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Fontes-Carvalho R, de Oliveira GMM, Gonçalves L, Rochitte CE. The Year in Cardiology 2018: ABC Cardiol and RPC at a glance. Arq Bras Cardiol 2019; 112:193-200. [PMID: 30785585 PMCID: PMC6371817 DOI: 10.5935/abc.20190015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 12/14/2018] [Accepted: 12/18/2018] [Indexed: 12/20/2022] Open
Affiliation(s)
- Ricardo Fontes-Carvalho
- Departamento de Cardiologia - Centro Hospitalar de Vila Nova de
Gaia, Vila Nova de Gaia - Portugal
- Departamento de Cirurgia e Fisiologia - Faculdade de Medicina -
Universidade do Porto, Porto - Portugal
| | - Glaucia Maria Moraes de Oliveira
- Faculdade de Medicina - Universidade Federal do Rio de Janeiro, Rio
de Janeiro, RJ - Brazil
- Instituto do Coração Edson Saad - Universidade
Federal do Rio de Janeiro, Rio de Janeiro, RJ - Brazil
| | - Lino Gonçalves
- Departamento de Cardiologia - Centro Hospitalar e
Universitário de Coimbra, Coimbra - Portugal
- Faculdade de Medicina - Universidade de Coimbra, Coimbra -
Portugal
| | - Carlos Eduardo Rochitte
- Instituto do Coração (InCor) - Faculdade de Medicina
da Universidade de São Paulo, São Paulo, SP - Brazil
- Hospital do Coração (HCOR), São Paulo, SP -
Brazil
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Borrayo Sanchez G, Rosas Peralta M, Martínez Montañez OG, Justiniano Cordero S, Fajardo Dolci G, Sepulveda Vildosola AC, Arriaga Dávila J. Implementation of a Nationwide Strategy for the Prevention, Treatment, and Rehabilitation of Cardiovascular Disease "A Todo Corazón". Arch Med Res 2018; 49:598-608. [PMID: 30579626 DOI: 10.1016/j.arcmed.2018.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 12/06/2018] [Indexed: 11/28/2022]
Abstract
The cardiovascular diseases (CVDs) have a growing impact over the world mortality, affecting mostly low and middle-income countries. This is due to changes in the population pyramid and the increase in unhealthy lifestyles that predispose the global population to cardiovascular risk factors such as overweight, obesity, smoking, hypertension, diabetes, dyslipidemias and metabolic syndrome. Ischemic heart disease and the cerebral vascular event remain the first causes of death reported by the World Health Organization (WHO) for more than a decade. Mexico has high prevalence in obesity, overweight, hypertension and diabetes in the population over 20 years old; Within the OECD countries (Organization for Economic Cooperation and Development) are the country with the highest mortality due to acute myocardial infarction over 45 years in the first 30 days. In order to face the growing pandemic of CVDs, the IMSS, it has developed and implemented a comprehensive care program called "A Todo Corazon", it is the first program of integral care which seeks to strengthen the actions to improving the impact of CVDs from health. This review is focused on describing the 7 axes that make up the program; each axe is described in detail. Axes one to three are dedicated to promotion and primary prevention of CVDs. Axes 4 and 5 are dedicated to infarction code, as a national strategy to confront the principal cause of death in Mexico. Finally axes 6 and 7 are dedicated to intensive care, secondary prevention and rehabilitation of CVDs.
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Affiliation(s)
- Gabriela Borrayo Sanchez
- Programa "A Todo Corazon", Centro Médico, Nacional, Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.
| | - Martín Rosas Peralta
- Área de Proyectos Especiales del Programa "A Todo Corazon", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Olga Georgina Martínez Montañez
- Programa "A Todo Corazon", Dirección de Prestaciones Médicas, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | | | - German Fajardo Dolci
- Facultad de Medicina, Universidad NacionalAutónoma de México, Ciudad de México, México
| | - Ana Carolina Sepulveda Vildosola
- Unidad de Investigación, Educación y Politicas en Salud, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Jesus Arriaga Dávila
- Dirección de Prestaciones Médicas, Instituto Mexicano del Seguro Social, Ciudad de México, México
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Fernandez-Jimenez R, Al-Kazaz M, Jaslow R, Carvajal I, Fuster V. Children Present a Window of Opportunity for Promoting Health: JACC Review Topic of the Week. J Am Coll Cardiol 2018; 72:3310-3319. [PMID: 30527619 DOI: 10.1016/j.jacc.2018.10.031] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/05/2018] [Accepted: 10/15/2018] [Indexed: 01/04/2023]
Abstract
Cardiovascular disease is the leading cause of death and disability in the world, largely because of risk factors modifiable by changes in behavior. There is evolving evidence that our behavior as adults has its roots in the environment that we live in from early childhood. Early sustained multicomponent educational programs focused on health promotion in children may represent a window of opportunity to potentially prevent disease in adulthood. The integration of school-based, family-based, and community-based strategies, along with the support of public policies, are likely necessary for the success of these programs. In this review, the authors describe the future of promoting health. Specifically: 1) reasons why children should be a focus for health promotion (alarming trends of risk factors, association between unhealthy factors and subclinical disease, and cost-effectiveness); 2) strategies for health promotion in children (school-based, family-based, and community-based approaches) along with legislative efforts; and 3) research gaps are discussed.
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Affiliation(s)
- Rodrigo Fernandez-Jimenez
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Mohamed Al-Kazaz
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Risa Jaslow
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Isabel Carvajal
- Foundation for Science, Health and Education (Fundación SHE), Barcelona, Spain
| | - Valentin Fuster
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain.
