has the potential for prevention of 80% of cardiovascular disease cases. The present study focuses on disclosing barriers for maintaining specific lifestyle changes by exploring associations between perceiving these barriers and various sociodemographic and health-related characteristics. Data were collected through a web-based questionnaire survey and included 962 respondents who initially accepted treatment for a hypothetical cardiovascular risk, and who subsequently stated that they preferred lifestyle changes to medication. Logistic regression was used to analyse associations between barriers to lifestyle changes and relevant covariates. A total of 45% of respondents were identified with at least one barrier to introducing 30 min extra exercise daily, 30% of respondents reported at least one barrier to dietary change, and among smokers at least one barrier to smoking cessation was reported by 62% of the respondents. The perception of specific barriers to lifestyle change depended on sociodemographic and health-related characteristics. We observed a considerable heterogeneity between different social groups in the population regarding a number of barriers to lifestyle change. Our study demonstrates that social inequality exists in the ability to take appropriate preventive measures through lifestyle changes to stay healthy. This finding underlines the challenge of social inequality even in populations with equal and cost-free access to health care. Our study suggests supplementing traditional public campaigns to counter cardiovascular disease by using individualized and targeted initiatives.
Nielsen, Jesper Bo; Leppin, Anja; Gyrd-Hansen, Dort e; Jarb?l, Dorte Ejg; S?ndergaard, Jens; Larsen, Pia Veldt
BACKGROUND: Elimination of modifiable risk factors including unhealthy lifestyle has the potential for prevention of 80% of cardiovascular disease cases. The present study focuses on disclosing barriers for maintaining specific lifestyle changes by exploring associations between perceiving these barriers and various sociodemographic and health-related characteristics.METHODS: Data were collected through a web-based questionnaire survey and included 962 respondents who initially accepted treat...
Manschot, A; van Oostrom, S H; Smit, H A; Verschuren, W M M; Picavet, H S J
To study whether being diagnosed with a cardiovascular disease (CVD) or diabetes mellitus (DM) is associated with improvements in lifestyles. We used data from the Doetinchem Cohort Study, a prospective study among 6386 Dutch men and women initially aged 20-59years who were examined four times over 15years (1987-2007). Logistic and linear regression models were used to assess the effect of a self-reported diagnosis of CVD (n=403) or DM (n=221) on smoking, alcohol consumption, weight, diet and physical activity. Self-reported diagnosis of CVD increased rates of smoking cessation (OR=2.2, 95%CI 1.6 - 3.1). Adults reporting a diagnosis of DM (relatively) decreased weight (3.2%, 95%CI 2.2 - 4.2), (relatively) decreased energy intake (4.2%, 95%CI 0.7 - 7.7), decreased energy percentage from saturated fat (0.4%, 95%CI 0.0 - 0.9) and increased fish consumption (2.8 g/day, 95%CI 0.4 - 5.1). A self-reported diagnosis of CVD or DM was not associated with changes in physical activity. A diagnosis of CVD or DM may act, along with possible effects of medical treatment, as a trigger to adopt a healthier lifestyle in terms of smoking cessation, healthier diet and weight loss. Copyright © 2013 Elsevier Inc. All rights reserved.
Full Text Available Cardiovascular disease (CVD is the driving force behind the discrepancy in life expectancy between indigenous and non-indigenous groups in many countries. Preceding CVD many indigenous groups exhibit a cluster of cardiometabolic risk factors, including overweight-obesity, diabetes, high cholesterol, and high blood pressure. In turn, modifiable lifestyle risk factors contribute to the development of this cluster of cardiometabolic conditions. Modifiable lifestyle risk factors include, but are not limited to, physical inactivity, poor nutrition, excessive alcohol consumption, and cigarette smoking. Notably, these metabolic and lifestyle risk factors are relatively simple to monitor and track. The current review will look at modifiable cardiometabolic (overweight-obesity, diabetes mellitus, high cholesterol, and high blood pressure and lifestyle (physical inactivity, poor nutrition, risky alcohol behavior, and cigarette smoking risk factors among indigenous populations from Australia (Aboriginal Australians and Torres Strait Islanders, New Zealand (Mβori and the United States (Native Americans. Discussion will focus on the causal relationship between modifiable lifestyle risk factors and cardiometabolic outcomes, as well as, simple measurements for tracking these risk factors.
Hulsegge, Gerben; Looman, Moniek; Smit, Henriëtte A; Daviglus, Martha L; van der Schouw, Yvonne T; Verschuren, W M Monique
The associations between overall lifestyle profile and cardiovascular disease (CVD) and death have been mainly investigated in cross-sectional studies. The full benefits of a healthy lifestyle may therefore be underestimated, and the magnitude of benefits associated with changes in lifestyle remains unclear. We quantified the association of changes in lifestyle profiles over 5 years with risk of CVD and all-cause mortality. Lifestyle factors (ie, diet, physical activity, smoking, alcohol consumption) and body mass index were assessed and dichotomized as healthy/unhealthy among 5263 adults ages 26 to 66 in 1993-1997 and 5 years later (1998-2002). Multivariable-adjusted hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were estimated to quantify associations of change in lifestyle with fatal/nonfatal CVD and all-cause mortality that occurred 8 to 15 years after 1998-2002. Independent of baseline lifestyles, each decrement in number of healthy lifestyle factors was, on average, associated with 35% higher risk of CVD (HR, 1.35; 95% CI, 1.12-1.63) and 37% higher risk of all-cause mortality (HR, 1.37; 95% CI, 1.10-1.70); no association was noted with increase in the number of healthy lifestyle factors (P>0.5). Individuals who maintained 4 to 5 healthy lifestyle factors had 2.5 times lower risk of CVD (HR, 0.43; 95% CI, 0.25-0.63) and all-cause mortality (HR, 0.40; 95% CI, 0.22-0.73) than those who maintained only 0 to 1 healthy lifestyle factor. Our findings suggest that the benefits of healthy lifestyles may be easier lost than gained over a 5-year period. This underscores the need for efforts to promote maintenance of healthy lifestyles throughout the life course. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
Favourable lifestyles promote cardiovascular protection. Exercise can induce beneficial changes in the genome that decrease low-density lipoprotein cholesterol (LDL-C) and increase anti-inflammatory markers. The Mediterranean dietary pattern, fortified by nuts, while not reducing weight, reduces mortality. Lifestyle ...
Slavíček, Jaroslav; Kittnar, Otomar; Fraser, Gary E.; Medová, Eva; Konečná, Jana; Žižka, Robert; Dohnalová, Alena; Novák, Vladimír
Summary The morbidity and mortality of the cardiovascular diseases is high in the developed countries. The lifestyle changes are capable to decrease it by 50%. The aim of the present study was to measure the parameters of some risk factors before and after a one-week NEW START rehabilitative retreat. 1,349 volunteers, 320 men, 1,029 woman, mean age 51±14.5 (SD) years participated in 30 rehabilitative retreats from 1999–2006 in the Czech Republic, using a low-fat, low-energy, lacto-ovo-vegetarian diet and exercise, in a stress-free environment. Body weight, height, BMI, blood pressure, heart rate, serum cholesterol and blood glucose were measured. Body weight decreased in 1,223 measured persons from 71.2±14.38 (SD) to 70.6±14.02 kg (pSeventh-day Adventists than in controls who never observed the diet and avail the lifestyle programs. The parameters were nonsignificantly changed one year after finishing the retreat in the sample of 68 persons showing the positive effect of retreats. Our results showed, that the intake of a low-fat, low-energy diet, over the course of one week in a stress-free environment, had positive impact on the risk factors of cardiovascular diseases. PMID:19256282
Full Text Available Cardiovascular disease (CVD remains the leading cause of death among American adults accounting for approximately one-third of all deaths. It has been shown, however, that the actual causes of death are related to lifestyle behaviors such as tobacco use, poor diet and physical activity and alcohol consumption. A pharmacist-run employee health program, started in 2008, sought to lower CVD risk through the use of individualized lifestyle behavior programming, medication therapy management, and care coordination activities. Following one year of participation in the program, employee participants were shown to significantly increase exercise quantity (p < 0.001, fruit and vegetable consumption (p < 0.001, and decrease self-reported stress level (p = 0.006. The percentage of program participants simultaneously adherent to the recommended levels of exercise, combined fruit and vegetable intake and tobacco abstinence at one-year was 34.5% vs. 5.5% at baseline. This compares with only 5.1% of the U.S. population adherent to the same three behaviors. Pharmacists can positively impact healthy lifestyle behaviors when working in an employee health setting.
Evidence is accumulating that lifestyle factors influence the incidence of fatal and non-fatal cardiovascular diseases (CVD). A healthy diet, being physically active, moderate alcohol consumption and not smoking are associated with a lower CVD risk. In
Barbieri, R H
The management and consumption of energy resources are undergoing radical change. That change is prompting reevaluation of traditional patterns of economic interaction; the roles of public participation in the political process. This article discusses the roots of the energy dilemma, the impact of energy on the decision-making process, social change, and energy policy formulation. The impact of this reevaluation on lifestyles and attitudes toward energy are also discussed. Efforts towards the search for a solution are presented.
Siren, Reijo; Eriksson, Johan G; Vanhanen, Hannu
To examine the long-term impact of health counselling among middle-aged men at high risk of CVD. An observational study with a 5-year follow-up. All men aged 40 years in Helsinki have been invited to a visit to evaluate CVD risk from 2006 onwards. A modified version of the North Karelia project risk tool (CVD risk score) served to assess the risk. High-risk men received lifestyle counselling based on their individual risk profile in 2006 and were invited to a follow-up visit in 2011. Of the 389 originally high-risk men, 159 participated in the follow-up visits in 2011. Based on their follow-up in relation the further risk communication, we divided the participants into three groups: primary health care, occupational health care and no control visits. Lifestyle and CVD risk score change. All groups showed improvements in lifestyles. The CVD risk score decreased the most in the group that continued the risk communication visits in their primary health care centre (6.1 to 4.8 [95% CI -1.6 to -0.6]) compared to those who continued risk communication visits in their occupational health care (6.0 to 5.4 [95% CI -1.3 to 0.3]), and to those with no risk communication visits (6.0 to 5.9 [95% CI -0.5 to 0.4]). These findings indicate that individualized lifestyle counselling improves health behaviour and reduces total CVD risk among middle-aged men at high risk of CVD. Sustained improvement in risk factor status requires ongoing risk communication with health care providers. KEY POINTS Studies of short duration have shown that lifestyle changes reduce the risk of cardiovascular disease among high-risk individuals. Sustaining these lifestyle changes and maintaining the lower disease risk attained can prove challenging. Cardiovascular disease (CVD) risk assessment and individualized health counselling for high-risk men, when implemented in primary health care, have the potential to initiate lifestyle changes that support risk reduction. Attaining a sustainable reduction in CVD
Khalib A. Latiff
Full Text Available Cardiovascular problem is one of the leading cause of death in Malaysia and now invaded to the sub-urban and rural areas. To prevent and control of this problem, several main risk factors needed to be known and shall be reexamined and ranked according to the priority. The objectives of this research paper was to identify several dominant risk factor related to cardiovascular problem. A cross sectional study was carried out from March 2000 – June 2001 on a total of 8159 rural population aged 18 and above to measure the prevalence of the common cardiovascular risk factors. Those risk factors are systolic blood pressure, diastolic blood pressure, serum cholesterol level, obesity index, blood glucose level, smoking, physical activity and mental stress. Overall prevalence of common cardiovascular risk factors were higher, dominated by physical inactivity (65.7%, hypercholesterolemia – TC:HC (62.3%, mental stress (55.5% and obesity (53.7%. Smoking was also high at 49.9% especially among men. However systolic hypertension, diastolic hypertension and diabetes mellitus; although increased by age, its prevalence is relatively low at 23.7%, 19.2%, and 6.3% respectively. Cardiovascular risk factors related to lifestyle are much evidenced as compared to risk factors related to the biological influence. Therefore, all initiatives in community health intervention should be mobilized specifically on prevention and control of lifestyle-related risk factors. (Med J Indones 2008; 17: 50-6Keywords: cardiovascular problem, community intervention, lifestyle-linked risk factors
Georgousopoulou, Ekavi N; Mellor, Duane D; Naumovski, Nenad; Polychronopoulos, Evangelos; Tyrovolas, Stefanos; Piscopo, Suzanne; Valacchi, Giuseppe; Anastasiou, Foteini; Zeimbekis, Akis; Bountziouka, Vassiliki; Gotsis, Efthimios; Metallinos, George; Tyrovola, Dimitra; Foscolou, Alexandra; Tur, Josep-Antoni; Matalas, Antonia-Leda; Lionis, Christos; Sidossis, Labros; Panagiotakos, Demosthenes
Adherence to a Mediterranean dietary pattern is a well-established protective factor against cardiovascular disease (CVD). However, diet quality is only one aspect of the overall healthy lifestyle adopted by Mediterranean populations. The latter has never been evaluated as a multi-factorial composite lifestyle. Thus, the aim of the present study was to provide a broader picture of the Mediterranean lifestyle and its effects on CVD risk, among elderly individuals. During 2005-2015, 2,749 older (aged 65-100 years) from 21 Mediterranean islands (MEDIS) and the rural Mani region (Peloponnesus) of Greece were voluntarily enrolled onto the study. Dietary habits, physical activity status, socio-demographic characteristics, lifestyle parameters (sleep, smoking habits, social life and educational status) and clinical profile aspects were derived through standard procedures. The overall prevalence of the traditional CVD risk factors were 62.3% for hypertension, 22.3% for diabetes mellitus (type 2) and 47.7% for hypercholesterolemia. The presence of diabetes mellitus was positively predicted by the geriatric depression scale (GDS) [odds ratio (OR) =1.13, 95% confidence interval (CI): 1.02-1.25] and by an urban residential environment (OR =2.57, 95% CI: 1.10-6.06) after adjusting for several confounders. Presence of hypertension was predicted by increasing age (OR =1.07, 95% CI: 1.02-1.12), increasing body mass index (BMI) (OR =1.12, 95% CI: 1.04-1.21), the habit of midday sleep (OR =2.07, 95% CI: 1.07-4.02) and inversely predicted by the frequency of socializing with friends (OR =0.767, 95% CI: 0.616-0.955). The estimated score in the GDS was the only independent positive predictor for the presence of hypercholesterolemia (OR =1.10, 95% CI: 1.01-1.21). Lifestyle parameters such as social life, midday sleep (siesta) and residential environment are strongly associated with the presence of CVD risk factors in elderly and should be part of broader CVD prevention strategies to
Greaves, Colin; Gillison, Fiona; Stathi, Afroditi; Bennett, Paul; Reddy, Prasuna; Dunbar, James; Perry, Rachel; Messom, Daniel; Chandler, Roger; Francis, Margaret; Davis, Mark; Green, Colin; Evans, Philip; Taylor, Gordon
In the UK, thousands of people with high cardiovascular risk are being identified by a national risk-assessment programme (NHS Health Checks). Waste the Waist is an evidence-informed, theory-driven (modified Health Action Process Approach), group-based intervention designed to promote healthy eating and physical activity for people with high cardiovascular risk. This pilot randomised controlled trial aimed to assess the feasibility of delivering the Waste the Waist intervention in UK primary care and of conducting a full-scale randomised controlled trial. We also conducted exploratory analyses of changes in weight. Patients aged 40-74 with a Body Mass Index of 28 or more and high cardiovascular risk were identified from risk-assessment data or from practice database searches. Participants were randomised, using an online computerised randomisation algorithm, to receive usual care and standardised information on cardiovascular risk and lifestyle (Controls) or nine sessions of the Waste the Waist programme (Intervention). Group allocation was concealed until the point of randomisation. Thereafter, the statistician, but not participants or data collectors were blinded to group allocation. Weight, physical activity (accelerometry) and cardiovascular risk markers (blood tests) were measured at 0, 4 and 12 months. 108 participants (22% of those approached) were recruited (55 intervention, 53 controls) from 6 practices and 89% provided data at both 4 and 12 months. Participants had a mean age of 65 and 70% were male. Intervention participants attended 72% of group sessions. Based on last observations carried forward, the intervention group did not lose significantly more weight than controls at 12 months, although the difference was significant when co-interventions and co-morbidities that could affect weight were taken into account (Mean Diff 2.6Kg. 95%CI: -4.8 to -0.3, p = 0.025). No significant differences were found in physical activity. The Waste the Waist
Illamola Martin, Laura; Rodríguez Cristobal, Juan José; Alonso-Villaverde, Carlos; Salvador-González, Betlem; Moral Pelaez, Irene
To determine whether the benefit on cardiovascular risk factors (CVRF) persists 5 years after an intensive intervention in lifestyle (LS) that lasted 2 years, in patients with hyperfibrinogenaemia and moderate or high cardiovascular risk. multicentre prospective observational study. 13 Primary Care Centres in Barcelona and Baix Llobregat. A total of 300 patients who completed the EFAP study (146 intervention group, 154 control group). The EFAP study, conducted on patients with normal cholesterol and elevated fibrinogen showed that lifestyle interventions are effective in reducing CVRF. After the EFAP study, the 2 groups followed the usual controls, and re-assessed after 5 years. Age, gender, cardiovascular diseases (CVD) (diabetes, dyslipidaemia, hypertension, obesity), laboratory parameters (fibrinogen, glucose, full blood count, cholesterol, triglycerides), blood pressure, weight, height, body mass index (BMI), tobacco and alcohol use, REGICOR. At 5 years, the intervention group had a lower abdominal circumference (98 and 101cm, respectively, P=.043), a lower weight (76.30 and 75.04kg, respectively, P<.001), and BMI (29.5 and 30.97kg/m 2 , P=.018). Fibrinogen level was lower in the intervention group (330.33 and 320.27 mg/dl respectively, P < .001), and REGICOR risk was also lower in the intervention group (5.65 and 5.59 respectively, P < .06). The benefit of an intensive intervention in LS for 2 years to reduce CVRF persists at 5 years, but decreases its intensity over time. It is recommended to repeat the interventions periodically to maintain the beneficial effect on LS. Copyright © 2017. Publicado por Elsevier España, S.L.U.
Background: The aim of the study was to determine the lifestyle and cardiovascular risk factors among hypertensives and the use of antihypertensive medication in Lagos, Nigeria. Methods: Two hundred and fifty consecutive patients who were attending the outpatients' clinic cardiology unit of the medical department of ...
Rijks, Jesse M; Plat, Jogchum; Dorenbos, Elke; Penders, Bas; Gerver, Willem-Jan M; Vreugdenhil, Anita C E
Overweight and obese children have an increased risk to develop cardiovascular diseases (CVDs) in which thyroid-stimulating hormone (TSH) has been suggested as an intermediary factor. However, results of cross-sectional studies are inconclusive, and intervention studies investigating changes in TSH concentrations in association with changes in cardiovascular risk parameters in overweight and obese children are scarce. To gain insight in associations of circulating TSH concentrations and cardiovascular risk parameters in overweight and obese children. Nonrandomized lifestyle intervention. Centre for Overweight Adolescent and Children's Healthcare. Three hundred thirty euthyroid overweight and obese children. Long-term lifestyle intervention. TSH concentrations, pituitary TSH release in response to thyrotropin-releasing hormone (TRH), and cardiovascular risk parameters. At baseline, serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triacylglycerol (TAG), and monocyte chemotactic protein 1 concentrations were significantly associated with serum TSH concentrations. TSH release by the pituitary in response to exogenous TRH was not associated with cardiovascular risk parameters. During lifestyle intervention, several cardiovascular risk parameters significantly improved. In children whose body mass index z score improved, changes in TSH concentrations were significantly associated with changes in TC, LDL-C, and TAG concentrations. In euthyroid overweight and obese children, circulating TSH concentrations are positively associated with markers representing increased CVD risk. Changes in TSH concentrations are also associated with changes in lipid concentrations in children with successful weight loss, which is consistent with TSH being an intermediary factor in modulating lipid and lipoprotein metabolism. Copyright © 2017 Endocrine Society
Americans are a diverse people, but their values, dreams, and attitudes place them in distinct lifestyle groups. Nine adult lifestyles are described and how they may change in response to future economic, social, and political conditions is examined. (RM)
Improving patient adherence to lifestyle advice (IMPALA): a cluster-randomised controlled trial on the implementation of a nurse-led intervention for cardiovascular risk management in primary care (protocol).
Koelewijn-van Loon, M.S.; Steenkiste, B.C. van; Ronda, G.; Wensing, M.J.P.; Stoffers, H.E.; Elwyn, G.; Grol, R.P.T.M.; Weijden, G.D.E.M. van der
BACKGROUND: Many patients at high risk of cardiovascular diseases are managed and monitored in general practice. Recommendations for cardiovascular risk management, including lifestyle change, are clearly described in the Dutch national guideline. Although lifestyle interventions, such as advice on
Tsay, Shiow-Luan; Ko, Wang-Sheng; Lin, Kuan-Pin
Leading a healthy lifestyle not only alleviates the physical problems but also improves the quality of life of cancer survivors. Healthcare professionals should understand the benefits of altering lifestyle behaviors to provide effective intervention programs to assist cancer survivors to improve their health. The aim of this study was to understand the experiences of cancer survivors in changing their lifestyle after a cancer diagnosis. A qualitative descriptive study was conducted on 13 cancer survivors who were sampled purposively from a regional teaching hospital in central Taiwan. Data were collected using in-depth interviews that were guided by semistructured, open-ended questions and analyzed using content analysis. The analysis of interview data revealed four main themes: motivation of lifestyle change, exploring ways toward a healthy lifestyle, making adjustments in lifestyle, and feeling the benefits of lifestyle changes. In striving for survival, an unwillingness to bear the suffering from treatment and their acceptance of responsibility and gratitude to family members prompted most of the participants to change their lifestyle proactively. They had received inadequate lifestyle guidance and sought health lifestyle information on their own. After a period of research and self-contemplation, most of the participants adopted a consistently healthy lifestyle, changed their dietary consumption habits, abstained from tobacco and alcohol, and managed emotional problems that were caused by the disease. Participants who changed to a healthy lifestyle realized benefits in the physical, emotional, and life domains. It is hoped that these findings help healthcare professionals to better appreciate that a cancer diagnosis is a critical opportunity to link the disease to lifestyle choices in the minds of cancer survivors. Healthcare professionals should ask cancer survivors about their lifestyle and then provide appropriate advice and education on healthy lifestyles
Heather L. Blackburn
Full Text Available Heart disease and related sequelae are a leading cause of death and healthcare expenditure throughout the world. Although many patients opt for surgical interventions, lifestyle modification programs focusing on nutrition and exercise have shown substantial health benefits and are becoming increasing popular. We conducted a year-long lifestyle modification program to mediate cardiovascular risk through traditional risk factors and to investigate how molecular changes, if present, may contribute to long-term risk reduction. Here we describe the lifestyle intervention, including clinical and molecular data collected, and provide details of the experimental methods and quality control parameters for the gene expression data generated from participants and non-intervention controls. Our findings suggest successful and sustained modulation of gene expression through healthy lifestyle changes may have beneficial effects on vascular health that cannot be discerned from traditional risk factor profiles. The data are deposited in the Gene Expression Omnibus, series GSE46097 and GSE66175.
Fouwels, Annemarie J.; Bredie, Sebastiaan J. H.; Wollersheim, Hub; Schippers, Gerard M.
ABSTRACT: BACKGROUND: To evaluate the vigilance of medical specialists as to the lifestyle of their cardiovascular outpatients by comparing lifestyle screening as registered in medical records versus a lifestyle questionnaire (LSQ), a study was carried out at the cardiovascular outpatient clinic of
Fouwels, A.J.; Bredie, S.J.H.; Wollersheim, H.C.H.; Schippers, G.M.
BACKGROUND: To evaluate the vigilance of medical specialists as to the lifestyle of their cardiovascular outpatients by comparing lifestyle screening as registered in medical records versus a lifestyle questionnaire (LSQ), a study was carried out at the cardiovascular outpatient clinic of the
Morton, Kirsty; Pattison, Helen; Langley, Chris; Powell, Rachael
Cardiovascular disease (CVD) progression is modifiable through lifestyle behaviors. Community pharmacists are ideally placed to facilitate self-management of cardiovascular health however research shows varied pharmacist engagement in providing lifestyle advice. This study explored community pharmacists' experiences and perceptions of providing lifestyle advice to patients with CVD. Semi-structured interviews were conducted with fifteen pharmacists (1 supermarket; 7 multiple; 7 independent) recruited through multiple methods from community pharmacies across the Midlands, England. A thematic analysis was conducted using a Framework approach. Pharmacists categorized patients according to their perceptions of the patients' ability to benefit from advice. Many barriers to providing lifestyle advice were identified. Confidence to provide lifestyle advice varied, with pharmacists most comfortable providing lifestyle advice in conjunction with conversations about medicines. Some pharmacists felt lifestyle advice was an integral part of their role whilst others questioned whether pharmacists should give lifestyle advice at all, particularly when receiving no remuneration for doing so. Pharmacists viewed providing lifestyle advice as important but identified many barriers to doing so. Lifestyle advice provision was influenced by pharmacists' perceptions of patients. Professional identity and associated role conflict appeared to underpin many of the barriers to pharmacists providing lifestyle advice. Pharmacists may benefit from enhanced training to: increase their confidence to provide lifestyle advice; integrate lifestyle advice with regular pharmaceutical practice and challenge their perceptions of some patients' receptiveness to lifestyle advice and behavior change. Changes to the way UK pharmacists are remunerated may increase the provision of lifestyle advice. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.
Chinapaw Marijke J
Full Text Available Abstract Background The number of people with cardiovascular disease (CVD and diabetes mellitus type 2 (T2DM is growing rapidly. To a large extend, this increase is due to lifestyle-dependent risk factors, such as overweight, reduced physical activity, and an unhealthy diet. Changing these risk factors has the potential to postpone or prevent the development of T2DM and CVD. It is hypothesized that a cognitive behavioral program (CBP, focused in particular on motivation and self-management in persons who are at high risk for CVD and/or T2DM, will improve their lifestyle behavior and, as a result, will reduce their risk of developing T2DM and CVD. Methods 12,000 inhabitants, 30-50 years of age living in several municipalities in the semi-rural region of West-Friesland will receive an invitation from their general practitioner (n = 13 to measure their own waist circumference with a tape measure. People with abdominal obesity (male waist ≥ 102 cm, female waist ≥ 88 cm will be invited to participate in the second step of the screening which includes blood pressure, a blood sample and anthropometric measurements. T2DM and CVD risk scores will then be calculated according to the ARIC and the SCORE formulae, respectively. People with a score that indicates a high risk of developing T2DM and/or CVD will then be randomly assigned to the intervention group (n = 300 or the control group (n = 300. Participants in the intervention group will follow a CBP aimed at modifying their dietary behavior, physical activity, and smoking behavior. The counseling methods that will be used are motivational interviewing (MI and problem solving treatment (PST, which focus in particular on intrinsic motivation for change and self-management of problems of the participants. The CBP will be provided by trained nurse practitioners in the participant's general practice, and will consists of a maximum of six individual sessions of 30 minutes, followed by 3-monthly booster
Full Text Available Lifestyle change (comprising adequate diet, physical activity, and behavior therapy represents the cornerstone of obesitytherapy. Dietary intervention consists primarily in reducing the energy content of the diet and secondarily in altering the relativemacronutrient composition. It is recommended to ingest low-calorie diets rather than very-low-calorie diets, because they aresafer and better accepted and provide at least similar long-term results. Low-fat diets have traditionally been prescribed forweight loss, because they facilitate energy restriction. Low-carbohydrate diets are helpful because they favor energy restriction,as well. Physical activity has favorable effects in obese patients: it prevents the decline in resting energy expenditure thataccompanies diet-induced weight loss, reduces the amount of free-fat mass lost, decreases the risk of developing type 2diabetes mellitus and of dying from cardiovascular disease, increases the rate of weight loss, and helps maintaining the resultson long term. Behavior therapy aims at altering eating and activity habits that promote obesity. It usually involves multiplestrategies, including stimulus control, self-monitoring, problem solving skills, cognitive restructuring, social support, andrelapse prevention. Many obese persons can achieve short-term weight loss by dieting alone. However, successful log-termresults are much more difficult to obtain and require a more complex strategy, including physical activity and behavior therapy.
Chomistek, Andrea K; Chiuve, Stephanie E; Eliassen, A Heather; Mukamal, Kenneth J; Willett, Walter C; Rimm, Eric B
Overall mortality rates from coronary heart disease (CHD) in the United States have declined in recent decades, but the rate has plateaued among younger women. The potential for further reductions in mortality rates among young women through changes in lifestyle is unknown. The aim of this study was to estimate the proportion of CHD cases and clinical cardiovascular disease (CVD) risk factors among young women that might be attributable to poor adherence to a healthy lifestyle. A prospective analysis was conducted among 88,940 women ages 27 to 44 years at baseline in the Nurses' Health Study II who were followed from 1991 to 2011. Lifestyle factors were updated repeatedly by questionnaire. A healthy lifestyle was defined as not smoking, a normal body mass index, physical activity ≥ 2.5 h/week, television viewing ≤ 7 h/week, diet in the top 40% of the Alternative Healthy Eating Index-2010, and 0.1 to 14.9 g/day of alcohol. To estimate the proportion of CHD and clinical CVD risk factors (diabetes, hypertension, and hypercholesterolemia) that could be attributed to poor adherence to a healthy lifestyle, we calculated the population-attributable risk percent. During 20 years of follow-up, we documented 456 incident CHD cases. In multivariable-adjusted models, nonsmoking, a healthy body mass index, exercise, and a healthy diet were independently and significantly associated with lower CHD risk. Compared with women with no healthy lifestyle factors, the hazard ratio for CHD for women with 6 lifestyle factors was 0.08 (95% confidence interval: 0.03 to 0.22). Approximately 73% (95% confidence interval: 39% to 89%) of CHD cases were attributable to poor adherence to a healthy lifestyle. Similarly, 46% (95% confidence interval: 43% to 49%) of clinical CVD risk factor cases were attributable to a poor lifestyle. Primordial prevention through maintenance of a healthy lifestyle among young women may substantially lower the burden of CVD. Copyright © 2015 American College
Ciliska, Donna; Wilson, Douglas M. C.
This article is the second in a series of six on lifestyle assessment and behavior change. The first article presented an assessment tool called FANTASTIC, which has been tested for reliability and is currently in wide use. After assessment, family physicians must help patients decide to change—and give them guidance on how to change—unhealthy behaviors. This article explains how the family physician can use educational, behavioral and relaxation strategies to increase patients' motivation, m...
Hashemi, Seyed Hesam Bani; Karimi, Samieh; Mahboobi, Hamidreza
Breast cancer is the second most common cause of death from cancer among women. Lifestyle changes are shown to be important in the prevention of breast cancer. Diet, physical activity, smoking, alcohol use, and vitamin and mineral use are key factors influencing the risk of breast cancer among women. Because these factors are related to each other, it is difficult to assess their individual roles in breast cancer. Some of these factors are alterable, meaning that women can decrease their risk...
Morton, Kirsty; Pattison, Helen; Langley, Chris; Powell, Rachael
Background - Cardiovascular disease (CVD) progression is modifiable through lifestyle behaviors. Community pharmacists are ideally placed to facilitate self-management of cardiovascular health however research shows varied pharmacist engagement in providing lifestyle advice. Objective - This study explored community pharmacists' experiences and perceptions of providing lifestyle advice to patients with CVD. Methods - Semi-structured interviews were conducted with fifteen pharmacists (1 superm...
The effect of a comprehensive lifestyle intervention on cardiovascular risk factors in pharmacologically treated patients with stable cardiovascular disease compared to usual care : a randomised controlled trial
Hellemans, Irene M; van Tulder, Maurits W; Heymans, Martijn W; Rauwerda, Jan A; van Rossum, Albert C; Seidell, Jaap C; IJzelenberg, W.
BACKGROUND: The additional benefit of lifestyle interventions in patients receiving cardioprotective drug treatment to improve cardiovascular risk profile is not fully established.The objective was to evaluate the effectiveness of a target-driven multidisciplinary structured lifestyle intervention
Meyer, Ursina; Schindler, Christian; Bloesch, Tamara; Schmocker, Eliane; Zahner, Lukas; Puder, Jardena J; Kriemler, Susi
PURPOSE: Negative lifestyle factors are known to be associated with increased cardiovascular risk (CVR) in children, but research on their combined impact on a general population of children is sparse. Therefore, we aimed to quantify the combined impact of easily assessable negative lifestyle factors on the CVR scores of randomly selected children after 4 years. METHODS: Of the 540 randomly selected 6- to 13-year-old children, 502 children participated in a baseline health assessment, and ...
Full Text Available During the type-setting of the final version of the article,1 the title was misspelled on the website, page 2 of Word Document, and page 2 of PDF. The title was written as “Quantifying Socioeconomic and Lifestyle Related Health Risks: Burden of Cardiocascular Disease Among Indian Males” and the corrected title is “Quantifying Socioeconomic and Lifestyle Related Health Risks: Burden of Cardiovascular Disease Among Indian Males.”
Hojlund, Mikkel; Elliott, Anja Friis; Madsen, Nikolaj Juul
BACKGROUND: Patients with schizophrenia have high risk of early death from diabetes and cardiovascular diseases, partly because of poor lifestyle and partly because of long-lasting exposure to antipsychotic treatment. AIMS: To investigate the influence of a lifestyle intervention program on chang...
Jeffrey J. VanWormer
Full Text Available Prior research has shown that unhealthy lifestyles increase the risk for developing a number of chronic diseases, but there are few studies examining how lifestyle changes impact metabolic syndrome. This study analyzed the association between two-year changes in key lifestyle risk metrics and incident metabolic syndrome in adults. A retrospective cohort study was conducted using data from metabolic syndrome free adults in the Heart of New Ulm Project (New Ulm, MN. The outcome was incident metabolic syndrome observed two years after baseline in 2009. The primary predictor was change in optimal lifestyle score based on four behavioral risk factors, including smoking, alcohol use, fruit/vegetable consumption, and physical activity. In the analytical sample of 1059 adults, 12% developed metabolic syndrome by 2011. Multivariable regression models (adjusted for baseline lifestyle score, age, sex, education, cardiovascular disease, and diabetes revealed that a two-year decrease in optimal lifestyle score was associated with significantly greater odds of incident metabolic syndrome (OR = 2.92; 95% CI: 1.69, 5.04; p < 0.001. This association was primarily driven by changes in obesity, fruit/vegetable consumption, and alcohol intake. As compared to improving poor lifestyle habits, maintaining a healthy lifestyle seemed to be most helpful in avoiding metabolic syndrome over the two-year study timeframe.
Full Text Available Background: Cardiovascular diseases are the current leading causes of death and disability globally. Objective: To assess the effects of a basic educational program for cardiovascular prevention in an unselected outpatient population. Methods: All participants received an educational program to change to a healthy lifestyle. Assessments were conducted at study enrollment and during follow-up. Symptoms, habits, ATP III parameters for metabolic syndrome, and American Heart Association’s 2020 parameters of cardiovascular health were assessed. Results: A total of 15,073 participants aged ≥ 18 years entered the study. Data analysis was conducted in 3,009 patients who completed a second assessment. An improvement in weight (from 76.6 ± 15.3 to 76.4 ± 15.3 kg, p = 0.002, dyspnea on exertion NYHA grade II (from 23.4% to 21.0% and grade III (from 15.8% to 14.0% and a decrease in the proportion of current active smokers (from 3.6% to 2.9%, p = 0.002 could be documented. The proportion of patients with levels of triglycerides > 150 mg/dL (from 46.3% to 42.4%, p 100 mg/dL (from 69.3% to 65.5%, p < 0.001 improved. A ≥ 20% improvement of AHA 2020 metrics at the level graded as poor was found for smoking (-21.1%, diet (-29.8%, and cholesterol level (-23.6%. A large dropout as a surrogate indicator for low patient adherence was documented throughout the first 5 visits, 80% between the first and second assessments, 55.6% between the second and third assessments, 43.6% between the third and fourth assessments, and 38% between the fourth and fifth assessments. Conclusion: A simple, basic educational program may improve symptoms and modifiable cardiovascular risk factors, but shows low patient adherence.
A meta-analysis of 16 studies focused on short- and long-term cognitive effects of statins found ... risk for new diabetes is more than outweighed by cardiovascular benefits. Thus, in ..... Carter AA, Gomes T, Camacho X, et al. Risk of incident ...
Paillard, F; Bruckert, E; Naelten, G; Picard, P; van Ganse, E
Data on the characteristics of consumers of phytosterol-enriched products and modalities of consumption are rare. An observational study evaluating the lifestyle characteristics and cardiovascular risk (CVR) profile of phytosterol-enriched yogurt consumers was performed in France. Subjects were recruited from general practitioners via electronic medical records. Data were obtained from 358 consumers and 422 nonconsumers with 519 subject questionnaires (243 consumers, 276 nonconsumers; 67% response). Consumers had more cardiovascular risk factors than nonconsumers (2.0 ± 1.5 versus 1.6 ± 1.4; P Phytosterol-enriched yogurt intake conformed to recommendations in two-thirds of consumers and was mainly consumed because of concerns over cholesterol levels and CVR. The higher cardiovascular disease risk profile of phytosterol-enriched yogurt consumers corresponds to a population for whom European guidelines recommend lifestyle changes to manage cholesterol. The coherence of the data in terms of risk factors, adherence to lifestyle recommendations and the consumption of phytosterol-enriched yogurt conforming to recommendations reflects a health-conscious consumer population. © 2014 The British Dietetic Association Ltd.
P. Chu (Paula); A. Pandya; J.A. Salomon (Joshua A); S.J. Goldie (Sue J); Hunink, M.G.M. (M.G. Myriam)
textabstractBackground-Evidence shows that healthy diet, exercise, smoking interventions, and stress reduction reduce cardiovascular disease risk. We aimed to compare the effectiveness of these lifestyle interventions for individual risk profiles and determine their rank order in reducing 10-year
Deijle, Inger A.; Van Schaik, Sander M.; Van Wegen, Erwin E.H.; Weinstein, Henry C.; Kwakkel, Gert; Van Den Berg-Vos, Renske M.
Background and Purpose - Patients with a transient ischemic attack or ischemic stroke have an increased risk of subsequent cardiovascular events. The purpose of this systematic review and meta-analysis was to determine whether lifestyle interventions focusing on behaviorally modifiable risk factors
Full Text Available Objective. Lifestyle modification programs are different but typically include both nutritional aspects and physical activity as main domains with different behavioral and/or psychological strategies designed to affect change. A fundamental role in modifying unhealthy habits is played by personal motivation for change. The present study sought to investigate, in a group of 100 overweight/obese outpatients with and/or without TMD2, treatment seeking, the effect of an intensive lifestyle program on medical measures and motivational profile for physical activity (PA and healthy nutrition (NUTR. Method. Subjects participated in an intensive multidisciplinary lifestyle intervention at C.U.R.I.A.MO. Before and after the intervention, patients received a comprehensive evaluation of their clinical, anthropometric, and metabolic states and motivation to lifestyle changes. Results. Data showed differences before and after intervention in both medical and motivational measures. Before the intervention patients reported to be ready, open, and determined to change and gave importance to healthy habits. After the intervention patients continued to be determined but increased the actions toward the change showing a higher degree of maintenance and of acquisition of habits especially in the physical domain of the new lifestyle. Conclusion. Data support the notion that the motivation should be followed during all the lifestyle interventions to support the change on both domains of the lifestyle program.
Livia, Buratta; Elisa, Reginato; Claudia, Ranucci; Roberto, Pippi; Cristina, Aiello; Emilia, Sbroma Tomaro; Chiara, Perrone; Alberto, Tirimagni; Angelo, Russo; Pierpaolo, De Feo; Claudia, Mazzeschi
Lifestyle modification programs are different but typically include both nutritional aspects and physical activity as main domains with different behavioral and/or psychological strategies designed to affect change. A fundamental role in modifying unhealthy habits is played by personal motivation for change. The present study sought to investigate, in a group of 100 overweight/obese outpatients with and/or without TMD2, treatment seeking, the effect of an intensive lifestyle program on medical measures and motivational profile for physical activity (PA) and healthy nutrition (NUTR). Subjects participated in an intensive multidisciplinary lifestyle intervention at C.U.R.I.A.MO. Before and after the intervention, patients received a comprehensive evaluation of their clinical, anthropometric, and metabolic states and motivation to lifestyle changes. Data showed differences before and after intervention in both medical and motivational measures. Before the intervention patients reported to be ready, open, and determined to change and gave importance to healthy habits. After the intervention patients continued to be determined but increased the actions toward the change showing a higher degree of maintenance and of acquisition of habits especially in the physical domain of the new lifestyle. Data support the notion that the motivation should be followed during all the lifestyle interventions to support the change on both domains of the lifestyle program.
Celeste van Rinsum; Sanne Gerards; Geert Rutten; Nicole Philippens; Ester Janssen; Bjorn Winkens; Ien van de Goor; Stef Kremers
Combined lifestyle interventions (CLIs) can be effective in reducing weight and improving lifestyle-related behaviours but it is unclear how CLIs can best be implemented in practice in order to achieve sustained lifestyle changes. The Coaching on Lifestyle programme (CooL) is a CLI in the Netherlands, in which professional lifestyle coaches counsel adults and children (and/or their parents) who are obese or at high risk of obesity to achieve a sustained healthier lifestyle. The CooL intervent...
Kandula, Namratha R; Patel, Yasin; Dave, Swapna; Seguil, Paola; Kumar, Santosh; Baker, David W; Spring, Bonnie; Siddique, Juned
Disseminating and implementing evidence-based, cardiovascular disease (CVD) prevention lifestyle interventions in community settings and in ethnic minority populations is a challenge. We describe the design and methods for the South Asian Heart Lifestyle Intervention (SAHELI) study, a pilot study designed to determine the feasibility and initial efficacy of a culturally-targeted, community-based lifestyle intervention to improve physical activity and diet behaviors among medically underserved South Asians (SAs). Participants with at least one CVD risk factor will be randomized to either a lifestyle intervention or a control group. Participants in both groups will be screened in a community setting and receive a primary care referral after randomization. Intervention participants will receive 6weeks of group classes, followed by 12weeks of individual telephone support where they will be encouraged to initiate and maintain a healthy lifestyle goal. Control participants will receive their screening results and monthly mailings on CVD prevention. Primary outcomes will be changes in moderate/vigorous physical activity and saturated fat intake between baseline, 3-, and 6-month follow-up. Secondary outcomes will be changes in weight, clinical risk factors, primary care visits, self-efficacy, and social support. This study will be one of the first to pilot-test a lifestyle intervention for SAs, one of the fastest growing racial/ethnic groups in the U.S. and one with disparate CVD risk. Results of this pilot study will provide preliminary data about the efficacy of a lifestyle intervention on CVD risk in SAs and inform community-engaged CVD prevention efforts in an increasingly diverse U.S. population. © 2013.
Loprinzi, Paul D; Branscum, Adam; Hanks, June; Smit, Ellen
To estimate the prevalence of healthy lifestyle characteristics and to examine the association between different combinations of healthy lifestyle characteristics and cardiovascular disease biomarkers. The prevalence of healthy lifestyle characteristics was estimated for the US adult population (N=4745) using 2003-2006 National Health and Nutrition Examination Survey data for the following parameters: being sufficiently active (accelerometer), eating a healthy diet (Healthy Eating Index based on 24-hour recalls), being a nonsmoker (serum cotinine level), and having a recommended body fat percentage (dual-energy X-ray absorptiometry). Cardiovascular biomarkers included mean arterial pressure, C-reactive protein, white blood cells (WBCs), total cholesterol, high-density lipoprotein cholesterol (HDL-C), total cholesterol to HDL-C ratio, fasting low-density lipoprotein cholesterol, fasting triglycerides, fasting glucose, fasting insulin, insulin resistance, hemoglobin A1c, and homocysteine. The study was conducted from August 15, 2013, through January 5, 2016. Only 2.7% (95% CI, 1.9%-3.4%) of all adults had all 4 healthy lifestyle characteristics. Participants with 3 or 4 compared with 0 healthy lifestyle characteristics had more favorable biomarker levels except for mean arterial blood pressure, fasting glucose, and hemoglobin A1c. Having at least 1 or 2 compared with 0 healthy lifestyle characteristics was favorably associated with C-reactive protein, WBCs, HDL-C, total cholesterol, and homocysteine. For HDL-C and total cholesterol, the strongest correlate was body fat percentage. For homocysteine, a healthy diet and not smoking were strong correlates; for WBCs, diet was not a strong correlate. Although multiple healthy lifestyle characteristics are important, specific health characteristics may be more important for particular cardiovascular disease risk factors. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All
Melissa S. Burroughs Peña
Full Text Available Cardiovascular disease is the leading cause of mortality in Cuba. Lifestyle risk factors for coronary heart disease (CHD in Cubans have not been compared to risk factors in Cuban Americans. Articles spanning the last 20 years were reviewed. The data on Cuban Americans are largely based on the Hispanic Health and Nutrition Examination Survey (HHANES, 1982–1984, while more recent data on epidemiological trends in Cuba are available. The prevalence of obesity and type 2 diabetes mellitus remains greater in Cuban Americans than in Cubans. However, dietary preferences, low physical activity, and tobacco use are contributing to the rising rates of obesity, type 2 diabetes mellitus, and CHD in Cuba, putting Cubans at increased cardiovascular risk. Comprehensive national strategies for cardiovascular prevention that address these modifiable lifestyle risk factors are necessary to address the increasing threat to public health in Cuba.
Consumers can be empowered for changing lifestyles by reducing some of their individual limitations, but it is also important to reduce some of the external constraints that make changes towards a more sustainable lifestyle difficult. In terms of reducing consumers' subjectively felt restrictions...
Livia, Buratta; Elisa, Reginato; Claudia, Ranucci; Roberto, Pippi; Cristina, Aiello; Emilia, Sbroma Tomaro; Chiara, Perrone; Alberto, Tirimagni; Angelo, Russo; Pierpaolo, De Feo; Claudia, Mazzeschi
Objective. Lifestyle modification programs are different but typically include both nutritional aspects and physical activity as main domains with different behavioral and/or psychological strategies designed to affect change. A fundamental role in modifying unhealthy habits is played by personal motivation for change. The present study sought to investigate, in a group of 100 overweight/obese outpatients with and/or without TMD2, treatment seeking, the effect of an intensive lifestyle progra...
Altamirano-Diaz, Luis; Rombeek, Meghan; De Jesus, Stefanie; Welisch, Eva; Prapavessis, Harry; Dempsey, Adam A; Fraser, Douglas; Miller, Michael R; Norozi, Kambiz
Children with overweight/obesity and congenital heart disease (CHD) are at increased cardiovascular risk. A lifestyle intervention may help reduce these risks. We sought to determine the feasibility of a smartphone-based lifestyle intervention to improve cardiovascular health outcomes in children with overweight/obesity and CHD. We examined the effect of bi-weekly nutrition and fitness counseling delivered via smartphone over 12 months. Thirty-four youth, previously diagnosed with CHD and with overweight or obesity, participated in the intervention. They were divided into two groups depending on whether the heart disease required surgical correction (operated, n = 19) or not (non-operated, n = 15). Anthropometry, body composition cardiorespiratory exercise capacity, and cardio-metabolic risk factors were assessed at baseline, 6 months, and 12 months. Statistically significant decreases in waist circumference (WC), body mass index z -score, WC z -score, and waist to height ratio z -score were observed at 6 and 12 months in the operated group. A significant linear increase in lean body mass was observed in both groups. The study also had a high retention rate and a low attrition rate. The observed changes in anthropometry were positive with significant improvement to some cardiovascular and metabolic risk indicators. However, this was only observed in the operated group suggesting that other factors, such as perception of condition and self-efficacy, may influence lifestyle behaviors. The results from this pilot study clearly demonstrate the feasibility to perform a larger controlled study on remote lifestyle intervention in children with congenital heart defects and overweight or obesity.
Full Text Available BackgroundChildren with overweight/obesity and congenital heart disease (CHD are at increased cardiovascular risk. A lifestyle intervention may help reduce these risks. We sought to determine the feasibility of a smartphone-based lifestyle intervention to improve cardiovascular health outcomes in children with overweight/obesity and CHD.MethodsWe examined the effect of bi-weekly nutrition and fitness counseling delivered via smartphone over 12 months. Thirty-four youth, previously diagnosed with CHD and with overweight or obesity, participated in the intervention. They were divided into two groups depending on whether the heart disease required surgical correction (operated, n = 19 or not (non-operated, n = 15. Anthropometry, body composition cardiorespiratory exercise capacity, and cardio-metabolic risk factors were assessed at baseline, 6 months, and 12 months.ResultsStatistically significant decreases in waist circumference (WC, body mass index z-score, WC z-score, and waist to height ratio z-score were observed at 6 and 12 months in the operated group. A significant linear increase in lean body mass was observed in both groups. The study also had a high retention rate and a low attrition rate.ConclusionThe observed changes in anthropometry were positive with significant improvement to some cardiovascular and metabolic risk indicators. However, this was only observed in the operated group suggesting that other factors, such as perception of condition and self-efficacy, may influence lifestyle behaviors. The results from this pilot study clearly demonstrate the feasibility to perform a larger controlled study on remote lifestyle intervention in children with congenital heart defects and overweight or obesity.
Lilit Vanikovna Egshatyan
Full Text Available In this review are discussed experimental and clinical data about the role of gut microbiota and its changes associated with age and lifestyle. The large intestinal microbiota plays an important role in normal bowel function and the maintenance of host health through the formation of short chain fatty acids, modulation of immune system reactivity, and development of colonization resistance. The intestinal microflora is a peculiar indicator of the condition of a microorganism reacting to age, physiological, dietary, and geographical factors from change of qualitative and quantitative structure. Studies have demonstrated that obesity and metabolic syndrome may be associated with profound microbiotal changes. Changes in gut microbiota control metabolic endotoxemia - induced chronic inflammation, oxidative stress, and metabolic disorder which are connected with the increased risk of development of cardiovascular diseases and pathology associated with age, which leads to accelerated aging. It is obvious that maintenance of a homeostasis and a normal metabolism is impossible without restoration of a variety of normal associations of intestinal microorganisms.
Husemoen, LL; Thomsen, TF; Fenger, M
BACKGROUND: Reduction in total homocysteine (tHcy) may be clinically relevant in the prevention of cardiovascular disease (CVD) in the general population. OBJECTIVE: To examine the effects of changes in various lifestyle habits and lifestyle related biological CVD risk markers on changes in t...... intervention and re-examination after one year. RESULTS: None of the studied lifestyle changes-- smoking, physical activity, dietary habits, and coffee, tea, and alcohol consumption-- was significantly associated with changes in tHcy, either overall, or in any of the MTHFR genotype subgroups. In addition...
Sudhir, Paulomi M
The present review examines the recent advances in psychological interventions for two major lifestyle disorders in adults namely, type 2 diabetes mellitus and cardiovascular disorders. The review summarizes findings from studies carried out between the years 2015 and 2017. The effectiveness of psychological interventions in the management of lifestyle disorders has been examined with respect to adaptation, self-care, adherence, negative emotions and improving quality of life. There is an increasing recognition that psychological interventions are important for prevention of lifestyle disorders and promotion of health. Key psychological interventions include self-management and educational interventions based on learning and motivational principles, patient empowerment, cognitive behaviour therapy, behavioural skills and coaching. Recent developments also include the use of information technology to deliver these interventions through internet, mobile applications and text messages. Another significant development is that of mindfulness-based interventions within the third-generation behaviour therapy approaches to reduce distress and increase acceptance. In addition, family and couples interventions have also been emphasised as necessary in maintenance of healthy behaviours. Studies examining psychological interventions in cardiovascular and type 2 diabetes mellitus support the efficacy of these interventions in bringing about changes in biochemical / physiological parameters and in psychological outcomes such as self-efficacy, knowledge, quality of life and a sense of empowerment.
Wagner, Malene; Nielsen, Karina; Jensen, Peter Errboe
Ischemic heart disease (IHD) is a major cause of death for women worldwide, and thus it is important to focus on lifestyle changes to reduce the impact of the disease on women’s everyday lives. Nine women were interviewed using an explorative approach to describe women’s lifestyle changes after...... being diagnosed with IHD. Three major themes emerged; ‘Heart disease: A life-changing event’, ‘Social life – both inhibiting and promoting lifestyle changes’ and ‘Maintaining changes: An ongoing challenge and a conscious choice’. Ischemic heart disease caused anxiety, and the women strived to find...
Huang, Yuxin; Li, Jihu; Zhu, Xiaolin; Sun, Jiao; Ji, Linong; Hu, Dayi; Pan, Changyu; Tan, Wen; Jiang, Suyuan; Tao, Xiaoming
This subanalysis of a cross-sectional, nationwide study was undertaken to assess the relationship between healthy lifestyle behaviors and multiple cardiovascular risk factors among people with type 2 diabetes mellitus (T2DM). Data collected from 25,454 participants, including demographics, lifestyle behaviors and cardiovascular risk profiles, were analyzed. Blood pressure control as well as blood glucose and blood lipid (3Bs) levels were measured as multi-risk factors for cardiovascular disease. Healthy lifestyle behaviors included regular exercise, nonsmoking status and no alcohol consumption. The relationship between the healthy lifestyle behavior(s) and control of 3B(s) was calculated. Of the 25,454 eligible participants, 4171 (16.4%) were current smokers, 2011 (7.9%) currently consumed alcohol, and 11,174 (43.9%) did not exercise. In total, 654 (2.6%) reported all three unhealthy lifestyle behaviors. Most participants (71.1%) had received at least a high school education and were more likely to smoke and drink as compared to those with lower education. Unhealthy lifestyle behaviors were commonly found in participants with low atherosclerosis risk, such as non-elderly people and those with an above-college education level. Unhealthy lifestyle is associated with poor 3B control and worse medication adherence. Unhealthy lifestyles are common in Chinese people with T2DM, especially in people who are non-elderly and above-college educated. Interventions aimed at changing risky lifestyle behaviors are required for improved outcomes for Chinese patients with T2DM.
Nakano, Takahiro; Kasuga, Kosho; Murase, Tomohiko; Suzuki, Kazuhiro
Background: Unhealthy lifestyles during childhood constitute a public health problem in Japan. However, current health education in Japan is ineffective in counteracting them. Previous studies contend that healthy lifestyles in children vary by academic grade and sex. This study examined changes throughout childhood suggests some intervention…
Jørgensen, Marit E; Borch-Johnsen, Knut; Bjerregaard, Peter
BACKGROUND: The association between obesity and cardiovascular disease risk differs across populations. Whether such differences in obesity-related risk factors exist within population groups of the same genetic origin but with differences in lifestyle remains to be determined. OBJECTIVE: The aim...... was to analyze whether obesity was associated with the same degree of metabolic disturbances in 2 groups of genetically homogeneous Inuit who were exposed to considerable differences in lifestyle. DESIGN: We studied obesity and cardiovascular disease risk factors in a cross-sectional population survey of 2311...... Inuit living in Denmark (n = 995) or Greenland (n = 1316). The participants received an oral-glucose-tolerance test. Blood tests were supplemented by structured interviews and anthropometric and blood pressure measurements. RESULTS: The trend in the association between obesity and metabolic effects...
Cardiovascular pathophysiological changes, such as hypertension and enlarged ventricles, reflect the altered functions of the heart and its circulation during ill-health. This article examines the normal and altered anatomy of the cardiac valves, the contractile elements and enzymes of the myocardium, the significance of the different factors associated with cardiac output, and the role of the autonomic nervous system in the heart beat. It also explores how certain diseases alter these functions and result in cardiac symptoms. Nurses can benefit from knowledge of these specific changes, for example, by being able to ask relevant questions in order to ascertain the nature of a patients condition, by being able to take an effective patient history and by being able to read diagnostic results, such as electrocardiograms and cardiac enzyme results. All this will help nurses to promote sound cardiac care based on a physiological rationale.
Pérez-Manchón, David; Alvarez-García, Gema María; González-López, Esteban
Study the relationship between motivation to change unhealthy life styles and cardiovascular risk. Cross sectional study, random, stratified by age, carried out in the field of primary care with a sample of 369 people. It was felt that with smoking or smoking cessation active consumption less than a year, the physical habit was valued at work and leisure, food habits were assessed in adherence to mediterranean diet and the stages of motivation were categorized precontemplative phase to maintenance phase. The cardiovascular risk was stratified with the SCORE table calibrated in Spain. The 49.6% were men and 50.4% were women, with an average age of 41.2 years. The prevalence of smoking was 31.4% (95% CI 26.56-36,30), 58% in sedentary lifestyle (95% CI 52.27-62,63) and 68% for bad diet (95% CI 63.97-73,69). The 69.8% of smokers, 77.8% of sedentary and 48.4% of people without proper diet was precontemplative to change their lifestyles. Precontemplative stages in unhealthy life styles have association with risk factors and increase the global cardiovascular risk. The transtheoretical model is a useful tool for the assessment of unhealthy behaviors in lifestyles. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.
Williams, Yvette Gail
Many children in U.S. K-12 schools struggle with childhood obesity. A healthy lifestyle taught in a child's early years is essential for student learning, and it can set the pace for healthy choices to be made in adulthood. The purpose of this exploratory case study was to explore the experiences of parents in Montgomery County, Ohio, who…
Temporelli, Pier Luigi; Zito, Giovanni; Faggiano, Pompilio
Cardiologists' cardiovascular profile and lifestyle habits are poorly known worldwide. To offer a snapshot of the personal health habits of Italian cardiologists, the Survey on Cardiac Risk Profile and Lifestyle Habits in a Cohort of Italian Cardiologists (SOCRATES) was undertaken. A Web-based electronic self-reported survey, accessible through a dedicated Web site, was used for data entry, and data were transferred through the Web to a central database. The survey was divided into 4 sections: baseline characteristics, medical illnesses and traditional cardiovascular risk factors, lifestyle habits, and selected medication use. The e-mail databases of 3 national scientific societies were used to survey a large and representative sample of Italian cardiologists. During the 3-month period of the survey, 1,770 of the 5,240 cardiologists contacted (33.7%) completed and returned ≥1 sections of the questionnaire. More than 49% of the participants had 1 of the 5 classic risk factors (hypertension, hypercholesterolemia, active smoking, diabetes, and previous vascular events). More than 28% of respondents had 2 to 5 risk factors, and only 22.1% had none and therefore, according to age and gender, could be considered at low to intermediate risk. Despite the reported risk factors, >90% of cardiologists had a self-reported risk perception quantified as mild, such as low or intermediate. Furthermore, overweight and obesity, physical inactivity, and stress at work or at home were commonly reported, as well as limited use of cardiovascular drugs, such as statins or aspirin. In conclusion, the average cardiovascular profile of Italian cardiologist is unlikely to be considered ideal or even favorable according to recent statements and guidelines regarding cardiovascular risk. Copyright © 2013 Elsevier Inc. All rights reserved.
Dorte Ejg Jarbøl
For conclusion we found a pervasive preference for lifestyle changes over medical treatment when individuals were promised the same benefits. Lifestyle risk factors and socioeconomic characteristics were associated with preference for lifestyle changes as well as belief in ability to maintain lifestyle changes. For health professionals risk communication should not only focus on patient preferences but also on patients' beliefs in their own ability to initiate lifestyle changes and possible barriers against maintaining changes.
Kandula, Namratha R.; Patel, Yasin; Dave, Swapna; Seguil, Paola; Kumar, Santosh; Baker, David W.; Spring, Bonnie; Siddique, Juned
Disseminating and implementing evidence-based, cardiovascular disease (CVD) prevention lifestyle interventions in community settings and in ethnic minority populations is a challenge. We describe the design and methods for the South Asian heart lifestyle intervention (SAHELI) study, a pilot study designed to determine the feasibility and initial efficacy of a culturally-targeted, community-based lifestyle intervention to improve physical activity and diet behaviors among medically underserved...
