Impact of Training Programs on Awareness and Practice of Lifestyle Modifications among Hypertensive Patients Attending Outpatient Clinic of the University College Hospital, Ibadan, Nigeria

Aim: This study sought to investigate the impact of training programs on hypertensive patients' awareness and practice of lifestyle modifications in out-patient clinics of the University College Hospital (UCH) Ibadan, Nigeria. Methodology: The study design was a cross-sectional survey conducted at the out-patient clinics of the University College Hospital (UCH), Ibadan, Nigeria. This setting was chosen due to the accessibility of hypertensive patients receiving regular care and follow-up. The sample size comprised 274 hypertensive patients attending the out-patient clinics for regular hypertension management. A simple random sampling method was employed to select study participants, ensuring a fair representation of the target population. A structured questionnaire was used to collect data from the participants and results were analysed using SPSS. Results: Findings indicate that the training programs greatly increased awareness of hypertension and lifestyle factors affecting hypertension for most participants (74.42%), with all participants recommending the programs. A significant majority of participants (95.74%) reported being on hypertension medication, while nearly all (99.22%) had received some form of training or counselling on lifestyle modification for hypertension management. Notably, all participants reported having made lifestyle changes following the training programs, with the majority rating the effectiveness of the programs as highly effective (57.36%). Further analysis indicated a statistically significant relationship between the effectiveness of the training programs and the participants' age, sex, educational level, and occupation. The most frequent lifestyle modification post-training was dietary changes, with 54.65% of participants reporting that they always engage in a healthy diet for hypertension management. However, the frequency of engagement in other lifestyle modifications, such as regular physical activity and weight management, was not as high. The majority of participants reported significant improvements in hypertension symptoms following the lifestyle modifications. Conclusion: These findings demonstrate that targeted training programs can significantly enhance hypertensive patients' awareness and practice of beneficial lifestyle modifications, thus improving health outcomes. Further, the study underscores the need for such training programs to be tailored according to the age, sex, educational level, and occupation of the patients to maximize their impact.

Prevalence of normal weight obesity in young adults of Western Uttar Pradesh – A community-based study

Background: Obesity is described as a build-up of abnormal or excessive fat that risks life. A body mass index (BMI) is a screening tool for overweight and obesity. For a long time, BMI has been used as a marker to measure obesity. However, a significant limitation of using BMI is its failure to differentiate between a high body fat content and preserved or increased lean mass, especially in patients or subjects with a BMI <30 kg/m2. Normal weight obese (NWO) is such individuals who have high fat content but a normal BMI. To identify such individuals and to save them from morbidity associated with obesity, this study was carried out. Aims and Objectives: The objective of the study was to estimate the prevalence of NWO in healthy young adults (aged between 18 and 30 years) and to suggest the methods of primary prevention for obesity. Materials and Methods: In this observational cross-sectional study, the 324 subjects were selected randomly from the residents, students, and employees of Swami Vivekananda Subharti University. Subjects were chosen according to the study’s inclusion and exclusion criteria and also, based on the self-structure questionnaire. A general and systemic examination was carried out. The body composition of these subjects was done by bioelectric impedance analyzer BODY STAT QUAD SCAN 4000. Data were analysis using R-software (1.25 version), and unpaired t-test was applied. P < 0.05 was taken as significant in this study. Results: The prevalence of NWO in males was found to be 24.6% and females to be 13.4%. The body composition parameters of NWO and NWNO differed significantly. Conclusion: The increase rate of NWO is reason for concern and routine screening of body composition parameters should be done at health setups to identify that these NWO individuals and timely interventions can be made.

Current treatment landscape for obesity in Singapore

The rising prevalence of obesity in Singapore is a harbinger for a corresponding increase in obesity-related complications such as type 2 diabetes mellitus (T2DM) and coronary heart disease. Obesity is a complex disease driven by multiple factors, and hence, treatment cannot follow a 'one-size-fits-all' approach. Lifestyle modifications involving dietary interventions, physical activity and behavioural changes remain the cornerstone of obesity management. However, similar to other chronic diseases such as T2DM and hypertension, lifestyle modifications are often insufficient on their own, hence the importance of other treatment modalities including pharmacotherapy, endoscopic bariatric therapy and metabolic-bariatric surgery. Weight loss medications currently approved in Singapore include phentermine, orlistat, liraglutide and naltrexone-bupropion. In recent years, endoscopic bariatric therapies have evolved as an effective, minimally invasive and durable therapeutic option for obesity. Metabolic-bariatric surgery remains the most effective and durable treatment for patients with severe obesity, with an average weight loss of 25%-30% after one year.

