Lifestyle Changes Research Articles

Cardiovascular Disease Risk in the Obese Population in Kuwait: A Systematic Review and Meta-Analysis.

The increasing prevalence of obesity and associated cardiovascular diseases (CVDs) in Kuwait requires a comprehensive analysis of its contributing factors and health outcomes. This systematic review and meta-analysis aimed to synthesize the current evidence on the relationship between obesity and CVDs and identify the main factors driving obesity in the Kuwaiti population. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, multiple databases were systematically searched, identifying 980 articles. After removing duplicates and screening the articles against the inclusion criteria (observational or intervention studies published from 2001 to 2024 in English, conducted in Kuwait or on Kuwaitis, examining obesity (body mass index or validated measures) and CVDs (coronary artery disease, stroke, heart attack, hypertension, dyslipidemia, diabetes), 44 published studies from 2001 to 2024 were included in the final analysis. The studies varied widely in design and population, complicating the estimation of the total number of participants. The pooled prevalence of overweight patients was 36% (95% CI: 25-47) with high heterogeneity (I2=99.86%) and a statistically non-significant difference (p>0.01). Likewise, the pooled prevalence of overweight patients was 31% (95% CI: 23-40,I2=99.03%), with a statistically non-significant difference (p>0.01). The key factors contributing to obesity in Kuwait include a sedentary lifestyle, unhealthy diet, poor sleep quality, stress, genetic predisposition, metabolic disorders, environmental factors, and cultural factors. Sedentary behavior and unhealthy diets, exacerbated by rapid urbanization and economic growth, were prominent contributors. Genetic studies have identified specific genetic variants associated with obesity. Stress and poor sleep quality were significant factors, particularly in urban environments. A strong association was found between obesity and various CVD risk factors, including hypertension, dyslipidemia, and diabetes mellitus, with pooled population attributable risk estimates of 15%-18%, 13%-15%, and 10%, respectively. These findings underscore the multifaceted nature of obesity in Kuwait, which is influenced by lifestyle, dietary habits, genetic factors, and socioeconomic changes. Age- and gender-specific analyses revealed higher obesity rates in adults aged 40-60 years and stronger associations with CVD in females. The consistent link between obesity and CVD risk factors highlights the urgent need for targeted public health interventions. Obesity contributes significantly to the CVD burden in Kuwait, driven by a combination of lifestyle, genetic, and environmental factors. Comprehensive strategies addressing these determinants are essential to mitigate the obesity epidemic and its associated health risks in the Kuwaiti population.

How Public Relation Exist and Operate in the Organisation?

With the development of technology and the change of life style, organisations are seeking more effectiveness and efficient way to practice the public relations. How public relation works in the organisations has been studies extensively. This essay will focus on how public relation exist and operate in the organisation from three different aspects which are traditional media, social media and stakeholder engagement which link one-way or two-way Grunig and Hunt’s models. The one-way or two-way Grunig and Hunt’s models will be explained in the essay as well. Moreover, the essay will take M&M’s chocolate, Brisbane City Council and Manila Water Company as three examples to testify how the three approaches working in the public relations in society. Finally, it is recommended that the organisations are better to choose the suitable method basing on the organisations’ strategy and which ethical framework they applied.

Unveiling the Metabolomic Profile of Oily Sensitive Skin: A Non-Invasive Approach

Skin barrier impairment is becoming increasingly common due to changes in lifestyle and modern living environments. Oily sensitive skin (OSS) is a condition that is characterized by an impaired skin barrier. Thus, examining the differences between OSS and healthy skin will enable a more objective evaluation of the characteristics of OSS and facilitate investigations of potential treatments. Initially, a self-assessment questionnaire was used to identify patients with OSS. Biophysical measurements and LAST scores were used to determine whether skin barrier function was impaired. Epidermal biophysical properties, including skin hydration, transepidermal water loss (TEWL), sebum content, erythema index (EI), and a* value, were measured with noninvasive instruments. We subsequently devised a noninvasive D-square sampling technique to identify changes in the skin metabolome in conjunction with an untargeted metabolomics analysis with an Orbitrap Q ExactiveTM series mass spectrometer. In the stratum corneum of 47 subjects, 516 skin metabolites were identified. In subjects with OSS, there was an increase in the abundance of 15 metabolites and a decrease in the abundance of 48 metabolites. The participants with OSS were found to have the greatest disruptions in sphingolipid and amino acid metabolism. The results revealed that an impaired skin barrier is present in patients with OSS and offers a molecular target for screening for skin barrier damage.

