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Cognitive Aging : Role of Cardiovascular Disease Risk Factors / Vieillissement Cognitif : Rôle des Facteurs de Risque CardiovasculaireKaffashian, Sara 01 February 2013 (has links)
De nombreux facteurs de risque cardiovasculaire comme l’hypercholestérolémie, l’hypertension, et le diabète sont comptés parmi les facteurs de risque modifiables les plus importants pour le déclin cognitif et la démence. L’exposition à ces facteurs de risque au cours de la vie en particulier avant l’âge de 65 ans ainsi que leur agrégation contribuent de manière plus importante au déclin cognitif. Peu d’études se sont intéressées aux mesures composites de risque cardiovasculaire par rapport à la fonction cognitive chez les sujets de moins de 65 ans. L’objectif de cette thèse était d’étudier l’association entre les mesures composites de risque et le déclin cognitif au cours de la phase précocedu vieillissement. Les données de la cohorte Whitehall II dans laquelle les fonctions cognitives ont été mesurées à trois reprises ont été utilisées pour étudier l’association entre le syndrome métabolique et deux scores de risque de Framingham (de maladie cardiovasculaire globale et d’AVC), et la fonction cognitive et le déclin cognitif sur 10 ans. Les scores de risque cardiovasculaire de Framingham ont aussi été comparés avec un score de risque de démence. De toutes les mesures composites de risque étudiées, les scores de risque de Framingham montraient la plus forteassociation avec le déclin cognitif. Un risque cardiovasculaire plus élevé était associé à un déclin plus rapide dans de multiples tests cognitifs dont la fluence verbale, le vocabulaire et la cognition globale. Ces résultats suggèrent d’une part qu’un risque cardiovasculaire plus élevé contribue au déclin cognitif dès la phase précoce de vieillissement et d’autre part que l’estimation du risque cardiovasculaire et son effet sur la fonction cognitive nécessite une approche multifactorielle.L’identification et la réduction de facteurs de risque cardiovasculaire peuvent avoir un impact important sur la réduction du déclin cognitif et de la démence. / Several cardiovascular disease risk factors including, dyslipidemia, high blood pressure, and diabetes have been proposed as important modifiable risk factors for cognitive decline and dementia. These risk factors often co-occur and their aggregation is associated with increased risk of cardiovascular disease and dementia. However, studies of composite measures of cardiovascular disease risk in relation to cognitive outcomes in non-elderly populations are scarce. The aim of this thesis was to examine composite measures of risk in relation to cognition and longitudinal cognitive change amongmiddle-aged adults. Data from the Whitehall II study were used to study the associations between the metabolic syndrome, two Framingham risk scores; the Framingham stroke and general cardiovascular disease risk scores, and cognition, based on three cognitive assessments over 10 years. In addition, these two (cardio)vascular risk scores were compared with the CAIDE dementia risk score. Of all composite measures of risk examined, the two Framingham risk scores were the best predictors of 10-year cognitive decline. Higher cardiovascular risk was associated with faster 10-year decline inmultiple cognitive tests including verbal fluency, vocabulary and global cognition. These results suggest that multiple cardiovascular disease risk factors contribute to cognitive decline starting in midlife and that multi-risk factor models such as cardiovascular risk scores may be better suited to assessing risk of cognitive decline. Early identification and treatment of cardiovascular disease risk factors may offer the possibility of markedly delaying or preventing cognitive decline.
