Hypertension During Pregnancy Raise Risk For Heart Disease

Hypertension (high blood pressure) occurs in approximately 8 to 10 percent of pregnancies. Research showed that women with hypertension during pregnancy might have a higher risk of hypertension even decades after maternity. This would in turn lead to an increased risk of a number of chronic diseases including heart disease. 

A group of researchers from National Institutes of Health, Imperial College London, Oulu University Hospital, Oulu, Finland and University of Oulu, Oulu, Finland reported that hypertension during pregnancy, even once or twice during routine medical care, can indicate substantially higher risks of heart and kidney disease and diabetes. Their findings were published on February 12, 2013 in the American Heart Association journal ‘Circulation’.

Previous study had shown that higher heart and kidney disease risk in women with preeclampsia, which is a serious pregnancy-related disease marked with hypertension and measurable protein in the urine.

The new study followed Finnish women who had babies in 1966 for 40 years. The risk of heart or kidney disease or diabetes in later life was calculated among women with hypertension during pregnancy.

Compared to women with normal blood pressure during pregnancy, women who had hypertension during pregnancy had 14 percent to over 100 percent higher risk of cardiovascular diseases (heart disease and stroke) later in life. These women were also 2 to 5 times more likely to die from heart attacks, a 1.4- to 2.2-fold higher risk of having diabetes in later life. Women who had hypertension during pregnancy and healthy blood pressure levels after that had a 1.6- to 2.5-fold higher risk of having hypertension requiring medication or hospitalization later in life. Women with transient hypertension with and without measurable protein in the urine had a 1.9- to 2.8-fold higher risk of kidney disease in later life. Transient hypertension is temporary high blood pressure that will return to normal later.

According to researchers, women who had hypertension or who had diagnosed with hypertension during pregnancy for the first time might benefit from comprehensive heart disease risk factor checks by their doctors so as to reduce their long-term risk of heart disease.

Future study should find out how lifestyle chances during pregnancy would affect the risk of developing hypertension and it is important that these researches focus on how lifestyle changes and clinical follow-up after pregnancy could improve these women’s long-term health.

As the study was limited to non-Hispanic Caucasian Finnish women, researchers are not certain whether results would apply to other racial and ethnic groups.

Metabolism Disorders Relate To Heart Disease And Stroke

Metabolism is the process one’s body uses to get or make energy from the food eaten. A metabolic disorder occurs when abnormal chemical reactions in the body disrupt the process. When this happens, one might have too much of some substances or too little of others that are required to keep one stay healthy. One can develop a metabolic disorder when some organs like liver or pancreas become diseased or do not function normally. Diabetes is a good example.

Excess abdominal fat, higher blood pressure, higher levels of insulin, glucose and triglycerides, and lower levels of the HDL (high-density lipoprotein) or the so-called good cholesterol are some of the metabolic disorders that can be found in young children, according to a study by researchers from the University of Eastern Finland.

The study, which was published on April 29, 2013 in journal ‘Circulation’, revealed that the accumulation of these metabolic risk factors in overweight children were linked to mild artery wall stiffness. The findings also indicated that of single disorders, higher levels of insulin, triglyceride and blood pressure were linked to artery wall stiffness, and boys with excess abdominal fat and higher blood pressure levels were associated with a reduced arterial dilation after maximal exercise in a bicycle test. 

Relations of overweight, impaired glucose and fat metabolism and blood pressure to artery wall stiffness and arterial dilation capacity in 173 healthy children aged between 6 and 8 years in Kuopio, eastern Finland were analyzed.

Actually, the study comprised part of the Physical Activity and Nutrition in Children (PANIC) study, which was carried out by a research group in the Institute of Biomedicine at the University of Eastern Finland. The PANIC study provides valuable information on children's physical activity, nutrition, fitness, body composition, metabolism, vascular function, learning, oral health, sleep, pain and other factors of the quality of life.

Results of the new study, which suggested that metabolic disorders developing already in childhood could cause mild arterial stiffness and impair vascular health, stressed the importance of lifestyle improvement in childhood for prevention of metabolic and vascular dysfunction leading to atherosclerotic events.

Arterial stiffness and reduced arterial dilation can predict atherosclerosis, also known as the hardening of the arteries, and in turn could weaken tissues of blood and oxygen, resulting in damage or tissue death. Atherosclerosis is a common cause of heart attack, high blood pressure and stroke.

Depression Could Raise Stroke Risk!

According to Stroke Association in the United Kingdom, about half of stroke survivor will suffer depression in the first year following their stroke. Depression can happen soon after a stroke or several months later, and it can range from mild to severe.

On the other hand, depression could raise stroke risks, too! In a paper published on May 16, 2013 in ‘Stroke: Journal of the American Heart Association’, researchers from University of Queensland in Australia reported that depressed middle-aged women have almost double the risk of having a stroke.

A total of 10,547 women aged between 47 and 52 years old were involved in the 12-year study. These women were surveyed and answered questions about their mental, physical health and other personal details every 3 years from 1998 to 2010.

It was found that depressed women had a 2.4 times increased risk of stroke compared to those who were not depressed. Even after eliminating several factors that could raise stroke risks, depressed women were still found to be 1.9 times more likely to have a stroke. Those eliminated factors include age; socioeconomic status; lifestyle habits like smoking, alcohol and physical activity; and physiological conditions including high blood pressure, heart disease, being overweight and diabetes.

This is the first large-scale study that examined the relationship between depression and stroke in younger middle-aged women. About 24 percent of participants reported being depressed and 177 first-time strokes occurred during the study.

Researchers stressed that despite the increased stroke risk linked to depression was large in the study, the absolute stroke risk was still quite low for the age group studied. Only about 1.5 percent of all women had a stroke, as compared to about 2.1 percent of American women in the 40s and 50s. Among depressed women, the risk was raised to slightly more than 2 percent. Researchers also pointed out that similar results could also be expected among American and European women.

While it is not clear why depression might be strongly associated with stroke in this age group, it is possible that body’s inflammatory and immunological processes and their effects on the blood vessels might be part of the reasons.

Current guidelines for stroke prevention might overlook the potential role of depression. Hence, doctors should recognize the serious nature of poor mental health and its long-term effect when treating women. In the meantime, more targeted approaches are required to prevent and treat depression among younger women.

There is no doubt that depression, heart disease and stroke are all related. It is probably because stroke and heart disease share some risk factors, like high blood pressure and being overweight. For instance, a recent study had found that older people with heart disease and had more severe and frequent depression symptoms were more likely to have a stroke.

