Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective studies

Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective studies | BMJ.

This article is available freely via Open Access. Please click on the above link to view it fully.

Abstract

Objective To investigate the association between intake of dietary fibre and whole grains and risk of colorectal cancer.

Design Systematic review and meta-analysis of prospective observational studies.

Data sources PubMed and several other databases up to December 2010 and the reference lists of studies included in the analysis as well as those listed in published meta-analyses.

Study selection Prospective cohort and nested case-control studies of dietary fibre or whole grain intake and incidence of colorectal cancer.

Results 25 prospective studies were included in the analysis. The summary relative risk of developing colorectal cancer for 10 g daily of total dietary fibre (16 studies) was 0.90 (95% confidence interval 0.86 to 0.94, I²=0%), for fruit fibre (n=9) was 0.93 (0.82 to 1.05, I²=23%), for vegetable fibre (n=9) was 0.98 (0.91 to 1.06, I²=0%), for legume fibre (n=4) was 0.62 (0.27 to 1.42, I²=58%), and for cereal fibre (n=8) was 0.90 (0.83 to 0.97, I²=0%). The summary relative risk for an increment of three servings daily of whole grains (n=6) was 0.83 (0.78 to 0.89, I²=18%).

Conclusion A high intake of dietary fibre, in particular cereal fibre and whole grains, was associated with a reduced risk of colorectal cancer. Further studies should report more detailed results, including those for subtypes of fibre and be stratified by other risk factors to rule out residual confounding. Further assessment of the impact of measurement errors on the risk estimates is also warranted.

 

Functional outcomes of multi-condition collaborative care and successful ageing: results of randomised trial

Functional outcomes of multi-condition collaborative care and successful ageing: results of randomised trial | BMJ.

Abstract

Objective To evaluate the effectiveness of integrated care for chronic physical diseases and depression in reducing disability and improving quality of life.

Design A randomised controlled trial of multi-condition collaborative care for depression and poorly controlled diabetes and/or risk factors for coronary heart disease compared with usual care among middle aged and elderly people

Setting Fourteen primary care clinics in Seattle, Washington.

Participants Patients with diabetes or coronary heart disease, or both, and blood pressure above 140/90 mm Hg, low density lipoprotein concentration >3.37 mmol/L, or glycated haemoglobin 8.5% or higher, and PHQ-9 depression scores of ≥10.

Intervention A 12 month intervention to improve depression, glycaemic control, blood pressure, and lipid control by integrating a “treat to target” programme for diabetes and risk factors for coronary heart disease with collaborative care for depression. The intervention combined self management support, monitoring of disease control, and pharmacotherapy to control depression, hyperglycaemia, hypertension, and hyperlipidaemia.

Main outcome measures Social role disability (Sheehan disability scale), global quality of life rating, and World Health Organization disability assessment schedule (WHODAS-2) scales to measure disabilities in activities of daily living (mobility, self care, household maintenance).

Results Of 214 patients enrolled (106 intervention and 108 usual care), disability and quality of life measures were obtained for 97 intervention patients at six months (92%) and 92 at 12 months (87%), and for 96 usual care patients at six months (89%) and 92 at 12 months (85%). Improvements from baseline on the Sheehan disability scale (−0.9, 95% confidence interval −1.5 to −0.2; P=0.006) and global quality of life rating (0.7, 0.2 to 1.2; P=0.005) were significantly greater at six and 12 months in patients in the intervention group. There was a trend toward greater improvement in disabilities in activities of daily living (−1.5, −3.3 to 0.4; P=0.10).

Conclusions Integrated care that covers chronic physical disease and comorbid depression can reduce social role disability and enhance global quality of life.

 

Repeat offenders appear to have worse health in middle-age

A life of crime appears to damage offenders’ health once they reach their 40s, new research suggests.

via BBC News – Repeat offenders appear to have worse health in middle-age.

Tactical analysis of the Barcelona counter-attack

Tactical analysis of the Barcelona counter-attack — Sarmento et al. 45 (15): A4 — British Journal of Sports Medicine.

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Abstract

The purpose of this study was to observe and to characterise the tactical performance in the counter-attack (CA) of the Football Club Barcelona (FCB) in the 2009/2010 sporting season, using sequential analysis. Sixty-two sequences of CA, resulting from twelve games, were encoded using the observational instrument developed by Sarmento et al (Medicina (Kaunas) 2010;46:401–7). The reliability of the data was calculated by the intra- and inter-observer agreement, and values above 0.90 for all criteria were achieved. Observational methodology was used, with special reference to the sequential analysis. For the treatment of the data SDIS-GSEQ software was used. There is a probability that the recovery of the ball possession (RBP) by disarm is followed by a dribble (Z=2.24) and, when the RBP is due an intervention of the goalkeeper, there are a tendency to the sequence to keep going by the right side of the field, in a controlled way, performing actions like the dribble (Z=2.47) and the conduction of the ball (Z=2.71). The execution of the “long pass” is related with ends of the offensive process (EOP) without efficacy, like the EOP due the rules of the game (Z=2.21). In the other hand, the results showed that have behaviours, as the dribble (Z=3.32), the crossing (z=2.82), and the intervention of the opponent without efficacy (Z=3.32), that induce the shot with the goal. The detection of behaviour patterns in the CA of the FCB proves to be particularly interesting. The study of these regularities made it possible, in a phased way, to characterize the observed offensive actions and provide important information for coaches that can be used in the training process.

 

Health minister warns on targets as waiting times rise

Health Minister Lesley Griffiths has warned NHS managers they must meet strict targets or face the consequences.

via BBC News – Health minister warns on targets as waiting times rise.

Stafford Hospital’s A&E department to close at night

Plans to temporarily close Stafford Hospital’s accident and emergency (A&E) unit at night have been approved.

via BBC News – Stafford Hospital’s A&E department to close at night.

Assura Medical staff told to give chlamydia tests to family and friends

via Assura Medical staff told to give chlamydia tests to family and friends | News | Health Service Journal.

This article is solely the work of the HSJ. For a full copy of the article please contact the library.

A private company which has taken over NHS sexual health services in Teeside instructed staff to hand out chlamydia tests to family and friends in a bid to hit screening targets, a leaked memo has revealed

 

NHS lacks leadership consistency, peers told

Britain lacks “a consistency of leadership” in overseeing the NHS due to the changes of health secretary, a Conservative Peer has said.

via NHS lacks leadership consistency, peers told | News | Health Service Journal.

This article is solely the work of the HSJ. For a full copy of the article please contact the library.