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Effect of a controlled lifestyle intervention on medication use and costs: The Healthy Lifestyle Community Program (cohort 2) (2023)
Kranz, Ragna-Marie ; Kettler, Carmen ; Anand, Corinna ; Koeder, Christian ; Husain, Sarah ; Schoch, Nora ; Buyken, Anette ; Englert, Heike
Background: Establishing a healthy lifestyle has a great potential to reduce the prevalence of non-communicable diseases (NCDs) and their risk factors. NCDs contribute immensely to the economic costs of the health care system arising from therapy, medication use, and productivity loss. Aim: The aim of this study was to evaluate the effect of the Healthy Lifestyle Community Program (cohort 2; HLCP-2) on medication use and consequently on medication costs for selected NCDs (diabetes, hypertension, and dyslipidemia). Methods: Data stem from a 24-month non-randomised, controlled intervention trial aiming to improve risk factors for NCDs. Participants completed questionnaires at six measurement time points assessing medication use, from which costs were calculated. The following medication groups were included in the analysis as NCD medication: glucose-lowering medications (GLM), antihypertensive drugs (AHD) and lipid-lowering drugs (LLD). Statistical tests for inter- and intra-group comparison and multiple regression analysis were performed. Results: In total, 118 participants (intervention group [IG]: n = 79; control group [CG]: n = 39) were considered. Compared to baseline medication use decreased slightly in the IG and increased in the CG. Costs for NCD medication were significantly lower in the IG than in the CG after 6 (p = 0.004), 12 (p = 0.040), 18 (p = 0.003) and 24 months (p = 0.008). After multiple regression analysis and adjusting for confounders, change of costs differed significantly between the groups in all final models. Conclusion: The HLCP-2 was able to moderately prevent an increase of medication use and thus reduce costs for medication to treat NCDs with the greatest impact on AHD.
Warum wir zufriedene (interne) Kunden haben müssen (2023)
Bernhold, Torben
Effects of a lifestyle intervention on the biomarkers of oxidative stress in non-communicable diseases: A systematic review (2023)
Husain, Sarah ; Hillmann, Katharina ; Hengst, Karin ; Englert, Heike
Oxidative stress plays a critical role in the pathogenesis of chronic diseases. Therefore, improvement of oxidative stress status through lifestyle intervention can play a vital role in preventing and treating chronic diseases. This systematic review aims to provide an overview of articles published in the last decade examining the association between lifestyle intervention and oxidative stress biomarkers in the context of non-communicable diseases. The electronic databases PubMed and Web of Science were searched for relevant studies, following the PRISMA (Preferred Reporting of Systematic Reviews and Meta-Analyses) guidelines. This systematic review focused on the four important oxidative stress biomarkers; glutathione (GSH), superoxide dismutase (SOD), catalase, and malondialdehyde. 671 articles were identified, of which nine met the inclusion criteria. A trend emerged, showing that lifestyle modifications that focus on diet and physical health can improve oxidative stress in the form of an increase in superoxide dismutase and CAT levels and a decrease in Malondialdehyde levels in participants with non-communicable diseases (NCDs), GSH levels were not affected. However, the results are difficult to compare because of the heterogeneity of the methods of the biomarkers studied. Our review indicates that oxidative stress can be influenced by lifestyle modifications and may be an effective tool for the prevention and management of non-communicable diseases. This review also elucidated the importance of analyzing multiple oxidative stress biomarkers to evaluate oxidative stress, it further highlights the need to conduct long-term lifestyle intervention studies on oxidative stress biomarkers to understand the connection between oxidative stress biomarkers, NCDs and Lifestyle intervention.
Consumption Corridors - Living a Good Life within Sustainable Limits (2021)
Fuchs, Doris ; Sahakian, Marlyne ; Gumpert, Tobias ; Gumpert, Antonietta ; Maniates, Michael ; Lorek, Sylvia ; Graf, Antonia
Consumption Corridors: Living a Good Life within Sustainable Limits explores how to enhance peoples’ chances to live a good life in a world of ecological and social limits. Rejecting familiar recitations of problems of ecological decline and planetary boundaries, this compact book instead offers a spirited explication of what everyone desires: a good life. Fundamental concepts of the good life are explained and explored, as are forces that threaten the good life for all. The remedy, says the book’s seven international authors, lies with the concept of consumption corridors, enabled by mechanisms of citizen engagement and deliberative democracy. Across fve concise chapters, readers are invited into conversation about how wellbeing can be enriched by social change that joins “needs satisfaction” with consumerist restraint, social justice, and environmental sustainability. In this endeavour, lower limits of consumption that ensure minimal needs satisfaction for all are important, and enjoy ample precedent. But upper limits to consumption, argue the authors, are equally essential, and attainable, especially in those domains where limits enhance rather than undermine essential freedoms.
Who cares (for whom)
Spangenberg, Joachim H. ; Lorek, Sylvia
Ten new insights in climate science 2021: a horizon scan (2021)
Martin, Maria ; ..., ... ; ..., ... ; Lorek, Sylvia ; ..., ...
A synthesis is made of 10 topics within climate research, where there have been significant advances since January 2020. The insights are based on input from an international open call with broad disciplinary scope. Findings include: (1) the options to still keep global warming below 1.5 °C; (2) the impact of non-CO2 factors in global warming; (3) a new dimension of fire extremes forced by climate change; (4) the increasing pressure on interconnected climate tipping elements; (5) the dimensions of climate justice; (6) political challenges impeding the effectiveness of carbon pricing; (7) demand-side solutions as vehicles of climate mitigation; (8) the potentials and caveats of nature-based solutions; (9) how building resilience of marine ecosystems is possible; and (10) that the costs of climate change mitigation policies can be more than justified by the benefits to the health of humans and nature.