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The effect of four reduced-fat diets varying in glycaemic index, glycaemic load, carbohydrate and protein, on weight loss, body composition and cardiovascular disease risk factors.Price, Joanna McMillan January 2006 (has links)
Doctor of Philosophy (PhD) / Introduction: The conventional approach to weight loss, recommended by almost all health authorities around the world, has been to reduce the total amount of fat in the diet and replace with carbohydrates. However, research trials using this approach have produced only modest results at best, and despite the active promotion of low fat eating and an apparent decline in fat consumption, rates of overweight and obesity have continued to climb. More recently low glycaemic index (GI) and high protein diets have become popular and are widely used by the public. However, only a small number of randomised controlled trials have been conducted and none directly comparing the two. Both approaches effectively reduce glycaemic load (GL) and aim to reduce post-prandial glycaemia and insulinaemia. This study aimed to evaluate the ability of diets with reduced GL to enhance the weight loss effects of a reduced-fat diet, to compare the two approaches of reducing GL on metabolic and anthropometric changes, and to investigate any benefit of combining both approaches to produce the lowest GL. Methods: We conducted a 12-week intervention in 129 overweight or obese young adults who were assigned to one of four diets with varying GL, protein, carbohydrate and GI, but similar fat (30% energy), fat type and fibre content. DIET 1 (highest GL) contained 55% E as carbohydrate; DIET 2 was a low-GI version of DIET 1; DIET 3 was a high protein diet with 25% E as protein; DIET 4 (lowest GL) was a low-GI version of DIET 3. The increase in protein in DIETS 3 and 4 came primarily from lean red meat. All key foods and some pre-prepared frozen meals were provided to maximise dietary compliance. Outcome measures were body weight, body fat, lean mass, waist circumference and the following blood parameters: total cholesterol, LDL-cholesterol, HDL-cholesterol, triacylglycerols (TAG), free fatty acids, C-reactive protein, fasting insulin, fasting glucose and leptin. Insulin resistance and β-cell function were assessed using homeostatic model assessment (HOMA) and the newer computer models HOMA2-insulin sensitivity and HOMA2-β-cell function. Results: While all groups lost similar amounts of weight (4.2 to 6.2% of initial weight, p=0.09), the proportion who lost >5% of body weight varied significantly by diet: 31%, 56%, 66% and 33% in groups 1, 2, 3 and 4 respectively (p=0.011). Differences were strongest in women (76% of the total group) who showed significant differences among groups in percentage weight change (-3.7 ± 0.6%, -5.7 ± 0.6%, -6.5 ± 0.5%, -4.1 ± 0.7% respectively, p=0.005) and fat loss (-3.1 ± 0.4kg, -4.9 ± 0.6kg, -4.8 ± 0.4kg, -3.6 ± 0.7kg respectively, p=0.007). Total and LDL-cholesterol increased on DIET 3 (high protein) compared to a fall on diet 2 (high carbohydrate/low-GI, p=0.013). TAG, HDL-cholesterol and glucose homeostasis improved on all four diets, with no effect of diet composition. Goals for energy distribution were not achieved exactly: both carbohydrate groups ate less fat and the diet 2 group ate more fibre. Conclusions: Reducing GL, through either substituting low-GI foods or replacing some carbohydrate with protein, improved the efficacy of a reduced-fat diet in women and in those with high TAG. Combining both approaches to produce the lowest GL did not promote further weight or body fat loss. Although weight loss was similar in all four diets for the group as a whole, overall clinical outcomes were superior on the high carbohydrate, low-GI diet.
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CARDIOVASCULAR DISEASE RISK FACTORS AMONG EMERGING ADULTS IN COLLEGEAbshire, Demetrius A 01 January 2014 (has links)
The purpose of this dissertation was to examine factors associated with cardiovascular disease (CVD) risk among emerging adults in college aged 18-25 years. CVD risks that develop during this period often persist into adulthood making it an ideal time to target CVD prevention. The specific aims of this dissertation were to 1) explore perceptions of cardiovascular risk among emerging adult men in college; 2) compare differences in unhealthy behaviors and obesity between emerging adults in college living in rural, Appalachian Kentucky and urban Fayette County, Kentucky; and 3) compare measures of general and abdominal obesity in predicting blood pressure among emerging adults in college.
Specific Aim One was addressed by a qualitative study of perceptions of cardiovascular risk in 10 emerging adult males in college. Specific Aims Two and Three were addressed by a study of emerging adult college students living in rural, Appalachian and urban Fayette County, Kentucky. We hypothesized that students in rural, Appalachian Kentucky would engage in more unhealthy behaviors and be obese due to living in an austere environment with barriers to healthy behaviors. Although obesity and hypertension are known to be related, researchers have not determined whether body fat distribution, general vs. abdominal, is predictive of blood pressure in emerging adults. Knowing which body fat distribution is the strongest predictor of blood pressure may help in evaluating cardiovascular risk in emerging adults.
Emerging adult men emphasized difficulty engaging in CVD health behaviors while attending college and choose to ignore long-term CVD risk. Overcoming college-specific and developmental barriers to engaging in healthy behaviors is critical to reducing cardiovascular risk in this population. Students living in rural, Appalachian Kentucky had more CVD risk behaviors and more were obese compared to those in urban Fayette County, Kentucky. Reducing CVD risk behaviors and obesity among students in rural Appalachian Kentucky may help decrease the high burden of CVD in this region. Findings suggest that waist circumference was the best predictor of systolic blood pressure among emerging adults in college.
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Obesity as a metabolic syndrome determinant and the influence of physical activity in treatment and prevention / Jeanine BenekeBeneke, Jeanine January 2005 (has links)
The prevalence of obesity in both the developed and developing world have
increased, which leads to diverse health outcomes and is placing a heavy
burden on the economy. Abdominal obesity proved to be one of the main
features in predicting metabolic and cardiovascular disease (CVD) risk and
may be the link that unifies the metabolic syndrome (MS) through pro-inflammatory
pathways. While the pathogenesis of the MS and each of its
components are complex and not well understood, abdominal obesity remains
the mechanism that relates to increased lipolysis causing the liver to increase
blood glucose and very low lipoprotein output. This in turns leads to raised
blood glucose, triglycerides, low-density lipoprotein cholesterol (LDL-C), blood
pressure and inflammatory markers (C-reactive protein, interleukin-6 and
tumor necrosis factor-a) and decreased high-density lipoprotein cholesterol
(HDL-C). Prevention of the metabolic syndrome and treatment of its main
characteristics are now considered of utmost importance in order to combat
the increased CVD risk and all-cause mortality. Decreasing sedentary
behaviour through regular physical activity is a key element in successful
treatment of obesity through an increase in energy expenditure, but the ability
to decrease low-grade systemic inflammation may be an even greater
outcome.
