Improvement in medical risk factors and quality of life in women and men with coronary artery disease in the Multicenter Lifestyle Demonstration Project

Koertge, Jenny; Weidner, Gerdi; Elliott-Eller, Melanie; Scherwitz, Larry; Merritt-Worden, Terri; Marlin, Ruth; Lipsenthal, Lee; Guarneri, Mimi; Finkel, Robert J.; Saunders, Donald E.; McCormac, Patty; Scheer, Judith M.; Collins, R; Ornish, Dean

doi:10.1016/s0002-9149(03)00320-5

Cited by 145 publications

(110 citation statements)

References 23 publications

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“…[71][72][73][74] However, those studies were not included in our systematic review for Ն1 of the following reasons: the design was not a randomized control trial, 72,73 body weight was not a primary outcome, 74 the intensity of intervention varied (ie, very-low-fat diets combined with other intensive lifestyle changes were compared with usual care), 74 or longterm follow-up data were not included. 71 Protein Evidence of long-term effectiveness (Ͼ1 year after treatment) of a high-protein, low-carbohydrate diet (also known as a protein-sparing modified fast [PSMF]) is extremely limited.…”

Section: Carbohydrates and Fatmentioning

confidence: 99%

Recommendations for Treatment of Child and Adolescent Overweight and Obesity

et al. 2007

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In this article, we review evidence about the treatment of obesity that may have applications in primary care, community, and tertiary care settings. We examine current information about eating behaviors, physical activity behaviors, and sedentary behaviors that may affect weight in children and adolescents. We also review studies of multidisciplinary behavior-based obesity treatment programs and information about more aggressive forms of treatment. The writing group has drawn from the available evidence to propose a comprehensive 4-step or stagedcare approach for weight management that includes the following stages: (1) Prevention Plus; (2) structured weight management; (3) comprehensive multidisciplinary intervention; and (4) tertiary care intervention. We suggest that providers encourage healthy behaviors while using techniques to motivate patients and families, and interventions should be tailored to the individual child and family. Although more intense treatment stages will generally occur outside the typical office setting, offices can implement less intense intervention strategies. We not ony address specific patient behavior goals but also encourage practices to modify office systems to streamline office-based care and to prepare to coordinate with professionals and programs outside the office for more intensive interventions. S254SPEAR et al by guest on August 28, 2018 www.aappublications.org/news Downloaded from T REATMENT FOR CHILDREN who are overweight or obese seems easy, that is, just counsel children and their families to eat less and to exercise more. In practice, however, treatment of childhood obesity is time-consuming, frustrating, difficult, and expensive. In fact, choosing the most effective methods for treating overweight and obesity in children is complex at best. This is especially true for primary care providers, who have limited resources to offer interventions within their offices or programs and few providers to whom they can refer patients.The need for evidence-based treatment recommendations is a critical health care issue, because obese children and adolescents are at risk for developing many of the comorbidities seen in obese adults. Studies demonstrated that fasting serum glucose, insulin, and triglyceride levels and the prevalence of impaired glucose tolerance and systolic hypertension increase significantly as children become obese (BMI of Ն95th percentile). 1 Even children and adolescents who are overweight (BMI of 85th to 94th percentile) are at risk for comorbidities. Therefore, interventions using dietary modifications, increased physical activity, and behavioral therapy may be beneficial for overweight children and adolescents, with more-aggressive intervention directed toward obese children and adolescents. 2 Health care professionals, however, may find it difficult to determine which interventions will be most efficacious for their patients. To date, no clinical trials have determined whether specific dietary modifications alone (ie, without behavioral interven...

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Section: Carbohydrates and Fatmentioning

confidence: 99%

Recommendations for Treatment of Child and Adolescent Overweight and Obesity

et al. 2007

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“…The Lifestyle Heart Trial intervention program has been replicated successfully in the clinical setting. 250 The studies of de Lorgeril et al and Singh and colleagues were primarily nutritional interventions. 244,245 The Lyon Diet Heart Study was a randomized secondary prevention trial that tested whether an ␣-linolenic acid-rich Mediterranean-type diet reduced rates of recurrence after a first MI compared with a "prudent" Western diet.…”

Section: Coronary Artery Diseasementioning

confidence: 99%

“…245 Finally, the process of systematically initiating the use of lipid-lowering medications, along with aspirin, ␤-blockers, and angiotensin-converting enzyme inhibitors, in patients hospitalized with an acute coronary event, in conjunction with dietary and exercise counseling, has been shown to benefit from a collaborative approach by healthcare profes-sionals. 250 In the CHAMP program, 38 an in-hospital, nursecase manager approach resulted in increased use of these preventive medications and was associated with improved risk factor measures such as lower LDL-C levels and a reduction in recurrent MI and mortality at 1 year.…”

