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Rasaei N, Daneshzad E, Soveid N, Clark CCT, Mirzaei K. The association between fatty acid quality indices and quality of life among overweight and obese women: A cross-sectional study. Front Public Health 2023; 10:1030726. [PMID: 36777780 PMCID: PMC9908951 DOI: 10.3389/fpubh.2022.1030726] [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: 09/21/2022] [Accepted: 12/12/2022] [Indexed: 01/27/2023] Open
Abstract
Background Reduced quality of life (QOL) is a major public health challenge affecting the global population. Fatty acid quality indices (FAQIs) are novel determinants of QOL and may impact various aspects of QOL. Prior research has established a significant link between dietary habits and QOL. However, the association between FAQIs and specific dimensions of QOL has not been established. Therefore, we aimed to investigate the association between FAQIs and QOL in overweight and obese women. Methods In total, 378 adult overweight or obese women participated in this cross-sectional study. Several anthropometric indices, systolic and diastolic blood pressure, and biochemical factors were measured using standard protocols. Dietary intake was assessed using a validated and reliable semi-quantitative food frequency questionnaire (the FFQ, 147 items). The cholesterol-saturated fat index (CSI) and the ratio of omega-6/omega-3 (N6/N3) essential fatty acids consumed were employed as FAQIs. The SF-36 questionnaire was administered to measure QOL. Linear logistic regression was used, in the form of raw and adjusted models, to evaluate the associations between FAQIs and QOL. Results The study sample consisted of 279 participants for whom ω-6/ω-3 ratio was measured and 378 participants for whom CSI was measured. The mean (±SD) age of participants was 36.65 ± 9.07 years. Linear logistic regression, with adjustment for potential confounders, such as age, energy intake, body mass index, employment, and thyroid status, indicated that ω-6/ω-3 intake ratio was negatively and marginally significantly associated with general health (β = -139.94, 95% CI: [-286.54, 6.66]; p = 0.061) and physical role limitations (β= -337.68, 95% CI: [-679.99, 1.61]; p = 0.051). A significant negative association was observed between ω-6/ω-3 intake ratio and social functioning (β = -247.54, 95% CI: [-458.14, -36.94]; p = 0.021), which indicates that obese and overweight women with a higher ω-6/ω-3 intake ratio obtained lower scores on social functioning. Conclusions It was found that FAQI scores were negatively associated with certain QOL measures among overweight and obese Iranian women, suggesting that a higher consumption of fatty acids, especially trans and saturated fatty acids, may be associated with lower QOL.
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Affiliation(s)
- Niloufar Rasaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Elnaz Daneshzad
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Neda Soveid
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Cain C. T. Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran,*Correspondence: Khadijeh Mirzaei ✉
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Zou S, Feng G, Li D, Ge P, Wang S, Liu T, Li H, Lai Y, Tan Z, Huang Y, Huang J, Zhang C, Wu Y, Ming WK. Lifestyles and health-related quality of life in Chinese people: a national family study. BMC Public Health 2022; 22:2208. [PMID: 36443710 PMCID: PMC9706972 DOI: 10.1186/s12889-022-14680-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 09/06/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND There were few studies that investigated health-related quality of life (HRQoL) of the general population in China, and many of them reported limitations in sampling. OBJECTIVE To investigate the relationship between lifestyles and HRQoL in the Chinese population in both individual and family levels. METHOD Online questionnaires were distributed across China to collect demographic information and participants' HRQoL using EuroQoL 5 Dimension scales. The EuroQoL Group's 5 Dimension scale (EQ-5D) index and EuroQoL Group's visual analog scale (EQ VAS) score were calculated to evaluate the HRQoL. RESULTS A total of 1305 valid questionnaires were included. Higher HRQoL was found in people with intend to lower oil intake, intend to lower salt intake, intend to lower sugar intake, balanced diet, moderate sports every week, a sport hobby and joining a fitness organization (all p<.05). HRQoL was higher among male (female as reference), healthy weight (unhealthy weight as reference) (both p<.05). Negative correlation was found between HRQoL and clinical medical history and drinking history. Small families (1-2 persons, 83.19 ± 20.14) had poorer HRQoL (EQ VAS score) than big families (≥3 persons, 85.00 ± 17.96, p <.05). CONCLUSION In China, people with healthy dietary habits, regular sports habits, healthy weight and male groups tended to have better HRQoL. Clinical medical history and drinking history were negatively related to HRQoL. Small families tend to have poorer HRQoL than big families. The finding implicated influence of the number of family members on people's perception of health and provided scientific evidence for the current policies to encourage birth in China. For a better HRQoL, we suggest people live in big families and take measures to lower salt/sugar/oil intake and exercise regularly in daily life.
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Affiliation(s)
- Shiqian Zou
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 Huangpu W Ave, Tianhe District, Guangzhou, 510632, Guangdong Province, China
| | - Guanrui Feng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 Huangpu W Ave, Tianhe District, Guangzhou, 510632, Guangdong Province, China
| | - Danyang Li
- Medical College of Xi'an Peihua University, Xi'an, China
| | - Pu Ge
- Key Research Base of Philosophy and Social Sciences in Shaanxi Province, Health Culture Research Center of Shaanxi, Xi'an, China
| | - Siyi Wang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 Huangpu W Ave, Tianhe District, Guangzhou, 510632, Guangdong Province, China
| | - Tinlun Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 Huangpu W Ave, Tianhe District, Guangzhou, 510632, Guangdong Province, China
| | - Haijun Li
- School of Pharmacy, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Yongjie Lai
- Key Research Base of Philosophy and Social Sciences in Shaanxi Province, Health Culture Research Center of Shaanxi, Xi'an, China
- School of Pharmaceutical Science, Shandong University, Jinan, Shandong, China
| | - Zijian Tan
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 Huangpu W Ave, Tianhe District, Guangzhou, 510632, Guangdong Province, China
| | - Yuling Huang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 Huangpu W Ave, Tianhe District, Guangzhou, 510632, Guangdong Province, China
| | - Jian Huang
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, St Mary's Campus, Imperial College London, Norfolk Place, British, London, UK
| | - Casper Zhang
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Yibo Wu
- Key Research Base of Philosophy and Social Sciences in Shaanxi Province, Health Culture Research Center of Shaanxi, Xi'an, China.
- Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, China.
| | - Wai-Kit Ming
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 Huangpu W Ave, Tianhe District, Guangzhou, 510632, Guangdong Province, China.
