Effects of therapeutic lifestyle changes on peripheral artery tonometry in patients with abdominal obesity

BACKGROUND AND AIMS

Abdominal obesity (AO) is associated with endothelial function (EF) alteration and increased global cardiovascular (CV) risk. Therapeutic lifestyle changes (TLSC) reduce CV risk, but the impact on EF assessed by peripheral artery tonometry (PAT) is unknown. In this study, we aimed to prospectively assess the effects of TLSC on EF measured by PAT in increased CV risk patients with AO.

METHODS AND RESULTS

150 patients with AO and moderate CV risk were randomized to groups receiving a one-year intervention of either conventional medical care (control group, CG) or an intensive TLSC program (intervention group, IG). Vascular studies (EF by PAT, intima-media thickness (IMT)) and lifestyle (LS) assessment were performed before and after intervention. The PAT ratio improved in the IG and worsened in the CG. The global CV risk was reduced (P = 0.017) in the IG due to a significant decrease in systolic blood pressure (P < 0.001), increase in HDL cholesterol and ApolipoproteinA1 (P = 0.013). More individuals in the IG than in the CG quit smoking (P = 0.001) and increased their physical activity (P = 0.014). The improvement in at least two LS components was associated with a PAT ratio increase (2.44 IC: 95% 0.99-6.00, P = 0.051). The PAT ratio increase determined less IMT progression (-1.1 IC: 95% 0.91-1.00, P = 0.053).

CONCLUSIONS

Good adherence to a TLSC program reduces global CV risk and determines PAT ratio improvement. The PAT ratio increase is the main determinant of lower IMT progression.

Patterns of regular drug use in Spanish childbearing women: changes elicited by pregnancy

OBJECTIVE

To determine drug use in Spanish women before pregnancy and from conception to the awareness of pregnancy (early period of pregnancy, EPP), as well as to analyse attitudinal changes when pregnancy was planned or known.

METHODS

Trained gynaecologists used a structured questionnaire to collect demographic and obstetric characteristics, histories of regular drug taking before pregnancy, attitudes towards drug taking during pregnancy and current drug use in the EPP. Women were interviewed at their first antenatal visit during the first trimester.

RESULTS

Two hundred and seventy-two women were included (mean age 29.3 years and 66.3 days of gestation). Before pregnancy, 24% regularly took drugs, 70% of them more than twice a week; a significantly higher frequency was found in those receiving public antenatal care and in those who had had less education. In 39% of women, awareness of pregnancy did not change their attitudes towards regular drug use. Among those who decided to suppress their regular drug intake, 58% did so when their pregnancy was confirmed and 42% when they planned it. In women who planned their pregnancy, 30.1% stopped when they tried to become pregnant. However, 62% of all women took drugs during the EPP. In private antenatal care significantly more drugs were taken per patient. By the 168 women 278 compounds were consumed during the EPP: 40% were analgesics (mainly paracetamol and acetylsalicylic acid) and 25% were digestive and metabolic drugs (mainly antacids and laxatives). Drugs were often used more than twice a week, particularly in women receiving public antenatal care and in those who had had less education.

CONCLUSION

Drug taking is common in Spanish women of childbearing age, and many of those in our study did not decide to stop during the EPP. Few women avoid drugs when planning a pregnancy. Therefore, gynaecologists must advise against drug taking in patients who wish to become pregnant and suggest that unnecessary drug use be avoided when the pregnancy is already diagnosed.

[The effect of pregnancy on the consumption of tobacco and alcohol]

OBJECTIVES

To determine if the knowledge of pregnancy modifies smoking and drinking habits and if some socio-demographic variables exert any influence in these changes.

DESIGN

Descriptive observational study with a sectional design (prevalence study).

SETTING

Obstetric service of a Spanish general hospital, and also three private centres in the same area.

PARTICIPANTS

271 women (mean age of 29 years) under 14 weeks of gestation (mean of 9 weeks) who attended to their first gynaecology visit and accepted to participate in the study.

