Sugar-sweetened beverage consumption, correlates and interventions among Australian Aboriginal and Torres Strait Islander communities: a scoping review protocol

Introduction: Aboriginal and Torres Strait Islander communities of Australia experience poorer health outcomes in the areas of overweight and obesity, diabetes and cardiovascular disease. Contributing to this burden of disease in the Australian community generally and in Aboriginal and Torres Strait Islander communities, is the consumption of sugar-sweetened beverages (SSBs). We have described a protocol for a review to systematically scope articles that document use of SSBs and interventions to reduce their consumption with Aboriginal and Torres Strait Islander people. These results will inform future work that investigates interventions aimed at reducing harm associated with SSB consumption. Methods and analysis: This scoping review draws on a methodology that uses a six-step approach to search databases including PubMed, SCOPUS, CINAHL, Informit (including Informit: Indigenous Peoples), Joanna Briggs Institute EBP Database and Mura, between January 1980 and February 2017. Two reviewers will be engaged to search for and screen studies independently, using formulated selection criteria, for inclusion in our review. We will include primary research studies, systematic reviews including meta-analysis or meta-synthesis, reports and unpublished grey literature. Results will be entered into a table identifying study details and characteristics, summarised using a Preferred Reporting Items for Systematic Reviews and Meta-Analysis chart and then critically analysed. Ethics and dissemination: This review will not require ethics committee review. Results will be disseminated at appropriate scientific meetings, as well as through the Aboriginal and Torres Strait Islander community.Jodie C Avery, Jacqueline A Bowden, Joanne Dono, Odette R Gibson, Aimee Brownbill, Wendy Keech, David Roder, Caroline L Mille

Long-term cardiovascular risks and statin treatment impact on socioeconomic inequalities: microsimulation model

Background: UK cardiovascular disease (CVD) incidence and mortality have declined in recent decades but socioeconomic inequalities persist. Aims: We present a new CVD model and project health outcomes and impact of guideline-recommended statin treatment across quintiles of socioeconomic deprivation in UK. Design and Setting: Lifetime microsimulation model developed using 117,896 participants in 16 statin trials and 501,854 UK Biobank (UKB) participants and quality of life data from national health surveys. Method: We developed a CVD microsimulation model using risk equations for myocardial infarction, stroke, coronary revascularisation, cancer, vascular and nonvascular death, estimated using trial data. We calibrated and further developed this model in the UKB cohort, including further characteristics and a diabetes risk equation, and validated the model in UKB and Whitehall II cohorts. We used the model to predict CVD incidence, life expectancy, quality-adjusted life years (QALYs) and impact of UK guideline-recommended statin treatment across quintiles of socioeconomic deprivation. Results: Age, sex, socioeconomic deprivation, smoking, hypertension, diabetes and cardiovascular events were key CVD risk determinants. Model-predicted event rates corresponded well to observed rates across participant categories. The model projected strong gradients in remaining life expectancy, with 4-to-5 years (5-to-8 QALYs) gaps between the least and most socioeconomically deprived quintiles. Guideline-recommended statin treatment was projected to increase QALYs with larger gains in quintiles of higher deprivation. Conclusions: The study demonstrated the potential of guideline-recommended statin treatment to reduce socioeconomic inequalities. This CVD model is a novel resource for individualised long-term projections of health outcomes and effects of CVD treatments

Intensity-dependent effects of aerobic training on pressure pain threshold in overweight men: A randomized trial

