Resistance training improves body composition and increases matrix metalloproteinase 2 activity in biceps and gastrocnemius muscles of diet-induced obese rats

OBJECTIVE:

We investigated the influence of resistance training on body composition and matrix metalloproteinase 2 activity in skeletal muscles of rats fed a high-fat diet.

METHODS:

Thirty-two Wistar rats were divided into four experimental groups (n = 8/each) according to diet and exercise status: Control (standard diet), Obese Control (high-fat diet), Resistance Training (standard diet) and Obese Resistance Training (high-fat diet) groups. Animals were fed a high-fat diet for 12 weeks to promote excessive weight gain. Resistance Training groups performed 12 weeks of training periods after this period in a vertical ladder three times/week. Fat percentage, fat-free mass and fat mass were assessed using dual-energy X-ray absorptiometry, and matrix metalloproteinase 2 activity in biceps and gastrocnemius muscles was analyzed using zymography.

RESULTS:

Resistance training significantly reduced body and fat masses and fat percentages in both trained groups (p<0.05). The maximal carrying load between trained groups was not different, but relative force was higher in the Resistance Training group (p<0.05). Of note, increased matrix metalloproteinase 2 activity was noted in the tested muscles of both trained groups (p<0.05).

CONCLUSION:

In conclusion, altered body composition and muscle matrix metalloproteinase 2 activity promoted by excessive weight gain were positively modified by resistance training.     

The effects of exercise modalities on adiposity in obese rats

OBJECTIVE:

The aim of the present study was to evaluate the effect of both swimming and resistance training on tumor necrosis factor-alpha and interleukin-10 expression, adipocyte area and lipid profiles in rats fed a high-fat diet.

METHODS:

The study was conducted over an eight-week period on Wistar adult rats, who were divided into six groups as follows (n = 10 per group): sedentary chow diet, sedentary high-fat diet, swimming plus chow diet, swimming plus high-fat diet, resistance training plus chow diet, and resistance training plus high-fat diet. Rats in the resistance training groups climbed a vertical ladder with weights on their tails once every three days. The swimming groups swam for 60 minutes/day, five days/week.

RESULTS:

The high-fat diet groups had higher body weights, a greater amount of adipose tissue, and higher tumor necrosis factor-alpha expression in the visceral adipose tissue. Furthermore, the high-fat diet promoted a negative change in the lipid profile. In the resistance training high-fat group, the tumor necrosis factor-alpha expression was lower than that in the swimming high-fat and sedentary high-fat groups. Moreover, smaller visceral and retroperitoneal adipocyte areas were found in the resistance training high-fat group than in the sedentary high-fat group. In the swimming high-fat group, the tumor necrosis factor-alpha expression was lower and the epididymal and retroperitoneal adipocyte areas were smaller compared with the sedentary high-fat group.

CONCLUSION:

The results showed that both exercise modalities improved the lipid profile, adiposity and obesity-associated inflammation in rats, suggesting their use as an alternative to control the deleterious effects of a high-fat diet in humans.     

Effects of traditional Chinese medicine on rats with Type II diabetes induced by high-fat diet and streptozotocin: a urine metabonomic study

Background

Type II diabetes has become a serious threat to human health in recent years. Among adults above 20 years old in China, the prevalence rate of diabetes is 9.7%. Thus, it is imperative to study the mechanisms underlying type II diabetes to develop effective therapeutic treatments.

Objective

To examine metabolic changes in a rat model of type II diabetes and explore mechanisms underlying the beneficial effects of traditional Chinese medicine (TCM) in this model. 120 rats were divided into four groups, including a control group, a high-fat diet group (high-fat diet and streptozotocin injection), a TCM group (high-fat diet, streptozotocin injection, followed by TCM administration), and a rosiglitazone maleate group (high-fat diet, streptozotocin injection, followed by rosiglitazone maleate administration). Metabolites in urine samples from 1–3 weeks (time point 1) and 4–6 weeks (time point 2) of drug administration were compared by gas chromatography-mass spectrometry (GC-MS).

Results

Our results showed that in the high-fat diet group, at time point 2, the levels of dihydroxybenzoic acid, L-ascorbic acid, D-gluconic acid, octadecanoic acid, and glutaric acid in urine were significantly higher than at time point 1. In the TCM group, at time point 2, the urine levels of L-ascorbic acid were markedly lower than at time point 1.

