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Evaluation of Pictorial Dietary Assessment Tool for Hospitalized Patients with Diabetes: Cost, Accuracy, and User Satisfaction Analysis. Nutrients 2017; 10:nu10010027. [PMID: 29283401 PMCID: PMC5793255 DOI: 10.3390/nu10010027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 12/22/2017] [Accepted: 12/22/2017] [Indexed: 01/04/2023] Open
Abstract
Although nutritional screening and dietary monitoring in clinical settings are important, studies on related user satisfaction and cost benefit are still lacking. This study aimed to: (1) elucidate the cost of implementing a newly developed dietary monitoring tool, the Pictorial Dietary Assessment Tool (PDAT); and (2) investigate the accuracy of estimation and satisfaction of healthcare staff after the use of the PDAT. A cross-over intervention study was conducted among 132 hospitalized patients with diabetes. Cost and time for the implementation of PDAT in comparison to modified Comstock was estimated using the activity-based costing approach. Accuracy was expressed as the percentages of energy and protein obtained by both methods, which were within 15% and 30%, respectively, of those obtained by the food weighing. Satisfaction of healthcare staff was measured using a standardized questionnaire. Time to complete the food intake recording of patients using PDAT (2.31 ± 0.70 min) was shorter than when modified Comstock (3.53 ± 1.27 min) was used (p < 0.001). Overall cost per patient was slightly higher for PDAT (United States Dollar 0.27 ± 0.02) than for modified Comstock (USD 0.26 ± 0.04 (p < 0.05)). The accuracy of energy intake estimated by modified Comstock was 10% lower than that of PDAT. There was poorer accuracy of protein intake estimated by modified Comstock (<40%) compared to that estimated by the PDAT (>71%) (p < 0.05). Mean user satisfaction of healthcare staff was significantly higher for PDAT than that for modified Comstock (p < 0.05). PDAT requires a shorter time to be completed and was rated better than modified Comstock.
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Krishan P, Bedi O, Rani M. Impact of diet restriction in the management of diabetes: evidences from preclinical studies. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2017; 391:235-245. [PMID: 29249036 DOI: 10.1007/s00210-017-1453-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 12/11/2017] [Indexed: 11/28/2022]
Abstract
The inappropriate dietary habits lead to the onset of age-related pathologies which include diabetes and cardiovascular ailments. Dietary restriction and nutritional therapy play an important role in the prevention of these chronic ailments. Preclinical research provides a basis for the therapeutic exploration of new dietary interventions for the clinical trials to potentiate the scientific management of diabetes and its related complications which further help in translating these nutritional improvements from bench to bedside. Within the same context, numerous therapeutically proved preclinical dietary interventions like high-fiber diet, caloric restriction, soy isoflavone-containing diets, etc., have shown the promising results for the management of diabetes and the associated complications. The focus of the present review is to highlight the various preclinical evidences of diet restriction for the management of diabetes and which will be helpful for enlightening the new ideas of nutritional therapy for future research exploration. In addition, some potential approaches are also discussed which are associated with various nutritional interventions to combat progressive diabetes and the associated disorders. Graphical abstract ᅟ.
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Affiliation(s)
- Pawan Krishan
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, India.
| | - Onkar Bedi
- JRF, DST-SERB, New Delhi, Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, Punjab, India
| | - Monika Rani
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, Punjab, India
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Brown A, Guess N, Dornhorst A, Taheri S, Frost G. Insulin-associated weight gain in obese type 2 diabetes mellitus patients: What can be done? Diabetes Obes Metab 2017; 19:1655-1668. [PMID: 28509408 DOI: 10.1111/dom.13009] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 05/06/2017] [Accepted: 05/11/2017] [Indexed: 12/11/2022]
Abstract
Insulin therapy (IT) is initiated for patients with type 2 diabetes mellitus when glycaemic targets are not met with diet and other hypoglycaemic agents. The initiation of IT improves glycaemic control and reduces the risk of microvascular complications. There is, however, an associated weight gain following IT, which may adversely affect diabetic and cardiovascular morbidity and mortality. A 3 to 9 kg insulin-associated weight gain (IAWG) is reported to occur in the first year of initiating IT, predominantly caused by adipose tissue. The potential causes for this weight gain include an increase in energy intake linked to a fear of hypoglycaemia, a reduction in glycosuria, catch-up weight, and central effects on weight and appetite regulation. Patients with type 2 diabetes who are receiving IT often have multiple co-morbidities, including obesity, that are exacerbated by weight gain, making the management of their diabetes and obesity challenging. There are several treatment strategies for patients with type 2 diabetes, who require IT, that attenuate weight gain, help improve glycaemic control, and help promote body weight homeostasis. This review addresses the effects of insulin initiation and intensification on IAWG, and explores its potential underlying mechanisms, the predictors for this weight gain, and the available treatment options for managing and limiting weight gain.