Diabetes Or Hypertension Link To Higher Sleep Apnea Risk

Obstructive sleep apnea (OSA) is a condition in which breathing repeatedly stops and starts during sleep. It is a potentially serious disorder since people with OSA are at risk of developing cardiovascular disease if it is not appropriately treated. During OSA, the sudden decline in blood oxygen levels would raise the blood pressure and strain the cardiovascular system. Besides cardiovascular disease, people with OSA can also have other complications including daytime fatigue and eye problems.

During the 27th Annual Meeting of the Associated Professional Sleep Societies, LLC (APSS) held between June 1 and 5, 2013 at the Baltimore Convention Center, the American Academy of Sleep Medicine (AASM) is advising people with Type-2 diabetes or hypertension to be evaluated for sleep apnea by a board-certified sleep medicine physician.

Patients suffering from Type-2 diabetes and hypertension are at much higher risk for OSA, as shown by overwhelming clinical evidence, Research also indicated that treating OSA could help manage these 2 disorders, including improved insulin sensitivity, blood pressure and cholesterol.

As revealed by Centers for Disease Control and Prevention (CDC), 25.6 million Americans aged 20 years or older suffer from diabetes. 90 to 95 percent of these patients are Type-2 diabetics. 7 in 10 people with Type-2 diabetes also have OSA, and it was found that the severity of the sleep disorder directly affects the glucose control.

Treating sleep apnea in diabetics could not only lower their nighttime glucose levels and insulin sensitivity but also provide them with benefits of improved sleep unrelated to diabetes, including better alertness during the day and improved memory as well as cognitive function.

According to a recent study by the University of Chicago, continuous positive airway pressure (CPAP) treatment of sleep apnea might have an effect comparable to prescribed oral diabetes medications.

In the study, average 24-hour glucose levels were reduced and post-breakfast glucose response was improved in Type-2 diabetics with OSA, with just one week of optimal CPAP. CPAP therapy also reduced dawn phenomenon, an early-morning surge in blood sugar in people with Type-2 diabetes, by 45 percent.

About 67 million Americans have hypertension, or 1 in every 3 adults. 30 to 40 percent of these patients also have sleep apnea. Approximately 80 percent of those who do not respond to hypertensive drugs have sleep apnea.

The nighttime and daytime blood pressure will decline with appropriate sleep apnea treatment. For patients with moderate to severe sleep apnea, the treatment would give them the greatest improvement. Reducing blood pressure would naturally lower the risk of cardiovascular disease and improve the overall health.

Less Salt More Potassium For Stroke Prevention!

About 98 percent of Americans consume an average 3436 milligrams of salt (sodium) daily, which is more than twice the recommended amount for a healthy diet, according to American Heart Association (AHA).

Higher intake of sodium is tied to a higher risk of developing hypertension (high blood pressure) that would eventually lead to heart disease and stroke, as suggested by many studies. However, little is known about that lower potassium consumption could also lead to high blood pressure.

Several studies published on April 4, 2013 in the ‘British Medical Journal’ (BMJ reported that less salt and more potassium in a person's diet could lower blood pressure and hence the risk of stroke. In the first study, researchers from the Queen Mary University of London and Affiliated Hospital of LuZhou Medical College, China argued that while the current recommendations to lower salt intake from 9-12 to 5-6 grams per day will have a major effect on blood pressure, a further reduction of 3 grams per day will have a greater effect and should become the long-term objective for population salt intake.

Using data collected from 34 trials consisting of 3230 participants, researchers examined people with hypertension and those with normal blood pressure. The results showed that notable decreases in blood pressure in both groups after 4 or more weeks of modest salt intake. The change in the diet did lower their risk of heart attack, heart failure as well as stroke.

The second study by a group of scientists from Britain, Germany and Switzerland found that lower salt intake reduced blood pressure yet had no negative impact on hormone levels, blood lipids, or kidney function, as shown by high quality evidence. A total of 56 reports were analyzed, 37 of which were of high quality. A reduction in sodium intake could lower blood pressure in kids, as demonstrated by moderate quality evidence.

Lower sodium intake was also linked to a reduced risk of stroke and fatal coronary heart disease in adults. The totality of evidence suggested that most people will likely benefit from lowering sodium intake.

Researchers from Britain and Switzerland examined data in the third study on potassium intake and health from 33 reports consisting of 128,644 healthy volunteers. The high quality evidence showed that higher potassium intake reduced blood pressure in people with hypertension but had no adverse effect on hormone levels, kidney function, or blood lipids in adults. Meanwhile, moderate quality evidence also indicated that higher potassium intake was linked to a 24 percent lower risk of stroke.

Link Between Restaurant Meal And Weight Gain

Since 1980, the number of obese American adults has doubled to more than 78 million, according to an estimate made by the Centers for Disease Control and Prevention (CDC). People who are obese are more likely to develop chronic diseases such as heart disease and diabetes. Meanwhile, obesity costs the American economy an estimated $147 billion a year in medical expenses and lost productivity.

Unhealthy diet and sedentary have been accused to be 2 of the important factors that cause the obesity epidemic. Fast food consumption is definitely linked to disease risk. However, the disease-promoting potential of meals from sit-down restaurants has not given enough attention.

A study conducted by researchers from the University of Toronto found that a single meal at a North American restaurant might contain more than half the calories an average person needs for the entire day. The findings were published in the ‘Journal Of The American Medical Association’ (JAMA).

Hundreds of meals at 19 sit-down chain restaurants were sampled and it was found that average breakfast, lunch and dinner meals each contained 1128 calories, or 56 percent of the daily 2000-calorie recommendation.

Salt, fat, saturated fat and cholesterol levels were also found to be extremely high in these meals, which contained 2269 milligrams of salt or 151 percent of the daily-recommended amount for most adults (1500 milligrams), 89 percent of the daily value for fat, 83 percent of the daily value for saturated fat, and 60 percent of the daily value for cholesterol.

In another paper also published in JAMA, researchers from Tufts University focused on dishes available at 33 small independent and small chain restaurants in the Boston area, and samples were taken from Mexican, American, Chinese, Italian, Japanese, Thai, Indian, Greek and Vietnamese restaurants.

Their findings showed that, on average, these meals contained 1,327 calories, which significantly exceeds the estimated energy needs of an individual adult at a single meal. Meanwhile, the researchers discovered that more than 75 percent of the meals contained at least 1000 calories and nearly 8 percent of meals contained 2000 calories. And surprisingly, they also found that calorie content was nearly 50 percent greater than that of popular meals from the largest national chain restaurants.