Diagnosis and Management of Lean Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Systematic Review.

Lean metabolic dysfunction-associated steatotic liver disease (MASLD) defies traditional views of fatty liver diseases by manifesting in nonobese individuals. The renaming from nonalcoholic fatty liver disease to MASLD underscores a broader understanding of its pathophysiology, highlighting the complex interplay of metabolic factors beyond obesity. Despite its clinical importance, diagnosing and managing lean MASLD remains challenging due to its historical ties to obesity and a general lack of awareness about its unique characteristics. On December 4, 2023, a systematic literature search was conducted across six databases, focusing on peer-reviewed studies in English related to the diagnosis and management of lean MASLD. This study was registered with the International Prospective Register of Systematic Reviews (CRD42023489308). Out of 95 studies following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 43 addressed diagnosis and surveillance, whereas 52 explored management strategies. The results revealed the difficulties in diagnosing lean MASLD, pointing out the limitations of traditional markers and the potential of advanced imaging techniques. Management strategies discussed included lifestyle changes and possible pharmacological treatments tailored to the specific metabolic features of this patient group. The study highlights the necessity for increased clinical awareness, regular monitoring, and personalized therapeutic approaches for lean MASLD. It calls for further research to refine diagnostic criteria and develop targeted treatments, aiming to enhance care for individuals with lean MASLD.

EFICÁCIA E SEGURANÇA DA SEMAGLUTIDA NO TRATAMENTO DA OBESIDADE

Obesity is a chronic disease that affects millions of people worldwide. It is a multifactorial condition involving genetic, social, environmental, and behavioral factors. The treatment of obesity is complex and may involve lifestyle changes, medication, and surgery. In this sense, the general objective of this work is to investigate the efficacy and safety of semaglutide in the treatment of obesity in patients who are not diabetic. The methodology used will be an integrative literature review, which consists of the identification, synthesis, and critical analysis of published studies on the subject. The research will be carried out in books and scientific articles available on digital platforms. The results of this study may contribute to a better understanding of obesity, as well as correlating the effects of semaglutide, its efficacy, and safety in the treatment of obesity.

DC cardioversion of atrial fibrillation

Direct current (DC) cardioversion is an everyday clinical procedure used to restore sinus rhythm from atrial fibrillation. This review summarises the current state of art in Denmark. Sufficient anticoagulation must be ensured before DC cardioversion to reduce the risk of thromboembolism. Biphasic maximum energy shocks delivered via anterolateral electrodes are recommended. Overall success is high, and the complication rate is low. Relapse of atrial fibrillation is common, and a long-term treatment strategy which may include antiarrhythmics, ablation and lifestyle change should be established in collaboration with the patient.

Discursive Positioning in Practitioner-Parent-Child Communication in Traditional Chinese Medicine Consultations

ABSTRACT This study examines practitioner-parent-child communication in Traditional Chinese Medicine (TCM) consultations. Employing the theoretical framework of positioning theory, this discourse study investigates the interactions among Chinese medicine practitioners, parents, and child patients. The data, recordings of 21 pediatric consultation sessions, were gathered from the Department of Chinese Medicine at a hospital in China. The findings reveal that parents position themselves as representatives of their child patients, who, conversely, play a passive role with limited participation in consultations. This phenomenon is consistent with previous studies on doctor-parent-patient communication in Western medicine settings. As caretakers, parents also position themselves as experts in their child’s health, articulating the child’s health conditions and demonstrating some familiarity with TCM. Emphasizing the importance of lifestyle changes for the child’s health and recovery, practitioners strategically position themselves as both medical professionals and parenting advisors and give direct advice to parents. This study argues that the positioning of parents may diminish child patients’ participation. The study enhances our understanding of doctor-parent-child communication in the context of TCM by elucidating the positioning of the participants. It concludes by discussing the significance of child patients’ engagement and the implementation of a patient-centered approach in TCM consultations.