Aims
The aims of this study was firstly, to determine by means of a literature review,
how obesity could be related to a state of chronic systemic inflammation
(increased CRP and IL-6). Secondly to determine whether physical activity
could serve as a suitable method to decrease inflammation associated with
obesity and related disorders. Thirdly to determine if abdominal obesity is a
predictor of the metabolic syndrome and CVD and finally, to determine if
measures of obesity can predict risk for the metabolic syndrome and CVD
risk.
Methods
For this review study, a computer-assisted literature search were utilized to
identify research published between 1990 and 2005. the following databases
were utilized for the search: NEXUS, Science Direct, PubMed and Medline.
Keywords related to obesity (abdominal obesity, overweight), metabolic
syndrome (insulin resistance syndrome, dysmetabolic syndrome, syndrome
X), cardiovascular disease (coronary heart disease, coronary artery disease),
cardiovascular risk factors (hypertension, dyslipidemia, diabetes mellitus,
physical activity), inflammatory markers (CRP, IL-6, chronic low-grade
inflammation) and physical activity (fitness, exercise and training) were
included as part of the search, including the references identified by previous
reviewers (not identified as part of the computerized literature search).
Results and conclusions
Several research studies concluded that obesity could be an
inflammatory disorder due to low-grade systemic inflammation. Adipose
tissue is known to be a sectretory organ producing cytokines, acute
phase reactants and other circulating factors. The synthesis of adipose
tissue TNF-a could induce the production of IL-6, CRP and other acute
phase reactants. CRP is a acute phase reactant, synthesized primarily
in hepatocytes and secreted by the liver in response to a variety of
inflammatory cytokines of which IL-6 and TNF-a are mainly involved.
CRP increases rapidly in response to trauma, inflammation and
infection. Thus, enhanced levels of CRP can be used as a marker of
inflammation.
Several studies of large population cohorts provide evidence for an
inverse, independent dose-response relation between plasma CRP
concentration and level of physical activity in both men and women.
Trends for decreased IL-6, TNF-a and CRP concentrations were linear
with increasing amounts of reported exercise in most of the research
studies, physical activity proved effective in lowering measures of
adiposity (BMI, WHR, WC and percentage body fat) and obesity related
inflammatory markers (CRP & IL-6). Thereby indicating a potential anti-inflammatory
effect.
In the studies reviewed in this article abdominal obesity is identified as
a predictor and independent risk factor for CVD in both men and
women. High levels of deep abdominal fat have also been correlated
with components of the metabolic syndrome, glucose intolerance,
hyperinsulinemia, hypertension, diabetes, increases in plasma
triglyceride levels and a decrease in HDL-C levels (dyslipidemia) in
many of the studies. Prospective epidemiological studies have revealed
that abdominal obesity (determined by WC and WHR) conveys an
independent prediction of CVD risk and is more relevant compared to
general obesity (determined by BMI).
Abdominal fat has been linked to metabolic risk factors like high systolic
blood pressure, atherogenic dyslipidemia, with increased serum TG
and decreased HDL-C, and glucose intolerance. Although magnetic
resonance imaging (MRI) and computerized tomography (CT) have
been used successfully in many studies to measure adipose
compartments of the abdomen (subcutaneous and visceral fat),
anthropometrical measures like WHR and WC have been proven to be
an effective measure in predicting the metabolic syndrome. WC has
also been included in the metabolic syndrome definitions of the WHO,
ATP Ill and new IDF. / The prevalence of obesity in both the developed and developing world have
increased, which leads to diverse health outcomes and is placing a heavy
burden on the economy. Abdominal obesity proved to be one of the main
features in predicting metabolic and cardiovascular disease (CVD) risk and
may be the link that unifies the metabolic syndrome (MS) through pro-inflammatory
pathways. While the pathogenesis of the MS and each of its
components are complex and not well understood, abdominal obesity remains
the mechanism that relates to increased lipolysis causing the liver to increase
blood glucose and very low lipoprotein output. This in turns leads to raised
blood glucose, triglycerides, low-density lipoprotein cholesterol (LDL-C), blood
pressure and inflammatory markers (C-reactive protein, interleukin-6 and
tumor necrosis factor-a) and decreased high-density lipoprotein cholesterol
(HDL-C). Prevention of the metabolic syndrome and treatment of its main
characteristics are now considered of utmost importance in order to combat
the increased CVD risk and all-cause mortality. Decreasing sedentary
behaviour through regular physical activity is a key element in successful
treatment of obesity through an increase in energy expenditure, but the ability
to decrease low-grade systemic inflammation may be an even greater
outcome.