Purpose: To investigate the chronic and acute effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on pressure pain thresholds (PPT) in overweight men. Methods: Twenty-eight participants performed stationary cycling exercise three times per week for 6 weeks. Participants were randomly allocated to HIIT (10 × 1-min intervals at 90% peak heart rate) or MICT (30 min at 65–75% peak heart rate). PPTs were assessed over the rectus femoris, tibialis anterior and upper trapezius before and after the 6-week training programme (chronic effect) as well as before and after the first, middle and final exercise sessions (acute effect). Results: For chronic exercise, PPTs increased more after MICT compared to HIIT over the rectus femoris (p = 0.009, effect size r = 0.54) and tibialis anterior (p = 0.012, r = 0.54), but not the trapezius (p = 0.399, r = 0.29). The effect of acute exercise on PPT was more varied and ranged from moderate hypoalgesia to moderate hyperalgesia. Overall, however, there was no consistent change in PPT after acute exercise for HIIT or MICT (p ≥ 0.231, r ≥ −0.31 and ≤0.31). Conclusion: Six weeks of MICT cycling (chronic exercise) increased PPT for the lower body, but not upper body, in overweight men, whereas HIIT did not provide any hypoalgesic effect for chronic exercise. The acute effect of exercise on PPT was highly variable and negligible overall. Significance: This study shows that aerobic training increases pressure pain threshold in pain-free adults. This effect was observed only for MICT over-exercised muscles, implying intensity- and site-specific effects of exercise training on pain threshold

Effects of Fenofibrate Treatment on Cardiovascular Disease Risk in 9,795 Individuals With Type 2 Diabetes and Various Components of the Metabolic Syndrome: The Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study

OBJECTIVE—We explored whether cardiovascular disease (CVD) risk and the effects of fenofibrate differed in subjects with and without metabolic syndrome and according to various features of metabolic syndrome defined by the Adult Treatment Panel III (ATP III) in subjects with type 2 diabetes in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study

Effects of Fenofibrate Treatment on Cardiovascular Disease Risk in 9,795 Individuals With Type 2 Diabetes and Various Components of the Metabolic Syndrome: The Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study

OBJECTIVE—We explored whether cardiovascular disease (CVD) risk and the effects of fenofibrate differed in subjects with and without metabolic syndrome and according to various features of metabolic syndrome defined by the Adult Treatment Panel III (ATP III) in subjects with type 2 diabetes in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study

High-intensity interval training for reducing blood pressure: a randomized trial vs. moderate-intensity continuous training in males with overweight or obesity

The optimal exercise-training characteristics for reducing blood pressure (BP) are unclear. We investigated the effects of 6-weeks of high-intensity interval training (HIIT) or moderate-intensity continuous training (MICT) on BP and aortic stiffness in males with overweight or obesity. Twenty-eight participants (18–45 years; BMI: 25–35 kg/m2) performed stationary cycling three times per week for 6 weeks. Participants were randomly allocated (unblinded) to work-matched HIIT (N = 16; 10 × 1-min intervals at 90–100% peak workload) or MICT (N = 12; 30 min at 65–75% peak heart rate). Central (aortic) and peripheral (brachial) BP and aortic stiffness was assessed before and after training. There were no significant group × time interactions for any BP measure (all p > 0.21). HIIT induced moderate reductions in central (systolic/diastolic ∆: −4.6/−3.5 mmHg, effect size d = −0.51/−0.40) and peripheral BP (−5.2/−4 mmHg, d = −0.45/−0.47). MICT induced moderate reductions in diastolic BP only (peripheral: −3.4 mmHg, d = −0.57; central: −3 mmHg, d = −0.50). The magnitude of improvement in BP was strongly negatively correlated with baseline BP (r = −0.66 to −0.78), with stronger correlations observed for HIIT (r = −0.73 to −0.88) compared with MICT (r = −0.43 to −0.61). HIIT was effective for reducing BP (~3–5 mmHg) in the overweight to obese cohort. Exercise training induced positive changes in central (aortic) BP. The BP-lowering effects of exercise training are more prominent in those with higher baseline BP, with stronger correlation in HIIT than MICT

The effect of high-intensity interval training and moderate-intensity continuous training on aerobic fitness and body composition in males with overweight or obesity: A randomized trial