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Hajihashemi P, Haghighatdoost F, Mohammadifard N, Maghroun M, Sajjadi F, Najafi F, Farshidi H, Lotfizadeh M, Solati K, Kazemi T, Karimi S, Roohafza H, Sabri M, de Oliveira C, Silveira EA, Sarrafzadegan N. The association of dietary macronutrient quality indices with depression and anxiety symptoms and quality of life in Iranian adults: The LipoKAP study. J Affect Disord 2022; 317:409-416. [PMID: 36037992 DOI: 10.1016/j.jad.2022.08.046] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 07/27/2022] [Accepted: 08/20/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Macronutrients' quality may impact differently on mental health and quality of life (QOL). This study aimed to investigate the potential relationship between the carbohydrate quality index (CQI), fat quality index (FQI), protein quality index (PQI), the affective mental symptoms and QOL among Iranian adults. METHODS The LipoKAP is a cross-sectional study, conducted with 2456 adults in Iran. A validated food frequency questionnaire was used to evaluate usual dietary intakes. A validated Iranian version of the Hospital Anxiety and Depression Scale was used to assess the severity of anxiety and depression. QOL was assessed by EQ-5D. RESULT In the fully adjusted model, participants in the highest tertile of CQI had lower QOL than those in the lowest tertile (OR = 1.35; 95 % CI: 1.06, 1.73). Individuals in the top tertile of FQI (OR = 0.71; 95 % CI: 0.55, 0.91) and PQI (OR = 0.78; 95 % CI: 0.60; 1.01) were less likely to report lower QOL than those in the bottom tertile. An inverse association was found between PQI and depressive symptoms (OR = 0.72, 95 % CI: 0.55, 0.95), but not for CQI and FQI. LIMITATIONS The cross-sectional design of the study and the use of a memory-based dietary tool may limit the generalizability of our findings. CONCLUSION Higher PQI was associated with lower risk of depressive symptoms and having a low-quality life. Although CQI and FQI were not related to depressive and anxiety symptoms, higher values of FQI were associated with better QOL, while CQI showed an inverse association.
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Affiliation(s)
- Parisa Hajihashemi
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Haghighatdoost
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Maryam Maghroun
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firouzeh Sajjadi
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farid Najafi
- Research Center for Environmental determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Farshidi
- Hormozgan Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandarabbas, Iran
| | - Masoud Lotfizadeh
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Kamal Solati
- Department of Psychiatry, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Tooba Kazemi
- Birjand Cardiovascular Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Simin Karimi
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Roohafza
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammadreza Sabri
- Prdiatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, UK
| | - Erika Aparecida Silveira
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, UK; Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Brazil
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
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The Study of Nutrient Intake and Adolescent Girls' Quality of Life in a Rural Area of Indonesia. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9081248. [PMID: 36010138 PMCID: PMC9406564 DOI: 10.3390/children9081248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/06/2022] [Accepted: 08/15/2022] [Indexed: 12/17/2022]
Abstract
An inadequate nutrient intake correlates with malnutrition, a problem affecting many adolescents worldwide. Nutrient intake is associated with quality of life (QoL). Our study analyzed the relationship between nutrient intake and adolescents’ QoL. We conducted a cross-sectional study. Through simple random sampling, 157 adolescent girls were selected. Nutrition status was assessed using anthropometric measurements. Nutrient intake was collected using the food frequency questionnaire (FFQ). WHOQOL BREF was used to explore adolescent girls’ quality of life. The median of nutrient intake: energy (908.25 kcal); protein (24.16 g); carbohydrate (128.89 g); fat (21.89 g); vitamin A (77.10 mg); vitamin E (1.40 mg); vitamin B1 (0.19 mg); vitamin B2 (0.29 mg); vitamin B6 (0.45 mg); folic acid (35.13 mg); vitamin C (12.60 mg); calcium (197.46 mg); magnesium (93.72 mg); iron (2.64 mg); and zinc (2.09 mg). The adolescents’ QoL scores were physical health 44 (25–81), psychological domain 56 (19–94), social relationships 56 (19–94), and environmental domain 56 (31–100). The strongest correlations were between (1) physical health with carbohydrates, vitamin C, and fat; (2) psychological domain with calcium; (3) social relationships with carbohydrates and vitamin C; and (4) environmental domain with BMI and zinc. There was a significant positive correlation between the intake of some nutrients and adolescents’ QoL, despite the observation of some significant negative correlations. The findings of this study indicate that more attention should be focused on adolescents’ nutrient intake in order to improve their QoL.
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Matison AP, Milte CM, Shaw JE, Magliano DJ, Daly RM, Torres SJ. Association between dietary protein intake and changes in health-related quality of life in older adults: findings from the AusDiab 12-year prospective study. BMC Geriatr 2022; 22:211. [PMID: 35291939 PMCID: PMC8925096 DOI: 10.1186/s12877-022-02894-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 02/14/2022] [Indexed: 01/05/2023] Open
Abstract
Background Adequate dietary protein intake is recommended for older adults to optimise muscle health and function, and support recovery from illness, however, its effect on health-related quality of life (HRQoL) is unclear. The aim of this study was to examine the association between total protein intake and different sources of dietary protein and HRQoL in Australians aged 60 years and older over a 12-year period. Methods This study used data from the Australian Diabetes, Obesity and Lifestyle study (AusDiab), a 12-year population-based prospective study. The sample included 752 (386 females) adults aged 60 years and older. Protein intake was estimated at baseline (1999/2000) from a 74-item Food Frequency Questionnaire, and HRQoL using the 36-item Short-form Health Survey assessed at baseline (1999/2000) and after 12 years (2011/12). The association between protein intake and change in HRQoL was evaluated using multivariate regression analysis adjusted for relevant confounders. The difference in change in HRQoL between participants with total protein intakes of < 1.0 g/kg/day, intakes of between 1.0–1.2 g/kg/day and intakes of > 1.2 g/kg/day were assessed using one-way ANCOVA. Results Total protein intake at baseline was not associated with 12-year changes in physical component summary (PCS) or mental component summary (MCS) scores of HRQoL. Higher animal, red meat and processed animal protein intakes were associated with deteriorations in PCS scores after adjusting for relevant confounders (β = − 0.04; 95% CI: − 0.07, −0.01 ; p = 0.009; β = − 0.05; 95% CI: − 0.08, − 0.01; p = 0.018; β = − 0.17; 95% CI: − 0.31, − 0.02; p = 0.027 respectively). Higher red meat protein intake was associated with deteriorations in MCS scores after adjusting for relevant confounders (β = − 0.04; 95% CI: − 0.08, − 0.01; p = 0.011). There was no difference in 12-year changes in PCS or MCS between participants consuming total protein of < 1.0 g/kg/day, 1.0–1.2 g/kg/day and intakes of > 1.2 g/kg/day. Conclusion There was no relationship between total dietary protein intake and HRQoL, but higher protein intakes from animal, red meat and processed animal sources were associated with a deterioration in HRQoL scores over 12 years. Due to the number of associations examined and high drop out of older less healthy participants, further research is required to confirm the associations detected in healthy and less healthy participants, with a view to making protein intake recommendations for older adults. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02894-y.
