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Talavera-Rodríguez I, Banegas JR, de la Cruz JJ, Martínez-Gómez D, Ruiz-Canela M, Ortolá R, Hershey MS, Artalejo FR, Sotos-Prieto M. Mediterranean lifestyle index and 24-h systolic blood pressure and heart rate in community-dwelling older adults. GeroScience 2024; 46:1357-1369. [PMID: 37561386 PMCID: PMC10828285 DOI: 10.1007/s11357-023-00898-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/28/2023] [Indexed: 08/11/2023] Open
Abstract
Specific foods, nutrients, dietary patterns, and physical activity are associated with lower blood pressure (BP) and heart rate (HR), but little is known about the joint effect of lifestyle factors captured in a multidimensional score. We assessed the association of a validated Mediterranean-lifestyle (MEDLIFE) index with 24-h-ambulatory BP and HR in everyday life among community-living older adults. Data were taken from 2,184 individuals (51% females, mean age: 71.4 years) from the Seniors-ENRICA-2 cohort. The MEDLIFE index consisted of 29 items arranged in three blocks: 1) Food consumption; 2) Dietary habits; and 3) Physical activity, rest, and conviviality. A higher MEDLIFE score (0-29 points) represented a better Mediterranean lifestyle adherence. 24-h-ambulatory BP and HR were obtained with validated oscillometric devices. Analyses were performed with linear regression adjusted for the main confounders. The MEDLIFE-highest quintile (vs Q1) was associated with lower nighttime systolic BP (SBP) (-3.17 mmHg [95% CI: -5.25, -1.08]; p-trend = 0.011), greater nocturnal-SBP fall (1.67% [0.51, 2.83]; p-trend = 0.052), and lower HR (-2.04 bpm [daytime], -2.33 bpm [nighttime], and -1.93 bpm [24-h]; all p-trend < 0.001). Results were similar for each of the three blocks of MEDLIFE and by hypertension status (yes/no). Among older adults, higher adherence to MEDLIFE was associated with lower nighttime SBP, greater nocturnal-SBP fall, and lower HR in their everyday life. These results suggest a synergistic BP-related protection from the components of the Mediterranean lifestyle. Future studies should determine whether these results replicate in older adults from other Mediterranean and non-Mediterranean countries.
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Affiliation(s)
- Irene Talavera-Rodríguez
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049, Madrid, Spain
| | - José R Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Juan J de la Cruz
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - David Martínez-Gómez
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM + CSIC, Madrid, Spain
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, Navarra Institute for Health Research (IdisNa), University of Navarra, 31008, Pamplona, Spain
- CIBEROBN (CIBER of Pathophysiology of Obesity and Nutrition), Madrid, Spain
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Maria S Hershey
- Department of Preventive Medicine and Public Health, Navarra Institute for Health Research (IdisNa), University of Navarra, 31008, Pamplona, Spain
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Fernando Rodríguez Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049, Madrid, Spain
- CIBEROBN (CIBER of Pathophysiology of Obesity and Nutrition), Madrid, Spain
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049, Madrid, Spain.
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
- IMDEA-Food Institute, CEI UAM + CSIC, Madrid, Spain.
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
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Ling J, Chen S, Zhang N, Robbins LB, Kerver JM. Happy Family, Healthy Kids: A Healthy Eating and Stress Management Program in Low-Income Parent-Preschooler Dyads. Nurs Res 2024; 73:3-15. [PMID: 37768980 DOI: 10.1097/nnr.0000000000000697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
BACKGROUND Substantial effort has been invested to combat childhood obesity, but overall effects are disappointing, especially in low-income racial minority children. One possible reason is a lack of focus on the important stress-eating connection. Stress can negatively influence eating behaviors, leading to an increased appetite for high-fat and energy-dense foods. OBJECTIVE This study aimed to evaluate the preliminary effects of a healthy eating and stress management program targeting multiple theoretical variables on improving eating behavior (dyads' fruit/vegetable intake, emotional eating), food insecurity, anthropometric characteristics (dyads' body mass index, % body fat), cardiovascular health (dyads' blood pressure), and mental well-being (parental stress). METHODS A one-group, quasi-experimental pilot study was conducted among 107 low-income parent-preschooler dyads. The 14-week program included a parent component, a parent-preschooler learning component, and a day care-based preschooler component. RESULTS The program had positive effects on improving dyads' fruit/vegetable intake, food insecurity, body mass index, and blood pressure and parents' nutrition knowledge, self-efficacy, support, food resource management behavior, problem-focused coping, and home eating environment. The overall satisfaction rate was 95.2%, and 88.1% stated that the program assisted their families with having a healthy lifestyle. DISCUSSION Results support the preliminary effects of the program on improving health outcomes in rural and urban low-income families. Although warranting further investigation with a more rigorous randomized controlled trial, the healthy eating and stress management program provides a potential solution to the current coexistence of an obesity epidemic and mental health crisis.
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Usman MS, Davies M, Hall ME, Verma S, Anker SD, Rosenstock J, Butler J. The cardiovascular effects of novel weight loss therapies. Eur Heart J 2023; 44:5036-5048. [PMID: 37966486 DOI: 10.1093/eurheartj/ehad664] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/03/2023] [Accepted: 09/26/2023] [Indexed: 11/16/2023] Open
Abstract
The prevalence of overweight and obesity has reached pandemic proportions. Obesity is known to increase the risk for Type 2 diabetes and hypertension, as well as the risk for overt cardiovascular (CV) disease, including myocardial infarction, heart failure, and stroke. The rising prevalence of obesity may counteract the recent advances in primary and secondary prevention of CV disease. Overweight and obesity are common in patients with CV disease; however, cardiologists face several challenges in managing body weight in this population. Many may not consider obesity as a therapeutic target probably because there were no previous highly effective and safe pharmacologic interventions to consider. In addition, they may not have the expertise or resources to implement lifestyle interventions and may have limited familiarity with obesity pharmacotherapy. Moreover, the long-term CV effects of obesity pharmacotherapy remain uncertain due to limited CV outcome data with weight loss as the primary intervention. Although current CV guidelines recognize the importance of weight loss, they primarily focus on lifestyle modifications, with fewer details on strategies to utilize obesity pharmacotherapy and surgery. However, the recent 2022 American Diabetes Association/European Association for the Study of Diabetes consensus on the management of Type 2 diabetes has moved up weight management to the front of the treatment algorithm, by prioritizing the use of pharmacologic interventions such as glucagon-like peptide-1 receptor agonists and dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 receptor agonists, which have potent weight-lowering effects, in addition to glucose-lowering effects. This review appraises the current evidence regarding the CV effects of weight-loss interventions. Considering this evidence, practical guidance is provided to assist cardiologists in developing and implementing treatment plans, which may allow optimal weight management while maximizing CV benefits and minimizing side effects to improve the overall well-being of people with CV disease.
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Affiliation(s)
- Muhammad Shariq Usman
- Department of Medicine, UT Southwestern Medical Center, Dallas, TX, USA
- Department of Medicine, Parkland Health and Hospital System, Dallas, TX, USA
| | - Melanie Davies
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Gwendolen Rd, Leicester, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester, UK
| | - Michael E Hall
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Subodh Verma
- Division of Cardiac Surgery, St.Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Stefan D Anker
- Department of Cardiology (CVK) and Berlin Institute of Health Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany
- Institute of Heart Diseases, Wrocław Medical University, Wrocław, Poland
| | | | - Javed Butler
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
- Baylor Scott and White Research Institute, Dallas, TX, USA
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Ndumele CE, Rangaswami J, Chow SL, Neeland IJ, Tuttle KR, Khan SS, Coresh J, Mathew RO, Baker-Smith CM, Carnethon MR, Despres JP, Ho JE, Joseph JJ, Kernan WN, Khera A, Kosiborod MN, Lekavich CL, Lewis EF, Lo KB, Ozkan B, Palaniappan LP, Patel SS, Pencina MJ, Powell-Wiley TM, Sperling LS, Virani SS, Wright JT, Rajgopal Singh R, Elkind MSV. Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association. Circulation 2023; 148:1606-1635. [PMID: 37807924 DOI: 10.1161/cir.0000000000001184] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Cardiovascular-kidney-metabolic health reflects the interplay among metabolic risk factors, chronic kidney disease, and the cardiovascular system and has profound impacts on morbidity and mortality. There are multisystem consequences of poor cardiovascular-kidney-metabolic health, with the most significant clinical impact being the high associated incidence of cardiovascular disease events and cardiovascular mortality. There is a high prevalence of poor cardiovascular-kidney-metabolic health in the population, with a disproportionate burden seen among those with adverse social determinants of health. However, there is also a growing number of therapeutic options that favorably affect metabolic risk factors, kidney function, or both that also have cardioprotective effects. To improve cardiovascular-kidney-metabolic health and related outcomes in the population, there is a critical need for (1) more clarity on the definition of cardiovascular-kidney-metabolic syndrome; (2) an approach to cardiovascular-kidney-metabolic staging that promotes prevention across the life course; (3) prediction algorithms that include the exposures and outcomes most relevant to cardiovascular-kidney-metabolic health; and (4) strategies for the prevention and management of cardiovascular disease in relation to cardiovascular-kidney-metabolic health that reflect harmonization across major subspecialty guidelines and emerging scientific evidence. It is also critical to incorporate considerations of social determinants of health into care models for cardiovascular-kidney-metabolic syndrome and to reduce care fragmentation by facilitating approaches for patient-centered interdisciplinary care. This presidential advisory provides guidance on the definition, staging, prediction paradigms, and holistic approaches to care for patients with cardiovascular-kidney-metabolic syndrome and details a multicomponent vision for effectively and equitably enhancing cardiovascular-kidney-metabolic health in the population.
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Alzahrani AA, Alqahtani AS, Vennu V, Bindawas SM. Feasibility and Efficacy of Low-to-Moderate Intensity Aerobic Exercise Training in Reducing Resting Blood Pressure in Sedentary Older Saudis with Hypertension Living in Social Home Care: A Pilot Randomized Controlled Trial. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1171. [PMID: 37374375 DOI: 10.3390/medicina59061171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 05/30/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: The effect of non-pharmacological aerobic exercise training on blood pressure in sedentary older individuals receiving social home care in Saudi Arabia has not been investigated. This study aimed to examine the effects of aerobic exercise on blood pressure in sedentary older Saudis with hypertension residing in these settings. Materials and Methods: A pilot randomized control trial was conducted with 27 sedentary individuals, aged 60-85, diagnosed with hypertension, and living in social home care in Makkah, Saudi Arabia. Recruitment took place between November 2020 and January 2021, and participants were randomly assigned to either the experimental or control group. The experimental group engaged in three 45 min sessions of low-to-moderate intensity aerobic activity per week for eight weeks. This trail was registered with the ISRCTN registry (ISRCTN50726324). Results: Following eight weeks of mild to moderate aerobic exercise training, the primary outcome of resting blood pressure showed a significant reduction in the experimental group (systolic blood pressure: mean difference [MD] = 2.91 mmHg, 95% confidence interval [CI] = 1.61, 4.21, p = 0.001; and diastolic blood pressure: MD = 1.33 mmHg, 95% CI = 1.16, 1.50, p = 0.001) compared to the control group. Within the experimental group, there was also a significant decrease in systolic blood pressure (MD = -2.75 mmHg, 95% CI = -7.73, 2.22, p = 0.005) and diastolic blood pressure (MD = -0.83 mmHg, 95% CI = -5.81, 4.14, p = 0.02). Conclusions: This trial demonstrates the feasibility and potential benefits of low-to-moderate intensity aerobic exercise training in reducing resting blood pressure among sedentary older Saudis with hypertension residing in this aged care setting.
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Affiliation(s)
- Abdulrahman A Alzahrani
- Social Care Center for the Elderly, Mecca 12840, Saudi Arabia
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Abdulfattah S Alqahtani
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Vishal Vennu
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Saad M Bindawas
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
- King Salman Center for Disability Research, Riyadh 11614, Saudi Arabia
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Khalafi M, Symonds ME, Ghasemi F, Rosenkranz SK, Rohani H, Hossein Sakhaei M. The effects of exercise training on postprandial glycemia and insulinemia in adults with overweight or obesity and with cardiometabolic disorders: a systematic review and meta-analysis. Diabetes Res Clin Pract 2023:110741. [PMID: 37276984 DOI: 10.1016/j.diabres.2023.110741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/11/2023] [Accepted: 05/30/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND We performed a systematic review and meta-analysis to investigate the effects of exercise training on postprandial glycemia (PPG) and insulinemia (PPI) in adults with overweight or obesity and with cardiometabolic disorders. METHODS PubMed, Web of Science, and Scopus databases were searched until May 2022 using the key words "exercise," "postprandial," and "randomized control trial" to identify original studies investigating the effects of exercise training on PPG and/or PPI in adults with a body mass indexes (BMI) ≥ 25 kg.m2. Standardized mean differences (SMD) and 95% confidence intervals (CIs) were calculated using random effects models to calculate effect sizes for outcomes and to generate forest plots. Sub-group analyses and meta-regressions were performed for potential categorical and continuous moderators. RESULTS Twenty-nine studies involving 41 intervention arms and 1,401 participants were included in the systematic review and meta-analysis. Overall, exercise training significantly decreased PPG [-0.36 (95% CI -0.50 to -0.22), p=0.001] and PPI [-0.37 (95% CI -0.52 to -0.21), p=0.001]. Subgroup analyses showed that PPG decreased following both aerobic and resistance training; whereas PPI was reduced following aerobic training, independent of age, BMI, and baseline glucose levels. Meta-regression analyses showed that frequency of exercise sessions, intervention durations, and duration of exercise time, did not moderate the effects of exercise training on PPI or PPG (p>0.05). CONCLUSION In adults with overweight or obesity and with cardiometabolic disorders, exercise training is effective for reducing PPG and PPI, across ages and BMIs, irrespective of baseline glucose levels and exercise training characteristics.
