In Case You Missed It: AHA’s EPI / NPAM 2010
Highlights of AHA’s Joint Conference on Nutrition, Physical Activity and Metabolism and Cardiovascular Disease Epidemiology and Prevention a Hearty Success
By Suvarna Sheth, BioSpace.com
The American Heart Association (AHA) hosted a joint conference on Nutrition, Physical Activity and Metabolism (NPAM) and Cardiovascular Disease Epidemiology and Prevention (EPI) from March 2-5, at the Hilton Union Square in San Francisco, California.
The unique program with 800 participants was designed to encourage and promote the development, advancement and exchange of new information about treating and preventing heart disease and stroke. “A lot mediates your risk-factors for cardiovascular disease like elevated blood pressure, diabetes, and cholesterol,” says Dr. Lawrence Appel, professor of medicine specializing in heart disease and hypertension research at Johns Hopkins University School of Medicine in Baltimore, Maryland. “This conference dealt with understanding those risk factors and addressing synergies that might retard the epidemic of heart disease that we have.” Appel, co-chair of the conference along with Eric Rimm, Sc.D FAHA, says the conference was successful not only because it took place in San Francisco, but because word has caught on that the conference is a dynamic counsel geared toward addressing the strategic goal of the AHA, which is to improve cardiovascular health by 20% while reducing cardiovascular disease by 20%. He says the energy throughout the conference was positive. “Prevention is tough because you are trying to prevent disease from developing over decades,” Appel says, “but, there’s a passion here, and you can sense it.” Highlights of the session packed joint conference include the following topics: • The link between diabetes and heart disease and sugar-sweetened drinks • Coffee drinkers are less likely to be hospitalized for heart rhythm disturbances • Teaching students’ about food and society may help improve their diets The link between diabetes and heart disease and sugar-sweetened drinks Among the popular topics during the Cardiovascular Disease Epidemiology and Prevention section of the AHA conference was research on diabetes and heart disease and sugar-sweetened drinks. More Americans now drink sugar-sweetened sodas, sport drinks and fruit drinks daily. Researchers have found increased consumption of sweetened beverages has led to more diabetes and heart disease over the past decade. Using the Coronary Heart Disease (CHD) Policy Model, a computer simulation model of the national population age 35 and older, researchers estimate that the increased consumption of sugar-sweetened beverages between 1990 and 2000 contributed to 130,000 new cases of diabetes, 14,000 new cases of coronary heart disease, and 50,000 additional life-years burdened by coronary heart disease over the past decade. | RC Photographic Productions RC Photographic Productions RC Photographic Productions |
“Our study is unique because it gives us a sense of the impact of sugared drink consumption at a population-wide level,” says Dr. Litsa Lambrakos, study lead investigator and internal medicine resident at the University of California, San Francisco (UCSF). “With the CHD Policy Model, we have the opportunity to translate information from other studies on sugar-sweetened beverage consumption and diabetes risk into projected estimates of diabetes and heart disease in the U.S. population.”
She says this is important because it provides a “big picture” that might serve as a more effective impetus for the implementation of health policies to curb soft drink consumption.
“I do not think that it is a surprise that sugared drinks lead to diabetes and health problems— we were aware of this before we did our study,” Lambrakos says, “the purpose of our study was to quantify this.”
Through the CHD Policy Model, researchers estimate additional disease caused by the drinks has increased coronary heart disease healthcare costs by 300-500 million U.S. dollars between 2000-2010. Researchers say this underestimates true costs because it does not account for the increased costs associated with the treatment and care of patients with diabetes alone.
“If we could curb sugar-sweetened beverage consumption, we may be able to reduce a small but substantial number of diabetes and heart disease cases,” Lambrakos says. This could yield large benefits for the health of the U.S. population and also help stem health care costs.
Lambrakos hopes the general public has a greater awareness of the adverse health outcomes of consuming these drinks over time and an understanding that these drinks should not be considered a staple of the American diet.