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Affiliation(s)
- Annabel P Matison
- Deakin University, Institute for Physical Activity and Nutrition, 221 Burwood Highway, Burwood, Victoria, 3125, Australia. .,Centre for Healthy Brain Ageing, University of New South Wales, School of Psychiatry, Level 1, AGSM (G27) Gate 11, Botany Street, Sydney, New South Wales, 2052, Australia.
| | - Catherine M Milte
- Deakin University, Institute for Physical Activity and Nutrition, 221 Burwood Highway, Burwood, Victoria, 3125, Australia
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Level 4, 99 Commercial Road, Melbourne, Victoria, 3004, Australia
| | - Dianna J Magliano
- Baker Heart and Diabetes Institute, Level 4, 99 Commercial Road, Melbourne, Victoria, 3004, Australia
| | - Robin M Daly
- Deakin University, Institute for Physical Activity and Nutrition, 221 Burwood Highway, Burwood, Victoria, 3125, Australia
| | - Susan J Torres
- Deakin University, Institute for Physical Activity and Nutrition, 221 Burwood Highway, Burwood, Victoria, 3125, Australia
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Sugar-sweetened beverage consumption and incidence of breast cancer: the Seguimiento Universidad de Navarra (SUN) Project. Eur J Nutr 2018; 58:2875-2886. [DOI: 10.1007/s00394-018-1839-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 09/27/2018] [Indexed: 12/18/2022]
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Galilea-Zabalza I, Buil-Cosiales P, Salas-Salvadó J, Toledo E, Ortega-Azorín C, Díez-Espino J, Vázquez-Ruiz Z, Zomeño MD, Vioque J, Martínez JA, Romaguera D, Perez-Farinos N, López-Miranda J, Estruch R, Bueno-Cavanillas A, Arós F, Tur JA, Tinahones F, Serra-Majem L, Marcos-Delgado A, Ortega-Calvo M, Vázquez C, Pintó X, Vidal J, Daimiel L, Delgado-Rodríguez M, Matía P, Corella D, Diaz-López A, Babio N, Muñoz MA, Fitó M, González-Palacios S, Abete I, García-Rios A, Ros E, Martínez-González MÁ. Mediterranean diet and quality of life: Baseline cross-sectional analysis of the PREDIMED-PLUS trial. PLoS One 2018; 13:e0198974. [PMID: 29912978 PMCID: PMC6005498 DOI: 10.1371/journal.pone.0198974] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 05/28/2018] [Indexed: 11/18/2022] Open
Abstract
We assessed if a 17-item score capturing adherence to a traditional Mediterranean diet (MedDiet) was associated with better health-related quality of life among older Spanish men and women with overweight or obesity harboring the metabolic syndrome. We analyzed baseline data from 6430 men and women (age 55-70 years) participating in the PREDIMED-Plus study. PREDIMED-Plus is a multi-centre randomized trial testing an energy-restricted MedDiet combined with promotion of physical activity and behavioral therapy for primary cardiovascular prevention compared to a MedDiet alone. Participants answered a 36-item questionnaire about health-related quality of life (HRQoL) and a 17-item questionnaire that assessed adherence to an MedDiet. We used ANCOVA and multivariable-adjusted linear regression models to compare baseline adjusted means of the quality of life scales according to categories of adherence to the MedDiet. Higher adherence to the MedDiet was independently associated with significantly better scores in the eight dimensions of HRQoL. Adjusted differences of > = 3 points between the highest and the lowest dietary adherence groups to the MedDiet were observed for vitality, emotional role, and mental health and of > = 2 points for the other dimensions. In conclusion, this study shows a positive association between adherence to a MedDiet and several dimensions of quality of life.
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Affiliation(s)
- Iñigo Galilea-Zabalza
- Atención Primaria. Osasunbidea-Servicio Navarro de Salud. Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Pilar Buil-Cosiales
- Atención Primaria. Osasunbidea-Servicio Navarro de Salud. Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra-IdiSNA, Pamplona, Spain
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Human Nutrition Unit, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Estefanía Toledo
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra-IdiSNA, Pamplona, Spain
| | - Carolina Ortega-Azorín
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Javier Díez-Espino
- Atención Primaria. Osasunbidea-Servicio Navarro de Salud. Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra-IdiSNA, Pamplona, Spain
| | - Zenaida Vázquez-Ruiz
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra-IdiSNA, Pamplona, Spain
| | - María Dolores Zomeño
- Cardiovascular Risk and Nutrition, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
- Blanquerna School of Life Sciences, Universitat Ramon Llull, Barcelona, Spain
| | - Jesús Vioque
- CIBER Epidemiología y Salud Pública (CIBEResp), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Nuritional Epidemiology Unit, Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain
| | - José Alfredo Martínez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nutrition and Food Sciences, Physiology and Toxicology, University of Navarra, Pamplona, Spain
| | - Dora Romaguera
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases, Palma, Spain
| | | | - José López-Miranda
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, Reina Sofia University Hospital, University of Córdoba-IMIBIC, Córdoba, Spain
| | - Ramón Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Aurora Bueno-Cavanillas
- Blanquerna School of Life Sciences, Universitat Ramon Llull, Barcelona, Spain
- Department of Preventive Medicine, University of Granada, Granada, Spain
| | - Fernando Arós
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Cardiology OSI ARABA. University Hospital Araba, Vitoria, Spain
- University of the Basque Country UPV/EHU, Vitoria-Gasteiz. Spain
| | - Josep Antoni Tur
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology, University Hospital, University of Málaga, Málaga, Spain
| | - Francisco Tinahones
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology, University Hospital, University of Málaga, Málaga, Spain
| | - Lluis Serra-Majem
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Institute for Biomedical Research, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Alba Marcos-Delgado
- Blanquerna School of Life Sciences, Universitat Ramon Llull, Barcelona, Spain
- Instituto de Biomedicina (IBIOMED); Universidad de León, León, Spain
| | - Manuel Ortega-Calvo
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Family Medicine, Distrito Sanitario Atencion Primaria, Centro de Salud Las Palmeritas, Sevilla, Spain
| | - Clotilde Vázquez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology, Fundación Jiménez-Díaz, Madrid, Spain
| | - Xavier Pintó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Josep Vidal
- CIBER Diabetes y enfermedades metabólicas (CIBERdem), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Lidia Daimiel
- Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Miguel Delgado-Rodríguez
- Blanquerna School of Life Sciences, Universitat Ramon Llull, Barcelona, Spain
- Division of Preventive Medicine, University of Jaén, Jaén, Spain
| | - Pilar Matía
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Dolores Corella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Andrés Diaz-López
