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Engaging with the discourse on lifestyle modifications: Evidence from India
Arima Mishra
Health, Culture and Society , 2011, DOI: 10.5195/hcs.2011.28
Abstract: Lifestyle modifications through a range of health care practices are considered central to the management, control and prevention of chronic non-communicable diseases. While there is a critical perspective on the epistemologies of such global health discourses in existing literature, empirical evidence on how people engage with such prescriptive lifestyle modifications in different cultural contexts is very limited. The paper in this context draws on illness narratives of heart patients to discuss about the anxiety and uncertainty expressed by patients and others about notions of what constitutes ‘healthy’ and ‘risky’. It specifically unpacks the global-local dynamics in the construction of risk and healthy lifestyle and examines the contexts in which such global discourses are embodied, resisted or negotiated in different cultural contexts. The paper also examines how global health discourses travel to local sites through popular press. The paper draws on evidence collected through analyzing two Indian national English dailies and in-depth interviews with heart patients and their family members in Delhi, India in 2007-2008.
Should lifestyle modifications be promoted to prevent breast cancer?
Anthony Howell, Michelle Harvie
Breast Cancer Research , 2008, DOI: 10.1186/bcr2171
Abstract: There is no clear evidence that any particular component of diet increases breast cancer risk with the exception of alcohol [3]. However, there is evidence from observational studies that weight gain, particularly between the ages of 20 and 50 years, is associated with increased risk for breast cancer; a 20 kg increase in weight is associated with a doubling of risk compared with women whose weight remains stable [4]. An overview of exercise studies indicated that regular moderate exercise is associated with a reduction in risk of about 30% compared with no or minor exercise [5]. Thus, their observational studies indicate that risk is related to diet and exercise, but the important question is whether there is any evidence that changing lifestyle reduces risk.Animal studies of changing dietary composition (for example, a change in fat content) without reducing calories have been inconclusive [6]. The only large-scale randomized dietary composition intervention trial is the Women's Health Initiative Dietary Modification Trial. This trial was established in 1992 to test whether reducing dietary fat content to about 20% of calories from fat, increasing fruit and vegetables to five or more portions per day, and grains to more than six portions per day could reduce breast cancer. Women were randomly assigned to the dietary modification intervention group (40% [n = 19,541]) or to the control group (60% [n = 29,294]). All women were postmenopausal, between the ages of 50 and 79 years [7]. After a period of follow-up of 6 to 8 years, there were no significant reductions in breast or other cancers or in the incidence of new cases of diabetes or cardiovascular disease [7-9]. Most of the dietary change targets were not met and compliance with the intervention fell from 57% at 3 years to 31% and 18% at 6 and 9 years, respectively. This study was well funded and well performed by a large number of professionals at 40 expert clinical centres throughout the USA. The results indica
Epidemiology, risk factors, and lifestyle modifications for gout
Kenneth G Saag, Hyon Choi
Arthritis Research & Therapy , 2006, DOI: 10.1186/ar1907
Abstract: Assessing the incidence and prevalence of gout is challenging because of its episodic nature. In the USA gout estimates vary, depending on the population being described. For example, male veterans are at heightened risk for developing gout because of their numerous risk factors, as seen in the Normative Aging Study conducted by the US Department of Veterans Affairs (Fig. 1) [1]. In contrast, white male physicians exhibited a cumulative incidence of gout over a 30-year period of approximately 8.6%, with 5.9% having primary gout (gout without a history of diuretic use) [2]. African-American physicians may have an even higher rate of gout [3]. Although data on physicians cannot accurately be generalized to the public, doctors do more accurately self-report suspected gout than the lay population, from whom many of the other gout estimates were derived.The Rochester epidemiology study [4] has reported on the change in gout incidence over time. Comparing men and women from two cohorts – one from 1977 to 1978 and another from 1995 to 1996 – Arromdee and coworkers found that the age- and sex-adjusted annual incidence rate for primary gout in the USA rose from 20.2/100,000 persons to 45.9/100,000 persons; no change in the incidence of secondary gout related to thiazide diuretic therapy was observed. Gout has also been shown to increase somewhat linearly over a person's lifespan. This perceived rise in gout prevalence is primarily associated with an aging population, but it is also potentially associated with a number of changing societal trends. Based on self-reported gout from the National Health Interview Survey [5], in 1992 about 2 million people were characterized as having gout. In 1996 there were increases in gout incidence of up to 4.6% in men and 2% in women among those in the higher risk age range of 65 years or older, leading to an estimated overall prevalence of between 0.5% and 1%.The prevalence of gout also appears to be rising in certain populations. A multice