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Díaz-Gutiérrez J, Ruiz-Canela M, Gea A, Fernández-Montero A, Martínez-González MÁ. Relación entre un índice de estilo de vida saludable y el riesgo de enfermedad cardiovascular en la cohorte SUN. Rev Esp Cardiol 2018. [DOI: 10.1016/j.recesp.2017.09.026] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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55
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Impact of Lipids on Cardiovascular Health. J Am Coll Cardiol 2018; 72:1141-1156. [DOI: 10.1016/j.jacc.2018.06.046] [Citation(s) in RCA: 176] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/03/2018] [Accepted: 06/26/2018] [Indexed: 11/20/2022]
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Hodder RK, O'Brien KM, Stacey FG, Wyse RJ, Clinton‐McHarg T, Tzelepis F, James EL, Bartlem KM, Nathan NK, Sutherland R, Robson E, Yoong SL, Wolfenden L. Interventions for increasing fruit and vegetable consumption in children aged five years and under. Cochrane Database Syst Rev 2018; 5:CD008552. [PMID: 29770960 PMCID: PMC6373580 DOI: 10.1002/14651858.cd008552.pub5] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Insufficient consumption of fruits and vegetables in childhood increases the risk of future non-communicable diseases, including cardiovascular disease. Interventions to increase consumption of fruit and vegetables, such as those focused on specific child-feeding strategies and parent nutrition education interventions in early childhood may therefore be an effective strategy in reducing this disease burden. OBJECTIVES To assess the effectiveness, cost effectiveness and associated adverse events of interventions designed to increase the consumption of fruit, vegetables or both amongst children aged five years and under. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase and two clinical trials registries to identify eligible trials on 25 January 2018. We searched Proquest Dissertations and Theses in November 2017. We reviewed reference lists of included trials and handsearched three international nutrition journals. We contacted authors of included studies to identify further potentially relevant trials. SELECTION CRITERIA We included randomised controlled trials, including cluster-randomised controlled trials and cross-over trials, of any intervention primarily targeting consumption of fruit, vegetables or both among children aged five years and under, and incorporating a dietary or biochemical assessment of fruit or vegetable consumption. Two review authors independently screened titles and abstracts of identified papers; a third review author resolved disagreements. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the risks of bias of included studies; a third review author resolved disagreements. Due to unexplained heterogeneity, we used random-effects models in meta-analyses for the primary review outcomes where we identified sufficient trials. We calculated standardised mean differences (SMDs) to account for the heterogeneity of fruit and vegetable consumption measures. We conducted assessments of risks of bias and evaluated the quality of evidence (GRADE approach) using Cochrane procedures. MAIN RESULTS We included 63 trials with 178 trial arms and 11,698 participants. Thirty-nine trials examined the impact of child-feeding practices (e.g. repeated food exposure) in increasing child vegetable intake. Fourteen trials examined the impact of parent nutrition education in increasing child fruit and vegetable intake. Nine studies examined the impact of multicomponent interventions (e.g. parent nutrition education and preschool policy changes) in increasing child fruit and vegetable intake. One study examined the effect of a nutrition education intervention delivered to children in increasing child fruit and vegetable intake.We judged 14 of the 63 included trials as free from high risks of bias across all domains; performance, detection and attrition bias were the most common domains judged at high risk of bias for the remaining studies.There is very low quality evidence that child-feeding practices versus no intervention may have a small positive effect on child vegetable consumption equivalent to an increase of 3.50 g as-desired consumption of vegetables (SMD 0.33, 95% CI 0.13 to 0.54; participants = 1741; studies = 13). Multicomponent interventions versus no intervention may have a very small effect on child consumption of fruit and vegetables (SMD 0.35, 95% CI 0.04 to 0.66; participants = 2009; studies = 5; low-quality evidence), equivalent to an increase of 0.37 cups of fruit and vegetables per day. It is uncertain whether there are any short-term differences in child consumption of fruit and vegetables in meta-analyses of trials examining parent nutrition education versus no intervention (SMD 0.12, 95% CI -0.03 to 0.28; participants = 3078; studies = 11; very low-quality evidence).Insufficient data were available to assess long-term effectiveness, cost effectiveness and unintended adverse consequences of interventions. Studies reported receiving governmental or charitable funds, except for four studies reporting industry funding. AUTHORS' CONCLUSIONS Despite identifying 63 eligible trials of various intervention approaches, the evidence for how to increase children's fruit and vegetable consumption remains limited. There was very low- and low-quality evidence respectively that child-feeding practice and multicomponent interventions may lead to very small increases in fruit and vegetable consumption in children aged five years and younger. It is uncertain whether parent nutrition education interventions are effective in increasing fruit and vegetable consumption in children aged five years and younger. Given that the quality of the evidence is very low or low, future research will likely change estimates and conclusions. Long-term follow-up is required and future research should adopt more rigorous methods to advance the field.This is a living systematic review. Living systematic reviews offer a new approach to review updating, in which the review is continually updated, incorporating relevant new evidence as it becomes available. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review.