Prevalence and determinants of cardiovascular disease in a rural area of Kancheepuram district, Tamil Nadu: a cross sectional study

Background: Cardio vascular disease (CVD) is the number 1 cause of death globally and an estimated 17.7 million people died from CVD in 2015, representing 31% of all global deaths. In India CVD accounts for 25% of all deaths. The objectives of the study was to estimate the prevalence of CVD among the study population and to determine the association between CVD and various risk factors.Methods: This is a cross sectional study carried out in the rural field practice area attached to SBMCH. The study group were 400 adults (20-60 years). The data was collected using a structured questionnaire containing socio-demographic particulars, details regarding CVD risk factors and physical measurements. Data was entered in MS Excel and analysed using SPSS 15 software.Results: Prevalence of CVD is 24.3% and of which hypertension (18%), coronary artery disease (6%), stroke (2.2%) and valvular heart disease (1%). The prevalence of risk factors are age >40 (63%), tobacco use (17.8%), alcohol use (22.3%), physical inactivity (52%), unhealthy diet (61.4%), obesity (19.7%), diabetes (13.6%) and positive family history (21.4%). There is a strong statistically significant association between CVD and age (p=0.008, OR-1.968), tobacco use (p<0.0001, OR-10.029), obesity (p<0.0001, OR-13.462) and positive family history (p<0.0001, OR-13.964).Conclusions: In this study prevalence of CVD is high. It is necessary to minimize the burden of growing CVD by controlling the rates of the risky behaviours by lifestyle modification and by increasing awareness regarding CVD.

Lipid Profile in Prediabetes - A Comparative Study

Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia with deranged fat, carbohydrate and protein metabolism that results from improper secretion or action of insulin. The precursor state to diabetes mellitus is called as Prediabetes in which not all symptoms of diabetes are present but the blood sugar is abnormally high. Dyslipidemia which as often as possible happens in diabetes play out an imperative job in quickening of macrovascular difficulty and add to expand danger of cardiovascular ailment. We conducted this study to assess the role of lipid profile in prediabetics, compared between group of asymptomatic diabetes and healthy controls. Methods: This was a hospital based cross sectional case control study in which 89 individuals with established diagnosis of Prediabetics were included on the basis of a predefined inclusion and exclusion criteria.89 healthy aged matched individuals were enrolled in the control group. A detailed personal, family and past history was taken in all the cases and a thorough clinical examination was done. Family history of diabetes and hypertension was particularly asked and noted down. Demographic details such as age, sex and socioeconomic status was noted in all the cases. Weight and BMI was analyzed. Diagnosis of prediabetes was done on the basis of ADA criteria. Lipid Profile were carried out under the guidance of physician for all cases and data was recorded for evaluation. Statistical analysis was done using SSPS 21.0 software. P value less than 0.05 was taken as statistically significant. Results: Out of a total 178 patients there were 96 males and 82 females with an M: F ratio of 1:0.854. The mean age of patients in group 1 and 2 was 50.92 ± 12.42 and 50.30 ± 12.64 respectively. The mean BMI of subjects in Group 1 was 25.58 ± 3.25kg/m2 and 25.80 ± 3.43 kg/m2 respectively. The mean age and BMI of the patients was found to be comparable in both the groups. The mean systolic and diastolic blood pressure values were found to be comparable in both the groups with no statistically significant difference (P>0.05). The FBS and PPBS values of subjects in Group 1 were significantly lesser (93.77±15.47mg/dl and 121.79±11.29mg/dl) as compared to FBS and PPBS values of subjects in Group 2 (112.52±16.40mg/dl and 177.23±17.31mg/dl). This difference was statistically significant as per Student t-test (p<0.05). The Glycosylated Hemoglobin (HbA1c) values of subjects in Group 1 (5.27±0.25%) were significantly lesser as compared to HbA1c values of subjects in Group 2 (6.14±0.34%). Total cholesterol, Triglycerides, LDL, HDL, VLDL, TG/HDL and LDL/HDL ratio were found to be statistically significantly different in both the groups (P<0.05). Conclusion: Lipid profile in prediabetic subjects containing Total cholesterol, TG, TG/HDL ratio and LDL/HDL ratio are remarkably raised compared to normal healthy subjects and HDL cholesterol is lower than normal subjects. These finding underlines the need for detection of prediabetics so that appropriate interventions can be done.