Chu, Paula; Pandya, Ankur; Salomon, Joshua A; Goldie, Sue J; Hunink, M G Myriam
Evidence shows that healthy diet, exercise, smoking interventions, and stress reduction reduce cardiovascular disease risk. We aimed to compare the effectiveness of these lifestyle interventions for individual risk profiles and determine their rank order in reducing 10-year cardiovascular disease risk. We computed risks using the American College of Cardiology/American Heart Association Pooled Cohort Equations for a variety of individual profiles. Using published literature on risk factor reductions through diverse lifestyle interventions-group therapy for stopping smoking, Mediterranean diet, aerobic exercise (walking), and yoga-we calculated the risk reduction through each of these interventions to determine the strategy associated with the maximum benefit for each profile. Sensitivity analyses were conducted to test the robustness of the results. In the base-case analysis, yoga was associated with the largest 10-year cardiovascular disease risk reductions (maximum absolute reduction 16.7% for the highest-risk individuals). Walking generally ranked second (max 11.4%), followed by Mediterranean diet (max 9.2%), and group therapy for smoking (max 1.6%). If the individual was a current smoker and successfully quit smoking (ie, achieved complete smoking cessation), then stopping smoking yielded the largest reduction. Probabilistic and 1-way sensitivity analysis confirmed the demonstrated trend. This study reports the comparative effectiveness of several forms of lifestyle modifications and found smoking cessation and yoga to be the most effective forms of cardiovascular disease prevention. Future research should focus on patient adherence to personalized therapies, cost-effectiveness of these strategies, and the potential for enhanced benefit when interventions are performed simultaneously rather than as single measures. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
Gupta, Rajeev; Misra, Anoop; Pais, Prem; Rastogi, Priyanka; Gupta, V P
There is a wide disparity in prevalence and cardiovascular disease mortality in different Indian states. To determine significance of various nutritional factors and other lifestyle variables in explaining this difference in cardiovascular disease mortality we performed an analysis. Mortality data were obtained from the Registrar General of India. In 1998 the annual death rate for India was 840/100,000 population. Cardiovascular diseases contribute to 27% of these deaths and its crude mortality rate was 227/100,000. Major differences in cardiovascular disease mortality rates in different Indian states were reported varying from 75-100 in sub-Himalayan states of Nagaland, Meghalaya, Himachal Pradesh and Sikkim to a high of 360-430 in Andhra Pradesh, Tamil Nadu, Punjab and Goa. Lifestyle data were obtained from national surveys conducted by the government of India. The second National Family Health Survey (26 states, 92,447 households, 301,984 adults) conducted in 1998-1999 reported on various demographic and lifestyle variables and India Nutrition Profile Study reported dietary intake of 177,841 adults (18 states, 75,229 men, 102,612 women). Cardiovascular disease mortality rates were correlated with smoking, literacy levels, prevalence of stunted growth at 3-years (as marker of fetal undernutrition), adult mean body mass index, prevalence of overweight and obesity, dietary consumption of calories, cereals and pulses, green leafy vegetables, roots, tubers and other vegetables, milk and milk products, fats and oils, and sugar and jaggery. As a major confounder in different states is poverty, all the partial correlation coefficients were adjusted for illiteracy, fertility rate and infant mortality rate. There was a significant positive correlation of cardiovascular disease mortality with prevalence of obesity (R=0.37) and dietary consumption of fats (R=0.67), milk and its products (R=0.27) and sugars (R=0.51) and negative correlation with green leafy vegetable intake
Mozaffarian, Dariush; Kamineni, Aruna; Carnethon, Mercedes; Djoussé, Luc; Mukamal, Kenneth J; Siscovick, David
The combined impact of lifestyle factors on incidence of diabetes mellitus later in life is not well established. The objective of this study was to determine how lifestyle factors, assessed in combination, relate to new-onset diabetes in a broad and relatively unselected population of older adults. We prospectively examined associations of lifestyle factors, measured using repeated assessments later in life, with incident diabetes mellitus during a 10-year period (1989-1998) among 4883 men and women 65 years or older (mean [SD] age at baseline, 73  years) enrolled in the Cardiovascular Health Study. Low-risk lifestyle groups were defined by physical activity level (leisure-time activity and walking pace) above the median; dietary score (higher fiber intake and polyunsaturated to saturated fat ratio, lower trans-fat intake and lower mean glycemic index) in the top 2 quintiles; never smoked or former smoker more than 20 years ago or for fewer than 5 pack-years; alcohol use (predominantly light or moderate); body mass index less than 25 (calculated as weight in kilograms divided by height in meters squared); and waist circumference of 88 cm for women or 92 cm for men. The main outcome measure was incident diabetes defined annually by new use of insulin or oral hypoglycemic medications. We also evaluated fasting and 2-hour postchallenge glucose levels. During 34,539 person-years, 337 new cases of drug-treated diabetes mellitus occurred (9.8 per 1000 person-years). After adjustment for age, sex, race, educational level, and annual income, each lifestyle factor was independently associated with incident diabetes. Overall, the rate of incident diabetes was 35% lower (relative risk, 0.65; 95% confidence interval, 0.59-0.71) for each 1 additional lifestyle factor in the low-risk group. Participants whose physical activity level and dietary, smoking, and alcohol habits were all in the low-risk group had an 82% lower incidence of diabetes (relative risk, 0.18; 95
Chris J. Kapelios
Full Text Available Abstract Background There are about 70 small islands in the Aegean and Ionian Sea, of less than 300 Km2 and 5000 inhabitants each, comprising a total population of more than 75,000 individuals with geographical and socioeconomic characteristics of special interest. The objective of the present study was to assess lifestyle characteristics and the state of cardiovascular risk of the population of a small Eastern Mediterranean island, Elafonisos. Methods PERSEAS (Prospective Evaluation of cardiovascular Risk Surrogates in Elafonisos Area Study is an ongoing, population-based, longitudinal survey of cardiovascular risk factors, life-style characteristics and related morbidity/mortality performed in a small and relatively isolated island of the Aegean Sea, named Elafonisos. Validated, closed-ended questionnaires for demographic, socio-economic, clinical and lifestyle characteristics were distributed and analyzed. The MedDietScore, a validated Mediterranean diet score was also calculated. In addition, all participants underwent measurement of anthropometric parameters, blood pressure and a full blood panel for glucose and lipids. Results The analysis included 596 individuals who represented 74.5% of the target population. The mean age of the population was 49.5 ± 19.6 years and 48.2% were males. Fifty participants (8.4% had a history of cardiovascular disease (CVD. The rates of reported diabetes, hypertension, and hypercholesterolemia were 7.7%, 30.9% and 30.9% respectively, with screen-detection of each condition accounting for an additional 4.0%, 12.9%, and 23.3% of cases, respectively. Four hundred and seven individuals (68.3% were overweight or obese, 25% reported being physically inactive and 36.6% were active smokers. The median MedDietScore was 25 [interquartile range: 6, range 12–47] with higher values significantly associated with older age, better education, increased physical activity, absence of history of diabetes and known
Meyer, Ursina; Schindler, Christian; Bloesch, Tamara; Schmocker, Eliane; Zahner, Lukas; Puder, Jardena J; Kriemler, Susi
Negative lifestyle factors are known to be associated with increased cardiovascular risk (CVR) in children, but research on their combined impact on a general population of children is sparse. Therefore, we aimed to quantify the combined impact of easily assessable negative lifestyle factors on the CVR scores of randomly selected children after 4 years. Of the 540 randomly selected 6- to 13-year-old children, 502 children participated in a baseline health assessment, and 64% were assessed again after 4 years. Measures included anthropometry, fasting blood samples, and a health assessment questionnaire. Participants scored one point for each negative lifestyle factor at baseline: overweight; physical inactivity; high media consumption; little outdoor time; skipping breakfast; and having a parent who has ever smoked, is inactive, or overweight. A CVR score at follow-up was constructed by averaging sex- and age-related z-scores of waist circumference, blood pressure, glucose, inverted high-density lipoprotein, and triglycerides. The age-, sex-, pubertal stage-, and social class-adjusted probabilities (95% confidence interval) for being in the highest CVR score tertile at follow-up for children who had at most one (n = 48), two (n = 64), three (n = 56), four (n = 41), or five or more (n = 14) risky lifestyle factors were 15.4% (8.9-25.3), 24.3% (17.4-32.8), 36.0% (28.6-44.2), 49.8% (38.6-61.0), and 63.5% (47.2-77.2), respectively. Even in childhood, an accumulation of negative lifestyle factors is associated with higher CVR scores after 4 years. These negative lifestyle factors are easy to assess in clinical practice and allow early detection and prevention of CVR in childhood. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Dekkers, J.C.; Wier, M.F. van; Arins, G.A.M.; Hendriksen, I.J.M.; Pronk, N.P.; Smid, T.; Mechelen, W. van
Background: Overweight (Body Mass Index [BMI] ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2) are associated with increased cardiovascular risk, posing a considerable burden to public health. The main aim of this study was to investigate lifestyle intervention effects on cardiovascular risk factors in
Eguchi, Eri; Iso, Hiroyasu; Honjo, Kaori; Yatsuya, Hiroshi; Tamakoshi, Akiko
We examined the effect of education level on the association between healthy lifestyle behaviors and cardiovascular mortality in the Japanese population. A total of 42,647 community-based men and women aged 40–79 years were enrolled at baseline (1988–1990), followed through 2009. The components of the healthy lifestyle score included the intake of fruits, fish, and milk; body mass index; exercise; avoidance of smoking; moderate alcohol intake; and moderate sleep duration. During the 19.3 years of follow-up, 8,314 all-cause and 2,377 total cardiovascular mortality cases were noted. Inverse associations were observed between healthy lifestyle scores and total cardiovascular disease (CVD) for both the lower and higher education level groups. Multivariable hazard ratios (95% confidence interval) for CVD mortality from the highest to the lowest healthy lifestyle scores, and the population attributable fraction (95% CIs) without healthy lifestyle scores of 7–8 were 0.51 (0.33–0.52) and 42% (24–58%), and 0.38 (0.27–0.47) and 55% (36–69%) for the higher and lower education levels, respectively. Our findings suggest that the association between higher CVD mortality and lower education level can be explained by the individuals’ lower adherence to a healthy lifestyle; hence, lifestyle modification would be beneficial for the prevention of cardiovascular mortality, irrespective of the education level. PMID:28057921
Cuenca-García, M; Ortega, F B; Ruiz, J R; González-Gross, M; Labayen, I; Jago, R; Martínez-Gómez, D; Dallongeville, J; Bel-Serrat, S; Marcos, A; Manios, Y; Breidenassel, C; Widhalm, K; Gottrand, F; Ferrari, M; Kafatos, A; Molnár, D; Moreno, L A; De Henauw, S; Castillo, M J; Sjöström, M
To investigate the combined influence of diet quality and physical activity on cardiovascular disease (CVD) risk factors in adolescents, adolescents (n = 1513; 12.5-17.5 years) participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence study were studied. Dietary intake was registered using a 24-h recall and a diet quality index was calculated. Physical activity was assessed by accelerometry. Lifestyle groups were computed as: healthy diet and active, unhealthy diet but active, healthy diet but inactive, and unhealthy diet and inactive. CVD risk factor measurements included cardiorespiratory fitness, adiposity indicators, blood lipid profile, blood pressure, and insulin resistance. A CVD risk score was computed. The healthy diet and active group had a healthier cardiorespiratory profile, fat mass index (FMI), triglycerides, and high-density lipoprotein cholesterol (HDL-C) levels and total cholesterol (TC)/HDL-C ratio (all P ≤ 0.05). Overall, active adolescents showed higher cardiorespiratory fitness, lower FMI, TC/HDL-C ratio, and homeostasis model assessment index and healthier blood pressure than their inactive peers with either healthy or unhealthy diet (all P ≤ 0.05). Healthy diet and active group had healthier CVD risk score compared with the inactive groups (all P ≤ 0.02). Thus, a combination of healthy diet and active lifestyle is associated with decreased CVD risk in adolescents. Moreover, an active lifestyle may reduce the adverse consequences of an unhealthy diet. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Mochari-Greenberger, Heidi; Mosca, Lori
To determine whether caregiver burdens are associated with lifestyle behaviors 1 year following the hospitalization of a family member with cardiovascular disease (CVD). Prospective follow-up study of National Heart Lung and Blood Institute sponsored Family Intervention Trial for Heart Health participants. Hospital-based recruitment/baseline visit with 1-year follow-up. Family members of hospitalized CVD patients (N = 423; 67% female; 36% racial/ethnic minority; mean age 49 years). Systematic evaluation at 1 year to determine heart-healthy diet (defined as caregiver burdens (five domains: employment, financial, physical, social, and time; Caregiver Strain Questionnaire). Logistic regression adjusted for covariates. Heart-healthy diet was less frequent among caregivers citing feeling overwhelmed (odds ratio [OR] = .50; 95% confidence interval [CI] = .26-.97), sleep disturbance (OR = .51; 95% CI = .27-.96), financial strain (OR = .41; 95% CI = .20-.86), upsetting behavior (OR = .48; 95% CI = .25-.92), and/or time demands (OR = .47; 95% CI = .26-.85) as burdens. Physical activity was less frequent among caregivers reporting financial strain (OR = .32; 95% CI = .13-.81) or upsetting patient behavior (OR = .33; 95% CI = .15-.76) as burdens. The most commonly cited caregiver burdens included changes in personal plans (39%), time demands (38%), and sleep disturbance (30%). Caregiver burdens were associated with nonachievement of heart-healthy diet and physical activity behaviors among family caregivers 1 year after patient discharge. When developing heart-health promotion interventions, caregiver burden should be considered as a possible barrier to prevention among family members of CVD patients.
Nakano, Takahiro; Kasuga, Kosho; Murase, Tomohiko; Suzuki, Kazuhiro
Unhealthy lifestyles during childhood constitute a public health problem in Japan. However, current health education in Japan is ineffective in counteracting them. Previous studies contend that healthy lifestyles in children vary by academic grade and sex. This study examined changes throughout childhood suggests some intervention points for lifestyle education. The participants were 2833 elementary and junior high school students living in Japanese rural areas. Data on 26 variables assigned to 5 subfactors were collected. We estimated the composite score of each subfactor on the basis of item response theory. A 2-way ANOVA and a graph review were performed to explore the differences and changes by sex and grade. Most of the main effects for sex and grade were statistically significant. Lifestyle behaviors acquired early in elementary school were lost as students progressed to higher grades. The research indicated the following emphases: (1) Physical activity and leisure habits should be focused on girls and hygiene habits on boys; (2) Continuous education for a healthy lifestyle is essential to maintain good health among children; (3) Education for healthy lifestyle can be classified into 2 important stages such as for dietary and sleeping habits, education from the upper grades of elementary school is important, whereas for other routine activities, reeducation in junior high school is effective. © 2013, American School Health Association.
R. James Barnard
Full Text Available Cancer is the second leading cause of death in the USA and an abundance of evidence suggests that lifestyle factors including smoking, the typical high-fat, refined-sugar diet and physical inactivity account for the majority of cancer. This review focuses on diet and inactivity as major factors for cancer promotion by inducing insulin resistance and hyperinsulinemia. Elevated levels of serum insulin impact on the liver primarily, increasing the production of insulin-like growth factor I (IGF-I while reducing the production of insulin-like growth factor binding protein 1 (IGFBP-1 resulting in stimulation of tumor cell growth and inhibition of apoptosis (programmed cell death. Adopting a diet low in fat and high in fiber-rich starch foods, which would also include an abundance of antioxidants, combined with regular aerobic exercise might control insulin resistance, reduce the resulting serum factors and thus reduce the risk for many different cancers commonly seen in the USA.
One of the most influential publications on land-use change is a small booklet, published by the International Geosphere-Biosphere Programme (IGBP) and the Human Dimensions of Global Environmental Change Programme (HDP). It was written -- as its subtitle says -- as a "proposal for an IGBP-HDP Core Project" on "Relating Land Use and Global Land-Cover Change". The booklet can be seen as some kind of programmatic statement to guide international collaborative research on global land-use change. ...
Groeneveld, Iris F; Proper, Karin I; van der Beek, Allard J; Hildebrandt, Vincent H; van Mechelen, Willem
The goal of this review was to summarize the evidence for an effect of lifestyle-targeted interventions at the workplace on the main biological risk factors for cardiovascular disease (CVD). We performed an extensive systematic literature search for randomized controlled trials (RCT) that met the following inclusion criteria: (i) targeted at workers; (ii) aimed at increasing physical activity and/or improving diet; and (iii) measured body weight, body fat, blood pressure, blood lipids and/or blood glucose. We used a nine-item methodological quality list to determine the quality of each study. A best-evidence system was applied, taking into account study quality and consistency of effects. Our review included 31 RCT, describing a diversity of interventions (eg counseling, group education, or exercise). Of these studies, 18 were of high quality. Strong evidence was found for a positive effect on body fat, one of the strongest predictors of CVD risk. Among populations "at risk", there was strong evidence for a positive effect on body weight. Due to inconsistencies in results between studies, there was no evidence for the effectiveness of interventions on the remaining outcomes. We found strong evidence for the effectiveness of workplace lifestyle-based interventions on body fat and, in populations at risk for CVD, body weight. Populations with an elevated risk of CVD seemed to benefit most from lifestyle interventions; supervised exercise interventions appeared the least effective intervention strategy. To gain better insight into the mechanisms that led to the intervention effects, the participants' compliance with the intervention and the lifestyle changes achieved should be reported in future studies.
Ornish, D; Scherwitz, L W; Billings, J H; Brown, S E; Gould, K L; Merritt, T A; Sparler, S; Armstrong, W T; Ports, T A; Kirkeeide, R L; Hogeboom, C; Brand, R J
The Lifestyle Heart Trial demonstrated that intensive lifestyle changes may lead to regression of coronary atherosclerosis after 1 year. To determine the feasibility of patients to sustain intensive lifestyle changes for a total of 5 years and the effects of these lifestyle changes (without lipid-lowering drugs) on coronary heart disease. Randomized controlled trial conducted from 1986 to 1992 using a randomized invitational design. Forty-eight patients with moderate to severe coronary heart disease were randomized to an intensive lifestyle change group or to a usual-care control group, and 35 completed the 5-year follow-up quantitative coronary arteriography. Two tertiary care university medical centers. Intensive lifestyle changes (10% fat whole foods vegetarian diet, aerobic exercise, stress management training, smoking cessation, group psychosocial support) for 5 years. Adherence to intensive lifestyle changes, changes in coronary artery percent diameter stenosis, and cardiac events. Experimental group patients (20 [71%] of 28 patients completed 5-year follow-up) made and maintained comprehensive lifestyle changes for 5 years, whereas control group patients (15 [75%] of 20 patients completed 5-year follow-up) made more moderate changes. In the experimental group, the average percent diameter stenosis at baseline decreased 1.75 absolute percentage points after 1 year (a 4.5% relative improvement) and by 3.1 absolute percentage points after 5 years (a 7.9% relative improvement). In contrast, the average percent diameter stenosis in the control group increased by 2.3 percentage points after 1 year (a 5.4% relative worsening) and by 11.8 percentage points after 5 years (a 27.7% relative worsening) (P=.001 between groups. Twenty-five cardiac events occurred in 28 experimental group patients vs 45 events in 20 control group patients during the 5-year follow-up (risk ratio for any event for the control group, 2.47 [95% confidence interval, 1.48-4.20]). More regression
Gubbi, Sriram; Schwartz, Elianna; Crandall, Jill; Verghese, Joe; Holtzer, Roee; Atzmon, Gil; Braunstein, Rebecca; Barzilai, Nir; Milman, Sofiya
Offspring of parents with exceptional longevity (OPEL) manifest lower prevalence of cardiovascular disease (CVD), but the role of lifestyle factors in this unique cohort is not known. Our study tested whether OPEL have lesser prevalence of CVD independent of lifestyle factors. Prevalence of CVD and CVD risk factors was assessed in a population of community-dwelling Ashkenazi Jewish adults aged 65 to 94 years. Participants included OPEL (n = 395), defined as having at least 1 parent living past the age of 95 years, and offspring of parents with usual survival (OPUS, n = 450), defined as having neither parent survive to 95 years. Medical and lifestyle information was obtained using standardized questionnaires. Socioeconomic status was defined based on validated classification scores. Dietary intake was evaluated with the Block Brief Food Frequency Questionnaire (2000) in a subgroup of the study population (n = 234). Our study found no significant differences in the prevalence of obesity, smoking, alcohol use, physical activity, social strata scores, and dietary intake between the 2 groups. After adjustment for age and gender, the OPEL demonstrated 29% lower odds of having hypertension (95% confidence interval [CI] 0.53 to 0.95), 65% lower odds of having had a stroke (95% CI 0.14 to 0.88), and 35% lower odds of having CVD (95% CI 0.43 to 0.98), compared with OPUS. In conclusion, exceptional parental longevity is associated with lower prevalence of CVD independent of lifestyle, socioeconomic status, and nutrition, thus highlighting the potential role of genetics in disease-free survival among individuals with exceptional parental longevity. Copyright © 2017 Elsevier Inc. All rights reserved.
Brandt, Carl Joakim; Clemensen, Jane; Nielsen, Jesper Bo
Objectives Assisting patients in lifestyle change using collaborative e-health tools can be an efficient treatment for non-communicable diseases like diabetes, cardiovascular disease and chronic obstructive lung disease that are caused or aggravated by unhealthy living in the form of unhealthy diet......, physical inactivity or tobacco smoking. In a prospective pilot study, we tested an online collaborative e-health tool in general practice. The aim of this study was to identify drivers of importance for long-term personal lifestyle changes from a patient perspective when using a collaborative e-health tool......, including the support of peers and healthcare professionals. Setting General practice clinics in the Region of Southern Denmark. Participants 10 overweight patients who had previously successfully used a hybrid online collaborative e-health tool with both face-to-face and online consultations to lose weight...
Oikarinen, Anne; Engblom, Janne; Kääriäinen, Maria; Kyngäs, Helvi
Since a history of stroke or transient ischaemic attack is a major risk factor for a recurrent event, lifestyle counselling during the hospital phase is an essential component of treatment and may increase the probability of lifestyle change. To study the effect of risk factor-targeted lifestyle counselling intervention on working-age stroke patients' adherence to lifestyle changes. A quasi-experimental, nonequivalent control group pretest-post-test design. Stroke patients in an acute neurological unit were divided into a control group (n = 75) receiving standard counselling and an experimental group (n = 75) receiving risk factor-targeted counselling. Lifestyle data and clinical outcomes were collected at hospital between January 2010 and October 2011, while data on adherence to lifestyle changes 3, 6, and 12 months after discharge. The baseline lifestyle habits did not differ significantly other than in alcohol behaviour. Both groups increased their intake, but the intervention group to a lesser degree. However, the experimental group significantly lost their weight for the first 3 and 6 months; at 3 months reduction in cigarette consumption and at 6 months significant increases in smoking cessation were also achieved. All improved some of their lifestyle habits. Intervention was associated with support from nurses as well as from family and friends. Adherence scores were higher in the experimental group. Some short-term advantages in lifestyle habits due to the intervention were noted. Participants in both groups improved some of their lifestyle habits. © 2016 Nordic College of Caring Science.
Ghaisas, Samruddhi; Pyatak, Elizabeth A.; Blanche, Erna; Clark, Florence
Pressure ulcers (PrUs) are a major burden to patients with spinal cord injury (SCI), affecting their psychological, physical, and social well-being. Lifestyle choices are thought to contribute to the risk of developing PrUs. This article focuses on the interaction between lifestyle choices and the development of PrUs in community settings among participants in the University of Southern California–Rancho Los Amigos National Rehabilitation Center Pressure Ulcer Prevention Study (PUPS II), a randomized controlled trial of a lifestyle intervention for adults with SCI. We conducted a secondary cross-case analysis of treatment notes of 47 PUPS II participants and identified four patterns relating PrU development to lifestyle changes: positive PrU changes (e.g., healing PrUs) with positive lifestyle changes, negative or no PrU changes with positive lifestyle changes, positive PrU changes with minor lifestyle changes, and negative or no PrU changes with no lifestyle changes. We present case studies exemplifying each pattern. PMID:25553751
Goossens, Joline; Beeckman, Dimitri; Van Hecke, Ann; Delbaere, Ilse; Verhaeghe, Sofie
(1) to study preconception lifestyle changes and associated factors in women with planned pregnancies; (2) to assess the prevalence of risk factors for adverse pregnancy outcomes in women not reporting any preconception lifestyle changes; and (3) to explore the need for and use of preconception-related advice. secondary data analysis of a cross-sectional study about pregnancy planning. six Flemish Hospitals (Belgium). four hundred and thirty women with a planned pregnancy ending in birth. preconception lifestyle changes were measured during the first 5 days postpartum using the validated London Measure of Unplanned Pregnancy. The following changes were assessed: folic acid or multivitamin intake, smoking reduction or cessation, alcohol reduction or cessation, caffeine reduction or cessation, eating more healthily, achieving a healthier weight, obtaining medical or health advice, or another self-reported preconception lifestyle change. most women (83%) that planned their pregnancy reported ≥1 lifestyle change in preparation for pregnancy. Overall, nulliparous women (OR 2.18, 95% CI 1.23-3.87) and women with a previous miscarriage (OR 2.44, 95% CI 1.14-5.21) were more likely to prepare for pregnancy, while experiencing financial difficulties (OR 0.20, 95% CI 0.04-0.97) or having a lower educational level (OR 0.56, 95% CI 0.32-0.99) decreased the likelihood of preparing for pregnancy. Half of the women (48%) obtained advice about preconception health, and 86% of these women received their advice from a professional caregiver. Three-quarters (77%) of the women who did not improve their lifestyle before conceiving reported one or more risk factors for adverse pregnancy outcomes. multiparous women and women of lower socio-economic status were less likely to change their lifestyle before conception. Strategies to promote preconception health in these women need to be tailored to their needs and characteristics to overcome barriers to change. It may be advantageous to
Iozzi, Louis A.
"Technology and Changing Lifestyles" is one of the "Preparing for Tomorrow's World" (PTW) program modules. PTW is an interdisciplinary, future-oriented program incorporating information from the sciences and social sciences and addressing societal concerns which interface science/technology/society. The program promotes…
Xiao, Ryan C; Sannidhi, Deepa; McBride, Yasamina; McCargo, Tracie; Stern, Theodore A
Background Lifestyle medicine is the science and application of healthy lifestyles as interventions for the prevention and treatment of disease, and has gained significant momentum as a specialty in recent years. College is a critical time for maintenance and acquisition of healthy habits. Longer-term, more intensive web-based and in-person lifestyle medicine interventions can have a positive effect. Students who are exposed to components of lifestyle medicine in their education have improvements in their health behaviors. A semester-long undergraduate course focused on lifestyle medicine can be a useful intervention to help adopt and sustain healthy habits. Objective To describe a novel, evidence based curriculum for a course teaching the concepts of Lifestyle Medicine based on a web-based course offered at the Harvard Extension School. Methods The course was delivered in a web-based format. The Lifestyle Medicine course used evidence based principles to guide students toward a “coach approach” to behavior change, increasing their self-efficacy regarding various lifestyle-related preventive behaviors. Students are made to understand the cultural trends and national guidelines that have shaped lifestyle medicine recommendations relating to behaviors. They are encouraged to engage in behavior change. Course topics include physical activity, nutrition, addiction, sleep, stress, and lifestyle coaching and counseling. The course addressed all of the American College of Preventive Medicine/American College of Lifestyle Medicine competencies save for the competency of office systems and technologies to support lifestyle medicine counseling. Results The course was well-received, earning a ranking of 4.9/5 at the school. Conclusions A novel, semester-long course on Lifestyle Medicine at the Harvard Extension School is described. Student evaluations suggest the course was well-received. Further research is needed to evaluate whether such a course empowers students to
Whittemore, Robin; Chase, Susan K; Mandle, Carol Lynn; Roy, Callista
Integration is an emerging concept in the study of self-management and chronic illness, yet this process and how it occurs is not well understood. This investigation, part of a triangulated study, focused on the experience of integrating type 2 diabetes treatment recommendations into an existing lifestyle while participating in a nurse-coaching intervention. An interpretive method elicited data from nurse-coaching sessions (4), field notes, and an interview in 9 women with type 2 diabetes. The process of data reduction and analysis (Miles & Huberman, 1994) was used to interpret data. The core process of integrating lifestyle change in type 2 diabetes was multifaceted and complex. Challenges to the process of integrating lifestyle change included reconciling emotions, composing a structure, striving for satisfaction, exploring self and conflicts, discovering balance, and developing a new cadence to life. These challenges required acknowledgment in order for participants to progress toward integration. Balance was an integral component to the experience of integration, between structure and flexibility, fear and hope, conflict and acceptance, diabetes and life. Conceptualizations identified with this investigation extend understanding of theories of integration and lifestyle change and invite the development and testing of nursing interventions.
Mudd-Martin, Gia; Martinez, Maria C; Rayens, Mary Kay; Gokun, Yevgeniya; Meininger, Janet C
Suboptimal lifestyle factors in combination with genetic susceptibility contribute to cardiovascular disease and type 2 diabetes risk among Latinos. We describe a community-academic collaboration that developed and explored the feasibility of implementing a socioculturally tailored, healthy lifestyle intervention integrating genomics and family history education to reduce risk of cardiovascular disease and type 2 diabetes among Latinos. The community-based participatory research was conducted with communities in Kentucky, which has a rapidly growing Latino population. This growth underscores the need for socioculturally appropriate health resources. Su Corazon, Su Vida (Your Heart, Your Life) is a Spanish-language, healthy lifestyle educational program to reduce cardiovascular disease and type 2 diabetes risk among Latinos. Twenty natural leaders from an urban Latino community in Kentucky participated in sociocultural tailoring of the program and development of a genomics and family history module. The tailored program was presented to 22 participants to explore implementation feasibility and assess appropriateness for community use. Preintervention and postintervention assessments of genomic knowledge and lifestyle behaviors and qualitative postintervention evaluations were conducted. Postintervention improvements in health-promoting lifestyle choices and genomic knowledge specific to cardiovascular disease and type 2 diabetes suggested that the program may be effective in reducing risk. Feedback indicated the program was socioculturally acceptable and responsive to community needs. These findings indicated that a tailored healthy lifestyle program integrating genomics and family history education was socioculturally appropriate and may feasibly be implemented to reduce cardiovascular disease and type 2 diabetes risk in a Latino community with limited health care resources. The project highlights contributions of community-based processes in tailoring
Mirela Manuela GHEORGHE
Full Text Available We are experiencing a period where we are faced with rising healthcare costs, as well as an increased disease impact on the entire population of the country. Although the slogan “prevention is cheaper than cure” may seem old-fashioned, however, it is more true than ever. It is necessary to offer health education and also to promote health care in Romania, in accordance with the international standards, as adopted by the European Union. Health Promotion is the art and science of helping people change their lifestyle in order to achieve a state of optimal health, restoring the harmony at all levels of human existence. Promoting a lifestyle which given certain conditions maximizes health, welfare and human fulfilment represents a goal that does not belong exclusively to the health sector; all fields of activity, all those sectors that define the life of an individual or a community are essential parts of achieving a healthy lifestyle. Modern men adopt a lifestyle where sedentary life, overeating, smoking, erratic working hours and alcohol use are common behaviours. Therefore, they become vulnerable to a new class of diseases of multi-factorial aetiology where the lifestyle plays a prominent role. Although the lifestyle may be complex, it is still under personal control and lead by the ability to choose extensively, which can be of benefit to the person's life and health. Choices regarding health involve more than objective information. Health education should be an ongoing concern for health professionals and health educators, psychologists, sociologists, family, for those who through effective collaboration contribute to ensuring physical and mental health in the community, in the increasingly demanding conditions of the modern life, which raise difficult issues regarding human adaptability.
Knudsen, Marie Veje; Laustsen, Sussie; Petersen, Annemette Krintel
Lifestyle following heart disease is considered important to prevent and reduce cardiovascular risk factors. Thus, cardiac rehabilitation is focused on potential lifestyle changes. Further insight into patients’ perspective on lifestyle after cardiac rehabilitation is needed as changing habits fo...
White, J.; Greene, G.; Kivimaki, M.; Batty, G. D.
BACKGROUND: To examine the combined influence of changes in physical activity, diet, smoking and alcohol consumption on all-cause mortality. METHODS: Health behaviours were assessed in 1984/1985 and 1991/1992 in 8123 adults from the UK (4666 women, median age 41.0 years). An unhealthy lifestyle score was calculated, allocating one point for smoking, fruits and vegetables 21 units of alcohol (men) per week. RESULTS: There were 2003 deaths over a median follow-up of 6.6 years (IQR 5.9-7.2) foll...
Petersen, Kristina E N; Johnsen, Nina F; Olsen, Anja
guidelines into account. The objective of the present prospective cohort study was to investigate the combined impact of adherence to five lifestyle factors (smoking, alcohol intake, physical activity, waist circumference and diet) on all-cause, cancer and cardiovascular mortality based on international...
Groeneveld, I.F.; Proper, K.I.; Beek, A.J. van der; Hildebrandt, V.H.; Mechelen, W.V.
Objective: The goal of this review was to summarize the evidence for an effect of lifestyle-targeted interventions at the workplace on the main biological risk factors for cardiovascular disease (CVD). Methods: We performed an extensive systematic literature search for randomized controlled trials
Groeneveld, Iris F.; Proper, Karin I.; van der Beek, Allard J.; Hildebrandt, Vincent H.; van Mechelen, Willem
The goal of this review was to summarize the evidence for an effect of lifestyle-targeted interventions at the workplace on the main biological risk factors for cardiovascular disease (CVD). We performed an extensive systematic literature search for randomized controlled trials (RCT) that met the
Celeste van Rinsum
Full Text Available Combined lifestyle interventions (CLIs can be effective in reducing weight and improving lifestyle-related behaviours but it is unclear how CLIs can best be implemented in practice in order to achieve sustained lifestyle changes. The Coaching on Lifestyle programme (CooL is a CLI in the Netherlands, in which professional lifestyle coaches counsel adults and children (and/or their parents who are obese or at high risk of obesity to achieve a sustained healthier lifestyle. The CooL intervention consists of group and individual sessions addressing the topics of physical activity, dietary behaviours, sleep and stress. Our longitudinal one-group pre-post study aimed to identify lifestyle changes among participants (adults, children and their parents at 8 and 18 months after initiation. We assessed constructs ranging from motivation and behaviour-specific cognitions to behaviours and health outcomes. Positive and sustained changes among adults were found regarding perceived autonomy, motivation, perceived barriers, lifestyle behaviours, quality of life and weight. Among children and their parents, few improvements were found regarding behaviours and quality of life. CooL has been successful in coaching adult participants towards sustained behavioural change during the intervention period. Mixed results and smaller effect sizes were found for children and their parents.
Olga Yurevna Kutumova
Full Text Available The sociological research carried showed that provision of educational information is the main method of motivating people to change their lifestyle and break harmful habits. The mass media are in the first position in the rating as the most effective public awareness development means and healthcare professional advice goes second.A patient usually receives such advice when visiting a healthcare institution to be given diagnosis or treatment or in the course of health assessment or scheduled preventive medical examination. 45% of the Krasnoyarsk Region smokers considered changing their lifestyle and quitting smoking, 36,9% of the residents made such attempt and 8,4% broke the harmful habit after watching television features and under the influence of outdoor advertising. Information that was received from a doctor about risks of developing major no communicable diseases (cardiovascular, oncology, respiratory due to smoking motivated only 36, 9% of the population to change the lifestyle, which mostly included young people aged 18-24. For 63,6% of the region residents there was no positive effect of health professional advice received during a visit to a healthcare institution for a certain purpose. Thus, the received results testify to the bigger importance of educational promotion of mass media in motivation to change of a way of life and refusal of smoking, in comparison with information received from health workers.
Serrano Ripoll, M J; Oliván-Blázquez, B; Vicens-Pons, E; Roca, M; Gili, M; Leiva, A; García-Campayo, J; Demarzo, M P; García-Toro, M
Modifying some lifestyle factors can be useful in depression, at least as an adjuvant treatment. Combining different lifestyle interventions seems to be an adequate strategy to increase their antidepressant efficacy according with preliminary studies, but this issue has not been enough investigated. The present study is a randomized, double-blinded, multicentre, two arm-parallel clinical trials, with a 12 month follow-up. The sample consisted of 273 Primary Care patients. Four combined hygienic-dietary written recommendations were given to the patients about diet, exercise, light exposure and sleep hygiene. Both active and control interventions were associated with improvement on BDI (Beck Depression Inventory) scores. However, there were not statistically significant differences (7.0 vs. 7.6; p=0.594). We were unable to monitor whether patients carry out recommendations. Intervention could be too difficult to accomplish for depressed patients without enough support and supervision. Just giving written lifestyle recommendations are not enough for depressive patients to benefit from them, so perhaps lifestyle change recommendations work or do not work on Depression depending on how they are presented to patients and on monitoring systems of their implementation. Copyright © 2015 Elsevier B.V. All rights reserved.
SUET TING CHOI
Providing translated diabetes education from English to Chinese is not enough to promote healthy lifestyle changes among Chinese Australians with type 2 diabetes. This thesis explored the behaviour patterns of Chinese patients during diabetes education and identified the most successful education approaches. The research involved a review of literature and an exploratory qualitative study across three countries. The findings suggest health professionals working with Chinese Australian patient...
O'Neil, C E; Nicklas, T A; Myers, L; Johnson, C C; Berenson, G S
The primary purposes of this article are to highlight important issues related to cardiovascular risk factors and behavior life-styles in young women and to examine racial (black-white) differences in risk factors that relate to cardiovascular disease. In childhood, some girls show cardiovascular risk factors of higher blood pressure levels, dyslipidemia, and obesity, all of which continue into young adulthood. Factors that contribute to abnormal risk factors are a high-saturated fat diet, excess energy intake related to inactivity, and cigarette smoking. Trends of obesity are documented; and young white girls are continuing to use tobacco, more so than boys and black girls. Although the onset of clinical cardiovascular disease is delayed in women, the stage is set in childhood for the development of early cardiovascular risk.
Moran, Lisa J; Hutchison, Samantha K; Norman, Robert J; Teede, Helena J
Polycystic ovary syndrome (PCOS) affects 4% to 18% of reproductive-aged women and is associated with reproductive, metabolic and psychological dysfunction. Obesity worsens the presentation of PCOS and weight management (weight loss, maintenance or prevention of excess weight gain) is proposed as an initial treatment strategy, best achieved through lifestyle changes incorporating diet, exercise and behavioural interventions. To assess the effectiveness of lifestyle treatment in improving reproductive, anthropometric (weight and body composition), metabolic and quality of life factors in PCOS. Electronic databases (Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE, EMBASE, PsycINFO, CINAHL, AMED) (date of last search 7/9/2010), controlled trials register, conference abstracts, relevant journals, reference lists of relevant papers and reviews and grey literature databases, with no language restrictions applied. Randomised controlled trials comparing lifestyle treatment (diet, exercise, behavioural or combined treatments) to minimal or no treatment in women with PCOS. Two authors independently selected trials, assessed methodological quality and risk of bias and extracted data. Six studies were included with n=164 participants. Three studies compared physical activity to minimal dietary and behavioural advice or no advice. Three studies compared combined dietary, exercise and behavioural interventions to minimal intervention. Risk of bias varied with 4/6 having adequate sequence generation and clinician or outcome assessor blinding and 3/6 having adequate allocation concealment, complete outcome data and being free of selective reporting. There were no studies assessing the fertility primary outcomes of pregnancy, live birth and miscarriage and no data for meta-analysis on ovulation or menstrual regularity. Lifestyle intervention provided benefits when compared to minimal treatment for secondary reproductive, anthropometric and
Karaca, Sefayet; Erge, Sema; Cesuroglu, Tomris; Polimanti, Renato
Cardiovascular and metabolic traits (CMT) are influenced by complex interactive processes including diet, lifestyle, and genetic predisposition. The present study investigated the interactions of these risk factors in relation to CMTs in the Turkish population. We applied bootstrap agglomerative hierarchical clustering and Bayesian network learning algorithms to identify the causative relationships among genes involved in different biological mechanisms (i.e., lipid metabolism, hormone metabolism, cellular detoxification, aging, and energy metabolism), lifestyle (i.e., physical activity, smoking behavior, and metropolitan residency), anthropometric traits (i.e., body mass index, body fat ratio, and waist-to-hip ratio), and dietary habits (i.e., daily intakes of macro- and micronutrients) in relation to CMTs (i.e., health conditions and blood parameters). We identified significant correlations between dietary habits (soybean and vitamin B12 intakes) and different cardiometabolic diseases that were confirmed by the Bayesian network-learning algorithm. Genetic factors contributed to these disease risks also through the pleiotropy of some genetic variants (i.e., F5 rs6025 and MTR rs180508). However, we also observed that certain genetic associations are indirect since they are due to the causative relationships among the CMTs (e.g., APOC3 rs5128 is associated with low-density lipoproteins cholesterol and, by extension, total cholesterol). Our study applied a novel approach to integrate various sources of information and dissect the complex interactive processes related to CMTs. Our data indicated that complex causative networks are present: causative relationships exist among CMTs and are affected by genetic factors (with pleiotropic and non-pleiotropic effects) and dietary habits. Copyright © 2016 Elsevier Inc. All rights reserved.
Full Text Available Objectives: This study aimed to compare cardiovascular disease (CVD risk factors, lifestyle habits and pharmacological treatment in two groups of elder adults with 20 years difference in their mean age. Methods: This study comprised 590 women including two groups with mean age of 42.4±5.5 vs. 66.5±4.0 years, and 486 men of two groups with mean age of 44.1±5.6 vs. 63.9±7.0 years. Data on physical examination, fasting blood analyses, 7-day dietary re-cords, physical activity, smoking and actual medication use were recorded. Results: Compared with younger individuals, seniors had a more adverse risk factor profile in terms of abdominal obesity, over-weight, hyperglycemia, hypertension, dyslipoproteinemia without differences in HDL-C. But this is not reflected by lifestyle behav-ior. Less than 2% of the elderly and 17% of the younger adults were current smoker. Furthermore, the pattern of physical activ-ity was different in terms of more continuous sports in seniors contrasting with extremes between no sports and more than twice a week in the younger group. Seniors consumed significantly less carbohydrates including more monosaccharide and less polysaccharides, more alcohol and water. The intake of fat and protein was higher in elder women than in all other groups. One third of seniors took antihypertensive medications and 12% used lipid modifying drugs. Conclusions: Different levels of prevention against CVDs and their risk factors shall be considered for various age groups of population. The findings of this study emphasize on the necessity of preventive measures against smoking and physical inactivity in younger adults and dietary habits in seniors.
Full Text Available Objectives: This study aimed to compare cardiovascular disease(CVD risk factors, lifestyle habits and pharmacological treatmentin two groups of elder adults with 20 years difference in theirmean age.Methods: This study comprised 590 women including two groupswith mean age of 42.4±5.5 vs. 66.5±4.0 years, and 486 men of twogroups with mean age of 44.1±5.6 vs. 63.9±7.0 years. Data onphysical examination, fasting blood analyses, 7-day dietary records,physical activity, smoking and actual medication use wererecorded.Results: Compared with younger individuals, seniors had a moreadverse risk factor profile in terms of abdominal obesity, overweight,hyperglycemia, hypertension, dyslipoproteinemia withoutdifferences in HDL-C. But this is not reflected by lifestyle behavior.Less than 2% of the elderly and 17% of the younger adultswere current smoker. Furthermore, the pattern of physical activitywas different in terms of more continuous sports in seniorscontrasting with extremes between no sports and more than twicea week in the younger group. Seniors consumed significantly lesscarbohydrates including more monosaccharide and less polysaccharides,more alcohol and water. The intake of fat and proteinwas higher in elder women than in all other groups. One third ofseniors took antihypertensive medications and 12% used lipidmodifying drugs.Conclusions: Different levels of prevention against CVDs andtheir risk factors shall be considered for various age groups ofpopulation. The findings of this study emphasize on the necessityof preventive measures against smoking and physical inactivity inyounger adults and dietary habits in seniors.
Full Text Available With the rapid and widespread adoption of mobile devices, mobile phones offer an opportunity to deliver cardiovascular disease (CVD interventions. This study evaluated the efficacy of a mobile phone-based lifestyle intervention aimed at reducing the overall CVD risk at a health management center in Guangzhou, China. We recruited 589 workers from eight work units. Based on a group-randomized design, work units were randomly assigned either to receive the mobile phone-based lifestyle interventions or usual care. The reduction in 10-year CVD risk at 1-year follow-up for the intervention group was not statistically significant (–1.05%, p = 0.096. However, the mean risk increased significantly by 1.77% (p = 0.047 for the control group. The difference of the changes between treatment arms in CVD risk was –2.83% (p = 0.001. In addition, there were statistically significant changes for the intervention group relative to the controls, from baseline to year 1, in systolic blood pressure (–5.55 vs. 6.89 mmHg; p < 0.001, diastolic blood pressure (–6.61 vs. 5.62 mmHg; p < 0.001, total cholesterol (–0.36 vs. –0.10 mmol/L; p = 0.005, fasting plasma glucose (–0.31 vs. 0.02 mmol/L; p < 0.001, BMI (–0.57 vs. 0.29 kg/m2; p < 0.001, and waist hip ratio (–0.02 vs. 0.01; p < 0.001. Mobile phone-based intervention may therefore be a potential solution for reducing CVD risk in China.
Khare, Manorama M; Cursio, John F; Locklin, Cara A; Bates, Nancy J; Loo, Ryan K
Cardiovascular disease (CVD) is the leading cause of death for Hispanic women in the United States. In 2001, the Illinois Department of Public Health received funding from the Centers for Disease Control and Prevention to implement the enhanced WISEWOMAN program (IWP) to address the disproportionate CVD risk among uninsured and underinsured women enrolled in the Illinois Breast and Cervical Cancer Early Detection Program. This paper presents the results of the Spanish-language arm of the IWP. Spanish speaking IWP participants were recruited from two sites, and randomized into either the minimum intervention (MI) or the enhanced intervention (EI) group. Both groups received CVD risk factor screening and educational handouts. The EI group also received an integrated 12-week nutrition and physical activity lifestyle change intervention. Of the 180 Spanish-speaking immigrants in this sample, 90 (50%) received the EI and 90 (50%) received the MI. At baseline there were no significant differences between group demographics or clinical values. At post-intervention, the EI group showed improvements in fat intake, fiber intake, moderate intensity physical activity, and total physical activity. At 1 year only the change in fiber intake remained. A significant improvement was also seen in body mass index (BMI) at the 1-year follow-up. The IWP Spanish-language arm was moderately successful in addressing risk factors for CVD in this population. The behavior changes that sustained up to a year were an increase in fiber intake and a decrease in BMI.
Sardella, Chiara; Cappellani, Daniele; Urbani, Claudio; Manetti, Luca; Marconcini, Giulia; Tomisti, Luca; Lupi, Isabella; Rossi, Giuseppe; Scattina, Ilaria; Lombardi, Martina; Di Bello, Vitantonio; Marcocci, Claudio; Martino, Enio; Bogazzi, Fausto
The primary objective of this study is to identify the predictors of comorbidities and major adverse cardiovascular events (MACE) that can develop after diagnosis of acromegaly. The role of therapy for acromegaly in the event of such complications was also evaluated. Retrospective cohort study was conducted on 200 consecutive acromegalic patients in a tertiary referral center. The following outcomes were evaluated: diabetes, hypertension and MACE. Each patient was included in the analysis of a specific outcome, unless they were affected when acromegaly was diagnosed, and further classified as follows: (i) in remission after adenomectomy (Hx), (ii) controlled by somatostatin analogues (SSA) (SSAc) or (iii) not controlled by SSA (SSAnc). Data were evaluated using Cox regression analysis. After diagnosis of acromegaly, diabetes occurred in 40.8% of patients. The SSAnc group had a three-fold higher risk of diabetes (HR: 3.32, P = 0.006), whereas the SSAc group had a 1.4-fold higher risk of diabetes (HR: 1.43, P = 0.38) compared with the Hx group. Hypertension occurred in 35.5% of patients, after diagnosis. The determinants of hypertension were age (HR: 1.06, P = 0.01) and BMI (HR: 1.05, P = 0.01). MACE occurred in 11.8% of patients, after diagnosis. Age (HR: 1.09, P = 0.005) and smoking habit (HR: 5.95, P = 0.01) were predictors of MACE. Conversely, therapy for acromegaly did not influence hypertension or MACE. After diagnosis of acromegaly, control of the disease (irrespective of the type of treatment) and lifestyle are predictors of comorbidities and major adverse cardiovascular events. © 2016 European Society of Endocrinology.
Frates, Elizabeth Pegg; Xiao, Ryan C; Sannidhi, Deepa; McBride, Yasamina; McCargo, Tracie; Stern, Theodore A
Lifestyle medicine is the science and application of healthy lifestyles as interventions for the prevention and treatment of disease, and has gained significant momentum as a specialty in recent years. College is a critical time for maintenance and acquisition of healthy habits. Longer-term, more intensive web-based and in-person lifestyle medicine interventions can have a positive effect. Students who are exposed to components of lifestyle medicine in their education have improvements in their health behaviors. A semester-long undergraduate course focused on lifestyle medicine can be a useful intervention to help adopt and sustain healthy habits. To describe a novel, evidence based curriculum for a course teaching the concepts of Lifestyle Medicine based on a web-based course offered at the Harvard Extension School. The course was delivered in a web-based format. The Lifestyle Medicine course used evidence based principles to guide students toward a "coach approach" to behavior change, increasing their self-efficacy regarding various lifestyle-related preventive behaviors. Students are made to understand the cultural trends and national guidelines that have shaped lifestyle medicine recommendations relating to behaviors. They are encouraged to engage in behavior change. Course topics include physical activity, nutrition, addiction, sleep, stress, and lifestyle coaching and counseling. The course addressed all of the American College of Preventive Medicine/American College of Lifestyle Medicine competencies save for the competency of office systems and technologies to support lifestyle medicine counseling. The course was well-received, earning a ranking of 4.9/5 at the school. A novel, semester-long course on Lifestyle Medicine at the Harvard Extension School is described. Student evaluations suggest the course was well-received. Further research is needed to evaluate whether such a course empowers students to adopt behavior changes. ©Elizabeth Pegg Frates, Ryan C
Michishita, Ryoma; Matsuda, Takuro; Kawakami, Shotaro; Tanaka, Satoshi; Kiyonaga, Akira; Tanaka, Hiroaki; Morito, Natsumi; Higaki, Yasuki
Background: This study was designed to evaluate whether changes in lifestyle behaviors are correlated with the incidence of chronic kidney disease (CKD). Methods: The subjects consisted of 316 men without a history of cardiovascular disease, stroke, or renal dysfunction or dialysis treatment. The following lifestyle behaviors were evaluated using a standardized self-administered questionnaire: habitual moderate exercise, daily physical activity, walking speed, eating speed, late-night din...
Karppinen, Jaro; Leino-Arjas, Päivi; Solovieva, Svetlana; Varonen, Helena; Kalso, Eija; Ukkola, Olavi; Viikari-Juntura, Eira
Lumbar radicular pain is a fairly common health problem, yet its risk factors are far from clear. There are no published systematic reviews on associations between cardiovascular or lifestyle risk factors and lumbar radicular pain or sciatica. The aim of this systematic literature review was to assess associations between these risk factors and lumbar radicular pain or sciatica. We conducted a systematic search of the Medline database for all original articles on lumbar radicular pain or sciatica published until August 2006. Twenty-two papers from 19 studies were included in the review. Overweight or obesity was associated with sciatica in most of the case-control and cohort studies. Some studies showed an increased risk of lumbar radicular pain in smokers with a long smoking history or in those with high levels of physical activity. A few case-control studies showed an association between serum C-reactive protein and sciatica. No consistent associations were found for serum lipids levels or high blood pressure. In summary, the associations of overweight, long smoking history, high physical activity and a high serum C-reactive protein level with lumbar radicular pain or sciatica were substantiated by the present review. However, more prospective studies are needed in order to further clarify these associations and the mechanisms of action. PMID:17525856
O'Keefe, Evan L; DiNicolantonio, James J; Patil, Harshal; Helzberg, John H; Lavie, Carl J
Within the next 15years, India is projected to overtake China as the world's most populous nation. Due to the rapid pace of urbanization and modernization fueling population growth, in conjunction with a genetic predisposition to insulin resistance, India is suffering a rising epidemic of non-communicable diseases (NCDs), including coronary artery disease (CAD), type 2 diabetes mellitus (T2DM), and stroke. In addition to the genetic predisposition, major negative lifestyle factors are contributing to the alarming outbreak of cardiovascular disease (CVD) among the Asian Indian population; these factors include: 1) a diet high in added sugar, refined grains and other processed foods, 2) physical inactivity, 3) vitamin D deficiency (VDD), and 4) smoking/pollution. These risk factors are all highly modifiable, and steps to improve these issues should be taken urgently to avoid a worsening NCD crisis among the inhabitants of the South Asian subcontinent as well as for people with Asian Indian ethnicity worldwide. Copyright © 2015 Elsevier Inc. All rights reserved.
Drevenhorn, Eva; Kjellgren, Karin I; Bengtson, Ann
The purpose of the study was to explore the effects of using a structured nursing intervention programme in hypertension care. Counselling on lifestyle changes to address hypertension helps patients reduce risk factors such as smoking, high alcohol consumption, overweight, dyslipidemia, negative stress and physical inactivity. The study was performed as a pre-test-post-test study. All 177 patients diagnosed with hypertension visiting a health centre in Southern Sweden were invited to be counselled by a public health nurse about hypertension, cardiovascular risk factors and non-pharmacological treatment with 15 months follow up. One hundred patients participated in the study. Systolic blood pressure decreased overall (p changed their medication. The level of exercise increased and a reduction in systolic blood pressure and in women's weight were the most obvious results of this intervention study. The study elucidates the challenge of executing health behaviour changes. Counselling following a hypertension programme gives hypertensive patients a chance to execute lifestyle changes and have their medication adjusted to achieve goals for blood pressure control. Further prospective studies in this area, with well-defined intervention approaches and several years of follow up, are necessary.
Faggianoi, Pompilio; Temporelli, Pier Luigi; Zito, Giovanni; Bovenzi, Francesco; Colivicchi, Furio; Fattirolli, Francesco; Greco, Cesare; Mureddu, Gianfrancesco; Riccio, Carmine; Scherillo, Marino; Uguccioni, Massimo; Faden, Giacomo
To offer a snapshot of the personal health habits of Italian cardiologists, the Survey on Cardiac Risk Profile and Lifestyle Habits in a Cohort of Italian Cardiologists (SOCRATES) study was undertaken. Cardiologists' cardiovascular profile and lifestyle habits are poorly known worldwide. A Web-based electronic self-reported survey, accessible through a dedicated website, was used for data entry, and data were transferred via the web to a central database. The survey was divided in 4 sections: baseline characteristics, medical illnesses and traditional cardiovascular risk factors, lifestyle habits and selected medication use. The e-mail databases of three national scientific societies were used to survey a large and representative sample of Italian cardiologists. During the 3-month period of the survey, 1770 out of the 5240 cardiologists contacted (33.7%) completed and returned one or more sections of the questionnaire. More than 49% of the participants had 1 out of 5 classical risk factors (e.g. hypertension, hypercholesterolemia, active smoking, diabetes and previous vascular events). More than 28% of respondents had 2 to 5 risk factors and only 22.1% had none and therefore, according to age and sex, could be considered at low-intermediate risk. Despite the reported risk factors, more than 90% of cardiologists had a self-reported risk perception quantified as mild, such as low or intermediate. Furthermore, overweight/obesity, physical inactivity and stress at work or at home were commonly reported, as well as a limited use of cardiovascular drugs, such as statins or aspirin. The average cardiovascular profile of Italian cardiologist is unlikely to be considered ideal or even favorable according to recent statements and guidelines regarding cardiovascular risk. Thus, there is a large room for improvement and a need for education and intervention.
Hocking, Clare; Kroksmark, Ulla
Abstract Occupational therapists and occupational scientists are increasingly aware of the relationship between occupation and global climate change, with some working to raise awareness of the issues and others proposing that an occupational perspective can make a valuable contribution to understanding and addressing the issues. In this discussion paper the United Nations Global Survey on Sustainable Lifestyles ( 1 ), which reports young adults' beliefs about everyday occupations that have a substantial impact on the environment (food, housekeeping, and transportation) is introduced. The authors argue that the survey findings are a valuable resource for occupational therapists who are concerned about global climate change and work with young adults (age 18-35), providing valuable insights into their concerns and preferences in relation to sustainability. To illustrate the insights contained in the reports, findings from four countries are presented: New Zealand and Sweden, the authors' countries of origin, and the Philippines and Lebanon which have people living in New Zealand and Sweden. Application to individual and community-based interventions to promote more sustainable lifestyles is suggested, along with studies to examine the perspectives of young adults with a disability, as their concerns and sustainability preferences might differ due to the barriers that limit their participation in educational and vocational occupations.
Pennathur, Subramaniam; Jaiswal, Mamta; Vivekanandan-Giri, Anuradha; White, Elizabeth A; Ang, Lynn; Raffel, David M; Rubenfire, Melvyn; Pop-Busui, Rodica
To assess the role of oxidative stress in mediating adverse outcomes in metabolic syndrome (MetS) and resultant cardiovascular autonomic neuropathy (CAN), and to evaluate the effects of lifestyle interventions on measures of oxidative stress and CAN in subjects with MetS. Pilot study in 25 non-diabetic subjects with MetS (age 49±10years, 76% females) participating in a 24-week lifestyle intervention (supervised aerobic exercise/Mediterranean diet), and 25 age-matched healthy controls. CAN was assessed by cardiovascular reflex tests, heart rate variability (HRV) and PET imaging with sympathetic analog [ 11 C] meta-hydroxyephedrine ([ 11 C]HED). Specific oxidative fingerprints were measured by liquid-chromatography/mass-spectrometry (LC/MS). At baseline, MetS subjects had significantly higher oxidative stress markers [3-nitrotyrosine (234±158 vs. 54±47μmol/mol tyrosine), ortho-tyrosine (59±38 vs. 18±10μmol/molphenylalanine, all P<0.0001], and impaired HRV at rest and during deep breathing (P=0.039 and P=0.021 respectively) compared to controls. Twenty-four-week lifestyle intervention significantly reduced all oxidative stress markers (all P<0.01) but did not change any of the CAN measures. Subjects with MetS present with signs of CAN and increased oxidative stress in the absence of diabetes. The 24-week lifestyle intervention was effective in ameliorating oxidative stress, but did not improve measures of CAN. Larger clinical trials with longer duration are required to confirm these findings. Copyright © 2017 Elsevier Inc. All rights reserved.
Diaz, Keith M; Booth, John N; Calhoun, David A; Irvin, Marguerite R; Howard, George; Safford, Monika M; Muntner, Paul; Shimbo, Daichi
Few data exist on whether healthy lifestyle factors are associated with better prognosis among individuals with apparent treatment-resistant hypertension, a high-risk phenotype of hypertension. The purpose of this study was to assess the association of healthy lifestyle factors with cardiovascular events, all-cause mortality, and cardiovascular mortality among individuals with apparent treatment-resistant hypertension. We studied participants (n=2043) from the population-based Reasons for Geographic and Racial Differences in Stroke (REGARDS) study with apparent treatment-resistant hypertension (blood pressure ≥140/90 mm Hg despite the use of 3 antihypertensive medication classes or the use of ≥4 classes of antihypertensive medication regardless of blood pressure control). Six healthy lifestyle factors adapted from guidelines for the management of hypertension (normal waist circumference, physical activity ≥4 times/week, nonsmoking, moderate alcohol consumption, high Dietary Approaches to Stop Hypertension diet score, and low sodium-to-potassium intake ratio) were examined. A greater number of healthy lifestyle factors were associated with lower risk for cardiovascular events (n=360) during a mean follow-up of 4.5 years. Multivariable-adjusted hazard ratios [HR (95% confidence interval)] for cardiovascular events comparing individuals with 2, 3, and 4 to 6 versus 0 to 1 healthy lifestyle factors were 0.91 (0.68-1.21), 0.80 (0.57-1.14), and 0.63 (0.41-0.95), respectively (P-trend=0.020). Physical activity and nonsmoking were individual healthy lifestyle factors significantly associated with lower risk for cardiovascular events. Similar associations were observed between healthy lifestyle factors and risk for all-cause and cardiovascular mortality. In conclusion, healthy lifestyle factors, particularly physical activity and nonsmoking, are associated with a lower risk for cardiovascular events and mortality among individuals with apparent treatment
Matheus Lacerda Viana
Full Text Available The unsustainable use of natural resources is not a current issue and it began since the Agricultural Revolution, which characterizes the change in the relationship between man and nature. The first major environmental impacts emerged and as a result of this new way of life that went from nomadism to sedentary lifestyles, there was an increase of human productive capacity and the emergence of other crafts that were not directly related to food production. This paper provides a complete definition of the key concepts, suggest a few alternatives which people can apply on their daily lives, and relate them to the framework that rules sustainability. The main arguments for this work are that citizens in the developed world can reduce the pressure being placed on the state of the environment and contribute to sustainable development by saving energy and water, reducing waste, and choosing a transportation which emits less pollutants.
Lakerveld, J.; Bot, S.D.M.; Chin A Paw, M.J.M.; van Tulder, M.W.; Kingo, L.; Nijpels, G.
Effective, cost-effective, safe, and feasible interventions to improve lifestyle behavior in at-risk populations are needed in primary care. In the Hoorn Prevention Study, the authors implemented a theory-based lifestyle intervention in which trained practice nurses used an innovative combination of
Leiva, Ana María; Martínez, María Adela; Cristi-Montero, Carlos; Salas, Carlos; Ramírez-Campillo, Rodrigo; Díaz Martínez, Ximena; Aguilar-Farías, Nicolás; Celis-Morales, Carlos
Sedentary behavior is a main risk factor for cardiovascular disease and mortality. To investigate the association between sedentary behavior and metabolic and cardiovascular risk factors. We assessed 322 participants aged between 18 to 65 years. Physical activity and sedentary behavior were measured with accelerometers (Actigraph®). Body mass index (BMI), waist circumference, percentage of body fat, diet and blood markers (glucose, lipid profile, insulin and HOMA-IR) were measured with standardized protocols. Thirty four percent of participants were physically inactive and spent on average 8.7 h/day on sedentary activities. Per one hour increase in sedentary behavior there were significant adverse changes in glucose (4.79 mg/dl), insulin (2.73 pmol/l), HOMA-IR (0.75), BMI (0.69 kg/m²), waist circumference (1.95 cm), fat mass (1.03%), total cholesterol (9.73 mg/dl), HDL-cholesterol (-3.50 mg/dl), LDL-cholesterol (10.7 mg/dl) and triglycerides (12.4 mg/dl). These findings were independent of main confounding factors including total physical activity, dietary factors, BMI and socio-demographics. The detrimental effect of sedentary behaviors on cardiometabolic and obesity-related traits is independent of physical activity levels. Therefore, reducing sedentary time should be targeted in the population apart from increasing their physical activity levels.
Nse, Odunaiya; Quinette, Louw; Okechukwu, Ogah
Well developed and validated lifestyle cardiovascular disease (CVD) risk factors questionnaires is the key to obtaining accurate information to enable planning of CVD prevention program which is a necessity in developing countries. We conducted this review to assess methods and processes used for development and content validation of lifestyle CVD risk factors questionnaires and possibly develop an evidence based guideline for development and content validation of lifestyle CVD risk factors questionnaires. Relevant databases at the Stellenbosch University library were searched for studies conducted between 2008 and 2012, in English language and among humans. Using the following databases; pubmed, cinahl, psyc info and proquest. Search terms used were CVD risk factors, questionnaires, smoking, alcohol, physical activity and diet. Methods identified for development of lifestyle CVD risk factors were; review of literature either systematic or traditional, involvement of expert and /or target population using focus group discussion/interview, clinical experience of authors and deductive reasoning of authors. For validation, methods used were; the involvement of expert panel, the use of target population and factor analysis. Combination of methods produces questionnaires with good content validity and other psychometric properties which we consider good.
Mee, L. D.; Lowe, C. D.; Langmead, O.; McQuatters-Gollop, A.; Attrill, M.; Cooper, P.; Gilbert, A.; Knudsen, S.; Garnacho, E.
