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The insulin response to a standard oral glucose tolerance test (OGTT) and other anthropometric and biochemical risk factors for coronary heart disease (CHD) were measured in a random sample of 107 Edinburgh men, who were initially studied in 1976 when they were 40 and who were reexamined in 1988-89. Fasting glucose and glucose response to OGTT were higher in 1988-89 than in 1976. In contrast, insulin levels did not differ between the initial and follow-up study either before or after the glucose load. Body mass indices increased, except triceps skinfold. Changing patterns in both fasting and OGTT insulin or glucose levels in individuals were related to changes in bodyweight or in subscapular skinfolds. Modifications in serum total and HDL cholesterol were related to changes in fasting insulin and insulin area, respectively, but not to glucose data. Eleven men developed clinical CHD. Neither glucose nor insulin measures obtained in 1976 differed between those with and without CHD. Weight-height index and abdominal skin-folds were higher in those with CHD. HDL cholesterol was significantly lower (P less than 0.05). Abdominal skin-fold but not body mass index remained significant when adjusted for HDL cholesterol. This small study confirms the importance of central obesity and low HDL cholesterol but failed to identify insulin as a risk factor for CHD in this Scottish population.
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PMID:Glucose tolerance, plasma insulin, HDL cholesterol and obesity: 12-year follow-up and development of coronary heart disease in Edinburgh men. 163 60

The hypothesis that the high mortality from coronary heart disease (CHD) in South Asians settled overseas compared with other populations is due to metabolic disturbances related to insulin resistance was tested in a population survey of 3193 men and 561 women aged 40-69 years in London, UK. The sample was assembled from industrial workforces and general practitioners' lists. In comparison with the European group, the South Asian group had a higher prevalence of diabetes (19% vs 4%), higher blood pressures, higher fasting and post-glucose serum insulin concentrations, higher plasma triglyceride, and lower HDL cholesterol concentrations. Mean waist-hip girth ratios and trunk skinfolds were higher in the South Asian than in the European group. Within each ethnic group waist-hip ratio was correlated with glucose intolerance, insulin, blood pressure, and triglyceride. These results confirm the existence of an insulin resistance syndrome, prevalent in South Asian populations and associated with a pronounced tendency to central obesity in this group. Control of obesity and greater physical activity offer the best chances for prevention of diabetes and CHD in South Asian people.
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PMID:Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. 167 45

This article details the development, delivery, and evaluation of a six-session nutrition course entitled "Eating Today for a Healthier Tomorrow." The course addressed nutrition practices associated with the reduction of risk for coronary heart disease, cancer, osteoporosis, and obesity. Teaching teams, consisting of an extension agent and a registered dietitian, were used in course delivery. A wide variety of printed and audiovisual teaching aids helped participants learn through discussion, goal setting, games, and food tasting. Evaluation components of the course included demographic and pre- and post-course food frequency information as well as an overall evaluation by each participant. Post-course evaluation data were collected at a reunion session held 2 months after course completion. One hundred forty-two of 195 participants (73%) completed the course and the evaluation. Three-fourths of the participants had a family history of at least one of the life-style diseases addressed by the course. The food frequency results indicated that participants made some significant changes in their food practices. They decreased the number of times they selected high-fat cheese, regular red meats, foods from the saturated fatty acid group, desserts, sodium-rich products, and tea/coffee (p less than .05), and they increased selection of low-fat dairy products (p less than .05). Further study is recommended to determine whether individuals maintain the dietary changes and how those changes affect others in the person's immediate environment.
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PMID:A risk-reduction nutrition course for adults. 168 28

To evaluate the hypothesis that endocrine profiles change with aging independently of specific disease states, we examined the age trends of 17 major sex hormones, metabolites, and related serum proteins in 2 large groups of adult males drawn from the Massachusetts Male Aging Study, a population-based cross-sectional survey of men aged 39-70 yr conducted in 1986-89. Group 1 consisted of 415 men who were free of obesity, alcoholism, all prescription medication, prostate problems, and chronic illness (cancer, coronary heart disease, hypertension, diabetes, and ulcer). Group 2 consisted of 1294 men who reported 1 or more of the above conditions. Each age trend was satisfactorily described by a constant percent change per yr between ages 39-70 yr. Free testosterone declined by 1.2%/yr, and albumin-bound testosterone by 1.0%/yr. Sex hormone-binding globulin (SHBG), the major serum carrier of testosterone, increased by 1.2%/yr, with the net effect that total serum testosterone declined more slowly (0.4%/yr) than the free or albumin-bound pools alone. Among the major androgens and metabolites, androstane-3 alpha,17 beta-diol (androstanediol; 0.8%/yr) and androstanediol glucuronide (0.6%/yr) declined less rapidly than free testosterone, while 5 alpha-dihydrotestosterone remained essentially constant between ages 39-70 yr. Androstenedione declined at 1.3%/yr, a rate comparable to that of free testosterone, while the adrenal androgen dehydroepiandrosterone (3.1%/yr) and its sulfate (2.2%/yr) declined 2-3 times more rapidly. The levels of testosterone, SHBG, and several androgen metabolites followed a parallel course in groups 1 and 2, remaining consistently 10-15% lower in group 2 across the age range of the study. Subgroup analyses suggested that obese subjects might be responsible for much of the group difference in androgen level. Serum concentrations of estrogens and cortisol did not change significantly with age or differ between groups. Of the pituitary gonadotropins, FSH increased at 1.9%/yr, LH increased at 1.3%/yr, and PRL declined at 0.4%/yr, with no significant difference between groups 1 and 2.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Age, disease, and changing sex hormone levels in middle-aged men: results of the Massachusetts Male Aging Study. 171 16

