Cardiovascular Journal of Africa: Vol 28 No 6 (November/December 2017)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 29, No 1, January/February 2018 AFRICA 11
Are we complying with practice guidelines? Af J Emerg Med 2014; 4:
104–108.
26. Di Domenicantonio R, Cappai G, Sciattella P, Belleudi V, Di Martino
M, Agabiti N. The trade-off between travel time from home to hospital
and door to balloon time in determining mortality among STEMI
patients undergoing PCI. Plos One 2016; 11(6): e0158336. PMID:
27336859, PMCID: PMC4918978, DOI: 10.1371/journal.pone.0158336.
27. Health Professions Council of South Africa. Capabilities of Emergency
Care Providers. [Online]; 2011 [cited 2016 Nov 6. Available from:
gency_care/capabilities_baa_eae_ecp_ect_jul_2013_final.pdf”
28. Health Professions Council of South Africa. Revised Clinical Practice
Guidelines. [Online]; 2016 [cited 2016 Nov 6. Available from: “http://
GUIDELINES_2016.pdf”
29. Andrea PA, van Hoving DJ, Wood D, Smith WP. A 5-year analysis of
the helicopter air mercy service in Richards Bay, South Africa. S Afr Med
J 2014; 104(2): 124–126. PMID: 24893543, DOI:10.7196/SAMJ.7310.
30. Knudsen L, Stengaard C, Hansen MT, Lassen JF, Terkelsen CJ. Earlier
reperfusion in patients with ST-elevation myocardial infarction by use of
helicopter. Scand J Trauma, Resus Emerg Med 2012; 20(70): 1–5. PMID:
23036101, PMCID: PMC3502227, DOI: 10.1186/1757-7241-20-70.
31. Muhlbauer D, Naidoo R, Hardcastle TC. An analysis of patients
transported by a private helicopter emergency medical service in
South Africa. S Afr Med J 2016; 106(2): 201–205. PMID: 26821904,
DOI:10.7196/SAMJ.2016.v106i2.9919.
32. Kerem Y, Eastvold JS, Faragoi D, Strasburger D, Motzny SE, Kulstad
EB. The role of prehospital electrocardiograms in the recognition of
ST-segment elevation myocardial infarctions and reperfusion times. J
Emerg Med 2014; 46(2): 202–207. PMID: 24268634, DOI: 10.1016/j.
jemermed.2013.08.084.
33. Kawakami S, Tahara Y, Noguchi T, Yagi N, Kataoka Y. Time to reper-
fusion in ST-segment elevation myocardial infarction patients with vs.
without pre-hospital mobile telemedicine 12-lead electrocardiogram
transmission. Circ J 2016; 80(7): 1624–1633. PMID: 27250917, DOI:
10.1253 -15-1322.
34. Statistics South Africa. General Household Survey: 2013 Statistical
release – P0318. Pretoria: Statistics South Africa; 2014.
Nutrition advice aimed at children also improves parents’ diets
Nutrition advice aimed at children also improves parents’
diets, according to research published recently in the European
Journal of Preventive Cardiology.
‘Diets high in unsaturated fat and low in saturated fat have
been associated with a reduced risk of cardiovascular events
and death in adults,’ said lead author Dr Johanna Jaakkola, a
postdoctoral researcher at the University of Turku, Finland.
‘Very little is known about the long-term effects of nutrition
advice for children on the diets and health of parents.’
The longitudinal randomised Special Turku Coronary
Risk Factor Intervention Project (STRIP) decreased the
saturated fat intake and improved the cardiovascular health of
children by recommending foods rich in unsaturated instead
of saturated fat. The current study examined whether the
long-term dietary intervention focused on children was also
associated with parental dietary intake and cardiometabolic
risk factors over two decades of follow up.
The primary results of the STRIP study have been
previously reported. Briefly, the study included 1 107 infants
and their parents who were recruited from well-baby clinics
in Turku, Finland, between 1989 and 1992. Families were
randomly assigned to the dietary intervention (562) or
control (545) groups.
The intervention group received dietary counselling at
least once a year by a nutritionist from the child’s age of
eight months to the age of 20 years. Counselling was first
given only to the parents, and from the age of seven years, the
children were also met alone. The main focus of the dietary
intervention was to reduce the child’s intake of saturated fat
and concomitantly increase the child’s unsaturated fat intake.
As previously reported, the repeated dietary counselling
led to decreased saturated fat intake in the intervention
children, and lower serum low-density lipoprotein (LDL)
cholesterol concentration from infancy until 19 years of age.
For the current study, parental dietary intake was assessed
by a one-day food record biennially from the child’s age of
nine to 19 years. Weight and height, and blood pressure,
serum lipid, glucose and insulin levels of the parents were
measured repeatedly from the child’s age of seven months
until 20 years.
The investigators found that the child-oriented dietary
counselling increased the intake of polyunsaturated and
monounsaturated fats and decreased the saturated fat intake
of intervention mothers and fathers compared to control
parents between the child’s ages of nine and 19 years.
In addition, the child-oriented dietary counselling
tended to decrease serum total and LDL concentrations in
intervention mothers compared to control mothers. There
was a similar trend in fathers but it was not statistically
significant.
Dr Jaakkola said: ‘The child-oriented dietary intervention
contributed advantageously to the parental diet in the long
term and tended to reflect lipid concentrations, particularly
in mothers. Presumably all family members eat the same
foods and therefore child-oriented dietary counselling also
affects parents’ diets.’
‘“Dietary intake may have been more strongly associated
with maternal than paternal serum lipid levels because
mothers might have more actively participated in the study
and complied better with the diet,’ she continued. ‘There is
also the possibility that the improvement in the fathers’ diets
was not strong enough to cause a statistically significant
difference in serum lipid levels.’
Dr Jaakkola concluded: ‘Our study emphasises that
long-term dietary counselling directed at children may be
an efficient way to also improve the diets of parents. These
findings could be used to plan public health counselling
programmes.’
Source: European Society of Cardiology Press Office