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Affiliation(s)
- Rebecca K Hodder
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Kate M O'Brien
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Fiona G Stacey
- University of Newcastle, Hunter Medical Research Institute, Priority
Research Centre in Health Behaviour, and Priority Research Centre in
Physical Activity and NutritionSchool of Medicine and Public HealthCallaghanAustralia2287
| | - Rebecca J Wyse
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
| | - Tara Clinton‐McHarg
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
| | - Flora Tzelepis
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
| | - Erica L James
- University of Newcastle, Hunter Medical Research InstituteSchool of Medicine and Public HealthUniversity DriveCallaghanAustralia2308
| | - Kate M Bartlem
- University of NewcastleSchool of PsychologyUniversity DriveCallaghanAustralia2308
| | - Nicole K Nathan
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Rachel Sutherland
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Emma Robson
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Sze Lin Yoong
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Luke Wolfenden
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
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Hodder RK, Stacey FG, O'Brien KM, Wyse RJ, Clinton‐McHarg T, Tzelepis F, James EL, Bartlem KM, Nathan NK, Sutherland R, Robson E, Yoong SL, Wolfenden L. Interventions for increasing fruit and vegetable consumption in children aged five years and under. Cochrane Database Syst Rev 2018; 1:CD008552. [PMID: 29365346 PMCID: PMC6491117 DOI: 10.1002/14651858.cd008552.pub4] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Insufficient consumption of fruits and vegetables in childhood increases the risk of future chronic diseases, including cardiovascular disease. OBJECTIVES To assess the effectiveness, cost effectiveness and associated adverse events of interventions designed to increase the consumption of fruit, vegetables or both amongst children aged five years and under. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE and Embase to identify eligible trials on 25 September 2017. We searched Proquest Dissertations and Theses and two clinical trial registers in November 2017. We reviewed reference lists of included trials and handsearched three international nutrition journals. We contacted authors of included studies to identify further potentially relevant trials. SELECTION CRITERIA We included randomised controlled trials, including cluster-randomised controlled trials and cross-over trials, of any intervention primarily targeting consumption of fruit, vegetables or both among children aged five years and under, and incorporating a dietary or biochemical assessment of fruit or vegetable consumption. Two review authors independently screened titles and abstracts of identified papers; a third review author resolved disagreements. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the risks of bias of included studies; a third review author resolved disagreements. Due to unexplained heterogeneity, we used random-effects models in meta-analyses for the primary review outcomes where we identified sufficient trials. We calculated standardised mean differences (SMDs) to account for the heterogeneity of fruit and vegetable consumption measures. We conducted assessments of risks of bias and evaluated the quality of evidence (GRADE approach) using Cochrane procedures. MAIN RESULTS We included 55 trials with 154 trial arms and 11,108 participants. Thirty-three trials examined the impact of child-feeding practices (e.g. repeated food exposure) in increasing child vegetable intake. Thirteen trials examined the impact of parent nutrition education in increasing child fruit and vegetable intake. Eight studies examined the impact of multicomponent interventions (e.g. parent nutrition education and preschool policy changes) in increasing child fruit and vegetable intake. One study examined the effect of a nutrition intervention delivered to children in increasing child fruit and vegetable intake.We judged 14 of the 55 included trials as free from high risks of bias across all domains; performance, detection and attrition bias were the most common domains judged at high risk of bias for the remaining studies.Meta-analysis of trials examining child-feeding practices versus no intervention revealed a positive effect on child vegetable consumption (SMD 0.38, 95% confidence interval (CI) 0.15 to 0.61; n = 1509; 11 studies; very low-quality evidence), equivalent to a mean difference of 4.03 g of vegetables. There were no short-term differences in child consumption of fruit and vegetables in meta-analyses of trials examining parent nutrition education versus no intervention (SMD 0.11, 95% CI -0.05 to 0.28; n = 3023; 10 studies; very low-quality evidence) or multicomponent interventions versus no intervention (SMD 0.28, 95% CI -0.06 to 0.63; n = 1861; 4 studies; very low-quality evidence).Insufficient data were available to assess long-term effectiveness, cost effectiveness and unintended adverse consequences of interventions. Studies reported receiving governmental or charitable funds, except for three studies reporting industry funding. AUTHORS' CONCLUSIONS Despite identifying 55 eligible trials of various intervention approaches, the evidence for how to increase children's fruit and vegetable consumption remains sparse. There was very low-quality evidence that child-feeding practice interventions are effective in increasing vegetable consumption in children aged five years and younger, however the effect size was very small and long-term follow-up is required. There was very low-quality evidence that parent nutrition education and multicomponent interventions are not effective in increasing fruit and vegetable consumption in children aged five years and younger. All findings should be considered with caution, given most included trials could not be combined in meta-analyses. Given the very low-quality evidence, future research will very likely change estimates and conclusions. Such research should adopt more rigorous methods to advance the field.This is a living systematic review. Living systematic reviews offer a new approach to review updating, in which the review is continually updated, incorporating relevant new evidence as it becomes available. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review.
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Affiliation(s)
- Rebecca K Hodder
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Fiona G Stacey
- University of Newcastle, Hunter Medical Research Institute, Priority Research Centre in Health Behaviour, and Priority Research Centre in Physical Activity and NutritionSchool of Medicine and Public HealthCallaghanAustralia2287
| | - Kate M O'Brien
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Rebecca J Wyse
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
| | - Tara Clinton‐McHarg
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
| | - Flora Tzelepis
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
| | - Erica L James
- University of Newcastle, Hunter Medical Research InstituteSchool of Medicine and Public HealthUniversity DriveCallaghanAustralia2308
| | - Kate M Bartlem
- University of NewcastleSchool of PsychologyUniversity DriveCallaghanAustralia2308
| | - Nicole K Nathan
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Rachel Sutherland
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Emma Robson
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Sze Lin Yoong
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Luke Wolfenden
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
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Díaz-Gutiérrez J, Ruiz-Canela M, Gea A, Fernández-Montero A, Martínez-González MÁ. Association Between a Healthy Lifestyle Score and the Risk of Cardiovascular Disease in the SUN Cohort. ACTA ACUST UNITED AC 2017; 71:1001-1009. [PMID: 29287797 DOI: 10.1016/j.rec.2017.10.038] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 10/04/2017] [Indexed: 01/21/2023]
Abstract
INTRODUCTION AND OBJECTIVES A healthy lifestyle (HLS) is essential to attaining optimal cardiovascular health. Our objective was to assess the association between a HLS score and the incidence of hard cardiovascular disease (CVD) events. METHODS The SUN project is a dynamic, prospective, multipurpose cohort of Spanish university graduates with a retention proportion of 92%. In 19 336 participants, we calculated a HLS score ranging from 0 to 10 points: never smoking, physical activity (> 20 METs-h/wk), Mediterranean diet adherence (≥ 4/8 points), low body mass index (≤ 22), moderate alcohol intake (women, 0.1-5g/d; men, 0.1-10g/d), low television exposure (≤ 2h/d), no binge drinking (≤ 5 alcoholic drinks anytime), taking a short afternoon nap (< 30min/d), meeting up with friends> 1h/d and working> 40h/wk. RESULTS After a median follow-up of 10.4 years, we identified 140 incident cases of CVD. After adjustment for potential confounders, the highest category of HLS score adherence (7-10 points) showed a significant 78% relative reduction in the risk of primary CVD compared with the lowest category (0-3 points) (adjusted HR, 0.22; 95%CI, 0.11-0.46). Each healthy habit was individually associated with a lower risk of CVD. CONCLUSIONS A HLS score including several simple healthy habits was associated with a lower risk of developing primary CVD. This index may be useful to reinforce CVD prevention without the need to include traditional risk factors.
