American association of clinical endocrinologists and american college of endocrinology guidelines for management of dyslipidemia and prevention of cardiovascular disease

Context: It is well established in the literature that healthier diets cost more than unhealthy diets. Objective: The aim of this review was to examine the contribution of food prices and diet cost to socioeconomic inequalities in diet quality. Data Sources: A systematic literature search of the PubMed, Google Scholar, and Web of Science databases was performed. Study Selection: Publications linking food prices, dietary quality, and socioeconomic status were selected. Data Extraction: Where possible, review conclusions were illustrated using a French national database of commonly consumed foods and their mean retail prices. Data Synthesis: Foods of lower nutritional value and lower-quality diets generally cost less per calorie and tended to be selected by groups of lower socioeconomic status. A number of nutrient-dense foods were available at low cost but were not always palatable or culturally acceptable to the low-income consumer. Acceptable healthier diets were uniformly associated with higher costs. Food budgets in poverty were insufficient to ensure optimum diets. Conclusions: Socioeconomic disparities in diet quality may be explained by the higher cost of healthy diets. Identifying food patterns that are nutrient rich, affordable, and appealing should be a priority to fight social inequalities in nutrition and health.

https://hal-amu.archives-ouvertes.fr/hal-01774670/document

Contribution of food prices and diet cost to socioeconomic disparities in diet quality and health: a systematic review and analysis.

American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice are systematically developed statements to assist health care professionals in medical decision-making for specific clinical conditions, but are in no way a substitute for a medical professional’s independent judgment and should not be considered medical advice. Most of the content herein is based on literature reviews. In areas of uncertainty, professional judgment was applied. These guidelines are a working document that reflects the state of the field at the time of publication. Because rapid changes in this area are expected, periodic revisions are inevitable. We encourage medical professionals to use this information in conjunction with, and not as a replacement for, their best clinical judgment. The presented recommendations may not be appropriate in all situations. Any decision by practitioners to apply these guidelines must be made in light of local resources and individual patient circumstances.

http://www.serm.md/ghiduri/diverse/AACE_GUIDELINES_FOR_MANAGEMENT_OF_DYSLIPIDEMIA_AND.pdf

American association of clinical endocrinologists' guidelines for management of dyslipidemia and prevention of atherosclerosis

Background The projected rise in the incidence of type 2 diabetes mellitus (T2DM) could develop into a substantial health problem worldwide. Whether diet, physical activity or both can prevent or delay T2DM and its associated complications in at-risk people is unknown. Objectives To assess the effects of diet, physical activity or both on the prevention or delay of T2DM and its associated complications in people at increased risk of developing T2DM. Search methods This is an update of the Cochrane Review published in 2008. We searched the CENTRAL, MEDLINE, Embase, ClinicalTrials.gov, ICTRP Search Portal and reference lists of systematic reviews, articles and health technology assessment reports. The date of the last search of all databases was January 2017. We continuously used a MEDLINE email alert service to identify newly published studies using the same search strategy as described for MEDLINE up to September 2017. Selection criteria We included randomised controlled trials (RCTs) with a duration of two years or more. Data collection and analysis We used standard Cochrane methodology for data collection and analysis. We assessed the overall quality of the evidence using GRADE. Main results We included 12 RCTs randomising 5238 people. One trial contributed 41% of all participants. The duration of the interventions varied from two to six years. We judged none of the included trials at low risk of bias for all 'Risk of bias' domains.Eleven trials compared diet plus physical activity with standard or no treatment. Nine RCTs included participants with impaired glucose tolerance (IGT), one RCT included participants with IGT, impaired fasting blood glucose (IFG) or both, and one RCT included people with fasting glucose levels between 5.3 to 6.9 mmol/L. A total of 12 deaths occurred in 2049 participants in the diet plus physical activity groups compared with 10 in 2050 participants in the comparator groups (RR 1.12, 95% CI 0.50 to 2.50; 95% prediction interval 0.44 to 2.88; 4099 participants, 10 trials; very low-quality evidence). The definition of T2DM incidence varied among the included trials. Altogether 315 of 2122 diet plus physical activity participants (14.8%) developed T2DM compared with 614 of 2389 comparator participants (25.7%) (RR 0.57, 95% CI 0.50 to 0.64; 95% prediction interval 0.50 to 0.65; 4511 participants, 11 trials; moderate-quality evidence). Two trials reported serious adverse events. In one trial no adverse events occurred. In the other trial one of 51 diet plus physical activity participants compared with none of 51 comparator participants experienced a serious adverse event (low-quality evidence). Cardiovascular mortality was rarely reported (four of 1626 diet plus physical activity participants and four of 1637 comparator participants (the RR ranged between 0.94 and 3.16; 3263 participants, 7 trials; very low-quality evidence). Only one trial reported that no non-fatal myocardial infarction or non-fatal stroke had occurred (low-quality evidence). Two trials reported that none of the participants had experienced hypoglycaemia. One trial investigated health-related quality of life in 2144 participants and noted that a minimal important difference between intervention groups was not reached (very low-quality evidence). Three trials evaluated costs of the interventions in 2755 participants. The largest trial of these reported an analysis of costs from the health system perspective and society perspective reflecting USD 31,500 and USD 51,600 per quality-adjusted life year (QALY) with diet plus physical activity, respectively (low-quality evidence). There were no data on blindness or end-stage renal disease.One trial compared a diet-only intervention with a physical-activity intervention or standard treatment. The participants had IGT. Three of 130 participants in the diet group compared with none of the 141 participants in the physical activity group died (very low-quality evidence). None of the participants died because of cardiovascular disease (very low-quality evidence). Altogether 57 of 130 diet participants (43.8%) compared with 58 of 141 physical activity participants (41.1%) group developed T2DM (very low-quality evidence). No adverse events were recorded (very low-quality evidence). There were no data on non-fatal myocardial infarction, non-fatal stroke, blindness, end-stage renal disease, health-related quality of life or socioeconomic effects.Two trials compared physical activity with standard treatment in 397 participants. One trial included participants with IGT, the other trial included participants with IGT, IFG or both. One trial reported that none of the 141 physical activity participants compared with three of 133 control participants died. The other trial reported that three of 84 physical activity participants and one of 39 control participants died (very low-quality evidence). In one trial T2DM developed in 58 of 141 physical activity participants (41.1%) compared with 90 of 133 control participants (67.7%). In the other trial 10 of 84 physical activity participants (11.9%) compared with seven of 39 control participants (18%) developed T2DM (very low-quality evidence). Serious adverse events were rarely reported (one trial noted no events, one trial described events in three of 66 physical activity participants compared with one of 39 control participants - very low-quality evidence). Only one trial reported on cardiovascular mortality (none of 274 participants died - very low-quality evidence). Non-fatal myocardial infarction or stroke were rarely observed in the one trial randomising 123 participants (very low-quality evidence). One trial reported that none of the participants in the trial experienced hypoglycaemia. One trial investigating health-related quality of life in 123 participants showed no substantial differences between intervention groups (very low-quality evidence). There were no data on blindness or socioeconomic effects. Authors' conclusions There is no firm evidence that diet alone or physical activity alone compared to standard treatment influences the risk of T2DM and especially its associated complications in people at increased risk of developing T2DM. However, diet plus physical activity reduces or delays the incidence of T2DM in people with IGT. Data are lacking for the effect of diet plus physical activity for people with intermediate hyperglycaemia defined by other glycaemic variables. Most RCTs did not investigate patient-important outcomes.

