Christina Stuwe’s triple-bypass, open-heart surgery in 2018 was a life-saving procedure for the Calgary mother.
A staggering 70 per cent of Canadians report an unhealthy diet—a risk factor which is often closely associated with the development of chronic disease.
Low-carbohydrate high-fat (LCHF) diets have shown to improve weight loss and cardiovascular health. But for many people, it’s not often clear when or how to implement such a change.
A new UBC Okanagan study explores how primary care physicians and allied health professionals can help patients adopt dietary and lifestyle interventions to improve their overall health.
“LCHF diets restrict the body’s glucose to create a metabolic state called ketosis that focuses a body’s metabolism on fats as opposed to carbohydrates,” says Southern Medical Program student Alex Myshak-Davis and study lead author.
In a family practice setting, study participants chose from four different intake options of carbohydrates, proteins and fats to select a ratio that best matched their personal health goals.
“Hypertension is the most common chronic disease, followed by Type 2 diabetes, obesity, osteoarthritis and chronic kidney disease amongst the study group,” says Dr. Janet Evans, a Kelowna-based family physician and affiliate clinician with the Centre for Chronic Disease and Management (CCDPM) based at UBC Okanagan.
Patients participated in educational sessions led by a registered nurse on a one-on-one basis or a small group. Follow-up support included a combination of in-person or telephone consultations and small group sessions. These were about 20 minutes long and included a review of progress, successes, struggles and strategies to help patients reach their goals.
“Participants who followed an LCHF diet experienced weight loss and a body mass index (BMI) reduction,” says Myshak-Davis. “Those who participated in ongoing health education with the registered nurse saw a greater improvement in weight, BMI, blood pressure, diabetes control and kidney function.”
Ultimately, the results demonstrate how health education and promotion delivered in a primary care setting can lead to improved health outcomes and quality of life for patients, adds Dr. Evans.
Dr. Brodie Sakakibara, CCDPM investigator and Assistant Professor with the UBC Department of Occupational Science and Occupational Therapy, was a key contributor to this study which was published recently in Family Practice.
TUESDAY, Jan. 31, 2023 (HealthDay News) — Self-reported lifestyle and health behavior information can predict incident chronic kidney disease (CKD), according to a study published in the January issue of the Clinical Journal of the American Society of Nephrology.
Ariana J. Noel, M.D., from the University of Ottawa in Canada, and colleagues developed and validated a survey-based prediction equation to identify individuals at risk for incident CKD. Data were obtained from 22,200 adults with an estimated glomerular filtration rate (eGFR) ≥70 mL/min/1.73 m2 who completed a comprehensive general population health survey between 2000 and 2015. Demographics, comorbidities, lifestyle factors, diet, and mood were included in prediction equations. Models with and without baseline eGFR were derived and validated externally in 15,522 participants from the U.K. Biobank. The primary outcome was new-onset CKD.
The researchers found that during a median follow-up of 4.2 years, new-onset CKD occurred in 1,981 participants (9 percent). Lifestyle factors (smoking, alcohol, physical activity) and comorbid illnesses (diabetes, hypertension, cancer) were included in the final models. For individuals with and without a baseline eGFR measure, the model was discriminating (five-year C statistic, 83.5 and 81.0, respectively) and was well calibrated. The five-year C-statistic was 78.1 and 66.0 in external validation with and without baseline eGFR, respectively, and maintained calibration.
“Our equation demonstrated excellent discrimination and calibration, and may serve as a patient-facing tool to improve CKD awareness and education,” the authors write.
Several authors disclosed financial ties to the biopharmaceutical industry.
Christina Stuwe’s triple-bypass, open-heart surgery in 2018 was a life-saving procedure for the Calgary mother.
But the need for the surgery nearly went undetected by health professionals, as tests for her irregular heartbeat came back inconclusive and she was told to come back in a year.
It was only after Stuwe and her husband pushed for further testing, including an angiogram, that they discovered multiple blocked arteries in her heart — and the fact she unknowingly had a heart attack three years earlier.
“The way my heart was reacting really put everyone off, and they couldn’t really explain it,” Stuwe said.
“Once something was identified with my heart, it was like it was being put off even though we obviously knew something was wrong . . . If I had waited a year, who knows, I might have had another heart attack and been gone.”
Stuwe’s experience highlights a Canadian health system that sometimes struggles to provide adequate care to women with cardiovascular disease.
Gendered gaps in medical diagnosis and care, as well as research and awareness, put women at heightened risk from both heart and brain disease, according to a report from the Heart and Stroke Foundation released Wednesday.
That report says women face different risk factors than men for heart disease due to biological differences, but that health systems historically have fallen short in considering those differences. The inequities worsen when factoring in groups including women of colour, women with low socioeconomic status and women living in rural or remote areas.
Heart disease is the leading cause of premature death in Canadian women, said Dr. Kara Nerenberg, a clinician-scientist at the University of Calgary Cumming School of Medicine whose work focuses on preventing heart disease and stroke in younger women.
She said in the past, much cardiovascular research specific to women has been excluded by researchers to avoid dealing with the complexities of menstrual cycles or pregnancies in their studies.
That means some treatments developed to treat heart disease that work well in men don’t work for women, Nerenberg said.
“That’s potentially because of a different biology, the hormonal changes and how it affects drug metabolism, or even just the dosing of medications,” Nerenberg said, adding women are underdiagnosed when it comes to heart disease.
