BMJ Nutrition, Prevention and Health最新文献

{"title":"Relative validity and reliability of a diet risk score (DRS) for clinical practice.","authors":"Emily A Johnston,&nbsp;Kristina S Petersen,&nbsp;Jeannette M Beasley,&nbsp;Tobias Krussig,&nbsp;Diane C Mitchell,&nbsp;Linda V Van Horn,&nbsp;Rick Weiss,&nbsp;Penny M Kris-Etherton","doi":"10.1136/bmjnph-2020-000134","DOIUrl":"https://doi.org/10.1136/bmjnph-2020-000134","url":null,"abstract":"<p><strong>Introduction: </strong>Adherence to cardioprotective dietary patterns can reduce risk for developing cardiometabolic disease. Rates of diet assessment and counselling by physicians are low. Use of a diet screener that rapidly identifies individuals at higher risk due to suboptimal dietary choices could increase diet assessment and brief counselling in clinical care.</p><p><strong>Methods: </strong>We evaluated the relative validity and reliability of a 9-item diet risk score (DRS) based on the Healthy Eating Index (HEI)-2015, a comprehensive measure of diet quality calculated from a 160-item, validated food frequency questionnaire (FFQ). We hypothesised that DRS (0 (low risk) to 27 (high risk)) would inversely correlate with HEI-2015 score. Adults aged 35 to 75 years were recruited from a national research volunteer registry (ResearchMatch.org) and completed the DRS and FFQ in random order on one occasion. To measure reliability, participants repeated the DRS within 3 months.</p><p><strong>Results: </strong>In total, 126 adults (87% female) completed the study. Mean HEI-2015 score was 63.3 (95% CI: 61.1 to 65.4); mean DRS was 11.8 (95% CI: 10.8 to 12.8). DRS and HEI-2015 scores were inversely correlated (r=-0.6, p<0.001; R²=0.36). The DRS ranked 37% (n=47) of subjects in the same quintile, 41% (n=52) within ±1 quintile of the HEI-2015 (weighted κ: 0.28). The DRS had high reliability (n=102, ICC: 0.83). DRS mean completion time was 2 min.</p><p><strong>Conclusions: </strong>The DRS is a brief diet assessment tool, validated against a FFQ, that can reliably identify patients with reported suboptimal intake. Future studies should evaluate the effectiveness of DRS-guided diet assessment in clinical care. <b>Trial registration details</b> ClinicalTrials.gov (NCT03805373).</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":" ","pages":"263-269"},"PeriodicalIF":0.0,"publicationDate":"2020-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/bmjnph-2020-000134","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25317239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Farming for life: impact of medical prescriptions for fresh vegetables on cardiometabolic health for adults with or at risk of type 2 diabetes in a predominantly Mexican-American population.","authors":"David Kerr,&nbsp;Souptik Barua,&nbsp;Namino Glantz,&nbsp;Casey Conneely,&nbsp;Mary Kujan,&nbsp;Wendy Bevier,&nbsp;Arianna Larez,&nbsp;Ashutosh Sabharwal","doi":"10.1136/bmjnph-2020-000133","DOIUrl":"https://doi.org/10.1136/bmjnph-2020-000133","url":null,"abstract":"<p><strong>Introduction: </strong>Poor diet is the leading cause of poor health in USA, with fresh vegetable consumption below recommended levels. We aimed to assess the impact of medical prescriptions for fresh (defined as picked within 72 hours) vegetables, at no cost to participants on cardiometabolic outcomes among adults (predominantly Mexican-American women) with or at risk of type 2 diabetes (T2D).</p><p><strong>Methods: </strong>Between February 2019 and March 2020, 159 participants (122 female, 75% of Mexican heritage, 31% with non-insulin treated T2D, age 52.5 (13.2) years) were recruited using community outreach materials in English and Spanish, and received prescriptions for 21 servings/week of fresh vegetable for 10 weeks. Pre-post comparisons were made of weight; waist circumference; blood pressure; Hemoglobin A_1c (HbA_1c, a measure of long-term blood glucose control); self-reported sleep, mood and pain; vegetable, tortilla and soda consumption. After obtaining devices for this study, 66 of 72 participants asked, agreed to wear blinded continuous glucose monitors (CGM).</p><p><strong>Results: </strong>Paired data were available for 131 participants. Over 3 months, waist circumference fell (-0.77 (95% CI -1.42 to 0.12) cm, p=0.022), as did systolic blood pressure (SBP) (-2.42 (95% CI -4.56 to 0.28) mm Hg, p=0.037), which was greater among individuals with baseline SBP >130 mm Hg (-7.5 (95% CI -12.4 to 2.6) mm Hg, p=0.005). Weight reduced by -0.4 (-0.7 to -0.04) kg, p=0.029 among women. For participants with baseline HbA_1c >7.0%, HbA_1c fell by -0.35 (-0.8 to -0.1), p=0.009. For participants with paired CGM data (n=40), time in range 70-180 mg/dL improved (from 97.4% to 98.9%, p<0.01). Food insecurity (p<0.001), tortilla (p<0.0001) and soda (p=0.013) consumption significantly decreased. Self-reported sleep, mood and pain level scores also improved (all p<0.01).