scholarly journals The effectiveness of general practice-based health checks on health behaviour and incidence on non-communicable diseases in individuals with low socioeconomic position: a randomised controlled trial in Denmark

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e029180 ◽  
Author(s):  
Nina Kamstrup-Larsen ◽  
Susanne Oksbjerg Dalton ◽  
Morten Grønbæk ◽  
Marie Broholm-Jørgensen ◽  
Janus Laust Thomsen ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Practice ◽  
Health Behaviour ◽  
Intervention Group ◽  
Metabolic Risk Factors ◽  
Health Check ◽  
Control Group ◽  
Metabolic Risk ◽  
Health Checks

BackgroundThe effectiveness of health checks aimed at the general population is disputable. However, it is not clear whether health checks aimed at certain groups at high risk may reduce adverse health behaviour and identify persons with metabolic risk factors and non-communicable diseases (NCDs).ObjectivesTo assess the effect of general practice-based health checks on health behaviour and incidence on NCDs in individuals with low socioeconomic position.MethodsIndividuals with no formal education beyond lower secondary school and aged 45–64 years were randomly assigned to the intervention group of a preventive health check or to control group of usual care in a 1:1 allocation. Randomisation was stratified by gender and 5-year age group. Due to the real-life setting, blinding of participants was only possible in the control group. Effects were analysed as intention to treat (ITT) and per protocol. The trial was undertaken in 32 general practice units in Copenhagen, Denmark.InterventionInvitation to a prescheduled preventive health check from the general practitioner (GP) followed by a health consultation and an offer of follow-up with health risk behaviour change or preventive medical treatment, if necessary.Primary outcome measuresSmoking status at 12-month follow-up. Secondary outcomes included status in other health behaviours such as alcohol consumption, physical activity and body mass index (measured by self-administered questionnaire), as well as incidence of metabolic risk factors and NCDs such as hypertension, hypercholesterolaemia, chronic obstructive pulmonary disease, diabetes mellitus, hypothyroidism, hyperthyroidism and depression (drawn from national healthcare registries).Results1104 participants were included in the study. For the primary outcome, 710 participants were included in the per protocol analysis, excluding individuals who did not attend the health check, and 1104 participants were included in the ITT analysis. At 12-month follow-up, 37% were daily smokers in the intervention group and 37% in the control group (ORs=0.99, 95% CI: 0.76 to 1.30). No difference in health behaviour nor in the incidence of metabolic risk factors and NCDs between the intervention and control group were found. Side effects were comparable across the two groups.ConclusionThe lack of effectiveness may be due to low intensity of intervention, a high prevalence of metabolic risk factors and NCDs among the participants at baseline as well as a high number of contacts with the GPs in general or to the fact that general practices are not an effective setting for prevention.Trial registration numberNCT01979107.

Effects of nutrition education on cardio-metabolic outcomes: A randomised clinical trial

2019 ◽  
Vol 79 (4) ◽  
pp. 458-470
Author(s):  
Hildemar Dos Santos ◽  
W Lawrence Beeson ◽  
Gina Segovia-Siapco ◽  
Brenda Koranda ◽  
Tony Jehi
Keyword(s):  
Risk Factors ◽  
Clinical Trial ◽  
Health Education ◽  
Intervention Group ◽  
Density Lipoprotein ◽  
Randomised Clinical Trial ◽  
Metabolic Risk Factors ◽  
Lipoprotein Cholesterol ◽  
Control Group ◽  
Metabolic Risk

Objective: The aim of this study was to assess the effect of Full Plate Diet (FPD) on the primary prevention of cardio-metabolic risk factors. Design: Randomised clinical trial. Setting: Drayson Center, Loma Linda University, CA, USA. Methods: Forty individuals were randomly assigned to either an intervention group receiving the FPD health education for 10 weeks or to a control group not receiving this intervention. Comprehensive evaluations of clinical and anthropometric outcomes were conducted at baseline and at the end of intervention. To assess within-group changes and between-group differences, a general linear model was used. Results: Significant reductions in weight (−1.54 kg, 95% confidence interval [CI] −2.5, −.54) and total cholesterol (TC) (−11.7 mg/dL; 95% CI −21.4, −2) and non-significant reductions in means for low-density lipoprotein cholesterol (LDL-C) (−7.3 mg/dL, 95% CI −16, 1.5) and triglycerides (−18.7 mg/dL, 95% CI −46, 8.5) were observed in the intervention group after 10 weeks compared with baseline. These reductions were non-significantly higher in the intervention compared with the control group. There were no significant mean changes in systolic and diastolic blood pressure, high-density lipoprotein cholesterol (HDL-C) and haemoglobin A1c (A1c) in the intervention group after 10 weeks. Conclusion: A multi-component programme comprising 10 weeks of health education that emphasised the high intake of fibre failed to significantly reduce cardio-metabolic risk factors. It did show a downward trend in triglycerides, TC and body weight that may be of clinical importance suggesting that a future investigation with a longer intervention duration is needed.

