The Healthy Eating and Living Against Noncommunicable Diseases Study: An Innovative Family-Based Intervention

2020 ◽  
Vol 46 (6) ◽  
pp. 569-579
Author(s):  
Niyati Parekh ◽  
Gabrielle Khalife ◽  
Natalie Hellmers ◽  
Gail D’Eramo Melkus

Objective Inadequate nutrition literacy within families is a barrier for healthy dietary choices and influences chronic disease risk. This pilot study examined the feasibility of providing an in-person nutrition intervention for families at high risk of developing prediabetes or type 2 diabetes and cardiovascular risk-factors. Methods Eligible families had at least one member with a non-communicable disease (NCD) or metabolic risk factor, fluency in English, willingness to attend all three educational sessions and complete questionnaires as a family unit. Sessions included didactic and experiential activities on food label reading, portion sizing, physical activity and modifiable lifestyle factors to reduce NCD risk. Demographics and fruit and vegetable screeners were collected from all participants at baseline and after completion of sessions. Families participated in focus groups to evaluate the program. Results Twelve families (n=35;17 adults;18 children) were recruited from New York City. Participants self-identified as Asian, Hispanic or Black. Adults had a mean age of 40y, BMI of 32.29kg/m2, household income of $35,000-$49,000y, and 13 of 17 adult participants had college degrees. Children ranged from 1-17y. Based on focus group feedback, three sessions were acceptable, families reported enjoying interactive activities and group learning and requested child-friendly activities. They reported improved knowledge of food labels, strategies for grocery shopping, portion-sizing, and increased awareness of the links between diet quality and NCDs. Conclusions and Implications The study met recruitment goals within 4 months. The educational intervention was acceptable and may be scaled-up for future studies on NCD prevention, particularly prediabetes and type 2 diabetes.

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Ichiro Komiya ◽  
Akira Yamamoto ◽  
Suguru Sunakawa ◽  
Tamio Wakugami

Abstract Background Pemafibrate, a selective PPARα modulator, has the beneficial effects on serum triglycerides (TGs) and very low density lipoprotein (VLDL), especially in patients with diabetes mellitus or metabolic syndrome. However, its effect on the low density lipoprotein cholesterol (LDL-C) levels is still undefined. LDL-C increased in some cases together with a decrease in TGs, and the profile of lipids, especially LDL-C, during pemafibrate administration was evaluated. Methods Pemafibrate was administered to type 2 diabetes patients with hypertriglyceridemia. Fifty-one type 2 diabetes patients (mean age 62 ± 13 years) with a high rate of hypertension and no renal insufficiency were analyzed. Pemafibrate 0.2 mg (0.1 mg twice daily) was administered, and serum lipids were monitored every 4–8 weeks from 8 weeks before administration to 24 weeks after administration. LDL-C was measured by the direct method. Lipoprotein fractions were measured by electrophoresis (polyacrylamide gel, PAG), and LDL-migration index (LDL-MI) was calculated to estimate small, dense LDL. Results Pemafibrate reduced serum TGs, midband and VLDL fractions by PAG. Pemafibrate increased LDL-C levels from baseline by 5.3% (− 3.8–19.1, IQR). Patients were divided into 2 groups: LDL-C increase of > 5.3% (group I, n = 25) and < 5.3% (group NI, n = 26) after pemafibrate. Compared to group NI, group I had lower LDL-C (2.53 [1.96–3.26] vs. 3.36 [3.05–3.72] mmol/L, P = 0.0009), higher TGs (3.71 [2.62–6.69] vs. 3.25 [2.64–3.80] mmol/L), lower LDL by PAG (34.2 [14.5, SD] vs. 46.4% [6.5], P = 0.0011), higher VLDL by PAG (28.2 [10.8] vs. 22.0% [5.2], P = 0.0234), and higher LDL-MI (0.421 [0.391–0.450] vs. 0.354 [0.341–0.396], P < 0.0001) at baseline. Pemafibrate decreased LDL-MI in group I, and the differences between the groups disappeared. These results showed contradictory effects of pemafibrate on LDL-C levels, and these effects were dependent on the baseline levels of LDL-C and TGs. Conclusions Pemafibrate significantly reduced TGs, VLDL, midband, and small, dense LDL, but increased LDL-C in diabetes patients with higher baseline TGs and lower baseline LDL-C. Even if pre-dose LDL-C remains in the normal range, pemafibrate improves LDL composition and may reduce cardiovascular disease risk.


Obesity ◽  
2008 ◽  
Vol 16 (6) ◽  
pp. 1370-1376 ◽  
Author(s):  
Saverio Stranges ◽  
Lisa B. Rafalson ◽  
Jacek Dmochowski ◽  
Karol Rejman ◽  
Russell P. Tracy ◽  
...  

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