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Affiliation(s)
- Mousa Khalafi
- Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran.
| | - Michael E Symonds
- Centre for Perinatal Research, Academic Unit of Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom
| | - Faeghe Ghasemi
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Guilan, Iran
| | - Sara K Rosenkranz
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Hadi Rohani
- Department of Exercise Physiology, Sport Sciences Research Institute, Tehran, Iran
| | - Mohammad Hossein Sakhaei
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Guilan, Iran
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Li B, Wang J, Zhou X, Wang W, Gao Z, Tang X, Yan L, Wan Q, Luo Z, Qin G, Chen L, Ning G, Mu Y. Lipid accumulation product is closely associated with hypertension and prehypertension in prediabetic population in China: results from the REACTION study. Hypertens Res 2023; 46:708-719. [PMID: 36513744 DOI: 10.1038/s41440-022-01113-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 12/15/2022]
Abstract
Prediabetes with hypertension or prehypertension increases the risk of cardiovascular events. Lipid accumulation product (LAP) is a powerful marker of visceral obesity. The current study aimed to explore the relationship between LAP and hypertension and prehypertension among prediabetic individuals. A total of 12,388 prediabetic participants from the REACTION study were recruited. LAP was calculated from waist circumference and fasting triglyceride levels. Multiple logistic regression models were conducted to assess the relationship between LAP and hypertension and prehypertension. Multiple logistic regression analysis showed that elevated LAP was associated with hypertension (Q2: odds ratio (OR): 1.263, P < 0.001; Q3: OR: 1.613, P < 0.001; Q4: OR: 1.754, P < 0.001) and prehypertension (Q2: OR: 1.255, P = 0.005; Q3: OR: 1.340, P = 0.002; Q4: OR: 1.765, P < 0.001). The results of the stratified analysis showed that prediabetic people with higher LAP levels and characterized by overweight, normal weight and a high waist-to-hip ratio (WHR) were more likely to have hypertension, and prediabetic people with higher LAP levels and characterized by overweight, normal weight, a high WHR, age <65, and low and high levels of physical activity were more likely to have prehypertension. In conclusion, visceral obesity assessed by LAP is significantly associated with hypertension and prehypertension in the Chinese prediabetic population.
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Affiliation(s)
- Binqi Li
- School of Medicine, Nankai University, No. 94 Weijin Road, Tianjin, 300071, China.,Department of Endocrinology, First Medical Center of PLA General Hospital, Beijing, China
| | - Jie Wang
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, P. R. China
| | - Xin Zhou
- Graduate School, Chinese PLA General Hospital, Beijing, China.,Department of Medical Oncology, Senior Department of Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.,The Second Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Weiqing Wang
- Shanghai National Research Centre for Endocrine and Metabolic Diseases, State Key Laboratory of Medical Genomics, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhengnan Gao
- Dalian Central Hospital, Dalian, Liaoning, China
| | - Xulei Tang
- First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Li Yan
- Zhongshan University Sun Yat-sen Memorial Hospital, Guangzhou, Guangdong, China
| | - Qin Wan
- Southwest Medical University Affiliated Hospital, Luzhou, Sichuan, China
| | - Zuojie Luo
- First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Guijun Qin
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Lulu Chen
- Wuhan Union Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Guang Ning
- Shanghai National Research Centre for Endocrine and Metabolic Diseases, State Key Laboratory of Medical Genomics, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yiming Mu
- School of Medicine, Nankai University, No. 94 Weijin Road, Tianjin, 300071, China. .,Department of Endocrinology, First Medical Center of PLA General Hospital, Beijing, China. .,Graduate School, Chinese PLA General Hospital, Beijing, China.
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Effects of eight-week aerobic exercises combined with resistance training on cardiovascular risk factors in women. BIOMEDICAL HUMAN KINETICS 2023. [DOI: 10.2478/bhk-2023-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Abstract
Study aim: Main purpose of this study is to examine the effects of moderate-intensity exercises for eight weeks, combined with cardio and resistance exercises, on the cardiovascular risk factors for women.
Material and methods:Atotal of 30 volunteer females between the ages of 40 and 65 participated in the study. The volunteers were divided into two groups as exercise and control. The exercise group was given exercises three days aweek. Height, weight, body mass index, waist, hip, waist-to-hip ratio, resting blood pressure, resting heart rate, total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, glucose levels were collected before and after the exercise program.
Results: There was asignificant decrease in weight, body mass index, hip circumference levels after the exercise program (p < 0.05), while no significant difference was detected for waist circumference and waist-to-hip ratios p > 0.05). While asignificant decrease in systolic blood pressure, diastolic blood pressure, and triglycerides levels of the exercise group was observed after the exercise program (p < 0.05), no significant change was found in glucose, cholesterol, high density lipoprotein, and low density lipoprotein levels (p > 0.05).
Conclusion: It was observed that moderate intensity exercises combined with cardio and resistance exercises resulted with positive effects on cardiovascular risk factors.
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Yamashiro K, Utaka Y, Tanei S, Ogata F, Nakamura T, Kawasaki N. A survey on the relationship between blood pressure and self-reported lifestyle habits and ideal body image in Japanese university students: a cross-sectional study. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01783-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Koo BK. Non-pharmacologic treatment for obesity. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2022. [DOI: 10.5124/jkma.2022.65.7.400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: The prevalence of obesity has been rapidly increasing in the Korean population. Obesity is a well-known risk factor for various chronic diseases, including diabetes mellitus, hypertension, dyslipidemia, atherosclerosis, chronic kidney disease, degenerative arthritis, and autoimmune diseases. It also increases the risks of different malignancies, gall bladder disease, and pancreatitis.Current Concepts: Lifestyle intervention assisted by frequent behavioral therapy is crucial despite the modest amount of weight loss achieved. Energy intake restriction combined with increased physical activity can not only facilitate weight loss but also improve metabolic health. Furthermore, this combination can help maintain weight reduction during and after lifestyle interventions. Energy intake restriction with a daily deficit of 500–1,000 kcal and physical activity including aerobic exercise for 150 minutes or more per week and resistance training 2–4 times a week are generally recommended for obesity management.Discussion and Conclusion: Comprehensive lifestyle intervention should be individualized and supported by a multidisciplinary team. A long-term behavioral intervention is necessary for success in obesity treatment.
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A New Body Weight Lifelog Outliers Generation Method: Reflecting Characteristics of Body Weight Data. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Lifelogs are generated in our daily lives and contain useful information for health monitoring. Nowadays, one can easily obtain various lifelogs from a wearable device such as a smartwatch. These lifelogs could include noise and outliers. In general, the amount of noise and outliers is significantly smaller than that of normal data, resulting in class imbalance. To achieve good analytic accuracy, the noise and outliers should be filtered. Lifelogs have specific characteristics: low volatility and periodicity. It is very important to continuously analyze and manage them within a specific time. To solve the class imbalance problem of outliers in weight lifelog data, we propose a new outlier generation method that reflects the characteristics of body weight. This study compared the proposed method with the SMOTE-based data augmentation and the GAN-based data augmentation methods. Our results confirm that our proposed method for outlier detection was better than the SVM, XGBOOST, and CATBOOST algorithms. Through them, we can reduce the data imbalance level, improve data quality, and improve analytics accuracy.
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Krishnamoorthy Y, Nagarajan R, Murali S. Effectiveness of multiple combined lifestyle interventions in reducing blood pressure among patients with prehypertension and hypertension: a network meta-analysis. J Public Health (Oxf) 2022:6535708. [PMID: 35211753 DOI: 10.1093/pubmed/fdac027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/07/2022] [Accepted: 02/01/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Different combinations of lifestyle interventions have been studied with varying results on hypertension control. Hence, this review was done to compare multiple combined lifestyle intervention in reducing blood pressure (BP) among patients with prehypertension or hypertension. METHODS We conducted systematic search in the following databases: MEDLINE, PubMed Central, CENTRAL, ScienceDirect, Google Scholar from 1964 until November 2020. Estimates of comparative intervention effect from network meta-analyses (random-effects model) were represented as mean difference (MD) with 95% confidence interval. RESULTS In total, 14 studies with 2451 participants were included. Almost all the studies had high risk of bias. Healthy diet (HD) and physical activity (PA) combination showed highest mean reduction in systolic BP (-9.88 mmHg) and diastolic BP (-6.28 mmHg) followed by HD + PA + smoking cessation + alcohol restriction combination (systolic BP = -6.58 mmHg, diastolic BP = -4.09 mmHg) compared with usual care. HD and PA combination had the highest probability of being the best intervention (82.8% for SBP and 81.7% for DBP). CONCLUSION We found that HD and PA are the most important combination of lifestyle modifications for prehypertensive and hypertensive patients. Hence, a coordinated approach is required from the clinicians by integrating beneficial effect of these modifications through education, counselling and support. SUMMARY BOX
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Affiliation(s)
| | - Ramya Nagarajan
- Scientist-B, Indian Council of Medical Research- National Institute of Epidemiology, Chennai 600077, India
| | - Sharan Murali
- Scientist-B, Indian Council of Medical Research- National Institute of Epidemiology, Chennai 600077, India
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Hinderliter AL, Smith P, Sherwood A, Blumenthal J. Lifestyle Interventions Reduce the Need for Guideline-Directed Antihypertensive Medication. Am J Hypertens 2021; 34:1100-1107. [PMID: 34107031 PMCID: PMC8557445 DOI: 10.1093/ajh/hpab090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/05/2021] [Accepted: 06/07/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The 2017 ACC-AHA Hypertension Guideline recommends initiation of antihypertensive drug therapy based on blood pressure (BP) and an assessment of global cardiovascular disease (CVD) risk, but intensive lifestyle modification may lower BP to below recommended thresholds for treatment in some patients. METHODS We examined the effects of lifestyle modification on calculated CVD risk and on the indications for BP-lowering medications in individuals with untreated hypertension. Participants included 144 adults with BP 130-160/80-99 mm Hg who were randomized to 16 weeks of DASH (Dietary Approaches to Stop Hypertension) diet plus behavioral weight management (DASH + WM), DASH diet alone (DASH), or Usual Care. RESULTS The mean age of the study cohort was 52.0 years; the average baseline BP was 138 ± 9/86 ± 6 mm Hg. The 10-year CVD risk, as calculated by the Pooled Cohort Equations, was 5.7%. The adjusted 10-year risk fell to 4.4% in the DASH + WM group and to 5.0% in the DASH arm, but was not significantly changed (5.7%) in the Usual Care controls. The percentages of participants with guideline-based indications for antihypertensive drugs fell from 51% to 18% in the DASH + WM group and from 48% to 22% in the DASH group; and did not change significantly (49% to 44%) in the Usual Care group (P = 0.010 for the active intervention groups vs. Usual Care; P = 0.042 for DASH + WM vs. DASH). CONCLUSIONS These data demonstrate that in men and women with mildly elevated BP, lifestyle interventions can lower the calculated CVD risk and dramatically decrease the number of individuals for whom guideline-directed antihypertensive medication is indicated.
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Affiliation(s)
- Alan L Hinderliter
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Patrick Smith
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - Andrew Sherwood
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - James Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
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14
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van der Avoort CMT, Ten Haaf DSM, Bongers CCWG, van Oorschot F, Verdijk LB, van Loon LJC, Hopman MTE. Increasing Nitrate-Rich Vegetable Intake Lowers Ambulatory Blood Pressure in (pre)Hypertensive Middle-Aged and Older Adults: A 12-Wk Randomized Controlled Trial. J Nutr 2021; 151:2667-2679. [PMID: 34236392 DOI: 10.1093/jn/nxab157] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/28/2020] [Accepted: 04/29/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Emerging evidence suggests that increasing dietary nitrate intake may be an effective approach to improve cardiovascular health. However, the effects of a prolonged elevation of nitrate intake through an increase in vegetable consumption are understudied. OBJECTIVE Our primary aim was to determine the impact of 12 wk of increased daily consumption of nitrate-rich vegetables or nitrate supplementation on blood pressure (BP) in (pre)hypertensive middle-aged and older adults. METHODS In a 12-wk randomized, controlled study (Nijmegen, The Netherlands), 77 (pre)hypertensive participants (BP: 144 ± 13/87 ± 7 mmHg, age: 65 ± 10 y) either received an intervention with personalized monitoring and feedback aiming to consume ∼250-300 g nitrate-rich vegetables/d (∼350-400 mg nitrate/d; n = 25), beetroot juice supplementation (400 mg nitrate/d; n = 26), or no intervention (control; n = 26). Before and after intervention, 24-h ambulatory BP was measured. Data were analyzed using repeated measures ANOVA (time × treatment), followed by within-group (paired t-test) and between-group analyses (1-factor ANOVA) where appropriate. RESULTS The 24-h systolic BP (SBP) (primary outcome) changed significantly (P-interaction time × treatment = 0.017) with an increase in the control group (131 ± 8 compared with 135 ± 10 mmHg; P = 0.036); a strong tendency for a decline in the nitrate-rich vegetable group (129 ± 10 compared with 126 ± 9 mmHg; P = 0.051) which was different from control (P = 0.020); but no change in the beetroot juice group (133 ± 11 compared with 132 ± 12 mmHg; P = 0.56). A significant time × treatment interaction was also found for daytime SBP (secondary outcome, P = 0.011), with a significant decline in the nitrate-rich vegetable group (134 ± 10 compared with 129 ± 9 mmHg; P = 0.006) which was different from control (P = 0.010); but no changes in the beetroot juice (138 ± 12 compared with 137 ± 14 mmHg; P = 0.41) and control group (136 ± 10 compared with 137 ± 11 mmHg; P = 0.08). Diastolic BP (secondary outcome) did not change in any of the groups. CONCLUSIONS A prolonged dietary intervention focusing on high-nitrate vegetable intake is an effective strategy to lower SBP in (pre)hypertensive middle-aged and older adults. This trial was registered at www.trialregister.nl as NL7814.
