Eugene Bleecker | PubMed Health

PubMed2004

Diet-induced weight loss, exercise, and chronic inflammation in older, obese adults: a randomized controlled clinical trial.

BACKGROUND: Persistent, low-grade inflammation is an independent predictor of several chronic diseases and all-cause mortality. OBJECTIVE: The intention of this study was to determine the independent and combined effects of diet-induced weight loss and exercise on markers of chronic inflammation. DESIGN: Three hundred sixteen community-dwelling, older (> or = 60 y), overweight or obese [body mass index (in kg/m2) > or = 28], sedentary men and women with radiographic evidence of knee osteoarthritis were randomly assigned to four 18-mo treatments: healthy lifestyle control, diet-induced weight loss, exercise, and diet plus exercise. The exercise intervention consisted of combined weight training and walking for 1 h 3 times/wk. The weight-loss intervention consisted of a weekly session with a registered dietitian to provide education and support for lowering energy intake. RESULTS: The diet-induced weight-loss intervention resulted in significantly greater reductions in concentrations of C-reactive protein (P = 0.01), interleukin 6 (P = 0.009), and soluble tumor necrosis factor alpha receptor 1 (P = 0.007) than did no weight-loss treatment. Changes in soluble tumor necrosis factor alpha receptor 1 but not in C-reactive protein or interleukin 6 correlated with changes in body weight. Exercise training did not have a significant effect on these inflammatory biomarkers, and there was no significant interaction between weight loss and exercise training. CONCLUSIONS: These findings provide evidence from a randomized controlled trial that a dietary intervention designed to elicit weight loss reduces overall inflammation in older, obese persons. Additional studies are needed to assess the effects of different modes and intensities of exercise on inflammation.

Aged↗

PubMed2004

Changing patterns in asbestos-induced lung disease.

STUDY OBJECTIVES: To determine patterns in asbestos-induced lung diseases found in older, less exposed workers. DESIGN: Review of a database evaluating lung function, smoking status, form of asbestos-induced lung disease, and radiograph abnormalities. SETTING: Outpatient clinic. PARTICIPANTS: A total of 3383 asbestos-exposed workers referred for independent medical evaluation, including control subjects who lacked asbestos-specific radiograph abnormalities (n = 243), subjects with low International Labor Organization (ILO) scores (n = 2,685), high ILO scores (n = 312), bronchogenic cancer (n = 63), and mesothelioma (n = 80). Of these, 3,327 workers have specific smoking status information and 3,312 workers have lung volume measures. INTERVENTIONS: Chest radiographs were interpreted by a certified B-reader, and abnormalities were quantified according to the ILO scoring system. Spirometry and lung volume measurement were performed. Subjects completed a self-administered questionnaire that was reviewed at the time of examination. Control subjects were screened on two separate occasions at least 10 years apart to exclude subclinical or slowly progressive asbestos-induced lung disease. MEASUREMENTS AND RESULTS: The mean age of the population was 65.1 +/- 9.9 years, and the latency was 41.4 +/- 10.1 years (+/- SD). Most subjects (41.8%) had normal pulmonary function. Obstruction was the most common pulmonary function abnormality (25.4%), followed by restriction (19.3%) and a mixed pattern (6.0%). Most subjects (79.4%) had low ILO scores. Benign pleural abnormalities were the only findings in 54% of subjects with low ILO score. Subjects with high ILO scores were older, smoked more, and had a longer latency than subjects with low ILO scores and control subjects. Smokers were younger, had a shorter latency, and had paradoxically greater ILO scores than nonsmokers. Subjects with bronchogenic cancer and mesothelioma had longer latencies than control subjects and subjects with benign asbestos-induced lung disease. CONCLUSIONS: Asbestos-induced lung disease today is characterized by low ILO scores, long latencies, greater disease magnitude in smokers, and a normal or obstructive pattern of pulmonary function abnormality. Spirometric evaluation in the absence of lung volume measurements caused misclassification that resulted in overestimation of the presence of a restrictive pattern of pulmonary function.

Adult↗