Lifestyle Modification Strategies Research Articles

Prevalence and associated risk factors of gout among patients at Khyber Teaching Hospital Peshawar: A cross-sectional study

Hyperuricemia and gout represent significant global public health challenges with varying prevalence rates across populations. This study aimed to investigate the prevalence and associated risk factors for gout among patients at the Khyber Teaching Hospital, Peshawar, Pakistan. This cross-sectional analytical study was conducted from January to March 2024 and involved 100 patients (57% female, 43% male) aged 18–65 years. Participants were recruited via systematic random sampling from the orthopedic department. Data collection included demographic information, anthropometric measurements, medical history, and serum uric acid levels, which were analyzed via the uricase enzymatic colorimetric method. 93% of the patients were between 21 and 60 years old, with 54% reporting a family history of gout. Notably, 95% of the participants presented elevated uric acid levels (>6.8 mg/dL in men, >6.0 mg/dL in women), with 40% falling within the 7.1–8.0 mg/dL range. The major comorbidities included hypertension (72%), thyroid problems (45%), and kidney disease (34%). Protein-rich diet consumption was reported by 84% of the participants, whereas alcohol consumption was reported by 17%. The general health assessment classified 65% of the participants as unhealthy. The findings indicate a greater prevalence of gout among females in this population, contradicting traditional patterns, along with significant associations with comorbidities and dietary factors. This study highlights the need for sex-specific screening protocols and comprehensive management approaches that address both primary gout symptoms and associated conditions. These results emphasize the importance of early intervention and lifestyle modification strategies in gout management within the South Asian.

Association between chronic kidney disease and cardiovascular disease risk factors in elderly: results from the first phase of Fasa and Shahedieh cohort studies

BackgroundChronic kidney disease (CKD) is associated with increased cardiovascular disease (CVD) risk factors and morbidity in the elderly population. This study aimed to examine the association between CKD and CVD risk factors in the elderly population of Fasa and Yazd (Shahdieh), Iran, using the data from the enrolment phase of Fasa and Shahedieh cohort studies.MethodsWe conducted a cross-sectional analytical study using data from Fasa and Shahedieh cohort studies, which enrolled 1487 and 1507 participants aged over 60 years, respectively. We collected data on demographic and clinical variables, kidney problems, and CVD from the two studies. We estimated the glomerular filtration rate (eGFR) using the modification of diet in renal disease (MDRD) formula and considered values less than 60 ml/min/1.73 m2 as CKD. We used independent t-tests, Spearman’s correlation coefficient, chi-square, one-way analysis of variance, and logistic regression to analyze the data. We performed the analyses using SPSS V. 22.0 software and set the significance level at 0.05.ResultsThe overall prevalence of CKD was 41.9%; 25.7% in women and 16.2% in men. The prevalence of CKD based on reported kidney problems was 1.7%, of which 54.7% were in stage 3 of CKD. Compared to participants in the early stages of CKD, participants in advanced stages had a higher prevalence of diabetes (p < 0.001), hypertension (p < 0.001), ischemic heart disease (IHD) (p < 0.001), and myocardial infarction (p < 0.001). In addition, participants in higher stages of CKD were more obese, had lower physical activity, smoked more, and consumed more opium (p < 0.001).ConclusionOur study showed that more than half of the patients were in stage three CKD, which is an advanced stage of this disease. Diabetes Melitus, hypertension, dyslipidemia, IHD, and myocardial infarction were more prevalent in patients than others. These findings demonstrate the importance of screening for CKD in patients with diabetes mellitus and hypertension. The results also suggest that lifestyle modification and prevention strategies are needed to reduce the burden of CKD and CVD in this population.

Culturally Tailored Lifestyle Modification Strategies for Hypertension Management: A Narrative Review.

