Association between breakfast skipping and blood pressure – a meta-analysis of 20 studies

Abstract

significance level of results was assessed with p 0.005. 67% of the participantas are only familiar with the approach to healthcare based on universal human rights, 22% have some knowledge of details, 11% are completely unaware of the problem. Foreign students demonstrate a slightly better understanding than their Bulgarian counterparts. Conclusions: Protection of human rights in healthcare should receive more attention in the university curriculum of medical students. Key messages: Medical students demonstrate respect towards human rights and human dignity of patients but little understanding of the approach necessary to guarantee their protecion in medical practice. The university education of medical students in issues of patients rights and dignity protection should be enhanced and more problem-based. Background: Habitual breakfast intake is important in terms of preventing lifestyle related disease, but the association between breakfast intake and blood pressure is still uncertain. The objective of this study was to clarify whether or not and how much skipping breakfast affects blood pressure by meta-analysis. Methods: We searched three electronic databases with a search formula and collected 233 articles. A total of 219 articles which did not meet the necessary requirements were excluded, leaving us with 14 articles. A standardized mean difference (d) was used for effect size, and we performed a random effects model. We used the Q-statistics and the I2 test to examine the heterogeneity of the effect size. Results: The pooled mean effect size in blood pressure (BP) was-0.10mmHg for systolic blood pressure (SBP) and À0.08mmHg for diastolic blood pressure (DBP), therefore the BP was higher in the breakfast skipping group than the breakfast intake group. In the further subgroup analysis by sex and age, SBP was also significantly higher in the breakfast skipping group than the breakfast intake group. Although moderate to high heterogeneity was detected among these effect sizes, the effect of the publication bias was estimated to be small. On the other hand, DBP was significantly higher in the breakfast skipping group than the breakfast intake group among female subjects and subjects under the age of 18, but there were no significant differences among male subjects and subjects at the age of 18 and over. The heterogeneity among the effect sizes, was lower in DBP than SBP, and the effect of the publication bias was also estimated to be small. Conclusions: The meta-analysis showed that the BP was higher in the breakfast skipping group than breakfast intake group, and this result suggested the benefit of habitual breakfast intake in order to prevent hypertension. Key messages: Habitual breakfast intake may be beneficial for the prevention hypertension. Skipping Breakfast is related to increased of blood pressure. Rock climbers knowledge, attitudes, and practices of injury prevention when travelling in India. Background: In 2016 the WHO reported age-specific death rate from injuries in lower middle-income countries is more than double that of high income countries (82.7 vs. 33.6 per 100,000 population). Low and middle-income countries (LMIC) are increasingly promoting adventure tourism activities such as rock climbing. This is the first study to evaluate rock climbers knowledge, attitudes, and practices of injury prevention when travelling in a lower middle-income country. Methods: A cross sectional study was conducted 18th January-1st March 2017 in the climbing destination of Hampi, India. The author visited pre-selected climbing areas and hostels for 3-5 hours each on a weekly rotation where climbers were invited to complete a self-administered questionnaire. A total of 161 responses were collected (95% response rate). One question asked participants to rate on a Likert-type scale (1: not confident at all-5: very confident) how they felt about receiving medical treatment in India. Results: 60% participants were aged 25-34, 96% were from a high income country, and 91% had travelled to a LMIC previously. 82% recognised risk of death from an injury in India is higher than in their home country. 73% recognised road traffic accident as the most common injury leading to death. The median score for confidence about receiving medical treatment in India was 2 (IQR 2-3). 20% avoid travel by 2-wheeled vehicle, 19% wear a motorcycle helmet, and 20% wear a car seatbelt. Conclusions: Rock climbing adventure tourists in India recognise the increased risk of death from sustaining an injury whilst travelling in a lower middle-income country and that the most common injury is road traffic accident, they are not confident about receiving medical care in India. Despite this, only a minority adhere to evidence based risk reduction strategies such as avoiding motorcycles, wearing a motorcycle helmet, and wearing a car seatbelt. Key messages: Climbing tourists in India are at risk of injury but poorly adhere to risk reduction strategies, they are an important subgroup as they are return travellers to LMICs thus are repeatedly at risk. National climbing councils, travel information websites, and adventure tourism boards can use this research to reinforce the importance of risk reduction strategies when travelling to LMICs.