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Affiliation(s)
- Cindy M T van der Avoort
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre, Maastricht, The Netherlands.,Institute of Sport and Exercise Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands.,Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dominique S M Ten Haaf
- Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Coen C W G Bongers
- Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Frederieke van Oorschot
- Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lex B Verdijk
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Luc J C van Loon
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre, Maastricht, The Netherlands.,Institute of Sport and Exercise Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Maria T E Hopman
- Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
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15
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Talbot D, Diop A, Lavigne-Robichaud M, Brisson C. The change in estimate method for selecting confounders: A simulation study. Stat Methods Med Res 2021; 30:2032-2044. [PMID: 34369220 PMCID: PMC8424612 DOI: 10.1177/09622802211034219] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND The change in estimate is a popular approach for selecting confounders in epidemiology. It is recommended in epidemiologic textbooks and articles over significance test of coefficients, but concerns have been raised concerning its validity. Few simulation studies have been conducted to investigate its performance. METHODS An extensive simulation study was realized to compare different implementations of the change in estimate method. The implementations were also compared when estimating the association of body mass index with diastolic blood pressure in the PROspective Québec Study on Work and Health. RESULTS All methods were susceptible to introduce important bias and to produce confidence intervals that included the true effect much less often than expected in at least some scenarios. Overall mixed results were obtained regarding the accuracy of estimators, as measured by the mean squared error. No implementation adequately differentiated confounders from non-confounders. In the real data analysis, none of the implementation decreased the estimated standard error. CONCLUSION Based on these results, it is questionable whether change in estimate methods are beneficial in general, considering their low ability to improve the precision of estimates without introducing bias and inability to yield valid confidence intervals or to identify true confounders.
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Affiliation(s)
- Denis Talbot
- Département de médecine sociale et préventive, Université Laval, Québec, Canada
- Unité santé des populations et pratiques optimales en santé, CHU de Québec – Université Laval research center, Québec, Canada
| | - Awa Diop
- Département de médecine sociale et préventive, Université Laval, Québec, Canada
- Unité santé des populations et pratiques optimales en santé, CHU de Québec – Université Laval research center, Québec, Canada
- Département de mathématiques et de statistique, Université Laval, Université Laval, Québec, Canada
| | - Mathilde Lavigne-Robichaud
- Département de médecine sociale et préventive, Université Laval, Québec, Canada
- Unité santé des populations et pratiques optimales en santé, CHU de Québec – Université Laval research center, Québec, Canada
| | - Chantal Brisson
- Département de médecine sociale et préventive, Université Laval, Québec, Canada
- Unité santé des populations et pratiques optimales en santé, CHU de Québec – Université Laval research center, Québec, Canada
- Centre de recherche sur les soins et les services de première ligne de l’Université Laval, Québec, Canada
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16
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Krassovskaia PM, Chaves AB, Houmard JA, Broskey NT. Exercise during Pregnancy: Developmental Programming Effects and Future Directions in Humans. Int J Sports Med 2021; 43:107-118. [PMID: 34344043 DOI: 10.1055/a-1524-2278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Epidemiological studies show that low birth weight is associated with mortality from cardiovascular disease in adulthood, indicating that chronic diseases could be influenced by hormonal or metabolic insults encountered in utero. This concept, now known as the Developmental Origins of Health and Disease hypothesis, postulates that the intrauterine environment may alter the structure and function of the organs of the fetus as well as the expression of genes that impart an increased vulnerability to chronic diseases later in life. Lifestyle interventions initiated during the prenatal period are crucial as there is the potential to attenuate progression towards chronic diseases. However, how lifestyle interventions such as physical activity directly affect human offspring metabolism and the potential mechanisms involved in regulating metabolic balance at the cellular level are not known. The purpose of this review is to highlight the effects of exercise during pregnancy on offspring metabolic health and emphasize gaps in the current human literature and suggestions for future research.
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Affiliation(s)
- Polina M Krassovskaia
- Human Performance Laboratory, Department of Kinesiology, East Carolina University, Greenville, United States.,East Carolina Diabetes & Obesity Institute, East Carolina University, Greenville, United States
| | - Alec B Chaves
- Human Performance Laboratory, Department of Kinesiology, East Carolina University, Greenville, United States.,East Carolina Diabetes & Obesity Institute, East Carolina University, Greenville, United States
| | - Joseph A Houmard
- Human Performance Laboratory, Department of Kinesiology, East Carolina University, Greenville, United States.,East Carolina Diabetes & Obesity Institute, East Carolina University, Greenville, United States
| | - Nicholas T Broskey
- Human Performance Laboratory, Department of Kinesiology, East Carolina University, Greenville, United States.,East Carolina Diabetes & Obesity Institute, East Carolina University, Greenville, United States
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17
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Morze J, Rücker G, Danielewicz A, Przybyłowicz K, Neuenschwander M, Schlesinger S, Schwingshackl L. Impact of different training modalities on anthropometric outcomes in patients with obesity: A systematic review and network meta-analysis. Obes Rev 2021; 22:e13218. [PMID: 33624411 PMCID: PMC8244024 DOI: 10.1111/obr.13218] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/08/2021] [Accepted: 01/15/2021] [Indexed: 12/15/2022]
Abstract
Obesity management guidelines consistently advise aerobic training for weight loss, whereas recommendations for other training modalities are sparse. This systematic review and network meta-analysis (NMA) aimed to compare the long-term effects of different training modalities on anthropometric outcomes in patients with obesity. MEDLINE, Cochrane CENTRAL, and Web of Science were searched to identify the following: (1) randomized controlled trials (RCTs); (2) conducted in adults with a mean body mass index (BMI) ≥30 kg/m2 ; (3) comparing aerobic, resistance, combined, or high-intensity interval training head-to-head or to control for ≥6 months; and (4) reporting changes in body weight (BW), BMI, waist circumference (WC), fat mass (FM), or fat-free mass (FFM). Random-effects NMA models were fitted in a frequentist approach. GRADE framework was used to assess certainty of evidence. Thirty-two RCTs with 4774 participants with obesity were included in this review. Aerobic training was ranked as best for improving BW, BMI, and WC and combined training for improving FM, as well as equally with resistance training most effective for improving FFM. Low to moderate certainty of evidence supports use of aerobic training to improve anthropometric outcomes in obesity, and its combination with resistance training provides additional benefit for reducing FM and increasing FFM.
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Affiliation(s)
- Jakub Morze
- Department of Cardiology and Internal Diseases, University of Warmia and Mazury, Olsztyn, Poland.,Department of Human Nutrition, University of Warmia and Mazury, Olsztyn, Poland
| | - Gerta Rücker
- Institute of Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Anna Danielewicz
- Department of Human Nutrition, University of Warmia and Mazury, Olsztyn, Poland
| | | | - Manuela Neuenschwander
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Sabrina Schlesinger
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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18
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Nishimoto M, Murashima M, Yoshida H, Eriguchi M, Tasaki H, Fukata F, Kosugi T, Matsui M, Samejima KI, Iseki K, Asahi K, Yamagata K, Fujimoto S, Konta T, Narita I, Moriyama T, Kasahara M, Shibagaki Y, Kondo M, Watanabe T, Tsuruya K. Impact of self-reported walking habit on slower decline in renal function among the general population in a longitudinal study: the Japan Specific Health Checkups (J-SHC) Study. J Nephrol 2021; 34:1845-1853. [PMID: 33929690 DOI: 10.1007/s40620-021-01041-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 03/23/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Association between physical activity and decline in renal function among the general population is not fully understood. METHODS This is a longitudinal study on subjects who participated in the Japanese nationwide Specific Health Checkup program between 2008 and 2014. The exposure of interest was baseline self-reported walking habit. The outcomes were annual change and incidence of 30% decline in estimated glomerular filtration rate (eGFR). Changes in eGFR were compared using a linear mixed-effects model. Cox proportional hazard models were used to examine the association between self-reported walking habit and 30% decline in eGFR. RESULTS Among 332,166 subjects, 168,574 reported walking habit at baseline. The annual changes in eGFR [95% confidence interval (CI)] among subjects with and without baseline self-reported walking habit were - 0.17 (- 0.19 to - 0.16) and - 0.26 (- 0.27 to - 0.24) mL/min/1.73 m2/year, respectively (P for interaction between time and baseline self-reported walking habit, < 0.001). During a median follow-up of 3.3 years, 9166 of 314,489 subjects exhibited 30% decline in eGFR. The incidence of 30% decline in eGFR was significantly lower among subjects with self-reported walking habit after adjustment for potential confounders including time-varying blood pressure, body mass index, lipid profile, and hemoglobin A1c, with hazard ratio (95% CI) of 0.93 (0.89-0.97). Sensitivity analysis restricted to subjects with unchanged self-reported walking habit from baseline or analysis with time-varying self-reported walking habit yielded similar results. CONCLUSIONS Self-reported walking habit was associated with significantly slower decline in eGFR. This association appeared to be independent of its effects on metabolic improvement.
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Affiliation(s)
- Masatoshi Nishimoto
- Department of Nephrology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Miho Murashima
- Department of Nephrology, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Hisako Yoshida
- Department of Medical Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Masahiro Eriguchi
- Department of Nephrology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Hikari Tasaki
- Department of Nephrology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Fumihiro Fukata
- Department of Nephrology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Takaaki Kosugi
- Department of Nephrology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Masaru Matsui
- Department of Nephrology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Ken-Ichi Samejima
- Department of Nephrology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Kunitoshi Iseki
- Steering Committee of The Japan Specific Health Checkups (J-SHC) Study Group, Fukushima, Japan
| | - Koichi Asahi
- Steering Committee of The Japan Specific Health Checkups (J-SHC) Study Group, Fukushima, Japan
| | - Kunihiro Yamagata
- Steering Committee of The Japan Specific Health Checkups (J-SHC) Study Group, Fukushima, Japan
| | - Shouichi Fujimoto
- Steering Committee of The Japan Specific Health Checkups (J-SHC) Study Group, Fukushima, Japan
| | - Tsuneo Konta
- Steering Committee of The Japan Specific Health Checkups (J-SHC) Study Group, Fukushima, Japan
| | - Ichiei Narita
- Steering Committee of The Japan Specific Health Checkups (J-SHC) Study Group, Fukushima, Japan
| | - Toshiki Moriyama
- Steering Committee of The Japan Specific Health Checkups (J-SHC) Study Group, Fukushima, Japan
| | - Masato Kasahara
- Steering Committee of The Japan Specific Health Checkups (J-SHC) Study Group, Fukushima, Japan
| | - Yugo Shibagaki
- Steering Committee of The Japan Specific Health Checkups (J-SHC) Study Group, Fukushima, Japan
| | - Masahide Kondo
- Steering Committee of The Japan Specific Health Checkups (J-SHC) Study Group, Fukushima, Japan
| | - Tsuyoshi Watanabe
- Steering Committee of The Japan Specific Health Checkups (J-SHC) Study Group, Fukushima, Japan
| | - Kazuhiko Tsuruya
- Department of Nephrology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan. .,Steering Committee of The Japan Specific Health Checkups (J-SHC) Study Group, Fukushima, Japan.
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19
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Fang H, Liu C, Cavdar O. The relation between submaximal aerobic exercise improving vascular elasticity through loss of visceral fat and antihypertensive. Clin Exp Hypertens 2021; 43:203-210. [PMID: 33233955 DOI: 10.1080/10641963.2020.1847127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Purpose: We sought to observe the effect of submaximal aerobic exercise on abdominal obesity in hypertension patients and to clarify a correlation between blood pressure improvement and visceral fat, along with arterial elasticity. Materials and Methods: According to the treatment plan, the patients were divided into two groups: the combined treatment group and the single drug group. During the training period, the subjects in the combined treatment group performed a 60 min treadmill exercise at 65% of Pmax. PWV was measured using blood pressure pulse-wave detectors before and after treatment. We assessed carotid stiffness and visceral fat area by B‑mode ultrasonography. Results: The 24-h SBP and DBP changed significantly in the two groups in the pre- and post-treatment comparison. Significant statistical differences among SBP and DBP in the two groups of combination therapy and drug therapy after 12 months were demonstrated. Visceral fat area was significantly reduced in the combination therapy group compared to the drug therapy group at the last assessment. Compared with the drug group, arterial compliance in the combination therapy group was higher after treatment. Blood pressure showed significant positive correlation with visceral fat area, PWV, β‑stiffness, Ep, and PWVβ in the combination therapy group. Conclusion: The combination of drug therapy and is more effective than just pursuing single drug treatment of hypertension in patients with abdominal obesity. Submaximal aerobic exercise contributes to anti-hypertension. The main mechanism of anti-hypertension in combination with drug therapy and submaximal aerobic exercise is the improvement of vascular elasticity and decreased central body-fat distribution.
