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Alghadir AH, Gabr SA, Iqbal A. Enhancing cognitive performance and mitigating dyslipidemia: the impact of moderate aerobic training on sedentary older adults. BMC Geriatr 2024; 24:678. [PMID: 39138393 PMCID: PMC11323678 DOI: 10.1186/s12877-024-05276-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 08/02/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND The present study aimed to evaluate the effects of 24 weeks of moderate aerobic exercise on lipids and lipoprotein levels; Lipo (a) markers, and their association with cognitive performance in healthy older adults. METHODS A total of 150 healthy subjects (100 males and 50 females; age range: 65-95 years) were recruited for this study. Based on the LOTCA test score, subjects were classified into two groups: the control group (n = 50) and the cognitive impairment group (n = 100). Cognitive functioning, leisure-time physical activity (LTPA), lipid profile, total cholesterol, TG, HDL-c, LDL-C, and lipo(a) were assessed at baseline and post-24-week aerobic exercise interventions using LOTCA battery, pre-validated Global Physical Activity Questionnaire (GPAQ) version II, colorimetric, and immunoassay techniques, respectively. RESULTS Significant improvements in cognitive function and modulation in lipid profile and lipoprotein (a) markers were reported in all older subjects following 24 weeks of moderate exercise. LOTCA-7-sets scores significantly correlated with physical activity status and the regulation of lipids and Lipo (a) markers. Physically active persons showed higher cognitive performance along with a reduction in the levels of T-Cholest., TG, LDL-C, Lipo (a), and an increase in the levels of HDL-C and aerobic fitness VO2max compared with sedentary participants. Cognitive performance correlated positively with increased aerobic fitness, HDL-C, and negatively with T-Cholest., TG, LDL-C, and Lipo (a). However, a significant increase in the improvement of motor praxis, vasomotor organization, thinking operations, attention, and concentration were reported among older adults. CONCLUSIONS The study findings revealed that supervised moderate aerobic training for 24 weeks significantly enhances cognitive functions via mitigating older adults' lipid profiles and lipoprotein (a). Cognitive performance is positively correlated with aerobic fitness and HDL-C level and negatively with T-Cholest., TH, LDL-C, and Lipo (a).
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Affiliation(s)
- Ahmad H Alghadir
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia
| | - Sami A Gabr
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia
| | - Amir Iqbal
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia.
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Yoon JY, Park WJ, Kim HK, Kang HC, Park CK, Choi W. Association between Weight Change and Incidence of Dyslipidemia in Young Adults: A Retrospective Cohort Study of Korean Male Soldiers. J Obes Metab Syndr 2024; 33:36-44. [PMID: 38246603 PMCID: PMC11000516 DOI: 10.7570/jomes23056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Background Recent lifestyle changes have increased the prevalence of dyslipidemia in Korea. Young men are known to have a low awareness of dyslipidemia and a lack of motivation to maintain their weight. However, the association between weight change and dyslipidemia in young adults has not been thoroughly examined. Methods Data from the Armed Forces Medical Command Defense Medical Information System database were used. In this study, 15,068 soldiers who underwent private and corporal health examinations between May 2020 and April 2022 were included. The difference in weights between the two different health examinations was used to quantify weight change. Four components of the lipid profile were used to assess dyslipidemia during the corporal health examination. Results After adjusting for relevant covariates, weight gain was associated with increased risk of dyslipidemia (adjusted odds ratio [OR], 1.38 [95% confidence interval, CI, 1.15 to 1.64] for the 5% to 10% weight gain group; and OR, 2.02 [95% CI, 1.59 to 2.55] for the ≥10% weight gain group), whereas weight loss was associated with decreased risk (adjusted OR, 0.82 [95% CI, 0.68 to 0.98] for the 5% to 10% weight loss group; and OR, 0.38 [95% CI, 0.27 to 0.53] for the ≥10% weight loss group). In subgroup analysis based on the participants' baseline body mass index, smoking status, regular exercise habits, and hypertension status, there were no significant differences between the subgroups. Conclusion Weight change was associated with dyslipidemia in Korean male soldiers. The findings suggest that limiting weight gain in young adults by encouraging a healthy lifestyle may help prevent dyslipidemia.
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Affiliation(s)
- Joon-Young Yoon
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
- The 31th Infantry Division of Republic of Korea Army, Gwangju, Korea
| | - Won Ju Park
- Department of Occupational and Environmental Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Hee Kyung Kim
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Ho-Cheol Kang
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Cheol-Kyu Park
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Wonsuk Choi
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
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Braga PGS, Freitas FR, Bachi ALL, Amirato GR, Baroni RV, Alves MJNN, Vieira RP, Vaisberg MW, Aldin MN, Kalil Filho R, Figueiredo Neto AM, Damasceno NRT, Tavoni TM, Maranhão RC. Regular Practice of Physical Activity Improves Cholesterol Transfers to High-Density Lipoprotein (HDL) and Other HDL Metabolic Parameters in Older Adults. Nutrients 2023; 15:4871. [PMID: 38068730 PMCID: PMC10708266 DOI: 10.3390/nu15234871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/15/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
The effects of regular physical activity on two important anti-atherosclerosis functions of high-density lipoprotein (HDL), namely its capacity to receive both forms of cholesterol and its anti-oxidant function, were investigated in this study comparing older adults with young individuals. One-hundred and eight healthy adult individuals were enrolled and separated into the following groups: active older (60-80 yrs, n = 24); inactive older (60-79 yrs, n = 21); active young (20-34 yrs, n = 39); and inactive young (20-35 yrs, n = 24). All performed cardiopulmonary tests. Blood samples were collected in order to assess the following measures: lipid profile, HDL anti-oxidant capacity, paraoxonase-1 activity, HDL subfractions, and lipid transfer to HDL. Comparing active older and active young groups with inactive older and inactive young groups, respectively, the active groups presented higher HDL-C levels (p < 0.01 for both comparisons), unesterified cholesterol transfer (p < 0.01, p < 0.05), and intermediate and larger HDL subfractions (p < 0.001, p < 0.01) than the respective inactive groups. In addition, the active young group showed higher esterified cholesterol transfer than the inactive young group (p < 0.05). As expected, the two active groups had higher VO2peak than the inactive groups; VO2peak was higher in the two younger than in the two older groups (p < 0.05). No differences in unesterified and esterified cholesterol transfers and HDL subfractions were found between active young and active older groups. HDL anti-oxidant capacity and paraoxonase-1 activity were equal in all four study groups. Our data highlight and strengthen the benefits of regular practice of physical activity on an important HDL function, the capacity of HDL to receive cholesterol, despite the age-dependent decrease in VO2peak.
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Affiliation(s)
- Pedro G. S. Braga
- Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, Brazil; (P.G.S.B.); (R.V.B.); (T.M.T.)
| | - Fatima R. Freitas
- Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, Brazil; (P.G.S.B.); (R.V.B.); (T.M.T.)
| | - André L. L. Bachi
- Post-Graduation Program in Health Sciences, Santo Amaro University (UNISA), Sao Paulo 04829-300, Brazil
| | - Gislene R. Amirato
- Centro Educacional e Esportivo Mane Garrincha, Secretaria Municipal de Esportes, Lazer e Recreacao, Sao Paulo 04039-034, Brazil
| | - Roberta V. Baroni
- Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, Brazil; (P.G.S.B.); (R.V.B.); (T.M.T.)
| | - Maria Janieire N. N. Alves
- Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, Brazil; (P.G.S.B.); (R.V.B.); (T.M.T.)
| | - Rodolfo P. Vieira
- Post-Graduate Program in Sciences of Human Movement and Rehabilitation, Universidade Federal de Sao Paulo (UNIFESP), Santos 11060-001, Brazil
- Post-Graduate Program in Human Movement and Rehabilitation and in Pharmaceutical Sciences, Evangelical University of Goiás (Unievangélica), Anápolis 75083-515, Brazil
- Post-Graduate Program in Bioengineering, Universidade Brasil, São Paulo 08230-030, Brazil
| | - Mauro W. Vaisberg
- Departamento de Medicina, Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo 04023-062, Brazil;
| | - Marlene N. Aldin
- Departamento de Nutricao, Faculdade de Saude Publica da Universidade de São Paulo (FSP-USP), Sao Paulo 01246-904, Brazil
| | - Roberto Kalil Filho
- Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, Brazil; (P.G.S.B.); (R.V.B.); (T.M.T.)
| | | | - Nágila R. T. Damasceno
- Departamento de Nutricao, Faculdade de Saude Publica da Universidade de São Paulo (FSP-USP), Sao Paulo 01246-904, Brazil
| | - Thauany M. Tavoni
- Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, Brazil; (P.G.S.B.); (R.V.B.); (T.M.T.)
| | - Raul C. Maranhão
- Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, Brazil; (P.G.S.B.); (R.V.B.); (T.M.T.)
- Faculdade de Ciencias Farmaceuticas, Universidade de Sao Paulo, Sao Paulo 05508-000, Brazil
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Balasekaran G, Mayo M, Ng YC. Effects of large exercise-induced weight loss on insulin sensitivity and metabolic risk factors in young males with obesity. J Sports Med Phys Fitness 2023; 63:1075-1083. [PMID: 37382410 DOI: 10.23736/s0022-4707.23.14846-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
BACKGROUND Obesity around the world is increasing at an alarming rate. One of the issues with obesity is whether exercise with large energy expenditure have any effect on obesity risk factors such as insulin resistance and coronary heart diseases. METHODS Twenty participants (mean age: 19.5±1.09 years) with Body Mass Index (BMI) of >30 kg/m2, and body fat percentage (BF%) of >25% completed an institutionalized regimented training (IRT) for 16 weeks. 12-hour fasting blood samples were collected at least 48 hours after the last exercise session. Glucose and insulin variables were determined through an oral glucose tolerance test. Participants underwent 446 hours of IRT and ate from four standardized meal menus per day with a caloric intake of 3066 kcal. RESULTS IRT resulted in a significant weight loss of 13.48±1.97 kg. Pre- and Post-Training total cholesterol (4.80±0.92 vs. 4.12±0.82 mmol/L) (P<0.01), low-density lipoprotein cholesterol (3.04±0.83 vs. 2.51±0.74 mmol/L) (P<0.01), triglycerides (1.19±0.57 vs. 0.74±0.30 mmol/L) (P<0.01) and apolipoprotein levels (Apo-A: 133.30±13.10 vs. 120.40±14.54 mg/dL; Apo-B: 88.08±25.72 vs. 70.12±18.21 mg/dL) (P<0.01) were significantly reduced, and glucose tolerance and insulin sensitivity were also improved. CONCLUSIONS Large exercise-induced weight loss can be achieved through IRT and may be a solution for weight loss for individuals with obesity to reduce obesity related complications.
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Affiliation(s)
- Govindasamy Balasekaran
- Human Bioenergetics Laboratory, Section of Physical Education and Sports Science, National Institute of Education, Nanyang Technological University, Singapore, Singapore -
| | - Melissa Mayo
- Human Bioenergetics Laboratory, Section of Physical Education and Sports Science, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Yew C Ng
- Human Bioenergetics Laboratory, Section of Physical Education and Sports Science, National Institute of Education, Nanyang Technological University, Singapore, Singapore
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Khalafi M, Sakhaei MH, Kazeminasab F, Rosenkranz SK, Symonds ME. Exercise training, dietary intervention, or combined interventions and their effects on lipid profiles in adults with overweight and obesity: A systematic review and meta-analysis of randomized clinical trials. Nutr Metab Cardiovasc Dis 2023; 33:1662-1683. [PMID: 37414662 DOI: 10.1016/j.numecd.2023.05.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/09/2023] [Accepted: 05/18/2023] [Indexed: 07/08/2023]
Abstract
AIMS We performed a systematic review and meta-analysis to compare the effects of Ex (exercise training) vs. DI (dietary intervention) vs. combined Ex and DI on total cholesterol (TC), low-density lipoprotein cholesterol (LDL), triglycerides (TG), and high-density lipoprotein cholesterol (HDL) in adults with overweight and obesity. DATA SYNTHESIS PubMed, Web of Science, and Scopus were searched to identify original articles published until March 2022, using keywords for the categories "exercise training," "dietary intervention," "overweight and obesity," and "randomized." Studies that included lipid profiles as outcomes and performed in adults with body mass indexes (BMIs) ≥ 25 kg/m2 were included. A total of 80 studies involving 4804 adult participants were included in the meta-analysis. Ex was not as effective as DI for reducing TC and TG and was less effective for reducing LDL. In addition, Ex increased HDL to a greater extent than DI. Combined interventions decreased TC, TG, and LDL but did not increase HDL more than Ex alone. Combined interventions failed to reduce TC or LDL but decreased TG and increased HDL more than DI alone. CONCLUSIONS Our results suggest that the combination of Ex and DI can be more effective than either Ex or DI alone in improving lipid profiles in adults with overweight and obesity.
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Affiliation(s)
- Mousa Khalafi
- Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran.
| | - Mohammad Hossein Sakhaei
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Guilan, Iran.
| | - Fatemeh Kazeminasab
- Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran.
| | - Sara K Rosenkranz
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV, USA.
| | - Michael E Symonds
- Centre for Perinatal Research, Academic Unit of Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, United Kingdom.
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Wood G, Taylor E, Ng V, Murrell A, Patil A, van der Touw T, Wolden M, Andronicos N, Smart NA. Estimating the Effect of Aerobic Exercise Training on Novel Lipid Biomarkers: A Systematic Review and Multivariate Meta-Analysis of Randomized Controlled Trials. Sports Med 2023; 53:871-886. [PMID: 36862340 PMCID: PMC10036419 DOI: 10.1007/s40279-023-01817-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND Aerobic exercise training (AET) prescribed as lipid management treatment positively affects the standard lipid profile and reduces cardiovascular disease (CVD) risk. Apolipoproteins, lipid and apolipoprotein ratios, and lipoprotein sub-fractions may more effectively predict CVD risk than the standard lipid profile but an AET response in these biomarkers has not been established. OBJECTIVES We conducted a quantitative systematic review of randomised controlled trials (RCTs) to (1) determine the effects of AET on lipoprotein sub-fractions, apolipoproteins and relevant ratios; and (2) identify study or intervention covariates associated with change in these biomarkers. METHODS We searched PubMed, EMBASE, all Web of Science and EBSCO health and medical online databases from inception to 31 December 2021. We included published RCTs of adult humans with ≥ 10 per group of participants; an AET intervention duration ≥ 12 weeks of at least moderate intensity (> 40% maximum oxygen consumption); and reporting pre/post measurements. Non-sedentary subjects, or those with chronic disease other than Metabolic Syndrome factors, or pregnant/lactating, as well as trials testing diet/medications, or resistance/isometric/unconventional training interventions, were excluded. RESULTS Fifty-seven RCTs totalling 3194 participants were analysed. Multivariate meta-analysis showed AET significantly raised antiatherogenic apolipoproteins and lipoprotein sub-fractions (mmol/L mean difference (MD) 0.047 (95% confidence interval (CI) 0.011, 0.082), P = .01); lowered atherogenic apoliproteins and lipoprotein sub-fractions (mmol/L MD - 0.08 (95% CI - 0.161, 0.0003), P = .05); and improved atherogenic lipid ratios (MD - 0.201 (95% CI - 0.291, - 0.111), P < .0001). Multivariate meta-regression showed intervention variables contributed to change in lipid, sub-fraction, and apoliprotein ratios. CONCLUSION Aerobic exercise training positively impacts atherogenic lipid and apolipoprotein ratios, alipoproteins, and lipoprotein sub-fractions; and antiatherogenic apolipoproteins and lipoprotein sub-fractions. Cardiovascular disease risk predicted by these biomarkers may be lowered when AET is prescribed as treatment or prevention. PROSPERO ID CRD42020151925.