INTERVENTIONS

By means of direct interview to women, investigators filled a questionnaire with demographic characteristics, obstetric data, smoking and drinking habits and changes in these habits as a response to their pregnancy were also recorded.

MEASUREMENTS AND MAIN RESULTS

Almost eighty percent of them planned their pregnancy, and 14.8% were using some contraceptive method when they became pregnant. Before learning of their pregnancy most of the women smoked cigarettes (53.5%), and a low proportion consumed alcohol at meals (20.3%) or between meals (10.7%). After knowledge of their pregnancy, 46.9% of smokers, 56.4% of drinkers during meals, and 86.2% of drinkers between meals, stopped these habits. Those women who smoked fewer cigarettes showed a higher capacity to stop consumption. It was also observed that those who gave up drinking at meals were those who drank less alcohol and who had no university degree.

CONCLUSIONS

A high prevalence of smoking among fertile women was observed, although an important proportion of them stopped this consumption after learning about their pregnancy. This change was less frequent among the heavy smokers. Consequently, the establishment of specific programs for encouraging abstinence of alcohol and cigarette consumption in several population groups as described, could be recommended.

Effect of inclusion of sugar beet pulp, pelleting and season on laying hen performance

1. The effect of three metabolisable energy (ME) concentrations 12.2, 11.3 and 10.5 MJ ME/kg and two forms of diet (mash and pellet) on egg production in summer and winter were studied. The different ME values were obtained by diluting the 12.2 MJ ME/kg diet with sugar beet pulp of 2.88 MJ/kg DM. In a 3rd summer experiment the water intake of hens on these diets was examined. Data were analysed by factorial analysis of variance, and the relationship between performance and dietary energy concentration was examined by regression analysis. 2. The use of low energy diets (10.5 to 11.3 MJ ME/kg) decreased egg production in both seasons, but pelleting diets improved egg production and egg weight in summer. Egg weight was not affected by energy density in winter, but decreased in the summer when energy density increased. 3. In winter, food consumption was not affected by the dietary ME, while in summer food consumption increased when the dietary ME increased. Therefore, energy intake was not the same at all energy densities, but tended to increase as the energy density increased. 4. In summer, pelleting improved food efficiency and egg production and increased water consumption and the ratio of water to food intake. Water intake and water: food ratio decreased with increasing dietary energy concentration.

Performance of laying hens as affected by the supplementation of a barley-based diet with a crude enzyme preparation from Trichoderma viride

Two experiments were conducted to compare the performance of Leghorn hens fed a barley-based diet (68.93%) containing three levels of a Trichoderma viride enzyme supplement (0, 100 and 200 mg kg−1 as treatments T2, T3 and T4, respectively) with those obtained when fed a corn-based diet (Treatment T1). In exp. 1, 80 hens were used to determine performance during four 28-d periods, between 21 and 37 wk of age. Egg production, feed consumption, feed efficiency and egg weight of the hens were not affected by enzyme supplement and were similar to those of hens fed the corn diet (P > 0.05). There were also no significant effects on feed consumption per gram of egg or per bird per day (P > 0.05). There was a significant interaction for egg weight between enzyme addition and periods (P < 0.034), indicating that enzyme supplementation improved egg size in the early periods. In exp. 2, 20 hens were fed the same diets to measure water consumption and the ratio of water to feed consumption. Water consumption was not affected (P < 0.07) but the ratio of water to feed was significantly reduced (P < 0.0005) when enzyme was added to the barley-based diet. Water consumption in g d−1 was 172 for T1, 215 for T2, 211 for T3, and 195 for T4, and the water to feed ratios were 1.40, 1.85, 1.66, and 1.56, respectively. These results demonstrate that barley can replace corn in layer diets and that the addition of enzyme to barley-based diets appears to improve egg size and to reduce water consumption relative to feed intake in young laying hens. Key words: Laying hens, performance, water consumption, β-glucans, enzyme supplementation