Conclusion

Our studies demonstrated that examining urine metabolic changes provided important insights into the mechanisms underlying type II diabetes as well as the therapeutic effects of TCM.     

Adhesion-preventing properties of 4% icodextrin and canola oil: a comparative experimental study

OBJECTIVE:

Postsurgical abdominal adhesions are common, serious postoperative complications. The present study compared the usefulness of 4% icodextrin and canola oil in preventing postoperative peritoneal adhesions.

METHODS:

Twenty-four Wistar albino rats were divided into three groups. Following a laparotomy, a serosal abrasion was made by brushing the cecum, and 3 mL of 0.9% NaCl, 4% icodextrin, or 3 mL of canola oil were intraperitoneally administered for the control, icodextrin, and canola oil groups, respectively. The abdomen was then closed. All of the rats were sacrificed at day 10. Macroscopic, histopathological, and biochemical evaluations were performed. The results were statistically analyzed using Kruskal–Wallis and ANOVA tests.

RESULTS:

Macroscopic analyses revealed that both canola oil and 4% icodextrin reduced adhesion formation, but the difference was not statistically significant (p = 0.17). The histopathological examinations revealed no significant differences in terms of giant cell, lymphocyte/plasmocyte, neutrophil, ICAM1, or PECAM1 scores. However, both canola oil and 4% icodextrin significantly reduced fibrosis (p = 0.025). In the canola oil group, the histiocytic reactions were significantly increased (p = 0.001), and the hydroxyproline levels were significantly lower than those in the other groups (p = 0.034).

CONCLUSIONS:

In the present study, canola oil was determined to be superior to 4% icodextrin in lowering hydroxyproline levels and increasing histiocytic reactions. Considering these results, we believe that canola oil is a promising agent for preventing adhesion formation.     

Weight reduction improves markers of hepatic function and insulin resistance in type-2 diabetic patients with non-alcoholic fatty liver

Objective

The incidence of non-alcoholic fatty liver disease (NAFLD) is increasing dramatically affecting up to 30% of the population worldwide. At present, treatment options are limited and pharmacological management of NAFLD has had disappointing results. Some of the best available evidence to improve NAFLD concerns lifestyle modification.

Objective

To detect the degree of weight reduction needed to improve the markers of hepatic function and insulin resistance in type-2 diabetics with NAFLD.

Methods

One hundred type-2 diabetic male patients with NAFLD were included into this study and divided into two equal groups. Group (A) received aerobic exercise training in addition to diet regimen. Group (B) received no treatment intervention.

Results

There was a 26.99%, 40.8%, 33.81%, 32.73%, 37.8% and 15 % reduction in mean values of Alkaline Phosphatase (ALP), Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Gamma - Glutamyltransferase (GGT) and Homeostasis Model Assessment-Insulin Resistance-index (HOMA-IR) and BMI respectively in group (A) at the end of the study. While there were significant differences between mean levels of the investigated parameters in group (A) and group (B) after treatment.

Conclusion

About 15 % reduction in BMI is effective to improve the liver condition and insulin resistance in type-2 diabetics with NAFLD.     

Comparison of the Body Adiposity Index to Body Mass Index in Korean Women

Purpose

Obesity is a major public health issue and is associated with many metabolic abnormalities. Consequently, the assessment of obesity is very important. A new measurement, the body adiposity index (BAI), has recently been proposed to provide valid estimates of body fat percentages. The objective of this study was to compare the BAI and body mass index (BMI) as measurements of body adiposity and metabolic risk.

Materials and Methods

This was a cross-sectional analysis performed on Korean women. The weight, height, and hip circumferences of 2950 women (mean age 25±5 years old, 18-39 years) were measured, and their BMI and BAI [hip circumference (cm)/height (m)^1.5-18] values were calculated. Bioelectric impedance analysis was used to evaluate body fat content. Glucose tolerance status was assessed with a 75-g oral glucose tolerance test, and insulin sensitivity was estimated with the insulin sensitivity index.