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Affiliation(s)
- Gina Wood
- School of Science and Technology in the Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, NSW, 2351, Australia.
- School of Allied Health, Curtin University, Bentley, WA, 6102, Australia.
| | - Emily Taylor
- School of Science and Technology in the Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, NSW, 2351, Australia
| | - Vanessa Ng
- School of Science and Technology in the Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, NSW, 2351, Australia
| | - Anna Murrell
- School of Rural Medicine in the Faculty of Medicine and Health, University of New England, Armidale, NSW, 2351, Australia
| | - Aditya Patil
- School of Science and Technology in the Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, NSW, 2351, Australia
| | - Tom van der Touw
- School of Science and Technology in the Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, NSW, 2351, Australia
| | - Mitch Wolden
- Physical Therapy Program, University of Jamestown, Fargo, ND, 58104, USA
| | - Nick Andronicos
- School of Science and Technology in the Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, NSW, 2351, Australia
| | - Neil A Smart
- School of Science and Technology in the Faculty of Science, Agriculture, Business and Law, University of New England, Armidale, NSW, 2351, Australia
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Coll-Risco I, de la Flor Alemany M, Acosta-Manzano P, Borges-Cosic M, Camiletti-Moirón D, Baena-García L, Aparicio VA. The influence of an exercise program in middle-aged women on dietary habits. The FLAMENCO project. Menopause 2022; 29:1416-1422. [PMID: 36126236 DOI: 10.1097/gme.0000000000002071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To determine the extent to which following an exercise training program can modify dietary habits and adherence to the Mediterranean diet (MD) compared with a counseling group. METHODS These are secondary analyses from the FLAMENCO (Fitness League Against MENopause COst) project. The present randomized controlled trial included 150 perimenopausal women who were randomized into counseling (n = 75) or exercise (n = 75) groups. The counseling group attended conferences on a healthy lifestyle. The exercise group followed concurrently a 4-month (60 min/session, 3 d/wk) training and did not take part in the conferences. A validated food frequency questionnaire and the Mediterranean diet score were used to assess dietary habits and adherence to the MD, respectively. RESULTS The fish/shellfish intake was reduced in the counseling group and increased in the exercise group, with a difference between groups of 1.16 servings/wk ( P < 0.01). The counseling group reduced their beer intake, and the exercise group increased it, with a difference between groups of 1.07 servings/wk ( P < 0.01). CONCLUSION The exercise intervention did not have a significant impact on dietary habits or MD adherence scores in perimenopausal women. Notwithstanding, women in the exercise group increased their beer consumption, which might have been promoted by the social meetings after the exercise training.
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Affiliation(s)
| | | | | | | | - Daniel Camiletti-Moirón
- Department of Physical Education, Faculty of Educational Sciences, University of Cádiz, Cádiz, Spain
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Cheng P, Zhang J, Liu W, Sun Q, Fu Z, Lin H, Bi S, Zhu J. Tea consumption and cerebral hemorrhage risk: a meta-analysis. Acta Neurol Belg 2022; 122:1247-1259. [PMID: 35633472 DOI: 10.1007/s13760-022-01973-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 04/27/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Tea contains many polyphenols with biological properties such as antithrombosis and antioxidation. Recent observational studies on tea consumption concerning cerebral hemorrhage risk have reported inconsistent results. This meta-analysis aimed to summarize the accumulated evidence on the association between tea consumption and cerebral hemorrhage risk. METHODS Web of Science, PubMed, Embase, and Scopus databases were searched to identify relevant studies through December 2021. Relative risks (RRs) or odds ratios (ORs) from observational studies were synthesized. RESULTS Ten studies involving over 721,827 participants were included. Higher tea consumption was correlated with a 23% (RR = 0.77; 95% CI 0.66-0.89) lower risk of cerebral hemorrhage. Subgroup meta-analyses indicated higher tea consumption was beneficial in preventing cerebral hemorrhage risk for green tea, alcohol-adjusted, fruit/vegetables-adjusted, and physical activity-adjusted subgroups, respectively (P < 0.01). Dose-response analysis indicated each one-cup (120 ml/cup) increment in tea or green tea intake/day was correlated with an average of 2% (RR = 0.98, 95% CI 0.976-0.990), or 6% (RR = 0.94; 95% CI 0.92-0.97) lower cerebral hemorrhage risk. CONCLUSIONS This study suggests that daily tea consumption is related to a lower risk of cerebral hemorrhage among adults. Green tea consumption appears to be more beneficial in preventing cerebral hemorrhage. Physical activity, fruit/vegetables, and alcohol may affect the relationship between tea consumption and hemorrhagic stroke. Future studies should investigate the interplay of tea with these factors.
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Affiliation(s)
- Pengfei Cheng
- Department of Neurology, Tianjin Medical University Nankai Hospital, No. 6 Changjiang Road, Nankai District, Tianjin, 300100, China.
- Department of Neurology, The First Affiliated Hospital of Jiamusi University, Jiamusi, 154002, China.
| | - Junxiang Zhang
- Department of Neurology, The First Affiliated Hospital of Jiamusi University, Jiamusi, 154002, China
| | - Wenting Liu
- Department of Neurology, The First Affiliated Hospital of Jiamusi University, Jiamusi, 154002, China
| | - Quan Sun
- College of Basic Medicine, Jiamusi University, Jiamusi, 154002, China
| | - Zhaoxin Fu
- Department of Nephrology, The First Affiliated Hospital of Jiamusi University, Jiamusi, 154002, China
| | - Hao Lin
- Department of Neurology, Shenzhen Longhua District Central Hospital, Shenzhen, China
| | - Sheng Bi
- Department of Neurology, The First Affiliated Hospital of Jiamusi University, Jiamusi, 154002, China
| | - Jiaying Zhu
- Department of Neurology, The First Affiliated Hospital of Jiamusi University, Jiamusi, 154002, China
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Clay AW, Crane MM, Bloomsmith MA. Weight management towards physiological and behavioral wellbeing for chimpanzees living under human care. Zoo Biol 2022; 41:200-217. [PMID: 35037298 DOI: 10.1002/zoo.21668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/17/2021] [Accepted: 12/08/2021] [Indexed: 11/11/2022]
Abstract
Across a period of 54 months, several changes were made to the feeding protocols of 32 adult chimpanzees living at the Yerkes National Primate Research Center Field Station. Before implementing any changes in diet, baseline data were collected for 6 months. During Baseline (BS), the chimpanzees received unlimited amounts of primate biscuits twice a day and a limited amount of produce as enrichment. Treatment One (T1) dietary modifications included an increased amount of vegetables, primarily leafy greens, and biscuit feedings scheduled to occur an hour after vegetables were provided to the chimpanzees. T1 lasted for 1 year. At the end of T1, most of the chimpanzees had gained weight. Treatment Two (T2) occurred over the span of 3 years, during which all the chimpanzees were switched from unlimited, group-distributed primate biscuits to individually prescribed amounts of biscuits, fed in\dividually, and increased daily feedings of leafy greens. By the end of T2, 10 of 15 chimpanzees who were overweight or obese at the start of the project were within range of ideal body condition, and 4 of the remaining 5 were improved. All the chimpanzees who started the project within ideal range were still within ideal range. Significantly more time was invested in eating, foraging, and processing food during T2 (p < .05), more appropriately replicating the natural time budget for a chimpanzee. There were not any increases in abnormal, stress-related, or agonistic behaviors as a function of dietary modifications. Inactivity, however, was significantly higher (p < .05) during the later protocol, and locomotion was concurrently lower (p < .05).
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Affiliation(s)
- Andrea W Clay
- Yerkes National Primate Research Center, Lawrenceville, Georgia, USA
| | - Maria M Crane
- Yerkes National Primate Research Center, Lawrenceville, Georgia, USA
| | - Mollie A Bloomsmith
- Yerkes National Primate Research Center, Lawrenceville, Georgia, USA.,Yerkes National Primate Research Center, Main Center, Atlanta, Georgia, USA
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Hafez S, Eid Z, Alabasi S, Darwiche Y, Channaoui S, Hess DC. Mechanisms of Preconditioning Exercise-Induced Neurovascular Protection in Stroke. J Stroke 2021; 23:312-326. [PMID: 34649377 PMCID: PMC8521252 DOI: 10.5853/jos.2020.03006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/13/2021] [Indexed: 12/27/2022] Open
Abstract
Ischemic stroke is a leading cause of death and disability. Tissue plasminogen activator is the only U.S. Food and Drug Administration approved thrombolytic therapy for ischemic stroke patients till date. However, its use is limited due to increased risk of bleeding and narrow therapeutic window. Most of the preclinically tested pharmacological agents failed to be translated to the clinic. This drives the need for alternative therapeutic approaches that not only provide enhanced neuroprotection, but also reduce the risk of stroke. Physical exercise is a sort of preconditioning that provides the body with brief ischemic episodes that can protect the body from subsequent severe ischemic attacks like stroke. Physical exercise is known to improve cardiovascular health. However, its role in providing neuroprotection in stroke is not clear. Clinical observational studies showed a correlation between regular physical exercise and reduced risk and severity of ischemic stroke and better outcomes after stroke. However, the underlying mechanisms through which prestroke exercise can reduce the stroke injury and improve the outcomes are not completely understood. The purpose of this review is to: demonstrate the impact of exercise on stroke outcomes and show the potential role of exercise in stroke prevention and recovery; uncover the underlying mechanisms through which exercise reduces the neurovascular injury and improves stroke outcomes aiming to develop novel therapeutic approaches.
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Affiliation(s)
- Sherif Hafez
- Department of Pharmaceutical Sciences, College of Pharmacy Mercer University, Atlanta, GA, USA.,Neurology Department, Augusta University, Augusta, GA, USA
| | - Zeina Eid
- College of Pharmacy Larkin University, Miami, FL, USA
| | - Sara Alabasi
- College of Pharmacy Larkin University, Miami, FL, USA
| | | | | | - David C Hess
- Neurology Department, Augusta University, Augusta, GA, USA
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11
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Ghanemi A, Yoshioka M, St-Amand J. Trefoil Factor Family Member 2: From a High-Fat-Induced Gene to a Potential Obesity Therapy Target. Metabolites 2021; 11:metabo11080536. [PMID: 34436477 PMCID: PMC8401738 DOI: 10.3390/metabo11080536] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 12/11/2022] Open
Abstract
Obesity has its epidemiological patterns continuously increasing. With controlling both diet and exercise being the main approaches to manage the energy metabolism balance, a high-fat (HF) diet is of particular importance. Indeed, lipids have a low satiety potential but a high caloric density. Thus, focusing on pharmacologically targetable pathways remains an approach with promising therapeutic potential. Within this context, trefoil factor family member 2 (Tff2) has been characterized as specifically induced by HF diet rather than low-fat diet. TFF2 has also been linked to diverse neurological mechanisms and metabolic patterns suggesting its role in energy balance. The hypothesis is that TFF2 would be a HF diet-induced signal that regulates metabolism with a focus on lipids. Within this review, we put the spotlight on key findings highlighting this line of thought. Importantly, the hypothetical mechanisms pointed highlight TFF2 as an important contributor to obesity development via increasing lipids intestinal absorption and anabolism. Therefore, an outlook for future experimental activities and evaluation of the therapeutic potential of TFF2 inhibition is given. Indeed, its knockdown or downregulation would contribute to an antiobesity phenotype. We believe this work represents an addition to our understanding of the lipidic molecular implications in obesity, which will contribute to develop therapies aiming to manage the lipidic metabolic pathways including the absorption, storage and metabolism via targeting TFF2-related pathways. We briefly discuss important relevant concepts for both basic and clinical researchers.
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Affiliation(s)
- Abdelaziz Ghanemi
- Functional Genomics Laboratory, CREMI, Québec Genome Center, CHUL-CHU de Québec Research Center, Quebec, QC G1V 4G2, Canada; (A.G.); (M.Y.)
- Department of Molecular Medicine, Faculty of Medicine, Laval University, Quebec, QC G1V 0A6, Canada
| | - Mayumi Yoshioka
- Functional Genomics Laboratory, CREMI, Québec Genome Center, CHUL-CHU de Québec Research Center, Quebec, QC G1V 4G2, Canada; (A.G.); (M.Y.)
| | - Jonny St-Amand
- Functional Genomics Laboratory, CREMI, Québec Genome Center, CHUL-CHU de Québec Research Center, Quebec, QC G1V 4G2, Canada; (A.G.); (M.Y.)
- Department of Molecular Medicine, Faculty of Medicine, Laval University, Quebec, QC G1V 0A6, Canada
- Correspondence:
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12
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Lankester J, Zanetti D, Ingelsson E, Assimes TL. Alcohol use and cardiometabolic risk in the UK Biobank: A Mendelian randomization study. PLoS One 2021; 16:e0255801. [PMID: 34379647 PMCID: PMC8357114 DOI: 10.1371/journal.pone.0255801] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 07/25/2021] [Indexed: 12/13/2022] Open
Abstract
Observational studies suggest alcohol use promotes the development of some adverse cardiometabolic traits but protects against others including outcomes related to coronary artery disease. We used Mendelian randomization (MR) to explore causal relationships between the degree of alcohol consumption and several cardiometabolic traits in the UK Biobank. Using the well-established ADH1B Arg47His variant (rs1229984) and up to 24 additional SNPs recently found to be associated with alcohol consumption in an independent dataset as instruments, we conducted two-stage least squares and inverse weighted variance MR analyses, both as one-sample analyses in the UK Biobank and as two-sample analyses in external consortia. In the UK Biobank inverse variance weighted analyses, we found that one additional drink of alcohol per day was positively associated with systolic blood pressure (beta = 2.65 mmHg [1.40, 3.89]), hemorrhagic stroke (OR = 2.25 [1.41, 3.60]), and atrial fibrillation (OR = 1.26 [1.07, 1.48]), which were replicated in multivariable analyses. Alcohol was also associated with all cardiovascular disease and all-cause death. A positive association with myocardial infarction did not replicate in multivariable analysis, with suggestive mediation through blood pressure; similarly, a positive association between alcohol use with type 2 diabetes was mitigated by BMI in multivariable analysis. Findings were generally null in replication with two-sample analyses. Alcohol was not protective for any disease outcome with any analysis method, dataset, or strata. Stratifications by sex and smoking in the UK Biobank revealed higher point estimates of risk for several outcomes for men and mixed results for smoking strata, but no statistically significant heterogeneity. Our results are consistent with an overall harmful and/or null effect of alcohol on cardiometabolic health at all levels of use and suggest that even moderate alcohol use should not be promoted as a part of a healthy diet and lifestyle.