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Affiliation(s)
- Jesús Díaz-Gutiérrez
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Navarra, Pamplona, Navarra, Spain
| | - Miguel Ruiz-Canela
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Navarra, Pamplona, Navarra, Spain; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain
| | - Alfredo Gea
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Navarra, Pamplona, Navarra, Spain; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain
| | - Alejandro Fernández-Montero
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain; Departamento de Medicina del Trabajo, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
| | - Miguel Ángel Martínez-González
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Navarra, Pamplona, Navarra, Spain; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain; Departamento de Nutrición, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States.
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Hodder RK, Stacey FG, Wyse RJ, O'Brien KM, Clinton‐McHarg T, Tzelepis F, Nathan NK, James EL, Bartlem KM, Sutherland R, Robson E, Yoong SL, Wolfenden L. Interventions for increasing fruit and vegetable consumption in children aged five years and under. Cochrane Database Syst Rev 2017; 9:CD008552. [PMID: 28945919 PMCID: PMC6483688 DOI: 10.1002/14651858.cd008552.pub3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Insufficient consumption of fruits and vegetables in childhood increases the risk of future chronic diseases, including cardiovascular disease. OBJECTIVES To assess the effectiveness, cost effectiveness and associated adverse events of interventions designed to increase the consumption of fruit, vegetables or both amongst children aged five years and under. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE, Embase Classic and Embase to identify eligible trials on 30 September 2016. We searched CINAHL and PsycINFO in July 2016, Proquest Dissertations and Theses in November 2016 and three clinical trial registers in November 2016 and June 2017. We reviewed reference lists of included trials and handsearched three international nutrition journals. We contacted authors of included studies to identify further potentially relevant trials. SELECTION CRITERIA We included randomised controlled trials, including cluster-randomised controlled trials and cross-over trials, of any intervention primarily targeting consumption of fruit, vegetables or both among children aged five years and under, and incorporating a dietary or biochemical assessment of fruit or vegetable consumption. Two review authors independently screened titles and abstracts of identified papers; a third review author resolved disagreements. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the risks of bias of included studies; a third review author resolved disagreements. Due to unexplained heterogeneity, we used random-effects models in meta-analyses for the primary review outcomes where we identified sufficient trials. We calculated standardised mean differences (SMDs) to account for the heterogeneity of fruit and vegetable consumption measures.We conducted assessments of risks of bias and evaluated the quality of evidence (GRADE approach) using Cochrane procedures. MAIN RESULTS We included 50 trials with 137 trial arms and 10,267 participants. Thirty trials examined the impact of child-feeding practices (e.g. repeated food exposure) in increasing child vegetable intake. Eleven trials examined the impact of parent nutrition education in increasing child fruit and vegetable intake. Eight studies examined the impact of multicomponent interventions (e.g. parent nutrition education and preschool policy changes) in increasing child fruit and vegetable intake. One study examined the effect of a nutrition intervention delivered to children in increasing child fruit and vegetable intake.Thirteen of the 50 included trials were judged as free from high risks of bias across all domains; performance, detection and attrition bias were the most common domains judged at high risk of bias of remaining studies.Meta-analysis of trials examining child-feeding practices versus no intervention revealed a positive effect on child vegetable consumption (SMD 0.38, 95% CI 0.15 to 0.61; n = 1509; 11 studies; very low-quality evidence), equivalent to a mean difference of 4.03 grams of vegetables. There were no short-term differences in child consumption of fruit and vegetables in meta-analyses of trials examining parent nutrition education versus no intervention (SMD 0.11, 95% CI -0.05 to 0.28; n = 3023; 10 studies; very low-quality evidence) or multicomponent interventions versus no intervention (SMD 0.28, 95% CI -0.06 to 0.63; n = 1861; 4 studies; very low-quality evidence).Insufficient data were available to assess long-term effectiveness, cost effectiveness and unintended adverse consequences of interventions.Studies reported receiving governmental or charitable funds, except for two studies reporting industry funding. AUTHORS' CONCLUSIONS Despite identifying 50 eligible trials of various intervention approaches, the evidence for how to increase fruit and vegetable consumption of children remains sparse. There was very low-quality evidence child-feeding practice interventions are effective in increasing vegetable consumption of children aged five years and younger, however the effect size was very small and long-term follow-up is required. There was very low-quality evidence that parent nutrition education and multicomponent interventions are not effective in increasing fruit and vegetable consumption of children aged five years and younger. All findings should be considered with caution, given most included trials could not be combined in meta-analyses. Given the very low-quality evidence, future research will very likely change estimates and conclusions. Such research should adopt more rigorous methods to advance the field.This is a living systematic review. Living systematic reviews offer a new approach to review updating, in which the review is continually updated, incorporating relevant new evidence as it becomes available. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review.
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Affiliation(s)
- Rebecca K Hodder
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Fiona G Stacey
- University of Newcastle, Hunter Medical Research Institute, Priority Research Centre in Health Behaviour, and Priority Research Centre in Physical Activity and NutritionSchool of Medicine and Public HealthCallaghanAustralia2287
| | - Rebecca J Wyse
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
| | | | - Tara Clinton‐McHarg
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
| | - Flora Tzelepis
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
| | - Nicole K Nathan
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Erica L James
- University of Newcastle, Hunter Medical Research InstituteSchool of Medicine and Public HealthUniversity DriveCallaghanAustralia2308
| | - Kate M Bartlem
- University of NewcastleSchool of PsychologyUniversity DriveCallaghanAustralia2308
| | - Rachel Sutherland
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Emma Robson
- Hunter New England Local Health DistrictHunter Population HealthLocked Bag 10WallsendAustralia
| | - Sze Lin Yoong
- Hunter New England Local Health DistrictHunter New England Population HealthLocked Bag 10WallsendAustralia2287
| | - Luke Wolfenden
- University of NewcastleSchool of Medicine and Public HealthCallaghanAustralia2308
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Affiliation(s)
- Parag H Joshi
- From the Departments of Internal Medicine (Cardiology) (P.H.J., J.A.H.) and Molecular Biology (J.A.H.), University of Texas Southwestern Medical Center, Dallas.
