Sri Lanka health system review

Sri Lanka has achieved strong health outcomes over and above what is commensurate with its income level. The country has made significant gains in essential health indicators, witnessed a steady increase in life expectancy among its people, and eliminated malaria, filariasis, polio and neonatal tetanus. The Sri Lanka HiT review presents a comprehensive overview of the different aspects of the country’s health system, and the background and context within which the health system is situated. The review also presents information on reforms to address emerging health needs such as the growing challenge of noncommunicable diseases (NCDs) and serving a rapidly ageing population.Health system in transition reviews (HiTs) provide a detailed description of a country’s health system, and policy and reform developments.

Weight loss in videoconference and in-person iDiet weight loss programs in worksites and community groups.

OBJECTIVE: To examine the association of program delivery factors with weight loss (WL) in enrollees in iDiet® , a commercial WL program. METHODS: Data were from 644 adults enrolling in an 11-week group WL program and 461 who reported weight to 11 weeks (complete reporters). Predictors of %WL were analyzed using ANCOVA, including meeting type (in-person vs. videoconference), participant type (worksite employees vs. community members), age, gender, BMI, and payment structure. RESULTS: Mean starting BMI was 32.4 ± 7.1 (mean ± SD); WL was 6.1 ± 3.9% in all enrollees in an intention-to-treat analysis and 7.4 ± 3.4% in complete reporters. Videoconference participants, older adults, and enrollees in incentivized programs were more likely to be complete reporters (P < 0.004). %WL at 11 weeks was not associated with gender, starting BMI, or videoconference versus in-person groups. Worksite participants had greater %WL than community participants (+1.2%, P < 0.001), and there was no significant difference in %WL between programs paid by the employee or employer. Greater %WL was achieved by individuals ≥30 versus < 30 years (+2.2%, P < 0.001) and by those enrolling in January-March versus April-June (+1.4%, P = 0.02). CONCLUSIONS: iDiet participants had clinically impactful mean WL. The observed high mean WL in worksites and videoconference-delivered programs broadens options for scalable WL program implementation.

Nutrition modulation of human aging: The calorie restriction paradigm.

Globally, the aging population is growing rapidly, creating an urgent need to attenuate age-related health conditions, including metabolic disease and disability. A promising strategy for healthy aging based on consistently positive results from studies with a variety of species, including non-human primates (NHP), is calorie restriction (CR), or the restriction of energy intake while maintaining intake of essential nutrients. The burgeoning evidence for this approach in humans is reviewed and the major study to date to address this question, CALERIE (Comprehensive Assessment of the Long-term Effects of Reducing Intake of Energy), is described. CALERIE findings indicate the feasibility of CR in non-obese humans, confirm observations in NHP, and are consistent with improvements in disease risk reduction and potential anti-aging effects. Finally, the mechanisms of CR in humans are reviewed which sums up the fact that evolutionarily conserved mechanisms mediate the anti-aging effects of CR. Overall, the prospect for further research in both NHP and humans is highly encouraging.

Effectiveness of Workplace Weight Management Interventions: a Systematic Review.

A systematic review was conducted of randomized trials of workplace weight management interventions, including trials with dietary, physical activity, environmental, behavioral, and incentive-based components. Main outcomes were defined as change in weight-related measures. Keywords related to weight management and workplace interventions were used to search relevant databases, and 23 eligible studies were reviewed in detail using a data extraction form and quality assessment checklist. The trials were conducted mainly in the USA and Europe, with four additional countries represented. Interventions were mostly multicomponent and were implemented in both sexes and in a range of employment categories. Intervention effectiveness appeared unrelated to region of the world and was highest in 6-12-month trials. The results ranged widely from clinically significant 8.8-kg weight loss in one trial to less effective than the control treatment in others. Some workplace interventions achieve clinically significant benefits, and further studies are needed to replicate those results in wider sociocultural and geographical contexts.