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Lifestyle Intervention for Chronic Diseases Prevention

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 January 2014) | Viewed by 207811

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Special Issue Editors

Prof. Dr. Jaakko Tuomilehto

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Guest Editor

Center for Vascular Prevention, Danube University Krems, Krems, Austria
Interests: diabetes; prevention; epidemiology; cardiovascular disease; controlled trials; risk prediction

Dr. Noël Christopher Barengo

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Associate Editor

University of Tolima Ibagué, Tolima, Colombia
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Dear Colleagues,

The global burden and threat of non-communicable diseases constitute a major challenge for development in the twenty-first century, one that undermines social and economic development throughout the world and threatens the achievement of internationally-agreed development goals in low-income and middle-income countries. An estimated 36 million deaths, or 63% of the 57 million deaths that occurred globally in 2008, were due to non-communicable diseases, comprising mainly cardiovascular diseases (48%), cancers (21%), chronic respiratory diseases (12%) and diabetes (3.5%). Diabetes, in particular, represents one of the biggest challenges, since its prevalence has increased dramatically during the last decades, and the number of people with diabetes is estimated to increase from current 336 million to 552 million by 2030. The efforts to prevent non-communicable diseases need to start as early as possible and address all susceptibility factors.

Lifestyle interventions have shown to be effective in the prevention of diabetes and other non-communicable diseases. New technologies may offer innovative approaches in primary, secondary and tertiary prevention that may reach more people than current interventions.

This special issue has a focus on challenges and solutions of lifestyle interventions for diabetes and other non-communicable diseases, with the goal to share scientific knowledge on how we can reduce the burden of non-communicable diseases through lifestyle interventions at both the population level and in people at high risk. Both empirical and review paper submissions are welcome. Papers on innovative interventions to prevent non-communicable diseases are especially encouraged.

Prof. Dr. Jaakko O. Tuomilehto
Dr. Noël C. Barengo
Guest Editors

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Keywords

non-communicable diseases
prevention
intervention
lifestyle
technologies

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Published Papers (9 papers)

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Research

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976 KiB

Open AccessArticle

Recruitment and Baseline Characteristics of Participants in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER)—A Randomized Controlled Lifestyle Trial

by Tiia Ngandu, Jenni Lehtisalo, Esko Levälahti, Tiina Laatikainen, Jaana Lindström, Markku Peltonen, Alina Solomon, Satu Ahtiluoto, Riitta Antikainen, Tuomo Hänninen, Antti Jula, Francesca Mangialasche, Teemu Paajanen, Satu Pajala, Rainer Rauramaa, Timo Strandberg, Jaakko Tuomilehto, Hilkka Soininen and Miia Kivipelto

Int. J. Environ. Res. Public Health 2014, 11(9), 9345-9360; https://doi.org/10.3390/ijerph110909345 - 10 Sep 2014

Cited by 73 | Viewed by 12078

Abstract

Our aim is to describe the study recruitment and baseline characteristics of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) study population. Potential study participants (age 60–77 years, the dementia risk score ≥6) were identified from previous population-based survey cohorts and invited to the screening visit. To be eligible, cognitive performance measured at the screening visit had to be at the mean level or slightly lower than expected for age. Of those invited (n = 5496), 48% (n = 2654) attended the screening visit, and finally 1260 eligible participants were randomized to the intervention and control groups (1:1). The screening visit non-attendees were slightly older, less educated, and had more vascular risk factors and diseases present. The mean (SD) age of the randomized participants was 69.4 (4.7) years, Mini-Mental State Examination 26.7 (2.0) points, systolic blood pressure 140.1 (16.2) mmHg, total serum cholesterol 5.2 (1.0) mmol/L for, and fasting glucose 6.1 (0.9) mmol/L for, with no difference between intervention and control groups. Several modifiable risk factors were present at baseline indicating an opportunity for the intervention. The FINGER study will provide important information on the effect of lifestyle intervention to prevent cognitive impairment among at risk persons. Full article

(This article belongs to the Special Issue Lifestyle Intervention for Chronic Diseases Prevention)

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324 KiB

Open AccessArticle

Sudomotor Function as a Tool for Cardiorespiratory Fitness Level Evaluation: Comparison with Maximal Exercise Capacity

by Anu Raisanen, Jyrki Eklund, Jean-Henri Calvet and Jaakko Tuomilehto

Int. J. Environ. Res. Public Health 2014, 11(6), 5839-5848; https://doi.org/10.3390/ijerph110605839 - 30 May 2014