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Human Nutrition Unit, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Nancy Babio
- Human Nutrition Unit, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Miguel Angel Muñoz
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipids and Cardiovascular Epidemiology Research Unit, Institut Municipal d’Investigació Mèdica (IMIM), Barcelona, Spain
| | - Montse Fitó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipids and Cardiovascular Epidemiology Research Unit, Institut Municipal d’Investigació Mèdica (IMIM), Barcelona, Spain
| | - Sandra González-Palacios
- CIBER Epidemiología y Salud Pública (CIBEResp), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Nuritional Epidemiology Unit, Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain
| | - Itziar Abete
- Department of Nutrition and Food Sciences, Physiology and Toxicology, University of Navarra, Pamplona, Spain
| | - Antonio García-Rios
- Department of Internal Medicine, Reina Sofia University Hospital, University of Córdoba-IMIBIC, Córdoba, Spain
| | - Emilio Ros
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Miguel Ángel Martínez-González
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra-IdiSNA, Pamplona, Spain
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, United State of America
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Alonso-Domínguez R, Gómez-Marcos MA, Patino-Alonso MC, Sánchez-Aguadero N, Agudo-Conde C, Castaño-Sánchez C, García-Ortiz L, Recio-Rodríguez JI. Effectiveness of a multifactorial intervention based on an application for smartphones, heart-healthy walks and a nutritional workshop in patients with type 2 diabetes mellitus in primary care (EMID): study protocol for a randomised controlled trial. BMJ Open 2017; 7:e016191. [PMID: 28912193 PMCID: PMC5640135 DOI: 10.1136/bmjopen-2017-016191] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION New information and communication technologies (ICTs) may promote lifestyle changes, but no adequate evidence is available on their combined effect of ICTs with multifactorial interventions aimed at improving diet and increasing physical activity in patients with type 2 diabetes mellitus (DM2). The primary objective of this study is to assess the effect of a multifactorial intervention to increase physical activity and adherence to Mediterranean diet in DM2. METHODS AND ANALYSIS: Study scope and population: The study will be conducted at 'La Alamedilla' primary care research unit in Salamanca (Spain). 200 patients with DM2 of both sexes, aged 25-70 years and who meet the inclusion criteria and sign the informed consent will be recruited. Each participant will attend the clinic at baseline and 3 and 12 months after intervention. INTERVENTION Both groups will be given short advice on diet and physical activity. The intervention group will also take five heart-healthy walks and attend a group session on diet education and will be trained on use of an application for smartphone (EVIDENT II) for 3 months. VARIABLES AND MEASUREMENT INSTRUMENTS The main study endpoints will be changes in physical activity, as assessed by a pedometer and the International Physical Activity Questionnaire, and adherence to the Mediterranean diet, as evaluated by an adherence questionnaire and the Diet Quality Index. Anthropometric parameters and laboratory values, lifestyles and quality of life will also be assessed. ETHICS AND DISSEMINATION It was approved by the Clinical Research Ethics Committee of Salamanca on 28/11/2016. TRIAL REGISTRATION NCT02991079; Pre-results.
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Affiliation(s)
- Rosario Alonso-Domínguez
- Primary Care Research Unit, The Alamedilla Health Center, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
| | - Manuel A Gómez-Marcos
- Department of Medicine, Primary Care Research Unit, The Alamedilla Health Center, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), University of Salamanca. Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
| | - Maria C Patino-Alonso
- Department of Statistics, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), University of Salamanca, Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
| | - Natalia Sánchez-Aguadero
- Primary Care Research Unit, The Alamedilla Health Center, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
| | - Cristina Agudo-Conde
- Primary Care Research Unit, The Alamedilla Health Center, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
| | - Carmen Castaño-Sánchez
- Primary Care Research Unit, The Alamedilla Health Center, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
| | - Luis García-Ortiz
- Department of Biomedical and Diagnostic Sciences, Primary Care Research Unit, The Alamedilla Health Center, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), University of Salamanca, Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
| | - José I Recio-Rodríguez
- Department of Nursing and Physiotherapy, Primary Care Research Unit, The Alamedilla Health Center, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), University of Salamanca. Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
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9
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Major Depressive Disorder in Patients With Doctoral Degrees: Patient-reported Depressive Symptom Severity, Functioning, and Quality of Life Before and After Initial Treatment in the STAR*D Study. J Psychiatr Pract 2017; 23:328-341. [PMID: 28961662 DOI: 10.1097/pra.0000000000000251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE This study examined patients with medical or doctoral degrees diagnosed with major depressive disorder (MDD) by analyzing patient-reported depressive symptom severity, functioning, and quality of life (QOL) before and after treatment of MDD. METHODS Analyses were conducted in a sample of 2280 adult outpatient participants with MDD from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study with complete entry and exit scores for the level 1 (citalopram monotherapy) trial. The sample contained 62 participants who had completed medical or doctoral degrees (DOCS) and 2218 participants without medical or doctoral degrees (non-DOCS). QOL was assessed with the Quality of Life Enjoyment and Satisfaction Questionnaire, functioning was assessed with the Work and Social Adjustment Scale, and depressive symptom severity was assessed with the Quick Inventory of Depressive Symptomatology-Self Report. RESULTS Both groups (DOCS and non-DOCS) had significant improvement in depressive symptom severity, functioning, and QOL following treatment (with equivalent improvements in mean change values). However, the DOCS group demonstrated larger effect sizes in symptom reduction for depression, increase in functioning, and improvement in QOL compared with the non-DOCS group. Participants who achieved remission from MDD at exit showed significantly greater improvement than nonremitters on functioning and QOL. CONCLUSIONS Findings from this study indicated that, following citalopram monotherapy, the participants in the DOCS group achieved greater reductions in depressive symptom severity (based on effect sizes) than the participants in the non-DOCS group. For both treatment groups, the findings also showed the positive effect that remission status from MDD can have on QOL and functioning.