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Affiliation(s)
- Joanna Lankester
- Department of Medicine (Division of Cardiovascular Medicine), Stanford University School of Medicine, Stanford, CA, United States of America
| | - Daniela Zanetti
- Department of Medicine (Division of Cardiovascular Medicine), Stanford University School of Medicine, Stanford, CA, United States of America
| | - Erik Ingelsson
- Department of Medicine (Division of Cardiovascular Medicine), Stanford University School of Medicine, Stanford, CA, United States of America
- GlaxoSmithKline, Inc., Brentford, England, United Kingdom
| | - Themistocles L. Assimes
- Department of Medicine (Division of Cardiovascular Medicine), Stanford University School of Medicine, Stanford, CA, United States of America
- VA Palo Alto Health Care System, Palo Alto, CA, United States of America
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13
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Guha D, Mukherjee R, Aich P. Effects of two potential probiotic Lactobacillus bacteria on adipogenesis in vitro. Life Sci 2021; 278:119538. [PMID: 33932443 DOI: 10.1016/j.lfs.2021.119538] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/31/2021] [Accepted: 04/07/2021] [Indexed: 12/12/2022]
Abstract
AIMS Overweight is a major global health problem. Various methodologies to get rid of the extra fat are available, but usually, those are associated with adverse side effects. Probiotics, on the contrary, seem to have the potential to help reduce fat accumulation without much apparent adversity. In this study, we have evaluated a pair of well-documented probiotics for their anti-obesogenic effects. MAIN METHODS We used strains of Lactobacillus acidophilus (LA) and a cocktail (LDB-ST) of Lactobacillus delbruckei sp. bulgaricus (LDB) and Streptococcus thermophilus (ST) in this study. The murine pre-adipocyte cell line 3T3-L1 was terminally differentiated to matured adipocytes to use as a model to evaluate the bacteria's anti-obesogenic effects. The optimal dose for treatment of both the probiotics was determined using a cell viability assay. We assessed the probiotic internalization potential of differentiated 3T3-L1 cells by flow cytometry, fluorescence microscopy, and cell lysis method. We determined the lipolytic and anti-adipogenic potential of probiotics by intracellular lipid staining, spectrophotometry, and gene expression analysis. KEY FINDINGS Both probiotics were effective lipolytic agents as revealed by reducing cellular lipids and down-regulation of mammalian adipogenesis marker genes in terminally differentiated 3T3-L1 cells. SIGNIFICANCE Previous studies from our group had proven the immune-modulatory properties of these probiotics on an immune-biased mouse model. The present study demonstrates LA and LDB-ST to be effective against adipogenesis. Further in vivo studies will be conducted to strengthen this claim.
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Affiliation(s)
- Dipanjan Guha
- School of Biological Sciences, National Institute of Science Education and Research (NISER), P.O. - Bhimpur-Padanpur, Jatni - 752050, Dist.-Khurda, Odisha, India; Homi Bhabha National Institute (HBNI), Training School Complex, Anushaktinagar, Mumbai 400 094, India
| | - Raktim Mukherjee
- School of Biological Sciences, National Institute of Science Education and Research (NISER), P.O. - Bhimpur-Padanpur, Jatni - 752050, Dist.-Khurda, Odisha, India; Homi Bhabha National Institute (HBNI), Training School Complex, Anushaktinagar, Mumbai 400 094, India
| | - Palok Aich
- School of Biological Sciences, National Institute of Science Education and Research (NISER), P.O. - Bhimpur-Padanpur, Jatni - 752050, Dist.-Khurda, Odisha, India; Homi Bhabha National Institute (HBNI), Training School Complex, Anushaktinagar, Mumbai 400 094, India.
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14
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Pauley M, Mays C, Bailes JR, Schwartzman ML, Castle M, McCoy M, Patick C, Preston D, Nudelman MJR, Denning KL, Bellner L, Werthammer J. Carbohydrate-Restricted Diet: A Successful Strategy for Short-Term Management in Youth with Severe Obesity-An Observational Study. Metab Syndr Relat Disord 2021; 19:281-287. [PMID: 33566732 PMCID: PMC8823673 DOI: 10.1089/met.2020.0078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: Obesity affects ∼20% of children in the United States and reports of successful dietary treatment are lacking. This study aimed to determine the change in body weight in severely obese youth after carbohydrate-restricted dietary intervention. Methods: This single-center study of a carbohydrate-restricted diet (≤30 grams per day), with unlimited calories, fat, and protein for 3–4 months, examined two groups of severely obese youth of ages 5–18 years: Group A, retrospectively reviewed charts of severely obese youth referred to the Pediatric Obesity Clinic at Hoops Family Children's Hospital and the Ambulatory Division of Marshall Pediatrics, Marshall University School of Medicine, in Huntington, WV, between July 1, 2014 and June 30, 2017 (n = 130), and Group B, prospective participants, referred between July 1, 2018 and December 31, 2018, followed with laboratory studies pre- and postdietary intervention (n = 8). Results: In Group A, 310 participants began the diet, 130 (42%) returned after 3–4 months. Group B had 14 enrollees who began the diet, and 8 followed up at 3–4 months (57%). Girls compared with boys were more likely to complete the diet (P = 0.02). Participants <12 years age were almost twice as likely to complete the diet compared with those 12–18 years (64% vs. 36%, P < 0.01); however, the older group subjects who completed the diet had the same percentage of weight loss compared with those <12 years (6.9% vs. 6.9%). Group A had reductions in weight of 5.1 kg (P < 0.001), body mass index (BMI) 2.5 kg/m2 (P < 0.001), and percentage weight loss 6.9% (P < 0.001). Group B had reductions in weight 9.6 kg (P < 0.01), BMI 4 kg/m2 (P < 0.01), and percentage weight loss 9% (P < 0.01). In addition, participants had significant reductions of fasting serum insulin (P < 0.01), triglycerides (P < 0.01), and 20-hydroxyeicosatetraenoic acid (P < 0.01). Conclusions: This study demonstrated a carbohydrate-restricted diet, utilized short term, effectively reduced weight in a large percentage of severely obese youth, and can be replicated in a busy primary care office.
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Affiliation(s)
- Meghan Pauley
- Department of Pediatrics, Marshall University School of Medicine, Huntington, West Virginia, USA
| | - Chadd Mays
- Division of Pediatric Critical Care, Helen DeVos Children's Hospital, Grand Rapids, Michigan, USA
| | - James R Bailes
- Hoops Family Children's Hospital, Huntington, West Virginia, USA
| | | | - Mark Castle
- Marshall University School of Medicine, Huntington, West Virginia, USA
| | - Marji McCoy
- Marshall University School of Medicine, Huntington, West Virginia, USA
| | - Casey Patick
- Department of Pediatrics, Marshall University School of Medicine, Huntington, West Virginia, USA
| | - Deborah Preston
- Department of Pediatrics, Marshall University School of Medicine, Huntington, West Virginia, USA
| | - Matthew J R Nudelman
- Department of Pediatrics, Marshall University School of Medicine, Huntington, West Virginia, USA
| | - Krista L Denning
- Department of Pathology, Marshall University School of Medicine, Huntington, West Virginia, USA
| | - Lars Bellner
- Department of Pharmacology, New York Medical College School of Medicine, Valhalla, New York, USA
| | - Joseph Werthammer
- Department of Pediatrics, Marshall University School of Medicine, Huntington, West Virginia, USA
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15
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Discovery and characterization of pentacyclic triterpenoid acids in Styrax as potent and reversible pancreatic lipase inhibitors. J Funct Foods 2020. [DOI: 10.1016/j.jff.2020.104159] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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16
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Hooper L, Martin N, Jimoh OF, Kirk C, Foster E, Abdelhamid AS. Reduction in saturated fat intake for cardiovascular disease. Cochrane Database Syst Rev 2020; 8:CD011737. [PMID: 32827219 PMCID: PMC8092457 DOI: 10.1002/14651858.cd011737.pub3] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Reducing saturated fat reduces serum cholesterol, but effects on other intermediate outcomes may be less clear. Additionally, it is unclear whether the energy from saturated fats eliminated from the diet are more helpfully replaced by polyunsaturated fats, monounsaturated fats, carbohydrate or protein. OBJECTIVES To assess the effect of reducing saturated fat intake and replacing it with carbohydrate (CHO), polyunsaturated (PUFA), monounsaturated fat (MUFA) and/or protein on mortality and cardiovascular morbidity, using all available randomised clinical trials. SEARCH METHODS We updated our searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid) and Embase (Ovid) on 15 October 2019, and searched Clinicaltrials.gov and WHO International Clinical Trials Registry Platform (ICTRP) on 17 October 2019. SELECTION CRITERIA Included trials fulfilled the following criteria: 1) randomised; 2) intention to reduce saturated fat intake OR intention to alter dietary fats and achieving a reduction in saturated fat; 3) compared with higher saturated fat intake or usual diet; 4) not multifactorial; 5) in adult humans with or without cardiovascular disease (but not acutely ill, pregnant or breastfeeding); 6) intervention duration at least 24 months; 7) mortality or cardiovascular morbidity data available. DATA COLLECTION AND ANALYSIS Two review authors independently assessed inclusion, extracted study data and assessed risk of bias. We performed random-effects meta-analyses, meta-regression, subgrouping, sensitivity analyses, funnel plots and GRADE assessment. MAIN RESULTS We included 15 randomised controlled trials (RCTs) (16 comparisons, 56,675 participants), that used a variety of interventions from providing all food to advice on reducing saturated fat. The included long-term trials suggested that reducing dietary saturated fat reduced the risk of combined cardiovascular events by 17% (risk ratio (RR) 0.83; 95% confidence interval (CI) 0.70 to 0.98, 12 trials, 53,758 participants of whom 8% had a cardiovascular event, I² = 67%, GRADE moderate-quality evidence). Meta-regression suggested that greater reductions in saturated fat (reflected in greater reductions in serum cholesterol) resulted in greater reductions in risk of CVD events, explaining most heterogeneity between trials. The number needed to treat for an additional beneficial outcome (NNTB) was 56 in primary prevention trials, so 56 people need to reduce their saturated fat intake for ~four years for one person to avoid experiencing a CVD event. In secondary prevention trials, the NNTB was 53. Subgrouping did not suggest significant differences between replacement of saturated fat calories with polyunsaturated fat or carbohydrate, and data on replacement with monounsaturated fat and protein was very limited. We found little or no effect of reducing saturated fat on all-cause mortality (RR 0.96; 95% CI 0.90 to 1.03; 11 trials, 55,858 participants) or cardiovascular mortality (RR 0.95; 95% CI 0.80 to 1.12, 10 trials, 53,421 participants), both with GRADE moderate-quality evidence. There was little or no effect of reducing saturated fats on non-fatal myocardial infarction (RR 0.97, 95% CI 0.87 to 1.07) or CHD mortality (RR 0.97, 95% CI 0.82 to 1.16, both low-quality evidence), but effects on total (fatal or non-fatal) myocardial infarction, stroke and CHD events (fatal or non-fatal) were all unclear as the evidence was of very low quality. There was little or no effect on cancer mortality, cancer diagnoses, diabetes diagnosis, HDL cholesterol, serum triglycerides or blood pressure, and small reductions in weight, serum total cholesterol, LDL cholesterol and BMI. There was no evidence of harmful effects of reducing saturated fat intakes. AUTHORS' CONCLUSIONS The findings of this updated review suggest that reducing saturated fat intake for at least two years causes a potentially important reduction in combined cardiovascular events. Replacing the energy from saturated fat with polyunsaturated fat or carbohydrate appear to be useful strategies, while effects of replacement with monounsaturated fat are unclear. The reduction in combined cardiovascular events resulting from reducing saturated fat did not alter by study duration, sex or baseline level of cardiovascular risk, but greater reduction in saturated fat caused greater reductions in cardiovascular events.
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Affiliation(s)
- Lee Hooper
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Nicole Martin
- Institute of Health Informatics Research, University College London, London, UK
| | - Oluseyi F Jimoh
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Christian Kirk
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Eve Foster
- Norwich Medical School, University of East Anglia, Norwich, UK
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17
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Hooper L, Abdelhamid AS, Jimoh OF, Bunn D, Skeaff CM. Effects of total fat intake on body fatness in adults. Cochrane Database Syst Rev 2020; 6:CD013636. [PMID: 32476140 PMCID: PMC7262429 DOI: 10.1002/14651858.cd013636] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The ideal proportion of energy from fat in our food and its relation to body weight is not clear. In order to prevent overweight and obesity in the general population, we need to understand the relationship between the proportion of energy from fat and resulting weight and body fatness in the general population. OBJECTIVES To assess the effects of proportion of energy intake from fat on measures of body fatness (including body weight, waist circumference, percentage body fat and body mass index) in people not aiming to lose weight, using all appropriate randomised controlled trials (RCTs) of at least six months duration. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, Clinicaltrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) to October 2019. We did not limit the search by language. SELECTION CRITERIA Trials fulfilled the following criteria: 1) randomised intervention trial, 2) included adults aged at least 18 years, 3) randomised to a lower fat versus higher fat diet, without the intention to reduce weight in any participants, 4) not multifactorial and 5) assessed a measure of weight or body fatness after at least six months. We duplicated inclusion decisions and resolved disagreement by discussion or referral to a third party. DATA COLLECTION AND ANALYSIS We extracted data on the population, intervention, control and outcome measures in duplicate. We extracted measures of body fatness (body weight, BMI, percentage body fat and waist circumference) independently in duplicate at all available time points. We performed random-effects meta-analyses, meta-regression, subgrouping, sensitivity, funnel plot analyses and GRADE assessment. MAIN RESULTS We included 37 RCTs (57,079 participants). There is consistent high-quality evidence from RCTs that reducing total fat intake results in small reductions in body fatness; this was seen in almost all included studies and was highly resistant to sensitivity analyses (GRADE high-consistency evidence, not downgraded). The effect of eating less fat (compared with higher fat intake) is a mean body weight reduction of 1.4 kg (95% confidence interval (CI) -1.7 to -1.1 kg, in 53,875 participants from 26 RCTs, I2 = 75%). The heterogeneity was explained in subgrouping and meta-regression. These suggested that greater weight loss results from greater fat reductions in people with lower fat intake at baseline, and people with higher body mass index (BMI) at baseline. The size of the effect on weight does not alter over time and is mirrored by reductions in BMI (MD -0.5 kg/m2, 95% CI -0.6 to -0.3, 46,539 participants in 14 trials, I2 = 21%), waist circumference (MD -0.5 cm, 95% CI -0.7 to -0.2, 16,620 participants in 3 trials; I2 = 21%), and percentage body fat (MD -0.3% body fat, 95% CI -0.6 to 0.00, P = 0.05, in 2350 participants in 2 trials; I2 = 0%). There was no suggestion of harms associated with low fat diets that might mitigate any benefits on body fatness. The reduction in body weight was reflected in small reductions in LDL (-0.13 mmol/L, 95% CI -0.21 to -0.05), and total cholesterol (-0.23 mmol/L, 95% CI -0.32 to -0.14), with little or no effect on HDL cholesterol (-0.02 mmol/L, 95% CI -0.03 to 0.00), triglycerides (0.01 mmol/L, 95% CI -0.05 to 0.07), systolic (-0.75 mmHg, 95% CI -1.42 to -0.07) or diastolic blood pressure(-0.52 mmHg, 95% CI -0.95 to -0.09), all GRADE high-consistency evidence or quality of life (0.04, 95% CI 0.01 to 0.07, on a scale of 0 to 10, GRADE low-consistency evidence). AUTHORS' CONCLUSIONS Trials where participants were randomised to a lower fat intake versus a higher fat intake, but with no intention to reduce weight, showed a consistent, stable but small effect of low fat intake on body fatness: slightly lower weight, BMI, waist circumference and percentage body fat compared with higher fat arms. Greater fat reduction, lower baseline fat intake and higher baseline BMI were all associated with greater reductions in weight. There was no evidence of harm to serum lipids, blood pressure or quality of life, but rather of small benefits or no effect.