| | - Joseph A Hill
- From the Departments of Internal Medicine (Cardiology) (P.H.J., J.A.H.) and Molecular Biology (J.A.H.), University of Texas Southwestern Medical Center, Dallas
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Rationale and Design of Family-Based Approach in a Minority Community Integrating Systems-Biology for Promotion of Health (FAMILIA). Am Heart J 2017; 187:170-181. [PMID: 28454800 DOI: 10.1016/j.ahj.2017.02.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 02/08/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND The 2020 American Heart Association Impact Goal aims to improve cardiovascular health of all Americans by 20% while reducing deaths from cardiovascular disease and stroke by 20%. A large step toward this goal would be to better understand and take advantage of the significant intersection between behavior and biology across the entire life-span. In the proposed FAMILIA studies, we aim to directly address this major knowledge and clinical health gap by implementing an integrated family-centric health promotion intervention and focusing on the intersection of environment and behavior, while understanding the genetic and biologic basis of cardiovascular disease. METHODS We plan to recruit 600 preschool children and their 600 parents or caregivers from 12-15 Head Start schools in Harlem, NY, and perform a 2:1 (2 intervention/1 control) cluster randomization of the schools. The preschool children will receive our intensive 37-hour educational program as the intervention for 4 months. For the adults, those in the "intervention" group will be randomly assigned to 1 of 2 intervention programs: an "individual-focused" or "peer-to-peer based." The primary outcome in children will be a composite score of knowledge (K), attitudes (A), habits (H), related to body mass index Z score (B), exercise (E), and alimentation (A) (KAH-BEA), using questionnaires and anthropometric measurements. For adults, the primary outcome will be a composite score for behaviors/outcomes related to blood pressure, exercise, weight, alimentation (diet) and tobacco (smoking; Fuster-BEWAT score). Saliva will be collected from the children for SNP genotyping, and blood will be collected from adults for RNA sequencing to identify network models and predictors of primary prevention outcomes. CONCLUSION The FAMILIA studies seek to demonstrate that targeting a younger age group (3-5 years) and using a family-based approach may be a critical strategy in promoting cardiovascular health across the life-span.
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Bibiloni MDM, Fernández-Blanco J, Pujol-Plana N, Martín-Galindo N, Fernández-Vallejo MM, Roca-Domingo M, Chamorro-Medina J, Tur JA. [Improving diet quality in children through a new nutritional education programme: INFADIMED]. GACETA SANITARIA 2017; 31:472-477. [PMID: 28410796 DOI: 10.1016/j.gaceta.2016.10.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 10/14/2016] [Accepted: 10/19/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the results of a nutritional education programme developed by using available local resources to improve diet quality and decrease overweight and obesity prevalence among children. METHOD A longitudinal intervention study by means of nutritional education (INFADIMED) in children (aged 3-7 years) from Vilafranca del Penedès (Barcelona, Spain), recruited from preschool centres and primary schools, with an intervention or INFADIMED group (n=319; 50.2% female) and a control group (n=880; 49.8% female). Weight, height and body mass index were measured in both groups at the beginning and at the end of the programme. Adherence to the Mediterranean diet was also assessed using the KIDMED test. RESULTS Consumption of fruit or juices, vegetables, yogurt and/or cheese, pasta or rice, and nuts increased, while skipping breakfast, consumption of bakery products for breakfast, and/or consumption of sweets several times per day decreased in the INFADIMED group. INFADIMED also changed, from the beginning to the end of the study, the adherence to a Mediterranean diet: high (39.2% to 70.5%), acceptable (49.2% to 28.2%), and low (11.6% to 1.3%). Approximately 2.6% of the participants in the control group and 11.3% of the participants in the INFADIMED group who were overweight and obese changed to normal weight (odds ratio: 4.08; 95% confidence interval: 2.37-7.04). CONCLUSIONS INFADIMED is a nutritional education programme with benefits on both diet quality and overweight and obesity prevalence among children.
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Affiliation(s)
- Maria Del Mar Bibiloni
- Grupo de Investigación en Nutrición Comunitaria y Estrés Oxidativo, Universidad de las Islas Baleares, Palma de Mallorca, España; CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, España
| | | | - Noemí Pujol-Plana
- Equipo de Atención Primaria Garraf-Rural, Sant Pere de Ribes, España
| | - Núria Martín-Galindo
- Equipo de Pediatría Territorial Alt Penedès-Garraf, VIlafranca del Penedès, España
| | | | | | | | - Josep A Tur
- Grupo de Investigación en Nutrición Comunitaria y Estrés Oxidativo, Universidad de las Islas Baleares, Palma de Mallorca, España; CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, España.
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Gorga E, Regazzoni V, Bansilal S, Carubelli V, Trichaki E, Gavazzoni M, Lombardi C, Raddino R, Metra M. School and family-based interventions for promoting a healthy lifestyle among children and adolescents in Italy: a systematic review. J Cardiovasc Med (Hagerstown) 2017; 17:547-55. [PMID: 27168142 DOI: 10.2459/jcm.0000000000000404] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIMS Cardiovascular diseases affect adult population but risk factors develop as a result of known or assumed behavior since childhood. In Italy, up to 22.2% of children are overweight, 10.6% are obese, and 2.5% have severe obesity. METHODS We performed a systematic review of the literature to identify studies and initiatives addressing health promotion among children in Italy. Given the high heterogeneity of interventions and outcomes assessed we opted to perform a qualitative synthesis of the results. We described also nonrandomized trial where the intervention of primary prevention was very innovative, explained in detail, and reached an improving outcome for participants. RESULTS We identified 11 projects since 1983, only five were randomized control trials. Three involved children and teachers of primary and secondary schools and were based on specific curricular lectures about health. One was based on a game developed for high schools with the purpose to promote healthy lifestyle and physical activity. The fifth project was based on an enhanced physical activity program. CONCLUSION Our results show that school and family should be considered as the privileged places for health promotion. In Italy, the development of scientific-validated lifestyle interventions for children is still an unmet need.