RC Photographic Productions RC Photographic Productions RC Photographic Productions RC Photographic Productions | Coffee drinkers less likely to be hospitalized for heart rhythm disturbances Another popular topic during the Cardiovascular Disease Epidemiology and Prevention portion of the conference was research on coffee consumption and heart rhythm. Researchers at the Kaiser Permanente Medical Care Program in Oakland, California, found that people who reported drinking four or more cups of coffee a day had an 18 percent lower risk of hospitalization for heart rhythm disturbances. Dr. Arthur Klatsky, lead investigator of the study and senior consultant in cardiology at the Kaiser Permanente Medical Care Program says this is a statistically significant finding. “Our hypothesis before we looked at coffee and heart rhythm was that there would be little or no relationship,” Klatsky says, “we did not expect to find an inverse relationship, by that I mean people are less likely to be hospitalized for heart rhythm problems if they drink coffee.” Klatsky says the results are important because it is the first large study to show this relationship. The large, long-term observational study looked at 130,054 individuals, 18 to 90 years old, the majority being less than 50 years old. From this population, Klatsky and his investigators found about 2 percent (3,317) were hospitalized for rhythm disturbances; 50 percent of which were for atrial fibrillation, the most common heart rhythm problem. The 18 percent reduction in risk was consistent in men and women, different ethnic groups, smokers and nonsmokers. Klatsky says his team’s findings, however, still need to be confirmed. “One study doesn’t always prove cause and effect,” he says, “this is an observational study that doesn’t have explanations for every possibility.” He says the only way to test all relationships would be by doing a randomized control trial. “We have to be careful,” Klasky says, “we’re certainly not ready to advise people to drink coffee to protect themselves from heart rhythm problems.” Having said that, he does think the study should reassure people who drink 2-3 cups of coffee a day because it’s very likely that their coffee consumption isn’t going to cause major rhythm disturbances. He says the study is important in the prevention of heart problems because of the large amount of people that consume caffeinated beverages in this country. “75% of people in this country drink coffee and a lot of others take caffeinated products,” Klatsky says, “most people have concerns and want to know if their habits are good, bad or neutral for them.” Klatsky looked forward to presenting his data. For one thing, he said it was going to surprise a lot of people. “It’s always fun to find something that’s surprising and contrary to what was thought,” he says “and it’s always interesting to present data, get people’s ideas, questions and feedback from which there is energy to explore even further.” Teaching students’ about food and society may help improve their diets Teaching college students about societal issues related to food and agriculture may help them choose healthier diets, according to research presented during the AHA Nutrition, Physical Activity and Metabolism session. Researchers from Stanford University found that a college course focused on social, environmental, and ethical issues related to food and food production produced greater improvements in healthful eating than classes focused on health. The research compared two groups: 28 college undergraduates who participated in a “Food and Society” course and 72 undergraduates who participated in one of three courses about health. All students were surveyed before the classes began and then again three months later at the completion of the class. Among those surveyed, those that took the “Food and Society” course reported overall improvement in their healthful eating diet score, while the general health students reported no significant changes in eating habits. “Food and Society” students also reported an increase in vegetable consumption, from an average of 27.9 servings per week to 32.1 servings. They also demonstrated a decrease in high-fat dairy consumption, from an average of 8.5 servings per week to 6.3. “These finding are significant,” says Eric B. Hekler, Ph.D., lead study author and a post-doctoral research fellow at the Stanford Prevention Research Center at Stanford University, “because it suggests that food-related social issues may be a stronger motivating force for college students than a message of health.” |
Hekler says the study did not focus on weight-loss and thus does not offer an explanation to the link between society and obesity. Regardless, he says the broader conceptual approach of what he dubs “stealth interventions,” (the type of intervention done in the study), does have broader implications for earlier in life.
He says the key observation is that to change behavior, a clinician needs to frame the information as something that is relevant to the person they are talking too. “For younger folks, health is likely not that strong of a motivator, but saving the world may be,” he says.
Based on this, a “stealth intervention” would talk about the saving the world as a motivator for the behavior of interest. Hekler says health implications wouldn’t be discussed because younger people won’t be motivated by health. Hekler hopes this research will help clinicians think more about the motivations of the people they are trying to change and to then link the behavior the clinician wants with the motivation of the person.
Appel hopes attendees will walk away from this year’s AHA conference with new energy, and new ideas about how to implement prevention strategies whether it’s at the level of individual patients or within populations.
“It’s about new studies, and developing novel strategies for intervention,” he says. Though everyone has their own goal, he hopes researchers will “tweak” what they’re doing in some way, “whether it’s to improve technology, implement an intervention, improve behavioral counseling, or better the measurement of a particular assay,” he says.
”I’ve never left the conference without an idea of what I’m going to implement,” Appel says, “I can’t say every conference is created equal, but I always leave with something new.”
For a list of upcoming conferences, visit: http://www.americanheart.org/presenter.jhtml?identifier=1200035To access abstracts and other releases from the conference, visit: http://www.americanheart.org/presenter.jhtml?identifier=3065525