A hospital-based cross-sectional study on yoga and meditation in patients of hypertension in Western India

Background: Yoga and meditation hold promise as a non-pharmacological management of hypertension as they have shown to lower blood pressure. This study aimed at (1) assessing the awareness about benefits of yoga and meditation in hypertension among patients and finding its socio-demographic correlates, (2) estimating the practice of yoga and meditation in hypertensives, its pattern and impact on blood pressure control.Methods: This cross-sectional study was conducted on 400 hypertensive patients. Statistical association was tested with chi square and independent t tests.Results: It was observed that only 9% respondents were aware of the benefits of yoga and meditation in hypertension while 12.8% practised the same. On probing it was found that these 3.8% practised yoga and meditation only because their physician had advised them to do so without even knowing their benefits. This points out the importance of physician advice which can be even more effective if pros and cons are properly explained. People who were aware of the benefits were 51.9 times more likely to practise them (p<0.001). Highly significant association was observed between awareness regarding lifestyle modifications like yoga and meditation and gender, socioeconomic status, education and locality (urban non-slum/urban slum/rural).Conclusions: The complementary use of non-pharmacological treatment or lifestyle modifications like yoga and meditation can go a long way to lower blood pressure and such options need to be provided by the health care providers and the gap in awareness elicited in our study needs to be addressed.

Probiotic and Lifestyle Modification in Obese Pediatrics with Non-Alcoholic Fatty Liver Disease

Background: Non alcoholic fatty liver disease is an upcoming causes of chronic liver disease in pediatric population in Asia. Aims & Objective: To evaluate the potential of probiotic VSL#3 and Lifestyle modification in obese pediatrics with Non alcoholic fatty liver disease (NAFLD). Material & Methods: we conducted clinical trial in 106 obese children in age group of 5 to18 years and divided in to four groups;VSL#3 plus lifestyle intervention (n=26), VSL#3 (n=27), Lifestyle intervention (n=26) and Placebo (n=27) received interventions for four months. To identify NAFLD by ultrasonography, Body mass index (BMI), mid arm circumference (MAC), waist circumference (WC) and triceps skinfold thickness (TSF) were done. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), low-density lipoprotein cholesterol(LDL-c),high-density lipoprotein cholesterol (HDL-c), triglyceride (TG), cholesterol, fasting blood glucose(FBG), high sensitivity C-reactive protein (HSCRP), uric acid, obesity hormones were measured along with their dietary intake at baseline and post trial. Results: VSL#3 plus lifestyle intervention significantly the most pronounced therapy for reducing fatty liver grades, anthropometric with biochemical parameters and beneficial impact on obesity hormones (p<0.001) as compared to single therapy of VSL#3 and lifestyle intervention alone. Conclusion: Combined therapy of VSL#3 plus lifestyle intervention is promising treatment for management of NAFLD in Indian obese children.