European society is experiencing unprecedented changes triggered by expansion of the European Union, the fall of Communism, economic growth and the onset of globalisation. Europe's regional seas, the Baltic, Black Sea, Mediterranean and North-East Atlantic (including the North Sea), provide key goods and services to the human population but have suffered from severe degradation in past decades. Their integrity as coupled social and ecological systems depends on how humanity will anticipate potential problems and deal with its ecological footprint in the future. We report the outcome of an EU-funded 15-country, 28 institution project entitled European Lifestyles and Marine Ecosystems (ELME). Our studies were designed to inform new EU policy and legislation that incorporates Ecosystem-Based Management. ELME has modelled the key relationships between economic and social drivers (D), environmental pressures (P) and changes in the state of the environment (S) in Europe's regional seas. We examined four key issues in each sea: habitat change, eutrophication, chemical pollution and fisheries. We developed conceptual models for each regional sea and employed a novel stochastic modelling technique to examine the interrelationship between key components of the conceptual models. We used the models to examine 2-3 decade projections of current trends in D, P and S and how a number of alternative development scenarios might modify these trends. These simulations demonstrate the vulnerability of Europe's seas to human pressure. As affluence increases in countries acceding to the EU, so does the demand for marine goods and services. There are `winners' and `losers' amongst marine species; the winners are often species that are opportunistic invaders or those with low economic value. In the case of eutrophication, semi-enclosed seas such as the Baltic or Black Sea are already affected by the `legacy of the past'; nutrients that have accumulated in soils, ground waters and
Lee, Windy W M; Choi, K C; Yum, Royce W Y; Yu, Doris S F; Chair, S Y
Clinically, there is an increasing trend in using motivational interviewing as a counseling method to help clients with cardiovascular diseases to modify their unhealthy lifestyle in order to decrease the risk of disease occurrence. As motivational interviewing has gained increased attention, research has been conducted to examine its effectiveness. This review attempts to identify the best available evidence related to the effectiveness of motivational interviewing on lifestyle modification, physiological and psychological outcomes for clients at risk of developing or with established cardiovascular diseases. Systematic review of studies incorporating motivational interviewing in modifying lifestyles, improving physiological and psychological outcomes for clients at risk of or diagnosed with cardiovascular diseases. Major English and Chinese electronic databases were searched to identify citations that reported the effectiveness of motivational interviewing. The searched databases included MEDLINE, British Nursing Index, CINAHL Plus, PsycINFO, SCOPUS, CJN, CBM, HyRead, WanFang Data, Digital Dissertation Consortium, and so on. Two reviewers independently assessed the relevance of citations based on the inclusion criteria. Full texts of potential citations were retrieved for more detailed review. Critical appraisal was conducted by using the standardized critical appraisal checklist for randomized and quasi-randomized controlled studies from the Joanna Briggs Institute - Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStaRI). After eligibility screening, 14 articles describing 9 studies satisfied the inclusion criteria and were included in the analysis. Only certain outcomes in certain studies were pooled for meta-analysis because of the large variability of the studies included, other findings were presented in narrative form. For lifestyle modification, the review showed that motivational interviewing could be more effective than usual care on
Groeneveld Iris F
Full Text Available Abstract Background The prevalence of overweight and elevated cardiovascular disease (CVD risk among workers in the construction industry is relatively high. Improving lifestyle lowers CVD risk and may have work-related benefits. The purpose of the study was to evaluate the effects on physical activity (PA, diet, and smoking of a lifestyle intervention consisting of individual counseling among male workers in the construction industry with an elevated risk of cardiovascular disease (CVD. Methods In a randomized controlled trial including 816 male blue- and white-collar workers in the construction industry with an elevated risk of CVD, usual care was compared to a 6-month lifestyle intervention. The intervention consisted of individual counseling using motivational interviewing techniques, and was delivered by an occupational physician or occupational nurse. In three face to face and four telephone contacts, the participant's risk profile, personal determinants, and barriers for behavior change were discussed, and personal goals were set. Participants chose to aim at either diet and PA, or smoking. Data were collected at baseline and after six and 12 months, by means of a questionnaire. To analyse the data, linear and logistic regression analyses were performed. Results The intervention had a statistically significant beneficial effect on snack intake (β-1.9, 95%CI -3.7; -0.02 and fruit intake (β 1.7, 95%CI 0.6; 2.9 at 6 months. The effect on snack intake was sustained until 12 months; 6 months after the intervention had ended (β -1.9, 95%CI -3.6; -0.2. The intervention effects on leisure time PA and metabolic equivalent-minutes were not statistically significant. The beneficial effect on smoking was statistically significant at 6 (OR smoking 0.3, 95%CI 0.1;0.7, but not at 12 months (OR 0.8, 95%CI 0.4; 1.6. Conclusions Beneficial effects on smoking, fruit, and snack intake can be achieved by an individual-based lifestyle intervention among
Riley, Callum James; Gavin, Matthew
Riley, Callum James, and Matthew Gavin. Physiological changes to the cardiovascular system at high altitude and its effects on cardiovascular disease. High Alt Med Biol. 18:102-113, 2017.-The physiological changes to the cardiovascular system in response to the high altitude environment are well understood. More recently, we have begun to understand how these changes may affect and cause detriment to cardiovascular disease. In addition to this, the increasing availability of altitude simulation has dramatically improved our understanding of the physiology of high altitude. This has allowed further study on the effect of altitude in those with cardiovascular disease in a safe and controlled environment as well as in healthy individuals. Using a thorough PubMed search, this review aims to integrate recent advances in cardiovascular physiology at altitude with previous understanding, as well as its potential implications on cardiovascular disease. Altogether, it was found that the changes at altitude to cardiovascular physiology are profound enough to have a noteworthy effect on many forms of cardiovascular disease. While often asymptomatic, there is some risk in high altitude exposure for individuals with certain cardiovascular diseases. Although controlled research in patients with cardiovascular disease was largely lacking, meaning firm conclusions cannot be drawn, these risks should be a consideration to both the individual and their physician.
Lindqvist, Maria; Lindkvist, Marie; Eurenius, Eva; Persson, Margareta; Mogren, Ingrid
Pregnant women are generally more motivated to change their lifestyle habits compared with non-pregnant women. However, the ability to change these habits depends on the motivation to change. This study describes pregnant women's self-reported motivation and ability to change lifestyle habits and their relation to body mass index (BMI), self-rated health, educational level and country of origin. This cross-sectional study combined data from the Maternal Health Care Register in Västerbotten (MHCR-VB) and the Salut Programme Register (Salut-R). Data were collected from 3,868 pregnant residents in Västerbotten County (northern Sweden) between 2011 and 2012. Chi-square test, two independent samples t-test and univariate and multivariate logistic regression were performed. Most of the pregnant women (61.3%) were satisfied with their self-reported lifestyle habits irrespective of BMI, self-rated health, educational level, and country of origin. Many reported that they wanted to increase their physical activity, improve their dietary habits, and reduce their weight. In general, they estimated their ability to change their lifestyle habits as equal to their motivation of change. Women who reported a large or very large motivation to change their lifestyle habits were characterized by higher BMI and higher educational level. Most of the participating pregnant women were satisfied with their lifestyle habits, although they reported being further motivated to change some of them. Health care professionals encountering fertile and pregnant women may have a unique opportunity to support and promote lifestyle changes, taking into account women's motivation for change. Future research should focus on factors that motivate pregnant women to change their lifestyle, explore barriers for change of lifestyle and how support best may be provided to pregnant women. In addition, studies on lifestyle and motivation for lifestyle change from non-Nordic countries are called for. Copyright
Full Text Available Previous studies indicated that lifestyle-related cardiovascular risk factors tend to be clustered in certain individuals. However, population-based studies, especially from developing countries with substantial economic heterogeneity, are extremely limited. Our study provides updated data on the clustering of cardiovascular risk factors, as well as the impact of lifestyle on those factors in China.A representative sample of adult population in China was obtained using a multistage, stratified sampling method. We investigated the clustering of four cardiovascular disease (CVD risk factors (defined as two or more of the following: hypertension, diabetes, dyslipidemia and overweight and their association with unhealthy lifestyles (habitual drinking, physical inactivity, chronic use of non-steroidal anti-inflammatory drugs (NSAIDs and a low modified Dietary Approaches to Stop Hypertension (DASH score.Among the 46,683 participants enrolled in this study, only 31.1% were free of any pre-defined CVD risk factor. A total of 20,292 subjects had clustering of CVD risk factors, and 83.5% of them were younger than 65 years old. The adjusted prevalence of CVD risk factor clustering was 36.2%, and the prevalence was higher among males than among females (37.9% vs. 34.5%. Habitual drinking, physical inactivity, and chronic use of NSAIDs were positively associated with the clustering of CVD risk factors, with ORs of 1.60 (95% confidence interval [CI] 1.40 to1.85, 1.20 (95%CI 1.11 to 1.30 and 2.17 (95%CI 1.84 to 2.55, respectively. The modified DASH score was inversely associated with the clustering of CVD risk factors, with an OR of 0.73 (95%CI 0.67 to 0.78 for those with modified DASH scores in the top tertile. The lifestyle risk factors were more prominent among participants with low socioeconomic status.Clustering of CVD risk factors was common in China. Lifestyle modification might be an effective strategy to control CVD risk factors.
Kouwenhoven-Pasmooij, Tessa A; Djikanovic, Bosiljka; Robroek, Suzan J W; Helmhout, Pieter; Burdorf, Alex; Hunink, M G Myriam
The prevalence of unhealthy lifestyles and preventable chronic diseases is high. They lead to disabilities and sickness absence, which might be reduced if health promotion measures were applied. Therefore, we developed the PerfectFit health promotion intervention with a "blended care"-approach, which consists of a web-based health risk assessment (HRA) including tailored and personalized advice, followed by motivational interviewing (MI). We hypothesize that adding MI to a web-based HRA leads to better health outcomes. The objective is to describe the design and baseline characteristics of the PerfectFit study, which is being conducted among employees with high cardiovascular risk in the military workforce, the police organization and an academic hospital. PerfectFit is a cluster randomized controlled trial, consisting of two arms. Based on cardiovascular risk profiling, done between 2012 and 2014, we included employees based on one or more risk factors and motivation to participate. One arm is the 'limited' health program (control) that consists of: (a) an HRA as a decision aid for lifestyle changes, including tailored and personalized advice, and pros and cons of the options, and (b) a newsletter every 3 months. The other arm is the 'extensive' program (intervention), which is additionally offered MI-sessions by trained occupational physicians, 4 face-to-face and 3 by telephone, and is offered more choices of health promotion activities in the HRA. During the follow-up period, participants choose the health promotion activities they personally prefer. After six and twelve months, outcomes will be assessed by online questionnaires. After twelve months the cardiovascular risk profiling will be repeated. The primary outcome is self-reported general health. Secondary outcomes are self-reported work ability, CVD-risk score, sickness absence, productivity loss at work, participation in health promotion activities, changes in lifestyle (smoking, alcohol consumption
Tennakoon, Sampath U B; Kumar, Bernadette N; Meyer, Haakon E
Sri Lankans in Oslo have previously been shown to have lower risk of cardiovascular disease compared with those in Kandy, Sri Lanka. Here we present lifestyle risk factors for cardiovascular diseases: frequency and type of fat consumed, frequency of fruit and vegetable intake, alcohol consumption, and leisure time physical activity between 1145 Sri Lankans living in Oslo and 678 Tamils and Sinhalese Sri Lankans living in Kandy as possible explanatory factors for the differences observed. Those in Oslo were consuming healthier fats and reported higher levels of physical activity but frequency of vegetable and fruit consumption was lower. Alcohol consumption among women was negligible. Type of fats consumed might be protective for Oslo group compared with predominantly saturated fat diet in Kandy. Higher leisure time physical activity may also be protective for the Oslo group. Higher frequency of consumption of vegetables and fruits may be beneficial in Kandy. © 2013 APJPH.
Improving patient adherence to lifestyle advice (IMPALA: a cluster-randomised controlled trial on the implementation of a nurse-led intervention for cardiovascular risk management in primary care (protocol
Full Text Available Abstract Background Many patients at high risk of cardiovascular diseases are managed and monitored in general practice. Recommendations for cardiovascular risk management, including lifestyle change, are clearly described in the Dutch national guideline. Although lifestyle interventions, such as advice on diet, physical exercise, smoking and alcohol, have moderate, but potentially relevant effects in these patients, adherence to lifestyle advice in general practice is not optimal. The IMPALA study intends to improve adherence to lifestyle advice by involving patients in decision making on cardiovascular prevention by nurse-led clinics. The aim of this paper is to describe the design and methods of a study to evaluate an intervention aimed at involving patients in cardiovascular risk management. Methods A cluster-randomised controlled trial in 20 general practices, 10 practices in the intervention arm and 10 in the control arm, starting on October 2005. A total of 720 patients without existing cardiovascular diseases but eligible for cardiovascular risk assessment will be recruited. In both arms, the general practitioners and nurses will be trained to apply the national guideline for cardiovascular risk management. Nurses in the intervention arm will receive an extended training in risk assessment, risk communication, the use of a decision aid and adapted motivational interviewing. This communication technique will be used to support the shared decision-making process about risk reduction. The intervention comprises 2 consultations and 1 follow-up telephone call. The nurses in the control arm will give usual care after the risk estimation, according to the national guideline. Primary outcome measures are self-reported adherence to lifestyle advice and drug treatment. Secondary outcome measures are the patients' perception of risk and their motivation to change their behaviour. The measurements will take place at baseline and after 12 and 52
Brandt, Carl Joakim; Søgaard, Gabrielle Isidora; Clemensen, Jane
BACKGROUND: Wearables, fitness apps, and patient home monitoring devices are used increasingly by patients and other individuals with lifestyle challenges. All Danish general practitioners (GPs) use digital health records and electronic health (eHealth) consultations on a daily basis, but how...... they perceive the increasing demand for lifestyle advice and whether they see eHealth as part of their lifestyle support should be explored further. OBJECTIVE: This study aimed to explore GPs' perspectives on eHealth devices and apps and the use of eHealth in supporting healthy lifestyle behavior...... or in partnership with 1 to 4 colleagues and all use electronic patient health records for prescription, referral, and asynchronous electronic consultations. We performed qualitative, semistructured, individual in-depth interviews with the GPs in their own office about how they used eHealth and mHealth devices...
Nordentoft, Merete; Krogh, Jesper; Krogholm, Kirstine Suszkiewicz
A significant share of the excess mortality among people suffering from mental illness is due to unhealthy lifestyles. Obesity, smoking, unhealthy diets and sedentary behaviour is twice as frequent among people with mental illness, but the willingness to improve lifestyle is as high as in healthy...... people. Based on a review of the literature we conclude that it is possible for people with mental illness to change their lifestyle, but they encounter a number of barriers to lifestyle changes, including their symptoms, adverse drug effects and their life situations....
Nakajima, Hiroshi; Tsuchiya, Naoki; Shiga, Toshikazu; Hata, Yutaka
Health is quite important to be realized in our daily life. However, its idea covers wide area and has individual dependency. Activities in health care have been widely developed by medical, drag, insurance, food, and other types of industries mainly centering diseases. In this article, systems approach named Systems Health Care is introduced and discussed to generate new and precious values based on measurements in daily life to change lifestyle habits for realizing each health. Firstly, issues related to health such as its definitions are introduced and discussed by centering health rather than disease. In response to the discussions on health, Home and Medical Care is continuously introduced to point out the important role causality between life style and vital signal such as exercise and blood pressure based on detailed sampling time. Systems approaches of Systems Health Care are discussed from various points of views. Real applications of devices and services are used to make the studies and discussions deeper on the subjects of the article.
Lifestyle modification is fundamental to obesity treatment, but few studies have described the effects of structured lifestyle programmes specifically in bariatric patients. We sought to describe changes in anthropometric and metabolic characteristics in a cohort of bariatric patients after participation in a nurse-led, structured lifestyle programme.
Liu, Kiang; Daviglus, Martha L; Loria, Catherine M; Colangelo, Laura A; Spring, Bonnie; Moller, Arlen C; Lloyd-Jones, Donald M
A low cardiovascular disease risk profile (untreated cholesterol risk profile. We examined whether adopting a healthy lifestyle throughout young adulthood is associated with the presence of the low cardiovascular disease risk profile in middle age. The Coronary Artery Risk Development in (Young) Adults (CARDIA) study sample consisted of 3154 black and white participants 18 to 30 years of age at year 0 (1985-1986) who attended the year 0, 7, and 20 examinations. Healthy lifestyle factors defined at years 0, 7, and 20 included average body mass index risk profile at year 20 were 3.0%, 14.6%, 29.5%, 39.2%, and 60.7% for people with 0 or 1, 2, 3, 4, and 5 healthy lifestyle factors, respectively (P for trend risk profile in middle age. Public health and individual efforts are needed to improve the adoption and maintenance of healthy lifestyles in young adults.
Mildestvedt, Thomas; Meland, Eivind
Those who are socioeconomically disadvantaged and people with emotional problems have a poorer prognosis for cardiovascular disease. The authors wanted to examine: (1) what effect household income, emotional status, high-risk smoking status, and severity of heart disease had on the ability of individuals to make dietary and exercise improvements after heart disease and (2) to what extent unfavourable lifestyle outcomes among disadvantaged people were mediated by motivational problems. A two-year follow-up study of the combined cohorts of a randomized controlled trial. Level of exercise and present dietary habits were measured at inclusion and after 6 and 24 months. Different motivational factors and emotional distress were measured during rehabilitation. Autonomous self-regulation was lowest among smokers (b = -0.31, p = 0.02) and female participants (b = 0.39, p = 0.004). Participants with high scores of emotional distress predicted lower motivation for all the measures. We found no association between socioeconomic status (household income) and the ability to perform lifestyle changes. Current smoking status predicted lower ability to obtain lifestyle changes on all measures. Emotional distress was related to lower ability to increase physical activity at 6 months' but not at 24 months' follow-up. The mediating effects of motivational factors were insignificant. The results of this study do not support the suspicion that preventive efforts accentuate the socioeconomic differences in cardiovascular health. Health-promotive efforts after heart disease should safeguard that high-risk groups such as smokers are not discouraged from improving their lifestyle in other areas.
Ketelaar, Sarah M.; Frings-Dresen, Monique H. W.; Sluiter, Judith K.
A change of medical students' health behavior over time may be related to a change in their opinion regarding the relationship between physicians' own health behavior and effective healthy lifestyle counseling in patients. To investigate Dutch medical students' (1) change of health behavior over
Full Text Available Background: The Vascular lifestyle-Intervention and Screening in phArmacies (VISA study investigates diet and lifestyle factors associated with risk of cardiovascular disease (CVD. As part of the study methodology, a short Food Frequency Questionnaire (FFQ, the VISA-FFQ, was adapted from the Norwegian NORDIET-FFQ. Objective: The aim of this study was to evaluate the VISA-FFQ and its ability to estimate intakes of foods and lifestyle factors in screening for elevated risk of CVD. The evaluation included assessment of relative validity of intake of milk fat and assessment of reproducibility of several foods and lifestyle factors. Design: Relative validity of milk fat estimated from the VISA-FFQ was assessed in 307 participants by comparing estimated dietary intake of the fatty acids pentadecanoic acid (15:0 and heptadecanoic acid (17:0, from milk fat with whole blood biomarkers 15:0 and 17:0. Reproducibility was evaluated in 122 participants by comparing consistency in intakes of different foods and lifestyle factors reported by the VISA-FFQ and administered twice with a 4-week interval. Results: Dietary 15:0 milk fat estimated from the VISA-FFQ correlated positively with whole blood 15:0 (r = 0.32, P < 0.05. Men presented higher correlations than women did. Acceptable and consistent reproducibility (r = 0.44–0.94 and no large difference between test and retest was observed for most beverages, milk products, spreads on bread and meat (all of which included food items categorised into at least two fat categories and also for eggs, fruits and vegetables, nuts, pasta and rice, dessert/sweets, smoking and physical activity. Reproducibility did not consistently meet a satisfactory standard (r ≤ 0.41 or large difference between test and retest for unsweetened cereals, fatty fish, cakes, oils, white-, bread, crispbread and rice. Conclusion: The validity of the VISA-FFQ was acceptable for intake of milk fat, and there was an overall satisfactory
Danaei, Mina; Palenik, Charles John; Abdollahifard, Gholamreza; Askarian, Mehrdad
A healthy lifestyle is important because of its long-term benefits; however, there is a paucity of information concerning health choices among Iranians. We evaluated personal health behaviors, attempts to change unhealthy behaviors, and factors affecting attempts at change. The design of this cross-sectional study was to assemble a representative cadre of >18-year-old adults in Shiraz, Iran, using a multistage cluster sampling technique. Validated questionnaires collected participant's demographic information, such as weight, height, cigarette smoking history, physical activity, and attempts at lifestyle changes during the previous year. To determine predictors of attempts to change unhealthy lifestyle and to identify confounders, we applied single and multivariable logistic regression methods, respectively. A confidence interval of 95% was calculated for each odds ratio. The prevalence of attempts to change unhealthy lifestyle was 42%, 64.8%, and 27.8%, respectively, for losing weight, being more physically active, and smoking cessation. Unemployment, low levels of education, and decreased socioeconomic status have important roles in attempts to change lifestyle conditions. Low socioeconomic status was a risk factor for quitting smoking. Occupation (unemployed/homemaker) and low level of education were two significant factors for being more physically active. The prevalence of inadequate physical activity and being overweight or obese was considerable in Shiraz, Iran. Attempts to change unhealthy lifestyle were less than ideal. Social determinants of health factors including unemployment and low levels of education and socioeconomic status play important roles in attempts to change current lifestyles.
Stack, Austin G
Tobacco use is a major modifiable cardiovascular risk factor in the general population and contributes to excess cardiovascular risk. Emerging evidence from large-scale observational studies suggests that continued tobacco use is also an independent cardiovascular risk factor among patients with chronic kidney disease (CKD). The benefits of smoking cessation programs on improving the heath status of patients and reducing mortality are unequivocal in the general population. Despite this, there has been little effort in pursuing tobacco cessation programs in dialysis cohorts or those with lesser degrees of kidney impairment. Most of our attention to date has focused on the development of "kidney-specific" interventions that reduce rates of renal disease progression and improve dialysis outcomes. The purpose of this current review is to describe the epidemiology of tobacco use among patients with CKD, draw attention to its negative impact on cardiovascular morbidity and mortality, and finally highlight potential strategies for successful intervention. We hope that this study heightens the importance of tobacco use in CKD, stimulates renewed interest in the barriers and challenges that exist in achieving smoking cessation, and endorses the efficacy of intervention strategies and the immeasurable benefits of quitting on cardiovascular and noncardiovascular outcomes.
O'Halloran, Peggy; Lazovich, DeAnn; Patterson, Ruth E.; Harnack, Lisa; French, Simone; Curry, Sue J.; Beresford, Shirley A. A.
Examined the impact of lifestyle on the effectiveness of a low-intensity dietary intervention. Analysis of data from the Eating Patterns Study indicated that people who practiced certain combinations of health behaviors responded differently to the low-intensity dietary intervention. People with high-risk behaviors were the least successful in…
Cole, Judith A; Smith, Susan M; Hart, Nigel; Cupples, Margaret E
Healthy lifestyles help to prevent coronary heart disease (CHD) but outcomes from secondary prevention interventions which support lifestyle change have been disappointing. This study is a novel, in-depth exploration of patient factors affecting lifestyle behaviour change within an intervention designed to improve secondary prevention for patients with CHD in primary care using personalised tailored support. We aimed to explore patients' perceptions of factors affecting lifestyle change within a trial of this intervention (the SPHERE Study), using semi-structured, one-to-one interviews, with patients in general practice. Interviews (45) were conducted in purposively selected general practices (15) which had participated in the SPHERE Study. Individuals, with CHD, were selected to include those who succeeded in improving physical activity levels and dietary fibre intake and those who did not. We explored motivations, barriers to lifestyle change and information utilised by patients. Data collection and analysis, using a thematic framework and the constant comparative method, were iterative, continuing until data saturation was achieved. We identified novel barriers to lifestyle change: such disincentives included strong negative influences of social networks, linked to cultural norms which encouraged consumption of 'delicious' but unhealthy food and discouraged engagement in physical activity. Findings illustrated how personalised support within an ongoing trusted patient-professional relationship was valued. Previously known barriers and facilitators relating to support, beliefs and information were confirmed. Intervention development in supporting lifestyle change in secondary prevention needs to more effectively address patients' difficulties in overcoming negative social influences and maintaining interest in living healthily.
Amelsvoort, van L.G.P.M.
Background: Evidence available so far indicates a 40% excess cardiovascular disease risk among shift workers. As, in the Netherlands alone, about one million people are working in shifts, this might have a considerable public health impact. Factors responsible
Coffeng, Jennifer K; van der Ploeg, Hidde P; Castellano, José M; Fernández-Alvira, Juan M; Ibáñez, Borja; García-Lunar, Inés; van der Beek, Allard J; Fernández-Ortiz, Antonio; Mocoroa, Agustín; García-Leal, Laura; Cárdenas, Evelyn; Rojas, Carolina; Martínez-Castro, María I; Santiago-Sacristán, Silvia; Fernández-Gallardo, Miriam; Mendiguren, José M; Bansilal, Sameer; van Mechelen, Willem; Fuster, Valentín
Cardiovascular disease (CVD) is the leading cause of death worldwide. With atherosclerosis as the underlying cause for many CVD events, prevention or reduction of subclinical atherosclerotic plaque burden (SAPB) through a healthier lifestyle may have substantial public health benefits. The objective was to describe the protocol of a randomized controlled trial investigating the effectiveness of a 30-month worksite-based lifestyle program aimed to promote cardiovascular health in participants having a high or a low degree of SAPB compared with standard care. We will conduct a randomized controlled trial including middle-aged bank employees from the Progression of Early Subclinical Atherosclerosis cohort, stratified by SAPB (high SAPB n=260, low SAPB n=590). Within each stratum, participants will be randomized 1:1 to receive a lifestyle program or standard care. The program consists of 3 elements: (a) 12 personalized lifestyle counseling sessions using Motivational Interviewing over a 30-month period, (b) a wrist-worn physical activity tracker, and (c) a sit-stand workstation. Primary outcome measure is a composite score of blood pressure, physical activity, sedentary time, body weight, diet, and smoking (ie, adapted Fuster-BEWAT score) measured at baseline and at 1-, 2-, and 3-year follow-up. The study will provide insights into the effectiveness of a 30-month worksite-based lifestyle program to promote cardiovascular health compared with standard care in participants with a high or low degree of SAPB. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
Groeneveld, I.F.; Proper, K.I.; Beek, A.J. van der; Hildebrandt, V.H.; Mechelen, W. van
Background: The prevalence of overweight and elevated cardiovascular disease (CVD) risk among workers in the construction industry is relatively high. Improving lifestyle lowers CVD risk and may have work-related benefits. The purpose of the study was to evaluate the effects on physical activity
Mesters, I.; Keulen, H.M. van; Vries, H. de; Brug, J.
Counselor competence in telephone Motivation Interviewing (MI) to change lifestyle behaviors in a primary care population was assessed using the Motivational Interviewing Treatment Integrity (MITI) rating system. Counselor behavior was evaluated by trained raters. Twenty minutes of a random sample
Galdas, Paul M; Oliffe, John L; Wong, Sabrina T; Ratner, Pamela A; Johnson, Joy L; Kelly, Mary T
To describe how culture underlies Canadian Punjabi Sikh men's experiences of adopting lifestyle changes following myocardial infarction (MI). Qualitative, interpretive design. In-depth, individual interviews were conducted with 27 Canadian Punjabi Sikh men post-MI. Data were analysed using constant comparative methods. Cultural influences were identified in Punjabi Sikh men's descriptions of their experience of adopting lifestyle changes. Actions related to self-care, rehabilitation and lifestyle change post-MI were embedded in collectivist family and community contexts. Three themes, derived from the data, were found to intertwine with these contexts; they related to food consumption, physical exercise and faith and religion. These findings highlight how collectivist ideals influence Canadian Punjabi Sikh men's adoption of lifestyle changes post-MI. The content and processes by which healthcare providers deliver heart health and rehabilitation to Canadian Punjabi Sikh men might be guided, at least in part, by the collectivist cultural practices underpinning our findings.
Johnston, Nina; Bodegard, Johan; Jerström, Susanna; Åkesson, Johanna; Brorsson, Hilja; Alfredsson, Joakim; Albertsson, Per A; Karlsson, Jan-Erik; Varenhorst, Christoph
Patients with myocardial infarction (MI) seldom reach recommended targets for secondary prevention. This study evaluated a smartphone application ("app") aimed at improving treatment adherence and cardiovascular lifestyle in MI patients. Multicenter, randomized trial. A total of 174 ticagrelor-treated MI patients were randomized to either an interactive patient support tool (active group) or a simplified tool (control group) in addition to usual post-MI care. Primary end point was a composite nonadherence score measuring patient-registered ticagrelor adherence, defined as a combination of adherence failure events (2 missed doses registered in 7-day cycles) and treatment gaps (4 consecutive missed doses). Secondary end points included change in cardiovascular risk factors, quality of life (European Quality of Life-5 Dimensions), and patient device satisfaction (System Usability Scale). Patient mean age was 58 years, 81% were men, and 21% were current smokers. At 6 months, greater patient-registered drug adherence was achieved in the active vs the control group (nonadherence score: 16.6 vs 22.8 [P = .025]). Numerically, the active group was associated with higher degree of smoking cessation, increased physical activity, and change in quality of life; however, this did not reach statistical significance. Patient satisfaction was significantly higher in the active vs the control group (system usability score: 87.3 vs 78.1 [P = .001]). In MI patients, use of an interactive patient support tool improved patient self-reported drug adherence and may be associated with a trend toward improved cardiovascular lifestyle changes and quality of life. Use of a disease-specific interactive patient support tool may be an appreciated, simple, and promising complement to standard secondary prevention. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
Pfaeffli Dale, Leila; Dobson, Rosie; Whittaker, Robyn; Maddison, Ralph
Mobile wireless devices (mHealth) have been used to deliver cardiovascular disease self-management interventions to educate and support patients in making healthy lifestyle changes. This systematic review aimed to determine the effectiveness of mHealth interventions on behavioural lifestyle changes and medication adherence for cardiovascular disease self-management. A comprehensive literature search was conducted from inception through to 3 March 2015 using MEDLINE, PubMed, PsycINFO, EMBASE and The Cochrane Library. Eligible studies used an experimental trial design to determine the effectiveness of an mHealth intervention to change lifestyle behaviours in any cardiovascular disease population. Data extracted included intervention and comparison group characteristics with a specific focus on the use of behaviour change techniques. Seven studies met our inclusion criteria and were included in the qualitative synthesis. All interventions were delivered in part by mobile phone text messaging. Three studies were effective at improving adherence to medication and two studies increased physical activity behaviour. No effects were observed on dietary behaviour or smoking cessation, measured in one study each. Simple text messaging interventions appeared to be most effective; however, no clear relationships were found between study findings and intervention dose, duration or behaviour change techniques targeted. Our review found mHealth has the potential to change lifestyle behaviour. Results are still limited to a small number of trials, inconsistent outcome measures and ineffective reporting of intervention characteristics. Large scale, longitudinal studies are now warranted to gain a clear understanding of the effects of mHealth on behaviour change in the cardiovascular disease population. © The European Society of Cardiology 2015.
Elwell, Laura; Powell, Jane; Wordsworth, Sharon; Cummins, Carole
Research exists examining the challenges of delivering lifestyle behaviour change initiatives in practice. However, at present much of this research has been conducted with primary care health professionals, or in acute adult hospital settings. The purpose of this study was to identify barriers and facilitators associated with implementing routine lifestyle behaviour change brief advice into practice in an acute children's hospital. Thirty-three health professionals (nurses, junior doctors, allied health professionals and clinical support staff) from inpatient and outpatient departments at a UK children's hospital were interviewed about their attitudes and beliefs towards supporting lifestyle behaviour change in hospital patients and their families. Responses were analysed using thematic framework analysis. Health professionals identified a range of barriers and facilitators to supporting lifestyle behaviour change in a children's hospital. These included (1) personal experience of effectiveness, (2) constraints associated with the hospital environment, (3) appropriateness of advice delivery given the patient's condition and care pathway and (4) job role priorities, and (5) perceived benefits of the advice given. Delivery of lifestyle behaviour change advice was often seen as an educational activity, rather than a behaviour change activity. Factors underpinning the successful delivery of routine lifestyle behaviour change support must be understood if this is to be implemented effectively in paediatric acute settings. This study reveals key areas where paediatric health professionals may need further support and training to achieve successful implementation.
Michishita, Ryoma; Matsuda, Takuro; Kawakami, Shotaro; Tanaka, Satoshi; Kiyonaga, Akira; Tanaka, Hiroaki; Morito, Natsumi; Higaki, Yasuki
This study was designed to evaluate whether changes in lifestyle behaviors are correlated with the incidence of chronic kidney disease (CKD). The subjects consisted of 316 men without a history of cardiovascular disease, stroke, or renal dysfunction or dialysis treatment. The following lifestyle behaviors were evaluated using a standardized self-administered questionnaire: habitual moderate exercise, daily physical activity, walking speed, eating speed, late-night dinner, bedtime snacking, skipping breakfast, and drinking and smoking habits. The subjects were divided into four categories according to the change in each lifestyle behavior from baseline to the end of follow-up (healthy-healthy, unhealthy-healthy, healthy-unhealthy and unhealthy-unhealthy). A multivariate analysis showed that, with respect to habitual moderate exercise and late-night dinner, maintaining an unhealthy lifestyle resulted in a significantly higher odds ratio (OR) for the incidence of CKD than maintaining a lifestyle (OR 8.94; 95% confidence interval [CI], 1.10-15.40 for habitual moderate exercise and OR 4.00; 95% CI, 1.38-11.57 for late-night dinner). In addition, with respect to bedtime snacking, the change from a healthy to an unhealthy lifestyle and maintaining an unhealthy lifestyle resulted in significantly higher OR for incidence of CKD than maintaining a healthy lifestyle (OR 4.44; 95% CI, 1.05-13.93 for healthy-unhealthy group and OR 11.02; 95% CI, 2.83-26.69 for unhealthy-unhealthy group). The results of the present study suggest that the lack of habitual moderate exercise, late-night dinner, and bedtime snacking may increase the risk of CKD. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.
Vermunt, P.W.A.; Milder, I.E.J.; Wielaard, F.; Baan, C.A.; Schelfhout, J.D.M.; Westert, G.P.; van Oers, J.A.M.
Background Despite the favorable effects of behavior change interventions on diabetes risk, lifestyle modification is a complicated process. In this study we therefore investigated opportunities for refining a lifestyle intervention for type 2 diabetes prevention, based on participant perceptions of
Photiou, A; Anning, J H; Mészáros, J; Vajda, I; Mészáros, Z; Sziva, A; Prókai, A; Ng, N
General socioeconomic conditions as well as the physical environment have undergone remarkable changes in Hungary during the past 30 years. Unfortunately, these positive processes have resulted in a reduction of habitual physical activity along with unfavorable changes in dietary habits. Therefore, the purpose of the present study was to compare some selected morphological and functional parameters of 7-14-year-old Hungarian schoolboys living in the middle of the 1970s and at the beginning of the new millennium. It was hypothesized that there would be significant differences in morphological and functional characteristics of the Hungarian schoolboy populations, because they were assessed 30 years apart. Means of height, body mass, body mass index (BMI), the sum of five skinfold tests, percentage of body fat, and two running performance times (400 m and 1,200 m) of the boys (N = 3,672) studied in 1975 were compared to those of the boys (N = 3,758) in 2005. Data were analyzed using two-tailed independent samples t tests (p changes in body mass and height. In addition, boys in 2005 had significantly more subcutaneous fat compared to 1975. The running times for the two distances were significantly poorer at the time of the second investigation. The remarkable and unfavorable changes in body composition and cardiorespiratory performance were attributed to the continuously decreasing intensity of habitual physical exercise and a lifestyle that had become more sedentary (watching TV playing computer games, etc.). Radical interventions are necessary to reduce these risks associated with the high prevalence of cardiovascular disease in Hungary, and the challenge to resolve the problem requires combined efforts at the educational, societal, corporate, and governmental levels.
Gueli, Nicoló; Piccirillo, Gianfanco; Troisi, Giovanni; Cicconetti, Paolo; Meloni, Fortunato; Ettorre, Evaristo; Verico, Paola; D'Arcangelo, Enzo; Cacciafesta, Mauro
The cardiovascular pathologies are the most common causes of death in the elderly patient. To single out the main risk factors in order to effectively prevent the onset of the disease, the authors experimented a special computerized tool, the neural network, that works out a mathematical relation that can obtain certain data (defined as output) as a function of other data (defined as input). Data were processed from a sample of 276 subjects of both sexes aged 26-69 years old. The output data were: high/low cholesterolemia, HDL cholesterol, triglyceridemia with respect to an established cut-off; the input data were: sex, age, build, weight, married/single, number of children, number of cigarettes smoked/day, amount of wine and number of cups of coffee. We conclude that: (i) a relationship exists, deduced from a neural network, between a set of input variables and a dichotomous output variable; (ii) this relationship can be expressed as a mathematical function; (iii) a neural network, having learned the data on a sufficiently large population, can provide valid predictive data for a single individual with a high probability (up to 93.33%) that the response it gives is correct. In this study, such a result is found for two of the three cardiovascular risk indicators considered (cholesterol and triglycerides); (iv) the repetition of the neural network analysis of the cases in question after a "pruning" operation provided a somewhat less good performance; (v) a statistical analysis conducted on those same cases has confirmed the existence of a strong relationship between the input and the output variables. Therefore the neural network is a valid instrument for providing predictive in a single subject on cardiovascular pathology risks.
Y. John Mei
Full Text Available Lifestyle changes such as in physical exercise, social activity, and diet can mitigate cognitive decline and improve quality of life in caregivers and care recipients with cognitive impairment. However, caregiver perspectives on lifestyle change remain largely unexamined. This study compares perspectives among caregivers for those with dementia and those with mild cognitive impairment (MCI. Interviews were conducted with caregivers in two sites in China, and thematic similarities and differences were examined between the two groups. Caregivers from both groups identified exercise, social activity, and diet as healthy ways of life. Differences were found in approaching lifestyle change based on health of the care recipient. Caregivers for patients with dementia found more often that they had no time or possibility for change, while caregivers for individuals with MCI were more often hopeful about change.
Astin, Felicity; Horrocks, Judith; Closs, S Jose
Coronary heart disease is an incurable condition. The only approach known to slow its progression is healthy lifestyle change and concordance with cardio-protective medicines. Few people fully succeed in these daily activities so potential health improvements are not fully realised. Little is known about peoples' experiences of managing lifestyle change. The aim of this study was to synthesise qualitative research to explain how participants make lifestyle change after a cardiac event and explore this within the wider illness experience. A qualitative synthesis was conducted drawing upon the principles of meta-ethnography. Qualitative studies were identified through a systematic search of 7 databases using explicit criteria. Key concepts were identified and translated across studies. Findings were discussed and diagrammed during a series of audiotaped meetings. The final synthesis is grounded in findings from 27 studies, with over 500 participants (56% male) across 8 countries. All participants experienced a change in their self-identity from what was 'familiar' to 'unfamiliar'. The transition process involved 'finding new limits and a life worth living' , 'finding support for self' and 'finding a new normal'. Analyses of these concepts led to the generation of a third order construct, namely an ongoing process of 'reassessing past, present and future lives' as participants considered their changed identity. Participants experienced a strong urge to get back to 'normal'. Support from family and friends could enable or constrain life change and lifestyle changes. Lifestyle change was but one small part of a wider 'life' change that occurred. The final synthesis presents an interpretation, not evident in the primary studies, of a person-centred model to explain how lifestyle change is situated within 'wider' life changes. The magnitude of individual responses to a changed health status varied. Participants experienced distress as their notion of self identity
Background Coronary heart disease is an incurable condition. The only approach known to slow its progression is healthy lifestyle change and concordance with cardio-protective medicines. Few people fully succeed in these daily activities so potential health improvements are not fully realised. Little is known about peoples’ experiences of managing lifestyle change. The aim of this study was to synthesise qualitative research to explain how participants make lifestyle change after a cardiac event and explore this within the wider illness experience. Methods A qualitative synthesis was conducted drawing upon the principles of meta-ethnography. Qualitative studies were identified through a systematic search of 7 databases using explicit criteria. Key concepts were identified and translated across studies. Findings were discussed and diagrammed during a series of audiotaped meetings. Results The final synthesis is grounded in findings from 27 studies, with over 500 participants (56% male) across 8 countries. All participants experienced a change in their self-identity from what was ‘familiar’ to ‘unfamiliar’. The transition process involved ‘finding new limits and a life worth living’ , ‘finding support for self’ and ‘finding a new normal’. Analyses of these concepts led to the generation of a third order construct, namely an ongoing process of ‘reassessing past, present and future lives’ as participants considered their changed identity. Participants experienced a strong urge to get back to ‘normal’. Support from family and friends could enable or constrain life change and lifestyle changes. Lifestyle change was but one small part of a wider ‘life’ change that occurred. Conclusions The final synthesis presents an interpretation, not evident in the primary studies, of a person-centred model to explain how lifestyle change is situated within ‘wider’ life changes. The magnitude of individual responses to a changed health status
van Oppen Patricia
Full Text Available Abstract Background In patients with type 2 diabetes, the risk for cardiovascular disease is substantial. To achieve a more favourable risk profile, lifestyle changes on diet, physical activity and smoking status are needed. This will involve changes in behaviour, which is difficult to achieve. Cognitive behavioural therapies focussing on self-management have been shown to be effective. We have developed an intervention combining techniques of Motivational Interviewing (MI and Problem Solving Treatment (PST. The aim of our study is to investigate if adding a combined behavioural intervention to managed care, is effective in achieving changes in lifestyle and cardiovascular risk profile. Methods Patients with type 2 diabetes will be selected from general practices (n = 13, who are participating in a managed diabetes care system. Patients will be randomised into an intervention group receiving cognitive behaviour therapy (CBT in addition to managed care, and a control group that will receive managed care only. The CBT consists of three to six individual sessions of 30 minutes to increase the patient's motivation, by using principles of MI, and ability to change their lifestyle, by using PST. The first session will start with a risk assessment of diabetes complications that will be used to focus the intervention. The primary outcome measure is the difference between intervention and control group in change in cardiovascular risk score. For this purpose blood pressure, HbA1c, total and HDL-cholesterol and smoking status will be assessed. Secondary outcome measures are quality of life, patient satisfaction, physical activity, eating behaviour, smoking status, depression and determinants of behaviour change. Differences between changes in the two groups will be analysed according to the intention-to-treat principle, with 95% confidence intervals. The power calculation is based on the risk for cardiovascular disease and we calculated that 97 patients
Wang, Chuangshi; Li, Wei; Yin, Lu; Bo, Jian; Peng, Yaguang; Wang, Yang
The study aimed to explore the gap of prevalence of healthy lifestyle behaviors including smoking cessation, quitting drinking, physical activity and healthy eating between Chinese adults with and without cardiovascular diseases (CVDs). This study is a cross-sectional component of Prospective Urban Rural Epidemiology (PURE)-China study, which recruited ~46,000 participants from 70 rural and 45 urban communities between 2005 and 2009. Participants were divided into disease (with CVDs) and control (without any diseases) groups. The adjusted rates were estimated for different strata by the generalized, linear mixed-effects model, including community as a random effect with additional adjustment for age, sex, education and income. Among 40,490 participants, healthy lifestyle behaviors (disease group versus control group: urban areas: 7.8% versus 8.1%; rural areas: 3.4% versus 3.2%). The rates of smoking cessation and quitting drinking were significantly higher in disease group for both urban and rural residents (Phealthy lifestyle behaviors except physical activity in low-income regions (Phealthy eating among rural residents from low-income regions (Phealthy lifestyle behaviors, but it still indicated a large gap between the actual and ideal adoption of healthy lifestyle behaviors, which called for the promotion of population-wide strategies to modify lifestyle behaviors in addition to individual health-care intervention strategies.
Satia, Jessie A; Campbell, Marci K; Galanko, Joseph A; James, Aimee; Carr, Carol; Sandler, Robert S
Lifestyle changes in persons diagnosed with cancer are important because they may impact prognosis, co-morbidities, and survival. This report describes longitudinal changes in lifestyle behaviors and health status among colon cancer survivors (n = 278) and population-based controls (n = 459) in North Carolina (39% African American), and examines demographic and psychosocial correlates of healthy lifestyle changes following a colon cancer diagnosis. Data are from surveys of a population-based cohort of colon cancer patients on diagnosis (the North Carolina Colon Cancer Study, NCCCS) and approximately 2 years post-diagnosis [the North Carolina Strategies to Improve Diet, Exercise, and Screening Study (NC STRIDES)], and population-based controls. Both studies collected information on demographic/lifestyle characteristics and medical history. The NCCCS reflects pre-diagnosis or pre-interview patterns, whereas NC STRIDES queried on current practices. Between the NCCCS and NC STRIDES, colon cancer survivors reported significant increases in vegetable intake, physical activity, and supplement use (all P dietary supplement post-diagnosis, whereas being retired correlated with increased vegetable intake, all P Colon cancer survivors reported making significant improvements in multiple health-related behaviors. Health care providers should communicate with persons diagnosed with colon cancer to ensure that they are making healthy lifestyle changes.
Sargeant, Joan; Valli, Michel; Ferrier, Suzanne; MacLeod, Heather
Many patients today have health concerns related to lifestyle factors. This has created a situation where physicians are regularly confronted with the challenge of how to conduct lifestyle counseling with patients. Specific strategies can enable physicians to more effectively navigate this complex area of communication with patients, improving patient response in adopting healthy behaviours and increasing physician satisfaction with this task. To evaluate the impact of a lifestyle counseling workshop incorporating the motivational enhancement and transtheoretical models upon primary care clinicians' counseling practice patterns, especially communication and counseling skills, and attitudes toward lifestyle counseling. This study used a mixed method research design. Forty-three clinicians completed a post-workshop evaluation and identified intended changes to practice following the workshop. Twelve participated in interviews several months later to explore the kinds of changes made and influences upon them. Forty-one (95.3%) questionnaire respondents reported an intention to change their practice. Main changes reported were: asking more questions, listening more, assessing patients' readiness to change, tailoring counseling to patients' readiness to change. They seemed to have acquired and retained new knowledge and most were able to apply the new skills in their practices. Many reported feeling more comfortable and/or confident when interacting with patients in need of lifestyle change. But, time constraints, comfort with current skills, lack of self-efficacy, and fears of missing opportunities to influence patients, moderated participants' ability to adopt and maintain new approaches. While primary care clinicians can successfully learn specific lifestyle counseling skills and incorporate them into their practice following a two-hour evidence-based workshop, individual, educational and system factors can interfere.
Primary care physicians should be actively involved in prevention of obesity, early detection and motivating people for life style change. Motivation is an important first step towards any action or behaviour change and clinicians can assess and enhance a person's motivation to change well before extensive damage is done ...
Liu, Kiang; Daviglus, Martha L.; Loria, Catherine M.; Colangelo, Laura A.; Spring, Bonnie; Moller, Arlen C.; Lloyd-Jones, Donald M.
Background A low cardiovascular disease (CVD) risk profile (untreated cholesterol risk profile. We examined whether adopting a healthy lifestyle throughout young adulthood is associated with presence of the low CVD risk profile in middle age. Methods and Results The CARDIA study sample consisted of 3,154 black and white participants aged 18 to 30 years at Year 0 (Y0, 1985-86) who attended the Year 0, 7 and 20 (Y0, Y7 and Y20) examinations. Healthy lifestyle factors (HLFs) defined at Y0, Y7 and Y20 included: 1) Average BMI risk profile at Y20 were 3.0%, 14.6%, 29.5%, 39.2% and 60.7% for people with 0 or 1, 2, 3, 4, and 5 HLFs, respectively (p-trend risk profile in middle age. Public health and individual efforts are needed to improve adoption and maintenance of healthy lifestyles in young adults. PMID:22291127
Effect of major lifestyle risk factors, independent and jointly, on life expectancy with and without cardiovascular disease: results from the Consortium on Health and Ageing Network of Cohorts in Europe and the United States (CHANCES).
O'Doherty, Mark G; Cairns, Karen; O'Neill, Vikki; Lamrock, Felicity; Jørgensen, Torben; Brenner, Hermann; Schöttker, Ben; Wilsgaard, Tom; Siganos, Galatios; Kuulasmaa, Kari; Boffetta, Paolo; Trichopoulou, Antonia; Kee, Frank
Seldom have studies taken account of changes in lifestyle habits in the elderly, or investigated their impact on disease-free life expectancy (LE) and LE with cardiovascular disease (CVD). Using data on subjects aged 50+ years from three European cohorts (RCPH, ESTHER and Tromsø), we used multi-state Markov models to calculate the independent and joint effects of smoking, physical activity, obesity and alcohol consumption on LE with and without CVD. Men and women aged 50 years who have a favourable lifestyle (overweight but not obese, light/moderate drinker, non-smoker and participates in vigorous physical activity) lived between 7.4 (in Tromsø men) and 15.7 (in ESTHER women) years longer than those with an unfavourable lifestyle (overweight but not obese, light/moderate drinker, smoker and does not participate in physical activity). The greater part of the extra life years was in terms of "disease-free" years, though a healthy lifestyle was also associated with extra years lived after a CVD event. There are sizeable benefits to LE without CVD and also for survival after CVD onset when people favour a lifestyle characterized by salutary behaviours. Remaining a non-smoker yielded the greatest extra years in overall LE, when compared to the effects of routinely taking physical activity, being overweight but not obese, and drinking in moderation. The majority of the overall LE benefit is in disease free years. Therefore, it is important for policy makers and the public to know that prevention through maintaining a favourable lifestyle is "never too late".
African Journal for Physical Activity and Health Sciences ... of cardiovascular disease and decreasing risk factors is to change unhealthy lifestyle habits. Due to the ... diet, blood pressure, hypokinetic disease, physical activity, and stress levels.
Salt, Blood Pressure and Cardiovascular Changes in Human and Experimental Studies – A Review. ... Some of the pathophysiological changes include cardiac hypertrophy and enhanced cardiac contractility, enhanced contraction of blood vessels and veins in response to constrictor agonists and diminished relaxation of ...
Gwinup, G; Haw, T; Elias, A
Video games are one of the most popular recreational activities among Americans of all ages, especially teenaged boys and young men. Studies of the health hazards of video-game playing have linked seizures, psychologic disturbances, and other health problems with the games. The study reported here measured changes in blood pressure and heart rate that occurred in 23 young men when they played a video game. The mean systolic blood pressure for the entire group was considerably higher during play than before or after and was significantly higher in novice players than in more skilled players. Heart rate was also significantly higher during play. In view of these results, other cardiovascular changes might be expected to occur during video-game playing. Although the changes reported here were minor, even minor cardiovascular alterations could potentially prove serious in persons with cardiovascular disease.
Full Text Available Cardiometabolic risk factors or their precursors are observed in childhood and may continue into adulthood. We investigated the effects of parental overweight and cardiometabolic diseases and pediatric lifestyle factors on the clustering of cardiovascular risk factors among adolescents, and examined the mediating and modifying effects of pediatric adiposity on these associations. Representative adolescents (n = 2727; age, 12–16 years were randomly recruited through multistage stratified sampling from 36 schools in Southern Taiwan. Adolescent and parent surveys were conducted in schools and participant homes, respectively. Their demographic factors, diet patterns, and physical, anthropometric, and clinical parameters were collected and analyzed. Adolescents with 1–2 and ≥3 risk components for pediatric metabolic syndrome (MetS were defined as potential MetS (pot-MetS and MetS, respectively. Adolescents whose parents were overweight/obese, or with diabetes and hypertension had a higher prevalence ratio of pot-MetS and MetS (1.5–1.6 and 1.9–4.2-fold, respectively. Low physical activity (<952.4 MET·min/week, long screen time (≥3 h/day and high sugar-sweetened beverage intake (>500 mL/day were associated with a 3.3- (95% confidence intervals (CI = 1.5–7.3, 2.2- (95% CI = 1.1–4.4, and 26.9-fold (95% CI = 3.2–229.0 odds ratio (OR of MetS, respectively. Pediatric body mass index (BMI accounted for 18.8%–95.6% and 16.9%–60.3% increased prevalence ratios of these parental and pediatric risk factors for MetS. The OR of pot-MetS + MetS for sugar-sweetened beverage consumption was multiplicatively enhanced among adolescents with overweight/obesity (combined OR, 8.6-fold (95% CI = 4.3–17.3; p for multiplicative interaction, 0.009. The results suggest that parental overweight and cardiometabolic diseases and pediatric sedentary and high sugar-intake lifestyles correlate with the development of adolescent MetS, and an elevated child BMI
Factores de riesgo cardiovascular y estilos de vida de estudiantes universitarios / Cardiovascular Risk Factors and Lifestyle Habits in College Students / Fatores de risco cardiovascular e estilo de vida em estudantes universitários
Clara Inés Padilla-García, Enf. Mg.
los estudiantes universitarios. Dentro de los más relevantes riesgos modificables están la obesidad y el sedentarismo que con un adecuado acompañamiento podrían disminuir. A pesar de que la mayoría de los jóvenes universitarios entran en el rango de adulto joven, se encuentran casos de hipertensión. [Padilla CI, Jaimes ML, Fajardo S, Ramos AM. Factores de riesgo cardiovascular y estilos de vida de estudiantes universitarios. MedUNAB 2014; 17(2:X-X] Introduction: The main risk factors of cardiovascular diseases are: obesity, high blood pressure, smoking, lack of physical activity, and unhealthy diet among others. Cardiovascular diseases are showing at earlier ages turning a public health issue that affects the person experiencing it, his/her family, and the health system since it increases costs. Objective: To determine the cardiovascular risk factors and lifestyles habits in students of a private college. Methodology: Observational descriptive study with transversal focus. The sample was not shuffled, it was composed of 323 students who attend a private university in the city of Bucaramanga Colombia. The given questionnaire allowed the identification of sociodemographic characteristics, cardiovascular risk factors and lifestyle habits in college students. Results: The average age of students participating in this study was 20 years. 73.7% were women and 26.3% men. 13.8% of students presented overweight issues and 5% were obese. 1.9% had systolic hypertension and 2.2% dyastolic hypertension. By gender, 24.8% were women, and 7.3% were men who presented abnormal waist measurement. 49.8% of students had history of chronic diseases. 13% suffer from chronic diseases like diabetes, high blood pressure, and cardiopathy. 46.7% of students have drunk alcohol, 9.28% smoke and 41.8% do not exercise a week. Conclusions: Cardiovascular risk factors exist among college students. Among the most relevant risk factors are obesity and sedentarism but with an appropriate care can
Goldsmith, Daena J; Lindholm, Kristin A; Bute, Jennifer J
Persons who have experienced a myocardial infarction (MI) and/or coronary artery bypass graft (CABG) surgery may benefit from a low-fat diet, regular exercise, smoking cessation, and stress management. Yet many patients do not make these changes. A spouse or partner's attempts at support may facilitate or interfere with patient behavior change. The present study explores dilemmas that may arise when couples talk about lifestyle changes following one person's MI or CABG. In interviews carried out in Urbana-Champaign, Illinois, and surrounding communities with 25 patients and 16 partners we found communicating support for lifestyle change may be interpreted as undesired control or criticism. The caring conveyed by talking may be viewed positively but can also threaten patient autonomy and entrap partners in unwanted expectations and obligations. Finally, lifestyle change conversations may reflect empowered patients collaborating with partners to take control of health but can also serve as potent reminders of loss. These multiple, potentially conflicting meanings give an account for why talking with a partner does not always facilitate patient lifestyle change. Understanding these dilemmas also suggests practical implications for helping patients and partners.
Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Pisinger, Charlotta
A low vitamin D level has been associated with increased cardiovascular disease risk but possible mechanisms remain unclear. We investigated the association between vitamin D levels and 5-year changes in blood pressure, lipid profile and incidence of the metabolic syndrome, hypertension and hyper......A low vitamin D level has been associated with increased cardiovascular disease risk but possible mechanisms remain unclear. We investigated the association between vitamin D levels and 5-year changes in blood pressure, lipid profile and incidence of the metabolic syndrome, hypertension...
Full Text Available The global burden of disease due to cardiovascular diseases (CVDs is escalating, and the changing trends of CVD risk factors are identified among Indians experiencing rapid health transition. Contributory causes include: growing population with demographic shifts and altered age profile, socio-economic factors, lifestyle changes due to urbanization. Indians are also having genetic predisposition to cardiovascular diseases and adult are susceptible to vascular disease linking possible gene-environment interactions influencing ethnic diversity. Altered diets with more of junk foods along with diminished physical activity are additive factors contributing to the acceleration of CVD epidemics, along with all form of tobacco use. The pace of health transition, however, varies across geographical regions from urban to rural population with consequent variations in the relative burdens of the dominant CVDs. A comprehensive public health response must be looked to plan over all strategies to integrate policies and programs that effectively impact on the multiple determinants of CVDs to provide protection over the life span through primordial, primary and secondary prevention. Populations as well as individuals at risk must be protected through initiatives, enable nutrition-based preventive strategies to protect and promote cardiovascular health.
Khuwaja, Ali Khan; Lalani, Saima; Azam, Iqbal Syed; Ali, Badar Sabir; Jabbar, Abdual; Dhanani, Raheem
Background. We evaluated the prevalence and clustering pattern of cardiovascular disease (CVD) related lifestyle factors and their association with CVD among patients with type 2 diabetes. We also examined the association of these factors with various socio-demographic characteristics. Methods. A total of 1000 patients with type 2 diabetes were interviewed in a cross-sectional, multi-center study in out-patient clinics in Karachi, Pakistan. Results. In this study 30.3% study participants had CVD. Majority of the patients were physically inactive and had adverse psychosocial factors. Forty percent of the study participants were exposed to passive smoking while 12.7% were current smokers. Only 8.8% of study subjects had none of the studied lifestyle factor, 27.5% had one, while 63.7% had two or three factors. CVDs were independently associated with physical inactivity, adverse psychosocial factors, passive smoking and clustering of two or three lifestyle factors. Physical inactivity was more prevalent among females and patients with no/less education. Proportion of adverse psychosocial factors were higher among females, elders and patients with no/less education. Clustering of these lifestyle factors was significantly higher among females, elderly and no/less educated patients. Conclusion. These results suggest the need of comprehensive and integrated interventions to reduce the prevalence of lifestyle factors. PMID:21837274
Elosua-Bayés, Marc; Martí-Lluch, Ruth; García-Gil, María Del Mar; Camós, Lourdes; Comas-Cufí, Marc; Blanch, Jordi; Ponjoan, Anna; Alves-Cabratosa, Lia; Elosua, Roberto; Grau, María; Marrugat, Jaume; Ramos, Rafel
The cardio-ankle vascular index (CAVI) assesses arterial stiffness. We aimed to describe the distribution of CAVI in a Mediterranean population, to determine the proportion of CAVI ≥ 9 by sex and coronary risk level, and to assess the association of CAVI with classic cardiovascular risk factors and lifestyle patterns. This cross-sectional study was based on the population of Girona province. The CAVI was measured using the VaSera VS-1500. Of 2613 individuals included in this study, the prevalence of CAVI ≥ 9 was 46.8% in men and 36.0% in women and significantly increased with coronary risk: from 21.1% and 24.8%, respectively to 76.7%, in the low-risk group, and 61.9% in the high-risk group. The CAVI increased with age in both sexes, being higher in men across all age groups. In men, CAVI ≥ 9 was associated with hypertension (OR, 2.70; 95%CI, 1.90-3.87) and diabetes (OR, 2.38; 95%CI, 1.52-3.78), body mass index (BMI) ≤ 25 to < 30 (OR, 0.44; 95%CI, 0.27-0.72) and BMI ≥ 30 (OR, 0.28; 95%CI, 0.14-0.58), and physical activity (OR, 0.66; 95%CI, 0.47-0.92). In women, CAVI ≥ 9 was associated with hypertension (OR, 2.22; 95%CI, 1.59-3.09), hypercholesterolemia (OR, 1.40; 95%CI, 1.01-1.94), and BMI ≥ 30 (OR, 0.38; 95%CI, 0.20-0.71). The CAVI increases with age and is higher in men than in women. This index is associated with classic risk factors and coronary risk. It could be a good predictive biomarker, but further follow-up studies are required to assess its added value to cardiovascular risk stratification. Copyright © 2017. Published by Elsevier España, S.L.U.
Full Text Available Abstract Background Temporary work assignments in the United States (US are widely considered to have negative health outcomes on Asians mostly due to adverse changes in diet and exercise, though there is little research on this phenomenon. This study investigated the impact of lifestyle changes on the biological and psychological health and health behaviours of Japanese people on temporary assignments in the US. Methods In this cross sectional survey, we distributed a 38 item self-administered questionnaire addressing health habits, mental health function, lifestyle changes and dietary habits to adult Japanese patients presenting for general physicals at a family medicine clinic serving Japanese patients. We conducted simple statistics and regression analysis between length of stay and other health outcomes to determine whether length of residence in the US was predictive of negative lifestyle changes. Results Most participants reported increased caloric intake, weight gain, and less exercise. They also reported increased time with family. More women than men reported physical symptoms and anxiety related to stress. Smoking and alcohol intake were essentially unchanged. No associations were identified between length of residence in the US and health lifestyle habits or other health outcomes. Conclusion Negative lifestyle changes occur in diet and exercise for overseas Japanese people, but a positive change in increased family time was found. Women appear to be at a greater risk for somatic disorders than men. As duration of stay does not appear predictive of adverse changes, clinicians should advise patients going abroad of these risks regardless of the term of the work assignment.
Ackerstaff, A. H.; Hilgers, F. J.; Aaronson, N. K.; Balm, A. J.
Functional changes after total laryngectomy, including voice quality, hyposmia and dysgeusia, nasal discharge, swallowing and smoking habits were studied by means of a structured interview with 63 laryngectomized patients. Eighty per cent of the patients reported that they were satisfied with the
Bekkers, M.B.M.; Koppes, L.L.J.; Rodenburg, W.; Steeg, H. van; Proper, K.I.
Objective: To prospectively study the association of night and shift work with weight change and lifestyle behaviors. Methods: Workers participating in the Netherlands Working Conditions Cohort Study (2008 and 2009) (N = 5951) reported night and shift work, weight and height. Groups included stable
Bekkers, M.B.M; Koppes, L.L.J.; Rodenburg, W.; Steeg, H. van; Proper, K.I.
Objective: To prospectively study the association of night and shift work with weight change and lifestyle behaviors. Methods: Workers participating in the Netherlands Working Conditions Cohort Study (2008 and 2009) (N = 5951) reported night and shift work, weight and height. Groups included stable
Bekkers, M.B.M.; Koppes, L.L.J.; Rodenburg, W.; van Steeg, H.; Proper, K.I.
Objective: To prospectively study the association of night and shift work with weight change and lifestyle behaviors. Methods: Workers participating in the Netherlands Working Conditions Cohort Study (2008 and 2009) (N = 5951) reported night and shift work, weight and height. Groups included stable
Fennis, Bob M.; Andreassen, Tor W.; Lervik-Olsen, Line
To curb the trend towards obesity and unhealthy living, people may need to change their entire lifestyle to a healthier alternative, something that is frequently perceived to be problematic. The present research, using a large, representative community sample, hypothesized and found that a key
Gentry-Maharaj, Aleksandra; Glazer, Clara; Burnell, Matthew
of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). DESIGN: Prospective birth cohort analysis. SETTING: Population cohort invited between 2001 and 2005 from age-sex registers of 27 Primary Care Trusts in England, Wales and Northern Ireland and recruited through 13 National Health Service......-reported data on reproductive factors provided at recruitment were explored using tabular and graphical summaries to examine for differences between the birth cohorts. OUTCOME MEASURES: Trends in mean age at menarche and menopause, use of oral contraceptives, change in family size, infertility treatments, tubal...... to reflect the reproductive history of the UK female postmenopausal population of similar age. Since these are risk factors for hormone-related cancers, these trends are important in understanding the changing incidence of these cancers. TRIAL REGISTRATION NUMBER: International Standard Randomised Controlled...
Mathur, Maya B; Gould, Michael; Khazeni, Nayer
Background: Direct-to-consumer (DTC) prescription drug advertisements are thought to induce "boomerang effects," meaning they reduce the perceived effectiveness of a potential alternative option: non-pharmaceutical treatment via lifestyle change. Past research has observed such effects using artificially created, text-only advertisements that may not adequate capture the complex, conflicting portrayal of lifestyle change in real television advertisements. In other risk domains, individual "problem status" often moderates boomerang effects, such that subjects who currently engage in the risky behavior exhibit the strongest boomerang effects. Objectives: We aimed to assess whether priming with real DTC television advertisements elicited boomerang effects on perceptions of lifestyle change and whether these effects, if present, were moderated by individual problem status. Methods: We assembled a sample of real, previously aired DTC television advertisements in order to naturalistically capture the portrayal of lifestyle change in real advertisements. We randomized 819 adults in the United States recruited via Amazon Mechanical Turk to view or not view an advertisement for a prescription drug. We further randomized subjects to judge either lifestyle change or drugs on three measures: general effectiveness, disease severity for a hypothetical patient, and personal intention to use the intervention if diagnosed with the target health condition. Results: Advertisement exposure induced a statistically significant, but weak, boomerang effect on general effectiveness ( p = 0.01, partial R 2 = 0.007) and did not affect disease severity score ( p = 0.32, partial R 2 = 0.0009). Advertisement exposure elicited a reverse boomerang effect of similar effect size on personal intentions, such that advertisement-exposed subjects reported comparatively higher intentions to use lifestyle change relative to drugs ( p = 0.006, partial R 2 = 0.008). Individual problem status did not
Maya B. Mathur
Full Text Available Background: Direct-to-consumer (DTC prescription drug advertisements are thought to induce boomerang effects, meaning they reduce the perceived effectiveness of the alternative option: non-pharmaceutical treatment via lifestyle change. Past research has observed such effects using artificially created, text-only advertisements that may not adequate capture the complex, conflicting portrayal of lifestyle change in real television advertisements. Research in other risk domains has found that individual problem status often moderates boomerang effects, such that subjects who currently engage in the risky behavior exhibit the strongest boomerang effects. Objectives: We aimed to assess whether priming with real direct-to-consumer (DTC television advertisements elicited boomerang effects on perceptions of lifestyle change and whether these effects, if present, were moderated by individual problem status. Methods: We assembled a sample of real, previously aired DTC television advertisements in order to naturalistically capture the portrayal of lifestyle change in real advertisements. We randomized 819 adults in the United States recruited via Amazon Mechanical Turk to view or not view an advertisement for a prescription drug. We further randomized subjects to judge either lifestyle change or drugs on three measures: general effectiveness, disease severity for a hypothetical patient, and personal intention to use the intervention if diagnosed with the target health condition. Results: Advertisement exposure induced a statistically significant, but weak, boomerang effect on general effectiveness (p = 0.01, partial R2 = 0.007 and did not affect disease severity score (p = 0.32, partial R2 = 0.0009. Advertisement exposure elicited a reverse boomerang effect of similar effect size on personal intentions, such that advertisement-exposed subjects reported comparatively higher intentions to use lifestyle change relative to drugs (p = 0.006, partial R2 = 0
Changes in smoking during a community-based cardiovascular disease intervention programme - The Coronary Risk Factor Study. ... South African Medical Journal ... Smoking quit rates were strongly " associated with initial smoking level, with light smokers being significanty more successful quitters than heavy smokers.