Aims
The aims of this study was firstly, to determine by means of a literature review,
how obesity could be related to a state of chronic systemic inflammation
(increased CRP and IL-6). Secondly to determine whether physical activity
could serve as a suitable method to decrease inflammation associated with
obesity and related disorders. Thirdly to determine if abdominal obesity is a
predictor of the metabolic syndrome and CVD and finally, to determine if
measures of obesity can predict risk for the metabolic syndrome and CVD
risk.
Methods
For this review study, a computer-assisted literature search were utilized to
identify research published between 1990 and 2005. the following databases
were utilized for the search: NEXUS, Science Direct, PubMed and Medline.
Keywords related to obesity (abdominal obesity, overweight), metabolic
syndrome (insulin resistance syndrome, dysmetabolic syndrome, syndrome
X), cardiovascular disease (coronary heart disease, coronary artery disease),
cardiovascular risk factors (hypertension, dyslipidemia, diabetes mellitus,
physical activity), inflammatory markers (CRP, IL-6, chronic low-grade
inflammation) and physical activity (fitness, exercise and training) were
included as part of the search, including the references identified by previous
reviewers (not identified as part of the computerized literature search).
Results and conclusions
Several research studies concluded that obesity could be an
inflammatory disorder due to low-grade systemic inflammation. Adipose
tissue is known to be a sectretory organ producing cytokines, acute
phase reactants and other circulating factors. The synthesis of adipose
tissue TNF-a could induce the production of IL-6, CRP and other acute
phase reactants. CRP is a acute phase reactant, synthesized primarily
in hepatocytes and secreted by the liver in response to a variety of
inflammatory cytokines of which IL-6 and TNF-a are mainly involved.
CRP increases rapidly in response to trauma, inflammation and
infection. Thus, enhanced levels of CRP can be used as a marker of
inflammation.
Several studies of large population cohorts provide evidence for an
inverse, independent dose-response relation between plasma CRP
concentration and level of physical activity in both men and women.
Trends for decreased IL-6, TNF-a and CRP concentrations were linear
with increasing amounts of reported exercise in most of the research
studies, physical activity proved effective in lowering measures of
adiposity (BMI, WHR, WC and percentage body fat) and obesity related
inflammatory markers (CRP & IL-6). Thereby indicating a potential anti-inflammatory
effect.
In the studies reviewed in this article abdominal obesity is identified as
a predictor and independent risk factor for CVD in both men and
women. High levels of deep abdominal fat have also been correlated
with components of the metabolic syndrome, glucose intolerance,
hyperinsulinemia, hypertension, diabetes, increases in plasma
triglyceride levels and a decrease in HDL-C levels (dyslipidemia) in
many of the studies. Prospective epidemiological studies have revealed
that abdominal obesity (determined by WC and WHR) conveys an
independent prediction of CVD risk and is more relevant compared to
general obesity (determined by BMI).
Abdominal fat has been linked to metabolic risk factors like high systolic
blood pressure, atherogenic dyslipidemia, with increased serum TG
and decreased HDL-C, and glucose intolerance. Although magnetic
resonance imaging (MRI) and computerized tomography (CT) have
been used successfully in many studies to measure adipose
compartments of the abdomen (subcutaneous and visceral fat),
anthropometrical measures like WHR and WC have been proven to be
an effective measure in predicting the metabolic syndrome. WC has
also been included in the metabolic syndrome definitions of the WHO,
ATP Ill and new IDF. / Thesis (M.A. (Human Movement Science))--North-West University, Potchefstroom Campus, 2006.
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Obesity as a metabolic syndrome determinant and the influence of physical activity in treatment and prevention / Jeanine BenekeBeneke, Jeanine January 2005 (has links)
The prevalence of obesity in both the developed and developing world have
increased, which leads to diverse health outcomes and is placing a heavy
burden on the economy. Abdominal obesity proved to be one of the main
features in predicting metabolic and cardiovascular disease (CVD) risk and
may be the link that unifies the metabolic syndrome (MS) through pro-inflammatory
pathways. While the pathogenesis of the MS and each of its
components are complex and not well understood, abdominal obesity remains
the mechanism that relates to increased lipolysis causing the liver to increase
blood glucose and very low lipoprotein output. This in turns leads to raised
blood glucose, triglycerides, low-density lipoprotein cholesterol (LDL-C), blood
pressure and inflammatory markers (C-reactive protein, interleukin-6 and
tumor necrosis factor-a) and decreased high-density lipoprotein cholesterol
(HDL-C). Prevention of the metabolic syndrome and treatment of its main
characteristics are now considered of utmost importance in order to combat
the increased CVD risk and all-cause mortality. Decreasing sedentary
behaviour through regular physical activity is a key element in successful
treatment of obesity through an increase in energy expenditure, but the ability
to decrease low-grade systemic inflammation may be an even greater
outcome.
