Diet sehat itu lebih mahal

Penelitian di Australia ini mendapatkan bahwa kebiasaan makan yang sehat lebih mahal sehingga membebani untuk keluarga yang welfare-dependent.

 

A healthy diet consistent with Australian health recommendations is too expensive for welfare-dependent families

Christine Kettings ¹ and Andrew J. Sinclair ¹ Melanie Voevodin ²

¹ School of Exercise and Nutrition Science, Deakin University, Melbourne, Victoria ² Nestlé Healthcare Nutrition, Melbourne, Victoria

Correspondence to: 
Melanie Voevodin, Nestlé Healthcare Nutrition, 20-24 Howleys Road, Notting Hill, Victoria 3168, Australia. Fax: (03) 8588 0599; e-mail:melanie.voevodin@au.nestle.com

KEYWORDS

food cost • food security • Australian Dietary Guidelines • low-income family

ABSTRACT

Objective: Examine the cost of healthy food habits for welfare-dependent families in Australia.

Method: A seven-day meal plan was developed, based on Australian public health recommendations, for two typical welfare-dependent families: a couple-family (two adults, two children) and a one-parent family (one adult, two children). The cost of the meal plan was calculated using market brand and generic brand grocery items, and total cost compared to income.

Results: In Australia, the cost of healthy food habits uses about 40% of the disposable income of welfare-dependent families. Families earning an average income would spend only 20% of their disposable income to buy the same healthy food. Substituting generic brands for market brands reduced the weekly food cost by about 13%. This is one of few economic models to include generic brands.

Conclusion: Compared with average-income Australian families, healthy food habits are a fiscal challenge to welfare-dependent families.

Implications: These results provide a benchmark for economic and social policy analysis, and the influence disposable income has on prioritising healthy food habits.

Sleep Duration and Hyperglycemia Among Obese and Nonobese Children Aged 3 to 6 Years

Penelitian cross-sectional ini mencari hubungan antara durasi tidur dan hiperglikemia pada anak prasekolah. Ternyata kurang tidur berhubungan dengan hiperglikemia. Namun untuk menemukan hubungan kausal perlu penelitian lebih mendalam.

 

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Sleep Duration and Hyperglycemia Among Obese and Nonobese Children Aged 3 to 6 Years

Zhen Tian, MD; Tao Ye, MD; Xiaoyan Zhang, MD; Enqing Liu, MD; Wei Wang, MD; Ping Wang, MD; Gongshu Liu, MD;Xilin Yang, PhD; Gang Hu, MD, PhD, MPH; Zhijie Yu, MD, PhD, MPH 

Arch Pediatr Adolesc Med. 2010;164(1):46-52.

Objective  To investigate the association between sleep duration and risk of hyperglycemia among preschool Chinese children.

Design  A population-based cross-sectional study.

Setting  Seventy-one randomly selected kindergartens in Tianjin, China.

Participants  Six hundred nineteen obese (body mass index z score >1.65) and 617 nonobese (body mass index z score <1.65) children aged 3 to 6 years were recruited and matched by age.

Main Exposure  Sleep duration.

Main Outcome Measures  Hyperglycemia, defined as a fasting glucose level of 100 mg/dL or higher.

Results  Obese children were more likely to have shorter sleep duration (<8 hours) compared with their nonobese counterparts (P < .001). Compared with those who slept for 9 or 10 hours per night, those who slept for 8 hours or less hada significantly higher likelihood of having hyperglycemia, controlling for age and sex (odds ratio [OR], 1.65; 95% confidence interval [CI], 1.12-2.45). After further adjustment for other potential confounders, the association still remained statistically significant (OR, 1.64; 95% CI, 1.09-2.46). In the stratified multivariable analyses, those who were obese and slept for 8 hours or less had an increased risk of having hyperglycemia (OR, 2.12; 95% CI, 1.06-4.21) compared with those who were nonobese and slept for 9 hours or more.

Conclusions  Shorter sleep duration is associated with an increased risk of having hyperglycemia among preschool Chinese children. Whether adequate sleep may help maintain euglycemia among children, especially for those who are overweight or obese, warrants further investigation.

Ezetimibe vs. niacin added to statins for secondary prevention of CAD

Penelitian ini membandingkan efektivitas NIACIN vs EZETIMIBE dalam hal meningkatkan kadar kolesterol HDL dan menurunkan kadar kolesterol LDL serta perbedaan rerata ketebalan carotid intima media setelah 14 bulan intervensi pada pasien yang mendapatkan preparat statin.

 

Hasilnya pada kelompok niacin terjadi peningkatan HDL, penurunan LDL dan trigliserida secara signifikan. Kelompok ezetimibe terjadi penurunan HDL, LDL dan trigliserida. Dalam hal ketebalan carotid intima media niacin lebih unggul.

Anehnya pada kelompok ezetimibe penurunan LDL berhubungan signifikan dengan penebalan carotid intima media (R=–0.31, P<0.001).

Insiden kejadian kardiovaskuler mayor pada kelompok niacin lebih rendah dibanding kelompok ezetimibe (1% vs. 5%, P=0.04 by the chi-square test).

 

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N Engl J Med 361(22):2113-2122, 26 November 2009. © 2009 to the Massachusetts Medical Society
Extended-Release Niacin or Ezetimibe and Carotid Intima-Media Thickness. Allen J. Taylor, Todd C. Villines, Eric J. Stanek, et al. 

ABSTRACT

Background Treatment added to statin monotherapy to further modify the lipid profile may include combination therapy to either raise the high-density lipoprotein (HDL) cholesterol level or further lower the low-density lipoprotein (LDL) cholesterol level.

Methods We enrolled patients who had coronary heart disease or a coronary heart disease risk equivalent, who were receiving long-term statin therapy, and in whom an LDL cholesterol level under 100 mg per deciliter (2.6 mmol per liter) and an HDL cholesterol level under 50 mg per deciliter for men or 55 mg per deciliter for women (1.3 or 1.4 mmol per liter, respectively) had been achieved. The patients were randomly assigned to receive extended-release niacin (target dose, 2000 mg per day) or ezetimibe (10 mg per day). The primary end point was the between-group difference in the change from baseline in the mean common carotid intima–media thickness after 14 months. The trial was terminated early, on the basis of efficacy, according to a prespecified analysisconducted after 208 patients had completed the trial.

Results The mean HDL cholesterol level in the niacin group increased by 18.4% over the 14-month study period, to 50 mg per deciliter (P<0.001), and the mean LDL cholesterol level in the ezetimibe group decreased by 19.2%, to 66 mg per deciliter (1.7 mmol per liter) (P<0.001). Niacin therapy significantly reduced LDL cholesterol and triglyceride levels; ezetimibe reduced the HDL cholesterol and triglyceride levels. As compared with ezetimibe,niacin had greater efficacy regarding the change in mean carotid intima–media thickness over 14 months (P=0.003), leading to significant reduction of both mean (P=0.001) and maximal carotid intima–media thickness (P0.001 for all comparisons). Paradoxically, greater reductions in the LDL cholesterol level in association with ezetimibe were significantly associated with an increase in the carotid intima–media thickness (R=–0.31, P<0.001). The incidence of major cardiovascular events was lower in the niacin group than in the ezetimibe group (1% vs. 5%, P=0.04 by the chi-square test).

Conclusions This comparative-effectiveness trial shows that the use of extended-release niacin causes a significant regression of carotid intima–media thickness when combined with a statin and that niacin is superior to ezetimibe.