Bekkers, Marga B M; Koppes, Lando L J; Rodenburg, Wendy; van Steeg, Harry; Proper, Karin I
To prospectively study the association of night and shift work with weight change and lifestyle behaviors. Workers participating in the Netherlands Working Conditions Cohort Study (2008 and 2009) (N = 5951) reported night and shift work, weight and height. Groups included stable night or shift work, from day work to night or shift work, from night or shift work to day work, and no night or shift work in 2008 and 2009. Regression analyses were used to study association changes in night and shift work with weight change and changes in lifestyle behaviors. A larger weight change was seen in normal-weight workers changing from day to shift work (β = 0.93%; 95% confidence interval, 0.01 to 1.85) compared with stable no shift workers. No further associations of night and shift work with weight change were observed, neither in normal-weight, overweight, and obese workers. Despite the fact that starting night or shift work is associated with some unhealthy lifestyle habits, this study did not confirm a positive association of night and shift work with weight change over 1 year, except for normal-weight workers moving from day to shift work.
Wu, Yangfeng; Benjamin, Emelia J; MacMahon, Stephen
With one-fifth of the world's total population, China's prevention and control of cardiovascular disease (CVD) may affect the success of worldwide efforts to achieve sustainable CVD reduction. Understanding China's current cardiovascular epidemic requires awareness of the economic development in the past decades. The rapid economic transformations (industrialization, marketization, urbanization, globalization, and informationalization) contributed to the aging demography, unhealthy lifestyles, and environmental changes. The latter have predisposed to increasing cardiovascular risk factors and the CVD pandemic. Rising CVD rates have had a major economic impact, which has challenged the healthcare system and the whole society. With recognition of the importance of health, initial political steps and national actions have been taken to address the CVD epidemic. Looking to the future, we recommend that 4 priorities should be taken: pursue multisectorial government and nongovernment strategies targeting the underlying causes of CVD (the whole-of-government and whole-of-society policy); give priority to prevention; reform the healthcare system to fit the nature of noncommunicable diseases; and conduct research for evidence-based, low-cost, simple, sustainable, and scalable interventions. By pursuing the 4 priorities, the pandemic of CVD and other major noncommunicable diseases in China will be reversed and the global sustainable development goal achieved. © 2016 American Heart Association, Inc.
The first group included patients who received statins as a lipid-lowering therapy, the second one — statins + fibrates, the third one — those who were not taking antidiabetic therapy. As a result of treatment, all groups showed a decrease in body weight: the 1st one — by 3.94 %, the second one — by 3.63 % and the third one — by 5.48 %. The significant reduction in total cholesterol and triglyceride levels after the treatment was observed in the group of those who were not taking lipid-lowering therapy. In the group of patients who received statins, a statistically significant decrease in triglyceride levels was observed. Thus, we can conclude that the use of Guarem, by slowing down the evacuation of the stomach, leads to weight loss, normalization of triglycerides, cholesterol levels, contributes to changes in dietary habits (adapts to the regimen of small, frequent feeding, reduction in the volume and caloric content of food.
Bolbrinker, J; Zaidi Touis, L; Gohlke, H; Weisser, B; Kreutz, R
In the 2013 European Society of Hypertension (ESH) and European Society of Cardiology (ESC) guidelines for the management of arterial hypertension, six lifestyle changes for treatment are recommended for the first time with class I, level of evidence A. We initiated a survey among physicians to explore their awareness and consideration of lifestyle changes in hypertension management. The survey included questions regarding demographics as well as awareness and implementation of the recommended lifestyle changes. It was conducted at two German and two European scientific meetings in 2015. In all, 1064 (37.4% female) physicians participated (806 at the European and 258 at the German meetings). Of the six recommended lifestyle changes, self-reported awareness was highest for regular exercise (85.8%) followed by reduction of weight (66.2%). The least frequently self-reported lifestyle changes were the advice to quit smoking (47.3%) and moderation of alcohol consumption (36.3%). Similar frequencies were observed for the lifestyle changes implemented by physicians in their care of patients. A close correlation between awareness of guideline recommendations and their implementation into clinical management was observed. European physicians place a stronger emphasis on regular exercise and weight reduction than on the other recommended lifestyle changes. Moderation of alcohol consumption is the least emphasized lifestyle change.
Ladd, Sandra L; Toscano, William B; Cowings, Patricia S; Gabrieli, John D E
These studies examined memory encoding to determine whether the mere exposure effect could be categorized as a form of conceptual or perceptual implicit priming and, if it was not conceptual or perceptual, whether cardiovascular psychophysiology could reveal its nature. Experiment 1 examined the effects of study phase level of processing on recognition, the mere exposure effect, and word identification implicit priming. Deep relative to shallow processing improved recognition but did not influence the mere exposure effect for nonwords or word identification implicit priming for words. Experiments 2 and 3 examined the effect of study-test changes in font and orientation, respectively, on the mere exposure effect and word identification implicit priming. Different study-test font and orientation reduced word identification implicit priming but had no influence on the mere exposure effect. Experiments 4 and 5 developed and used, respectively, a cardiovascular psychophysiological implicit priming paradigm to examine whether stimulus-specific cardiovascular reactivity at study predicted the mere exposure effect at test. Blood volume pulse change at study was significantly greater for nonwords that were later preferred than for nonwords that were not preferred at test. There was no difference in blood volume pulse change for words at study that were later either identified or not identified at test. Fluency effects, at encoding or retrieval, are an unlikely explanation for these behavioral and cardiovascular findings. The relation of blood volume pulse to affect suggests that an affective process that is not conceptual or perceptual contributes to the mere exposure effect.
Vadheim, Liane M.; Brewer, Kari A.; Kassner, Darcy R.; Vanderwood, Karl K.; Hall, Taryn O.; Butcher, Marcene K.; Helgerson, Steven D.; Harwell, Todd S.
Purpose: To evaluate the feasibility of translating the Diabetes Prevention Program (DPP) lifestyle intervention into practice in a rural community. Methods: In 2008, the Montana Diabetes Control Program worked collaboratively with Holy Rosary Healthcare to implement an adapted group-based DPP lifestyle intervention. Adults at high risk for…
Vassbakk-Brovold, Karianne; Berntsen, Sveinung; Fegran, Liv; Lian, Henrik; Mjåland, Odd; Mjåland, Svein; Nordin, Karin; Seiler, Stephen; Kersten, Christian
This study aimed to explore the feasibility of an individualized comprehensive lifestyle intervention in cancer patients undergoing curative or palliative chemotherapy. At one cancer center, serving a population of 180,000, 100 consecutive of 161 eligible newly diagnosed cancer patients starting curative or palliative chemotherapy entered a 12-month comprehensive, individualized lifestyle intervention. Participants received a grouped startup course and monthly counseling, based on self-reported and electronically evaluated lifestyle behaviors. Patients with completed baseline and end of study measurements are included in the final analyses. Patients who did not complete end of study measurements are defined as dropouts. More completers (n = 61) vs. dropouts (n = 39) were married or living together (87 vs. 69%, p = .031), and significantly higher baseline physical activity levels (960 vs. 489 min . wk -1 , p = .010), more healthy dietary choices (14 vs 11 points, p = .038) and fewer smokers (8 vs. 23%, p = .036) were observed among completers vs. dropouts. Logistic regression revealed younger (odds ratios (OR): 0.95, 95% confidence interval (CI): 0.91, 0.99) and more patients diagnosed with breast cancer vs. more severe cancer types (OR: 0.16, 95% CI: 0.04, 0.56) among completers vs. dropouts. Improvements were observed in completers healthy (37%, p < 0.001) and unhealthy dietary habits (23%, p = .002), and distress (94%, p < .001). No significant reductions were observed in physical activity levels. Patients treated with palliative intent did not reduce their physical activity levels while healthy dietary habits (38%, p = 0.021) and distress (104%, p = 0.012) was improved. Favorable and possibly clinical relevant lifestyle changes were observed in cancer patients undergoing curative or palliative chemotherapy after a 12-month comprehensive and individualized lifestyle intervention. Palliative patients were able to
Kamimura, Akiko; Sin, Kai; Pye, Mu; Meng, Hsien-Wen
Refugees resettled in the US may be at risk for cardiovascular disease (CVD). However, little is known about CVD-related issues among Karen refugees who have migrated to the US from the Thai-Myanmar border. The purpose of this study was to examine CVD-related health beliefs and lifestyle issues among Karen refugees resettled in the US. Karen refugees resettled in the US from the Thai-Myanmar border (n=195) participated in a survey study on health beliefs related to CVD, salt intake, physical activity (PA), and smoking in the fall of 2016. A high-salt diet, physical inactivity, and smoking were major lifestyle problems. Participants who adhered to a low-salt diet considered themselves to be susceptible to CVD. Most participants did not engage in regular PA. Regular PA was associated with less perceived susceptibility to CVD and greater perceived benefits of a healthy lifestyle for decreasing the likelihood of CVD. Each refugee population may require individualized strategies to promote PA and a healthy diet. Future studies should develop health education programs that are specifically designed for Karen refugees and evaluate such programs. In addition to health education programs on healthy lifestyle choices, tobacco cessation programs seem to be necessary for Karen refugees. At the same time, it is important to foster strategies to increase the utilization of preventive care among this population by promoting free or reduced-fee resources in the community to further promote their health.
Trevor S. Ferguson
Full Text Available ObjectivesSocioeconomic disparities in health have emerged as an important area in public health, but studies from Afro-Caribbean populations are uncommon. In this study, we report on educational health disparities in cardiovascular disease (CVD risk factors (hypertension, diabetes mellitus, hypercholesterolemia, and obesity, among Jamaican adults.MethodsWe analyzed data from the Jamaica Health and Lifestyle Survey 2007–2008. Trained research staff administered questionnaires and obtained measurements of blood pressure, anthropometrics, glucose and cholesterol. CVD risk factors were defined by internationally accepted cut-points. Educational level was classified as primary or lower, junior secondary, full secondary, and post-secondary. Educational disparities were assessed using age-adjusted or age-specific prevalence ratios and prevalence differences obtained from Poisson regression models. Post-secondary education was used as the reference category for all comparisons. Analyses were weighted for complex survey design to yield nationally representative estimates.ResultsThe sample included 678 men and 1,553 women with mean age of 39.4 years. The effect of education on CVD risk factors differed between men and women and by age group among women. Age-adjusted prevalence of diabetes mellitus was higher among men with less education, with prevalence differences ranging from 6.9 to 7.4 percentage points (p < 0.05 for each group. Prevalence ratios for diabetes among men ranged from 3.3 to 3.5 but were not statistically significant. Age-specific prevalence of hypertension was generally higher among the less educated women, with statistically significant prevalence differences ranging from 6.0 to 45.6 percentage points and prevalence ratios ranging from 2.5 to 4.3. Similarly, estimates for obesity and hypercholesterolemia suggested that prevalence was higher among the less educated younger women (25–39 years and among more educated older
Fennis, Bob M; Andreassen, Tor W; Lervik-Olsen, Line
To curb the trend towards obesity and unhealthy living, people may need to change their entire lifestyle to a healthier alternative, something that is frequently perceived to be problematic. The present research, using a large, representative community sample, hypothesized and found that a key factor responsible for why people do not intend to change lifestyles is a sense of commitment to past behavior. However we also found that the contribution of commitment was attenuated for individuals with a stronger tendency for behavioral disinhibition thus underscoring the "bright side" of this individual difference characteristic that traditionally has been mainly associated with impulsive and indulging behavior. Overall, the present findings add to our understanding of factors inhibiting and promoting healthy behavior change.
Full Text Available This research assessed whether greater attachment to an Aboriginal community buffers against the negative effects of stigma and promotes positive health outcomes. Aboriginal Australians ( n = 203 living with hepatitis C completed a survey assessing community attachment, stigma, resilience, quality of life, treatment intent, hepatitis C knowledge and positive lifestyle changes. A stronger sense of community attachment was associated with greater resilience, increased quality of life, less hepatitis C–related stigma and with increased lifestyle changes after diagnosis. Hence, community attachment can buffer against the negative health effects of stigma and may promote the resources to engage in positive behaviour changes, ultimately increasing long-term health outcomes.
Emília de Carvalho Coutinho
Full Text Available Pregnancy is a period influenced by the interaction of several factors, therefore this study aimed to identify changes in lifestyles due to pregnancy and childbirth in Portuguese and immigrant women in Portugal. This is a qualitative study, using the semi-structured interview, with eighty-two Portuguese and immigrant women. Content analysis was used, with verbatim classification supported by Nvivo 10. It was authorized by an Ethics Commission. Results revealed that the primary changes in lifestyles due to pregnancy were in eating habits (nutrition, daily activity, exposure to danger, sleep and rest patterns, social and family relationships, going out, self-care, work, clothing and footwear, travel, health monitoring and sexual activity and substances consumption. The main change after the birth, manifested by these women, was that their lives began to revolve around their baby.
Ahlin, Kristina; Billhult, Annika
The objective of this study was to describe how women handle necessary lifestyle changes due to a chronic disease using diabetes as a model. Interview study. Ten women living in western Sweden were interviewed. In-depth interviews and analysis were performed using the phenomenological ideas of Giorgi. Ten women diagnosed with type 2 diabetes, mean age 65. All were either on disability pension or retired with varying complications ranging from none to stroke. The findings revealed five themes: the ambiguous feeling of others' involvement, becoming a victim of pressurizing demands, experiencing knowledge deficits, experiencing an urge, and finding reasons to justify not changing. The invariant meaning of a continuous inner struggle illuminates the experience of making lifestyle changes for women with type 2 diabetes. The findings of the present study show that it is vital for health care professionals to treat women diagnosed with type 2 diabetes with great respect and understanding regarding the struggle that they are going through. By being aware of the everyday burden for these women, acknowledging the fact that they want their lives to go on as before, may serve as a "key" to assist women in changing attitudes towards living in accordance with the disease and appreciating the lifestyle changes as a challenge as they become healthier and improve their quality of life.
Schwingel, Andiara; Linares, Deborah E; Gálvez, Patricia; Adamson, Brynn; Aguayo, Liliana; Bobitt, Julie; Castañeda, Yvette; Sebastião, Emerson; Marquez, David X
Despite the burgeoning U.S. Latino population and their increased risk of chronic disease, little emphasis had been placed on developing culturally sensitive lifestyle interventions in this area. This article examines older Latinas' sociocultural context relative to health with the goal of developing a culturally sensitive health behavior intervention. Photo-elicitation indicated two emerging themes that influenced lifestyle choices: family caregiving and religion. Researchers partnered with a faith-based organization to develop and implement a 6-month lifestyle intervention for Latinas ages 50 and older: Abuelas en Acción (AEA). At completion, interviews were conducted to understand women's experiences and the influence AEA had on their lifestyles and health. Findings suggest that religious content empowered and deeply affected women; however, the intergenerational content presented significant challenges for instruction, retention, and implementation. We discuss findings in relation to the health intervention literature and provide suggestions for future interventions drawing on religion, family, and health behavior change. © The Author(s) 2015.
Alayli-Goebbels, Adrienne F G; van Exel, Job; Ament, André J H A; de Vries, Nanne K; Bot, Sandra D M; Severens, Johan L
To use contingent valuation (CV) to derive individual consumer values for both health and broader benefits of a public-health intervention directed at lifestyle behaviour change (LBC) and to examine the feasibility and validity of the method. Participants of a lifestyle intervention trial (n = 515) were invited to complete an online CV survey. Respondents (n = 312) expressed willingness to invest money and time for changes in life expectancy, health-related quality of life (HRQOL) and broader quality of life aspects. Internal validity was tested for by exploring associations between explanatory variables (i.e. income, paid work, experience and risk factors for cardiovascular diseases) and willingness to invest, and by examining ordering effects and respondents' sensitivity to the scope of the benefits. The majority of respondents (94.3%) attached value to benefits of LBC, and 87.4% were willing to invest both money and time. Respondents were willing to invest more for improvements in HRQOL (€42/month; 3 h/week) and broader quality of life aspects (€40/month; 2.6 h/week) than for improvements in life expectancy (€24/month; 2 h/week). Protest answers were limited (3%) and findings regarding internal validity were mixed. The importance of broader quality of life outcomes to consumers suggests that these outcomes are relevant to be considered in the decision making. Our research showed that CV is a feasible method to value both health and broader outcomes of LBC, but generalizability to other areas of public health still needs to be examined. Mixed evidence regarding internal validity pleads for caution to use CV as only the base for decision making. © 2014 John Wiley & Sons Ltd.
Kašparová, Eva; Van de Putte, Anton P; Marshall, Craig; Janko, Karel
Major climatic changes in the Pleistocene had significant effects on marine organisms and the environments in which they lived. The presence of divergent patterns of demographic history even among phylogenetically closely-related species sharing climatic changes raises questions as to the respective influence of species-specific traits on population structure. In this work we tested whether the lifestyle of Antarctic notothenioid benthic and pelagic fish species from the Southern Ocean influenced the concerted population response to Pleistocene climatic fluctuations. This was done by a comparative analysis of sequence variation at the cyt b and S7 loci in nine newly sequenced and four re-analysed species. We found that all species underwent more or less intensive changes in population size but we also found consistent differences between demographic histories of pelagic and benthic species. Contemporary pelagic populations are significantly more genetically diverse and bear traces of older demographic expansions than less diverse benthic species that show evidence of more recent population expansions. Our findings suggest that the lifestyles of different species have strong influences on their responses to the same environmental events. Our data, in conjunction with previous studies showing a constant diversification tempo of these species during the Pleistocene, support the hypothesis that Pleistocene glaciations had a smaller effect on pelagic species than on benthic species whose survival may have relied upon ephemeral refugia in shallow shelf waters. These findings suggest that the interaction between lifestyle and environmental changes should be considered in genetic analyses.
O'Doherty, Mark G.; Cairns, Karen; O'Neill, Vikki
-state Markov models to calculate the independent and joint effects of smoking, physical activity, obesity and alcohol consumption on LE with and without CVD. Men and women aged 50 years who have a favourable lifestyle (overweight but not obese, light/moderate drinker, non-smoker and participates in vigorous......-free” years, though a healthy lifestyle was also associated with extra years lived after a CVD event. There are sizeable benefits to LE without CVD and also for survival after CVD onset when people favour a lifestyle characterized by salutary behaviours. Remaining a non-smoker yielded the greatest extra years...... physical activity) lived between 7.4 (in Tromsø men) and 15.7 (in ESTHER women) years longer than those with an unfavourable lifestyle (overweight but not obese, light/moderate drinker, smoker and does not participate in physical activity). The greater part of the extra life years was in terms of “disease...
Pezza, P E
Symbolic interactionism is a body of thought which attends to how the meaning of a message may be mutually defined in the process of social interaction. As interactionism and its qualitative methodologies have been increasingly recognized as useful and appropriate complements to other approaches, health education has been slow to respond. Proposed here is the application of an interactionist perspective to the study of contemporary efforts made to promote lifestyle change and better health. A specific case is made for examining the interaction which takes place when employers strive to promote employee health. Particular attention is paid to the following questions: 1. How may employer communication of corporate goals for employee lifestyle change best be studied?; 2. Are the messages transmitted by employers and those received by employees the same?; 3. What may be some unanticipated consequences of the health promotion effort and its messages?; and 4. Can the interactionist perspective be used to enlighten the planning process for health promotion programs?
Bekkers, M.B.M; Koppes, L.L.J.; Rodenburg, W.; Steeg, H. van; Proper, K.I.
Objective: To prospectively study the association of night and shift work with weight change and lifestyle behaviors. Methods: Workers participating in the Netherlands Working Conditions Cohort Study (2008 and 2009) (N = 5951) reported night and shift work, weight and height. Groups included stable night or shift work, from day work to night or shift work, from night or shift work to day work, and no night or shift work in 2008 and 2009. Regression analyses were used to study association chan...
Brandt, Carl Joakim; Søgaard, Gabrielle Isidora; Clemensen, Jane; Sndergaard, Jens; Nielsen, Jesper Bo
Wearables, fitness apps, and patient home monitoring devices are used increasingly by patients and other individuals with lifestyle challenges. All Danish general practitioners (GPs) use digital health records and electronic health (eHealth) consultations on a daily basis, but how they perceive the increasing demand for lifestyle advice and whether they see eHealth as part of their lifestyle support should be explored further. This study aimed to explore GPs' perspectives on eHealth devices and apps and the use of eHealth in supporting healthy lifestyle behavior for their patients and themselves. A total of 10 (5 female and 5 male) GPs were recruited by purposive sampling, aged 38 to 69 years (mean 51 years), of which 4 had an urban uptake of patients and 6 a rural uptake. All of them worked in the region of Southern Denmark where GPs typically work alone or in partnership with 1 to 4 colleagues and all use electronic patient health records for prescription, referral, and asynchronous electronic consultations. We performed qualitative, semistructured, individual in-depth interviews with the GPs in their own office about how they used eHealth and mHealth devices to help patients challenged with lifestyle issues and themselves. We also interviewed how they treated lifestyle-challenged patients in general and how they imagined eHealth could be used in the future. All GPs had smartphones or tablets, and everyone communicated on a daily basis with patients about disease and medicine via their electronic health record and the internet. We identified 3 themes concerning the use of eHealth: (1) how eHealth is used for patients; (2) general practitioners' own experience with improving lifestyle and eHealth support; and (3) relevant coaching techniques for transformation into eHealth. GPs used eHealth frequently for themselves but only infrequently for their patients. GPs are familiar with behavioral change techniques and are ready to use them in eHealth if they are used to
Mittal, Tarun K; Cleghorn, Christine L; Cade, Janet E; Barr, Suzanne; Grove, Tim; Bassett, Paul; Wood, David A; Kotseva, Kornelia
Background A high prevalence of stress-related disorders is well known among healthcare professionals. We set out to assess the prevalence of cardiovascular risk factors and compliance with national dietary and physical activity recommendations in NHS staff in the UK with comparison between clinical and non-clinical staff, and national surveys. Design A multi-centre cross-sectional study. Methods A web-based questionnaire was developed to include anonymised data on demographics, job role, cardiovascular risk factors and diseases, dietary habits, physical activity and barriers towards healthy lifestyle. This was distributed to staff in four NHS hospitals via emails. Results A total of 1158 staff completed the survey (response rate 13%) with equal distribution between the clinical and non-clinical groups. Most staff were aged 26-60 years and 79% were women. Half of the staff were either overweight or obese (51%) with no difference between the groups ( P = 0.176), but there was a lower prevalence of cardiovascular risk factors compared to the general population. The survey revealed a low compliance (17%) with the recommended intake of five-a-day portions of fruit and vegetables, and that of moderate or vigorous physical activity (56%), with no difference between the clinical and non-clinical staff ( P = 0.6). However, more clinical staff were exceeding the alcohol recommendations ( P = 0.02). Lack of fitness facilities and managerial support, coupled with long working hours, were the main reported barriers to a healthy lifestyle. Conclusions In this survey of UK NHS staff, half were found to be overweight or obese with a lower prevalence of cardiovascular risk factors compared to the general population. There was a low compliance with the five-a-day fruit and vegetables recommendation and physical activity guidelines, with no difference between the clinical and non-clinical staff.
Full Text Available Background and Aims: It is not yet understood how attitudes concerning dementia risk may affect motivation to change health behaviours and lifestyle. This study was designed to develop a reliable and valid theory-based measure to understand beliefs underpinning the lifestyle and health behavioural changes needed for dementia risk reduction. Methods: 617 participants aged ≥50 years completed a theory-based questionnaire, namely, the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction (MCLHB-DRR scale. The MCLHB-DRR consists of 53 items, reflecting seven subscales of the Health Belief Model. Results: Confirmatory factor analysis was performed and revealed that a seven-factor solution with 27 items fitted the data (comparative fit index = 0.920, root-mean-square error of approximation = 0.047 better than the original 53 items. Internal reliability (α = 0.608-0.864 and test-retest reliability (α = 0.552-0.776 were moderate to high. Measurement of invariance across gender and age was also demonstrated. Conclusions: These results propose that the MCLHB-DRR is a useful tool in assessing the beliefs and attitudes of males and females aged ≥50 years towards dementia risk reduction. This measure can be used in the development and evaluation of interventions aimed at dementia prevention.
Alm-Roijer, Carin; Stagmo, Martin; Udén, Giggi; Erhardt, Leif
Many patients with coronary heart disease (CHD) are not managed adequately, and we often fail to reach treatment targets. To investigate if knowledge of risk factors for CHD, measured by a questionnaire, would show any relation to advice to compliance to lifestyle changes to attain treatment goals and adherence to drug therapy. Men and women event were screened consecutively (509) from the medical records. Responders (392) were interviewed, examined and received a questionnaire. Three hundred and forty-seven patients answered the questionnaire regarding their general knowledge of risk factors for CHD, compliance to lifestyle changes to attain treatment goals and adherence to drug therapy. There were statistically significant correlations between general knowledge about risk factors for CHD and compliance to certain lifestyle changes: weight, physical activity, stress management, diet, attainment of lipid level goals and the likelihood of taking prescribed blood pressure-lowering drugs. General knowledge of risk factors had no correlation to blood glucose or blood pressure levels nor on smoking habits or treatment patterns for prescribed lipid- and blood glucose-lowering drugs. Knowledge correlates to patient behaviour with respect to some risk factors, which should be recognised in preventive programs.
Aadahl, Mette; von Huth Smith, L; Pisinger, Charlotte
OBJECTIVE: To evaluate whether five-year changes in self-reported physical activity level were associated with changes in waist circumference, weight, serum lipids and blood pressure. METHODS: In the Inter99 study (1999-2006) in Copenhagen, Denmark, 4039 men and women (30-60 years) answered quest....... Change in physical activity level induced a significant change in HDL concentration in men only. Women's use of hormone replacement therapy may partly explain this gender difference.......OBJECTIVE: To evaluate whether five-year changes in self-reported physical activity level were associated with changes in waist circumference, weight, serum lipids and blood pressure. METHODS: In the Inter99 study (1999-2006) in Copenhagen, Denmark, 4039 men and women (30-60 years) answered...... questions on lifestyle and provided blood samples and anthropometric measures at baseline and after five years. Multiple regression analyses were performed with five-year value of each cardiovascular biomarker as outcome and change in physical activity level as explanatory variable. RESULTS: Approximately...
Nurse-led motivational interviewing to change the lifestyle of patients with type 2 diabetes (MILD-project: protocol for a cluster, randomized, controlled trial on implementing lifestyle recommendations
Full Text Available Abstract Background The diabetes of many patients is managed in general practice; healthcare providers aim to promote healthful behaviors, such as healthful diet, adequate physical activity, and smoking cessation. These measures may decrease insulin resistance, improve glycemic control, lipid abnormalities, and hypertension. They may also prevent cardiovascular disease and complications of diabetes. However, professionals do not adhere optimally to guidelines for lifestyle counseling. Motivational interviewing to change the lifestyle of patients with type 2 diabetes is intended to improve diabetes care in accordance with the national guidelines for lifestyle counseling. Primary care nurses will be trained in motivational interviewing embedded in structured care in general practice. The aim of this paper is to describe the design and methods of a study evaluating the effects of the nurses' training on patient outcomes. Methods/Design A cluster, randomized, controlled trial involving 70 general practices (35 practices in the intervention arm and 35 in the control arm starting in March 2007. A total of 700 patients with type 2 diabetes will be recruited. The patients in the intervention arm will receive care from the primary care nurse, who will receive training in an implementation strategy with motivational interviewing as the core component. Other components of this strategy will be adaptation of the diabetes protocol to local circumstances, introduction of a social map for lifestyle support, and educational and supportive tools for sustaining motivational interviewing. The control arm will be encouraged to maintain usual care. The effect measures will be the care process, metabolic parameters (glycosylated hemoglobin, blood pressure and lipids, lifestyle (diet, physical activity, smoking, and alcohol, health-related quality of life, and patients' willingness to change behaviors. The measurements will take place at baseline and after 14 months
Ó Súilleabháin, Páraic S; Howard, Siobhán; Hughes, Brian M
Underlying psychophysiological mechanisms of effect linking openness to experience to health outcomes, and particularly cardiovascular well-being, are unknown. This study examined the role of openness in the context of cardiovascular responsivity to acute psychological stress. Continuous cardiovascular response data were collected for 74 healthy young female adults across an experimental protocol, including differing counterbalanced acute stressors. Openness was measured via self-report questionnaire. Analysis of covariance revealed openness was associated with systolic blood pressure (SBP; p = .016), and diastolic blood pressure (DBP; p = .036) responsivity across the protocol. Openness was also associated with heart rate (HR) responding to the initial stress exposure (p = .044). Examination of cardiovascular adaptation revealed that higher openness was associated with significant SBP (p = .001), DBP (p = .009), and HR (p = .002) habituation in response to the second differing acute stress exposure. Taken together, the findings suggest persons higher in openness are characterized by an adaptive cardiovascular stress response profile within the context of changing acute stress exposures. This study is also the first to demonstrate individual differences in cardiovascular adaptation across a protocol consisting of differing stress exposures. More broadly, this research also suggests that future research may benefit from conceptualizing an adaptive fitness of openness within the context of change. In summary, the present study provides evidence that higher openness stimulates short-term stress responsivity, while ensuring cardiovascular habituation to change in stress across time. © 2017 Society for Psychophysiological Research.
Alexandre M. Lehnen
Full Text Available Metabolic syndrome has been defined as a group of risk factors that directly contribute to the development of cardiovascular disease and/or type 2 diabetes. Insulin resistance seems to have a fundamental role in the genesis of this syndrome. Over the past years to the present day, basic and translational research has used small animal models to explore the pathophysiology of metabolic syndrome and to develop novel therapies that might slow the progression of this prevalent condition. In this paper we discuss the animal models used for the study of metabolic syndrome, with particular focus on cardiovascular changes, since they are the main cause of death associated with the condition in humans.
Allard, K. O.; Thomsen, J. F.; Mikkelsen, S.
controlling for potential confounders. There were no other significant findings in the expected direction except for some of the confounders. CONCLUSIONS:: We found only limited and inconsistent support for the hypothesis that a poor psychosocial work environment is associated with an adverse lifestyle......OBJECTIVE:: To evaluate the effect of the demand-control-support model, the effort-reward imbalance model, and emotional demands on smoking, alcohol consumption, physical activity, and body mass index. METHODS:: This is a 2-year prospective cohort study of 3224 public sector employees. Measures...... were assessed with questionnaires. Multiple regression analyses were used to predict changes in lifestyle factors. RESULTS:: Low reward predicted smoking, low-decision latitude predicted being inactive, and high demands predicted high-alcohol consumption but only for men at follow-up even after...
Allard, Karin Olofsson; Thomsen, Jane Frølund; Mikkelsen, Sigurd; Rugulies, Reiner; Mors, Ole; Kærgaard, Anette; Kolstad, Henrik A; Kaerlev, Linda; Andersen, Johan Hviid; Hansen, Ase Marie; Bonde, Jens Peter
To evaluate the effect of the demand-control-support model, the effort-reward imbalance model, and emotional demands on smoking, alcohol consumption, physical activity, and body mass index. This is a 2-year prospective cohort study of 3224 public sector employees. Measures were assessed with questionnaires. Multiple regression analyses were used to predict changes in lifestyle factors. Low reward predicted smoking, low-decision latitude predicted being inactive, and high demands predicted high-alcohol consumption but only for men at follow-up even after controlling for potential confounders. There were no other significant findings in the expected direction except for some of the confounders. We found only limited and inconsistent support for the hypothesis that a poor psychosocial work environment is associated with an adverse lifestyle.
Mark S. McIntosh
Full Text Available This article describes the unique perspective of a clinician who was originally trained as an acute care specialist but in recent years had the opportunity to witness the positive impact of therapeutic lifestyle change (TLC programs in managing chronic diseases. Through experience gained from conducting a multi-center clinical trial investigating the effects of TLC program in people with metabolic syndrome, Dr. Mark S. McIntosh discusses various aspects and challenges pertinent to implementing a successful TLC program. Patients, physicians, lifestyle counselors, work places, and home environment are all critical in forming an alliance for transforming the current sick-care approach to preventive, wellness-focused approach that is far more efficient,rewarding, and financially sustainable.
Oggioni, C; Cena, H; Wells, J C K; Lara, J; Celis-Morales, C; Siervo, M
Global dietary and lifestyle trends are primary risk factors for communicable and non-communicable diseases. An ecological analysis was conducted to examine the association of global dietary and lifestyle patterns with total cholesterol concentrations. This study also investigated whether total cholesterol modified the association between dietary and lifestyle habits with disability-adjusted-life-years-lost (DALYs) for infectious and cardiovascular diseases (CVDs). Country-specific mean total cholesterol concentrations and DALYs for infectious and CVDs were obtained. Data were then matched to country-specific food and energy availability for consumption and information on obesity, physical inactivity, urbanization, gross domestic product (GDP), life expectancy and smoking. Stepwise multiple regression models were developed to identify significant predictors of total cholesterol concentrations and DALYs for infectious and CVDs. Life expectancy and egg and meat consumption were significantly associated with cholesterol concentrations. DALYs for infectious diseases were associated with smoking, life expectancy and per capita GDP. Smoking was the only predictor of DALYs for CVDs. The improvement of socio-demographic conditions and economic growth is likely to reduce the burden of communicable diseases in developing countries. A concurring increase in non-communicable diseases is expected, and these results have, yet again, identified smoking as a primary risk factor for CVDs. Copyright © 2015 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.
Marit B Rise
Full Text Available BACKGROUND: Disease management is crucial in type 2 diabetes. Diabetes self-management education aims to provide the knowledge necessary to make and maintain lifestyle changes. However, few studies have investigated the processes after such courses. The aim of this study was to investigate how participants make and maintain lifestyle changes after participating in group-based type 2 diabetes self-management education. METHODS: Data was collected through qualitative semi-structured interviews with 23 patients who attended educational group programs in Central Norway. The participants were asked how they had used the advice given and what they had changed after the course. RESULTS: Knowledge was essential for making lifestyle changes following education. Three factors affected whether lifestyle changes were implemented: obtaining new knowledge, taking responsibility, and receiving confirmation of an already healthy lifestyle. Four factors motivated individuals to maintain changes: support from others, experiencing an effect, fear of complications, and the formation of new habits. CONCLUSION: Knowledge was used to make and maintain changes in diet, medication and physical activity. Knowledge also acted as confirmation of an already adequate lifestyle. Knowledge led to no changes if diabetes appeared "not that scary" or if changes appeared too time consuming. Those involved in diabetes education need to be aware of the challenges in convincing asymptomatic patients about the benefits of adherence to self-management behaviour.
Nilsen, V; Bakke, P S; Rohde, G; Gallefoss, F
To determine whether the sense of coherence (SOC) could predict the outcome of an 18-month lifestyle intervention program for subjects at risk of type 2 diabetes. Subjects at high risk of type 2 diabetes mellitus were recruited to a low-intensity lifestyle intervention program by their general practitioners. Weight reduction ≥ 5% and improvement in exercise capacity of ≥ 10% from baseline to follow-up indicated a clinically significant lifestyle change. SOC was measured using the 13-item SOC questionnaire. The study involved 213 subjects with a mean body mass index of 37 (SD ± 6). Complete follow-up data were obtained for 131 (62%). Twenty-six participants had clinically significant lifestyle changes. There was a 21% increase in the odds of a clinically significant lifestyle change for each point increase in the baseline SOC score (odds ratio = 1.21; confidence interval = 1.11-1.32). The success rate was 14 times higher in the highest SOC score tertile group compared with the lowest. High SOC scores were good predictors of successful lifestyle change in subjects at risk of type 2 diabetes. SOC-13 can be used in daily practice to increase clinical awareness on the impact of mastery on the outcome of life-style intervention programs. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
Crowe, Catherine; Gibson, Irene; Cunningham, Katie; Kerins, Claire; Costello, Caroline; Windle, Jane; O Shea, Paula M; Hynes, Mary; McGuire, Brian; Kilkelly, Katriona; Griffin, Helena; O Brien, Tim; Jones, Jenni; Finucane, Francis M
Lifestyle modification is fundamental to obesity treatment, but few studies have described the effects of structured lifestyle programmes specifically in bariatric patients. We sought to describe changes in anthropometric and metabolic characteristics in a cohort of bariatric patients after participation in a nurse-led, structured lifestyle programme. We conducted a retrospective, observational cohort study of adults with a body mass index (BMI) ≥ 40 kgm(-2) (or ≥ 35 kgm(-2) with significant co-morbidity) who were attending a regional bariatric service and who completed a single centre, 8-week, nurse-led multidisciplinary lifestyle modification programme. Weight, height, waist circumference, blood pressure, HbA1c, fasting glucose and lipid profiles as well as functional capacity (Incremental Shuttle Walk Test) and questionnaire-based anxiety and depression scores before and after the programme were compared in per-protocol analyses. Of 183 bariatric patients enrolled, 150 (81.9%) completed the programme. Mean age of completers was 47.9 ± 1.2 years. 34.7% were male. There were statistically significant reductions in weight (129.6 ± 25.9 v 126.9 ± 26.1 kg, p triglyceride levels, with an increase in functional capacity (5.9 ± 1.7 v 6.8 ± 2.1 metabolic equivalents of thermogenesis (METS), p structured lifestyle programme had improved adiposity, fitness, lipid profiles, psychosocial health, blood pressure and glycaemia. Further assessment of this programme in a pragmatic randomised controlled trial seems warranted.
Phillips, R L; Kuzma, J W; Beeson, W L; Lotz, T
The authors examine the influence of selection versus life-style on mortality from various causes for a population of 23,000 California Seventh-Day Adventists. The data are compared with data from a control group of 112,726 other Californians. The selective factors considered include education, occupation, and marital status
Gillison, Fiona; Stathi, Afroditi; Reddy, Prasuna; Perry, Rachel; Taylor, Gordon; Bennett, Paul; Dunbar, James; Greaves, Colin
Process evaluation is important for improving theories of behavior change and behavioral intervention methods. The present study reports on the process outcomes of a pilot test of the theoretical model (the Process Model for Lifestyle Behavior Change; PMLBC) underpinning an evidence-informed, theory-driven, group-based intervention designed to promote healthy eating and physical activity for people with high cardiovascular risk. 108 people at high risk of diabetes or heart disease were randomized to a group-based weight management intervention targeting diet and physical activity plus usual care, or to usual care. The intervention comprised nine group based sessions designed to promote motivation, social support, self-regulation and understanding of the behavior change process. Weight loss, diet, physical activity and theoretically defined mediators of change were measured pre-intervention, and after four and 12 months. The intervention resulted in significant improvements in fiber intake (M between-group difference = 5.7 g/day, p behavior change, and the predicted mechanisms of change specified in the PMBLC were largely supported. Improvements in self-efficacy and understanding of the behavior change process were associated with engagement in coping planning and self-monitoring activities, and successful dietary change at four and 12 months. While participants reported improvements in motivational and social support variables, there was no effect of these, or of the intervention overall, on physical activity. The data broadly support the theoretical model for supporting some dietary changes, but not for physical activity. Systematic intervention design allowed us to identify where improvements to the intervention may be implemented to promote change in all proposed mediators. More work is needed to explore effective mechanisms within interventions to promote physical activity behavior.
Linmans, Joris J; Knottnerus, J André; Spigt, Mark
It is unknown to what extend patients with type 2 diabetes mellitus (T2DM) in primary care are motivated to change their lifestyle. We assessed the level of motivation to change lifestyle and the agreement for that level between patients and healthcare professionals. Patients with T2DM (150) filled in a questionnaire to assess the level of motivation to change their lifestyle, using a single question with three answer options. We investigated the agreement for this level between these patients and their healthcare professionals (12 professionals). In addition, we investigated and compared the level of physical activity as indicated by the patients and the healthcare professionals. A large part of the patients reported to have a deficient physical activity level (35% according to patients, 47% according to healthcare professionals, kappa 0.32) and were not motivated to change their lifestyle level (29% according to patients, 43% according to healthcare professionals, kappa 0.13). Patients tended to overestimate their physical activity and their motivation to change in comparison with their healthcare professionals. Patients with T2DM in primary care should increase their physical activity level. Healthcare professionals often do not know whether patients are motivated to change their lifestyle, and should therefore assess motivation regularly to optimize lifestyle management. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
Følling, Ingrid S; Solbjør, Marit; Helvik, Anne-S
Changing lifestyle is challenging and difficult. The Norwegian Directorate of Health recommends that all municipalities establish Healthy Life Centres targeted to people with lifestyle issues. Little is known about the background, experiences and reflections of participants. More information is needed about participants to shape effective lifestyle interventions with lasting effect. This study explores how participants in a lifestyle intervention programme describe previous life experiences in relation to changing lifestyle. Semi-structured qualitative in-depth interviews were performed with 23 participants (16 women and 7 men) aged 18 - 70 years. The data were analysed using systematic text condensation searching for issues describing participants' responses, and looking for the essence, aiming to share the basis of life-world experiences as valid knowledge. Participants identified two main themes: being stuck in old habits, and being burdened with emotional baggage from their previous negative experiences. Participants expressed a wish to change their lifestyles, but were unable to act in accordance with the health knowledge they possessed. Previous experiences with lifestyle change kept them from initiating attempts without professional assistance. Participants also described being burdened by an emotional baggage with problems from childhood and/or with family, work and social life issues. Respondents said that they felt that emotional baggage was an important explanation for why they were stuck in old habits and that conversely, being stuck in old habits added load to their already emotional baggage and made it heavier. Behavioural change can be hard to perform as psychological distress from life baggage can influence the ability to change. The study participants' experience of being stuck in old habits and having substantial emotional baggage raises questions as to whether or not Healthy Life Centres are able to help participants who need to make a lifestyle
Scisney-Matlock, Margaret; Bosworth, Hayden B; Giger, Joyce Newman; Strickland, Ora L; Harrison, R Van; Coverson, Dorothy; Shah, Nirav R; Dennison, Cheryl R; Dunbar-Jacob, Jacqueline M; Jones, Loretta; Ogedegbe, Gbenga; Batts-Turner, Marian L; Jamerson, Kenneth A
African Americans with high blood pressure (BP) can benefit greatly from therapeutic lifestyle changes (TLC) such as diet modification, physical activity, and weight management. However, they and their health care providers face many barriers in modifying health behaviors. A multidisciplinary panel synthesized the scientific data on TLC in African Americans for efficacy in improving BP control, barriers to behavioral change, and strategies to overcome those barriers. Therapeutic lifestyle change interventions should emphasize patient self-management, supported by providers, family, and the community. Interventions should be tailored to an individual's cultural heritage, beliefs, and behavioral norms. Simultaneously targeting multiple factors that impede BP control will maximize the likelihood of success. The panel cited limited progress with integrating the Dietary Approaches to Stop Hypertension (DASH) eating plan into the African American diet as an example of the need for more strategically developed interventions. Culturally sensitive instruments to assess impact will help guide improved provision of TLC in special populations. The challenge of improving BP control in African Americans and delivery of hypertension care requires changes at the health system and public policy levels. At the patient level, culturally sensitive interventions that apply the strategies described and optimize community involvement will advance TLC in African Americans with high BP.
Cochrane, Shannon K; Chen, Shyh-Huei; Fitzgerald, Jodi D; Dodson, John A; Fielding, Roger A; King, Abby C; McDermott, Mary M; Manini, Todd M; Marsh, Anthony P; Newman, Anne B; Pahor, Marco; Tudor-Locke, Catrine; Ambrosius, Walter T; Buford, Thomas W
Data are sparse regarding the value of physical activity (PA) surveillance among older adults-particularly among those with mobility limitations. The objective of this study was to examine longitudinal associations between objectively measured daily PA and the incidence of cardiovascular events among older adults in the LIFE (Lifestyle Interventions and Independence for Elders) study. Cardiovascular events were adjudicated based on medical records review, and cardiovascular risk factors were controlled for in the analysis. Home-based activity data were collected by hip-worn accelerometers at baseline and at 6, 12, and 24 months postrandomization to either a physical activity or health education intervention. LIFE study participants (n=1590; age 78.9±5.2 [SD] years; 67.2% women) at baseline had an 11% lower incidence of experiencing a subsequent cardiovascular event per 500 steps taken per day based on activity data (hazard ratio, 0.89; 95% confidence interval, 0.84-0.96; P =0.001). At baseline, every 30 minutes spent performing activities ≥500 counts per minute (hazard ratio, 0.75; confidence interval, 0.65-0.89 [ P =0.001]) were also associated with a lower incidence of cardiovascular events. Throughout follow-up (6, 12, and 24 months), both the number of steps per day (per 500 steps; hazard ratio, 0.90, confidence interval, 0.85-0.96 [ P =0.001]) and duration of activity ≥500 counts per minute (per 30 minutes; hazard ratio, 0.76; confidence interval, 0.63-0.90 [ P =0.002]) were significantly associated with lower cardiovascular event rates. Objective measurements of physical activity via accelerometry were associated with cardiovascular events among older adults with limited mobility (summary score >10 on the Short Physical Performance Battery) both using baseline and longitudinal data. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01072500. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
Storm, Vera; Dörenkämper, Julia; Reinwand, Dominique Alexandra; Wienert, Julian; De Vries, Hein; Lippke, Sonia
Web-based computer-tailored interventions for multiple health behaviors can improve the strength of behavior habits in people who want to reduce their cardiovascular risk. Nonetheless, few randomized controlled trials have tested this assumption to date. The study aim was to test an 8-week Web-based computer-tailored intervention designed to improve habit strength for physical activity and fruit and vegetable consumption among people who want to reduce their cardiovascular risk. In a randomized controlled design, self-reported changes in perceived habit strength, self-efficacy, and planning across different domains of physical activity as well as fruit and vegetable consumption were evaluated. This study was a randomized controlled trial involving an intervention group (n=403) and a waiting control group (n=387). Web-based data collection was performed in Germany and the Netherlands during 2013-2015. The intervention content was based on the Health Action Process Approach and involved personalized feedback on lifestyle behaviors, which indicated whether participants complied with behavioral guidelines for physical activity and fruit and vegetable consumption. There were three Web-based assessments: baseline (T0, N=790), a posttest 8 weeks after the baseline (T1, n=206), and a follow-up 3 months after the baseline (T2, n=121). Data analysis was conducted by analyzing variances and structural equation analysis. Significant group by time interactions revealed superior treatment effects for the intervention group, with substantially higher increases in self-reported habit strength for physical activity (F1,199=7.71, P=.006, Cohen's d=0.37) and fruit and vegetable consumption (F1,199=7.71, P=.006, Cohen's d=0.30) at posttest T1 for the intervention group. Mediation analyses yielded behavior-specific sequential mediator effects for T1 planning and T1 self-efficacy between the intervention and habit strength at follow-up T2 (fruit and vegetable consumption: beta=0.12, 95
Centis, Elena; Moscatiello, Simona; Bugianesi, Elisabetta; Bellentani, Stefano; Fracanzani, Anna Ludovica; Calugi, Simona; Petta, Salvatore; Dalle Grave, Riccardo; Marchesini, Giulio
Healthy diet and physical activity are the treatment cornerstones of non-alcoholic fatty liver disease (NAFLD); their effectiveness is however limited by difficulties in implementing lifestyle changes. We aimed at determining the stage of change and associated psychological factors as a prerequisite to refine strategies to implement behavior changes. We studied 138 consecutive NAFLD patients (73% male, age 19-73 years). The diagnosis was confirmed by liver biopsy in 64 cases (steatohepatitis, 47%). All cases completed the validated EMME-3 questionnaire, consisting of two parallel sets of instruments (for diet and physical activity, respectively) and providing stages of change according to transtheoretical model. Logistic regression analysis was used to identify factors associated with stages making behavioral changes more demanding. The individual profiles were variable; for diet, no cases had precontemplation as prevalent stage of change (highest score in individual profiles); 36% had contemplation. For physical activity, 50% were classified in either precontemplation or contemplation. Minor differences were recorded in relation to associated metabolic complications or steatohepatitis. Logistic regression identified male sex (odds ratio, 4.51; 95% confidence interval, 1.69-12.08) and age (1.70; 1.20-2.43 per decade) as the independent parameters predicting precontemplation or contemplation for diet. No predictors were identified for physical activity. NAFLD cases have scarce readiness to lifestyle changes, particularly with regard to physical activity. Defining stages of change and motivation offers the opportunity to improve clinical care of NAFLD people through individual programs exploiting the powerful potential of behavioral counseling, an issue to be tested in longitudinal studies. Copyright © 2012 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
den Braver, N R; de Vet, E; Duijzer, G; Ter Beek, J; Jansen, S C; Hiddink, G J; Feskens, E J M; Haveman-Nies, A
Although there are many effective lifestyle interventions for type 2 diabetes (T2DM) prevention, insight into effective intervention pathways, especially of long-term interventions, is often lacking. This study aims to provide insight into the effective intervention pathways of the SLIMMER diabetes prevention intervention using mediation analyses. In total, 240 participants at increased risk of T2DM were included in the analyses over 18 months. The intervention was a combined lifestyle intervention with a dietary and a physical activity (PA) component. The primary and secondary outcomes were change in fasting insulin (pmol/L) and change in body weight (kg) after 18 months, respectively. Firstly, in a multiple mediator model, we investigated whether significant changes in these outcomes were mediated by changes in dietary and PA behavior. Secondly, in multiple single mediator models, we investigated whether changes in dietary and PA behavior were mediated by changes in behavioral determinants and the participants' psychological profile. The mediation analyses used linear regression models, where significance of indirect effects was calculated with bootstrapping. The effect of the intervention on decreased fasting insulin was 40% mediated by change in dietary and PA behavior, where dietary behavior was an independent mediator of the association (34%). The effect of the intervention on decreased body weight was 20% mediated by change in dietary and PA behavior, where PA behavior was an independent mediator (17%). The intervention significantly changed intake of fruit, fat from bread spread, and fiber from bread. Change in fruit intake was mediated by change in action control (combination of consciousness, self-control, and effort), motivation, self-efficacy, intention, and skills. Change in fat intake was mediated by change in action control and psychological profile. No mediators could be identified for change in fiber intake. The change in PA behavior was mediated
Jackson, Sandra L; Staimez, Lisa R; Safo, Sandra; Long, Qi; Rhee, Mary K; Cunningham, Solveig A; Olson, Darin E; Tomolo, Anne M; Ramakrishnan, Usha; Narayan, Venkat K M; Phillips, Lawrence S
Clinical trials show lifestyle change programs are beneficial, yet large-scale, successful translation of these programs is scarce. We investigated the association between participation in the largest U.S. lifestyle change program, MOVE!, and diabetes control outcomes. This longitudinal, retrospective cohort study used Veterans Health Administration databases of patients with diabetes who participated in MOVE! between 2005 and 2012, or met eligibility criteria (BMI ≥25kg/m 2 ) but did not participate. Main outcomes were diabetic eye disease, renal disease, and medication intensification. There were 400,170 eligible patients with diabetes, including 87,366 (22%) MOVE! Included patients were 96% male, 77% white, with mean age 58years and BMI 34kg/m 2 . Controlling for baseline measurements and age, race, sex, BMI, and antidiabetes medications, MOVE! participants had lower body weight (-0.6kg), random plasma glucose (-2.8mg/dL), and HbA1c (-0.1%) at 12months compared to nonparticipants (each plifestyle change programs in U.S. health systems may improve health among the growing patient population with diabetes. Published by Elsevier Inc.
Hjarnoe, Lulu; Leppin, Anja
Seafaring is a risky occupation when compared to land-based industries as incidence rates of mortality and morbidity are higher. This trend is partly due to a higher number of accidents but also higher incidence of lifestyle-related diseases like cardiovascular disease and lung cancer. In Denmark, the proportion of smokers as well as of overweight and obese persons is higher among seafarers compared to the general population. This high burden of risk indicates that this occupational group might be a growing challenge at sea in regard to safety and health issues and there is a need to further our understanding of the health promotion approaches that work. A single-group pre-post design was conducted in 2008-2009 in order to identify changes in lifestyle related behaviors and health risk factors among seafarers (N: 606) in two Danish shipping companies after implementing two structural health promotion interventions (healthy cooking courses for ship cooks and improvement of fitness facilities) as well as health education interventions (smoking cessation courses, individual exercise guidance and extra health check-ups) at the maritime workplace. Baseline and follow-up data were collected with a self-administrated standardized questionnaire and individual health profiling assessing parameters such as physical health and physical fitness. In addition, qualitative interviews with participants and non-participants were conducted in order to gain in-depth information on experiences with the intervention processes. Significant changes were identified for levels of fitness, daily sugar intake and metabolic syndrome. However, these results were not associated with participating in the health educational interventions. One possible explanation for the improved fitness rate could be the upgrading of fitness equipment onboard the ships provided by the management level. The decrease in daily sugar intake and prevalence of seafarers with metabolic syndrome might be associated with
Callegaro, Giovana Dorneles; Koerich, Cintia; Lanzoni, Gabriela Marcellino de Melo; Baggio, Maria Aparecida; Erdmann, Alacoque Lorenzini
The study aimed to understand how patients mean your experience process of living after surgical revascularization. Will be presented in this article, a category and seven subcategories that represent significant changes from that experience, that is, the "consequences" component of the paradigm model, according to Grounded Theory, method of study. Participated in data collection 23 subjects The interviews were semi-structured and took place from October 2010 to August 2011. Significant changes are related to aspects of social and sexual life, work diet physical activity and drug treatment. We conclude that surgical revascularization experience encourages the reflection and the (re) think the lifestyle, it has limitations and difficulties that challenge changes in daily habits of patients and families to live a healthier process.
Sebire, Simon J; Toumpakari, Zoi; Turner, Katrina M; Cooper, Ashley R; Page, Angie S; Malpass, Alice; Andrews, Robert C
Diagnosis with Type 2 Diabetes is an opportunity for individuals to change their physical activity and dietary behaviours. Diabetes treatment guidelines recommend theory-based, patient-centred care and advocate the provision of support for patient motivation but the motivational experiences of people newly diagnosed with diabetes have not been well studied. Framed in self-determination theory, this study aimed to qualitatively explore how this patient group articulate and experience different types of motivation when attempting lifestyle change. A secondary analysis of semi-structured interview data collected with 30 (n female = 18, n male = 12) adults who had been newly diagnosed with type two diabetes and were participants in the Early ACTID trial was undertaken. Deductive directed content analysis was performed using NVivo V10 and researcher triangulation to identify and describe patient experiences and narratives that reflected the motivation types outlined in self-determination theory and if/how these changed over time. The findings revealed the diversity in motivation quality both between and within individuals over time and that patients with newly-diagnosed diabetes have multifaceted often competing motivations for lifestyle behaviour change. Applying self-determination theory, we identified that many participants reported relatively dominant controlled motivation to comply with lifestyle recommendations, avoid their non-compliance being "found out" or supress guilt following lapses in behaviour change attempts. Such narratives were accompanied by experiences of frustrating slow behaviour change progress. More autonomous motivation was expressed as something often achieved over time and reflected goals to improve health, quality of life or family time. Motivational internalisation was evident and some participants had integrated their behaviour change to a new way of life which they found resilient to common barriers. Motivation for lifestyle change
Schultz, Martin G; Hordern, Matthew D; Leano, Rodel; Coombes, Jeffrey S; Marwick, Thomas H; Sharman, James E
A hypertensive response to exercise (HRE) is common in patients with type 2 diabetes and is associated with increased left ventricular (LV) mass and mortality. This study aimed to determine whether lifestyle modification would improve exercise blood pressure (BP) and reduce LV mass in patients with type 2 diabetes. One hundred and eighty-five patients with type 2 diabetes were randomized to 1 yr of lifestyle intervention (n=97, mean ± SD age=54.7 ± 11.3 yr, 51% men) or usual care (control; n=88, age=53.8 ± 8.1 yr, 61% men). Brachial BP was measured at rest and during a graded maximal exercise test at baseline and 1 yr. Patients also underwent two-dimensional echocardiography to determine LV dimensions. A subgroup of 61 patients had resting and exercise central BP estimated from radial tonometry. An HRE was defined as a maximal exercise systolic BP of ≥210 mm Hg for men and ≥190 mm Hg for women. At study entry, there were 101 patients (55%) with an HRE (n=51 controls). Compared with controls, lifestyle intervention significantly reduced the propensity to develop an HRE in those participants who did not have HRE at baseline (29.8% vs 59.5%, P=0.006). However, absolute values of exercise and resting (brachial and central) BP and LV mass were not significantly changed (all P values >0.05). There were significant (all P values HRE but does not reduce cardiac size after 1 yr in patients with type 2 diabetes. © 2011 by the American College of Sports Medicine
Johnson, Jennie E; Gulanick, Meg; Penckofer, Sue; Kouba, Joanne
Evidence indicates that a healthy lifestyle can reduce cardiovascular disease risk, yet many people engage in unhealthy behaviors. New technologies such as coronary artery calcium (CAC) screening detect atherosclerosis before clinical disease is manifested. Knowledge of an abnormal finding could provide the "teachable moment" to enhance motivation for change. The aim of this study was to examine how knowledge of CAC score affects risk perception, likelihood of taking action, and health-promoting behavior change in persons at high risk for cardiovascular disease. This study used a descriptive prospective design with 174 high-risk adults (≥3 major risk factors) recruited at a radiology center offering CAC scans. Baseline self-report surveys using the Perception of Risk of Heart Disease Scale, the Benefits and Barriers Scale, the Quality of Life Index, and the Health-Promoting Lifestyle Profile II were completed immediately after a screening CAC scan but before results were known. Follow-up occurred 3 months later using mailed packets. Participants' mean age was 58 years; 62% were men, 89% were white, and most were well educated. There was no significant change in risk perception scores over time or between groups, except for a positive interaction in the moderate-risk group (CAC scores of 101-400) (P = .004). Quality of life remained unchanged. Health-promoting behavior changes increased in all groups over time (P behavior change were perceived barriers (β = -.41; P Knowledge of CAC score does impact risk perception for some at-risk groups. This knowledge does enhance motivation for behavior change. Knowledge of CAC score does not impact quality of life. It is hoped that through improved understanding of the effect of CAC scoring on behavior change, nurses can better assist patients to modify behaviors during teachable moments.
Estilos de vida asociados al riesgo cardiovascular global en trabajadores universitarios del Estado de México Lifestyle conditions related to global cardiovascular risk among university workers in the State of Mexico
Full Text Available OBJETIVO: Evaluar la asociación del estilo de vida con el riesgo cardiovascular (RCV en trabajadores universitarios del Estado de México. MATERIAL Y MÉTODOS: Estudio de casos y controles anidado en una cohorte. Se evaluaron variables del estilo de vida, sociodemográficas, antropométricas y antecedentes familiares. El análisis estimó razones de momios pareadas crudas y ajustadas a través de regresión logística condicional. RESULTADOS: Se estudiaron 342 casos con RCV y 684 controles. En los trabajadores con sobrepeso u obesidad, el RCV superó al de aquéllos con peso normal. Los antecedentes familiares de infarto del miocardio se asociaron directamente, y la actividad física moderada-vigorosa inversamente con el RCV, en modelos con interacciones entre género y actividad física; esta relación se mantuvo sólo en los hombres. CONCLUSIONES: Los resultados muestran el papel preponderante de la actividad física moderada-vigorosa como factor del estilo de vida asociado con menor RCV.OBJETIVES: To assess the relationship between lifestyle and cardiovascular risk (CR among university workers in the State of Mexico. MATERIAL AND METHODS: A nested case-control study was conducted and lifestyle, sociodemographic, anthropometric, body mass index and family history of cardiovascular disease were assessed. The analysis included the estimation of crude and adjusted odds ratios (OR using conditional logistic regression. RESULTS: The study included 342 workers with CR and 684 controls. CR was greater for workers with overweight or obesity than for those with normal weight. Family history of myocardial infarction was directly associated with CR, while physical activity was inversely associated. In models with interactions of gender and physical activity, this relation was observed only for men. CONCLUSIONS: Results show an inverse association between the lifestyle factor of physical activity and CR.
Wilks, Désirée C; Rank, Melanie; Christle, Jeff; Langhof, Helmut; Siegrist, Monika; Halle, Martin
Impaired heart rate recovery (HRR) is a strong predictor of overall mortality and cardio-metabolic risk. This study aimed at investigating (1) the effect of participation in a lifestyle-change programme for weight loss on HRR in overweight and obese children and (2) potential associations between the changes in one minute HRR (HRR1) and fitness, weight loss and cardio-metabolic risk. The analysis included 429 individuals (169 boys) aged 13.9 ± 2.3 years who participated in an inpatient weight loss programme for four to six weeks. At baseline and the end of the programme clinical investigations were performed, including blood analyses, blood pressure, anthropometry and maximal cycle ergometer exercise testing with continuous heart rate (HR) monitoring. HRR was calculated as the difference between the highest exercising HR and HR at one, three and five minutes post-exercise. Average body weight decreased from 90.7 ± 22.5 kg to 81.9 ± 20.0 kg and peak exercise capacity increased from 1.66 ± 0.38 W/kg to 2.05 ± 0.45 W/kg (p exercise capacity (p inpatient weight loss programme in overweight and obese children. This was not associated with improvements in body weight and cardio-metabolic risk; hence HRR would be a valuable addition to cardiovascular risk assessment in this group. © The European Society of Cardiology 2012.
