Background: Marital status is associated with prognosis in patients with cardiovascular disease (CVD). However, the influence of partners on successful modification of lifestyle-related risk factors (LRFs) in secondary CVD prevention is unclear. Therefore, we studied the association between the presence of a partner, partner participation in lifestyle interventions and LRF modification in patients with coronary artery disease (CAD). Methods: In a secondary analysis of the RESPONSE-2 trial (n = 711), which compared nurse-coordinated referral to community-based lifestyle programs (smoking cessation, weight reduction and/or physical activity) to usual care in patients with CAD, we investigated the association between the presence of a partner and the level of partner participation on improvement in >1 LRF (urinary cotinine <200 ng/l, ≥5% weight reduction, ≥10% increased 6-min walking distance) without deterioration in other LRFs at 12 months follow-up. Results: The proportion of patients with a partner was 80% (571/711); 19% women (108/571). In the intervention group, 48% (141/293) had a participating partner in ≥1 lifestyle program. Overall, the presence of a partner was associated with patients' successful LRF modification (adjusted risk ratio (aRR) 1.93, 95% confidence interval (CI) 1.40-2.51). A participating partner was associated with successful weight reduction (aRR 1.73, 95% CI 1.15-2.35). Conclusion: The presence of a partner is associated with LRF improvement in patients with CAD. Moreover, patients with partners participating in lifestyle programs are more successful in reducing weight. Involving partners of CAD patients in weight reduction interventions should be considered in routine practice.
Objective: To study the effects of a comprehensive secondary prevention programme on weight loss and to identify determinants of weight change in patients with coronary artery disease (CAD). Methods: We performed a secondary analysis focusing on the subgroup of overweight CAD patients (BMI ≥27 kg/m2) in the Randomised Evaluation of Secondary Prevention by Outpatient Nurse SpEcialists-2 (RESPONSE-2) multicentre randomised trial. We evaluated weight change from baseline to 12-month follow-up; multivariable logistic regression with backward elimination was used to identify determinants of weight change. Results: Intervention patients (n=280) lost significantly more weight than control patients (n=257) (-2.4±7.1 kg vs -0.2±4.6 kg; p<0.001). Individual weight change varied widely, with weight gain (≥1.0 kg) occurring in 36% of interventions versus 41% controls (p=0.21). In the intervention group, weight loss of ≥5% was associated with higher age (OR 2.94), lower educational level (OR 1.91), non-smoking status (OR 2.92), motivation to start with weight loss directly after the baseline visit (OR 2.31) and weight loss programme participation (OR 3.33), whereas weight gain (≥1 kg) was associated with smoking cessation ≤6 months before or during hospitalisation (OR 3.21), non-Caucasian ethnicity (OR 2.77), smoking at baseline (OR 2.70), lower age (<65 years) (OR 1.47) and weight loss programme participation (OR 0.59). Conclusion: The comprehensive secondary prevention programme was, on average, effective in achieving weight loss. However, wide variation was observed. As weight gain was observed in over one in three participants in both groups, prevention of weight gain may be as important as attempts to lose weight.
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A substantial proportion of chronic disease patients do not respond to self-management interventions, which suggests that one size interventions do not fit all, demanding more tailored interventions. To compose more individualized strategies, we aim to increase our understanding of characteristics associated with patient activation for self-management and to evaluate whether these are disease-transcending. A cross-sectional survey study was conducted in primary and secondary care in patients with type-2 Diabetes Mellitus (DM-II), Chronic Obstructive Pulmonary Disease (COPD), Chronic Heart Failure (CHF) and Chronic Renal Disease (CRD). Using multiple linear regression analysis, we analyzed associations between self-management activation (13-item Patient Activation Measure; PAM-13) and a wide range of socio-demographic, clinical, and psychosocial determinants. Furthermore, we assessed whether the associations between the determinants and the PAM were disease-transcending by testing whether disease was an effect modifier. In addition, we identified determinants associated with low activation for self-management using logistic regression analysis. We included 1154 patients (53% response rate); 422 DM-II patients, 290 COPD patients, 223 HF patients and 219 CRD patients. Mean age was 69.6±10.9. Multiple linear regression analysis revealed 9 explanatory determinants of activation for selfmanagement: age, BMI, educational level, financial distress, physical health status, depression, illness perception, social support and underlying disease, explaining a variance of 16.3%. All associations, except for social support, were disease transcending. This study explored factors associated with varying levels of activation for self-management. These results are a first step in supporting clinicians and researchers to identify subpopulations of chronic disease patients less likely to be engaged in self-management. Increased scientific efforts are needed to explain the greater part of the factors that contribute to the complex nature of patient activation for self-management.