scholarly journals The COVID-19 pandemic and temporal change in metabolic risk factors for cardiovascular disease: a natural experiment within the HELIUS study.

2021 ◽  
Author(s):  
Bryn Hummel ◽  
Mara Yerkes ◽  
Ralf E Harskamp ◽  
Henrike Galenkamp ◽  
Anton E Kunst ◽  
...  
Keyword(s):  
Risk Factors ◽  
Natural Experiment ◽  
Exposed Group ◽  
Metabolic Risk Factors ◽  
Control Group ◽  
Metabolic Risk ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Helius Study

Abstract Objective We studied the association between the coronavirus disease 2019 (COVID-19) pandemic, including the restrictive measures, and metabolic risk factors for cardiovascular disease (CVD) in women and men. Next, we analysed whether changes in these metabolic risk factors were mediated by psychological and behavioural mechanisms. Design In this natural experiment, we assessed changes from baseline in metabolic CVD risk factors in the exposed group (whose follow-up measurements were taken during the pandemic), and compared these to the changes in the control group (whose follow-up measurements were taken before the pandemic). Participants This study used data from 6962 participants from six different ethnic groups (Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan) of the HELIUS study, based in Amsterdam, the Netherlands. We included women and men without prior CVD, who participated in both the baseline (2011-2015) and follow-up measurements (2019-2021). Outcome measures Changes between baseline and follow-up measurements in six metabolic CVD risk factors were calculated for systolic and diastolic blood pressure (SBP, DBP), total cholesterol (TC), fasting plasma glucose (FPG), haemoglobin A1c (HbA1c), and estimated glomerular filtration rate (eGFR). Results The exposed group experienced somewhat less favourable changes over time in SBP, DBP and FPG (the latter only in women) than the control group, while temporal changes in HbA1c and eGFR were more favourable among the control group. For instance, SBP was 1.119 mmHg [0.046, 2.193] higher in exposed than non-exposed women, and 1.380 [0.288, 2471] in men. Changes in SBP and DBP were partially mediated by changes in behavioural factors, most notably BMI and alcohol consumption. Conclusions The COVID-19 pandemic, including the restrictive lockdown measures, is associated with a deterioration of several CVD risk factors in women and men. These findings may aid in decision making concerning the management of and the recovery following the pandemic

Correlation of Metabolic Risk Factors with Sessile Serrated Lesions

2020 ◽  
Vol 29 (2) ◽  
pp. 175-179
Author(s):  
Melania Macarie ◽  
Simona Bataga ◽  
Simona Mocan ◽  
Monica Pantea ◽  
Razvan Opaschi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Statistical Significance ◽  
Interval Cancer ◽  
Metabolic Risk Factors ◽  
Control Group ◽  
Anatomical Site ◽  
Metabolic Risk ◽  
Right Colon ◽  
Serrated Lesions ◽  
The Right