Italian meals had the highest average calories per meal (1,755), followed by American (1,494 calories) and Chinese (1,474 calories). Vietnamese meals had the least number of calories on average (922), and Japanese meals had the second lowest (1,027).

Obese Men Likely Hyperactive During Childhood!

Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders for kids aged between 3 and 17. It can sometimes continue through adolescence and adulthood. The average age of onset is 7 years old.

The Centers for Disease Control and Prevention (CDC) in the United States revealed that nearly 7 percent of children and teenagers have been diagnosed with ADHD and boys are more than twice as likely to have such disorder as girls are.

Obese men are likely hyperactive during their childhood, according to a recent study. Researchers from New York University found that boys who were diagnosed with ADHD in elementary school were more likely to grow up to be obese adults than those who do not have the condition.

Their findings, which were published on May 20, 2013 in ‘Pediatrics’, indicated that participants with a history of ADHD were 8.6 kilos heavier than those without ADHD after surveying 2 groups of 41-year-old men.

Data was drawn from 207 white boys with ADHD at around 8 years old. They were followed as they grew up. Another group of teenage boys without ADHD were added to the study10 years later. These boys were similar to the original participants.

At the age of 41, 111 men from each group were still in the study and were asked to report their weight. It was found that men with a history of ADHD weighed 96.6 kilos on average and 41.4 percent of them were obese. In comparison, men without ADHD weighed 88 kilos on average and 21.6 percent of them were obese.

Some of the common symptoms of ADHD, such as lack of impulse control, difficulty paying attention and poor planning skills, can lead to unhealthy food choices and irregular eating patterns that continue into adulthood. These behaviors could be responsible for the weigh gain.

While the findings were based on male participants, the researchers suspected that the results could well hold true for women.

It is hoped that the new findings will prompt parents to help their children, especially boys, develop healthy eating habits, and they should pay special attention to the change in weight over time.

Being a global health concern, obesity is the culprit for many chronic diseases including Type-2 diabetes, high blood pressure, heart disease and stroke.

Smoking Ban Saves Life!

Among about 6 million deaths caused by smoking annually, more than 5 million are smokers while more than 600,000 are non-smokers being exposed to second-hand smoke. This is the statistics released by the World Health Organization (WHO). The annual number of death could rise to more than 8 million by 2030.

Smoking can cause not only cancer but also many other chronic diseases including heart disease, stroke and peripheral vascular disease. It will also raise the cost of health care and hinder economic development. Hence, many countries have implemented control to curb the number of smokers.

In July 2013, researchers from Georgetown University Medical Center in Washington and associates published a paper in the Bulletin of the World Health Organization reporting that the tobacco control measures implemented in 41 countries including Pakistan, Argentina and Italy between 2007 and 2010 will prevent some 7.4 million premature deaths by 2050.

These countries represented nearly one billion people or one-seventh of the world’s population in 2008. The total number of smokers in those countries was nearly 290 million in 2007.

Tobacco control measures, which include higher taxes on tobacco products, bans on adverts and controls on lighting up in public, were on track to persuade an estimated 15 million people not to smoke. Wider use of the controls could also lead to lower health care costs and higher birth weights for babies.

Increasing taxes and banning smoking in offices, restaurants and other public places were the most effective measures. The first method would prevent 3.5 million smoking related deaths, while the second would prevent 2.5 million.

A sharp drop in smoking rates was seen in Turkey as a result of control measures: from 47.9 percent in 2008 to 41.5 percent in 2012. The implemented measures include raising taxes on tobacco products to 75 percent of the final retail price, smoke-free air policies, warnings on cigarette packages, bans on advertising, promotion and sponsorship, and offering treatments to kick the habit.

Another study, conducted by a team of scientists based in the United States, Britain and India, revealed that banning smoking in the workplace and levying a tobacco tax could prevent more than 9 million deaths from cardiovascular disease in India over the next decade.

Smoking is blamed for the deaths of 1 in 5 men in India. The deaths from cardiovascular disease linked to tobacco use are projected to increase by 12 percent over the next 10 years. Their findings, which were published in ‘PLoS Medicine’, confirmed that smoke-free laws and increased tobacco taxes were the single 2 most effective measures. These 2 measures alone would reduce heart attack deaths by 6 million and stroke deaths by 3.7 million (a total of 9.7 million) over the next 10 years.

Sugary Drinks Linked To Higher Diabetes Risk!

According to the World Health Organization (WHO), more than 310 million people worldwide have Type-2 diabetes. In the United Kingdom, about 2.9 million people are affected by it.

Type-2 diabetes, the most common form of diabetes, is a long-term condition characterized by insulin resistance, which means the body does not use insulin properly. Patients with Type-2 diabetes will have high blood sugar. Long term complications from high blood sugar can include heart disease, kidney failure, stroke, blindness and even limb amputations.

Researchers from various institutions in Europe found that drinking just a can of sugar-laced soda drink a day increases the risk of developing diabetes by more than a fifth. The results were published in July 2013 in ‘Diabetologia’, the journal of the European Association for the Study of Diabetes.

In order to find out whether a link between sugary drinks and diabetes risk also existed in Europe, the researchers used data including 12,403 Type-2 diabetics and a random population of 16,154 people identified within EPIC (European Prospective Investigation into Cancer and Nutrition). These participants, who came from Britain, Germany, Denmark, Italy, Spain, Sweden, France, Italy, and Netherlands, were questioned about their diet, including how many sugary and artificially sweetened soft drinks and juices they drank each day. 

It was found that every extra 340 ml serving of sugar-sweetened drink increases the risk of diabetes by 22 percent, compared with drinking just 1 can a month or less. The risk was lowered to 18 percent after taking into account people’s total calorie intake and body-mass index (BMI), a measurement of body fat based on height and weight. But consumption of pure or diluted fruit juice was found not significantly linked to diabetes risk.

Consumption of sugary drinks increases the risk of developing diabetes beyond the effect on body weight, the researchers warned, people can be thin yet still develop diabetes.

Results of this study were similar to previous research showing that North Americans who consume sugary beverages have a 25 percent increased risk of diabetes. While an association between consumption of sugary drinks and higher risk of Type-2 diabetes was found, the study did not prove a cause-and-effect relationship.

Surge in diabetes cases are caused by unhealthy lifestyle. The International Diabetes Federation forecast that the number of diabetics worldwide will almost double to an estimated 552 million by 2030.

Heart Disease Prevention With Pets!

Pets have been thought to be human’s best friends. For nearly 25 years, researchers have shown that living with pets can provide certain health benefits to the pet owners.