Hypertension (HTN) is a significant global health challenge affecting billions of individuals worldwide. The prevalence of HTN varies considerably across the globe due to diverse factors, such as lifestyle influenced by culture, genetics, health care access, and socioeconomic conditions. Lifestyle modification has a substantial impact on blood pressure management; however, some cultural practices and behaviors affect recommended lifestyle modification strategies for HTN management. The purpose of this review was to explore lifestyle modification strategies for HTN management from a cultural perspective. Lifestyle modification, including physical activity, stress reduction, changes in dietary patterns (adopting a low-sodium diet and intake of fruit and vegetables), and weight management, provide an effective non-pharmacologic intervention for the management of hypertension. Individual's cultural practices have the potential to determine their diet, physical activity levels, knowledge, and perception about HTN, adherence to treatment and medications, and the use of local herbal preparations for HTN management. Culture focuses on individuals' belief, practices and how these beliefs and practices influence their lifestyle behaviors for HTN management. It is important to consider patients' cultural beliefs before recommending lifestyle behaviors for HTN management.

Body mass index and sarcopenia and mortality risk among older hypertensive outpatients; the Nambu Cohort Study.

Maintaining ideal body weight and muscle strength through lifestyle modification is essential for improving activities of daily living (ADL) and life expectancy in hypertensive patients. The effect of weight reduction in older patients with hypertension, however, is controversial. We evaluated the prognostic significance of body mass index (BMI) and handgrip strength (HG) in older patients with hypertension. Patients were stratified by the combination of BMI and HG. COX regression analysis was used to assess the mortality risk. A total of 563 patients (age 77 [71-84] years, 50% male, 40% frailty) were followed for a median duration of 41 (34-43) months. In total, 59 deaths occurred during the follow-up period. Validation of mortality by BMI level revealed that patients with BMI < 22 kg/m2 were likely to have higher mortality risk. Low HG, however, was associated with a 3.7-fold increased mortality risk. The risk of all-cause mortality using BMI combined with HG (adjusted hazard ratio [95% confidence interval]) was as follows: (1) Normal HG + 22 kg/m2 ≤ BMI, reference; (2) Normal HG + BMI < 22 kg/m2, 2.39 (0.12-16.46); (3) Low HG + 22 kg/m2 ≤ BMI, 4.01 (1.42-14.38); and (4) Low HG + BMI < 22 kg/m2, 4.55 (1.33-18.13). These findings demonstrate that weight reduction may deteriorate the mortality risk in older patients with hypertension, and new lifestyle modification strategies for improving ADL, quality of life, and prognosis are warranted for older patients with hypertension. We assessed the association between BMI, handgrip strength, and risk of all-cause mortality to evaluate the validity of weight reduction in older patients with hypertension.

Investigating the impact of lifestyle factors on kidney patients: insights from epidemiological studies

This paper investigates the impact of lifestyle factors on kidney patients, drawing insights from various epidemiological studies. Chronic kidney disease (CKD) has emerged as a global health concern, with millions affected worldwide, highlighting the need for a deeper understanding of modifiable risk factors that can influence the onset and progression of the disease. Lifestyle factors such as diet, physical activity, smoking, alcohol consumption, and stress management play a crucial role in either exacerbating or mitigating the risk of kidney disease. Through an examination of key epidemiological studies, this paper explores how these factors contribute to kidney health and disease management. Research indicates that diets high in sodium and protein, particularly from animal sources, are associated with worsening kidney function, whereas plant-based diets, low in sodium, may have protective effects. Similarly, regular physical activity has been shown to improve kidney function, while a sedentary lifestyle may lead to its decline. Smoking and excessive alcohol consumption have long been identified as significant contributors to the progression of CKD, as epidemiological studies reveal a clear link between these behaviors and kidney health deterioration. In addition to physical health factors, the paper highlights the importance of mental health, noting that stress and psychological well-being can also affect kidney function, with chronic stress contributing to poor outcomes in patients with kidney disease. Based on these findings, the paper discusses potential lifestyle modification strategies that could serve as preventive and management tools for kidney patients. These include dietary interventions, tailored exercise programs, smoking cessation, reduced alcohol consumption, and stress reduction techniques.

