Long-term sustainability of a physical activity and nutrition intervention for rural adults with or at risk of metabolic syndrome.

OBJECTIVE: To determine longer-term (18-month) sustainability of a six-month physical activity and nutrition intervention for 50-69-year-olds with or at risk of metabolic syndrome residing in a rural Australian community. METHODS: Participants (n=151) were followed-up at 12 and 18 months post-intervention. Changes in nutrition behaviours (fat and fibre barometer); physical activity behaviours (IPAQ); anthropometry (waist-hip ratio, weight, BMI), blood pressure, blood parameters (triglycerides, glucose, LDL-, HDL-, non-HDL, total-cholesterol) were analysed using t-tests and repeated measures ANOVA. RESULTS: Across three time points (6, 12 and 18 months) marginal decrease was observed for waist circumference (p=0.001), a modest increase was observed for diastolic blood pressure (p=0.010) and other outcome measures remained stable. CONCLUSION: Maintenance and ongoing improvement of health behaviours in the longer-term is challenging. Future studies must look for ways to embed interventions into communities so they are sustainable and investigate new approaches to reduce the risk of chronic disease. Implications for public health: Metabolic syndrome is a major health issue in Australia and worldwide. Early identification and management are required to prevent the progression to chronic disease. This 18-month follow-up showed that outcomes measures remained relatively stable; however, there is a need to investigate opportunities for embedded community interventions to support long-term health behaviour change

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Investigating the media power of a population health monitoring survey: Case study of the NSW Schools Physical Activity and Nutrition Survey (SPANS)

Objective: To examine the extent and nature of news coverage of a governmentfunded population monitoring survey of children and the potential implications of this coverage for public health advocacy. Methods: Case study of the NSW Schools Physical Activity and Nutrition Survey (SPANS), a population monitoring survey of school-aged children's weight and weightrelated behaviours, conducted in 1997, 2004 and 2010. Printed news items from all Australian newspapers between January 1997 and December 2011 mentioning the survey findings were identified from the Factiva database and a descriptive analysis of the content conducted. Results: Overall, 144 news items were identified. The news angles focused mainly on physical activity/sedentary behaviour; overweight/obesity and nutrition; however these angles changed between 1997 and 2011, with angles focused on physical activity/sedentary behaviour increasing, compared with overweight/obesity and nutrition angles (p=0.001). Responsibility for obesity and weight-related behaviours was most frequently assigned to parents and food marketing, and the most common solutions were policy strategies and parental/child education and support. Conclusions: Population health surveys are newsworthy and when coupled with strategic dissemination, media can contribute to communicating health issues and interpreting findings in ways that are relevant for consumers, policy makers and stakeholders. Implications: This case study emphasises the news value of government-funded population surveys, while providing a cautionary note about media focus on individual studies rather than a larger body of research evidence. © 2013 The Authors

Reduction of diabetes risk in routine clinical practice: Are physical activity and nutrition interventions feasible and are the outcomes from reference trials replicable? A systematic review and meta-analysis

Background. The clinical effectiveness of intensive lifestyle interventions in preventing or delaying diabetes in people at high risk has been established from randomised trials of structured, intensive interventions conducted in several countries over the past two decades. The challenge is to translate them into routine clinical settings. The objective of this review is to determine whether lifestyle interventions delivered to high-risk adult patients in routine clinical care settings are feasible and effective in achieving reductions in risk factors for diabetes. Methods. Data sources: MEDLINE (PubMed), EMBASE, CINAHL, The Cochrane Library, Google Scholar, and grey literature were searched for English-language articles published from January 1990 to August 2009. The reference lists of all articles collected were checked to ensure that no relevant suitable studies were missed. Study selection: We included RCTs, before/after evaluations, cohort studies with or without a control group and interrupted time series analyses of lifestyle interventions with the stated aim of diabetes risk reduction or diabetes prevention, conducted in routine clinical settings and delivered by healthcare providers such as family physicians, practice nurses, allied health personnel, or other healthcare staff associated with a health service. Outcomes of interest were weight loss, reduction in waist circumference, improvement of impaired fasting glucose or oral glucose tolerance test (OGTT) results, improvements in fat and fibre intakes, increased level of engagement in physical activity and reduction in diabetes incidence. Results. Twelve from 41 potentially relevant studies were included in the review. Four studies were suitable for meta-analysis. A significant positive effect of the interventions on weight was reported by all study types. The meta-analysis showed that lifestyle interventions achieved weight and waist circumference reductions after one year. However, no clear effects on biochemical or clinical parameters were observed, possibly due to short follow-up periods or lack of power of the studies meta-analysed. Changes in dietary parameters or physical activity were generally not reported. Most studies assessing feasibility were supportive of implementation of lifestyle interventions in routine clinical care. Conclusion. Lifestyle interventions for patients at high risk of diabetes, delivered by a variety of healthcare providers in routine clinical settings, are feasible but appear to be of limited clinical benefit one year after intervention. Despite convincing evidence from structured intensive trials, this systematic review showed that translation into routine practice has less effect on diabetes risk reduction. © 2010 Cardona-Morrell et al; licensee BioMed Central Ltd