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Affiliation(s)
- Hong Fang
- Department of Cardiology, Tongji Hospital, School of Medicine, Tongji University , Shanghai, China
| | - Chi Liu
- National clinical research center for aging and medicine, Jing an district Central Hospital , Shanghai, China
| | - Omer Cavdar
- Department of Cardiology, Tongji Hospital, School of Medicine, Tongji University , Shanghai, China
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20
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Saco-Ledo G, Valenzuela PL, Ruiz-Hurtado G, Ruilope LM, Lucia A. Exercise Reduces Ambulatory Blood Pressure in Patients With Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc 2020; 9:e018487. [PMID: 33280503 PMCID: PMC7955398 DOI: 10.1161/jaha.120.018487] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background Although exercise training reduces office blood pressure (BP), scarcer evidence is available on whether these benefits also apply to ambulatory blood pressure (ABP), which is a stronger predictor of cardiovascular disease and mortality. The present study aims to assess the effects of exercise training on ABP in patients with hypertension based on evidence from randomized controlled trials. Methods and Results A systematic search of randomized controlled trials on the aforementioned topic was conducted in PubMed and Scopus (since inception to April 1, 2020). The mean difference between interventions (along with 95% CI) for systolic BP and diastolic BP was assessed using a random-effects model. Sub-analyses were performed attending to (1) whether participants were taking antihypertensive drugs and (2) exercise modalities. Fifteen studies (including 910 participants with hypertension) met the inclusion criteria. Interventions lasted 8 to 24 weeks (3-5 sessions/week). Exercise significantly reduced 24-hour (systolic BP, -5.4 mm Hg; [95% CI, -9.2 to -1.6]; diastolic BP, -3.0 mm Hg [-5.4 to -0.6]), daytime (systolic BP, -4.5 mm Hg [-6.6 to -2.3]; diastolic BP, -3.2 mm Hg [-4.8 to -1.5]), and nighttime ABP (systolic BP, -4.7 mm Hg [-8.4 to -1.0]; diastolic BP, -3.1 mm Hg [-5.3 to -0.9]). In separate analyses, exercise benefits on all ABP measures were significant for patients taking medication (all P<0.05) but not for untreated patients (although differences between medicated and non-medicated patients were not significant), and only aerobic exercise provided significant benefits (P<0.05). Conclusions Aerobic exercise is an effective coadjuvant treatment for reducing ABP in medicated patients with hypertension.
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Affiliation(s)
- Gonzalo Saco-Ledo
- Bioenergy and Motion Analysis Laboratory National Research Center on Human Evolution (CENIEH) Burgos Spain
| | | | - Gema Ruiz-Hurtado
- Hypertension Unit and Cardiorenal Translational Laboratory Hospital 12 de Octubre Madrid Spain.,Research Institute of the Hospital Universitario 12 de Octubre ('imas12') Madrid Spain
| | - Luis M Ruilope
- Hypertension Unit and Cardiorenal Translational Laboratory Hospital 12 de Octubre Madrid Spain.,Research Institute of the Hospital Universitario 12 de Octubre ('imas12') Madrid Spain
| | - Alejandro Lucia
- Research Institute of the Hospital Universitario 12 de Octubre ('imas12') Madrid Spain.,Faculty of Sport Sciences European University of Madrid Spain
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21
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Valenzuela PL, Carrera-Bastos P, Gálvez BG, Ruiz-Hurtado G, Ordovas JM, Ruilope LM, Lucia A. Lifestyle interventions for the prevention and treatment of hypertension. Nat Rev Cardiol 2020; 18:251-275. [PMID: 33037326 DOI: 10.1038/s41569-020-00437-9] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/24/2020] [Indexed: 02/07/2023]
Abstract
Hypertension affects approximately one third of the world's adult population and is a major cause of premature death despite considerable advances in pharmacological treatments. Growing evidence supports the use of lifestyle interventions for the prevention and adjuvant treatment of hypertension. In this Review, we provide a summary of the epidemiological research supporting the preventive and antihypertensive effects of major lifestyle interventions (regular physical exercise, body weight management and healthy dietary patterns), as well as other less traditional recommendations such as stress management and the promotion of adequate sleep patterns coupled with circadian entrainment. We also discuss the physiological mechanisms underlying the beneficial effects of these lifestyle interventions on hypertension, which include not only the prevention of traditional risk factors (such as obesity and insulin resistance) and improvements in vascular health through an improved redox and inflammatory status, but also reduced sympathetic overactivation and non-traditional mechanisms such as increased secretion of myokines.
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Affiliation(s)
| | - Pedro Carrera-Bastos
- Centre for Primary Health Care Research, Lund University/Region Skane, Skane University Hospital, Malmö, Sweden
| | - Beatriz G Gálvez
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Gema Ruiz-Hurtado
- Research Institute of the Hospital Universitario 12 de Octubre (imas12), Madrid, Spain.,CIBER-CV, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - José M Ordovas
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA.,IMDEA Alimentacion, Madrid, Spain
| | - Luis M Ruilope
- Research Institute of the Hospital Universitario 12 de Octubre (imas12), Madrid, Spain.,CIBER-CV, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Alejandro Lucia
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain. .,Research Institute of the Hospital Universitario 12 de Octubre (imas12), Madrid, Spain.
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22
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Fu J, Liu Y, Zhang L, Zhou L, Li D, Quan H, Zhu L, Hu F, Li X, Meng S, Yan R, Zhao S, Onwuka JU, Yang B, Sun D, Zhao Y. Nonpharmacologic Interventions for Reducing Blood Pressure in Adults With Prehypertension to Established Hypertension. J Am Heart Assoc 2020; 9:e016804. [PMID: 32975166 PMCID: PMC7792371 DOI: 10.1161/jaha.120.016804] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Nonpharmacologic interventions that modify lifestyle can lower blood pressure (BP) and have been assessed in numerous randomized controlled trials and pairwise meta‐analyses. It is still unclear which intervention would be most efficacious. Methods and Results Bayesian network meta‐analyses were performed to estimate the comparative effectiveness of different interventions for lowering BP. From 60 166 potentially relevant articles, 120 eligible articles (14 923 participants) with a median follow‐up of 12 weeks, assessing 22 nonpharmacologic interventions, were included. According to the surface under the cumulative ranking probabilities and Grading of Recommendations Assessment, Development and Evaluation (GRADE) quality of evidence, for adults with prehypertension to established hypertension, high‐quality evidence indicated that the Dietary Approach to Stop Hypertension (DASH) was superior to usual care and all other nonpharmacologic interventions in lowering systolic BP (weighted mean difference, 6.97 mm Hg; 95% credible interval, 4.50–9.47) and diastolic BP (weighted mean difference, 3.54 mm Hg; 95% credible interval, 1.80–5.28). Compared with usual care, moderate‐ to high‐quality evidence indicated that aerobic exercise, isometric training, low‐sodium and high‐potassium salt, comprehensive lifestyle modification, breathing‐control, and meditation could lower systolic BP and diastolic BP. For patients with hypertension, moderate‐ to high‐quality evidence suggested that the interventions listed (except comprehensive lifestyle modification) were associated with greater systolic BP and diastolic BP reduction than usual care; salt restriction was also effective in lowering both systolic BP and diastolic BP. Among overweight and obese participants, low‐calorie diet and low‐calorie diet plus exercise could lower more BP than exercise. Conclusions DASH might be the most effective intervention in lowering BP for adults with prehypertension to established hypertension. Aerobic exercise, isometric training, low‐sodium and high‐potassium salt, comprehensive lifestyle modification, salt restriction, breathing‐control, meditation and low‐calorie diet also have obvious effects on BP reduction.
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Affiliation(s)
- Jinming Fu
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Yupeng Liu
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Lei Zhang
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Lu Zhou
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Dapeng Li
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Hude Quan
- Department of Community Health Sciences University of Calgary Alberta Canada
| | - Lin Zhu
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Fulan Hu
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Xia Li
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Shuhan Meng
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Ran Yan
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Suhua Zhao
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Justina Ucheojor Onwuka
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Baofeng Yang
- Department of Pharmacology and the State-Province Key Laboratory of Biomedicine and Pharmaceutics Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Dianjun Sun
- Center for Endemic Disease Control Chinese Center for Disease Control and Prevention Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Yashuang Zhao
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
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Foulkes S, Kukuljan S, Nowson CA, Sanders KM, Daly RM. Effects of a multi-modal resistance exercise program and calcium-vitamin D 3 fortified milk on blood pressure and blood lipids in middle-aged and older men: secondary analysis of an 18-month factorial design randomised controlled trial. Eur J Nutr 2020; 60:1289-1299. [PMID: 32666313 DOI: 10.1007/s00394-020-02325-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 07/01/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE Physical activity and dietary interventions are recommended as front-line therapy for prevention and management of cardiovascular disease. This study investigated the independent and combined effects of low-fat, calcium-vitamin D3 fortified milk and multi-modal exercise training on blood pressure (BP) and blood lipids in middle-aged and older men. METHODS This was a pre-planned secondary analysis of an 18-month, randomised controlled trial. Community-dwelling men aged 50-79 years (n = 180) were randomised into (i) exercise + fortified milk; (ii) fortified milk; (iii) exercise; or (iv) control. The low-fat milk (400 mL/day) was fortified with 1,000 mg/day calcium and 800 IU/day of vitamin-D3, whilst the exercise intervention consisted of three sessions/week of resistance- and weight-bearing impact exercises. Resting BP and fasting lipids were assessed at baseline, 6 (lipids only), 12 and 18 months. RESULTS Mean ± SD serum 25(OH)D and calcium intake for the entire cohort at baseline was 86 ± 36 nmol/L and 1002 ± 397 mg/day, respectively, with 10% classified as vitamin-D insufficient and 58% reporting a calcium intake below 1000 mg/day. There were no exercise-by-fortified milk interactions, nor any main-group effects for exercise or milk on BP or lipids at any time. However, there were significant reductions from baseline to 18 months in systolic (mean change, 5-8 mmHg) and diastolic (4-6 mmHg) BP in the exercise, fortified milk and control groups. All results remained largely unchanged after adjusting for use of anti-hypertensive or lipid lowering medication, weight or fat mass, or only including men with hypertension (n = 89) or dyslipidemia (n = 130) at baseline. CONCLUSION Supplementation with low-fat, calcium + vitamin D3 fortified milk and a multi-modal exercise program, alone or in combination, was not effective for improving BP or blood lipids in community-dwelling middle-aged and older men.
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Affiliation(s)
- Stephen Foulkes
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Melbourne, 3125, Australia
| | - Sonja Kukuljan
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Melbourne, 3125, Australia
| | - Caryl A Nowson
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Melbourne, 3125, Australia
| | - Kerrie M Sanders
- Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Melbourne, 3125, Australia.
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Bauer K, Lau T, Schwille‐Kiuntke J, Schild S, Hauner H, Stengel A, Zipfel S, Mack I. Conventional weight loss interventions across the different
BMI
obesity classes: A systematic review and quantitative comparative analysis. EUROPEAN EATING DISORDERS REVIEW 2020; 28:492-512. [DOI: 10.1002/erv.2741] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/29/2020] [Accepted: 04/13/2020] [Indexed: 01/16/2023]
Affiliation(s)
- Kerstin Bauer
- Department of Psychosomatic Medicine and Psychotherapy University Hospital Tübingen Tübingen Germany
| | - Teresa Lau
- Department of Psychosomatic Medicine and Psychotherapy University Hospital Tübingen Tübingen Germany
| | - Juliane Schwille‐Kiuntke
- Department of Psychosomatic Medicine and Psychotherapy University Hospital Tübingen Tübingen Germany
- Institute of Occupational and Social Medicine and Health Services Research University of Tübingen Tübingen Germany
| | - Sandra Schild
- Department of Psychosomatic Medicine and Psychotherapy University Hospital Tübingen Tübingen Germany
| | - Hans Hauner
- Institute of Nutritional Medicine, School of Medicine Technical university of Munich Munich Germany
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy University Hospital Tübingen Tübingen Germany
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine Charité‐Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy University Hospital Tübingen Tübingen Germany
| | - Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy University Hospital Tübingen Tübingen Germany
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Chan SW, Tomlinson B. Effects of Bilberry Supplementation on Metabolic and Cardiovascular Disease Risk. Molecules 2020; 25:E1653. [PMID: 32260262 PMCID: PMC7180827 DOI: 10.3390/molecules25071653] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 04/01/2020] [Indexed: 02/06/2023] Open
Abstract
Metabolic syndrome is a cluster of interrelated conditions that is associated with an increased risk of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). Oxidative stress may impair normal physiological functions, leading to various illnesses. T2DM is considered to be associated with increased oxidative stress, inflammation, and dyslipidemia, which may play a significant role in the development of cardiovascular complications, cancer and vision loss through cataracts and retinopathy. While conventional therapies are a cornerstone for the management of the major risk factors of metabolic syndrome, increasing antioxidant defense by increasing intake of antioxidant-rich foods may improve long term prospects in CVD, obesity and T2DM. Bilberry (Vaccinium myrtillus L.) is one of the richest natural sources of anthocyanins which give berries their red/purple/blue coloration. Anthocyanins are powerful antioxidants and are reported to play an important role in the prevention of metabolic disease and CVD as well as cancer and other conditions. This review focuses on the potential effects of bilberry supplementation on metabolic and cardiovascular risk factors. Although there is evidence to support the use of bilberry supplementation as part of a healthy diet, the potential benefits from the use of bilberry supplementation in patients with T2DM or CVD needs to be clarified in large clinical trials.