O28 EVALUATE THE IMPACT OF STRUCTURED TRAINING COURSE ON HEALTHCARE PROVIDERS KNOWLEDGE AND AWARENESS OF LIFESTYLE MODIFICATIONS FOR HYPERTENSION MANAGEMENT

Background: This study explores how structured training program enhances healthcare professionals’ awareness of lifestyle modifications for hypertension. Assessing its impact on both knowledge and patient guidance, with an aim to improve healthcare delivery by equipping professionals with informed strategies for lifestyle modification. Design and Methods: A quasi-experimental design was employed with sample size of 750 HCPs. The Hypertension Knowledge-Level Scale (HK-LS), a modified questionnaire based on guidelines from the World Health Organization (WHO), was utilized to assess participants’ understanding of hypertension, knowledge of lifestyle modification, and clinical practice. A 12-week online course comprising seven modules was delivered to the HCPs, followed by pre- and post-tests to measure changes in knowledge regarding lifestyle modifications. Results: The analysis revealed a substantial increase in HCPs knowledge levels post-intervention compared to pre-intervention regarding hypertension (t = 4.90, p = 0.001), lifestyle modification (t = 3.62, p = 0.001), and their proficiency in offering lifestyle advice to patients (t = 3.56, p = 0.001). In addition to these positive outcomes among HCPs, the intervention also highlighted significant gender disparities in attendance and outcomes among participants. Females exhibited a higher attendance rate of 75% compared to males, with consequent improvements in practice, while males showed a more substantial enhancement in knowledge levels post-intervention. These findings underscore the importance of addressing gender-specific barriers to improvement, such as socio-cultural factors for females and preconceived notions for males, to optimize the effectiveness of future interventions in promoting healthier behaviors and outcomes. Conclusions: Structured training programs are imperative for enhancing HCPs’ knowledge of lifestyle modification, particularly in the context of hypertension, as a crucial component of primary prevention strategies. This signifies the effectiveness of the structured training program in enhancing HCPs’ comprehension of hypertension management and their ability to guide patients toward adopting healthier lifestyles.

Re-PROGRAM: The evaluation of a brief intervention program for patients with functional seizures in an outpatient hospital setting.

Functional seizures (FS) account for 20%-25% of referrals to specialist epilepsy clinics. They are associated with major disability, increased mortality, and frequent and costly health care use. Current guidelines emphasize the importance of implementing clinical pathways to coordinate and deliver effective treatment, but there are few targeted evidence-based interventions that reliably improve patient outcomes, and treatment resources are limited. We conducted a retrospective evaluation of Re-PROGRAM, a novel, brief intervention for functional seizure patients, to assess its feasibility in an outpatient setting. Twenty-nine patients with FS undertook Re-PROGRAM between August 2020 and January 2022 at the Alfred Hospital Functional Seizures Clinic, Melbourne, Australia. The intervention comprised five 60-90-min consecutive weekly appointments via telehealth, where psychologists engaged patients in a structured program of seizure management skills, lifestyle modification, and behavioral activation strategies. Following the intervention, patient feedback was collected in routine clinical follow-up as well as with a 24-item self-report pre-/postintervention comparison questionnaire. All 29 patients who enrolled in Re-PROGRAM completed the scheduled sessions. Of those who returned the postintervention questionnaire (n = 16), 15 reported a reduction in seizure frequency. Four patients were lost to follow-up. Of the remaining nine, eight reported seizure frequency reduction during clinical follow-up. Qualitative analysis of the feedback revealed the majority of patients reported reduced seizure duration, intensity, and bothersomeness, and patients felt improvements in their sense of control over seizures, confidence to use seizure control strategies, assertive communication, problem solving, coping skills, relationships with others, and their day-to-day functioning. This retrospective evaluation demonstrates the feasibility and acceptability of Re-PROGRAM as a brief intervention for individuals diagnosed with FS delivered in a clinical outpatient setting and warrants further investigation in larger scale, randomized controlled studies.