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Sharifi MH, Eftekhari MH, Ostovan MA, Rezaianazadeh A. Effects of a therapeutic lifestyle change diet and supplementation with Q10 plus L-carnitine on quality of life in patients with myocardial infarction: A randomized clinical trial. J Cardiovasc Thorac Res 2017; 9:21-28. [PMID: 28451084 PMCID: PMC5402023 DOI: 10.15171/jcvtr.2017.03] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 02/08/2017] [Indexed: 12/13/2022] Open
Abstract
Introduction: Myocardial infarction (MI) has a deleterious effect on quality of life (QoL), which can affect cardiac prognosis after MI. Thus, new strategies have to be identified for improving the QoL. To our knowledge, no studies have been conducted on the impact of therapeutic lifestyle change (TLC) diet and L-carnitine plus Q10 supplementation on QoL after MI. Methods: The study aimed to measure 128 MI patients' QoL using MacNew QoL questionnaire (global scales and physical, emotional, and social subscales) before and 3 months after the intervention. The patients were divided into 4 groups. Group A received TLC diet, group B orally received Q10 150 mg/d and L-carnitine 1200 mg/d, and group C received a combination of carnitine plus Q10 and TLC diet. Finally, group D, as the control group, only underwent the routine care. Results: The results showed a significant increase in MacNew questionnaire's physical, emotional, and social subscales in the four groups after the intervention. The results of within-group analysis showed that the physical and emotional subscales changed significantly (P < 0.001 and P < 0.022, respectively). In the emotional subscale, TLC group showed a significant improvement compared to groups B and D (P < 0.019 and P < 0.001, respectively), but not group C (P < 0.681). In the physical subscale, Q10 plus L-carnitine group showed a significant improvement compared to groups A and D (P < 0.001 and P < 0.0001, respectively), but not group C (P < 0.860). In the global scale, combination of carnitine plus Q10 and TLC diet group demonstrated a considerable improvement compared to groups A, B, and D (P < 0.001, P < 0.001, and P < 0.001, respectively). Nevertheless, the results of within-group analysis revealed no significant differences among the four groups regarding the social subscale (P < 0.229). Conclusion: Both TLC diet and supplementation with Q10 and L- carnitine had a positive effect on the physical and emotional subscales of MacNew questionnaire and may improve post-MI prognosis. Based on the results, combination of Q10 plus L-carnitine and TLC die can be a potential intervention for improving QoL and secondary prevention.
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Affiliation(s)
| | | | - Mohammad Ali Ostovan
- Department of Cardiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Rezaianazadeh
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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11
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Sanchez-Aguadero N, Alonso-Dominguez R, Garcia-Ortiz L, Agudo-Conde C, Rodriguez-Martin C, de Cabo-Laso A, Sanchez-Salgado B, Ramos R, Maderuelo-Fernandez JA, Gomez-Marcos MA, Recio-Rodriguez JI. Diet and physical activity in people with intermediate cardiovascular risk and their relationship with the health-related quality of life: results from the MARK study. Health Qual Life Outcomes 2016; 14:169. [PMID: 27927210 PMCID: PMC5142320 DOI: 10.1186/s12955-016-0572-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 12/01/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND To analyze the interplay between diet, physical activity and health-related quality of life in a Spanish randomly selected sample of individuals attended in general practitioners offices with intermediate cardiovascular risk. METHODS This study analyzed 314 subjects, aged 35-74 years (50.6% women), from the MARK study, conducted in Spain. Health related quality of life was measured by the SF-12 questionnaire. The assessment of the lifestyles included the diet quality index, the adherence to the Mediterranean diet and the leisure time physical activity practice. RESULTS The highest values of health related quality of life were obtained in the area of vitality (51.05 ± 11.13), while the lowest were found in the general health (39.89 ± 8.85). In the multiple linear regression analysis, after adjustment for age, gender and other confounders, for each point of increase in the Mediterranean diet adherence score, there was an increase of 1.177 points in the mental component value (p < 0.01). Similarly, for each point of increase in the Diet Quality Index Score, there was an increase in the mental component of 0.553 (p < 0.05). Likewise, the physical activity was positively associated with the physical function and vitality (β = 0.090 and 0.087, (p < 0.01 and p < 0.05), respectively). CONCLUSIONS In people with intermediate cardiovascular risk, better food habits and greater adherence to the Mediterranean diet are associated with higher scores on the mental component of quality of life. Likewise, increased physical activity is related with positive scores on the physical function.
