Lifestyle Research Center

Cooranbong, Australia

Lifestyle Research Center

Cooranbong, Australia

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Kent L.,Lifestyle Research Center | Morton D.,Lifestyle Research Center | Hurlow T.,Waratah Medical Services | Rankin P.,Lifestyle Research Center | Diehl H.,Lifestyle Medicine Institute
BMJ Open | Year: 2013

Objective: To examine the long-term (three or more years) effectiveness of the volunteer-delivered Complete Health Improvement Program (CHIP) intervention. Design: Cohort study. Setting: Hawera, New Zealand. Participants: Of the total cohort of 284 individuals who self-selected to complete the CHIP lifestyle intervention between 2007 and 2009, 106 (37% of the original cohort, mean age=64.9±7.4 years, range 42-87 years; 35% males, 65% female) returned in 2012 for a complimentary follow-up health assessment (mean follow-up duration=49.2+10.4 months). Intervention: 30-day lifestyle modification programme (diet, physical activity, substance use and stress management) delivered by volunteers in a community setting. Main outcome measures: Changes in body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP), fasting plasma glucose (FPG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglycerides (TG). Results: After approximately 4 years, participants with elevated biometrics at programme entry maintained significantly lowered BMI (-3.2%; 34.8±5.4 vs 33.7±5.3 kg/m2, p=0.02), DBP (-9.4%; 89.1±4.1 vs 80.8±12.6 mm Hg, p=0.005), TC (-5.5%; 6.1±0.7 vs 5.8±1.0 mmol/L, p=0.04) and TG (-27.5%; 2.4±0.8 vs 1.7±0.7 mmol/L, p=0.002). SBP, HDL, LDL and FPG were not significantly different from baseline. Participants with elevated baseline biometrics who reported being compliant to the lifestyle principles promoted in the intervention (N=71, 67% of follow-up participants) recorded further reductions in BMI (-4.2%; 34.8±4.5 vs 33.4±4.8 kg/m2, p=0.02), DBP (-13.3%; 88.3±3.2 vs 77.1±12.1 mm Hg, p=0.005) and FPG (-10.4%; 7.0±1.5 vs 6.3±1.3 mmol/L, p=0.02). Conclusions: Individuals who returned for follow-up assessment and entered the CHIP lifestyle intervention with elevated risk factors were able to maintain improvements in most biometrics for more than 3 years. The results suggest that the community-based CHIP lifestyle intervention can be effective in the longer term, even when delivered by volunteers.


Kent L.,Lifestyle Research Center | McPherson M.,World Health Organization | Higgins N.,Communicable Disease Prevention and Control Unit
Journal of Water and Health | Year: 2015

Increased temperatures provide optimal conditions for pathogen survival, virulence and replication as well as increased opportunities for human-pathogen interaction. This paper examined the relationship between notifications of cryptosporidiosis and temperature in metropolitan and rural areas of Victoria, Australia between 2001 and 2009. A negative binomial regression model was used to analyse monthly average maximum and minimum temperatures, rainfall and the monthly count of cryptosporidiosis notifications. In the metropolitan area, a 1 °C increase in monthly average minimum temperature of the current month was associated with a 22% increase in cryptosporidiosis notifications (incident rate ratio (IRR) 1.22; 95% confidence interval (CI) 1.13-1.31). In the rural area, a 1 WC increase in monthly average minimum temperature, lagged by 3 months, was associated with a 9% decrease in cryptosporidiosis notifications (IRR 0.91; 95% CI 0.86-0.97). Rainfall was not associated with notifications in either area. These relationships should be considered when planning public health response to ecological risks as well as when developing policies involving climate change. Rising ambient temperature may be an early warning signal for intensifying prevention efforts, including appropriate education for pool users about cryptosporidiosis infection and management, which might become more important as temperatures are projected to increase as a result of climate change. © 2015 IWA Publishing.