Facilitators and barriers to implementing the Diabetes Prevention Program in rural church settings: A qualitative study using the Consolidated Framework for Implementation Research.

The CDC's Diabetes Prevention Program (DPP) is an effective lifestyle intervention to prevent type 2 diabetes (T2D). However, DPP implementation in rural areas is limited. This study sought to address this gap by implementing DPP in rural church settings through a community-academic partnership and identifying implementation facilitators and barriers. This was a cross-sectional qualitative study. Semistructured interviews guided by the Consolidated Framework for Implementation Research (CFIR) assessed church leaders' and lifestyle coaches' perceptions of implementing DPP in rural churches. Thematic analysis was used to identify key themes through an inductive approach; then, these emergent themes were deductively linked to CFIR constructs. COREQ guidelines were used to report study findings. Twenty-five stakeholders participated. Facilitators to implementing DPP included its evidence-based effectiveness in preventing T2D, as well as support from the academic partner in terms of funding, training, and communication. Additionally, DPP's alignment with community needs, along with the active engagement of pastors in participant recruitment, supported implementation. Several barriers hindered DPP implementation, including transportation and childcare issues, as well as program participants' medical conditions/disabilities limiting their participation. Furthermore, rural residents' reluctance to adopt lifestyle changes and loyalty to family churches posed challenges to their engagement in DPP. This study identified contextual factors influencing DPP implementation in rural communities. Findings highlight the importance of tailored strategies that leverage facilitators while proactively addressing barriers, including rural residents' reluctance to attend programs outside their church, resistance to lifestyle changes, and transportation issues to ensure successful DPP implementation in rural areas.

Function-based risk reduction intervention for lifestyle-related disorders among inactive 40-year-old people: a pilot randomised controlled trial

Background Interventions for preventing or reducing the development of lifestyle-related disorders should be investigated as these conditions are becoming increasingly prevalent and having large effects on quality of life and life expectancy globally. The aim of this pilot study was to prepare for a full-scale randomised controlled trial by evaluating the short-term changes resulting from a function-based preventive intervention aimed at lifestyle-related disorders on a small group of physically inactive 40-year-old people. Change in objectively measured physical activity, functional capacity according to a risk profile, and goal attainment were main outcomes.MethodsParticipants (n = 27) underwent functional examinations including tests of fitness, strength, mobility, balance, and posture as well as standard medical examinations including weight measures, blood pressure and blood tests and were randomised to two groups. The intervention group (n = 15) received feedback from all the examinations and lifestyle counselling based on a functional profile. The control group (n = 12) received feedback only from the standard medical examination. Follow-up was at 3–4 months. Changes in physical activity measured with accelerometers, functional levels on the functional profile, goal attainment and subjective assessments of health-related quality of life, motivation, function, and physical activity were examined, as were standard medical parameters.ResultsChange in mean time in moderate or more intense physical activity was 9 min higher in the intervention group (95% confidence interval -6.35, 24.51) and change in sedentary time was 42 min lower (-95.24, 11.32). The intervention group showed a higher increase in motivation for change 1.58 on 10-point scale (0.20, 2.97) and indicated more improvement on the functional risk levels concerning fitness (-0.06, 0.90). Correlation between objectively measured and self-assessed physical activity and function increased after the intervention. Most participants in the intervention group achieved some or all of their goals.ConclusionsThis small-scale pilot intervention with functional examinations and lifestyle counselling showed positive tendencies for change in short-term physical activity level. It seemed to lead to better understanding of personal functional capacity and increased motivation for lifestyle changes. Setting and fulfilling meaningful goals for lifestyle-related changes seemed to influence levels on the functional profile in positive directions. Research on larger and more diverse populations will be necessary to better understand the implications of the intervention.Trial registrationClinicalTrials.gov: NCT05535296 first posted on 10/09/2022.