Psychological Impact of COVID 19 Pandemic on Mental Health of Children Admitted to a Tertiary Care Centre

Background To prevent the COVID 19 transmission and reduce the burden on health systems, schools were closed and classes shifted to home-based distance learning models with online learning activities. Being quarantined in homes caused great psychological burden to children. This study was done to study the impact of COVID 19 on mental health of children and their screen and sleep behaviour before and during the pandemic.MethodsAdmitted children aged between 4-14 years and their siblings of same age group were enrolled after getting informed consent from their parents. The information regarding their socio-demographic factors, screen time, sleep time, physical activity and psychological problems were assessed using Paediatric symptom checklist Questionnaire. Outcome was measured by the scores obtained according to their age. Screen time and sleep behaviour was assessed using the guidelines proposed by American Academy of Paediatrics.ResultsTwenty-seven (15.81%) of 171 children had psychological impairment. The 11–14-year-olds and children living in urban area were more affected. All participants had abnormal screen time with respect to their age during COVID 19 pandemic and 99.4 % had increased screen time compared to pre COVID era. Abnormal sleep pattern was seen in 26.9 % and compared with pre-Covid times 73.6 % of the participants had less physical activity. Conclusions Implementation of psychosocial intervention and lifestyle modification strategies at community level is the need of the hour. Post Covid era remnant and sequalae of psychological impairment needs to be assessed.

Screening for non-communicable diseases and counselling for risk factors modification in health &amp; wellbeing clinic at a tertiary care hospital

Non-communicable diseases like diabetes and hypertension are highly prevalent and make a substantive contribution to the global burden of morbidity and mortality in both developing and developed countries. Because lifestyle behaviors have been shown to be effective in preventing and treating several types of diseases that can ultimately lead to a high prevalence of morbidity and mortality, several widely accepted treatment guidelines for specific diseases include lifestyle modification strategies. We aim to identify the suspected cases of Diabetes Mellitus and Hypertension &amp; the risk factors among screened participants. We found 18% of them were found to be suspected as diabetics and 5% of them were suspected to be hypertension. We observed statistically significant association with risk factors between both the known cases and suspected cases of diabetes mellitus and hypertension. Screening programs can strengthen healthcare system initiatives and reduce the growing burden of both diabetes and hypertension in India.

The ABCs of the 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA guideline for the management of patients with chronic coronary disease.

The 2023 Multisociety Guideline for the Management of Chronic Coronary Disease (CCD) updates recommendations for CCD, formerly known as "stable ischemic heart disease." This condition encompasses a spectrum of coronary vascular pathologies from subclinical to clinical ischemic heart disease. The new "ABC" mnemonic offers clinicians a streamlined framework for applying Class One Recommendations (COR1) and integrating recent updates into CCD management. A critical analysis of the 2023 CCD guidelines was conducted, with this review highlighting key elements. The review outlines crucial changes, including novel recommendations supported by current clinical evidence. The focus is on these developments, clarifying their importance for day-to-day clinical practice. The review encourages a synergistic approach between primary healthcare providers and cardiologists to develop comprehensive strategies for lifestyle modification and medication therapy in CCD care. Furthermore, it suggests that utilizing comprehensive risk assessment tools can refine medical decision-making, ultimately enhancing patient care and clinical outcomes.

Construct validity of the 12-item Short Form Health Survey (SF-12) version 2 and the impact of lifestyle modifications on the health-related quality of life among Indian adults with prediabetes: results from the D-CLIP trial.

This study aimed to validate the factor structure of the 12-item Short-Form (SF-12) health-related quality of life (HRQOL) survey for Indian adults and assess the impact of lifestyle modification on the SF-12 of Indian adults with prediabetes. To validate the context-specific construct of the SF-12, two-factor confirmatory factor analysis (CFA) was performed using data from 1285 adults residing in Chennai, India, who screened for the Diabetes Community Lifestyle Improvement Program (D-CLIP). D-CLIP was a randomized controlled trial of 578 participants with prediabetes (283 treatment, 293 control), focusing on the effect of lifestyle modifications on the prevention of diabetes. Physical and mental component scores (PCS and MCS) were computed by using CFA standardized factor loadings. Multiple linear regression was subsequently conducted to estimate the effect of lifestyle modification on post-study changes of PCS and MCS among D-CLIP participants. Cronbach's alpha and CFA fit indices demonstrated acceptable reliability and model fit of the SF-12 for Indian adults. The intervention group showed greater mean change in PCS after study participation compared to the controls (1.63 ± 0.82, p = 0.046); no significant difference was observed for MCS between two groups (1.00 ± 0.85, p = 0.242). The study confirmed that the SF-12 is suitable for assessing the physical and mental health dimensions of HRQOL for Indian adults. Our findings suggest that the benefits of diabetes prevention lifestyle modification strategies may primarily enhance the physical well-being of adults with prediabetes. Further studies validating the SF-12 in a broader Asian Indian population are needed. Clinicaltrials.gov, NCT01283308.

