Leukocyte-dependent effects of platelet-rich plasma on cartilage loss and thermal hyperalgesia in a mouse model of post-traumatic osteoarthritis.

OBJECTIVE: Platelet-rich plasma (PRP) is an emerging therapeutic strategy for treatment of osteoarthritis (OA); however, there is a lack of preclinical and clinical evidence for its efficacy and its mechanism of action is unclear. In the current study, we utilized leukocyte poor-PRP (LP-PRP) and leukocyte rich-PRP (LR-PRP) to mimic clinical point of care formulations and assessed their potential to alter disease progression in a mouse model of post-traumatic OA. METHOD: Three-month-old wild-type male FVB/N mice received destabilization of the medial meniscus (DMM) surgery to induce OA. To assess the efficacy of LP-PRP and LR-PRP, mice were given intraarticular injections at 2-, 7- and 28-days post-surgery. Mice were then assessed at 5-, 9-, and 13-weeks post-surgery for changes in chronic pain using the hot plate nociceptive assay. At 14-weeks, OA pathogenesis was evaluated using histology and phase-contrast µCT. RESULTS: Treatment with LP-PRP and to a lesser extent LR-PRP preserved cartilage volume and surface area compared to phosphate-buffered saline (PBS) as measured by phase-contrast µCT. However, both treatments had higher Osteoarthritis Research Society International (OARSI) and synovitis scores compared to sham, and neither substantially improved scores compared to PBS controls. With respect to thermal hyperalgesia, PBS-treated mice displayed reduced latency to response compared to sham, and LR-PRP but not LP-PRP improved latency to response at 5-, 9- and 13-weeks post-surgery compared to PBS. CONCLUSION: The results of this study suggest that effects of PRP therapy on OA progression and disease-induced hyperalgesia may be leukocyte-dependent. And while LP-PRP and to a lesser extent LR-PRP protect from volume and surface loss, significant pathology is still seen within OA joints. Future work is needed to understand how the different components of PRP effect OA pathogenesis and pain, and how these could be modified to achieve greater therapeutic efficacy.

Cognitive coping and goal adjustment in people with Peripheral Arterial Disease: relationships with depressive symptoms.

OBJECTIVE: The aim was to study relationships between cognitive coping strategies, goal adjustment processes (goal disengagement and re-engagement) and symptoms of depression in people with Peripheral Arterial Disease (PAD). METHODS: The sample consisted of 88 patients with PAD. Strategies of cognitive coping, goal disengagement, goal re-engagement, and depression were measured by written questionnaires. The main statistical methods were Pearson correlations and Multiple Regression Analyses. RESULTS: The results showed that a ruminative and catastrophizing way of coping in response to the disabilities was related to more depressive symptoms in this group. In contrast, coping by seeking and re-engaging in alternative, meaningful goals was related to less depressive symptoms. CONCLUSION: These findings suggest that improvements in cognitive and goal-related coping strategies might reduce the level or risk of depressive symptomatology. This confirms the need for specific intervention programs that bring about effective changes in the coping strategies of people suffering from PAD. PRACTICE IMPLICATIONS: As both cognitive and goal-related coping are generally assumed to be mechanisms that are subject to potential influence and change, the results of this study provide important targets for such an intervention.

[Practice guideline 'Medical treatment of COPD']. / Richtlijn 'Medicamenteuze behandeling van COPD'.