The Effect of Lifestyle Modification Intervention with Motivational Construct on Dietary Macronutrient Intake among Obese Adults

@#Introduction: An unhealthy dietary practice as a result of environmental and societal changes is increasingly exposed to adults. These unhealthy practices lead to an increased cardiometabolic risk, and obese adults are at a higher risk as compared to normal-weight adults. The best strategy to promote healthy lifestyle practices among Malaysian obese adult is still fragmented. Materials and Methods: A single-centre randomised controlled trial was carried out to determine the effect of the lifestyle modification intervention (LMI) with the motivational construct, in comparison to the current standard LMI on the dietary macronutrient intake among obese adults. The dietary macronutrient intake and changes in body weight were assessed at baseline and after six months. Seventy-nine participants completed the study. Results: Our finding showed that six months of LMI with motivational construct resulted in a higher reduction of total fat and cholesterol from the dietary intake as compared to the control. In addition, the participants in the intervention group had a significant body weight loss after six months (-1.97 kg, 95% CI: -0.324, 1.360, t(39) = 3.397, p = 0.002). Conclusion: This study demonstrates that the intervention had a meaningful impact on improving the dietary macronutrient intake, which is beneficial to support body weight loss in obese adults. Future trials with additional nutritional biomarkers are needed to extend these findings.

Effect of intensive lifestyle modification & metformin on cardiovascular risk in prediabetes: A pilot randomized control trial

Background & objectives: Prediabetes is associated with increased prevalence of cardiovascular disease (CVD). In participants with prediabetes, the effects of exercise and metformin were evaluated on high-sensitivity C-reactive protein (hsCRP) and carotid intima-media thickness (CIMT), surrogate markers of atherosclerosis and CVD compared with standard care. Methods: In a pilot randomized control trial, the participants were randomized in to three arms: standard care (STD), intensive lifestyle modification (ILSM) or ILSM and metformin (ILSM+Met) and followed up for six months. Monitoring of ILSM was done by a trained healthcare facilitator. hsCRP, CIMT and other relevant parameters were measured before and after intervention. Results: A total of 103 participants were randomized into three arms and followed up for six months. At six months, there was a reduction from baseline in weight and fasting blood sugar (FBS) (P <0.01) in all three arms and a reduction in haemoglobin A1c (P =0.03) only in the ILSM+Met arm. The differences in hsCRP over six months within the STD, ILSM and ILSM+Met arms were ?0.12 (95% confidence interval, ?1.81, 2.08), ?0.58 (?2.64, 0.43) and ?0.11 (?1.84, 1.56), respectively. There was no difference in hsCRP, CIMT (right) or CIMT (left) between the three arms at six months. Interpretation & conclusions: There was a reduction in weight and FBS from baseline in all three arms. There was, however, no difference seen in hsCRP and CIMT in the two intervention arms compared to standard care. Larger studies with long-term follow up need to be done to detect differences in risk markers for CVD in prediabetes.

Systematic Review on Effects of Acupuncture Combined with Lifestyle Modification on Essential Hypertension / 中国中医药信息杂志

Objective To evaluate the effects of acupuncture combined with lifestyle modification for essential hypertension by Meta-analysis. Methods Clinical randomized controlled trial literature about acupuncture combined with lifestyle modification for essential hypertension in CNKI, WanFang Data, CBM, VIP, PubMed, Embase, and Web of Science since establishment to February 20, 2017 were retrieved. Data extraction and quality assessment of studies were conducted by two researchers independently, and the Meta-analysis was performed by the software of RevMan5.3. Results 5 articles involving 467 patients were included. The results of Meta-analysis showed that acupuncture combined with lifestyle modification had more significant effect than lifestyle modification alone in lowing SBP [SMD=-1.52(-2.40,-0.64)], in lowing DBP [SMD=-1.02(-2.01,-0.03)], total effective rates [RR=1.27(1.13, 1.43)]. Conclusion Compared with lifestyle modification alone, acupuncture combined with lifestyle modification have significant effects for patients with essential hypertension, but because of the fewer studies included, bigger heterogeneity between studies and the lower quality of included studies still exist, the results should be further verified, and clinical applications should be treated with caution.

Management of Patients with Nonalcoholic Fatty Liver Disease with Lifestyle Modification / 임상당뇨병

In the management and treatment of nonalcoholic fatty liver disease (NAFLD) ranging from hepatic steatosis (HS) to nonalcoholic steatohepatitis (NASH), the goals in patients without NASH or hepatic fibrosis are weight reduction through lifestyle modification such as nutritional and exercise intervention and control of associated metabolic morbidities including obesity, metabolic syndrome, and type 2 diabetes. Weight reduction of at least 3% to 5% could improve steatosis, and the characteristics of NASH histopathology with a dose-response curve between the degree of weight loss and improvement of histopathology. The patients with NAFLD could achieve weight reduction with hypocaloric diet with or without exercise, but not with exercise alone. Despite the absence of a weight loss effect of exercise alone, it may prevent or alleviate HS and associated metabolic parameters.

