Influence of Weight Reduction on Blood Pressure; A Meta-analysis of Randomized Controlled Trials

Increased body weight is a strong risk factor for hypertension. A meta-analysis of randomized controlled trials was performed to estimate the effect of weight reduction on blood pressure overall and in population subgroups. Twenty-five randomized, controlled trials (comprising 34 strata) published between 1966 and 2002 with a total of 4874 participants were included. A random-effects model was used to account for heterogeneity among trials. A net weight reduction of -5.1 kg (95% confidence interval [CI], -6.03 to -4.25) by means of energy restriction, increased physical activity, or both reduced systolic blood pressure by -4.44 mm Hg (95% CI, -5.93 to -2.95) and diastolic blood pressure by -3.57 mm Hg (95% CI, -4.88 to -2.25). Blood pressure reductions were -1.05 mm Hg (95% CI, -1.43 to -0.66) systolic and -0.92 mm Hg (95% CI, -1.28 to -0.55) diastolic when expressed per kilogram of weight loss. As expected, significantly larger blood pressure reductions were observed in populations with an average weight loss >5 kg than in populations with less weight loss, both for systolic (-6.63 mm Hg [95% CI, -8.43 to -4.82] vs -2.70 mm Hg [ 95% CI, -4.59 to -0.81]) and diastolic (-5.12 mm Hg [95% CI, -6.48 to -3.75] vs -2.01 mm Hg [95% CI, -3.47 to -0.54]) blood pressure. The effect on diastolic blood pressure was significantly larger in populations taking antihypertensive drugs than in untreated populations (-5.31 mm Hg [95% CI, -6.64 to -3.99] vs -2.91 mm Hg [95% CI, -3.66 to -2.16]). This meta-analysis clearly shows that weight loss is important for the prevention and treatment of hypertension

Exploring food insecurity and obesity in Dutch disadvantaged neighborhoods: a cross-sectional mediation analysis

Background: Food insecurity is related to risk of adverse health outcomes such as obesity, but the explanatory factors underlying this association are still unclear. This study aimed to assess the association between food insecurity and obesity, and to explore potential mediation by sociodemographic and lifestyle factors. Methods: This cross-sectional study was conducted among 250 participants in a deprived urban area in the Netherlands. Data on sociodemographic and lifestyle factors, food insecurity status and diet quality were collected using questionnaires. Diet quality was determined based on current national dietary guidelines. BMI was calculated from self-reported height and weight. Regression analyses were performed to explore the association between food insecurity and BMI status. Mediation analyses were performed to estimate the total-, direct-, and indirect effect and proportion of total effect mediated of the food insecurity-obesity association. Results: The overall prevalence of food insecurity was 26%. Food insecurity was associated with obesity (OR = 2.49, 95%CI = 1.16, 5.33), but not with overweight (OR = 1.15, 95%CI = 0.54, 2.45) in the unadjusted model. The food insecurity-obesity association was partially mediated by living situation (proportion mediated: 15.4%), diet quality (− 18.6%), and smoking status (− 15.8%) after adjustment for other covariates. Conclusions: The findings of this study suggest an association between food insecurity and obesity. Living situation, diet quality and smoking status explained part, but not all, of the total association between food insecurity and obesity. Future longitudinal studies are warranted to examine the temporal order of the food insecurity-obesity association and potential mediators in this relationship. In addition, food insecurity and its potential consequences need to be taken into account in obesity prevention programs and policies

Mutagenicity of aromatic glycidyl ethers with Salmonella

6 aromatic glycidyl ethers containing naphthyl, biphenyl or benzylphenyl substituents were synthesized. These epoxides together with the commercially available compounds 2-biphenylyl glycidyl ether were examined for dose--mutagenicity relationships using the plate incorporation Ames test with Salmonella typhimurium strains TA100 and TA1535. Structure--mutagenicity relationships were further examined for these compounds and 3 phenyl glycidyl ethers by concurrent testing at a single dose with strain TA100. Meaningful correlations could not be established for the mutagenicity of these epoxides to their molecular volumes, partition values, nor to their reactivities with the model nucleophile, 4-(4-nitrobenzyl) pyridine. However, it was noted that increased conjugated aromatic unsaturation with its resulting planarity led to increased mutagenicity and that this effect decreased when it was further removed from the epoxide moiety.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/27147/1/0000141.pd

Mutagenicity of aryl propylene and butylene oxides with Salmonella

10 aryl propylene oxides and 6 aryl butylene oxides were synthesized. Dose-mutagenicity relationships were studied for these compounds and for 1,2-epoxybutane, using both the preincubation and plate incorporation Ames tests with Salmonella typhimurium strains TA100 and TA1535. Structure-mutagenicity relationships were further examined by concurrent testing at single doses with the plate incorporation assay in strain TA100. In both series of compounds, mutagenicity showed very weak correlation to chemical reactivity, molar volume and partition values. However, all compounds were mutagenic in at least one system with the propylene oxides being more mutagenic than the corresponding butylene oxide derivatives. The naphthyl derivatives in each series were the most mutagenic.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/26518/1/0000056.pd

Food insecurity among Dutch food bank recipients: a cross-sectional study.