The practice guideline 'Medical treatment of COPD' completes the practice guideline for diagnostics and non-medicinal treatment. Patients with stable chronic obstructive pulmonary disease (COPD) and minor complaints can be treated with short-acting beta-2-adrenoceptor agonists or anticholinergics or a combination of these. In cases of insufficient clinical control of the condition or if patients use their medication for maintenance, a long-acting bronchodilator is the drug of choice. In patients with severe or very severe COPD (stage III-IV of the criteria of the Global Initiative for Obstructive Lung Disease (GOLD) or with cardiac comorbidity, there is a slight preference for the long-acting anticholinergic tiotropium. Inhaled corticosteroids (ICS) reduce the exacerbation frequency in patients with moderate to severe or very severe COPD (GOLD stage II-IV) and recurrent exacerbations. A combination of ICS with long-acting beta-2-adrenoceptor agonists (LABA) is prescribed in patients with GOLD stage III-IV with at least 2 exacerbations in the past year, a deterioration of the quality of life and with symptoms, if treatment with a LABA alone or an ICS alone results in insufficient improvement. Anticholinergics and beta-2-adrenoceptor agonists have a similar effect on bronchodilation in patients with an acute exacerbation of COPD. If improvement is inadequate, patients with an exacerbation should be treated with prednisolone 30 mg for a period of 7 to 14 days. In outpatients and clinical patients with an exacerbation ofCOPD, an antibiotic is added to prednisolone in very poor lung function (forced expiratory volume in 1 second (FEV1) < 30%) or another risk factor of a severe disease course, such as a respiratory rate > or = 30/min, a systolic blood pressure < 90 mmHg, and disorientation in time, place or person.

[Summary of the practice guideline 'Asthma in children' (second revision) from the Dutch College of General Practitioners]. / Samenvatting van de standaard 'astma bij kinderen' (tweede herziening) van het Nederlands Huisartsen Genootschap.

A number of important changes have been made in the second revision of the guideline 'Asthma in children' from the Dutch College of General Practitioners. In children under the age of 6 years, the symptoms stuffiness and recurrent cough are no longer considered part of the symptomatic diagnosis of asthma. Wheezing has become the key symptom of asthma. In children aged 6 years or more, spirometry is the optimal method for both diagnosis and monitoring. This method is preferred over peak flow measurement. Inhalation allergies should be investigated in children under the age of 6 years because the presence of an inhalation allergy may influence the management approach. Starting asthma medication in children under the age of 6 years should always be considered a therapeutic trial, and its effect should always be evaluated. The prescription of allergen-resistant mattresses and bed coverings is only effective when it is one component of a set of allergen reduction measures. At this time, the Dutch Health Council recommends influenza vaccination in children with asthma.

[Summary of the practice guideline 'Headache' from the Dutch College of General Practitioners]. / Samenvatting van de standaard 'Hoofdpijn' van het Nederlands Huisartsen Genootschap.

The previous guideline 'Migraine' has been replaced by the guideline 'Headache', which includes tension headache, migraine, substance-induced headache and cluster headache. For evaluation of the diagnosis and treatment of these types of headache, regular follow-up of these patients is necessary, preferably on the basis of a headache diary. In an individual patient, migraine and tension headache can occur interchangeably, even in the course of one attack. Ergotamine is no longer recommended for the treatment of migraine attacks in new patients. The pharmacotherapy of migraine must be adjusted to the medication already used by the patient and the severity of the attacks. The recommended treatment for substance-induced headache is to withdraw the responsible medicines completely; explanation, motivation, and support are very important.

[Summary of the practice guideline 'Anxiety disorders' (first revision) from the Dutch College of General Practitioners]. / Samenvatting van de standaard 'Angststoornissen' (eerste herziening) van het Nederlands Huisartsen Genootschap.

Anxiety disorders are characterised by excessive fears leading to distress or social disability. Anxiety disorders are difficult to recognise. General practitioners (GPs) should consider the possibility more often, especially in patients who make frequent visits with unexplained physical symptoms. The cornerstone of treatment is patient education, which can be supported by information leaflets provided by the Dutch College of General Practitioners. Cognitive behavioural therapy and antidepressants are equally effective therapies in most anxiety disorders. The choice should be made in collaboration with the patient. Pharmacological treatment is the first choice when a comorbid depression is involved. Cognitive behavioural therapy by the GP is optional considering the limitations of skills and time in general practice. Tricyclic antidepressants and selective serotonin re-uptake inhibitors are equally effective with most anxiety disorders. The choice must be made on the basis of side effects, comorbidity, and co-medication. Antidepressant therapy should be given for at least 6-12 months. The GP's choice oftreatment should lead to improvement within 8-12 weeks. Otherwise, consultation of or referral to a specialist in mental health care is mandatory.

