3.“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
4.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
5.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
6.Genetic and healthy lifestyle factors in relation to the incidence and prognosis of severe liver disease in the Chinese population.
Yuanjie PANG ; Jun LV ; Christiana KARTSONAKI ; Canqing YU ; Yu GUO ; Yiping CHEN ; Ling YANG ; Iona Y MILLWOOD ; Robin G WALTERS ; Silu LV ; Sushila BURGESS ; Sam SANSOME ; Junshi CHEN ; Zhengming CHEN ; Liming LI
Chinese Medical Journal 2023;136(16):1929-1936
BACKGROUND:
Severe liver disease (SLD), including cirrhosis and liver cancer, constitutes a major disease burden in China. We aimed to examine the association of genetic and healthy lifestyle factors with the incidence and prognosis of SLD.
METHODS:
The study population included 504,009 participants from the prospective China Kadoorie Biobank aged 30-79 years. The individuals were from 10 diverse areas in China without a history of cancer or liver disease at baseline. Cox regression was used to estimate adjusted hazard ratios (HRs) for incident SLD and death after SLD diagnosis associated with healthy lifestyle factors (smoking, alcohol, physical activity, and central adiposity). Additionally, the contribution of genetic risk for hepatitis B virus (HBV, assessed by genetic variants in major histocompatibility complex, class II, DP/DQ [ HLA - DP / DQ ] genes) was also estimated.
RESULTS:
Compared with those with 0-1 healthy lifestyle factor, participants with 2, 3, and 4 factors had 12% (HR 0.88 [95% confidence interval [CI] 0.85, 0.92]), 26% (HR 0.74 [95%CI: 0.69, 0.79]), and 44% (HR 0.56 [95%CI: 0.48, 0.65]) lower risks of SLD, respectively. Inverse associations were observed among participants with both low and high genetic risks (HR per 1-point increase 0.83 [95%CI: 0.74, 0.94] and 0.91 [95%CI: 0.82, 1.02], respectively; Pinteraction = 0.51), although with a non-significant trend among those with a high genetic risk. Inverse associations were also observed between healthy lifestyle factors and liver biomarkers regardless of the genetic risk. Despite the limited power, healthy lifestyle factors were associated with a lower risk of death after incident SLD among participants with a low genetic risk (HR 0.59 [95%CI: 0.37, 0.96]).
CONCLUSIONS
Lifestyle modification may be beneficial in terms of lowering the risk of SLD regardless of the genetic risk. Moreover, it is also important for improving the prognosis of SLD in individuals with a low genetic risk. Future studies are warranted to examine the impact of healthy lifestyles on SLD prognosis, particularly among individuals with a high genetic risk.
Humans
;
Prospective Studies
;
Incidence
;
East Asian People
;
Healthy Lifestyle
;
Risk Factors
;
Liver Neoplasms
;
Prognosis
;
China/epidemiology*
8.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
9.A case-control study on the association between a healthy lifestyle and obesity among adult twins in Shanghai.
Rong Fei ZHOU ; Zhen Ni ZHU ; Zheng Yuan WANG ; Jia Jie ZANG ; Xiao Dong JIA ; Jun LYU ; Li Ming LI ; Fan WU
Chinese Journal of Epidemiology 2023;44(6):862-867
Objective: To investigate the associations between the numbers of healthy lifestyles and overweight/obesity and abdominal obesity in adult twins in Shanghai. Methods: Based on the Shanghai Twin Registry System Phase Ⅱ survey data in 2017-2018, a case-control study was conducted to analyze the association between healthy lifestyles and obesity and further adjusted for confounders by a co-twin control study. Results: A total of 7 864 adult twins (3 932 pairs) were included. In the co-twin case-control analysis for monozygotic twins, compared with participants with 0 to 2 healthy lifestyles, those with 3 and 4 to 5 healthy lifestyles had a 49% (OR=0.51, 95%CI: 0.28-0.93) and 70% (OR=0.30, 95%CI: 0.13-0.69) lower risk of overweight/obesity, respectively, and a 17% (OR=0.83, 95%CI: 0.44-1.57) and 66% (OR=0.34, 95%CI: 0.14-0.80) lower risk of abdominal obesity, respectively. For each additional healthy lifestyle, the risk of developing overweight/obesity was reduced by 41% (OR=0.59, 95%CI: 0.42-0.85), and the risk of developing abdominal obesity was reduced by 37% (OR=0.63, 95%CI: 0.44-0.90). Conclusion: An increasing number of healthy lifestyles was associated with a marked decreased risk for both overweight/obesity and abdominal obesity.
Adult
;
Humans
;
Case-Control Studies
;
China/epidemiology*
;
Healthy Lifestyle
;
Obesity/epidemiology*
;
Obesity, Abdominal/epidemiology*
;
Overweight/epidemiology*
;
Twins, Monozygotic


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