1.“Lifestyle Redo” managing dyslipidemia as risk factor for cardiovascular disease in adults through lifestyle intervention
Harris E. Acero, RMT, MMHA ; Mary Jane Botabara Yap, RN, MPH, DrPH ; Mechelle A. Palma, MD, MMHA, CFP, DPCLM, DipIBLM, FPCLM, FACLM
The Filipino Family Physician 2023;61(1):21-26
Background:
Cardiovascular disease (CVD) is a leading cause of death around the world including the Philippines. Dyslipidemia and lifestyle have been considered as important modifiable risk factors. Experts in the Philippines have recommended that among individuals with dyslipidemia, lifestyle modification should be advised regardless of their present condition or risk profile. However, a key limitation of the most recent guidelines is the lack of studies on lifestyle interventions involving Filipinos.
Objective:
This study aimed to provide preliminary evidence for the use of a lifestyle medicine intervention program in the management of dyslipidemia as risk factor for cardiovascular disease.
Methods:
This study employed a mixed method of quantitative and qualitative research designs. The tools used were selfadministered questionnaires, collecting and examining documents. Measures to improve validity in qualitative studies have also been employed such as respondent validation and rival explanation. Triangulation with the findings from the other qualitative methodologies was also employed. Ethical approval was granted.
Results:
The first part of the study has a total of 66 participants who underwent a lifestyle intervention program in a single clinic, comprising of 26 male and 40 female subjects were selected through convenient sampling method. Around 50% of the participants were 40-59 years old, 42.4% were 30-39 years old, and only 7.6% were 60-89 years old. The knowledge of the respondents had an overall mean of 7.73 (SD=1.16) which is interpreted as high knowledge. The attitude of the respondents had a mean of 3.58 (SD=0.50) which is interpreted as very positive. The respondents also had a good lifestyle practice with overall mean of 2.76 (SD=0.49). The second part of the study consisted of eight participants with 3 males and 5 females who were chosen through purposive sampling. All participants experienced reduction of their LDL-C and total cholesterol levels after the 12-week lifestyle intervention. Two participants had increased triglyceride levels. The select group also showed reduction in the blood glucose levels and body mass index.
Conclusion
This study revealed that participants had good knowledge and attitude regarding cardiovascular diseases and its risk factors. Yet, there is still a high number of those who do not efficiently practice healthy lifestyle and diet. Additional information should be extracted to establish the dietary intake of participants which contributed to the increase in triglyceride levels of some select participants.
lifestyle
;
ischemic heart disease
;
dyslipidemia
2.Physician’s lifestyle counseling knowledge, attitude, and practice: A basis for lifestyle medicine continuing medical education (CME)
Mechelle A. Palma, MD, MMHA, CFP, DPCLM, DipIBLM, FPCLM, FACLM
The Filipino Family Physician 2023;61(1):55-60
Background:
The close association of lifestyle with the pathogenesis of chronic diseases has been established since early times. Lifestyle medicine provides an evidence-based solution to the Non-communicable disease epidemic. However, physicians do not receive adequate training on lifestyle counseling and intervention in both undergraduate education and graduate medical training. Objective: The aim of this study was to examine whether knowledge and attitude regarding lifestyle medicine and the Physicians’ personal lifestyle practices will determine the presence or absence of lifestyle counseling in their medical practice.
Methods:
An online survey questionnaire was formed and spread through the internet. The questionnaire consisted of four parts- demographics, physicians’ personal lifestyle practices, their attitudes, and knowledge about Lifestyle Medicine. Ethical approval was granted.
Results:
Out of 188 respondents, 81.4% were females with mean age ranging between 40-49 years. 49 (26.1%) were residents, 84 (44.7%) were Fellows and the remaining participants were Diplomates. 71.3% and 48.4% of respondents said that they include animal and plant food in their diet. The results regarding attitude and knowledge of the doctors of Lifestyle Medicine were mostly insignificant.
Conclusion
The study doesn’t only provide information about the knowledge gap and lack of counseling skills but also highlights the urgent need for lifestyle medicine education programs for the new trainees as well as practicing physicians.
lifestyle
;
continuing education
;
nutrition
;
medical education
3.The meanings of diabetes, healthy lifestyle and barriers to healthy lifestyle among Filipino immigrants in the United States
REIMUND SERAFICA ; SUSAN HAYES LANE
Philippine Journal of Nursing 2016;86(1):29-38
The purpose of this study was to explore the knowledge, perception, and beliefs of newly
arrived Filipino immigrants regarding Type 2 Diabetes Mellitus (T2DM), healthy lifestyle,
and perceived barriers to healthy lifestyle.