Responsiveness, longitudinal- and cross-sectional construct validity of the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) in Dutch children with asthma.

OBJECTIVE: Health-related quality of life is an important measure in evaluations of the management of childhood asthma. In this study, we assessed psychometric properties, responsiveness, and longitudinal and cross-sectional construct validity of the Dutch version of the 23-item Pediatric Asthma Quality of Life Questionnaire (PAQLQ). METHODS: The study group consisted of 238 6-18-year olds with asthma, with complete respiratory symptom diaries in the course of one winter season; each child had one (or more) PAQLQ measurement(s) concerning one (or more) week(s) with relatively many symptoms (n = 238). Each child also had one PAQLQ measurement concerning another week with relatively few symptoms (n = 238). The PAQLQ scores of the 238 children for a week with few symptoms (the symptom diary scores remained below a predefined level everyday) were compared with their PAQLQ scores for another week with many symptoms (on day 1 of that week, symptom diary scores had been above the predefined level). Additionally, in a subgroup of the study group that had experienced two or more 'weeks with many symptoms' (n = 101), we compared the PAQLQ-scores for two different weeks with many symptoms of these children. RESULTS: Only the domain Emotions showed a ceiling effect (>25% had the maximum score). All Cronbach's alpha's of the PAQLQ total score and domains were >0.70, except for Activities (alpha = 0.54). Mean PAQLQ-scores were significantly different (p < 0.01; n = 238) between one week with few symptoms and another week with many symptoms. Contrary, in the subgroup of children with PAQLQ-measurements regarding more than one week with many symptoms (n = 101), mean PAQLQ-scores did not differ significantly (p > or = 0.05) between 1 week with many symptoms and another week with many symptoms. These results indicate responsiveness. (Changes in) lower respiratory tract symptoms, indicative of asthma severity, correlated better with (changes in) PAQLQ scores than (changes in) upper respiratory tract symptoms, which supports the longitudinal and cross-sectional construct validity. CONCLUSION: The assessed properties of the PAQLQ linguistic validation into Dutch were similar to those originally established for the PAQLQ in Canada. This study showed that the Dutch PAQLQ has adequate psychometric properties, excellent responsiveness, and that the longitudinal and cross-sectional construct validity is supported.

Childhood factors associated with asthma remission after 30 year follow up.

BACKGROUND: Factors contributing to either "complete" or "clinical" remission of asthma are important to know since there is no cure for the disease. METHODS: A cohort of 119 allergic asthmatic children was examined three times with a mean follow up of 30 years. They were aged 5-14 years at visit 1 (1966-9), 21-33 years at visit 2 (1983-6), and 32-42 years at visit 3 (1995-6). Complete remission of asthma at visit 3 was defined as no asthma symptoms, no use of inhaled corticosteroids, normal lung function (FEV1 >90% predicted), and no bronchial hyperresponsiveness (PC10 >16 mg/ml). Clinical remission was defined as no asthma symptoms and no use of inhaled corticosteroids. RESULTS: 22% of the group was in complete remission of asthma at visit 3 and a further 30% was in clinical remission (total 52%); 57% of subjects in clinical remission had bronchial hyperresponsiveness and/or a low lung function. Logistic regression analyses showed that a higher FEV1 in childhood and more improvement in FEV1 from age 5-14 to 21-33 were associated with both complete and clinical asthma remission at age 32-42. CONCLUSIONS: Complete remission of asthma was present in a small subset of asthmatics while half the subjects showed clinical remission. Both complete and clinical remission were associated with a higher lung function level in childhood and a higher subsequent increase in FEV1. These results support the view that defining remission only on the basis of symptoms and medication use will overlook subjects with subclinical active disease and possibly associated airway remodelling.

