Mothers in Recovery: An Occupational Perspective

The purposes of this study were to discover the stories of mothers regarding their journeys to addiction and through recovery, to explore the impact of addiction on the occupational performance of mothers and to identify the factors perceived by these mothers as important in their treatment. A narrative inquiry with thematic analysis of data was utilized; semi‐structured interviews were conducted with 10 women in treatment for alcohol or other drug addiction who were all mothers of minor children. Alterations in occupational identity, occupational performance patterns and performance capacity were revealed. Environmental elements contributing to addiction and those important in recovery were identified and included structure (or the lack of it) and the persons populating the social environment. This qualitative study is not generalizable and should be viewed as relevant to these informants in this context; participants had histories of chronic substance addiction and are not representative of all addictions patients. Findings can be viewed within the context of other research to help enrich the reader's understanding of the complexity of issues. Further research is recommended to test the efficacy of occupational therapy interventions for substance addictions. Possible intervention studies might include those focused on environmental structure, exploration of interests in treatment and co‐occupations of mother and child. Copyright © 2011 John Wiley & Sons, Ltd.     

The Metabolic Syndrome

The metabolic syndrome is a cluster of symptoms associated with insulin resistance and known to precede the onset of type 2 diabetes. Overweight and obesity contribute significantly to the development of the metabolic syndrome. In fact, weight loss has a huge impact in decreasing the symptoms associated with the metabolic syndrome. Several studies have demonstrated that just by losing 7% to 10% of initial body weight is sufficient to have improvement in waist circumference, dyslipidemias (elevated triglycerides and low high-density-lipoprotein cholesterol), trunk fat, and plasma glucose. This paper underlines the importance of weight loss and type of diet in reversing the symptoms of the metabolic syndrome     

The Homocysteine and Metabolic Syndrome: A Mendelian Randomization Study

Homocysteine (Hcy) is well known to be increased in the metabolic syndrome (MetS) incidence. However, it remains unclear whether the relationship is causal or not. Recently, Mendelian Randomization (MR) has been popularly used to assess the causal influence. In this study, we adopted MR to investigate the causal influence of Hcy on MetS in adults using three independent cohorts. We considered one-sample MR and two-sample MR. We analyzed one-sample MR in 5902 individuals (2090 MetS cases and 3812 controls) from the KARE and two-sample MR from the HEXA (676 cases and 3017 controls) and CAVAS (1052 cases and 764 controls) datasets to evaluate whether genetically increased Hcy level influences the risk of MetS. In observation studies, the odds of MetS increased with higher Hcy concentrations (odds ratio (OR) 1.17, 95%CI 1.12–1.22, p < 0.01). One-sample MR was performed using two-stage least-squares regression, with an MTHFR C677T and weighted Hcy generic risk score as an instrument. Two-sample MR was performed with five genetic variants (rs12567136, rs1801133, rs2336377, rs1624230, and rs1836883) by GWAS data as the instrumental variables. For sensitivity analysis, weighted median and MR–Egger regression were used. Using one-sample MR, we found an increased risk of MetS (OR 2.07 per 1-SD Hcy increase). Two-sample MR supported that increased Hcy was significantly associated with increased MetS risk by using the inverse variance weighted (IVW) method (beta 0.723, SE 0.119, and p < 0.001), the weighted median regression method (beta 0.734, SE 0.097, and p < 0.001), and the MR–Egger method (beta 2.073, SE 0.843, and p = 0.014) in meta-analysis. The MR–Egger slope showed no evidence of pleiotropic effects (intercept −0.097, p = 0.107). In conclusion, this study represented the MR approach and elucidates the significant relationship between Hcy and the risk of MetS in the Korean population.     