This is a qualitative study. A sample (n=40) of newly-arrived (less than six years in United
States) first generation Filipino immigrants, not diagnosed with T2DM, living in
southeastern part of United States were the focus of the study. Face to face interviews
were conducted using an interview guide. No further interviews were conducted after data
were saturated. The data sources were field notes and audio-recorded interviews, which
were transcribed verbatim by the researcher. This study complied with the protocol for
human subjects’ protection as obtained from the institutional review board. Prior to analyses
of the transcripts, each transcript was read at least twice and compared to the recordings to
ensure accuracy and completeness. To ensure trustworthiness, selected transcripts were
reviewed and coded by two experience qualitative researchers to ensure inter-coder
reliability.
A significant number of the participants had little knowledge and few beliefs about T2DM.
The perceptions of T2DM were varied, but several beliefs were widely held: (a) T2DM is a
“sugar disease” that is based on sweet food intake, (b) participants were aiming to achieved
healthy lifestyles through diet, exercise and prayers and (c) T2DM can result from several
factors, including barriers to healthy lifestyle that includes stress, possible discrimination,
and not enough information to navigate health resources. Although immigration brings
opportunities, there are also numerous risks. Some of the diabetes beliefs that this study
delineates provide anchors for future culturally appropriate intervention programs for recent
Filipino immigrants. One of the major findings in this study was the low diabetes literacy
among the participants. Immigrants with low diabetes literacy may have lower awareness of
the disease condition, which may have a negative impact on their disease prevention
behaviors. Migratory background is also an important factor influencing beliefs about
disease prevention. These results provide information for the design of health programs for
the prevention of T2DM in the Philippines and United States.
Acculturation
;
Healthy Lifestyle
;
Diabetes Mellitus, Type 2
6.Physical Inactivity, Sedentary Behavior and Chronic Diseases.
Karimé GONZÁLEZ ; Jorge FUENTES ; José Luis MÁRQUEZ
Korean Journal of Family Medicine 2017;38(3):111-115
New research into physical activity suggests that it is no longer sufficient just to meet minimum levels recommended by health guidelines in order to reduce cardiovascular risk. Both physical inactivity and sedentary behavior have their own health hazards and need to be addressed separately, in order to explore their different deleterious mechanisms. The aim of this review was to define and to characterize both concepts, and their relationship with major non-communicable chronic diseases. A PubMed database search was undertaken, using the following key words: physical activity, physical inactivity, sedentarism, sedentary behavior, and non-communicable chronic disease. This literature review provides an updated view on physical inactivity and sedentary behavior, and reevaluates their prevalence and association with major non-communicable chronic disease.
Chronic Disease*
;
Motor Activity
;
Prevalence
;
Public Health
;
Sedentary Lifestyle
7.Research progress on proactive healthy lifestyle and disease immunoprevention.
Guang Huan YANG ; Meng Dan LIU ; Xiao Lin HU ; Hui WANG ; Xiao Guang LI
Chinese Journal of Preventive Medicine 2023;57(1):78-85
The paradox of increasing health needs and limited health resources prompted a change in the traditional concept of disease prevention and control, and the concept of proactive health has emerged. Proactive health aimed to prevent and control disease and improve the body's immunity by using controlled methods and means to activate the body's self-healing ability and to identify foreign harmful substances as well as damage factors and tumor cells that the body itself may produce while giving full play to individual initiative. With the continuous development of science, people could maintain and improve their immune system from many aspects, which could be roughly divided into nonpharmaceutical interventions and pharmaceutical interventions. Nonpharmacological interventions included changing lifestyles and habits, adjusting the nutritional structure and intake of food, regulating mindsets and emotions, and improving the living and working environment, etc. This review systematically elaborated on the functions and molecular mechanisms of nutrition, exercise, sleep, and emotion in regulating immunity, to provide some scientific evidence and theoretical support for proactive health.
Humans
;
Cancer Vaccines
;
Immunotherapy
;
Life Style
;
Nutritional Status
;
Healthy Lifestyle
8.A case report of non-alcoholic fatty liver disease in a 10 year old boy: Challenge in the approach and management
Pauline Tan Ngo, MD, FPPS, FPSPC
The Filipino Family Physician 2023;61(1):41-46
:
According to the World Health Organization, in 2019, an estimated 38.2 million children under the age of 5 years were overweight or obese. With this increased prevalence along came the rise of its comorbidities such as non-alcoholic fatty liver disease (NAFLD) at early ages. The general objective of this case study is to bring awareness of NAFLD in the young. The specific objective is to present a case of a ten year old boy with non alcoholic liver disease and the challenge in the management.