Novel Therapeutic Approach for Obesity: Seaweeds as an Alternative Medicine with the Latest Conventional Therapy.

The prevalence of overweight and obesity is increasing worldwide. Common comorbidities related to obesity, significantly polygenic disorders, cardiovascular disease, and heart conditions affect social and monetary systems. Over the past decade, research in drug discovery and development has opened new paths for alternative and conventional medicine. With a deeper comprehension of its underlying mechanisms, obesity is now recognized more as a chronic condition rather than merely a result of lifestyle choices. Nonetheless, addressing it solely through lifestyle changes is challenging due to the intricate nature of energy regulation dysfunction. The Federal Drug Administration (FDA) has approved six medications for the management of overweight and obesity. Seaweed are plants and algae that grow in oceans, rivers, and lakes. Studies have shown that seaweed has therapeutic potential in the management of body weight and obesity. Seaweed compounds such as carotenoids, xanthophyll, astaxanthin, fucoidans, and fucoxanthin have been demonstrated as potential bioactive components in the treatment of obesity. The abundance of natural seaweed bioactive compounds has been explored for their therapeutic potential for treating obesity worldwide. Keeping this view, this review covered the latest developments in the discovery of varied anti-obese seaweed and its bioactive components for the management of obesity.

Determination of digital biomarkers of disease progression for digital phenotyping of patients with arterial hypertension.

Background: To compare the effectiveness of digital phenotyping of patients diagnosed with arterial hypertension with traditional monitoring methods over a three-year period. Patients and methods: The study was conducted from January 2021 to January 2024 among 800 patients diagnosed with arterial hypertension at 6 clinics in Moscow, Russia, evenly divided into experimental (identification of digital biomarkers of disease progression for digital phenotyping) and control (standard monitoring methods) groups. The intervention included lifestyle changes focused on increasing physical activity, improving sleep quality, reducing stress, and modifying diet. Significant improvements were observed in the experimental group compared to the control group. Systolic blood pressure decreased by 10 mmHg (p<0.001), pulse by 5 beats per minute (p<0.001), and stress level by 2 points (p<0.001) in the experimental group. Additionally, physical activity increased by 15 minutes per day (p<0.001), and sleep quality improved by 2 points on a scale from 1 to 10 (p<0.001). Results: Multiple regression analysis showed a decrease in the significance of digital biomarkers over the study period, indicating a positive response to the intervention. Conclusions: The obtained results emphasize the importance of comprehensive interventions in managing arterial hypertension and its related conditions. Implementing comprehensive lifestyle changes can lead to significant health improvements and serve as an effective preventive strategy. Further research is needed to explore optimal intervention strategies for promoting societal health.

Perceptions of brain health and aging among middle-aged latinos: A qualitative paper

ObjectivesLatinos living in the US are disproportionately impacted by Alzheimer’s disease and related dementias (ADRD). To develop culturally-informed interventions, a first step is engaging with key stakeholders. The present study aimed to explore perspectives on brain health and aging among middle-aged Latinos living in Chicago, IL. MethodsIndividual, semi-structured interviews were conducted with 30 English- or Spanish-speaking Latinos between 35 to 64 years old. Questions from a previously used interview guide were leveraged and addressed knowledge about the brain, perceptions of healthy and unhealthy aging, ideas of how to care for the brain, where knowledge was acquired, and suggestions for disseminating brain health education. Responses were analyzed using thematic analysis. ResultsThe following themes were identified: (1) Understanding of the brain is varied (including cognitive, behavioral, anatomical, and psychological descriptions); (2) Perceptions surrounding healthy aging are broad and demonstrate a depth of understanding (e.g., physical and cognitive abilities, independence, positive emotions, and sociability), yet understanding of signs of an unhealthy brain is somewhat limited (e.g., focus on memory); (3) Brain health promotion is largely viewed as actionable (spanning physical health, cognitively stimulating activities, emotional wellbeing, medical self-management, and social connectedness); (4) Suggestions for disseminating education included media, clinics, churches, libraries, and community centers, with consideration of possible barriers and facilitators to behavior change (e.g., finances, prioritizing family). ConclusionsResults showed significant heterogeneity in understanding of the brain, albeit with promising attitudes that actions can be taken to protect one’s brain from ADRD. Practice ImplicationsTakeaways include the need for increasing education on normative versus nonnormative memory loss and signs of ADRD beyond memory impairment. Messaging may benefit from utilizing analogies, considering familism and spirituality, and highlighting lifestyle changes that do not carry a financial burden or place blame on individuals.