Aims
The aims of this study was firstly, to determine by means of a literature review,
how obesity could be related to a state of chronic systemic inflammation
(increased CRP and IL-6). Secondly to determine whether physical activity
could serve as a suitable method to decrease inflammation associated with
obesity and related disorders. Thirdly to determine if abdominal obesity is a
predictor of the metabolic syndrome and CVD and finally, to determine if
measures of obesity can predict risk for the metabolic syndrome and CVD
risk.
Methods
For this review study, a computer-assisted literature search were utilized to
identify research published between 1990 and 2005. the following databases
were utilized for the search: NEXUS, Science Direct, PubMed and Medline.
Keywords related to obesity (abdominal obesity, overweight), metabolic
syndrome (insulin resistance syndrome, dysmetabolic syndrome, syndrome
X), cardiovascular disease (coronary heart disease, coronary artery disease),
cardiovascular risk factors (hypertension, dyslipidemia, diabetes mellitus,
physical activity), inflammatory markers (CRP, IL-6, chronic low-grade
inflammation) and physical activity (fitness, exercise and training) were
included as part of the search, including the references identified by previous
reviewers (not identified as part of the computerized literature search).
Results and conclusions
Several research studies concluded that obesity could be an
inflammatory disorder due to low-grade systemic inflammation. Adipose
tissue is known to be a sectretory organ producing cytokines, acute
phase reactants and other circulating factors. The synthesis of adipose
tissue TNF-a could induce the production of IL-6, CRP and other acute
phase reactants. CRP is a acute phase reactant, synthesized primarily
in hepatocytes and secreted by the liver in response to a variety of
inflammatory cytokines of which IL-6 and TNF-a are mainly involved.
CRP increases rapidly in response to trauma, inflammation and
infection. Thus, enhanced levels of CRP can be used as a marker of
inflammation.
Several studies of large population cohorts provide evidence for an
inverse, independent dose-response relation between plasma CRP
concentration and level of physical activity in both men and women.
Trends for decreased IL-6, TNF-a and CRP concentrations were linear
with increasing amounts of reported exercise in most of the research
studies, physical activity proved effective in lowering measures of
adiposity (BMI, WHR, WC and percentage body fat) and obesity related
inflammatory markers (CRP & IL-6). Thereby indicating a potential anti-inflammatory
effect.
In the studies reviewed in this article abdominal obesity is identified as
a predictor and independent risk factor for CVD in both men and
women. High levels of deep abdominal fat have also been correlated
with components of the metabolic syndrome, glucose intolerance,
hyperinsulinemia, hypertension, diabetes, increases in plasma
triglyceride levels and a decrease in HDL-C levels (dyslipidemia) in
many of the studies. Prospective epidemiological studies have revealed
that abdominal obesity (determined by WC and WHR) conveys an
independent prediction of CVD risk and is more relevant compared to
general obesity (determined by BMI).
Abdominal fat has been linked to metabolic risk factors like high systolic
blood pressure, atherogenic dyslipidemia, with increased serum TG
and decreased HDL-C, and glucose intolerance. Although magnetic
resonance imaging (MRI) and computerized tomography (CT) have
been used successfully in many studies to measure adipose
compartments of the abdomen (subcutaneous and visceral fat),
anthropometrical measures like WHR and WC have been proven to be
an effective measure in predicting the metabolic syndrome. WC has
also been included in the metabolic syndrome definitions of the WHO,
ATP Ill and new IDF. / The prevalence of obesity in both the developed and developing world have
increased, which leads to diverse health outcomes and is placing a heavy
burden on the economy. Abdominal obesity proved to be one of the main
features in predicting metabolic and cardiovascular disease (CVD) risk and
may be the link that unifies the metabolic syndrome (MS) through pro-inflammatory
pathways. While the pathogenesis of the MS and each of its
components are complex and not well understood, abdominal obesity remains
the mechanism that relates to increased lipolysis causing the liver to increase
blood glucose and very low lipoprotein output. This in turns leads to raised
blood glucose, triglycerides, low-density lipoprotein cholesterol (LDL-C), blood
pressure and inflammatory markers (C-reactive protein, interleukin-6 and
tumor necrosis factor-a) and decreased high-density lipoprotein cholesterol
(HDL-C). Prevention of the metabolic syndrome and treatment of its main
characteristics are now considered of utmost importance in order to combat
the increased CVD risk and all-cause mortality. Decreasing sedentary
behaviour through regular physical activity is a key element in successful
treatment of obesity through an increase in energy expenditure, but the ability
to decrease low-grade systemic inflammation may be an even greater
outcome.
