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 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To improve diet and reduce risk for obesity and chronic disease, we developed, implemented and evaluated a pilot intervention trial with 23 large and small food stores in the Republic of the Marshall Islands (12 intervention, 11 control). The intervention included both mass media (radio announcements, newspaper ads, video) and in-store (cooking demonstrations, taste tests, shelf labeling) components. Consumer exposure to the mass media components was high (65% had heard half or more of the radio announcements, 74% had seen at least one of the newspaper ads). Consumer exposure to the in-store components of the intervention was moderate (61% attended at least one cooking demonstrations, 59% received at least one recipe card). After adjustment for age, sex and education level, increased exposure to the intervention was associated with higher diabetes knowledge (p<0.05) and label reading knowledge (p<0.05), but not with increased self-efficacy for performing promoted healthy behaviors. The intervention was associated with increased purchasing of certain promoted foods (p<0.005), including oatmeal, turkey chili, fish, canned fruit and local vegetables. It was also associated with improvements in healthiness of cooking methods (p<0.05). Food store centered interventions have great potential for changing cognitive and behavioral factors relating to food choice and preparation, and may contribute to lessening the burden of diet-related chronic disease worldwide.
Pac Health Dialog 2007 Sep
PMID:A pilot food store intervention in the Republic of the Marshall Islands. 1958 6

Breast cancer is a multifactorial disease which has created a significant health problem worldwide. The literature suggests that there is an increase the prevalence of breast cancer among the Pacific Islanders in the last two decades. Factors which influence breast cancer risk include gender, genetic mutation, diet, parity and endocrine. Nutritional studies and epidemiological surveys show that dietary and lifestyle factors play significant role in breast cancer risk. Breast cancer risk is reduced by regular intake of fruits, vegetables and omega-3 fatty acids-rich diet. Whereas obesity, smoking, alcohol consumption and sedentary lifestyle increase breast cancer risk. Breast feeding practice is protective against breast cancer. Intensive awareness campaigns and public education are necessary to discourage risk behaviour among the Pacific Islanders.
Pac Health Dialog 2007 Sep
PMID:Towards prevention of breast cancer in the Pacific: influence of diet and lifestyle. 1958 9

Both in the United States and many regions of the world, chronic kidney disease and end-stage renal disease (ESRD) in patients with diabetes mellitus have reached epidemic proportions in recent years. The large prevalent diabetic ESRD population in the US involves remarkable risk in African Americans and an increasing population of elderly diabetic patients, including many octogenarians. In the US and globally, over 90% of diabetic ESRD patients have type 2 diabetes. The multinational epidemic of diabetic ESRD has been linked to increases in the prevalence of diabetes in many populations, related to obesity, ageing, and physical inactivity. It is anticipated that the worldwide prevalence of diabetes over the next 20 years will reach a level twice that of the year 2000. The excessive morbidity and mortality of the diabetic ESRD population are well documented. However, the growth in incidence and prevalence rates for diabetic ESRD has remained somewhat stable in the US in recent years, and new data suggest that the incidence of ESRD expressed per diabetic population may finally be declining, suggesting that proven therapies are making "progress on progression."
Semin Dial
PMID:Diabetic CKD/ESRD 2010: a progress report? 2021 Sep 17

Percutaneous peritoneal dialysis (PD) catheter manipulation successfully corrects displacement and contributes to catheter salvage. We describe a new device for the percutaneous treatment of malpositioned PD catheters, the modified Malecot introducer technique, which is an improvement over previous methods because its flexible consistency also allows the manipulation of swan-neck catheters. Twenty-one patients experienced catheter displacement managed by the new introducer: 12 males, average time in PD 13.7+/-23.2 months, six with "swan-neck" catheter, seven obese, and six with previous abdominal surgery. Catheter manipulation was technically successful in 19 of 21 cases (90.4%) by the end of the first week and in 15 cases (71.4%) at 1 month. An additional eight episodes of malposition occurred ranging from 10 to 300 days after the first manipulation. A second manipulation using the same introducer was performed and resulted in long-term patency in seven patients. No complications were reported. In the long-term follow-up, only one patient removed PD catheter for mechanical dysfunction. Overall survival of manipulated catheters was 32.7+/-23.4 months. Function at 1 month correlated with function by the first week (r=0.513; p=0.017) and the need of a second manipulation with age (r=0.494; p=0.027) but not with obesity or previous abdominal surgery. We conclude that manipulation using the modified Malecot introducer is a simple and effective procedure for the correction of malpositioned PD catheters. It also represents a new alternative for the management of displaced "swan-neck" catheters.
Semin Dial
PMID:Salvage of malpositioned and malfunctioning peritoneal dialysis catheters by manipulation with a modified Malecot introducer. 2033 25