For instance, pets can help lessen anxiety, reduce stress, depression and loneliness. Several studies also reported that heart attack patients who have pets survive longer than those without, and male pet owners have less sign of heart disease than non-owners.

A scientific statements written by American Heart Association (AHA) indicated that owning a pet, particularly dog, might help decrease a person's heart disease risk and is associated with lower levels of obesity, blood pressure and cholesterol.

The statement was published online on May 9, 2013 in journal ‘Circulation’, after reviewing previous studies of the influence of pets. The researchers also pointed out that of all pets, dogs appear most likely to positively influence the level of human physical activity.

Dog owners engage in more physical activity and walking, and are more likely to achieve the recommended level of physical activity than non-owners of dogs. An online survey of 5,253 Japanese adults, quoted in the statement, revealed that dog owners engaged in significantly more walking and physical activity than non-owners, and were 54 percent more likely to achieve the recommended level of physical activity.

While there is a substantial body of data suggesting pet ownership is linked to a reduction in cardiovascular disease risk factors and increased survival in individuals with established cardiovascular disease, these studies could not prove owning a pet can directly cause a reduction in heart disease risk.

Hence, people should not simply adopt, rescue or buy a pet solely for the purpose of reducing cardiovascular disease. The researchers stressed that further research, including better quality studies, should be carried out to more definitively find out whether the act of adopting or acquiring a pet could lead to a lower risk in getting cardiovascular disease in those with pre-existing disease.

According to the American Pet Product Association 2011-2012 National Pet Owners Survey, about 78.2 million people in the United States own a dog and 86.4 million have a cat. However, based on the report by the Centers for Disease Control and Prevention (CDC), pet owners are still just as likely to be overweight as people without pets.

Heart disease prevention cannot be achieved by just owning a pet. It is possible that taking care of a pet requires its owner to get more exercise that can lower stress, weight and blood pressure, and benefits the heart. If a pet owner still sits on the couch and eats whatever they want, and smoke and does not control the blood pressure, then there is no benefit at all.

Is Blood Pressure Higher At Night?

High blood pressure, also known as hypertension, is a major risk factor for heart disease and stroke. It is a cause of chronic kidney disease, too. Affecting over 12 million people in the United Kingdom, hypertension is the single most important preventable cause of premature death.

While it is possible to improve blood pressure control by dietary and lifestyle changes, medication is often needed for patients for whom lifestyle changes are insufficient or ineffective. Meanwhile, regular blood pressure monitoring is also paramount for effective blood pressure control.

Nighttime blood pressure has been thought to be a strong predictor of both heart disease and stroke and previous studies had indicated that blood pressure measured over the arm falls at night during sleep.

However, the new data collected by researchers from University College London (UCL) using the new technology showed that the nighttime decline in blood pressure might be less extensive than previously thought. The findings were published in the June 2013’s issue of the journal ‘Hypertension’.

With the support by the National Institute for Health Research (NIHR), they developed a portable wrist watch-based device together with a Singaporean technology company (Healthstats International). The device contains a sensor in the strap that detects the pulse wave at the wrist, rather than measuring the pressure directly. By mathematically modeling the pulse wave, pressure at the aortic root (close to the heart) could be measured accurately over a full 24-hour period, without disturbing the person being monitored.

Patterns of brachial blood pressures (in the arm) and central aortic pressures (where blood exits the heart) were measured at the same time. Though similarities in the circadian rhythms of brachial and central aortic pressures were found, there was a significantly reduced nighttime dip in central aortic pressure relative to the corresponding nighttime dip in brachial pressure. The pressures by the heart do not dip as much during sleep as previously thought based on conventional pressure measurements taken from the arm.

The findings suggested that nocturnal aortic pressures are disproportionately higher than brachial pressures during sleep. Such information is very useful for professionals who are investigating the damage in the brain and heart caused by high blood pressure, and can have significant implications for the evaluation of future therapies. This would probably change the way high blood pressure is measured and treated.

Since the new developed watch can be worn continuously, it is possible for the health experts to program the device to sample the pulse wave day and night, and obtain measurements of the aortic pressure over a 24-hour period.

What Is Resistant Hypertension?

A person is said to have resistant hypertension if this person’s hypertension does not respond to a 3-drug combination therapy that includes a diuretic. A diuretic is any substance that promotes the production of urine. It is used to treat heart failure, liver cirrhosis, hypertension and certain kidney diseases.

In Singapore, about 25 percent of adults have high blood pressure, based on the 2010’s National Health Survey. Many of them take 2 to 3 types of hypertensive medications to control their blood pressure. About 3 to 5 percent of these patients, usually elderly, have resistant hypertension.

The 3 most common causes of resistant hypertension are: patients’ noncompliance to medications, secondary hypertension (usually from overactive adrenal glands) and fluid retention (usually expansion from kidney failure). More importantly, doctors have to ensure that what appears to be resistant hypertension is not actually pseudo hypertension or white coat hypertension.

Pseudohypertension is when blood pressure measurements are high but the blood pressure is actually normal. It is not very common, and is usually found in older patients. White coat hypertension is a scenario in which a person has high blood pressure readings only when he or she is in medical setting. The blood pressure can be normal when measuring at home.

Persistent uncontrolled hypertension is a significant risk factor for stroke and heart disease. Studies have shown that each incremental increase of 20 mmHg in systolic blood pressure and 10 mmHg in diastolic (minimum) blood pressure above normal levels directly correlates to a doubling of the risk of death from cardiovascular disease over a 10-year period.

It was also found that a lowering of 5 mmHg in blood pressure results in a decline of 14 percent in the risk of stroke, a 9 percent in the risk of heart disease and a 7 percent in the risk of death.

Sometimes, targeting the kidneys can treat high blood pressure. A minimally invasive procedure is used to remove the renal sympathetic nerves so that kidney would stop reacting excessively and the blood pressure would drop.

Such procedure, however, might not be suitable for all patients. It can only be employed for patients with normal kidney function. The kidney arteries need to be relatively disease-free and more than 4mm in diameter. Its main complications are damage to the kidney arteries or side effects from using contrast agents.

The National Heart Centre Singapore carried out the first such procedure in September 2011. Studies in Europe and Australia have shown that patients who have been followed up for 2 years without unfavorable effects.

Simple CPR Could Have Long-Term Benefit!

CPR (Cardiopulmonary resuscitation) is an emergency procedure for a person who has cardiac arrest. Its purpose is to preserve intact brain function until further measures to restore spontaneous blood circulation and breathing. A standard CPR normally involves chest compression together mouth-to-mouth or mouth-to-nose resuscitation.