The Needs of Nursing Education about Pre-Diabetic Patients / 임상당뇨병

The most effective method for prevention of diabetes in a pre-diabetic patient is improvement in life style. Thus, methods of nursing management rely on diabetes prevention education. A pre-diabetic patient needs to receive accurate diagnosis and undergo regular checkups focusing on diabetes through physician counseling. As diabetes education focuses on habit improvement including dietary therapy, exercise, and weight maintenance, efforts are needed to decrease risk factors of diabetes. Pre-diabetes education helps to prevent diabetes. Hence, general diabetes education and support should start in the pre-diabetic stage.

Lifestyle intervention might easily improve blood pressure in hypertensive men with the C genotype of angiotensin II type 2 receptor gene

BACKGROUND/OBJECTIVES: Recent studies have reported an association of the angiotensin II type 2 receptor (AT2R) 3123Cytosine/Adenine (3123C/A) polymorphism with essential hypertension and cardiovascular diseases. The purpose of the study was to investigate whether the AT2R 3123C/A polymorphism affects blood pressure for free-living hypertensive men during a 5-month intervention period. SUBJECTS/METHODS: The subjects were free-living hypertensive Japanese men aged 40 to 75 years who agreed to intervention in the period from 2004 to 2011. Detection of the AT2R 3123C/A polymorphism was determined by polymerase chain reaction. The dietary intervention was designed to decrease salt level and to increase potassium level through cooking instructions and self-monitoring of the diet. The exercise session consisted of activities such as stretching, resistance training, and walking. Blood pressure, urinary sodium and potassium excretion, dietary and lifestyle data, and non-fasting venous blood sample were collected at baseline and after the intervention period. RESULTS: Thirty nine subjects were eligible for participation and the follow-up rate was 97.4%. The C allele proportion was 57.9%. AT2R 3123C/A polymorphism was X-chromosome-linked, therefore we analyzed the C and A genotypes. At baseline, no significant differences were observed between the genotype groups. After the intervention, there were no significant differences in lifestyle habit between the groups. Nevertheless, the estimated salt excretion (g/day) was significantly decreased only in the C genotype (13.0-10.3, P = 0.031). No significant change was observed in systolic blood pressure (SBP) (mmHg) in the A genotype, but a significant decrease was observed in the C genotype (150.0-141.5, P = 0.024). CONCLUSTIONS: In the C genotype, it might be easy to improve SBP through lifestyle intervention in free-living hypertensive Japanese men, however generalization could not be achieved by the small sample size.

The interaction of Apolipoprotein A5 gene promoter region T-1131C polymorphism (rs12286037) and lifestyle modification on plasma triglyceride levels in Japanese

BACKGROUND/OBJECTIVE: Apolipoprotein A5 gene promoter region T-1131C polymorphism (APOA5 T-1131C) is known to be associated with elevated plasma TG levels, although little is known of the influence of the interaction between APOA5 T-1131C and lifestyle modification on TG levels. To investigate this matter, we studied APOA5 T-1131C and plasma TG levels of subjects participating in a three-month lifestyle modification program. SUBJECTS/METHODS: A three-month lifestyle modification program was conducted with 297 participants (Age: 57 +/- 8 years) in Izumo City, Japan, from 2001-2007. Changes in energy balance (the difference between energy intake and energy expenditure) and BMI were used to evaluate the participants' responses to the lifestyle modification. RESULTS: Even after adjusting for confounding factors, plasma TG levels were significantly different at baseline among three genotype subgroups: TT, 126 +/- 68 mg/dl; TC, 134 +/- 74 mg/dl; and CC, 172 +/- 101 mg/dl. Lifestyle modification resulted in significant reductions in plasma TG levels in the TT, TC, and CC genotype subgroups: -21.9 +/- 61.0 mg/dl, -20.9 +/- 51.0 mg/dl, and -42.6 +/- 78.5 mg/dl, respectively, with no significant differences between them. In a stepwise regression analysis, age, APOA5 T-1131C, body mass index (BMI), homeostasis model assessment-insulin resistance (HOMA-IR), and the 18:1/18:0 ratio showed independent association with plasma TG levels at baseline. In a general linear model analysis, APOA5 T-1131C C-allele carriers showed significantly greater TG reduction with decreased energy balance than wild type carriers after adjustment for age, gender, and baseline plasma TG levels. CONCLUSIONS: The genetic effects of APOA5 T-1131C independently affected plasma TG levels. However, lifestyle modification was effective in significantly reducing plasma TG levels despite the APOA5 T-1131C genotype background.