生活方式与代谢综合征的关系

目的探讨生活方式与代谢综合征的关系。方法采用流行病学现况研究的方法，于2003年1月对上海市平凉社区20～74岁居民进行调查，检测代谢综合征的相关指标并记录其生活方式。结果共调查和检测2132名，其中男性852名、女性1280名，代谢综合征现患率为13．4％。代谢综合征患者体质指数（BMI）、腰臀比（WHR）、收缩压（SBP）、舒张压（DBP）、甘油三酯（TG）、总胆固醇（Tc）、低密度脂蛋白胆固醇（LDL-C）及空腹血糖（FPG）均显著高于非代谢综合征者（P〈0．05），高密度脂蛋白胆固醇（HDL-C）显著低于非代谢综合征者（P〈0．05）。BMI、WHR及职业和休闲体力活动均与代谢综合征发生呈显著相关，其OR（95％CI）分别3．37（2．70～4．22）、7．25（5．53～9．51）、0．71（0．56～0．90）和0．74（0．58～0．94）。文化程度高者（受教育年限≥10年）代谢综合征现患率为38．5％，显著低于文化程度低者46．6％（P〈0．01）；其BMI、SBP、DBP、LDL-C、TC、FPG亦显著低于文化程度低者（P〈0．01）。结论影响代谢综合征的主要因素有BMI、WHR、职业和休闲体力活动；教育在代谢综合征现患率中扮演着重要角色。建立良好的生活方式在代谢综合征的预防和控制中有重要意义。     

Metabolic Syndrome and Sarcopenia

Skeletal muscle is a major organ of insulin-induced glucose metabolism. In addition, loss of muscle mass is closely linked to insulin resistance (IR) and metabolic syndrome (Met-S). Skeletal muscle loss and accumulation of intramuscular fat are associated with a variety of pathologies through a combination of factors, including oxidative stress, inflammatory cytokines, mitochondrial dysfunction, IR, and inactivity. Sarcopenia, defined by a loss of muscle mass and a decline in muscle quality and muscle function, is common in the elderly and is also often seen in patients with acute or chronic muscle-wasting diseases. The relationship between Met-S and sarcopenia has been attracting a great deal of attention these days. Persistent inflammation, fat deposition, and IR are thought to play a complex role in the association between Met-S and sarcopenia. Met-S and sarcopenia adversely affect QOL and contribute to increased frailty, weakness, dependence, and morbidity and mortality. Patients with Met-S and sarcopenia at the same time have a higher risk of several adverse health events than those with either Met-S or sarcopenia. Met-S can also be associated with sarcopenic obesity. In this review, the relationship between Met-S and sarcopenia will be outlined from the viewpoints of molecular mechanism and clinical impact.     

Resistant Maltodextrin and Metabolic Syndrome: A Review

Resistant maltodextrin is a non-viscous dietary fiber that is fermentable in the colon by colonic bacteria. The objective of this review is to summarize the studies of resistant maltodextrin and its effect on metabolic profile, such as blood glucose, lipid profile, and body weight. Several studies support the idea that resistant maltodextrin may improve blood glucose, insulin sensitivity, lipid profile, and obesity. However, the use of resistant maltodextrin should be limited to minimize the adverse effect on the gastrointestinal system. This review provides information regarding the benefits of resistant maltodextrin on metabolic health as well as its proposed mechanism to enhance the knowledge of this novel fiber.

• Key teaching points

• Resistant maltodextrin is a novel non-viscous dietary fiber classified as resistant starch type V that is produced by debranching of the starch structure.

• Resistant maltodextrin is fermentable in the colon and thus produces short-chain fatty acid.

• Resistant maltodextrin helps to maintain blood and lipid profiles as well as promote satiety and reducing food intake.

• High intake of resistant maltodextrin may cause gastrointestinal discomfort due to the gas production and increased osmotic pressure.

     

Recent Developments in Rodent Models of High-Fructose Diet-Induced Metabolic Syndrome: A Systematic Review

Metabolic syndrome (MetS) is the physiological clustering of hypertension, hyperglycemia, hyperinsulinemia, dyslipidemia, and insulin resistance. The MetS-related chronic illnesses encompass obesity, the cardiovascular system, renal operation, hepatic function, oncology, and mortality. To perform pre-clinical research, it is imperative that these symptoms be successfully induced and optimized in lower taxonomy. Therefore, novel and future applications for a disease model, if proven valid, can be extrapolated to humans. MetS model establishment is evaluated based on the significance of selected test parameters, paradigm shifts from new discoveries, and the accessibility of the latest technology or advanced methodologies. Ultimately, the outcome of animal studies should be advantageous for human clinical trials and solidify their position in advanced medicine for clinicians to treat and adapt to serious or specific medical situations. Rodents (Rattus norvegicus and Mus musculus) have been ideal models for mammalian studies since the 18th century and have been mapped extensively. This review compiles and compares studies published in the past five years between the multitude of rodent comparative models. The response factors, niche parameters, and replicability of diet protocols are also compiled and analyzed to offer insight into MetS-related disease-specific modelling.     