Section: Coronary Artery Diseasementioning

confidence: 99%

Managing Abnormal Blood Lipids

Fletcher¹,

Berra²,

Ades³

et al. 2005

Circulation

190

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Abstract-Current data and guidelines recommend treating abnormal blood lipids (ABL) to goal. This is a complex process and requires involvement from various healthcare professionals with a wide range of expertise. The model of a multidisciplinary case management approach for patients with ABL is well documented and described. This collaborative approach encompasses primary and secondary prevention across the lifespan, incorporates nutritional and exercise management as a significant component, defines the importance and indications for pharmacological therapy, and emphasizes the importance of adherence. Use of this collaborative approach for the treatment of ABL ultimately will improve cardiovascular and cerebrovascular morbidity and mortality. (Circulation. 2005;112:3184-3209.)

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“…One of the typical phenotypes associated with increased risk of CHD includes increased LDL cholesterol (LDL-C) and reduced concentrations of HDL. Several epidemiological and physiological data indicate that a change in lifestyle (diet, physical training) can significantly improve lipoprotein profile and prognosis of CHD (2,3). Meta-analysis of 60 controlled trials (4), focused on the effects of dietary FAs, clearly demonstrated a significant decrease in LDL concentration when saturated fatty acids (SFAs) in a diet were replaced with unsaturated FAs, and this decrease was accompanied by a significant decrease in HDL concentration.…”

mentioning

confidence: 99%

Replacement of dietary saturated FAs by PUFAs in diet and reverse cholesterol transport

Lesná

Suchánek

Kovář

et al. 2008

Journal of Lipid Research

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Dietary intervention is the first and usually successful approach in the treatment of high LDL cholesterol (LDL-C) concentration, but it is frequently accompanied by a decrease in HDL concentration. We studied 14 male volunteers on two different diets, high saturated fatty acid (SFA) and high PUFA, in a crossover design to test whether a decrease in HDL can affect reverse cholesterol transport from relabeled macrophages. A significant decrease of LDL-C (in mmol/l) after a PUFA diet compared with an SFA diet from 3.15 6 0.65 to 2.80 6 0.56 (P , 0.01) was accompanied by a significant decrease of HDL cholesterol (HDL-C) (in mmol/l) from 1.21 6 0.30 to 1.10 6 0.32 (P , 0.05). These changes did not affect cholesterol efflux (CHE) from macrophages (9.74 6 1.46% vs. 9.53 6 1.41%). There was no correlation between individual changes of HDL-C and changes of CHE. It is concluded that the decrease of HDL-C after successful dietary intervention of LDL-C is not accompanied by a decrease of CHE.-Kralova Lesna, I., P. Coronary heart disease (CHD) due to atherosclerosis of the coronary arteries is the main cause of mortality in the Western world (1). One of the typical phenotypes associated with increased risk of CHD includes increased LDL cholesterol (LDL-C) and reduced concentrations of HDL. Several epidemiological and physiological data indicate that a change in lifestyle (diet, physical training) can significantly improve lipoprotein profile and prognosis of CHD (2, 3). Meta-analysis of 60 controlled trials (4), focused on the effects of dietary FAs, clearly demonstrated a significant decrease in LDL concentration when saturated fatty acids (SFAs) in a diet were replaced with unsaturated FAs, and this decrease was accompanied by a significant decrease in HDL concentration. It is not clear whether such a decrease of HDL cholesterol (HDL-C) concentration compromises the otherwise atheroprotective effect of such a diet change.The importance of low concentrations of HDL as risk factor for cardiovascular diseases was initially demonstrated in Miller et al. (5), and this finding has been repeatedly confirmed (6, 7).HDL represents a large family of particles differing in size, shape, and composition. Among several protective actions of HDL [protection of endothelial function, and anti-oxidative, anti-inflamatory, and anti-aggregative effects (8-10)], the capacity of HDL to accept cellular lipids and reverse cholesterol transport (RCT) are thought to be the most important. RCT is the key pathway for efflux of cholesterol molecules to extracellular acceptors and their transport to the liver to be metabolized to bile acids. Despite the fact that RCT from macrophages contributes only a little to the whole centripetal transport of cholesterol, this pathway is crucial (11), inasmuch as accumulation of esterified cholesterol in these cells is one of the first features of atherosclerosis.RCT is a complex process involving several steps. First, unesterified cholesterol is carried out to the plasma membrane and then is taken up int...

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Improvement in medical risk factors and quality of life in women and men with coronary artery disease in the Multicenter Lifestyle Demonstration Project

Cited by 145 publications

References 23 publications

Recommendations for Treatment of Child and Adolescent Overweight and Obesity

Recommendations for Treatment of Child and Adolescent Overweight and Obesity

Managing Abnormal Blood Lipids

Replacement of dietary saturated FAs by PUFAs in diet and reverse cholesterol transport

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