Our unilateral diet has resulted in a deficiency of specific elements/components needed for well-functioning of the human body. Especially the element magnesium is low in our processed food and results in neuronal and muscular malfunctioning, problems in bone heath/strength, and increased chances of diabetes, depression and cardiovascular diseases. Furthermore, it has also been recognized that magnesium plays an important role in cognitive functioning (impairment and enhancement), especially for people suffering from neurodegenerative diseases (Parkinson disease, Alzheimer, etc). Recently, it has been reported that magnesium addition positively effects sleep and calmness (anti-stress). In order to increase the bioavailability of magnesium cations, organic acids such as citrate, glycerophosphate and glycinate are often used as counterions. However, the magnesium supplements that are currently on the market still suffer from low bio-availability and often do not enter the brain significantly.The preparation of dual/multiple ligands of magnesium in which the organic acid not only functions as a carrier but also has synergistically/complementary biological effects is widely unexplored and needs further development. As a result, there is a strong need for dual/multiple magnesium supplements that are non-toxic, stable, prepared via an economically and ecologically attractive route, resulting in high bioavailability of magnesium in vivo, preferably positively influencing cognition/concentration
Micro and macro algae are a rich source of lipids, proteins and carbohydrates, but also of secondary metabolites like phytosterols. Phytosterols have important health effects such as prevention of cardiovascular diseases. Global phytosterol market size was estimated at USD 709.7 million in 2019 and is expected to grow with a CAGR of 8.7% until 2027. Growing adoption of healthy lifestyle has bolstered demand for nutraceutical products. This is expected to be a major factor driving demand for phytosterols. Residues from algae are found in algae farming and processing, are found as beachings and are pruning residues from underwater Giant Kelp forests. Large amounts of brown seaweed beaches in the province of Zeeland and are discarded as waste. Pruning residues from Giant Kelp Forests harvests for the Namibian coast provide large amounts of biomass. ALGOL project considers all these biomass residues as raw material for added value creation. The ALGOL feasibility project will develop and evaluate green technologies for phytosterol extraction from algae biomass in a biocascading approach. Fucosterol is chosen because of its high added value, whereas lipids, protein and carbohydrates are lower in value and will hence be evaluated in follow-up projects. ALGOL will develop subcritical water, supercritical CO2 with modifiers and ethanol extraction technologies and compare these with conventional petroleum-based extractions and asses its technical, economic and environmental feasibility. Prototype nutraceutical/cosmeceutical products will be developed to demonstrate possible applications with fucosterol. A network of Dutch and African partners will supply micro and macro algae biomass, evaluate developed technologies and will prototype products with it, which are relevant to their own business interests. ALGOL project will create added value by taking a biocascading approach where first high-interest components are processed into high added value products as nutraceutical or cosmeceutical.
Micro and macro algae are a rich source of lipids, proteins and carbohydrates, but also of secondary metabolites like phytosterols. Phytosterols have important health effects such as prevention of cardiovascular diseases. Global phytosterol market size was estimated at USD 709.7 million in 2019 and is expected to grow with a CAGR of 8.7% until 2027. Growing adoption of healthy lifestyle has bolstered demand for nutraceutical products. This is expected to be a major factor driving demand for phytosterols.Residues from algae are found in algae farming and processing, are found as beachings and are pruning residues from underwater Giant Kelp forests. Large amounts of brown seaweed beaches in the province of Zeeland and are discarded as waste. Pruning residues from Giant Kelp Forests harvests for the Namibian coast provide large amounts of biomass. ALGOL project considers all these biomass residues as raw material for added value creation.The ALGOL feasibility project will develop and evaluate green technologies for phytosterol extraction from algae biomass in a biocascading approach. Fucosterol is chosen because of its high added value, whereas lipids, protein and carbohydrates are lower in value and will hence be evaluated in follow-up projects. ALGOL will develop subcritical water, supercritical CO2 with modifiers and ethanol extraction technologies and compare these with conventional petroleum-based extractions and asses its technical, economic and environmental feasibility. Prototype nutraceutical/cosmeceutical products will be developed to demonstrate possible applications with fucosterol.A network of Dutch and African partners will supply micro and macro algae biomass, evaluate developed technologies and will prototype products with it, which are relevant to their own business interests. ALGOL project will create added value by taking a biocascading approach where first high-interest components are processed into high added value products as nutraceutical or cosmeceutical.
