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At least 739 records · Page 41Linked to original sources

PubMed2003

The Ashkelon Hypertension Detection and Control Program (AHDC Program): a community approach to reducing cardiovascular mortality.

BACKGROUND: Blood pressure (BP) reduction is crucial in reducing cardiovascular (CV) morbidity and mortality in the community. Subjects aged 20-65 seldom visit the primary care clinics, so they are unlikely to be detected without an active outreach screening program. The aim of the project was to prepare a professional doctor-nurse screening team, who will instruct those found to be at high risk in control of their risk factors, in order to reduce CV morbidity and mortality. METHODS: During a 10-year period (1980-1990), teams examined 12,202 subjects, (mean age 51 +/- 7 years, range 20-65 years) accounting for 23.4% of the total regional population. High risk subjects underwent an intensive CV risk factor control program. RESULTS: Subjects (3,506 or 28.6%) were found to have one or more CV risk factors (hypertension, obesity, smoking, hypercholesterolemia). During an average of 2 years, follow-up BP, weight reduction, and smoking cessation remained statistically significant. Total cholesterol was unchanged. Over this period, the standardized mortality ratio (SMR) in the area for acute MI fell from 100 to 76 (P < 0.01), for CV disease from 129 to 107 (P < 0.0001), and for hypertension from 121 to 87 (P < 0.1 NS). The project saved many life-years at no additional net cost to society, and cost effectiveness analysis showed positive results. CONCLUSIONS: A community approach with mainly nonpharmacological treatment is feasible and cost effective in reducing CV morbidity and mortality.

Adolescent↗

PubMedDate not supplied

Weight reduction in the cardiac rehabilitation setting.

BACKGROUND: Most patients with coronary heart disease are overweight. However, only minimal weight loss occurs with participation in a standard cardiac rehabilitation (CR) program. METHODS: The study investigated 82 patients with coronary heart disease who entered an outpatient CR program and completed 36 sessions of exercise over a 12-week period. The effects of a structured, nurse-coordinated, weight loss intervention during phase 2 CR were compared with those observed in a CR control group receiving usual care. RESULTS: The intervention group lost an average of 4.3 +/- 2.8 kg (P <.0001), as compared with a weight loss of 1.7 +/- 2.6 kg (P <.001) in the control group (P <.005 between groups). The effect of the weight loss intervention on total cholesterol (172 +/- 34 to 166 +/- 29 mg/dL) differed from the response in a control group receiving usual care (180 +/- 30 to 187 +/- 28 mg/dL) (P <.05 between groups). The weight loss group experienced a significantly greater improvement (P <.05) than the control group in the physical function score on the Medical Outcomes Study SF-36 questionnaire. A significant correlation was found between the number of weight loss sessions an individual attended and the amount of weight loss experienced (R = 0.39; P <.05). CONCLUSIONS: The current study demonstrated that a behavioral weight loss intervention is effective in reducing body weight in a CR setting. Participants in the intervention group experienced significantly greater improvements in body weight, body mass index, and total cholesterol than a control group. Additionally, participants in the weight loss program reported greater improvements in their physical function score than the control patients.

Aged↗

PubMedDate not supplied

Predictors of plasma triglyceride elevation in patients participating in a coronary atherosclerosis treatment program.

PURPOSE: Low-fat, high-carbohydrate diets have been used successfully to prevent and treat coronary heart disease, although these diets have been shown to cause elevations in fasting plasma triglyceride concentrations. The present study investigated metabolic factors (glucose, insulin, body weight) associated with changes in plasma triglyceride concentrations in patients participating in a comprehensive, multidisciplinary program, which included the use of a very low-fat diet designed to regress atherosclerotic cardiovascular disease. METHODS: Thirty-six patients were entered into the study and placed on a 10% fat diet. Body mass index and fasting plasma insulin, glucose, lipids, and apolipoproteins were assessed at entrance into and after 3 months of participation in the program. Statistical analysis (discriminant function analysis) was used to identify factors that predicted elevations in plasma triglyceride that occurred during therapy. RESULTS: For the entire group, significant reductions in body weight (-2.4%), fasting glucose (-6%), total cholesterol (-8%), and low-density lipoprotein cholesterol (-11%) were observed, while insulin and triglycerides showed no significant changes. Twenty-one of the patients experienced an increase in fasting triglyceride concentration of 10% or greater. CONCLUSIONS: Three variables (baseline body mass index and fasting triglyceride and insulin concentrations) accurately classified 90% of those who would experience a > or = 10% elevation in triglycerides (P = 0.0002) and 67% of those who experienced no change. The present analysis provides a practical algorithm for clinicians to predict which patients will experience significant elevations in plasma triglyceride concentration when undergoing risk factor reduction that includes the consumption of a very low-fat, high-carbohydrate diet.