Biotinylated steroid derivatives as ligands for biospecific interaction analysis with monoclonal antibodies using immunosensor devices.

Systematic ligand-binding studies of the biospecific interaction between steroids and antisteroid antibodies can be performed in real time using biosensor techniques. In this study, quartz crystal microbalance (QCM) and surface plasmon resonance (SPR) biosensor systems were applied. Different biotinylated testosterone (T) and 17beta-estradiol (E2) derivatives were preincubated with streptavidin and immobilized on the sensor surfaces. We obtained low matrix densities of antigen enabling the investigation of the binding kinetics and position specificities of various anti-E2 and anti-T monoclonal antibodies (mAbs) to these steroidal compounds. The highest immunoreactivity of anti-E2 and anti-T mAbs is not necessarily for the specific modified steroid that was used as a protein-coupled hapten for immunization. The kinetic data confirm that both 3- and 19-specific anti-T mAbs do not discriminate between the 3- and 19-biotinylated T derivatives, whereas the 7alpha-biotinylated T probe showed no affinity to these two anti-T mAbs. In the case of the 3-specific anti-E2 mAb, comparable interaction data were found for 3- and 6alpha-biotinylated E2 compounds. The 6-specific anti-E2 mAb showed comparable ligand binding, but a significant higher dissociation rate to the position-specific antigen. The QCM and SPR results correspond well to the data from cross-reactivity studies in solution as well as to enzyme immunoassay equilibrium measurements.

Risk factors for growth and decline of lung function in asthmatic individuals up to age 42 years. A 30-year follow-up study.

Little is known about factors determining the outcome of childhood asthma. The purpose of this longitudinal study was to assess the factors in childhood that determine the level of FEV(1) in early adulthood in asthmatic individuals, and to examine factors associated with decline in FEV(1) during adulthood. Between 1966 and 1969, 119 allergic asthmatic subjects aged 5 to 14 yr were studied (Visit 1). Of these subjects, 101 (85%) were reinvestigated at ages 22 to 32 yr (Visit 2) and 32 to 42 yr (Visit 3). At the first survey and during follow-up, a standardized questionnaire was used, serum total IgE and peripheral blood eosinophils were measured, and physical examination, skin tests, lung function tests, and histamine challenge (provocative concentration causing a 10% decline in FEV(1); PC(10)) tests were performed according to the same protocol. Multiple linear regression analyses were performed with FEV(1) at Visit 2 and with the change of FEV(1) from Visit 2 to Visit 3 as outcome variables. A low FEV(1)% predicted at Visit 1 and PC(10)

Risk factors from childhood to adulthood for bronchial responsiveness at age 32-42 yr.

UNLABELLED: Bronchial responsiveness (BR) is an important risk factor for the development and outcome of asthma. This study assessed childhood risk factors for both the severity of BR in adulthood and either improvement or worsening of BR over time. Finally, we studied cross-sectional risk factors of BR in adulthood. Between 1966 and 1969, 119 allergic asthmatic children (5-14 yr of age) were studied. Of these, 101 (85%) subjects were reinvestigated at age 22-32 yr (visit 2), and at age 32-42 yr (visit 3). Spirometry, PC10 histamine, skin tests, blood eosinophils, and serum total IgE were measured and a questionnaire was used. Higher FEV1 values in childhood were associated with less severe BR at age 32-42 yr independent of other potential risk factors. Larger increases in FEV1 values both from visit 1 to 2 and from visit 2 to 3, a longer time interval from visit 1 to 3, and having pets in childhood were associated with less severe BR at age 32-42 yr. The same factors were found to be associated with less deterioration of BR from visit 2 to 3. In nonsmokers a higher IgE level at visit 2 was a risk factor for an increase in BR. At age 32-42 yr, a low level of lung function and the presence of asthma symptoms were associated with more severe BR, and older age and having pets were associated with less severe BR. IgE was related to more severe BR only in nonsmokers. CONCLUSIONS: A lower lung function in childhood and less improvement in FEV1 over time were associated with more severe BR in adulthood.

