As the population in Missouri ages and as health care costs continue to present a challenge to governments, employers and individuals, there is a greater awareness that lifestyle choices and changes will be critical in improving health and decreasing costs in the coming years. A key provision of maintaining or improving general health is increased physical activity and effective, regular exercise. This is even more important in light of the growing epidemic of obesity and inactivity in American society. The difficulty faced by health care providers and patients is that there exists some public confusion and uncertainty about what lifestyle changes are healthy and substantiated by good science and which ones are based on myth and the influence of lobbying dollars. Although no single compendium of articles can address all of the issues in this huge spectrum of nutrition and physical activity research, in this issue of Missouri Medicine there are six articles that shed substantial light on strategies that can be beneficially implemented for prevention and treatment of lifestyle related diseases associated with obesity and inactivity.
Is linoleic acid pro-inflammatory and should vegetable oils rich in linoleic acid be avoided? Kevin Fritsche summarizes the proposals that omega-polyunsaturated fatty acids (PUFA) such as linoleic acid may cause increases in inflammation. His recent meta-analysis of the literature clearly demonstrates that the science does not currently support the proposal that linoleic acid is pro-inflammatory and therefore the current recommendations for dietary intake of omega-6 PUFA are based on the best available evidence.
Health care providers often lack the time with patients to adequately assess lifestyle behaviors and recommend appropriate and customized changes. Sara Gable and Aneesh Tosh provide motivational interview techniques and some straightforward advice to quick assessment of lifestyle behaviors for children within the context of their specific family environment. These evidence-based strategies will help physicians assess lifestyle risks and suggest lifestyle changes specific to the patient and their family.
Although the obesity epidemic has gained wide attention, it appears to correlate with another major nutritionally centered epidemic of vitamin D deficiency. Catherine Peterson and Anthony Belenchia make a convincing case that there may be a partial causal link between these two epidemics. Vitamin D deficiency is not only found disproportionately in obese patients but correcting the deficiency improves glycemic control in the patients. This simple and safe intervention appears to be one effective treatment in obese patients and may confer a variety of other health benefits.
Fit To Recommend: Editor’s Choice.
Fitbit™ Wireless Activity Trackers
Tracks steps, distance, calories burned and stairs climbed.
Monitors your sleep and wakes you with a silent alarm.
Wirelessly syncs to computers and select smartphones.
Sweat, rain, and splash proof.
Includes clip, wireless sync dongle, charging cable and sleep band.
Source: www.fitbit.com
Editor’s Note
I have the ‘Zip’ Fitbit and my wife has the ‘One’ Fitbit. These are much better than the multitude of pedometers we’ve tried in the past. Weekly summaries available on free personalized account at fitbit.com website. I target 10,000 steps/day.
Standing Desks - Purported Benefits
A 2013 study by the University of Chester showed that using a standing desk caused the heart to beat an average of 10 beats faster per minute than when sitting. This equates to an additional 50 calories an hour burnt. Extrapolated over an average of 3 hours standing a day, 5 days a week, it equates to 750 calories a week; 30,000 extra calories burnt a year.
Prolonged stationary periods are linked with problems of blood glucose control and reduced production of the enzyme lipoprotein lipase, both of which contribute to an increased risk of heart attack. The study found the blood glucose of those using standing desks “fell back to normal levels after a meal far more quickly” than those who sat. One volunteer with arthritis also reported improved symptoms after using a standing desk.
Manufacturers of standing desks point to several studies showing reduced back injuries or less back pain for the users of standing desks. In February 2010, Olivia Judson wrote a post in the Opinionator (an online commentary section of the New York Times) about the benefits of using a standing desk. A study published in Diabetes Care established a relationship between ill health and a sedentary lifestyle and a study by the American Cancer Society published in July 2010, found that “time spent sitting was independently associated with total mortality, regardless of physical activity level.”
Source: wikipedia.com
Editor’s Note
Alternating use of both the standing and sitting position at work is desirable to minimize potential long time orthopedic and venous stasis problems. “Walk as much as possible” is as “sitting is the new smoking.”
It would certainly be easier to restrict caloric intake if we weren’t so hungry all of the time. In this issue Heather Leidy considers studies of ad libitum feeding of free living people with different protein intakes which indicate that weight control is enhanced and fat mass loss is enhanced with a higher protein diet. Further studies suggest a direct effect of protein on increasing satiety throughout the day. Approximately 30 grams of protein (approximately 1½ servings of high quality protein) per eating session seems to confer the increased satiety. Increasing high quality dietary protein may be an effective way to reduce appetite, maintain better weight control and improve body composition.
As the population ages, a key concern for many patients is the risk of bone fractures including hip and spine fracture. Melissa Cater and Pam Hinton explore the problem of low bone density and effective strategies to enhance bone density and strength. The common strategy to help patients with osteoporosis is pharmaceutical therapy designed to decrease bone resoprtion or increase bone formation. These drugs often have unpleasant side effects and have a low rate of compliance. They provide excellent evidence that weight bearing exercise with impact and resistance exercise are effective strategies to preserve bone mass and reduce the risk of fractures.
In our obesogenic environment, chronic inflammation arises in large part from white adipose tissue. Chronic inflammation may be a primary contributor to cardiovascular disease. Young-Min Park, Margo Myers and Victoria Vieira-Potter examine the evidence that indicates that physical inactivity is a direct cause of the inflammation associated with obesity and that physical activity can mitigate the inflammatory disturbances even without weight loss. A number of molecular mechanisms are outlined suggesting that exercise may reduce inflammation in white adipose tissue by a variety of pathways and mechanisms suggesting it is a simple an robust way to reduce chronic inflammation and the morbidity and mortality associated with chronic inflammation.
Biography
Christopher Hardin, PhD, is the Professor and Chair in the Department of Nutrition and Exercise Physiology and Professor in the Department of Medical Pharmacology and Physiology at Missouri University.
Contact: hardinc@missouri.edu
