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Hassan MA, Zhou W, Ye M, He H, Gao Z. The effectiveness of physical activity interventions on blood pressure in children and adolescents: A systematic review and network meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:699-708. [PMID: 38244922 PMCID: PMC11282348 DOI: 10.1016/j.jshs.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/18/2023] [Accepted: 11/09/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND High blood pressure (BP) is a major contributor to mortality and cardiovascular diseases. Despite the known benefits of exercise for reducing BP, it is crucial to identify the most effective physical activity (PA) intervention. This systematic review and network meta-analysis (NMA) aimed to evaluate the available evidence on the effectiveness of various PA interventions for reducing BP and to determine their hierarchy based on their impact on BP. METHODS A search of PubMed, SPORTDiscus, PsycINFO, Web of Science, CINAHL, Cochrane, and Eric databases was conducted up to December 2022 for this systematic review and NMA. Randomized controlled trials and quasi-experimental studies targeting healthy children and adolescents aged 6-12 years old were included in this study. Only studies that compared controlled and intervention groups using PA or exercise as the major influence were included. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three independent investigators performed the literature screening, data extraction, and risk of bias assessment. We used Bayesian arm-based NMA to synthesize the data. The primary outcomes were systolic BP and diastolic BP. We calculated the mean differences (MDs) in systolic BP and diastolic BP before and after treatment. Mean treatment differences were estimated using NMA and random-effect models. RESULTS We synthesized 27 studies involving 15,220 children and adolescents. PA combined with nutrition and behavior change was the most effective intervention for reducing both systolic BP and diastolic BP (MD = -8.64, 95% credible interval (95%CI):-11.44 to -5.84; MD = -6.75, 95%CI: -10.44 to -3.11), followed by interventions with multiple components (MD = -1.39, 95%CI: -1.94 to -0.84; MD = -2.54, 95%CI: -4.89 to -0.29). CONCLUSION Our findings suggest that PA interventions incorporating nutrition and behavior change, followed by interventions with multiple components, are most effective for reducing both systolic BP and diastolic BP in children and adolescents.
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Affiliation(s)
- Mohamed A Hassan
- School of Kinesiology, University of Minnesota-Twin Cities, Minneapolis, MN 55455, USA; Department of Methods and Curriculum, Physical Education College for Men, Helwan University, Cairo 12552, Egypt
| | - Wanjiang Zhou
- School of Kinesiology, University of Minnesota-Twin Cities, Minneapolis, MN 55455, USA
| | - Mingyi Ye
- China Institute of Sport and Health Science, Beijing Sport University, Beijing 100084, China
| | - Hui He
- China Institute of Sport and Health Science, Beijing Sport University, Beijing 100084, China
| | - Zan Gao
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, TN 37996, USA.
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Demissie GD, Birungi J, Haregu T, Thirunavukkarasu S, Oldenburg B. Effects of Lifestyle Interventions on Cardiovascular Disease Risk and Risk Factors Among Individuals at High Risk for Type 2 Diabetes: Protocol for a Systematic Review and Meta-Analysis of Randomized Controlled Trials. JMIR Res Protoc 2024; 13:e53517. [PMID: 38935416 PMCID: PMC11240064 DOI: 10.2196/53517] [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: 10/10/2023] [Accepted: 02/02/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Individuals at high risk for type 2 diabetes are also at an increased risk for developing cardiovascular disease (CVD). Although there are separate trials examining the effects of lifestyle interventions on absolute CVD risk among people at high risk for type 2 diabetes, a comprehensive evidence synthesis of these trials is lacking. OBJECTIVE We will systematically synthesize the evidence on the effects of lifestyle interventions in reducing absolute CVD risk and CVD risk factors among people at high risk for type 2 diabetes. METHODS We adhered to the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) statement in reporting the details of this protocol. Randomized controlled trials of diabetes prevention that examined the effects of lifestyle interventions for at least 6 months on absolute CVD risk and CVD risk factors among individuals at high risk for type 2 diabetes will be eligible. We will systematically search the MEDLINE, Embase, PsycINFO, CENTRAL, and Scopus databases and ClinicalTrials.gov using a mix of Medical Subject Headings and text words. Two authors will independently screen the abstract and title of the articles retrieved from the search, followed by full-text reviews using the inclusion and exclusion criteria and data extraction from the eligible studies. Article screening and data extraction will be performed in the Covidence software. The primary outcome will be the changes in absolute 10-year CVD risk, as estimated by risk prediction models. The secondary outcomes are the changes in CVD risk factors, including behavioral, clinical, biochemical, and psychosocial risk factors, and incidence of type 2 diabetes. RESULTS An initial database search was conducted in July 2023. After screening 1935 articles identified through the database search, 42 articles were considered eligible for inclusion. It is anticipated that the study findings will be submitted for publication in a peer-reviewed journal by the end of 2024. CONCLUSIONS This study will provide up-to-date, systematically synthesized evidence on the effects of lifestyle interventions on absolute CVD risk and CVD risk factors among individuals at high risk for type 2 diabetes. TRIAL REGISTRATION PROSPERO CRD42023429869; https://tinyurl.com/59ajy7rw. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53517.
