Behavioural medicine in health promotion

Behavioural medicine is a rapidly developing interdisciplinary field that integrates the physiological and psychosocial aspects of human behaviour and applies them to prevention. In the early stage of chronic non-infectious illnesses of great epidemiological significance the most important risk factors are the reversible psychophysiological regulation disturbances. According to the behavioural medicine model depressive symptomatology, hopelessness, anxiety, non-adaptive ways of coping, dysfunctional attitudes are common risk factors in the background of self-destructive behavioural disturbances, such as smoking, alcohol and drug abuse and suicidal behaviour. The basic link between physiological and psychological phenomena is the decision making process, the cognitive appraisal, evaluation of the given situation, which is very subjective and depends on the socialization process. The modern civilised way of life continuously creates situations in which we experience loss of control, and therefore the psychological and physiological balance can only be obtained with great difficulty. Especially under conditions of sudden cultural and socioeconomic transition strengthening adaptive ways of coping and preventing emotional disturbances are fundamental in health promotion.     

Tea polyphenols for health promotion

People have been consuming brewed tea from the leaves of the Camellia sinensis plant for almost 50 centuries. Although health benefits have been attributed to tea, especially green tea consumption since the beginning of its history, scientific investigations of this beverage and its constituents have been underway for less than three decades. Currently, tea, in the form of green or black tea, next to water, is the most widely consumed beverage in the world. In vitro and animal studies provide strong evidence that polyphenols derived from tea may possess the bioactivity to affect the pathogenesis of several chronic diseases. Among all tea polyphenols, epigallocatechin-3-gallate has been shown to be responsible for much of the health promoting ability of green tea. Tea and tea preparations have been shown to inhibit tumorigenesis in a variety of animal models of carcinogenesis. However, with increasing interest in the health promoting properties of tea and a significant rise in scientific investigation, this review covers recent findings on the medicinal properties and health benefits of tea with special reference to cancer and cardiovascular diseases.     

Lycopene and tomato products in health promotion

International research through epidemiological techniques has provided information on risk factors and preventive approaches in chronic disease. Causation complementing this base of knowledge with laboratory research on associated markers for each disease has outlined the possible mechanisms whereby risk factors and preventive conditions operate. Furthermore, laboratory research in animal models and cell cultures has expanded the appropriate elements associated with each condition. Individuals in the Mediterranean area present with a lower risk of several important chronic diseases, including coronary heart disease and a number of types of cancer associated with nutritional traditions, such as breast, colon, and prostate cancer. Vegetables and fruits in general and cooked tomatoes, together with olive oil, appear to be the nutritional traditions that account for this lower risk. These results lead to public health recommendations to consume more vegetables and, especially, cooked tomatoes with olive oil.     

Importance of exercise immunology in health promotion

Chronic physical exercise with adequate intensity and volume associated with sufficient recovery promotes adaptations in several physiological systems. While intense and exhaustive exercise is considered an important immunosuppressor agent and increases the incidence of upper respiratory tract infections (URTI), moderate regular exercise has been associated with significant disease protection and is a complementary treatment of many chronic diseases. The effects of chronic exercise occur because physical training can induce several physiological, biochemical and psychological adaptations. More recently, the effect of acute exercise and training on the immunological system has been discussed, and many studies suggest the importance of the immune system in prevention and partial recovery in pathophysiological situations. Currently, there are two important hypotheses that may explain the effects of exercise and training on the immune system. These hypotheses including (1) the effect of exercise upon hormones and cytokines (2) because exercise can modulate glutamine concentration. In this review, we discuss the hypothesis that exercise may modulate immune functions and the importance of exercise immunology in respect to chronic illnesses, chronic heart failure, malnutrition and inflammation.     

In Defence of the Vegan Project

The vegan project is defined as the project that strives for radical legal reform to pass laws that would reserve the consumption of animal products to a very narrow range of situations, resulting in vegan diets being the default diets for the majority of human beings. Two objections that have been raised against such a project are described. The first is that such a project would jeopardise the nutritional adequacy of human diets. The second is that it would alienate human beings from nature. It is argued that neither undermines the vegan project.     