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Affiliation(s)
- Sze Wa Chan
- School of Health Sciences, Caritas Institute of Higher Education, Hong Kong SAR 999077, China
| | - Brian Tomlinson
- Faculty of Medicine, Macau University of Science & Technology, Macau 853, China
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26
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Miller CT, Fraser SF, Selig SE, Rice T, Grima M, van den Hoek DJ, Ika Sari C, Lambert GW, Dixon JB. Fitness, Strength and Body Composition during Weight Loss in Women with Clinically Severe Obesity: A Randomised Clinical Trial. Obes Facts 2020; 13:307-321. [PMID: 32702706 PMCID: PMC7588734 DOI: 10.1159/000506643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 01/08/2020] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION To determine whether combined exercise training with an energy-restricted diet leads to improved physical fitness and body composition when compared to energy restriction alone in free-living premenopausal women with clinically severe obesity. METHODS Sixty premenopausal women (BMI of 40.4 ± 6.7) were randomised to energy restriction only (ER) or to exercise plus energy restriction (EXER) for 12 months. Body composition and fitness were measured at baseline, 3, 6 and 12 months. RESULTS VO2 peak improved more for EXER compared to ER at 3 (mean difference ± SEM 2.5 ± 0.9 mL ∙ kg-1 ∙ min-1, p = 0.006) and 6 (3.1 ± 1.2 mL ∙ kg-1 ∙ min-1, p = 0.007) but not 12 months (2.3 ± 1.6 mL ∙ kg-1 ∙ min-1, p = 0.15). Muscle strength improved more for EXER compared to ER at all time points. No differences between groups for lean mass were observed at 12 months. CONCLUSION Combining exercise training with an energy-restricted diet did not lead to greater aerobic power, total body mass, fat mass or limit lean body mass loss at 12 months when compared to energy restriction alone for premenopausal women with clinically severe obesity in free-living situations. Future research should aim to determine an effective lifestyle approach which can be applied in the community setting for this high-risk group.
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Affiliation(s)
- Clint T Miller
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia,
| | - Steve F Fraser
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Steve E Selig
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Toni Rice
- Clinical Obesity Research Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Human Neurotransmitters and Clinical Obesity Research Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Mariee Grima
- Clinical Obesity Research Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Human Neurotransmitters and Clinical Obesity Research Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Daniel J van den Hoek
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
- School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
| | - Carolina Ika Sari
- Human Neurotransmitters and Clinical Obesity Research Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Gavin W Lambert
- Human Neurotransmitters and Clinical Obesity Research Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - John B Dixon
- Clinical Obesity Research Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
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An Approach to Obesity Management for Gastroenterologists and Hepatologists. CURRENT TREATMENT OPTIONS IN GASTROENTEROLOGY 2019; 17:587-601. [PMID: 31755071 DOI: 10.1007/s11938-019-00250-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE OF REVIEW Obesity is associated with multiple gastrointestinal and liver diseases such as gastroesophageal reflux disease, Barrett's esophagus, esophageal adenocarcinoma, cholelithiasis, colon polyps, and fatty liver disease. To effectively manage obesity, it is imperative to understand current and emerging therapies and procedures. FINDINGS Obesity is becoming increasingly prevalent and is associated with a growing monetary health care burden. Cardiac disease, cerebrovascular disease, and diabetes are among the leading causes of preventable and premature death of Americans related to obesity. In addition to behavioral modification (diet and exercise) and bariatric surgery, multiple pharmacotherapies and endoscopic procedures are newly approved and available for the management of obesity. This paper reviews the current literature on the treatments available for the management of obesity including behavior modification, pharmacotherapy, endoscopic weight loss procedures (endobariatrics), and bariatric surgery.
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Santhanam P, Sarkar S, Ahima RS. Relationship between lean body mass indices, physical activity, and systolic BP: Analysis of 1999-2006 NHANES data. J Clin Hypertens (Greenwich) 2019; 21:692-693. [PMID: 30892817 DOI: 10.1111/jch.13516] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Prasanna Santhanam
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sudipa Sarkar
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Rexford S Ahima
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Schroeder EC, Franke WD, Sharp RL, Lee DC. Comparative effectiveness of aerobic, resistance, and combined training on cardiovascular disease risk factors: A randomized controlled trial. PLoS One 2019; 14:e0210292. [PMID: 30615666 PMCID: PMC6322789 DOI: 10.1371/journal.pone.0210292] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 12/18/2018] [Indexed: 01/02/2023] Open
Abstract
Although exercise has well-documented health benefits on cardiovascular disease (CVD), the benefit of combination exercise on CVD risk factors in individuals with elevated risk has not been fully elucidated. We compared the effects of aerobic, resistance, and a combination of both aerobic and resistance training on CVD risk factors including peripheral and central BP, cardiorespiratory fitness (CRF), muscular strength, body composition, blood glucose and lipids. Sixty-nine adults (58±7 years) with an elevated blood pressure or hypertension, overweight/obesity, and sedentary lifestyle were randomized to one of the three 8-week exercise programs or a non-exercise control group. Participants in all three exercise groups had an equal total exercise time, 3 days/week (aerobic: 60 minutes/session vs. resistance: 60 minutes/session vs. combination: aerobic 30 minutes/session plus resistance 30 minutes/session). Combined training provided significant reductions in peripheral (-4 mmHg) and central diastolic BP (-4 mmHg), increase in CRF (4.9 ml/kg/min), increase in upper (4 kg) and lower (11 kg) body strength, and increase in lean body mass (0.8 kg) (p <0.05). Aerobic training only increased CRF (7.7 ml/kg/min), and reduced body weight (-1.0 kg) and fat mass (-0.9 kg) (p <0.05). Resistance training only increased lower body strength (13 kg) and reduced waist circumference (-1.7 cm) (p <0.05). However, neither aerobic or resistance training alone showed significant reductions in BP (p>0.05). Furthermore, a composite score of CVD risk factors indicated a greater reduction with combination training compared to the control group. In conclusion, among individuals at an increased risk for CVD, as little as 8-weeks of combined training may provide more comprehensive CVD benefits compared to time-matched aerobic or resistance training alone.
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Affiliation(s)
- Elizabeth C. Schroeder
- Department of Kinesiology and Nutrition, University of Illinois, Chicago, IL, United States of America
| | - Warren D. Franke
- Department of Kinesiology, Iowa State University, Ames, IA, United States of America
| | - Rick L. Sharp
- Department of Kinesiology, Iowa State University, Ames, IA, United States of America
| | - Duck-chul Lee
- Department of Kinesiology, Iowa State University, Ames, IA, United States of America
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31
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Rodrigues RD, Carvalho BL, Gonçalves GKN. Effect of physical exercise on cardiometabolic parameters in post-menopause: an integrative review. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2019. [DOI: 10.1590/1981-22562019022.190133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: To identify the evidence available in literature which relates the practice of physical exercise to improvements in the cardiovascular and metabolic parameters of postmenopausal women. Method: A search was performed of works published between 2008 and 2018 included in the MEDLINE, BDENF, IBCS and LILACS databases. Of the 792 studies identified, 23 met the inclusion criteria. Results: Following analysis, the studies were separated into three categories. In the first category it was observed that physical exercise improved lipid metabolism, reduced abdominal circumference and promoted weight loss. The second category revealed that physical exercise reduced systolic blood pressure, prevented the development of arterial hypertension and reduced the release of sympathomimetic hormones. In the third category the studies indicated that physical exercise elevated the antioxidant mediators and reversed the oxidative stress involved in the inflammatory reactions present in cardiovascular diseases. Conclusion: The studies confirm the beneficial effects of physical exercise on the metabolic and cardiovascular parameters of postmenopausal women.
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Ramos RM, Coelho-Júnior HJ, do Prado RCR, da Silva RS, Asano RY, Prestes J, Medeiros AIA, Rodrigues B, Assumpção CDO. Moderate Aerobic Training Decreases Blood Pressure but No Other Cardiovascular Risk Factors in Hypertensive Overweight/Obese Elderly Patients. Gerontol Geriatr Med 2018; 4:2333721418808645. [PMID: 30450368 PMCID: PMC6236479 DOI: 10.1177/2333721418808645] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/31/2018] [Accepted: 09/28/2018] [Indexed: 01/19/2023] Open
Abstract
Hypertension and obesity are prevalent diseases in elderly people, and their combination can cause deleterious effects on physiological system. Moderate intensity aerobic training (MIAT) seems to be a beneficial approach to control and treat these diseases separately. However, few studies have investigated the impact of MIAT on cardiovascular risk factors associated with these conditions (i.e., elevated blood pressure values, blood markers, and body composition). Therefore, the present study was designed to investigate the effects of MIAT on blood pressure, blood markers, and body composition in hypertensive overweight/obese elderly patients. Twenty-four hypertensive overweight/obese elderly patients were randomized into control group (CG) and training group (TG), submitted to 12 weeks of MIAT of 50 min, 3 days per week, at 60% of maximal HR (heart rate). There was a decrease in diastolic blood pressure (-10.1 ± 3.3; p = .01; effect size = 1.29) and mean arterial pressure (MAP; -8.2 ± 3.7; p = .04; effect size = 0.94) following 12 weeks of training in the TG as compared with baseline. There was an increase in triacylglycerol levels in the TG (+0.1 ± 0.0; p = .02). There were no significant changes in body composition for both groups. The present study revealed that 12 weeks of MIAT can decrease blood pressure in hypertensive obese elderly patients, with no significant modifications in blood markers and body composition.
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Affiliation(s)
| | | | | | | | - Ricardo Yukio Asano
- Universidade de São Paulo, Brasil.,Universidade Ibirapuera, São Paulo, Brasil
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Utilization of short message service (SMS) in non-pharmacological management of hypertension. A pilot study in an URBAN public hospital of Multan, Pakistan. J Public Health (Oxf) 2018. [DOI: 10.1007/s10389-018-0982-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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Fang K, Li H, Ma A, Dong J, Xie J, Zhou Y, Qi K, Wei Y, Li G, Cao J, Dong Z. Weight underestimation for adults in Beijing and its association with chronic disease awareness and weight management. Lipids Health Dis 2018; 17:225. [PMID: 30261901 PMCID: PMC6161346 DOI: 10.1186/s12944-018-0873-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 09/21/2018] [Indexed: 01/30/2023] Open
Abstract
Background Obesity is known to be a risk factor to a variety of chronic diseases. Weight misperception has an impact on weight-loss attitude and behavior. We aimed to investigate factors associated with weight underestimation, and to assess the effect of hypertension, diabetes and dyslipidemia awareness on weight underestimation and weight management for overweight and obese adults. Methods Data was obtained from the 2011 Beijing Non-communicable disease and risk factors Surveillance (BJNCDRS). A total of 19,932 participants with measures of weight and height were included in the analysis. Self-perception of weight was obtained by asking, “How do you describe your weight?”, and the question for weight management was “Are you taking any actions to control your body weight?”. Multiple logistic regression was used to investigate factors related to weight underestimation. Results For the underweight, normal weight, and overweight/obese categories, more than half of the participants perceived their weight accurately (63.6, 53.8, 66.2%, respectively). For overweight and obese adults, older age, male, rural residence, lower level of education, lower level of income, absence of hypertension, presence of diabetes and absence of dyslipidemia positively associated with weight underestimation, and awareness of having hypertension and dyslipidemia were negatively associated with weight underestimation (Adjusted OR(95%CI) were 0.70(0.61~ 0.79) and 0.71(0.62~ 0.80), respectively). Awareness of having hypertension and dyslipidemia were significantly associated with weight management (Adjusted OR (95%CI) were 1.42(1.25~ 1.62) and 1.53(1.36~ 1.72), respectively). There was no significant association between awareness of diabetes and weight underestimation(P > 0.05) or weight management(P > 0.05). Conclusions More than half of the participants perceived their weight accurately. For overweight/obese population, awareness of having hypertension and dyslipidemia could improve weight perception and weight management, whereas awareness of having diabetes might not.
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Affiliation(s)
- Kai Fang
- Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Hang Li
- Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Aijuan Ma
- Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Jing Dong
- Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Jin Xie
- Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Ying Zhou
- Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Kun Qi
- Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Yingqi Wei
- Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Gang Li
- Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Jie Cao
- Department of Epidemiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhong Dong
- Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing, China.