Diet, physical activity or both for prevention or delay of type 2 diabetes mellitus and its associated complications in people at increased risk of developing type 2 diabetes mellitus

Terminalia arjuna Wight & Arn.--a useful drug for cardiovascular disorders.

BackgroundPlant stanol esters in spreads have demonstrated efficacy in reducing serum cholesterol. The cost-effectiveness of plant stanol esters in the prevention of coronary heart disease, however...

Plant stanol esters are potentially cost-effective in the prevention of coronary heart disease in men: Bayesian modelling approach.

Several studies have shown that lifestyle changes including weight reduction, increased physical activity, and dietary modification are effective in preventing the development of type 2 diabetes (1–4). However, various barriers are known to interfere with the adoption of a healthier lifestyle. One such barrier is diet costs (5). A few studies have explored the relationship between the quality and costs of diets (6–13), and the results are conflicting. Observational studies (6–10) suggest that a healthy diet costs more, whereas intervention studies (11–13) suggest that a healthy diet is not more expensive than a less healthy diet. The aim of this study was to discover whether adopting a diet composed in line with the current nutrition recommendations (14) affects diet costs. The changes in the costs of a self-selected diet among participants in the Finnish Diabetes Prevention Study (DPS) were studied. The diet costs were compared between the control group and intervention group receiving intensive dietary and exercise counseling. Furthermore, the associations between background variables, diet quality determinants, and diet cost were analyzed.

The DPS was a randomized, controlled trial showing that an intensive lifestyle modification program including dietary and physical exercise counseling is highly effective in decreasing the risk of diabetes in high-risk subjects. The study design, subjects, inclusion and exclusion criteria, and intervention program have been previously …

https://care.diabetesjournals.org/content/diacare/30/5/1275.full.pdf

Costs of a self-selected, health-promoting diet among the participants of the Finnish Diabetes Prevention Study.

The present publication discloses a method, server, and system for a user's nutrition and exercise monitoring. According to the method, in a telecommunications system (1) information is stored on a server (2) or server group of the telecommunications network (1), and the stored data are provided to users (3) of the telecommunications network. In addition, in the telecommunications network foodstuffs' product and mean- value data, as well as data on forms of exercise are stored on the server (2) or server group, numerically readable codes, such as EAN codes, are combined with the foodstuff and exercise data, the users (3) are allowed to retrieve foodstuff and exercise data from the server (2) or server group, with the aid of product names, or numerically readable, or keyed-in codes, by browsing on the basis of product classifications, or by browsing a favourites list, user-specific physiological information, i.e. basic information, such as the weight, age, or height of the user (3), and variable information, such as the food portions eaten by the user (3) and/or the amount and type of exercise performed by the user, is also stored in the information network (1). According to the invention, the foodstuff, exercise, and user information is combined and models or predictions are created of the nutritional and energy balances of the user (3) utilizing temporal nutrition and exercise entries, on the basis of which the user is guided, by means of the information network, to a target diet and exercise, and information is also stored in the system (2) on the purchases made by the user, with the aid of a point-of- sale system (23), to facilitate the input of variable data on the user.

Method and server in a telecommunication system and a telecommunication system for facilitating weight control

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Plant stanol esters are potentially cost-effective in the prevention of coronary heart disease in men: Bayesian modelling approach.

Costs of a self-selected, health-promoting diet among the participants of the Finnish Diabetes Prevention Study.

Method and server in a telecommunication system and a telecommunication system for facilitating weight control