Cited by 24 | Viewed by 7510

Abstract

Physical inactivity is a modifiable risk factor for cardiovascular (CV) and metabolic disorders. VO₂max is the best method to assess cardio-respiratory fitness level but it is poorly adopted in clinical practice. Sudomotor dysfunction may develop early in metabolic diseases. This study aimed at comparing established CV risk evaluation techniques with SUDOSCAN; a quick and non-invasive method to assess sudomotor function. A questionnaire was filled-in; physical examination and VO₂max estimation using a maximal test on a bicycle ergometer were performed on active Finish workers. Hand and foot electrochemical skin conductance (ESC) were measured to assess sudomotor function. Subjects with the lowest fitness level were involved in a 12 month training program with recording of their weekly physical activity and a final fitness level evaluation. Significant differences in BMI; waist and body fat were seen according to SUDOSCAN risk score classification. Correlation between the risk score and estimated VO₂max was r = −0.57, p < 0.0001 for women and −0.48, p < 0.0001 for men. A significant increase in estimated VO₂max, in hand and foot ESC and in risk score was observed after lifestyle intervention and was more important in subjects with the highest weekly activity. SUDOSCAN could be used to assess cardio-metabolic disease risk status in a working population and to follow individual lifestyle interventions. Full article

(This article belongs to the Special Issue Lifestyle Intervention for Chronic Diseases Prevention)

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219 KiB

Open AccessArticle

Community-Based Recreational Football: A Novel Approach to Promote Physical Activity and Quality of Life in Prostate Cancer Survivors

by Ditte Marie Bruun, Eik Bjerre, Peter Krustrup, Klaus Brasso, Christoffer Johansen, Mikael Rørth and Julie Midtgaard

Int. J. Environ. Res. Public Health 2014, 11(6), 5567-5585; https://doi.org/10.3390/ijerph110605567 - 26 May 2014

Cited by 31 | Viewed by 8781

Abstract

As the number of cancer survivors continues to increase, there is an increasing focus on management of the long-term consequences of cancer including health promotion and prevention of co-morbidity. Prostate cancer is the most frequent type of cancer type in men and causes increased risk of heart disease, diabetes and osteoporosis. Epidemiological evidence points to a positive effect of regular physical activity on all-cause and prostate cancer mortality and current clinical evidence supports the use of exercise in cancer rehabilitation. However, the external validity of existing exercise studies is limited and the majority of prostate cancer survivors remain sedentary. Hence, novel approaches to evaluate and promote physical activity are warranted. This paper presents the rationale behind the delivery and evaluation of community-based recreational football offered in existing football clubs under the Danish Football Association to promote quality of life and physical activity adherence in prostate cancer survivors. The RE-AIM framework will be applied to evaluate the impact of the intervention including outcomes both at the individual and organizational level. By introducing community-based sport environments, the study offers a novel approach in the strive towards sustained physical activity adherence and accessibility in prostate cancer survivors. Full article

(This article belongs to the Special Issue Lifestyle Intervention for Chronic Diseases Prevention)

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425 KiB

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Physical Activity Levels in Women Attending Breast Screening, Receiving Chemotherapy and Post-Breast Cancer Treatment; A Cross-Sectional Study

by Ian M. Lahart, George S. Metsios, Alan M. Nevill and Amtul R. Carmichael

Int. J. Environ. Res. Public Health 2014, 11(5), 5487-5496; https://doi.org/10.3390/ijerph110505487 - 20 May 2014

Cited by 11 | Viewed by 7384

Abstract

Background: A lack of physical activity (PA) is a well-recognised risk factor in the development of breast cancer (BC) and evidence-base research on the impact of PA on BC survival is consolidating. However, evidence reveals that BC survivors have low levels of PA, suggesting the need of targeted interventions to enhance the PA behaviour of BC survivors. Unfortunately, there is lack of data from the UK about the PA behaviours of women at various stages of diagnosis and treatment of BC. Therefore, the aim of the present study was to assess PA levels in women at different stages of BC pathway. Patients and Methods: A convenient sample of patients was selected at various stages of presentation and treatment of BC. Patients attending for breast screening for NHSBSP (n = 188), post-operative patients attending for chemotherapy (n = 41) and BC patients within one year’s post-treatment (n = 80) were invited to take part in this cross-sectional study. Results: Based on the odds ratio, the likelihood of a chemotherapy participant not meeting PA guidelines (i.e., being in the low activity category) were three times higher than the odds of a NHSBPS attendee not meeting PA guidelines, and compared to post-treatment participants, the chemotherapy patient’s odds of not meeting PA guidelines was four times higher. The odds of NHSBPS attendees being in the high activity category compared to the moderate category were three times higher than that of a post-treatment participant. Conclusions: The current study suggests the need to establish robust PA interventions to enhance the PA behaviour of breast cancer survivors. Full article