上海市卢湾区办公楼宇职业办公人群不良建筑综合征调查

[目的]研究办公楼宇职业办公人群不良建筑综合征（sick building syndrome,SBS）与办公环境之间的关系及其主要影响因素。[方法]以是否使用集中式空调为标准将办公楼分组,对办公楼环境进行检测并调查其中办公人群,用个人5项症状（即眼干燥或疼痛,鼻塞、喉干燥或疼痛、头痛和疲倦感5项症状都出现的出现数并结合离开办公室症状消除作为判断依据）进行判别并分析其与环境指标之间的关系。[结果]使用集中式空调办公楼的主要环境影响因素是氨、噪声、湿度和新风量,不使用集中式空调办公楼的主要环境影响因素是甲醛、氨、噪声、温度、照度;使用集中武空调办公楼与不使用集中式空调办公楼办公人群的SBS症状检出率分别为13．2％与10．2％,疲倦、眼干燥或疼痛、皮肤干燥、头痛、喉干分别位居各类症状的前5位。[结论]办公环境温度、环境湿度、新风量3项指标与办公楼宇SBS人群存在相关关系,是办公环境SBS的主要影响因素。     

Second-Trimester Constituents of the Metabolic Syndrome and Pregnancy Outcome: An Observational Cohort Study

Background: Gestational diabetes mellitus (GDM) increases the risk of type 2 diabetes mellitus and cardiovascular disease (CVD) in women in later life. In the general population, metabolic syndrome (MetS) shows identical associations. The aim of this study was to evaluate the association between GDM, constituents of MetS and pregnancy outcomes. Methods: Of 2041 pregnant women undergoing an oral glucose tolerance test (OGTT) between 22 and 30 weeks of gestation, data were collected to evaluate the constituents of MetS. Odds ratios (ORs) were calculated to determine the associations between MetS and pregnancy outcomes. Results: GDM and obesity did not affect the risk of fetal growth abnormalities (SGA/LGA), preterm birth or preeclampsia (PE). Hypertension significantly increased the risk of SGA (OR—1.59), PE (OR—3.14), and preterm birth <37 weeks (OR—2.17) and <34 weeks (OR—2.96) and reduced the occurrence of LGA (OR—0.46). Dyslipidemia increased the risk of PE (OR—2.25), while proteinuria increased the risk of PE (OR—12.64) and preterm birth (OR—4.72). Having ≥2 constituents increased the risk of PE and preterm birth. Conclusions: Constituents of metabolic syndrome, rather than treating impaired glucose handling, increased the risk of preeclampsia, altered fetal growth and preterm birth. Obesity was not related to adverse outcomes.     

Bidirectional Associations between Daytime Napping Duration and Metabolic Syndrome: A Nationally Representative Cohort Study

Background: We aimed to examine the bidirectional associations between daytime napping duration and metabolic syndrome (MetS). Methods: Using data from the China Health and Retirement Longitudinal Study from 2011 to 2015, modified Poisson regression models were performed to explore the longitudinal associations of baseline napping duration with the occurrence and remission of MetS. Generalized estimating equation was conducted to explore the association between baseline MetS status with subsequent changes in daytime napping duration. Cross-lagged panel analysis was performed to further verify their bidirectional relationships. Results: During the four-year follow-up, among 5041 participants without MetS at baseline, extended naps were significantly associated with MetS occurrence, compared with non-napping. This association was only significant in individuals with adequate night-time sleep duration or good sleep quality of the 2898 participants with MetS at baseline. Excessive napping duration may be not favorable for MetS remission especially for adequate night-time sleepers. With respect to reverse associations, baseline MetS status significantly increased the napping duration during the subsequent follow-up period. Finally, there were significant bidirectional cross-lagged associations between napping duration and MetS severity score after adjusting for all covariates. Conclusions: Our study indicates bidirectional relationships exist between daytime napping duration and MetS. Interestingly, longer napping duration was detrimental to cardiometabolic health only in those with sufficient night-time sleep duration or good sleep quality.     