</p><p><strong>Conclusions: </strong>Medical prescriptions for fresh vegetables were associated with clinically relevant improvements in cardiovascular risk factors and quality of life variables (sleep, mood and pain level) in adults (predominantly Mexican-American and female) with or at risk of T2D.</p><p><strong>Trial registration number: </strong>ClinicalTrials.gov Identifier: NCT03940300.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":" ","pages":"239-246"},"PeriodicalIF":0.0,"publicationDate":"2020-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/bmjnph-2020-000133","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25317236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic risk of obesity as a modifier of associations between neighbourhood environment and body mass index: an observational study of 335 046 UK Biobank participants.","authors":"Kate E Mason,&nbsp;Luigi Palla,&nbsp;Neil Pearce,&nbsp;Jody Phelan,&nbsp;Steven Cummins","doi":"10.1136/bmjnph-2020-000107","DOIUrl":"https://doi.org/10.1136/bmjnph-2020-000107","url":null,"abstract":"<p><strong>Background: </strong>There is growing recognition that recent global increases in obesity are the product of a complex interplay between genetic and environmental factors. However, in gene-environment studies of obesity, 'environment' usually refers to individual behavioural factors that influence energy balance, whereas more upstream environmental factors are overlooked. We examined gene-environment interactions between genetic risk of obesity and two neighbourhood characteristics likely to be associated with obesity (proximity to takeaway/fast-food outlets and availability of physical activity facilities).</p><p><strong>Methods: </strong>We used data from 335 046 adults aged 40-70 in the UK Biobank cohort to conduct a population-based cross-sectional study of interactions between neighbourhood characteristics and genetic risk of obesity, in relation to body mass index (BMI). Proximity to a fast-food outlet was defined as distance from home address to nearest takeaway/fast-food outlet, and availability of physical activity facilities as the number of formal physical activity facilities within 1 km of home address. Genetic risk of obesity was operationalised by weighted Genetic Risk Scores of 91 or 69 single nucleotide polymorphisms (SNP), and by six individual SNPs considered separately. Multivariable, mixed-effects models with product terms for the gene-environment interactions were estimated.</p><p><strong>Results: </strong>After accounting for likely confounding, the association between proximity to takeaway/fast-food outlets and BMI was stronger among those at increased genetic risk of obesity, with evidence of an interaction with polygenic risk scores (p=0.018 and p=0.028 for 69-SNP and 91-SNP scores, respectively) and in particular with a SNP linked to <i>MC4R</i> (p=0.009), a gene known to regulate food intake. We found very little evidence of gene-environment interaction for the availability of physical activity facilities.</p><p><strong>Conclusions: </strong>Individuals at an increased genetic risk of obesity may be more sensitive to exposure to the local fast-food environment. Ensuring that neighbourhood residential environments are designed to promote a healthy weight may be particularly important for those with greater genetic susceptibility to obesity.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":" ","pages":"247-255"},"PeriodicalIF":0.0,"publicationDate":"2020-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/bmjnph-2020-000107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25317237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to dietary and physical activity guidelines among shift workers: associations with individual and work-related factors.","authors":"Ciara Kelly,&nbsp;Fiona M Nea,&nbsp;L Kirsty Pourshahidi,&nbsp;John M Kearney,&nbsp;Victoria O'Brien,&nbsp;M Barbara E Livingstone,&nbsp;Clare A Corish","doi":"10.1136/bmjnph-2020-000091","DOIUrl":"https://doi.org/10.1136/bmjnph-2020-000091","url":null,"abstract":"<p><strong>Objectives: </strong>Shift work is associated with adverse effects on the health and lifestyle behaviours of employees. This study aimed to examine factors associated with adherence among shift workers to selected indicators of dietary and physical activity guidelines.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 1300 shift workers. Data were collected using a 15 minute telephone-administered questionnaire. Logistic regression methods were used for data analysis.</p><p><strong>Results: </strong>Male shift workers (p<0.001, OR=0.55, 95% CI 0.40 to 0.74) and those of lower socioeconomic status (p=0.046, OR=0.75, 95% CI 0.57 to 0.99) were significantly less likely to consume five or more daily servings of fruits and vegetables. Shift workers with access to workplace vending machines were significantly more likely to consume soft drinks at least weekly (p=0.003, OR=1.64, 95% CI 1.18 to 2.27). Middle-aged shift workers (p=0.012, OR=0.65, 95% CI 0.46 to 0.91) and those reporting insufficient break times at work (p=0.026, OR=0.69, 95% CI 0.49 to 0.96) were significantly less likely to be sufficiently active.