Background and Aims: The importance of sessile serrated lesions (SSLs) in the pathogenesis of colorectal carcinoma has been recently established. These are supposed to cause the so-called “interval cancer”, having a rapidly progressive growth and being difficult to detect and to obtain an endoscopic complete resection. We aimed to establish the most important metabolic risk factors for sessile serrated lesions. Methods: We performed a retrospective case-control study, on a series of 2918 consecutive patients who underwent colonoscopy in Gastroenterology and Endoscopy Unit, County Clinical Emergency Hospital, Târgu-Mureș, Romania between 1 st of January 2015-31 th of December 2017. In order to evaluate the metabolic risk factors for polyps’ development, enrolled participants were stratified in two groups, a study group, 33 patients with SSLs lesions, and a control group, 138 patients with adenomatous polyps, selected by systematic sampling for age and anatomical site. Independent variables investigated were: gender, smoking, alcohol consumption, obesity, arterial hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia, hyperuricemia, nonalcoholic liver disease. Results: For SSLs the most common encountered localization was the right colon in 30.55% of cases. By comparative bivariate analysis between SSLs group and control group, it was observed that hypertension (p=0.03, OR 2.33, 95 %CI 1.03-5.24), obesity (p=0.03, OR 2.61, 95 %CI 1.08-6.30), hyperuricemia (p=0.04, OR 2.72, 95 %CI 1.28-7.55), high cholesterol (p=0.002, OR 3.42; 95 %CI 1.48-7.87), and high triglycerides level (p=0.0006, OR 5.75; 95 %CI 1.92-17.2) were statistically associated with SSLs development. By multivariate analysis hypertension and hypertriglyceridemia retained statistical significance. Conclusions: Our study showed that the highest prevalence of SSLs was in the right colon and hypertension and increased triglycerides levels were associated with the risk of SSLs development. These risk factors are easy to detect in clinical practice and may help identifying groups with high risk for colorectal cancer, where screening is recommended.

1108Effectiveness of nursing counseling for patients with cardiovascular risk factors: controlled clinical trial with a 24 months post-intervention follow-up

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Salazar ◽  
V Vilchez-Barboza ◽  
K Saez ◽  
T Paravic
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Intervention Group ◽  
Health Centers ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Post Intervention ◽  
Face To Face

Abstract Objective To establish the effect after 24 months of a face-to-face and telephone nursing counseling intervention, aimed at controlling cardiovascular risk factors (hypertension, dyslipidemia and overweight) and improving health-related quality of life (HRQoL) in patients of the cardiovascular health program of family health centers of Concepciόn, Chile. Methods Randomized controlled clinical trial with a 24 months post-intervention follow-up. 120 patients with cardiovascular risk factors under the cardiovascular health program were recruited from 6 family health centers and randomized into a control group (60) and an intervention group (60). The intervention group received the regular care in addition to face-to-face and telephone nursing counseling. Baseline measurements were taken and also at the end of the intervention (7 months). Participants returned then after 12 and 24 months for follow-up evaluations. A total of 109 subjects completed the intervention at 7 months and 45 returned at 24 months. During follow-up evaluations both groups continued to receive regular care given in the health centers. The measurements consisted of HRQoL (physical and mental health), systolic blood pressure (SBP) and diastolic blood pressure (DBP), body mass index (BMI), abdominal circumference (AC), total cholesterol (TC), low density lipoproteins (LDL-Chol), high density lipoprotein (HDL-Chol), atherogenicity index (LDL/HDL), cardiovascular risk factor (TC/HDL), 10-year coronary risk. Ethical requirements were considered and statistical analysis was carried out using MANCOVA and d-Cohen repeated measurements. Results The analysis of the effects of the intervention in the 24-month follow-up showed that subjects in the intervention group only maintained significant improvement of AC over time (F=3.18; p=0.03), compared to the control group. Conclusion Although participants in the intervention group only maintained the AC improvement over time, this can be regarded as an indirect indicator of the presence of intra-abdominal fat that makes it possible to predict and classify the risk of cardiovascular disease. Long-term follow-up studies are required to investigate behaviors and mechanisms that contribute to maintaining improvements in this indicator. Additionally, future research should include reinforcement activities, either face-to-face or by telephone, to help maintain the positive results of interventions. Acknowledgement/Funding Universidad de Concepciόn 214.082.049-1.0

scholarly journals Effect of Almond Consumption on Metabolic Risk Factors - Glucose, Hyperinsulinemia, Inflammatory Markers: A Randomized Controlled Trial in 16–25 year olds in Mumbai City

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1447-1447
Author(s):  
Jagmeet Madan ◽  
Panchali Moitra ◽  
Sharvari Desai ◽  
Sheryl Salis ◽  
Rekha Battalwar ◽  
...  
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Young Adults ◽  
Body Fat ◽  
Inflammatory Markers ◽  
Metabolic Risk Factors ◽  
Control Group ◽  
Metabolic Risk ◽  
Tnf Α ◽  
Mumbai City