Results

BMI was more significantly correlated with fat mass and fat percentage. Additionally, BMI was also more significantly associated with metabolic parameters, including fasting glucose, post-load 2-h glucose, fasting insulin, post-load 2-h insulin, triglycerides, and high density lipoprotein cholesterol than BAI. Receiver operating characteristic curve analysis revealed that BMI was a better tool for predicting body fat percentage than BAI. Insulin sensitivity and metabolic syndrome were more significantly associated with BMI than with BAI.

Conclusion

In Korean women, the current BMI-based classifications for obesity might be superior to BAI-based measurements for determining obesity and predicting metabolic risk.     

Sex Differences in the Association of Regional Fat Distribution with the Severity of Obstructive Sleep Apnea

Study Objectives:

To describe sex differences in the associations between severity of obstructive sleep apnea (OSA) and measures of obesity in body regions defined using both dual-energy absorptiometry and traditional anthropometric measures in a sleep-clinic sample.

Design:

A prospective case-series observational study.

Setting:

The Western Australian Sleep Health Study operating out of the Sir Charles Gairdner Hospital Sleep Clinic, Perth, Western Australia.

Participants:

Newly referred clinic patients (60 men, 36 women) suspected of having OSA.

Interventions:

N/A

Measurements and Results:

Obstructive sleep apnea severity was defined by apnea-hypopnoea index from laboratory-based overnight polysomnography. Body mass index, neck, waist and hip circumference, neck-to-waist ratio, and waist-to-hip ratio were measured. Dual energy absorptiometry measurements included percentage fat and lean tissue. Multivariate regression models for each sex were developed. In women, percentage of fat in the neck region and body mass index together explained 33% of the variance in apnea-hypopnea index. In men, percentage of fat in the abdominal region and neck-to-waist ratio together accounted for 37% of the variance in apnea-hypopnea index.

Conclusions:

Regional obesity is associated with obstructive sleep apnea severity, although differently in men and women. In women, a direct influence of neck fat on the upper airway patency is implicated. In men, abdominal obesity appears to be the predominant influence. The apnea-hypopnea index was best predicted by a combination of Dual Energy Absorptiometry-measured mass and traditional anthropometric measurements.

Citation:

Simpson L; Mukherjee S; Cooper MN; Ward KL; Lee JD; Fedson AC; Potter J; Hillman Fanzca DR; Eastwood P; Palmer LJ; Kirkness J. Sex differences in the association of regional fat distribution with the severity of obstructive sleep apnea. SLEEP 2010;33(4):467-474     

Schisandra Chinensis Baill,A Chinese Medicinal Herb,Alleviates High-Fat-Diet-Inducing Non-Alcoholic Steatohepatitis in Rats

Background

he present study aims to explore whether Schisandra chinensis Baill, a Chinese, medicinal herb can alleviates high-fat-diet-inducing non-alcoholic steatohepatitis in rats.

Materials and Methods

In the study, 24, male Wister rats with body weight between 180-220g, were included. The rats were randomly divided into four groups: model group, normal control group, rosiglitazone group, and Schisandra chinensis Baill group. The treatment lasted for 56, days. The high-fat diet used in the present study includes 25% lard, 2%, cholesterol 0.5%, sodium cholate, and 25%, Tween-80. The hepatic levels of superoxide dismutase (SOD), and malondialdehyde (MDA); the serum levels of total cholesterol (TC), and low-density lipoprotein cholesterol (LDLC), were detected.

Results

We found that the hepatic levels of SOD were significantly lower, and the serum levels of TC, LDLC as well as, the hepatic levels of MDA in model group were significantly higher than those of normal control group; rosiglitazone group and Schisandra chinensis Baill group (P<0.05), indicates that non-alcoholic steatohepatitis rats were successfully induced by high-fat diet. Schisandra chinensis Baill group presented a significant lower serum levels of LDLC, than rosiglitazone group (P<0.05); and the hepatic levels of SOD in Schisandra chinensis Baill group were significantly lower than rosiglitazone group (P<0.05). However, no significant difference existed between Schisandra chinensis Baill group, and rosiglitazone group on the hepatic levels of MDA and the serum levels of TC (P>0.05).

Conclusion

It is then concluded that Schisandra chinensis Baill can significantly alleviate the non-alcoholic steatohepatitis of the rats induced by high-fat diet, and it may be used as a complementary therapy for rosiglitazone.     