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Affiliation(s)
- Elio Gorga
- aCardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy bMount Sinai Cardiovascular Institute, New York, USA; Centro Nacional de Investigaciones Cardiovasculares (CNIC) Carlos III, Madrid, Spain
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Chatterjee NA, Giulianini F, Geelhoed B, Lunetta KL, Misialek JR, Niemeijer MN, Rienstra M, Rose LM, Smith AV, Arking DE, Ellinor PT, Heeringa J, Lin H, Lubitz SA, Soliman EZ, Verweij N, Alonso A, Benjamin EJ, Gudnason V, Stricker BHC, Van Der Harst P, Chasman DI, Albert CM. Genetic Obesity and the Risk of Atrial Fibrillation: Causal Estimates from Mendelian Randomization. Circulation 2017; 135:741-754. [PMID: 27974350 PMCID: PMC5322057 DOI: 10.1161/circulationaha.116.024921] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 12/05/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Observational studies have identified an association between body mass index (BMI) and incident atrial fibrillation (AF). Inferring causality from observational studies, however, is subject to residual confounding, reverse causation, and bias. The primary objective of this study was to evaluate the causal association between BMI and AF by using genetic predictors of BMI. METHODS We identified 51 646 individuals of European ancestry without AF at baseline from 7 prospective population-based cohorts initiated between 1987 and 2002 in the United States, Iceland, and the Netherlands with incident AF ascertained between 1987 and 2012. Cohort-specific mean follow-up ranged from 7.4 to 19.2 years, over which period there was a total of 4178 cases of incident AF. We performed a Mendelian randomization with instrumental variable analysis to estimate a cohort-specific causal hazard ratio for the association between BMI and AF. Two genetic instruments for BMI were used: FTO genotype (rs1558902) and a BMI gene score comprising 39 single-nucleotide polymorphisms identified by genome-wide association studies to be associated with BMI. Cohort-specific estimates were combined by random-effects, inverse variance-weighted meta-analysis. RESULTS In age- and sex-adjusted meta-analysis, both genetic instruments were significantly associated with BMI (FTO: 0.43 [95% confidence interval, 0.32-0.54] kg/m2 per A-allele, P<0.001; BMI gene score: 1.05 [95% confidence interval, 0.90-1.20] kg/m2 per 1-U increase, P<0.001) and incident AF (FTO, hazard ratio, 1.07 [1.02-1.11] per A-allele, P=0.004; BMI gene score, hazard ratio, 1.11 [1.05-1.18] per 1-U increase, P<0.001). Age- and sex-adjusted instrumental variable estimates for the causal association between BMI and incident AF were hazard ratio, 1.15 (1.04-1.26) per kg/m2, P=0.005 (FTO) and 1.11 (1.05-1.17) per kg/m2, P<0.001 (BMI gene score). Both of these estimates were consistent with the meta-analyzed estimate between observed BMI and AF (age- and sex-adjusted hazard ratio 1.05 [1.04-1.06] per kg/m2, P<0.001). Multivariable adjustment did not significantly change findings. CONCLUSIONS Our data are consistent with a causal relationship between BMI and incident AF. These data support the possibility that public health initiatives targeting primordial prevention of obesity may reduce the incidence of AF.
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Affiliation(s)
- Neal A. Chatterjee
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Franco Giulianini
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Bastiaan Geelhoed
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Kathryn L. Lunetta
- The Framingham Heart Study, Framingham, MA, USA; Cardiology and Preventive Medicine Sections, Boston University School of Medicine, Epidemiology Department, Boston University School of Public Health, Boston, MA, USA
| | - Jeffrey R. Misialek
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Maartje N. Niemeijer
- Department of Epidemiology, Erasmus Medical Center-University Medical Center, Rotterdam, The Netherlands
| | - Michiel Rienstra
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Lynda M. Rose
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Albert V. Smith
- Icelandic Heart Association, Research Institute, Kpoavogur, Iceland and University of Iceland, Reykjavik, Iceland
| | - Dan E. Arking
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Patrick T. Ellinor
- Cardiovascular Research Center and Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, MA, USA and Program in Medical and Population Genetics, The Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Jan Heeringa
- Department of Epidemiology, Erasmus Medical Center-University Medical Center, Rotterdam, The Netherlands
| | - Honghuang Lin
- The Framingham Heart Study, Framingham, MA, USA; Cardiology and Preventive Medicine Sections, Boston University School of Medicine, Epidemiology Department, Boston University School of Public Health, Boston, MA, USA
- Computational Biomedicine Section, Boston University School of Medicine, Boston, MA, USA
| | - Steven A. Lubitz
- Cardiovascular Research Center and Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, MA, USA and Program in Medical and Population Genetics, The Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Elsayed Z. Soliman
- Epidemiological Cardiology Research Center (EPICARE), Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Niek Verweij
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Emelia J. Benjamin
- The Framingham Heart Study, Framingham, MA, USA; Cardiology and Preventive Medicine Sections, Boston University School of Medicine, Epidemiology Department, Boston University School of Public Health, Boston, MA, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association, Research Institute, Kpoavogur, Iceland and University of Iceland, Reykjavik, Iceland
| | - Bruno H. C. Stricker
- Department of Epidemiology, Erasmus Medical Center-University Medical Center, Rotterdam, The Netherlands
| | - Pim Van Der Harst
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Daniel I. Chasman
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Christine M. Albert
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
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Ward DS, Welker E, Choate A, Henderson KE, Lott M, Tovar A, Wilson A, Sallis JF. Strength of obesity prevention interventions in early care and education settings: A systematic review. Prev Med 2017; 95 Suppl:S37-S52. [PMID: 27693295 DOI: 10.1016/j.ypmed.2016.09.033] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 09/20/2016] [Accepted: 09/23/2016] [Indexed: 10/20/2022]
Abstract
2010-2015; INTERNATIONAL: Given the high levels of obesity in young children, numbers of children in out-of-home care, and data suggesting a link between early care and education (ECE) participation and overweight/obesity, obesity prevention in ECE settings is critical. As the field has progressed, a number of interventions have been reviewed yet there is a need to summarize the data using more sophisticated analyses to answer questions on the effectiveness of interventions. We conducted a systematic review of obesity prevention interventions in center-based ECE settings published between 2010 and 2015. Our goal was to identify promising intervention characteristics associated with successful behavioral and anthropometric outcomes. A rigorous search strategy resulted in 43 interventions that met inclusion criteria. We developed a coding strategy to assess intervention strength, used a validated study quality assessment tool, and presented detailed descriptive information about interventions (e.g., target behaviors, intervention strategies, and mode of delivery). Intervention strength was positively correlated with reporting of positive anthropometric outcomes for physical activity, diet, and combined interventions, and parent engagement components increased the strength of these relationships. Study quality was modestly related to percent successful healthy eating outcomes. Relationships between intervention strength and behavioral outcomes demonstrated negative relationships for all behavioral outcomes. Specific components of intervention strength (number of intervention strategies, potential impact of strategies, frequency of use, and duration of intervention) were correlated with some of the anthropometric and parent engagement outcomes. The review provided tentative evidence that multi-component, multi-level ECE interventions with parental engagement are most likely to be effective with anthropometric outcomes.