Eosinophil and mast cell parameters in children with stable moderate asthma.

UNLABELLED: Mast cells and eosinophils are important cells that contribute to the process of inflammation in asthma either by activating other cells or by secreting products which are potentially toxic to the respiratory epithelium. The influx of these cells in the airways and the secretion of toxic products by these cells is abrogated by inhaled corticosteroids. METHODS: In a double blind randomised, placebo controlled, study in children with stable moderate asthma (N = 34, 15 children received fluticasone propionate (FP), an inhaled corticosteroid, and 19 children used a placebo), we investigated the influence of treatment with FP 100 microg b.d. on various parameters of inflammation: number of eosinophils, secretory products of eosinophils i.e. ECP and EDN (in serum and urine) and a secretory product of mast cells, histamine, which is determined as the compound to which histamine is converted and excreted by the human body: NT-methyl-histamine. RESULTS: Previously we reported that lung function increased and bronchial hyperresponsiveness decreased in the 30 children that completed the study during treatment with FP. In these children we found that none of the laboratory parameters of inflammation changed significantly during treatment with either FP or placebo. However, the decrease in urinary EDN almost reached significance (P = 0.07). CONCLUSIONS: Our results indicate that the number of eosinophils, serum ECP and EDN and urinary EDN as well as urinary NT-methyl-histamine do not reflect asthma disease activity in children with stable moderate asthma. Our data on urinary EDN warrant further study of the use of this parameter to monitor asthma in children.

Structure of the IGF-binding domain of the insulin-like growth factor-binding protein-5 (IGFBP-5): implications for IGF and IGF-I receptor interactions.

Binding proteins for insulin-like growth factors (IGFs) IGF-I and IGF-II, known as IGFBPs, control the distribution, function and activity of IGFs in various cell tissues and body fluids. Insulin-like growth factor-binding protein-5 (IGFBP-5) is known to modulate the stimulatory effects of IGFs and is the major IGF-binding protein in bone tissue. We have expressed two N-terminal fragments of IGFBP-5 in Escherichia coli; the first encodes the N-terminal domain of the protein (residues 1-104) and the second, mini-IGFBP-5, comprises residues Ala40 to Ile92. We show that the entire IGFBP-5 protein contains only one high-affinity binding site for IGFs, located in mini-IGFBP-5. The solution structure of mini-IGFBP-5, determined by nuclear magnetic resonance spectroscopy, discloses a rigid, globular structure that consists of a centrally located three-stranded anti-parallel beta-sheet. Its scaffold is stabilized further by two inside packed disulfide bridges. The binding to IGFs, which is in the nanomolar range, involves conserved Leu and Val residues localized in a hydrophobic patch on the surface of the IGFBP-5 protein. Remarkably, the IGF-I receptor binding assays of IGFBP-5 showed that IGFBP-5 inhibits the binding of IGFs to the IGF-I receptor, resulting in reduction of receptor stimulation and autophosphorylation. Compared with the full-length IGFBP-5, the smaller N-terminal fragments were less efficient inhibitors of the IGF-I receptor binding of IGFs.

Addition of salmeterol versus doubling the dose of beclomethasone in children with asthma. The Dutch Asthma Study Group.