Japanese study to organize proper lifestyle modifications for metabolic syndrome (J-STOP-MetS): Design and method  [cached]
Masanori Munakata,Hiroki Honma,Mitugu Akasi,Takaharu Araki
Vascular Health and Risk Management , 2008,
Abstract: Masanori Munakata1, Hiroki Honma2, Mitugu Akasi3, Takaharu Araki4, Takahiko Kawamura5, Masashi Kubota6, Tomoko Yokokawa7, Akira Maruhashi8, Toshihiro Toyonaga9 On behalf of the J-STOP-MetS Study GroupAll authors belong to Preventive Medical Centers of Rosai Hospital Groups in Japan; 1Tohoku Rosai Hospital, Sendai, Japan; 2Iwamizawa Rosai Hospital, Iwamizawa, Japan; 3Kantou Rosai Hospital, Kawasaki, Japan; 4Tokyo Rosai Hospital, Tokyo, Japan; 5Cyubu Rosai Hospital, Nagoya, Japan; 6Oosaka Rosai Hospital, Sakai, Japan; 7Kansai Rosai Hospital, Amagasaki, Japan; 8Chugoku Rosai Hospital, Kure, Japan; 9Kyusyu Rosai Hospital, Kokura, JapanAbstract: Prevalence of the metabolic syndrome is now a very serious health problem in Japan and a public preventive strategy is essential to reduce morbidity. A systematic interventional strategy for the metabolic syndrome remains to be established. In order to address this issue, a multi-center study; Japanese Study to Organize Proper lifestyle modification for the metabolic syndrome (J-STOP-MetS), has been established by nine preventive medical centers among Rosai hospital groups. This study comprises a cross-sectional study (J-STOP-MetS 1) and a prospective randomized control study (J-STOP-MetS 2). J-STOP-MetS 1 examines the causes of the metabolic syndrome by means of a questionnaire in a large cohort of patients with the metabolic syndrome and control subjects matched for age and sex. J-STOP-MetS 2 examines the hypothesis that guidance on lifestyle modifications will help at risk patients to reduce abdominal fat and cardiovascular risk factors. The metabolic syndrome patients are randomly assigned either to a single visit to a guidance group or multiple visits every two months. The individualized guidance is provided by the coordination of physician, trained nurse, dietician and exercise trainer. Several parameters are measured before and six months after the first guidance session, including, body weight, waist circumference, blood pressure, several blood markers and arterial stiffness. The J-STOP-MetS is the first large-scale clinical study of the metabolic syndrome in Japan and should provide important evidence for the practical management of the metabolic syndrome.Keywords: metabolic syndrome, J-STOP-MetS, hypertension, diabetes, dyslipidemia
Metabolic profiling detects early effects of environmental and lifestyle exposure to cadmium in a human population
James K Ellis, Toby J Athersuch, Laura DK Thomas, Friederike Teichert, Miriam Pérez-Trujillo, Claus Svendsen, David J Spurgeon, Rajinder Singh, Lars J?rup, Jacob G Bundy, Hector C Keun
BMC Medicine , 2012, DOI: 10.1186/1741-7015-10-61
Abstract: High-resolution 1H NMR spectroscopy (metabonomics) was used to acquire urinary metabolic profiles from 178 human volunteers. The spectral data were subjected to multivariate and univariate analysis to identify metabolites that were correlated with lifestyle or biological factors. Urinary levels of 8-oxo-deoxyguanosine were also measured, using mass spectrometry, as a marker of systemic oxidative stress.Six urinary metabolites, either associated with mitochondrial metabolism (citrate, 3-hydroxyisovalerate, 4-deoxy-erythronic acid) or one-carbon metabolism (dimethylglycine, creatinine, creatine), were associated with cadmium exposure. In particular, citrate levels retained a significant correlation to urinary cadmium and smoking status after controlling for age and sex. Oxidative stress (as determined by urinary 8-oxo-deoxyguanosine levels) was elevated in individuals with high cadmium exposure, supporting the hypothesis that heavy metal accumulation was causing mitochondrial dysfunction.This study shows evidence that an NMR-based metabolic profiling study in an uncontrolled human population is capable of identifying intermediate biomarkers of response to toxicants at true environmental concentrations, paving the way for exposome research.From the point of conception and throughout life, humans experience a broad range of physical, chemical and biological exposures. The health effects of such exposures will depend not only on dose but also on their interaction with each other and with the characteristics of the individual, such as age, sex and genotype. Hence, it is a persistent and significant challenge to understand how specific environmental factors produce effects on human health. Biomarkers already play an important role in characterizing both dose and effect; however, their full potential remains to be explored. Molecular profiling technologies ('-omics') have been suggested to be an important route to the discovery of novel biomarkers to improve exposure assess
