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Schwartz J, Oh P, Perotto MB, Rhodes RE, Firth W, Bredin SSD, Gaytán-González A, Warburton DER. A Critical Review on New Approaches for Chronic Disease Prevention in Brazil and Canada: From Wholistic Dietary Guidelines to Physical Activity Security. Front Cardiovasc Med 2021; 8:730373. [PMID: 34527714 PMCID: PMC8435680 DOI: 10.3389/fcvm.2021.730373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/10/2021] [Indexed: 01/12/2023] Open
Abstract
In light of new evidence on the prevention of chronic diseases and the elevated rates of overweight and obesity in Brazil and Canada, this critical review aims to interpret and synthesize current aspects regarding dietary and physical activity initiatives in both countries and make future recommendations. The pioneering work presented in the last Brazilian dietary guidelines has been called a model that can be applied globally, given its conceptualization of healthy eating that translates easily to practical guidance. The new Canadian Food Guide has incorporated similar aspects, also putting the country as a leader in dietary guidance. With these new recommendations, citizens in both Brazil and Canada have access to impactful evidence-informed nutritional guidelines. Both documents propose eating patterns that focus not only on health benefits, such as chronic disease prevention, but also incorporate well-being concerning cultural, economic, sociodemographic, biological, and ecological dimensions. A similar approach is required for physical activity to allow individuals to have attainable health and life goals and thereby fully enjoy their lives, regardless of geographical location, health status, and socioeconomic condition, a concept recently described as physical activity security. The wholistic dietary guidelines from both countries represent a change in paradigm in public health. Likewise, national evidence-based policies are warranted to reduce disparities in physical activity, allowing healthier and more active lifestyles for everyone.
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Affiliation(s)
- Juliano Schwartz
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
- Experimental Medicine Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Paul Oh
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Maira B. Perotto
- West Toronto Diabetes Education Program, LAMP Community Health Centre, Toronto, ON, Canada
| | - Ryan E. Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Wanda Firth
- Hearts & Health in Motion Program, Nova Scotia Health, QEII Health Sciences Centre, Halifax, NS, Canada
| | - Shannon S. D. Bredin
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, BC, Canada
| | - Alejandro Gaytán-González
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, BC, Canada
- Institute of Applied Sciences for Physical Activity and Sport, University of Guadalajara, Guadalajara, Mexico
| | - Darren E. R. Warburton
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
- Experimental Medicine Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, BC, Canada
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Bodker A, Visotcky A, Gutterman D, Widlansky ME, Kulinski J. The impact of standing desks on cardiometabolic and vascular health. Vasc Med 2021; 26:374-382. [PMID: 33813968 PMCID: PMC9578685 DOI: 10.1177/1358863x211001934] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Sedentary behavior is associated with cardiovascular disease (CVD) and mortality, independent of physical activity. The biological mechanisms underlying these associations are largely unknown. We hypothesized that obese subjects with sedentary desk jobs, when assigned a sit-stand desk, will reduce daily sedentary time, and show improvement in arterial flow-mediated dilation (FMD), an early indicator of CVD. Overweight and obese subjects without known CVD were recruited at our institution and given an adjustable sit-stand desk at work. Activities were quantified with an accelerometer for 7 days at baseline and during the intervention. FMD of the brachial and superficial femoral arteries, fasting lipids, insulin and glucose labs, and anthropometrics were measured at baseline, and 12 and 24 weeks. Repeated one-way ANOVA tests were used to compare measurements over time. Fifteen participants were enrolled (93% female, mean age 40 ± 5 years, mean body mass index [BMI] 33 ± 5). Mean daily sedentary time at work decreased by 90 minutes from baseline (385 ± 49 minutes) to 12 weeks (297 ± 80 minutes, p = 0.002) and 24 weeks (295 ± 127 minutes, p = 0.015). Femoral FMD increased from baseline (4.9 ± 1.7%) to 12 weeks (6.4 ± 2.3%, p = 0.043) and further to 24 weeks (8.1 ± 3.2%, p = 0.009). Significant improvement in fasting triglycerides and insulin resistance occurred. There was no change in brachial FMD, exercise activity, step counts, weight, or BMI. A significant reduction in sedentary time during working hours was identified with utilization of a sit-stand desk and sustained over 24 weeks. Improvements in FMD, triglycerides, and insulin resistance provide insight into mechanisms of adverse health risks associated with sedentary behavior.
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Affiliation(s)
- Ariel Bodker
- Division of Cardiology, Department of Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Alexis Visotcky
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI
| | - David Gutterman
- Division of Cardiology, Department of Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Michael E. Widlansky
- Division of Cardiology, Department of Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Jacquelyn Kulinski
- Division of Cardiology, Department of Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI
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Rana MN, Neeland IJ. Taking a 'stand' against cardiovascular disease in the era of COVID-19. Vasc Med 2021; 26:383-385. [PMID: 33985391 DOI: 10.1177/1358863x211012750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Mariam N Rana
- Department of Medicine, University Hospitals, Cleveland, OH, USA.,Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Ian J Neeland
- Department of Medicine, University Hospitals, Cleveland, OH, USA.,Department of Medicine, Case Western Reserve University, Cleveland, OH, USA.,Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, USA
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Improving Physical Activity and Body Composition in a Medical Workplace Using Brief Goal Setting. Mayo Clin Proc Innov Qual Outcomes 2019; 3:495-505. [PMID: 31993569 PMCID: PMC6978599 DOI: 10.1016/j.mayocpiqo.2019.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Objective To evaluate the use of a wearable activity tracker and brief feedback in the workplace to motivate employees to improve activity. Patients and Methods A total of 135 adult participants were randomized to 1 of 3 groups: control group (blinded to their step activity), intervention group (received counseling based on their step count), or no step-tracking device group. Participants were recruited from June 27, 2016, through February 21, 2018. Results Most of the 135 participants were women (84%), with a mean ± SD age of 42.6±10.1 years. Most participants (96%) completed 11 of the 12 weeks of step counts. Comparing treatment groups at week 12 (end of treatment), the intervention group (vs the control group) had significantly more steps (644.8; P<.01), had an 11.1% increase in step count from baseline (P<.01), was more likely to achieve goal (odds ratio=1.73; P=.02), increased distance traveled per week (0.46 miles; P<.01) and calories burned (90.6; P<.01), and had a decrease in some bioelectrical impedance measurements over time, including a greater loss in body fat mass (–0.90 kg; P=.01), percentage fat (–0.96; P<.01), and visceral fat level (–0.60; P<.01). Finally, the intervention group indicated significantly greater satisfaction with their assigned randomization (89% vs 77%; P=.01) and greater confidence in the effectiveness of their activity tracker (P<.01). Conclusion Brief counseling accompanied by use of a step-counting device can improve workplace activity, which, in turn, can increase steps and decrease body fat, including visceral fat. Trial Registration clinicaltrials.gov Identifier: NCT02794727
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