Prevalence of a Healthy Lifestyle Among Individuals With Cardiovascular Disease in High-, Middle- and Low-Income Countries: The Prospective Urban Rural Epidemiology (PURE) Study.

Prevalence of a Healthy Lifestyle Among Individuals With Cardiovascular Disease in High-, Middle- and Low-Income Countries: The Prospective Urban Rural Epidemiology (PURE) Study.

JAMA. 2013 Apr 17; 309(15): 1613-1621
Teo K, Lear S, Islam S, Mony P, Dehghan M, Li W, Rosengren A, Lopez-Jaramillo P, Diaz R, Oliveira G, Miskan M, Rangarajan S, Iqbal R, Ilow R, Puone T, Bahonar A, Gulec S, Darwish EA, Lanas F, Vijaykumar K, Rahman O, Chifamba J, Hou Y, Li N, Yusuf S,

IMPORTANCE Little is known about adoption of healthy lifestyle behaviors among individuals with a coronary heart disease (CHD) or stroke event in communities across a range of countries worldwide. OBJECTIVE To examine the prevalence of avoidance or cessation of smoking, eating a healthy diet, and undertaking regular physical activities by individuals with a CHD or stroke event. DESIGN, SETTING, AND PARTICIPANTS Prospective Urban Rural Epidemiology (PURE) was a large, prospective cohort study that used an epidemiological survey of 153 996 adults, aged 35 to 70 years, from 628 urban and rural communities in 3 high-income countries (HIC), 7 upper-middle-income countries (UMIC), 3 lower-middle-income countries (LMIC), and 4 low-income countries (LIC), who were enrolled between January 2003 and December 2009. MAIN OUTCOME MEASURES Smoking status (current, former, never), level of exercise (low, <600 metabolic equivalent task [MET]-min/wk; moderate, 600-3000 MET-min/wk; high, >3000 MET-min/wk), and diet (classified by the Food Frequency Questionnaire and defined using the Alternative Healthy Eating Index). RESULTS Among 7519 individuals with self-reported CHD (past event: median, 5.0 [interquartile range {IQR}, 2.0-10.0] years ago) or stroke (past event: median, 4.0 [IQR, 2.0-8.0] years ago), 18.5% (95% CI, 17.6%-19.4%) continued to smoke; only 35.1% (95% CI, 29.6%-41.0%) undertook high levels of work- or leisure-related physical activity, and 39.0% (95% CI, 30.0%-48.7%) had healthy diets; 14.3% (95% CI, 11.7%-17.3%) did not undertake any of the 3 healthy lifestyle behaviors and 4.3% (95% CI, 3.1%-5.8%) had all 3. Overall, 52.5% (95% CI, 50.7%-54.3%) quit smoking (by income country classification: 74.9% [95% CI, 71.1%-78.6%] in HIC; 56.5% [95% CI, 53.4%-58.6%] in UMIC; 42.6% [95% CI, 39.6%-45.6%] in LMIC; and 38.1% [95% CI, 33.1%-43.2%] in LIC). Levels of physical activity increased with increasing country income but this trend was not statistically significant. The lowest prevalence of eating healthy diets was in LIC (25.8%; 95% CI, 13.0%-44.8%) compared with LMIC (43.2%; 95% CI, 30.0%-57.4%), UMIC (45.1%, 95% CI, 30.9%-60.1%), and HIC (43.4%, 95% CI, 21.0%-68.7%). CONCLUSION AND RELEVANCE Among a sample of patients with a CHD or stroke event from countries with varying income levels, the prevalence of healthy lifestyle behaviors was low, with even lower levels in poorer countries. HubMed – eating


Evaluation of needs among patients with severe mental illness. A community study.

Actas Esp Psiquiatr. 2013 Mar; 41(2): 115-121
Zúñiga A, Navarro JB, Lago P, Olivas F, Muray E, Crespo M

Introduction: Patients suffering from severe mental disorder present a mixed complexity of clinical and social needs which can be reliably evaluated through the Camberwell Assessment of Needs (CAN). In his study, several social, personal and clinical variables will be examined as predictive factors of the detected needs of these patients. Methodology: A sample of 518 patients included in a program of Severe Mental Disorder and treated at two centers in Barcelona was assessed with the CAN. Descriptive statistics and Poisson and negative binomial regression models were applied to identify predictive factors of needs. Results: The average number of needs was 5.1 (4 met and 1.1 unmet needs), figures similar to those found in European cities (Epsilon study). The more often reported needs were symptoms of anxiety or psychological discomfort, psychotic symptoms, problems in the home care, lack of social contact, medical and eating problems. Factors associated to higher number of needs were low socioeconomic class, older age, worse overall performance and presence of psychotic disorder. Conclusions: Needs detected through CAN in patients suffering from severe mental illness, can be predicted by a set of variables including age, socio-economic class, overall performance and presence of psychotic disorder. These findings might be useful to plan the provision of services and strategies to satisfy the needs of patients with serious mental disorder. HubMed – eating


Distinctive unhealthy eating pattern in free-living middle-aged hypertensives when compared with dyslipidemic or overweight patients.