SDIMMMER: A Proposed Clinical Approach to Optimize Cellular Physiology in Regenerative Medicine.

SDIMMMER is an acronym intended for use in both clinical practice and medical research. It facilitates a comprehensive evaluation of a patient's metabolic profile and serves as a mnemonic for the following key assessment areas: Sleep, Diet, Microbiome, Metabolism, Medications, Exams, and Rehabilitation. In the clinical setting, SDIMMMER's primary objective is to monitor and manage the patient's metabolic status, particularly targeting low-grade chronic systemic inflammation, a hallmark of metabolic syndrome (MS). This inflammatory condition is characterized by elevated levels of circulating inflammatory cytokines and increased macrophage infiltration in peripheral tissues. SDIMMMER aims to enhance the effectiveness of ortho biological treatments by elevating growth factor levels, thereby enhancing patient outcomes. Additionally, SDIMMMER emphasizes guiding patients toward positive lifestyle changes to improve overall quality of life and foster a healthier metabolism. SDIMMMER introduces a patient metabolic profile quantification tool comprising 7 domains, totaling 35 items. Additionally, an instructional guide is provided to facilitate the application process. Its versatility spans various clinical and research domains, showcasing its potential to positively influence multiple fields.

Risk factors for second primary breast cancer by laterality, age, and race and ethnicity.

Epidemiologic studies of risk factors for second primary breast cancer (SBC) have been conducted primarily in non-Hispanic White (NHW) women. A racially- and ethnically-diverse population-based pooled cohort of 9,639 women with first primary stage I-III invasive breast cancer (FBC) was linked with the California Cancer Registry; 618 contralateral SBC (CSBC) and 278 ipsilateral SBC (ISBC), diagnosed >6 months after FBC, were identified. Using Fine and Gray models accounting for competing risks, we assessed associations of CSBC and ISBC risk with FBC clinical characteristics and epidemiologic factors. In younger women (FBC at age <50 years), higher CSBC risk was associated with ER/PR-negative FBC [hazard ratio (HR)=1.68], breast cancer family history (HR = 2.20), and nulliparity (HR = 1.37). In older women (FBC at age ≥50 years), higher risk was associated with breast cancer family history (HR = 1.32), premenopausal status (HR = 1.49), overweight (HR = 1.39), and higher alcohol consumption (HR = 1.34). For ISBC, higher risk was associated with married status (HR = 1.94) in younger women, and overweight (HR = 1.60) among older women. For CSBC, HR estimates were generally similar across racial and ethnic groups. Even after adjustment for these risk factors, compared with NHW women, risk remained elevated for CSBC in younger African American, Asian American, and Hispanic women, and for ISBC in older African American and Hispanic women with ER/PR-positive FBC. Our findings support genetic risk evaluation, enhanced screening, and lifestyle changes in women at higher risk of SBC. Additional risk factors must contribute to the unequal burden of SBC across racial and ethnic groups.

Modifying Non-communicable Disease Behaviours through Effective Health Communication and Behaviour Change: A Systematic Review