Impact of a Lifestyle Modification Program on Menstrual Irregularity among Overweight or Obese Women with Polycystic Ovarian Syndrome

PURPOSE: This study aimed to evaluate the impact of a lifestyle modification program on menstrual irregularity among overweight and obese women with polycystic ovarian syndrome. METHODS: A quasi experimental research design was used to conduct this study on 82 women with polycystic ovarian syndrome at the Gynecology and Obesity clinics of Mansoura University Hospital, Egypt. Two groups were included; the study group received a lifestyle modification program for 48 weeks, while the control group was not subjected to this program. Data collection was done for the following variables, a structured interview questionnaire was used to assess the women's general characteristics, menstrual patterns, and 24-hour dietary recall and the researcher took anthropometric measurements and assessed hirsutism by the Ferriman-Gallwey scale. RESULTS: After one year of lifestyle modification, the number of menstrual cycles significantly increased from 2.7+/-1.6 to 6.9+/-1.5 (t=12.26, p<.001) in the study group compared to insignificant minor changes among the control group (t=0.69, p=.488). Additionally, 58.5% were menstruating regularly compared to none in the control group (chi2=33.93, p<.001). CONCLUSION: Participating in a lifestyle modification program was effective in reducing menstrual cycle's irregularity among overweight and obese women with PCOS. Thus, it is recommended to motivate the nurses in counseling the PCOS women on lifestyle modifications.

Case report of rehabilitation of a subject with post polio syndrome.

Post-Polio Syndrome (PPS) affects polio survivor’s years after the initial polio attack. They report new musculoskeletal symptoms. The purpose of this case report was to determine the effect of a physical therapy intervention on these symptoms in a 53 year old male subject with residual poliomyelitis of left lower limb more than right. Strengthening and aerobic exercises along with lifestyle modification advices were found to be beneficial with respect to all outcome measures taken after 4 and 12 weeks of program, with deterioration in none. This is a first case report documenting benefits of physical therapy following PPS in India. Its findings support the use of exercise in subjects with late effects of poliomyelitis and provide clinically valuable knowledge regarding the treatment efficacy of PPS exercise regimens.

Nonalcoholic Fatty Liver Disease: Lifestyle Modification / 대한내과학회지

Non-alcoholic fatty liver disease (NAFLD) is the most common form of chronic liver disease. The prevalence of NAFLD is growing gradually worldwide with increases in obesity, sedentary lifestyles, and an unbalanced diet. NAFLD ranges from simple steatosis without inflammation to steatohepatitis that can progress to cirrhosis. There is no single effective treatment that has widespread effects in NAFLD. The cornerstone of treatment is lifestyle modification, including weight reduction, diet, and physical activity. An approximately 7-10% weight reduction via diet or physical activity can improve the liver histopathology. Risk factors for NAFLD include a high-calorie diet, high-lipid diet, high-carbohydrate diet, saturated fatty acids, trans fatty acids, cholesterol, high fructose intake, and low-choline diet. Factors that protect against NAFLD include a low-calorie diet, low-carbohydrate diet, low-lipid diet, monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA), dietary fiber, coffee, green tea, and light alcohol consumption. Physical activity also helps to manage NAFLD with or without weight reduction. Recent reports found that resistance training is as effective as aerobic training. Lifestyle modification has very low compliance. To maintain a treatment program, a multidisciplinary team approach is required that includes physicians, dietitians, physical trainers, and psychologists.