Aerobic fitness is associated with low cardiovascular disease risk: the impact of lifestyle on early risk factors for atherosclerosis in young healthy Swedish individuals – the Lifestyle, Biomarker, and Atherosclerosis study
Full Text Available Maria Fernström,1,* Ulrika Fernberg,2,* Gabriella Eliason,1 Anita Hurtig-Wennlöf1 1Department of Medical Diagnostics, Medical Faculty, School of Health Sciences, 2Medical Faculty, School of Medical Sciences, Örebro University, Örebro, Sweden *These authors contributed equally to this work Background: The progression of cardiovascular disease (CVD and atherosclerosis is slow and develops over decades. In the cross-sectional Swedish Lifestyle, Biomarker, and Atherosclerosis study, 834 young, self-reported healthy adults aged 18.0–25.9 years have been studied to identify early risk factors for atherosclerosis.Purpose: The aims of this study were to 1 assess selected cardiometabolic biomarkers, carotid intima–media thickness (cIMT as a marker of subclinical atherosclerosis, and lifestyle-related indicators (food habits, handgrip strength, and oxygen uptake, VO2 max; 2 analyze the assofciations between cIMT and lifestyle factors; and 3 identify subjects at risk of CVD using a risk score and to compare the characteristics of subjects with and without risk of CVD.Method: Blood samples were taken in a fasting state, and food habits were reported through a questionnaire. cIMT was measured by ultrasound, and VO2 max was measured by ergometer bike test. The risk score was calculated according to Wildman.Result: cIMT (mean ± standard deviation was 0.50±0.06 mm, and VO2 max values were 37.8±8.5 and 42.9±9.9 mL/kg/min, in women and men, respectively. No correlation was found between aerobic fitness expressed as VO2 max (mL/kg/min and cIMT. Using Wildman’s definition, 12% of the subjects were classified as being at risk of CVD, and 15% had homeostasis model assessment of insulin resistance. A total of 35% of women and 25% of men had lower high-density lipoprotein cholesterol than recommended. Food habits did not differ between those at risk and those not at risk. However, aerobic fitness measured as VO2 max (mL/kg/min differed; 47% of the
Chisholm, Anna; Hart, Jo; Mann, Karen V; Harkness, Elaine; Peters, Sarah
Doctors will increasingly encounter opportunities to support obese patients in lifestyle change efforts, but the extent to which medical schools prepare their students for this challenge is unknown. Further, despite evidence indicating theory-based techniques are effective in facilitating patients' behavioral changes, the methods taught to medical students and the means of content delivery are unclear. The authors reviewed the literature to investigate how effective educational interventions are in preparing medical students to facilitate lifestyle changes with obese patients. The authors systematically searched Excerpta Medica (EMBASE), PsycINFO, MEDLINE, and Scopus for educational interventions on obesity management for medical students published in English between January 1990 and November 2010 and matching PICOS (Population, Interventions, Comparators, Outcomes, Study design) inclusion criteria. Results of a narrative synthesis are presented. Of 1,680 studies initially identified, 36 (2%) full-text articles were reviewed, and 12 (1%) were included in the final dataset. Eleven (92%) of these studies had quantitative designs; of these, 7 (64%) did not include control groups. Nine (75%) of the 12 studies were atheoretical, and 4 (33%) described behavior management strategies. Despite positive reported outcomes regarding intervention evaluations, procedures to control for bias were infrequently reported, and conclusions were often unsupported by evidence. Evidence from this systematic review revealed data highly susceptible to bias; thus, intervention efficacy could not be determined. Additionally, evidence-based strategies to support patients' obesity-related behavior changes were not applied to these studies, and thus it remains unknown how best to equip medical students for this task.
Fissler, Patrick; Müller, Hans-Peter; Küster, Olivia C; Laptinskaya, Daria; Thurm, Franka; Woll, Alexander; Elbert, Thomas; Kassubek, Jan; von Arnim, Christine A F; Kolassa, Iris-Tatjana
Cognitive and physical activities can benefit cognition. However, knowledge about the neurobiological mechanisms underlying these activity-induced cognitive benefits is still limited, especially with regard to the role of white matter integrity (WMI), which is affected in cognitive aging and Alzheimer's disease. To address this knowledge gap, we investigated the immediate and long-term effects of cognitive or physical training on WMI, as well as the association between cognitive and physical lifestyles and changes in WMI over a 6-month period. Additionally, we explored whether changes in WMI underlie activity-related cognitive changes, and estimated the potential of both trainings to improve WMI by correlating training outcomes with WMI. In an observational and interventional pretest, posttest, 3-month follow-up design, we assigned 47 community-dwelling older adults at risk of dementia to 50 sessions of auditory processing and working memory training ( n = 13), 50 sessions of cardiovascular, strength, coordination, balance and flexibility exercises ( n = 14), or a control group ( n = 20). We measured lifestyles trough self-reports, cognitive training skills through training performance, functional physical fitness through the Senior Fitness Test, and global cognition through a cognitive test battery. WMI was assessed via a composite score of diffusion tensor imaging-based fractional anisotropy (FA) of three regions of interest shown to be affected in aging and Alzheimer's disease: the genu of corpus callosum, the fornix, and the hippocampal cingulum. Effects for training interventions on FA outcomes, as well as associations between lifestyles and changes in FA outcomes were not significant. Additional analyses did show associations between cognitive lifestyle and global cognitive changes at the posttest and the 3-month follow-up (β ≥ 0.40, p ≤ 0.02) and accounting for changes in WMI did not affect these relationships. The targeted training outcomes were
Robert J. Petrella
Full Text Available Background: Evidence is unequivocal that exercise training can improve health outcomes. However, despite this evidence, adoption of healthy lifestyles is poor. The physical environment is one possible determinant of successful adoption of healthy lifestyles that could influence outcomes in community-based intervention strategies. We developed a novel exercise prescription delivered in two different cohorts of older sedentary adults—one delivered by family physicians to patients with identified cardiovascular risk factors (CRF and the other delivered at a community exercise facility to a larger cohort of healthy sedentary adults (HSA. We then determined whether the place of residence and proximity to facilities promoting physical activity and healthy or unhealthy eating could influence clinical changes related to these community-based exercise prescriptions.Methods: Two different cohorts of older patients were administered similar exercise prescriptions. The CRF cohort was a sedentary group of 41 older adults with either high-normal blood pressure (120–139 mmHg/85–89 mmHg or impaired glucose tolerance (fasting glucose 6.1–6.9 mmol/l who were prescribed exercise by their family physicians at baseline and followed over 12 months. The HSA cohort consisted of 159 sedentary older adults who were prescribed a similar exercise prescription and then participated in a chronic training program over 5 years at a community-based training facility. Out- comes of interest were change in fitness (VO2max, resting systolic blood pressure (rSBP and body mass index (BMI. GIS-determined shortest distance to local facilities promoting physical activity and healthy versus unhealthy were compared at baseline and follow up using simple logistic regression.Those subjects in CRF group were further identified as responders (exhibited an above average change in VO2max and were then compared to non-responders according to their patterns of proximity to physical
Lee, Jane J.; Pedley, Alison; Hoffmann, Udo; Massaro, Joseph M.; Fox, Caroline S.
BACKGROUND Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) are associated with adverse cardiometabolic risk profiles. OBJECTIVES This study explored the degree to which changes in abdominal fat quantity and quality are associated with changes in cardiovascular disease (CVD) risk factors. METHODS Study participants (n = 1,106; 44.1% women; mean baseline age 45.1 years) were drawn from the Framingham Heart Study Third Generation cohort who participated in the computed tomography (CT) substudy Exams 1 and 2. Participants were followed for 6.1 years on average. Abdominal adipose tissue volume in cm3 and attenuation in Hounsfield units (HU) were determined by CT-acquired abdominal scans. RESULTS The mean fat volume change was an increase of 602 cm3 for SAT and an increase of 703 cm3 for VAT; the mean fat attenuation change was a decrease of 5.5HU for SAT and an increase of 0.07 HU for VAT. An increase in fat volume and decrease in fat attenuation were associated with adverse changes in CVD risk factors. An additional 500 cm3 increase in fat volume was associated with incident hypertension (odds ratio [OR]: 1.21 for SAT; OR: 1.30 for VAT), hypertriglyceridemia (OR: 1.15 for SAT; OR: 1.56 for VAT), and metabolic syndrome (OR: 1.43 for SAT; OR: 1.82 for VAT; all p abdominal adipose tissue attenuation. Most associations remained significant even after further accounting for body mass index change, waist circumference change, or respective abdominal adipose tissue volumes. CONCLUSIONS Increasing accumulation of fat quantity and decreasing fat attenuation are associated with worsening of CVD risk factors beyond the associations with generalized adiposity, central adiposity, or respective adipose tissue volumes. PMID:27687192
Amelsvoort, van L.G.P.M.; Schouten, E.G.; Kok, F.J.
The purpose of the study was to investigate whether the reported increased cardiovascular disease risk in shift workers could be explained by changes in cardiovascular risk factors. In a cohort of 239 shift and 157 daytime workers, 1-year changes in biological and lifestyle cardiovascular risk
M. H. Lotfi
Full Text Available Adverse lifestyle changes like rapid change in dietary habits coupled with decreased physical activity and increasing rates of alcohol and tobacco consumption can increase Coronary Artery Disease risk factors and its mortality even higher than the rates predicted. To evaluate the role of Adverse Lifestyle changes factors in the causation of CAD, a hospital based case-control study was conducted in an urban area of East Delhi from April 2002 to December 2003. A total of 500 subjects with age group 30-75 (250 cases and 250 controls, were included in this study. To obtain more validate comparisons, 250 controls also was selected from community of East Delhi. The tool of enquiry was a pre-tested and pre-coded questionnaire. A confidence level of 95% and study power of 80% were considered for the interpretation of possible significant findings. Sexwise stratified analysis was separately done for male and female subjects using Multiple Logistic Regression. Comparison of male cases with their counterparts in both control groups indicated that milk consumption, using saturated oils for cooking medium, and tobacco consumption could account for as CAD independent predictors (P < 0.001. The comparison of female cases with their counterparts in both control groups also showed that majority of those significantly were nuts consumer (P < 0.01. Male cases compared to males in hospital group and female cases compared with females in community control group significantly were nuts consumer and used saturated oils in their cookings respectively (P < 0.01. Our study showed that dietary factors such as consumption of milk, nuts, saturated oils and smoking, as misbehavior factor, could play an important role in the causation of Coronary Artery Diseases (CAD in urban area of East Delhi, India.
McConnell, Michael V; Shcherbina, Anna; Pavlovic, Aleksandra; Homburger, Julian R; Goldfeder, Rachel L; Waggot, Daryl; Cho, Mildred K; Rosenberger, Mary E; Haskell, William L; Myers, Jonathan; Champagne, Mary Ann; Mignot, Emmanuel; Landray, Martin; Tarassenko, Lionel; Harrington, Robert A; Yeung, Alan C; Ashley, Euan A
Studies have established the importance of physical activity and fitness, yet limited data exist on the associations between objective, real-world physical activity patterns, fitness, sleep, and cardiovascular health. To assess the feasibility of obtaining measures of physical activity, fitness, and sleep from smartphones and to gain insights into activity patterns associated with life satisfaction and self-reported disease. The MyHeart Counts smartphone app was made available in March 2015, and prospective participants downloaded the free app between March and October 2015. In this smartphone-based study of cardiovascular health, participants recorded physical activity, filled out health questionnaires, and completed a 6-minute walk test. The app was available to download within the United States. The feasibility of consent and data collection entirely on a smartphone, the use of machine learning to cluster participants, and the associations between activity patterns, life satisfaction, and self-reported disease. From the launch to the time of the data freeze for this study (March to October 2015), the number of individuals (self-selected) who consented to participate was 48 968, representing all 50 states and the District of Columbia. Their median age was 36 years (interquartile range, 27-50 years), and 82.2% (30 338 male, 6556 female, 10 other, and 3115 unknown) were male. In total, 40 017 (81.7% of those who consented) uploaded data. Among those who consented, 20 345 individuals (41.5%) completed 4 of the 7 days of motion data collection, and 4552 individuals (9.3%) completed all 7 days. Among those who consented, 40 017 (81.7%) filled out some portion of the questionnaires, and 4990 (10.2%) completed the 6-minute walk test, made available only at the end of 7 days. The Heart Age Questionnaire, also available after 7 days, required entering lipid values and age 40 to 79 years (among 17 245 individuals, 43.1% of participants). Consequently, 1334 (2
Xu, Zhi-Yu; Wang, Xuan-Yi; Liu, Chang-Qing; Li, Yang-Ting; Zhuang, Fang-Chen
The objective of the study was to identify the protective factors for the rapid decline in the risk of hepatitis A virus (HAV) infection in China between 1990 and 2006. Results of serological follow-up and data on annual hepatitis A incidence were analysed and correlated with economic growth and HAV vaccine output during the same period. In conclusion, both HAV vaccination and changing lifestyles associated with the booming economy contributed to the rapid risk decline. Changing lifestyles played a major role in the decline especially in the areas with booming economy.
Lee, In Ja; Ko, Yo Han; Kim, Chung Kyung; Kim, Hee Sol; Park, Da Jeong; Yoon, Hyeo Min; Jeong, Yu Jin [Dept. of Radiological Technology, Dongnam Health college, Suwon (Korea, Republic of)
The decrease of bone mineral density gives rise to the outbreak of osteopenia and makes the possibility of a bone fracture. It makes health problems in society. It's very important to prevent osteopenia in advance. Also it's critical to prevent and take care of it in adolescent because it's the most developing period comparing to middle ages because that bone mineral density decreases. There are genetic, physical and environmental factors that affect bone mineral density. Recently, a lifestyle and eating habits are also changing as the society atmosphere is gradually doing. This study have shown that 134 women and 75 men was chosen and responded to the survey of measuring bone mineral density and investigating a lifestyle. The measure of bone mineral density is to use Dual energy X-ray absorptiometry(DEXA) and check femoral neck and lumbar spine. Also questionaries was required to pre-made survey about their lifestyles. Analysis of data was done with SPSS program. Multiple regression analysis was used for the relation of bone mineral density, the heigths and BMI. The sample of Groups are checked for drinking, smoking or excercising about differences by t-test. The results of the experiments were; first, there is statistically significant differences in the comparisons between BMD and BMD. But there isn't any special correlation between drinking, smoking and BMD. Secondly, bone mineral density becomes low related to an intake of caffeine. Particularly, this is statically significant on women. Also there is statically significant correlation between femoral neck and quantity of motion for both men and women. Third, there is significant relation between eating habits and bone mineral density on women's lumbar spine. However, there is no significant relation between men's lumbar spine and women's one. Therefore, to prevent osteopenia, it's good to abstain from intaking caffeine within an hour after a meal. In addition, it
Lee, In Ja; Ko, Yo Han; Kim, Chung Kyung; Kim, Hee Sol; Park, Da Jeong; Yoon, Hyeo Min; Jeong, Yu Jin
The decrease of bone mineral density gives rise to the outbreak of osteopenia and makes the possibility of a bone fracture. It makes health problems in society. It's very important to prevent osteopenia in advance. Also it's critical to prevent and take care of it in adolescent because it's the most developing period comparing to middle ages because that bone mineral density decreases. There are genetic, physical and environmental factors that affect bone mineral density. Recently, a lifestyle and eating habits are also changing as the society atmosphere is gradually doing. This study have shown that 134 women and 75 men was chosen and responded to the survey of measuring bone mineral density and investigating a lifestyle. The measure of bone mineral density is to use Dual energy X-ray absorptiometry(DEXA) and check femoral neck and lumbar spine. Also questionaries was required to pre-made survey about their lifestyles. Analysis of data was done with SPSS program. Multiple regression analysis was used for the relation of bone mineral density, the heigths and BMI. The sample of Groups are checked for drinking, smoking or excercising about differences by t-test. The results of the experiments were; first, there is statistically significant differences in the comparisons between BMD and BMD. But there isn't any special correlation between drinking, smoking and BMD. Secondly, bone mineral density becomes low related to an intake of caffeine. Particularly, this is statically significant on women. Also there is statically significant correlation between femoral neck and quantity of motion for both men and women. Third, there is significant relation between eating habits and bone mineral density on women's lumbar spine. However, there is no significant relation between men's lumbar spine and women's one. Therefore, to prevent osteopenia, it's good to abstain from intaking caffeine within an hour after a meal. In addition, it
Full Text Available Abstract Background Childhood obesity is not only associated with adult obesity but also with increased risk of adult onset of type 2 diabetes and subsequent coronary heart disease. The potential effects of school-based health intervention programmes on cardiovascular risk and surrogate markers are unclear, as only few studies have attempted to investigate a complete risk profile including a detailed laboratory analysis or micro- and macrovascular function. In this study a comprehensive school-based randomized intervention programme will be investigated in 10-14-year old children addressing the influence of lifestyle intervention on inactivity, cardiometabolic risk factors and early signs of vascular disease. Methods/Design 15 secondary schools in Southern Germany are randomly assigned to intervention or control schools. Children in the fifth grade (10-11 years will be observed over four years. The study combines a school-based with a home-based approach, aiming at children, teachers and parents. The main components are weekly lifestyle-lessons for children, taught by regular classroom teachers to increase physical activity in- and outside of school, to improve eating patterns at school and at home, to reduce media consumption and to amplify well-being. In 4-6 annual meetings, teachers receive information about health-related topics with worksheets for children and supporting equipment, accounting for school-specific needs and strategies. Parents' trainings are provided on a regular basis. All examinations are performed at the beginning and at the end of every school year. Anthropometry includes measurements of BMI, waist and upper arm circumferences, skinfold thickness as well as peripheral blood pressure. Blood sampling includes lipid parameters, insulin, glucose, hsCRP, adiponectin, and IL-6 as well as testosteron and estrogen to determine maturation status. Vascular function is non-invasively assessed by measuring arterial stiffness in large
Pett, Marjorie; Clark, Lauren; Eldredge, Alison; Cardell, Beth; Jordan, Kristine; Chambless, Cathy; Burley, Jeff
We evaluated a 12-week recreation center-based healthy lifestyle intervention for 30 obese home-dwelling young adults (YA) with intellectual disabilities. Three cohorts participated: YA only, YA and parents, and parents only. The YA cohorts received a nutrition/exercise intervention; parents focused on modeling healthy lifestyle behaviors.…
Nordentoft, Merete; Krogh, Jesper; Krogholm, Kirstine Suszkiewicz
A significant share of the excess mortality among people suffering from mental illness is due to unhealthy lifestyles. Obesity, smoking, unhealthy diets and sedentary behaviour is twice as frequent among people with mental illness, but the willingness to improve lifestyle is as high as in healthy...
Dake Fidelia AA
Full Text Available Abstract Background Many countries have adopted health policies that are targeted at reducing the risk factors for chronic non-communicable diseases. These policies promote a healthy population by encouraging people to adopt healthy lifestyle behaviours. This paper examines healthy lifestyle behaviour among Ghanaian adults by comparing behaviours before and after the introduction of a national health policy. The paper also explores the socio-economic and demographic factors associated with healthy lifestyle behaviour. Method Descriptive, bivariate and multivariate regression techniques were employed on two nationally representative surveys (2003 World Health Survey (Ghana and 2008 Ghana Demographic and Health Survey to arrive at the results. Results While the prevalence of some negative lifestyle behaviours like smoking has reduced others like alcohol consumption has increased. Relatively fewer people adhered to consuming the recommended amount of fruit and vegetable servings per day in 2008 compared to 2003. While more females (7.0% exhibited healthier lifestyles, more males (9.0% exhibited risky lifestyle behaviours after the introduction of the policy. Conclusion The improvement in healthy lifestyle behaviours among female adult Ghanaians will help promote healthy living and potentially lead to a reduction in the prevalence of obesity among Ghanaian women. The increase in risky lifestyle behaviour among adult male Ghanaians even after the introduction of the health policy could lead to an increase in the risk of non-communicable diseases among men and the resultant burden of disease on them and their families will push more people into poverty.
Full Text Available Abstract Background There are good opportunities in Sweden for health promotion targeting expectant parents and parents of young children, as almost all are reached by antenatal and child health care. In 2005, a multisectoral child health promotion programme (the Salut Programme was launched to further strengthen such efforts. Methods Between June and December 2010 twenty-four in-depth interviews were conducted separately with first-time mothers and fathers when their child had reached 18 months of age. The aim was to explore their experiences of health promotion and lifestyle change during pregnancy and early parenthood. Qualitative manifest and latent content analysis was applied. Results Parents reported undertaking lifestyle changes to secure the health of the fetus during pregnancy, and in early parenthood to create a health-promoting environment for the child. Both women and men portrayed themselves as highly receptive to health messages regarding the effect of their lifestyle on fetal health, and they frequently mentioned risks related to tobacco and alcohol, as well as toxins and infectious agents in specific foods. However, health promotion strategies in pregnancy and early parenthood did not seem to influence parents to make lifestyle change primarily to promote their own health; a healthy lifestyle was simply perceived as 'common knowledge'. Although trust in health care was generally high, both women and men described some resistance to what they saw as preaching, or very directive counselling about healthy living and the lack of a holistic approach from health care providers. They also reported insufficient engagement with fathers in antenatal care and child health care. Conclusion Perceptions about risks to the offspring's health appear to be the primary driving force for lifestyle change during pregnancy and early parenthood. However, as parents' motivation to prioritise their own health per se seems to be low during this period
Lyons, Elizabeth J; Lewis, Zakkoyya H; Mayrsohn, Brian G; Rowland, Jennifer L
Electronic activity monitors (such as those manufactured by Fitbit, Jawbone, and Nike) improve on standard pedometers by providing automated feedback and interactive behavior change tools via mobile device or personal computer. These monitors are commercially popular and show promise for use in public health interventions. However, little is known about the content of their feedback applications and how individual monitors may differ from one another. The purpose of this study was to describe the behavior change techniques implemented in commercially available electronic activity monitors. Electronic activity monitors (N=13) were systematically identified and tested by 3 trained coders for at least 1 week each. All monitors measured lifestyle physical activity and provided feedback via an app (computer or mobile). Coding was based on a hierarchical list of 93 behavior change techniques. Further coding of potentially effective techniques and adherence to theory-based recommendations were based on findings from meta-analyses and meta-regressions in the research literature. All monitors provided tools for self-monitoring, feedback, and environmental change by definition. The next most prevalent techniques (13 out of 13 monitors) were goal-setting and emphasizing discrepancy between current and goal behavior. Review of behavioral goals, social support, social comparison, prompts/cues, rewards, and a focus on past success were found in more than half of the systems. The monitors included a range of 5-10 of 14 total techniques identified from the research literature as potentially effective. Most of the monitors included goal-setting, self-monitoring, and feedback content that closely matched recommendations from social cognitive theory. Electronic activity monitors contain a wide range of behavior change techniques typically used in clinical behavioral interventions. Thus, the monitors may represent a medium by which these interventions could be translated for
Hays, Laura M.; Hoen, Helena M.; Slaven, James E.; Finch, Emily A.; Marrero, David G.; Saha, Chandan; Ackermann, Ronald T.
Background: Moderate weight loss and physical activity (PA) can prevent or delay type 2 diabetes however there is a need for innovative, effective programs to promote PA in high-risk individuals. Purpose: We examined the effect of a group-based adaption of the DPP lifestyle intervention implemented in partnership with the YMCA (YDPP) on changes in…
A.F.G. Alayli-Goebbels (Adrienne F.G.); N.J.A. van Exel (Job); A.J.H.A. Ament (André); N.K. de Vries (Nanne); S.D.M. Bot (Sandra); J.L. Severens (Hans)
markdownabstract__Abstract__ Objective: To use contingent valuation (CV) to derive individual consumer values for both health and broader benefits of a public-health intervention directed at lifestyle behaviour change (LBC) and to examine the feasibility and validity of the method. Method:
Information and Risk Modification Trial (INFORM): design of a randomised controlled trial of communicating different types of information about coronary heart disease risk, alongside lifestyle advice, to achieve change in health-related behaviour.
Silarova, Barbora; Lucas, Joanne; Butterworth, Adam S; Di Angelantonio, Emanuele; Girling, Christine; Lawrence, Kathryn; Mackintosh, Stuart; Moore, Carmel; Payne, Rupert A; Sharp, Stephen J; Shefer, Guy; Tolkien, Zoe; Usher-Smith, Juliet; Walker, Matthew; Danesh, John; Griffin, Simon
Cardiovascular disease (CVD) remains the leading cause of death globally. Primary prevention of CVD requires cost-effective strategies to identify individuals at high risk in order to help target preventive interventions. An integral part of this approach is the use of CVD risk scores. Limitations in previous studies have prevented reliable inference about the potential advantages and the potential harms of using CVD risk scores as part of preventive strategies. We aim to evaluate short-term effects of providing different types of information about coronary heart disease (CHD) risk, alongside lifestyle advice, on health-related behaviours. In a parallel-group, open randomised trial, we are allocating 932 male and female blood donors with no previous history of CVD aged 40-84 years in England to either no intervention (control group) or to one of three active intervention groups: i) lifestyle advice only; ii) lifestyle advice plus information on estimated 10-year CHD risk based on phenotypic characteristics; and iii) lifestyle advice plus information on estimated 10-year CHD risk based on phenotypic and genetic characteristics. The primary outcome is change in objectively measured physical activity. Secondary outcomes include: objectively measured dietary behaviours; cardiovascular risk factors; current medication and healthcare usage; perceived risk; cognitive evaluation of provision of CHD risk scores; and psychological outcomes. The follow-up assessment takes place 12 weeks after randomisation. The experiences, attitudes and concerns of a subset of participants will be also studied using individual interviews and focus groups. The INFORM study has been designed to provide robust findings about the short-term effects of providing different types of information on estimated 10-year CHD risk and lifestyle advice on health-related behaviours. Current Controlled Trials ISRCTN17721237 . Registered 12 January 2015.
Baumann, Michèle; Tchicaya, Anastase; Lorentz, Nathalie; Le Bihan, Etienne
Patients with cardiovascular disease who underwent coronary angiography at the National Institute of Cardiac Surgery and Cardiological Intervention (INCCI) in Luxembourg were surveyed for cardiovascular risk factors (CVRF) (hypertension, hypercholesterolemia, diabetes, obesity, physical inactivity, tobacco consumption). In 2013/14, their life satisfaction (LS) was also assessed. Our aim was to analyse the relationships between LS on one hand and longitudinal changes in CVRF between 2008/09 and 2013/14 and socioeconomic factors on the other. 1289 patients completed a self-administered questionnaire. Life Satisfaction, originally recorded on a 1 to 10 scale of complete satisfaction was dichotomized into two groups: ≤ 7 and. >7. We then performed logistic multiple regressions. The event on which the probability was modelled, was LS > 7. Data were adjusted on age, sex and income. Longitudinal changes in CVRF were assessed by their presence or absence in 2008/09 and 2013/14 (categories: 'no-no'; 'no-yes'; 'yes-no'; 'yes-yes'). Physical activity in 2008/09 and 2013/14 was associated with a lower LS (OR = 0.469). The same pattern was observed for obesity and physical inactivity: lower LS was related to the presence of these risks (yes-yes; no-yes) in 2013/14 (mean OR for obesity and physical inactivity in 2013/14: 0.587 and 0.485 respectively), whereas their presence or absence in 2008/09 was not related to LS. Finally, patients who suffered from diabetes in 2008 were more likely to experience a decline in LS, particularly if their diabetes was less severe in 2013/14 (OR = 0.462). The lowest LS was observed when obesity or physical inactivity was present in 2013/14, newly or otherwise. The same trend was seen in diabetes among patients who had it in 2008/9, but were less severely affected in 2013/14. In secondary prevention, CVD-related upheavals could be minimised if professionals and patients became 'Partners in Healthcare' to better adhere to healthy
Fanning, Elizabeth A.
Discusses the general standard of health of Australians, the trend towards a lifestyle of fast foods and less excercise, and the relation between diet and three major diseases: heart disease, cancer, and stroke. (Author/SS)
Kostadinov, Iordan; Daniel, Mark; Jones, Michelle; Cargo, Margaret
Issue addressed The context of community-based childhood obesity prevention programs can influence the effects of these intervention programs. Leadership readiness for community mobilisation for childhood obesity prevention is one such contextual factor. This study assessed perceived community leadership readiness (PCLR) at two time points in a state-wide, multisite community-based childhood obesity prevention program. Methods PCLR was assessed across 168 suburbs of 20 intervention communities participating in South Australia's Obesity Prevention and Lifestyle (OPAL) program. Using a validated online PCLR tool, four key respondents from each community rated each suburb within their respective community on a nine-point scale for baseline and 2015. Average PCLR and change scores were calculated using the general linear model with suburbs nested in communities. Relationships between demographic variables and change in PCLR were evaluated using multiple regression. Ease of survey use was also assessed. Results Average PCLR increased between baseline (3.51, s.d.=0.82) and 2015 (5.23, s.d.=0.89). PCLR rose in 18 of 20 intervention communities. PCLR was inversely associated with suburb population size (r 2 =0.03, P=0.03, β=-0.25) and positively associated with intervention duration (r 2 change=0.08, P=0.00, β=0.29). Only 8% of survey respondents considered the online assessment tool difficult to use. Conclusions PCLR increased over the course of the OPAL intervention. PCLR varied between and within communities. Online assessment of PCLR has utility for multisite program evaluations. So what? Use of a novel, resource-efficient online tool to measure the key contextual factors of PCLR has enabled a better understanding of the success and generalisability of the OPAL program.
Christina M. Pettey
Full Text Available More than 80 million Americans have hypertension (HTN, and African Americans (AAs are disproportionately affected. AAs also have lower rates of adherence to HTN treatment. It is important to understand AAs’ perceptions of adherence to develop effective interventions. The aim of this study is to examine AAs’ perceptions of adherence to medications and lifestyle changes prescribed to treat HTN. In this qualitative study, we used purposive sampling to recruit Southern AAs with HTN aged 21 and older from a free, faith-based clinic. We recorded individual, in-person interviews about perceptions related to adherence to treatment of HTN and analyzed verbatim transcripts using content analysis and constant comparison. We also conducted medical record audits. Twenty-nine AAs participated (52% female, 38% were <50 years of age, 52% had taken anti-HTN medications for ≥5 years. Audits indicated that 65% had uncontrolled HTN during the previous year. Two main themes included causes of HTN and ways to improve blood pressure. Perceived causes of HTN included diet, stress, unhealthy actions, genes, and obesity. Ways to improve HTN included using cultural treatments “passed down,” increasing exercise, reducing stress, and losing weight. Many reported using home remedies to control HTN, including drinking pickle juice. More than half of this sample had uncontrolled HTN. They identified influences of culture on perceptions of adherence including causes and treatment of HTN, and possibly detrimental home remedies. It is imperative that clinicians identify culturally appropriate interventions for this high-risk group.
By using prospective energy scenarios, the objective of this study performed in the Nord-Pas-de-Calais region is to quantify energy savings induced by possible public policies or by lifestyle changes, and then to use the obtained results as tools of support to public decision, and means to make people aware of the end of an abundant and cheap oil, of the potential of solar energy, and of the benefits of energy sobriety. Four scenarios are thus defined. The first one concerns food habits, and corresponds to a more biological production, seasonal and less transformed foodstuffs, more vegetal plates, and reduced distances between producers and consumers. The second one concerns material goods: evolution towards more mutualization, re-use, and durability of products, and a reduced usage of equipment. The third one concerns buildings: the end of individual equipment and of always increasing surfaces, a modulated comfort depending on the room, and more collective organisations. The last scenario concerns displacements: less frequent displacements, shorter distances, use of soft modes, smaller vehicles, and energy saving in the use of vehicles
Sánchez, F; Aguilar, M; Porta, R; Urbano, F; Martínez, I; Bonaventura, I; Ribó, J M
A minor stroke does not cause sufficient alarm in patients to change their lifestyles. 46 patients who suffered strokes in the previous 2 years were contacted by telephone, recording rehabilitation programs, medical therapy and modification of dietary habits. It was discovered that only 50% of those requiring motor rehabilitation actually received such treatment; and only one of twenty carried on speech exercises. Subsequent ischemic events were reported by 22 patients: 12 of whom had strokes, 8 ischemic myocardial attacks and two patients suffered both conditions. The majority of patients followed the prescribed medical treatment and advice badly. Of the 46 patients reviewed, 31 were hypertensive and only 16 follow recommended diets. Out of 15 smokers only, 6 gave up, and from 21 with dislypemia only 10 modified their diets. Of all patients only the most severely affected complied satisfactorily to medical treatments; a possible explanation for this would be that the contact between patients and physician (neurologist and family doctors) was discontinued immediately after the patients discharge from hospital. It is recommended therefore that steps be taken to insure better communication between neurologist, general practitioner and patient; thereby improving prognosis.
Ng, Winda L; Peeters, Anna; Näslund, Ingmar; Ottosson, Johan; Johansson, Kari; Marcus, Claude; Shaw, Jonathan E; Bruze, Gustaf; Sundström, Johan; Neovius, Martin
To examine the change in use of hypnotics and/or sedatives after gastric bypass surgery or intensive lifestyle modification in adults with obesity. Adults with obesity who underwent gastric bypass surgery or initiated intensive lifestyle modification between 2007 and 2012 were identified through the Scandinavian Obesity Surgery Registry and a Swedish commercial weight loss database. The two cohorts were matched on BMI, age, sex, education, history of hypnotics and/or sedatives use, and treatment year (surgery n = 20,626; lifestyle n = 11,973; 77% women, mean age 41 years, mean BMI 41 kg/m 2 ). The proportion of participants with filled hypnotics and/or sedatives prescriptions was compared yearly for 3 years. In the matched treatment cohorts, 4% had filled prescriptions for hypnotics and/or sedatives during the year before treatment. At 1 year follow-up, following an average weight loss of 37 kg and 18 kg in the surgery and intensive lifestyle cohorts, respectively, this proportion had increased to 7% in the surgery cohort but remained at 4% in the intensive lifestyle cohort (risk ratio 1.7; 95% CI: 1.4-2.1); at 2 years, the proportion had increased to 11% versus 5% (risk ratio 2.0; 95% CI: 1.7-2.4); and at 3 years, it had increased to 14% versus 6% (risk ratio 2.2; 95% CI: 1.9-2.6). Gastric bypass surgery was associated with increased use of hypnotics and/or sedatives compared with intensive lifestyle modification. © 2017 The Authors. Obesity published by Wiley Periodicals, Inc. on behalf of The Obesity Society (TOS).
Ainscough, Kate M; Lindsay, Karen L; O'Sullivan, Elizabeth J; Gibney, Eileen R; McAuliffe, Fionnuala M
Antenatal healthy lifestyle interventions are frequently implemented in overweight and obese pregnancy, yet there is inconsistent reporting of the behaviour-change methods and behavioural outcomes. This limits our understanding of how and why such interventions were successful or not. The current paper discusses the application of behaviour-change theories and techniques within complex lifestyle interventions in overweight and obese pregnancy. The authors propose a decision tree to help guide researchers through intervention design, implementation and evaluation. The implications for adopting behaviour-change theories and techniques, and using appropriate guidance when constructing and evaluating interventions in research and clinical practice are also discussed. To enhance the evidence base for successful behaviour-change interventions during pregnancy, adoption of behaviour-change theories and techniques, and use of published guidelines when designing lifestyle interventions are necessary. The proposed decision tree may be a useful guide for researchers working to develop effective behaviour-change interventions in clinical settings. This guide directs researchers towards key literature sources that will be important in each stage of study development.
Cardiovascular disease causes 30% of deaths globally. By comparison, infectious disease accounts for 10% of global mortality. As these statistics indicate, cardiovascular disease is the most common cause of death in the world. In South Africa, through urbanisation and changes in lifestyle and dietary habits, the prevalence ...
Mild cognitive impairment and dementia are common disorders in the elderly. As the life span of the population in the Western world is increasing, the prevalence of cognitive disorders and the social and economic burden that coincide with that will increase. Recent data indicate that cardiovascular
Background: Diabetes Mellitus is a common chronic endocrine disorder of insulin secretion or function resulting in the disturbances of carbohydrate, fat and protein metabolism characterised by hyperglycemia. Cardiovascular complications are the most important cause of morbidity and mortality. Objectives: To assess the ...
Cardiovascular mortality, all-cause mortality, and diabetes incidence after lifestyle intervention for people with impaired glucose tolerance in the Da Qing Diabetes Prevention Study: a 23-year follow-up study.
Li, Guangwei; Zhang, Ping; Wang, Jinping; An, Yali; Gong, Qiuhong; Gregg, Edward W; Yang, Wenying; Zhang, Bo; Shuai, Ying; Hong, Jing; Engelgau, Michael M; Li, Hui; Roglic, Gojka; Hu, Yinghua; Bennett, Peter H
Lifestyle interventions among people with impaired glucose tolerance reduce the incidence of diabetes, but their effect on all-cause and cardiovascular disease mortality is unclear. We assessed the long-term effect of lifestyle intervention on long-term outcomes among adults with impaired glucose tolerance who participated in the Da Qing Diabetes Prevention Study. The study was a cluster randomised trial in which 33 clinics in Da Qing, China-serving 577 adults with impaired glucose tolerance-were randomised (1:1:1:1) to a control group or lifestyle intervention groups (diet or exercise or both). Patients were enrolled in 1986 and the intervention phase lasted for 6 years. In 2009, we followed up participants to assess the primary outcomes of cardiovascular mortality, all-cause mortality, and incidence of diabetes in the intention-to-treat population. Of the 577 patients, 439 were assigned to the intervention group and 138 were assigned to the control group (one refused baseline examination). 542 (94%) of 576 participants had complete data for mortality and 568 (99%) contributed data to the analysis. 174 participants died during the 23 years of follow-up (121 in the intervention group vs 53 in the control group). Cumulative incidence of cardiovascular disease mortality was 11.9% (95% CI 8.8-15.0) in the intervention group versus 19.6% (12.9-26.3) in the control group (hazard ratio [HR] 0.59, 95% CI 0.36-0.96; p=0.033). All-cause mortality was 28.1% (95% CI 23.9-32.4) versus 38.4% (30.3-46.5; HR 0.71, 95% CI 0.51-0.99; p=0.049). Incidence of diabetes was 72.6% (68.4-76.8) versus 89.9% (84.9-94.9; HR 0.55, 95% CI 0.40-0.76; p=0.001). A 6-year lifestyle intervention programme for Chinese people with impaired glucose tolerance can reduce incidence of cardiovascular and all-cause mortality and diabetes. These findings emphasise the long-term clinical benefits of lifestyle intervention for patients with impaired glucose tolerance and provide further justification for
Chang, C T
There is an increase in the prevalence of overweight and obesity in Malaysia. Besides prevalence studies, not much is known about either overweight or obese individuals. The objective of this study was to determine the stages of change in losing weight and the self-efficacy in eating control of three indigenous groups of overweight and obese adults in Sarawak, Malaysia. A cross-sectional study was conducted in one rural region in Sarawak using a purposive sample. A structured questionnaire, which included two scales: (1) Weight: Stages of change (SOC) to assess readiness to change; and (2) Weight Efficacy Lifestyle Questionnaire (WEL) (both adopted from the transtheoretical model of change); and a set of pre-tested questionnaires on socio-demographic data, the presence of health problems and self-assessment of weight appropriateness, was used to interview respondents. The stage distribution for weight loss of these adults respondents (n = 271) showed that 60.5% (n = 164) were in the pre-contemplation stage, 20.7% (n = 56) were in the contemplation stage, 8.5% (n = 23) were in the preparation stage, and 8.9% (n = 24) were in the action stage, while only 1.5% (n = 4) were in the maintenance stage. Except for education, the stage differences were generally stable across age, sex, race, household income, presence or absence of health problem, self-perceived weight and presence of overweight or obesity. Respondents were least able to control their eating under social pressure and food availability, according to their WEL score. A large proportion of the overweight or obese adults was not intending to lose weight. The factor structure of the two WEL original subscales enabled partial differentiation between respondents who were able or unable to resist eating in situations where there were availability of food and experienced physical discomfort. The study results indicate the importance of assessing individuals' SOC score in order to implement stage-matched intervention
Boeijinga, Anniek; Hoeken, Hans; Sanders, José
The working environment, the nature of the work, and the characteristics of truck drivers as a social group typically pose great challenges for the truck drivers' health and health promotion activities aiming to improve it. The purpose was to obtain a better understanding of (a) Dutch truck drivers' perceptions of health and lifestyle themes, and (b) the challenges they experience in their pursuit of a more healthy lifestyle, as a guiding framework for the development of health interventions targeting this occupational group. In this qualitative study, we conducted and analyzed 20 semi-structured interviews and seven cases of participant observations with Dutch truck drivers. Grounded theory was used to analyze the data. Our findings illustrate that Dutch truck drivers wish to improve their lifestyle but have unproductive associations with concepts of healthy living as well as a tendency to downplay their health risks. In addition, they experience barriers within their work and personal environment that prevent them from translating their intentions into actual lifestyle changes. Based on the insights derived from the interviews, we discuss recommendations for the development of more effective health promotion interventions for truck drivers.
Gooding, Holly C; Ning, Hongyan; Gillman, Matthew W; Shay, Christina; Allen, Norrina; Goff, David C; Lloyd-Jones, Donald; Chiuve, Stephanie
Few tools exist for assessing the risk for early atherosclerotic cardiovascular disease (ASCVD) events in young adults. To assess the performance of the Healthy Heart Score (HHS), a lifestyle-based tool that estimates ASCVD events in older adults, for ASCVD events occurring before 55 years of age. This prospective cohort study included 4893 US adults aged 18 to 30 years from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Participants underwent measurement of lifestyle factors from March 25, 1985, through June 7, 1986, and were followed up for a median of 27.1 years (interquartile range, 26.9-27.2 years). Data for this study were analyzed from February 24 through December 12, 2016. The HHS includes age, smoking status, body mass index, alcohol intake, exercise, and a diet score composed of self-reported daily intake of cereal fiber, fruits and/or vegetables, nuts, sugar-sweetened beverages, and red and/or processed meats. The HHS in the CARDIA study was calculated using sex-specific equations produced by its derivation cohorts. The ability of the HHS to assess the 25-year risk for ASCVD (death from coronary heart disease, nonfatal myocardial infarction, and fatal or nonfatal ischemic stroke) in the total sample, in race- and sex-specific subgroups, and in those with and without clinical ASCVD risk factors at baseline. Model discrimination was assessed with the Harrell C statistic; model calibration, with Greenwood-Nam-D'Agostino statistics. The study population of 4893 participants included 2205 men (45.1%) and 2688 women (54.9%) with a mean (SD) age at baseline of 24.8 (3.6) years; 2483 (50.7%) were black; and 427 (8.7%) had at least 1 clinical ASCVD risk factor (hypertension, hyperlipidemia, or diabetes types 1 and 2). Among these participants, 64 premature ASCVD events occurred in women and 99 in men. The HHS showed moderate discrimination for ASCVD risk assessment in this diverse population of mostly healthy young adults (C statistic, 0
Full Text Available Background There is evidence showing that commercially available health and lifestyle apps can be used as co-adjuvants to clinical interventions and for the prevention of chronic and non-communicable diseases. This can be particularly significant to support and improve wellbeing of young people given their familiarity with these resources. However it is important to understand the content and consistency of Behaviour Change Techniques (BCT’s embedded in the apps to maximise their potential benefits. Objectives This study explores the BCT content of a selected list of health and lifestyle tracking apps in three behavioural dimensions: physical activity, sleep and diet. We identified BCT commonalities within and between categories to detect the most frequently used and arguably more effective techniques in the context of wellbeing and promotion of health behaviours. Methods Apps were selected by using keywords and by reviewing the “health and fitness” category of GooglePlay (477 apps. The selection criteria included free apps (even if they also offered paid versions and being common to GooglePlay and AppStore. A background review of each app was also completed. Selected apps were classified according to user ratings in GooglePlay (apps with less that 4+ star ratings were disregarded. The top ten apps in each category were selected, making it a total of 30 for the analysis. Three coders used the apps for two months and were trained to use a comprehensive 93 items taxonomy (BCTv1 to complete the analysis. Results Strong BCT similarities were found across all three categories, suggesting a consistent basic content composition. Out of all 93 BCTS’s 8 were identified as being present in at least 50% of the apps. 6 of these BCT’s are concentrated in categories “1. Goals and Planning” and “2. Feedback and Monitoring”. BCT “Social support (unspecified” was coded for in 63% of the apps, as it was present through different features in
van der Beek Allard J
Full Text Available Abstract Background Non-response and drop-out are problems that are commonly encountered in health promotion trials. Understanding the health-related characteristics of non-participants and drop-outs and the reasons for non-participation and drop-out may be beneficial for future intervention trials. Methods Male construction workers with an elevated risk of cardiovascular disease (CVD were invited to participate in a lifestyle intervention study. In order to investigate the associations between participation and CVD risk factors, and drop-out and CVD risk factors, crude and multiple logistic regression analyses were performed. The reasons for non-participation and drop-out were assessed qualitatively. Results 20% of the workers who were invited decided to participate; 8.6% of the participants dropped out before the first follow-up measurement. The main reasons for non-participation were 'no interest', 'current (para-medical treatment', and 'feeling healthy', and for drop-out they were 'lack of motivation', 'current (para-medical treatment', and 'disappointment'. Participants were 4.2 years older, had a higher blood pressure, higher total cholesterol, and lower HDL cholesterol than non-participants, and were more likely to report 'tiredness and/or stress' and 'chest pain and/or shortness of breath'. After adjusting for age, most risk factors were not significantly associated with participation. Drop-outs were 4.6 years younger than those who completed the study. The prevalence of smoking was higher among non-participants and drop-outs. Conclusion Participants had a worse CVD risk profile than non-participants, mainly because of the difference in age. Non-participants and drop-outs were younger and more likely to be smokers. The main reasons for non-participation and drop-out were health-related. Investigators in the field of health promotion should be encouraged to share comparable information. Trial registration Current Controlled Trials ISRCTN
Christina M. Gant
Full Text Available Cardiovascular risk management is an integral part of treatment in Type 2 Diabetes Mellitus (T2DM, and requires pharmacological as well as nutritional management. We hypothesize that a systematic assessment of both pharmacological and nutritional management can identify targets for the improvement of treatment quality. Therefore, we analysed blood pressure (BP management in the DIAbetes and LifEstyle Cohort Twente (DIALECT. DIALECT is an observational cohort from routine diabetes care, performed at the ZGT Hospital (Almelo and Hengelo, The Netherlands. BP was measured for 15 minutes with one minute intervals. Sodium and potassium intake was derived from 24-hour urinary excretion. We determined the adherence to pharmacological and non-pharmacological guidelines in patients with BP on target (BP-OT and BP not on target (BP-NOT. In total, 450 patients were included from August 2009 until January 2016. The mean age was 63 ± 9 years, and the majority was male (58%. In total, 53% had BP-OT. In those with BP-NOT, pharmacological management was suboptimal (zero to two antihypertensive drugs in 62% of patients, and nutritional guideline adherence was suboptimal in 100% of patients (only 8% had a sodium intake on target, 66% had a potassium intake on target, 3% had a sodium-to-potassium ratio on target, and body mass index was <30 kg/m2 in 35%. These data show pharmacological undertreatment and a low adherence to nutritional guidelines. Uncontrolled BP is common in T2DM, and our data show a window of opportunity for improving BP control, especially in nutritional management. To improve treatment quality, we advocate to incorporate the integrated monitoring of nutritional management in quality improvement cycles in routine care.
Barr, E L M; Boyko, E J; Zimmet, P Z; Wolfe, R; Tonkin, A M; Shaw, J E
Hyperglycaemia is a risk factor for cardiovascular disease (CVD) and all-cause mortality in individuals without diabetes. We investigated: (1) whether the risk of all-cause and CVD mortality extended continuously throughout the range of fasting plasma glucose (FPG), 2 h plasma glucose (2hPG) and HbA(1c) values; and (2) the ability of these measures to improve risk prediction for mortality. Data on 10,026 people aged >or=25 years without diagnosed diabetes were obtained from the population-based Australian Diabetes, Obesity and Lifestyle study. Between 1999 and 2000, FPG, 2hPG and HbA(1c) were assessed and all-cause (332 deaths) and CVD (88 deaths) mortality were obtained after 7 years. Both 2hPG and HbA(1c) exhibited linear relationships with all-cause and CVD mortality, whereas FPG showed J-shaped relationships. The adjusted HR (95% CI) for all-cause mortality per SD increase was 1.2 (1.1-1.3) for 2hPG and 1.1 (1.0-1.2) for HbA(1c). The HR for FPG or=5.1 mmol/l (per SD increase) the HR was 1.1 (1.0-1.2). Corresponding HRs for CVD mortality were 1.2 (1.0-1.4), 1.2 (1.0-1.3), 4.0 (2.1-7.6) and 1.3 (1.1-1.4). The discriminative ability of each measure was similar; no measure substantially improved individual risk identification over traditional risk factors. In individuals without diagnosed diabetes, 2hPG and FPG, but not HbA(1c) were significant predictors of all-cause mortality, whereas all measures were significant predictors of CVD mortality. However, these glucose measures did not substantially improve individual risk identification.
Critchley, Christine R; Hardie, Elizabeth A; Moore, Susan M
To examine the psychological process of lifestyle change among adults at risk for type 2 diabetes. A randomized control trial in which 307 volunteers (intervention, n = 208; wait control, n = 99) diagnosed with prediabetes completed a six-session group-based intervention to promote healthier living. Participants' motivation to change, diet and exercise self-efficacy, mood, knowledge about diabetes, activity levels, healthy eating, waist circumference, and weight were assessed before and after the program. Participation in the program was associated with significant increases in healthy eating and physical activity, reductions in waist and weight, and improvements in motivation, positive mood, self-efficacy, and knowledge. Examination of the pathways to lifestyle change showed that the educational aspect of the program increased activity levels because it increased diabetes knowledge and improved mood. Eating behavior was not mediated by any of the psychological variables. Improvements in diet and physical activity were, in turn, directly associated with changes in weight and waist circumference. Although the program significantly improved motivation, self-efficacy, and mood, its impact on knowledge uniquely explained the increase in physical activity. Group-based programs that are tailored to lifestyle behaviors may provide a cost-effective method of diabetes prevention, but more research is needed to explain why they improve healthy eating.
Kempf, K; Dirk, M; Kolb, H; Hebestreit, A; Bittner, G; Martin, S
Healthy diet and physical activity can improve metabolic control in patients with type 2 diabetes mellitus. However, lifestyle change without external help is difficult: an alteration of mental attitude is necessary to achieve long-term success. A computer-based motivational program ("Da Vinci") has been developed to help patients to change their mental attitudes and beliefs. Patients with type 2 diabetes were supervised by psychological trainers in four sessions at ten study centers. The interactive computer program allowed for identification of motivation restraints and overcoming them. Parameters of carbohydrate metabolism were measured at the beginning and end of the three-months program as well as three and six months after end of program. All participants (n = 61) developed a positive attitude towards the range of their action and by themselves changed their lifestyle. After three months their weight (-4.6 kg; p motivational program, which is intended to alter mental attitude and beliefs, but not to teach knowledge about diabetes, participants were able to significantly improve their metabolic control. As these improvements were maintained long-term, this points to sustainable lifestyle change. © Georg Thieme Verlag KG Stuttgart · New York.
Koetaka, Hanayo; Ohno, Yuko; Morimoto, Kanehisa
To reveal change patterns in self-reported lifestyle data for 9 years, and examine the characteristics of changes by type of lifestyle and ageing. The authors used the lifestyle data of 7,080 male workers aged 20-59 who received checkups for 9 years. The proportions of change patterns during the 9 years were determined in seven health practices; smoking, eating breakfast, sleeping hours, working hours, physical exercise, eating nutritional balanced diets, and mental stress. Among seven health practices, the keep rate of good health practice was highest for the non-smoking (90.8 %), followed by eating breakfast (69.0 %);and the lowest was physical exercise (13.7 %). The keep rate of poor health practice was highest for smoking (73.8 %), followed by non-physical exercise (67.1 %). The lowest rate of multiple changes during 10 years was smoking (7.1 %); the highest was mental stress (68.5 %). As for the life style on smoking and eating breakfast seemed to be stable, using the data obtained at a specific point in time wouldn't much affect the results. On the contrary, for other life styles, they showed poor continuity during 9 years, so it would be necessary to take into consideration the time point of data collection.
Karwacki-Marugg, Claire L; Schnatz, J David
The purpose was to compare long-term involvement (LTI) vs short-term involvement (STI) of patients in a Lipid Education Service (LES) and to assess the effects of life-style changes. Patients were referred for LTI and STI by their physicians. Three-hundred eighty-one consecutive patients, 287 LTI and 94 STI, were analyzed. The lipids in LTI patients were all significantly improved. Sixty-six percent of all LDL values were at goal as were 77% of HDL and 62% of triglyceride (NCEP-II criteria). Sixty-two percent of LDL values in coronary artery disease patients were at goal contrasted to a reported range of 9.6%-71%. Life-style changes made significant differences in the percentage of patients at lipid goals. In postprogram follow-up there were significant differences between LTI and STI patients. The LTI patients did much better in improving lipid levels at postprogram follow-up than did STI patients. These results demonstrate the importance of making life-style changes as well as the importance of intensive efforts in achieving meaningful and lasting change.
Korre, Maria; Sotos-Prieto, Mercedes; Kales, Stefanos N
Cardiovascular disease (CVD) causes almost half of all on-duty deaths in US firefighters and is an important and costly cause of morbidity. In addition, cancer is a growing health concern in this population. Obesity and obesity-associated, cardiometabolic risk clustering are major, modifiable risk factors for fire service CVD and cancer risk. The Mediterranean diet (MedDiet) is proven effective in primary and secondary CVD prevention. It is also associated with a decreased risk of cancer and other chronic diseases. Moreover, it can be adapted into successful workplace interventions. Emerging data from our group regarding the US Fire Service show that greater compliance with the MedDiet is associated with improved CVD risk profiles and less weight gain among career firefighters. Moreover, the fact that career firefighters take a considerable number of meals communally on the job also represents an excellent opportunity for a workplace Mediterranean Diet Nutritional Intervention (MDNI). The devastating effects of obesity, CVD, and cancer on the US fire service are recognized, but currently few effective preventive programs exist. The consistently positive health benefits from following a MedDiet and promising preliminary data in the fire service justify translational research to determine the most effective means of delivering MDNIs to US firefighters. Therefore, a high priority should be assigned to efforts, which can help further disseminate and implement our program of novel behavior change strategies, "Survival Mediterranean Style," throughout the US fire service and eventually to other occupations.
Full Text Available Cardiovascular disease (CVD causes almost half of all on-duty deaths in US firefighters and is an important and costly cause of morbidity. In addition, cancer is a growing health concern in this population. Obesity and obesity-associated, cardiometabolic risk clustering are major, modifiable risk factors for fire service CVD and cancer risk. The Mediterranean diet (MedDiet is proven effective in primary and secondary CVD prevention. It is also associated with a decreased risk of cancer and other chronic diseases. Moreover, it can be adapted into successful workplace interventions. Emerging data from our group regarding the US Fire Service show that greater compliance with the MedDiet is associated with improved CVD risk profiles and less weight gain among career firefighters. Moreover, the fact that career firefighters take a considerable number of meals communally on the job also represents an excellent opportunity for a workplace Mediterranean Diet Nutritional Intervention (MDNI. The devastating effects of obesity, CVD, and cancer on the US fire service are recognized, but currently few effective preventive programs exist. The consistently positive health benefits from following a MedDiet and promising preliminary data in the fire service justify translational research to determine the most effective means of delivering MDNIs to US firefighters. Therefore, a high priority should be assigned to efforts, which can help further disseminate and implement our program of novel behavior change strategies, “Survival Mediterranean Style,” throughout the US fire service and eventually to other occupations.
Taylor, Rachael W.; Roy, Melyssa; Jospe, Michelle R.; Osborne, Hamish R.; Meredith-Jones, Kim J; Williams, Sheila M.; Brown, Rachel C.
Background Physical activity plays a critical role in health, including for effective weight maintenance, but adherence to guidelines is often poor. Similarly, although debate continues over whether a “best” diet exists for weight control, meta-analyses suggest little difference in outcomes between diets differing markedly in macronutrient composition, particularly over the longer-term. Thus a more important question is how best to encourage adherence to appropriate lifestyle change. While br...
Patient importance scores for prevention were associated with residence and gender. The villagers attached less importance to prevention. They also declared less willingness to change their lifestyle. Women had higher scores regarding prevention than men. More rural respondents would like to receive individual counselling from their GP regarding eating habits, physical activity, body weight, giving up smoking and safe alcohol use. Urban respondents were more likely to expect leaflets from their GPs on normalizing body weight.
Schalkwijk, A.A.H.; Bot, S.D.M.; de Vries, L.; Westerman, M.J.; Nijpels, G.; Elders, P.J.M.
Background: In order to improve and optimize future behavioral family lifestyle intervention programs, more information on the perceptions of obese children and their parents of these programs is needed. As such, the aim of this qualitative study is 1) to explore the expectations of obese children
Braver, den Nicole; Vet, de E.W.M.L.; Duijzer, G.; Beek, ter J.; Jansen, S.C.; Hiddink, G.J.; Feskens, E.J.M.; Haveman-Nies, A.
Although there are many effective lifestyle interventions for type 2 diabetes (T2DM) prevention, insight into effective intervention pathways, especially of long-term interventions, is often lacking. This study aims to provide insight into the effective intervention pathways of the
Vlachopoulos, Charalambos; Jackson, Graham; Stefanadis, Christodoulos; Montorsi, Piero
Erectile dysfunction is common in the patient with cardiovascular disease. It is an important component of the quality of life and it also confers an independent risk for future cardiovascular events. The usual 3-year time period between the onset of erectile dysfunction symptoms and a cardiovascular event offers an opportunity for risk mitigation. Thus, sexual function should be incorporated into cardiovascular disease risk assessment for all men. A comprehensive approach to cardiovascular risk reduction (comprising of both lifestyle changes and pharmacological treatment) improves overall vascular health, including sexual function. Proper sexual counselling improves the quality of life and increases adherence to medication. This review explores the critical connection between erectile dysfunction and cardiovascular disease and evaluates how this relationship may influence clinical practice. Algorithms for the management of patient with erectile dysfunction according to the risk for sexual activity and future cardiovascular events are proposed.
Baumann, Sophie; Toft, Ulla; Aadahl, Mette
five years, all participants in the intervention group (n = 6,091) received individual lifestyle counseling; participants at high risk of ischemic heart disease - according to pre-specified criteria - were also offered group-based counseling. The control group (n = 3,324) was followed by questionnaires.......6 min/week, p = 0.003) and less intake of saturated fat (OR = 0.31, 95% CI: 0.17-0.56) than the control group. Improvements in the intake of vegetables and fish achieved during the intervention were not maintained in the longer-term. CONCLUSIONS: Screening and lifestyle counseling had sustained effects....... Both groups were followed one, three, five, and ten years after baseline. Changes in physical activity and dietary habits (intake of vegetables, fruit, fish, and saturated fat) during and after the intervention were investigated using random-coefficient models. RESULTS: Five years after...
van Wier, Marieke F; Lakerveld, Jeroen; Bot, Sandra D M; Chinapaw, Mai J M; Nijpels, Giel; van Tulder, Maurits W
BACKGROUND: Cost-effectiveness studies of lifestyle interventions in people at risk for lifestyle-related diseases, addressing 'real-world' implementation, are needed. This study examines the cost-effectiveness of a primary care intervention from a societal perspective, compared with provision of
Hoedjes, Meeke; Berks, Durk; Vogel, Ineke; Franx, Arie; Duvekot, Johannes J; Oenema, Anke; Steegers, Eric A P; Raat, Hein
To describe the motivators and barriers to the adoption of a healthy postpartum lifestyle after a pregnancy complicated by preeclampsia, intrauterine growth restriction, and/or gestational diabetes. Thirty-six women with complicated pregnancies participated in six focus-group interviews that aimed to explore the perceptions of modifiable determinants of postpartum lifestyle. Although women expressed that they intended to live a healthy postpartum lifestyle, it was generally not achieved. The motivators included improving their own current health condition as well as modeling a healthy lifestyle for their children. Important barriers were reported to be lack of knowledge, poor recovery, and lack of professional support after delivery. The reported motivators and barriers can be used to develop a postpartum lifestyle intervention.
Patel, Naina; Ferrer, Harriet Batista; Tyrer, Freya; Wray, Paula; Farooqi, Azhar; Davies, Melanie J; Khunti, Kamlesh
Minority ethnic populations experience a disproportionate burden of health inequalities compared with the rest of the population, including an increased risk of type 2 diabetes (T2DM). The purpose of this narrative review was to explore knowledge and attitudes around diabetes, physical activity and diet and identify barriers and facilitators to healthy lifestyle changes in minority ethnic populations in the UK. The narrative review focused on three key research topics in relation to barriers and facilitators to healthy lifestyle changes in minority adult ethnic populations: (i) knowledge and attitudes about diabetes risk; (ii) current behaviours and knowledge about physical activity and diet; and (iii) barriers and facilitators to living a healthier lifestyle. Nearly all of the studies that we identified reported on South Asian minority ethnic populations; we found very few studies on other minority ethnic populations. Among South Asian communities, there was generally a good understanding of diabetes and its associated risk factors. However, knowledge about the levels of physical activity required to gain health benefits was relatively poor and eating patterns varied. Barriers to healthy lifestyle changes identified included language barriers, prioritising work over physical activity to provide for the family, cultural barriers with regard to serving and eating traditional food, different perceptions of a healthy body weight and fear of racial harassment or abuse when exercising. Additional barriers for South Asian women included expectations to remain in the home, fear for personal safety, lack of same gender venues and concerns over the acceptability of wearing 'western' exercise clothing. Facilitators included concern that weight gain might compromise family/carer responsibilities, desire to be healthy, T2DM diagnosis and exercise classes held in 'safe' environments such as places of worship. Our findings suggest that South Asian communities are less likely to
Kuhl, Elizabeth S; Clifford, Lisa M; Bandstra, Nancy F; Filigno, Stephanie S; Yeomans-Maldonado, Gloria; Rausch, Joseph R; Stark, Lori J
Preschoolers (ages 2-5 years) have been significantly underrepresented in the obesity treatment outcome literature, despite estimates that 12.1% are already obese. As such, little is known about the most important intervention targets for weight management within this age group. The aims of this study were (a) to examine lifestyle behavior changes for 30 obese preschoolers participating in a weight-control intervention and (b) to explore which lifestyle behavior changes predicted changes in body mass index (BMI) z score. Preschooler height, weight, diet (three 24-hr recalls), physical activity (accelerometry), and television use (parent report) were measured at baseline and posttreatment (6 months). A linear regression was conducted to examine pre- to posttreatment changes in diet (i.e., intake of calories, sugar-sweetened beverages, fruits and vegetables, and sweet and salty snacks) and activity (i.e., moderate-to-vigorous activity and television use) behaviors on changes in BMI z score. Despite significant reductions in sugar-sweetened beverage intake and television use, and increases in fruit and vegetable intake, only reductions in absolute caloric intake significantly predicted reductions in BMI z score. Our findings suggest that attaining healthy caloric goals may be the most important component of weight-control interventions for preschoolers. Future research using innovative methodologies, such as the Multiphase Optimization Strategy, may be helpful to prospectively identifying the lifestyle behavior changes that are most effective in helping families to achieve healthy weight outcomes for preschoolers and thereby improve intervention efficiency and decrease treatment burden for families. 2014 APA, all rights reserved
Prevalence of lifestyle-related cardiovascular risk factors in Peru: the PREVENCION study Prevalencia de factores de riesgo cardiovascular relacionados con el estilo de vida en Perú: el estudio PREVENCIÓN
Full Text Available OBJECTIVES: To estimate the prevalence of lifestyle-related cardiovascular risk factors in the adult population of Arequipa, the second largest city in Peru. METHODS: The prevalence and patterns of smoking, alcohol drinking, lack of physical activity, high-fat diet, and low fruit and vegetable intake were evaluated among 1 878 subjects (867 men and 1 011 women in a population-based study. RESULTS: The age-standardized prevalence of current smoking, former smoking, and never smoking were 21.6%, 14.3%, and 64.1%, respectively. The prevalence of current smoking was significantly higher in men than women (31.1% vs. 12.1%; P OBJETIVOS: Estimar la prevalencia de factores de riesgo cardiovascular relacionados con el estilo de vida de adultos de Arequipa, la segunda mayor ciudad de Perú. MÉTODOS: Se realizó un estudio de base poblacional para evaluar la prevalencia y los patrones de consumo de tabaco y bebidas alcohólicas, la falta de actividad física, la dieta rica en grasas y el bajo consumo de frutas y vegetales en 1 878 personas (867 hombres y 1 011 mujeres. RESULTADOS: Las prevalencias estandarizadas por la edad de los fumadores actuales, pasados y de los que nunca fumaron fueron 21,6%, 14,3% y 64,1%, respectivamente. La prevalencia de tabaquismo fue significativamente mayor en los hombres que en las mujeres (31,1% frente a 12,1%; P < 0,01. La prevalencia del consumo de bebidas alcohólicas fue de 37,7%, significativamente mayor en los hombres que en las mujeres (55,5% frente a 19,7%; P < 0,01. La prevalencia del consumo excesivo de alcohol fue de 21,1%, mayor en los hombres que en las mujeres (36,1% frente a 6,4%; P < 0,01. La gran mayoría de los bebedores presentó un patrón de consumo concentrado fundamentalmente en los fines de semana y los días feriados, más que el consumo habitual con las comidas en los días laborables. La proporción de personas con insuficiente actividad fue de 57,6%, significativamente mayor en las mujeres que en
Poe, A J; Knowlton, A A
Exosomes have an evolving role in paracrine and autocrine signaling, which is enhanced because these lipid vesicles are quite stable and can deliver miRNA, DNA, protein and other molecules to cells throughout the body. Most cell types release exosomes, and exosomes are found in all biological fluids, making them accessible biomarkers. Significantly, exosomes can carry a biologically potent cargo, which can alter the phenotype of recipient cells. In the cardiovascular system exosomes have been primarily studied for their role in mediating the beneficial effects of mesenchymal stem cells after myocardial injury. Exosomes released by cardiac cells in disease states, such as myocardial ischemia, can potentially have important pathophysiologic effects on other cardiac cells as well as on distant organs. Published by Elsevier Ltd.