Relationship between Dietary Magnesium Intake and Metabolic Syndrome

Metabolic syndrome (MetS) is increasingly prevalent, and the relationship between dietary magnesium and MetS remains controversial. Therefore, we aimed to explore the association and dose-response relationship between dietary magnesium intake and MetS and its single component. The sample was adults aged 18 years and above who participated in at least two follow-up surveys in 2009, 2015 and 2018. Food consumption data were collected from three consecutive 24-h dietary recalls. The multivariate Cox proportional risk regression model and restricted cubic spline (RCS) model were used to analyze the association and dose-response relationship between dietary magnesium intake and MetS and its components. In our study, 6104 subjects were included, with a total follow-up of 37,173.36 person-years, and the incidence was 33.16%. Cox regression analysis showed that the multivariable-adjusted Hazard Ratio (HR) for MetS comparing the highest to the lowest quintile of dietary magnesium intake was 0.84 (95% confidence intervals [CI] = 0.71–0.99). Central obesity, elevated TG, elevated blood pressure and elevated blood glucose were reduced by 18%, 41%, 20% and 42%, respectively. The risk of decreased HDL-C was reduced by 23% in the third quintile of dietary magnesium intake, with a slightly increased risk in the highest group. RCS analysis showed that the overall and non-linear associations between dietary magnesium and MetS and its components were statistically significant, the risk of them decreased significantly when magnesium intake was lower than 280 mg/day, and then the curve leveled off or slightly increased.     

代谢综合征患者血浆内脂素水平的变化

目的探讨代谢综合征(MS)患者血浆内脂素(visfatin)水平及与胰岛素抵抗(IR)的关系。方法筛选MS患者45例、年龄、性别相匹配的健康成年人40例为对照组。ELISA法测定各组空腹血浆visfatin水平,同时检测空腹血糖(FPG)、胰岛素(FINS)、血脂、血压,测量身高、体重、腰围、臀围计算体重指数(BNI)、腰臀比(WHR),采用HOMA-IR模型公式计算胰岛素抵抗指数。结果MS组visfatin水平明显高于对照组,差异有统计学意义。在MS组,visfatin与BMI、WC、FPG、2hPG、FINS、TG、HOMA-IR呈正相关,r值分别为0.378,0.231,0.419,0.363,0.448,0.423,P均<0.05;与HDL-C无明显相关关系。多元逐步回归分析表明,BMI和visfatin是HOMA-IR的独立影响因素。结论MS患者血浆visfatin水平增高,visfatin与机体糖、脂代谢紊乱密切联系。     

Effectiveness of Workplace-Based Diet and Lifestyle Interventions on Risk Factors in Workers with Metabolic Syndrome: A Systematic Review,Meta-Analysis and Meta-Regression

Workplace health interventions are essential to improve the health and well-being of workers and promote healthy lifestyle behaviours. We carried out a systematic review, meta-analysis and meta-regression of articles measuring the association between workplace dietary interventions and MetS risk. We recovered potentially eligible studies by searching MEDLINE, the Cochrane Library, Embase, Scopus and Web of Science, using the terms “Metabolic syndrome” and “Occupational Health”. A total of 311 references were retrieved and 13 documents were selected after applying the inclusion and exclusion criteria. Dietary interventions were grouped into six main types: basic education/counselling; specific diet/changes in diet and food intake; behavioural change/coaching; physical exercise; stress management; and internet/social networks. Most programmes included several components. The interventions considered together are beneficial, but the clinical results reflect only a minimal impact on MetS risk. According to the metaregression, the interventions with the greatest impact were those that used coaching techniques and those that promoted physical activity, leading to increased HDL (effect size = 1.58, sig = 0.043; and 2.02, 0.015, respectively) and decreased BMI (effect size = −0.79, sig = −0.009; and −0.77, 0.034, respectively). In contrast, interventions offering information on healthy habits and lifestyle had the contrary effect, leading to increased BMI (effect size = 0.78, sig = 0.006), systolic blood pressure (effect size = 4.85, sig = 0.038) and diastolic blood pressure (effect size = 3.34, sig = 0.001). It is necessary to improve the efficiency of dietary interventions aimed at lowering MetS risk in workers.     