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Affiliation(s)
- Lee Hooper
- Norwich Medical School, University of East Anglia, Norwich, UK
| | | | - Oluseyi F Jimoh
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Diane Bunn
- Norwich Medical School, University of East Anglia, Norwich, UK
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18
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Hooper L, Martin N, Jimoh OF, Kirk C, Foster E, Abdelhamid AS. Reduction in saturated fat intake for cardiovascular disease. Cochrane Database Syst Rev 2020; 5:CD011737. [PMID: 32428300 PMCID: PMC7388853 DOI: 10.1002/14651858.cd011737.pub2] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Reducing saturated fat reduces serum cholesterol, but effects on other intermediate outcomes may be less clear. Additionally, it is unclear whether the energy from saturated fats eliminated from the diet are more helpfully replaced by polyunsaturated fats, monounsaturated fats, carbohydrate or protein. OBJECTIVES To assess the effect of reducing saturated fat intake and replacing it with carbohydrate (CHO), polyunsaturated (PUFA), monounsaturated fat (MUFA) and/or protein on mortality and cardiovascular morbidity, using all available randomised clinical trials. SEARCH METHODS We updated our searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid) and Embase (Ovid) on 15 October 2019, and searched Clinicaltrials.gov and WHO International Clinical Trials Registry Platform (ICTRP) on 17 October 2019. SELECTION CRITERIA Included trials fulfilled the following criteria: 1) randomised; 2) intention to reduce saturated fat intake OR intention to alter dietary fats and achieving a reduction in saturated fat; 3) compared with higher saturated fat intake or usual diet; 4) not multifactorial; 5) in adult humans with or without cardiovascular disease (but not acutely ill, pregnant or breastfeeding); 6) intervention duration at least 24 months; 7) mortality or cardiovascular morbidity data available. DATA COLLECTION AND ANALYSIS Two review authors independently assessed inclusion, extracted study data and assessed risk of bias. We performed random-effects meta-analyses, meta-regression, subgrouping, sensitivity analyses, funnel plots and GRADE assessment. MAIN RESULTS We included 15 randomised controlled trials (RCTs) (16 comparisons, ~59,000 participants), that used a variety of interventions from providing all food to advice on reducing saturated fat. The included long-term trials suggested that reducing dietary saturated fat reduced the risk of combined cardiovascular events by 21% (risk ratio (RR) 0.79; 95% confidence interval (CI) 0.66 to 0.93, 11 trials, 53,300 participants of whom 8% had a cardiovascular event, I² = 65%, GRADE moderate-quality evidence). Meta-regression suggested that greater reductions in saturated fat (reflected in greater reductions in serum cholesterol) resulted in greater reductions in risk of CVD events, explaining most heterogeneity between trials. The number needed to treat for an additional beneficial outcome (NNTB) was 56 in primary prevention trials, so 56 people need to reduce their saturated fat intake for ~four years for one person to avoid experiencing a CVD event. In secondary prevention trials, the NNTB was 32. Subgrouping did not suggest significant differences between replacement of saturated fat calories with polyunsaturated fat or carbohydrate, and data on replacement with monounsaturated fat and protein was very limited. We found little or no effect of reducing saturated fat on all-cause mortality (RR 0.96; 95% CI 0.90 to 1.03; 11 trials, 55,858 participants) or cardiovascular mortality (RR 0.95; 95% CI 0.80 to 1.12, 10 trials, 53,421 participants), both with GRADE moderate-quality evidence. There was little or no effect of reducing saturated fats on non-fatal myocardial infarction (RR 0.97, 95% CI 0.87 to 1.07) or CHD mortality (RR 0.97, 95% CI 0.82 to 1.16, both low-quality evidence), but effects on total (fatal or non-fatal) myocardial infarction, stroke and CHD events (fatal or non-fatal) were all unclear as the evidence was of very low quality. There was little or no effect on cancer mortality, cancer diagnoses, diabetes diagnosis, HDL cholesterol, serum triglycerides or blood pressure, and small reductions in weight, serum total cholesterol, LDL cholesterol and BMI. There was no evidence of harmful effects of reducing saturated fat intakes. AUTHORS' CONCLUSIONS The findings of this updated review suggest that reducing saturated fat intake for at least two years causes a potentially important reduction in combined cardiovascular events. Replacing the energy from saturated fat with polyunsaturated fat or carbohydrate appear to be useful strategies, while effects of replacement with monounsaturated fat are unclear. The reduction in combined cardiovascular events resulting from reducing saturated fat did not alter by study duration, sex or baseline level of cardiovascular risk, but greater reduction in saturated fat caused greater reductions in cardiovascular events.
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Affiliation(s)
- Lee Hooper
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Nicole Martin
- Institute of Health Informatics Research, University College London, London, UK
| | - Oluseyi F Jimoh
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Christian Kirk
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Eve Foster
- Norwich Medical School, University of East Anglia, Norwich, UK
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Chen SF, Hu TM, Lan TH, Chiu HJ, Sheen LY, Loh EW. Severity of psychosis syndrome and change of metabolic abnormality in chronic schizophrenia patients: Severe negative syndrome may be related to a distinct lipid pathophysiology. Eur Psychiatry 2020; 29:167-71. [DOI: 10.1016/j.eurpsy.2013.04.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Revised: 03/30/2013] [Accepted: 04/21/2013] [Indexed: 12/01/2022] Open
Abstract
AbstractBackground:Metabolic abnormality is common among schizophrenia patients. Some metabolic traits were found associated with subgroups of schizophrenia patients.Objectives:We examined a possible relationship between metabolic abnormality and psychosis profile in schizophrenia patients.Method:Three hundred and seventy-two chronic schizophrenia patients treated with antipsychotics for more than 2 years were assessed with the Positive and Negative Syndrome Scale. A set of metabolic traits was measured at scheduled checkpoints between October 2004 and September 2006.Results:Multiple regressions adjusted for sex showed negative correlations between body mass index (BMI) and total score and all subscales; triglycerides (TG) was negatively correlated with total score and negative syndrome, while HDLC was positively correlated with negative syndrome. When sex interaction was concerned, total score was negatively correlated with BMI but not with others; negative syndrome was negatively correlated with BMI and positively with HDLC. No metabolic traits were correlated with positive syndrome or general psychopathology.Conclusions:Loss of body weight is a serious health problem in schizophrenia patients with severe psychosis syndrome, especially the negative syndrome. Schizophrenia patients with severe negative syndrome may have a distinct lipid pathophysiology in comparison with those who were less severe in the domain.
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Gunner F, Lindsay M, Brown P, Shaw A, Davey T, Lanham-New S, Griffin B, Fallowfield J. Impact of the occupational environment of a submerged submarine on cardiometabolic health of Royal Navy submariners. Occup Environ Med 2020; 77:368-373. [PMID: 32179635 DOI: 10.1136/oemed-2019-106292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 02/28/2020] [Accepted: 03/01/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To determine the effect of prolonged exposure to a submarine environment on biomarkers of cardiometabolic risk in Royal Navy (RN) submariners. METHODS Serum lipids (cholesterol (C), triglyceride (TG), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), non-HDL-C), glucose, insulin and anthropometrics were compared within three RN submarine crews before and after submerged patrols of 12 or 6 weeks, and with a crew that remained ashore (SUB-HOME). Dietary intake and activity patterns were self-reported during each patrol. Differences were assessed in crew characteristics using one-way analysis of variance and in serum lipids using paired t-tests. RESULTS Postpatrol, the mean body weight of submerged crews decreased (-1.4±4.2 kg, p=0.0001), but increased in SUB-HOME (1.9±1.8 kg, p=0.0001). Modest improvements in serum lipids (mean individual change (mmol/L); C=-0.3±0.7, p=0.0001; TG=-0.3±0.7, p=0.0001; HDL-C=-0.1±0.3, p=0.0001; non-HDL-C=-0.2±0.6, p=0.012), glucose (-0.2±0.5, p=0.0001) and insulin (-1.5±4.6 mU/L, p=0.001) were observed in submerged crews. Changes in serum lipids were positively associated with changes in body weight within crews combined. Energy intake was maintained during submerged patrols but was lower compared with non-submerged (11 139±2792 vs. 9617±2466 kJ, p=0.001; 11 062±2775 vs. 9632±2682 kJ, p=0.003). CONCLUSIONS The environment of a submerged submarine produced no adverse effects on serum biomarkers of cardiometabolic risk in crew. Conversely, modest improvements in these biomarkers were associated with a decrease in body weight.
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Affiliation(s)
- Frances Gunner
- Environmental and Medicine Sciences, Institute of Naval Medicine, Gosport, UK
| | - Michael Lindsay
- Underwater Medicine Division, Institute of Naval Medicine, Gosport, UK
| | - Pieter Brown
- Environmental and Medicine Sciences, Institute of Naval Medicine, Gosport, UK
| | - Anneliese Shaw
- Environmental and Medicine Sciences, Institute of Naval Medicine, Gosport, UK
| | - Trish Davey
- Environmental and Medicine Sciences, Institute of Naval Medicine, Gosport, UK
| | - Susan Lanham-New
- Department of Nutritional Sciences, University of Surrey Faculty of Health and Medical Sciences, Guildford, Surrey, UK
| | - Bruce Griffin
- Department of Nutritional Sciences, University of Surrey Faculty of Health and Medical Sciences, Guildford, Surrey, UK
| | - Joanne Fallowfield
- Environmental and Medicine Sciences, Institute of Naval Medicine, Gosport, UK
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21
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Santa-Maria CA, Coughlin JW, Sharma D, Armanios M, Blackford AL, Schreyer C, Dalcin A, Carpenter A, Jerome GJ, Armstrong DK, Chaudhry M, Cohen GI, Connolly RM, Fetting J, Miller RS, Smith KL, Snyder C, Wolfe A, Wolff AC, Huang CY, Appel LJ, Stearns V. The Effects of a Remote-based Weight Loss Program on Adipocytokines, Metabolic Markers, and Telomere Length in Breast Cancer Survivors: the POWER-Remote Trial. Clin Cancer Res 2020; 26:3024-3034. [PMID: 32071117 DOI: 10.1158/1078-0432.ccr-19-2935] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/29/2019] [Accepted: 02/14/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE We initiated a clinical trial to determine the proportion of breast cancer survivors achieving ≥5% weight loss using a remotely delivered weight loss intervention (POWER-remote) or a self-directed approach, and to determine the effects of the intervention on biomarkers of cancer risk including metabolism, inflammation, and telomere length. EXPERIMENTAL DESIGN Women with stage 0-III breast cancer, who completed local therapy and chemotherapy, with a body mass index ≥25 kg/m2 were randomized to a 12-month intervention (POWER-remote) versus a self-directed approach. The primary objective was to determine the number of women who achieved at least 5% weight loss at 6 months. We assessed baseline and 6-month change in a panel of adipocytokines (adiponectin, leptin, resistin, HGF, NGF, PAI1, TNFα, MCP1, IL1β, IL6, and IL8), metabolic factors (insulin, glucose, lipids, hs-CRP), and telomere length in peripheral blood mononuclear cells. RESULTS From 2013 to 2015, 96 women were enrolled, and 87 were evaluable for the primary analysis; 45 to POWER-remote and 42 to self-directed. At 6 months, 51% of women randomized to POWER-remote lost ≥5% of their baseline body weight, compared with 12% in the self-directed arm [OR, 7.9; 95% confidence interval (CI), 2.6-23.9; P = 0.0003]; proportion were similar at 12 months (51% vs 17%, respectively, P = 0.003). Weight loss correlated with significant decreases in leptin, and favorable modulation of inflammatory cytokines and lipid profiles. There was no significant change in telomere length at 6 months. CONCLUSIONS A remotely delivered weight loss intervention resulted in significant weight loss in breast cancer survivors, and favorable effects on several biomarkers.
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Affiliation(s)
- Cesar A Santa-Maria
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Janelle W Coughlin
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Dipali Sharma
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mary Armanios
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Amanda L Blackford
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Colleen Schreyer
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Arlene Dalcin
- The Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ashley Carpenter
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Gerald J Jerome
- Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Kinesiology, Towson University, Towson, Maryland
| | - Deborah K Armstrong
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Gary I Cohen
- Greater Baltimore Medical Center, Baltimore, Maryland
| | - Roisin M Connolly
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - John Fetting
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Robert S Miller
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Karen L Smith
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Claire Snyder
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Andrew Wolfe
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Antonio C Wolff
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Chiung-Yu Huang
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Lawrence J Appel
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Vered Stearns
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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22
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Hafez S, Khan MB, Awad ME, Wagner JD, Hess DC. Short-Term Acute Exercise Preconditioning Reduces Neurovascular Injury After Stroke Through Induced eNOS Activation. Transl Stroke Res 2019; 11:851-860. [PMID: 31858409 DOI: 10.1007/s12975-019-00767-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 10/24/2019] [Accepted: 12/05/2019] [Indexed: 12/18/2022]
Abstract
Physical exercise is known to reduce cardiovascular risk but its role in ischemic stroke is not clear. It was previously shown that an acute single bout of exercise reduced increased eNOS activation in the heart and reduced myocardial infarction. However, the impact of a single bout or short-term exercise on eNOS-induced neuroprotection after stroke was not previously studied. Accordingly, this study was designed to test the hypothesis that short-term acute exercise can provide "immediate neuroprotection" and improve stroke outcomes through induced eNOS activation. Male Wistar rats (300 g) were subjected to HIIT treadmill exercise for 4 days (25 min/day), break for 2 days, and then one acute bout for 30 min. Exercised animals were subjected to thromboembolic stroke 1 h, 6 h, 24 h, or 72 h after the last exercise session. At 24 h after stroke, control (sedentary) and exercised rats were tested for neurological outcomes, infarct size, and edema. The expression of active eNOS (p-S1177-eNOS) and active AMPK (p-T172-AMPK) was measured in the brain, cerebral vessels, and aorta. In an additional cohort, animals were treated with the eNOS inhibitor, L-NIO (I.P, 20 mg/kg), and stroked 1 h after exercise and compared with non-exercise animals. Acute exercise significantly reduced infarct size, edema, and improved functional outcomes, and significantly increased the expression of peNOS and pAMPK in the brain, cerebral vessels, and aorta. eNOS inhibition abolished the exercise-induced improvement in outcomes. Short-term acute preconditioning exercise reduced the neurovascular injury and improved functional outcomes after stroke through eNOS activation.
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Affiliation(s)
- Sherif Hafez
- Department of Neurology, Augusta University, Augusta, GA, 30912, USA. .,Department of Pharmaceutical Sciences, College of Pharmacy, Larkin University, 18301 N Miami Ave Suite 1, Miami, FL, 33169, USA.
| | | | - Mohamed E Awad
- Department of Oral Biology, Augusta University, Augusta, GA, 30912, USA
| | - Jesse D Wagner
- Department of Neurology, Augusta University, Augusta, GA, 30912, USA
| | - David C Hess
- Department of Neurology, Augusta University, Augusta, GA, 30912, USA
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Pedersen LR, Olsen RH, Anholm C, Astrup A, Eugen-Olsen J, Fenger M, Simonsen L, Walzem RL, Haugaard SB, Prescott E. Effects of 1 year of exercise training versus combined exercise training and weight loss on body composition, low-grade inflammation and lipids in overweight patients with coronary artery disease: a randomized trial. Cardiovasc Diabetol 2019; 18:127. [PMID: 31575375 PMCID: PMC6774219 DOI: 10.1186/s12933-019-0934-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 09/21/2019] [Indexed: 12/18/2022] Open
Abstract
Background Dyslipidaemia and low-grade inflammation are central in atherogenesis and linked to overweight and physical inactivity. Lifestyle changes are important in secondary prevention of coronary artery disease (CAD). We compared the effects of combined weight loss and interval training with interval training alone on physical fitness, body composition, dyslipidaemia and low-grade inflammation in overweight, sedentary participants with CAD. Methods Seventy CAD patients, BMI 28–40 kg/m2 and age 45–75 years were randomised to (1) 12 weeks’ aerobic interval training (AIT) at 90% of peak heart rate three times/week followed by 40 weeks’ AIT twice weekly or (2) a low energy diet (LED) (800–1000 kcal/day) for 8–10 weeks followed by 40 weeks’ weight maintenance including AIT twice weekly and a high-protein/low-glycaemic load diet. Effects of the intervention were evaluated by physical fitness, body weight and composition. Dyslipidaemia was described using both biochemical analysis of lipid concentrations and lipoprotein particle subclass distribution determined by density profiling. Low-grade inflammation was determined by C-reactive protein, soluble urokinase-type plasminogen activator receptor and tumour necrosis factor α. Effects on continuous outcomes were tested by mixed-models analysis. Results Twenty-six (74%) AIT and 29 (83%) LED + AIT participants completed the study. At baseline subject included 43 (78%) men; subjects averages were: age 63 years (6.2), body weight 95.9 kg (12.2) and VO2peak 20.7 mL O2/kg/min (4.9). Forty-six (84%) had pre-diabetes (i.e. impaired fasting glucose and/or impaired glucose tolerance). LED + AIT reduced body weight by 7.2 kg (− 8.4; − 6.1) and waist circumference by 6.6 cm (− 7.7; − 5.5) compared to 1.7 kg (− 0.7; − 2.6) and 3.3 cm (− 5.1; − 1.5) after AIT (within-group p < 0.001, between-group p < 0.001 and p = 0.018, respectively). Treatments caused similar changes in VO2peak and lowering of total cholesterol, triglycerides, non-HDL cholesterol and low-grade inflammation. A shift toward larger HDL particles was seen following LED + AIT while AIT elicited no change. Conclusions Both interventions were feasible. Both groups obtained improvements in VO2peak, serum-lipids and inflammation with superior weight loss and greater central fat loss following LED + AIT. Combined LED induced weight loss and exercise can be recommended to CAD patients. Trial registration NCT01724567, November 12, 2012, retrospectively registered (enrolment ended in April 2013).
