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Better population health through behavior change in adults: a call to action.
Spring, B, Ockene, JK, Gidding, SS, Mozaffarian, D, Moore, S, Rosal, MC, Brown, MD, Vafiadis, DK, Cohen, DL, Burke, LE, et al
Circulation. 2013;128(19):2169-76
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Plain language summary
Cardiovascular health is being lost from childhood through young adulthood and the major reasons are adverse health behaviours related to diet, physical activity, healthy weight maintenance, and smoking. This call to action focused mainly on the required behaviour change for adults to improve cardiovascular health. Recent literature demonstrated that the presence of ideal cardiovascular health behaviours and biomarkers is associated with longevity and freedom from cardiovascular and all-cause morbidity and mortality. This call for action outlines that: - Clinicians play a vital role in fostering healthier behaviours. - It is important to connect patients with health-promoting influences in their immediate environment in order to adopt healthier lifestyles. - Practical tools are needed to assess health behaviours – more effective healthcare system and policy improvements. Authors conclude that support for these endeavours needs to be available from all healthcare professionals and systems, particularly because the goal is to promote healthier lifestyles that reduce risk for all chronic disease.
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Zinc supplementation in the treatment of anorexia nervosa.
Brazilian Association of Nutrology
Revista da Associacao Medica Brasileira (1992). 2013;59(4):321-4
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Anorexia nervosa (AN) is a disorder characterised by significant weight loss, restrictive diets, a search for thinness and a distortion of body image. Zinc is a key micronutrient that plays essential roles in the body including in gene transcription regulation and enzyme reactions. There is a similarity between symptoms of zinc deficiency and AN; namely weight loss, changes in appetite and sexual dysfunction. This review aims to provide healthcare professionals with insight into the nutritional recommendations for zinc in patients with AN. The review suggests that there are clinical studies demonstrating a strong association between AN and low levels of serum zinc and low levels of urinary zinc suggesting a micronutrient deficiency in these individuals. The severity of zinc deficiency is associated with greater weight deficits and longer AN duration. It is also associated with higher levels of anxiety and depression in AN individuals. Zinc is key in smell and taste perception and the brain regions associated with interpreting eating as pleasurable. Reduced food intake and practices like purging and low-zinc diets may exacerbate any low levels and impair zinc absorption. A controlled study showed that oral supplementation resulted in a higher rate of body mass index (BMI) increase and an improvement in neurotransmitters. The review recommends: 1. Check serum levels of zinc in AN patients as it may be low. Zinc status may contribute to eating behaviour including gaining pleasure from eating, smell and taste. 2. Zinc supplementation of 15mg/daily for preventative purposes and 15-20mg/daily if zinc deficiency is identified after testing. The review recommends supplementation for a minimum of 2 months.