Latino children's health and the family-community health promotion model

A majority of Latino children in the US live in poverty. However, unlike other poor children, Latino children do not seem to have a consistent association between poverty and poor health. Instead, many poor Latino children have unexpectedly good health outcomes. This has been labeled an epidemiologic paradox. This paper proposes a new model of health, the family-community health promotion model, to account for this paradox. The family-community health promotion model emphasizes the family-community milieu of the child, in contrast to traditional models of health. In addition, the family-community model expands the outcome measures from physical health to functional health status, and underscores the contribution of cultural factors to functional health outcomes. In this paper, we applied the family-community health promotion model to four health outcomes: low birthweight, infant mortality, chronic and acute illness, and perceived health status. The implications of this model for research and policy are discussed.     

Food technology: challenge for health promotion

The food technology has brought countless benefits to today's food supply. Despite its many positive contributions, it has also brought unintended negative consequences. It is the time to mobilize the food technology to help the food supply more secure, safer and healthier, and here three possible approaches are foreseeable: First, we should continue to improve the conventional technologies. Many wholesome foods have been prepared and preserved using natural materials simply by fermentation. Second, we have to enhance the minimal processing as much as applicable. Third, new ingredients, intelligent packaging and functional foods should be explored to improve food supply and health. Today, consumer interest in the functional foods has been increased tremendously, and the future of food lies in the functional foods. However, the situations in the developing world are different from this. As food resource is limited in this region, food technology has to be emphasized to increase food supply. To help solve such complex problems, not only new technologies, but also conventional technologies have to be mobilized. Simultaneously, even higher technical capabilities have to be built up by applying new findings from the related disciplines to allow the food technology to play its vital role.     

Assessing oral health promotion determinants in active Greek elderly

doi: 10.1111/j.1741‐2358.2011.00491.x
Assessing oral health promotion determinants in active Greek elderly Objective: To explore older adults’ patterns and risk behaviours to be invoked in the allocation of strategies to promote oral health. Background: Access to dental services is determined by factors that serve as barriers to or enablers of older adults’ behaviour and attitudes towards oral health. Appropriate oral health promotion activities are of particular importance among the elderly in altering oral health behaviour through education, prevention and health protection. Methods: A cross‐sectional study was conducted among 108 dentate elderly subjects. They were attending a University Prosthetic Dentistry Clinic in Greece as patients seeking treatment. Participants underwent a clinical examination and an interview. Results: Data extracted revealed that cost and no disease awareness were the most frequently mentioned barriers to regular dental visits. Most of the participants presented low level of income and education and reduced presence of adverse dental health symptoms compared with the actual oral health status. Besides some predisposing factors, enabling and need variables significantly affected access to dental care services, participants’ number of remaining teeth and as a consequence oral health status. Conclusion: Profiling older adults’ demographics, economic, social and cultural status and their attitudes and beliefs could further contribute in developing universal activities and strategies for oral health promotion so as ageing challenges are favoured.     