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Affiliation(s)
- Lene Rørholm Pedersen
- Department of Cardiology, Bispebjerg University Hospital, University of Copenhagen, Building 67, 1st, Bispebjerg Bakke 23, 2400, Copenhagen, NW, Denmark. .,Department of Cardiology, University Hospital of Zealand, Roskilde, University of Copenhagen, Copenhagen, Denmark.
| | - Rasmus Huan Olsen
- Department of Cardiology, Bispebjerg University Hospital, University of Copenhagen, Building 67, 1st, Bispebjerg Bakke 23, 2400, Copenhagen, NW, Denmark
| | - Christian Anholm
- Department of Internal Medicine, Glostrup University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Eugen-Olsen
- Clinical Research Centre, Hvidovre University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Mogens Fenger
- Department of Medical Biochemistry, Genetics and Molecular Biochemistry, Hvidovre University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Lene Simonsen
- Department of Clinical Physiology and Nuclear Medicine, Bispebjerg University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Rosemary L Walzem
- Faculty of Nutrition, Texas A & M University, College Station, TX, USA
| | - Steen Bendix Haugaard
- Department of Internal Medicine, Amager and Hvidovre University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Eva Prescott
- Department of Cardiology, Bispebjerg University Hospital, University of Copenhagen, Building 67, 1st, Bispebjerg Bakke 23, 2400, Copenhagen, NW, Denmark
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Dietary weight loss intervention improves subclinical atherosclerosis and oxidative stress markers in leukocytes of obese humans. Int J Obes (Lond) 2019; 43:2200-2209. [PMID: 30622308 DOI: 10.1038/s41366-018-0309-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 11/09/2018] [Accepted: 12/06/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND The relationship between caloric restriction-mediated weight loss and the generation of ROS and its effects on atherosclerotic markers in obesity is not fully understood. Therefore, we set out to investigate whether dietary weight loss intervention improves markers of oxidative stress in leukocytes and subclinical parameters of atherosclerosis. SUBJECTS AND METHODS This was an interventional study of 59 obese subjects (BMI > 35 kg/m2) who underwent 6 months of dietary therapy, including a 6-week very-low-calorie diet (VLCD) followed by an 18-week low-calorie diet (LCD). We determined clinical parameters, inflammatory markers-hsCRP, TNFα and NFκB -, oxidative stress parameters-total superoxide, glutathione, catalase activity and protein carbonyl groups-, soluble cellular adhesion molecules-sICAM, sP-selectin, sPSGL-1 -, myeloperoxidase (MPO), leukocyte-endothelium cell interactions-rolling flux, velocity and adhesion-and LDL subfractions, before and after the dietary intervention. RESULTS After losing weight, an improvement was observed in the patients' anthropometric, blood pressure and metabolic parameters, and was associated with reduced inflammatory response (hsCRP, TNFα and NFκB). Oxidative stress parameters improved, since superoxide production and protein carbonyl content were reduced and antioxidant systems were enhanced. In addition, a significant reduction of subclinical markers of atherosclerosis-small and dense LDL particles, MPO, sP-selectin and leukocyte adhesion-and an increase in soluble PSGL-1 were reported. CONCLUSIONS Our findings reveal that the improvement of subclinical atherosclerotic markers after dietary weight loss intervention is associated with a reduction of oxidative stress in leukocytes and inflammatory pathways, suggesting that these are the underlying mechanisms responsible for the reduced risk of cardiovascular disease in obese subjects after losing weight.
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25
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Dansinger M, Williams PT, Superko HR, Asztalos BF, Schaefer EJ. Effects of weight change on HDL-cholesterol and its subfractions in over 28,000 men and women. J Clin Lipidol 2018; 13:308-316. [PMID: 30665769 DOI: 10.1016/j.jacl.2018.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 10/25/2018] [Accepted: 12/09/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Changes in body mass index (ΔBMI) have well-established relationships to changes in high-density lipoprotein (ΔHDL)-cholesterol concentrations; however, their relationships to ΔHDL subfractions are less well understood. OBJECTIVE Assess the associations between ΔHDL and ΔBMI in a very large cohort. METHOD Age and sex-adjusted Δapo A1 concentrations were measured within 10 HDL subfractions in 14,121 women and 13,969 men using two-dimensional HDL-mapping. Significance was identified at .01 < P ≤ .05 (*), .001 < P ≤ .01 (†), .0001 < P ≤ .001 (‡), and P ≤ .0001 (§). RESULTS ΔBMI was significantly associated with Δα-1 (very large HDL, slope ± SE, females: -0.39 ± 0.07§; males: -0.51 ± 0.05§), Δα-3 (medium HDL, females: 0.18 ± 0.04§; males: 0.19 ± 0.04§), and Δα-4 (small HDL, females: 0.14 ± 0.03§; males: 0.15 ± 0.04§ mg/dL per kg/m2). As a percent of baseline, the changes in α-1 per ΔBMI were nearly twice as great as the changes in HDL-cholesterol per ΔBMI in both males (-1.53% vs -0.77%) and females (-0.79% vs -0.42%). HDL-cholesterol decreased significantly in healthy-weight patients who became overweight, overweight patients who became class I or class II obese, class I obese patients who became class II obese, and class II obese patients who became class III. In contrast, HDL-cholesterol increased in class III obese patients who became class II or class I, class II obese patients who became class I or overweight, class I patients who became overweight or healthy weight, overweight patients who became healthy weight, and healthy weight patients who became underweight. CONCLUSIONS Weight change significantly affects HDL-cholesterol concentrations throughout the obesity spectrum. ΔBMI's effect on Δα-1 was nearly twice as great as its effect on HDL-cholesterol.
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Affiliation(s)
- Michael Dansinger
- Division of Endocrinology, Diabetes and Metabolism, Boston Heart Diagnostics, Framingham, MA, USA; Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, MA, USA.
| | - Paul T Williams
- Division of Endocrinology, Diabetes and Metabolism, Boston Heart Diagnostics, Framingham, MA, USA
| | - H Robert Superko
- Division of Endocrinology, Diabetes and Metabolism, Boston Heart Diagnostics, Framingham, MA, USA
| | - Bela F Asztalos
- Cardiovascular Nutrition Laboratory, USDA Human Nutrition Research Center at Tufts University, Boston, MA
| | - Ernst J Schaefer
- Division of Endocrinology, Diabetes and Metabolism, Boston Heart Diagnostics, Framingham, MA, USA; Cardiovascular Nutrition Laboratory, USDA Human Nutrition Research Center at Tufts University, Boston, MA
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Ghanemi A, Yoshioka M, St-Amand J. Broken Energy Homeostasis and Obesity Pathogenesis: The Surrounding Concepts. J Clin Med 2018; 7:E453. [PMID: 30463389 PMCID: PMC6262529 DOI: 10.3390/jcm7110453] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 11/15/2018] [Accepted: 11/19/2018] [Indexed: 11/16/2022] Open
Abstract
Obesity represents an abnormal fat accumulation resulting from energy imbalances. It represents a disease with heavy consequences on population health and society economy due to its related morbidities and epidemic proportion. Defining and classifying obesity and its related parameters of evaluation is the first challenge toward understanding this multifactorial health problem. Therefore, within this review we report selected illustrative examples of the underlying mechanisms beyond the obesity pathogenesis which is systemic rather than limited to fat accumulation. We also discuss the gut-brain axis and hormones as the controllers of energy homeostasis and report selected impacts of obesity on the key metabolic tissues. The concepts of "broken energy balance" is detailed as the obesity starting key step. Sleep shortage and psychological factors are also reported with influences on obesity development. Importantly, describing such mechanistic pathways would allow clinicians, biologists and researchers to develop and optimize approaches and methods in terms of diagnosis, classification, clinical evaluation, treatment and prognosis of obesity.
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Affiliation(s)
- Abdelaziz Ghanemi
- Department of Molecular Medicine, Faculty of Medicine, Laval University, Quebec G1V 0A6, Canada.
- Functional Genomics Laboratory, CREMI, Québec Genome Center, CHUL-CHU de Québec Research Center, Québec, Québec G1V 4G2, Canada.
| | - Mayumi Yoshioka
- Functional Genomics Laboratory, CREMI, Québec Genome Center, CHUL-CHU de Québec Research Center, Québec, Québec G1V 4G2, Canada.
| | - Jonny St-Amand
- Department of Molecular Medicine, Faculty of Medicine, Laval University, Quebec G1V 0A6, Canada.
- Functional Genomics Laboratory, CREMI, Québec Genome Center, CHUL-CHU de Québec Research Center, Québec, Québec G1V 4G2, Canada.
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Cook NR, Appel LJ, Whelton PK. Weight change and mortality: Long-term results from the trials of hypertension prevention. J Clin Hypertens (Greenwich) 2018; 20:1666-1673. [PMID: 30390361 DOI: 10.1111/jch.13418] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/18/2018] [Accepted: 08/03/2018] [Indexed: 12/31/2022]
Abstract
Although weight loss improves blood pressure (BP), its association with mortality remains unclear. In the Trials of Hypertension Prevention (TOHP), individuals aged 30-54 years with high normal BP were randomized to weight loss, usual care or other intervention over 18 months (TOHP I) or 3-4 years (TOHP II), with average 23-year mortality follow-up. We examined mortality and (a) randomized weight loss and (b) observed weight change among all with high baseline weight. Among 2964 randomized participants, 227 deaths occurred, with no intervention difference (hazard ratio (HR) = 0.97, 95% confidence interval (CI) = 0.75-1.26, P = 0.84). Among 3828 high-weight participants, weight change was directly related to mortality (HR = 1.14 per 5% change, 95% CI = 1.02-1.28, P = 0.019). During the trial 15% lost >5% (HR = 0.82), 29% lost 0-<=5% (HR = 0.94), 41% gained 0-<5% (reference), and 16% gained >5% (HR = 1.29) (P-trend = 0.046). This is consistent with a long-term beneficial effect of presumed intentional weight loss on mortality.
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Affiliation(s)
- Nancy R Cook
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Lawrence J Appel
- Welch Center for Prevention, Epidemiology, and Clinical Research, The Johns Hopkins University, Baltimore, Maryland
| | - Paul K Whelton
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
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Woudberg NJ, Mendham AE, Katz AA, Goedecke JH, Lecour S. Exercise intervention alters HDL subclass distribution and function in obese women. Lipids Health Dis 2018; 17:232. [PMID: 30301473 PMCID: PMC6178267 DOI: 10.1186/s12944-018-0879-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 09/27/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Obesity is associated with a change in high-density lipoprotein (HDL) function and subclass. Exercise training reduces cardiovascular risk in obese patients. We aimed to explore the effect of an exercise training stimulus on HDL functionality and subclass in obese women. METHODS Thirty-two obese black South African women were randomly assigned to exercise (combined aerobic and resistance exercise) or control (no exercise) conditions for 12-weeks. Pre- and post-testing included venous blood sampling for analysis of lipid profile and HDL functionality, by measuring cellular cholesterol efflux capacity, reduction in endothelial vascular cell adhesion molecule (VCAM) expression (anti-inflammatory function), paraoxonase (PON) (antioxidative function) and platelet activating factor acetylhydrolase (PAF-AH) activities (anti-thrombotic function). PON-1 and PAF-AH expression were determined in serum and in isolated HDL using Western blotting. Levels of large, intermediate and small HDL subclasses were measured using the Lipoprint® system. RESULTS Exercise training resulted in a decrease in body mass index (- 1.0 ± 0.5% vs + 1.2 ± 0.6%, p = 0.010), PON activity (- 8.7 ± 2.4% vs + 1.1 ± 3.0%, p = 0.021), PAF-AH serum expression (- 22.1 ± 8.0% vs + 16.9 ± 9.8, p = 0.002), and the distribution of small HDL subclasses (- 10.1 ± 5.4% vs + 15.7 ± 6.6%, p = 0.004) compared to controls. Exercise did not alter HDL cellular cholesterol efflux capacity and anti-inflammatory function. CONCLUSIONS These results demonstrate the potential for exercise training to modify HDL subclass distribution and HDL function in obese women. TRIAL REGISTRATION Clinical trials number: PACTR201711002789113 .
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Affiliation(s)
- Nicholas J Woudberg
- Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| | - Amy E Mendham
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.,Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Arieh A Katz
- UCT Research Unit for Receptor biology, Department of Integrative Biomedical Sciences and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Julia H Goedecke
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.,Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Sandrine Lecour
- Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Wu C, Han X, Yan X, Shang X, Zhang L, He M. Associations between physical activity and cataract treated surgically in patients with diabetes: findings from the 45 and Up Study. Br J Ophthalmol 2018; 103:1099-1105. [PMID: 30269101 DOI: 10.1136/bjophthalmol-2018-312407] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 07/19/2018] [Accepted: 09/04/2018] [Indexed: 01/24/2023]
Abstract
AIM To investigate the association between physical activity (PA) and incidence of cataract surgery among patients with diabetes. METHODS We obtained data from all diabetic subjects aged 45-65 years from the baseline of the prospective 45 and Up Study from 2006 to 2009 and linked to the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) until 2016. Diabetes was defined as self-reported on questionnaire or diabetes medication history based on PBS. Cataract surgery was determined based on the MBS, and metabolic equivalent intensity level number of PA sessions per week was used to assess PA. Cox regression was used to assess the association between baseline PA and cataract surgery during the follow-up. RESULTS A total of 9113 diabetic participants in the 45 and Up Study were included in the current analysis with a mean age of 57.3±5.2 years (43.6% female). During a mean follow-up of 8.8 years, 950 participants (10.4% of baseline) received cataract surgery with a corresponding incidence of 12.4/1000 person-years. Cox regression analysis showed that people with less PA (p=0.01), older age (p<0.001), female gender (p<0.001), higher educational level (p<0.001) and longer diabetic duration (p<0.001) had significantly higher cataract surgery risk. Participants with a PA level of ≥14 sessions per week had 19% decreased risk of cataract surgery compared to those with <5 sessions per week. Stratification analysis showed that participants with more obesity (p value for interaction=0.03), not taking insulin (p value for interaction=0.01) and without cardiovascular disease (p value for interaction=0.008) could benefit significantly more from PA in reducing their cataract surgery risk. CONCLUSIONS More vigorous PA was independently associated with a reduced risk of cataract surgery in working-aged patients with diabetes.