Prevalence and associated factors of increased risk for sleep-disordered breathing and its relationship with body mass index among medical students, intern doctors, and residents

BackgroundPoor sleep quality among medical professionals due to study demands and shift work significantly impacts health. Additionally, this group has a higher obesity prevalence compared with the general population. This study aims to evaluate the prevalence and associated factors of increased risk for sleep-disordered breathing (SDB) and its relationship with body mass index (BMI). MethodsA cross-sectional study was conducted using online self-assessment questionnaires. PSQI scores over 6.5 were categorized as an increased risk for SDB. Multivariable logistic regression analysis was performed to identify factors associated with an increased risk of SDB. Linear regression analysis was conducted to establish the relationship between PSQI and BMI. ResultsOverall, there were 307 participants, comprising 114 medical students, 120 intern doctors, and 73 residents. One-third of participants (36.5%, 95%CI:31.1–41.9%) had an increased risk of SDB. Residents had the highest proportion of obesity class 2 (13.9%). The risk factors of SDB included medical students (adjusted odds ratio [aOR]:3.17, 95%CI:1.09–9.24), having inadequate exercise (aOR:2.08, 95%CI:1.08–4.00) and sleeping less than 7 h a day (aOR:12.50, 95%CI:5.00–33.33), working more than 40 h per week on shift increased the odds of SDB (aOR:2.97, 95%CI:1.29–6.85). Furthermore, an inverse dose-response relationship between BMI and PSQI score was observed among female participants (β = −0.03, 95%CI: (-0.052)-(-0.005)). ConclusionTo enhance sleep quality, it is advisable to include both adequate exercise and 7–8 h of sleep. Adjusting protected sleep periods is recommended. Implementing lifestyle modification strategies would benefit physicians in training and promote a healthier environment.

Effect of Lifestyle Modification Strategy based on 5A’s Model on Body Image and Quality of Life among Women with Polycystic Ovary

Effect of Lifestyle Modification Strategy based on 5A’s Model on Body Image and Quality of Life among Women with Polycystic Ovary

DOSE: uma filosofia de estilo de vida para a prevenção da demência informada pelo desenvolvimento de medicamentos e pela epidemiologia

ABSTRACT This article aims to bridge the gap between drug development and lifestyle modification strategies for dementia prevention. First, it focuses on three lessons from drug development to inform lifestyle changes: dementia treatment-resistance, the importance of maximizing therapeutic dose, and obtaining actionable feedback from drug trials. Moreover, epidemiology reveals a mismatch between promising associations and later interventions, the specificity of different dementias, and the ethics of health promotion. The article will argue that lifestyle choices for dementia risk should be understood through the lens of a life philosophy rather than a testable scientific hypothesis. This philosophy known by "DOSE" has four components: Diet — Other life priorities — Stimulation — Exercise. Striking the balance between a healthy lifestyle and non-health priorities is a fundamentally personal question and challenge, particularly in resource-limited contexts. Finally, individual behaviors are only the tip of the iceberg of modifiable dementia risk, inviting collective action to ensure equitable prevention.