</p><p><strong>Conclusions: </strong>Individual, work schedule and workplace environment related factors were independently associated with selected indicators of adherence to dietary and physical activity guidelines in this cohort of shift workers.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":" ","pages":"229-238"},"PeriodicalIF":0.0,"publicationDate":"2020-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/bmjnph-2020-000091","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25317235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Connecting nutrition as a hard science and international knowledge networks: Proceedings of the Fourth International Summit on Medical and Public Health Nutrition Education and Research.","authors":"Eden M Barrett,&nbsp;Mhairi Brown,&nbsp;Luke Buckner,&nbsp;James Bradfield,&nbsp;Ali A Khalid,&nbsp;Celia Laur,&nbsp;Sumantra Ray","doi":"10.1136/bmjnph-2020-000090","DOIUrl":"https://doi.org/10.1136/bmjnph-2020-000090","url":null,"abstract":"<p><strong>Introduction: </strong>Nutrition is a 'hard' science in two ways; the scientific rigour required for quality nutrition research, and equally, the challenges faced in evidence translation. Ways in which quality nutrition research can be synthesised and evidence effectively translated into practice were the focus of the Fourth Annual International Summit on Medical and Public Health Nutrition Education and Research.</p><p><strong>Setting: </strong>Wolfson College, University of Cambridge, and Addenbrookes Hospital at the Cambridge Biomedical Campus, Cambridge, in July 2018.</p><p><strong>Key findings: </strong>Open communication and collaboration across disciplines and systems, including transfer of knowledge, ideas and data through international knowledge application networks, was presented as a key tool in enhancing nutrition research and translation of evidence. Increasing basic nutrition competence and confidence in medical professionals is needed to encourage the implementation of nutrition therapy in prevention and treatment of health outcomes.</p><p><strong>Conclusions: </strong>A sustained focus on producing quality nutrition research must be coupled with increased efforts in collaboration and building of knowledge networks, including educating and training multidisciplinary health and medical professionals in nutrition. Such efforts are needed to ensure nutrition is both reliable in its messaging and effective in translation into healthcare.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":" ","pages":"391-396"},"PeriodicalIF":0.0,"publicationDate":"2020-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/bmjnph-2020-000090","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25316686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rationale and description of a lifestyle intervention programme to achieve moderate weight loss in women with non-metastatic breast cancer: the lifestyle intervention part of the SUCCESS C Study.","authors":"Dagmar Hauner,&nbsp;Brigitte Rack,&nbsp;Thomas Friedl,&nbsp;Philip Hepp,&nbsp;Wolfgang Janni,&nbsp;Hans Hauner","doi":"10.1136/bmjnph-2020-000119","DOIUrl":"https://doi.org/10.1136/bmjnph-2020-000119","url":null,"abstract":"<p><strong>Objective: </strong>There is growing evidence from observational studies that lifestyle factors such as obesity, an unhealthy diet and lack of physical activity are associated with poor long-term outcome in women with breast cancer. The primary objective of the lifestyle modification part of the Simultaneous Study of Docetaxel Based Anthracycline Free Adjuvant Treatment Evaluation, as well as Life Style Intervention Strategies (SUCCESS C) Trial is to investigate the effect of an individualised lifestyle intervention programme aiming at moderate weight loss on disease-free survival in women with HER2/neu-negative breast cancer. Secondary objectives include the effect of the intervention on body weight, cardiovascular risk and quality of life.</p><p><strong>Methods: </strong>The SUCCESS C Trial is an open-label, multicentre, randomised controlled phase III study using a 2×2 factorial design in women with newly diagnosed HER2/neu-negative intermediate-risk to high-risk breast cancer. The first randomisation served to compare disease-free survival in patients treated with two different chemotherapy regimens (3642 participants). The second randomisation served to compare disease-free survival in patients with a body mass index of 24-40 kg/m² (2292 participants) receiving either a telephone-based individualised lifestyle intervention programme for moderate weight loss or general recommendations for a healthy lifestyle for 2 years. Outcome analyses will be conducted after 5 years of follow-up.</p><p><strong>Perspective: </strong>This study will provide information on the efficacy and safety of a comprehensive lifestyle intervention programme on disease-free survival in a large cohort of women with breast cancer. EU Clinical Trials Identifier: 2008-005453-38.