Flax seed lignan in disease prevention and health promotion

Lignans have been part of both diet and herbal medicines for centuries. It is only in the last half century that phytochemists have described the structures of the lignans. Pharmacologists have only become interested in the biological activity of lignans in the last few decades. Much of the early interest focused on podophyllotoxin type lignans and their derivatives. Recent literature has recorded very many new lignans or lignan derivatives with a diverse range of biological activities. In 1955, the isolation from flax seed and the structure of the lignan derivative secoisolariciresinol diglucoside (SDG) was reported. Possible biological activity of SDG, and the mammalian lignan metabolites, enterolactone and enterodiol, was initially reported about 20 years later. During the next 30 years, there has been extensive research on the biological effects of both flax seed and rye lignans since both are metabolized into the mammalian lignans. Research on the activity of lignans on breast, colon, prostate and thyroid cancer has generally shown beneficial effects although there are some studies with either no conclusive or negative effect. Lignans have been shown to have positive effects in lowering relative risk factors for heart disease. Use of flax seed or SDG has been shown to have positive effects in both lupus and polycystic kidney disease models. Studies of both type I and II diabetes models have reported positive results when using SDG. Flax seed has also been reported to be hepatoprotective. Reproductive effects have been observed with flax seed or SDG and have been found to be dose and time related. There are many possible mechanistic explanations for the observed bioactivities including involvement in hormonal metabolism or availability, angiogenesis, anti-oxidation and gene suppression. Abbreviations: ALA – alpha linolenic acid; ApcMin – adenomatous polyposis coli multiple intestinal neoplasia; BBdp – BioBreeding diabetic prone; CCl₄– carbon tetrachloride; CDC – Crop Development Centre; CHD – cardiovascular heart disease; DMBA – dimethylbenzanthracene; DNA – deoxyribonucleic acid; ER – estrogen receptor; λGT –γ-glutamyltranspeptidase; HDL – high-density lipoprotein; HMGA – hydroxymethyl glutaric acid; IDDM – insulin dependent diabetes mellitus; LDL – low-density lipoprotein; MRL/lpr, Murine Lupus/lymphoproliferative; MDA – malondiadehyde; NIDDM – non-insulin dependent diabetes mellitus; ORF – oxygen free radical; PAF – platelet activating factor; PKD – Polycystic kidney disease; PEPCK – phosphoenolpyruvate carboxykinase; PMNL – polymorphonuclear monocytes; STZ – streptozoticin; TC – total cholesterol; TG – triglycerides; SDG – secoisolariciresinol diglucoside; ZDF – Zucker diabetic fatty. This revised version was published online in June 2006 with corrections to the Cover Date.     

School-based health promotion: the physician as advocate

At the August 1995 meeting of the General Council of the CMA, a resolution supporting school-based health promotion (comprehensive School Health) was adopted. This article briefly reviews the research supporting this integrated approach to school and community programs, applies the recommended approach to reducing tobacco use and outlines a role for physicians in promoting Comprehensive School Health in their communities.     

Genes, diet and public health

Common chronic diseases such as coronary heart disease (CHD), diabetes, cancer, hypertension and obesity are significantly influenced by dietary and other behavioural habits. There is increasing scientific evidence that genetic factors (SNPs), conferring either protection or risk, also contribute importantly to the incidence of these diseases. SNPs are of particular interest because they influence disease in a complex but largely unknown manner by interacting with environmental and lifestyle factors. Because genetic factors also affect a person's response to dietary habits, SNPs likely will be useful in helping to determine and understand why individuals differ in their response to diets. Therefore, the discovery of SNPs will likely revolutionize not only the diagnosis of disease but also the practice of preventative medicine. Other developments, like new biomarkers and noninvasive imaging techniques, might turn out to be highly sensitive and specific in order to identify patients at risk, especially in cases with asymptomatic coronary heart disease. Thus, further knowledge of such new risk factors and their interaction with nutrition, has the potential to provide a more precise and personalized approach to prevent and treat chronic diseases like coronary artery disease, myocardial infarction and stroke.     

Oral health promotion programme for older migrant adults

Objectives: This study evaluated the impact of a community‐based oral health promotion programme on the use of oral health services, oral health knowledge, attitudes, and practices of older Greek and Italian adults attending community clubs and living in Melbourne, Australia. Methods: The oral health promotion intervention consisted of three components: a series of oral health seminars, held at the clubs in the participants’ native languages, the provision of oral health care products, and the production of oral health information sheets. The intervention programme was known as the Oral Health Information Seminars/Sheets (ORHIS). The content of each session was determined following suggestions and findings from the data collected. A pre‐test–post‐test non‐equivalent control group quasi‐experimental design was chosen to evaluate the intervention. A total of 520 independent‐living older adults, members of Greek or Italian social clubs participated in this evaluation. Results: Participants who took part in the intervention responded with higher levels of achievement than those in the control groups. After controlling for baseline variables, experimental groups were significantly more likely than the control groups at post‐test to have improved oral health attitudes, oral health knowledge, and self‐assessed physical health status, as well as, self‐reported oral hygiene practices and use of oral health services. Discussion: The ORHIS approach was successful within the setting of social clubs, and highly acceptable to these communities. As such, it represents a helpful approach for the design of (oral) health interventions in older adults. Further research is required to test the long‐tem impact including the economic evaluation of the ORHIS approach.