1.
The effect of weight loss interventions in truck drivers: Systematic review.
Pritchard, EK, Kim, HC, Nguyen, N, van Vreden, C, Xia, T, Iles, R
PloS one. 2022;(2):e0262893
Abstract
INTRODUCTION Truck driving is the most common vocation among males internationally with a high proportion overweight/obese due to a combination of work and lifestyle factors leading to health complications. With limited studies in this area, this systematic review aimed to identify and describe interventions addressing weight reduction in truck drivers. METHODS Five electronic databases were searched, January 2000 to June 2020 (CINAHL, Cochrane Library, Embase, Ovid MEDLINE, Scopus). Inclusion criteria: experimental primary studies, long-distance (≥500 kms) truck drivers, peer reviewed publications in English. Weight loss interventions included physical activity, diet, behavioral therapy, or health promotion/education programs. Exclusions: non-interventional studies, medications or surgical interventions. Two independent researchers completed screening, risk of bias (RoB) and data extraction with discrepancies managed by a third. Study descriptors, intervention details and outcomes were extracted. RESULTS Seven studies (two RCTs, five non-RCTs,) from three countries were included. Six provided either counselling/coaching or motivational interviewing in combination with other components e.g. written resources, online training, provision of exercise equipment. Four studies demonstrated significant effects with a combined approach, however, three had small sample sizes (<29). The effect sizes for 5/7 studies were medium to large size (5/7 studies), indicating likely clinical significance. RoB assessment revealed some concerns (RCTs), and for non-RCTs; one moderate, two serious and two with critical concerns. Based on the small number of RCTs and the biases they contain, the overall level of evidence in this topic is weak. CONCLUSION Interventions that include a combination of coaching and other resources may provide successful weight reduction for truck drivers and holds clinical significance in guiding the development of future interventions in this industry. However, additional trials across varied contexts with larger sample populations are needed.
2.
Does cigarette smoking exacerbate the effect of total cholesterol and high-density lipoprotein cholesterol on the risk of cardiovascular diseases?
Nakamura, K, Barzi, F, Huxley, R, Lam, TH, Suh, I, Woo, J, Kim, HC, Feigin, VL, Gu, D, Woodward, M, et al
Heart (British Cardiac Society). 2009;(11):909-16
Abstract
OBJECTIVE To explore whether an interaction between smoking and serum total cholesterol (TC) and/or decreased levels of serum high-density lipoprotein cholesterol (HDLC) exists for any major subtype of cardiovascular disease. DESIGN An individual participant overview of 34 cohort studies. SETTING The Asia-Pacific region. PARTICIPANTS People aged >or=20 years without a particular condition or risk factor. MEAN OUTCOME MEASURES Hazard ratios (HRs) and 95% confidence intervals (CIs) for both TC and HDLC by smoking status were estimated using Cox proportional hazard models adjusted for age and systolic blood pressure and stratified by study and sex. RESULTS During follow-up (median 4.0 years), 3298 coronary heart disease (CHD) and 4318 stroke events were recorded. For CHD, the HR (95% CI) for an additional 1.06 mmol/l increment in TC was greater in current smokers than in non-smokers: 1.54 (1.43 to 1.66) versus 1.38 (1.30 to 1.47); p = 0.02. Similarly, the HR (95% CI) for an additional 0.40 mmol/l decrement in HDLC was greater in current smokers than in non-smokers: 1.67 (1.35 to 2.07) versus 1.28 (1.10 to 1.49); p = 0.04. The positive association of TC with ischaemic stroke, and the negative association of TC with haemorrhagic stroke, were broadly similar for current smokers and non-smokers. Similarly, the risks of both the subtypes of stroke remained broadly unchanged as HDLC decreased in both current smokers and non-smokers. CONCLUSIONS Smoking exacerbated the effects of both TC and HDLC on CHD, although no interaction between smoking and TC or HDLC existed for either of the subtypes of stroke.