However, researchers from Descartes University in Paris, France and other institutions from Seattle (USA) and Sweden reported that people suffering cardiac arrest were less likely to die in subsequent years when bystanders performed simple CPR with chest compressions only. The findings were published online on December 10, 2012 in the journal ‘Circulation’.

This was more or less in line with the recommendation by the American Heart Association (AHA): a simpler form of CPR from bystanders is better than no aid at all. However, such recommendation does not apply to CPR performed in hospital or in community by medical personnel or people who are proficient in rescue breathing. Such recommendation also applies only to adult victims.

Data from 2 randomized trials that were reported in the ‘New England Journal of Medicine’ in 2010 were examined. More than 3,200 adults were involved. These victims had cardiac arrest likely due to heart disease problems rather than trauma, suffocating or drowning. Bystanders were instructed by dispatchers via phone to use either the standard or compression only form of CPR.

The researchers were able to follow 78 percent of the participants on longer-term outcomes. The one-year survival rate was found to be about 12 percent for chest compression alone and about 10 percent for standard CPR. Mortality was 9 percent lower in the compression-only group than in the standard CPR group, after adjusting for different factors. The survival benefit persisted over 5 years.

Nevertheless, the study only tracked survival and it could not assess patients’ function level or quality of life. Moreover, the original trials employed in the study were not meant for tracking long-term outcomes.

While there are concerns that victims who collapse of non-cardiac causes might not get the oxygen they need with the compression-only approach, the researchers confirmed they did not observe evidence of harm among those for whom oxygenation and ventilation might in theory be more important.

Victims would require fresh oxygen through mouth-to-mouth resuscitation only if they have been down for a longer or unknown period of time, according to other health experts. The majority of cardiac arrest events are likely caused by heart disease problems. It is most probably that some oxygen still remains in the blood when the victim’s heart has stopped for a short period of time. So proceeding with chest compression only should be beneficial for most circumstances.

How Is Insufficient Sleep Related To Weight Gain?

Obesity epidemic has been a hot issue for many industrial nations, and lately also for developing countries. World Health Organization (WHO) indicated that more than 1.4 billion adults aged 20 and older were overweight in 2008. The figure had nearly doubled since 1980.

Overweight or obesity can lead to numerous chronic diseases including diabetes, heart disease, hypertension (high blood pressure) and stroke. At least 2.8 million adults die every year because of obesity or overweight.

Scientists have suspected that there is a strong correlation between sleep deprivation and weight gain, as indicated by various studies over the years. For instance, one study reported that people who slept less than 6 hours a night had their body mass index (BMI) increased more than those who slept 7 to 8 hours. In another 16-year study, women slept 5 hours or less gained more weight than those who slept 7 hours a day. Nevertheless, the actual reasons behind these had yet to be unveiled.

BMI is a simple and common indicator to determine whether a person is overweight, obese or of normal weight. It is calculated by dividing the weight in kilos by the square of height in meters.

On August 6, 2013, researchers from the University of California in Berkeley reported in journal ‘Nature Communications’ that they had found a brain mechanism that could explain how sleep deprivation might lead to the development and maintenance of obesity.

In the study, researchers used magnetic resonance imaging (MRI) scans to spot changes in the brain activity of 23 participants. These participants had their head scanned twice: once after a full night of sleep and once after being deprived their shut-eye for a night. Their brain activity measured the next day as they selected items and portion sizes from pictures of 80 different food types.

Impaired activity in regions of the cortex that evaluate appetite and satiation was found among the sleep-deprived participants. Simultaneously, there was a boost in areas associated with craving. The study also found that high calorie foods became more desirable to the sleep deprived participants.

According to researchers, the link between sleep loss, weight gain and obesity can be explained by the impaired brain activity found in regions that control good judgment and decision making coupled with amplified activity in more reward-related brain regions.

They also believed that having enough amounts of sleep regularly might be a good way to promote weight control, which is achieved by priming the brain mechanisms governing appropriate food choices.

Has Outpatient Care Controlled Heart Disease Risk Factors?

While focusing on improving the quality of inpatient hospital care is critical to give the patients the best and appropriate treatments, the quality of outpatient care is equally important to have a better control of heart disease risk factors including hypertension, diabetes, and smoking.

According to a study conducted by American researchers from Duke University in Durham and Edward Heart Hospital in Naperville, the control of heart disease risk factors varies widely among outpatient practices. The findings were presented at the American Heart Association's Quality of Care and Outcomes Research Scientific Sessions 2013.

Electronic health records of 115,737 patients in 18 primary care and cardiology practices participating in The Guideline Advantage were compared from January 1, 2010 to March 31, 2012.

Among the participants, 65,212 (56.3 percent) had hypertension, 67,826 (58.6 percent) had hyperlipidemia, 8,815 (7.6 percent) had diabetes mellitus, 3,073 (2.7 percent) had a history of a stroke or transient ischemic attack, and 23,624 (20.4 percent) had coronary artery disease.

Guideline Advantage, a collaboration of the American Cancer Society, American Diabetes Association and American Heart Association, is a nationwide quality improvement program for outpatient care. It collects data through existing electronic health records to report adherence to established guidelines with an aim to reducing risks for chronic diseases.

In the study, the researchers found that the percentage of people aged 18 through 85 years with hypertension under control (less than 140/90 mm Hg) ranged between 58.7 percent and 75.1 percent; the percentage of diabetic patients aged 18 through 75 years with hyperlipidemia control (bad low density lipoprotein cholesterol under 100 mg/dL) was between 53.8 percent and 100 percent; and the percentage of patients aged 18 years and older screened for smoking, and receiving a tobacco cessation intervention, was between 53.8 percent and 86.1 percent.

The findings did identified multiple opportunities for improving quality of outpatient care for cardiovascular prevention. Outpatient care providers can use them to compare their standard with their peers on nationally derived measures of quality and learn to improve in collaboration with others instead of alone.

Would Mediterranean Diet Benefit Elderly?

Mediterranean diet is a nutritional recommendation that is built on high proportion of olive oil, fruits, vegetables, legumes, nuts, whole grains and fish. It follows closely the traditional dietary patterns of people living in the areas surrounding the Mediterranean Sea including Greece, southern Italy and Spain, and is also characterized by a moderate consumption of wine, dairy products, and poultry, together with a low consumption of red meat, sweet beverages, creams, and pastries.