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Arija V, Villalobos F, Pedret R, Vinuesa A, Jovani D, Pascual G, Basora J. Physical activity, cardiovascular health, quality of life and blood pressure control in hypertensive subjects: randomized clinical trial. Health Qual Life Outcomes 2018; 16:184. [PMID: 30217193 PMCID: PMC6137925 DOI: 10.1186/s12955-018-1008-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 09/03/2018] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Physical activity (PA) promotes cardiovascular health and health related quality of life (HRQoL), although the effect of that on blood pressure (BP) control has rarely been studied in hypertensive subjects. Our aim was to evaluate the effectiveness of a PA intervention programme on cardiovascular disease (CVD) risk, HRQoL and BP control in hypertensive subjects. METHODS A randomized clinical trial, with a PA intervention programme of 9 months duration, comprising a walking group of 120 min/week, supervised, and with socio-cultural activities. Participants were 207 hypertensive subjects (68.2 years, 76.8% women). PA (IPAQ-s), diet, CVD risk, BP, BMI, smoking, and HRQoL (SF-36) were assessed at baseline and at the end of the intervention. Changes in CVD risk and in HRQoL during the intervention was calculated (end-baseline score). Multivariate models were applied. RESULTS In multivariate models, the PA intervention programme, with no modification of the diet, decreased CVD risk (- 1.19 points) and the systolic BP (- 8.68 mmHg), and increased some areas of HRQoL (4.45 to 14.62 points). An increase in the percentage of subjects with controlled BP was observed by the PA programme itself (OR 5.395 to 5.785 according to multivariate models), and by the changes during the intervention in the decrease in CVD risk (OR 0.609) and in the increase in the HRQoL in physical component summary (OR 1.041), role physical (OR 1.010), and bodily pain (OR 1.014), independently of controlled BP at baseline. CONCLUSIONS This PA intervention programme improved cardiovascular health and HRQoL, and favoured BP control in primary care users with hypertension. TRIAL REGISTRATION Clinicaltrials.gov ID NCT02767739 ; Trial registered on May 5th, 2016. Retrospectively registered.
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Affiliation(s)
- Victoria Arija
- Unitat Suport a la Recerca Reus-Tarragona, Institut d'Investigació en Atenció Primária, IDIAP Jordi Gol (Barcelona), Camí de Riudoms 57, 43202, Reus, Spain.
- Institut d'Investigació Sanitària Pere Virgili, Reus, Tarragona, Spain.
- Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, Reus, Tarragona, Spain.
| | - Felipe Villalobos
- Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, Reus, Tarragona, Spain
| | - Roser Pedret
- Primary Health Care Area, Reus, Tarragona, Spain
- Institut Català de la Salut, Generalitat de Catalunya, Barcelona, Spain
| | - Angels Vinuesa
- Primary Health Care Area, Reus, Tarragona, Spain
- Institut Català de la Salut, Generalitat de Catalunya, Barcelona, Spain
| | - Dolors Jovani
- Primary Health Care Area, Reus, Tarragona, Spain
- Institut Català de la Salut, Generalitat de Catalunya, Barcelona, Spain
| | - Gabriel Pascual
- Primary Health Care Area, Reus, Tarragona, Spain
- Institut Català de la Salut, Generalitat de Catalunya, Barcelona, Spain
| | - Josep Basora
- Unitat Suport a la Recerca Reus-Tarragona, Institut d'Investigació en Atenció Primária, IDIAP Jordi Gol (Barcelona), Camí de Riudoms 57, 43202, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili, Reus, Tarragona, Spain
- Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, Reus, Tarragona, Spain
- Primary Health Care Area, Reus, Tarragona, Spain
- Institut Català de la Salut, Generalitat de Catalunya, Barcelona, Spain
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Butcher JT, Mintz JD, Larion S, Qiu S, Ruan L, Fulton DJ, Stepp DW. Increased Muscle Mass Protects Against Hypertension and Renal Injury in Obesity. J Am Heart Assoc 2018; 7:e009358. [PMID: 30369309 PMCID: PMC6201396 DOI: 10.1161/jaha.118.009358] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 06/20/2018] [Indexed: 01/06/2023]
Abstract
Background Obesity compromises cardiometabolic function and is associated with hypertension and chronic kidney disease. Exercise ameliorates these conditions, even without weight loss. Although the mechanisms of exercise's benefits remain unclear, augmented lean body mass is a suspected mechanism. Myostatin is a potent negative regulator of skeletal muscle mass that is upregulated in obesity and downregulated with exercise. The current study tested the hypothesis that deletion of myostatin would increase muscle mass and reduce blood pressure and kidney injury in obesity. Methods and Results Myostatin knockout mice were crossed to db/db mice, and metabolic and cardiovascular functions were examined. Deletion of myostatin increased skeletal muscle mass by ≈50% to 60% without concomitant weight loss or reduction in fat mass. Increased blood pressure in obesity was prevented by the deletion of myostatin, but did not confer additional benefit against salt loading. Kidney injury was evident because of increased albuminuria, which was abolished in obese mice lacking myostatin. Glycosuria, total urine volume, and whole kidney NOX-4 levels were increased in obesity and prevented by myostatin deletion, arguing that increased muscle mass provides a multipronged defense against renal dysfunction in obese mice. Conclusions These experimental observations suggest that loss of muscle mass is a novel risk factor in obesity-derived cardiovascular dysfunction. Interventions that increase muscle mass, either through exercise or pharmacologically, may help limit cardiovascular disease in obese individuals.
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Affiliation(s)
- Joshua T. Butcher
- Vascular Biology CenterMedical College of Georgia at Augusta UniversityAugustaGA
| | - James D. Mintz
- Vascular Biology CenterMedical College of Georgia at Augusta UniversityAugustaGA
| | - Sebastian Larion
- Vascular Biology CenterMedical College of Georgia at Augusta UniversityAugustaGA
| | - Shuiqing Qiu
- Vascular Biology CenterMedical College of Georgia at Augusta UniversityAugustaGA
| | - Ling Ruan
- Vascular Biology CenterMedical College of Georgia at Augusta UniversityAugustaGA
| | - David J. Fulton
- Vascular Biology CenterMedical College of Georgia at Augusta UniversityAugustaGA
- Department of PharmacologyMedical College of Georgia at Augusta UniversityAugustaGA
| | - David W. Stepp
- Vascular Biology CenterMedical College of Georgia at Augusta UniversityAugustaGA
- Department of PhysiologyMedical College of Georgia at Augusta UniversityAugustaGA
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Rivera-Mancía S, Colín-Ramírez E, Cartas-Rosado R, Infante O, Vargas-Barrón J, Vallejo M. Indicators of accumulated fat are stronger associated with prehypertension compared with indicators of circulating fat: A cross-sectional study. Medicine (Baltimore) 2018; 97:e11869. [PMID: 30142781 PMCID: PMC6113050 DOI: 10.1097/md.0000000000011869] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Recently, prehypertension has been considered as a risk factor for cardiovascular disease because it can progress to hypertension. The association between obesity and dyslipidemia with raised blood pressure has been reported in some studies; however, the ability of indicators of such conditions to predict prehypertension has been scarcely explored. In this cross-sectional study, we compared the ability of indicators of accumulated and circulating fat to discriminate between prehypertensive and normotensive Mexico City residents (n = 1377). The indicators were classified based on the parameters needed for their calculation: including only circulating fat (IOCFi) (e.g., Castelli risk indexes), including only accumulated fat (IOAFi) (e.g., waist circumference [WC]), and mixed (e.g., lipid accumulation product [LAP]). We compared the areas under the receiving operating characteristic curves (AURCs) and estimated the cutoff points for each indicator and their associated risk of prehypertension. The IOAFi had the greatest AURCs, followed by mixed and IOCFi; the AURCs for WC were the highest (AURC = 0.688 and 0.666 for women and men, respectively). The highest odds ratios for prehypertension were those associated with the cutoff points for IOAFi and LAP (e.g., OR = 2.8 for women with WC > 83.5 cm and OR = 2.6 for men with WC > 87.5 cm). Early detecting people at risk of cardiovascular disease is a necessity and given that WC had a better performance than the other indexes and it is relatively easy to measure, it has the potential of being used as a complementary measure in routine clinical examinations and by the general population as an auto-screening measurement to detect prehypertension.
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Affiliation(s)
| | | | | | | | | | - Maite Vallejo
- Department of Social Medicine Research, National Institute of Cardiology “Ignacio Chávez,” Mexico City, Mexico
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38
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Zhang Y, Qi L, Xu L, Sun X, Liu W, Zhou S, van de Vosse F, Greenwald SE. Effects of exercise modalities on central hemodynamics, arterial stiffness and cardiac function in cardiovascular disease: Systematic review and meta-analysis of randomized controlled trials. PLoS One 2018; 13:e0200829. [PMID: 30036390 PMCID: PMC6056055 DOI: 10.1371/journal.pone.0200829] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 06/29/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Exercise is accepted as an important contribution to the rehabilitation of patients with cardiovascular disease (CVD). This study aims to better understand the possible causes for lack of consensus and reviews the effects of three exercise modalities (aerobic, resistance and combined exercise) on central hemodynamics, arterial stiffness and cardiac function for better rehabilitation strategies in CVD. METHODS The electronic data sources, Cochrane Library, MEDLINE, Web of Science, EBSCO (CINAHL), and ScienceDirect from inception to July 2017 were searched for randomized controlled trials (RCTs) investigating the effect of exercise modalities in adult patients with CVD. The effect size was estimated as mean differences (MD) with 95% confidence intervals (CI). Subgroup analysis and meta-regression were used to study potential moderating factors. RESULTS Thirty-eight articles describing RCTs with a total of 2089 patients with CVD were included. The pooling revealed that aerobic exercise [MD(95%CI) = -5.87 (-8.85, -2.88), P = 0.0001] and resistance exercise [MD(95%CI) = -7.62 (-10.69, -4.54), P<0.00001] significantly decreased aortic systolic pressure (ASP). Resistance exercise significantly decreased aortic diastolic pressure [MD(95%CI) = -4(-5.63, -2.37), P<0.00001]. Aerobic exercise significantly decreased augmentation index (AIx) based on 24-week exercise duration and patients aged 50-60 years. Meanwhile, aerobic exercise significantly improved carotid-femoral pulse wave velocity (cf-PWV) [MD(95%CI) = -0.42 (-0.83, -0.01), P = 0.04], cardiac output (CO) [MD(95% CI) = 0.36(0.08, 0.64), P = 0.01] and left ventricular ejection fraction (LVEF) [MD(95%CI) = 3.02 (2.11, 3.93), P<0.00001]. Combined exercise significantly improved cf-PWV [MD(95%CI) = -1.15 (-1.95, -0.36), P = 0.004] and CO [MD(95% CI) = 0.9 (0.39, 1.41), P = 0.0006]. CONCLUSIONS Aerobic and resistance exercise significantly decreased ASP, and long-term aerobic exercise reduced AIx. Meanwhile, aerobic and combined exercise significantly improved central arterial stiffness and cardiac function in patients with CVD. These findings suggest that a well-planned regime could optimize the beneficial effects of exercise and can provide some evidence-based guidance for those involved in cardiovascular rehabilitation of patients with CVD.
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Affiliation(s)
- Yahui Zhang
- Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, Liaoning, China
| | - Lin Qi
- Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, Liaoning, China
| | - Lisheng Xu
- Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, Liaoning, China
- Key Laboratory of Medical Image Computing, Ministry of Education, Northeastern University, Shenyang, Liaoning, China
| | - Xingguo Sun
- Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Beijing, China
| | - Wenyan Liu
- Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, Liaoning, China
| | - Shuran Zhou
- Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, Liaoning, China
| | - Frans van de Vosse
- Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, Liaoning, China
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Stephen E. Greenwald
- Blizard Institute, Barts & The London School of Medicine &Dentistry, Queen Mary University of London, London, United Kingdom
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Abdul Aziz NS, Shahar S, Ambak R, Mohamad Nor NS, Jamil AT, Aris T. Influence of co-morbidity on body composition changes after weight loss intervention among overweight housewives: a follow-up study of the MyBFF@home. BMC WOMENS HEALTH 2018; 18:115. [PMID: 30066631 PMCID: PMC6069513 DOI: 10.1186/s12905-018-0600-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background Obesity is a risk factor for co-morbidities such as diabetes, hypertension, osteoarthritis and cardiovascular diseases. However, it is unclear if the presence of co-morbidities has any effect on the magnitude of body composition changes following weight reduction programmes. Thus, this study aimed to determine changes in body composition among obese housewives with and without co-morbidities after they participated in a weight loss intervention. Methods This is a follow-up study among 84 obese housewives without co-morbidities aged 18 to 59 years old who previously participated as a control group (delayed intervention, G1) in the My Body is Fit and Fabulous at Home (MyBFF@home) Phase II. Baseline data were obtained from 12 month data collection for this group. A new group of 42 obese housewives with co-morbidities (G2) were also recruited. Both groups received a 6 month intervention (July–December 2015) consisting of dietary counselling, physical activity (PA) and self-monitoring tools (PA diary, food diary and pedometer). Study parameters included weight, height, waist circumference, blood pressure and body compositions. Body compositions were measured using a bioelectrical impedance analysis device, Inbody 720. Descriptive and repeated measures ANOVA analyses were performed using SPSS 21. Results There were reductions in mean body fat, fat mass and visceral fat area, particularly among obese women without co-morbidities. There were also decreases fat and skeletal muscle from baseline to month six with mean difference − 0.12 (95% CI: -0.38, 0.14) and visceral fat area from month three to month six with mean difference − 9.22 (− 17.87, − 0.56) for G1. G2 showed a decreasing pattern of skeletal muscle from baseline to month six with mean difference − 0.01(95% CI: -0.38, 0.37). There was a significant difference for group effect of visceral fat area (p < 0.05) with mean difference of − 11.49(95% CI: -20.07, 2.91). It showed that the intervention programs was effective to reduce visceral fat area compared to other part of body composition. Conclusion Obese participants without co-morbidities showed more desirable changes in body composition. Visceral fat area was reduced regardless of morbidity status. Weight management efforts are therefore not as straightforward in those with co-morbidities compared to those without, and require thorough and tailor-made strategies for a better chance of success.