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Affiliation(s)
- Changfan Wu
- Department of Ophthalmology, Yijishan Hospital Wannan Medical College, Wuhu, China.,Centre for Eye Research Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
| | - Xiaotong Han
- Centre for Eye Research Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia.,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xixi Yan
- Centre for Eye Research Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia.,Eye Center, Renmin Hospital of Wuhan University, Eye Institute of Wuhan University, Wuhan, China
| | - Xianwen Shang
- Centre for Eye Research Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
| | - Lei Zhang
- Centre for Eye Research Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.,Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Victoria, Australia.,Research Centre for Public Health, Tsinghua University, Beijing, China
| | - Mingguang He
- Centre for Eye Research Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia .,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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Ghanemi A, St-Amand J. Redefining obesity toward classifying as a disease. Eur J Intern Med 2018; 55:20-22. [PMID: 29807850 DOI: 10.1016/j.ejim.2018.05.025] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 04/19/2018] [Accepted: 05/21/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Abdelaziz Ghanemi
- CREMI, CHU de Québec Research Center, Quebec, Canada; Department of Molecular Medicine, Faculty of Medicine, Laval University, Quebec, Canada
| | - Jonny St-Amand
- CREMI, CHU de Québec Research Center, Quebec, Canada; Department of Molecular Medicine, Faculty of Medicine, Laval University, Quebec, Canada.
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Bray GA, Heisel WE, Afshin A, Jensen MD, Dietz WH, Long M, Kushner RF, Daniels SR, Wadden TA, Tsai AG, Hu FB, Jakicic JM, Ryan DH, Wolfe BM, Inge TH. The Science of Obesity Management: An Endocrine Society Scientific Statement. Endocr Rev 2018; 39:79-132. [PMID: 29518206 PMCID: PMC5888222 DOI: 10.1210/er.2017-00253] [Citation(s) in RCA: 464] [Impact Index Per Article: 77.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 12/02/2017] [Indexed: 12/19/2022]
Abstract
The prevalence of obesity, measured by body mass index, has risen to unacceptable levels in both men and women in the United States and worldwide with resultant hazardous health implications. Genetic, environmental, and behavioral factors influence the development of obesity, and both the general public and health professionals stigmatize those who suffer from the disease. Obesity is associated with and contributes to a shortened life span, type 2 diabetes mellitus, cardiovascular disease, some cancers, kidney disease, obstructive sleep apnea, gout, osteoarthritis, and hepatobiliary disease, among others. Weight loss reduces all of these diseases in a dose-related manner-the more weight lost, the better the outcome. The phenotype of "medically healthy obesity" appears to be a transient state that progresses over time to an unhealthy phenotype, especially in children and adolescents. Weight loss is best achieved by reducing energy intake and increasing energy expenditure. Programs that are effective for weight loss include peer-reviewed and approved lifestyle modification programs, diets, commercial weight-loss programs, exercise programs, medications, and surgery. Over-the-counter herbal preparations that some patients use to treat obesity have limited, if any, data documenting their efficacy or safety, and there are few regulatory requirements. Weight regain is expected in all patients, especially when treatment is discontinued. When making treatment decisions, clinicians should consider body fat distribution and individual health risks in addition to body mass index.
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Affiliation(s)
- George A Bray
- Department of Clinical Obesity, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
| | - William E Heisel
- Institute of Health Metrics and Evaluation University of Washington, Seattle, Washington
| | - Ashkan Afshin
- Institute of Health Metrics and Evaluation University of Washington, Seattle, Washington
| | | | - William H Dietz
- Redstone Global Center for Prevention and Wellness, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia
| | - Michael Long
- Redstone Global Center for Prevention and Wellness, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia
| | | | - Stephen R Daniels
- Department of Pediatrics, University of Colorado Children Hospital, Denver, Colorado
| | - Thomas A Wadden
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Adam G Tsai
- Kaiser Permanente Colorado, Denver, Colorado
| | - Frank B Hu
- Department of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Donna H Ryan
- Department of Clinical Obesity, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
| | - Bruce M Wolfe
- Oregon Health and Science University, Portland, Oregon
| | - Thomas H Inge
- Department of Surgery, University of Colorado Denver, Aurora, Colorado
- Children’s Hospital Colorado, Aurora, Colorado
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32
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Rosenkilde M, Rygaard L, Nordby P, Nielsen LB, Stallknecht B. Exercise and weight loss effects on cardiovascular risk factors in overweight men. J Appl Physiol (1985) 2018. [PMID: 29543138 DOI: 10.1152/japplphysiol.01092.2017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Both exercise training and weight loss reduce cardiovascular risk, but the independent importance of the two strategies is unclear. We aimed to investigate independent and combined effects of exercise training and weight loss on lipoproteins and dyslipidemia in overweight sedentary men. Sixty individuals were randomized to 12 wk of endurance training (T), energy-reduced diet (D), training and energy increased diet (T-iD), or control (C). Equal energetic deficits (-600 kcal/day) were prescribed by exercise for T and caloric restriction for D. T-iD completed similar exercise but remained in energy balance due to the dietary replacement of calories expended during exercise. Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein (apo)B and A1, pre-β-HDL, and susceptibility of LDL-C to oxidation were measured. Body weight was reduced similarly between T (-5.9 ± 0.7 kg) and D (-5.2 ± 0.8 kg), whereas T-iD (-1.0 ± 0.5 kg) and C (0.1 ± 0.6 kg) remained weight stable. Plasma TC, LDL-C, and apolipoprotein B were reduced in T compared with C ( P < 0.001 for both), but this was not observed for D ( P > 0.17). Changes in TC and LDL-C were associated with changes in body weight and body fat ( P < 0.01). In T-iD, increases in HDL-C and apolipoprotein A1 were observed ( P < 0.001). In conclusion, an exercise-induced decline in body weight reduces proatherogenic apoB-containing lipoproteins, whereas exercise compensated by energy intake increases the key component of reverse cholesterol transport, i.e., apoA1-containing HDL-C. NEW & NOTEWORTHY Exercise has additive effects in lowering plasma lipoprotein particles to diet-induced weight loss in individuals with increased cardiovascular risk. In the present study, we investigated whether training per se would have beneficial cardiovascular effects. We found that 3 mo of exercise-induced weight loss reduced proatherogenic lipoproteins, whereas endurance training without weight loss improved factors involved in reverse cholesterol transport in a group of overweight sedentary men.
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Affiliation(s)
- Mads Rosenkilde
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, Universityof Copenhagen, Copenhagen , Denmark
| | - Lisbeth Rygaard
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, Universityof Copenhagen, Copenhagen , Denmark
| | - Pernille Nordby
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, Universityof Copenhagen, Copenhagen , Denmark
| | - Lars Bo Nielsen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, Universityof Copenhagen, Copenhagen , Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen , Denmark.,Rigshospitalet, Copenhagen , Denmark
| | - Bente Stallknecht
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, Universityof Copenhagen, Copenhagen , Denmark
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Rezaei R, Nasoohi S, Haghparast A, Khodagholi F, Bigdeli MR, Nourshahi M. High intensity exercise preconditioning provides differential protection against brain injury following experimental stroke. Life Sci 2018. [PMID: 29522768 DOI: 10.1016/j.lfs.2018.03.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIMS Different modes of physical activity provide cerebrovascular protection against thromboembolic events. Based on recent reports high intensity exercise protocols appear to raise cerebral VEGF levels leading to efficient cerebral angiogenesis. The present study aims to address if moderate continuous training (MCT) and high intensity interval training (HIT) differ in preconditioning against ischemic stroke. METHODS Wistar rats were subjected to HIT or MCT for 8 weeks before transient middle cerebral artery occlusion (tMCAO) surgery. As indexes for improved angiogenic signals, VEGF-A and its pivotal receptor VEGF-R2 were immunoblotted just before occlusive stroke. KEY FINDINGS Both training protocols induced a remarkable protection against neurological deficit and tissue injury following stroke. Cerebral infarctions were better improved in HIT animals which explained the slightly but not significantly higher neurological function. HIT brains developed higher levels of cortical VEGF-A and striatal VEGF-R2. SIGNIFICANCE These data conclude preconditioning with high intensity protocols might excel continued moderate exercise to induce VEGF signaling and alleviate stroke outcomes. Further investigations may provide complementary mechanistic views.
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Affiliation(s)
- Rasoul Rezaei
- Department of Sport Sciences, Faculty of Educational Sciences and Psychology, Shiraz University, Shiraz, Iran
| | - Sanaz Nasoohi
- Neuroscience Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Pharmacology and Toxicology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Haghparast
- Department of Pharmacology and Toxicology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Neurobiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fariba Khodagholi
- Department of Pharmacology and Toxicology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Neurobiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Maryam Nourshahi
- Department of Exercise Physiology, School of Physical Education and Sport Sciences, Shahid Beheshti University of Sciences, Tehran, Iran.
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Feher MD, Rampling MW, Brown J, Robinson R, Richmond W, Cholerton S, Bain BJ, Sever PS. Acute changes in Atherogenic and Thrombogenic Factors with Cessation of Smoking. J R Soc Med 2018; 83:146-8. [PMID: 2325055 PMCID: PMC1292556 DOI: 10.1177/014107689008300306] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Tobacco smoking is associated with alterations in several factors considered to be important in the atherosclerotic process. Thirty chronic smokers were studied 2 weeks before and 2 weeks after complete tobacco withdrawal. Significant reductions in fibrinogen, haematocrit, plasma viscosity and whole blood viscosity as well as a significant increase in HDL-cholesterol were observed. As these factors are important in both atherogenesis and thrombogenesis, these observations may give insight into tobacco-induced atherosclerotic disease and may be responsible for the more rapid reduction in the incidence of cardiovascular disease that is believed to occur after stopped smoking.
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Affiliation(s)
- M D Feher
- Department of Clinical Pharmacology, St Mary's Hospital Medical School, London
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35
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Fujiyoshi A. Cardiorespiratory fitness, a promising modality for treatment and risk prediction. Eur J Prev Cardiol 2018; 25:306-308. [DOI: 10.1177/2047487317751958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Akira Fujiyoshi
- Department of Public Health, Shiga University of Medical Science, Japan
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36
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Matsuzaki T, Douchi T, Oki T, Ishihara O, Okagaki R, Kajihara T, Tamura M, Kotsuji F, Tajima K, Kawano M, Ishizuka B, Irahara M. Weight reduction using a formula diet recovers menstruation in obese patients with an ovulatory disorder. Reprod Med Biol 2017; 16:268-275. [PMID: 29259477 PMCID: PMC5715880 DOI: 10.1002/rmb2.12034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 03/19/2017] [Indexed: 11/30/2022] Open
Abstract
Aim To determine the effectiveness of a formula diet in weight reduction and the recovery of menstruation in obese patients with ovulatory disorders. Methods After the enrollment of 39 obese women with ovulatory disorders, they replaced one or two of their three normal meals with a microdiet (MD) (240 kcal/meal) for 24 weeks. Physical, endocrinological, and biochemical tests were conducted before and at 12 and 24 weeks of the study. Of the 39 women enrolled, 26 were not taking clomiphene. They were divided into three groups according to their body weight outcomes and then analyzed for menstruation recovery. Results A weight reduction of ≥5% was observed in 31 (81.5%) of the 39 women. There were significant decreases in the body weight and Body Mass Index during the study. Menstruation returned in 18 (69%) of the 26 patients without clomiphene treatment, with the recovery being significantly more prevalent in the groups (totally 81.0%) that exhibited a 5%‐10% weight reduction and ≥10% weight reduction, compared to the group with a <5% weight reduction. Conclusion The use of a formula diet effectively reduced the patients’ body weight and led to the recovery of menstruation in these obese patients with ovulatory disorders.
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Affiliation(s)
- Toshiya Matsuzaki
- Department of Obstetrics and Gynecology Graduate School of Biomedical Sciences Tokushima University Tokushima Japan
| | - Tsutomu Douchi
- Department of Obstetrics and Gynecology Faculty of Medicine Kagoshima University Kagoshima Japan
| | - Toshimichi Oki
- Maternal and Child Health Nursing Faculty of Health Sciences Kagoshima University Kagoshima Japan
| | - Osamu Ishihara
- Department of Obstetrics and Gynecology Faculty of Medicine Saitama Medical University Saitama Japan
| | - Ryugo Okagaki
- Department of Obstetrics and Gynecology Faculty of Medicine Saitama Medical University Saitama Japan
| | - Takeshi Kajihara
- Department of Obstetrics and Gynecology Faculty of Medicine Saitama Medical University Saitama Japan
| | - Midori Tamura
- Department of Obstetrics and Gynecology St. Marianna University School of Medicine Kawasaki Japan
| | - Fumikazu Kotsuji
- Division of Obstetrics and Gynecology Takatsuki General Hospital Takatsuki Japan
| | - Kimihisa Tajima
- Division of Obstetrics and Gynecology Japanese Red Cross Fukui Hospital Fukui Japan
| | | | | | - Minoru Irahara
- Department of Obstetrics and Gynecology Graduate School of Biomedical Sciences Tokushima University Tokushima Japan
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Pastuszak Ż, Koźniewska E, Stępień A, Piusińska-Macoch A, Czernicki Z, Koszewski W. Importance rating of risk factors of ischemic stroke in patients over 85 years old in the polish population. Neurol Neurochir Pol 2017; 52:88-93. [PMID: 29196059 DOI: 10.1016/j.pjnns.2017.11.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 11/09/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The European population is aging and the number of elderly patients suffering from ischemic brain stroke increases. A better knowledge of the correlation between the risk factors and the course of the disease in old people may be useful for planning medical care and prophylactic strategies. AIM This prospective study aimed to perform a demographic and clinical analysis of the etiology of ischemic stroke, survival rate and severity of post-stroke disability in patients who developed ischemic stroke at the age of over 85 years in the Polish population. METHOD The study group consisted of 159 patients over 85 years old with ischemic stroke. The prevalence of risk factors such as sex, hypertension, hyperlipidemia, atrial fibrillation, heart failure and diabetes was evaluated. The outcome was assessed using the Barthel scale and the National Institutes of Health Stroke Scale. RESULTS The most common risk factors of ischemic stroke were hypertension and atrial fibrillation. Patients with atrial fibrillation had a more severe course of ischemic stroke. CONCLUSION The course of brain stroke in the Polish population is more severe in patients over 85 years old than in younger ones. The key risk factor in this group is atrial fibrillation.
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Affiliation(s)
- Żanna Pastuszak
- Department of Neurosurgery, Mossakowski Medical Research Centre, Polish Academy of Sciences, ul. Pawińskiego 5, 02-106 Warsaw, Poland.
| | - Ewa Koźniewska
- Department of Neurosurgery, Mossakowski Medical Research Centre, Polish Academy of Sciences, ul. Pawińskiego 5, 02-106 Warsaw, Poland
| | - Adam Stępień
- Department of Neurology, Military Institute of Medicine, ul. Szaserów 128, 04-141 Warsaw, Poland
| | - Anna Piusińska-Macoch
- Department of Neurology, Military Institute of Medicine, ul. Szaserów 128, 04-141 Warsaw, Poland
| | - Zbigniew Czernicki
- Department of Neurosurgery, Second Faculty of the Medical University of Warsaw, ul. Cegłowska 80, 01-809 Warsaw, Poland
| | - Waldemar Koszewski
- Department of Neurosurgery, Second Faculty of the Medical University of Warsaw, ul. Cegłowska 80, 01-809 Warsaw, Poland
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Abstract
Dyslipidemia is the risk of cardiovascular disease, and their relationship is clear. Lowering serum cholesterol can reduce the risk of coronary heart disease. At present, the main treatment is taking medicine, however, drug treatment has its limitations. Exercise not only has a positive effect on individuals with dyslipidemia, but can also help improve lipids profile. This review is intending to provide information on the effects of exercise training on both tranditional lipids, for example, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides and new lipids and lipoproteins such as non-high-density lipoprotein cholesterol, and postprandial lipoprotein. The mechanisms of aerobic exercise on lipids and lipoproteins are also briefly described.
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Affiliation(s)
- Yating Wang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Danyan Xu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China.