PubMed | World Health Organization, Communicable Disease Prevention and Control Unit and Lifestyle Research Center
Type: Journal Article | Journal: Journal of water and health | Year: 2015

Increased temperatures provide optimal conditions for pathogen survival, virulence and replication as well as increased opportunities for human-pathogen interaction. This paper examined the relationship between notifications of cryptosporidiosis and temperature in metropolitan and rural areas of Victoria, Australia between 2001 and 2009. A negative binomial regression model was used to analyse monthly average maximum and minimum temperatures, rainfall and the monthly count of cryptosporidiosis notifications. In the metropolitan area, a 1 C increase in monthly average minimum temperature of the current month was associated with a 22% increase in cryptosporidiosis notifications (incident rate ratio (IRR) 1.22; 95% confidence interval (CI) 1.13-1.31). In the rural area, a 1 C increase in monthly average minimum temperature, lagged by 3 months, was associated with a 9% decrease in cryptosporidiosis notifications (IRR 0.91; 95% CI 0.86-0.97). Rainfall was not associated with notifications in either area. These relationships should be considered when planning public health response to ecological risks as well as when developing policies involving climate change. Rising ambient temperature may be an early warning signal for intensifying prevention efforts, including appropriate education for pool users about cryptosporidiosis infection and management, which might become more important as temperatures are projected to increase as a result of climate change.


PubMed | Medical Nutrition Therapy Northwest, Spirituality and Worship Research Center, Lifestyle Medicine Institute and Lifestyle Research Center
Type: Journal Article | Journal: Journal of religion and health | Year: 2016

Seventh-day Adventist (SDA) and non-SDA (21.3 and 78.7%, respectively) individuals (n=7172) participating in the Complete Health Improvement Program, a 30-day diet and lifestyle intervention, in North America (241 programs, 2006-2012) were assessed for changes in selected chronic disease risk factors: body mass index (BMI), blood pressure (BP), pulse, lipid profile and fasting plasma glucose (FPG). Reductions were greater among the non-SDA for BMI, pulse and blood lipids. Furthermore, the majority of non-SDA in the highest risk classifications for BP, lipids and FPG, but only some lipids among SDA, were able to show improvement by 20% or more.


PubMed | Live Healthy Appalachia, Heritage University, Lifestyle Research Center and Loma Linda University
Type: | Journal: Advances in preventive medicine | Year: 2014

Most Western chronic diseases are closely tied to lifestyle behaviors, and many are preventable. Despite the well-distributed knowledge of these detrimental behaviors, effective efforts in disease prevention have been lacking. Many of these chronic diseases are related to obesity and type 2 diabetes, which have doubled in incidence during the last 35 years. The Complete Health Improvement Program (CHIP) is a community-based, comprehensive lifestyle modification approach to health that has shown success in addressing this problem. This pilot study demonstrates the effectiveness of CHIP in an underserved, rural, and vulnerable Appalachian population. Two hundred fourteen participants in CHIP collectively demonstrated significant reductions in body mass index, systolic and diastolic blood pressure, and fasting blood levels of total cholesterol, low-density lipoprotein, and glucose. If these results can be repeated in other at-risk populations, CHIP has the potential to help reduce the burden of preventable and treatable chronic diseases efficiently and cost-effectively.


Morton D.,Lifestyle Research Center | Callister R.,University of Newcastle
Sports Medicine | Year: 2014

Exercise-related transient abdominal pain (ETAP), commonly referred to as ‘stitch’, is an ailment well known in many sporting activities. It is especially prevalent in activities that involve repetitive torso movement with the torso in an extended position, such as running and horse riding. Approximately 70 % of runners report experiencing the pain in the past year and in a single running event approximately one in five participants can be expected to suffer the condition. ETAP is a localized pain that is most common in the lateral aspects of the mid abdomen along the costal border, although it may occur in any region of the abdomen. It may also be related to shoulder tip pain, which is the referred site from tissue innervated by the phrenic nerve. ETAP tends to be sharp or stabbing when severe, and cramping, aching, or pulling when less intense. The condition is exacerbated by the postprandial state, with hypertonic beverages being particularly provocative. ETAP is most common in the young but is unrelated to sex or body type. Well trained athletes are not immune from the condition, although they may experience it less frequently. Several theories have been presented to explain the mechanism responsible for the pain, including ischemia of the diaphragm; stress on the supportive visceral ligaments that attach the abdominal organs to the diaphragm; gastrointestinal ischemia or distension; cramping of the abdominal musculature; ischemic pain resulting from compression of the celiac artery by the median arcuate ligament; aggravation of the spinal nerves; and irritation of the parietal peritoneum. Of these theories, irritation of the parietal peritoneum best explains the features of ETAP; however, further investigations are required. Strategies for managing the pain are largely anecdotal, especially given that its etiology remains to be fully elucidated. Commonly purported prevention strategies include avoiding large volumes of food and beverages for at least 2 hours prior to exercise, especially hypertonic compounds; improving posture, especially in the thoracic region; and supporting the abdominal organs by improving core strength or wearing a supportive broad belt. Techniques for gaining relief from the pain during an episode are equivocal. This article presents a contemporary understanding of ETAP, which historically has received little research attention but over the past 15 years has been more carefully studied. © 2014, The Author(s).