Studies in adults revealed that addition of salmeterol to a moderate dose of inhaled corticosteroid resulted in better symptom control and higher PEF compared with doubling the dose of inhaled corticosteroid. The aim of this three group study was to compare the effects of a moderate dose of beclomethasone, the same dose of beclomethasone with salmeterol, and a doubling dose of beclomethasone on lung function and symptoms in children with moderate asthma. A total of 177 children already treated with inhaled corticosteroids, were randomized in a double-blind parallel study either to salmeterol 50 microg twice daily (BDP400+salm), beclomethasone 200 microg twice daily (BDP800), or placebo (BDP400) in addition to beclomethasone 200 microg twice daily. No significant differences between groups were found in FEV1, PD20 methacholine, symptom scores, and exacerbation rates after 1 yr. Salmeterol resulted in slightly better PEF in the first months of treatment. FEV1, and PD20 methacholine significantly improved in all groups. After 1 yr mean changes in FEV1, percent predicted were 4.3% (95% CI 1.3; 7.2), 5.8% (95% CI 2.9; 8.7), and 4.3% (95% CI 2.1; 6.5) for BDP400+salm, BDP800, and BDP400, respectively. Changes in airway responsiveness were 0.60 (95% CI 0.05; 1.14), 1.30 (95% CI 0.73; 1. 87), and 0.80 (95% CI 0.33; 1.27) doubling doses. Growth was significantly slower in the BDP800 group. We conclude that no additional benefit was found of adding either salmeterol or more beclomethasone to a daily dose of 400 microg beclomethasone in this group of children with excellent compliance of medication.

Alarmingly high prevalence of obesity in Curaçao: data from an interview survey stratified for socioeconomic status.

OBJECTIVE: The aim of the article is to report the prevalence of obesity, abdominal fatness and waist circumference in different socioeconomic classes in Curaçao. DESIGN: In 1993/1994 a health interview survey (the Curaçao Health Study) was carried out among a random sample (n = 2248, response rate = 85%) of the adult non-institutionalized population of Curaçao. METHODS: We analyzed the association between obesity (BMI > or = 30), abdominal fatness (waist hip ratio (WHR) > or = 0.95 for men, WHR > or = 0.80 for women) waist circumference (WC > or = 100 cm for men, WC > or = 91 cm for women) and socioeconomic status (SES) by age adjusted logistic regressions, for men and women separately. RESULTS: The prevalence of obesity was about 27%: 36% of the women and 19% of the men were obese. An at risk WHR was reported among 62.2% of the women and among 20.4% of the men. A WC above the cut-off point was reported for 44.3% women and 25.3% men. Compared to women of higher SES, the lower SES women have a two to three times higher risk of a BMI, WHR or WC exceeding the cut-off points. Among men, no statistically significant difference between an increased BMI, WHR or WC and SES factors was found. The overlap between the three measures is large, about 56% of the women scored similarly on all three measurements. Among men the overlap is even greater (73%). CONCLUSIONS: The prevalence of obesity in Curaçao is alarming. Low SES women are at the greatest risk of an increased BMI, WHR or WC. The obesity figures can be placed between industrialized societies and less modernized cultures. Action and additional research on the prevention of obesity in Curaçao are deemed necessary. The cut-off points in our study for WC in the non-white population are preliminary and need to be elucidated further.

High prevalence of obesity in Curacao: data from an interview survey stratified for socio-economic status - abstract

The aim of this paper is to report the prevalence of obesity and abdominal fatness in different socioeconomic classes in Curacao. In 1993/1994 a health interview survey (the Curacao Health Study) was carried out among a random sample (n = 2248, response rate = 85 percent) of the adult non-institutionalized population of Curacao. We analyzed the association between body mass index (BMI) and socioeconomic status (SES) as well as the relationship between waist-hip ratio (WHR) and SES by logistic regression models for men and women separately. The overall prevalence of obesity among women peaked at age 46 to 55 years (OR 4.195 percent CI 2.6 - 6.6) and between 56 to 65 (OR 1.7 95 percent CI 1.0 - 3.1) years in men. Women of lower SES are approximately twice as much at risk of being obesed compared to women of higher SES (OR 2.4 95 percent CI 1.7 - 3.4) for the low SES group. The percentage of participants with an at risk WHR (cut off point 0.80 for women and 0.95 for men) is more than three times higher among women than among men (62.2 percent versus 20.4 percent). WHR increased significantly with age among both genders. Compared to women of higher SES, the lower SES women have a three times higher risk of a WHR exceeding th cut off point (OR 3.0 95 percent CI 2.0 - 4.5). The overall prevalence of obesity was much higher than in Spain, Brazil and the Netherlands. The high prevalence of obesity in Curacao justifies action and research on the prevention of obesity in Curacao. (AU)

Lifestyle in Curaçao. Smoking, alcohol consumption, eating habits and exercise.