Hanna, Esmée; Gough, Brendan; Hudson, Nicky
The reproductive realm is routinely viewed as a feminised space requiring women's commitment and labour. By contrast, men's procreative contributions and 'reproductive masculinity' is represented as unproblematic, with men assumed to be fertile across the lifespan. Recent scientific research has, however, cast doubt over these longstanding assumptions, suggesting that a link does exist between 'lifestyle' factors and male fertility. The notion that fertility can be improved with effort (for both women and men) can be located within wider cultural and political shifts which construct individuals as increasingly responsible for acting on health messages and engaging in self-disciplining body projects. Through an exploration of 'lifestyle changes' within a men's online infertility discussion forum board, this paper examines how discourses of individualisation healthism and masculinity are reproduced and interlinked. Our thematic analysis indicates that 'lifestyle work' is construed as crucial for achieving conception - and as a means to demonstrate men's commitment to the dyadic goal of parenthood, which in turn may challenge and extend previous notions of 'reproductive masculinity'. © 2018 Foundation for the Sociology of Health & Illness.
Efeitos da sauna sobre doenças cardiovasculares e doenças relacionadas com o estilo de vida Efectos de la sauna sobre las enfermedades cardiovasculares y las relacionadas al estilo de vida Effects of sauna on cardiovascular and lifestyle-related diseases
the impact of the sauna on diseases and on health in general. Sauna can be beneficial or dangerous depending on its use. In the past few years the sauna is being considered beneficial for the cardiovascular diseases' patients, as the heart failure and lifestyle-related diseases, mainly by improving the peripheral endothelial function, through the increase of the cardiac output and peripheral vasodilation. The endothelial dysfunction is present in most of the cardiovascular diseases. The present article intends to review the sauna effects on the cardiovascular system in healthy individuals and in some cardiovascular diseases.
Whelan, Maxine E; Morgan, Paul S; Sherar, Lauren B; Orme, Mark W; Esliger, Dale W
Unhealthy behaviors, including smoking, poor nutrition, excessive alcohol consumption, physical inactivity and sedentary lifestyles, are global risk factors for non-communicable diseases and premature death. Functional magnetic resonance imaging (fMRI) offers a unique approach to optimize health messages by examining how the brain responds to information relating to health. Our aim was to systematically review fMRI studies that have investigated variations in brain activation in response to health messages relating to (i) smoking; (ii) alcohol consumption; (iii) physical activity; (iv) diet; and (v) sedentary behavior. The electronic databases used were Medline/PubMed, Web of Science (Core Collection), PsychINFO, SPORTDiscuss, Cochrane Library and Open Grey. Studies were included if they investigated subjects aged ≥10years and were published before January 2017. Of the 13,836 studies identified in the database search, 18 studies (smoking k=15; diet k=2; physical activity/sedentary behavior k=1) were included in the review. The prefrontal cortex was activated in seven (47%) of the smoking-related studies and the physical activity study. Results suggest that activation of the ventromedial, dorsolateral and medial prefrontal cortex regions were predictive of subsequent behavior change following exposure to aversive anti-smoking stimuli. Studies investigating the neurological responses to anti-smoking material were most abundant. Of note, the prefrontal cortex and amygdala were most commonly activated in response to health messages across lifestyle behaviors. The review highlights an important disparity between research focusing on different lifestyle behaviors. Insights from smoking literature suggest fMRI may help to optimize health messaging in relation to other lifestyle behaviors. Copyright © 2017 Elsevier Inc. All rights reserved.
Anaraki, Fakhryalsadat; Vafaie, Mohamad; Behboo, Roobic; Maghsoodi, Nakisa; Esmaeilpour, Sahar
Aim The aim of this was to investigate some clinical profiles and lifestyle changes in stoma patients. Background Stoma patients experienced multiple complications due to their ostomy formation. Patients and methods A cross-sectional study performed on 102 random samples of stoma patients. Any patient with adequate physical and mental capability to participate and having had an ostomy in place for at least 3 months was eligible to enter the study. Participants asked to answer study questions concerning age, sex, type of stoma, having permanent or temporary ostomy, underlying cause of stoma formation, type of cancers cause of stoma. Patient also questioned about some lifestyle changes because of stoma including: changing diet, sexual satisfaction (if sexually active after stoma formation), sense of depression, changing job, change clothing style. Results Colostomy was the most common type of stoma followed by ileostomy and urostomy. In 80.4% of patients under study the stoma was permanent. Most patients had a stoma because of cancer (77.5%), with colon cancer (41.2%) being the most common malignant diagnosis. The mean age of cancer patients (56.1±10.9) with stoma was significantly higher than non-cancer patients (44.7±12.9) (p ostomy. Conclusion In conclusion, stoma formation can caused multiple problems for both cancer and non-cancer patients. Counseling of patient is an important component of care that could help stoma patients to adjust with new situations. PMID:24834234
Thijs, G A
The European definition of General Practice states that GPs should use their core competence, amongst others, in their communication with patients. Their communication skills are particularly challenged in the field of lifestyle improvements. Most GPs feel they lack efficacy in achieving lifestyle changes. In November 2002 the Prevention Department of the Scientific Society of Flemish GPs (now Domus Medica) decided to start a project "consulting & behaviour change". Under this project, every Flemish GP should by the year 2007, have (amongst others things) a basic knowledge of the principles of lifestyle improvements and should be able to give a short advice to high risk patients. A literature search was conducted to make an inventory of models that could be used to train GPs. Experts at specific methods and topics were consulted to get acquainted with their specific approaches. Experts in the field of CME were gathered to discuss barriers and solutions to these barriers. During steering group meetings, several possible solutions were discussed. The Trans Theoretical Model (TTM-as theoretical framework) and brief motivational interviews (MI-as communication skill) were evaluated as offering the best opportunities for adapting the work situation of the GP. We promoted this approach to the GPs as an ABC concept (Anamnesis/Ask; Be the guide/Decision tree ("Beslissingsboom" in Dutch); Continuity) applied on different topics (smoke stop, alcohol, healthy food, physical activity). In our guidelines we pay more attention to brief motivational interviews for health behaviour changes. Recently we started developing an e-learning website as part of a larger learning project, this in cooperaion with different Flemish partners and disciplines. The Trans Theoretical Model and the brief motivational interviewing approach seem to be accepted by health care, educational and scientific organisations. The process of integrating this approach in the GP's daily practice has to be
Full Text Available Background Non-communicable diseases (NCDs place severe financial strain on global health resources. Diabetes mellitus, the second most prevalent NCD, has been attributed to 8.4% of deaths worldwide for adults aged 20-79 years (International Diabetes Federation, 2013 with physical inactivity attributable to 7% of cases (Lee et al., 2012. The recent surge in commercially available wearable technology has begun to allow individuals to self-monitor their physical activity and sedentary behaviour as well as the physiological response to these behaviours (e.g., health markers such as glucose levels. Equipped with feedback obtained from such wearables, individuals are better able to understand the relationship between the lifestyle behaviours they take (e.g. going for a walk after dinner and health consequences (e.g. less glucose excursions (area under the curve. However, in order to achieve true behaviour change, the feedback must be optimised. Innovative communications research suggest that health messages (and in our case feedback that activates brain regions such as the medial prefrontal cortex (Falk, Berkman, Mann, Harrison & Lieberman, 2010 can predict and are associated with successful behaviour change. Fortunately, functional magnetic resonance imaging (fMRI can map this neural activity whilst individuals receive various forms of personalised feedback. Such insight into the optimisation of feedback can improve the design and delivery of future behaviour change interventions. Aim Examine neural activity in response to personalised feedback in order to identify health messages most potent for behaviour change. Methods A mixed gender sample of 30 adults (aged 30-65 years will be recruited through campus advertisements at Loughborough University, UK. Physical activity and sedentary behaviour will be assessed using waist-worn ActiGraph GT3x-BT accelerometer (100Hz and LUMO posture sensor (30Hz, respectively. Both devices will be removed for sleep
Schulze, S; Lyng, K M; Bugge, K
Gasless laparoscopy produces smaller cardiopulmonary and systemic changes than carbon dioxide (CO2) laparoscopy during colonic surgery.......Gasless laparoscopy produces smaller cardiopulmonary and systemic changes than carbon dioxide (CO2) laparoscopy during colonic surgery....
Costache, Irina Iuliana; Ungureanu, Maria Christina; Iliescu, D; Petriş, A; Botnariu, Gina
Car- diovascular abnormalities associated with endocrine diseases are often frequent and due to complex relationships between endocrine glands (with internal secretion) and cardiovascular system (heart and vessels). Certain hormones secreted by the endocrine glands (particularly the thyroid and pituitary gland) excesses or deficiencies, are involved in morphogenesis, growth processes and activity regulation of cardiovascular system, most often in connection with the autonomic nervous system. There are also a lot of electrocardiographic changes caused by hormonal disorders that requires differential diagnosis and represents the source of erroneous diagnosis. Endocrine pathology occurred later than a heart disease, may worse heart function. Ignoring the cardiovascular events that may occur in the evolution of endo- crine diseases, may induce increased mortality due to cardiovascular complications.
Estilo de vida e saúde cardiovascular em adolescentes de escolas do município de São Paulo Estilo de vida y salud cardiovascular en adolescentes de escuelas del municipio de São Paulo Lifestyle and cardiovascular health in school adolescents from São Paulo
: Identificar en adolescentes, la prevalencia de sobrepeso y del estilo de vida asociado a riesgo para el desarrollo de enfermedades cardiovasculares, además de los factores que los influyen. MÉTODOS: Fue realizado un estudio observacional de datos individuales, transversal, con adolescentes matriculados en escuelas públicas y privadas del municipio de São Paulo, englobando los grados de 5ª a 8ª de la enseñanza fundamental; las informaciones fueron obtenidas a través de la aplicación de un cuestionario anónimo y de la realización de medidas de peso y altura. RESULTADOS: Fueron analizados 2.125 adolescentes, con edad media de 12,9 años. Del total estudiado: de 14,4% a 32,1% no practicaron deporte o competición; de 56,0% a 73,6% se quedaron más de dos horas frente a la TV, videogame o computadora; aproximadamente 80% consumieron frutas y legumbres de forma considerada inadecuada; de 34,9% a 45,3% relataron consumo aumentado de sal; y de 60,9% a 74,4% consumo de bebidas gaseosas. La prevalencia de sobrepeso varió de 18,7% a 41,6%. CONCLUSIÓN: Es alta la prevalencia en adolescentes escolares de factores de riesgo asociados al desarrollo de enfermedades cardiovasculares en el adulto. Otros estudios son necesarios para comprender mejor como esos factores de riesgo se correlacionan y, así, posibilitar la implementación de medidas preventivas, en la fase de la adolescencia, con vistas a la prevención de las enfermedades cardiovasculares do adulto.BACKGROUND: Cardiovascular disease is the leading cause of mortality worldwide. There is evidence demonstrating the association of this disease with cardiovascular risk factors related to lifestyle, incorporated in adolescence. OBJECTIVE: To identify, in adolescents, the prevalence of overweight and lifestyle factors associated with risk for developing cardiovascular diseases, and the factors that influence them. METHODS: It was conducted an observational study of individual cross-sectional data with adolescents enrolled in
Moyad, Mark A
Almost all aspects of urology are affected positively and negatively by certain lifestyle changes and dietary supplements. Some of these interventions have potential profound impacts independently or in combination with conventional therapy, others have no impact, and some could negatively impact treatment and overall health. The heart-healthiest recommendations have consistently served as the safest and most potentially effective options in urology from benign prostatic hyperplasia, chronic nonbacterial prostatitis, interstitial cystitis, multiple urologic cancers, male infertility, male and female sexual dysfunction, kidney stones, and Peyronie disease. Copyright © 2011 Elsevier Inc. All rights reserved.
McGill, Bronwyn; O'Hara, Blythe J; Bauman, Adrian; Grunseit, Anne C; Phongsavan, Philayrath
To identify the behavioral economics (BE) conceptual underpinnings of lifestyle financial incentive (FI) interventions. A mapping review of peer-reviewed literature was conducted by searching electronic databases. Inclusion criteria were real-world FI interventions explicitly mentioning BE, targeting individuals, or populations with lifestyle-related behavioral outcomes. Exclusion criteria were hypothetical studies, health professional focus, clinically oriented interventions. Study characteristics were tabulated according to purpose, categorization of BE concepts and FI types, design, outcome measures, study quality, and findings. Data Synthesis and Analysis: Financial incentives were categorized according to type and payment structure. Behavioral economics concepts explicitly used in the intervention design were grouped based on common patterns of thinking. The interplay between FI types, BE concepts, and outcome was assessed. Seventeen studies were identified from 1452 unique records. Analysis showed 76.5% (n = 13) of studies explicitly incorporated BE concepts. Six studies provided clear theoretical justification for the inclusion of BE. No pattern in the type of FI and BE concepts used was apparent. Not all FI interventions claiming BE inclusion did so. For interventions that explicitly included BE, the degree to which this was portrayed and woven into the design varied. This review identified BE concepts common to FI interventions, a first step in providing emergent and pragmatic information to public health and health promotion program planners.
Full Text Available AbstractObjective: The aims of this study are to determine the community-based studies on coronary heart disease (CHD and cerebrovascular disease (CVD prevalence in Turkey, critical appraisal of methodological appropriateness of these studies, and analyze the yearly trends using the research findings which have comparable data. Methods: The studies in this systematic review were selected by searching MEDLINE, ULAKBIM, Higher Education Thesis databases. The inclusion criteria were; to be 1 conducted in Turkey and 2 community-based, and cross-sectional, 3 providing at least one morbidity (prevalence or incidence rate of either coronary heart disease or cerebrovascular disease, 4 not to be conducted in hospital or nursing setting. A total of 23 studies were selected for critical evaluation, two researchers evaluated the studies using checklists. Results: According to the regression equations created by using five study data that had the same definition for the diseases, and provided CHD and CVD prevalence by age and sex, the estimated prevalence of CHD in 2008, for above the age of 35 was 10.7% in men, 12.7% in women while in 2012 it was 6.6% in men, 7.0% in women. In 2008, the estimated prevalence of CVD in men over the age 35 was 1.6%, 2.0% in women, while it was 1.3 in men and women in 2012, respectively. Conclusions: Most of the studies examining cardiovascular disease epidemiology in Turkey are either regional or do not provide comparable data as an appropriate method has not been used. Further studies should be nationwide, represent all regions, provide comparable data, and be conducted using valid diagnostic methods.Key Words: Prevalence, frequency, trend, coronary heart disease, cerebrovascular disease.
Full Text Available Abstract Background Type 2 Diabetes Mellitus (T2DM has become a major public health challenge in India. Factors relevant to the development and implementation of diabetes prevention programmes in resource-constrained countries, such as India, have been under-studied. The purpose of this study is to describe the findings from research aimed at informing the development and evaluation of a Diabetes Prevention Programme in Kerala, India (K-DPP. Methods Data were collected from three main sources: (1 a systematic review of key research literature; (2 a review of relevant policy documents; and (3 focus groups conducted among individuals with a high risk of progressing to diabetes. The key findings were then triangulated and synthesised. Results Prevalence of risk factors for diabetes is very high and increasing in Kerala. This situation is largely attributable to rapid changes in the lifestyle of people living in this state of India. The findings from the systematic review and focus groups identified many environmental and personal determinants of these unhealthy lifestyle changes, including: less than ideal accessibility to and availability of health services; cultural values and norms; optimistic bias and other misconceptions related to risk; and low expectations regarding one’s ability to make lifestyle changes in order to influence health and disease outcomes. On the other hand, there are existing intervention trials conducted in India which suggests that risk reduction is possible. These programmes utilize multi-level strategies including mass media, as well as strategies to enhance community and individual empowerment. India’s national programme for the prevention and control of major non-communicable diseases (NCD also provide a supportive environment for further community-based efforts to prevent diabetes. Conclusion These findings provide strong support for undertaking more research into the conduct of community-based diabetes prevention
Daivadanam, Meena; Absetz, Pilvikki; Sathish, Thirunavukkarasu; Thankappan, K R; Fisher, Edwin B; Philip, Neena Elezebeth; Mathews, Elezebeth; Oldenburg, Brian
Type 2 Diabetes Mellitus (T2DM) has become a major public health challenge in India. Factors relevant to the development and implementation of diabetes prevention programmes in resource-constrained countries, such as India, have been under-studied. The purpose of this study is to describe the findings from research aimed at informing the development and evaluation of a Diabetes Prevention Programme in Kerala, India (K-DPP). Data were collected from three main sources: (1) a systematic review of key research literature; (2) a review of relevant policy documents; and (3) focus groups conducted among individuals with a high risk of progressing to diabetes. The key findings were then triangulated and synthesised. Prevalence of risk factors for diabetes is very high and increasing in Kerala. This situation is largely attributable to rapid changes in the lifestyle of people living in this state of India. The findings from the systematic review and focus groups identified many environmental and personal determinants of these unhealthy lifestyle changes, including: less than ideal accessibility to and availability of health services; cultural values and norms; optimistic bias and other misconceptions related to risk; and low expectations regarding one's ability to make lifestyle changes in order to influence health and disease outcomes. On the other hand, there are existing intervention trials conducted in India which suggests that risk reduction is possible. These programmes utilize multi-level strategies including mass media, as well as strategies to enhance community and individual empowerment. India's national programme for the prevention and control of major non-communicable diseases (NCD) also provide a supportive environment for further community-based efforts to prevent diabetes. These findings provide strong support for undertaking more research into the conduct of community-based diabetes prevention in the rural areas of Kerala. We aim to develop, implement and
Savory, L A; Griffin, S J; Williams, K M; Prevost, A T; Kinmonth, A-L; Wareham, N J; Simmons, R K
To describe change in self-reported diet and plasma vitamin C, and to examine associations between change in diet and cardiovascular disease risk factors and modelled 10-year cardiovascular disease risk in the year following diagnosis of Type 2 diabetes. Eight hundred and sixty-seven individuals with screen-detected diabetes underwent assessment of self-reported diet, plasma vitamin C, cardiovascular disease risk factors and modelled cardiovascular disease risk at baseline and 1 year (n = 736) in the ADDITION-Cambridge trial. Multivariable linear regression was used to quantify the association between change in diet and cardiovascular disease risk at 1 year, adjusting for change in physical activity and cardio-protective medication. Participants reported significant reductions in energy, fat and sodium intake, and increases in fruit, vegetable and fibre intake over 1 year. The reduction in energy was equivalent to an average-sized chocolate bar; the increase in fruit was equal to one plum per day. There was a small increase in plasma vitamin C levels. Increases in fruit intake and plasma vitamin C were associated with small reductions in anthropometric and metabolic risk factors. Increased vegetable intake was associated with an increase in BMI and waist circumference. Reductions in fat, energy and sodium intake were associated with reduction in HbA1c , waist circumference and total cholesterol/modelled cardiovascular disease risk, respectively. Improvements in dietary behaviour in this screen-detected population were associated with small reductions in cardiovascular disease risk, independently of change in cardio-protective medication and physical activity. Dietary change may have a role to play in the reduction of cardiovascular disease risk following diagnosis of diabetes. © 2013 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.
Pedersen, Susanne S.; von Känel, Roland; Tully, Phillip J
Adaptation to living with cardiovascular disease may differ from patient to patient and is influenced not only by disease severity and limitations incurred by the disease but also by socioeconomic factors (e.g. health literacy), the patients' psychological make-up and susceptibility to distress. Co......-morbid depression and/or anxiety is prevalent in 20% of patients with cardiovascular disease, which may be either transient or chronic. Distress, such as depression, reduces adherence, serves as a barrier to behaviour change and the adoption of a healthy lifestyle, and increases the risk that patients drop out...
Horne, Justine; Madill, Janet; O'Connor, Colleen; Shelley, Jacob; Gilliland, Jason
Studying the impact of genetic testing interventions on lifestyle behaviour change has been a priority area of research in recent years. Substantial heterogeneity exists in the results and conclusions of this literature, which has yet to be explained using validated behaviour change theory and an assessment of the quality of genetic interventions. The theory of planned behaviour (TPB) helps to explain key contributors to behaviour change. It has been hypothesized that personalization could be added to this theory to help predict changes in health behaviours. This systematic review provides a detailed, comprehensive identification, assessment, and summary of primary research articles pertaining to lifestyle behaviour change (nutrition, physical activity, sleep, and smoking) resulting from genetic testing interventions. The present review further aims to provide in-depth analyses of studies conducted to date within the context of the TPB and the quality of genetic interventions provided to participants while aiming to determine whether or not genetic testing facilitates changes in lifestyle habits. This review is timely in light of a recently published "call-to-action" paper, highlighting the need to incorporate the TPB into personalized healthcare behaviour change research. Three bibliographic databases, one key website, and article reference lists were searched for relevant primary research articles. The PRISMA Flow Diagram and PRISMA Checklist were used to guide the search strategy and manuscript preparation. Out of 32,783 titles retrieved, 26 studies met the inclusion criteria. Three quality assessments were conducted and included: (1) risk of bias, (2) quality of genetic interventions, and (3) consideration of theoretical underpinnings - primarily the TPB. Risk of bias in studies was overall rated to be "fair." Consideration of the TPB was "poor," with no study making reference to this validated theory. While some studies (n = 11; 42%) made reference to other
Klemenc-Ketis, Zalika; Bulc, Mateja; Kersnik, Janko
Aim To assess patients’ attitudes toward changing unhealthy lifestyle, confidence in the success, and desired involvement of their family physicians in facilitating this change. Methods We conducted a cross-sectional study in 15 family physicians’ practices on a consecutive sample of 472 patients (44.9% men, mean age [± standard deviation] 49.3 ± 10.9 years) from October 2007 to May 2008. Patients were given a self-administered questionnaire on attitudes toward changing unhealthy diet, increasing physical activity, and reducing body weight. It also included questions on confidence in the success, planning lifestyle changes, and advice from family physicians. Results Nearly 20% of patients planned to change their eating habits, increase physical activity, and reach normal body weight. Approximately 30% of patients (more men than women) said that they wanted to receive advice on this issue from their family physicians. Younger patients and patients with higher education were more confident that they could improve their lifestyle. Patients who planned to change their lifestyle and were more confident in the success wanted to receive advice from their family physicians. Conclusion Family physicians should regularly ask the patients about the intention of changing their lifestyle and offer them help in carrying out this intention. PMID:21495204
Heinonen, Jukka; Jalas, Mikko; Juntunen, Jouni K.; Ala-Mantila, Sanna; Junnila, Seppo
An extensive body of literature demonstrates how higher density leads to more efficient energy use and lower greenhouse gas (GHG) emissions from transport and housing. However, our current understanding seems to be limited on the relationships between the urban form and the GHG emissions, namely how the urban form affects the lifestyles and thus the GHGs on a much wider scale than traditionally assumed. The urban form affects housing types, commuting distances, availability of different goods and services, social contacts and emulation, and the alternatives for pastimes, meaning that lifestyles are actually situated instead of personal projects. As almost all consumption, be it services or products, involves GHG emissions, looking at the emissions from transport and housing may not be sufficient to define whether one form would be more desirable than another. In the paper we analyze the urban form-lifestyle relationships in Finland together with the resulting GHG implications, employing both monetary expenditure and time use data to portray lifestyles in different basic urban forms: metropolitan, urban, semi-urban and rural. The GHG implications are assessed with a life cycle assessment (LCA) method that takes into account the GHG emissions embedded in different goods and services. The paper depicts that, while the direct emissions from transportation and housing energy slightly decrease with higher density, the reductions can be easily overridden by sources of indirect emissions. We also highlight that the indirect emissions actually seem to have strong structural determinants, often undermined in studies concerning sustainable urban forms. Further, we introduce a concept of ‘parallel consumption’ to explain how the lifestyles especially in more urbanized areas lead to multiplication of consumption outside of the limits of time budget and the living environment. This is also part I of a two-stage study. In part II we will depict how various other contextual
Heinonen, Jukka; Ala-Mantila, Sanna; Junnila, Seppo; Jalas, Mikko; Juntunen, Jouni K
An extensive body of literature demonstrates how higher density leads to more efficient energy use and lower greenhouse gas (GHG) emissions from transport and housing. However, our current understanding seems to be limited on the relationships between the urban form and the GHG emissions, namely how the urban form affects the lifestyles and thus the GHGs on a much wider scale than traditionally assumed. The urban form affects housing types, commuting distances, availability of different goods and services, social contacts and emulation, and the alternatives for pastimes, meaning that lifestyles are actually situated instead of personal projects. As almost all consumption, be it services or products, involves GHG emissions, looking at the emissions from transport and housing may not be sufficient to define whether one form would be more desirable than another. In the paper we analyze the urban form–lifestyle relationships in Finland together with the resulting GHG implications, employing both monetary expenditure and time use data to portray lifestyles in different basic urban forms: metropolitan, urban, semi-urban and rural. The GHG implications are assessed with a life cycle assessment (LCA) method that takes into account the GHG emissions embedded in different goods and services. The paper depicts that, while the direct emissions from transportation and housing energy slightly decrease with higher density, the reductions can be easily overridden by sources of indirect emissions. We also highlight that the indirect emissions actually seem to have strong structural determinants, often undermined in studies concerning sustainable urban forms. Further, we introduce a concept of ‘parallel consumption’ to explain how the lifestyles especially in more urbanized areas lead to multiplication of consumption outside of the limits of time budget and the living environment. This is also part I of a two-stage study. In part II we will depict how various other contextual
McNamara, K. P.; O'Reilly, S. L.; George, J.; Peterson, G. M.; Jackson, S. L.; Duncan, G.; Howarth, H.; Dunbar, J. A.
Background: Delivery of cardiovascular disease (CVD) prevention programs by community pharmacists appears effective and enhances health service access. However, their capacity to implement complex behavioural change processes during patient counselling remains largely unexplored. This study aims to determine intervention fidelity by pharmacists…
Vargas, Eric J; Zelis, Robert
Survey of medical curricula continues to show that nutrition education is not universally adequate. One measure of nutritional educational competence is a positive change in student eating habits. The objective of this study was to evaluate whether integrating nutrition education within the second-year cardiovascular course for medical students, using the "Rate Your Plate" (RYP) questionnaire, coupled with knowledge of student personal 30-year risk of a cardiovascular event was useful in changing students' eating behaviors. Thirty-two students completed an unpublished 24-item questionnaire (modified-RYP) about their eating habits in the spring of their first year. The same students then completed the questionnaire in the spring of their second year. Paired t test was used to analyze the difference in RYP scores. Pearson correlation coefficients were calculated for the Framingham 30-year cardiovascular event risk and change in RYP score to examine whether risk knowledge may have changed eating habits. Mean scores at baseline and 1 year later were 57.19 and 58.97, respectively (paired t test, P eating healthy at baseline, integration of nutrition education within the second-year cardiovascular medical curriculum was associated with improved heart healthy eating habits. Because student attitudes about prevention counseling are influenced by personal eating habits, this suggests that students with a more healthy diet will be more likely to recommend the same for their patients. Copyright © 2014 National Lipid Association. Published by Elsevier Inc. All rights reserved.
König, Daniel; Zdzieblik, Denise; Deibert, Peter; Berg, Aloys; Gollhofer, Albert; Büchert, Martin
The aim of the present study was to investigate the effect of a meal-replacement regimen vs. comprehensive lifestyle changes in overweight or obese subjects on intra-abdominal fat stores (Magnetic Resonance Imaging (MRI) measurements) and cardiometabolic risk factors. Forty-two obese men (n = 18) and women (n = 24) (age 49 ± 8 years; weight 96.3 ± 12.1 kg; BMI 32.7 ± 2.3 kg/m2) were selected for this randomized parallel-group design investigation. Subjects in the lifestyle group (LS-G; n = 22) received dietary counselling sessions and instructions how to increase physical activity. In the meal replacement group (MR-G; n = 20) meals were replaced by a low-calorie drink high in soy protein. After six months, subjects in the LS-G lost 8.88 ± 6.24 kg and subjects in the MR-G lost 7.1 ± 2.33 kg; p meal replacement group suggesting an additional effect of soy protein components.
Nutritional status, lifestyle and knowledge of predisposing factors on ... influenced their lifestyle, dietary habit and subsequently their nutritional/health status. Keywords: Hyperlipidemia, nutritional status, diet, diabetes, cardiovascular diseases ...
T.A. Kouwenhoven-Pasmooij (Tessa); B. Djikanovic (Bosiljka); S.J.W. Robroek (Suzan); Helmhout, P. (Pieter); A. Burdorf (Alex); M.G.M. Hunink (Myriam)
textabstractBackground: The prevalence of unhealthy lifestyles and preventable chronic diseases is high. They lead to disabilities and sickness absence, which might be reduced if health promotion measures were applied. Therefore, we developed the PerfectFit health promotion intervention with a
Conclusions: Overall, CVD risk seems to be low among Eastern Aegean Islanders; certain differences in CVD risk factors exist between Greek islanders and their counterparts living in Gökçeada, and those differences may be attributed to various environmental, cultural and lifestyle factors.
... Select a Language: Fact Sheet 652 HIV and Cardiovascular Disease HIV AND CARDIOVASCULAR DISEASE WHY SHOULD PEOPLE WITH HIV CARE ABOUT CVD? ... OF CVD? WHAT ABOUT CHANGING MEDICATIONS? HIV AND CARDIOVASCULAR DISEASE Cardiovascular disease (CVD) includes a group of problems ...
Whelan, Maxine E; Kingsnorth, Andrew P; Orme, Mark W; Sherar, Lauren B; Esliger, Dale W
Increasing physical activity (PA) reduces the risk of developing diabetes, highlighting the role of preventive medicine approaches. Changing lifestyle behaviours is difficult and is often predicated on the assumption that individuals are willing to change their lifestyles today to reduce the risk of developing disease years or even decades later. The self-monitoring technologies tested in this study will present PA feedback in real time, parallel with acute physiological data. Presenting the immediate health benefits of being more physically active may help enact change by observing the immediate consequences of that behaviour. The present study aims to assess user engagement with the self-monitoring technologies in individuals at moderate-to-high risk of developing type 2 diabetes. 45 individuals with a moderate-to-high risk, aged ≥40 years old and using a compatible smartphone, will be invited to take part in a 7-week protocol. Following 1 week of baseline measurements, participants will be randomised into one of three groups: group 1- glucose feedback followed by biobehavioural feedback (glucose plus PA); group 2-PA feedback followed by biobehavioural feedback; group 3-biobehavioural feedback. A PA monitor and a flash glucose monitor will be deployed during the intervention. Participants will wear both devices throughout the intervention but blinded to feedback depending on group allocation. The primary outcome is the level of participant engagement and will be assessed by device use and smartphone usage. Feasibility will be assessed by the practicality of the technology and screening for diabetes risk. Semistructured interviews will be conducted to explore participant experiences using the technologies. ISRCTN17545949. Registered on 15/05/2017. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Kent, Lillian M; Worsley, Anthony
To examine the effect of Seventh-day Adventist (SDA) membership on 'immunity' to the secular effects of changes in BMI. Three independent, cross-sectional, screening surveys conducted by Sydney Adventist Hospital in 1976, 1986 and 1988 and a survey conducted among residents of Melbourne in 2006. Two hundred and fifty-two SDA and 464 non-SDA in 1976; 166 SDA and 291 non-SDA in 1986; 120 SDA and 300-non SDA in 1988; and 251 SDA and 294 non-SDA in 2006. Height and weight measured by hospital staff in 1976, 1986 and 1988; self-reported by respondents in 2006. The mean BMI of non-SDA men increased between 1986 and 2006 (P < 0.001) but did not change for SDA men or non-SDA women. Despite small increases in SDA women's mean BMI (P = 0.030) between 1988 and 2006, this was no different to that of SDA men and non-SDA women in 2006. The diet and eating patterns of SDA men and women were more 'prudent' than those of non-SDA men and women, including more fruit, vegetables, grains, nuts and legumes, and less alcohol, meat, sweetened drinks and coffee. Many of these factors were found to be predictors of lower BMI. The 'prudent' dietary and lifestyle prescriptions of SDA men appear to have 'immunised' them to the secular effects of changes that occurred among non-SDA men's BMI. The dietary and lifestyle trends of SDA women did not reflect the increase in their BMI observed in 2006.
Dirk W. Droste
Full Text Available Background: Regular consumption of small amounts of red wine improves blood lipids. However, there is concern whether this beneficial effect might be counterbalanced by an increase in blood pressure (BP and heart rate (HR, which are risk factors for cerebro-cardiovascular disease. In particular, we studied whether regular consumption of red wine with and without lifestyle changes (LC; healthy diet and physical activity advice results in an increase in BP and HR. Methods: A prospective, unblinded randomized trial was performed in 108 patients (67% men with carotid atherosclerosis documented by ultrasound, a mean BP of 122/79 mm Hg and a mean HR of 71 bpm at inclusion in the study. Sixty-eight percent were known and treated hypertensives. The mean 24-hour BP at baseline was 122/79 mm Hg. Half of the study participants, the control group, was seen by a nurse at baseline, after 4 and after 20 weeks, and was instructed not to change their eating and physical activity habits. In the other half, a dietician performed five sessions of 30 min each (at baseline, after 1 week and after 2, 3 and 4 weeks giving advice on healthy eating based on a Mediterranean diet and physical exercise. The recommendations given were the following: 5 portions of fruit/vegetables per day, a diet low in absolute fat, a preference of vegetable oil (olive or rapeseed oil, whole-grain products, poultry, low-fat dairy products, 1 fat and 1 lean fish meal per week, reduced consumption of red meat, and avoidance of pork, ready-made meals, sugar and excessive salt intake. In addition, regular consumption of 1 bar of dark chocolate (25 g, >70% of cacao, 1-2 tomatoes, and 3-5 walnuts as well as at least 30 min of moderate daily physical activity were recommended. Within these two groups, half of the patients were randomized either to avoid alcohol completely or to drink 100 ml (women or 200 ml of red wine (men daily. Results: Neither LC nor red wine had an effect on the mean systolic
Full Text Available Background and purpose: Health related quality of life (HQOL has different dimensions and many factors affect it. The aim of this study was to investigate the association between lifestyle satisfaction and health- related quality of life in the population aged 40 year old and over. The question is, if there is not lifestyle satisfaction, how should be the pattern of tendency to behavioral changes? Materials and methods: This is a cross-sectional study. The statistical population is the inhabitants aged40 and over in Mazandaran province. One thousand and two hundred twenty five subjects by stratification and clustering random sampling were selected. The data were collected by face-to-face interview using the Persian version of the Short Form Health survey (SF-36. SF-36 is a standard questionnaire and Persian translation is valid and reliable. Lifestyle variable assessment includes smoking, physical activity, nutritional status, exercise and stress. Lifestyle satisfaction, tendency to behavioral change and demographic variables were assessed by separate questionnaire. The statistical analysis was performed by T-test and ANOVA by SPSS. Results: All health related quality of life components had meaningful relationship with lifestyle satisfaction. The mean of all the components of SF-36 measurements for those who had high lifestyle satisfaction were higher than the others (p<0.001.The highest amount of tendency to behavioral change was seen in nutritional status, exercise, stress control and smoking habits. Conclusion: According to the results, for promoting physical and mental health, lifestyle satisfaction must be increased. Nutrition, exercise, and giving up smoking are of great importance in physical health promotion.
Full Text Available Abstract Background Socioeconomic status (SES and lifestyle-related factors are determinants of subjective health. However, changes in SES are inevitable in times of natural disaster, while lifestyle-related factors remain modifiable. The aim of this study was to use a cross-sectional approach to examine lifestyle-related factors that may attenuate the negative impact of disaster-induced changes in SES on poor subjective health. Methods We analyzed 33,350 men and women aged 20–64 years who were living in evacuation zones due to the radiation accident in Fukushima, Japan. Disaster-induced changes in SES were defined by living arrangements and working conditions. Using Poisson regression analysis adjusted for confounders (model 1 and lifestyle-related factors as intermediate variables (model 2, we compared the prevalence ratios (PRs of poor subjective health of participants who did not undergo disaster-induced changes in SES (did not become unemployed, income did not decrease, and living in relative’s home/own home with that of participants who did undergo disaster-induced changes in SES (became unemployed, decreased income, or lived in an evacuation shelter, temporary housing, or rental housing/apartment. We calculated the percentage of excess risks explained by lifestyle-related factors as follows: ((PRmodel 1 − PRmodel 2/(PRmodel 1–1 × 100. Results Disaster-induced changes in SES were significantly associated with poor subjective health. The PRs (95% CIs among participants who underwent disaster-induced changes in SES were 2.02 (1.81–2.24 for men and 1.80 (1.65–1.97 for women. After adjusting for lifestyle-related factors, we found that the PRs in men and women were remarkably attenuated, decreasing to 1.56 (1.40–1.73 and 1.43 (1.31–1.55, respectively. Controlling for lifestyle-related factors resulted in PR attenuation by 45.1% (men and 46.3% (women. Satisfaction of sleep and participation in recreation and community
Clifton, Peter M
Gluteofemoral fat mass has been associated with improved cardiovascular disease risk factors. It is not clear if loss of this protective fat during weight loss partially negates the effect of loss of visceral fat. The aim of this study was to examine regional fat loss in a large weight-loss cohort from one center and to determine if fat loss in the leg and total lean tissue loss is harmful. We combined the data from 7 of our previously published 3-month weight-loss studies and examined the relationship between regional fat and lean tissue loss and changes in cardiovascular disease risk factors in 399 participants. At baseline, leg fat was positively associated with high-density lipoprotein cholesterol in women and inversely with fasting triglyceride level in both sexes. Abdominal lean tissue was also related to systolic blood pressure in men. Changes in regional fat and lean tissue were positively associated with changes in glucose, insulin, total cholesterol, triglycerides, low-density lipoprotein cholesterol and systolic and diastolic blood pressure ( r =0.11-0.22, P lean tissue dominating in multivariate regression. After adjustment for total weight or total fat change, these relationships disappeared except for a positive relationship between arm and lean leg mass loss and changes in triglycerides and systolic blood pressure. Loss of leg fat and leg lean tissue was directly associated with beneficial changes in cardiovascular disease risk markers. Loss of lean tissue may not have an adverse effect on cardiovascular disease risk, and measures to retain lean tissue during weight loss may not be necessary. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
O'Gorman, Clodagh S M
Children who appear healthy, even if they have one or more recognized cardiovascular risk factors, do not generally have outcomes of cardiovascular or other vascular disease during childhood. Historically, pediatric medicine has not aggressively screened for or treated cardiovascular risk factors in otherwise healthy children. However, studies such as the P-Day Study (Pathobiological Determinants of Atherosclerosis in Youth), and the Bogalusa Heart Study, indicate that healthy children at remarkably young ages can have evidence of significant atherosclerosis. With the increasing prevalence of pediatric obesity, can we expect more health problems related to the consequences of pediatric dyslipidemia, hypertriglyceridemia, and atherosclerosis in the future? For many years, medications have been available and used in adult populations to treat dyslipidemia. In recent years, reports of short-term safety of some of these medications in children have been published. However, none of these studies have detailed long-term follow-up, and therefore none have described potential late side-effects of early cholesterol-lowering therapy, or potential benefits in terms of reduction of or delay in cardiovascular or other vascular end-points. In 2007, the American Heart Association published a scientific statement on the use of cholesterol-lowering therapy in pediatric patients. In this review paper, we discuss some of the current literature on cholesterol-lowering therapy in children, including the statins that are currently available for use in children, and some of the cautions with using these and other cholesterol-lowering medications. A central tenet of this review is that medications are not a substitute for dietary and lifestyle interventions, and that even in children on cholesterol-lowering medications, physicians should take every opportunity to encourage children and their parents to make healthy diet and lifestyle choices.
A PROgramme of Lifestyle Intervention in Families for Cardiovascular risk reduction (PROLIFIC Study: design and rationale of a family based randomized controlled trial in individuals with family history of premature coronary heart disease
Full Text Available Abstract Background Recognizing patterns of coronary heart disease (CHD risk in families helps to identify and target individuals who may have the most to gain from preventive interventions. The overall goal of the study is to test the effectiveness and sustainability of an integrated care model for managing cardiovascular risk in high risk families. The proposed care model targets the structural and environmental conditions that predispose high risk families to development of CHD through the following interventions: 1 screening for cardiovascular risk factors, 2 providing lifestyle interventions 3 providing a framework for linkage to appropriate primary health care facility, and 4 active follow-up of intervention adherence. Methods Initially, a formative qualitative research component will gather information on understanding of diseases, barriers to care, specific components of the intervention package and feedback on the intervention. Then a cluster randomized controlled trial involving 740 families comprising 1480 participants will be conducted to determine whether the package of interventions (integrated care model is effective in reducing or preventing the progression of CHD risk factors and risk factor clustering in families. The sustainability and scalability of this intervention will be assessed through economic (cost-effectiveness analyses and qualitative evaluation (process outcomes to estimate value and acceptability. Scalability is informed by cost-effectiveness and acceptability of the integrated cardiovascular risk reduction approach. Discussion Knowledge generated from this trial has the potential to significantly affect new programmatic policy and clinical guidelines that will lead to improvements in cardiovascular health in India. Trial registration number NCT02771873, registered in May 2016 ( https://clinicaltrials.gov/ct2/show/results/NCT02771873
Li, Jiang; Linnan, Laura; Finkelstein, Eric A; Tate, Deborah F; Naseer, Carolyn; Evenson, Kelly R
We investigated perceptions among overweight and obese state employees about changes to health insurance that were designed to reduce the scope of health benefits for employees who are obese or who smoke. Before implementation of health benefit plan changes, 658 state employees who were overweight (ie, those with a body mass index [BMI] of 25-29.9) or obese (ie, those with a BMI of > or = 30) enrolled in a weight-loss intervention study were asked about their attitudes and beliefs concerning the new benefit plan changes. Thirty-one percent of employees with a measured BMI of 40 or greater self-reported a BMI of less than 40, suggesting they were unaware that their current BMI would place them in a higher-risk benefit plan. More than half of all respondents reported that the new benefit changes would motivate them to make behavioral changes, but fewer than half felt confident in their ability to make changes. Respondents with a BMI of 40 or greater were more likely than respondents in lower BMI categories to oppose the new changes focused on obesity (P benefit changes focused on tobacco use (P employees enrolled in a weight-loss study, limiting generalizability to the larger population of state employees. Benefit plan changes that require employees who are obese and smoke to pay more for health care may motivate some, but not all, individuals to change their behaviors. Since confidence to lose weight was lowest among individuals in the highest BMI categories, more-intense intervention options may be needed to achieve desired health behavior changes.
Li, Jiang; Linnan, Laura; Finkelstein, Eric A.; Tate, Deborah; Naseer, Carolyn; Evenson, Kelly R.
Background We investigated overweight state employees’ perceptions about health insurance benefit changes designed to reduce the scope of health benefits for employees who were obese or smoked. Methods Prior to implementation of health benefit plan changes, 658 overweight [body mass index (BMI) ≥25 kg/m2] state employees enrolled in a weight loss intervention study were asked about their attitudes and beliefs of the new benefit plan changes. Results Thirty-one percent of employees with a BMI≥40 kg/ m2 were unaware that their current BMI would place them in a higher risk benefit plan. More than half reported that the new benefit change would motivate them to make behavioral changes, but less than half felt confident in making changes. Respondents with a BMI≥40 kg/m2 were more likely to oppose the new changes focused on BMI categories compared to respondents in lower BMI categories (Pnon-smokers (Pconfidence to lose weight was lowest among those in the highest weight categories, health plan benefit modifications may be required to achieve desired health behavior changes. PMID:21901911
de Toledo Ferraz Alves, Tânia Corrêa; Scazufca, Márcia; Squarzoni, Paula; de Souza Duran, Fábio Luiz; Tamashiro-Duran, Jaqueline Hatsuko; Vallada, Homero P; Andrei, Anna; Wajngarten, Mauricio; Menezes, Paulo R; Busatto, Geraldo F
Vascular risk factors may play an important role in the pathophysiology of Alzheimer's disease (AD). While there is consistent evidence of gray matter (GM) abnormalities in earlier stages of AD, the presence of more subtle GM changes associated with vascular risk factors in the absence of clinically significant vascular events has been scarcely investigated. This study aimed to examine GM changes in elderly subjects with cardiovascular risk factors. We predicted that the presence of cardiovascular risk would be associated with GM abnormalities involving the temporal-parietal cortices and limbic structures. We recruited 248 dementia-free subjects, age range 66-75 years, from the population-based "São Paulo Ageing and Health Study", classified in accordance to their Framingham Coronary Heart Disease Risk (FCHDR) score to undergo an MRI scan. We performed an overall analysis of covariance, controlled to total GM and APOE4 status, to investigate the presence of regional GM abnormalities in association with FCHDR subgroups (high-risk, medium-risk, and low-risk), and followed by post hoc t-test. We also applied a co-relational design in order to investigate the presence of linear progression of the GM vulnerability in association with cardiovascular risk factor. Voxel-based morphometry showed that the presence of cardiovascular risk factors were associated with regional GM loss involving the temporal cortices bilaterally. Those results retained statistical significance after including APOE4 as a covariate of interest. We also observed that there was a negative correlation between FCHDR scores and rGM distribution in the parietal cortex. Subclinical cerebrovascular abnormalities involving GM loss may provide an important link between cardiovascular risk factors and AD.
Gant, Christina M.; Binnenmars, S. Heleen; van den Berg, Else; Bakker, Stephan J. L.; Navis, Gerjan; Laverman, Gozewijn D.
Cardiovascular risk management is an integral part of treatment in Type 2 Diabetes Mellitus (T2DM), and requires pharmacological as well as nutritional management. We hypothesize that a systematic assessment of both pharmacological and nutritional management can identify targets for the improvement
Albert, Janice L.; Samuda, Pauline M.; Molina, Veronika; Regis, Theresa Marietta; Severin, Merlyn; Finlay, Betty; Prevost, Jacqueline Lancaster
Obesity, cardiovascular diseases, and diabetes are becoming leading causes of morbidity and mortality in the Eastern Caribbean countries of St. Vincent and the Grenadines, Saint Lucia, Grenada, and Dominica. To promote healthful diets and lifestyles and encourage behavioral changes, Food-Based Dietary Guidelines (FBDG) were developed for the…
Hu, Mandy Xian; Lamers, Femke; de Geus, Eco J C; Penninx, Brenda W J H
Physical activity, alcohol use and smoking might affect cardiovascular disease through modifying autonomic nervous system (ANS) activity. We investigated: 1) whether there are consistent relationships between lifestyle factors and cardiac ANS activity over time, and 2) whether 2-year changes in
Jørgensen, Peter Godsk; Jensen, Jan S; Marott, Jacob L
endpoint was fatal cardiovascular disease (CVD) event and the secondary was fatal or nonfatal CVD event. In our study, 2,236 fatal CVD and 3,849 fatal or nonfatal CVD events occurred during a median of 11.9 and 9.8 years of follow-up. RESULTS: ECG changes were frequently present (30.6%) and associated......: In all, 6,991 participants from the Copenhagen Heart Study attending an examination at age ≥65 years were included. ECG changes were defined as Q waves, ST-segment depression, T-wave changes, ventricular conduction defects, and left ventricular hypertrophy based on the Minnesota code. The primary...
Feldman, Adina L; Long, Gráinne H; Johansson, Ingegerd; Weinehall, Lars; Fhärm, Eva; Wennberg, Patrik; Norberg, Margareta; Griffin, Simon J; Rolandsson, Olov
Promoting positive changes in lifestyle behavior in the whole population may be a feasible and effective approach to reducing type 2 diabetes burden, but the impact of population shifts of modifiable risk factors remains unclear. Currently most of the evidence on modifiable lifestyle behavior and type 2 diabetes risk on a population level comes from studies of between-individual differences. The objective of the study was to investigate the association and potential impact on disease burden for within-individual change in lifestyle behavior and diabetes risk. Population-based prospective cohort study of 35,680 participants aged 30-50 at baseline in 1990-2003 in Västerbotten County, Sweden (follow-up until 2013). Five self-reported modifiable lifestyle behaviors (tobacco use, physical activity, alcohol intake, dietary fiber intake and dietary fat intake) were measured at baseline and 10 year follow-up. Lifestyle behaviors were studied separately, and combined in a score. Incident diabetes was detected by oral glucose tolerance tests. Multivariate logistic regression models and population attributable fractions (PAF) were used to analyze the association between change in lifestyle behavior between baseline and 10 year follow-up, and risk of incident diabetes. Incident diabetes was detected in 1,184 (3.3%) participants at 10 year follow-up. There was a reduced diabetes risk associated with increase in dietary fiber intake, odds ratio (OR) 0.79 (95% confidence interval (CI) 0.66, 0.96) for increase of at least one unit standard deviation (3.0 g/1,000 kcal) of the baseline distribution, PAF 16.0% (95% CI 4.2, 26.4%). Increase in the lifestyle behavior score was associated with reduced diabetes risk, OR 0.92 (95% CI 0.85, 0.99) per unit increase of the score. These results support a causal link between lifestyle behavior and type 2 diabetes incidence. A small shift in lifestyle behaviors, in particular intake of dietary fiber, has the potential to reduce diabetes
Kulyk, Olga Anatoliyivna; op den Akker, Hendrikus J.A.; Klaassen, Randy; van Gemert-Pijnen, Julia E.W.C.; Hettinga, M; Smedberg, A
There is a fast growing number of eHealth systems aiming at supporting a healthy lifestyle. Tailored lifestyle coaching services offer individual users access to web portals where they can communicate about a growing number of ingredients of everyday life concern: physical activity, nutrition,
Healthy lifestyle interventions to combat noncommunicable disease-a novel nonhierarchical connectivity model for key stakeholders: a policy statement from the American Heart Association, European Society of Cardiology, European Association for Cardiovascular Prevention and Rehabilitation, and American College of Preventive Medicine.
Arena, Ross; Guazzi, Marco; Lianov, Liana; Whitsel, Laurie; Berra, Kathy; Lavie, Carl J; Kaminsky, Leonard; Williams, Mark; Hivert, Marie-France; Cherie Franklin, Nina; Myers, Jonathan; Dengel, Donald; Lloyd-Jones, Donald M; Pinto, Fausto J; Cosentino, Francesco; Halle, Martin; Gielen, Stephan; Dendale, Paul; Niebauer, Josef; Pelliccia, Antonio; Giannuzzi, Pantaleo; Corra, Ugo; Piepoli, Massimo F; Guthrie, George; Shurney, Dexter; Arena, Ross; Berra, Kathy; Dengel, Donald; Franklin, Nina Cherie; Hivert, Marie-France; Kaminsky, Leonard; Lavie, Carl J; Lloyd-Jones, Donald M; Myers, Jonathan; Whitsel, Laurie; Williams, Mark; Corra, Ugo; Cosentino, Francesco; Dendale, Paul; Giannuzzi, Pantaleo; Gielen, Stephan; Guazzi, Marco; Halle, Martin; Niebauer, Josef; Pelliccia, Antonio; Piepoli, Massimo F; Pinto, Fausto J; Guthrie, George; Lianov, Liana; Shurney, Dexter
Noncommunicable diseases (NCDs) have become the primary health concern for most countries around the world. Currently, more than 36 million people worldwide die from NCDs each year, accounting for 63% of annual global deaths; most are preventable. The global financial burden of NCDs is staggering, with an estimated 2010 global cost of $6.3 trillion (US dollars) that is projected to increase to $13 trillion by 2030. A number of NCDs share one or more common predisposing risk factors, all related to lifestyle to some degree: (1) cigarette smoking, (2) hypertension, (3) hyperglycemia, (4) dyslipidemia, (5) obesity, (6) physical inactivity, and (7) poor nutrition. In large part, prevention, control, or even reversal of the aforementioned modifiable risk factors are realized through leading a healthy lifestyle (HL). The challenge is how to initiate the global change, not toward increasing documentation of the scope of the problem but toward true action-creating, implementing, and sustaining HL initiatives that will result in positive, measurable changes in the previously defined poor health metrics. To achieve this task, a paradigm shift in how we approach NCD prevention and treatment is required. The goal of this American Heart Association/European Society of Cardiology/European Association for Cardiovascular Prevention and Rehabilitation/American College of Preventive Medicine policy statement is to define key stakeholders and highlight their connectivity with respect to HL initiatives. This policy encourages integrated action by all stakeholders to create the needed paradigm shift and achieve broad adoption of HL behaviors on a global scale. © 2015 Mayo Foundation for Medical Education and Research, and the European Society of Cardiology. This article is being published concurrently in Mayo Clinic Proceedings . The articles are identical except for minor stylistic and spelling differences in keeping with each journal's style. Either citation can be used when
Fang, Shona C; Rosen, Raymond C; Vita, Joseph A; Ganz, Peter; Kupelian, Varant
Erectile dysfunction (ED) is associated with cardiovascular disease (CVD); however, the association between change in ED status over time and future underlying CVD risk is unclear. The aim of this study was to investigate the association between change in ED status and Framingham CVD risk, as well change in Framingham risk. We studied 965 men free of CVD in the Boston Area Community Health (BACH) Survey, a longitudinal cohort study with three assessments. ED was assessed with the five-item International Index of Erectile Function at BACH I (2002-2005) and BACH II (2007-2010) and classified as no ED/transient ED/persistent ED. CVD risk was assessed with 10-year Framingham CVD risk algorithm at BACH I and BACH III (2010-2012). Linear regression models controlled for baseline age, socio-demographic and lifestyle factors, as well as baseline Framingham risk. Models were also stratified by age (≥/< 50 years). Framingham CVD risk and change in Framingham CVD risk were the main outcome measures. Transient and persistent ED was significantly associated with increased Framingham risk and change in risk over time in univariate and age-adjusted models. In younger men, persistent ED was associated with a Framingham risk that was 1.58 percentage points higher (95% confidence interval [CI]: 0.11, 3.06) and in older men, a Framingham risk that was 2.54 percentage points higher (95% CI: -1.5, 6.59), compared with those without ED. Change in Framingham risk over time was also associated with transient and persistent ED in men <50 years, but not in older men. Data suggest that even after taking into account other CVD risk factors, transient and persistent ED is associated with Framingham CVD risk and a greater increase in Framingham risk over time, particularly in younger men. Findings further support clinical assessment of CVD risk in men presenting with ED, especially those under 50 years. © 2014 International Society for Sexual Medicine.
Toft, Ulla; Kristoffersen, Lis; Ladelund, Steen
Few studies have investigated the specific effect of single intervention components in randomized controlled trials. The purpose was to investigate the effect of adding group-based diet and exercise counselling to individual life-style counselling on long-term changes in dietary habits....
Noordman, J.; Weijden, T.T. van der; Dulmen, A.M. van
OBJECTIVES: To systematically review the literature on the relative effectiveness of face-to-face communication-related behavior change techniques (BCTs) provided in primary care by either physicians or nurses to intervene on patients' lifestyle behavior. METHODS: PubMed, EMBASE, PsychINFO, CINAHL
Noordman, J.; Weijden, T. van der; Dulmen, S. van
Objectives: To systematically review the literature on the relative effectiveness of face-to-face communication-related behavior change techniques (BCTs) provided in primary care by either physicians or nurses to intervene on patients’ lifestyle behavior. Methods: PubMed, EMBASE, PsychINFO, CINAHL
Thomson, J. L.; Zoellner, J. M.; Tussing-Humphreys, L. M.; Goodman, M. H.
Many community-based lifestyle interventions targeting African Americans have reported positive effects on participants' dietary choices and physical activity habits. However, these effects vary and not all participants will have outcome changes. Moderation analysis can help explain differential effects observed, but are not often reported. Hence,…
Scattergood, Donna M
The Essential Vitality Program blends holistic nursing, functional medicine, and health coaching to promote lifestyle changes that modify risk factors of costly chronic disease. Karl is a client who experienced enhanced vitality, decreased chronic pain and medications use, and improved meaningful functioning, by partnering with a holistic nurse coach.
M Hernández Ruiz de Eguilaz, M; Batlle, M A; Martínez de Morentin, B; San-Cristóbal, R; Pérez-Díez, S; Navas-Carretero, S; Martínez, J A
A high caloric intake in today's nutrition and a sedentary lifestyle are the main causes of the notable increase in obesity in our society. In turn, this results in an increase in associated pathologies, such as metabolic syndrome and diabetes type 2. In the present work we review most recent studies and programs, which are significant due to their sample size and geographical diversity. It clearly shows that changes in alimentation and lifestyles are an effective instrument for combatting or delaying the onset of these diseases. In this sense, prevention is also key to avoiding serious consequences related to diabetes and metabolic syndrome, which can affect the life of the population.
Carlos Henrique Ferreira da Silva
Full Text Available This study aimed to evaluate the subjective perception of individuals participating in a long-lasting LSC program with obvious benefits in physical fitness, obesity and related feeding undetected. One hundred and four individuals (54.04 ± 7.7 years, of whom 74% were females with exercise / nutritional counseling for two years, there was random sub-sample comprising 24 individuals (16 females and 8 males was formed, and open non-structured interviews were conducted by using a guiding question. Within the categories found, 96% of respondents mentioned changes related to the physical domain after participating in the project; 67% reported psychological changes, and 83% mentioned changes in the social domain. Males and females showed a similar behavior to the feeling of better health, more energy and weight reduction or maintenance in the physical domain, the feeling of joy and satisfaction for the psychological realm and increased number of friends concerns the social domain. It is concluded that improvements by participating from participating in the LSC program was predominantly related to physical, psychological and social aspects, leading to the assumption that these are important factors that motivate individuals to continue participating in the preventive and therapeutic approach.
Siddique, Juned; de Chavez, Peter John; Craft, Lynette L; Freedson, Patty; Spring, Bonnie
To investigate whether changes in physical activity (PA) have an impact on sedentary behavior (SB) during a lifestyle intervention. Study design was a randomized trial. Participants (n = 204) were individuals with low PA and high sedentary leisure screen time from the Chicago area. Participants were randomized to either increase PA (iPA) or decrease sedentary leisure (dSED). The intervention consisted of decision support, coaching, and financial incentives. For iPA participants, the goal was at least 60 min/d of self-reported moderate-tovigorous-intensity PA (MVPA). For dSED participants the goal was less than 90 min/d of sedentary leisure screen time. Daily accelerometer-based measures of SB and bout-corrected MVPA were obtained. Linear mixed-effects models were fit to estimate the effect of the intervention on MVPA and total SB and to estimate the effect of daily changes in MVPA on daily SB. The iPA participants increased their bout-corrected MVPA by 14 min/d (p much of this time by reducing their SB.
Full Text Available ABSTRACT Objective To assess internal consistency and content validity of a questionnaire aimed to assess the stages of Behavioural Lifestyle Changes in a sample of school-aged children and adolescents aged 9 to 17 years-old. Methods This validation study involved 675 schoolchildren from three official school in the city of Bogota, Colombia. A self-administered questionnaire called Behavioural Lifestyle Changes has been designed to explore stages of change regarding to physical activity/exercise, fruit and vegetable consumption, alcohol abuse, tobacco use, and drug abuse. Cronbach-α, Kappa index and exploratory factor analysis were used for evaluating the internal consistency and validity of content, respectively. Results The study population consisted of 51.1% males and the participants’ average age was 12.7±2.4 years-old. Behavioural Lifestyle Changes scored 0.720 (range 0.691 to 0.730 on the Cronbach α and intra-observer reproducibility was good (Kappa=0.71. Exploratory factor analysis determined two factors (factor 1: physical activity/exercise, fruit and vegetable consumption, and factor 2: alcohol abuse tobacco use and drug abuse, explaining 67.78% of variance by the items and six interactions χ2/gL=11649.833; p<0.001. Conclusion Behavioural Lifestyle Changes Questionnaire was seen to have suitable internal consistency and validity. This instrument can be recommended, mainly within the context of primary attention for studying the stages involved in the lifestyle behavioural changes model on a school-based population.
Lau, C.; Vistisen, D.; Toft, U.
AimThis study aimed to assess whether group-based lifestyle counselling offered to a high-risk population subgroup had any effect beyond individual multifactorial interventions on fasting plasma glucose (FPG) and 2-h plasma glucose (2hPG) changes. MethodsIn a population-based study of 6784......% to low-intensity intervention (group B). All participants went through health examinations, risk assessments and individual lifestyle counselling. Participants in group A were further offered group-based lifestyle counselling. The intervention was repeated after 1 and 3 years. A total of 2738...... participants, 4053 were determined to be at high risk based on a risk estimate of ischaemic heart disease or the presence of risk factors (smoking, hypertension, hypercholesterolaemia, obesity, impaired glucose tolerance). Of these subjects, 90% were randomized to high-intensity intervention (group A) and 10...