Abstract Non-communicable diseases (NCD) account for 74% of global mortality. Approximately 86% of all premature deaths occur in low- and middle-income countries majorly attributed to lifestyle changes or behavioural risk factors. The theory-based behaviour change interventions (BCIs) appear promising, but their applicability is not explored within the national programmes. The current paper aims to review the effectiveness of theory-based BCI in modifying the NCD risk factors and provide insights into the national NCD programmes. Interventions conducted to evaluate theory-based BCIs between 2002 and 2022 in modifying behavioural risk factors for NCDs were identified from multiple databases (PubMed, Scopus, Google Scholar and Cochrane Library) for systematic review. The final analysis included 35 studies that used theories and models that broadly come under one of the four approaches, i.e. intrapersonal (targets inherent individual factors for behaviour change), interpersonal (targets the family or groups), community (target socio-cultural ecosystems) and integrated (combination of other three approaches). Twenty-seven studies showed significant results. The highest number of studies were of interpersonal approach using socio-cognitive theory and integrated (11 each), and strength of evidence was moderate for both. Twenty-six studies focused on physical inactivity and unhealthy diet. The review supports the effectiveness of behaviour change interventions for mitigating NCD risk factors. Further efforts, including implementation research study methods, should be directed to evaluate effects of these interventions on population health outcomes within specific cultural and social contexts.

Colorectal cancer and associated genetic, lifestyle, cigarette, nargileh-hookah use and alcohol consumption risk factors: a comprehensive case-control study.

This study aimed to investigate the causes and risk factors of colorectal cancer (CRC) in a Turkish population, focusing on various modifiable and non-modifiable risk factors. A hospital-based case-control design was employed to compare individuals with CRC (cases) to individuals without CRC (controls). Male and female participants were recruited from the surgery, internal medicine, and out-patient departments. The study encompassed socio-demographic data, clinical information, radiological diagnoses, and biochemical measurements. Univariable and multivariable logistic regressions were used to determine associated risk factors of CRC. The study included 704 individuals with CRC and 704 controls. Significant socio-demographic disparities were observed between the groups, with over 30% of the cases having lower levels of education and income compared to the controls. Lifestyle factors such as obesity, higher rates of smoking (cigarettes and hookah) and alcohol consumption were more prevalent among cases than controls. Further significant associations were identified with intestinal inflammation, obesity, processed food consumption, and symptoms such as abdominal pain, cramps, diarrhea, constipation, blood in stool, bloating, irritable bowel syndrome, nausea/vomiting, anemia, stress, fatigue, weakness, and weight loss. Diet analysis revealed that individuals with CRC consumed more red meat, processed and fast foods along with less pulses and vegetables. Genetic predispositions and exposure to chemicals also correlated strongly with increased CRC risk. Multivariable regression analysis identified, nausea/vomiting, constipation, intestinal disease, genetics factor, hookah-nargileh use, history of any cancer, family history of bowel cancer, constipation, cigarette smoking, stress, milk-yogurt consumption, obesity and red meat consumption as significant determinants for CRC. CRC risk is influenced by dietary, lifestyle, and genetic factors. Awareness of hereditary risk and participation in screening are crucial. Lifestyle changes, such as avoiding smoking, hookah, and alcohol use, and adopting a healthy diet, are essential for prevention.

Efficacy of a High-Protein Diet to Lower Glycemic Levels in Type 2 Diabetes Mellitus: A Systematic Review.

Diabetes is a metabolic disease with a high worldwide prevalence and an important factor in mortality and disability in the population. Complications can be reduced or prevented with lifestyle changes in physical activity, dietary habits, and smoking cessation. High-protein diets (HPDs, >30% or >1.0 g/Kg/day) decrease hyperglycemia in part due to their content of branched-chain amino acids (BCAAs), mainly leucine. Leucine (and other BCAAs) improve glucose metabolism by directly signaling in the medio-basal hypothalamus (MBH), increasing liver insulin sensitivity. To determine the effectiveness of an HPD to lower hyperglycemia, we analyzed the results of published clinical studies focusing on the levels of fasting plasma glucose and/or glycosylated hemoglobin (HbA1c) in patients with type 2 diabetes mellitus (T2DM). We carried out a systematic search for clinical studies using HPDs. We searched five databases (Scopus, Web of Science, PubMed, Epistemonikos, and Cochrane), collecting 179 articles and finally selecting 8 articles to analyze their results. In conclusion, HPDs are an effective alternative to reduce hyperglycemia in patients with T2DM, especially so-called Paleolithic diets, due to their higher-quality protein from animal and vegetal sources and their exclusion of grains, dairy products, salt, refined fats, and added sugars.