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Affiliation(s)
- Dianne S Ward
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States.
| | - Emily Welker
- Healthy Eating Research, Duke Global Health Institute, Duke University, Durham, NC, United States
| | - Ashley Choate
- Healthy Eating Research, Duke Global Health Institute, Duke University, Durham, NC, United States
| | | | - Megan Lott
- Healthy Eating Research, Duke Global Health Institute, Duke University, Durham, NC, United States
| | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, South Kingstown, RI, United States
| | - Amanda Wilson
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA, United States
| | - James F Sallis
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA, United States
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Little Beacons of Change: Targeting Preschool Children to Drive a Culture of Health. Glob Heart 2016; 11:467-468. [PMID: 27938844 DOI: 10.1016/j.gheart.2016.10.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 10/19/2016] [Indexed: 11/21/2022] Open
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Bentzon JF. Targeting Inflammation in Atherosclerosis ∗. J Am Coll Cardiol 2016; 68:2794-2796. [DOI: 10.1016/j.jacc.2016.11.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 10/18/2016] [Accepted: 11/01/2016] [Indexed: 12/25/2022]
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Fuster V. Editor-in-Chief's Top Picks From 2015: Part One. J Am Coll Cardiol 2016; 67:687-711. [PMID: 26868695 DOI: 10.1016/j.jacc.2015.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Each week, I record audio summaries for every article in JACC, as well as an issue summary. While this process has been time-consuming, I have become very familiar with every paper that we publish. Thus, I have personally selected the papers (both original investigations and review articles) from 13 distinct specialties for your review. In addition to my personal choices, I have included manuscripts that have been the most accessed or downloaded on our websites, as well as those selected by the JACC Editorial Board members. There are approximately 130 articles selected across this 2-part series, which represent less than 3% of the papers submitted to the Journal in 2015. In order to present the full breadth of this important research in a consumable fashion, we will present these manuscripts over the course of 2 issues in JACC. Part One includes the sections: Congenital Heart Disease, Coronary Disease & Interventions, CVD Prevention & Health Promotion, Cardiac Failure, Cardiomyopathies, Genetics, Omics, & Tissue Regeneration, and Hypertension (1-60). Part Two includes the sections: Imaging, Metabolic Disorders & Lipids, Rhythm Disorders, Statistics, Valvular Heart Disease, and Vascular Medicine.
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Vedanthan R, Bansilal S, Soto AV, Kovacic JC, Latina J, Jaslow R, Santana M, Gorga E, Kasarskis A, Hajjar R, Schadt EE, Björkegren JL, Fayad ZA, Fuster V. Family-Based Approaches to Cardiovascular Health Promotion. J Am Coll Cardiol 2016; 67:1725-37. [DOI: 10.1016/j.jacc.2016.01.036] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 12/22/2015] [Accepted: 01/03/2016] [Indexed: 02/04/2023]
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Rodriguez F, Harrington RA. The Role of Peer Support in Attaining Ideal Cardiovascular Health: Peer Pressure and Prevention. J Am Coll Cardiol 2016; 67:486-7. [PMID: 26562045 DOI: 10.1016/j.jacc.2015.10.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 10/27/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Fatima Rodriguez
- Division of Cardiovascular Medicine, Stanford University, Stanford, California
| | - Robert A Harrington
- Division of Cardiovascular Medicine, Stanford University, Stanford, California; Department of Medicine, Stanford University, Stanford, California.