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Affiliation(s)
- Natalia Sanchez-Aguadero
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (redIAPP), 37003 Salamanca, Spain
| | - Rosario Alonso-Dominguez
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (redIAPP), 37003 Salamanca, Spain
| | - Luis Garcia-Ortiz
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (redIAPP), 37003 Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - Cristina Agudo-Conde
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (redIAPP), 37003 Salamanca, Spain
| | - Carmela Rodriguez-Martin
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (redIAPP), 37003 Salamanca, Spain
| | - Angela de Cabo-Laso
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (redIAPP), 37003 Salamanca, Spain
| | - Benigna Sanchez-Salgado
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (redIAPP), 37003 Salamanca, Spain
| | - Rafel Ramos
- Research Unit Family Medicine, Girona. Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol), Translab Research Group. Medical Sciences Department, School of Medicine, University of Girona, Girona Biomedical Research Institute (IDIBGI), Dr. Trueta University Hospital, Catalonia, Spain
| | - Jose A. Maderuelo-Fernandez
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (redIAPP), 37003 Salamanca, Spain
| | - Manuel A. Gomez-Marcos
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (redIAPP), 37003 Salamanca, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Jose I. Recio-Rodriguez
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (redIAPP), 37003 Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
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12
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Wolever TMS, Chiasson JL, Josse RG, Leiter LA, Maheux P, Rabasa-Lhoret R, Rodger NW, Ryan EA. Effects of Changing the Amount and Source of Dietary Carbohydrates on Symptoms and Dietary Satisfaction Over a 1-Year Period in Subjects with Type 2 Diabetes: Canadian Trial of Carbohydrates in Diabetes (CCD). Can J Diabetes 2016; 41:164-176. [PMID: 27884550 DOI: 10.1016/j.jcjd.2016.08.223] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 07/20/2016] [Accepted: 08/22/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine the long-term effects of changing the amount or source of dietary carbohydrate on quality of life (QOL), symptoms and dietary satisfaction in people with type 2 diabetes. METHODS Subjects with diabetes treated by diet alone (n=162) were randomly assigned to high-carbohydrate/high-glycemic-index (HGI) diets; high-carbohydrate/low-glycemic-index (LGI) diets; or lower-carbohydrate/high-monounsaturated-fat (LC) diets for 1 year. We measured QOL at baseline and at study's end, and we measured symptoms and dietary satisfaction quarterly. RESULTS The HGI, LGI and LC diets contained, respectively, 47±1, 52±1 and 40±1% energy carbohydrate; 30±1, 27±1 and 40±1% fat with GI 64±0.4, 55±0.4 and 59±0.4. Significantly more participants reported increased flatulence on LGI than on LC and HGI diets at 3 months (41%, 19%, 14%; p<0.05), but not at 12 months (29%, 17%, 17%; ns). Abdominal distension was more severe (46% vs. 14%, 19%; p<0.05), and headache less severe (8% vs. 22%, 23%; p<0.05) on LGI than on both other diets. Increased appetite was more severe on LC (33%) than on HGI diets (14%, p<0.05). Joint/limb pains were less severe on LGI (16%) than HGI (28%) diets. LC elicited more severe gloomy thoughts (23%) than LGI (4%; p<0.05) but greater dietary-satisfaction (70%; p<0.05) than LGI (40%) and HGI (48%) diets. For all diets, glycated hemoglobin (A1C) levels increased less in those who gained less weight, had less increased appetite and were more satisfied with the enjoyment obtained from eating. CONCLUSIONS Each diet elicited increased severity of 1 or more symptoms than the other diets. Although overall dietary satisfaction was greater on the 40% carbohydrate diet than on the 50% carbohydrate diet, the LGI diet was no less satisfying than the HGI diet. Changes in appetite and dietary satisfaction may influence body weight and glycemic control, or vice-versa.
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Affiliation(s)
- Thomas M S Wolever
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada.
| | - Jean-Louis Chiasson
- Research Center (CHUM) Hôtel-Dieu de Montréal, University of Montréal, Montréal, Québec, Canada
| | - Robert G Josse
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Lawrence A Leiter
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Pierre Maheux
- Department of Medicine, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Rémi Rabasa-Lhoret
- IRCM (Institut de Recherches Cliniques de Montréal), Montréal, Québec, Canada
| | - N Wilson Rodger
- Department of Medicine, St. Joseph's Health Centre, Western University, London, Ontario, Canada
| | - Edmond A Ryan
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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IsHak WW, James DM, Mirocha J, Youssef H, Tobia G, Pi S, Collison KL, Cohen RM. Patient-reported functioning in major depressive disorder. Ther Adv Chronic Dis 2016; 7:160-9. [PMID: 27347363 DOI: 10.1177/2040622316639769] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES Compared with the general population, patients with major depressive disorder (MDD) report substantial deficits in their functioning that often go beyond the clinical resolution of depressive symptoms. This study examines the impact of MDD and its treatment on functioning. METHODS From the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial, we analyzed complete data of 2280 adult outpatients with MDD at entry and exit points of each level of antidepressant treatment and again 12 months post treatment. Functioning was measured using the Work and Social Adjustment Scale (WSAS). RESULTS The results show that only 7% of patients with MDD reported within-normal functioning before treatment. The proportion of patients achieving within-normal functioning (WSAS) scores significantly increased after treatment. However, the majority of patients (>60%) were still in the abnormal range on functioning at exit. Although remitted patients had greater improvements compared with nonremitters, a moderate proportion of remitted patients continued to experience ongoing deficits in functioning after treatment (20-40%). Follow-up data show that the proportions of patients experiencing normal scores for functioning after 12 months significantly decreased from the end of treatment to the follow-up phase, from 60.1% to 49% (p < 0.0001), a finding that was particularly significant in nonremitters. Limitations of this study include the reliance on self-report of functioning and the lack of information on patients who dropped out. CONCLUSION This study points to the importance of functional outcomes of MDD treatment as well as the need to develop personalized interventions to improve functioning in MDD.
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Affiliation(s)
- Waguih William IsHak
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, 8730 Alden Drive, Thalians E-132, Los Angeles, CA 90048, USA
| | - David M James
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - James Mirocha
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Haidy Youssef
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Gabriel Tobia
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Sarah Pi
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Katherine L Collison
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Robert M Cohen
- Department of Psychiatry, Emory University School of Medicine, Atlanta, GA, USA
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Assaf AR, Beresford SA, Risica PM, Aragaki A, Brunner RL, Bowen DJ, Naughton M, Rosal MC, Snetselaar L, Wenger N. Low-Fat Dietary Pattern Intervention and Health-Related Quality of Life: The Women's Health Initiative Randomized Controlled Dietary Modification Trial. J Acad Nutr Diet 2016; 116:259-271. [PMID: 26384466 PMCID: PMC4733402 DOI: 10.1016/j.jand.2015.07.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 07/15/2015] [Indexed: 01/09/2023]
Abstract
BACKGROUND Intensive dietary intervention programs may lead to benefits in vitality and other components of health quality. The Women's Health Initiative Dietary Modification (DM) intervention includes a large randomized controlled trial of an intensive intervention. OBJECTIVE To evaluate whether the intervention is associated with improved health-related quality of life (HRQoL) subscales, overall self-reported health, depression symptoms, cognitive functioning, and sleep quality. DESIGN This randomized controlled trial was analyzed as intent to treat. PARTICIPANTS Between 1993 and 1998, 48,835 women aged 50 to 79 years were recruited by 40 clinical centers across the United States. Eligibility included having fat intake at baseline ≥32% of total calories, and excluded women with any prior colorectal or breast cancer, recent other cancers, type 1 diabetes, or medical conditions with predicted survival <3 years. INTERVENTION Goals were to reduce calories from fat to 20%, increase vegetables and fruit to 5+ servings, and increase grain servings to 6+ servings a day. During the first year, 18 group sessions were held, with quarterly sessions thereafter. MAIN OUTCOME MEASURES The RAND 36-Item Health Survey was used to assess HRQoL at baseline, Year 1, and close-out (about 8 years postrandomization), and estimate differential HRQoL subscale change scores. STATISTICAL ANALYSES PERFORMED Mean change in HRQoL scores (Year 1 minus baseline) were compared by randomization group using linear models. RESULTS At 1 year, there was a differential change between intervention and comparison group of 1.7 units (95% CI 1.5, 2.0) in general health associated with the intervention. DM intervention improved physical functioning by 2.0 units (95% CI 1.7, 2.3), vitality by 1.9 units (95% CI 1.6, 2.2), and global quality of life by 0.09 units (95% CI 0.07, 0.12). With the exception of global quality of life, these effects were significantly modified by body mass index at baseline. CONCLUSIONS DM intervention was associated with small, but significant improvements in three HRQoL subscales: general health, physical functioning, and vitality at 1 year follow-up, with the largest improvements seen in the women with the greatest baseline body mass index.