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Affiliation(s)
- Getu Debalkie Demissie
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Josephine Birungi
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Tilahun Haregu
- Baker Heart and Diabetes Institute, Melbourne, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Sathish Thirunavukkarasu
- Baker Heart and Diabetes Institute, Melbourne, Australia
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA, United States
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA, United States
| | - Brian Oldenburg
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
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Padda I. Cardiovascular health amongst South Asian populations in British Columbia: A situational and comparative analysis of preventative strategies. Curr Probl Cardiol 2024; 49:102570. [PMID: 38604417 DOI: 10.1016/j.cpcardiol.2024.102570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 04/07/2024] [Accepted: 04/08/2024] [Indexed: 04/13/2024]
Abstract
This analysis provides an overview of cardiovascular health among South Asian populations in British Columbia (BC), Canada utilizing peer-reviewed literature, alongside data from public health authorities and relevant jurisdictions. The analysis identified risk factors for cardiovascular disease (CVD) amongst South Asians and discussed preventative public health strategies and interventions to mitigate disease burden. The situational analysis discussed the disproportionate increased risk for CVD in South Asians when compared to other ethnicities in BC, highlighting lifestyle choices, genetic predispositions, socio-economic status (SES), and post-migration-related challenges. The analysis identified a disproportionate increase in heart disease in South Asian males and females when compared to White males and females. A review of evidence from peer-reviewed literature identified previously conducted studies and intervention strategies to address CVD and its risk factors. Common themes across multiple studies included addressing physical inactivity and dietary habits as increased cholesterol, obesity, and DM reported as the most common prevalent CVD risk factors in South Asians. The most significantly studied modifiable risk factors in literature for South Asians included diet and physical inactivity. To identify promising public health interventions, a comparative analysis was conducted identifying multiple public health programs from three different jurisdictions: Ontario, New York, and California to better understand successful preventative strategies to decrease risk factors for CVD. A New York based study implemented preventive health programs at employment sites with high prevalence of South Asians, such as Taxi drivers. Successful interventions included culturally relevant diabetes prevention programs, community outreach and health risk assessments in religious centers, health fairs at employment sites, and culturally competent online behavioural modification programs addressing diet and physical activity. Findings from the analysis suggest successful implementation of programs include those from a cultural lens. These include culturally tailored virtual classes, programs with modified risk assessment tools, preventative health community outreach in religious centers, interventions at workplaces with a high number of South Asians, and behavioural modification programs with nutritionists and health coaches.
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Affiliation(s)
- Inderbir Padda
- University of Washington, School of Public Health, Seattle Washington, USA; Department of Internal Medicine, Richmond University Medical Center/Mount Sinai, Staten Island, NY, USA.
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Sieczkowska SM, Mazzolani BC, Smaira FI, Romero M, Pasoto SG, de Sá Pinto AL, Lima FR, De Oliveira VR, Ueda S, Benatti FB, Roschel H, Gualano B. Effects of a lifestyle intervention on cardiovascular risk factors in systemic lupus erythematosus patients: The study "Living well with lupus". Clin Rheumatol 2024; 43:1003-1013. [PMID: 38280124 DOI: 10.1007/s10067-024-06870-2] [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: 12/14/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 01/29/2024]
Abstract
OBJECTIVE The aim of the present study was to investigate the effects of a lifestyle intervention on cardiometabolic risk factors in patients with systemic lupus erythematosus with a high cardiovascular risk profile. METHODS This trial was conducted in Sao Paulo, Brazil between August 2020 and March 2023. The patients were randomly assigned to lifestyle intervention or control. The intervention was a 6-month multifaced program focused on behavioral changes through personalized recommendations for increasing physical activity (structured and non-structured) and improving eating aspects. Cardiometabolic risk score (primary outcome), anthropometry and visceral fat, aerobic capacity, blood pressure, inflammatory and oxidative stress markers, and blood flow and endothelial function were assessed before and after the intervention. RESULTS A total of 80 patients were randomized. Twelve and 6 patients dropped out due to personal reasons in the intervention and control groups, respectively. Average adherence rate for the intervention was 56.9%. Intention-to-treat analysis showed no significant difference between groups in the cardiometabolic risk score (intervention group - Pre: 1.7 ± 3.6; Post: -1.6 ± 4.0; control group - Pre: -1.9 ± 3.6; Post: -2.0 ± 3.8; estimated mean difference between groups at post: -0.4; 95% confidence intervals: -2.7; 1.9; p = 0.96). This finding was confirmed by exploratory, per-protocol analysis. No significant differences were observed between adherents vs. non-adherent participants. Secondary outcomes did not change between groups. CONCLUSION This 6-month, individualized, lifestyle intervention did not improve cardiovascular risk factors in SLE patients with a high cardiovascular risk profile. TRIAL REGISTRATION clinicaltrials.gov (NCT04431167).