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Li YH, Ueng KC, Jeng JS, Charng MJ, Lin TH, Chien KL, Wang CY, Chao TH, Liu PY, Su CH, Chien SC, Liou CW, Tang SC, Lee CC, Yu TY, Chen JW, Wu CC, Yeh HI. 2017 Taiwan lipid guidelines for high risk patients. J Formos Med Assoc 2017; 116:217-248. [PMID: 28242176 DOI: 10.1016/j.jfma.2016.11.013] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 11/26/2016] [Indexed: 12/20/2022] Open
Abstract
In Taiwan, the prevalence of hyperlipidemia increased due to lifestyle and dietary habit changes. Low density lipoprotein cholesterol (LDL-C) and non-high density lipoprotein cholesterol (non-HDL-C) are all significant predicting factors of coronary artery disease in Taiwan. We recognized that lipid control is especially important in patients with existed atherosclerotic cardiovascular diseases (ASCVD), including coronary artery disease (CAD), ischemic stroke and peripheral arterial disease (PAD). Because the risk of ASCVD is high in patients with diabetes mellitus (DM), chronic kidney disease (CKD) and familial hypercholesterolemia (FH), lipid control is also necessary in these patients. Lifestyle modification is the first step to control lipid. Weight reduction, regular physical exercise and limitation of alcohol intake all reduce triglyceride (TG) levels. Lipid-lowering drugs include HMG-CoA reductase inhibitors (statins), cholesterol absorption inhibitors (ezetimibe), proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, nicotinic acids (niacin), fibric acids derivatives (fibrates), and long-chain omega-3 fatty acids. Statin is usually the first line therapy. Combination therapy with statin and other lipid-lowering agents may be considered in some clinical settings. For patients with acute coronary syndrome (ACS) and stable CAD, LDL-C < 70 mg/dL is the major target. A lower target of LDL-C <55 mg/dL can be considered in ACS patients with DM. After treating LDL-C to target, non-HDL-C can be considered as a secondary target for patients with TG ≥ 200 mg/dL. The suggested non-HDL-C target is < 100 mg/dL in ACS and CAD patients. For patients with ischemic stroke or transient ischemic attack presumed to be of atherosclerotic origin, statin therapy is beneficial and LDL-C < 100 mg/dL is the suggested target. For patients with symptomatic carotid stenosis or intracranial arterial stenosis, in addition to antiplatelets and blood pressure control, LDL-C should be lowered to < 100 mg/dL. Statin is necessary for DM patients with CV disease and the LDL-C target is < 70 mg/dL. For diabetic patients who are ≥ 40 years of age, or who are < 40 years of age but have additional CV risk factors, the LDL-C target should be < 100 mg/dL. After achieving LDL-C target, combination of other lipid-lowering agents with statin is reasonable to attain TG < 150 mg/dL and HDL-C >40 in men and >50 mg/dL in women in DM. LDL-C increased CV risk in patients with CKD. In adults with glomerular filtration rate (GFR) < 60 mL/min/1.73m2 without chronic dialysis (CKD stage 3-5), statin therapy should be initiated if LDL-C ≥ 100 mg/dL. Ezetimibe can be added to statin to consolidate the CV protection in CKD patients. Mutations in LDL receptor, apolipoprotein B and PCSK9 genes are the common causes of FH. Diagnosis of FH usually depends on family history, clinical history of premature CAD, physical findings of xanthoma or corneal arcus and high levels of LDL-C. In addition to conventional lipid lowering therapies, adjunctive treatment with mipomersen, lomitapide, or PCSK9 inhibitors become necessary to further reduce LDL-C in patients with FH. Overall, these recommendations are to help the health care professionals in Taiwan to treat hyperlipidemia with current scientific evidences. We hope the prescription rate of lipid lowering drugs and control rate of hyperlipidemia in high risk patients could be increased by implementation of the clinical guidelines. The major purpose is to improve clinical outcomes of these high risk patients through the control of hyperlipidemia.
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Affiliation(s)
- Yi-Heng Li
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan
| | - Kwo-Chang Ueng
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Jiann-Shing Jeng
- Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Min-Ji Charng
- Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan
| | - Tsung-Hsien Lin
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kuo-Liong Chien
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Yuan Wang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ting-Hsing Chao
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan
| | - Ping-Yen Liu
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan
| | - Cheng-Huang Su
- Departments of Internal Medicine and Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Shih-Chieh Chien
- Departments of Internal Medicine and Medical Research, Mackay Memorial Hospital, Taipei, Taiwan
| | - Chia-Wei Liou
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Sung-Chun Tang
- Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chun-Chuan Lee
- Departments of Internal Medicine and Medical Research, Mackay Memorial Hospital, Taipei, Taiwan
| | - Tse-Ya Yu
- Department of Internal Medicine, Far-Eastern Memorial Hospital, Taipei, Taiwan
| | - Jaw-Wen Chen
- Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chau-Chung Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Hung-I Yeh
- Departments of Internal Medicine and Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.
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Lin CS, Shih CC, Yeh CC, Hu CJ, Chung CL, Chen TL, Liao CC. Risk of Stroke and Post-Stroke Adverse Events in Patients with Exacerbations of Chronic Obstructive Pulmonary Disease. PLoS One 2017; 12:e0169429. [PMID: 28060955 PMCID: PMC5217966 DOI: 10.1371/journal.pone.0169429] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 12/06/2016] [Indexed: 11/19/2022] Open
Abstract
Background The risk and outcomes of stroke in patients with chronic obstructive pulmonary disease exacerbations (COPDe) remain unclear. We examined whether patients with COPDe faced increased risk of stroke or post-stroke outcomes. Methods Using Taiwan’s National Health Insurance Research Database, we identified 1918 adults with COPDe and selected comparison cohorts of 3836 adults with COPD no exacerbations and 7672 adults without COPD who were frequency matched by age and sex in 2000–2008 (Study 1). Stroke event was identified during 2000–2013 follow-up period. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of stroke associated with COPDe were calculated. In a nested cohort study (Study 2) of 261686 new-diagnosed stroke patients in 2000–2009, we calculated adjusted odds ratios (ORs) and 95% CIs of adverse events after stroke in patients with COPDe. Results Patients with COPDe had increased stroke incidence, with an adjusted HR of 1.28 (95% CI, 1.03–1.59). In the Study 2, COPDe were associated with post-stroke mortality (OR, 1.34, 95% CI 1.20–1.52), epilepsy (OR, 1.43; 95% CI, (1.22–1.67), and pneumonia (OR, 1.50; 95% CI, 1.39–1.62). Previous intubation for COPD and inpatient admissions due to COPD were factors associated with post-stroke adverse events. Conclusion Patients who have had COPDe face increased risks of stroke and post-stroke adverse events.
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Affiliation(s)
- Chao-Shun Lin
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
- Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chun-Chuan Shih
- School of Chinese Medicine for Post-Baccalaureate, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chun-Chieh Yeh
- Department of Surgery, China Medical University Hospital, Taichung, Taiwan
- Department of Surgery, University of Illinois, Chicago, Illinois, United States of America
| | - Chaur-Jong Hu
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chi-Li Chung
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Ta-Liang Chen
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
- Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chien-Chang Liao
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
- Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Anesthesiology, Shuan Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- * E-mail:
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Locke JE, Reed RD, Massie A, MacLennan PA, Sawinski D, Kumar V, Mehta S, Mannon RB, Gaston R, Lewis CE, Segev DL. Obesity increases the risk of end-stage renal disease among living kidney donors. Kidney Int 2016; 91:699-703. [PMID: 28041626 DOI: 10.1016/j.kint.2016.10.014] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/23/2016] [Accepted: 10/06/2016] [Indexed: 12/31/2022]
Abstract
Determining candidacy for live kidney donation among obese individuals remains challenging. Among healthy non-donors, body mass index (BMI) above 30 is associated with a 16% increase in risk of end-stage renal disease (ESRD). However, the impact on the ESRD risk attributable to donation and living with only one kidney remains unknown. Here we studied the risk of ESRD associated with obesity at the time of donation among 119 769 live kidney donors in the United States. Maximum follow-up was 20 years. Obese (BMI above 30) live kidney donors were more likely male, African American, and had higher blood pressure. Estimated risk of ESRD 20 years after donation was 93.9 per 10 000 for obese; significantly greater than the 39.7 per 10 000 for non-obese live kidney donors. Adjusted for age, sex, ethnicity, blood pressure, baseline estimated glomerular filtration rate, and relationship to recipient, obese live kidney donors had a significant 86% increased risk of ESRD compared to their non-obese counterparts (adjusted hazard ratio 1.86; 95% confidence interval 1.05-3.30). For each unit increase in BMI above 27 kg/m2 there was an associated significant 7% increase in ESRD risk (1.07, 1.02-1.12). The impact of obesity on ESRD risk was similar for male and female donors, African American and Caucasian donors, and across the baseline estimated glomerular filtration rate spectrum. These findings may help to inform selection criteria and discussions with persons considering living kidney donation.
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Affiliation(s)
- Jayme E Locke
- University of Alabama at Birmingham School of Medicine, Comprehensive Transplant Institute, Birmingham, Alabama, USA.
| | - Rhiannon D Reed
- University of Alabama at Birmingham School of Medicine, Comprehensive Transplant Institute, Birmingham, Alabama, USA
| | - Allan Massie
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Paul A MacLennan
- University of Alabama at Birmingham School of Medicine, Comprehensive Transplant Institute, Birmingham, Alabama, USA
| | - Deirdre Sawinski
- University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Vineeta Kumar
- University of Alabama at Birmingham School of Medicine, Comprehensive Transplant Institute, Birmingham, Alabama, USA
| | - Shikha Mehta
- University of Alabama at Birmingham School of Medicine, Comprehensive Transplant Institute, Birmingham, Alabama, USA
| | - Roslyn B Mannon
- University of Alabama at Birmingham School of Medicine, Comprehensive Transplant Institute, Birmingham, Alabama, USA
| | - Robert Gaston
- University of Alabama at Birmingham School of Medicine, Comprehensive Transplant Institute, Birmingham, Alabama, USA
| | - Cora E Lewis
- University of Alabama at Birmingham School of Medicine, Comprehensive Transplant Institute, Birmingham, Alabama, USA
| | - Dorry L Segev
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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The Heterogeneity of Obesity: Fitting Treatments To Individuals - Republished Article. Behav Ther 2016; 47:950-965. [PMID: 27993343 DOI: 10.1016/j.beth.2016.11.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 11/04/2016] [Indexed: 11/23/2022]
Abstract
Body weight is regulated by a complex interaction of biological, behavioral, and cultural factors. The population as a whole is at risk for obesity because of increased intake of dietary fat, the consumption of calories in fewer meals per day, striking accessibility to palatable foods, and decreased physical activity. This risk may become a reality in individuals with certain biological predispositions (genetic tendency, low metabolic rate, increased fat cell number), specific eating patterns, and susceptibility to the extreme cultural pressure to be lean. These factors must be considered in establishing goals for treatment, which fall into medical and psychosocial categories. This includes defining a "reasonable" as opposed to "ideal" weight. A three-stage process is proposed for identifying the best treatment for an individual. This involves a classification decision, a stepped care decision, and then a matching decision. Criteria are provided for a comprehensive assessment of the overweight individual, and treatment options are reviewed for programs of varying intensity, cost, and risk.
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Fitzgerald JT, Singleton SP, Engels HJ, Cardinal BJ, Prasad AS, Hess JW. Reported Exercise Patterns and their Relationship to Lipid Levels among Healthy Older Adults. Res Aging 2016. [DOI: 10.1177/0164027596184005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There have been few studies concerning the relationship between exercise habits and lipid levels of older adults. This study examines this relationship using data from 117 healthy older adults who volunteered to participate in a health promotion project. Responses to a seven-day activity recall questionnaire, percentage of body fat as measured by bioelectric impedance, age, and gender were used to predict total cholesterol, HDL, LDL, and triglyceride levels. Only the model predicting HDL was significant (R2=. 15, p = .002). Subsequent regression analyses predicting HDL levels were limited to persons who participated in one or more exercise sessions in the previous week. For these active women, the model's ability to predict HDL improved (R2= .37,p = .005), with exercise level having the greatest effect. For the active men, the model's predictive ability was not significant. The findings suggest that for active women, level of physical activity does modestly influence HDL levels.
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Wu J, Yang L, Li S, Huang P, Liu Y, Wang Y, Tang H. Metabolomics Insights into the Modulatory Effects of Long-Term Low Calorie Intake in Mice. J Proteome Res 2016; 15:2299-308. [DOI: 10.1021/acs.jproteome.6b00336] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Junfang Wu
- Key
Laboratory of Magnetic Resonance in Biological Systems, State Key
Laboratory of Magnetic Resonance and Atomic and Molecular Physics,
Wuhan Centre for Magnetic Resonance, Wuhan Institute of Physics and
Mathematics, Chinese Academy of Sciences, Wuhan 430071, P. R. China
| | - Liu Yang
- Key
Laboratory of Nutrition and Metabolism, Institute for Nutritional
Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, P. R. China
| | - Shoufeng Li
- Key
Laboratory of Nutrition and Metabolism, Institute for Nutritional
Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, P. R. China
| | - Ping Huang
- Key
Laboratory of Nutrition and Metabolism, Institute for Nutritional
Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, P. R. China
| | - Yong Liu
- Key
Laboratory of Nutrition and Metabolism, Institute for Nutritional
Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, P. R. China
| | - Yulan Wang
- Key
Laboratory of Magnetic Resonance in Biological Systems, State Key
Laboratory of Magnetic Resonance and Atomic and Molecular Physics,
Wuhan Centre for Magnetic Resonance, Wuhan Institute of Physics and
Mathematics, Chinese Academy of Sciences, Wuhan 430071, P. R. China
- Collaborative
Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou 310058, P. R. China
| | - Huiru Tang
- Key
Laboratory of Magnetic Resonance in Biological Systems, State Key
Laboratory of Magnetic Resonance and Atomic and Molecular Physics,
Wuhan Centre for Magnetic Resonance, Wuhan Institute of Physics and
Mathematics, Chinese Academy of Sciences, Wuhan 430071, P. R. China
- State Key
Laboratory of Genetic Engineering, Collaborative Innovation Center
for Genetics and Development, Metabolomics and Systems Biology Laboratory,
School of Life Sciences, Fudan University, Shanghai 200433, P. R. China
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Hespanhol Junior LC, Pillay JD, van Mechelen W, Verhagen E. Meta-Analyses of the Effects of Habitual Running on Indices of Health in Physically Inactive Adults. Sports Med 2016; 45:1455-68. [PMID: 26178328 PMCID: PMC4579257 DOI: 10.1007/s40279-015-0359-y] [Citation(s) in RCA: 157] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background In order to implement running to promote physical activity, it is essential to quantify the extent to which running improves health. Objective The aim was to summarise the literature on the effects of endurance running on biomedical indices of health in physically inactive adults. Data Sources Electronic searches were conducted in October 2014 on PubMed, Embase, CINAHL, SPORTDiscus, PEDro, the Cochrane Library and LILACS, with no limits of date and language of publication. Study Selection Randomised controlled trials (with a minimum of 8 weeks of running training) that included physically inactive but healthy adults (18–65 years) were selected. The studies needed to compare intervention (i.e. endurance running) and control (i.e. no intervention) groups. Study Appraisal and Synthesis Methods Two authors evaluated study eligibility, extracted data, and assessed risk of bias; a third author resolved any uncertainties. Random-effects meta-analyses were performed to summarise the estimates for length of training and sex. A dose-response analysis was performed with random-effects meta-regression in order to investigate the relationship between running characteristics and effect sizes. Results After screening 22,380 records, 49 articles were included, of which 35 were used to combine data on ten biomedical indices of health. On average the running programs were composed of 3.7 ± 0.9 sessions/week, 2.3 ± 1.0 h/week, 14.4 ± 5.4 km/week, at 60–90 % of the maximum heart rate, and lasted 21.5 ± 16.8 weeks. After 1 year of training, running was effective in reducing body mass by 3.3 kg [95 % confidence interval (CI) 4.1–2.5], body fat by 2.7 % (95 % CI 5.1–0.2), resting heart rate by 6.7 min−1 (95 % CI 10.3–3.0) and triglycerides by 16.9 mg dl−1 (95 % CI 28.1–5.6). Also, running significantly increased maximal oxygen uptake (VO2max) by 7.1 ml min−1 kg−1 (95 % CI 5.0–9.1) and high-density lipoprotein (HDL) cholesterol by 3.3 mg dl−1 (95 % CI 1.2–5.4). No significant effect was found for lean body mass, body mass index, total cholesterol and low-density lipoprotein cholesterol after 1 year of training. In the dose-response analysis, larger effect sizes were found for longer length of training. Limitations It was only possible to combine the data of ten out the 161 outcome measures identified. Lack of information on training characteristics precluded a multivariate model in the dose-response analysis. Conclusions Endurance running was effective in providing substantial beneficial effects on body mass, body fat, resting heart rate, VO2max, triglycerides and HDL cholesterol in physically inactive adults. The longer the length of training, the larger the achieved health benefits. Clinicians and health authorities can use this information to advise individuals to run, and to support policies towards investing in running programs. Electronic supplementary material The online version of this article (doi:10.1007/s40279-015-0359-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Luiz Carlos Hespanhol Junior
- Department of Public and Occupational Health and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Julian David Pillay
- Department of Basic Medical Sciences, Durban University of Technology, PO Box 1334, Durban, 4001, South Africa.