Manganese Exposure and Metabolic Syndrome: A Systematic Review and Meta-Analysis

Manganese (Mn) is an essential element acting as a co-factor of superoxide dismutase, and it is potentially beneficial for cardiometabolic health by reducing oxidative stress. Although some studies have examined the relationship between Mn and metabolic syndrome (MetS), no systematic review and meta-analysis has been presented to summarize the evidence. Therefore, the present review examined the association between dietary and environmental Mn exposure, and MetS risk. A total of nine cross-sectional studies and three case-control studies were included, which assessed Mn from diet, serum, urine, and whole blood. The association of the highest Mn level from diet (three studies, odds ratio (OR): 0.83, 95% confidence interval (C.I.) = 0.57, 1.21), serum (two studies, OR: 0.87, 95% C.I. = 0.66, 1.14), urine (two studies, OR: 0.84, 95% C.I. = 0.59, 1.19), and whole blood (two studies, OR: 0.92, 95% C.I. = 0.53, 1.60) were insignificant, but some included studies have suggested a non-linear relationship of urinary and blood Mn with MetS, and higher dietary Mn may associate with a lower MetS risk in some of the included studies. While more evidence from prospective cohorts is needed, future studies should use novel statistical approaches to evaluate relative contribution of Mn on MetS risk along with other inter-related exposures.     

Hypomagnesemia and the Metabolic Syndrome among Apparently Healthy Kuwaiti Adults: A Cross-Sectional Study

Magnesium plays a key role in metabolic disorder development, and hypomagnesemia may be implicated in the pathogenesis of metabolic syndrome (MetS) and its components. In this cross-sectional study, we investigated the associations between hypomagnesemia, MetS, and MetS components among 231 adults (193 women and 38 men) living in Kuwait who were apparently healthy without chronic diseases. We used the International Diabetes Federation (IDF) and the United States National Cholesterol Education Program Adult Treatment Panel III (ATP III) criteria to define participants with MetS. The Ministry of Health cutoff for hypomagnesemia (<0.74 mmol/L) was employed. IDF- and ATP III-defined MetS prevalence was 22.1% and 15.2%, respectively. Hypomagnesemia occurred in 33.3% of all participants and 53.2% of participants with MetS (p < 0.001). Magnesemia correlated negatively with body mass index, waist circumference, systolic blood pressure [SBP], diastolic blood pressure (DBP), fasting blood glucose (FBG), low-density lipoprotein cholesterol level, and triglyceride level; magnesemia correlated positively with high-density lipoprotein cholesterol (HDL-C) levels (p < 0.001). Multivariate logistic regression, adjusting for BMI, age, and sex, showed that hypomagnesemia was associated with a 12- and 5-fold greater odds of getting IDF-defined (adjusted odds ratio [aOR] 11.70; 95% confidence interval [CI] 4.87–28.14) and ATP-defined (aOR 5.44; 95% CI 2.10–14.10) MetS, respectively, in the study population. Hypomagnesemia was significantly associated with a 3.62, 9.29, 7.01, 2.88, 3.64, and 3.27 higher odds of an increased waist circumference (95% CI 1.48–8.85), elevated serum triglyceride level (95% CI 3.97–21.73), elevated FBG (95% CI 3.25–15.11), elevated SBP (95% CI 1.16–7.11), elevated DBP (95% CI: 1.22–10.89), and lowered HDL-C level (95% CI 1.69–6.32), respectively. Hypomagnesemia could be a consequence of the pathophysiology of MetS and its individual components among adults in Kuwait.     

