Lifestyle Interventions Targeting Body Weight Changes during the Menopause Transition: A Systematic Review

Objective. To determine the effectiveness of exercise and/or nutrition interventions and to address body weight changes during the menopause transition. Methods. A systematic review of the literature was conducted using electronic databases, grey literature, and hand searching. Two independent researchers screened for studies using experimental designs to evaluate the impact of exercise and/or nutrition interventions on body weight and/or central weight gain performed during the menopausal transition. Studies were quality appraised using Cochrane risk of bias. Included studies were analyzed descriptively. Results. Of 3,564 unique citations screened, 3 studies were eligible (2 randomized controlled trials, and 1 pre/post study). Study quality ranged from low to high risk of bias. One randomized controlled trial with lower risk of bias concluded that participation in an exercise program combined with dietary interventions might mitigate body adiposity increases, which is normally observed during the menopause transition. The other two studies with higher risk of bias suggested that exercise might attenuate weight loss or weight gain and change abdominal adiposity patterns. Conclusions. High quality studies evaluating the effectiveness of interventions targeting body weight changes in women during their menopause transition are needed. Evidence from one higher quality study indicates an effective multifaceted intervention for women to minimize changes in body adiposity

Experiencing food insecurity in childhood: influences on eating habits and body weight in young adulthood

Abstract Objective: To examine how food insecurity in childhood up to adolescence relates to eating habits and weight status in young adulthood. Design: A longitudinal study design was used to derive trajectories of household food insecurity from age 4.5 to 13 years. Multivariable linear and logistical regression analyses were performed to model associations between being at high risk of food insecurity from age 4.5 to 13 years and both dietary and weight outcomes at age 22 years. Setting: A birth cohort study conducted in the Province of Quebec, Canada. Participants: 698 young adults participating in the Québec Longitudinal Study of Child Development. Results: After adjusting for sex, maternal education and immigrant status, household income and type of family, being at high risk (compared to low risk) of food insecurity in childhood up to adolescence was associated with consuming higher quantities of sugar-sweetened beverages (ßadj: 0.64; 95% CI: 0.27-1.00), non-whole-grain cereal products (ßadj: 0.32; 95% CI: 0.07-0.56), and processed meat (ßadj: 0.14; 95% CI: 0.02-0.25), with skipping breakfast (ORadj: 1.97; 95% CI: 1.08-3.53), with eating meals prepared out of home (ORadj: 3.38; 95% CI: 1.52-9.02), with experiencing food insecurity (ORadj: 3.03; 95% CI: 1.91-4.76), and with being obese (ORadj: 2.01; 95% CI: 1.12-3.64), once reaching young adulthood. Conclusion: Growing up in families experiencing food insecurity may negatively influence eating habits and weight status later in life. Our findings reinforce the importance of public-health policies and programs tackling poverty and food insecurity, particularly for families with young children

Mineral magnetic characterization of the Upper Pleniglacial Nussloch loess sequence (Germany): an insight into local environmental processes

Presently, most loess/palaeosol magnetic susceptibility records are interpreted as following either the wind-vigour model or the pedogenic enhancement model. However redoxomorphic processes induced by waterlogging, often referred to gleying in the loess literature, are also known to alter loess deposits but their impact on loess/palaeosol magnetic susceptibility records has received little attention. The reported rock magnetic study aims to characterize the mineral magnetic response of loess to waterlogging-induced redoxomorphic processes, thus improving our understanding of mineral magnetic changes within loess deposits with respect to environmental and climate conditions. The Nussloch loess-palaeosol deposit (Rhine Valley, Germany) was targeted because it is one of the best-studied Pleniglacial deposits for Western Europe in which numerous tundra gley intervals have been identified. Moreover, a comprehensive high-resolution environmental magnetism study has never been undertaken for this site. Various rock magnetism experiments were conducted at both room and low temperatures to characterise the composition, concentration and relative magnetic grain size of the mineral magnetic assemblage. The relative changes in magnetic parameters within the investigated loess interval are primarily controlled by (1) varying concentrations of coarse-grained ferrimagnetic particles of detrital (aeolian) origin and (2) dissolution of fine-grained ferrimagnetic particles related to in situ post-depositional alteration promoted by waterlogging-induced redoxomorphic processes. Goethite is found to be ubiquitous throughout the studied interval and is argued to have both a primary (aeolian) and secondary (in situ) origin. We conclude, that redoxomorphic processes induced by waterlogging, if present, will hinder the interpretation of magnetic susceptibility variations within loess and palaeosol deposits following the expected relationships dictated by the wind-vigour and the pedogenic enhancement magnetism models

Deterioration of the metabolic risk profile in women. Respective contributions of impaired glucose tolerance and visceral fat accumulation