Aims
The aims of this study was firstly, to determine by means of a literature review,
how obesity could be related to a state of chronic systemic inflammation
(increased CRP and IL-6). Secondly to determine whether physical activity
could serve as a suitable method to decrease inflammation associated with
obesity and related disorders. Thirdly to determine if abdominal obesity is a
predictor of the metabolic syndrome and CVD and finally, to determine if
measures of obesity can predict risk for the metabolic syndrome and CVD
risk.
Methods
For this review study, a computer-assisted literature search were utilized to
identify research published between 1990 and 2005. the following databases
were utilized for the search: NEXUS, Science Direct, PubMed and Medline.
Keywords related to obesity (abdominal obesity, overweight), metabolic
syndrome (insulin resistance syndrome, dysmetabolic syndrome, syndrome
X), cardiovascular disease (coronary heart disease, coronary artery disease),
cardiovascular risk factors (hypertension, dyslipidemia, diabetes mellitus,
physical activity), inflammatory markers (CRP, IL-6, chronic low-grade
inflammation) and physical activity (fitness, exercise and training) were
included as part of the search, including the references identified by previous
reviewers (not identified as part of the computerized literature search).
Results and conclusions
Several research studies concluded that obesity could be an
inflammatory disorder due to low-grade systemic inflammation. Adipose
tissue is known to be a sectretory organ producing cytokines, acute
phase reactants and other circulating factors. The synthesis of adipose
tissue TNF-a could induce the production of IL-6, CRP and other acute
phase reactants. CRP is a acute phase reactant, synthesized primarily
in hepatocytes and secreted by the liver in response to a variety of
inflammatory cytokines of which IL-6 and TNF-a are mainly involved.
CRP increases rapidly in response to trauma, inflammation and
infection. Thus, enhanced levels of CRP can be used as a marker of
inflammation.
Several studies of large population cohorts provide evidence for an
inverse, independent dose-response relation between plasma CRP
concentration and level of physical activity in both men and women.
Trends for decreased IL-6, TNF-a and CRP concentrations were linear
with increasing amounts of reported exercise in most of the research
studies, physical activity proved effective in lowering measures of
adiposity (BMI, WHR, WC and percentage body fat) and obesity related
inflammatory markers (CRP & IL-6). Thereby indicating a potential anti-inflammatory
effect.
In the studies reviewed in this article abdominal obesity is identified as
a predictor and independent risk factor for CVD in both men and
women. High levels of deep abdominal fat have also been correlated
with components of the metabolic syndrome, glucose intolerance,
hyperinsulinemia, hypertension, diabetes, increases in plasma
triglyceride levels and a decrease in HDL-C levels (dyslipidemia) in
many of the studies. Prospective epidemiological studies have revealed
that abdominal obesity (determined by WC and WHR) conveys an
independent prediction of CVD risk and is more relevant compared to
general obesity (determined by BMI).
Abdominal fat has been linked to metabolic risk factors like high systolic
blood pressure, atherogenic dyslipidemia, with increased serum TG
and decreased HDL-C, and glucose intolerance. Although magnetic
resonance imaging (MRI) and computerized tomography (CT) have
been used successfully in many studies to measure adipose
compartments of the abdomen (subcutaneous and visceral fat),
anthropometrical measures like WHR and WC have been proven to be
an effective measure in predicting the metabolic syndrome. WC has
also been included in the metabolic syndrome definitions of the WHO,
ATP Ill and new IDF. / Thesis (M.A. (Human Movement Science))--North-West University, Potchefstroom Campus, 2006.