The Curaçao Health Study was carried out among a randomized sample (n = 2248, response rate = 85%) of the adult non-institutionalized population in order to assess aspects of lifestyle that may pose health risks. Factors examined were tobacco and alcohol use, eating habits and exercise behaviour. Outcome variables were cross-tabulated by gender, age and socioeconomic status. 17.1% of the participants were smokers and 20.5% were regular drinkers, including 6.3% of the men who consumed alcohol excessively (4 or more glasses of alcohol a day). 75% of the participants did not exercise regularly, 37% did not eat vegetables daily, and half did not eat fruit daily. Other poor eating habits were the addition of extra sugar and salt to prepared food by 33% and 20% of the participants, respectively. On the whole, men had less healthy lifestyles than women, with the exception of exercise behaviour. People of high socioeconomic status (SES) drank less alcohol, and exercised more often than those of low SES. Considering the high prevalence of diabetes mellitus and hypertension in the Caribbean, research on lifestyle factors in other Caribbean countries is required to facilitate the development of regional prevention and intervention programmes.

Lifestyle in Curacao: smoking, alcohol consumption, eating habits and exercise

The Curacao Health Study was carried out among a randomized sample (n = 2248, response rate = 85 percent) of the adult non-institutionalized population in order to assess aspects of lifestyle that may pose health risks. Factors examined were tobacco and alcohol use, eating habits and exercise behaviour. Outcome variables were cross-tabulated by gender, age and socioeconomic status. 17.1 percent of the participants were smokers and 20.5 percent regular drinkers, including 6.3 percent of the men who consumed alcohol excessively (4 or more glasses of alcohol a day). 75 percent of the participants did not excercise regularly, 37 percent did not eat vegetables daily, and half did not eat fruit daily. Other poor eating habits were the addition of extra sugar and salt to prepared food by 33 percent and 20 percent of the participants, respectively. On the whole, men had less healthy lifestyles than women, with the exception of execise behaviour. People of high socioeconomic status (SES) drank less alcohol, and exercised more often than those of low SES. Considering the high prevalence of diabetes mellitus and hypertension in the Caribbean, research of lifestyle factors in other Caribbean countries is required to facilitate the development of regional prevention and intervention programmes. (AU)

Lifestyle in Curacao: smoking, alcohol consumption, eating habits and exercise

The Curacao Health Study was carried out among a randomized sample (n = 2248, response rate = 85 percent) of the adult non-institutionalized population in order to assess aspects of lifestyle that may pose health risks. Factors examined were tobacco and alcohol use, eating habits and exercise behaviour. Outcome variables were cross-tabulated by gender, age and socioeconomic status. 17.1 percent of the participants were smokers and 20.5 percent regular drinkers, including 6.3 percent of the men who consumed alcohol excessively (4 or more glasses of alcohol a day). 75 percent of the participants did not excercise regularly, 37 percent did not eat vegetables daily, and half did not eat fruit daily. Other poor eating habits were the addition of extra sugar and salt to prepared food by 33 percent and 20 percent of the participants, respectively. On the whole, men had less healthy lifestyles than women, with the exception of execise behaviour. People of high socioeconomic status (SES) drank less alcohol, and exercised more often than those of low SES. Considering the high prevalence of diabetes mellitus and hypertension in the Caribbean, research of lifestyle factors in other Caribbean countries is required to facilitate the development of regional prevention and intervention programmes.