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Moving Toward Global Primordial Prevention in Cardiovascular Disease: The Heart of the Matter. J Am Coll Cardiol 2016; 66:1535-1537. [PMID: 26429076 DOI: 10.1016/j.jacc.2015.08.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 08/17/2015] [Indexed: 11/23/2022]
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Fuster V. Stratified Approach to Health: Integration of Science and Education at the Right Time for Each Individual. J Am Coll Cardiol 2016; 66:1627-1629. [PMID: 26429088 DOI: 10.1016/j.jacc.2015.08.039] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Valentin Fuster
- Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
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Gómez-Pardo E, Fernández-Alvira JM, Vilanova M, Haro D, Martínez R, Carvajal I, Carral V, Rodríguez C, de Miguel M, Bodega P, Santos-Beneit G, Peñalvo JL, Marina I, Pérez-Farinós N, Dal Re M, Villar C, Robledo T, Vedanthan R, Bansilal S, Fuster V. A Comprehensive Lifestyle Peer Group-Based Intervention on Cardiovascular Risk Factors: The Randomized Controlled Fifty-Fifty Program. J Am Coll Cardiol 2015; 67:476-85. [PMID: 26562047 DOI: 10.1016/j.jacc.2015.10.033] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 10/22/2015] [Accepted: 10/29/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Cardiovascular diseases stem from modifiable risk factors. Peer support is a proven strategy for many chronic illnesses. Randomized trials assessing the efficacy of this strategy for global cardiovascular risk factor modification are lacking. OBJECTIVES This study assessed the hypothesis that a peer group strategy would help improve healthy behaviors in individuals with cardiovascular risk factors. METHODS A total of 543 adults 25 to 50 years of age with at least 1 risk factor were recruited; risk factors included hypertension (20%), overweight (82%), smoking (31%), and physical inactivity (81%). Subjects were randomized 1:1 to a peer group-based intervention group (IG) or a self-management control group (CG) for 12 months. Peer-elected leaders moderated monthly meetings involving role-play, brainstorming, and activities to address emotions, diet, and exercise. The primary outcome was mean change in a composite score related to blood pressure, exercise, weight, alimentation, and tobacco (Fuster-BEWAT score, 0 to 15). Multilevel models with municipality as a cluster variable were applied to assess differences between groups. RESULTS Participants' mean age was 42 ± 6 years, 71% were female, and they had a mean baseline Fuster-BEWAT score of 8.42 ± 2.35. After 1 year, the mean scores were significantly higher in the IG (n = 277) than in the CG (n = 266) (IG mean score: 8.84; 95% confidence interval (CI): 8.37 to 9.32; CG mean score: 8.17; 95% CI: 7.55 to 8.79; p = 0.02). The increase in the overall score was significantly larger in the IG compared with the CG (difference: 0.75; 95% CI: 0.32 to 1.18; p = 0.02). The mean improvement in the individual components was uniformly greater in the IG, with a significant difference for the tobacco component. CONCLUSIONS The peer group intervention had beneficial effects on cardiovascular risk factors, with significant improvements in the overall score and specifically on tobacco cessation. A follow-up assessment will be performed 1 year after the final assessment reported here to determine long-term sustainability of the improvements associated with peer group intervention. (Peer-Group-Based Intervention Program [Fifty-Fifty]; NCT02367963).
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Jose Luis Peñalvo
- Fundación Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain; Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Iñaki Marina
- Internal Medicine Department, Catalan Health Institute, Viladecans, Spain
| | | | - Marian Dal Re
- Spanish Agency for Consumer Affairs, Food Safety and Nutrition
| | - Carmen Villar
- Spanish Agency for Consumer Affairs, Food Safety and Nutrition
| | - Teresa Robledo
- Spanish Agency for Consumer Affairs, Food Safety and Nutrition
| | | | | | - Valentin Fuster
- SHE Foundation, Barcelona, Spain; Fundación Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain; Icahn School of Medicine at Mount Sinai, New York, New York.
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Santos-Beneit G, Sotos-Prieto M, Bodega P, Rodríguez C, Orrit X, Pérez-Escoda N, Bisquerra R, Fuster V, Peñalvo JL. Development and validation of a questionnaire to evaluate lifestyle-related behaviors in elementary school children. BMC Public Health 2015; 15:901. [PMID: 26377181 PMCID: PMC4571115 DOI: 10.1186/s12889-015-2248-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 09/08/2015] [Indexed: 11/19/2022] Open
Abstract
Background The SI! Program promotes cardiovascular health through a multilevel school-based intervention on four lifestyle-related components: diet, physical activity, understanding the body and heart, and management of emotions. We report here the development and validation of the KAH (knowledge, attitudes and habits)-questionnaire adapted for elementary school children (6–7 years old) as a tool for the forthcoming evaluation of the SI! Program, where the KAH scoring will be the primary outcome. The efficacy of such an intervention will be based on the improvements in children’s KAH towards a healthy lifestyle. Methods The questionnaire validation process started with a pool of items proposed by the pedagogical team who developed the SI! Program for elementary school. The questionnaire was finalized by decreasing the number of items from 155 to 48 using expert panels and statistical tests on the responses from 384 children (ages 6–7). A team of specialized psychologists administered the questionnaire at schools providing standard directions for the final administration. The internal consistency was assessed using Cronbach’s α coefficients. Reliability was measured through the split-half method, and problematic items were detected applying the item response theory. Analysis of variance and Tukey’s test of additivity were used for multiple comparisons. Results The final KAH-questionnaire for elementary school children should be administered to children individually by trained staff. The 48 items-questionnaire is divided evenly between the 4 components of the intervention, with an overall Cronbach’s α = 0.791 (α = 0.526 for diet, α = 0.537 for physical activity, α = 0.523 for human body and heart, and α = 0.537 for management of emotions). Conclusions The KAH-questionnaire is a reliable instrument to assess the efficacy of the SI! Program on instilling healthy lifestyle-related behaviors in elementary school children. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2248-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- G Santos-Beneit
- Foundation for Science Health and Education, Avda. Diagonal 442, 3°, 1ª, 08037, Barcelona, Spain.
| | - M Sotos-Prieto
- Foundation for Science Health and Education, Avda. Diagonal 442, 3°, 1ª, 08037, Barcelona, Spain. .,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - P Bodega
- Foundation for Science Health and Education, Avda. Diagonal 442, 3°, 1ª, 08037, Barcelona, Spain.
| | - C Rodríguez
- Foundation for Science Health and Education, Avda. Diagonal 442, 3°, 1ª, 08037, Barcelona, Spain.
| | - X Orrit
- Foundation for Science Health and Education, Avda. Diagonal 442, 3°, 1ª, 08037, Barcelona, Spain.
| | - N Pérez-Escoda
- GROP (Grup de Recerca en Orientació Psicopedagògica), Departament MIDE (Mètodes d'Investigació i Diagnòstic en Educació), Universitat de Barcelona, Barcelona, Spain.
| | - R Bisquerra
- GROP (Grup de Recerca en Orientació Psicopedagògica), Departament MIDE (Mètodes d'Investigació i Diagnòstic en Educació), Universitat de Barcelona, Barcelona, Spain.
| | - V Fuster
- Fundación Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain. .,Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - J L Peñalvo
- Fundación Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain. .,Friedman School of Nutrition Science and Policy at Tufts University, Boston, MA, USA.
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