Abstract Objectives A large percentage of Indian population has diabetes or is at risk of pre-diabetes. Almond consumption has shown benefits on cardio metabolic risk factors in adults. The present study explored the effect of almond consumption on determinants of metabolic dysfunction - blood glucose, insulin, selected inflammatory markers and oxidant damage in adolescents and young adults aged 16–25 years from Mumbai city. Daily almond consumption will reduce insulin levels, selected pro-inflammatory markers, improve lipid profile of 16–25 year old persons. Methods This cluster randomized trial was conducted on individuals with impaired levels of glucose (fasting glucose (5.6–6.9 mmol/L), 2 h post-glucose (7.8–11.0 mmol/L) and/or insulin (fasting insulin(≥15 mIU/ml)/glucose challenge insulin(≥80 mIU/ml). 421 individuals were selected after screening 1313 individuals. The almonds group (n = 107) consumed 56gm almonds daily for 90 days and was compared with a control group (n = 112) who consumed an iso-caloric snack for the same period. Blood samples were analysed at baseline, endline for glucose, insulin, HbA1C, LDL, HDL, TC, ox-LDL, TG, hs-CRP, IL-6, TNF-α, adiponectin, leptin. Body fat (%), visceral fat, weight, were measured. HOMA-IR, FG: FI ratio, BMI, WHR, WHtR were calculated. Dietary intakes were assessed at baseline, endline using 24-hour recall. Results Baseline values for all measurements, macronutrient intakes did not differ significantly between the two groups. Changes in anthropometric measurements between baseline and endline were not significantly different in both groups. Percent body fat increased in both groups but was four times more in the control than the almonds group. Almond consumption significantly decreased HbA1C, total cholesterol, LDL-C, IL-6. Stimulated insulin decreased post-intervention in both groups, but was greater in almonds group. FG: FI ratio decreased in almonds group. TNF-α decreased in almonds group while it increased in control group. Conclusions The present study shows the directionality for almond consumption to reduce inflammatory markers, total, LDL cholesterol levels and HbA1C levels in adolescents and young adults who were at risk for developing diabetes. Thus, almonds can be considered as one of the food-based strategies for preventing pre-diabetes. Funding Sources Research grant from Almond Board of California.

Feasibility of a Home-Based Exercise Program in Lung and Liver Transplant Recipients for Management of Post-Transplant Metabolic Syndrome: A Pilot Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Dmitry Rozenberg ◽  
Daniel Santa Mina ◽  
Sahar Nourouzpour ◽  
Encarna Camacho Perez ◽  
Brooke Stewart ◽  
...  
Keyword(s):  
Risk Factors ◽  
Resistance Training ◽  
Self Efficacy ◽  
Intervention Group ◽  
Exercise Program ◽  
Metabolic Risk Factors ◽  
Metabolic Risk ◽  
Transplant Recipients ◽  
Post Transplant ◽  
Home Based

