eHealth program targets Australian teenagers to reduce chronic disease risk

An eHealth program – the Health4Life Initiative, launched on 24 May at UNSW Sydney, and led by Professor Maree Teesson AC – aims to help Australian high school children reduce their chance of developing chronic diseases, including heart disease and mental health disorders, by preventing and modifying lifestyle risk behaviour that commonly emerges in adolescence. Unhealthy lifestyle behaviour, which a recently published study shows is well established by the late teenage years, co-occurs in clusters and is associated with mental health symptoms. The researchers found that more than three quarters of a sample of 853 18-year-olds had insufficient intake of vegetables (80%) and more than half reported binge drinking at least monthly (52%). More than 40% showed inadequate consumption of fruit (42%), approximately one-third reported sitting for longer than recommended periods (33%), and approximately one-quarter reported smoking (29%) or failing to meet physical activity guidelines (23%). The Health4Life Initiative is the first eHealth program to concurrently target six key lifestyle risk factors among secondary school students, before the onset of chronic disease. These include physical inactivity, poor diet, risky alcohol use, smoking, recreational screen time and poor sleep. The researchers aim to recruit 8000 students from 80 schools across New South Wales, Western Australia and Queensland to test the intervention, which includes an online school-based program, a smartphone tracker application and a booster app to help the students most at-risk.

Antidepressants linked to weight gain

Long term use of antidepressants is associated with a sustained increase in risk of weight gain over at least 5 years, according to a study by UK researchers published in the BMJ. The findings show that patients prescribed any of the 12 most commonly used antidepressants were more likely to experience weight gain than those not taking the drugs. The researchers analysed body weight and body mass measurement data from the UK Clinical Practice Research Datalink (CPRD) for over 300 000 adults with an average age of 51 years, whose body mass index (BMI) had been recorded three or more times during GP consultations from 2004 to 2014. Participants were grouped according to their BMI (from normal weight to severely obese) and whether or not they had been prescribed an antidepressant in a given year. Participants were then monitored for a total of 10 years. The researchers found that the absolute risk of gaining at least 5% weight without antidepressant use was 8.1 per 100 person years; whereas the risk with antidepressant use was 9.8 per 100 person years. This means that for every 59 people taking antidepressants, one extra person would gain at least 5% weight over the study period. The risk was greatest during the second and third years of treatment. During the second year of treatment, the risk of gaining at least 5% weight was 46% higher than in the general population, but no association was found during the first 12 months of treatment. This is an observational study, so no firm conclusions can be drawn about cause and effect. They also found that people who initially had normal weight had a higher risk of moving to either the overweight or obese groups, and people who were initially overweight had a higher risk of moving to the obese group if they were taking antidepressants.

Western diets see cancer rates soar

A new report published by the World Cancer Research Fund (WCRF) shows that overweight or obesity is a cause of at least 12 cancers, with liver, ovary, prostate (advanced), stomach (cardia), and mouth and throat (mouth, pharynx and larynx) cancer joining the ones from the WCRF report a decade ago – bowel (colorectum), breast (post-menopause), gallbladder, kidney, oesophagus, pancreas and womb. Other key findings include: regularly drinking sugar-sweetened drinks increases cancer risk because it causes weight gain, overweight and obesity; being physically active can help protect directly against three cancers – bowel (colon), breast (post-menopause) and womb (endometrium) – and also helps people maintain a healthy weight, reducing  cancer risk further; a healthy diet featuring wholegrains, vegetables, fruit and pulses and low in red and processed meat reduces cancer risk; drinking alcohol is strongly linked to an increased risk of six cancers (bowel, breast, liver, mouth and throat, oesophagus and stomach). Around one in six deaths annually worldwide are due to cancer. As more countries adopt Western lifestyles, the number of new cases of cancer is expected to rise by 58% to 24 million globally by 2035.

What’s online first at the MJA

28 May Research letter: Gluten in “gluten-free” food from food outlets in Melbourne: a cross-sectional study
Halmos et al; doi: 10.5694/mja17.00883
Gluten is sometimes present at clinically significant levels in “gluten-free” foods offered by Melbourne food businesses … OPEN ACCESS permanently.

28 May Podcast with Dr Jason Tye-Din, laboratory head at WEHI and consultant gastroenterologist at Royal Melbourne Hospital … OPEN ACCESS permanently.

28 May Research: Active surveillance of men with low risk prostate cancer: evidence from the Prostate Cancer Outcomes Registry – Victoria
Evans et al; doi: 10.5694/mja17.00559
Almost three-quarters of men did not have follow-up investigations consistent with standard protocols … OPEN ACCESS permanently.

28 May Podcast with Associate Professor Sue Evans, head of the Clinical Registry Unit at Monash University, and Ms Melanie Evans, PCOR-Vic Registry CoordinatorOPEN ACCESS permanently.

28 May Study protocol: Hyperglycaemia in early pregnancy: the Treatment of Booking Gestational diabetes Mellitus (TOBOGM) study. A randomised controlled trial
Simmons et al; doi: 10.5694/mja17.01129
This is the first multicentre RCT investigating the treatment of hyperglycaemia early in pregnancy … OPEN ACCESS permanently.

28 May Podcast with Professor David Simmons, director of the Diabetes, Obesity and Metabolism Translational Research Unit at Western Sydney University … OPEN ACCESS permanently.


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