Prevalence and Correlates of Metabolic Syndrome in the Adolescents of Rural Wardha

Background and Objective:

Metabolic syndrome is a major concern as a precursor of cardiometabolic diseases. The present study was designed to study the magnitude and correlates of metabolic syndrome among the adolescents of rural Wardha.

Materials and Methods:

A cross-sectional study was carried out among the adolescents (10-19 years) of Anji PHC. A sample of 405 was selected by random sampling from the sampling frame available with department of Community Medicine. We collected data about their sociodemographic variables and other cardiometabolic risk factors. Fasting blood sample was collected to measure lipid profile and blood glucose. Blood pressure and anthropometric measurements (height, weight, and waist circumference) were also taken.

Results:

Prevalence of metabolic syndrome using ATP-III criteria modified for adolescents was found to be 9.9% (95% CI: 7.3-13.1) in the study population and lower level of high-density lipoprotein (HDL) cholesterol was found with a prevalence of 58.3% (95% CI: 53.4-63.0). The prevalence of metabolic syndrome was found to be significantly (P < 0.05) associated with the presence of obesity and hypertension among family members.

Interpretation:

There was a moderately high prevalence of metabolic syndrome among rural adolescents.

Conclusion:

The early identification of cardiometabolic risk factors such as hypertension and obesity can help prevent metabolic syndrome, diabetes, and cardiovascular disease.     

The Role of Bioactive Compounds from Dietary Spices in the Management of Metabolic Syndrome: An Overview

Metabolic syndrome (MetS) is a combination of physiologically dysregulated parameters that can include elevated fasting blood glucose, high blood pressure, central obesity, increased triglyceride levels, insulin resistance, diabetes, elevated low density lipoprotein levels, and reduced high density lipoprotein levels in the blood. Effective clinical management of MetS is critical as it is strongly associated with long lasting and fatal complications in patients. Alongside standard care of lifestyle changes and medication, dietary supplements derived from herbal resources could be an alternative therapeutic strategy that is safe, efficient, culturally acceptable, and has few side effects. Of the dietary supplements, spicy foods have always been considered a great source of functional bioactive compounds. Herbal therapy is broadly used in many countries as a treatment or as a preventive measure in the management of MetS risk factors, including blood glucose, blood pressure, and blood lipid levels. Herein, an attempt is made to evaluate the recent studies in the management of MetS with herbal alternatives, and to explore the possibility of their use as therapeutic treatments or supplements.     

Added Fructose in Non-Alcoholic Fatty Liver Disease and in Metabolic Syndrome: A Narrative Review

Non-alcoholic fatty liver disease (NAFLD) represents the most common chronic liver disease and it is considered the hepatic manifestation of metabolic syndrome (MetS). Diet represents the key element in NAFLD and MetS treatment, but some nutrients could play a role in their pathophysiology. Among these, fructose added to foods via high fructose corn syrup (HFCS) and sucrose might participate in NAFLD and MetS onset and progression. Fructose induces de novo lipogenesis (DNL), endoplasmic reticulum stress and liver inflammation, promoting insulin resistance and dyslipidemia. Fructose also reduces fatty acids oxidation through the overproduction of malonyl CoA, favoring steatosis. Furthermore, recent studies suggest changes in intestinal permeability associated with fructose consumption that contribute to the risk of NAFLD and MetS. Finally, alterations in the hunger–satiety mechanism and in the synthesis of uric acid link the fructose intake to weight gain and hypertension, respectively. However, further studies are needed to better evaluate the causal relationship between fructose and metabolic diseases and to develop new therapeutic and preventive strategies against NAFLD and MetS.     

代谢综合征在社区的分析调查与监测、防治

资料与方法对呼家楼社区2001年至2003年接受体检的35岁以上居民3152人进行代谢综合征患病情况及其患病因素进行调查分析,了解代谢综合征的患病情况与易患因素。结论代谢综合征的发病率为11.3%。最终发现对WHO建议每日摄盐量知晓程度、健身活动增多,是保护性因素。讨论应根据研究结果,在社区采取相应防治与监测措施,降低社区居民的代谢综合征发病率。