Kent L.M.,Lifestyle Research Center | Morton D.P.,Lifestyle Research Center | Rankin P.M.,Lifestyle Research Center | Gobble J.E.,Medical Nutrition Therapy Northwest | Diehl H.A.,Lifestyle Medicine Institute
Journal of Nutrition Education and Behavior | Year: 2015

Objective: To determine the differential effect of gender on outcomes of the Complete Health Improvement Program, a chronic disease lifestyle intervention program. Design: Thirty-day cohort study. Setting: One hundred thirty-six venues around North America, 2006 to2009. Participants: A total of 5,046 participants (33.5% men, aged 57.9 ± 13.0 years; 66.5% women, aged 57.0± 12.9 years). Intervention: Diet, exercise, and stress management. Main Outcome Measures: Body mass index, diastolic blood pressure, systolic blood pressure, lipids, and fasting plasma glucose (FPG). Analysis: The researchers used t test and McNemar chi-square test of proportions, at P < .05. Results: Reductions were significantly greater for women for high-density lipoprotein (9.1% vs 7.6%) but greater for men for low-density lipoprotein cholesterol (16.3% vs 11.5%), total cholesterol (TC) (13.2% vs 10.1%), triglycerides (11.4% vs 5.6%), FPG (8.2% vs 5.3%), body mass index (3.5% vs 3%), diastolic blood pressure (5.5% vs 5.1%), and TC/high-density lipoprotein (6.3% vs 1.4%) but not different for systolic blood pressure (6% vs 5%). The greatest reductions were in participants with the highest baseline TC, low-density lipoprotein, triglycerides, and FPG classifications. Conclusions and Implications: The Complete Health Improvement Program effectively reduced chronic disease risk factors among both genders, but particularly men, with the largest reductions occurring in individuals at greatest risk. Physiological or behavioral factor explanations, including differences in adiposity and hormones, dietary intake, commitment and social support, are explored. Researchers should consider addressing gender differences in food preferences and eliciting commitment and differential support modes in the development of lifestyle interventions such as the Complete Health Improvement Program. © 2015 The Authors.


Kent L.M.,Lifestyle Research Center | Reierson P.,Adventist Development and Relief Agency ADRA Australia | Morton D.P.,Lifestyle Research Center
BMC public health | Year: 2015

BACKGROUND: Non-communicable diseases (NCDs) have reached epidemic proportions in Pacific Island countries. Unhealthy lifestyle is one of the major risk factors and lifestyle interventions have been shown to be efficacious for primary, secondary and early tertiary prevention. However, there is a paucity of evidence regarding effective community-based lifestyle interventions in the Pacific Islands. The Complete Health Improvement Program for high-income countries was contextualised for rural communities with relatively low-literacy rates in low-income countries using the REFLECT delivery approach. This study will assess the effect of this 'Live More' program to reduce participant's NCD risk factors and improve lifestyle behaviours associated with health and wellbeing, in low-literacy communities in countries of the South Pacific.METHODS/DESIGN: This study is a 6-month cluster-randomised controlled trial of 288 adults (equal proportions of men and women aged 18 years and over) with waist circumference of ≥92 cm for men and ≥80 cm for women in four rural villages in each of Fiji, Vanuatu and Solomon Islands. Participants will permanently reside in their village and be able to prepare their own meals. Two villages will be randomised to the 'Live More' intervention (n = 24) or to control receiving only country specific Ministry of Health literature (n = 24). Intervention participants will meet three times a week in the first month, then once a week for the next two months and once a month for the last three months. Themes covered include: NCDs and their causes; and the benefits of positive lifestyle choices, positive psychology, stress management, forgiveness and self-worth, and how these influence long-term health habits. Outcome assessments at baseline, 30-days, 3-months and 6-months include body mass index, waist circumference, blood lipids, blood pressure and blood glucose. Secondary outcomes include changes in medication and substance use, diet, physical activity, emotional health and supportive relationships, collected by lifestyle questionnaire at the same time points.DISCUSSION: This is the first lifestyle intervention using the Reflect approach to target NCDs. The findings from the study will be used to guide broader delivery of a lifestyle intervention to improve health and wellbeing across the South Pacific.TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12614001206617 .


