Changing behaviour

Individual change in behaviour has the potential to decrease the burden of chronic disease due to smoking, diet and low physical activity. Smoking quit rates can be increased by simple advice from a physician or trained counsellor, overall and in people at high risk of smoking related disease, with low intensity advice as effective as high intensity advice. Advice from a nurse, telephone counselling, individualised self help materials and taking exercise may also be beneficial. Training health professionals increases the frequency of offering antismoking interventions but may not increase their effectiveness. Nicotine replacement therapy, bupropion and nortriptyline may improve short term quit rates as part of smoking cessation strategies. Moclobemide, selective serotonin reuptake inhibitors, anxiolytics and acupuncture have not been shown to be beneficial. Smoking cessation programmes increase quit rates in pregnant women, but nicotine patches may not be beneficial compared with placebo. Physical activity in sedentary people may be increased by counselling, with input from exercise specialists possibly being more effective than physicians, in women over 80 years and in younger adults. Advice on eating a low cholesterol diet leads to a mean 0.2 to 0.3 mmol/L decrease in blood cholesterol concentration in the long term, but no consistent effect of this on morbidity or mortality has been shown. Intensive interventions to reduce sodium intake lead to small decreases in blood pressure, but may not reduce morbidity or mortality. Advice to lose weight leads to greater weight loss than no advice, and cognitive behavioural therapy may be more effective than dietary advice

Dark septate root endophytic fungi increase growth of Scots pine seedlings under elevated CO2 through enhanced nitrogen use efficiency.

Although increasing concentrations of atmospheric CO2 are predicted to have substantial impacts on plant growth and functioning of ecosystems, there is insufficient understanding of the responses of belowground processes to such increases. We investigated the effects of different dark septate root endophytic (DSE) fungi on growth and nutrient acquisition by Pinus sylvestris seedlings under conditions of N limitation and at ambient and elevated CO2 (350 or 700 µ1 CO2 l-1). Each seedling was inoculated with one of the following species: Phialocephala fortinii (two strains), Cadophora finlandica, Chloridium paucisporum, Scytalidium vaccinii, Meliniomyces variabilis and M. vraolstadiae. The trial lasted 125 days. During the final 27 days, the seedlings were labeled with 14CO2 and 15NH4+. We measured extraradical hyphal length, internal colonization, plant biomass, 14C allocation, and plant N and 15N content. Under elevated CO2, the biomass of seedlings inoculated with DSE fungi was on average 17% higher than in control seedlings. Simultaneously, below-ground respiration doubled or trebled, and as a consequence carbon use efficiency by the DSE fungi significantly decreased. Shoot N concentration decreased on average by 57% under elevated CO2 and was lowest in seedlings inoculated with S. vaccinii. Carbon gain by the seedlings despite reduced shoot N concentration indicates that DSE fungi increase plant nutrient use efficiency and are therefore more beneficial to the plant under elevated CO

The prevention and treatment of childhood obesity.

The effectiveness of interventions used in the prevention and treatment of childhood obesity published in a recent issue of Effective Heath Care is reviewed

Children's eating behaviours: The importance of the family setting

Childhood obesity has become a major public health challenge. Whilst it is accepted that the aetiology of obesity is complex, there is very little that targets the home environment and specifically looks at the family setting and how this influences children's eating behaviours. This research aimed to redress the balance by alerting people to the importance of the family environment as a contributory factor for childhood obesity. Using a grounded theory approach, 'Ordering of eating' highlights the importance of the family setting and demonstrates how micro and macro order influences the development of children's eating behaviours. © Journal compilation © 2008 Royal Geographical Society (with the Institute of British Geographers)

A BAC transgenic analysis of the Mrf4/Myf5 locus reveals interdigitated elements that control activation and maintenance of gene expression during muscle development