Adult↗

PubMed1982

Physical training programs for mass scale use: effects on cardiovascular disease--facts and theories.

A significant increase in the numbers of Americans exercising during the 1970's has occurred, stimulated by an increased desire to improve the quality and, hopefully, the quantity of life. Fitness improvement is associated with an increase in HDL-cholesterol and a reduction in blood pressure, serum total cholesterol, LDL- and VLDL-cholesterol, triglycerides, glucose, uric acid and with weight loss and decrease in percent body fat. Correlations of risk factor changes with weight loss are greater than correlations with fitness improvement. After controlling for weight loss correlation of triglycerides and uric acid and percent body fat fitness improvement remains significant. Risk factor reduction has been shown to occur with fitness improvement without weight loss and with weight loss unaccompanied by fitness change, but the largest risk factor changes occur in the presence of both weight loss and fitness improvement. The aerobics exercise program concentrates on developing cardiorespiratory fitness first and musculoskeletal strength secondarily. Various physical activities can be quantified by means of a point system based on the intensity and duration of the activity. A fitness goal of 30 points per week for men and 24 points per week for women is reasonable and achievable by nearly all, regardless of age or sex. The most beneficial effect of exercise may be a biochemical mediated feeling of well-being.

Adult↗

PubMed2006

An open-label pilot study of the combination therapy of metformin and fluoxetine for weight reduction.

BACKGROUND: Obesity is a very important risk factor for cardiovascular disease, type 2 diabetes mellitus, hypertension, osteoarthritis, fatty liver, metabolic syndrome and respiratory problems. Many weight-reducing drugs cannot be used in obese patients because of numerous complications. Fluoxetine, an antidepressant, and metformin, an antidiabetic drug, reduce weight as their side effect, but the potency of each drug is not always enough. Here, we studied the effects of combination therapy of them for weight reduction in obese women. MATERIALS AND METHODS: This study was designed as an open, prospective, controlled clinical trial. Obese and overweight patients referred to obesity clinics were first put under a diet and behavior therapy education program before being invited to this study. The patients who accepted drug therapy were put in the case group. Those who did not accept drug therapy were put in the control group. Fluoxetine, 20 mg daily, and metformin, 500 mg three times daily, were prescribed to the participants. Weight and body mass index (BMI) changes within case and control groups were analyzed by paired t-tests and between groups by t-testing. Side effects were evaluated by interview and questionnaire. SUBJECTS: Two hundred and three patients were referred to obesity clinics. Of these, 177 were female with 91 being volunteers for this study. Of this 91, 66 were in the case group and 25 in the control group. RESULTS: In a 6.68-month period, a 7.89 kg decrease in weight (9.32%) and a 3.43 U decrease in BMI (10.14%) were observed in participants of the case group that was statistically significant (P<0.0001). The participants of the control group were followed for a mean period of 8.12 months. In this period, the participants of the control group showed a 0.48 kg decrease in weight (0.52%) and a 0.11 U decrease in BMI (0.42%). This was not significant. No serious side effects of the drugs were observed in the case group. CONCLUSION: This open-label pilot study of combination therapy of metformin and fluoxetine gave encouraging weight reduction, and these results suggest the need for a randomized double-blind clinical trial comparing the two components and the combination to placebo.

Adult↗

PubMed1992

Prevention: the cost-effectiveness of the California Diabetes and Pregnancy Program.