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Affiliation(s)
- Sofia Mendes Sieczkowska
- Applied Physiology and Nutrition Research Group -School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Center of Lifestyle Medicine; Laboratory of Assessment and Conditioning in Rheumatology; Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455, 3° Andar, São Paulo, SP, 01246- 903, Brazil
| | - Bruna Caruso Mazzolani
- Applied Physiology and Nutrition Research Group -School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Center of Lifestyle Medicine; Laboratory of Assessment and Conditioning in Rheumatology; Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455, 3° Andar, São Paulo, SP, 01246- 903, Brazil
| | - Fabiana Infante Smaira
- Applied Physiology and Nutrition Research Group -School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Center of Lifestyle Medicine; Laboratory of Assessment and Conditioning in Rheumatology; Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455, 3° Andar, São Paulo, SP, 01246- 903, Brazil
| | - Marina Romero
- Applied Physiology and Nutrition Research Group -School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- School of Applied Sciences, Universidade Estadual de Campinas, Campinas, São Paulo, 13484-350, Brazil
| | - Sandra Gofinet Pasoto
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, 05403-010, Brazil
| | - Ana Lúcia de Sá Pinto
- Applied Physiology and Nutrition Research Group -School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, Av. Dr. Arnaldo, 455, Sao Paulo, SP, 05403-900, Brazil
| | - Fernanda Rodrigues Lima
- Applied Physiology and Nutrition Research Group -School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, Av. Dr. Arnaldo, 455, Sao Paulo, SP, 05403-900, Brazil
| | - Victor Rodrigues De Oliveira
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, 05403-010, Brazil
| | - Serli Ueda
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, 05403-010, Brazil
| | - Fabiana Braga Benatti
- Applied Physiology and Nutrition Research Group -School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- School of Applied Sciences, Universidade Estadual de Campinas, Campinas, São Paulo, 13484-350, Brazil
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group -School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Center of Lifestyle Medicine; Laboratory of Assessment and Conditioning in Rheumatology; Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455, 3° Andar, São Paulo, SP, 01246- 903, Brazil
- Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, Av. Dr. Arnaldo, 455, Sao Paulo, SP, 05403-900, Brazil
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group -School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
- Center of Lifestyle Medicine; Laboratory of Assessment and Conditioning in Rheumatology; Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455, 3° Andar, São Paulo, SP, 01246- 903, Brazil.
- Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, Av. Dr. Arnaldo, 455, Sao Paulo, SP, 05403-900, Brazil.
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Fournier E, Łuszczki E, Isacco L, Chanséaume-Bussiere E, Gryson C, Chambrier C, Drapeau V, Chaput JP, Thivel D. Toward an Integrated Consideration of 24 h Movement Guidelines and Nutritional Recommendations. Nutrients 2023; 15:2109. [PMID: 37432285 DOI: 10.3390/nu15092109] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 07/12/2023] Open
Abstract
While physical activity, sleep and sedentary behaviors are almost always considered independently, they should be considered as integrated human behaviors. The 24 h Movement approach proposes a concomitant consideration of these behaviors to promote overall health. Not only do these behaviors impact energy expenditure, but they have also been shown to separately impact energy intake, which should be further explored when considering the entire integration of these movement behaviors under the 24 h movement approach. After an evaluation of the prevalence of meeting the 24 h Movement and dietary recommendations, this review summarizes the available evidence (using English publications indexed in PubMed/MEDLINE) regarding the association between the 24 h Movement Guidelines and eating habits. Altogether, the results clearly show the beneficial impact of promoting the 24 h guidelines simultaneously, highlighting that the higher the number of respected movement recommendations, the better eating behaviors in both children and adults. Importantly, our results point out the importance of emphasizing the need to reach sedentary guidelines for better eating habits. Movement and dietary behaviors appear closely related, and giving recommendations on one might impact the other. Combining the 24 h Movement with dietary Guidelines might be more efficient than promoting them separately in public health strategies.
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Affiliation(s)
- Elora Fournier
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, CRNH Auvergne, 63000 Clermont-Ferrand, France
| | - Edyta Łuszczki
- Institute of Health Sciences, Medical College of Rzeszów University, 35-310 Rzeszów, Poland
| | - Laurie Isacco
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, CRNH Auvergne, 63000 Clermont-Ferrand, France
| | | | | | | | - Vicky Drapeau
- Department of Physical Education, Faculty of Education, Université Laval, Quebec, QC G1V 0A6, Canada
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 5B2, Canada
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, CRNH Auvergne, 63000 Clermont-Ferrand, France
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