Dietary patterns in Brazilian patients with non-alcoholic fatty liver disease: a cross-sectional study

OBJECTIVE:

Recent evidence suggests that non-alcoholic fatty liver disease is associated with diet. Our aim was to investigate the dietary patterns of a Brazilian population with this condition and compare them with the recommended diet.

METHODS:

A cross-sectional study was conducted on 96 non-alcoholic fatty liver disease patients before any dietetic counseling. All patients underwent abdominal ultrasound, biochemical tests, dietary evaluations, and anthropometric evaluations. Their food intake was assessed by a semi-quantitative food-frequency questionnaire and 24-hour food recall.

RESULTS:

The median patient age was 53 years, and 77% of the individuals were women. Most (67.7%) participants were obese, and a large waist circumference was observed in 80.2% subjects. Almost 70% of the participants had metabolic syndrome, and 62.3% presented evidence of either insulin resistance or overt diabetes. Most patients (51.5, 58.5, and 61.7%, respectively) exceeded the recommendations for energy intake, as well as total and saturated fat. All patients consumed less than the amount of recommended monounsaturated fatty acids, and 52.1 and 76.6% of them consumed less polyunsaturated fatty acids and fiber, respectively, than recommended. In most patients, the calcium, sodium, potassium, pyridoxine, and vitamin C intake did not meet the recommendations, and in 10.5-15.5% of individuals, the tolerable upper limit intake for sodium was exceeded. The patients presented a significantly high intake of meats, fats, sugars, legumes (beans), and vegetables and a low consumption of cereals, fruits, and dairy products compared with the recommendations.

CONCLUSIONS:

Although patients with non-alcoholic fatty liver disease exhibited high energy and lipid consumption, most of them had inadequate intake of some micronutrients. The possible role of nutrient-deficient intake in the development of non-alcoholic fatty liver disease warrants investigation.     

Low serum 25(OH)D levels are assoc?ated to h?gher BMI and metabolic syndrome parameters in adult subjects in Turkey

Background

The aim of this study was to investigate the association of 25(OH)D levels with biochemical, anthropometric, and metabolic data obtained from normal and obese people.

Methods

This study was carried out on 90 individuals between the ages of 18 to 63 that had various body mass indexes. Blood samples and anthropometric measurements were taken.

Results

Waist circumferences, fat mass, LDL cholesterol levels, HDL cholesterol levels, 25(OH)D levels, and triglyceride levels were significantly different according to the body mass index groups of the participants (p<0.05). When compared to the normal body mass index group, both other groups (overweight and obese) had higher waist circumferences, triglyceride levels, LDL cholesterol levels, fasting insulin levels, HOMA-IR ratios, parathyroid hormone levels, and fat mass, and had lower 25(OH)D levels (p<0.05). The overweight group participants had higher 25(OH)D levels than the obese group, and had lower waist circumferences, fat mass, fasting insulin level, HOMA-IR ratios, and HbA1C and PTH levels than those in the obese group (p<0.05).

Conclusion

In conclusion, the mean level of 25(OH)D is very low in overweight and obese individuals and low serum 25(OH)D levels appear to be associated with obesity, visceral obesity, hypertriglyceridemia, insulin resistance, and metabolic syndrome in obese patients.     

Web-based risk communication and planning in an obese population: exploratory study

Background

A healthy diet, low in saturated fat and high in fiber, is a popular medical recommendation in preventing cardiovascular disease (CVD). One approach to motivating healthier eating is to raise individuals’ awareness of their CVD risk and then help them form specific plans to change.

Objectives

The aim was to explore the combined impact of a Web-based CVD risk message and a fully automated planning tool on risk perceptions, intentions, and saturated fat intake changes over 4 weeks.

Methods

Of the 1187 men and women recruited online, 781 were randomly allocated to one of four conditions: a CVD risk message, the same CVD risk message paired with planning, planning on its own, and a control group. All outcome measures were assessed by online self-reports. Generalized linear modeling was used to analyze the data.

