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MidtermReview2011

MidtermReview2011 - Nurses health study In the 1990s the...

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Nurses health study. In the 1990s the Nurses Health study showed that Nurses taking hormone replacement therapy (HRT) had 1/3 as many heart attacks as Nurses who did not. By 2001 15 million women were taking HRT. Then in 2002 the Women’s Health Initiative published results showing that HRT did not decrease heart disease, but it did increase the incidence of breast cancer. Use of HRT dropped and incidence of breast cancer dropped by tens of thousands per year.
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Summary WHI low fat results Postmenopausal women in the intervention group were advised to reduce total fat intake to 20% of energy and to consume at least 5 servings of fruits and vegetables and 6 servings of grains daily; women in the control group continued their usual eating pattern. Dietary intervention was associated with a modest but statistically nonsignificant reduction in invasive breast cancer and no reductions in the risks of colorectal cancer, cardiovascular disease, coronary heart disease, or stroke.
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Hidden problems in observational studies Health user bias. Going to college reduces heart attacks by 50% in users of HRT. HRT use was associated with reduced deaths from homicide, suicide and accident in the Walnut Creek Study. Compliance bias. Coronary drug project, clofibrate and good adherers. Perscription bias.
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Copyright restrictions may apply. Smith, G. D. et al. Int. J. Epidemiol. 2001 30:1-11; doi:10.1093/ije/30.1.1 Meta-analysis of results of observational cohort studies of beta-carotene intake and cardiovascular mortality and of randomized controlled trials of the same issue93
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Exercise, Genetics, and Weight Loss Three views of exercise and obesity 1. You get back what you pay in If there are 3500 kcal per pound of body fat, then 3 hrs per week of running at 500 kcal per hr should result in ~0.4 lbs per week of weight loss 1. You get back more than you pay in Because “exercise speeds your metabolism”, you lose more than the 0.4 lb/wk noted above 1. I don’t know how those skinny runners do it, but it doesn’t work for me
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Exercise, Genetics, and Weight Loss Obesity Treatment – Exercise vs Diet PD Wood, M Stefanick, D Dreon, et al. New England Journal of Medicine 319:1173-9, 1988. Results Effects Group 7 Months 12 Months Wt change Diet -7.6 -7.2 (kg) Exercise -3.0 -4.0 Control +0.2 +0.6 Fat Change Diet -6.3 -5.9 (kg) Exercise -3.4 -4.1 Control -0.5 -0.3
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Exercise, Genetics, and Weight Loss Definitions Exercise intensity as % peak aerobic power Aerobic power is equated with oxygen uptake Peak aerobic power (VO 2 max) = peak O 2 uptake for a specific activity Relative body weight as body mass index (BMI) BMI = (wt in kg) ÷ (height in meters) 2 Normal 18-25, overweight 25-30, obese >30
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Exercise, Genetics, and Weight Loss Exercise in Older Adults Group vs home exercise training in healthy older men and women . A King, W Haskell, C Taylor, et al. JAMA 266:1535-42, 1991.
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