Vigorous physical activity can improve the health of both adults and children. Among adults, regular physical activity can reduce risk for chronic diseases such as coronary heart disease, hypertension, noninsulin-dependent diabetes mellitus, colon cancer, and depression, as well as lower all-cause death rates (1,2). Among children, regular physical activity can reduce chronic disease risk factors such as obesity, elevated cholesterol, and hypertension (3). Physical activity patterns established during childhood may extend into adulthood (4). This report examines the prevalence of vigorous physical activity among U.S. students in grades 9-12.
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PMID:Vigorous physical activity among high school students--United States, 1990. 173 Nov 78

Because of limited clinical investigations addressing the effectiveness of intervention to reduce known risk factors, it is difficult for primary care physicians to decide on which coronary heart disease risk factors to continue to screen for among older patients. The recently published report of the United States Preventive Services Task Force, using explicit screening criteria, has recommended that several risk factors be investigated for use among older adults. Recent longitudinal studies have found that a number of risk factors persist with advancing age-hypertension, left ventricular hypertrophy, impaired glucose metabolism, elevated cholesterol levels, obesity, smoking, physical inactivity, decline in vital capacity, and increased heart rate. Screening to identify many of these risks and treatment and counseling to modify them appear to improve survival. Evidence is less clear that diabetes mellitus and elevated cholesterol levels have the same significance for men and women as they age. Left ventricular hypertrophy and diabetes seem particularly important as risk factors for older women, whereas a high heart rate may be a greater risk for men.
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PMID:Screening persons aged 65 and older for coronary heart disease risk factors. 173 97

Using questionnaires, the authors evaluated the risk of coronary heart disease in different groups of Hungarian society. Among physicians, teachers, factory workers and agricultural workers, the latter seem to be at the highest risk. On the basis of these results obtained in a population of 363 agricultural employees, a detailed risk factor analysis was made. These results were compared with those of the Framingham Offspring Study. Hungarians show alarmingly often a high blood cholesterol level, hypertension, smoking and obesity (the latter factor in women). The more frequent occurrence of the three main risk factors (high blood cholesterol, hypertension, smoking) in young Hungarians is concordant with the fact that the incidence of myocardial infarction in young people in Hungary is one of the highest in the world. The frequency of a positive parental history and obesity in men is lower in the Hungarian population than in the American one. The risk of coronary heart disease in the examined Hungarian population is considered high. The authors have launched a preventive programme.
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PMID:An attempt to evaluate the risk factors related to coronary heart disease in Hungary. 174 19

A study of coronary heart disease and risk factors was conducted in a total Sri Lankan aboriginal population who face imminent extinction due to developmental programmes in the vicinity of their jungle homelands. Coronary heart disease was not detected among the aborigines. Hypertension was present in 5.7% of males and 1.9% of females. 39% of males smoked. Serum cholesterol, triglyceride and high density lipoprotein cholesterol levels were 5.25 mmol/l (SD 0.45), 1.99 mmol/l (SD 0.92) and 1.2 mmol/l (SD 0.2) respectively. Obesity was not seen and the level of physical activity was high. The rarity of coronary heart disease could be attributed to this favourable coronary risk profile.
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PMID:Coronary heart disease and coronary risk profile in a primitive population. 175 Jan 15

Northern Ireland has the highest incidence of coronary heart disease (CHD) in the world. The physical fitness, activity patterns, health knowledge, attitudes, and dietary habits of a random, stratified sample of 3211 Northern Irish children, comprising 1540 boys and 1671 girls, age range 11-18 years were examined. At all ages boys were significantly more active than girls. The most important finding was an appreciable decline in physical activity levels after the age of 14 years reaching extremely low levels in older girls. While 75% of exercise taken was not related to school, physical education classes constituted the only exercise taken by one third of pupils. Girls had healthier nutritional habits and were more inclined to employ weight control measures than boys. There was a preponderance of children with a higher body mass index indicating a tendency to obesity in the child population. Over 20% of school leavers of both sexes regularly smoked cigarettes and 20% regularly drank alcohol. The postulated relationship between childhood inactivity, adult sedentary lifestyle, and increased risk of CHD raises serious cause for concern regarding the future cardiovascular health of many children.
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PMID:Long term health implications of fitness and physical activity patterns. 177 91

The incidence of impaired glucose tolerance, the relation of blood glucose levels to the prevalence of risk factors for coronary heart disease (CHD) and to myocardial infarction morbidity and mortality were studied over 15 years among males aged 45-59 years, excluding patients with diabetes mellitus. The data analysis was made in quintils of glucose levels. Impaired glucose tolerance was detected in 20.6% of the males. In the fifth versus the first quintil, there was an increase in the prevalence of systolic and diastolic arterial hypertension (p less than 0.001), obesity (p less than 0.001), low physical activity and hypercholesterolemia (p less than 0.05). As compared with the first, the fifth quintil showed higher total mortality rates and higher myocardial infarction morbidity and cardiovascular disease and CHD morbidity rates. But for age, and major risk factors, the risk for CHD, total and cardiovascular mortality increase at low and high blood glucose concentrations.
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PMID:[Disorders of glucose tolerance and ischemic heart disease]. 177 10


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