1.
Smoking cessation improves cardiometabolic risk in overweight and obese subjects treated with varenicline and dietary counseling.
Heggen, E, Svendsen, M, Tonstad, S
Nutrition, metabolism, and cardiovascular diseases : NMCD. 2017;(4):335-341
Abstract
BACKGROUND AND AIM Weight gain after stopping smoking potentially counteracts improvements in cardiometabolic risks. We investigated changes in metabolic syndrome (MetS) components and homeostasis assessment model insulin resistance (HOMA-IR) in smokers given dietary counseling during their quit attempt. METHODS AND RESULTS Smokers (≥10 cigarettes/day) with BMI 25-40 kg/m2 were randomized to a low-carbohydrate or low-fat diet and treated with a standard course of varenicline for 12 weeks. Quitters were assessed according to the Russell standard (≤5 cigarettes after the quit date) validated with expired breath carbon monoxide (CO) < 10 ppm. Of 122 randomized participants, 108 (89%) completed clinical and laboratory assessments at 12 weeks. As changes in metabolic risk factors did not differ between dietary groups, we combined the groups to compare quitters to continuing smokers. We found similar weight change among 78 validated quitters as 30 continuing smokers (-0.1 ± 3.0 kg vs 0.3 ± 3.1 kg; p = 0.7) and change in waist circumference (-2.0 ± 3.8 cm vs -0.9 ± 3.9 cm; p = 0.2). Changes in triglyceride concentrations (-0.16 ± 0.52 mmol/l vs 0.21 ± 0.95 mmol/l; p = 0.015) and diastolic blood pressure (-0.9 ± 6 mmHg vs 1.9 ± 8 mmHg; p = 0.039) were more favorable in quitters. Changes in other cardiometabolic risks and HOMA-IR did not differ between quitters and continuous smokers, nor did energy intake or resting metabolic rate. CONCLUSION Dyslipidemia and blood pressure improved and no early weight gain was seen in quitters, suggesting that dietary intervention can mitigate some of the effects of stopping smoking on cardiometabolic risk factors in overweight and obese smokers. CLINICAL TRIALS REGISTRATION NCT01069458.
2.
[Pulmonary rehabilitation as an effective method for optimizing therapeutic and preventive measures in patients with chronic obstructive pulmonary disease concurrent with metabolic syndrome].
Budnevsky, AV, Isaeva, YV, Malysh, EY, Kozhevnikova, SA
Terapevticheskii arkhiv. 2016;(8):25-29
Abstract
AIM: to evaluate the impact of a pulmonary rehabilitation (PR) cycle based on patient education, smoking cessation, physical exercises, and balanced nutrition in addition to standard therapy for chronic obstructive pulmonary disease COPD in patients with this condition. SUBJECTS AND METHODS 70 patients (27 (38.6%) women and 43 (61.4%) men) aged 18 to 60 years (mean age, 48.31±0.64 years) with moderate COPD in remission concurrent with MS were examined. The comprehensive examination of the patients encompassed assessment of clinical, instrumental, and laboratory findings at baseline and 12 months. The patients were randomized into two groups: 1) 35 patients who underwent a RH cycle in addition to standard therapy for COPD; 2) 35 patients who received standard COPD treatment only. RESULTS Group 1 was found to have significant differences in reducing the number of patients with COPD exacerbations, emergency calls, hospitalizations, severity of clinical symptoms of COPD and their impact on the physical activity and health of the patients, as well as better quality of life and exercise tolerance. CONCLUSION The therapeutic and preventive measures for patients with COPD and MS should involve educational programs and physical trainings, which are developed, by taking into account of a comorbidity in order to optimize therapeutic and preventive measures and to improve quality of life in this category of patients.