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The effect of four reduced-fat diets varying in glycaemic index, glycaemic load, carbohydrate and protein, on weight loss, body composition and cardiovascular disease risk factors.Price, Joanna McMillan January 2006 (has links)
Doctor of Philosophy (PhD) / Introduction: The conventional approach to weight loss, recommended by almost all health authorities around the world, has been to reduce the total amount of fat in the diet and replace with carbohydrates. However, research trials using this approach have produced only modest results at best, and despite the active promotion of low fat eating and an apparent decline in fat consumption, rates of overweight and obesity have continued to climb. More recently low glycaemic index (GI) and high protein diets have become popular and are widely used by the public. However, only a small number of randomised controlled trials have been conducted and none directly comparing the two. Both approaches effectively reduce glycaemic load (GL) and aim to reduce post-prandial glycaemia and insulinaemia. This study aimed to evaluate the ability of diets with reduced GL to enhance the weight loss effects of a reduced-fat diet, to compare the two approaches of reducing GL on metabolic and anthropometric changes, and to investigate any benefit of combining both approaches to produce the lowest GL. Methods: We conducted a 12-week intervention in 129 overweight or obese young adults who were assigned to one of four diets with varying GL, protein, carbohydrate and GI, but similar fat (30% energy), fat type and fibre content. DIET 1 (highest GL) contained 55% E as carbohydrate; DIET 2 was a low-GI version of DIET 1; DIET 3 was a high protein diet with 25% E as protein; DIET 4 (lowest GL) was a low-GI version of DIET 3. The increase in protein in DIETS 3 and 4 came primarily from lean red meat. All key foods and some pre-prepared frozen meals were provided to maximise dietary compliance. Outcome measures were body weight, body fat, lean mass, waist circumference and the following blood parameters: total cholesterol, LDL-cholesterol, HDL-cholesterol, triacylglycerols (TAG), free fatty acids, C-reactive protein, fasting insulin, fasting glucose and leptin. Insulin resistance and β-cell function were assessed using homeostatic model assessment (HOMA) and the newer computer models HOMA2-insulin sensitivity and HOMA2-β-cell function. Results: While all groups lost similar amounts of weight (4.2 to 6.2% of initial weight, p=0.09), the proportion who lost >5% of body weight varied significantly by diet: 31%, 56%, 66% and 33% in groups 1, 2, 3 and 4 respectively (p=0.011). Differences were strongest in women (76% of the total group) who showed significant differences among groups in percentage weight change (-3.7 ± 0.6%, -5.7 ± 0.6%, -6.5 ± 0.5%, -4.1 ± 0.7% respectively, p=0.005) and fat loss (-3.1 ± 0.4kg, -4.9 ± 0.6kg, -4.8 ± 0.4kg, -3.6 ± 0.7kg respectively, p=0.007). Total and LDL-cholesterol increased on DIET 3 (high protein) compared to a fall on diet 2 (high carbohydrate/low-GI, p=0.013). TAG, HDL-cholesterol and glucose homeostasis improved on all four diets, with no effect of diet composition. Goals for energy distribution were not achieved exactly: both carbohydrate groups ate less fat and the diet 2 group ate more fibre. Conclusions: Reducing GL, through either substituting low-GI foods or replacing some carbohydrate with protein, improved the efficacy of a reduced-fat diet in women and in those with high TAG. Combining both approaches to produce the lowest GL did not promote further weight or body fat loss. Although weight loss was similar in all four diets for the group as a whole, overall clinical outcomes were superior on the high carbohydrate, low-GI diet.
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Investigation on the effects of air pollution on cardiovascular disease risk factors using epidemiological approaches:A longitudinal cohort studies in Thailand / 疫学アプローチを用いた大気汚染の循環器疾患リスクファクターに対する影響の研究:タイにおける縦断コホート研究PAOIN, KANAWAT 24 September 2021 (has links)
京都大学 / 新制・課程博士 / 博士(工学) / 甲第23494号 / 工博第4906号 / 新制||工||1766(附属図書館) / 京都大学大学院工学研究科都市環境工学専攻 / (主査)教授 高野 裕久, 教授 米田 稔, 准教授 上田 佳代 / 学位規則第4条第1項該当 / Doctor of Philosophy (Engineering) / Kyoto University / DFAM
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Dietary approaches to stop hypertension dietary pattern, physical activity, and risk of atherosclerotic cardiovascular diseaseGlanz, Eric 09 October 2019 (has links)
BACKGROUND: Atherosclerotic cardiovascular (ASCVD) disease is the leading cause of death in the United States. Longstanding poor nutrition habits and lack of exercise contribute to chronic inflammation and promote the development ASCVD. In clinical trials, the Dietary Approaches to Stop Hypertension (DASH) eating pattern, a diet rich in nutrients with anti-inflammatory and antioxidant properties, has been shown to reduce the risk of hypertension. Its role in overall cardiovascular (CV) health, both alone and in combination with an active lifestyle, is less clear.
OBJECTIVES: The primary goal of this study is to examine the relationships between the DASH eating pattern, physical activity, the development of incident cardiovascular disease (CVD). Specifically, we will evaluate the independent and combined effects of DASH and moderate to vigorous physical activity (MVPA) on cardiovascular event risk among men and women in the Framingham Heart Study Offspring (FOS) cohort.
METHODS: The DASH score was derived from two sets of three-day dietary records gathered during examination visits 3 and 5 in the prospective FOS cohort. Activity was self-reported and used to generate a composite score for MVPA. Scores were constructed for each individual by multiplying the number of hours spent during each day in sedentary, light, moderate, and vigorous activity by a standard weights reflecting the intensity of that activity. Subjects included 2503 individuals (1137 men and 1366 women), aged 30 years and older. Individuals were free of type II diabetes mellitus (T2DM), cancer, and cardiovascular disease at baseline. The DASH score was categorized according to adherence to the eating pattern, first as low, moderate, or high adherence and then dichotomized (DASH score <4.45 vs. ≥4.45). The MVPA score was classified into quintiles and also dichotomized (MVPA score <6.1 vs. ≥6.1). The dichotomous DASH and MVPA scores were then cross-classified and each subject was assigned to one of the following categories: (1) low DASH score / low activity (referent), (2) low DASH / high activity, (3) high DASH / low activity, and (4) high DASH / high activity. Follow-up started at exam 5 and continued through the ninth examination cycle in 2014. Cox proportional-hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all subjects and for men and women independently, adjusting for confounding by age, BMI, cigarettes smoked per day, and grams per day of alcohol consumed. Factors found not to confound the effects of DASH and MVPA on CV risk were excluded from final models.