“We know that even in Alberta, women receive fewer cardiac tests and fewer cardiac medications.”
Some conditions of pregnancy can increase risk of cardiovascular disease, Nerenberg said, underlining a need for better and more regular screenings for women.
She said health-care providers, as well as women, should be aware of different ways that heart disease presents itself between men and women.
“We do know that a lot of women will have the same symptoms of men of heart disease — chest pain, shortness of breath. But women also commonly experience different symptoms, like fatigue or different types of pain, and they may not describe it the same way as men,” she said.
“As a society as a whole, we need to put more attention to signs in our own bodies, and that’s male or female. I think too many times, we put things off because life is busy, but we have to pay attention to ourselves,” Stuwe said.
Summary: High consumption of ultra-processed foods, including soda, chips, and some white bread products, was associated with an increased risk of developing and dying from certain kinds of cancer, including brain cancer.
Source: Imperial College London
Higher consumption of ultra-processed foods may be linked to an increased risk of developing and dying from cancer, an Imperial College London-led observational study suggests.
Researchers from Imperial’s School of Public Health have produced the most comprehensive assessment to date of the association between ultra-processed foods and the risk of developing cancers.
Ultra-processed foods are food items which have been heavily processed during their production, such as fizzy drinks, mass-produced packaged breads, many ready meals and most breakfast cereals.
Ultra-processed foods are often relatively cheap, convenient, and heavily marketed, often as healthy options. But these foods are also generally higher in salt, fat, sugar, and contain artificial additives. It is now well documented that they are linked with a range of poor health outcomes including obesity, type 2 diabetes and cardiovascular disease.
The first UK study of its kind used UK Biobank records to collect information on the diets of 200,000 middle-aged adult participants. Researchers monitored participants’ health over a 10-year period, looking at the risk of developing any cancer overall as well as the specific risk of developing 34 types of cancer. They also looked at the risk of people dying from cancer.
The study found that higher consumption of ultra-processed foods was associated with a greater risk of developing cancer overall, and specifically with ovarian and brain cancers. It was also associated with an increased risk of dying from cancer, most notably with ovarian and breast cancers.
For every 10 percent increase in ultra-processed food in a person’s diet, there was an increased incidence of 2 percent for cancer overall, and a 19 percent increase for ovarian cancer specifically.
Each 10 percent increase in ultra-processed food consumption was also associated with increased mortality for cancer overall by 6 percent, alongside a 16 percent increase for breast cancer and a 30 percent increase for ovarian cancer.
These links remained after adjusting for a range of socio-economic, behavioral and dietary factors, such as smoking status, physical activity and body mass index (BMI).
The Imperial team carried out the study, which is published in eClinicalMedicine, in collaboration with researchers from the International Agency for Research on Cancer (IARC), University of São Paulo, and NOVA University Lisbon.
Previous research from the team reported the levels of consumption of ultra-processed foods in the UK, which are the highest in Europe for both adults and children. The team also found that higher consumption of ultra-processed foods was associated with a greater risk of developing obesity and type 2 diabetes in UK adults, and a greater weight gain in UK children extending from childhood to young adulthood.
Dr. Eszter Vamos, lead senior author for the study, from Imperial College London’s School of Public Health, said, “This study adds to the growing evidence that ultra-processed foods are likely to negatively impact our health including our risk for cancer. Given the high levels of consumption in UK adults and children, this has important implications for future health outcomes.
“Although our study cannot prove causation, other available evidence shows that reducing ultra-processed foods in our diet could provide important health benefits. Further research is needed to confirm these findings and understand the best public health strategies to reduce the widespread presence and harms of ultra-processed foods in our diet.”
Dr. Kiara Chang, first author for the study, from Imperial College London’s School of Public Health, said, “The average person in the UK consumes more than half of their daily energy intake from ultra-processed foods.
“This is exceptionally high and concerning as ultra-processed foods are produced with industrially derived ingredients and often use food additives to adjust color, flavor, consistency, texture, or extend shelf life.
“Our bodies may not react the same way to these ultra-processed ingredients and additives as they do to fresh and nutritious minimally processed foods. However, ultra-processed foods are everywhere and highly marketed with cheap price and attractive packaging to promote consumption. This shows our food environment needs urgent reform to protect the population from ultra-processed foods.”
The World Health Organization and the United Nations’ Food and Agriculture Organization has previously recommended restricting ultra-processed foods as part of a healthy sustainable diet.
There are ongoing efforts to reduce ultra-processed food consumption around the world, with countries such as Brazil, France and Canada updating their national dietary guidelines with recommendations to limit such foods. Brazil has also banned the marketing of ultra-processed foods in schools. There are currently no similar measures to tackle ultra-processed foods in the UK.
Dr. Chang added, “We need clear front of pack warning labels for ultra-processed foods to aid consumer choices, and our sugar tax should be extended to cover ultra-processed fizzy drinks, fruit-based and milk-based drinks, as well as other ultra-processed products.
“Lower income households are particularly vulnerable to these cheap and unhealthy ultra-processed foods. Minimally processed and freshly prepared meals should be subsidized to ensure everyone has access to healthy, nutritious and affordable options.”
The researchers note that their study is observational, so does not show a causal link between ultra-processed foods and cancer due to the observational nature of the research. More work is needed in this area to establish a causal link.
Original Research: The findings will appear in eClinicalMedicine
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