Effect of Caloric Restriction or Aerobic Exercise Training on Peak Oxygen Consumption and Quality of Life in Obese Older Patients With Heart Failure With Preserved Ejection Fraction

Researchers analyze risk factors associated with development of medical conditions. Acknowledgement of co morbidities is apparent when discussing hypertension. Older patients with heart failure with preserved ejection fraction (HFPEF) are likely to have significant weight issues. The presence of increased adipose tissue has been commonly seen in patients with HFPEF. Without any intervention for weight loss, the longevity of life is reduced.

A  study conducted in 2009 evaluated the impact of diet or exercise in obese older patients with HFPEF. They tested exercise capacity and quality of life outcomes as measurements to be interpreted. There were 100 participants in the study and they were randomized to either exercise, diet, exercise plus diet, or neither exercise nor diet.

The results showed a 7% reduction in body weight for patients that dieted and 3% reduction for patients that exercised. For patients that dieted and exercised, body weight decreased by 10% and the control group decreased by 1%. Both the exercise and diet groups improved aerobic exercise capacity and there was a synergistic effect seen from the diet plus exercise group in for exercise activity.

I think these results support the reoccurring theme of the significance of diet and exercise. As future healthcare providers, we want to encourage patients to take the steps towards well being. Pharmacists are well aware of the educating their patients of drug therapies but should not forget to inform the patients the importance of diet and exercise in conjunction for improving their life.

 

JAMA. 2016;315(1):36-46.

Prevalence of Sugar-Sweetened Beverage Intake Among Adults — 23 States and the District of Columbia, 2013

The 2015-2020 Dietary Guidelines for Americans states that only 10% of a person’s daily calories should come from added sugar. They identified sugar-sweetened drinks as one of the most significant sources of sugar in the U.S., and frequently consuming these types of beverages is associated with many health conditions such as Type 2 diabetes, obesity, and cardiovascular disease. In an NHANES study, it was found that 50.6% of U.S. adults drink at least one sugar-sweetened beverage per day, and in certain regions of the country, such as the Northeast and South, this intake was even higher, reaching 68.4% and 66.7%, respectively. When looking at specific states, Louisiana, Mississippi, and West Virginia have the highest rate of sugar-sweetened beverage consumption. When looking at other factors that cause an increase in sugar consumption, the highest prevalence was seen in adults ages 18-24 years old, in men, in non-Hispanic African Americans, in unemployed adults, and in people with less than a high school education. The intake of these high sugar-content beverages was also found to be an effective biomarker for inflammation and insulin resistance that can then lead to cardiovascular disease and diabetes. Public health actions that should be taken to reduce the intake of these sugary beverages include education and awareness initiatives, increasing the access to healthier food options, food service guidelines being more readily accessible, and the promotion of drinking water in schools and in the general population. In addition, health care providers can screen patients’ sugar content and provide counseling on how to reduce their intake and give resources to help support them in this change.

MMWR Morb Mortal Wkly Rep.2016;65(Early Release):169-174

I chose this article because obesity and diabetes are two extremely common illnesses facing the American population. Food and beverages that contain high levels of additives, including sugar, are a major source of these problems. As this survey has shown, this problem affects a high percentage of our population and this will only increase if we do not take action. Making healthier options, such as fruit, vegetables, and water more available to the public, especially is the Northeastern and Southern regions of the country, will help reduce the prevalence we are seeing. Pharmacists counsel patients everyday on the numerous medications that are available for these conditions associated with high sugar intake, but we should also be counseling the patient on life-style changes. What good is the medication if the person does not change the behavior that is the core of the problem? I believe we need to shift our focus from purely talking about the side effects of these types of medications to informing the public that these medications are actually side effects of their high-sugar intake, and although the medications are helpful, they should not be seen as the solution. As health care providers, we need to start motivating people to change their dietary behaviors to prevent these conditions from occurring, and to prevent people from taking additional and unnecessary medications.