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Affiliation(s)
- Adrian Brown
- Department of Medicine, Faculty of Medicine, Nutrition and Dietetic Research Group, Imperial College, London, UK
| | - Nicola Guess
- Department of Medicine, Faculty of Medicine, Nutrition and Dietetic Research Group, Imperial College, London, UK
- Division of Diabetes and Nutritional Sciences, Kings College London, London, UK
| | - Anne Dornhorst
- Department of Metabolic Medicine, Imperial College London, London, UK
| | - Shahrad Taheri
- Department of Metabolic Medicine, Imperial College London, London, UK
- Department of Medicine and Clinical Research Core, Weill Cornell Medicine, New York, New York
- Department of Medicine and Clinical Research Core, Weill Cornell Medicine, Doha, Qatar
| | - Gary Frost
- Department of Medicine, Faculty of Medicine, Nutrition and Dietetic Research Group, Imperial College, London, UK
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Academy of Nutrition and Dietetics: Revised 2017 Scope of Practice for the Registered Dietitian Nutritionist. J Acad Nutr Diet 2017; 118:141-165. [PMID: 29173834 DOI: 10.1016/j.jand.2017.10.002] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Indexed: 01/24/2023]
Abstract
The Academy of Nutrition and Dietetics (Academy) is the world's largest organization of food and nutrition professionals and the association that represents credentialed nutrition and dietetics practitioners-registered dietitian nutritionists (RDNs) and nutrition and dietetics technicians, registered (NDTRs). RDNs integrate research, professional development, and practice to stimulate innovation and discovery; collaborate to solve the greatest food and nutrition challenges now and in the future; focus on systemswide impact across the food, wellness, and health sectors; have a global impact in eliminating all forms of malnutrition; and amplify the contribution of nutrition and dietetics practitioners and expand workforce capacity and capability. The Revised 2017 Scope of Practice for the RDN reflects the position of the Academy on the essential role of the RDN in the direction and delivery of food and nutrition services. The scope of practice for the RDN is composed of education and credentialing, practice resources, Academy Standards of Practice and Professional Performance, codes of ethics, accreditation standards, state and federal regulations, national guidelines, and organizational policy and procedures. The Revised 2017 Scope of Practice for the RDN is used in conjunction with the Revised 2017 Standards of Practice (SOP) in Nutrition Care and the Standards of Professional Performance (SOPP) for RDNs. The SOP address activities related to direct patient and client care. The SOPP address behaviors related to the professional role of RDNs. These standards reflect the minimum competent level of nutrition and dietetics practice and professional performance for RDNs. A companion document addresses the scope of practice for the NDTR.
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MacLeod J, Franz MJ, Handu D, Gradwell E, Brown C, Evert A, Reppert A, Robinson M. Academy of Nutrition and Dietetics Nutrition Practice Guideline for Type 1 and Type 2 Diabetes in Adults: Nutrition Intervention Evidence Reviews and Recommendations. J Acad Nutr Diet 2017; 117:1637-1658. [DOI: 10.1016/j.jand.2017.03.023] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Indexed: 12/17/2022]
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Academy of Nutrition and Dietetics Nutrition Practice Guideline for Type 1 and Type 2 Diabetes in Adults: Systematic Review of Evidence for Medical Nutrition Therapy Effectiveness and Recommendations for Integration into the Nutrition Care Process. J Acad Nutr Diet 2017; 117:1659-1679. [DOI: 10.1016/j.jand.2017.03.022] [Citation(s) in RCA: 142] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Indexed: 01/03/2023]
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Steinke TJ, O'Callahan EL, York JL. Role of a registered dietitian in pediatric type 1 and type 2 diabetes. Transl Pediatr 2017; 6:365-372. [PMID: 29184817 PMCID: PMC5682368 DOI: 10.21037/tp.2017.09.05] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Type 1 and type 2 diabetes are complex, chronic diseases that are best managed by a multidisciplinary care team. Type 1 diabetes is most commonly diagnosed in the pediatric population, although the prevalence of type 2 diabetes in youth is increasing rapidly. A registered dietitian (RD) is a critical member of the diabetes team who provides focused nutrition education from diagnosis and throughout routine follow-up care. Specifically in the pediatric population, the RD also assesses growth and development, as well as eating behaviors, food choices and meal patterns. Based on a review of research, ongoing support from an RD improves glycemic control and delays onset of diabetes complications. In addition, dietitian-led nutrition education helps better manage lipid levels and aids in weight management. A sample model describing RD involvement in a pediatric diabetes care team is discussed in further detail.