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Affiliation(s)
- Annlouise R. Assaf
- Global Medical Affairs, Global Innovative Pharma Women’s Health Pfizer Inc. Eastern Point Road, MS 8260-2204 Groton, CT 06340 Tel: (860) 441-1961
| | - Shirley A.A. Beresford
- Epidemiology and Senior Associate Dean School of Public Health, University of Washington Box 357230 Seattle, WA 98195-7230 Tel: 206-543-9512
| | - Patricia Markham Risica
- Department Community Health Alpert Medical School, Brown University, Box G-S121-8, 121 South Main Street, Providence, RI 02912, Tel. 401-863-6550, Fax. 401-863-6651,
| | - Aaron Aragaki
- Women’s Health Initiative Clinical Coordinating Center, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue N, M3-B232, Seattle, WA 98109-1024, Tel. (206) 667-6734, Fax. (206) 667-4142,
| | - Robert L. Brunner
- Department of Nutrition, University of Nevada School of Medicine, 1664 North Virginia Street, Pennington Medical Education Building, Reno, NV 89557-0342, Tel. (775) 762-2479, Fax. (775) 784-6194,
| | - Deborah J. Bowen
- Department of Bioethics & Humanities, University of Washington, 1107 NE 45 St, Suit 305, Seattle, WA 98195-7120, Tel. (206) 616-5601, Fax. (206) 685-7515,
| | - Michelle Naughton
- Division of Population Sciences, Department of Internal Medicine, College of Medicine, The Ohio State University, 1590 N High St, Suite 525, Columbus, OH 43210, Tel. (614) 293-6390, Fax. (614) 293-5611,
| | - Milagros C. Rosal
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655, Tel. (508) 856-2656, Fax. (508) 856-3840,
| | - Linda Snetselaar
- College of Public Health, 111 Jessup Hall, University of Iowa, Iowa City, IA 52242, Tel. (319) 335-3565, Fax. (319) 335-3560,
| | - Nanette Wenger
- Professor Emeritus, Emory University School of Medicine, Department of Medicine, Division of Cardiology, 49 Jesse Hill Jr. Drive, SE, Atlanta, GA 30303, Tel. (404) 616-4420, Fax. (404) 616-3093,
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15
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IsHak WW, Mirocha J, James D, Tobia G, Vilhauer J, Fakhry H, Pi S, Hanson E, Nashawati R, Peselow ED, Cohen RM. Quality of life in major depressive disorder before/after multiple steps of treatment and one-year follow-up. Acta Psychiatr Scand 2015; 131:51-60. [PMID: 24954156 PMCID: PMC4267902 DOI: 10.1111/acps.12301] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/22/2014] [Indexed: 12/28/2022]
Abstract
OBJECTIVE This study examines the impact of major depressive disorder (MDD) and its treatment on quality of life (QOL). METHOD From the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial, we analyzed complete data of 2280 adult MDD out-patients at entry/exit of each level of antidepressant treatments and after 12 months of entry to follow-up. QOL was measured using the QOL Enjoyment and Satisfaction Questionnaire (Q-LES-Q). The proportions of patients scoring 'within-normal' QOL (within 10% of Q-LES-Q community norms) and those with 'severely impaired' QOL (>2 SD below Q-LES-Q community norms) were analyzed. RESULTS Before treatment, no more than 3% of MDD patients experienced 'within-normal' QOL. Following treatment, statistically significant improvements were detected; however, the proportion of patients achieving 'within-normal' QOL did not exceed 30%, with >50% of patients experiencing 'severely impaired' QOL. Although remitted patients had greater improvements compared with non-remitters, 32-60% continued to experience reduced QOL. 12-month follow-up data revealed that the proportion of patients experiencing 'within-normal' QOL show a statistically significant decrease in non-remitters. CONCLUSION Symptom-focused treatments of MDD may leave a misleading impression that patients have recovered when, in fact, they may be experiencing ongoing QOL deficits. These findings point to the need for investigating specific interventions to ameliorate QOL in MDD.
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Affiliation(s)
- Waguih William IsHak
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles (UCLA), Los Angeles, California, United States
| | - James Mirocha
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California, United States
| | - David James
- Stanford University and Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California, United States
| | - Gabriel Tobia
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California, United States
| | - Jennice Vilhauer
- Departments of Psychiatry, Emory University School of Medicine, Atlanta, Georgia, and Cedars-Sinai Medical Center, Los Angeles, California, United States
| | - Hala Fakhry
- Department of Psychiatry, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Sarah Pi
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, and University of California, Los Angeles, Los Angeles, California, United States
| | - Eric Hanson
- Loma Linda University, Loma Linda, California, United States
| | - Rama Nashawati
- University of Southern California and Cedars-Sinai Medical Center, Los Angeles, California, United States
| | - Eric D. Peselow
- Richmond University Medical Center and Freedom From Fear, Staten Island, New York, United States
| | - Robert M. Cohen
- Department of Psychiatry, Emory University School of Medicine, Atlanta, Georgia, United States
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Bardach SH, Schoenberg NE. The content of diet and physical activity consultations with older adults in primary care. PATIENT EDUCATION AND COUNSELING 2014; 95:319-324. [PMID: 24736190 PMCID: PMC4058830 DOI: 10.1016/j.pec.2014.03.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 03/11/2014] [Accepted: 03/22/2014] [Indexed: 06/01/2023]
Abstract
OBJECTIVE Despite numerous benefits of consuming a healthy diet and receiving regular physical activity, engagement in these behaviors is suboptimal. Since primary care visits are influential in promoting healthy behaviors, we sought to describe whether and how diet and physical activity are discussed during older adults' primary care visits. METHODS 115 adults aged 65 and older consented to have their routine primary care visits recorded. Audio-recorded visits were transcribed and diet and physical activity content was coded and analyzed. RESULTS Diet and physical activity were discussed in the majority of visits. When these discussions occurred, they lasted an average of a minute and a half. Encouragement and broad discussion of benefits of improved diet and physical activity levels were the common type of exchange. Discussions rarely involved patient behavioral self-assessments, patient questions, or providers' recommendations. CONCLUSIONS The majority of patient visits include discussion of diet and physical activity, but these discussions are often brief and rarely include recommendations. PRACTICE IMPLICATIONS Providers may want to consider ways to expand their lifestyle behavior discussions to increase patient involvement and provide more detailed, actionable recommendations for behavior change. Additionally, given time constraints, a wider array of approaches to lifestyle counseling may be necessary.