Results

Self-perceived consumption of low saturated fat foods (odds ratio 11.40, 95% CI 1.86–69.68) and intentions to change diet (odds ratio 21.20, 95% CI 2.6–172.4) increased more in participants allocated to the planning than the control group. No difference was observed between the four conditions with regard to percentage saturated fat intake changes. Contrary to our expectations, there was no difference in perceived and percentage saturated fat intake change between the CVD risk message plus planning group and the control group. Risk perceptions among those receiving the CVD risk message changed to be more in line with their age (change in slope_individual = 0.075, P = .01; change in slope_comparative = 0.100, P = .001), whereas there was no change among those who did not receive the CVD risk message.

Conclusion

There was no evidence that combining a CVD risk message with a planning tool reduces saturated fat intake more than either alone. Further research is required to identify ways in which matching motivational and volitional strategies can lead to greater behavior changes.

Trial Registration

International Standard Randomized Controlled Trial Number (ISRCTN): 91154001; http://www.controlled-trials.com/ISRCTN91154001 (Archived by WebCite at http://www.webcitation.org/62sBoGeOO)     

Fresh Soy Oil Protects Against Vascular Changes in an Estrogen-Deficient Rat Model: An Electron Microscopy Study

OBJECTIVE

To observe the effects of consuming repeatedly heated soy oil on the aortic tissues of estrogen-deficient rats.

METHODS

Thirty female Sprague Dawley rats (200–250 g) were divided equally into five groups. One group served as the normal control (NC) group. The four treated groups were ovariectomized and were fed as follows: 2% cholesterol diet (OVXC); 2% cholesterol diet + fresh soy oil (FSO); 2% cholesterol diet + once-heated soy oil (1HSO); and 2% cholesterol diet + five-times-heated soy oil (5HSO). After four months, the rats were sacrificed, and the aortic tissues were obtained for histological studies.

RESULTS

After four months of feeding, the NC, FSO and 1HSO groups had a lower body weight gain compared to the OVXC and 5HSO groups. The tunica intima/media ratio in the 5HSO group was significantly thicker (p < 0.05) compared to the NC, OVXC and FSO groups. Electron microscopy showed that endothelial cells were normally shaped in the FSO and NC groups but irregular in the 1HSO and 5HSO groups. A greater number of collagen fibers and vacuoles were observed in the 5HSO group compared to the other treatment groups.

CONCLUSIONS

Fresh soy oil offered protection in the estrogen-deficient state, as these rats had similar features to those of the NC group. The damage to the tunica intima and the increase in the ratio of tunica intima/media thickness showed the deleterious effect of consuming repeatedly heated soy oil in castrated female rats.     

Metabolic syndrome in patients with chronic hepatitis C virus genotype 1 infection who do not have obesity or type 2 diabetes

OBJECTIVE:

The individual components of metabolic syndrome may be independent predictors of mortality in patients with liver disease. We aimed to evaluate the prevalence of metabolic syndrome and its related components in hepatitis C virus–infected patients who are not obese and do not have type 2 diabetes.

METHODS:

This cross-sectional study included 125 patients infected with hepatitis C virus genotype 1. Metabolic syndrome was defined according to the International Diabetes Federation. Anthropometric data were measured according to standardized procedures. Bioimpedance analysis was performed on all patients.

RESULTS:

Metabolic syndrome was diagnosed in 21.6% of patients. Of the subjects with metabolic syndrome, 59.3% had hypertension, 77.8% had insulin resistance, 85.2% were overweight, 48.1% had a high waist circumference, 85.2% had an increased body fat percentage, and 92.3% had an elevated waist:hip ratio. In the bivariate analysis, female sex (OR 2.58; 95% CI: 1.09–6.25), elevated gamma-glutamyl transferase (γGT) (OR 2.63; 95% CI: 1.04–7.29), elevated fasting glucose (OR 8.05; 95% CI: 3.17-21.32), low HDL cholesterol (OR 2.80; 95% CI: 1.07–7.16), hypertriglyceridemia (OR 7.91; 95% CI: 2.88–22.71), elevated waist circumference (OR 10.33; 95% CI: 3.72–30.67), overweight (OR 11.33; 95% CI: 3.97–41.07), and increased body fat percentage (OR 8.34; 95% CI: 2.94–30.08) were independent determinants of metabolic syndrome. Using the final multivariate regression model, similar results were observed for abdominal fat (OR 9.98; 95% CI: 2.63–44.41) and total body fat percentage (OR 8.73; 95% CI: 2.33–42.34). However, metabolic syndrome risk was also high for those with blood glucose ≥5.55 mmol/L or HDL cholesterol <0.9 mmol/L (OR 16.69; 95% CI: 4.64–76.35; OR 7.23; 95% CI: 1.86–32.63, respectively).