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Affiliation(s)
- Tracie J Steinke
- Section of Endocrinology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Elena L O'Callahan
- Section of Endocrinology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jennifer L York
- Section of Endocrinology, Nationwide Children's Hospital, Columbus, OH, USA
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58
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Yang L, Ling W, Du Z, Chen Y, Li D, Deng S, Liu Z, Yang L. Effects of Anthocyanins on Cardiometabolic Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Adv Nutr 2017; 8:684-693. [PMID: 28916569 PMCID: PMC5593100 DOI: 10.3945/an.116.014852] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Numerous clinical trials have examined the role of anthocyanins on cardiometabolic health, but their effects have not been quantitatively synthesized and systematically evaluated. The aim of our study was to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the effects of anthocyanins on glycemic regulation and lipid profiles in both healthy populations and those with cardiometabolic diseases. The MEDLINE, EMBASE, Cochrane database, OVID EBM Reviews, and clinicaltrials.gov databases were searched until February 2017. RCTs with a duration of ≥2 wk that evaluated the effects of anthocyanins on glycemic control, insulin sensitivity, and lipids as either primary or secondary outcomes were included. The Cochrane Risk of Bias tool was used to assess the study quality. Standardized mean differences (SMDs) were determined by random-effects models. Meta-regression, sensitivity, and subgroup analyses were performed to explore the influence of covariates on the overall effects. Thirty-two RCTs (1491 participants) were eligible for meta-analysis. Anthocyanins significantly reduced fasting glucose (SMD: -0.31; 95% CI: -0.59, -0.04; I2 = 80.7%), 2-h postprandial glucose (SMD: -0.82; 95% CI: -1.49, -0.15; I2 = 77.7), glycated hemoglobin (SMD: -0.65; 95% CI: -1.00, -0.29; I2 = 72.7%), total cholesterol (SMD: -0.33; 95% CI: -0.62, -0.03; I2 = 86.9%), and LDL (SMD: -0.35; 95% CI: -0.66, -0.05; I2 = 85.2%). Sensitivity analyses showed that the overall effects remained similar by excluding the trials with a high or unclear risk of bias. The significant improvements in glycemic control and lipids support the benefits of anthocyanins in the prevention and management of cardiometabolic disease. Further well-designed RCTs are needed to evaluate the long-term effects of anthocyanins on metabolic profiles and to explore the optimal formula and dosage. The protocol for this review was registered at https://www.crd.york.ac.uk/PROSPERO/#index.php as CRD42016033210.
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Affiliation(s)
- LiPing Yang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition and
| | - WenHua Ling
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition and
| | - ZhiCheng Du
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yet-Sen University, Guangzhou, China
| | - YuMing Chen
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yet-Sen University, Guangzhou, China
| | - Dan Li
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition and
| | - ShiZhou Deng
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition and
| | - ZhaoMin Liu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition and
| | - LiLi Yang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition and
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59
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Magnuson BA, Carakostas MC, Moore NH, Poulos SP, Renwick AG. Biological fate of low-calorie sweeteners. Nutr Rev 2017; 74:670-689. [PMID: 27753624 DOI: 10.1093/nutrit/nuw032] [Citation(s) in RCA: 167] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
With continued efforts to find solutions to rising rates of obesity and diabetes, there is increased interest in the potential health benefits of the use of low- and no-calorie sweeteners (LNCSs). Concerns about safety often deter the use of LNCSs as a tool in helping control caloric intake, even though the safety of LNCS use has been affirmed by regulatory agencies worldwide. In many cases, an understanding of the biological fate of the different LNSCs can help health professionals to address safety concerns. The objectives of this review are to compare the similarities and differences in the chemistry, regulatory status, and biological fate (including absorption, distribution, metabolism, and excretion) of the commonly used LNCSs: acesulfame potassium, aspartame, saccharin, stevia leaf extract (steviol glycoside), and sucralose. Understanding the biological fate of the different LNCSs is helpful in evaluating whether reports of biological effects in animal studies or in humans are indicative of possible safety concerns. Illustrations of the usefulness of this information to address questions about LNCSs include discussion of systemic exposure to LNCSs, the use of sweetener combinations, and the potential for effects of LNCSs on the gut microflora.