Being low in saturated fat and high in monounsaturated fat and dietary fiber, Mediterranean diet has been praised for increasing longevity and preventing chronic disease and cognitive decline. In fact, initially healthy middle-aged adults in the Mediterranean region have found to have low incidence of fatal and non-fatal heart disease if they adhere closely to the Mediterranean diet.

In 2011, a systematic review found that a Mediterranean diet appeared to be more effective than a low-fat diet in achieving long-term changes to cardiovascular risk factors like lowering cholesterol level and blood pressure.

On April 17, 2013, a group of Spanish researchers reported in the ‘Journals of Gerontology Series A: Biological Sciences and Medical Sciences’ that adherence to a Mediterranean diet is associated with a lower risk of hyperuricemia.

Hyperuricemia is defined as a serum uric acid (SUA) concentration higher than 7 mg/dl in men and higher than 6 mg/dl in women. It is associated with metabolic syndrome, hypertension (high blood pressure), Type-2 diabetes mellitus, chronic kidney disease, gout and, cardiovascular morbidity and mortality. It is believed that the Mediterranean diet might help lower SUA concentration because of its antioxidant and anti-inflammatory properties.

7,447 male participants aged between 55 and 80 years old were examined in the 5-year study. These men were free from cardiovascular disease but had either Type-2 diabetes mellitus or were at risk of coronary heart disease. They were assigned to 1 of the 3 intervention diets: 2 were Mediterranean diets enriched with extra virgin olive oil or mixed nuts, and 1 was a control low-fat diet.

Only 4,449 participants were included in the analysis. Their concentrations of uric acid at baseline were available (of these, 1,551 were assigned to the Mediterranean diet plus olive oil group, 1,407 to the Mediterranean diet plus nut group, and 1,491 to the control low-fat diet group).

The findings of the study revealed positive health effects of a Mediterranean diet in older adults. The rates of reversion were higher among hyperuricemic participants at baseline who had greater adherence to the Mediterranean diets. Meanwhile, the researchers also found that the reversion of hyperuricemia was achieved by adherence to the Mediterranean Diet alone, without weight loss or changes to physical activity.

Prevent Heart Disease For Diabetics With Soccer Training

People with Type-2 diabetes are more likely to develop hypertension and heart disease, and situation worsens with physical inactivity. So diabetics are always advised to exercise regularly, in addition to adopting a health diet. For some serious cases, medications are prescribed to prevent possible medical complications.

A recent study, which was published on May 10, 2013 in journal ‘Medicine and Science in Sports and Exercise’, reported that soccer training can improve heart function, reduce blood pressure and elevate exercise capacity in patients with Type-2 diabetes. Soccer training can also reduce the need for medication.

Funded by the Nordea-fonden, the study was conducted by a group of researchers from the Copenhagen Centre for Team Sport and Health at the University of Copenhagen, Gentofte Hospital, Herlev Hospital, and Aarhus University in Denmark and University of Exeter in the United Kingdom.

The study involved 21 male Type-2 diabetics with an average age of 50 years without history of cardiovascular disease. 12 of the participants were asked to participate in a soccer-training group that trained one hour, twice a week. The remaining 9 participants were assigned to a control group with no change in lifestyle.

Examinations including comprehensive transthoracic echocardiography, measurements of blood pressure, maximal oxygen consumption (VO2max) and intermittent endurance capacity were performed before and after 12 and 24 weeks.

It was found that soccer training significantly improved flexibility of the heart and the cardiac muscle tissue was able to work 29 percent faster. This means that the heart had become 10 years younger after 3 months of training. This is certainly good news as many Type-2 diabetics have less flexible heart muscles that will increase the risk of heart failure. The heart’s contraction phase was better and the capacity of the heart to shorten was improved by 23 percent. Such result had not been reported with other types of physical activity.

The researchers also found that the blood pressure was greatly reduced. At the onset of the study, 60 percent of the participants had extremely high blood pressure and had been prescribed one or more pressure reducing medications. Soccer training cut the systolic and diastolic blood pressure by 8 mmHg. These effects are similar to those achieved by taking high blood pressure medications, thus significantly reducing the need for medication.

In addition, the study also showed that the participants' maximal oxygen uptake was raised by 12 percent and their intermittent exercise capacity was elevated by 42 percent. This would certainly lower the risk of other illnesses associated with Type-2 diabetes.

While soccer training has a great potential to help diabetics because of its ability to improve cardiac function, increase exercise capacity and lower blood pressure, it might not be suitable for diabetics of all ages.

Act Swiftly To Minimize Damage For Stroke Patients!

Being the third leading cause of death in the United States, stroke is a leading culprit of serious, long-term disability in adults. Each year, about 600,000 new strokes are reported in the United States.

A stroke, sometimes also called a brain attack, occurs when blood flow to the brain is interrupted. The brain cells in the affected area begin to die because they stop getting oxygen and nutrients they need to function.

Fortunately, treatments are available that can greatly reduce the damage caused by a stroke. But symptoms of a stroke must first be recognized. Such symptoms include numbness or feeling weak in the face, arm or leg, having trouble speaking or understanding, unexplained dizziness, and blurred or poor vision in one or both eyes.

Patients who suffer an ischemic stroke can be treated with a drug called t-PA that dissolves blood clots obstructing blood flow to the brain. But treatment must be done within 3 hours, and the patient must also be sent to hospital within 60 minutes in order to be evaluated and receive treatment. The earlier the clot is resolved, the more brain cells can be saved.

A 5-year study by the National Institute of Neurological Disorders and Stroke (NINDS) reported that some stroke patients who received t-PA (tissue plasminogen activator) within 3 hours of the start of stroke symptoms were at least 30 percent more likely to recover with little or no disability after 3 months.

Meanwhile, regular exercise can also help stroke patients as it triggers healing in the brain. According to the findings announced at the Canadian Stroke Congress in 2012, regular exercise within 6 months of suffering a stroke can improve memory, language, thinking and judgment problems by almost 50 percent.

Nevertheless, doing something to prevent a stroke before it occurs is better than trying to save the brain later on when getting one.

Hypertension (high blood pressure) has been known to be the strongest risk factor for stroke. But blood pressure can be controlled by regular exercise.

Exercising regularly makes the heart stronger. This decreases the force exerted on the arteries, and so blood pressure would not be raised. Regular exercise can also help a person maintain a healthy weight that can help control blood pressure, too.

Besides hypertension, heart disease, smoking, diabetes and high cholesterol are also some of the risk factors. So if one smokes, quit smoking immediately. If one has heart disease, diabetes or high cholesterol, getting and keeping them control is important because this will greatly lower the risk of getting a stroke.

Can Healthy Habits Counter Stress?