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":" ","pages":"213-219"},"PeriodicalIF":0.0,"publicationDate":"2020-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/bmjnph-2020-000119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25316368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of food aid and assistance in addressing the double burden of malnutrition in Ghana: a qualitative policy analysis.","authors":"Niisoja M Torto,&nbsp;Kelly D Brownell","doi":"10.1136/bmjnph-2020-000136","DOIUrl":"https://doi.org/10.1136/bmjnph-2020-000136","url":null,"abstract":"<p><strong>Background and aims: </strong>In many low-income and middle-income countries, the double burden of malnutrition threatens public health and economic progress, urging a re-evaluation of the roles and responsibilities of nutrition actors, both traditional and non-traditional. This study examines the food aid and assistance activities of the United Nations World Food Programme (WFP)-one non-traditional actor in the double burden conversation-and the potential for these activities to reach beyond their traditional mandate on undernutrition to also address overweight and obesity in Ghana.</p><p><strong>Methods: </strong>Information on WFP activities in Ghana from 2012 up through its planning into 2023 was extracted from 11 WFP planning, operations and evaluation documents. WFP activities were then judged against the WHO's framework on the determinants of the double burden of malnutrition to determine their potential to address the double burden. Semistructured interviews were also conducted with 17 key informants in the global nutrition landscape to identify challenges that may complicate the role of WFP and other actors in addressing the double burden.</p><p><strong>Results: </strong>The analysis demonstrates that WFP activities in Ghana can serve as a platform on which to address the double burden, particularly by targeting the food access, food systems and socioeconomic disadvantage determinants of the double burden. Actors' uncertainty with what role WFP should play in addressing the double burden, insufficient government attention to malnutrition and poor data on overweight and obesity were identified as potential challenges that complicate addressing the double burden.</p><p><strong>Conclusion: </strong>The findings suggest that integrating WFP as a partner in the effort to address the double burden in Ghana might help amplify progress. To better address the double burden, WFP might prioritise retrofitting existing activities rather than implementing new interventions.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":" ","pages":"196-204"},"PeriodicalIF":0.0,"publicationDate":"2020-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/bmjnph-2020-000136","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25316366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative research study on addressing barriers to healthy diet among low-income individuals at an urban, safety-net hospital.","authors":"Erin Cahill,&nbsp;Stacie R Schmidt,&nbsp;Tracey L Henry,&nbsp;Gayathri Kumar,&nbsp;Sara Berney,&nbsp;Jada Bussey-Jones,&nbsp;Amy Webb Girard","doi":"10.1136/bmjnph-2020-000064","DOIUrl":"https://doi.org/10.1136/bmjnph-2020-000064","url":null,"abstract":"<p><strong>Background: </strong>Some American households experience food insecurity, where access to adequate food is limited by lack of money and other resources. As such, we implemented a free 6-month Fruit and Vegetable Prescription Program within a large urban safety-net hospital.</p><p><strong>Methods: </strong>32 participants completed a baseline and postintervention qualitative evaluation about food-related behaviour 6 months after study completion. Deductive codes were developed based on the key topics addressed in the interviews; inductive codes were identified from analytically reading the transcripts. Transcripts were coded in MAXQDA V.12 (Release 12.3.2).</p><p><strong>Results: </strong>The information collected in the qualitative interviews highlights the many factors that affect dietary habits, including the environmental and individual influences that play a role in food choices people make. Participants expressed very positive sentiments overall about their programme participation.</p><p><strong>Conclusions: </strong>A multifaceted intervention that targets individual behaviour change, enhances nutritional knowledge and skills, and reduces socioeconomic barriers to accessing fresh produce may enhance participant knowledge and self-efficacy around healthy eating. However, socioeconomic factors remain as continual barriers to sustaining healthy eating over the long term. Ongoing efforts that address social determinants of health may be necessary to promote sustainability of behaviour change.