• Financial incentives help pregnant smokers quit
• Varenicline enables gradual smoking cessation
• Increasing varenicline dose in smokers
• Do smoking cessation aids change across quit attempts?
• Alcohol and tobacco imagery in YouTube music videos
• Extended run-in bupropion for smoking cessation
• Higher BMI may affect NRT efficacy
• Proactive outreach engages low-SES smokers
• Chemical composition of E-cigs available in NZ
• A brief intervention reduces passive smoking in babies

To subscribe to the Smoking Cessation Research Review, go to: http://www.researchreview.co.nz/

The committee concludes that this streamlined set of measures could provide consistent benchmarks for health progress across the nation and improve system performance in the highest-priority areas.

The report can be read for free online at:  http://www.iom.edu/Reports/2015/Vital-Signs-Core-Metrics.aspx

The study was based on data from the NIH-AARP Diet and Health Study, a prospective cohort study of 566,401 adults aged 50–71 years at recruitment in 1995–1996, and followed for a median of 10.5 years for cancer incidence, 12.6 years for cancer mortality, and 13.6 years for total mortality.

Based on the results of their analysis, the authors conclude that, "in both men and women, adherence to the ACS guidelines was associated with reductions in all-cancer incidence and the incidence of cancer at specific sites, as well as with reductions in cancer mortality and total mortality".

To read the full abstract, and for information on how to access the full text, go to: http://dx.doi.org/10.3945/ajcn.114.094854 or contact your DHB library, or organisational or local library for assistance.

Kabat, G.C., et al. (2015). Adherence to American Cancer Society cancer prevention guidelines and cancer incidence, cancer mortality, and total mortality. American Journal of Clinical Nutrition, 101(3), 558-569.

To read the free research paper in full, go to: http://www.parliament.nz/en-nz/parl-support/research-papers/00PLLawRP2014041/obesity-and-diabetes-in-new-zealand

Studies in this issue (attached below):

For the first time, a report from an ongoing, systematic review of global cancer research has identified potential links between diet, weight and physical activity and longer survival for women diagnosed with breast cancer.

In partnership with the American Institute for Cancer Research (AICR), World Cancer Research Fund (WCRF) International’s Continuous Update Project (CUP) today released a report that found indications of links between survival and:

• A healthy body weight
• Being physically active
• Eating foods containing fiber and soy
• A lower intake of fat, particularly saturated fat

To read the full media release and to view the report, go to: http://www.aicr.org/press/press-releases/2014/aicr-wcrf_breast_cancer_survivorship_report.html

Studies in this issue (attached below):

The Stanford Translational Research Integrated Database Environment (STRIDE) was utilized to identify all ASA PS 2 or 3 patients who underwent primary THA at Stanford Medical Center from February 1, 2008 through January 1, 2013. Patients were divided into five groups based on the BMI weight classification. Regression analysis was used to quantify relationships between BMI and the different components of total OR time.

1,332 patients were included in the study. There were no statistically significant differences in age, gender, height, and ASA PS classification between the BMI groups. Normal-weight patients had a total OR time of 138.9 min compared 167.9 min (P < 0.001) for morbidly obese patients. At a BMI > 35 kg/m2 each incremental BMI unit increase was associated with greater incremental total OR time increases.

The authors conclude that morbidly obese patients required significantly more total OR time than normal-weight patients undergoing a THA procedure. This increase in time is relevant when scheduling obese patients for surgery and has an important impact on health resource utilisation.

This is an open access article and is available to read in full text at: http://dx.doi.org/10.7717/peerj.530

Kadry, B., Press, C.D., Alosh, H., Opper, I.M., Orsini, J., Popov, I.A., Brodsky, J.B., Macario, A. (2014). Obesity increases operating room times in patients undergoing primary hip arthroplasty: A retrospective cohort analysis. PeerJ, 2:e530 

This study investigated the links between body mass index (BMI) and the most common site-specific cancers.

This study included 5·24 million individuals; of these 166,955 developed cancers of interest. BMI was associated with 17 of 22 cancers, but effects varied substantially by site. Each 5 kg/m2 increase in BMI was roughly linearly associated with cancers of the uterus, gallbladder, kidney, cervix, thyroid, and leukaemia. BMI was positively associated with liver, colon, ovarian, and postmenopausal breast cancers overall, but these effects varied by underlying BMI or individual-level characteristics. The study authors estimated that a 1 kg/m2 population-wide increase in BMI would result in 3790 additional annual UK patients developing one of the ten cancers positively associated with BMI.

Twenty-two prospective cohort studies were included in the analyses of this investigation. Two factors, smoking and alcohol consumption, showed statistically significant differences between Western and Asian populations, and the results were as follows (W/A): 2.05 (95% CI, 1.68 ~ 2.49)/1.27 (95% CI, 1.04 ~ 1.55) and 0.89 (95% CI, 0.76 ~ 1.04)/1.28 (95% CI, 1.07 ~ 1.53). The factor BMI = 18.5-21.9 kg/m2 showed statistically significant differences only in Western populations, 0.96 (95% CI, 0.93 ~ 0.99); the factor SBP = 120-139 mm Hg showed statistically significant differences only in Asian populations, 2.29 (95% CI, 1.04 ~ 5.09).

