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Abstract: . . . 11 Wald NJ, Law MR. A strategy to reduce cardiovascular disease by more than 80%. BMJ 2003;326:1419. 12 Jackson R, Lawes CMM, Bennett DA, Milne RJ, Rodgers A. Treatment with drugs to lower blood pressure and blood cholesterol based on an individuals cardiovascular risk. Lancet 2005;365:434-41. 13 Strong K, Mathers C, Leeder S, Beaglehole R. Preventing chronic diseases : how many lives can we save? Lancet 2005;366;1578-82. Nutritional supplements in cystic fibrosis A new study suggests theyre ineffective,but concordance may have been poor P eople with cystic fibrosis and their caregivers know that the better the patients nutritional status, the better their . . . . . . John Lynch professor Sam Harper research fellow Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada H3A 1A2 Competing interests: None declared. 1 Manuel DG, Lim J, Tanuseputro P, Anderson GM, Alter DA, Laupacis A, et al. Revisiting Rose: Strategies for reducing coronary heart disease . BMJ 2006;332:659-62. 2 Rose G. Sick individuals and sick populations. Int J Epidemiol 1985; 14:32-8. 3 Rose G. Environmental health: problems and prospects. J R Coll Physicians Lond 1991;25:48-52. 4 New Zealand Guideline Group. Assessment and management of cardio- vascular risk 2003. www.nzgg.org.nz/ . . . . . . et al. Trends in serum lipids and lipoproteins of adults, 1960-2002. JAMA 2005;294:1773-81. 8 Hunink M, Goldman L, Tosteson A, Mittleman M, Goldman P, Williams L, et al. The recent decline in mortality from CHD, 1980-1990. JAMA 1997;277:535-42. 9 Unal B, Alison J, Critchley A, Capewell A. Modelling the decline in coro- nary heart disease deaths in England and Wales, 1980-2000: comparing contributions from primary prevention and secondary prevention. BMJ 2005;331:614-7. 10 Tunstall-Pedoe H, Connaghan J, Woodward M, Tolonen H, Kuulasmaa K. Pattern of declining blood pressure across replicate population surveys of the WHO MONICA project, mid-1980s to mid-1990s, and the . . . . . . also associated with delayed puberty, a higher risk of pneumothorax, and a worse outcome after lung transplantation. 4 5 The increased demand for energy in cystic fibrosis is well recognised. 6 Despite this, almost 20% of children with cystic fibrosis fall below the fifth centile for weight set by the Centers for Disease Control and Prevention, 7 and their height and weight z scores often decline with age. Combating nutritional failure to ensure normal growth and weight gain is therefore a key challenge for the entire teamdoctors, nurses, dietitians, psycholo- gists, and social workers. Nutritional management in cystic fibrosis is difficult . . . --3000,4,375,3314,15647
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