Lifestyle

Feeling the pinch: the impact of weight loss surgery on cardiovascular risk

Weight loss (bariatric) surgery is becoming increasingly common as the obesity epidemic continues to flourish, and recent NICE guidelines have supported this approach. In this article, we review the procedures used in bariatric surgery, the impact on patients’ cardiovascular risk and type 2 diabetes, what the guidelines recommend and the long-term care of patients who have undergone this type of surgery.

Very low energy diets: the key facts

In recent years it seems as if there has been an increase in the popularity of very low energy diets (VLEDs) and new programmes are readily available to our patients on the high street. This article explains the background and theory behind VLEDs so that you can better inform and support your patients if they are considering one of these diets.

Whole grain breakfasts for trimmer waists

Central obesity remains a big issue in the UK. The accumulation of adipose tissue in the abdominal region is a particular risk factor for chronic disease and mortality.1 In 2008, 39% of adults in England had a waist circumference indicative of central obesity (above 88 cm for women and 102 cm for men).2,3 Two proven effective dietary strategies for reducing waist circumference are the inclusion of whole grain foods in the diet and the avoidance of meal skipping.4 Advice to start the day with whole grain breakfast cereal and/or whole grain bread combines these two strategies in one simple and feasible practical message.

How to advise patients on fortifying their diet

Adequate nutrition is an important part of keeping healthy. Some patients – particularly the elderly – may find it difficult to consume an adequate diet to provide all the components to maintain good health. In this case, fortifying the diet may be helpful. Our keep and copy guide over the page provides practical tips for you to photocopy and give to patients and their carers on how to fortify their diet without using oral nutritional supplements.

Take your gin without the tonic: prolonged QTc interval and torsades de pointes

Take your gin without the tonic: prolonged QTc interval and torsades de pointes – David Ripley, Fiona MacCormack, Mark Kinghan, Kate Willmer

Torsades de pointes (TdP) is a life-threatening ventricular arrhythmia associated with prolongation of the QT interval. This case report describes one possible cause of acquired prolongation of the QT interval, and discusses more broadly the topic of antiarrhythmic drug side-effects and interactions.

Dietary change post-MI – the key aspect of lifestyle change

Recent research suggests that post-MI patients are not being optimally managed. Awareness and implementation of guideline recommendations could improve outcomes in this patient group.

Give me sunshine: vitamin D and cardiovascular health

Vitamin D deficiency is a prevalent and important health issue that warrants vigilant systematic screening and appropriate treatment and follow-up on the part of physicians,especially those in the primary care and cardiovascular fields. In this article we review the sources and metabolism of vitamin D, the epidemiology of vitamin D deficiency, and the available evidence linking vitamin D deficiency to cardiovascular disease; and we suggest an approach to systematic screening and to treatment of vitamin D deficiency.

Vitamin D and cardiovascular health

Vitamin D deficiency is a prevalent and important health issue that warrants vigilant systematic screening and appropriate treatment and follow-up on the part of physicians, especially those in the primary care and cardiovascular fields. Although vitamin D deficiency has traditionally been associated primarily with bone disease, it is now clear that this is a multi-organ system disease. Epidemiological studies consistently show strong associations between vitamin D deficiency and bone disease, cancer and diabetes. Additionally, epidemiological evidence links vitamin D deficiency with cardiovascular risk factors, cardiovascular disease and mortality. Conclusive evidence to show that vitamin D supplementation improves cardiovascular prognosis is currently lacking, although randomised trials are under way to address this issue. In this article we review the sources and metabolism of vitamin D, the epidemiology of vitamin D deficiency, and the available evidence linking vitamin D deficiency to cardiovascular disease; and we suggest an approach to systematic screening and to treatment of vitamin D deficiency.

Eating healthily on a tight budget

Save the Children, a charity well known for its work helping children in war-torn or faminestruck countries, recently announced that it is now handing out grants to struggling UK families who cannot afford to feed themselves. In a recent report, the charity suggests that the credit crunch has led to an increase of 11.3% in cost of food over the last year. It is not surprising that many parents have now cut back on food expenditure, with the poorest of families spending less on their weekly shop than ever before. How can we provide patients with tips on eating healthily on a tight budget?

Bariatric surgery: an effective quick fix to prevent the complications of morbid obesity or prelude to long-term problems?

Water, water everywhere: maintaining a healthy fluid balance

As health professionals, we can spend considerable time encouraging patients to think about what they eat and how their diet affects their health. But we tend to focus less on what they drink, which is perhaps surprising because fluid intake also plays a vital role in maintaining good health.

Helping people to quit smoking

Helping people who smoke to quit is one of the most important steps we can take in reducing their risk of cardiovascular disease, in addition to reducing the other harms caused by smoking.

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