In a prime example of art imitating life the Christmas issue of the MJA is usually rather fat, followed by attempts to slim down in January. In keeping with this, this issue features articles on the importance of getting active and eating well — at any stage of life.
Want a quick way to find out a child’s risk of obesity? Ask how much television he/she watches, say Salmon et al. Their study of Melbourne primary school children revealed some interesting associations between time spent watching television, physical activity and dietary habits (→ Television viewing habits associated with obesity risk factors: a survey of Melbourne schoolchildren).
When Callaway et al calculated the body mass index of more than 14 000 women attending hospital for antenatal care they found that about a third were overweight, obese or morbidly obese. In “The prevalence and impact of overweight and obesity in an Australian obstetric population” they report the excess of adverse outcomes among these women and their babies. Nankervis et al explain that the reproductive effects of obesity go far beyond the problems encountered in pregnancy, and give advice on opportunistic intervention for overweight women (→ Obesity and reproductive health).
We devour media stories of quick fixes for weight problems, especially when showcased by stick-thin celebrities. Many question whether conventional low-fat diets truly work, as our society is becoming more obese. Stanton’s Clinical Update argues that our knowledge of what we eat is quite poor and that in nutrition rigorous evidence is notoriously difficult to gather. Yet, we do have good information on what is likely to work for weight loss. Browse to “Nutrition problems in an obesogenic environment” for some practical advice.
If weight loss comes down to reducing energy intake relative to expenditure, there is potentially a place for any intervention that reduces caloric intake. Meal replacement (where one or two main meals per day are replaced by a protein and carbohydrate drink fortified with vitamins and minerals) is one option. In “Are meal replacements an effective clinical tool for weight loss?”, Egger reviews the evidence for meal replacement and the products currently available in Australia.
Activity and activities
People with heart disease stand to benefit even more than the rest of the population from regular exercise. Yet, clear guidelines have been lacking for the amount and type of exercise that should be undertaken. In a position statement from the National Heart Foundation, Briffa et al fill the void (→ Physical activity for people with cardiovascular disease: recommendations of the National Heart Foundation of Australia).
Walking is good for you, walking a dog is even better, and just spending time with a dog is pretty good too. So say Motooka et al after studying autonomic nervous activity in elderly people allocated to walk with and without, and interact with, a dog (→ Effect of dog-walking on autonomic nervous activity in senior citizens).
A longitudinal study of elderly people in Dubbo NSW is now in its 18th year. As the cohort ages, the occurrence of various disorders of ageing increases. In “Lifestyle factors and risk of dementia: Dubbo Study of the elderly” Simons et al report on the lifestyle factors that appear to be associated both positively and negatively with eventual hospital or nursing home admission for dementia.
Hepatitis case finding
About 5% of babies born to women with active hepatitis C will be infected, and some will go on to develop severe liver disease as young adults. However, at present hepatitis C is underdiagnosed in Australian children, and detecting it in babies can be problematic. In “The silent infection: should we be testing for perinatal hepatitis C and, if so, how?”, Hardikar et al explain why we should screen all infants whose mothers have the disease, and how this can be done.
An elderly man with longstanding sarcoidosis presents with cognitive decline. The signs point to a diagnosis of neurosarcoidosis, but his treating doctors consider other possibilities. In “Cryptococcal dementia in a patient with sarcoidosis”, Deb et al draw out the lessons from this interesting case.
What men want
According to Smith et al, when it comes to medical care, it’s a woman’s world. Rather than blaming men for their seeming inability to attend to their own health needs, the authors argue that we should provide health services in a more male-friendly manner (→ What do we know about men’s help-seeking and health service use?).
A lead start
A young woman who has sniffed petrol since childhood gives birth prematurely to an infant who does poorly and is found to have lead intoxication. This is the first report of congenital lead poisoning from such a cause and, as Powell and colleagues point out, it holds many lessons for anyone caring for women and children in similar situations (→ Succimer therapy for congenital lead poisoning from maternal petrol sniffing).
Another time . . . another place
Obesity is the commonest disease in the United States. The aged are particularly prone to it, when one by one other physical pleasures have been outlived or denied, and there remains only the joys of the table.
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