WSTĘP. Celem pracy jest określenie, czy upośledzona tolerancja glukozy (IGT, impaired glucose tolerance) odpowiada za pogorszenie profilu metabolicznego u kobiet, uwzględniając nagromadzenie trzewnej tkanki tłuszczowej, mierzone w tomografii komputerowej. MATERIAŁ I METODY. Przebadano 203 kobiety z prawidłowym wynikiem testu tolerancji glukozy (NGT, normal glucose tolerance) oraz 46 kobiet z upośledzoną tolerancją glukozy - glikemia mierzona 2 godziny po doustnym obciążeniu 75 g glukozy - 7,8-11,1 mmol/l. WYNIKI. U kobiet z IGT stwierdzano większe nagromadzenie trzewnej tkanki tłuszczowej oraz wyższe stężenie glukozy na czczo w osoczu, insuliny oraz C-peptydu, a także wyższe stężenie cholesterolu, triglicerydów i apolipoproteiny B (apoB) oraz większy stosunek cholesterolu całkowitego do cholesterolu frakcji HDL, zmniejszenie maksymalnej wielkości cząsteczek LDL, niższe stężenie cholesterolu frakcji HDL i HDL 2 oraz wyższe ciśnienie tętnicze (p < 0,01) niż u kobiet z NTG. Porównując 27 par kobiet pod kątem nagromadzenia trzewnej tkanki tłuszczowej i masy tłuszczowej oraz występowania menopauzy, wcześniej stwierdzone różnice w zakresie stężenia cholesterolu frakcji LDL, maksymalnej wielkości cząsteczek LDL, niższego stężenia cholesterolu frakcji HDL i HDL2, a także stosunku cholesterolu całkowitego do cholesterolu frakcji HDL i ciśnienia tętniczego zniknęły, natomiast stężenie triglicerydów pozostawało znamiennie wyższe u kobiet z upośledzoną tolerancją glukozy. WNIOSKI. Nagromadzenie trzewnej tkanki tłuszczowej jest głównym czynnikiem powodującym pogorszenie wielu parametrów metabolicznych u kobiet z IGT, z wyjątkiem stężenia triglicerydów, które różniło się znamiennie pomiędzy kobietami z NGT a kobietami z IGT, nawet po skorygowaniu w odniesieniu do trzewnej tkanki tłuszczowej.INTRODUCTION. To determine whether the impaired glucose tolerance (IGT) state contributes to the deterioration of the metabolic profile in women after taking into account the contribution of visceral adipose tissue (AT) accumulation, as measured by computed tomography. MATERIAL AND METHODS. We studied 203 women with normal glucose tolerance (NGT) and 46 women with IGT, defined as a glycemia between 7.8 and 11.1 mmol/l measured 2 h after a 75-g oral glucose load. RESULTS. Women with IGT were characterized by a higher visceral AT accumulation and by higher concentrations of fasting plasma glucose, insulin, and C-peptide as well as by higher plasma concentrations of cholesterol, triglycerides, and apolipoprotein B (apoB) and by greater cholesterol&#8211;to&#8211;HDL- -cholesterol ratio, reduced LDL peak particle size, lower HDL-cholesterol and HDL2-cholesterol concentrations, and higher blood pressure (p < 0.01) than women with NGT. When we matched 27 pairs of women for visceral AT and fat mass as well as for menopausal status, differences previously found in LDL-cholesterol, LDL peak particle size, HDL-cholesterol, and HDL2-cholesterol concentrations as well as in the cholesterol&#8211;to&#8211;HDL-cholesterol ratio and blood pressure were eliminated, whereas triglyceride concentrations remained significantly higher in women with IGT. CONCLUSIONS. A high visceral AT accumulation is a major factor involved in the deterioration of many metabolic variables in women with IGT, with the notable exception of triglyceride concentrations, which remained significantly different between women with NGT and women with IGT after adjustment for visceral fat

The Feasibility of a Primary Care Based Navigation Service to Support Access to Health and Social Resources: The Access to Resources in the Community (ARC) Model

Introduction: We established a patient centric navigation model embedded in primary care (PC) to support access to the broad range of health and social resources; the Access to Resources in the Community (ARC) model. Methods: We evaluated the feasibility of ARC using the rapid cycle evaluations of the intervention processes, patient and PC provider surveys, and navigator log data. PC providers enrolled were asked to refer patients in whom they identified a health and/or social need to the ARC navigator. Results: Participants: 26 family physicians in four practices, and 82 of the 131 patients they referred. ARC was easily integrated in PC practices and was especially valued in the non-interprofessional practices. Patient overall satisfaction was very high (89%). Sixty patients completed the post-intervention surveys, and 33 reported accessing one or more service(s). Conclusion: The ARC Model is an innovative approach to reach and support a broad range of patients access needed resources. The Model is feasible and acceptable to PC providers and patients, and has demonstrated potential for improving patients’ access to health and social resources. This study has informed a pragmatic randomized controlled trial to evaluate the ARC navigation to an existing web and telephone navigation service (Ontario 211)

Approaches and challenges to the study of loess—Introduction to the LoessFest Special Issue