Barriers to Pro-Environmental Behavior Change: A Review of Qualitative Research

In recent decades, reports of deforestation, mass extinctions, biodiversity loss, and emergencies like floods and droughts have clearly highlighted the impact of human activities on climate change. This underscores the need for significant lifestyle changes to mitigate this impact. Pro-environmental behavior (PEB) change involves adopting actions that protect the environment and reducing environmentally harmful activities to promote sustainability. While qualitative research may provide unique insights into PEB barriers that are challenging to capture through quantitative methods, reports of qualitative studies are scattered across different literatures with little integration. With the present review, we bring together qualitative studies on PEB barriers and examine whether those studies reveal barriers compatible with existing barrier frameworks from environmental psychology. We identified 38 qualitative studies on barriers to PEB change. Our analysis revealed that most of the barriers to individual pro-environmental action identified in qualitative studies align with environmental psychology frameworks. These barriers were experienced not only by individuals in their role as consumer or citizen, but also by community-level actors (e.g., seeking to implement pro-environmental policies) and industrial decision-makers (e.g., aiming to reduce the ecological footprint of their business activities). Our findings underscore the multifaceted nature of barriers to PEB change and emphasize the importance of addressing structural and institutional factors alongside individual-level interventions.

Implementation lessons learned from the University of California’s Diabetes Prevention Program Initiative

BackgroundThe University of California’s Diabetes Prevention Program (UC DPP) Initiative was implemented systemwide to address diabetes and obesity risk on all 10 campuses. As little is known about implementing lifestyle change programs in university settings, we examined implementation partners’ (i.e., UC DPP leaders and campus leads) perceptions of factors influencing program success on UC campuses.MethodsWe conducted qualitative interviews with UC DPP leaders and campus leads to examine challenges and opportunities with university-based DPP delivery models. Interviews were recorded, professionally transcribed, and reviewed in detail by the research team. Transcripts were analyzed using rapid qualitative analysis (RQA). The study was approved by the UCLA Institutional Review Board. All implementation partners provided verbal informed consent.ResultsTwenty-six implementation partners (8 UC DPP leaders and 18 campus leads) completed interviews in 2021. Seven themes were identified as critical for implementation, including (1) marketing and recruitment (i.e., market and recruit broadly through established channels as well as target at-risk populations); (2) enrollment (i.e., offer the program during convenient times and let participants know what to expect); (3) use an adaptable, evidence-based program; (4) secure funding for the program, participants, lifestyle coaches, and space; (5) hire experienced and dedicated staff and lifestyle coaches; (6) ensure leadership support; and (7) utilize campus linkages and resources. Perceptions of challenges faced with respect to these themes are also described.ConclusionsThis is one of the first studies to examine the challenges and opportunities of delivering an intensive lifestyle change program across 10 university sites. Understanding factors that enhance success of university-based diabetes prevention programs can facilitate UC DPP efforts and help inform delivery strategies of health and wellness programs across other university settings more broadly.

Obesity Control and Supplementary Nutraceuticals as Cofactors of Brain Plasticity in Multiple Sclerosis Populations.

Multiple sclerosis (MS) is an immune-mediated disease characterized by inflammation, demyelination, and neurodegeneration within the central nervous system. Brain plasticity, the brain's ability to adapt its structure and function, plays a crucial role in mitigating MS's impact. This paper explores the potential benefits of lifestyle changes and nutraceuticals on brain plasticity in the MS population. Lifestyle modifications, including physical activity and dietary adjustments, can enhance brain plasticity by upregulating neurotrophic factors, promoting synaptogenesis, and reducing oxidative stress. Nutraceuticals, such as vitamin D, omega-3 fatty acids, and antioxidants like alpha lipoic acid, have shown promise in supporting brain health through anti-inflammatory and neuroprotective mechanisms. Regular physical activity has been linked to increased levels of brain-derived neurotrophic factor and improved cognitive function. Dietary interventions, including caloric restriction and the intake of polyphenols, can also positively influence brain plasticity. Integrating these lifestyle changes and nutraceuticals into the management of MS can provide a complementary approach to traditional therapies, potentially improving neurological outcomes and enhancing the quality of life for the MS population.