Humans and the Water Environment: The Need for Coordinated Data Collection  [PDF]
John B. Braden,Maria Christina Jolejole-Foreman,Daniel W. Schneider
Water , 2014, DOI: 10.3390/w6010001
Abstract: Efforts to observe humans in relation to nature over time and at large scale are few and disjointed in ways that impede progress in building scientific foundations for sustainability. Two water-oriented national-scale case studies highlight the challenges of integrating existing natural system and social system data: one concerns the influence of environmental attitudes and water quality on water conservation efforts; the other explores relationships between environmental attitudes, water quality and recreation behavior. The case studies show that coupled research conducted at large scale can yield new insights, but uncoordinated data limit meaningful inference. We propose salient features of a coordinated observation program for water.
Lifestyle Adjustment Process to Maintain Family Life for Mothers with Children Who Need Home Medical Care  [PDF]
Yuko Nakakita, Yuko Tomari
Health (Health) , 2018, DOI: 10.4236/health.2018.1012127
Abstract: This aim is to clarify lifestyle adjustment process to maintain family life for mothers with children who need home medical care. We conducted semi-structured interviews with the mothers of children who required home medical care comprising procedures such as suction of sputum and respiratory management over a period of several years since the initiation of home medical care, and analyzed the results using the modified grounded theory approach (M-GTA). We found the process to be composed of nine categories. Immediately after their child who required home medical care began living at home, mothers were concerned about the protection of their unstable child and, therefore, made care of the child a priority. However, they gradually started experiencing the need to engage services for the child in the course of their daily lives and live their lives with assistance. In the course of this new lifestyle, mothers began to regulate their fluctuating feelings and discover a new lifestyle for the family by making the father’s role clear and having him take on some responsibilities, such as dealing with people outside the household. As a result, once making home medical care consistent with the family’s lifestyle, even if this care was not at the same level as that provided while the child was hospitalized, mothers felt they found a way that allowed them to spend time with their other children. In addition, they began to perceive the necessity of maintaining their health, which is crucial to the child’s care. Overall, this facilitated incorporation of prospects for the family’s future life because they tended to pay more attention to their health and the health of their other children. Further, this contributed in coordination of the selection of services that would benefit the entire family, thereby maintaining the family’s lifestyle.
The LIFESTYLE study: costs and effects of a structured lifestyle program in overweight and obese subfertile women to reduce the need for fertility treatment and improve reproductive outcome. A randomised controlled trial
Meike AQ Mutsaerts, Henk Groen, Nancy CW ter Bogt, Johanna HT Bolster, Jolande A Land, Wanda JE Bemelmans, Walter KH Kuchenbecker, Peter GA Hompes, Nick S Macklon, Ronald P Stolk, Fulco van der Veen, Jacques WM Maas, Nicole F Klijn, Eugenie M Kaaijk, Gerrit JE Oosterhuis, Peter XJM Bouckaert, Jaap M Schierbeek, Yvonne M van Kasteren, Annemiek W Nap, Frank J Broekmans, Egbert A Brinkhuis, Carolien AM Koks, Jan M Burggraaff, Adrienne S Blankhart, Denise AM Perquin, Marie H Gerards, Robert JAB Mulder, Ed TCM Gondrie, Ben WJ Mol, Annemieke Hoek
BMC Women's Health , 2010, DOI: 10.1186/1472-6874-10-22
