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Lifestyle Changes in Relation to Initiation of Antihypertensive and Lipid-Lowering Medication: A Cohort Study.
Korhonen, MJ, Pentti, J, Hartikainen, J, Ilomäki, J, Setoguchi, S, Liew, D, Kivimäki, M, Vahtera, J
Journal of the American Heart Association. 2020;9(4):e014168
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Lifestyle modification remains a key component of cardiovascular disease prevention before and concurrently with pharmacologic interventions. The aim of this study was to assess the extent to which initiation of antihypertensive or lipid-lowering (statin) therapy predicts changes in lifestyle factors in Finnish adults. The study is a large cohort study. Participants (84% = females) were drawn from the Finnish Public-Sector study cohort of employees of 10 towns and 6 hospital districts. Results show that: - initiators experienced greater increases in body mass index and were more likely to become obese than did non-initiators. - the likelihood of becoming physically inactive was higher among initiators. - smokers who initiated preventive medication were more likely to either quit or decrease smoking compared with untreated smokers. - although average alcohol consumption decreased more among initiators than non-initiators, there was no difference in the odds of heavy drinking. Authors conclude that more effective measures are needed to support the recommended lifestyle change in relation to the initiation of pharmacologic interventions for primary prevention.
Abstract
Background Lifestyle modification is a key component of cardiovascular disease prevention before and concurrently with pharmacologic interventions. We evaluated whether lifestyle factors change in relation to the initiation of antihypertensive or lipid-lowering medication (statins). Methods and Results The study population comprised 41 225 participants of the FPS (Finnish Public Sector) study aged ≥40 years who were free of cardiovascular disease at baseline and responded to ≥2 consecutive surveys administered in 4-year intervals in 2000-2013. Medication use was ascertained through pharmacy-claims data. Using a series of pre-post data sets, we compared changes in body mass index, physical activity, alcohol consumption, and smoking between 8837 initiators and 46 021 noninitiators of antihypertensive medications or statins. In participants who initiated medication use, body mass index increased more (difference in change 0.19; 95% CI, 0.16-0.22) and physical activity declined (-0.09 metabolic equivalent of task hour/day; 95% CI, -0.16 to -0.02) compared with noninitiators. The likelihood of becoming obese (odds ratio: 1.82; 95% CI, 1.63-2.03) and physically inactive (odds ratio: 1.08; 95% CI, 1.01-1.17) was higher in initiators. However, medication initiation was associated with greater decline in average alcohol consumption (-1.85 g/week; 95% CI, -3.67 to -0.14) and higher odds of quitting smoking (odds ratio for current smoking in the second survey: 0.74; 95% CI, 0.64-0.85). Conclusions These findings suggest that initiation of antihypertensive and statin medication is associated with lifestyle changes, some favorable and others unfavorable. Weight management and physical activity should be encouraged in individuals prescribed these medications.
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Adherence to the Mediterranean Diet and Its Association with Body Composition and Physical Fitness in Spanish University Students.
Cobo-Cuenca, AI, Garrido-Miguel, M, Soriano-Cano, A, Ferri-Morales, A, Martínez-Vizcaíno, V, Martín-Espinosa, NM
Nutrients. 2019;11(11)
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The Mediterranean diet (MD) represents a dietary pattern that incorporates healthy traditional eating habits which includes high consumption of vegetables, fruit, legumes, nuts, beans, whole grains, fish, and unsaturated fats, and low consumption of red meat and dairy products. The Mediterranean Diet Adherence Screener (MEDAS-14 items) is a valid instrument for the estimation of adherence to the MD. The objectives of this study were to: 1. Estimate the prevalence of the adherence to the MD 2. Assess the association of adherence to the MD with physical fitness and body composition 3. Know the ability of each MEDAS item in the same sample to predict MD adherence. This study is a cross-sectional observational study which was performed with 310 first-year Spanish university students, aged between 18 and 30 years. Results indicate low prevalence of good adherence to the MD; and the participants with good adherence had high protein and low-fat intake compared to those with medium to low adherence. Furthermore, higher levels of physical fitness were also noticed amongst participants with good adherence to the MD. Twelve of the 14 items of the MEDAS score were associated with a high adherence to the MD. Authors conclude that MD adherence benefits both cardiorespiratory and muscular fitness amongst young adults.
Abstract
The aims of this study were to assess the association of adherence to the Mediterranean diet (MD) with physical fitness and body composition in Spanish university students and to determine the ability to predict the MD adherence of each Mediterranean Diet Adherence Screener (MEDAS) item. A cross-sectional study was performed involving 310 first-year university students. Adherence to the MD was evaluated with MEDAS-14 items. Anthropometric variables, body composition, and physical fitness were assessed. Muscle strength was determined based on handgrip strength and the standing long jump test. Cardiorespiratory fitness (CRF) was measured using the Course-Navette test. Only 24% of the university students had good adherence to the MD. The ANCOVA models showed a significant difference between participants with high adherence to the MD and those with medium and low adherence in CRF (p = 0.017) and dynamometry (p = 0.005). Logistic binary regression showed that consuming >2 vegetables/day (OR = 20.1; CI: 10.1-30.1; p < 0.001), using olive oil (OR = 10.6; CI: 1.4-19.8; p = 0.021), consuming <3 commercial sweets/week (OR = 10.1; IC: 5.1-19.7; p < 0.001), and consuming ≥3 fruits/day (OR = 8.8; CI: 4.9-15.7; p < 0.001) were the items most associated with high adherence to the MD. In conclusion, a high level of adherence to the MD is associated with high-level muscular fitness and CRF in Spanish university students.