BACKGROUND Post-transplant metabolic syndrome (PTMS) is a common contributor to morbidity and mortality in solid organ transplant recipients in the late post-transplant period (≥ 1-year). Patients diagnosed with PTMS are at higher risk of cardiovascular disease and frequently experience decreased physical function and health-related quality of life (HRQL). Studies in the early post-transplant period (< 1-year) have shown the benefits of facility-based exercise training on physical function and HRQL, but have not evaluated the effects on metabolic risk factors. It remains unclear whether home-based exercise programs are feasible and can be sustained with sufficient adherence and exercise dose to have effects on PTMS. This protocol outlines the methodology of a randomized controlled trial of a partly-supervised home-based exercise program in lung (LTx) and liver (OLT) transplant recipients. OBJECTIVE 1) To evaluate the feasibility (i.e. recruitment rate, program adherence, attrition, safety, and participant satisfaction) of a 12-week individualized, home-based aerobic and resistance training program in LTx and OLT recipients initiated 12 to 18 months post-transplant; and 2) to assess estimates of intervention efficacy on metabolic risk factors, self-efficacy for exercise, and HRQL. METHODS 20 LTx and 20 OLT recipients with two or more cardio-metabolic risk factors at 12-18 months post-transplant will be randomized to an intervention group (home-based exercise training) or a control group. The intervention group will receive an individualized exercise prescription comprising aerobic and resistance training 3-5 times per week for 12 weeks. Participants will meet with a qualified exercise professional weekly (via videoconference) to guide exercise progression, provide support, and promote exercise self-efficacy. Participants in both study groups will receive one counselling session on healthy eating with a dietitian at the beginning of the intervention. For the primary aim, feasibility will be assessed through recruitment rate, program adherence, satisfaction, attrition, and safety. Secondary outcomes will be measured at baseline and 12-weeks, and include assessments of metabolic risk factors (i.e. insulin resistance, abdominal obesity, blood pressure, and cholesterol), HRQL, and exercise self-efficacy. Descriptive statistics will be used to summarize program feasibility and effect estimates (means and 95% confidence interval) for sample size calculations in future trials. RESULTS Enrollment for this study started in July 2021. It is estimated that the study period will be 18 months with data collection completed by December 2022. CONCLUSIONS A partly-supervised home-based, individually tailored exercise program that promotes aerobic and resistance training and exercise self-efficacy may prove to be an important intervention for improving the metabolic profile of LTx and OLT recipients with cardio-metabolic risk factors. Thus, characterizing the feasibility and effect estimates of home-based exercise constitutes the first step in the development of future clinical trials designed to reduce the high morbidity associated with PTMS. CLINICALTRIAL https://clinicaltrials.gov/ct2/show/NCT04965142

Abstract 18258: High-intensity Interval Training Improves Aerobic Capacity and Metabolic Risk Factors in Older Adults: A Randomized Controlled Trial

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Chueh-Lung Hwang ◽  
Jeung-Ki Yoo ◽  
Han-Kyul Kim ◽  
Moon-Hyon Hwang ◽  
Eileen M Handberg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Older Adults ◽  
Oxygen Consumption ◽  
Aerobic Capacity ◽  
Metabolic Risk Factors ◽  
Peak Oxygen Consumption ◽  
Control Group ◽  
Metabolic Risk ◽  
Maximal Heart Rate

Introduction: Aging is associated with increased cardiovascular disease risk including reduced aerobic capacity and increased metabolic risk factors. Aerobic exercise training improves the risk for cardiovascular disease. The optimal exercise regimen for older adults, however, remains unknown. We tested the hypothesis that high-intensity interval training (HIIT) would be more effective than isocaloric moderate-intensity continuous training (MICT) in improving aerobic capacity and metabolic risks factors in older adults. Methods: Thirty eight sedentary older adults (age 65±1.0 yrs; mean±SE), free of cardiovascular disease, were randomly assigned to HIIT (n=13), MICT (n=13) or non-exercise control group (n=12). HIIT consisted of cycling at alternating intensities of 90 and 70% maximal heart rate for 40 minutes while MICT consisted of cycling at 70% maximal heart rate for 47 minutes. HIIT and MICT were performed on Airdyne bicycles, 4 days/week for 8 weeks, under supervision. Aerobic capacity was assessed by peak oxygen consumption during an incremental treadmill test. Metabolic risk factors included fasting lipid profile, glucose, insulin, and insulin resistance (homeostasis model assessment; HOMA-IR). Body composition was assessed using dual-energy x-ray absorptiometry. All measures were obtained at baseline and following the intervention. Results: Peak oxygen consumption increased by 2.8 ml/kg/min (23.0±1.6 vs. 25.7±1.5, pre- vs. post-intervention; P <0.05) in HIIT, but did not change in MICT and control group (26.0±1.5 vs. 26.2±1.4 and 23.5±1.4 vs. 24.0±1.4, respectively; P >0.05). Insulin and HOMA-IR improved only in HIIT (-1.9±0.6μU/ml and -0.42±0.16, P <0.05; respectively) and these changes were negatively associated with the change in peak oxygen consumption (r=-0.37, P <0.05 for both). Overall, lipids, body weight, body fat, and fat-free mass did not change in response to the intervention in any of the groups (P>0.05). Conclusions: HIIT but not MICT improves aerobic capacity and glucose control in healthy older adults without affecting lipids or body composition.

Sign in / Sign up

Export Citation Format

Share Document