RESULTS: During a median follow-up of approximately 20 years, 286 and 177 incident CVD cases were documented among men and women, respectively. Women in the highest DASH adherence category had approximately 28% lower total CVD risk than women in
the lowest adherence group (HR, 0.72; 95% CI: 0.48-1.10). Effects in men were weaker. Women in the highest quintile of MVPA score had approximately 44% lower risk of CVD than women in the lowest quintile (HR, 0.66; 95% (0.40-1.10). Overall, CVD risk was 26% lower (HR: 0.74 (95% CI: 0.55-0.99) for those in quintile 5 vs. quintile 1. Women in the High DASH/High MVPA category had a 43% lower total CVD risk than women in the Low DASH/Low MVPA group (High DASH/High MVPA: HR, 0.57; 95% (0.36-0.90)). These associations ere generally stronger in women than men.
CONCLUSIONS: In this prospective cohort study, active individuals with higher adherence to DASH was associated with a lower atherosclerotic CVD risk compared to those with lower activity and DASH adherence. The beneficial effects of diet in particular were stronger among women than men.
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Cardiac Risk, Patient-Physician Communication, And Exercise Among Patients With Type 2 DiabetesDoyle, Todd A. January 2007 (has links)
No description available.
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Effect of acute exercise and diet manipulations on postprandial metabolism in boys and girlsThackray, Alice E. January 2014 (has links)
Elevated postprandial triacylglycerol concentrations ([TAG]) are associated with the development and progression of atherosclerosis, and are established as an independent risk factor for future cardiovascular disease. Considering the majority of the daytime is spent in a postprandial state typically, and the paediatric origins of atherosclerosis are well established, lifestyle interventions including manipulations of exercise energy expenditure and dietary energy intake should be initiated early in life. Therefore, this thesis aimed to investigate the postprandial metabolic responses to different exercise and energy intake manipulations in boys and girls, with concentrations of circulating TAG representing the primary outcome of interest. To achieve this, a total of 60 healthy 11 to 13 year old boys and girls were recruited into five experimental studies. The first experimental study (Chapter 4) demonstrated that a single session of high-intensity interval running (HIIR) involving 10 x 1 min intervals at 100% maximal aerobic speed (MAS) resulted in a moderate reduction in postprandial plasma [TAG] in 11 to 12 year old boys. In the second experimental study (Chapter 5), immediate replacement of the moderate-intensity exercise-induced energy deficit negated the reduction in postprandial plasma [TAG] in 11 to 13 year old boys. Furthermore, an exercise-induced energy deficit was required to promote an increase in whole-body fat oxidation. The importance of the associated energy deficit was explored further in Chapter 6, which demonstrated that a moderate-intensity exercise-induced energy deficit elicited a greater reduction in postprandial plasma [TAG] than an isoenergetic diet-induced energy deficit in 11 to 13 year old girls (21% vs. 10% respectively). Chapter 7 compared the effect of 10 x 1 min interval runs at 100% MAS (HIIR) and 5 x 1 min interval runs at 100% MAS combined with a mild reduction in habitual energy intake by 0.82 MJ (195 kcal; HIIR-ER) on postprandial metabolism in 11 to 13 year old girls. Acute manipulations of low volume HIIR and ER reduced postprandial plasma [TAG] and increased resting whole-body fat oxidation, with the magnitude of effect marginally, although not meaningfully, greater following HIIR than HIIR-ER. The final experimental chapter (Chapter 8) compared directly healthy 11 to 13 year old boys and girls postprandial TAG responses to acute HIIR. Although postprandial plasma [TAG] was substantially lower in boys compared with girls, the magnitude of reduction following HIIR was similar between the sexes (11% vs. 10% respectively). Collectively, these studies demonstrate the efficacy of acute moderate- and high-intensity exercise, and to a lesser extent energy-intake restriction, to reduce postprandial plasma [TAG] and increase resting whole-body fat oxidation in boys and girls. Furthermore, the beneficial effect of exercise on postprandial metabolism appears dependent on the maintenance of the associated energy deficit. These lifestyle interventions have the potential to provide a practical, effective and engaging stimulus to promote a healthier cardiovascular risk profile in early adolescence.
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