BACKGROUND: The California Diabetes and Pregnancy Program is a new preventive approach to improving pregnancy outcomes through intensive diabetes management preconception and early in pregnancy. METHODS: Hospital charges and length of stay data were collected on 102 program enrollees and 218 control cases. Ninety program enrollees and 90 control cases were matched on mother's age. White's classification, and race. Regression models controlled for these variables in addition to MediCal status, birth weight, and enrollment in the program. RESULTS: Hospital charges were about 30% less for program participants and days in the hospital were roughly 25% less. The program effects were larger for women that enrolled before 8 weeks gestation. More serious diabetics were also found to have larger reductions in charges and days. CONCLUSION: After adjusting for inflation and differences in charges across hospitals, $5.19 is saved for every dollar spent on the program.

Birth Weight↗

PubMed1998

[Therapy of obesity in childhood and adolescence].

Major therapeutic goal of the treatment of childhood obesity is to prevent immediate and long-term adverse health consequences. In obese adults weight loss is always necessary to achieve normal or tolerable weight. During infancy and childhood keeping body weight constant while body height increases can be acceptable. If substantial body weight loss in children and adolescents is mandatory, it is necessary to consider the special physiological peculiarities of the growing organism during weight reduction. The main cornerstones of therapeutic regimens for long-term weight reduction in childhood obesity are: eating behaviour modification resulting in changes in food selection, dietary fat intake and caloric restriction, instruction to increase physical activity in everyday life and guidance to an active life style. Integrated therapeutic programs including these components based on behaviour modification have been shown to be the most successful in long-term effect on body weight. Treatment of obesity is most successful if realistic goals are set, if parental support is strong and if behaviour therapy is provided during the course of treatment to help both child and parent achieve these goals.

Adolescent↗

PubMed1979

Physiologic effects on adult men of circuit strength training and jogging.

The purpose of this study was to determine the effects of 8 weeks of circuit strength training (CST) followed by 8 weeks of jogging and then 8 weeks, of CST or jogging. During the final 8 weeks, the subjects were randomly assigned to either CST or jogging groups. The subjects (n=16, x age = 29 yrs) exercised 3 days/week. The strength training involved 2 circuits of reciprocal exercises using isokinetic devices with 10 to 15 repetitions/set and 30 seconds of rest between sets. The subjects jogged 3 miles/day during the jogging program. After the initial 8 weeks of CST, significant changes were found in treadmill performance time, maximum oxygen uptake (VO2max), maximum pulmonary ventilation (VEmax), body fat, total skinfold fat, fat weight, lean weight, isotonic bench and leg press, and isokinetic slow speed, fast speed, and power endurance measures. The jogging program elicited significantly greater changes in treadmill performance time and VO2max. Further reductions were found in total skinfolds and waist girth during the jogging program. Leg strength was maintained during jogging but upper body strength was reduced significantly. Physiologic levels were maintained during the final 8 weeks and showed no differences between the CST and jogging groups.

Adult↗

PubMed1993

Effects of work-site health promotion on illness-related absenteeism.

This study examined the effects of work-site health promotion on employee absenteeism. Thirty-two work sites were randomized to programs for weight control and smoking cessation or to no treatment for 2 years. The prevalence of self-reported absences from work was assessed at baseline and follow-up. Results using work site as the unit of analysis showed a net reduction in the percent of workers reporting a sick day in the last month in treatment versus control work sites of 3.7% (P = .04) and 3.4% (P = .06) in cross-sectional and cohort analysis, respectively. Further analyses found that the rate of participation in smoking (P = .09) but not weight programs (P = .72) was positively associated with change in sick day prevalence and that this effect was strongest in baseline smokers (P = .002). It is concluded that work-site smoking cessation programs may yield important short-term economic benefits by reducing employee absenteeism.

Absenteeism↗

PubMed1998

Effects of programming intake on performance and carcass characteristics of feedlot cattle.