Abstract: Multicenter randomised controlled trial in subfertile women (age 18-39 year) with a body mass index between 29 and 40 kg/m2. Exclusion criteria are azoospermia, use of donor semen, severe endometriosis, premature ovarian failure, endocrinopathies or pre-existent hypertensive disorders.In the intervention group the aim is a weight loss of at least 5% to10% in a six-month period, to be achieved by the combination of a diet, increase of physical activity and behavioural modification. After six months, in case no conception has been achieved, these patients will start fertility treatment according to the Dutch fertility guidelines. In the control group treatment will be started according to Dutch fertility guidelines, independently of the patient's weight.The primary outcome measure is a healthy singleton born after at least 37 weeks of gestation after vaginal delivery. Secondary outcome parameters including pregnancy outcome and complications, percentage of women needing fertility treatment, clinical and ongoing pregnancy rates, body weight, quality of life and costs.Data will be analysed according to the intention to treat principle, and cost-effectiveness analysis will be performed to compare the costs and health effects in the intervention and control group.The trial will provide evidence for costs and effects of a lifestyle intervention aiming at weight reduction in overweight and obese subfertile women and will offer guidance to clinicians for the treatment of these patients.Dutch Trial Register NTR1530There is indisputable evidence for the adverse effects of overweight and obesity on women's reproductive health. Overweight and obesity affect reproductive capacity in the general population [1] as well as in subfertile couples [2]. Ovulatory subfertile women with a body mass index (BMI) of 29 kg/m2 or higher have a 4% lower pregnancy rate per kg/m2 increase per year, compared to ovulatory subfertile women with a BMI below 29. In the Netherlands, approximately 30% o
Selenium metabolism in animals and humans

环境科学学报(英文版) , 1996,
Abstract: The main purpose of this paper is to point out the differences in the metabolism of Se between animals and humans. This is not to imply that the work with animals is not applicable to human because the use of animals in Se research has greatly assisted in understanding Se metabolism in human subjects. It is fair to conclude that until results are confirmed in humans it is risky to draw conclusions on Se metabolism in human based solely on animal data. Although animals have provided some extremely useful information on metabolism of Se,there is convincing evidence to indicate that some features of Se metabolism are unique to human. A few examples were given to support this contention.
Understanding Postprandial Inflammation and Its Relationship to Lifestyle Behaviour and Metabolic Diseases  [PDF]
Boudewijn Klop,Spencer D. Proctor,John C. Mamo,Kathleen M. Botham,Manuel Castro Cabezas
International Journal of Vascular Medicine , 2012, DOI: 10.1155/2012/947417
Abstract: Postprandial hyperlipidemia with accumulation of remnant lipoproteins is a common metabolic disturbance associated with atherosclerosis and vascular dysfunction, particularly during chronic disease states such as obesity, the metabolic syndrome and, diabetes. Remnant lipoproteins become attached to the vascular wall, where they can penetrate intact endothelium causing foam cell formation. Postprandial remnant lipoproteins can activate circulating leukocytes, upregulate the expression of endothelial adhesion molecules, facilitate adhesion and migration of inflammatory cells into the subendothelial space, and activate the complement system. Since humans are postprandial most of the day, the continuous generation of remnants after each meal may be one of the triggers for the development of atherosclerosis. Modulation of postprandial lipemia by lifestyle changes and pharmacological interventions could result in a further decrease of cardiovascular mortality and morbidity. This paper will provide an update on current concepts concerning the relationship between postprandial lipemia, inflammation, vascular function, and therapeutic options. 1. Introduction Atherosclerosis is the primary cause of death in the world [1]. Classical risk factors such as smoking, hypertension, fasting hyperlipidemia, insulin resistance, increased body fat mass, and unfavourable body fat distribution are strongly interrelated and can often be found in one and the same subject. Subjects with fasting hypertriglyceridemia usually have elevated postprandial lipids due to the close correlation of fasting and postprandial triglycerides (TG) [2]. Postprandial lipemia has gained interest because of recent reports showing that nonfasting TG independently predict the risk for atherosclerosis [3, 4] and are possibly even stronger predictors of cardiovascular disease (CVD) than fasting TG [3, 5]. Atherosclerosis is considered a low-grade chronic inflammatory disease [6], and both the postprandial phase and chronic disease states such as the metabolic syndrome are associated with increased inflammation. This paper outlines recent developments in the understanding of postprandial inflammation and its relationship with vascular function, metabolic diseases, and lifestyle behaviour. 2. Metabolism of Postprandial Lipemia Dietary fat is absorbed in the intestine and secreted into lymph by enterocytes in TG-rich chylomicrons. Once in the circulation, chylomicrons rapidly undergo hydrolysis to produce cholesterol-dense lipoprotein remnants which are taken up by the liver [7, 8]. After a fatty meal,
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