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Recent efforts to integrate biomedical and behavioral science perspectives and techniques have revealed the creativity and efficacy of behavioral health approaches to health enhancement and disease prevention. There are expectations that behavioral medicine and behavioral health will be significant in approaches toward changing life style, improving patient's compliance with medical advice, and in rehabilitation. Three examples of actual practice of behavioral procedures in a public health center are studied-behavior therapies for obesity and hypercholesterolemia, and prompting of patient clinic utilization behavior by a letter of introduction. The importance of proper selection of target problems, staff training is emphasized. In conclusion, it is recommended that behavioral science and its techniques of assessment and treatment are incorporated into public health activities, especially in the field of health education.
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PMID:[Behavior therapy as a new procedure in health education--recommendation for introducing behavior science into personal health services]. 163 37

We have studied hypertension, obesity, diabetes and hypercholesterolaemia in those aged 45-79 years in the Cretan low risk population of Spili (n = 249; attendance 82%) to see if these conditions interacted in the same way as previously described for high risk populations. Hypertension, diabetes, obesity, and hypercholesterolaemia were found to be at least as prevalent in Spili as in Sweden. Furthermore, the previously described 'Metabolic Syndrome X', with insulin resistance and hyperinsulinaemia as a common denominator also seemed to exist in the Spili population where patients with these conditions had higher insulin and C-peptide levels than normals. Our finding should be viewed against the low prevalence of past myocardial infarction in Cretan men from Spili reported by us and confirming the results of the Seven Countries Study.
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PMID:Characteristics of the 'metabolic syndrome X' in a cardiovascular low risk population in Crete. 843 84

1. Groups of lean and obese LA/N-cp and obese Type II diabetic SHR/N-cp rats were fed semisynthetic diets with or without the alpha-glucosidase inhibitor acarbose (ACB, 100 mg/kg diet, p.o.) from 8 until 15 weeks of age, and measures of fasting serum total cholesterol (TC), insulin (INS), and hepatic HMG-CoA synthase activity determined at the end of the study. 2. ACB was without marked effect on mean food intake in either strain or either phenotype, and resulted in less weight gain and decreased adipose mass in obese LA/N-cp rats. INS was greater in the obese than the lean phenotype of both strains, and ACB resulted in greater reductions in INS in obese LA/N-cp than in obese LA/N-cp rats. 3. Serum TC concentrations were greater in the obese than in the lean phenotype of both strains, and ACB resulted in decreases in TC in both strains and in lower beta:alpha lipoprotein cholesterol ratios in obese LA/N-cp rats. Liver HMG Co-A synthase activity was greater in lean than obese rats and ACB resulted in normalization of enzyme activity in obese LA/N-cp but not SHR/N-cp rats. 4. These results confirm the hypercholesterolemia which occurs in the obese phenotype of the corpulent rat strains, and indicates that ACB may bring about significant reductions in body weight and fatness, TC, and in improved beta:alpha lipoprotein ratios and HMG-CoA synthase activity in obesity.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The effects of the intestinal glucosidase inhibitor acarbose on cholesterogenesis in corpulent rats. 168 84

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

Risk factors for cardiovascular diseases, which are the leading cause of mortality in the industrialized countries, are well investigated; however, the results of intervention studies on the therapy of single risk factors were disappointing in the past. Recently, there has been growing evidence that there might be a closer pathophysiological relation between arterial hypertension, hypercholesterolemia, obesity, impaired glucose tolerance and genetic disposition than previously thought. For the treatment of the individual patient, this concept requires a complete work-up and comprehensive therapy of all risk factors. The therapy of several mildly elevated risk factors may be more beneficial than a too vigorous reduction of the blood pressure alone. At the beginning of every therapeutic regimen, there has to be a nonpharmacological approach. Diet and weight reduction even in mild obesity are more efficient in influencing several risk factors at the same time than pharmacological therapy. Metabolic consequences of drug treatment have to be carefully monitored.
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PMID:[Combination therapy of cardiovascular risk factors]. 173 4

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

The aim of the present study was to evaluate the prevalence of certain cardiovascular risk factors in the population of Asepeyo-Elche. The study sample was a working population of 697 persons (71.8% males and 28.2% females) with ages ranging from 15 to 65 years (mean age 34.7 +/- 13.2 years), seen during the first 6 months of 1990 in the health care center of Asepeyo-Elche. The evaluated cardiovascular risk factors and their prevalence rates were: hypertension (14.2%), hypercholesterolemia (18.5%), smoking (52.5%), hyperglycemia (3.5%), obesity (28.2%) and sedentariness (80.3%). We conclude that in our working population the prevalence rates of some cardiovascular risk factors are high and that intervention programs to modify the diet and lifestyle are mandatory to prevent the pathogenetic consequences of these factors.
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PMID:[Cardiovascular risk factors in the working population of Alicante]. 175 30

As the life expectancy of women increases, a greater percentage of women's lives will be spent in the menopause. The greatest cause of morbidity and mortality during that period is cardiovascular disease. The associated risks that predispose to the development of cardiovascular disease are multifactoral and include hypertension, diabetes mellitus, smoking, obesity, family history, and elevated cholesterol levels. The menopause, per se, is associated with an increased risk because of the unfavorable changes in cholesterol metabolism secondary to estrogen deprivation. The replacement of estrogen to menopausal women is believed to improve the lipid profile and reduce the atherogenic changes that increase the risk of cardiovascular disease. However, this form of preventative therapy is futile unless other factors that promote cardiovascular disease also are modified. Such modification may be achieved by following a well-balanced diet, combined with an exercise program, cessation of smoking, weight control, and the monitoring of blood pressure and diabetes in high-risk patients.
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PMID:Menopause and cardiovascular disease. 177 31

The middle years for women present many challenges and opportunities. The changes of life--physical, psychosocial, developmental, and environmental--can be rewarding, positive experiences. At the same time, as women enter the middle years, they may face a number of health problems. Preparation for health maintenance, illness prevention, and coping with problems as they occur can prevent many of the potential health alterations through life style changes. Even when these health problems are unpreventable, modification of behaviors and habits may ameliorate some of their consequences. The nurse is the logical person to educate and counsel women on how to lower their risks for midlife health problems. An overview of the health status of women at midlife is presented, including current life expectancy, mortality, and morbidity data. Risk factors and risk assessment specific to diseases prevalent in midlife and older women are reviewed, with emphasis on nutrition and obesity. Nursing strategies for reducing the risk factors (obesity, hypercholesterolemia, and sedentary life style) related to many of the health concerns of midlife women are presented.
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PMID:Nutrition and health patterns in midlife women. 177 36


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