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Affiliation(s)
| | - Nancy E Schoenberg
- Department of Behavioral Science, University of Kentucky, Lexington, USA
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Andreeva VA, Latarche C, Hercberg S, Briançon S, Galan P, Kesse-Guyot E. B vitamin and/or n-3 fatty acid supplementation and health-related quality of life: ancillary findings from the SU.FOL.OM3 randomized trial. PLoS One 2014; 9:e84844. [PMID: 24465438 PMCID: PMC3894946 DOI: 10.1371/journal.pone.0084844] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 11/19/2013] [Indexed: 02/07/2023] Open
Abstract
Background Despite growing attention to nutrition and quality of life in cardiovascular disease survivors, the impact of dietary factors according to disease type or to quality of life domain is poorly understood. We investigated the effects of B vitamin and/or n-3 fatty acid supplementation on health-related quality of life among survivors of stroke, myocardial infarction, or unstable angina. Methods We performed ancillary analyses of the SU.FOL.OM3 trial (2003–2009; France). In total, 2,501 men (mean age = 61 y) and women (mean age = 63 y) were randomized in a 2×2 factorial design to: 1) 0.56 mg 5-methyl-tetrahydrofolate, 3 mg vitamin B6, 0.02 mg vitamin B12; 2) 600 mg eicosapentaenoic and docosahexaenoic acids in a 2∶1 ratio; 3) B vitamins and n-3 fatty acids combined; or 4) placebo. Health-related quality of life was evaluated at follow-up with the Medical Outcomes Study 36-Item Short Form Health Survey. Data from 2,029 individuals were used in this analysis. Results After 3.1±0.4 y, no effects of supplementation with either B vitamins or n-3 fatty acids on quality of life (physical or mental health domains) were found. However, participants receiving B vitamins had slightly more activity limitations due to emotional problems compared with those not receiving B vitamins (mean difference = 3.8; 95% CI: 0.4, 7.1). A significant interaction of treatment by prior disease revealed an inverse association between n-3 fatty acids and vitality among myocardial infarction survivors (mean difference = 2.9; 95% CI: 0.5, 5.2). Conclusions There were no beneficial effects of supplementation with relatively low doses of B vitamins or n-3 fatty acids on health-related quality of life in cardiovascular disease survivors. The adverse effects of B vitamins on activity limitations and of n-3 fatty acids on vitality among individuals with prior myocardial infarction merit confirmation.
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Affiliation(s)
- Valentina A. Andreeva
- Nutritional Epidemiology Research Unit, Sorbonne-Paris-Cité, University of Paris XIII, French Institute of Health and Medical Research, National Institute of Agronomic Research, National Conservatory of Arts and Crafts, Bobigny, France
- * E-mail:
| | - Clotilde Latarche
- University Hospital Center, Department of Clinical Epidemiology and Evaluation, Nancy, France
- Université de Lorraine, Université Paris Descartes, Nancy, France
| | - Serge Hercberg
- Nutritional Epidemiology Research Unit, Sorbonne-Paris-Cité, University of Paris XIII, French Institute of Health and Medical Research, National Institute of Agronomic Research, National Conservatory of Arts and Crafts, Bobigny, France
- Department of Public Health, Avicenne Hospital, Bobigny, France
| | - Serge Briançon
- University Hospital Center, Department of Clinical Epidemiology and Evaluation, Nancy, France
- Université de Lorraine, Université Paris Descartes, Nancy, France
| | - Pilar Galan
- Nutritional Epidemiology Research Unit, Sorbonne-Paris-Cité, University of Paris XIII, French Institute of Health and Medical Research, National Institute of Agronomic Research, National Conservatory of Arts and Crafts, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Nutritional Epidemiology Research Unit, Sorbonne-Paris-Cité, University of Paris XIII, French Institute of Health and Medical Research, National Institute of Agronomic Research, National Conservatory of Arts and Crafts, Bobigny, France
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Abstract
Obsessive-compulsive disorder (OCD) has a profound impact with a high disease burden. In order to truly understand the scope of the effect OCD has on the patient population, one must take into account not only the relentless symptoms beleaguering the patients but also examine their overall ability to enjoy their life. Quality of life (QOL) assessments/improvements are becoming an increasingly important component of healthcare, especially in the mental health field. This review examines QOL in OCD, as well as the influence of comorbidities, and the impact that OCD treatment has on QOL. We searched MEDLINE/PUBMED and PsycINFO databases from 1980-2011 using keywords "obsessive compulsive disorder" OR "OCD" AND "quality of life" OR "QOL." Fifty-eight studies meeting specific selection criteria were ultimately included in this review. The results show that QOL in OCD is significantly impaired when compared to QOL in the general population and in patients with other psychiatric and medical disorders. Likewise, QOL in OCD also appears to be largely affected by comorbid conditions, which should be taken into account when developing a treatment plan. Furthermore, QOL in OCD has been shown to improve with medications and with both individual and group psychotherapy, albeit not to the levels enjoyed by community norms. QOL assessment in both clinical and research settings is important to examine the disease burden, to monitor treatment effectiveness, and to determine full recovery from OCD. Treatment providers should strive to not only reach symptom abatement, but also to assure that patients have regained satisfaction and functioning in their daily lives.
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