While stress can be positive, it becomes negative when it continues without relief until a condition called distress occurs. Distress can cause physical symptoms including headaches, upset stomach, elevated blood pressure, chest pain, and sleeping problems.

Stress can also lead to or worsen certain symptoms or diseases, including high blood pressure, heart disease, diabetes, skin conditions, depression and anxiety. It is estimated that 43 percent of all adults suffer stress related health ailments.

A paper published on May 13, 2013 in the ‘Canadian Medical Association Journal’ by researchers from the University College London and other institutions reported that job strain was linked to a 25 percent higher chance of getting a heart attack or dying of heart problems. But the risks could be cut by 50 percent among people, either stressed or otherwise, who maintained a healthy lifestyle comparing to those who drank, smoked or were obese. Job stress was defined in the study as having a lot of demands at work with little control.

Though people have been encouraged to reduce work stress for heart disease prevention, this is sometimes unrealistic for certain group of people. As such, researchers were eager to find out whether adopting an otherwise healthy lifestyle would reduce heart disease risk among those with job strain.

Using data gathered from 7 European studies that surveyed 107,200 people about their general lifestyle habits that included how much strain they were under at work, the researchers found that about 1 in 6 initially reported being under job strain. None of these participants had heart disease at the start of the study.

Over the next 7 years, on average, there were about 1,100 heart attacks or deaths from heart disease. Over a decade, it was found that 12 cases per 1,000 generally healthy people without job strain and 31 per 1,000 people with job strain and multiple lifestyle risks like rarely exercising or having more than 3 or 4 alcoholic drinks a day.

Analysis also showed that approximately 4 percent of all heart attacks and deaths from heart disease could be due to job strain and about 26 percent to drinking, smoking, obesity and lack of physical activity.

Nevertheless, the new study might underestimate the link between job strain and heart disease. Furthermore, other types of job stress that may influence heart risks, like having low social support and job insecurity, were not taken into account.

The new study also did not prove that pressure at work causes heart problems, though the results are in tandem with past studies that suggested chronic stress, including from job strain, could have negative health effects.

Meanwhile, the American Heart Association (AHA) also advise people with stress to adopt positive healthy habits that include performing daily physical activity, giving up bad habits, getting enough sleep and trying not to worry.

Why Risk Of Stroke Declined In Singapore?

In Singapore, the risk of getting a stroke for all age groups has been reduced each year. According to The Ministry of Health (MOH), the rate of strokes per 100,000 people has lowered from 175 in 2007 to 158 in 2011. The number of deaths from stroke has also dropped from 39 in 2007 to 34 per 100,000 people in 2011. All the figures were after adjusting for an older population.

Stroke is, however, still the fourth leading cause of death that accounts for 9 percent of total mortality in Singapore. People who are most at risk are those are elderly, smokers, hypertensive (high blood pressure), and those who have high cholesterol and diabetes.

A study on 240 acute ischemic stroke patients at the National University Hospital (NUH), Singapore found that hypertension was the most prevalent risk factor (75 percent), followed by high cholesterol (57 percent), atrial fibrillation (35 percent), diabetes mellitus (29 percent) and smoking (26 percent). The findings can be found in March 2013’s issue of JAMA (The Journal Of The American Medical Association) Neurology.

Fortunately, besides the number of smoking, diabetes and obesity that have increased, the number of Singapore residents aged between 18 and 69 years old with hypertension and high cholesterol has declined since 1998.

32.5 percent of Singapore residents had hypertension and 28.2 percent had high cholesterol in 1998 but the 2010’s National Health Survey showed that only 23.5 percent had hypertension and 17.4 percent had high cholesterol.

Being the strongest risk factor for stroke, hypertension puts a person at about 4 times higher risk of developing a stroke than a non-hypertensive person. But if the condition can be well controlled with lifestyle modifications and medication, the risk of getting a stroke could be cut by 40 to 50 percent.

There are 2 types of stroke, namely ischemic and hemorrhagic. 80 percent of all strokes here belong to ischemic stroke, which occurs when a blood vessel to the brain is blocked, usually by a blood clot. A hemorrhagic stroke occurs when a blood vessel in the brain ruptures, causing bleeding in or around the brain. This type of stroke, though fewer in number, results in more deaths than ischemic strokes.

The declining death rate in Singapore could be due to better hospital care and stroke treatment, and more importantly, people can take better care of themselves. Meanwhile, better preventive treatment with medications to reduce high cholesterol and hypertension do help lower the rate at which Singaporeans are getting strokes.

While primary prevention is very important, preventing further strokes cannot be overlooked too. The risk for a stroke patient to get another stroke is 10 percent in the first year following a stroke, with the risk highest in the first month.

Another Risk For The Obese!

Obese people are more likely to develop heart disease, stroke, high blood pressure, high cholesterol and even certain kinds of cancer. A recent study reported on January 21, 2013 in ‘Emergency Medicine Journal’ that they are also facing a much higher risk, up to 80 percent, of dying in a car collision compared with people of normal weigh.

Using the United States databank on road accidents, the Fatality Analysis Reporting System (FARS), researchers from the University of California at Berkeley and the University of West Virginia dug out data from 1996 to 2008, covering more than 57,000 collisions that involved 2 cars.

They only looked at cases in which both parties involved in the collision had been driving vehicles of similar size and types. The final dataset used covered 3,403 pairs of drivers. Almost half of these drivers were of normal weight, 1 in 3 was overweight, and almost 1 in 5 (18 percent) was obese.

The risk of fatality against victim’s estimated body mass index (BMI) were compared. BMI is used to assess whether a person is fat and is calculated by dividing one's weight in kilograms by the square of one's height in meters. An adult is said to be of normal weight if his or her BMI is between 18.5 and 24.9. Below this range, this person is considered underweight; between 25 and 29.9 is considered overweight, and 30 and above is obese.

After taking into account of factors like age and alcohol use, the researchers found that underweight drivers had higher risk of 19 percent compared to those of normal weight. The increased risk was 21, 51 and 80 percent respectively for those of BMI between 30 and 34.9, between 35 and 39.9, and those who were extremely obese with BMI of 40 and above. Obese women were at even higher risk. Among those of BMI between 35 and 39.9, the risk of death was double compared with people of normal weight.

According to the data from hospitals’ intensive-care units, obese victims in the car accidents tended to have more chest injuries and fewer head injuries, were likelier to have more complications, required longer hospital stays, and were likelier to die of their injuries. The obese drivers were more likely to leave the seatbelt unbuckled or partially fastened because it is uncomfortable. Another reason could be the passenger vehicles are well designed to protect normal-weight vehicle occupants but not for overweight or obese patients.