CONCLUSION:

Metabolic syndrome is highly prevalent among hepatitis C virus–infected patients without type 2 diabetes or obesity. Metabolic syndrome was significantly associated with hypertension, insulin resistance, increased abdominal fat, and overweight.     

Hypoadiponectinemia is Related to Sympathetic Activation and Severity of Obstructive Sleep Apnea

Study Objectives:

Hypoadiponectinemia is associated with cardiovascular morbidity and diabetes mellitus. We hypothesize that adiponectin may be downregulated in sleep apnea through various mechanisms, contributing to cardiometabolic risks. This study investigated the relationship between serum adiponectin and sleep disordered breathing and its potential determinants.

Design:

Cross-sectional study.

Subjects and setting:

Adult men without prevailing medical comorbidity from the sleep clinic in a teaching hospital.

Measurements & Results:

One hundred thirty-four men underwent polysomnography, with mean age of 43.9 (9.8) years, and median apnea-hypopnea index (AHI) of 17.1 (5.7, 46.6). Overnight urine samples for catecholamines and blood samples for analyses of insulin, glucose and adiponectin levels from fasting subjects were taken. Insulin resistance was estimated by homeostasis model assessment (HOMA-IR). Magnetic resonance imaging was performed to quantify the amount of abdominal visceral fat. Serum adiponectin level, adjusted for age, body mass index, and visceral fat volume, was significantly lower in subjects with severe obstructive sleep apnea (AHI ≥ 30) compared with those with an AHI of less than 30: 4.0 (3.1, 5.4) versus 5.4 (3.6, 7.9) μg/mL, P = 0.039. After we adjusted for adiposity, adiponectin levels remained negatively correlated with AHI (P = 0.037), arousal index (P = 0.022), HOMA-IR/fasting insulin (P < 0.001), and urinary norepinephrine and normetanephrine (P < 0.008). In a multiple stepwise regression model, the independent determinants of adiponectin after adjustment for adiposity were HOMA-IR (P < 0.001) and urinary norepinephrine and normetanephrine (P = 0.037).

Conclusions:

Adiponectin was suppressed in subjects with severe obstructive sleep apnea, independent of obesity. Adiponectin levels were determined by insulin resistance and sympathetic activation, factors that may be totally or partially attributed to sleep disordered breathing.

Citation:

Lam JCM; Xu A; Tam S; Khong PL; Yao TJ; Lam DCL; Lai AYK; Lam B; Lam KSL; Ip MSM. Hypoadiponectinemia is related to sympathetic activation and severity of obstructive sleep apnea. SLEEP 2008;31(12):1721–1727.     

A long-term study of bone mineral density in patients with phenylketonuria under diet therapy

Introduction

Dietary control of classic phenylketonuria (PKU) needs restriction of natural proteins; adequate protein intake is achieved by adding low phenylalanine (phe) formulae. The adequacy of this diet for normal bone mineralization had not been sufficiently evaluated. Our aim was to evaluate and follow up bone mineral density (BMD) in children and adolescents with PKU within a 2-year time interval to assess the adequacy of a phenylalanine restricted diet for bone mineralization and to search for a possible relationship between BMD, dietary control and blood phenylalanine (phe) concentrations.

Material and methods

Thirty-two patients with classic PKU (3-19 years) were evaluated for their bone mineral status using dual energy X-ray absorptiometry (DEXA) both at the beginning (baseline) and the end (follow-up) of the study.

Results

Low BMD was detected in 31.25% at the start and in 6.25% of patients after 2 years follows-up. No relationship was found between BMD and the duration of diet compliance and phe level as well.

Conclusions

In this study the low BMD detected in our patients was both at baseline and follow-up independent of diet restriction. A yearly DEXA would be highly beneficial for early detection and treatment, thus preventing osteoporosis and decreasing the risk of fractures. We also suggest the importance of searching for new emerging therapies such as enzyme substitution or gene therapy as low protein diet compliance was not enough to maintain normal bone mineral density.     