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Affiliation(s)
- Nur Shahida Abdul Aziz
- Institute for Public Health, National Institute of Health, Ministry of Health Malaysia, 50590, Kuala Lumpur, Malaysia.
| | - Suzana Shahar
- Department of Nutrition and Dietetics, Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Rashidah Ambak
- Institute for Public Health, National Institute of Health, Ministry of Health Malaysia, 50590, Kuala Lumpur, Malaysia
| | - Noor Safiza Mohamad Nor
- Institute for Public Health, National Institute of Health, Ministry of Health Malaysia, 50590, Kuala Lumpur, Malaysia
| | - Ahmad Taufik Jamil
- Population Health and Preventive Medicine, Faculty of Medicine, University Technology MARA (UiTM), Sungai Buloh Campus, Sungai Buloh, Selangor Darul Ehsan, Malaysia
| | - Tahir Aris
- Institute for Public Health, National Institute of Health, Ministry of Health Malaysia, 50590, Kuala Lumpur, Malaysia
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Sarfati D, McLeod M, Stanley J, Signal V, Stairmand J, Krebs J, Dowell A, Leung W, Davies C, Grainger R. BetaMe: impact of a comprehensive digital health programme on HbA1c and weight at 12 months for people with diabetes and pre-diabetes: study protocol for a randomised controlled trial. Trials 2018; 19:161. [PMID: 29506562 PMCID: PMC5836439 DOI: 10.1186/s13063-018-2528-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 02/05/2018] [Indexed: 01/06/2023] Open
Abstract
Background Long-term conditions (LTCs) are the biggest contributor to health loss in New Zealand. The economic cost and burden on the health system is substantial and growing. Self-management strategies offer a potential way to reduce the pressure on health services. This study evaluates a comprehensive self-management programme (the BetaMe programme) delivered by mobile and web-based technologies for people with Type 2 diabetes (T2DM) and pre-diabetes. The primary aim of this study is to evaluate the effectiveness of the BetaMe programme versus usual care among primary care populations in improving the control of T2DM and pre-diabetes, as measured by change in HbA1c and weight over 12 months. Methods Participants will be recruited through two primary healthcare organisations and a Māori healthcare provider in New Zealand (n = 430). Eligible participants will be 18 to 75 years old, with T2DM or pre-diabetes, with an HbA1c of 41–70 mmol/mol up to 2 years prior to study commencement. Eligible participants who consent to participate will be individually randomised to the control arm (usual care) or intervention arm (usual care and BetaMe). The programme consists of a 16-week core followed by a maintenance period of 36 weeks. It incorporates (1) individualised health coaching, (2) goal setting and tracking, (3) peer support in an online forum and (4) educational resources and behaviour-change tools. The primary outcome measures are change in HbA1c and weight at 12 months. Secondary outcomes are changes in waist circumference, blood pressure, patient activation and diabetes-specific behaviours. All outcomes will be assessed at 4 and 12 months for the total study population and for Māori and Pacific participants specifically. All primary analyses will be based on intention-to-treat. Primary analysis will use linear mixed models comparing mean outcome levels adjusted for initial baseline characteristics at 12 months. Discussion This is a randomised controlled trial of a comprehensive self-management intervention for people with diabetes and pre-diabetes. If effective, this programme would allow healthcare providers to deliver an intervention that is person-centred and supports the self-care of people with T2DM, pre-diabetes and potentially other LTCs. Trial registration Australian New Zealand Clinical Trials Registry, ID: ACTRN12617000549325. Registered on 19 April 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-2528-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Diana Sarfati
- Department of Public Health, University of Otago Wellington, PO Box 7343, Wellington, New Zealand.
| | - Melissa McLeod
- Department of Public Health, University of Otago Wellington, PO Box 7343, Wellington, New Zealand
| | - James Stanley
- Biostatistical Group, Dean's Department, University of Otago Wellington, PO Box 7343, Wellington, New Zealand
| | - Virginia Signal
- Department of Public Health, University of Otago Wellington, PO Box 7343, Wellington, New Zealand
| | - Jeannine Stairmand
- Department of Public Health, University of Otago Wellington, PO Box 7343, Wellington, New Zealand
| | - Jeremy Krebs
- Department of Medicine, University of Otago Wellington, PO Box 7343, Wellington, New Zealand
| | - Anthony Dowell
- Department of Primary Health Care and General Practice, University of Otago Wellington, PO Box 7343, Wellington, New Zealand
| | - William Leung
- Department of Public Health, University of Otago Wellington, PO Box 7343, Wellington, New Zealand.,Department of Medicine, University of Auckland, PO Box 1142, Auckland, New Zealand
| | | | - Rebecca Grainger
- Department of Medicine, University of Otago Wellington, PO Box 7343, Wellington, New Zealand
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Liu X, Byrd JB, Rodriguez CJ. Use of physician-recommended non-pharmacological strategies for hypertension control among hypertensive patients. J Clin Hypertens (Greenwich) 2018; 20:518-527. [PMID: 29450958 DOI: 10.1111/jch.13203] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 10/20/2017] [Accepted: 11/07/2017] [Indexed: 12/24/2022]
Abstract
This study aims to evaluate the 4 non-pharmacological strategies adopted by patients for hypertension control and patient characteristics that affect the choice of strategies. Four thousand hypertensive patients aged ≥18 years were selected from the National Health and Nutrition Examination Survey. Odds ratios of the choice of strategies were analyzed using weighted logistic models. Clinical recommendations of non-pharmacological strategies for hypertension control were relatively low. More exercise was the least frequent strategy used for hypertension control. More patients reported using ≥3 strategies than using ≤2 strategies (79.1% vs 20.9%, P < .0001). Non-Hispanic blacks were more likely to use each individual strategy and to use ≥3 strategies simultaneously. Patients with obesity and diabetes were less likely to attempt weight control or more exercise, but more likely to use ≥3 strategies than peers. Educational programs should be developed to enhance physician's advice for lifestyle modifications and to increase patient's acceptance of physical activity.
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Affiliation(s)
- Xuefeng Liu
- Department of Systems, Populations, and Leadership, University of Michigan, Ann Arbor, MI, USA.,Frankel Cardiovascular Center, University of Michigan School of Medicine, Ann Arbor, MI, USA
| | - James Brian Byrd
- Division of Cardiovascular Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - Carlos J Rodriguez
- Division of Public Health Sciences, Department of Epidemiology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Department of Internal Medicine (Cardiology), Wake Forest School of Medicine, Winston-Salem, NC, USA
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Relationship between body mass and ambulatory blood pressure: comparison with office blood pressure measurement and effect of treatment. J Hum Hypertens 2017; 32:122-128. [PMID: 29203908 PMCID: PMC5826780 DOI: 10.1038/s41371-017-0021-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 09/08/2017] [Accepted: 10/19/2017] [Indexed: 01/19/2023]
Abstract
Epidemiologic studies assessing the relationship between blood pressure (BP), body mass and cardiovascular events have primarily been based on office BP measurements, and few data are available in the elderly. The aim of the present study was to evaluate the relationship between body mass index (BMI) and BP values obtained by ambulatory blood pressure monitoring (ABPM) as compared to office BP measurements, and the effect of anti-hypertensive treatment on the relationship. The study population consisted of 813 subjects participating in the Cardiovascular Abnormalities and Brain Lesions (CABL) study who underwent 24-hour ABPM. Office BP (mean of 2 measurements) was found to be associated with increasing BMI, for both SBP (p≤0.05) and DBP (p≤0.001). In contrast, there was no association seen of increasing BMI with ABPM parameters in the overall cohort, even after adjusting for age and gender. However, among subjects not on anti-hypertensive treatment, office SBP and DBP measurements were significantly correlated with increasing BMI (p≤0.01) as were daytime SBP and 24-hour SBP, although with a smaller spread across BMI subgroups compared with office readings. In treated hypertensives, there was only a trend toward increasing office DBP and increasing DBP variability with higher BMI. Our results suggest that body mass may be a less significant influence on BP values in the elderly when ABPM rather than office measurements are considered, particularly in patients receiving anti-hypertensive treatment.
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Bishwajit G, Yaya S, Seydou I. Diabetes mellitus and high blood pressure in relation to BMI among adult non-pregnant women in Bangladesh. Diabetes Metab Syndr 2017; 11 Suppl 1:S217-S221. [PMID: 27993540 DOI: 10.1016/j.dsx.2016.12.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 12/12/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate the association between overweight and obesity (in terms of BMI) and diabetes, HBP and diabetes-HBP comorbidity among adult women non-pregnant in Bangladesh. METHODS Information about demographics, socioeconomic, blood pressure and blood glucose levels were collected for 2022 women ageing above 35 years were collected from Bangladesh Demographic and Health Survey (BDHS 2011). The primary outcome variables were diabetes and high blood pressure. Diabetes was defined as fasting plasma glucose value ≥7.0mmol/L and HBP as systolic blood pressure ≥140mmHg or diastolic blood pressure ≥90mmHg. Blood pressure and plasma glucose measurement were performed by standard clinical procedures. Data were analysed using cross-tabulation, chi-square tests and logistic regression methods. RESULTS Mean age of the participants was 41.42 (SD=4.37). 38.7% of the women had BMI values ≥25. The prevalence of HBP, diabetes, and diabetes-HBP comorbidity was respectively 18% and 5.1%, and 2%. The adjusted odds of having diabetes, HBP and Diabetes-HBP comorbidity were respectively 2.14 (p=0.002; 95%CI=1.31-3.48), 2.3 (p=<0.0001; 95%CI=1.70-2.98), and 3.4 (p=0.004; 95%CI=1.47-7.81) times higher among overweight/obese women compared to those with normal weight. CONCLUSIONS Overweight and obesity account for a major proportion of diabetes, HBP and the comorbidity of these two among non-pregnant women. There remains a considerable risk for future expansion of diabetes and HBP as the prevalence of overweight/obesity is rising constantly. Maintaining a healthy BMI needs to be regarded as among the most important diabetes and HBP preventive strategies among Bangladeshi women.
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Affiliation(s)
- Ghose Bishwajit
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka 1000, Bangladesh; School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Canada.
| | - Ide Seydou
- Interdisciplinary School of Health Sciences, University of Ottawa, Canada.
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Tussing-Humphreys L, Lamar M, Blumenthal JA, Babyak M, Fantuzzi G, Blumstein L, Schiffer L, Fitzgibbon ML. Building research in diet and cognition: The BRIDGE randomized controlled trial. Contemp Clin Trials 2017; 59:87-97. [PMID: 28600159 PMCID: PMC7289155 DOI: 10.1016/j.cct.2017.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 05/31/2017] [Accepted: 06/05/2017] [Indexed: 02/07/2023]
Abstract
Obesity has been linked to cognitive impairment, cognitive decline and dementia. Given that 38.5% of U.S. adults 60years and older are obese and these numbers are rapidly increasing, strategies to decouple obesity from cognitive decline are needed. Innovative lifestyle strategies that may postpone the onset of subclinical symptoms or even arrest the transition to overt dementia in at-risk individuals are critically needed. Poor diet is central to the development of obesity and diet may affect cognition. Adherence to a Mediterranean Diet (MedDiet) is associated with reduced risk of cognitive impairment and dementia. Furthermore, weight loss through caloric restriction improves cognitive function. This paper describes the Building Research in Diet and CoGnition (BRIDGE) study, a randomized trial examining the effect of the MedDiet, with and without weight loss, on cognitive functioning in obese older adults. Obese (BMI≥30 and ≤50kg/m2) older adults (≥55years) (n=180) will be randomized in a 2:2:1 allocation scheme to: Typical Diet Control; MedDiet alone, without weight loss; or MedDiet lifestyle intervention to promote weight loss and weight loss maintenance. Both MedDiet intervention groups will meet for one individual session and 27 group sessions over an 8-month period. Individuals in the control group will not receive instruction on changing lifestyle habits. Outcomes will be assessed at baseline, 8 and 14months. The primary outcome is cognitive functioning; secondary outcomes will include changes in body weight, diet, cardiovascular, metabolic, and inflammatory biomarkers.
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Affiliation(s)
- Lisa Tussing-Humphreys
- Department of Medicine, Division of Academic Internal Medicine, University of Illinois at Chicago, Chicago, IL 60608, United States; Cancer Center, Population Behavior and Health Outcome Program, University of Illinois at Chicago, Chicago, IL 60612, United States
| | - Melissa Lamar
- Department of Medicine and the Institute of Minority Health Research, University of Illinois at Chicago, Chicago, IL 60612, United States; The Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, United States
| | - James A Blumenthal
- Department of Psychiatry, Division of Behavioral Medicine, Duke University, Durham, NC 27710, United States
| | - Michael Babyak
- Department of Psychiatry, Division of Behavioral Medicine, Duke University, Durham, NC 27710, United States
| | - Giamila Fantuzzi
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL 60612, United States
| | - Lara Blumstein
- Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, Chicago, IL 60608, United States
| | - Linda Schiffer
- Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, Chicago, IL 60608, United States
| | - Marian L Fitzgibbon
- Cancer Center, Population Behavior and Health Outcome Program, University of Illinois at Chicago, Chicago, IL 60612, United States; Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, Chicago, IL 60608, United States; Department of Pediatrics, University of Illinois at Chicago, Chicago, IL 60612, United States.