The case study is a 10 year old boy diagnosed to be overweight, hypertriglyceridemia and non-alcoholic fatty liver disease.
Baseline weight and body mass index were taken on his first visit and follow up.
CBC, Na+, K+, Creatinine, SGPT, FBS, Uric Acid, Total cholesterol, triglycerides, high density lipoprotein, Low density lipoprotein, HBsAg, Anti-HBs, ultrasound of the abdomen and fibroscan of the liver were done.
Nutritional counselling was given but not followed. Physical activity prescription of at least 30 minutes/day moderate intensity exercise five times/week. This was done for 1 hour/day five times/week. He was also prescribed N acetylcysteine, Fish oil and Vitamin D.
After six and a half months, triglycerides became normal however weight and BMI remain the same. Non-alcoholic liver disease was still present on repeat abdominal ultrasound.
Conclusion
1. By engaging in exercise for 6 1/2 months, patient NP was able to normalize the elevated triglyceride level. 2. Without dietary modification, patient wasn’t able to improve his body mass index. His ultrasound still showed the presence of fatty liver. 3. Physicians have the power to influence patients on developing healthy behaviors. They need to take time to engage and listen and help patient discover by themselves lifestyle behaviors that can impact their health. 4. There is a great challenge in instituting this therapeutic intervention for a teenager especially when he is asymptomatic and do not see the need for it. To elicit a better outcome of this patient, it will entail the adoption of the lifestyle modification by the entire family. To set clear and achievable goals and a collaborative management to include a dietician, a health coach and a behavioral therapist may aid compliance.
Pediatric
;
non-alcoholic fatty liver disease (NAFLD)
;
hypertriglyceridemia
;
lifestyle
9.Physical Activity of Patients with Chronic Schizophrenia and Related Clinical Factors.
Sook Hyun LEE ; Gyurin KIM ; Chul Eung KIM ; Seunghyong RYU
Psychiatry Investigation 2018;15(8):811-817
OBJECTIVE: This study aimed to investigate clinical factors contributing to the low physical activity (PA) of patients with chronic schizophrenia. METHODS: PA was measured in 50 outpatients with chronic schizophrenia using the International Physical Activity Questionnaire Short Form (IPAQ-SF). Psychopathology, psychosocial functioning, and extrapyramidal symptoms were assessed using the 18 item-Brief Psychiatric Rating Scale (BPRS-18), Global Assessment of Functioning (GAF), and Drug-Induced Extrapyramidal Symptom Scale (DIEPSS), respectively. We examined differences in these clinical variables between “inactive,”“minimally active,” and “health enhancing physical activity” groups. Linear regression analysis was used to examine the clinical factors explaining low PA levels in patients with schizophrenia. RESULTS: Subjects spent an average of 130.18±238.89 min/wk on moderate/vigorous-intensity PA and only 26% of them met the recommended PA guideline of 150 minutes of at least moderate PA per week. The inactive group showed significantly higher BPRS-18 and DIEPSS scores, and a lower GAF score than the other groups. Linear regression analysis showed that DIEPSS scores independently explained the amount of total PA (p=0.001) and time spent being sedentary (p=0.028). CONCLUSION: This study provides preliminary evidence that extrapyramidal symptoms could be a major impediment to the PA of patients with schizophrenia.
Humans
;
Linear Models
;
Motor Activity*
;
Outpatients
;
Psychopathology
;
Schizophrenia*
;
Sedentary Lifestyle
10.Effects of Three-Week Stair Climbing Exercise for Weight Control: A Case Series Study.
Juheon CHOI ; Kyungmo KANG ; Jong Seung KIM ; Bumjo OH
The Korean Journal of Sports Medicine 2016;34(2):185-189
This study is designed to check whether everyday-life stair climbing, which is a low-cost and readily accessible form of exercise, is effective for reducing overweight of sedentary people in various health indicators. We selected four overweight people and measured body weight, body fat percentage, muscle quantity, pulmonary function, lower-extremity strength and volume of thigh muscle and fat. After 3-week exercise of climbing stairs in more than 5 minutes twice a day, same procedures were taken. Body weight was reduced by 3.35 kg on average (standard deviation [SD], 0.79), and body fat mass by 2.53 kg (SD, 1.36). Lower extremity strength improved about 5%, and slight loss of thigh fat (right 3.2%; left 13.4%) was observed. However, pulmonary function and muscle quantity did not grow significantly. Although only four people may not be representative as targets, but it is suggested that stair climbing has sufficient utility as an easily accessible exercise.
Adipose Tissue
;
Body Weight
;
Lower Extremity
;
Overweight
;
Respiratory Function Tests
;
Sedentary Lifestyle
;
Thigh