J Hypertens. 2013 Apr 16;
Meneton P, Kesse-Guyot E, Fezeu L, Galan P, Hercberg S, Ménard J

OBJECTIVE:: To evaluate habitual dietary intakes in patients with established hypertension, dyslipidemia and/or overweight. METHODS:: A national sample of 6167 French free-living patients, aged 45-65 years, in whom daily food and nutrient intakes (24-h records) and clinical status were regularly monitored between 1994 and 2002. RESULTS:: For each disorder, affected patients have reduced fat and energy intakes compared with nonaffected participants after adjustment for confounding factors. In addition, after further adjustment for energy intake, dyslipidemic patients eat less cheeses, sweets, eggs and appetizers, whereas overweight patients eat less bread and sweets, more yoghurts, vegetables, meats and poultries in comparison to their nonaffected counterparts. By contrast, hypertensive patients drink more wines and less milk, eat less yoghurts, fruits and vegetables, more processed meats than participants without hypertension. Nutrient intakes also reflect these distinctive eating patterns as shown by reduced carbohydrate intake and increased protein and mineral intakes in overweight patients and increased alcohol intake and decreased mineral intakes in hypertensives when compared with nonaffected participants. Among affected patients, antihypertensive and hypolipidemic drug treatments are not associated with additional differences in daily food and nutrient intakes except eggs that are consumed in smaller amounts by treated dyslipidemic patients. CONCLUSION:: Hypertensive patients maintain an unhealthy eating pattern that tends to perpetuate their disorder in contrast to dyslipidemic or overweight patients who adopt more protective diets. The origin of this behavioural difference and poor adherence to practice guidelines between hypertensives and other cardiovascular risk patients needs to be investigated. HubMed – eating


Index-Based Dietary Patterns and Risk of Esophageal and Gastric Cancer in a Large Cohort Study.

Clin Gastroenterol Hepatol. 2013 Apr 13;
Li WQ, Park Y, Wu JW, Ren JS, Goldstein AM, Taylor PR, Hollenbeck AR, Freedman ND, Abnet CC

BACKGROUND & AIMS: Diet could affect risk for esophageal and gastric cancers, but associations have been inconsistent. The diet is complex, so studies of dietary patterns, rather than studies of individual foods, might be more likely to identify cancer risk factors. There is limited research on index-based dietary patterns and esophageal and gastric cancers. We prospectively evaluated associations between the Healthy Eating Index-2005 (HEI-2005) and alternate Mediterranean Diet (aMED) scores and risk of esophageal and gastric cancers. METHODS: We analyzed data from 494,968 participants in the National Institutes of Health (NIH)-AARP Diet and Health study, in which AARP members (51-70 y old) completed a self-administered baseline food frequency questionnaire between 1995 and 1996. Their answers were used to estimate scores for each index. RESULTS: During the follow-up period (1995-2006), participants developed 215 esophageal squamous cell carcinomas (ESCCs), 633 esophageal adenocarcinomas (EACs), 453 gastric cardia adenocarcinomas, and 501 gastric non-cardia adenocarcinomas. Higher scores from the HEI-2005 were associated with a reduced risk of ESCC (comparing the highest quintile with the lowest: hazard ratio [HR], 0.51; 95% confidence interval [CI], 0.31-0.86; Ptrend=.001) and EAC (HR, 0.75; 95% CI, 0.57-0.98; Ptrend=.01). We observed an inverse association between ESCC, but not EAC, and higher aMED score (meaning a higher-quality diet). HEI-2005 and aMED scores were not significantly associated with gastric cardia or noncardia adenocarcinomas. CONCLUSIONS: Using data collected from 1995 through 2006 from the NIH-AARP Diet and Health Study, HEI-2005 and aMED scores were inversely associated with risk for esophageal cancers-particularly ESCC. Adherence to dietary recommendations might help prevent esophageal cancers. HubMed – eating


Development and Evaluation of a Bio-ion Measurement System on Acupoints for Meridian Diagnosis.

J Acupunct Meridian Stud. 2013 Apr; 6(2): 110-118
Kim SB, Shin TM, Lee YH

The aim of this study was to develop a new method of measuring the meridian energy potential (MEP) at an acupoint with bioelectrical impedance in order to establish an objective meridian diagnosis. To confirm the reflection of the changes in body composition at acupoints, the changes in the MEP on the bladder meridian before, during and after cupping were observed. Additionally, to evaluate the usefulness of diagnosis, the MEP on the stomach meridian before and after a meal was measured. Significant increases were found at every acupoint during cupping and after eating a meal. It was confirmed that the MEP data reflected changes in body composition at every acupoint and that these changes were associated with functioning of the associated internal organs. In conclusion, we propose the usefulness of this method, which can indicate the state of acupoints. HubMed – eating