Medical treatment of obesity and lifestyle modification have limited effectiveness in treating it in morbidly obese individuals. Importantly, bariatric surgery is regarded as the only therapy that is effective in maintaining significant weight loss in morbidly obese individuals. Despite the fact that bariatric surgery-induced weight loss is associated with a significant decrease in morbidity and mortality and improvement in renal function, bariatric surgery has recently been shown to be associated with a significant risk of nephrolithiasis. The main risk factor for nephrolithiasis is increased excretion of urinary oxalate. In this review, we discuss the association between bariatric surgery, an increased risk of renal stone formation and oxalate nephropathy.
Nephrol Dial Transplant 2010 Oct
PMID:Bariatric surgery and renal function: a precarious balance between benefit and harm. 2092

Insulin resistance (IR), the reciprocal of insulin sensitivity is a known complication of advanced chronic kidney disease (CKD) and is associated with a number of metabolic derangements. The complex metabolic abnormalities observed in CKD such as vitamin D deficiency, obesity, metabolic acidosis, inflammation, and accumulation of "uremic toxins" are believed to contribute to the etiology of IR and acquired defects in the insulin-receptor signaling pathway in this patient population. Only a few investigations have explored the validity of commonly used assessment methods in comparison to gold standard hyperinsulinemic hyperglycemic clamp technique in CKD patients. An important consequence of insulin resistance is its role in the pathogenesis of protein energy wasting, a state of metabolic derangement characterized by loss of somatic and visceral protein stores not entirely accounted for by inadequate nutrient intake. In the general population, insulin resistance has been associated with accelerated protein catabolism. Among end-stage renal disease (ESRD) patients, enhanced muscle protein breakdown has been observed in patients with Type II diabetes compared to ESRD patients without diabetes. In the absence of diabetes mellitus (DM) or severe obesity, insulin resistance is detectable in dialysis patients and strongly associated with increased muscle protein breakdown, primarily mediated by the ubiquitin-proteasome pathway. Recent epidemiological data indicate a survival advantage and better nutritional status in insulin-free Type II DM patients treated with insulin sensitizer thiazolidinediones. Given the high prevalence of protein energy wasting in ESRD and its unequivocal association with adverse clinical outcomes, insulin resistance may represent an important modifiable target for intervention in the ESRD population.
Semin Dial
PMID:Insulin resistance and protein energy metabolism in patients with advanced chronic kidney disease. 2070 17

Although a diet low in protein is well known to reduce the risk of progression in patients with chronic kidney disease (CKD), the impact of dietary fat content and fat quality has largely been ignored. As a reduced protein intake results in an obligatory reduction in energy intake, and as CKD patients often suffer from energy malnutrition, this issue deserves greater attention. The present review aims to summarize what is currently known about dietary fat intake in CKD and suggests areas for further study. We conclude that although overweight per se is an important risk factor for the development of CKD, the role of obesity as a risk factor for complications in manifest CKD remains unclear. Current data support a balanced increase in dietary fat intake in patients with CKD to compensate for reduced energy intake in protein-restricted diets and anorexic patients. However, patients who are obese should be encouraged to lose weight while maintaining or, preferably, increasing muscle mass.
Semin Dial
PMID:To eat or not to eat: dietary fat in uremia is the question. 2070 18