The optimal exercise training characteristics for improving body composition in individuals with obesity are not clear. This study assessed the effects of 6-weeks of high-intensity interval training (HIIT) or moderate-intensity continuous training (MICT) on aerobic fitness and body composition in males with overweight or obesity. Twenty-eight participants (18–45 years; BMI: 25–35 kg/m2) performed stationary cycling 3 times per week for 6 weeks. Participants were randomly allocated to work-matched HIIT (N = 16) (10 × 1-min intervals at ~90% peak heart rate) or MICT (N = 12) (30 min at 65–75% peak heart rate). Maximal aerobic capacity (VO2peak) and body composition were assessed before and after 6-week training. Both HIIT and MICT induced moderate increases in aerobic fitness (Δ% VO2peak: HIIT 9 ± 8%, ES = 0.42; MICT: 7 ± 13%, ES = 0.32) and work capacity (Δ% peak workload: HIIT 13 ± 10%, ES = 0.69: MICT 17 ± 15%, ES = 0.76), but these changes did not differ significantly between the groups (all p > 0.16). The effects of HIIT or MICT on body composition outcomes were negligible to small across whole-body and all regional-specific sites (all effect sizes ES = −0.19 to 0.38) and did not differ significantly between the groups (all p > 0.21). Short-term (6-weeks) cycling training did not improve body composition in males with overweight or obesity. Improvements in aerobic fitness were comparable between work-matched HIIT and MICT

Exercise for affect and enjoyment in overweight or obese males: a comparison of high-intensity interval training and moderate-intensity continuous training

High-intensity interval training (HIIT) is effective for generating positive cardiovascular health and fitness benefits. This study compared HIIT and moderate-intensity continuous training (MICT) for affective state and enjoyment in sedentary males with overweight or obesity. Twenty-eight participants performed stationary cycling for 6 weeks × 3 sessions/week. Participants were randomly allocated to HIIT (N=16) (10 × 1-minute intervals at ~90% peak heart rate) or MICT (N=12) (30 minutes at 65-75% peak heart rate). Affective state changes were assessed after 6-weeks training. Enjoyment and acute change in affect were assessed after individual training sessions. HIIT participants reported improved positive affect following 6 weeks training (∆ 3.6 ± 4.6, p = 0.007, effect size d = 0.70), without corresponding improvement in negative affect (p = 0.48, d = -0.19). MICT did not induce any improvement in positive affect (p = 0.56, d = 0.16) or negative affect (p = 0.23, d = -0.41). Enjoyment ratings were comparable for both exercise formats (HIIT: 4.4 ± 0.4 on a 7-point scale; MICT: 4.3 ± 0.3; p = 0.70, d = 0.15). Six weeks of HIIT induced improvement in positive affect in sedentary participants with overweight or obesity. Enjoyment of training was only slightly above neutral levels for both training formats. What’s already known about this topic? Exercise training can improve general affect however the optimal exercise characteristics for improving affect are unclear. Studies assessing the relative enjoyment of HIIT in comparison to MICT have largely been equivocal to date. What does this study add? HIIT can improve affective state in males with overweight or obesity. Six weeks of stationary cycling HIIT were rated as only mildly enjoyable, comparable to ratings for MICT

Low alanine aminotransferase and higher cardiovascular events in type 2 diabetes: analysis of the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study

Aims Non-alcoholic fatty liver disease (NAFLD) is common in type 2 diabetes and associated with higher risk of cardiovascular disease. This study aimed to determine whether alanine aminotransferase (ALT) or gamma-glutamyltransferase (GGT), as markers of liver health and NAFLD, might predict cardiovascular events in this population. Methods Data from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study were analysed to examine the relationship between liver enzymes and incident cardiovascular events (nonfatal myocardial infarction, stroke, coronary and other cardiovascular death, coronary or carotid revascularization) over 5 years. Results ALT had a linear inverse relationship with the first cardiovascular event on study. After adjustment, for every standard deviation higher baseline ALT (13.2U/L), the risk of an event was 7%(95%CI 4–13, P=0.02) lower. Participants with ALT below and above the reference range 8–41 U/L for women and 9–59 U/L for men, had a hazard ratio of an event of 1.86(95%CI, 1.12–3.09) and 0.65(95%CI, 0.49–0.87), respectively (P=0.001). No relationship was found for GGT. Conclusions The data may indicate that in type 2 diabetes — associated with higher ALT due to prevalent NAFLD — lower ALT is a marker of hepatic or systemic frailty rather than health