The authors conclude that the prevalences of risk factors affect the stroke morbidity in Western and Asian populations, which may be biased by race. They go on to say that the meta-analysis of population-based studies suggests that different preventive measures should be adopted for Western and Asian population groups that are at high risk for stroke.

This is an open access article and can be downloaded and read in full text at: http://dx.doi.org/10.1186/1471-2458-14-776

Chen, X., et al. (2014). Risk factors of stroke in Western and Asian countries: A systematic review and meta-analysis of prospective cohort studies. BMC Public Health, 14, 776.

The drop-in event at the Northcote Citizens Centre offered a ‘health warrant of fitness’ for men, including heart health, screening for diabetes, a free spot/mole check and a consultation with registered nurses.

To read the full story on the Massey University website, go to: http://www.massey.ac.nz/massey/about-massey/news/article.cfm?mnarticle_uuid=574B17AE-A76F-7CF7-3D26-AE863D580297

• Antenatal lifestyle advice for overweight/obese women
• Exposure to takeaway outlets, consumption and bodyweight
• Metabolic mediators of the effects of BMI on CHD and stroke
• Ambulatory activity changes and CV events in impaired glucose tolerance
• Sociodemographic differences in fast food price sensitivity
• Adherence to metformin safety guidelines
• Hospital admissions in relation to BMI in women
• Lifestyle interventions for diabetes prevention in the real world
• ER phentermine/topiramate for preventing progression to type 2 diabetes
• Working-age diabetics are more susceptible to influenza.

To subscribe to the Diabetes and Obesity Research Review, go to: http://researchreview.co.nz

To read the full abstract, and for access to a free full text version of the article, go to: http://www.biomedcentral.com/1741-7015/12/45/abstract

Reeves, G. K., et al. (2014). Hospital admissions in relation to body mass index in UK women: A prospective cohort study. BMC Medicine, 12, 45, doi:10.1186/1741-7015-12-45.

Studies in this issue (attached below):

This study investigated how much of the effects of body-mass index (BMI) on coronary heart disease and stroke are mediated through blood pressure, cholesterol, and glucose, and how much is independent of these factors.

The authors pooled data from 97 prospective cohort studies (1·8 million participants) between 1948 and 2005. The data included 57,161 coronary heart disease and 31,093 stroke events.

After reviewing this data the authors concluded that "interventions that reduce high blood pressure, cholesterol, and glucose might address about half of excess risk of coronary heart disease and three-quarters of excess risk of stroke associated with high BMI. Maintenance of optimum bodyweight is needed for the full benefits".

Based on their analysis, the authors conclude that "obesity is strongly related to hospitalization for heart failure in people with Type 2 diabetes, and the relationship is somewhat stronger for men than for women.

To read the full abstract, and for information on how to access the full text, go to: http://dx.doi.org/10.1111/dme.12340 or contact your DHB library, or organisational or local library for assistance.

Glogner, S., et al. (2014). The association between BMI and hospitalization for heart failure in 83 021 persons with Type 2 diabetes: a population-based study from the Swedish National Diabetes Registry. Diabetic Medicine, 31(5), 586–594.

This study quantified the association between body mass index (BMI) category and multimorbidity in a large cohort (223,089) registered in primary care.

Research at the Australian National University has found increased body mass index significantly increases the risk of heart disease – regardless of exercise level, smoking status and whether or not someone has diabetes.

Over 158,000 Australian participants of the Sax Institute’s 45 and Up Study with no history of cardiovascular disease were tracked over four years to see how incremental increases in body mass index (BMI) increased their risk of going to hospital for a range of cardiovascular diseases.

The study found even relatively minor increases in BMI come with increased cardiovascular risk.

“The risk of heart attack and angina increased by 23 per cent with each 5 unit increase in BMI,” said lead author of the paper outlining the study, Dr Grace Joshy of the National Centre for Epidemiology and Population Health (NCEPH) at ANU.

“The lowest risk is for a BMI from 20 – 22.5 and then it increases gradually from there. For moderately overweight people, the risk is 43% higher. For a BMI of above 32.5, the risk of heart attack and angina is more than doubled.”

“We used to think that it was only people with very serious weight problems that were at an elevated risk of heart disease,” said senior author Professor Emily Banks of NCEPH and the Sax Institute.

“These are the first large-scale Australia data to show us that there is no ‘safe’ level of overweight, when it comes to heart disease. The increase in risk was found in people who did and did not exercise, those with and without diabetes and in urban, rural and remote areas.”

“If you want to minimise your risk you need to pay attention to your weight. It’s a serious matter and it does impact your risk of cardiovascular disease,” said Professor Banks.

“Improving your odds is alright in a horse race but the race to a heart attack is certainly not one you would want to win,” said Dr Rob Grenfell, Heart Foundation National Director, Cardiovascular Health.