We conducted two experiments to determine the effects of various intake restriction strategies on performance and carcass characteristics of feedlot cattle. In Exp. 1, 104 steer calves (273 +/- 12 kg BW) were allotted to 12 pens. During Period 1 (273 to 372 kg BW), steers were limit-fed according to net energy equations to achieve predicted gains of .91, 1.13, or 1.36 kg/d. Control steers were offered ad libitum access to feed during this period. During Period 2 (372 to 535 kg BW), all steers were offered ad libitum access to feed. In Period 1, steers limit-fed for predicted gains of .91, 1.13, and 1.36 kg/d gained 1.03, 1.22, and 1.40 kg/d, respectively. Control steers offered ad libitum access to feed gained 1.66 kg/d. Steers that were limit-fed in Period 1 were able to compensate in Period 2; for the total experiment, there were no differences (P > .10) among the four feeding strategies investigated for rate of gain, feed efficiency, total feed intake, and carcass characteristics. Experiment 2 used 107 steer calves (300 +/- 11 kg BW). Four feeding strategies were compared: step-wise increases in intake to program for increasing rate of gain, stepwise decreases in intake to program for decreasing rate of gain, feeding to hold gain constant at 1.36 kg/d, or offering steers ad libitum access to feed throughout the experiment to allow for maximum gains. When averaged over the total experiment, growth rate and days on feed were not affected (P > .10) by feeding system. Steers fed to achieve a step-wise increase in growth rate throughout the experiment had the lowest (P < .09) daily intakes and the highest (P < .09) feed efficiencies. Steers fed for increasing gains required 109 kg/steer less (P < .09) total feed to reach market weight than those offered ad libitum access to feed throughout the experiment. Feeding strategy had little effect on carcass characteristics. We concluded that as intake is restricted to a greater extent, net energy equations are less accurate in predicting rate of gain. Programming intake during the feeding period can result in significant reductions in feed expenditures.

Animal Feed↗

PubMed2003

Effects of protein vs. carbohydrate-rich diets on fuel utilisation in obese women during weight loss.

BACKGROUND: Energy restriction is a common therapeutic approach for weight reduction, but the most effective macronutrient distribution of the hypoenergetic diet as well as the role of the metabolic processes involved require further investigations. OBJECTIVE: To study the effect of a high protein (HP) hypoenergetic diet compared with a high carbohydrate (HC) hypoenergetic diet on fuel utilisation changes during the weight loss process in obese women. DESIGN: Eleven obese (BMI>30) women were randomly assigned to a 10w dietary intervention study comparing HP (30% protein) or HC (55% carbohydrate) energy restricted diets providing 30% energy fat content. Substrate utilisation was evaluated by indirect calorimetry. Body weight and composition (Bod Pod) and blood measurements were performed before and after weight loss. RESULTS: On average, the individuals on the HP dietary group lost 4.4 kg more than those in the HC program (p<0.50), which was mainly due to a fat mass loss (3.7 kg, p<0.05) with no statistical differences in lean body mass reduction. These losses were accompanied by a significant decrease in fasting leptin in the HP group (-52%; P<0.05). On the other hand post-absorptive lipid oxidation decreased in the HC group (-48%) and remained unchanged in the HP groups. CONCLUSIONS: The replacement of some dietary carbohydrate by protein in energy restricted diets, improves weight and fat losses and specifically promotes lipid oxidation in the fasting state, without major different in lean body mass depletion.

Adipose Tissue↗

PubMed2004

[Diet and physical activity in the treatment of obesity].

There is strong evidence from studies that hypocaloric, low-fat diets and physical activity can induce weight loss in obese patients. Nutrition therapy and increased physical activity improve obesity-associated risk factors and can prevent or delay comorbidities. Combined interventions of nutrition, physical activity and behavior therapy provide the most successful therapy for weight loss and weight maintenance. While exercise activity alone reduces weight only slightly, the combination of both, diet- and exercise-therapy, leads to significant weight reduction. Moreover, exercise activity reduces the diet-induced loss of fat-free mass and favors weight reduction through an increased metabolic rate. Nutrition therapy, physical activity and behavior therapy are basic components of a comprehensive weight loss therapy and weight control program in obesity.

Cardiovascular Diseases↗

PubMed2002

Effects of walking or resistance training on weight loss maintenance in obese, middle-aged men: a randomized trial.