PubMed | Lifestyle Research Center
Type: Journal Article | Journal: Sports medicine (Auckland, N.Z.) | Year: 2015

Exercise-related transient abdominal pain (ETAP), commonly referred to as stitch, is an ailment well known in many sporting activities. It is especially prevalent in activities that involve repetitive torso movement with the torso in an extended position, such as running and horse riding. Approximately 70% of runners report experiencing the pain in the past year and in a single running event approximately one in five participants can be expected to suffer the condition. ETAP is a localized pain that is most common in the lateral aspects of the mid abdomen along the costal border, although it may occur in any region of the abdomen. It may also be related to shoulder tip pain, which is the referred site from tissue innervated by the phrenic nerve. ETAP tends to be sharp or stabbing when severe, and cramping, aching, or pulling when less intense. The condition is exacerbated by the postprandial state, with hypertonic beverages being particularly provocative. ETAP is most common in the young but is unrelated to sex or body type. Well trained athletes are not immune from the condition, although they may experience it less frequently. Several theories have been presented to explain the mechanism responsible for the pain, including ischemia of the diaphragm; stress on the supportive visceral ligaments that attach the abdominal organs to the diaphragm; gastrointestinal ischemia or distension; cramping of the abdominal musculature; ischemic pain resulting from compression of the celiac artery by the median arcuate ligament; aggravation of the spinal nerves; and irritation of the parietal peritoneum. Of these theories, irritation of the parietal peritoneum best explains the features of ETAP; however, further investigations are required. Strategies for managing the pain are largely anecdotal, especially given that its etiology remains to be fully elucidated. Commonly purported prevention strategies include avoiding large volumes of food and beverages for at least 2 hours prior to exercise, especially hypertonic compounds; improving posture, especially in the thoracic region; and supporting the abdominal organs by improving core strength or wearing a supportive broad belt. Techniques for gaining relief from the pain during an episode are equivocal. This article presents a contemporary understanding of ETAP, which historically has received little research attention but over the past 15 years has been more carefully studied.


PubMed | Medical Nutrition Therapy Northwest, Lifestyle Medicine Institute and Lifestyle Research Center
Type: Journal Article | Journal: Journal of nutrition education and behavior | Year: 2014

To determine the differential effect of gender on outcomes of the Complete Health Improvement Program, a chronic disease lifestyle intervention program.Thirty-day cohort study.One hundred thirty-six venues around North America, 2006 to2009.A total of 5,046 participants (33.5% men, aged 57.9 13.0 years; 66.5% women, aged 57.0 12.9 years).Diet, exercise, and stress management.Body mass index, diastolic blood pressure, systolic blood pressure, lipids, and fasting plasma glucose (FPG).The researchers used t test and McNemar chi-square test of proportions, at P < .05.Reductions were significantly greater for women for high-density lipoprotein (9.1% vs 7.6%) but greater for men for low-density lipoprotein cholesterol (16.3% vs 11.5%), total cholesterol (TC) (13.2% vs 10.1%), triglycerides (11.4% vs 5.6%), FPG (8.2% vs 5.3%), body mass index (3.5% vs 3%), diastolic blood pressure (5.5% vs 5.1%), and TC/high-density lipoprotein (6.3% vs 1.4%) but not different for systolic blood pressure (6% vs 5%). The greatest reductions were in participants with the highest baseline TC, low-density lipoprotein, triglycerides, and FPG classifications.The Complete Health Improvement Program effectively reduced chronic disease risk factors among both genders, but particularly men, with the largest reductions occurring in individuals at greatest risk. Physiological or behavioral factor explanations, including differences in adiposity and hormones, dietary intake, commitment and social support, are explored. Researchers should consider addressing gender differences in food preferences and eliciting commitment and differential support modes in the development of lifestyle interventions such as the Complete Health Improvement Program.

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