Equity within ecological limits - Grand Challenge for Sustainable Consumption (2021)
Lorek, Sylvia
Advancing the concept of consumption corridors and exploring its implications (2021)
Sahakian, Marlyne ; Fuchs, Doris ; Lorek, Sylvia ; DiGiulio, Antonietta
As a salutogenic concept, “consumption corridors” aims to support what is necessary for sustainable wellbeing to be achieved in relation to the Earth system, with a deep consideration for justice and equity. Living in consumption corridors is a representation of everyday life whereby people live within limits, so that all people – now and in the future – can access what is needed to live a good life. In this special issue, a series of scholars and practitioners have come together to further develop the concept, engage with its ethodological implications, and relate it to consumption domains and policy implications. We begin by introducing how the concept emerged, in relation to the complexity of grappling with the societal transformations required for achieving more sustainable forms of consumption. We then present the different contributions, which demonstrate the importance of considering both maximum and minimum consumption standards, the relevance of human-need theories, as well as the difference between achieving wellbeing and the means necessary for doing so. We conclude by opening up to areas that merit further deliberation: how to relate consumption corridors to everyday-life dynamics, but also to the critical question of power relations at play in implementing consumption corridors.
The Political Economy of (Un)Sustainable Production and Consumption: A Multidisciplinary Synthesis for Research and Action (2021)
Mathai, Manu V. ; Isenhour, Cindy ; Stevis, Dimitris ; Vergragt, Philip ; Bengtsson, Magnus ; Lorek, Sylvia ; Mortensen, Lars Fogh ; Coscieme, Luca ; Scott, David ; Waheed, Ambreen ; Alfredsson, Eva
Despite widespread recognition of the need to transition toward more sustainable production and consumption and numerous initiatives to that end, global resource extraction and corresponding socio-ecological degradation continue to grow. Understanding the causes of this persistent failure is a necessary step towards more effective action. This article contributes to that understanding by synthesizing theory and evidence that links unsustainable production-consumption systems to power and inequality. While sustainable consumption and production research and action mostly focuses on technological or behavioral change, the socio-ecological inequalities driving production-consumption systems built into the organization of our global political economy, remain largely overlooked. In response, we propose a structural political economy orientation that seeks explicitly to reduce these inequalities and advance environmental justice and, thus, create the conditions for sustainable production-consumption systems. We then propose three important arenas of research and action towards sustainable production-consumption systems: justice, governance, and co-production of knowledge and action. These arenas, collectively and individually, can serve as entry points to study and act on the dynamics of (un)sustainable production-consumption systems. This can be done at the micro level, with respect to specific commodity chains or systems of provisioning, or at meso and macro levels with respect to national and global production networks. Our proposed orientation helps distinguish research and practice proposals into those emphasizing management and compensation resulting often in persistence of unsustainability, from those proffering structural changes in unsustainable production-consumption systems. We invite critique and collaboration to develop this research and action agenda further.
Eight Weeks of Lifestyle Change: What are the Effects of the Healthy Lifestyle Community Programme (Cohort 1) on Cortisol Awakening Response (CAR) and Perceived Stress? (2022)
Anand, Corinna ; Hengst, Karin ; Gellner, Reinhold ; Englert, Heike
Background: Stress and cortisol dysregulation are linked to NCDs. Moreover, stress favours unhealthy lifestyle patterns, which increase the risk for NCDs. The role of the Cortisol Awakening Response (CAR) and the effect of lifestyle interventions on the same remain unclear. Methods: The impact of the intensive 8-week phase of the Healthy Lifestyle Community Programme (HLCP, cohort 1) on parameters of the CAR, ie cortisol values 0 (sample [S]1), 30), 45 and 60 minutes post-awakening, average peak, S1-peak delta and area under the increase curve (AUCI), and perceived stress levels (PSL) was evaluated in a non-randomized, controlled trial. Covariates of the CAR (eg sleep measures) and irregularities in sampling were assessed. The intervention focussed on stress management, a healthy diet, regular exercise, and social support. Participants were recruited from the general population. Multiple linear regression analyses were conducted. Results: 97 participants (age: 56 ± 10 years; 71% female), with 68 in the intervention group (IG; age: 55 ± 8, 77% female) and 29 participants in the control group (CG; age: 59 ± 12, 59% female), were included in the analysis. The baseline characteristics of both groups were comparable, except participants of IG were younger. On average, the PSL at baseline was low in both groups (IG: 9.7 ± 5.4 points; CG: 8.5 ± 6.9 points; p = .165), but 22% (n = 15) in the IG and 20% (n = 6) in the CG reported a high PSL. Most participants reported irregularities in CAR sampling, eg interruption of sleep (IG: 80% CG: 81%). After 8 weeks, most CAR parameters and the PSL decreased in the IG and CG, resulting in no differences of change between the groups. In the IG only, a decrease of PSL was linked to an increase of CAR parameters, eg AUCI (correlation coefficient = −0.307; p = .017). Conclusion: The HLCP may potentially reduce PSL and change the CAR, but results cannot be clearly attributed to the programme. Methodological challenges and multiple confounders, limit suitability of the CAR in the context of lifestyle interventions. Other measures (eg hair-cortisol) may give further insights. Trial registration: German Clinical Trials Register (DRKS); DRKS00018821; www.drks.de
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