Telemedicine Service Use: A New Metric

Background

Policy makers and funding agencies require relevant information on current practices of the use of telemedicine infrastructure and services. Several metrics have been used to describe average use of telemedicine services. None are adequate.

Objective

To identify and assess a new metric–consultations per site per week (C/S/W).

Methods

To determine existing usage, all papers and abstracts published between January 2005 and December 2009 in the Journal of Telemedicine and Telecare and Telemedicine Journal and eHealth were reviewed. Pilot studies, research projects, services reporting less than one year’s data and teleradiology services were excluded.

Results

In total, 210 reports of telemedicine services were identified, 77 of which provided sufficient data to calculate C/S/W. Average use was low, 1.8±3.5 (median 0.7) C/S/W, with 61% of services reporting less than 1 C/S/W and 71% reporting 2 or fewer C/S/W. Studies reporting on data from 2006 to 2009 showed less use (average 1.5±2.3; median 0.7 C/S/W) than earlier reports from 1996 to 2005 (1.7±2.5; median 0.7 C/S/W).

Conclusions

The use of this new metric, C/S/W, is proposed as a standard measure of telemedicine service use. The generally low results opens debate about how well current clinical services are used.     

Exploratory study of web-based planning and mobile text reminders in an overweight population

Background

Forming specific health plans can help translate good intentions into action. Mobile text reminders can further enhance the effects of planning on behavior.

Objective

Our aim was to explore the combined impact of a Web-based, fully automated planning tool and mobile text reminders on intention to change saturated fat intake, self-reported saturated fat intake, and portion size changes over 4 weeks.

Methods

Of 1013 men and women recruited online, 858 were randomly allocated to 1 of 3 conditions: a planning tool (PT), combined planning tool and text reminders (PTT), and a control group. All outcome measures were assessed by online self-reports. Analysis of covariance was used to analyze the data.

Results

Participants allocated to the PT (mean_{sat urated fat} 3.6, mean_{copingplanning} 3) and PTT (mean_saturatedfat 3.5, mean_{copingplanning} 3.1) reported a lower consumption of high-fat foods (F _2,571 = 4.74, P = .009) and higher levels of coping planning (F _2,571 = 7.22, P < .001) than the control group (mean_{sat urated f at} 3.9, mean_{copingplanning} 2.8). Participants in the PTT condition also reported smaller portion sizes of high-fat foods (mean 2.8; F _{2, 569} = 4.12, P = .0) than the control group (mean_portions 3.1). The reduction in portion size was driven primarily by the male participants in the PTT (P = .003). We found no significant group differences in terms of percentage saturated fat intake, intentions, action planning, self-efficacy, or feedback on the intervention.

Conclusions

These findings support the use of Web-based tools and mobile technologies to change dietary behavior. The combination of a fully automated Web-based planning tool with mobile text reminders led to lower self-reported consumption of high-fat foods and greater reductions in portion sizes than in a control condition.

Trial Registration

International Standard Randomized Controlled Trial Number (ISRCTN): 61819220; http://www.controlled-trials.com/ISRCTN61819220 (Archived by WebCite at http://www.webcitation.org/63YiSy6R8)     

Association between a Serotonin Transporter Length Polymorphism and Primary Insomnia

Study Objective:

To test the hypothesis that a 44-base-pair insertion/deletion polymorphism in the 5'' regulatory region of the serotonin transporter gene (5-HTTLPR) is associated with primary insomnia.

Design:

Association study.

Setting:

Sleep laboratory at the Central Institute of Mental Health, Mannheim, Germany.

Patients:

157 patients with primary insomnia and 827 healthy controls.

Interventions:

N/A.

Measurement and Results:

We found the short (s-) allele of the 5-HTTLPR to be significantly more frequent in patients suffering from insomnia than in control individuals (47.1% vs. 39.9%: OR = 1.34).

Conclusions:

This finding contributes to the understanding of the pathophysiology of primary insomnia and suggests a biological basis between the prevalent comorbidity of primary insomnia and other psychiatric disorders.

Citation:

Deuschle M; Schredl M; Schilling C; Wöust S; Frank J; Witt SH; Rietschel M; Buckert M; Meyer-Lindenberg A; Schulze TG. Association between a serotonin transporter length polymorphism and primary insomnia. SLEEP 2010;33(3):343-347.