(This article belongs to the Special Issue Lifestyle Intervention for Chronic Diseases Prevention)

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399 KiB

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Hypertension in Obese Type 2 Diabetes Patients is Associated with Increases in Insulin Resistance and IL-6 Cytokine Levels: Potential Targets for an Efficient Preventive Intervention

by Ljiljana Lukic, Nebojsa M. Lalic, Natasa Rajkovic, Aleksandra Jotic, Katarina Lalic, Tanja Milicic, Jelena P. Seferovic, Marija Macesic and Jelena Stanarcic Gajovic

Int. J. Environ. Res. Public Health 2014, 11(4), 3586-3598; https://doi.org/10.3390/ijerph110403586 - 28 Mar 2014

Cited by 68 | Viewed by 9530

Abstract

Increased body weight as well as type 2 diabetes (T2D) are found to be associated with increased incidence of hypertension, although the mechanisms facilitating hypertension in T2D or nondiabetic individuals are not clear. Therefore, in this study we compared the levels of insulin resistance (IR:OGIS), plasma insulin (PI:RIA) levels, and pro-inflammatory cytokines (IL-6 and TNF-α: ELISA), being risk factors previously found to be associated with hypertension, in T2D patients showing increased body weight (obese and overweight, BMI ≥ 25 kg/m²) with hypertension (group A, N = 30), or without hypertension (group B, N = 30), and in nonobese (BMI < 25 kg/m²), normotensive controls (group C, N = 15). We found that OGIS index was the lowest (A: 267 ± 35.42 vs. B: 342.89 ± 32.0, p < 0.01) and PI levels were the highest (A: 31.05 ± 8.24 vs. B: 17.23 ± 3.23, p < 0.01) in group A. In addition, IL-6 levels were higher in group A (A: 15.46 ± 5.15 vs. B: 11.77 ± 6.09; p < 0.05) while there was no difference in TNF-α levels. Our results have shown that appearance of hypertension in T2D patients with increased body weight was dependent on further increase in IR which was associated with the rise in pro-inflammatory IL-6 cytokine. The results imply that lifestyle intervention aimed to decrease IR might be beneficial in reducing the risk for hypertension in those T2D individuals. Full article

(This article belongs to the Special Issue Lifestyle Intervention for Chronic Diseases Prevention)

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243 KiB

Open AccessArticle

A Simple Tool for Diet Evaluation in Primary Health Care: Validation of a 16-Item Food Intake Questionnaire

by Katri Hemiö, Auli Pölönen, Kirsti Ahonen, Mikko Kosola, Katriina Viitasalo and Jaana Lindström

Int. J. Environ. Res. Public Health 2014, 11(3), 2683-2697; https://doi.org/10.3390/ijerph110302683 - 4 Mar 2014

Cited by 28 | Viewed by 11481

Abstract

Our aim was to validate a 16-item food intake questionnaire (16-FIQ) and create an easy to use method to estimate patients’ nutrient intake in primary health care. Participants (52 men, 25 women) completed a 7-day food record and a 16-FIQ. Food and nutrient intakes were calculated and compared using Spearman correlation. Further, nutrient intakes were compared using kappa-statistics and exact and opposite agreement of intake tertiles. The results indicated that the 16-FIQ reliably categorized individuals according to their nutrient intakes. Methods to estimate nutrient intake based on the answers given in 16-FIQ were created. In linear regression models nutrient intake estimates from the food records were used as the dependent variables and sum variables derived from the 16-FIQ were used as the independent variables. Valid regression models were created for the energy proportion of fat, saturated fat, and sucrose and the amount of fibre (g), vitamin C (mg), iron (mg), and vitamin D (μg) intake. The 16-FIQ is a valid method for estimating nutrient intakes in group level. In addition, the 16-FIQ could be a useful tool to facilitate identification of people in need of dietary counselling and to monitor the effect of counselling in primary health care. Full article

(This article belongs to the Special Issue Lifestyle Intervention for Chronic Diseases Prevention)

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238 KiB

Open AccessArticle

Benefits of Selected Physical Exercise Programs in Detention: A Randomized Controlled Study

by Claudia Battaglia, Alessandra Di Cagno, Giovanni Fiorilli, Arrigo Giombini, Federica Fagnani, Paolo Borrione, Marco Marchetti and Fabio Pigozzi