A Review in Changes in Lifestyle to Prevent PCOD and PCOS

Endocrine disorders that are common and impact a considerable section of the female population are Polycystic Ovary Syndrome (PCOS) and Polycystic Ovary Disorder (PCOD). Lifestyle decisions are critical in the beginning and advancement of many conditions, even if hormonal and genetic factors play a part in their development. In order to prevent PCOD and PCOS, a thorough lifestyle modification approach is presented in this abstract along with its essential elements. Targeted dietary, exercise, stress-reduction, and sleep pattern modifications are all part of the suggested intervention. The key to controlling insulin levels and fostering hormonal balance is eating a well-balanced, nutrient-rich diet that emphasizes whole foods and minimizes processed carbohydrates and saturated fats. Frequent exercise is emphasized for the benefits it offers to managing weight, sensitivity to insulin, and general health. Techniques for reducing stress, including mindfulness and getting enough sleep, are essential to reducing the negative effects of long-term stress on hormone variations. The importance of good sleep hygiene is underscored by the connection between insulin resistance and hormonal dysregulation that accompany PCOD and PCOS, as well as insulin resistance. The abstract also discusses the significance of education and awareness campaigns to provide people the information they need to make wise lifestyle decisions. It is advised that public health programs be implemented to support early intervention, encourage better lifestyle choices, and lower the prevalence of PCOS and PCOD in the general population. In conclusion, by addressing food choices, physical exercise, stress management, and sleep hygiene, the suggested lifestyle modification strategy offers a comprehensive framework for preventing PCOD and PCOS. These adjustments, when combined with educational programs, have the potential to lower the incidence and severity of these prevalent endocrine problems, improving the health of women all over the world in the process.

Sarcopenia and malnutrition in patients with liver diseases

This review focuses on the most current information on the pathogenesis, diagnosis and treatment of sarcopenia and malnutrition in patients with liver disease. Sarcopenia and malnutrition are common complications of liver diseases. Liver cirrhosis, as a stage of the pathological process, serves as the main predisposing factor for the development of malnutrition and sarcopenia. The frequency of sarcopenia in liver cirrhosis is 30–50% and reaches 100% in decompensated patients. The main pathogenetic links are: impaired proteostasis of skeletal muscles, systemic inflammation and changes in gut microbiota. In recent years, enough data have been accumulated to consider these conditions as a prognostically unfavorable factor in patients with liver cirrhosis of various etiologies, affecting their quality of life and survival, as well as worsening the out-comes of transplantation. This dictates the necessity to define unified approaches to diagnostics and correction of these conditions. Currently, tests are used for diagnosis, which allow to assess muscle strength and function. Muscle mass is assessed using instrumental methods by measuring individual muscles and calculating skeletal muscle indices. In patients with liver cirrhosis and concomitant sarcopenia and malnutrition, nutritional and lifestyle modification strategies are applicable for correction in addition to therapy aimed at elimination of the etiologic factor. The aim of the review is to evaluate the problems of diagnosis and effective treatment of malnutrition and sarcopenia in patients with liver disease based on literature data. The article presents an overview of the main strategies for the approach, diagnosis and correction of these conditions.

Capacity of Clinical Officers to Care for Patients with Hypertension and Type 2 Diabetes Mellitus in Rural Healthcare Facilities in Kisumu County, Kenya

This study aimed to investigate the ability of clinical staff in a rural Kenyan health facility to manage patients with hypertension and type 2 diabetes mellitus. The study involved 146 clinicians from 56 medical facilities who were interviewed using semi-structured questionnaires, simulations, and observational instruments. Descriptive analysis was performed using SPSS version 24. Results showed that lack of knowledge of risk factors for HTN&amp;amp; T2DMHTN &amp;amp; T2DM, inability to perform a complete physical examination, inability to identify first-line medications for either hypertension or type 2 diabetes mellitus, unavailability of assigned patient follow-up clinic day/staff/room, and lack of treatment guidelines for hypertension and diabetes were associated with an inability to manage such patients. However, concurrent prescription of anti-hypertension medication along with advice on lifestyle modification strategies was associated with an ability to do so (OR 0.079; 95% CI0.016-0.934; P=P = 0.002). The study recommends that clinical staff receive education on the risk factors, physical examination, and first-line medications for managing hypertension and type 2 diabetes mellitus. Additionally, the study highlights the importance of having scheduled clinic days, assigned staff, dedicated rooms, and protocols and guidelines to improve the management of these conditions

Lifestyle and Pharmacological Interventions and Treatment Indications for the Management of Obesity in Children and Adolescents.