In September 2016, the annual meeting of the International Union for Quaternary Research's Loess and Pedostratigraphy Focus Group, traditionally referred to as a LoessFest, met in Eau Claire, Wisconsin, USA. The 2016 LoessFest focused on thin loess deposits and loess transportation surfaces. This LoessFest included 75 registered participants from 10 countries. Almost half of the participants were from outside the United States, and 18 of the participants were students. This review is the introduction to the special issue for Quaternary Research that originated from presentations and discussions at the 2016 LoessFest. This introduction highlights current understanding and ongoing work on loess in various regions of the world and provides brief summaries of some of the current approaches/strategies used to study loess deposits

A therapy parameter-based model for predicting blood glucose concentrations in patients with type 1 diabetes

In this paper, the problem of predicting blood glucose concentrations (BG) for the treatment of patients with type 1 diabetes, is addressed. Predicting BG is of very high importance as most treatments, which consist in exogenous insulin injections, rely on the availability of BG predictions. Many models that can be used for predicting BG are available in the literature. However, it is widely admitted that it is almost impossible to perfectly model blood glucose dynamics while still being able to identify model parameters using only blood glucose measurements. The main contribution of this work is to propose a simple and identiable linear dynamical model, which is based on the static prediction model of standard therapy. It is shown that the model parameters are intrinsically correlated with physician-set therapy parameters and that the reduction of the number of model parameters to identify leads to inferior data fits but to equivalent or slightly improved prediction capabilities compared to state-of-the-art models: a sign of an appropriate model structure and superior reliability. The validation of the proposed dynamic model is performed using data from the UVa simulator and real clinical data, and potential uses of the proposed model for state estimation and BG control are discussed

Qualité et sécurité des services de santé offerts en situation linguistique minoritaire en Ontario : investigations des données administratives de santé

Dans cet article, nous présentons une synthèse de plusieurs analyses récentes réalisées par notre groupe de recherche à partir de données administratives de santé pour mesurer la qualité et la sécurité des services de santé offerts aux francophones et allophones en Ontario, Canada. Les résultats de nos analyses démontrent que les Ontariennes et les Ontariens qui reçoivent des soins dans leur principale langue d’usage ont généralement de meilleurs résultats cliniques comparés à ceux qui reçoivent des soins dans une langue autre que leur principale langue d’usage. Ceci suggère que la qualité et la sécurité des soins offerts aux patients et aux patientes en situation de discordance linguistique pourraient être améliorées par le pairage de professionnel-patient parlant la même langue, par exemple, en référant un patient à un médecin qui parle la langue du patient, ou en s’assurant que les francophones ont accès aux services en français en milieux désignés en Ontario en vertu de la Loi sur les services en français et que les allophones puissent bénéficier de davantage de services d’interprétariat.In this paper, we synthesize several analyses performed by our research group which used administrative health data to measure the quality and safety of healthcare services offered to Francophones and allophones in Ontario, Canada. The results of our analyses show that Ontarians who receive care in their primary language spoken generally have better clinical outcomes compared to Ontarians who receive care in a language other than their primary language spoken. This suggests that the quality and safety of care offered to patients in language-discordant situations could be improved by pairing professionals with patients who speak the same language, for example, by referring a patient to a physician who speaks the patient’s language, or by ensuring that Francophones have access to services in French in designated regions in Ontario in accordance with the French Language Services Act and that allophones can benefit from more interpreting services

A Multilevel Analysis of Neighbourhood Built and Social Environments and Adult Self-Reported Physical Activity and Body Mass Index in Ottawa, Canada

Canadian research examining the combined effects of social and built environments on physical activity (PA) and obesity is limited. The purpose of this study was to determine the relationships among built and social environments and PA and overweight/obesity in 85 Ottawa neighbourhoods. Self-reported PA, height and weight were collected from 3,883 adults using the International PA Questionnaire from the 2003-2007 samples of the Rapid Risk Factor Surveillance System. Data on neighbourhood characteristics were obtained from the Ottawa Neighbourhood Study; a large study of neighbourhoods and health in Ottawa. Two-level binomial logistic regression models stratified by sex were used to examine the relationships of environmental and individual variables with PA and overweight/obesity while using survey weights. Results identified that approximately half of the adults were insufficiently active or overweight/obese. Multilevel models identified that for every additional convenience store, men were two times more likely to be physically active (OR = 2.08, 95% CI: 1.72, 2.43) and with every additional specialty food store women were almost two times more likely to be overweight or obese (OR = 1.77, 95% CI: 1.33, 2.20). Higher green space was associated with a reduced likelihood of PA (OR = 0.93, 95% CI: 0.86, 0.99) and increased odds of overweight and obesity in men (OR = 1.10, 95% CI: 1.01, 1.19), and decreased odds of overweight/obesity in women (OR = 0.66, 95% CI: 0.44, 0.89). In men, neighbourhood socioeconomic scores, voting rates and sense of community belonging were all significantly associated with overweight/obesity. Intraclass coefficients were low, but identified that the majority of neighbourhood variation in outcomes was explained by the models. Findings identified that green space, food landscapes and social cohesiveness may play different roles on PA and overweight/obesity in men and women and future prospective studies are needed