Int. J. Environ. Res. Public Health 2013, 10(11), 5683-5696; https://doi.org/10.3390/ijerph10115683 - 31 Oct 2013

Cited by 31 | Viewed by 10500

Abstract

The aim of the study was to determine which kind of physical activity could be useful to inmate populations to improve their health status and fitness levels. A repeated measure design was used to evaluate the effects of two different training protocols on subjects in a state of detention, tested pre- and post-experimental protocol.Seventy-five male subjects were enrolled in the studyand randomly allocated to three groups: the cardiovascular plus resistance training protocol group (CRT) (n = 25; mean age 30.9 ± 8.9 years),the high-intensity strength training protocol group (HIST) (n = 25; mean age 33.9 ± 6.8 years), and a control group (C) (n = 25; mean age 32.9 ± 8.9 years) receiving no treatment. All subjects underwent a clinical assessmentandfitness tests. MANOVA revealed significant multivariate effects on group (p < 0.01) and group-training interaction (p < 0.05). CRT protocol resulted the most effective protocol to reach the best outcome in fitness tests. Both CRT and HIST protocols produced significant gains in the functional capacity (cardio-respiratory capacity and cardiovascular disease risk decrease) of incarcerated males. The significant gains obtained in functional capacity reflect the great potential of supervised exercise interventions for improving the health status of incarcerated people. Full article

(This article belongs to the Special Issue Lifestyle Intervention for Chronic Diseases Prevention)

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Review

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489 KiB

Open AccessReview

What Works in Community-Based Interventions Promoting Physical Activity and Healthy Eating? A Review of Reviews

by Tilman Brand, Claudia R. Pischke, Berit Steenbock, Johanna Schoenbach, Saskia Poettgen, Florence Samkange-Zeeb and Hajo Zeeb

Int. J. Environ. Res. Public Health 2014, 11(6), 5866-5888; https://doi.org/10.3390/ijerph110605866 - 30 May 2014

Cited by 70 | Viewed by 14321

Abstract

Chronic diseases, such as type II diabetes, are on the rise worldwide. There is consistent evidence that physical activity and healthy eating are important lifestyle factors which affect the risk for chronic diseases. Community-based interventions are of particular public health interest as they reach target groups in their natural living environment and may thus achieve high population-level impacts. We conducted a systematic literature search to assess the effectiveness of community-based interventions to promote physical activity and healthy eating. Specifically, we searched for promising intervention strategies in this setting. We narratively summarized the results of 18 systematic reviews. Among children and adolescents, we found moderate evidence for effects on weight change in primary school-aged children for interventions containing a school component. The evidence for interventions aimed at general adult populations was inconclusive. Self-monitoring, group-based components, and motivational signs to encourage stair use were identified as promising strategies to increase physical activity. Among adults at risk for type II diabetes, evidence was found for beneficial effects on weight change and diabetes incidence. However, interventions for this group were not integrated in more comprehensive community-based approaches. Full article

(This article belongs to the Special Issue Lifestyle Intervention for Chronic Diseases Prevention)

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363 KiB

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Ketogenic Diet for Obesity: Friend or Foe?

by Antonio Paoli

Int. J. Environ. Res. Public Health 2014, 11(2), 2092-2107; https://doi.org/10.3390/ijerph110202092 - 19 Feb 2014

Cited by 222 | Viewed by 124723

Abstract

Obesity is reaching epidemic proportions and is a strong risk factor for a number of cardiovascular and metabolic disorders such as hypertension, type 2 diabetes, dyslipidemia, atherosclerosis, and also certain types of cancers. Despite the constant recommendations of health care organizations regarding the importance of weight control, this goal often fails. Genetic predisposition in combination with inactive lifestyles and high caloric intake leads to excessive weight gain. Even though there may be agreement about the concept that lifestyle changes affecting dietary habits and physical activity are essential to promote weight loss and weight control, the ideal amount and type of exercise and also the ideal diet are still under debate. For many years, nutritional intervention studies have been focused on reducing dietary fat with little positive results over the long-term. One of the most studied strategies in the recent years for weight loss is the ketogenic diet. Many studies have shown that this kind of nutritional approach has a solid physiological and biochemical basis and is able to induce effective weight loss along with improvement in several cardiovascular risk parameters. This review discusses the physiological basis of ketogenic diets and the rationale for their use in obesity, discussing the strengths and the weaknesses of these diets together with cautions that should be used in obese patients. Full article

(This article belongs to the Special Issue Lifestyle Intervention for Chronic Diseases Prevention)

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