“This study highlights that as you put more weight on you become more at risk of doing real damage to your heart.  Which is why it’s incredibly important for all Australians to manage their blood pressure, cholesterol and blood sugar levels, stop smoking, exercise daily and eat a healthy diet,” said Dr Grenfell.

The 45 and Up Study is managed by the Sax Institute in collaboration with partners: Cancer Council NSW; National Heart Foundation of Australia (NSW Division); NSW Ministry of Health; beyondblue; Ageing, Disability and Home Care, Department of Family and Community Services NSW; the Australian Red Cross Blood Service; and UnitingCare Ageing.

The original media release can be viewed at: http://news.anu.edu.au/2013/10/23/rising-body-mass-index-increases-heart-risk/

Studies in this issue (attached below):

In some studies, interventions were conducted exclusively by pharmacists. In others, they worked in collaboration with physicians, nurses, dietitians, or physical therapists.. Interventions included medication management, educational interventions, feedback to physicians, measurement of CVD risk factors, or patient-reminder systems. Compared with usual care, pharmacist care was associated with significant reductions for systolic BP; diastolic BP; total cholesterol; LDL cholesterol ; and BMI. Pharmacist care was not associated with a significant change in HDL cholesterol.

To view the full abstract and for information on how to access the full text, go to:
http://care.diabetesjournals.org/content/35/12/2706.abstract or contact your DHB library, or organisational or local library for assistance.

Santschi, V., et al. (2012). Pharmacist interventions to improve cardiovascular disease risk factors in diabetes: A systematic review and meta-analysis of randomized controlled trials. Diabetes Care, 35:2706-2717.

It finds that having a body mass index outside the normal range significantly worsens risk parameters for cardiovascular disease in school aged children. This effect, already substantial in overweight children, increases in obesity and could be larger than previously thought. They authors note that there is a need to establish whether acceptable parameter cut-off levels not considering weight are a valid measure of risk in modern children and whether methods used in their study and reporting should be standardised.

This is an open access article and is available to read in full text at: http://www.bmj.com/content/345/bmj.e4759

Friedemann, C., et al. (2012). Cardiovascular disease risk in healthy children and its association with body mass index: Systematic review and meta-analysis. BMJ, 345:e4759

• Gastric bypass in type 2 diabetes with mild obesity
• Retinal screening intervals
• Physical inactivity and major noncommunicable diseases
• BMI and mortality in acute MI
• Diabetes patients’ willingness to discuss self-care
• Basal insulin and CV and other outcomes in dysglycaemia
• Type 2 diabetes susceptibility loci and weight loss
• Bovine insulin in infant formula and β-cell autoimmunity
• Diabetes and sexual function in women
• Antipsychotics and foetal/maternal metabolic effects

To subscribe to the research review, go to: http://www.researchreview.co.nz

Beginning in 2000, survey and medical record information was obtained from 8,334 participants in Translating Research Into Action for Diabetes (TRIAD), a study of diabetes care in managed care. The National Death Index was searched annually to obtain data on deaths over an 8-year follow-up period (2000–2007). Predictors examined included age, sex, race, education, income, smoking, age at diagnosis of diabetes, duration and treatment of diabetes, BMI, complications, comorbidities, and medication use.

After analysing the data the study authors concluded that risk of death can be predicted in people with type 2 diabetes using simple demographic, socioeconomic, and biological risk factors with fair reliability. Such prediction equations are essential for computer simulation models of diabetes progression and may, with further validation, be useful for patient management.

McEwen, L. N. et al. (2012). Predictors of mortality over 8 years in type 2 diabetic patients: Translating Research Into Action for Diabetes (TRIAD). Diabetes Care, [Epublished 19 March 2012].

To read the full abstract, and for information on how to access the full text, go to: http://care.diabetesjournals.org/content/early/2012/03/13/dc11-2281.abstract or contact your local or organisational library for assistance.

Molsted, S., Tribler, J., & Snorgaard, O. (2012). Musculoskeletal pain in patients with type 2 diabetes. Diabetes Research and Clinical Practice, Article in Press, published online 16 January 2012.

To read the full abstract, and for information on how to access the full text, go to: http://www.diabetesresearchclinicalpractice.com/article/S0168-8227%2811%2900704-2/abstract or contact your local or organisational library for assistance.

The study, reported in the Journal of Diabetes, followed the cohort for an average of 7.8 years and the authors concluded that favourable lifestyle factors can potentially achieve substantial reductions in premature mortality among people with diabetes.

This research was part of the European Prospective Investigation into Cancer and Nutrition–Potsdam (EPIC-Potsdam) study.

Nöthlings, U., Ford, E. S., Kröger, J. & Boeing, H. (2010). Lifestyle factors and mortality among adults with diabetes: Findings from the European Prospective Investigation into Cancer and Nutrition–Potsdam study. Journal of Diabetes, 2: 112–117.

The full-text version of the article can be found at http://onlinelibrary.wiley.com/doi/10.1111/j.1753-0407.2010.00069.x/full

Further information on the EPIC-Potsdam study can be found at http://www.dife.de/en/index.php - select Research  and then EPI.