The muscle-specific transcription factors Myf5 and Mrf4 are two of the four myogenic regulatory factors involved in the transcriptional cascade responsible for skeletal myogenesis in the vertebrate embryo. Myf5 is the first of these four genes to be expressed in the mouse. We have previously described discrete enhancers that drive Myf5 expression in epaxial and hypaxial somites, branchial arches and central nervous system, and argued that additional elements are required for proper expression (Summerbell, D., Ashby, P.R., Coutelle, O., Cox, D., Yee, S.P. and Rigby, P.W.J. (2000) Development 127, 3745-3757). We have now investigated the transcriptional regulation of both Myf5 and Mrf4 using bacterial artificial chromosome transgenesis. We show that a clone containing Myf5 and 140 kb of upstream sequences is sufficient to recapitulate the known expression patterns of both genes. Our results confirm and reinforce the conclusion of our earlier studies, that Myf5 expression is regulated differently in each of a considerable number of populations of muscle progenitors, and they begin to illuminate the evolutionary origins of this complex regulation. We further show that separate elements are involved in the activation and maintenance of expression in the various precursor populations, reflecting the diversity of the signals that control myogenesis. Mrf4 expression requires at least four elements, one of which may be shared with Myf5, providing a possible explanation for the linkage of these genes throughout vertebrate phylogeny. Further complexity is revealed by the demonstration that elements which control Mrf4 and Myf5 are embedded in an unrelated neighbouring gene.J. J. C. was supported by a Research Training Fellowship from the Medical Research Council (UK), which also paid for this work.Peer reviewe

Detection of Xanthomegnin in Epidermal Materials Infected with Trichophyton rubrum

Xanthomegnin, a mutagenic mycotoxin best known as an agent of nephropathy and death in farm animals exposed to food-borne Penicillium and Aspergillus fungi, was first isolated about 35 y ago as a diffusing pigment from cultures of the dermatophyte, Trichophyton megninii. This study investigates the production of xanthomegnin by the most common dermatophytic species, Trichophyton rubrum, both in dermatologic nail specimens and in culture. In view of the labile nature of xanthomegnin, a chromatographic procedure was developed to allow high-performance liquid chromatography analysis within 1 h of sample extraction. In cultures, Tricho- phyton rubrum produced xanthomegnin as a major pigment that appears to give the culture its characteristic red colony reverse. Xanthomegnin was also repeatedly extracted from human nail and skin material infected by Trichophyton rubrum. The level of xanthomegnin present, however, varied among the clinical samples studied. Xanthomegnin was not detected in uninfected nails. These results show that patients with Trichophyton rubrum infections may be exposed to xanthomegnin, although the consequences of such an exposure are not currently known

Reduced or modified dietary fat for preventing cardiovascular disease

BACKGROUND: Reduction or modification of dietary fat can improve total cholesterol levels, but may also have a variety of effects, both positive and negative, on other cardiovascular risk factors. OBJECTIVES: The aim of this systematic review was to assess the effect of reduction or modification of dietary fats on total and cardiovascular mortality and cardiovascular morbidity over at least 6 months, using all available randomized clinical trials. SEARCH STRATEGY: The Cochrane Library, MEDLINE, EMBASE, CAB Abstracts, CVRCT registry and related Cochrane Groups' trial registers were searched through spring 1998, SIGLE to January 1999. Trials known to experts in the field and biographies were included through May 1999. SELECTION CRITERIA: Trials fulfilled the following criteria: 1) randomized with appropriate control group, 2) intention to reduce or modify fat or cholesterol intake (excluding exclusively omega-3 fat interventions), 3) not multi factorial, 4) healthy adult humans, 5) intervention at least six months, 6) mortality or cardiovascular morbidity data available. Inclusion decisions were duplicated, disagreement resolved by discussion or a third party. DATA COLLECTION AND ANALYSIS: Rate data were extracted by two independent reviewers and meta-analysis performed using random effects methodology. Meta-regression and funnel plots were used. MAIN RESULTS: Twenty seven studies were included (40 intervention arms, 30,901 person-years). There was no significant effect on total mortality (rate ratio 0.98, 95% CI 0.86 to 1.12), a trend towards protection form cardiovascular mortality (rate ratio 0.91, 95% CI 0.77 to 1.07), and significant protection from cardiovascular events (rate ratio 0.84, 95% CI 0.72 to 0.99). The latter became non-significant on sensitivity analysis. Trials where participants were involved for more than 2 years showed significant reductions in the rate of cardiovascular events and a suggestion of protection from total mortality. The degree of protection from cardiovascular events appeared similar in high and low risk groups, but was statistically significant only in the former. REVIEWER'S CONCLUSIONS: The findings are suggestive of a small but potentially important reduction in cardiovascular risk in trials longer than two years. Lifestyle advice to all those at high risk of cardiovascular disease (especially where statins are unavailable or rationed), and to lower risk population groups, should continue to include permanent reduction of dietary saturated fat and partial replacement by unsaturates