Objective: To determine the prevalence of (very) low food security among Dutch food bank recipients, and to identify potential demographic, lifestyle and nutrition-related factors associated with (very) low food security. Setting: 11 of 135 Dutch food banks were selected throughout the Netherlands. Participants: 251 Dutch food bank recipients participated in the study (93 men and 158 women). Inclusion criteria for participation were: (1) at least 18 years of age, (2) sufficiently fluent in Dutch to participate in oral and written interviews, (3) recipient of a Dutch food bank for at least 1 month and (4) collect own food parcel at the food bank. A single member per household was included. Primary outcome: Level of food security. Results: The prevalence of food insecurity was 72.9% (N=183), of which 40.4% (N=74) reported very low food security. Of the very low food secure participants, 56.8% (N=42) reported they were ever hungry but did not eat because they could not afford enough food in the previous 3 months. Adjusted multinomial logistic regression analyses showed that households without children were less likely to experience low food security (OR 0.39 (95% CI 0.18 to 0.88)) and men (OR 0.24 (95% CI 0.11 to 0.51)) were less likely to experience very low food security, while low-educated recipients (OR 5.05 (95% CI 1.37 to 18.61)) were more likely to experience very low food security. Furthermore, recipients with high satisfaction with overall food intake (OR 0.46 (95% CI 0.27 to 0.78)), high perceived healthiness of overall food intake (OR 0.34 (95% CI 0.19 to 0.62)) or high self-efficacy of eating healthy (OR 0.62 (95% CI 0.40 to 0.96)) were less likely to experience very low food security. Conclusions: Our study showed high prevalence rates of food insecurity among Dutch food bank recipients, and identified subgroups at increased risk of food insecurity. More research is urgently needed on the underlying determinants of food insecurity and the effectiveness of food assistance by food banks

Misperception of self-reported adherence to the fruit, vegetable and fish guidelines in older Dutch adults

In this study we investigated (the degree of) misperception of adherence to the fruit, vegetable and fish guidelines in older Dutch adults and examined to what extent misperception is associated with socio-economic position (SEP) and other demographic, lifestyle and nutrition-related characteristics. The sample included 1057 community dwelling adults, aged 55-85 years, who participated in the Longitudinal Aging Study Amsterdam. Respondents completed a lifestyle questionnaire which included a food frequency questionnaire to calculate fruit, vegetable and fish intake. After current dietary guidelines were explained, respondents were asked to indicate whether they believed they adhered to the fruit, vegetable and fish guidelines. Characteristics potentially associated with misperception included level of income and education, lifestyle factors, nutritional knowledge, as well as attitude, social support and self-efficacy toward healthy eating. In the total sample, 69.1% of the older adults reported to adhere to the fruit guideline, 77.5% to the vegetable guideline, and 36.4% to the fish guideline. Based on the calculated intake data, 82.6% adhered to the fruit guideline, 65.5% to the vegetable guideline and 33.8% to the fish guideline. Overestimation of adherence was most common for the vegetable guideline (18.7%). Multivariate analysis, adjusted for level of income as well as for attitude and self-efficacy toward healthy eating, showed that lower educated respondents were more likely to overestimate their adherence to the vegetable guideline (relative index of inequality (RII): 2.97 (95% CI: 1.47-6.01)). Overestimation rates for fish (3.4%) and fruit (2.3%) were lower and not associated with any of the characteristics. This study showed that overestimation in older adults was common for adherence to the vegetable guideline and especially in those with a lower education level, but not for adherence to the fruit and fish guideline. © 2014 Elsevier Ltd

Motivations to eat healthily in older Dutch adults; a cross-sectional study

Background: To influence dietary behaviors, more insight in food choice motivations is necessary. This study identified what motivations older adults have to eat healthily and investigated to what extent these motivations are particular to specific subgroups according to socio-economic position and other demographic, lifestyle and health characteristics. Methods: We used data from 1,050 older Dutch adults who participated in the Longitudinal Aging Study Amsterdam (65-80 years, independently living, normal cognitive status). Motivations to eat healthily and characteristics were measured with a self-reported questionnaire. We used logistic regression analyses to estimate odds ratios (OR) and 95% CI for the association between subgroups and motivations to eat healthily. Results: The most reported motivations to eat healthily were: "feeling fit" (51.7%), "current health" (49.7%) and "body weight" (39.2%). Multivariate analyses showed that older adults with chronic diseases (≥2 vs. no chronic disease OR: 4.41, 95% CI: 2.31-8.44) and a poor self-rated health (poor vs. good OR: 2.31, 95% CI: 1.22-3.73) were more likely to report "current disease" as a motivation to eat healthily. Groups from lower socio-economic positions were less likely to report "to prevent diseases" (low income vs. high OR: 0.52, 95% CI: 0.32-0.86, low education vs. high OR: 0.43, 95% CI: 0.27-0.70) and older adults with obesity were less likely to report "current health" (obese vs. normal weight OR: 0.47, 95% CI: 0.32-0.69) as motivations to eat healthily. Conclusion: Multivariate analyses showed that the presence of a disease in older adults is an important motivation for them to eat healthily, which might indicate that older adults with health problems are aware of the link between their disease and nutrition. Older adults from lower socio-economic positions or those with obesity require a specific approach because disease prevention seems to be of lesser importance for these groups, even though a healthy diet could improve their health. Future research should investigate the reasons behind the motives of low socio-economic position and obese older adults