Effects of plant-based diets on weight status: A systematic review

There is an increasing number of people who convert to a plant-based diet. The desire for health benefits, including weight management, is often a contributing factor behind this dietary choice. The purpose of this review was to evaluate intervention studies assessing the effects of different plant-based diets on body mass index and weight. A literature search was conducted in PubMed until December 2019. Twenty-two publications from 19 studies were included. The majority of them were randomized controlled trials comparing a low-fat vegan diet to an omnivore diet in participants with overweight, type 2 diabetes mellitus and/or cardiovascular disease. All studies reported weight reductions, of which seven revealed significant differences, and four revealed non-significant differences between the intervention and the control groups. The results suggest that plant-based diets may improve weight status in some patient groups. Due to restrictions in fat intake in many studies, followed by reduced energy intake, the effects of the different interventions differ depending on the specific plant-based diets investigated. Future research should aim to include a representative study population and apply study diets without dietary restrictions.publishedVersio

Metabolic Syndrome Risk in Young Adults Attending West Virginia University

The prevalence of Metabolic Syndrome (MetS) is increasing throughout the United States across age groups. The purpose of this study was to collect descriptive baseline anthropometric and biochemical data to determine MetS prevalence in 18 to 24 year olds and to assess change in MetS risk after a 10 week web-based intervention. MetS was defined using the National Cholesterol Education Program\u27s Third Adult Treatment Panel (NCEP ATP III) definition. Blood pressure, anthropometric and biochemical measures were obtained at baseline, post-intervention and 15 months. The overall prevalence of MetS at baseline was 15.1% (n = 14). The prevalence of one or two components of MetS was 33.1% and 23.7%, respectively. Significant differences between male and females subjects were observed for elevated waist circumference (p = 0.0055), elevated blood pressure (p = 0.0075) and impaired fasting blood glucose measures (p = 0.0345). Of all MetS components, fasting blood glucose (p = 0.0318) measures exhibited the most notable decrease from baseline to post-intervention between the intervention and control group. Additional downward trends moving toward improvement were observed for several of the subjects in the intervention group exhibiting MetS risk from baseline to post-intervention, but this trend was not sustained at the 15 month follow-up. Due to the large percentage of individuals moving toward the onset of MetS, a more aggressive and specific behavior tailored intervention may have yielded better outcomes in this high risk population of subjects. Identification of MetS early in life is needed in order to reduce the onset of chronic disease. Therefore, implementing a screening process to identify at-risk young adults will help tailor more effective behavioral interventions

Impact of a community-based diabetes self-management program on key metabolic parameters

OBJECTIVE: Characterize the impact of a pharmacist-led diabetes self-management program on three key metabolic parameters: glycosylated hemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL-C), and mean arterial blood pressure (MAP) among employee health program participants. METHODS: A self-insured company in the Kansas City metropolitan area began offering a pharmacist-led diabetes self-management program to eligible company employees and their dependents in 2008. A retrospective pre-post analysis was conducted to determine if the program affected key metabolic parameters in participants by determining mean change after one year of participation. RESULTS: Among 183 program participants, 65 participants met inclusion criteria. All three key metabolic parameters were significantly reduced from baseline to one year of program participation: HbA1c decreased from 8.1% to 7.3% (p=0.007); LDL-C decreased from 108.3 mg/dL to 96.4 mg/dL (p=0.009); and MAP decreased from 96.1 to 92.3 mm Hg (p=0.005). CONCLUSIONS: The pharmacist-led diabetes self-management program demonstrated significant reductions in HbA1c, LDL-C, and MAP from baseline to one year of program participation. Improvements were statistically significant and clinically relevant for each parameter. Previous studies indicate these reductions may cause reduced overall healthcare costs

Implementing a Protocol to Monitor Cardiometabolic Syndrome in Patients Prescribed Atypical Antipsychotics

Atypical or second-generation antipsychotics (SGAs) are a vital part of the management of many psychotic disorders, as well as behavioral and psychological symptoms. However, these medications have serious cardiometabolic complications, such as an increase in obesity, glucose intolerance, dyslipidemia, and hypertension, and can place the patient at serious risk for cardiovascular disease. The American Diabetes Association (ADA) and the American Psychiatric Association (APA) recommend clinical guidelines for metabolic screening, which requires the regular monitoring of patients treated with SGAs (ADA, 2004). The goal of this quality improvement project was to 1) implement a metabolic screening protocol based on ADA and APA guidelines for patients admitted to an acute psychiatric hospital who were treated with second-generation antipsychotics and 2) increase healthcare personnel awareness of metabolic monitoring guidelines and metabolic syndrome. This quality improvement project was implemented at an inpatient behavioral hospital in New England. A protocol for the monitoring of metabolic disturbances was placed in thirty patients’ medical charts, who were age eighteen and over, had been prescribed SGAs, and had been taking the medication daily since the admission to the hospital. Twenty-one psychiatric mental health staff members attended the educational interventions that were conducted by the author of the project A retrospective chart review was performed post-intervention to assess guideline adherence by comparing the percentage of tests ordered pre-intervention versus the during the post-intervention period. Data were collected over a three-month period starting from November 2018 until January 2019. The healthcare personnel awareness of metabolic monitoring guidelines and metabolic syndrome have been evaluated by a survey. After the intervention period, there were slight increases in the numbers of orders for hemoglobin A1c and lipid panel, but rates of other baseline monitoring parameters (such as weight and blood pressure) remained the same or did not improve. The waist circumference was one of the indicators that had not been measured, even after the implementation of the screening protocol

Cardiovascular Disease Risk Factor Patterns and Their Implications for Intervention Strategies in Vietnam

Background. Data on cardiovascular disease risk factors (CVDRFs) in Vietnam are limited. This study explores the prevalence of each CVDRF and how they cluster to evaluate CVDRF burdens and potential prevention strategies. Methods. A cross-sectional survey in 2009 (2,130 adults) was done to collect data on behavioural CVDRF, anthropometry and blood pressure, lipidaemia profiles, and oral glucose tolerance tests. Four metabolic CVDRFs (hypertension, dyslipidaemia, diabetes, and obesity) and five behavioural CVDRFs (smoking, excessive alcohol intake, unhealthy diet, physical inactivity, and stress) were analysed to identify their prevalence, cluster patterns, and social predictors. Framingham scores were applied to estimate the global 10-year CVD risks and potential benefits of CVD prevention strategies. Results. The age-standardised prevalence of having at least 2/4 metabolic, 2/5 behavioural, or 4/9 major CVDRF was 28%, 27%, 13% in women and 32%, 62%, 34% in men. Within-individual clustering of metabolic factors was more common among older women and in urban areas. High overall CVD risk (≥20% over 10 years) identified 20% of men and 5% of women—especially at higher ages—who had coexisting CVDRF. Conclusion. Multiple CVDRFs were common in Vietnamese adults with different clustering patterns across sex/age groups. Tackling any single risk factor would not be efficient