Cason-Wilkerson, Rochelle; Goldberg, Shauna; Albright, Karen; Allison, Mandy; Haemer, Matthew
Childhood obesity disproportionately affects low-income minority populations, yet there is a paucity of literature about effective interventions in this population. This study sought to understand the experience of low-income majority Hispanic families engaged in obesity treatment. We conducted six focus groups (2=English, 4=Spanish) with families who completed a community-based, family-oriented obesity treatment program, using standard qualitative focus group interview methods. Transcripts were recorded, transcribed, and analyzed for thematic content. Two coders using the software program ATLAS.ti (v.7.0; Scientific Software Development GmbH, Berlin, Germany) coded each transcript independently; reflexive team analysis with three study team members was used to reach a consensus. Participants (n=37) indicated high program satisfaction. Parents reported buying less junk/fast food, increased consumption of fruits and vegetables, preparing and eating more meals as a family, and increasing their families' physical activity (PA). Four barrier and facilitator themes emerged. Barrier themes were time and financial cost, parent's lack of time and energy, influence of family members, and challenges regarding physical environment. Facilitator themes were skill building around healthy eating and parenting, family involvement, and long-term health concerns. Unanticipated findings, parents reported, were that changes resulted in children sleeping better, feeling happier, and less irritability. Despite low-income families experiencing barriers to lifestyle changes to manage obesity, they made positive dietary changes and increased PA by learning specific skills and including the whole family in those changes. Additionally, some unexpected benefits were noted, including improved sleep, less irritability, and children appearing happier. Future studies should consider using these parent-identified outcomes as secondary measures of program effectiveness.
O'Hara, Blythe J; Grunseit, Anne; Phongsavan, Philayrath; Bellew, William; Briggs, Megan; Bauman, Adrian E
Mass media campaigns aimed at influencing lifestyle risk factors are one way that governments are attempting to address chronic disease risk. In Australia, a national campaign aimed at encouraging Australians to make changes in lifestyle-related behaviors was implemented from 2008 to 2011. The first phase, Measure Up (2008-2009), focused on why lifestyle changes are needed by increasing awareness of the link between waist circumference and chronic disease risk. The second phase, Swap It, Don't Stop It (2011), emphasized how adults can change their behaviors. Cross-sectional telephone surveys (after the campaign) were undertaken in July and November 2011 to evaluate the Swap It, Don't Stop It campaign and included measures of campaign awareness and lifestyle-related behavior change. Survey participants (N = 5,097) were similar across the two survey periods. Prompted campaign awareness was 62% (16% for unprompted awareness); females, younger respondents (18-44 years), those in paid employment, and those who spoke English at home were more likely to report prompted/unprompted campaign awareness. Moreover, 16% of survey respondents reported any swapping behavior in the previous 6 months, with the majority (14%) reporting only one swap; younger respondents and those in paid employment were significantly more likely to report having implemented a swapping behavior. The campaign achieved modest population awareness but demonstrated limited effect in terms of nudging behaviors. This evaluation indicates that encouraging swapping behaviors as a prelude to lifestyle change may not result from a mass media campaign alone; a comprehensive multicomponent population approach may be required.
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide. Lifestyle improvements including dietary changes are important for CVD prevention. This thesis aimed to advance insights in the role of phytosterols, lipid-like compounds present in foods or plant origin, in
Full Text Available Abstract Background Taking advantage of developed image technology, it is expected that image presentation would be utilized to promote health in the field of medical care and public health. To accumulate knowledge on biomedical effects induced by image presentation, an essential prerequisite for these purposes, studies on autonomic responses in more than one physiological system would be necessary. In this study, changes in parameters of the pupillary light reflex and cardiovascular reflex evoked by motion pictures were examined, which would be utilized to evaluate the effects of images, and to avoid side effects. Methods Three stereoscopic video movies with different properties were field-sequentially rear-projected through two LCD projectors on an 80-inch screen. Seven healthy young subjects watched movies in a dark room. Pupillary parameters were measured before and after presentation of movies by an infrared pupillometer. ECG and radial blood pressure were continuously monitored. The maximum cross-correlation coefficient between heart rate and blood pressure, ρmax, was used as an index to evaluate changes in the cardiovascular reflex. Results Parameters of pupillary and cardiovascular reflexes changed differently after subjects watched three different video movies. Amplitudes of the pupillary light reflex, CR, increased when subjects watched two CG movies (movies A and D, while they did not change after watching a movie with the real scenery (movie R. The ρmax was significantly larger after presentation of the movie D. Scores of the questionnaire for subjective evaluation of physical condition increased after presentation of all movies, but their relationship with changes in CR and ρmax was different in three movies. Possible causes of these biomedical differences are discussed. Conclusion The autonomic responses were effective to monitor biomedical effects induced by image presentation. Further accumulation of data on multiple autonomic
From, Unni; Kristensen, Nete Nørgaard
for in-depth exploration and contextualisation of this field, with its increasing relevance for 21st century consumer cultures. For the first time, this book presents a wide range of studies which have engaged with the field of lifestyle journalism in order to outline the various political, economic......Lifestyle journalism has experienced enormous growth in the media over the past two decades, but scholars in the fields of journalism and communication studies have so far paid relatively little attention to a field that is still sometimes seen as "not real journalism". There is now an urgent need......, social and cultural tensions within it. Taking a comparative view, the collection includes studies covering four continents, including countries such as Australia, China, Norway, Denmark, Singapore, the UK and the USA. While keeping the broader lifestyle field in mind, the chapters focus on a variety...
From, Unni; Kristensen, Nete Nørgaard
Lifestyle journalism has experienced enormous growth in the media over the past two decades, but scholars in the fields of journalism and communication studies have so far paid relatively little attention to a field that is still sometimes seen as "not real journalism". There is now an urgent need...... for in-depth exploration and contextualisation of this field, with its increasing relevance for 21st century consumer cultures. For the first time, this book presents a wide range of studies which have engaged with the field of lifestyle journalism in order to outline the various political, economic...... of sub-fields such as travel, music, food, health, fashion and personal technology journalism. This volume provides a fascinating account of the different facets of lifestyle journalism, and charts the way forward for a more sustained analysis of the field. This book was originally published as a special...
Walseth, Liv Tveit; Schei, Edvin
Adjustments of everyday life in order to prevent disease or treat illness afflict partly unconscious preferences and cultural expectations that are often difficult to change. How should one, in medical contexts, talk with patients about everyday life in ways that might penetrate this blurred complexity, and help people find goals and make decisions that are both compatible with a good life and possible to accomplish? In this article we pursue the question by discussing how Habermas' theory of communicative action can be implemented in decision-making processes in general practice. The theory of deliberative decision-making offers practical guidelines for what to talk about and how to do it. For a decision to be rooted in patients' everyday life it has to take into consideration the patient's practical circumstances, emotions and preferences, and what he or she perceives as ethically right behaviour towards other people. The aim is a balanced conversation, demonstrating respect, consistency and sincerity, as well as offering information and clarifying reasons. Verbalising reasons for one's preferences may increase awareness of values and norms, which can then be reflected upon, producing decisions rooted in what the patient perceives as good and right behaviour. The asymmetry of medical encounters is both a resource and a challenge, demanding patient-centred medical leadership, characterised by empathy and ability to take the patient's perspective. The implementation and adjustments of Habermas' theory in general practice is illustrated by a case story. Finally, applications of the theory are discussed.
Economical burden for the individuals and for the national budgets of chronic cardio-vasculo-metabolic diseases is high and is rapidly increasing. Costs of treatments and prevention are very different in countries of diverse culture, ethnicity, social-economical situations, but prevention with healthy foods and with adequate physical activity are cheaper than medicines anywhere in the world. A great couple of studies approved cost-effectiveness of interventions directed to the change of life style factors. Cheaper is to influence the whole, yet healthy population, but interventions on people with high risk are more target-specific and usually more expensive. Enhanced physical activity (minimum 30 minutes five times per week with low-medium intensity, plus resistance exercises for maintain the muscle mass and force, plus stretching and calisthenics to maintain joints motility) can be promoted by few hundred-few ten hundred euros or dollars. Price of gain in Quality/Disability-Adjusted Life Years expressed as Incremental Cost Effectiveness/Utility Ratio is known, estimated or modelled, and offers a good value of money.
Full Text Available This paper explores how participation and sustainability are being addressed by architects within the Building Schools for the Future (BSF programme in the UK. The intentions promoted by the programme are certainly ambitious, but the ways to fulfil these aims are ill-explored. Simply focusing on providing innovative learning technologies, or indeed teaching young people about physical sustainability features in buildings, will not necessarily teach them the skills they will need to respond to the environmental and social challenges of a rapidly changing world. However, anticipating those skills is one of the most problematic issues of the programme. The involvement of young people in the design of schools is used to suggest empowerment, place-making and to promote social cohesion but this is set against government design literature which advocates for exemplars, standard layouts and best practice, all leading to forms of standardisation. The potentials for tokenistic student involvement and conflict with policy aims are evident. This paper explores two issues: how to foster in young people an ethic towards future generations, and the role of co-design practices in this process. Michael Oakeshott calls teaching the conversation of mankind. In this paper, I look at the philosophy of Hannah Arendt, Emmanuel Levinas, Maurice Merleau-Ponty and Luce Irigaray to argue that investigating the ethical dilemmas of the programme through critical dialogue with students offers an approach to meeting government objectives, building sustainable schools, and fostering sustainable citizenship.
Gato, Worlanyo E; Acquah, Samuel; Apenteng, Bettye A; Opoku, Samuel T; Boakye, Blessed K
Despite the significant increase in the incidence of diabetes in Ghana, research in this area has been lagging. The purpose of the study was to assess the risk factors associated with diabetes in the Cape Coast metropolis of Ghana, and to describe nutritional practices and efforts toward lifestyle change. A convenient sample of 482 adults from the Cape Coast metropolis was surveyed using a self-reported questionnaire. The survey collected information on the demographic, socioeconomic characteristics, health status and routine nutritional practices of respondents. The aims of the study were addressed using multivariable regression analyses. A total of 8% of respondents reported that they had been diagnosed with diabetes. Older age and body weight were found to be independently associated with diabetes. Individuals living with diabetes were no more likely than those without diabetes to have taken active steps at reducing their weight. The percentage of self-reported diabetes in this population was consistent with what has been reported in previous studies in Ghana. The findings from this study highlight the need for more patient education on physical activity and weight management. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: email@example.com.
Randhawa, Mohammad Akram; Mahfouz, Salah Al-Din Mahmoud; Selim, Noor Ahmed; Yar, Taley; Gillessen, Anton
Treatment of gastro esophageal reflux disease (GERD) is becoming a challenge for medical profession. Proton pump inhibitors (PPIs) are commonly recommended but many disadvantages of these drugs are being reported, particularly when used for long term. Transient lower esophageal sphincter relaxations (TLESRs) are important cause of acid reflux. Gastric distention in upper stomach is the strongest stimulus for generation of TLESRs and is aggravated by intake of food in between meals. In an earlier cases report, two meals a day with intake of only fluids in between was suggested as a remedy for GERD. Present pilot study was conducted on 20 patients with endoscopically proven reflux esophagitis (Los Angles Grade a, b or c), who followed our advice to take meal twice a day with consumption of only soft drinks (fruit juices, tea, coffee, water, etc) in between and no medication for two weeks. On 14th day 15 patients (75%) were free of reflux symptoms, 2 (10%) had partial improvement and 3 (15%) reported no difference. It is concluded that two meals a day with intake of only fluids in between, whenever the patient feels hungry or thirsty, is a useful dietary regimen for the management of GERD. Further investigations are needed to confirm the benefits of this physiological lifestyle change.
Husemoen, L L N; Linneberg, A; Fenger, M
to increased tHcy in cross-sectional studies. In addition, the methylenetetrahydrofolate reductase (MTHFR) C677T gene variant is an important determinant of elevated tHcy. The main objective of the study was to examine the effect of changes in biological risk factors and lifestyle on tHcy in relation to MTHFR......, physical activity, smoking status, coffee, tea, total alcohol or wine consumption. An inverse relationship was observed between changes in tHcy and changes in the intake of beer in TT individuals but not in CC/CT individuals (P (interaction)=0.01). In addition, changes in tHcy were positively associated......BACKGROUND/OBJECTIVES: Total homocysteine (tHcy) has been associated with increased risk of several diseases in the general population. It is not clear whether these associations are causal. A less healthy lifestyle as well as a less favorable biological risk factor profile have been related...
Full Text Available Insufficient physical activity in the world annually is the cause of death of 1.9 million people. According to the data from the World Health Report, physical inactivity is about to become the global problem. Regular physical activity and good physical shape raise the functional capacity and the quality of patient’s life. With physical activity it is possible to improve metabolic, endothelial, lateral-muscular, pulmonary and cardiovascular functions of an organism, but also the function of the autonomous nervous system. The endothelium has the important role in maintaining the normal cardiovascular tonus and blood fluidity by reducing the platelet activity and the adhesion of leukocytes, and also by restricting the reaction of vascular inflammation. The aim of this paper was to present the recent data about effects of cardiovascular rehabilitation and physical training on lipoproteins’ status and markers of endothelial function. The impact of physical activity on the lipid status is accomplished by affecting the enzymes of lipoprotein metabolism, including the lipoprotein and the liver lipase and the movable protein of cholesterol ester (11. The studies point out that aerobic physical activity result in increasing of HDL concentration and the decrease of the triglycerides value, total and LDL cholesterol. The connection, which is dose-dependant, exists between physical activity and the lipid level, as the arguments which suggest that the duration of physical activity is the key parameter in modification of the lipid metabolism. Physical activity leads to the beneficial changes in the cardiovascular and lipid indicators and improves the endothelial function in the secondary prevention of coronary disease. Reduction of the lipid parameters by introducing physical rehabilitation and dietetic regime lie in the basis of secondary prevention of coronary disease. Furthermore, there is a constant improvement in NO biodisposability and therewith the
Bobak, M; Skodova, Z; Pisa, Z; Poledne, R; Marmot, M
BACKGROUND: Mortality from cardiovascular diseases is substantially higher in central and eastern Europe than in the west. After the fall of communism, these countries have undergone radical changes in their political, social, and economic environments but little is known about the impact of these changes on health behaviours or risk factors. Data from the Czech Republic, a country whose mortality rates from cardiovascular diseases are among the highest, were analysed in this report. OBJECTIVES: To examine the trends in cardiovascular risk factors in Czech population over the last decade during which a major and sudden change of the political and social system occurred in 1989, and whether the trends differed in relation to age and educational group. DESIGN AND SETTING: Data from three cross sectional surveys conducted in 1985, 1988, and 1992 as a part of the MONICA project were analysed. The surveys examined random samples of men and women aged 25-64 in six Czech districts and measured the following risk factors: smoking, blood pressure, body mass index (BMI), and total and high density lipoprotein (HDL) cholesterol. RESULTS: The numbers of subjects (response rate) examined were 2573 (84%) in 1985, 2769 (87%) in 1988, and 2353 (73%) in 1992. Total cholesterol and body mass index increased between 1985 and 1988 and decreased between 1988 and 1992. The prevalence of smoking was declining slightly in men between 1985 and 1992 but remained stable in women. There were only small changes in blood pressure. The decline in cholesterol and BMI in 1988-92 may be related to changes in foods consumption after the price deregulation in 1991. An improvement in risk profile was more pronounced in younger age groups, and the declines in cholesterol and obesity were substantially larger in men and women with higher education. By contrast, there was an increase in smoking in women educated only to primary level. CONCLUSION: Substantial changes in cholesterol, obesity, and women
Frey, M. A.; Tomaselli, C. M.; Hoffler, W. G.
The cardiovascular responses to postural change, and how they are affected by aging, are inadequately described in women. Therefore, the authors examined the influence of age and sex on the responses of blood pressure, cardiac output, heart rate, and other variables to change in posture. Measurements were made after 10 minutes each in the supine, seated, and standing positions in 22 men and 25 women who ranged in age from 21 to 59 years. Several variables differed, both by sex and by age, when subjects were supine. On rising, subjects' diastolic and mean arterial pressures, heart rate, total peripheral resistance (TPR), and thoracic impedance increased; cardiac output, stroke volume, and mean stroke ejection rate decreased; and changes in all variables, except heart rate, were greater from supine to sitting than sitting to standing. The increase in heart rate was greater in the younger subjects, and increases in TPR and thoracic impedance were greater in the older subjects. Stroke volume decreased less, and TPR and thoracic impedance increased more, in the women than in the men. The increase in TPR was particularly pronounced in the older women. These studies show that the cardiovascular responses to standing differ, in some respects, between the sexes and with age. The authors suggest that the sex differences are, in part, related to greater decrease of thoracic blood volume with standing in women than in men, and that the age differences result, in part, from decreased responsiveness of the high-pressure baroreceptor system.
Healthy Lifestyle Interventions to Combat Noncommunicable Disease—A Novel Nonhierarchical Connectivity Model for Key Stakeholders: A Policy Statement From the American Heart Association, European Society of Cardiology, European Association for Cardiovascular Prevention and Rehabilitation, and American College of Preventive Medicine.
Arena, Ross; Guazzi, Marco; Lianov, Liana; Whitsel, Laurie; Berra, Kathy; Lavie, Carl J; Kaminsky, Leonard; Williams, Mark; Hivert, Marie-France; Franklin, Nina Cherie; Myers, Jonathan; Dengel, Donald; Lloyd-Jones, Donald M; Pinto, Fausto J; Cosentino, Francesco; Halle, Martin; Gielen, Stephan; Dendale, Paul; Niebauer, Josef; Pelliccia, Antonio; Giannuzzi, Pantaleo; Corra, Ugo; Piepoli, Massimo F; Guthrie, George; Shurney, Dexter
Noncommunicable diseases (NCDs) have become the primary health concern for most countries around the world. Currently, more than 36 million people worldwide die from NCDs each year, accounting for 63% of annual global deaths; most are preventable. The global financial burden of NCDs is staggering, with an estimated 2010 global cost of $6.3 trillion (US dollars) that is projected to increase to $13 trillion by 2030. A number of NCDs share one or more common predisposing risk factors, all related to lifestyle to some degree: (1) cigarette smoking, (2) hypertension, (3) hyperglycemia, (4) dyslipidemia, (5) obesity, (6) physical inactivity, and (7) poor nutrition. In large part, prevention, control, or even reversal of the aforementioned modifiable risk factors are realized through leading a healthy lifestyle (HL). The challenge is how to initiate the global change, not toward increasing documentation of the scope of the problem but toward true action-creating, implementing, and sustaining HL initiatives that will result in positive, measurable changes in the previously defined poor health metrics. To achieve this task, a paradigm shift in how we approach NCD prevention and treatment is required. The goal of this American Heart Association/European Society of Cardiology/European Association for Cardiovascular Prevention and Rehabilitation/American College of Preventive Medicine policy statement is to define key stakeholders and highlight their connectivity with respect to HL initiatives. This policy encourages integrated action by all stakeholders to create the needed paradigm shift and achieve broad adoption of HL behaviors on a global scale. Copyright © 2015 Mayo Foundation for Medical Education and Research and the European Society of Cardiology. Published by Elsevier Inc. All rights reserved.
Ritz, Eberhard; Schwenger, Vedat
There is increasing evidence that lifestyle factors impact on the risk of developing chronic kidney disease (CKD) and the risk of progression of CKD. Equally important is the consideration that patients with CKD are more likely to die from cardiovascular disease than to reach the stage of end-stage renal failure. It is advantageous that manoeuvres that interfere with progression at the same time also reduce the risk of cardiovascular events. Lifestyle factors that aggravate progression include, among others, smoking, obesity and dietary salt intake. Alcohol consumption, according to some preliminary information, has a bimodal relationship to cardiovascular risk and progression, with moderate consumption being protective.
Clodagh SM O’Gorman
Full Text Available Clodagh SM O’Gorman1, Michael B O’Neill2, Louise S Conwell31Graduate Entry Medical School, University of Limerick, Ireland, and Mid-Western Regional Hospital, Limerick, Ireland; 2Mayo General Hospital, Castlebar, Ireland; 3Royal Children’s Hospital, Brisbane, Discipline of Pediatrics and Child Health, and School of Medicine, University of Queensland, Brisbane, AustraliaAbstract: Children who appear healthy, even if they have one or more recognized cardiovascular risk factors, do not generally have outcomes of cardiovascular or other vascular disease during childhood. Historically, pediatric medicine has not aggressively screened for or treated cardiovascular risk factors in otherwise healthy children. However, studies such as the P-Day Study (Pathobiological Determinants of Atherosclerosis in Youth, and the Bogalusa Heart Study, indicate that healthy children at remarkably young ages can have evidence of significant atherosclerosis. With the increasing prevalence of pediatric obesity, can we expect more health problems related to the consequences of pediatric dyslipidemia, hypertriglyceridemia, and atherosclerosis in the future? For many years, medications have been available and used in adult populations to treat dyslipidemia. In recent years, reports of short-term safety of some of these medications in children have been published. However, none of these studies have detailed long-term follow-up, and therefore none have described potential late side-effects of early cholesterol-lowering therapy, or potential benefits in terms of reduction of or delay in cardiovascular or other vascular end-points. In 2007, the American Heart Association published a scientific statement on the use of cholesterol-lowering therapy in pediatric patients. In this review paper, we discuss some of the current literature on cholesterol-lowering therapy in children, including the statins that are currently available for use in children, and some of the cautions
Saengtipbovorn, Saruta; Taneepanichskul, Surasak
Currently, there is an increased prevalence of diabetes mellitus among the elderly. Chronic inflammation from diabetes mellitus effects glycemic control and increases risk of diabetes complications. To assess the effectiveness of a Lifestyle Change plus Dental Care (LCDC) program by improved knowledge, attitude, and practice (KAP) toward oral health and diabetes mellitus among the elderly with type 2 diabetes. A quasi-experimental study was conducted in two Health Centers (HC 54 intervention and HC 59 control) between October 2013 and April 2014. Sixty-six diabetic patients per health center were recruited. At baseline, the intervention group attended a 20-minute lifestyle and oral health education program, individual lifestyle counseling using motivational interviewing, application of self-regulation manual, and individual oral hygiene instruction. At 3-month follow-up, the intervention group received individual lifestyle counseling and oral hygiene instruction. The intervention group received booster education every visit by viewing a 15-minute educational video. The control group received the routine program. Participants were assessed at baseline, 3-month, and 6-month follow-up for knowledge, attitude, and practice (KAP) toward oral health and diabetes mellitus. Data was analyzed by using descriptive statistic, Chi-square test, Fisher's exact test, and repeated measure ANOVA. After the 6-month follow-up, repeated measure ANOVA analysis showed that participants in the intervention group had significantly higher knowledge and attitude toward oral health and diabetes mellitus. The participants in the intervention group were more likely to exercise, modify diet, have foot examinations, always wear covered shoes, participate in self-feet screening, use dental floss, and use inter-proximal brush than the control group with statistically significant differences. The combination of lifestyle change and dental care in one program improved knowledge, attitude
Savolainen, Jorma; Kautiainen, Hannu; Miettola, Juhani; Niskanen, Leo; Mäntyselkä, Pekka
The Lapinlahti 2005 study was carried out to explore cardiovascular disease risk factors, lifestyle and quality of life in Lapinlahti residents in eastern Finland. Our aim was to study the association between lifestyle and health-related quality of life (HRQoL) in the community. The present study is based on the baseline data of the followed up (2005-2010) population-based cohort (N = 376, n of males = 184). A trained research nurse measured weight, height, waist circumference and blood pressure. Self-reported HRQoL was measured using a 15D questionnaire. A BDI-21 inventory was used to assess the presence of self-reported depressive symptoms. Lifestyle factors (nutrition, exercise, smoking and alcohol use) were examined with a structured questionnaire. Each lifestyle item was valued as -1, 0 or 1, depending on how well it corresponded to the recommendations. Based on the index the participants were divided into three lifestyle sum tertiles: I = unhealthy, II = neutral and III = healthy. The age- and sex-adjusted linear trend between the tertiles was tested. The 15D score had a positive linear relationship with the lifestyle tertiles (P = .0048 for linearity, age- and sex-adjusted). Respectively, self-reported depressive symptoms were less frequent among subjects with a healthier lifestyle (P = .038). People who are expected to strive most to change their lifestyle have the lowest quality of life and psychological welfare, which should be taken into account in both clinical work and health promotion.
Agrawal, Praween; Gupta, Kamla; Mishra, Vinod; Agrawal, Sutapa
We examined the effects of sedentary lifestyle and dietary habits on body mass index (BMI) change in a follow-up study of 325 women (aged 15-49 years) in Delhi, systematically selected from the 1998-1999 National Family Health Survey samples who were re-interviewed after 4 years in 2003. Information was collected on height, weight, dietary habits, and sedentary lifestyle through face-to-face interviews. Overall, a 2.0-point increase in mean BMI was found among women in just 4 years. Every second normal-BMI woman, two in five overweight women, and every fourth obese woman experienced a > 2.0-point increase in her mean BMI. High sedentary lifestyle (OR: 2.63; 95% CI: 1.29-5.35) emerged as the main predictor of a > 2.0-point increase in mean BMI in adjusted analysis, but there was weak evidence of association with the dietary covariates. Our findings suggest that a high sedentary lifestyle is a determinant of weight gain among adult women in urban India.
Holt, R I G
Primary prevention of diabetes and cardiovascular disease is an important priority for people with schizophrenia. This review aims to identify lifestyle and pharmacological interventions that reduce diabetes and cardiovascular disease in people with schizophrenia. PubMed and other electronic databases were searched to identify relevant articles. Lifestyle interventions that focus on diet and physical activity reduce the incidence of diabetes. Similar programmes in people with schizophrenia have led to significant weight loss and may reasonably be expected to reduce diabetes in the long-term. Metformin may be considered when lifestyle change is not feasible or effective. Lifestyle interventions, particularly smoking cessation, are likely to be effective in reducing cardiovascular disease in people with schizophrenia. Although cardiovascular prevention trials with statins have not been performed in people with schizophrenia, similar reductions in cholesterol has been seen as in the general population and statins should be considered for those at high risk. Traditional cardiovascular risk prediction models perform well in identifying those at high cardiovascular risk, but bespoke prediction models using data from people with schizophrenia perform better. Reducing diabetes and cardiovascular disease requires a coordinated and concerted effort from mental and physical health teams working across primary and secondary care. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Baron-Epel, Orna; Hofstetter, C Richard; Irvin, Veronica L; Kang, Sunny; Hovell, Melbourne F
Studies of changes in health following immigration are inconsistent, and few are based on longitudinal designs to test associations based on change. This study identified factors that predicted changes in self-reported health (SRH) among California residents of Korean descent. A sample of California residents of Korean descent were interviewed and followed-up 2 or 3 times by telephone during 2001-2009. The questionnaires dealt with SRH, lifestyle behaviors (smoking, physical activity, and fast food consumption), and socioeconomic measures. Statistical analysis included random-intercepts longitudinal regression models predicting change in SRH. A similar percentage of respondents reported improved and deteriorating SRH (30.3% and 29.1%, respectively). Smoking, consumption of fast foods, age, percentage of life spent in the United States, and being female were predictors of deteriorating SRH, whereas physical activity, education, and living with a partner were predictive of improvement in SRH. The effect of immigration on SRH is influenced by socioeconomic factors and lifestyle practices. Results support promotion of healthy lifestyle practices among immigrants. © 2015 APJPH.
Møller, Mette; Haustein, Sonja
Despite recent improvements in general road safety levels, young male drivers in most western countries continue to be overrepresented in road traffic accidents. Lifestyle related motivational factors are a key element in the young male driver problem. Based on 379 posted questionnaires completed...... showed a similar life style at the age of 23. The study confirmed the importance of lifestyle related motivational factors for driving behaviour among young drivers. © 2013 Elsevier Ltd. All rights reserved.......Despite recent improvements in general road safety levels, young male drivers in most western countries continue to be overrepresented in road traffic accidents. Lifestyle related motivational factors are a key element in the young male driver problem. Based on 379 posted questionnaires completed...
Taylor, Rachael W; Roy, Melyssa; Jospe, Michelle R; Osborne, Hamish R; Meredith-Jones, Kim J; Williams, Sheila M; Brown, Rachel C
Physical activity plays a critical role in health, including for effective weight maintenance, but adherence to guidelines is often poor. Similarly, although debate continues over whether a "best" diet exists for weight control, meta-analyses suggest little difference in outcomes between diets differing markedly in macronutrient composition, particularly over the longer-term. Thus a more important question is how best to encourage adherence to appropriate lifestyle change. While brief support is effective, it has on-going cost implications. While self-monitoring (weight, diet, physical activity) is a cornerstone of effective weight management, little formal evaluation of the role that self-monitoring technology can play in enhancing adherence to change has occurred to date. People who eat in response to hunger have improved weight control, yet how best to train individuals to recognise when true physical hunger occurs and to limit consumption to those times, requires further study. SWIFT (Support strategies for Whole-food diets, Intermittent Fasting, and Training) is a two-year randomised controlled trial in 250 overweight (body mass index of 27 or greater) adults that will examine different ways of supporting people to make appropriate changes to diet and exercise habits for long-term weight control. Participants will be randomised to one of five intervention groups: control, brief support (monthly weigh-ins and meeting), app (use of MyFitnessPal with limited support), daily self-weighing (with brief monthly feedback), or hunger training (four-week programme which trains individuals to only eat when physically hungry) for 24 months. Outcome assessments include weight, waist circumference, body composition (dual-energy x-ray absorptiometry), inflammatory markers, blood lipids, adiponectin and ghrelin, blood pressure, diet (3-day diet records), physical activity (accelerometry) and aerobic fitness, and eating behaviour. SWIFT is powered to detect clinically
measurements, it could change their lipid profile. Moreover, the intervention was more effective on improving lipid profile in children over 10 years of age. Therefore, effective interventional strategies must be invented and implemented on children based on their age group. Keywords: Children Obesity, Education, Anthropometry, Lipid Profile, Lifestyle.
In recent years Doppler sonography has been approved as a valuable noninvasive method for identification of the extracranial vascular obturations. On the other hand obturational pathology of the extracranial arteries have often been associated with different cardiovascular diseases, and this requires perfect awareness of blood flow changes in the latter. The current study considers the specific flow changes in extracranial cerebral arteries in patients with ischemic heart disease (III-IV) (functional grade - FG - NYHA), and those with concomitant congestive heart failure (III-IV FG), as compared to healthy subjects. In the patients with ischemic heart disease without heart failure the changes are not as significant as compared to healthy subjects (p<0.1). Congestive heart failure is related to significant changes in some of the Doppler parameters. In the last stage of congestive heart failure spectral waveform of the internal carotid arteries also changes. Additionally the changes of spectral waveform of the carotid arteries in different heart diseases are represented: Idiopathic Subvalvular Aortic Stenosis, Valvular Aortic Stenosis and Regurgitation, Supravalvular Aortic Stenosis, Aortic Coarctation, Patent Ductus Botalli, Orthostatismus, Tamponade. Some of the changes are very specific and the Doppler technique would be useful for diagnosis of these diseases. 7 refs., 12 figs. (author)
Institute of Public Health in Ireland (IPH)
IPH responded to the Seanad Consultation Committee on the consultation topic ‘Changes in lifestyle can prevent approximately one third of cancers. How does Government and Society respond to this challenge?’. Between 2010 and 2020 the total number of cancers in Ireland is projected to increase by 40% for women and by just over 50% for men (National Cancer Registry). A focus is needed on developing social, economical and built environments that support healthy choices. I...
Giraldo Mario A
Full Text Available Abstract Background In 1995, a study was conducted to identify the effects of traditional and westernized environments on the prevalence of type 2 diabetes in Pima Indians (Pimas in Mexico and the United States. The study concluded that the more traditional lifestyle in Mexico had a protective effect against this metabolic disorder. In the ensuing 15 years, the environmental circumstances of the Mexican Pimas changed, and a follow-up study was conducted to determine the role environmental change plays in the development of diabetes in this genetically susceptible population. A major element of environmental transition relates to land-use and land-cover (LULC changes that could affect physical activity and promote an obesogenic environment. This study examined changes in the region’s LULC to determine whether there have been transitions in agricultural land use and urbanization that would be consistent with a more sedentary lifestyle. Changes were assessed from 1994 aerial photographs and 2007 satellite images. Results The land-cover analysis showed that mixed vegetation and dense trees cover most of the study area. It suggested a rural environment that includes a low percentage of impermeable areas, and it indicated that the area experiencing human intervention covers 7% of the total area. The land-use-change findings showed a decrease or no change in agricultural or ranching areas and a decrease in farmland due to reforestation or revegetation. Three variables from the land-use-change analysis were examined as proxies for lifestyle change: urban development, dwelling-unit density, and variation in the road network. Two of the measures –the amount of urbanization and the number and density of dwelling units—showed increases, most notably in the town of Maycoba. There were only minor changes in the road network: most of the road segments are short and concentrated in Maycoba where most of the buildings, points of interest (e.g., church
Full Text Available Abstract Background High levels of rural to urban migration are a feature of most African countries. Our aim was to investigate changes, and their determinants, in cardiovascular risk factors on rural to urban migration in Tanzania. Methods Men and women (15 to 59 years intending to migrate from Morogoro rural region to Dar es Salaam for at least 6 months were identified. Measurements were made at least one week but no more than one month prior to migration, and 1 to 3 monthly after migration. Outcome measures included body mass index, blood pressure, fasting lipids, and self reported physical activity and diet. Results One hundred and three men, 106 women, mean age 29 years, were recruited and 132 (63.2% followed to 12 months. All the figures presented here refer to the difference between baseline and 12 months in these 132 individuals. Vigorous physical activity declined (79.4% to 26.5% in men, 37.8% to 15.6% in women, p -1 respectively, p -1, p = 0.01, and triglycerides fell (0.31 mmoll-1, p = 0.034. Blood pressure appeared to fall in both men and women. For example, in men systolic blood pressure fell by 5.4 mmHg, p = 0.007, and in women by 8.6 mmHg, p = 0.001. Conclusion The lower level of physical activity and increasing weight will increase the risk of diabetes and cardiovascular disease. However, changes in diet were mixed, and may have contributed to mixed changes in lipid profiles and a lack of rise in blood pressure. A better understanding of the changes occurring on rural to urban migration is needed to guide preventive measures.
Senanayake, Madapathage Gayan Buddhika; Wickramasinghe, Sumudu Indika; Samaraweera, Sudath; De Silva, Pubudu; Edirippulige, Sisira
Tuberculosis (TB) is a major global health problem, commonly seen in underdeveloped countries. The probability of contracting the disease is significantly higher among the economically vulnerable and the socially disadvantaged. Risk factors associated with TB can also change over time. In the Sri Lankan context, no study has explored how these factors impact patients. Therefore, we aimed to explore social status, associated risk factors and lifestyle changes during the treatment period of TB patients attending a tertiary respiratory center in Colombo, Sri Lanka. The descriptive cross-sectional study was conducted in 2011. The study population consisted of diagnosed tuberculosis patients above the age of 15 years. Patient records were retrieved from the TB patient registry for the Colombo district. Systematic sampling was used to identify patients to be invited to the study. An interviewer-administered questionnaire was used for data collection. Data were collected on social status (example, level of education, employment, and income), associated risk factors (example, smoking and alcohol consumption, contact history, narcotic drug use) and lifestyle changes during treatment (example, employment status, social interactions). The analysis included a logistic regression model to explore the association between social status and risk factors. The total number of patients included in the study was 425. Tuberculosis was found to be strongly prevalent among participants from the lower socio-economic status. It was also common in participants with a low level of education, unemployed, if employed, those who are engaged in unskilled employment and have low levels of income. Risk factors associated with the patients were smoking, alcohol consumptions, narcotic drug use, imprisonment, close contact history with active TB patients and chronic medical conditions. Changes in employment and the reduction of social-interactions were the main lifestyle changes of the participants
WELL.ME - Wellbeing therapy based on real-time personalized mobile architecture, vs. cognitive therapy, to reduce psychological distress and promote healthy lifestyle in cardiovascular disease patients: study protocol for a randomized controlled trial.
Compare, Angelo; Kouloulias, Vassilis; Apostolos, Vontas; Peña, Wendy Moreno; Molinari, Enrico; Grossi, Enzo; Efstathios, Efstathopoulos; Carenini, Michele
There is compelling evidence that psychological factors may have the same or even greater impact on the possibility of adverse events on cardiac diseases (CD) than other traditional clinical risk factors. Anxiety and depression are predictors of short- and long-term adverse outcomes, increased risk for higher rates of in-hospital complications, re-infarction, malignant arrhythmias, and mortality in CD patients. Despite researchers finding that cognitive behavior therapy (CBT) reduced depressive and anxiety symptoms, the fact that such results are maintained only in the short term and the lack of maintenance of the long-term affects the absence of changes in lifestyles, preventing the possibility of a wide generalization of results. Recently wellbeing therapy (WBT) has been proposed as a useful approach to improve healthy lifestyle behaviors and reduce psychological distress. The present randomized controlled study will test WBT, in comparison with CBT, as far as the reduction of symptoms of depression, anxiety and psychological distress, and the improvement of lifestyle behaviors and quality of life in cardiac patients are concerned. Moreover, innovations in communication technologies allow patients to be constantly followed in real life. Therefore WBT based on personalized mobile technology will allow the testing of its effectiveness in comparison with usual WBT. The present study is a large outpatient study on the treatment of co-morbid depression, anxiety, and psychological distress in cardiac patients. The most important issues of this study are its randomized design, the focus on promotion of health-related behaviors, and the use of innovative technologies supporting patients' wellbeing in real life and in a continuous way. First results are expected in 2012. ClinicalTrials.gov Identifier: NCT01543815.
Bruckert, E; Masana, L; Chapman, M J; Descamps, O; Bosi, E; Allaert, F A
Assess the evolution of cardiovascular lifestyle behaviors in hypercholesterolemic patients concomitantly with changes in their daily intake of phytosterol-supplemented yoghurt (Phyto-SY). Nationwide prospective observational study conducted in general practices across France and Spain. Each practitioner suggested lifestyle changes to five consecutive patients with hypercholesterolemia (whether or not they were taking hypocholesterolemic drugs) and recommended daily consumption of Phyto-SY. The study design involved an inclusion visit, a patient's self-monitoring assessment after 1 month, and a final visit after 4 months. Primary evaluation criterion: changes in dietary habits assessed by a standardized Nutritional Lifestyle score. Secondary criteria: changes in lipid profile, anthropometry (waist circumference) and lifestyle behavior. A total of 2376 hypercholesterolemic patients (of whom 54.8% were women) were included. The average age was 56.2 years old. The Nutritional Lifestyle score improved from 15.4 ± 5.4 to 8.7 ± 4.0 (p 30 min) increased from 59.3% to 78.3% (p < 0.0001). The overweight rate decreased from 22.8% to 17.5% (p < 0.0001) and waist circumference from 94.6 ± 13.3 cm to 93.0 ± 12.8 cm (p < 0.0001). Nutritional Lifestyles and other lifestyle markers' improvement were parallel to adherence to Phyto-SY adherence. Improvements in Nutritional Lifestyle scores, which included regular consumption of Phyto-SY over 4 months, was significantly linked to healthier lifestyles and to beneficial modifications in atherogenic lipid profiles, which reflected patient empowerment in a 'real life' context.
Full Text Available Scott R Collier,1 Michael Landram21Vascular Biology and Autonomic Studies Laboratory, Appalachian State University, Boone, NC, USA; 2Università degli Studi di Roma “Foro Italico”, Rome, ItalyAbstract: Prehypertension is a warning to individuals with resting blood pressures between 120/80 mmHg and 139/89 mmHg of an insidious progression of blood pressure towards hypertensive levels (≥140/90 mmHg. Prehypertension is associated with increased cardiovascular risk and end organ damage compared with individuals who are normotensive. This review primarily focuses on internal and external factors associated with the prevalence of prehypertension. Elucidating all of the factors associated with a rise in resting blood pressure and comparing the effects of medication versus lifestyle changes may aid the clinician in developing a preventive and/or treatment strategy for each individual.Keywords: sex differences, blood pressure, lifestyle changes
Lau, C; Vistisen, D; Toft, U; Tetens, I; Glümer, C; Pedersen, O; Jørgensen, T; Borch-Johnsen, K
This study aimed to assess whether group-based lifestyle counselling offered to a high-risk population subgroup had any effect beyond individual multifactorial interventions on fasting plasma glucose (FPG) and 2-h plasma glucose (2hPG) changes. In a population-based study of 6784 participants, 4053 were determined to be at high risk based on a risk estimate of ischaemic heart disease or the presence of risk factors (smoking, hypertension, hypercholesterolaemia, obesity, impaired glucose tolerance). Of these subjects, 90% were randomized to high-intensity intervention (group A) and 10% to low-intensity intervention (group B). All participants went through health examinations, risk assessments and individual lifestyle counselling. Participants in group A were further offered group-based lifestyle counselling. The intervention was repeated after 1 and 3 years. A total of 2738 participants free of diabetes at baseline (1999-2001) and with at least one FPG and/or 2hPG measurement during 5 years of follow-up were included in the analyses. Differences in changes of plasma glucose between groups A and B were analyzed using multilevel linear regression. For FPG, crude 5-year changes were significantly different between the two groups (group A: -0.003 mmol/L vs group B: -0.079 mmol/L; P=0.0427). After adjusting for relevant confounders, no differences in FPG changes were observed (P=0.116). Also, no significant differences in the 5-year changes in 2hPG between the two groups were observed (group A: - 0.127 mmol/L vs group B: -0.201 mmol/L; P=0.546). Offering additional group-based intervention to a high-risk population subgroup had no clinical effects on changes in plasma glucose beyond those of individualized multifactorial interventions. Copyright © 2011 Elsevier Masson SAS. All rights reserved.
Full Text Available Obesity has become a pandemic threat in the latest 30 years. The trend of the prevalence of overweight and obesity has got an overall increase in every part of the world, regardless of ethnicity, life-style and social ties. High food intake, genetic, and sedentary have been related to obesity; it has been also hypothesized that gut microbiota could have an impact on the complex mechanism underlying the weight gain. This review aims to illustrate the actual literature about gut microbiota and its relation with obesity and to analyze the possible implications of factors such as diet and life-style onto the composition of gut microbiota, that can lead to overweight/obesity condition.
Annalisa, Noce; Alessio, Tarantino; Claudette, Tsague Djoutsop; Erald, Vasili; Antonino, De Lorenzo; Nicola, Di Daniele
Obesity has become a pandemic threat in the latest 30 years. The trend of the prevalence of overweight and obesity has got an overall increase in every part of the world, regardless of ethnicity, life-style and social ties. High food intake, genetic, and sedentary have been related to obesity; it has been also hypothesized that gut microbiota could have an impact on the complex mechanism underlying the weight gain. This review aims to illustrate the actual literature about gut microbiota and its relation with obesity and to analyze the possible implications of factors such as diet and life-style onto the composition of gut microbiota, that can lead to overweight/obesity condition.
Babatunde-Sowole, Olutoyin O; Power, Tamara; Davidson, Patricia; Ballard, Charlotte; Jackson, Debra
This paper reports on women's experiences of weight gain and obesity as they became acculturated to the Australian diet and lifestyle. Migrants from sub-Saharan Africa have a much higher risk of obesity than the native population when settling in industrialised countries. Qualitative. Women in this study reported weight gain post-migration. This was attributed to increased access to a wide variety of food including takeaway food and more sedentary lifestyles. Obesity has long-term consequences for health and well-being. Further research is needed to support a healthy transition to life in Australia. Gaining insight into the underlying reasons that West African immigrants to Australia become obese could contribute to assisting health professionals design culturally appropriate interventions and health education programmes to support new arrivals.
... they are good for your heart, swimming and biking DO NOT increase bone density. Other Lifestyle Changes ... A.D.A.M. Editorial team. Related MedlinePlus Health Topics Benefits of Exercise Exercise and Physical Fitness ...
Saihara, Keishi; Hamasaki, Shuichi; Ishida, Sanemasa; Kataoka, Tetsuro; Yoshikawa, Akiko; Orihara, Koji; Ogawa, Masakazu; Oketani, Naoya; Fukudome, Tsuyoshi; Atsuchi, Nobuhiko; Shinsato, Takuro; Okui, Hideki; Kubozono, Takuro; Ichiki, Hitoshi; Kuwahata, So; Mizoguchi, Etsuko; Fujita, Shoji; Takumi, Takuro; Ninomiya, Yuichi; Tomita, Kaai; Tei, Chuwa
An unhealthy lifestyle can increase the risk of cardiovascular disease. However, the mechanism by which lifestyle influences the development of cardiovascular disease remains unclear. Since coronary endothelial function is a predictor of cardiovascular prognosis, the goal of this study was to characterize the effect of enjoying hobbies on coronary endothelial function and cardiovascular outcomes. A total of 121 consecutive patients (76 men, 45 women) with almost normal coronary arteries underwent Doppler flow study of the left anterior descending coronary artery following sequential administration of papaverine, acetylcholine, and nitroglycerin. On the basis of responses to questionnaires, patients were divided into two groups; the Hobby group (n = 71) who enjoyed hobbies, and the Non-hobby group (n = 50) who had no hobbies. Cardiovascular outcomes were assessed at long-term follow-up using medical records or questionnaire surveys for major adverse cardiovascular events (MACE).The average follow-up period was 916 +/- 515 days. There were no significant differences in demographics when comparing the two groups. The percent change in coronary blood flow and coronary artery diameter induced by acetylcholine was significantly greater in the Hobby group than in the Non-hobby group (49% +/- 77% vs 25% +/- 37%, P hobbies was the only independent predictor of MACE (odds ratio 8.1 [95% confidence interval 1.60, 41.90], P = 0.01) among the variables tested. In the early stages of arteriosclerosis, enjoying hobbies may improve cardiovascular outcomes via its favorable effects on coronary endothelial function.
Cardiovascular risk factors are prevalent among relatively young adult, clinically stable outpatients attending clinics across the UAE. These findings support targeted screening of outpatients visiting a general practitioner, which may provide opportunity for early discovery and ongoing management of risk factors, including recommending lifestyle changes. The ACE trial is registered under NCT01243138.
Tonnon, S.C.; Proper, K.I.; van der Ploeg, H.P.; Westerman, M.J.; Sijbesma, E.; van der Beek, A.J.
Background: Lifestyle interventions have proven effective for lowering a cardiovascular risk profile by improving lifestyle behaviors, blood glucose and blood cholesterol levels. However, implementation of lifestyle interventions is often met with barriers. This qualitative study sought to determine
Hicks, Robert A; Hall, Peter A; Staines, William R; McIlroy, William E
The left and right prefrontal cortices are linked to networks that control approach and withdrawal motivation, respectively. The relationship between activity in the left and right prefrontal activity is used to assess brain states and specifically their link to motivational behaviours and tendencies. The most common measure used in this context is called the frontal alpha asymmetry (FAA), which compares alpha (8-13Hz) power at each region. Interestingly, research shows that FAA is influenced by aerobic exercise by increasing relative left prefrontal cortex activity. In turn this effect may be beneficial for individuals with mood disorders that are associated with abnormal motivational tendencies. However, it is unknown whether changes in FAA after exercise are due to cardiovascular demands of activity or simply the movement required for the exercise. Therefore, this study aimed to investigate the influence of aerobic exercise and 'no intensity' bilateral movement cycling on FAA in young healthy adults. Results showed aerobic exercise caused a significant increase in FAA scores 22-38min after exercise. However, movement did not lead to a significant change in FAA. This suggests there is an intensity required for physical activity to evoke a change in FAA. Copyright © 2017 Elsevier B.V. All rights reserved.
Luterkort, M; Gennser, G
The role of fetal cardiovascular function in the reduced intrauterine growth rate of breech pregnancy was studied in fetuses with different presentations. Hemodynamic responses to postural changes were also investigated in fetuses in horizontal and vertical positions. Thirty-one normal pregnancies, with 15 fetuses presenting by the breech and 16 fetuses by the vertex, were included in the study. Diameter pulse waves from the fetal descending aorta were measured using equipment combining real-time ultrasound imaging with phase-locked echo-tracking. No differences in basal pulse wave parameters were demonstrated between breech and vertex fetuses nor did any differences appear when maternal posture was changed from horizontal to upright or vice versa. The present observations suggest that fetal circulatory factors are less likely to be a primary cause of the reduced intrauterine growth in breech presentation. Tilting of the fetus in late gestation seems to produce neither a redistribution of its blood volume nor secondary adaptations to an orthostatic challenge. The hydrostatic effect of amniotic fluid presumably precludes the requirement of fetal circulatory adaptation to postural changes.
Petruski-Ivleva, Natalia; Viera, Anthony J; Shimbo, Daichi; Muntner, Paul; Avery, Christy L; Schneider, Andrea L C; Couper, David; Kucharska-Newton, Anna
Elevated blood pressure in midlife contributes significantly to the risk of cardiovascular disease. However, patterns of blood pressure increase may differ among individuals and may result in differential risk. Our goal was to examine the contribution of longitudinal patterns of blood pressure change to incidence of heart failure, coronary heart disease, stroke, and cardiovascular disease mortality. Latent class growth models were used to identify patterns of change in blood pressure across 4 clinical examinations (1987-1998) among 9845 Atherosclerosis Risk in Communities (ARIC) cohort participants (mean age, 53.7 [SD 5.7] years). Patterns of change in systolic blood pressure included slowly and steeply increasing, a decreasing and a sustained elevated blood pressure. Changes in diastolic and mid-blood pressure (½ systolic+½ diastolic) were less pronounced. The association of blood pressure pattern group membership with incidence of clinical outcomes was examined in follow-up from the fourth clinical examination (1996-1998) to December 31, 2011, using Poisson regression models adjusted for demographic and metabolic characteristics, and hypertension medication use. A gradient of rates of all events was observed across the identified patterns. Associations were attenuated after adjustment for covariates. Cumulative systolic blood pressure load, rather than the temporal pattern of change in systolic blood pressure itself, plays a role in determining the risk of cardiovascular disease, in particular, of heart failure and cardiovascular disease mortality, independent of blood pressure level measured at one point in time. © 2016 American Heart Association, Inc.
Full Text Available BACKGROUND: There is evidence for a role of ionizing radiation in cardiovascular diseases. The goal of this work was to identify changes in oxidative and nitrative stress pathways and the status of the endothelinergic system during progression of atherosclerosis in ApoE-deficient mice after single and repeated exposure to ionizing radiation. METHODS AND RESULTS: B6.129P2-ApoE tmlUnc mice on a low-fat diet were acutely exposed (whole body to Co60 (γ (single dose 0, 0.5, and 2 Gy at a dose rate of 36.32 cGy/min, or repeatedly (cumulative dose 0 and 2 Gy at a dose-rate of 0.1 cGy/min for 5 d/wk, over a period of 4 weeks. Biological endpoints were investigated after 3-6 months of recovery post-radiation. The nitrative stress marker 3-nitrotyrosine and the vasoregulator peptides endothelin-1 and endothelin-3 in plasma were increased (p<0.05 in a dose-dependent manner 3-6 months after acute or chronic exposure to radiation. The oxidative stress marker 8-isoprostane was not affected by radiation, while plasma 8-hydroxydeoxyguanosine and L-3,4-dihydroxyphenylalanine decreased (p<0.05 after treatment. At 2Gy radiation dose, serum cholesterol was increased (p = 0.008 relative to controls. Percent lesion area increased (p = 0.005 with age of animal, but not with radiation treatment. CONCLUSIONS: Our observations are consistent with persistent nitrative stress and activation of the endothelinergic system in ApoE-/- mice after low-level ionizing radiation exposures. These mechanisms are known factors in the progression of atherosclerosis and other cardiovascular diseases.
Tomita, S; Fuzikawa, K; Nishimori, I; Tsuda, N; Miyagawa, N [Nagasaki Univ. (Japan). School of Medicine
In order to investigate irradiation injury of the kidney and effect of injured kidney on the whole body, especially cardiovascular changes, a single kidney was extracted from Wistar female rats and only the remaining kidney was irradiated with a great amount of radiation in 4000 R dose experimentally. After seven weeks of irradiation, atrophy and involution of the highest region of the kidney were found. Histologically, fibrous proliferation of interstice accompanied with atrophy of the renal tubule, and slightly increased nuclei and lobulation of the glomerulus were recognized. After 15 weeks of irradiation, atrophy and involution of the whole kidney were found. Histologically, fibrous proliferation of interstice in the kidney accompanied with a high degree of atrophy of the renal tubule, marked increase and lobulation of mesangium ground substance of the glomerulus and mild hypertrophy of arteriole were recognized. Mild degeneration of myocardium was recognized. In the long-term cases passing 29 and 34 weeks after irradiation, blood pressure just before slaughter rose to 250 mmHg. The kidney showed malignant nephrosclerosis-like lesion, and panarteritis was found in the mesentery and peri-pancreatic artery. In the heart, hypertonic myocardosis was recognized. A rise of blood pressure which was observed in this experiment occurred in circulation degenerations resulted from the secondary hypertrophy of the blood vessels accompanied with fibrous proliferation of the interstice which appeared after degeneration of renal tubule. It was thought that panarteritis of cardiovascular system of the whole body, especially mesentery and peri-pancreatic artery, and fibrinoid degeneration of arteriole of the kidney were due to hypertension and angiopathic factors (non-vasopressor extracts from the injured kidney).
Barr, E L M; Cameron, A J; Balkau, B; Zimmet, P Z; Welborn, T A; Tonkin, A M; Shaw, J E
We assessed whether the relationships between insulin sensitivity and all-cause mortality as well as fatal or non-fatal cardiovascular disease (CVD) events are independent of elevated blood glucose, high blood pressure, dyslipidaemia and body composition in individuals without diagnosed diabetes. Between 1999 and 2000, baseline fasting insulin, glucose and lipids, 2 h plasma glucose, HbA(1c), anthropometrics, blood pressure, medication use, smoking and history of CVD were collected from 8,533 adults aged >35 years from the population-based Australian Diabetes, Obesity and Lifestyle study. Insulin sensitivity was estimated by HOMA of insulin sensitivity (HOMA-%S). Deaths and fatal or non-fatal CVD events were ascertained through linkage to the National Death Index and medical records adjudication. After a median of 5.0 years there were 277 deaths and 225 CVD events. HOMA-%S was not associated with all-cause mortality. Compared with the most insulin-sensitive quintile, the combined fatal or non-fatal CVD HR (95% CI) for quintiles of decreasing HOMA-%S were 1.1 (0.6-1.9), 1.4 (0.9-2.3), 1.6 (1.0-2.5) and 2.0 (1.3-3.1), adjusting for age and sex. Smoking, CVD history, hypertension, lipid-lowering medication, total cholesterol and waist-to-hip ratio moderately attenuated this relationship. However, the association was rendered non-significant by adding HDL. Fasting plasma glucose, but not HOMA-%S significantly improved the prediction of CVD, beyond that seen with other risk factors. In this cohort, HOMA-%S showed no association with all-cause mortality and only a modest association with CVD events, largely explained by its association with HDL. Fasting plasma glucose was a better predictor of CVD than HOMA-%S.
Kashani, Mariam; Eliasson, Arn H; Walizer, Elaine M; Fuller, Clarie E; Engler, Renata J; Villines, Todd C; Vernalis, Marina N
Background: Self-efficacy, defined as confidence in the ability to carry out behavior to achieve a desired goal, is considered to be a prerequisite for behavior change. Self-efficacy correlates with cardiovascular health although optimal timing to incorporate self-efficacy strategies is not well established. We sought to study the effect of an empowerment approach implemented in the introductory phase of a multicomponent lifestyle intervention on cardiovascular health outcomes. Design: Prospe...
Grant, Richard W; Meigs, James B; Florez, Jose C; Park, Elyse R; Green, Robert C; Waxler, Jessica L; Delahanty, Linda M; O'Brien, Kelsey E
The efficacy of diabetes genetic risk testing to motivate behavior change for diabetes prevention is currently unknown. This paper presents key issues in the design and implementation of one of the first randomized trials (The Genetic Counseling/Lifestyle Change (GC/LC) Study for Diabetes Prevention) to test whether knowledge of diabetes genetic risk can motivate patients to adopt healthier behaviors. Because individuals may react differently to receiving 'higher' vs 'lower' genetic risk results, we designed a 3-arm parallel group study to separately test the hypotheses that: (1) patients receiving 'higher' diabetes genetic risk results will increase healthy behaviors compared to untested controls, and (2) patients receiving 'lower' diabetes genetic risk results will decrease healthy behaviors compared to untested controls. In this paper we describe several challenges to implementing this study, including: (1) the application of a novel diabetes risk score derived from genetic epidemiology studies to a clinical population, (2) the use of the principle of Mendelian randomization to efficiently exclude 'average' diabetes genetic risk patients from the intervention, and (3) the development of a diabetes genetic risk counseling intervention that maintained the ethical need to motivate behavior change in both 'higher' and 'lower' diabetes genetic risk result recipients. Diabetes genetic risk scores were developed by aggregating the results of 36 diabetes-associated single nucleotide polymorphisms. Relative risk for type 2 diabetes was calculated using Framingham Offspring Study outcomes, grouped by quartiles into 'higher', 'average' (middle two quartiles) and 'lower' genetic risk. From these relative risks, revised absolute risks were estimated using the overall absolute risk for the study group. For study efficiency, we excluded all patients receiving 'average' diabetes risk results from the subsequent intervention. This post-randomization allocation strategy was
Tessier, Jillian M; Erickson, Zachary D; Meyer, Hilary B; Baker, Matthew R; Gelberg, Hollie A; Arnold, Irina Y; Kwan, Crystal; Chamberlin, Valery; Rosen, Jennifer A; Shah, Chandresh; Hellemann, Gerhard; Lewis, Melissa M; Nguyen, Charles; Sachinvala, Neena; Amrami, Binyamin; Pierre, Joseph M; Ames, Donna
Veterans with mental illness tend to have shorter life spans and suboptimal physical health because of a variety of factors. These factors include poor nutrition, being overweight, and smoking cigarettes. Nonphysical contributors that may affect quality of life are the stigma associated with mental illness, social difficulties, and spiritual crises. Current mental health treatment focuses primarily on the delivery of medication and evidence-based psychotherapies, which may not affect all the above areas of a Veteran's life as they focus primarily on improving psychological symptoms. Clinicians may find greater success using integrative, comprehensive, multifaceted programs to treat these problems spanning the biological, psychological, social, and spiritual domains. These pilot studies test an adjunctive, holistic, behavioral approach to treat mental illness. This pilot work explores the hypotheses that engagement in a greater number of therapeutic lifestyle changes (TLCs) leads to improvement in quality of life, reduction of psychiatric symptoms, and weight loss. Institutional Review Boards for human subjects at the Veterans Affairs (VA) Greater Los Angeles and Long Beach Healthcare Systems approved pilot study activities at their sites. Pilot Study 1 was a prospective survey study of Veterans with mental illness, who gained weight on an atypical antipsychotic medication regimen, participating in a weight management study. At each session of the 1-year study, researchers asked a convenience sample of 55 Veterans in the treatment arm whether they engaged in each of the eight TLCs: exercise, nutrition/diet, stress management and relaxation, time in nature, relationships, service to others, religious or spiritual involvement, and recreation. Pilot Study 2 applied the TLC behavioral intervention and examined 19 Veterans with mental illness, who attended four classes about TLCs, received individual counseling over 9 weeks, and maintained journals to track TLC practice
Lipscombe, Lorraine L; Banerjee, Ananya Tina; McTavish, Sarah; Mukerji, Geetha; Lowe, Julia; Ray, Joel; Evans, Marilyn; Feig, Denice S
Women with gestational diabetes mellitus (GDM) have a high risk of future diabetes, which can be prevented with lifestyle modification. Prior diabetes prevention programmes in this population have been limited by lack of adherence. The aim of this study is to evaluate readiness for behaviour change at different time points after GDM diagnosis and identify barriers and facilitators, to inform a lifestyle modification programme specifically designed for this group. The objective of this paper is to present the rationale and methodological design of this study. The ongoing prospective cohort study has recruited a multi-ethnic cohort of 1353 women with GDM from 7 Ontario, Canada hospitals during their pregnancy. A questionnaire was developed to evaluate stage of readiness for behaviour change, and sociodemographic, psychosocial, and clinical predictors of healthy diet and physical activity. Thus far, 960 women (71%) have completed a baseline survey prior to delivery. Prospective postpartum follow-up is ongoing. We are surveying women at 2 time-points after delivery: 3-12 months postpartum, and 13-24 months postpartum. Survey data will be linked to health care administrative databases for long-term follow-up for diabetes. Qualitative interviews were conducted in a subset of women to gain a deeper understanding of barriers and facilitators to lifestyle change. Our study is a fundamental first step in effectively addressing diabetes prevention in women with GDM. Our findings will aid in the design of a diabetes prevention intervention specifically targeted to women with recent GDM, which can then be evaluated in a clinical trial. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Stelter, Reinhard; Andersen, Vinnie
was to support women in their attempts to remain physically active and to develop and maintain a healthy lifestyle. The main objective of this article is to take a close look at the best way to achieve this – not by telling the women what to do or by pushing them towards specific goals, but by inviting them...... into a space of common reflection and joint action. In that sense, the interaction (not intervention) will take its point of departure in a broad, collaboratively inspired approach that is broader in focus than widespread interventions, which are often exclusively based on motivational interviewing. The goal...
Stubbs, RJ; McConnon, A; Gibbs, M; Raats, M; Whybrow, S
This analysis examined the lifestyle correlates of weight loss maintenance in 1428 participants of a slimming organisation, who had been members for a mean SD of 16 16 months, had lost 13.8% 9.2% weight and were trying to maintain, or increase, their weight loss during a subsequent 6 month study period. Data were collected as part of the DiOGenes study(1). Ethical approval was given by the University of Surrey Ethics Committee. Adults were recruited between August 2006 and July 2008 from Slim...
Full Text Available In awake rats a single recurrent larger tidal volume (deep breaths occurs at regular intervals, followed by oscillations in arterial pressure and heart rate. In the present study we recorded the changes in blood pressure, heart rate and ventilation during the wakefulness-sleep cycle identified by electrocorticographic records in order to determine whether the deep breaths and cardiovascular oscillations were associated with changes in the electrocorticogram. During several episodes of slow-wave sleep (SWS in 7 rats the deep breaths and oscillations in arterial pressure and heart rate were preceded by SWS desynchronization. The interval between deep breaths during SWS was 71 ± 4 s, the period between initial desynchronization and the generation of deep breaths was 3.98 ± 0.45 s and the duration of SWS desynchronization was 11 ± 0.65 s. Hypotension (-16 ± 1 mmHg and tachycardia (+15 ± 5 bpm were observed during deep breaths in the SWS state. These data indicate that the oscillations in arterial pressure and heart rate during SWS are associated with deep breaths, which in turn are preceded by desynchronization of the electrocorticogram in this state of sleep
van Dulmen Sandra
Full Text Available Abstract Background The general practitioner (GP can play an important role in promoting a healthy lifestyle, which is especially relevant in people with an elevated risk of cardiovascular diseases due to hypertension. Therefore, the aim of this study was to determine the frequency and content of lifestyle counseling about weight loss, nutrition, physical activity, and smoking by GPs in hypertension-related visits. A distinction was made between the assessment of lifestyle (gathering information or measuring weight or waist circumference and giving lifestyle advice (giving a specific advice to change the patient's behavior or referring the patient to other sources of information or other health professionals. Methods For this study, we observed 212 video recordings of hypertension-related visits collected within the Second Dutch National Survey of General Practice in 2000/2001. Results The mean duration of visits was 9.8 minutes (range 2.5 to 30 minutes. In 40% of the visits lifestyle was discussed (n = 84, but in 81% of these visits this discussion lasted shorter than a quarter of the visit. An assessment of lifestyle was made in 77 visits (36%, most commonly regarding body weight and nutrition. In most cases the patient initiated the discussion about nutrition and physical activity, whereas the assessment of weight and smoking status was mostly initiated by the GP. In 35 visits (17% the GP gave lifestyle advice, but in only one fifth of these visits the patient's motivation or perceived barriers for changing behavior were assessed. Supporting factors were not discussed at all. Conclusion In 40% of the hypertension-related visits lifestyle topics were discussed. However, both the frequency and quality of lifestyle advice can be improved.