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Tran WC, Huynh D, Chan T, Chesla CA, Park M. Understanding barriers to medication, dietary, and lifestyle treatments prescribed in polycystic kidney disease. BMC Nephrol 2017; 18:214. [PMID: 28679364 PMCID: PMC5498983 DOI: 10.1186/s12882-017-0641-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 06/26/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Autosomal dominant polycystic kidney disease (PKD) is the most common genetic renal disease and the fourth leading cause of end-stage renal disease in the United States. Although there is no cure for PKD, several treatments are considered to be beneficial, including blood pressure control, exercise, low-salt diet, and high volume water intake. However, levels of understanding of the importance of these treatments and adherence to these recommendations vary among patients. This study explores illness perception models of patients with PKD to reveal barriers in adherence to prescribed therapies; satisfaction with medical care; and sources of medical information. METHODS We designed a phenomenological interview study to evaluate illness perception models of individuals with PKD. Patients were identified from the national PKD Foundation e-mail distribution list (N = 190) and responded voluntarily to an introductory survey (N = 50). Seventeen PKD patients in the Bay Area were scheduled for one-on-one in-depth interviews with one trained interviewer (W-CT). Open-ended questions administered with an interview guide were used to evaluate patients' beliefs. RESULTS Mean age was 56.6 +/- 12 years (range 29-78); 65% were female. Many of the PKD patients in this study were highly motivated and willing to incorporate blood pressure, exercise, low-salt diet, and high volume water intake into their daily routines. Barriers to adherence to these therapies include personal beliefs and confusion due to unclear recommendations. CONCLUSIONS These findings suggest there is variability between what patients understand about their disease and treatments and what they believe their doctors have told them. Not all physicians focus on lifestyle-based treatments, but the majority of PKD patients in our study are motivated and willing to incorporate blood pressure control, exercise, low-salt diet, and high volume water intake into their daily routines and would like specific recommendations on how to implement these. These findings support a role for further exploring patient beliefs about the disease and its necessary treatments in order to design strategies to improve communication and meet the needs of these patients.
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Affiliation(s)
- Wen-Ching Tran
- School of Medicine, University of California, San Francisco, CA, USA
| | - David Huynh
- Division of Nephrology, Department of Medicine, University of California, 521 Parnassus Ave, C443, Box 0532, San Francisco, CA, 94143, USA
| | - Tea Chan
- Division of Nephrology, Department of Medicine, University of California, 521 Parnassus Ave, C443, Box 0532, San Francisco, CA, 94143, USA
| | - Catherine A Chesla
- Department of Family Health Care Nursing, University of California, San Francisco, CA, USA
| | - Meyeon Park
- Division of Nephrology, Department of Medicine, University of California, 521 Parnassus Ave, C443, Box 0532, San Francisco, CA, 94143, USA.
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Nascimento LS, Santos AC, Lucena JMS, Silva LGO, Almeida AEM, Brasileiro-Santos MS. Acute and chronic effects of aerobic exercise on blood pressure in resistant hypertension: study protocol for a randomized controlled trial. Trials 2017; 18:250. [PMID: 28578691 PMCID: PMC5457580 DOI: 10.1186/s13063-017-1985-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 05/15/2017] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Resistant hypertension is a specific condition that affects approximately 10% of subjects with hypertension, and is characterized by persistently high blood pressure levels even using therapy of three or more antihypertensive agents or with blood pressure control using therapy with four or more antihypertensive agents. Changes in lifestyle, such as physical exercise, are indicated for controlling blood pressure. However, investigating studies about this therapy in individuals with resistant hypertension are few. METHODS/DESIGN This is a randomized controlled clinical trial. Forty-eight patients with resistant hypertension will be submitted to perform four short-term interventions: aerobic exercise sessions (mild-, moderate- and high-intensity) and control session, in random order and on separate days. After the short-term sessions, the patients will be randomly allocated into four groups for 8 weeks of follow-up: mild-, moderate- and high-intensity aerobic exercise, and a control group. The primary outcome is the occurrence of blood pressure reduction (office and ambulatory analysis, and acute and chronic effects). Secondary outcomes are autonomic and hemodynamic mechanisms: cardiac and vasomotor autonomic modulation, spontaneous baroreflex sensitivity, forearm blood flow and vascular resistance. DISCUSSION The importance of exercise for hypertension has been known for decades, but little is known about the effects on patients with resistant hypertension. This study will help to understand whether different aerobic exercise intensities can induce different responses, as well as by what mechanisms adjustments in blood pressure levels may occur. TRIAL REGISTRATION ClinicalTrials.gov, ID: NCT02670681 . Registered on 28 January 2016 (first version); Brazilian Registry Platform Clinical Trials: protocol RBR-5q24zh . Registered on 24 June 2015.
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Affiliation(s)
- LS Nascimento
- Laboratório de Estudos do Treinamento Físico Aplicado a Saúde, Departamento de Educação Física, Universidade Federal da Paraíba, Castelo Branco I, CEP 58051-900 João Pessoa, Paraíba Brasil
- Programa Associado de Pós-Graduação em Educação Física UPE/UFPB, João Pessoa, Paraíba Brasil
| | - AC Santos
- Laboratório de Estudos do Treinamento Físico Aplicado a Saúde, Departamento de Educação Física, Universidade Federal da Paraíba, Castelo Branco I, CEP 58051-900 João Pessoa, Paraíba Brasil
- Programa Associado de Pós-Graduação em Educação Física UPE/UFPB, João Pessoa, Paraíba Brasil
| | - JMS Lucena
- Universidade Federal do Tocantins, Campus Universitário de Tocantinópolis, Centro, CEP 77900-000 Tocantinópolis, Tocantins Brasil
| | - LGO Silva
- Laboratório de Estudos do Treinamento Físico Aplicado a Saúde, Departamento de Educação Física, Universidade Federal da Paraíba, Castelo Branco I, CEP 58051-900 João Pessoa, Paraíba Brasil
| | - AEM Almeida
- Laboratório de Estudos do Treinamento Físico Aplicado a Saúde, Departamento de Educação Física, Universidade Federal da Paraíba, Castelo Branco I, CEP 58051-900 João Pessoa, Paraíba Brasil
| | - MS Brasileiro-Santos
- Laboratório de Estudos do Treinamento Físico Aplicado a Saúde, Departamento de Educação Física, Universidade Federal da Paraíba, Castelo Branco I, CEP 58051-900 João Pessoa, Paraíba Brasil
- Programa Associado de Pós-Graduação em Educação Física UPE/UFPB, João Pessoa, Paraíba Brasil
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Jung CH, Jung SH, Lee B, Rosenberg M, Reaven GM, Kim SH. Relationship among age, insulin resistance, and blood pressure. ACTA ACUST UNITED AC 2017; 11:359-365.e2. [PMID: 28558951 DOI: 10.1016/j.jash.2017.04.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 03/02/2017] [Accepted: 04/05/2017] [Indexed: 10/19/2022]
Abstract
The effect of age to modify the relationship between insulin resistance and hypertension is unclear. In this retrospective, cross-sectional study, median age was used to create two age groups (<52 vs. ≥52 years), and comparisons were made of metabolic characteristics, including steady-state plasma glucose (SSPG) concentrations measured during the insulin suppression test to quantify insulin resistance. Individuals were stratified into SSPG tertiles and categorized as having normal blood pressure (BP), prehypertension, or hypertension. SSPG concentrations were similar in the two age groups (161 vs. 164 mg/dL). In the most insulin-resistant tertile, distribution of normal BP, prehypertension, and hypertension was equal in those aged <52 years, whereas in those aged ≥52 years, prevalence of hypertension was increased approximately fivefold compared with those with normal BP. Multivariate regression analysis demonstrated significant interaction between age and SSPG in predicting systolic BP (P = .023). In stratified analysis, SSPG, but not age, was an independent predictor of systolic BP and diastolic BP in ≥52 years group, whereas the reverse was true in the younger group. The adverse impact of insulin resistance on BP was accentuated in older individuals and may have a greater impact than further aging.
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Affiliation(s)
- Chan-Hee Jung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University School of Medicine, Bucheon Hospital, Bucheon, Gyeonggido, Republic of Korea
| | - Sang Hee Jung
- Department of Obstetrics and Gynecology, Cha University School of Medicine, Bundang Hospital, Seongnam, Gyeonggido, Republic of Korea
| | - Bora Lee
- Department of Biostatistics, Soonchunhyang University School of Medicine, Bucheon Hospital, Bucheon, Gyeonggido, Republic of Korea
| | - Melanie Rosenberg
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Gerald M Reaven
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Sun H Kim
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
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van der Pol M, Hennessy D, Manns B. The role of time and risk preferences in adherence to physician advice on health behavior change. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2017; 18:373-386. [PMID: 27086320 DOI: 10.1007/s10198-016-0800-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 04/05/2016] [Indexed: 05/20/2023]
Abstract
Changing physical activity and dietary behavior in chronic disease patients is associated with significant health benefits but is difficult to achieve. An often-used strategy is for the physician or other health professional to encourage behavior changes by providing advice on the health consequences of such behaviors. However, adherence to advice on health behavior change varies across individuals. This paper uses data from a population-based cross-sectional survey of 1849 individuals with chronic disease to explore whether differences in individuals' time and risk preferences can help explain differences in adherence. Health behaviors are viewed as investments in health capital within the Grossman model. Physician advice plays a role in the model in that it improves the understanding of the future health consequences of investments. It can be hypothesized that the effect of advice on health behavior will depend on an individuals' time and risk preference. Within the survey, which measured a variety of health-related behaviors and outcomes, including receipt and compliance with advice on dietary and physical activity changes, time preferences were measured using financial planning horizon, and risk preferences were measured through a commonly used question which asked respondents to indicate their willingness to take risks on a ten-point scale. Results suggest that time preferences play a role in adherence to physical activity advice. While time preferences also play a role in adherence to dietary advice, this effect is only apparent for males. Risk preferences do not seem to be associated with adherence. The results suggest that increasing the salience of more immediate benefits of health behavior change may improve adherence.
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Affiliation(s)
- Marjon van der Pol
- Health Economics Research Unit, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, Scotland, UK.
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DeAndrade S, El Rayess F, Goldman R. Perspectives on Hypertension in the New England Cape Verdean Community. J Racial Ethn Health Disparities 2017; 5:162-169. [PMID: 28284019 DOI: 10.1007/s40615-017-0353-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/13/2017] [Accepted: 02/15/2017] [Indexed: 11/28/2022]
Abstract
This study characterizes patient understanding of hypertension and its management in a Cape Verdean immigrant community. We conducted 20 semi-structured interviews with Cape Verdean Creole-speaking adults about their beliefs and behaviors regarding hypertension. Fourteen women and six men ages 35-87 were interviewed. The majority of the participants believed hypertension is symptomatic, with headache being the most common symptom. Many reported taking anti-hypertensive medication, though some took medication only when they felt symptoms. The majority were unfamiliar with a normal blood pressure reading. Most believed hypertension is related to stress and salt intake, though few reported making the recommended lifestyle changes. None of the participants communicated with physicians in their native language, relying instead on interpreters, family members or other languages to communicate. Participants identified language as a serious barrier to care. Our sample had a poor understanding of hypertension as a chronic, asymptomatic disease. Given the high prevalence of hypertension in this community, and the unavailability of Cape Verdean Creole-speaking interpreters and providers for individual patient visits, Cape Verdean patients may benefit from group education or medical visits conducted in Creole.
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Affiliation(s)
| | - Fadya El Rayess
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Roberta Goldman
- Warren Alpert Medical School of Brown University, Providence, RI, USA
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50
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Galdino G, Silva AM, Bogão JA, Braz de Oliveira MP, Araújo HAGDO, Oliveira MS, Maldonado ACD, Ulisses de Oliveira H, Borges JBC. Association between respiratory muscle strength and reduction of arterial blood pressure levels after aerobic training in hypertensive subjects. J Phys Ther Sci 2017; 28:3421-3426. [PMID: 28174465 PMCID: PMC5276774 DOI: 10.1589/jpts.28.3421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 08/23/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of present study was associate the increase of respiratory muscle
strength with blood pressure levels in hypertensive subjects who underwent an aerobic
exercise program. [Subjects and Methods] 90 hypertensive subjects were divided in two
groups: intervention and control. All participants had an interview with a physiotherapist
and were evaluated by 6-minute walk test, maximal inspiratory pressure, maximal expiratory
pressure, heart rate, systolic blood pressure and diastolic blood pressure, before and
after the 8 weeks. In the intervention group, the subjects underwent aerobic exercise
program, 2 times a week for 8 weeks [Results] After the program, the levels of blood
pressure were significantly reduced and the distance walked in the 6-minute walk test and
the respiratory muscle strength were increased, compared to pre intervention and control
group values. However, there was no correlation between the results provided by 6-minute
walk test, maximal inspiratory pressure and maximal expiratory pressure with systolic
arterial blood pressure levels. Nonetheless, the distance walked correlated with
respiratory muscle strength values, in the intervention group. [Conclusion] The present
study demonstrated that the aerobic training was effective in reducing the arterial blood
pressure in hypertensive subjects associated with an improvement of physical conditioning
and respiratory muscle strength.
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