This paper presents a summary of Pohnpei, Federated States Micronesia's involvement in a global health study focused on documenting traditional food systems in different parts of the world and providing evidence that local resources are critical for food security, nutrition and health. The Pohnpei study was based in Mand Community, Madolenihmw. The study found that there was a great diversity of foods locally available (381 food items documented), but these were underused. Overweight, obesity, diabetes, and vitamin A deficiency were identified as serious problems. Interventions included community meetings, school activities, and agriculture workshops, cooking classes, charcoal oven development, weight loss and planting competitions, poster campaigns and other relevant mass media. Significant dietary improvements were achieved following the intervention efforts, as well as positive changes in attitude towards local food including: decrease in average daily rice consumption from 846 g/person in 2005 to 544 g/person in 2007 (p = 0.0002); increase in provitamin A carotenoid intake from 227 microg/person in 2005 to 475 microg/person in 2007 (p = 0.02); increased frequency of consumption of local banana (53%), giant swamp taro (476%), local vegetables (130%); and increased dietary diversity (4.8 local food groups consumed in 2005 to 5.5 in 2007). Another positive outcome in Pohnpei was the popularization of the slogan "Let's Go Local."
Pac Health Dialog 2010 Apr
PMID:Pohnpei, FSM case study in a global health project documents its local food resources and successfully promotes local food for health. 2096 45

'Diabesity' is the term for diabetes occurring in the context of obesity. In this review, we will overview the latest epidemiological data available describing the rising prevalence, health impact and economic impact of diabesity. We will also outline the measures required to slowdown this newly evolving epidemic. The global prevalence of diabetes in 2010 was 284 million people worldwide constituting around 6.4% of the world population, which is higher than was projected in earlier studies. Furthermore, the projections for 2030 show the prevalence to reach 439 million individuals comprising ~7.7% of the world population. The burden of diabetes on the world economy has been rising steadily in the last decade to reach $376 billion in 2010 and is expected to reach $490 billion in 2030. Diabesity represents a substantial economic burden as reflected by diabetes and obesity consuming 14 and 5.7% of the USA's total health expenditure, respectively, representing the highest known expenditure on diabesity worldwide. When costs associated with being overweight were also included, the upper limit of obesity expenditure rises to 9.1% of the USA's total healthcare expenditure. The highest recorded expenditure on diabetes alone was in Saudi Arabia consuming 21% of the country's total health expenditure, with no data available about the health expenditure on obesity. The health impact of diabesity is substantial to include long-term diabetic complications, reduction in health-related functioning, reduction of quality of life and reduced overall life expectancy. Long-term complications include myocardial infarction, cerebrovascular stroke and end-stage renal disease. Also recent advances have found that there is an association between chronic stress, depression and sleeping troubles to both diabetes and obesity. This century is the unprecedented diabetogenic era in human history. It is thus urgent to take steps including screening, prevention and early management in an attempt to control this evolving epidemic of diabesity.
Nephrol Dial Transplant 2011 Jan
PMID:Diabesity: an overview of a rising epidemic. 2104 78

Obtaining renal tissue is often critical in the diagnosis and management of patients with renal disease of unknown etiology. Bleeding diathesis, liver disease, and obesity are common contraindications for percutaneous renal biopsy. In high-risk patients, transjugular renal biopsy is believed to be a safe and effective procedure. This study reports the experience of an academic interventional nephrology program with performing transjugular renal biopsy. We performed a retrospective observational study of 23 patients with either acute or chronic kidney disease with contraindications for percutaneous renal biopsy. All transjugular renal biopsies were performed by interventional nephrologists at our university. We studied the efficacy and safety of transjugular renal biopsy in these patients. Twenty out of 23 (87%) of the procedures yielded adequate tissue for pathologic diagnosis. Three (13%) patients required blood transfusions, none required coil embolization or nephrectomy, and there were no deaths. Even though performing transjugular renal biopsy requires considerable technical expertise and must be performed in an interventional radiology suite, it can be safely and effectively performed by well-trained interventional nephrologists to achieve pathological diagnosis.
Semin Dial
PMID:Safety and efficacy of transjugular renal biopsy performed by interventional nephrologists. 2119 47


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