Obesity is a multifactorial chronic impairment that further decreases quality of life and life expectancy. Worldwide, childhood obesity has become a pandemic health issue causing several comorbidities that frequently present already in childhood, including cardiovascular (hypertension, dyslipidemia), metabolic (Type 2 diabetes mellitus, fatty liver disease, metabolic syndrome), respiratory, gastrointestinal and musculoskeletal disorders. In addition, obese children frequently experience stress and psychosocial symptoms, including mood disorders, anxiety, prejudice and low self-esteem. Given that cardiovascular risk factors and pediatric obesity have the tendency to pertain into adulthood, obesity management, including weight control and physical activity, should start before the late teens and certainly before the first signs of atherosclerosis can be detected. This review aims to concisely present options for childhood obesity management, including lifestyle modification strategies and pharmacological treatment, as well as the respective treatment indications for the general practitioner.

Making the Case for Standardized Outcome Measures in Exercise and Physical Activity Research in Chronic Kidney Disease

Physical activity and exercise are core components of lifestyle modification strategies for the management of chronic kidney disease (CKD). Yet, physical activity levels have consistently remained poor across all stages of CKD. Exercise interventions, including aerobic and resistance training, and lifestyle interventions promoting physical activity, have been shown to improve a multitude of clinical endpoints and factors important to patients; however, despite the evidence, the provision of physical activity in clinical practice is still inadequate. The usefulness of any study hinges on the adequacy and clinical relevance of the outcomes and outcome measures used. Inconsistent reporting and wide disparities in outcome use across studies limit evidence synthesis to help guide clinical practice. The kidney exercise and physical activity field has been particularly prone to inconsistent outcome reporting. To ensure research is relevant and able to influence clinical practice and future research, we need to ensure the use (and reporting) of standardized, relevant outcome measures. Core outcome sets (COS) have been widely developed across many chronic conditions, yet these COS have not been tailored to physical activity and exercise in CKD. Outcomes in clinical research need to be relevant to the intervention being employed. From this perspective, we summarize the importance that standardizing outcomes and outcome measures may have in relation to physical activity and exercise interventions for people living with kidney disease.

Investigating self-reported efficacy of lifestyle medicine approaches to tackle erectile dysfunction: a cross-sectional eSurvey based study

BackgroundErectile dysfunction (ED) is the most common sexual dysfunction in men. Some types of ED are amenable to treatment using lifestyle medicine approaches with or without pharmacotherapy.AimInvestigate self-reported efficacy of lifestyle medicine approaches to tackle ED.MethodsA cross-sectional online survey of 1177 community dwelling adults explored the prevalence and methods used to tackle ED in the community setting. We examined differences between participants with and without ED. Variables associated with ED in univariable analyses were included in a multivariable logistic regression to identify variables independently associated with the condition.OutcomesSelf-reported measure: perceived effectiveness of lifestyle medicine interventions to tackle ED.ResultsMost respondents (76.5%) had experienced ED, and this was associated with having a long-term condition, taking anti-hypertensive medication, hypercholesterolaemia and obesity. Medication was the most common management strategy overall (65.9%), followed by stress management (43.5%) and weight loss (40.4%). Over half (53.9%) did not use any lifestyle modification strategies to tackle ED. Only 7.0% of ED sufferers received a mental health assessment and 29.2% received other tests (e.g., blood test, medical imaging) by GPs. Cardiovascular training was identified as the best rated strategy by its users (37.8%). Supplements (35.1%) and weight training/physical activity (32.6%) were also positively rated.Clinical implicationsStructured education to general practitioners and community dwelling adults about the impact of lifestyle behaviour modification and how this could influence the appearance or trajectory of ED could help improve personal choice when tackling ED.Strengths and limitationsTo our knowledge, this is the first study to collect eSurvey responses from community dwelling adults to gauge their reliance and perceived effectiveness of lifestyle medicine approaches to tackle ED. The principal limitation was the lack of follow-up, and not recording other information including lifestyle factors such as nutrition, smoking, and the use of alcohol and recreational drugs, which may have enabled a fuller exploration of the factors that could influence the primary outcome measures examined.ConclusionDespite the high prevalence of ED, there is not enough awareness in the community setting about effective and low-cost lifestyle medicine strategies, including cardiovascular training and the use of supplements and weight training, to help tackle this common condition.