Taking into account of the fact that more than 33 percent of adult men and 35 percent of adult women are obese, the ability of passenger vehicles to protect overweight or obese occupants may have increasing important public health occupations.

Are People Still Consuming Too Much Salt?

Being one of the oldest food seasonings, salt has 2 major components: sodium and chloride ions. Salt is needed by human body to perform a variety of essential functions. Besides helping maintain fluid in the body cells and transmitting information in the nerves and muscles, salt can also be used in the uptake of certain nutrients form the small intestines.

While human require only a small quantity of salt each day, the salt consumption has increased to a level that is harmful to the body. Statistics showed that most Americans eat more than twice the recommended daily allowance of sodium.

Excess intake of sodium can lead to hypertension (high blood pressure), which in turn is a major risk factor for stroke and heart disease. About 80 percent of the sodium consumed by Americans is from restaurants and food manufacturers.

Despite the urge by health experts to cut salt intake for better health, the amount of salt found in processed or fast food is still high, according to a study that was published online on May 13, 2013 in the ‘Journal Of The American Medical Association’.

The findings showed that there was little change in terms of sodium content in sample of 480 processed and restaurant food from 2005 to 2011. The sample is only a small percentage of the thousands of foods in restaurants and grocery stores.

Though some products like sliced cheddar cheese and canned tomato soup did show decreases, others showed increases. Restaurant French fries, cheese pizza, whole-wheat bread, Caesar dressing, and barbecue sauce were found to have higher sodium in 2011 than 2005. A decrease of at least 30 percent was found in some of the products studied, but an increase of at least 30 percent was found in a greater number of products.

As suggested by some research, lowering salt intake could save up to 150,000 lives a year in the United States. There are, however, different views on whether consumers should cut sodium or whether the food industry should face tighter regulations.

Judge by what the new study has revealed, it seems that voluntary approach has failed. The food industry has not been making much changes. Hence, the researchers urge government to step in to protect the public by imposing regulations on the food industry. Otherwise, it is estimated that at least one million deaths and $100 billion in health-care costs will be incurred in the coming decade.

Can Tomato Cut Stroke Risk?

Intake of fruits and vegetables and levels of serum carotenoids have been tied to lower risk of stroke but the so far the findings have been inconsistent.

To examine if serum concentrations of major carotenoids (alpha-tocopherol and retinol) were related to any stroke risk in men, researchers from various institutions in Finland looked at 1,031 Finnish men when they were first enrolled in the study in the early 1990s.

These men, aged between 46 and 65 years old, were part of a larger study examining at risk factors for the development of cardiovascular disease (heart disease and stroke). The findings were published in the October 9, 2012’s issue of the medical journal ‘Neurology’.

When the study began, blood levels of lycopene, alpha- and beta-carotene, and Vitamins E and A of these participants were measured. 7 years later, same measurements were done for most men. The men were followed an average of 12 years.

During the follow-up period, there were 11 strokes among the one-quarter of men with the highest lycopene levels, compared to 25 among the one-quarter with the lowest levels. Even after taking into accounts of some major factors that affect stroke risk, like smoking, high blood pressure and diabetes, the high-lycopene group still had a 55 percent lower risk of suffering a stroke.

The study had some limitations, though. For instance, it lacked information on the men's overall diet habits that might explain why lycopene was linked to lower risk. The findings did, however, support the current advice to get plenty of fruits and vegetables, and reinforced the prevailing recommendations for people to get a well-balanced diet, with fruits and vegetables.

Lycopene is a chemical that gives a reddish hue to foods like tomatoes, red peppers, watermelon and papaya. It is a potent antioxidant that helps protect body cells from damage that can ultimately lead to disease. Research also suggested that lycopene might help fight inflammation and blood clots better than other antioxidants.

But in cutting stroke, diet does play an important role. The so-called “DASH” diet, which has been shown to reduce blood pressure and cholesterol levels, suggests cutting salt and getting more fiber-rich grains, nuts and legumes, and a low-fat dairy, as well as 4 to 5 servings of fruits and vegetables a day.

In 2010, the United States updated its dietary guidelines, stating that Americans should raise their fruit and vegetable intake - at least 2 and half cups of fruits and vegetables per day can reduce risk of heart attack and stroke.

Can Smart Mobile Devices Help Lose Weight?

Being obese or overweight is no longer an individual issue. It has become a serious global health crisis. In the United States alone, it is estimated that nearly 68 percent of adults are either overweight or obese, and 5 to 10 percent of all healthcare costs in the United States are devoted to dealing with obesity related diseases, including diabetes, heart disease, high blood pressure and stroke.

Technology has been accused as a culprit among many other factors responsible for obesity epidemic. But recently, a group of researchers from various institutions including the Northwestern University Feinberg School of Medicine in Chicago found that mobile devices that enable people to track how much they eat and exercise might help them lose weight.

Their findings, which were published on January 28, 2013 in the ‘Archives of Internal Medicine’, reported that overweight and obese adults could lose an average of over 3.6 kilos more when they had personal digital assistants (PDAs) and occasional phone coaching to assist them, in addition to a group program.

69 overweight and obese people, who were in their late 50s and were referred to a Veterans Affairs clinic for weight-loss support, participated in the study.

Over a trial period of 6 months, the participants were enrolled in 12 group sessions that focused on nutrition, exercise and behavioral changes to promote weight loss. Half of the participants were given a PDA to record their food and activity throughout the day and there was a coach who was in contact with them by phone.

At the end of the trial period, those in the PDA group had lost an average of almost 10 pounds (4.5 kilos) and 41 percent of these participants had met the goal of losing at least 5 percent of their initial body weight. In comparison, those not in the PDA group had lost an average of 2 pounds (1 kilo) and only 11 percent of them had achieved the weight loss goal.

The most important thing about weight loss is self-monitoring - watch and keep a record of what is eaten. App (program) on a mobile device is cheaper and can easily be personalized. It can not only help people keep track of their eating habit but also help re-engage people who have trouble. Moreover, it can widely be available whenever people carry their mobile phones or PDAs.

While PDAs are mostly not in use nowadays, the emergence of smart phones such as iPhone, Android and Window phones can serve almost the same purpose. In the United States, smartphone usages continued to climb and more than 61 percent of mobile subscribers owned a smartphone.

Nevertheless, there is evidence that apps on mobile devices alone do not have much of an impact. Hence, experts believe that technology can only be used as an aid to help from a doctor or nutritionist.