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":" ","pages":"383-386"},"PeriodicalIF":0.0,"publicationDate":"2020-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/bmjnph-2020-000064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25317166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifestyle medicine for type 2 diabetes: practice-based evidence for long-term efficacy of a multicomponent lifestyle intervention (Reverse Diabetes2 Now).","authors":"Gerda K Pot,&nbsp;Marieke Ce Battjes-Fries,&nbsp;Olga N Patijn,&nbsp;Nynke van der Zijl,&nbsp;Hanno Pijl,&nbsp;Peter Voshol","doi":"10.1136/bmjnph-2020-000081","DOIUrl":"https://doi.org/10.1136/bmjnph-2020-000081","url":null,"abstract":"<p><strong>Introduction: </strong>A wealth of evidence supports short-term efficacy of lifestyle interventions in type 2 diabetes (T2D). However, little is known about long-term effects of lifestyle interventions in real-life settings.</p><p><strong>Methods: </strong>This observational, single-arm study evaluated long-term impact of 'Voeding Leeft: Reverse-Diabetes2-Now', a 6-month multicomponent lifestyle programme, on glycaemic control and glucose-lowering medication (GLmed) use, other T2D parameters and quality of life in 438 T2D participants at 6, 12, 18 and 24 months using paired sample t-tests, χ² and generalised linear models.</p><p><strong>Results: </strong>At 24 months, 234 participants provided information on GLmed and HbA1c ('responders'). 67% of the responders used less GLmed, and 28% ceased all GLmed. Notably, 71% of insulin users at baseline (n=47 of 66 insulin users) were off insulin at 24 months. Mean HbA1c levels were similar at 24 months compared with baseline (55.6±12.8 vs. 56.3±10.5 mmol/mol, p=0.43), but more responders had HbA1c levels ≤53 mmol/mol at 24 months (53% vs 45% at baseline). Furthermore, triglyceride levels (-0.34±1.02 mmol/L, p=0.004), body weight (-7.0±6.8 kg, p<0.001), waist circumference (-7.9±8.2 cm, p<0.001), body mass index (-2.4±2.3 kg/m², p<0.001) and total cholesterol/high-density lipoprotein (HDL) ratio (-0.22±1.24, p=0.044) were lower, while HDL (+0.17 ± 0.53 mmol/L, p<0.001) and low-density lipoprotein-cholesterol levels (+0.18 ± 1.06 mmol/L, p=0.040) were slightly higher. No differences were observed in fasting glucose or total cholesterol levels. Quality of life and self-reported health significantly improved.</p><p><strong>Conclusion: </strong>This study indicates robust, durable real-life benefits of this lifestyle group programme after up to 24 months of follow-up, particularly in terms of medication use, body weight and quality of life in T2D patients.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":" ","pages":"188-195"},"PeriodicalIF":0.0,"publicationDate":"2020-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/bmjnph-2020-000081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25316365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modification of vitamin B6 on the associations of blood lead levels and cardiovascular diseases in the US adults.","authors":"Jia Wei,&nbsp;John S Ji","doi":"10.1136/bmjnph-2020-000088","DOIUrl":"https://doi.org/10.1136/bmjnph-2020-000088","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) is a leading cause of death in the US population. Lead exposure is an important risk factor of CVDs, as is associated with elevated homocysteine level and oxidative stress. We aim to examine whether vitamin B6, which has been shown to reduce homocysteine level, can modify the relationship between blood lead and the risk of CVDs.</p><p><strong>Methods: </strong>Cross-sectional data on ever-report CVDs (congestive heart failure, coronary heart disease, angina pectoris, heart attack and stroke), blood lead level (BLL) and vitamin B6 in the form of plasma pyridoxal 5'-phosphate were obtained from US National Health and Nutrition Examination Survey 2005-2006 for adults≥20 years old. The association between CVDs and quartiles of BLL was estimated using multivariate logistic regression models adjusted for demographics factors, lifestyle variables, stress variables, comorbidities and CVD biomarkers (C reactive protein, homocysteine, cholesterol) and was stratified by vitamin B6 deficiency level (<20 nmol/L) and median value of vitamin B6 (42.5 nmol/L).</p><p><strong>Results: </strong>Positive associations between BLL and CVDs only appeared in the vitamin B6 deficiency group, with quartile 2 to quartile 4 of BLL showing higher risk of CVDs (OR=3.1, 95% CI 0.9 to 10.6; OR=6.5, 95% CI 1.4 to 30.8; OR=5.5, 95% CI 1.4 to 21.7) compared with quartile 1. When stratified by median value of vitamin B6, a significant association between higher CVD risk with higher BLL was only observed in subjects with low vitamin B6 (p trend=0.004).</p><p><strong>Conclusions: </strong>Vitamin B6 could modify the association between BLL and CVDs, which suggests a potential value of vitamin B6 in influencing the effects of lead exposure on the cardiovascular system.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":" ","pages":"180-187"},"PeriodicalIF":0.0,"publicationDate":"2020-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/bmjnph-2020-000088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25316364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}