| | - Willem van Mechelen
- Department of Public and Occupational Health and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Evert Verhagen
- Department of Public and Occupational Health and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
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Abstract
Diabetes mellitus is associated with a considerably increased risk of premature atherosclerotic cardiovascular disease. Intensive glycemic control has essentially failed to significantly improve cardiovascular outcomes in clinical trials. Dyslipidemia is common in diabetes and there is strong evidence that cholesterol lowering improves cardiovascular outcomes, even in patients with apparently unremarkable lipid profiles. Here, the authors review the pathophysiology and implications of the alterations in lipoproteins observed in both type 1 and type 2 diabetes, the effect of medications commonly used in the management of diabetes on the lipid profile, the evidence for lifestyle and pharmaceutical interventions, and national and international recommendations for the management of dyslipidemia in patients with diabetes.
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Affiliation(s)
- Jonathan D Schofield
- Faculty of Medical and Human Sciences, Institute of Human Development, University of Manchester, Manchester, UK.
- University Department of Medicine, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
| | - Yifen Liu
- Faculty of Medical and Human Sciences, Institute of Human Development, University of Manchester, Manchester, UK
| | - Prasanna Rao-Balakrishna
- University Department of Medicine, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Rayaz A Malik
- Faculty of Medical and Human Sciences, Institute of Human Development, University of Manchester, Manchester, UK
- Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Handrean Soran
- University Department of Medicine, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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47
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Washburn RA, Honas JJ, Ptomey LT, Mayo MS, Lee J, Sullivan DK, Lambourne K, Willis EA, Donnelly JE. Energy and Macronutrient Intake in the Midwest Exercise Trial 2 (MET-2). Med Sci Sports Exerc 2016; 47:1941-9. [PMID: 25574796 DOI: 10.1249/mss.0000000000000611] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE This study aimed to examine the effect of exercise training over 10 months at two levels of energy expenditure on energy and macronutrient intake in a sample of previously sedentary, overweight/obese young adults. METHODS We conducted a 10-month trial in 141 young adults who were randomized to either supervised exercise 5 d·wk(-1) at 400 and 600 kcal per session or nonexercise control. Participants were instructed to maintain their usual ad libitum diet. Energy/macronutrient intake was assessed at baseline and 3.5, 7, and 10 months over 7-d periods of ad libitum eating in a university cafeteria using digital photography. Foods consumed outside the cafeteria were assessed using multiple-pass recalls. RESULTS There were no significant between-group differences in absolute energy intake at baseline or at any other time point in the total sample or in men. In women, absolute energy intake was significantly greater in the 600-kcal-per-session group versus controls at both 3.5 and 7 months. There were no significant between-group differences in relative energy intake (kcal·kg·d(-1)) at any time point in the total sample, in men or women. There were no significant within- or between-group differences of change in absolute or relative energy intake in any of the three study groups in the total sample or in men or women. No clinically relevant changes in macronutrient intake were observed. CONCLUSIONS Aerobic exercise training does not significantly alter energy or macronutrient intake in overweight and obese young adults. The possibility of a threshold level beyond which increased exercise energy expenditure fails to produce a more negative energy balance and potential sex differences in the energy intake response to increased levels of exercise are potentially important.
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Affiliation(s)
- Richard A Washburn
- 1Cardiovascular Research Institute, Division of Internal Medicine, University of Kansas Medical Center, Kansas City, KS; 2Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS; 3Institute for Measurement, Methodology, Analysis, and Policy, Texas Tech University, Lubbock, TX; and 4Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS
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Imran TF, Patel Y, Ellison RC, Carr JJ, Arnett DK, Pankow JS, Heiss G, Hunt SC, Gaziano JM, Djoussé L. Walking and Calcified Atherosclerotic Plaque in the Coronary Arteries: The National Heart, Lung, and Blood Institute Family Heart Study. Arterioscler Thromb Vasc Biol 2016; 36:1272-7. [PMID: 27102966 DOI: 10.1161/atvbaha.116.307284] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 03/31/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Studies have reported mixed findings on the association between physical activity and subclinical atherosclerosis. We sought to examine whether walking is associated with prevalent coronary artery calcification (CAC) and aortic calcification. APPROACH AND RESULTS In a cross-sectional design, we studied 2971 participants of the National Heart, Lung, and Blood Institute Family Heart Study without a history of myocardial infarction, coronary artery bypass grafting, or percutaneous transluminal angioplasty. A standardized questionnaire was used to ascertain the number of blocks walked daily to compute walking metabolic equivalent hours. CAC was measured by cardiac computed tomography. We defined prevalent CAC and aortic calcification using an Agatston score of at least 100 and used generalized estimating equations to calculate adjusted prevalence ratios. Mean age was 55 years, and 60% of participants were women. Compared with the ≤3.75-Met-h/wk group, prevalence ratios for CAC after adjusting for age, sex, race, smoking, alcohol use, total physical activity (excluding walking), and familial clustering were 0.53 (95% confidence interval, 0.35-0.79) for >3.75 to 7.5 Met-h/wk, 0.72 (95% confidence interval, 0.52-0.99) for >7.5 to 15 Met-h/wk, and 0.54 (95% confidence interval, 0.36-0.81) for >15 to 22.5 Met-h/wk, (P trend=0.01). The walking-CAC relationship remained significant for those with body mass index ≥25 (P trend=0.02) and persisted with CAC cutoffs of 300, 200, 150, and 50 but not 0. When examined as a continuous variable, a J-shaped association between walking and CAC was found. The walking-aortic calcification association was not significant. CONCLUSIONS Our findings suggest that walking is associated with lower prevalent CAC (but not aortic calcification) in adults without known heart disease.
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Affiliation(s)
- Tasnim F Imran
- From the Department of Medicine, Brigham and Women's Hospital and Boston Veterans Affairs Healthcare System, Harvard Medical School, Boston, MA (T.F.I., Y.P., J.M.G., L.D.); Preventive Medicine and Epidemiology, Boston University School of Medicine, MA (R.C.E.); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN (J.J.C.); Department of Epidemiology, University of Alabama at Birmingham (D.K.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (J.S.P.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Cardiovascular Genetics, Department of Medicine, University of Utah, Salt Lake City (S.C.H.).
| | - Yash Patel
- From the Department of Medicine, Brigham and Women's Hospital and Boston Veterans Affairs Healthcare System, Harvard Medical School, Boston, MA (T.F.I., Y.P., J.M.G., L.D.); Preventive Medicine and Epidemiology, Boston University School of Medicine, MA (R.C.E.); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN (J.J.C.); Department of Epidemiology, University of Alabama at Birmingham (D.K.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (J.S.P.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Cardiovascular Genetics, Department of Medicine, University of Utah, Salt Lake City (S.C.H.)
| | - R Curtis Ellison
- From the Department of Medicine, Brigham and Women's Hospital and Boston Veterans Affairs Healthcare System, Harvard Medical School, Boston, MA (T.F.I., Y.P., J.M.G., L.D.); Preventive Medicine and Epidemiology, Boston University School of Medicine, MA (R.C.E.); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN (J.J.C.); Department of Epidemiology, University of Alabama at Birmingham (D.K.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (J.S.P.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Cardiovascular Genetics, Department of Medicine, University of Utah, Salt Lake City (S.C.H.)
| | - J Jeffrey Carr
- From the Department of Medicine, Brigham and Women's Hospital and Boston Veterans Affairs Healthcare System, Harvard Medical School, Boston, MA (T.F.I., Y.P., J.M.G., L.D.); Preventive Medicine and Epidemiology, Boston University School of Medicine, MA (R.C.E.); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN (J.J.C.); Department of Epidemiology, University of Alabama at Birmingham (D.K.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (J.S.P.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Cardiovascular Genetics, Department of Medicine, University of Utah, Salt Lake City (S.C.H.)
| | - Donna K Arnett
- From the Department of Medicine, Brigham and Women's Hospital and Boston Veterans Affairs Healthcare System, Harvard Medical School, Boston, MA (T.F.I., Y.P., J.M.G., L.D.); Preventive Medicine and Epidemiology, Boston University School of Medicine, MA (R.C.E.); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN (J.J.C.); Department of Epidemiology, University of Alabama at Birmingham (D.K.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (J.S.P.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Cardiovascular Genetics, Department of Medicine, University of Utah, Salt Lake City (S.C.H.)
| | - James S Pankow
- From the Department of Medicine, Brigham and Women's Hospital and Boston Veterans Affairs Healthcare System, Harvard Medical School, Boston, MA (T.F.I., Y.P., J.M.G., L.D.); Preventive Medicine and Epidemiology, Boston University School of Medicine, MA (R.C.E.); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN (J.J.C.); Department of Epidemiology, University of Alabama at Birmingham (D.K.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (J.S.P.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Cardiovascular Genetics, Department of Medicine, University of Utah, Salt Lake City (S.C.H.)
| | - Gerardo Heiss
- From the Department of Medicine, Brigham and Women's Hospital and Boston Veterans Affairs Healthcare System, Harvard Medical School, Boston, MA (T.F.I., Y.P., J.M.G., L.D.); Preventive Medicine and Epidemiology, Boston University School of Medicine, MA (R.C.E.); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN (J.J.C.); Department of Epidemiology, University of Alabama at Birmingham (D.K.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (J.S.P.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Cardiovascular Genetics, Department of Medicine, University of Utah, Salt Lake City (S.C.H.)
| | - Steven C Hunt
- From the Department of Medicine, Brigham and Women's Hospital and Boston Veterans Affairs Healthcare System, Harvard Medical School, Boston, MA (T.F.I., Y.P., J.M.G., L.D.); Preventive Medicine and Epidemiology, Boston University School of Medicine, MA (R.C.E.); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN (J.J.C.); Department of Epidemiology, University of Alabama at Birmingham (D.K.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (J.S.P.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Cardiovascular Genetics, Department of Medicine, University of Utah, Salt Lake City (S.C.H.)
| | - J Michael Gaziano
- From the Department of Medicine, Brigham and Women's Hospital and Boston Veterans Affairs Healthcare System, Harvard Medical School, Boston, MA (T.F.I., Y.P., J.M.G., L.D.); Preventive Medicine and Epidemiology, Boston University School of Medicine, MA (R.C.E.); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN (J.J.C.); Department of Epidemiology, University of Alabama at Birmingham (D.K.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (J.S.P.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Cardiovascular Genetics, Department of Medicine, University of Utah, Salt Lake City (S.C.H.)
| | - Luc Djoussé
- From the Department of Medicine, Brigham and Women's Hospital and Boston Veterans Affairs Healthcare System, Harvard Medical School, Boston, MA (T.F.I., Y.P., J.M.G., L.D.); Preventive Medicine and Epidemiology, Boston University School of Medicine, MA (R.C.E.); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN (J.J.C.); Department of Epidemiology, University of Alabama at Birmingham (D.K.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (J.S.P.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Cardiovascular Genetics, Department of Medicine, University of Utah, Salt Lake City (S.C.H.)
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Pedersen LR, Olsen RH, Anholm C, Walzem RL, Fenger M, Eugen-Olsen J, Haugaard SB, Prescott E. Weight loss is superior to exercise in improving the atherogenic lipid profile in a sedentary, overweight population with stable coronary artery disease: A randomized trial. Atherosclerosis 2016; 246:221-8. [DOI: 10.1016/j.atherosclerosis.2016.01.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 12/26/2015] [Accepted: 01/01/2016] [Indexed: 11/28/2022]
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Aktekin A, Kazan K, Gunes P, Yekrek M, Muftuoglu T, Saglam A. Hematological, Biochemical, and Immunological Laboratory and Histomorphological Effects of Sleeve Gastrectomy on Female Rats. Indian J Surg 2016; 77:557-62. [PMID: 26730064 DOI: 10.1007/s12262-013-0921-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 04/22/2013] [Indexed: 12/19/2022] Open
Abstract
Restriction of food intake leads to immunologic and histomorphological changes in rats demonstrated by Moriyama. This study is planned to show how sleeve gastrectomy restricts food intake and its effects on biochemical liver function, immunologic and hematologic laboratory parameters, and histomorphological changes in rats. We used sleeve gastrectomy model on seven young adult female rats and compared study group with sham and control groups. Food consumption of rats was measured. All rats were sacrificed on the 50th day, and blood and tissue samples were collected. There was a significant low food intake in sleeve gastrectomy group (p = 0.013). No differences were observed on hematologic, biochemical, and immunologic laboratory parameters between groups. Toxicity parameters in liver samples such as cytoplasmic atrophy, single-cell hepatocellular necrosis, and necrotic eosinophilic cells were significantly high in sleeve gastrectomy group (p = 0.005). Histomorphological examination of the spleen and kidneys revealed significant changes in sleeve gastrectomy and sham groups compared with controls (p = 0.004 and p = 0.018, respectively). Although sleeve gastrectomy does not lead to alteration in hematologic, biochemical, and immunologic laboratory parameters, it causes decreased food consumption, which results in toxicological histomorphological changes in rat liver as well as some changes in kidney and spleen samples.
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Affiliation(s)
- Ali Aktekin
- 4th General Surgery Clinic, Haydarpasa Numune Training and Research Hospital, 17 Selimiye Uskudar, 34668 Istanbul, Turkey
| | - Kazım Kazan
- 4th General Surgery Clinic, Haydarpasa Numune Training and Research Hospital, 17 Selimiye Uskudar, 34668 Istanbul, Turkey
| | - Pembegul Gunes
- Pathology Section, Haydarpasa Numune Training and Research Hospital, 17 Selimiye Uskudar, 34668 Istanbul, Turkey
| | - Murat Yekrek
- Biochemistry Section, Haydarpasa Numune Training and Research Hospital, 17 Selimiye Uskudar, 34668 Istanbul, Turkey
| | - Tolga Muftuoglu
- 4th General Surgery Clinic, Haydarpasa Numune Training and Research Hospital, 17 Selimiye Uskudar, 34668 Istanbul, Turkey
| | - Abdullah Saglam
- 4th General Surgery Clinic, Haydarpasa Numune Training and Research Hospital, 17 Selimiye Uskudar, 34668 Istanbul, Turkey
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