OBJECTIVE: To investigate whether walking or resistance training improves weight maintenance after weight loss when added to dietary counselling. DESIGN: Two months' weight reduction with very-low-energy-diet (VLED) followed by randomization into three groups (control, walking, resistance training) for 6 months' weight maintenance (WM) program and 23 months' unsupervised follow-up. During VLED and WM all groups received similar dietary counselling. SUBJECTS: The main inclusion criteria were BMI >30 kg/m(2), waist>100 cm and physical inactivity (exercise < or = once a week). Ninety healthy, obese (mean BMI 32.9 kg/m(2) and waist 112.5 cm), 35-50 y-old men started the study and 68 were measured at the end of the study. MEASUREMENTS: Weight and body composition assessed by underwater weighing. Exercise diaries and dietary records to assess energy balance. RESULTS: During VLED the mean body weight decreased from 106.0 (s.d. 9.9) kg to 91.7 (9.4) kg. Weight was regained mostly during follow-up and in the end of the study the mean weight in groups was 99.9-102.0 kg. Exercise training did not improve short or long-term weight maintenance when compared to the control group. However, resistance training attenuated the regain of body fat mass during WM (P=0.0l), but not during follow-up. In the combined groups the estimated total energy expenditure (EE) of reported physical activity was associated with less weight regain during WM. EE of 10.1 MJ/week was associated with maintaining weight after weight loss. EE of physical activity tended to decrease after WM in exercise groups due to poor long-term adherence to prescribed exercise. Energy intake seemed to increase during follow-up. CONCLUSION: Exercise training of moderate dose did not seem to improve long-term weight maintenance because of poor adherence to prescribed exercise.

Adult↗

PubMed1989

Use of a consultant to assist a dietetic association in its media and public relations efforts.

During 1987, the Philadelphia Dietetic Association (PDA) enlisted the aid of a public relations consultant to increase media contacts and thereby accomplish a threefold goal of (a) establishing the dietetic association and its registered dietitian members as the local nutrition experts; (b) distributing reliable, current nutrition information; and (c) marketing the PDA's DIAL-A-DIETITIAN service. Through the advice of the consultant, a media tipsheet, published monthly, was created. This publication, the Nutrition Informationist, effectively increased media contacts from two in 1986 to 19 in 1987 and resulted in a total of 8 hours of air time. Weight reduction, fad diets, and sports nutrition proved to be the most popular topics. Public service announcements (PSAs) concerning the DIAL-A-DIETITIAN program were developed by the consultant to assist the public in gaining access to local registered dietitians. Calls to that service increased 75% (from an average of 47.5 to 83.0 calls) the month following the distribution of PSAs to radio stations. The positive outcome of this collaborative effort shows that public relations consultants can be a useful resource for local dietetic associations, aiding them in their efforts to reach the media and the public and to improve their image.

Consultants↗

PubMed1997

A triplet pregnancy after in vitro fertilization is a procedure-related complication that should be prevented by replacement of two embryos only.

OBJECTIVE: To investigate whether the incidence and obstetric outcome of triplet pregnancies after IVF treatment justify strict limitation of the number of embryos to be replaced to two. DESIGN: Retrospective analysis. SETTING: A transport IVF program. PATIENT(S): All patients who had more than one embryo replaced. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Obstetric outcome, pregnancy. RESULT(S): High-order pregnancies occurred in 24 cases (23 triplets and 1 quadruplet). Three patients opted for selective embryo reduction (12.5%). Three triplet pregnancies spontaneously reduced to twins. Comparison of 18 triplets, reaching at least 20 weeks' gestation, with 54 twin pregnancies shows a higher perinatal mortality in the triplet group, causing 6 out of 18 patients to be confronted with at least one perinatal death. Triplets were born at a lower gestational age, had a lower birth weight, and a higher hospital admission rate of longer duration. Replacement of two, three, or four embryos did not lead to differences in pregnancy rates in the population studied. When a pregnancy occurred after replacement of three embryos, the risk of having a triplet pregnancy was 7.5%. CONCLUSION(S): The obstetric outcome of triplet pregnancies in our population indicates that triplet pregnancies after IVF treatment have to be prevented. Selective embryo reduction is acceptable for few patients only and can therefore not be seen as a solution. Replacement of three embryos results in triplet pregnancy in an unacceptably high percentage. Replacement of two embryos only gives acceptable IVF results and is the method chosen in the IVF program in Rotterdam to prevent triplet pregnancies.