Primary Prevention of Alzheimer's Disease: Is It an Attainable Goal?

Alzheimer's disease (AD) is the leading cause of dementia, and the most prevalent neurodegenerative disease in the elderly. The prevalence of AD is predicted to rise as life expectancy grows across populations. The exact cause of this devastating disease is still unknown; however, it is an aging-related multi-factorial disorder, and growing evidence supports the contribution of modifiable environmental factors to unmodifiable factors such as gene and ageing itself. The recent advancement of methodologies and techniques for early diagnosis of AD facilitates the investigation of strategies to reduce the risk for AD progression in the earliest stages of the disease. Pharmacological attempts at curing, halting or modifying it have, by and large, been unsuccessful, and no breakthrough is seen in the near future. However, a lot of elements that seem to contribute to the disease such as risk factors have been identified, mainly from epidemiological and basic research studies. Many of these are amenable to lifestyle modification. Therefore, prevention in the preclinical stage is likely the most effective way to decrease the incidence of this age-associated dreadful neurodegenerative condition, and its associated burden for individuals and society. We provide an overview of modifiable risk factors for AD along with the supporting evidence.

Effect of lifestyle modification and metformin on Fetuin-A in Metabolic Syndrome / Journal of the ASEAN Federation of Endocrine Societies

Objective@#To evaluate the effects of lifestyle modification and metformin on fetuin-A in metabolic syndrome (MetS) as defined in 2006 by the International Diabetes Federation (IDF). @*Methodology@#Forty MetS subjects were randomly assigned to treatment with placebo (n=20) or metformin (n=20) in addition to lifestyle modification for 12 weeks. @*Results@#All 40 participants completed the study. After 12 weeks, both groups had significant reductions in weight (p<0.001), body mass index (BMI) (p<0.001), waist circumference (WC) (p<0.001), systolic blood pressure (SBP) (p<0.001), and diastolic blood pressure (DBP) (p<0.001). The placebo group also had significant improvement in fasting plasma glucose (FPG) (p<0.001) and C-reactive protein (CRP) (<0.05). Weight, BMI, WC, FPG, 2-hour postprandial glucose (2h-PPG), high density lipoprotein cholesterol (HDL-C), triglycerides (TG) and fetuin-A in the metformin group decreased significantly compared to the placebo group. Reduction of plasma fetuin-A was significantly associated with TG in the metformin group. @*Conclusion@#Lifestyle modification and treatment with metformin for 12 weeks improved cardio-metabolic risk factors in MetS and reduced fetuin-A levels. Further investigations are required to confirm the effects of lifestyle modification and metformin after an extended follow-up period.

The effects of dietary modification, aerobic exercise training, and combined dietary modification and aerobic exercise training on central and peripheral arterial stiffness in obese men / 体力科学

Obesity and increasing of arterial stiffness are known as independent risk factors for cardiovascular disease. Previously, we demonstrated that dietary modification or aerobic exercise training can decrease arterial stiffness in obese individuals. However, it has not been compared the effect of dietary modification and/or aerobic exercise training on arterial stiffness in obese men. We compared the effect of three patterns of lifestyle modification (i.e., dietary modification, aerobic exercise training or combined them) on arterial stiffness in obese men. Fifty-three obese men completed the 12-week lifestyle modification program, dietary modification (D), aerobic exercise training (E) or combined D and E (DE). Before and after the program, all participants were measured central, peripheral, and systemic arterial stiffness (measured by carotid-femoral pulse wave velocity [cfPWV], femoral-ankle PWV [faPWV] and brachial-ankle PWV [baPWV]). We demonstrated that the degree of decrease in BMI was the greatest after DE, and that was greater after D than E. The level of decrease in baPWV after DE was the greatest among three interventions. On the other hand, the level of decrease in baPWV in D group was similar to E group. These results suggested that systemic arterial stiffness may be decreased by different mechanisms between D and E groups. We demonstrated that dietary modification decreased central and systemic arterial stiffness, and aerobic exercise training decreased central, systemic, and peripheral arterial stiffness in obese individuals. We also showed an additional effect of decreasing systemic arterial stiffness by combining dietary modification and aerobic exercise training in obese individuals.