Gongora, Maria Carolina; Wenger, Nanette K.
Pregnancy causes significant metabolic and hemodynamic changes in a woman’s physiology to allow for fetal growth. The inability to adapt to these changes might result in the development of hypertensive disorders of pregnancy (hypertension, preeclampsia or eclampsia), gestational diabetes and preterm birth. Contrary to previous beliefs these complications are not limited to the pregnancy period and may leave permanent vascular and metabolic damage. There is in addition, a direct association between these disorders and increased risk of future cardiovascular disease (CVD, including hypertension, ischemic heart disease, heart failure and stroke) and diabetes mellitus. Despite abundant evidence of this association, women who present with these complications of pregnancy do not receive adequate postpartum follow up and counseling regarding their increased risk of future CVD. The postpartum period in these women represents a unique opportunity to intervene with lifestyle modifications designed to reduce the development of premature cardiovascular complications. In some cases it allows early diagnosis and treatment of chronic hypertension or diabetes mellitus. The awareness of this relationship is growing in the medical community, especially among obstetricians and primary care physicians, who play a pivotal role in detecting these complications and assuring appropriate follow up. PMID:26473833
Maria Carolina Gongora
Full Text Available Pregnancy causes significant metabolic and hemodynamic changes in a woman’s physiology to allow for fetal growth. The inability to adapt to these changes might result in the development of hypertensive disorders of pregnancy (hypertension, preeclampsia or eclampsia, gestational diabetes and preterm birth. Contrary to previous beliefs these complications are not limited to the pregnancy period and may leave permanent vascular and metabolic damage. There is in addition, a direct association between these disorders and increased risk of future cardiovascular disease (CVD, including hypertension, ischemic heart disease, heart failure and stroke and diabetes mellitus. Despite abundant evidence of this association, women who present with these complications of pregnancy do not receive adequate postpartum follow up and counseling regarding their increased risk of future CVD. The postpartum period in these women represents a unique opportunity to intervene with lifestyle modifications designed to reduce the development of premature cardiovascular complications. In some cases it allows early diagnosis and treatment of chronic hypertension or diabetes mellitus. The awareness of this relationship is growing in the medical community, especially among obstetricians and primary care physicians, who play a pivotal role in detecting these complications and assuring appropriate follow up.
Kaleta, Dorota; Makowiec-Dabrowska, Teresa; Jegier, Anna
In many countries around the world, negative changes in lifestyles are observed. The aim of this study was to analyze the influence of selected lifestyle indicators on work ability among professionally active individuals. The study was performed in the randomly selected group of full-time employees (94 men and 93 women) living in the city of Lódź. Work ability was measured with the work ability index and lifestyle characteristic was assessed with the healthy lifestyle index. We analyzed four lifestyle indicators: non-smoking, healthy weight, fiber intake per day, and regular physical activity. Logistic regression was used to estimate odds ratios and 95% confidence intervals to control the effects of lifestyle and work ability. The analysis of lifestyle index indicated that 27.7, 30.9, 27.7 and 11.7% of men and 15.1, 21.5, 35.5 and 26.9% of women scored 0, 1, 2, 3 points, respectively. Only 2.1% of men and 1.1% of women met the criteria for the healthy lifestyle (score 4). Work ability was excellent, good and moderate in 38.3, 46.8 and 14.9% of men, and in 39.8, 14.9 and 19.3% of women, respectively. Poor work ability was found in 9.7% women. Work ability was strongly associated with lifestyle in both men and women. Among men with index score = 0, the risk of moderate work ability was nearly seven times higher than in men whose lifestyle index score exceeded 1 or more points (OR = 6.67; 95% CI: 1.94-22.90). Among women with lifestyle index score = 0, the risk of moderate or lower work ability was also highly elevated as compared to those with lifestyle index = 1 or higher (OR = 14.44; 95% CI: 3.53-59.04). Prophylactic schedules associated with the improvement of lifestyles should be addressed to all adults. Future programs aimed at increasing work ability should consider work- and lifestyle-related factors.
Since the leading cause of morbidity and mortality is cardiovascular diseases, every individual should think regularly about possessing and maintaining cardiovascular health. In reality, this self-processing is delayed until the occurrence of complications related to cardiovascular inefficiency manifested as chest pain and/or dyspnea. However, people should be trained to think about their cardiovascular health issues as a vital need from early childhood. This goal is achievable by understanding it as a "true human derive" and its consecutive "behaviors". Most people are unaware of their real needs, and even if they know all of their cardiovascular needs, this knowledge is not projected in their behaviors. In the present paper, I try to outline the Herzberg two-factor hypothesis and Maslow's hierarchy of needs.
Since the leading cause of morbidity and mortality is cardiovascular diseases, every individual should think regularly about possessing and maintaining cardiovascular health. In reality, this self-processing is delayed until the occurrence of complications related to cardiovascular inefficiency manifested as chest pain and/or dyspnea. However, people should be trained to think about their cardiovascular health issues as a vital need from early childhood. This goal is achievable by understanding it as a "true human derive" and its consecutive "behaviors". Most people are unaware of their real needs, and even if they know all of their cardiovascular needs, this knowledge is not projected in their behaviors. In the present paper, I try to outline the Herzberg two-factor hypothesis and Maslow's hierarchy of needs. PMID:24963317
Wallace, Robyn A.; Schluter, Philip
Background: Little is known about the cardiovascular disease (CVD) risk factor profile for older adults with intellectual disability (ID). As many CVD risk factors are treatable by lifestyle changes, confirmation of the risk factor profile for older adults with ID could substantially impact upon preventive health practices for this group. Method:…
Emmen, Maria J.; Peters, Ellen; Elving, Lammy D.; Bredie, Sebastian J. H.; Wollersheim, Hub; Bleijenberg, Gijs; Schippers, Gerard M.
OBJECTIVE: Examining the prevalence of risk behavior and motivation to change among hospital outpatients with a high cardiovascular risk, and the implementation and results of a brief behavioral feedback intervention by internists. METHODS: One hundred and sixty-one patients completed a lifestyle
Emmen, M.J.; Peters, E.; Elving, L.D.; Bredie, S.J.H.; Wollersheim, H.; Bleijenberg, G.; Schippers, G.M.
Objective: Examining the prevalence of risk behavior and motivation to change among hospital outpatients with a high cardiovascular risk, and the implementation and results of a brief behavioral feedback intervention by internists. Methods: One hundred and sixty-one patients completed a lifestyle
Emmen, M.J.; Peters, E.; Elving, L.D.; Bredie, S.J.H.; Wollersheim, H.C.H.; Bleijenberg, G.; Schippers, G.M.
OBJECTIVE: Examining the prevalence of risk behavior and motivation to change among hospital outpatients with a high cardiovascular risk, and the implementation and results of a brief behavioral feedback intervention by internists. METHODS: One hundred and sixty-one patients completed a lifestyle
Full Text Available Tocotrienols have been reported to improve lipid profiles, reduce atherosclerotic lesions, decrease blood glucose and glycated haemoglobin concentrations, normalise blood pressure in vivo and inhibit adipogenesis in vitro, yet their role in the metabolic syndrome has not been investigated. In this study, we investigated the effects of palm tocotrienol-rich fraction (TRF on high carbohydrate, high fat diet-induced metabolic, cardiovascular and liver dysfunction in rats. Rats fed a high carbohydrate, high fat diet for 16 weeks developed abdominal obesity, hypertension, impaired glucose and insulin tolerance with increased ventricular stiffness, lower systolic function and reduced liver function. TRF treatment improved ventricular function, attenuated cardiac stiffness and hypertension, and improved glucose and insulin tolerance, with reduced left ventricular collagen deposition and inflammatory cell infiltration. TRF improved liver structure and function with reduced plasma liver enzymes, inflammatory cell infiltration, fat vacuoles and balloon hepatocytes. TRF reduced plasma free fatty acid and triglyceride concentrations but only omental fat deposition was decreased in the abdomen. These results suggest that tocotrienols protect the heart and liver, and improve plasma glucose and lipid profiles with minimal changes in abdominal obesity in this model of human metabolic syndrome.
Jensen, Annesofie L.; Wind, Gitte; Langdahl, Bente Lomholt
-based knowledge and personal experiences and preferences, respectively, leading to a two-way exchange of information and deliberation about recommendations. Though teachers and patients explored the implications of the decisions and shared their preferences, teachers stressed that the patients ultimately had......Patients with chronic diseases like osteoporosis constantly have to make decisions related to their disease. Multifaceted osteoporosis group education (GE) may support patients’ decision-making. This study investigated multifaceted osteoporosis GE focusing on the impact of GE on patients’ decision....... Results. Attending GE had an impact on the patients’ decision-making in all educational themes. Patients decided on new ways to manage osteoporosis and made decisions regarding bone health and how to implement a lifestyle ensuring bone health. During GE, teachers and patients shared evidence...
Schweier, Rebecca; Grande, Gesine; Richter, Cynthia; Riedel-Heller, Steffi G; Romppel, Matthias
To investigate the use of lebensstil-aendern.de ("lifestyle change"), a website providing peer narratives of experiences with successful lifestyle change, and to analyze whether peer model characteristics, clip content, and media type have an influence on the number of visitors, dwell time, and exit rates. An in-depth statistical analysis of website use with multilevel regression analyses. In two years, lebensstil-aendern.de attracted 12,844 visitors. The in-depth statistical analysis of usage rates demonstrated that audio clips were less popular than video or text-only clips, longer clips attracted more visitors, and clips by younger and female interviewees were preferred. User preferences for clip content categories differed between heart and back pain patients. Clips about stress management drew the smallest numbers of visitors in both indication modules. Patients are interested in the experiences of others. Because the quality of information for user-generated content is generally low, healthcare providers should include quality-assured patient narratives in their interventions. User preferences for content, medium, and peer characteristics need to be taken into account. If healthcare providers decide to include patient experiences in their websites, they should plan their intervention according to the different needs and preferences of users. Copyright © 2018 Elsevier B.V. All rights reserved.
Full Text Available Abstract Background Few studies have investigated the specific effect of single intervention components in randomized controlled trials. The purpose was to investigate the effect of adding group-based diet and exercise counselling to individual life-style counselling on long-term changes in dietary habits. Methods The study was a randomized controlled intervention study. From a general Danish population, aged 30 to 60 years (n = 61,301, two random sample were drawn (group A, n = 11,708; group B, n = 1,308. Subjects were invited for a health screening program. Participation rate was 52.5%. All participants received individual life-style counselling. Individuals at high risk of ischemic heart disease in group A were furthermore offered group-based life-style counselling. The intervention was repeated for high-risk individuals after one and three years. At five-year follow-up all participants were invited for a health examination. High risk individuals were included in this study (n = 2 356 and changes in dietary intake were analyzed using multilevel linear regression analyses. Results At one-year follow-up group A had significantly increased the unsaturated/saturated fat ratio compared to group B and in men a significantly greater decrease in saturated fat intake was found in group A compared to group B (net change: -1.13 E%; P = 0.003. No differences were found between group A and B at three-year follow-up. At five-year follow-up group A had significantly increased the unsaturated/saturated fat ratio (net change: 0.09; P = 0.01 and the fish intake compared to group B (net change: 5.4 g/day; P = 0.05. Further, in men a non-significant tendency of a greater decrease was found at five year follow-up in group A compared to group B (net change: -0.68 E%; P = 0.10. The intake of fibre and vegetables increased in both groups, however, no significant difference was found between the groups. No differences between groups were found for saturated fat
Groot, P.C.E. de
This thesis presents studies on vascular adaptation to physical inactivity and deconditioning. Although it is clear that physical inactivity is an important risk factor for cardiovascular disease, the underlying physiological mechanisms have not yet been elucidated. In contrast to physical
Gabus, Vincent; Wuerzner, Grégoire; Saubade, Mathieu; Favre, Lucie; Jacot Sadowski, Isabelle; Nanchen, David
Atherosclerosis is a disease which develops very gradually over decades. Under the influence of modifiable cardiovascular risk factors, such as blood pressure, LDL-cholesterol level, smoking or lifestyle, clinical symptoms of atherosclerosis manifest more or less early in life. When cardiovascular risk factors accumulate, the risk of having a cardiovascular event increases and the benefits of prevention measures are greater. This article summarizes existing strategies for controlling modifiable cardiovascular risk factors in primary prevention. The physician can rely on an interprofessional network of cardiovascular prevention. Managing risk factors while respecting the autonomy and priorities of the patient will bring the greatest benefit.
Full Text Available Shashi K AgarwalMedical Director, Agarwal Health Center, NJ, USAAbstract: Regular physical activity during leisure time has been shown to be associated with better health outcomes. The American Heart Association, the Centers for Disease Control and Prevention and the American College of Sports Medicine all recommend regular physical activity of moderate intensity for the prevention and complementary treatment of several diseases. The therapeutic role of exercise in maintaining good health and treating diseases is not new. The benefits of physical activity date back to Susruta, a 600 BC physician in India, who prescribed exercise to patients. Hippocrates (460–377 BC wrote “in order to remain healthy, the entire day should be devoted exclusively to ways and means of increasing one's strength and staying healthy, and the best way to do so is through physical exercise.” Plato (427–347 BC referred to medicine as a sister art to physical exercise while the noted ancient Greek physician Galen (129–217 AD penned several essays on aerobic fitness and strengthening muscles. This article briefly reviews the beneficial effects of physical activity on cardiovascular diseases.Keywords: exercise, cardiovascular disease, lifestyle changes, physical activity, good health
Mar 2, 2016 ... lifestyle, diet and lack of adequate exercise which have led to ... may have influenced their lifestyle, dietary habit and subsequently their nutritional/health status. Key words: Hyperlipidemia, nutritional status, diet, diabetes, cardiovascular diseases. .... only secondary school education, 5.8% had only primary.
Strak, Maciej; Janssen, Nicole; Beelen, Rob; Schmitz, Oliver; Karssenberg, Derek; Houthuijs, Danny; van den Brink, Carolien; Dijst, Martin; Brunekreef, Bert; Hoek, Gerard
and overweight were negatively associated with air pollution. The effect estimates were small (mostly air pollutant standard deviations). Direction and magnitude of the associations depended on the pollutant, use of continuous vs. categorical scale of the lifestyle variable, and level of adjustment for individual and area-level SES. Associations further differed between subgroups (age, sex) in the population. Despite the small associations between air pollution and smoking intensity, indirect adjustment resulted in considerable changes of air pollution risk estimates for cardiovascular and especially lung cancer mortality. Individual lifestyle-related risk factors were weakly associated with long-term exposure to air pollution in the Netherlands. Indirect adjustment for missing lifestyle factors in administrative data cohort studies may substantially affect air pollution mortality risk estimates. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.
Leticia Espinosa González
Full Text Available La calidad de vida depende directamente del medio natural y su calidad. La valoración sobre la salud no solo depende de las necesidades y los conocimientos del individuo, sino también de las condiciones de vida y trabajo. Se realiza un estudio donde se muestran los cambios sociales del modo y estilo de vida de la población y su relación con el proceso salud-enfermedad, así como los cambios del modo y estilo de vida que ayudan a promover salud y prevenir enfermedades, basados precisamente en la existencia de los factores determinantes del estado de salud y la modificación que sufren estos por el constante desarrollo social y científico-técnico. Se constata que el modo y estilo de vida de la población depende del sistema socioeconómico imperante. Los cambios del modo y estilo de vida determinan cambios en las condiciones y la calidad de vida de las personas y modifican el proceso salud-enfermedad.The quality of life depends directly on the natural environment and its quality. The assessment of health depends not only on the needs and knowledge of the individual, but also on the living and working conditions. Based precisely on the existance of determinants of the health status and on the modification they suffer due to the constant social, scientific and technical development, we propose ourselves to show the social changes of the lifestyle of the population and their relation to the health-disease process, and to prove how these changes help to promote health and to prevent diseases. The changes of the lifestyle determine changes in the conditions and quality of life of the persons and modify the health-disease process.
Full Text Available Hereditary cystatin C amyloid angiopathy (HCCAA is an autosomal dominant disease with high penetrance, manifest by brain hemorrhages in young normotensive adults. In Iceland, this condition is caused by the L68Q mutation in the cystatin C gene, with contemporary carriers reaching an average age of only 30 years. Here, we report, based both on linkage disequilibrium and genealogical evidence, that all known copies of this mutation derive from a common ancestor born roughly 18 generations ago. Intriguingly, the genealogies reveal that obligate L68Q carriers born 1825 to 1900 experienced a drastic reduction in life span, from 65 years to the present-day average. At the same time, a parent-of-origin effect emerged, whereby maternal inheritance of the mutation was associated with a 9 year reduction in life span relative to paternal inheritance. As these trends can be observed in several different extended families, many generations after the mutational event, it seems likely that some environmental factor is responsible, perhaps linked to radical changes in the life-style of Icelanders during this period. A mutation with such radically different phenotypic effects in reaction to normal variation in human life-style not only opens the possibility of preventive strategies for HCCAA, but it may also provide novel insights into the complex relationship between genotype and environment in human disease.
Full Text Available Abstract Background To examine the effects of a 6 month lifestyle intervention on quality of life, depression, self-efficacy and eating behavior changes in overweight and obese endometrial cancer survivors. Methods Early stage endometrial cancer survivors were randomized to intervention (n = 23 or usual care (n = 22 groups. Chi-square, Student's t-test and repeated measures analysis of variance were used in intent-to-treat analyses. Outcomes were also examined according to weight loss. Results Morbidly obese patients had significantly lower self-efficacy, specifically when feeling physical discomfort. There was a significant improvement for self-efficacy related to social pressure (p = .03 and restraint (p = .02 in the LI group. There was a significant difference for emotional well-being quality of life (p = .02, self-efficacy related to negative emotions (p Conclusion This pilot lifestyle intervention had no effect on quality of life or depression but did improve self-efficacy and some eating behaviors. Trial Registration http://www.clinicaltrials.gov; NCT00420979
Pujante, Pedro; Hellín, María D; Fornovi, Aisa; Martínez Camblor, Pablo; Ferrer, Mercedes; García-Zafra, Victoria; Hernández, Antonio M; Frutos, María D; Luján-Monpeán, Juan; Tébar, Javier
Bariatric surgery is a valuable tool for metabolic control in obese diabetic patients. The aim of this study was to determine changes in weight and carbohydrate and lipid metabolism in obese diabetic patients during the first 4 years after bariatric surgery. A retrospective study was performed in 104 patients (71 women; mean age, 53.0 [0.9] years; mean body mass index, 46.8 [0.7]) with type 2 diabetes mellitus (median duration, 3 years) who underwent laparoscopic proximal gastric bypass. Blood glucose levels and glycated hemoglobin concentrations decreased during the first 1-3 postoperative months. Values stabilized for the rest of the study period, allowing hypoglycemic treatment to be discontinued in 80% of the patients. No significant differences were observed as a function of the body mass index, diabetes mellitus duration, or previous antidiabetic treatment. Weight decreased during the first 15-24 months and slightly increased afterward. Levels of total cholesterol, triglycerides, and low-density lipoprotein significantly decreased, and target values were reached after 12 months in 80% of the patients. No correlation was found between these reductions and weight loss. Similarly, high-density lipoprotein concentrations decreased until 12 months after surgery. Although concentrations showed a subsequent slight increase, target or lower high-density lipoprotein values were achieved at 24 months postintervention in 85% of the patients. Bariatric surgery is effective for the treatment of obese diabetic patients, contributing to their metabolic control and reducing their cardiovascular risk. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.
Rabczenko, Daniel; Wojtyniak, Bogdan; Kuchcik, Magdalena; Seroka, Wojciech
The paper presents results of analysis of short-term effect of changes in maximal daily temperature on daily mortality from cardiovascular diseases in warm season in years 1999-2006. Analysis was carried out in six large Polish cities--Katowice, Kraków, Łódź, Poznań, Warszawa and Wrocław. Generalized additive models were used in the analysis. Potential confounding factors--long term changes of mortality, day of week and other meteorological factors (atmospheric pressure, humidity, mean wind speed) were taken into account during model building process. Analysis was done for two age groups--0-69 and 70 years and older. Significant, positive association between daily maximal temperature and risk of death from cardiovascular diseases was found only in older age group.
Vancampfort, Davy; Madou, Tomas; Moens, Herman; De Backer, Tanja; Vanhalst, Patrick; Helon, Chris; Naert, Pieter; Rosenbaum, Simon; Stubbs, Brendon; Probst, Michel
There is a need for theoretically-based research on the motivational processes linked to the adoption and maintenance of an active lifestyle in people with affective disorders. Within the Self-Determination Theory (SDT) framework, we investigated the SDT tenets in people with major depressive disorder or bipolar disorder by examining the factor structure of the Behavioural Regulation in Exercise Questionnaire-2 (BREQ-2) and by investigating associations between motivation, the Positive and Negative Affect Scale (PANAS) and International Physical Activity Questionnaire (IPAQ) scores. A total of 165 patients (105 ♀) (45.6 ± 14.2 years) agreed to participate. An exploratory factor analysis demonstrated sufficient convergence with the original factor for amotivation, and external and introjected regulation. The items of identified and intrinsic regulation loaded on the same factor, which was labelled autonomous regulation. Significant correlations were found between the total IPAQ score and the subscales amotivation, external regulation, introjected regulation and autonomous regulation. The relative autonomy index (RAI) was associated with the PANAS scores. Differences in RAI were found between physically inactive and active participants. Our results suggest that in people with affective disorders the level of autonomous motivation may play an important role in the adoption and maintenance of health promoting behaviours. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Plavcová, Eva; Kyselý, Jan
Roč. 58, č. 6 (2014), s. 1327-1337 ISSN 0020-7128 R&D Projects: GA ČR(CZ) GAP209/11/1985 Institutional support: RVO:68378289 Keywords : weather * pressure change * cardiovascular disease * morbidity * mortality * Central Europe Subject RIV: DG - Athmosphere Sciences, Meteorology Impact factor: 3.246, year: 2014 http://link.springer.com/article/10.1007/s00484-013-0735-y
Nilsen, Vegard; Bakke, Per Sigvald; Rohde, Gudrun; Gallefoss, Frode
To assess health-related quality of life (HRQOL) of subjects at risk of type 2 diabetes undergoing lifestyle intervention, and predictors for improved HRQOL. The Finnish Diabetes Risk Score was used by general practitioners to identify individuals at risk. Low-intensity interventions with an 18-month follow-up were employed. HRQOL was assessed using the SF-36 at baseline and compared with results from a general Norwegian population survey and further at 6 and 18 months. Simple and multiple linear regression analyses were applied to identify predictors of changes in HRQOL of clinical importance. Two hundred and thirteen participants (50 % women; mean age: 46 years, mean body mass index: 37) were included: 182 returned for 18-month follow-up, of whom 172 completed the HRQOL questionnaire. HRQOL was reduced with clinical significance compared with general Norwegians. The mean changes in HRQOL from the baseline to the follow-up were not of clinical importance. However, one out of three individuals achieved a moderate or large clinical improvement in HRQOL. The best determinant for improved HRQOL was obtained for a composite, clinically significant lifestyle change, i.e. both a weight reduction of at least 5 % and an improvement in exercise capacity of at least 10 %, which was associated with an improvement in five out of the eight SF-36 domains. Subjects at risk of type 2 diabetes report a clinically important reduction in HRQOL compared with general Norwegians. The best predictor of improved HRQOL was a small weight loss combined with a small improvement in aerobic capacity.
Verreth, Wim; Verhamme, Peter; Pelat, Michael; Ganame, Javier; Bielicki, John K.; Mertens, Ann; Quarck, Rozenn; Benhabiles, Nora; Marguerie, Gerard; Mackness, Bharti; Mackness, Mike; Ninio, Ewa; Herregods, Marie-Christine; Balligand, Jean-Luc; Holvoet, Paul
Weight-loss in obese insulin-resistant, but not in insulin-sensitive, persons reduces CHD risk. It is not known to what extent changes in the adipose gene expression profile are important for reducing CHD risk. We studied the effect of diet restriction-induced weight-loss on gene expression in adipose tissue, atherosclerosis and cardiovascular function in mice with combined leptin and LDL-receptor deficiency. Obesity, hypertriglyceridemia and insulin-resistance are associated with hypertension, impaired left ventricle function and accelerated atherosclerosis in those mice. Diet restriction during 12 weeks caused a 45% weight-loss and changes in the gene expression in adipose tissue of PPARa and PPAR? and of key genes regulating glucose transport and insulin sensitivity, lipid metabolism, oxidative stress and inflammation, most of which are under the transcriptional control of PPARs. These changes were associated with increased insulin-sensitivity, decreased hypertriglyceridemia, reduced mean 24-hour blood pressure and heart rate, restored circadian variations of blood pressure and heart rate, increased ejection fraction, and reduced atherosclerosis. Thus, induction of PPARa and PPAR? in adipose tissue is a key mechanism for reducing atherosclerosis and improving cardiovascular function resulting from weight-loss. Our observations point to the critical role of PPARs in the pathogenesis of cardiovascular features of the metabolic syndrome.
Nguyen, Vi; George, Jacob
Nonalcoholic fatty liver disease (NAFLD) encompasses a spectrum of abnormalities that can range from bland liver fat (steatosis), to hepatic inflammation and liver injury (steatohepatitis). It is estimated that NAFLD will become the principal cause of liver disease in Western nations and the leading indication for liver transplantation. Advancements in disease recognition and management are therefore paramount. Although the development of new, reliable drug therapies is vital, lifestyle interventions remain the most effective treatment modality. In addition to weight loss as a primary measure of treatment success, there is growing recognition that other endpoints, including the prevention or delay of diabetes onset, reduced cardiovascular events, prevention of cancer, and improved overall mortality, are equally important outcomes that can be independently modified by lifestyle change. Moreover, NAFLD is inextricably part of a complex, systemic disease process that is linked with deeply entrenched maladaptive lifestyle behaviors. Thus, a holistic, multidisciplinary, and individualized approach to disease management will be the key to achieving any realistic population-level change. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Rogério Brandão Wichi
Full Text Available The aging process is associated with alterations in the cardiovascular and autonomic nervous systems. Autonomic changes related to aging involve parasympathetic and sympathetic alterations leading to a higher incidence of cardiovascular disease morbidity and mortality. Several studies have suggested that physical exercise is effective in preventing deleterious changes. Chronic exercise in geriatrics seems to be associated with improvement in the cardiovascular system and seems to promote a healthy lifestyle. In this review, we address the major effects of aging on the autonomic nervous system in the context of cardiovascular control. We examine the use of chronic exercise to prevent cardiovascular changes during the aging process.
Wichi, Rogério Brandão; De Angelis, Kátia; Jones, Lia; Irigoyen, Maria Claudia
The aging process is associated with alterations in the cardiovascular and autonomic nervous systems. Autonomic changes related to aging involve parasympathetic and sympathetic alterations leading to a higher incidence of cardiovascular disease morbidity and mortality. Several studies have suggested that physical exercise is effective in preventing deleterious changes. Chronic exercise in geriatrics seems to be associated with improvement in the cardiovascular system and seems to promote a healthy lifestyle. In this review, we address the major effects of aging on the autonomic nervous system in the context of cardiovascular control. We examine the use of chronic exercise to prevent cardiovascular changes during the aging process. PMID:19330253
van Rinsum, Celeste E; Gerards, Sanne M P L; Rutten, Geert M; van de Goor, Ien A M; Kremers, Stef P J
Combined lifestyle interventions (CLIs) have proved to be effective in changing and maintaining behavioural lifestyle changes and reducing overweight and obesity, in clinical and real-world settings. In this CLI, lifestyle coaches are expected to promote lifestyle changes of participants regarding physical activity and diet. In the Coaching on Lifestyle (CooL) intervention, which takes a period of 8 to 10 months, lifestyle coaches counsel adults and children aged 4 years and older (and their parents) who are obese or are overweight with an increased risk of developing cardiovascular diseases or type II diabetes. In group and individual sessions, themes such as physical activity, dietary behaviours, sleep and stress are addressed. The aim of the present study is to monitor the implementation process of the CooL intervention and to examine how the lifestyle coaches contribute to a healthier lifestyle of the participants. This action-oriented study involves monitoring the implementation process of the CooL intervention and examining the lifestyle changes achieved by participants over time, in a one-group pre-post design using mixed methods. Methods include semi-structured interviews, observations, document analysis, biomedical parameters and questionnaires. The added value of the CooL study lies in its action-oriented approach and the use of mixed methods, including both qualitative and quantitative research methods. The long-term coaching used in the CooL intervention is expected to have beneficial effects on sustained lifestyle changes. NTR6208 ; date registered: 13-01-2017.
Lanfer, Anne; Mehlig, Kirsten; Heitmann, Berit L
Accumulating evidence consistently shows that small hip circumference (HC) is related to increased risk of cardiovascular disease (CVD), coronary heart disease, diabetes, and premature death in women. This study aims to clarify whether this inverse association can be found in both normal...
Aengevaeren, V.L.; Hopman, M.T.E.; Thijssen, D.H.J.; Kimmenade, R.R.J. van; Boer, M.J. de; Eijsvogels, T.M.H.
BACKGROUND: Healthy athletes demonstrated increased B-type natriuretic peptide (BNP) concentrations following exercise, but it is unknown whether these responses are exaggerated in individuals with cardiovascular risk factors (CVRF) or disease (CVD). We compared exercise-induced increases in BNP
Lindahl, Bernt; Nilssön, Torbjörn K; Borch-Johnsen, Knut
AIMS: To compare data on cardiovascular risk factor changes in lipids, insulin, proinsulin, fibrinolysis, leptin and C-reactive protein, and on diabetes incidence, in relation to changes in lifestyle. METHODS: The study was a randomized lifestyle intervention trial conducted in northern Sweden......, and reduced the risk for type 2 diabetes, but the effects persisted only as long as the new lifestyle was maintained. Increased physical activity seemed to be the behaviour that was most easy to preserve....... between 1995 and 2000, in 168 individuals with impaired glucose tolerance (IGT) and body mass index above 27 at start. The intensive intervention group (n = 83) was subjected to a 1-month residential lifestyle programme. The usual care group (n = 85) participated in a health examination ending...
Hou, Yi-Chou; Lin, Yen-Ju; Lu, Kuo-Cheng; Chiang, Han-Sun; Chang, Chia-Chi; Yang, Li-King
Music therapy has been applied in hemodialysis (HD) patients for relieving mental stress. Whether the stress-relieving effect by music therapy is predictive of clinical outcome in HD patients is still unclear. We recruited a convenience sample of 99 patients on maintenance HD and randomly assigned them to the experimental (n=49) or control (n=50) group. The experimental group received relaxing music therapy for 1 week, whereas the control group received no music therapy. In the experimental group, we compared cardiovascular mortality in the patients with and without cortisol changes. The salivary cortisol level was lowered after 1 week of music therapy in the experimental group (-2.41±3.08 vs 1.66±2.11 pg/mL, P 0.6 pg/mL (83.8% vs 63.6%, P predict cardiovascular mortality in patients under maintenance HD.
Purpose: To examine relationships among psychosocial constructs (PSC) of behavior change and post-intervention changes in physical activity (PA) and dietary outcomes. Design: Non-controlled, pre- post-experimental intervention. Setting: Midsized, southern United States city. Subjects: 269 prima...
Malekshah, Akbar Fazel-tabar; Zaroudi, Marsa; Etemadi, Arash; Islami, Farhad; Sepanlou, Sadaf; Sharafkhah, Maryam; Keshtkar, Abbas-Ali; Khademi, Hooman; Poustchi, Hossein; Hekmatdoost, Azita; Pourshams, Akram; Sani, Akbar Feiz; Jafari, Elham; Kamangar, Farin; Dawsey, Sanford M; Abnet, Christian C.; Pharoah, Paul D; Berennan, Paul J; Boffetta, Paolo; Esmaillzadeh, Ahmad; Malekzadeh, Reza
Background Most studies that have assessed the association between combined lifestyle factors and mortality outcomes have been conducted in populations of developed countries. Objectives The aim of this study was to examine the association between combined lifestyle scores and risk of all-cause and cause-specific mortality for the first time among Iranian adults. Methods The study population included 50,045 Iranians, 40–75 years of age, who were enrolled in the Golestan Cohort Study, between 2004 and 2008. The lifestyle risk factors used in this study included cigarette smoking, physical inactivity, and Alternative Healthy Eating Index. The lifestyle score ranged from zero (non-healthy) to 3 (most healthy) points. From the study baseline up to analysis, a total of 4691 mortality cases were recorded. Participants with chronic diseases at baseline, outlier reports of calorie intake, missing data, and body mass index of less than 18.5 were excluded from the analyses. Cox regression models were fitted to establish the association between combined lifestyle scores and mortality outcomes. Results After implementing the exclusion criteria, data from 40,708 participants were included in analyses. During 8.08 years of follow-up, 3,039 cases of death due to all causes were recorded. The adjusted hazard ratio of healthy life style score, compared with non-healthy lifestyle score, was 0.68(95% CI: 0.54, 0.86) for all-cause mortality, 0.53(95% CI: 0.37, 0.77) for cardiovascular mortality, and 0.82(95% CI: 0.53; 1.26) for mortality due to cancer. When we excluded the first two years of follow up from the analysis, the protective association between healthy lifestyle score and cardiovascular death did not change much 0.55 (95% CI: 0.36, 0.84), but the inverse association with all-cause mortality became weaker 0.72 (95% CI: 0.55, 0.94), and the association with cancer mortality was non-significant 0.92 (95% CI: 0.58, 1.48). In the gender-stratified analysis, we found an inverse
Lubjuhn, S.; Pratt, N.
This paper argues that Entertainment-Education (E-E) is a striking communication strategy for reaching middle and lower socio-economic classes with climate-friendly lifestyle messages. On the international level (e.g. in the US and the Netherlands) E-E approaches are being theoretically grounded, whereas in Germany they are not yet. Therefore further theoretical discussion and mapping of E-E approaches is central for future research. As a first step towards providing further theoretical foundations for E-E in the field of sustainability, the authors suggest a threefold mapping of E-E approaches. The threefold mapping of E-E approaches for communicating climate-friendly lifestyles to middle and lower class consumers is based on recent results from academic research and practical developments on the media market. The commonalities among the three is that they all promote pro-sustainability messages in an affective-orientated rather than cognitive-orientated, factual manner. Differences can be found in: the sender of the sustainability message, the targeted consumer groups and the media approach in use. Based on this, the paper draws the conclusion that two new paths for further research activities in the field of Entertainment-Education can be proposed: (1) Improving the existing approaches in practice by using theoretical foundation from the E-E field. This comprises at its core (A) to do formative, process and summative effect research on the messages and (B) to use E-E theory from the field of social psychology, sociology and communication science for further improvement and (2) Generating new E-E theories by analyzing the existing practical approaches in the media to communicate climate change.
Lubjuhn, S; Pratt, N
This paper argues that Entertainment-Education (E-E) is a striking communication strategy for reaching middle and lower socio-economic classes with climate-friendly lifestyle messages. On the international level (e.g. in the US and the Netherlands) E-E approaches are being theoretically grounded, whereas in Germany they are not yet. Therefore further theoretical discussion and mapping of E-E approaches is central for future research. As a first step towards providing further theoretical foundations for E-E in the field of sustainability, the authors suggest a threefold mapping of E-E approaches. The threefold mapping of E-E approaches for communicating climate-friendly lifestyles to middle and lower class consumers is based on recent results from academic research and practical developments on the media market. The commonalities among the three is that they all promote pro-sustainability messages in an affective-orientated rather than cognitive-orientated, factual manner. Differences can be found in: the sender of the sustainability message, the targeted consumer groups and the media approach in use. Based on this, the paper draws the conclusion that two new paths for further research activities in the field of Entertainment-Education can be proposed: (1) Improving the existing approaches in practice by using theoretical foundation from the E-E field. This comprises at its core (A) to do formative, process and summative effect research on the messages and (B) to use E-E theory from the field of social psychology, sociology and communication science for further improvement and (2) Generating new E-E theories by analyzing the existing practical approaches in the media to communicate climate change.
Yong, Mei; Germann, Christina; Lang, Stefan; Oberlinner, Christoph
A potential "healthy shift worker effect" may bias the studied effect of shift work on health. The observed differences among shift and day workers in health behavior and health outcomes can be caused by: (i) primary selection, (ii) the influence from the shift work-related environment, and (iii) the impact of shift work. We aimed to study these potential sources. A cohort of 4754 male trainees who had finished their professional training and started their career in production in a chemical company between 1995 and 2012 was identified. Among them, 1348 (28%) were involved in rotating shift work and 3406 (72%) in day work. Information on health behavior and risk factors for cardiovascular diseases was retrieved from the medical examinations. This information was then compared (i) at the beginning of training, (ii) at the end of training, and (iii) 3 years after the employment, in relation to the working time. At the beginning of the training, the prevalence of smokers was higher among future shift workers (26% versus 21%), from 1995 to 2012. During the training and the first three years of employment, a marginal decline of systolic blood pressure and an elevation of triglyceride were related with shift work. No difference was found with respect to other risk factors for cardiovascular diseases. Our findings do not support a primary selection in favor of shift workers. An impact of shift work on the risk profile of cardiovascular diseases was not indicated in the observation period.
Di Mauro, Debora; Currò, Monica; Trimarchi, Fabio; Vecchio, Mercurio; Rizzo, Giuseppina; Barreca, Davide; Visalli, Giuseppa; Ientile, Riccardo; Caccamo, Daniela
Methylene-tetrahydrofolate reductase (MTHFR) and paraoxonase 1 (PON1) gene polymorphisms have been associated with hyperhomocysteinemia and oxidative stress increase, that are established cardiovascular risk factors. Given that intense physical activity may increase the susceptibility to adverse cardiovascular outcomes, here we investigated the effects of MTHFR C677T and A1298C as well as PON1 Q192R gene polymorphisms on cardiovascular risk markers in twenty-eight male water polo elite players. The mean plasma levels of homocysteine (Hcy) and advanced oxidation protein products (AOPP) were above reference limits in resting conditions, and increased after competition. Moreover, a positive correlation was found between Hcy and AOPP concentrations, and also between their variations (ratio post-exercise/pre-exercise values) and the variations of lactic dehydrogenase (LDH) and creatine kinase (CK) activities, known as muscle damage markers. The highest Hcy and AOPP values were found in subjects having either MTHFR CT/AC or TT/AA, and PON1 QR192 genotype, respectively. After exercise, Hcy concentrations significantly increased in CT/AC or TT/AA subjects than in athletes having other MTHFR genotypes. A training-induced increase in plasma levels of LDH and CK activities, as well as myoglobin concentrations, was also observed, even if significant differences were found only for CK activity in athletes with MTHFR CT/AC or TT/AA athletes. © Georg Thieme Verlag KG Stuttgart · New York.
... Disease Venous Thromboembolism Aortic Aneurysm More Medication or Lifestyle Changes for Pre-diabetes Updated:Aug 30,2016 What’s best? Medication or ... doesn’t “fix” things, or make a healthy lifestyle less important. Some people with diabetes will always need some help from medications, but ...
Herzfeld, T.; Huffman, S.K.; Rizov, M.
This paper presents evidence on the impact of individual as well as regional characteristics on changes in fat, protein, alcohol and cigarette consumption, and on diet’s diversity between 1994 and 2004. The results from a dynamic econometric model suggest that among individual determinants such as
Taylor Barry J
Full Text Available Abstract Background Because parental recognition of overweight in young children is poor, we need to determine how best to inform parents that their child is overweight in a way that enhances their acceptance and supports motivation for positive change. This study will assess 1 whether weight feedback delivered using motivational interviewing increases parental acceptance of their child's weight status and enhances motivation for behaviour change, and 2 whether a family-based individualised lifestyle intervention, delivered primarily by a MInT mentor with limited support from "expert" consultants in psychology, nutrition and physical activity, can improve weight outcomes after 12 and 24 months in young overweight children, compared with usual care. Methods/Design 1500 children aged 4-8 years will be screened for overweight (height, weight, waist, blood pressure, body composition. Parents will complete questionnaires on feeding practices, physical activity, diet, parenting, motivation for healthy lifestyles, and demographics. Parents of children classified as overweight (BMI ≥ CDC 85th will receive feedback about the results using Motivational interviewing or Usual care. Parental responses to feedback will be assessed two weeks later and participants will be invited into the intervention. Additional baseline measurements (accelerometry, diet, quality of life, child behaviour will be collected and families will be randomised to Tailored package or Usual care. Parents in the Usual care condition will meet once with an advisor who will offer general advice regarding healthy eating and activity. Parents in the Tailored package condition will attend a single session with an "expert team" (MInT mentor, dietitian, physical activity advisor, clinical psychologist to identify current challenges for the family, develop tailored goals for change, and plan behavioural strategies that best suit each family. The mentor will continue to provide support to the
Taylor, Rachael W; Brown, Deirdre; Dawson, Anna M; Haszard, Jill; Cox, Adell; Rose, Elaine A; Taylor, Barry J; Meredith-Jones, Kim; Treacy, Lee; Ross, Jim; William, Sheila M
Because parental recognition of overweight in young children is poor, we need to determine how best to inform parents that their child is overweight in a way that enhances their acceptance and supports motivation for positive change. This study will assess 1) whether weight feedback delivered using motivational interviewing increases parental acceptance of their child's weight status and enhances motivation for behaviour change, and 2) whether a family-based individualised lifestyle intervention, delivered primarily by a MInT mentor with limited support from "expert" consultants in psychology, nutrition and physical activity, can improve weight outcomes after 12 and 24 months in young overweight children, compared with usual care. 1500 children aged 4-8 years will be screened for overweight (height, weight, waist, blood pressure, body composition). Parents will complete questionnaires on feeding practices, physical activity, diet, parenting, motivation for healthy lifestyles, and demographics. Parents of children classified as overweight (BMI > or = CDC 85th) will receive feedback about the results using Motivational interviewing or Usual care. Parental responses to feedback will be assessed two weeks later and participants will be invited into the intervention. Additional baseline measurements (accelerometry, diet, quality of life, child behaviour) will be collected and families will be randomised to Tailored package or Usual care. Parents in the Usual care condition will meet once with an advisor who will offer general advice regarding healthy eating and activity. Parents in the Tailored package condition will attend a single session with an "expert team" (MInT mentor, dietitian, physical activity advisor, clinical psychologist) to identify current challenges for the family, develop tailored goals for change, and plan behavioural strategies that best suit each family. The mentor will continue to provide support to the family via telephone and in
Gonçalves Mota, Maria Paula; Santos, Zirlene; Soares, Jorge; Pereira, Ana; Fonseca, Sandra; Peixoto, Francisco; Gaivão, Isabel; Oliveira, Maria
Aging is dependent on biological processes that determine the aging of the organism at the cellular level. The Oxidative Stress Theory of Aging might explain some of the age-related changes in cell macromolecules. Moreover, exposome and lifestyle may also induce changes in cell damage induced by oxidative stress. The aim of the present study was to analyze the related redox changes in lymphocyte function of healthy women over 40 years old. Three groups: younger (YG: 40-49 years), middle aged (MAG: 50-59 years), and older (OG: ≥60 years) were evaluated on anthropometric variables, blood pressure, cardiovascular fitness, lifestyle habits, perceived stress, DNA damage, malondialdehyde, catalase activity, and total antioxidant capacity. Physical activity and cardiovascular fitness were significantly higher in YG and MAG as compared to the OG. Systolic blood pressure increased significantly with group age. Frequency and total amount of alcohol intake were lower in the OG and higher in the MAG. No significant differences were observed between the three groups in oxidative stress parameters. Only alcohol consumption was associated with the higher DNA FPG-sensitive sites, and only in the YG ( p stress parameters measured in the healthy women over the age of 40 who took part in the study. Conscious lifestyle behaviors (decrease in alcohol and smoking habits) could have impaired the expected age-related oxidative stress increase.
Mai, K S; Sandbaek, A; Borch-Johnsen, K
. The screening comprised two main steps: identification of high-risk individuals by a mailed risk score questionnaire, and subsequent testing of high-risk individuals by their general practitioner. Questionnaires on physical exercise [International Physical Activity Questionnaire (IPAQ), short form], smoking...... habits and alcohol consumption were mailed to the target population 1 month prior to the offer of screening, and at 12 months' follow-up. At follow-up, additional questions regarding perceived changes in dietary habits, smoking, alcohol consumption and exercise were included. Three pairs of comparison...... groups were analysed. RESULTS: One year after screening, smokers who underwent further testing reduced smoking by one daily cigarette more than people at low risk of diabetes. The rate of smokers was not reduced, and the result was not confirmed by data regarding perceived change. Alcohol intake...
Byrne, Sahara; Niederdeppe, Jeff; Avery, Rosemary J; Cantor, Jonathan
Previous research suggests that direct-to-consumer (DTC) advertisements for pharmaceutical drugs have the potential to influence consumers' perceptions of whether symptoms should be treated medically and/or through behavior change. However, the relative frequency of messages emphasizing these approaches in pharmaceutical advertising remains largely unknown. A content analysis of print and television advertisements for cholesterol management medication between 1994 and 2005 (for print) and between 1999 and 2007 (for television) was conducted. First, the extent to which established theoretical constructs drawn from health communication scholarship are depicted in the content of DTC cholesterol advertisements is quantified. Second, specific claims about behavior change inefficacy when a pharmaceutical alternative is available are identified. Findings indicate that DTC ads offer many mixed messages about the efficacy of diet and exercise in reducing cholesterol and risk of heart disease. Theoretical and practical implications of this work are discussed.
Parrinello, Christina M; Lutsey, Pamela L; Ballantyne, Christie M; Folsom, Aaron R; Pankow, James S; Selvin, Elizabeth
Single measurements of elevated high-sensitivity C-reactive protein (hs-CRP) are associated with increased risk of diabetes, cardiovascular disease, and mortality. Large increases or sustained elevations in hs-CRP may be associated with even greater risk of these outcomes. The objective of this study was to characterize the association of 6-year change in hs-CRP with incident diabetes, incident cardiovascular events (heart disease, stroke, and heart failure), and mortality. We included 10,160 ARIC participants with hs-CRP measured at visits 2 (1990-1992) and 4 (1996-1998). Change in hs-CRP was categorized as sustained low/moderate (<3 mg/L at both visits), decreased (≥3 mg/L at visit 2 and <3 mg/L at visit 4), increased (<3 mg/L at visit 2 and ≥3 mg/L at visit 4), and sustained elevated (≥3 mg/L at both visits). Cox proportional hazards models were used to assess the association of 6-year change in hs-CRP with incident diabetes, cardiovascular events, and death during ~15 years after visit 4. Compared with persons with sustained low/moderate hs-CRP, those with increased or sustained elevated hs-CRP had an increased risk of incident diabetes (hazard ratios [95% CIs] 1.56 [1.38-1.76] and 1.39 [1.25-1.56], respectively), whereas those with deceased hs-CRP did not. Persons with sustained elevated hs-CRP had an increased risk of coronary heart disease, ischemic stroke, heart failure, and mortality (hazard ratios [95% CIs] 1.51 [1.23-1.85], 1.70 [1.32-2.20], 1.60 [1.35-1.89], and 1.52 [1.37-1.69], respectively) compared with those with sustained low/moderate hs-CRP. Associations for sustained elevated hs-CRP were greater than for those with increased hs-CRP over 6 years. Large increases or sustained elevations in hs-CRP over a 6-year period were associated with a subsequent increased risk of diabetes, and persons with sustained elevations in hs-CRP were at the highest risk for cardiovascular disease and mortality. Two measurements of hs-CRP are better than one for
Full Text Available The rising prevalence of obesity and excessive adiposity are global public health concerns. Understanding determinants of changes in adiposity over time is critical for informing effective evidence-based prevention or treatment. However, limited information is available to achieve this objective. Cultural, demographic, environmental, and behavioral factors including socio-economic status (SES likely account for obesity development. To this end, we related these variables to anthropometric measures in 1058 black adult Tswana-speaking South Africans who were HIV negative in a prospective study over five years. Body mass index (BMI and waist circumference increased in both sexes, whereas triceps skinfold thickness remained the same. Over the five years, women moved to higher BMI categories and more were diagnosed with central obesity. Age correlated negatively, whereas SES, physical activity, energy, and fat intake correlated positively with adiposity markers in women. In men, SES, marital status, physical activity, and being urban predicted increases in adiposity. For women, SES and urbanicity increased, whereas menopause and smoking decreased adiposity. Among men, smokers had less change in BMI than those that never smoked over five years. Our findings suggest that interventions, focusing on the urban living, the married and those with the highest SES—the high-risk groups identified herein—are of primary importance to contain morbidity and premature mortality due to obesity in black South Africans.
Stuiver, Arjan; Brookhuis, Karel A; de Waard, Dick; Mulder, Ben
With on-going increases in traffic density and the availability of more and more in-vehicle technology, driver overload is a growing concern. To reduce the burden of workload on the driver, it is essential that support systems that become available are able to use estimations of drivers' workload. In this paper a short-term cardiovascular approach to assess drivers' mental workload is described using data collected in a driving simulator study. The effects of short lasting increases in task demand (40s) on heart rate and blood pressure and derived variability measures are applied as indicators of mental effort. Fifteen drivers participated in 6 sessions of 1.5h in a driving simulator study. Two traffic density levels (7.5minute segments) were compared in which short-segments (40s) of fog were used to induce additional workload demands. Higher traffic density was reflected in increased systolic blood pressure and decreased blood pressure variability. Heart rate variability and blood pressure variability measures decreased during driving in fog in the low traffic condition, indicating increased effort investment during fog in this condition. The results show that the described short-term measures can be applied to give an indication of cardiovascular reactivity as a function workload. Copyright © 2014 Elsevier B.V. All rights reserved.
Pires, António, E-mail: firstname.lastname@example.org; Martins, Paula [Centro Hospitalar e Universitário de Coimbra, Coimbra (Portugal); Pereira, Ana Margarida [Laboratório de Fisiologia - Instituto Biomédico de Investigação da Luz e Imagem da Faculdade de Medicina da Universidade de Coimbra, Coimbra (Portugal); Silva, Patricia Vaz; Marinho, Joana [Centro Hospitalar e Universitário de Coimbra, Coimbra (Portugal); Marques, Margarida [Laboratório de Estatística da Faculdade de Medicina da Universidade de Coimbra - Instituto Biomédico de Investigação da Luz e Imagem, Coimbra (Portugal); Castela, Eduardo [Centro Hospitalar e Universitário de Coimbra, Coimbra (Portugal); Sena, Cristina; Seiça, Raquel [Laboratório de Fisiologia - Instituto Biomédico de Investigação da Luz e Imagem da Faculdade de Medicina da Universidade de Coimbra, Coimbra (Portugal)
Obesity-related comorbidities are present in young obese children, providing a platform for early adult cardiovascular disorders. To compare and correlate markers of adiposity to metabolic disturbances, vascular and cardiac morphology in a European pediatric obese cohort. We carried out an observational and transversal analysis in a cohort consisting of 121 obese children of both sexes, between the ages of 6 and 17 years. The control group consisted of 40 children with normal body mass index within the same age range. Markers of adiposity, plasma lipids and lipoproteins, homeostasis model assessment-insulin resistance, common carotid artery intima-media thickness and left ventricular diameters were analyzed. There were statistically significant differences between the control and obese groups for the variables analyzed, all higher in the obese group, except for age, high-density lipoprotein cholesterol and adiponectin, higher in the control group. In the obese group, body mass index was directly correlated to left ventricular mass (r=0.542; p=0.001), the homeostasis model assessment-insulin resistance (r=0.378; p=<0.001) and mean common carotid artery intima-media thickness (r=0.378; p=<0.001). In that same group, insulin resistance was present in 38.1%, 12.5% had a combined dyslipidemic pattern, and eccentric hypertrophy was the most common left ventricular geometric pattern. These results suggest that these markers may be used in clinical practice to stratify cardiovascular risk, as well as to assess the impact of weight control programs.
Kim, Yang Sook; Park, Chang Yoon
This investigation was aimed to study the effect of contrast media on the cardiovascular system. So in this study, pithed rats were used whether alteration in cardiovascular system by contrast media were controlled centrally. Furthermore, several hypertonic solutions were also used to clarify the effect of contrast media. The results are as follows: 1. Intravenous injection of contrast media in rats (2.5 ml/kg) caused hypotension and bradycardia. The effects were neither blocked by pretreatment of atropine nor pyribenzamine+atropine. 2. NaCI 4.7%, dextrose 24.8%, urea 9.0% and glycerol 10.1% (v/v) which were equiosmolar with contrast media, caused hypotension, but did not affect the heart rate. 3. In pithed rats, intravenous injection of Angiografin increased blood pressure in a dose-dependant manner, and caused decrease in heart rate compared with those of control rats. 4. In pithed rats, bradycardia by intravascular injection with Angiografin was partially blocked by atropine. 5. Metrizamide of which iodine content was adjusted to 280 mg/ml caused increased in blood pressure when was injected intravenously in pithed rats with little effect on heart rate. 6. When perfused with contrast media in rat hindlimb at 15 ml/min./kg speed both perfusion pressure and flow effluent increased, simultaneously. These results suggest that hypotension might be caused by the central effect due to hyperosmolarity of contrast media and bradycardia caused by both parasympathetic stimulation and direct inhibitory action on the cardiac conductive system.
Pires, António; Martins, Paula; Pereira, Ana Margarida; Silva, Patricia Vaz; Marinho, Joana; Marques, Margarida; Castela, Eduardo; Sena, Cristina; Seiça, Raquel
Obesity-related comorbidities are present in young obese children, providing a platform for early adult cardiovascular disorders. To compare and correlate markers of adiposity to metabolic disturbances, vascular and cardiac morphology in a European pediatric obese cohort. We carried out an observational and transversal analysis in a cohort consisting of 121 obese children of both sexes, between the ages of 6 and 17 years. The control group consisted of 40 children with normal body mass index within the same age range. Markers of adiposity, plasma lipids and lipoproteins, homeostasis model assessment-insulin resistance, common carotid artery intima-media thickness and left ventricular diameters were analyzed. There were statistically significant differences between the control and obese groups for the variables analyzed, all higher in the obese group, except for age, high-density lipoprotein cholesterol and adiponectin, higher in the control group. In the obese group, body mass index was directly correlated to left ventricular mass (r=0.542; p=0.001), the homeostasis model assessment-insulin resistance (r=0.378; p=<0.001) and mean common carotid artery intima-media thickness (r=0.378; p=<0.001). In that same group, insulin resistance was present in 38.1%, 12.5% had a combined dyslipidemic pattern, and eccentric hypertrophy was the most common left ventricular geometric pattern. These results suggest that these markers may be used in clinical practice to stratify cardiovascular risk, as well as to assess the impact of weight control programs
Full Text Available OBJETIVO: Avaliar a eficácia de um programa destinado a promover mudanças no estilo de vida por meio de intervenção psicológica associado à terapia farmacológica para redução do risco coronariano em pacientes com hipertensão não-controlada, sobrepeso e dislipidemia acompanhados durante 11 meses. MÉTODOS: Estudo controlado e aleatório com 74 pacientes distribuídos para três programas de tratamento distintos. Um grupo (TC recebeu exclusivamente tratamento farmacológico convencional. O grupo de orientação (GO recebeu tratamento farmacológico e participou de um programa de orientação para controle dos fatores de risco cardiovascular. O terceiro grupo (IPEV recebeu tratamento farmacológico e participou de um programa de intervenção psicológica breve destinado a reduzir o nível de estresse e mudar o comportamento alimentar. A principal medida de avaliação foi o índice de risco de Framingham. RESULTADOS: Os pacientes do grupo TC obtiveram uma redução média de 18% (p = 0,001 no risco coronariano; os pacientes do grupo GO apresentaram um aumento de risco de 0,8% (NS; e os pacientes do grupo IPEV obtiveram uma redução média de 27% no índice de risco de Framingham (p = 0,001. CONCLUSÃO: O tratamento farmacológico aliado a um programa de intervenção psicológica destinado a reduzir o nível de estresse e mudar o comportamento alimentar resultou em benefícios adicionais na redução de risco coronariano.OBJECTIVE: To evaluate the efficacy of a program of lifestyle change through psychological intervention, combined with pharmacological therapy, for coronary risk reduction in uncontrolled hypertensive patients with overweight and dyslipidemia over 11 months of follow-up. METHODS: A randomized controlled trial with 74 patients assigned to three different treatment programs. One group (CT only received conventional pharmacological treatment. Another group (OG received pharmacological treatment and participated in a
Harris-Glocker, Miranda; Davidson, Kristin; Kochman, Lynda; Guzick, David; Hoeger, Kathleen
We studied the effect of metformin or placebo in a lifestyle modification program (LSM) combined with oral contraceptives (OC) on quality of life parameters measured by the PCOS questionnaire (PCOSQ) in obese adolescent women with validated PCOS.
Niu, Kaijun; Momma, Haruki; Kobayashi, Yoritoshi; Guan, Lei; Chujo, Masahiko; Otomo, Atsushi; Ouchi, Eriko; Nagatomi, Ryoichi
Few epidemiological studies have assessed the relationship between the traditional Japanese dietary pattern and longitudinal changes in cardiovascular disease risk factors among Japanese people. We designed a 3-year longitudinal study of 980 subjects living in Japan to evaluate how the Japanese dietary pattern is related to longitudinal changes in well-recognized risk factors for cardiovascular disease among apparently healthy Japanese adults. Dietary consumption was assessed via a validated food frequency questionnaire. Principal component analysis was used to derive three major dietary patterns-"Japanese," "sweets-fruits-cooked wheaten food," and "Izakaya (Japanese Pub)" from 39 food groups. After adjustment for potential confounders, the mean (95% confidence interval) for the change per year in diastolic blood pressure for men, systolic blood pressure, and diastolic blood pressure for women related to the "Japanese" dietary pattern factor score tertiles were 0.89 (0.10, 1.68), 2.25 (0.19, 4.31), and 0.75 (-1.00, 2.50) for the lowest tertile, 0.77 (-0.02, 1.56), 1.01 (-1.13, 3.15), and 0.44 (-1.38, 2.26) for the middle tertile and - 0.04 (-0.81, 0.72), -0.48 (-2.52, 1.56), and -0.77 (-2.51, 0.96) for the highest tertile (trend P value = 0.03, pattern factor score tertiles and the longitudinal change in serum triglyceride concentration only in men (trend P value = 0.02). Greater adherence to a traditional Japanese diet was independently related to a decreased change every year in diastolic blood pressure in men and women and in systolic blood pressure in women over a 3-year follow-up period. The findings suggest that the "Japanese" dietary pattern appeared to be related to a fall in blood pressure, which might have a beneficial effect on cardiovascular disease. A randomized trial is required to clarify the underlying mechanism.
Noordman, Janneke; van der Weijden, Trudy; van Dulmen, Sandra
To systematically review the literature on the relative effectiveness of face-to-face communication-related behavior change techniques (BCTs) provided in primary care by either physicians or nurses to intervene on patients' lifestyle behavior. PubMed, EMBASE, PsychINFO, CINAHL and The Cochrane Library were searched for studies published before October 2010. Fifty studies were included and assessed on methodological quality. Twenty-eight studies reported significantly favorable health outcomes following communication-related BCTs. In these studies, 'behavioral counseling' was most frequently used (15 times), followed by motivational interviewing (eight times), education and advice (both seven times). Physicians and nurses seem equally capable of providing face-to-face communication-related BCTs in primary care. Behavioral counseling, motivational interviewing, education and advice all seem effective communication-related BCTs. However, BCTs were also found in less successful studies. Furthermore, based on existing literature, one primary care profession does not seem better equipped than the other to provide face-to-face communication-related BCTs. There is evidence that behavioral counseling, motivational interviewing, education and advice can be used as effective communication-related BCTs by physicians and nurses. However, further research is needed to examine the underlying working mechanisms of communication-related BCTs, and whether they meet the requirements of patients and primary care providers. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Sandra S. Hacon
Full Text Available In the Amazon Basin, naturally occurring methylmercury bioaccumulates in fish, which is a key source of protein consumed by riverine populations. The hydroelectric power-plant project at Santo Antônio Falls allows us to compare the Hg exposure of riverine populations sparsely distributed on both sides of the Madeira river before the area is to be flooded. From 2009 to 2011, we concluded a population survey of the area (N = 2,008; representing circa 80% of community residents that estimated fish consumption and mercury exposure of riverine populations with different degrees of lifestyle related to fish consumption. Fish samples from the Madeira river (N = 1,615 and 110 species were analyzed for Hg. Hair-Hg was significantly lower (p < 0.001 in less isolated communities near to the capital of Porto Velho (median 2.32 ppm than in subsistence communities in the Cuniã Lake, 180 km from Porto Velho city (median 6.3 ppm. Fish Hg concentrations ranged from 0.01 to 6.06 µg/g, depending on fish size and feeding behavior. Currently available fish in the Madeira river show a wide variability in Hg concentrations. Despite cultural similarities, riparians showed hair-Hg distribution patterns that reflect changes in fish-eating habits driven by subsistence characteristics.
Hacon, Sandra S; Dórea, José G; Fonseca, Márlon de F; Oliveira, Beatriz A; Mourão, Dennys S; Ruiz, Claudia M V; Gonçalves, Rodrigo A; Mariani, Carolina F; Bastos, Wanderley R
In the Amazon Basin, naturally occurring methylmercury bioaccumulates in fish, which is a key source of protein consumed by riverine populations. The hydroelectric power-plant project at Santo Antônio Falls allows us to compare the Hg exposure of riverine populations sparsely distributed on both sides of the Madeira river before the area is to be flooded. From 2009 to 2011, we concluded a population survey of the area (N = 2,008; representing circa 80% of community residents) that estimated fish consumption and mercury exposure of riverine populations with different degrees of lifestyle related to fish consumption. Fish samples from the Madeira river (N = 1,615) and 110 species were analyzed for Hg. Hair-Hg was significantly lower (p < 0.001) in less isolated communities near to the capital of Porto Velho (median 2.32 ppm) than in subsistence communities in the Cuniã Lake, 180 km from Porto Velho city (median 6.3 ppm). Fish Hg concentrations ranged from 0.01 to 6.06 µg/g, depending on fish size and feeding behavior. Currently available fish in the Madeira river show a wide variability in Hg concentrations. Despite cultural similarities, riparians showed hair-Hg distribution patterns that reflect changes in fish-eating habits driven by subsistence characteristics.
Tretli, S; Gaard, M
There are biologic reasons to believe that the period between the larche and the first full-term pregnancy is a particularly sensitive period in a woman's life regarding the development of breast cancer. In this ecologic study, data provided by the Norwegian Cancer Registry were analyzed to compare risk of breast cancer among women who experienced this sensitive period before, during, or after World War II. An ordinary age-cohort model and a model where the cohort was described by exposure by calendar period and sensitivity to this exposure at different ages, were fitted to the data. The incidence of breast cancer was lower than expected among women who experienced puberty during the war. The estimated configuration of the exposure variable showed an increase in exposure up to the start of WWII to twice the level in 1916, dropped by 13 percent during the war, and increased again after the war. The level in 1975 was approximately 2.7 times higher than the level in 1916. The results indicate that one or more lifestyle factors that changed among adolescent women during the war, influenced their risk of breast cancer. Dietary intake of energy, fat, meat, milk, fish, fresh vegetables, and potatoes, in addition to physical activity level and height, are important factors to consider in relation to breast cancer risk.
Ghazi F. Sharkas
Full Text Availabl