Birth Weight↗

PubMed2006

[Individualized health education with sports gym use and dietary advice for overweight and obese persons in a community. Kokuho Health-up model Program in Chikusei-shi (former Kyowa town)].

OBJECTIVE: We aimed to evaluate the effect of a community-based health educational program for overweight or obesity persons, as the Kokuho Health-up model Program in Kyowa area of Chikusei-shi. METHODS: The subjects were men and women aged 35 to 60 years who participated in annual health check-ups from 1998 to 2003 and were living in Chikusei-shi (Former Kyowa town) Ibaraki prefecture, had a body mass index > or = 25.0 kg/m2 at baseline, and agreed to a 6-month intervention. The participants were divided into 59 persons for the intense intervention group (health checkups, dietary advice, monthly individual health education, and exercise in sports facilities three times/ week), 62 persons for the moderate intervention group (health checkups, dietary advice, monthly individual health education, and exercise in sports facilities or at home once/week), and 34 persons for the control group (only health checkups). Criteria for the metabolic syndrome were those published by the Japanese 8 committee. RESULT: During the 6-month intervention, the follow-up rate was 86%. At the baseline, there were no differences in physical status or lifestyles among the intervention and control groups. The frequency of use of sports facilities was 6.4 times/month for the intense intervention group and 1.9 times/month for the moderate intervention group. Mean body weight did not change in the control group (70.6 kg to 70.9 kg, P = 0.84) but decreased in the intense intervention group (71.4 kg to 69.5 kg, P < 0.001) and moderate intervention group (69.5 kg to 66.7 kg, P < 0.001). Mean abdominal circumference increased in the control group (91.0 cm to 93.9 cm, P = 0.001) but did not change in intense intervention group (90.1 cm to 90.0 cm, P = 0.29) or moderate intervention group (90.4 cm to 88.7 cm, P = 0.39). The prevalence of metabolic syndrome increased in the control group (18.2% to 40.0%, P = 0.01) but did not change in either of the intervention groups. CONCLUSIONS: We found a significant reduction of body weight and an attenuation of the increase of metabolic syndrome in both intensive and moderate intervention groups. The present community-based educational program may be effective for health promotion with overweight or obese middle-aged adults.

Adult↗

PubMed1992

Evaluation of hypertension screening in the Hutterite population.

The purpose of this study was to examine the impact of a hypertension screening program on Hutterites from Alberta, Canada who were found to have a diastolic blood pressure greater than 90 mm Hg. At approximately 16 months postscreening, 200 subjects completed a self-administered questionnaire requesting information about physician follow-up and pharmacologic and nonpharmacologic therapy. Seventy-four percent of the subjects reported that they had their blood pressure measured at least twice since screening. A third of the respondents reported changes in pharmacologic management. Subjects reported weight loss (36%), and salt and alcohol reduction (64% and 48%, respectively) as nonpharmacologic methods for lowering blood pressure. In terms of physician follow-up and pharmacologic and nonpharmacologic modification, the screening program was effective.

Adult↗

PubMed2001

A solid waste audit and directions for waste reduction at the University of British Columbia, Canada.

A novel design for a solid waste audit was developed and applied to the University of British Columbia, Canada, in 1998. This audit was designed to determine the characteristics of the residual solid waste generated by the campus and provide directions for waste reduction. The methodology was constructed to address complications in solid waste sampling, including spatial and temporal variation in waste, extrapolation from the study area, and study validation. Accounting for spatial effects decreased the variation in calculating total waste loads. Additionally, collecting information on user flow provided a means to decrease daily variation in solid waste and allow extrapolation over time and space. The total annual waste estimated from the experimental design was compared to documented values and was found to differ by -18%. The majority of this discrepancy was likely attributable to the unauthorised disposal of construction and demolition waste. Several options were proposed to address waste minimisation goals. These included: enhancing the current recycling program, source reduction of plastic materials, and/or diverting organic material to composting (maximum diversion: approximately 320, approximately 270, and approximately 1510 t yr(-1), respectively). The greatest diversion by weight would be accomplished through the diversion of organic material, as it was estimated to comprise 70% of the projected waste stream. The audit methodology designed is most appropriate for facilities/regions that have a separate collection system for seasonal wastes and have a means for tracking user flow.

British Columbia↗