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Affiliation(s)
- Bernadene A Magnuson
- B.A. Magnuson is with Health Science Consultants, Inc, Mississauga, Ontario, Canada. M.C. Carakostas is with MC Scientific Consulting, LLC, Dataw Island, South Carolina, USA. N.H. Moore is with Veritox, Inc, Redmond, Washington, USA. S.P. Poulos is with the Calorie Control Council, Atlanta, Georgia, USA. A.G. Renwick is with the Faculty of Medicine, University of Southampton, Southampton, United Kingdom.
| | - Michael C Carakostas
- B.A. Magnuson is with Health Science Consultants, Inc, Mississauga, Ontario, Canada. M.C. Carakostas is with MC Scientific Consulting, LLC, Dataw Island, South Carolina, USA. N.H. Moore is with Veritox, Inc, Redmond, Washington, USA. S.P. Poulos is with the Calorie Control Council, Atlanta, Georgia, USA. A.G. Renwick is with the Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Nadia H Moore
- B.A. Magnuson is with Health Science Consultants, Inc, Mississauga, Ontario, Canada. M.C. Carakostas is with MC Scientific Consulting, LLC, Dataw Island, South Carolina, USA. N.H. Moore is with Veritox, Inc, Redmond, Washington, USA. S.P. Poulos is with the Calorie Control Council, Atlanta, Georgia, USA. A.G. Renwick is with the Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Sylvia P Poulos
- B.A. Magnuson is with Health Science Consultants, Inc, Mississauga, Ontario, Canada. M.C. Carakostas is with MC Scientific Consulting, LLC, Dataw Island, South Carolina, USA. N.H. Moore is with Veritox, Inc, Redmond, Washington, USA. S.P. Poulos is with the Calorie Control Council, Atlanta, Georgia, USA. A.G. Renwick is with the Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Andrew G Renwick
- B.A. Magnuson is with Health Science Consultants, Inc, Mississauga, Ontario, Canada. M.C. Carakostas is with MC Scientific Consulting, LLC, Dataw Island, South Carolina, USA. N.H. Moore is with Veritox, Inc, Redmond, Washington, USA. S.P. Poulos is with the Calorie Control Council, Atlanta, Georgia, USA. A.G. Renwick is with the Faculty of Medicine, University of Southampton, Southampton, United Kingdom
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60
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Marincic PZ, Hardin A, Salazar MV, Scott S, Fan SX, Gaillard PR. Diabetes Self-Management Education and Medical Nutrition Therapy Improve Patient Outcomes: A Pilot Study Documenting the Efficacy of Registered Dietitian Nutritionist Interventions through Retrospective Chart Review. J Acad Nutr Diet 2017; 117:1254-1264. [DOI: 10.1016/j.jand.2017.01.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 01/20/2017] [Indexed: 10/19/2022]
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Turksoy K, Frantz N, Quinn L, Dumin M, Kilkus J, Hibner B, Cinar A, Littlejohn E. Automated Insulin Delivery-The Light at the End of the Tunnel. J Pediatr 2017; 186:17-28.e9. [PMID: 28396030 DOI: 10.1016/j.jpeds.2017.02.055] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 02/13/2017] [Accepted: 02/20/2017] [Indexed: 12/28/2022]
Affiliation(s)
- Kamuran Turksoy
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL
| | - Nicole Frantz
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL
| | - Laurie Quinn
- College of Nursing, University of Illinois at Chicago, Chicago, IL
| | - Magdalena Dumin
- Biological Sciences Division, University of Chicago, Chicago, IL
| | - Jennifer Kilkus
- Biological Sciences Division, University of Chicago, Chicago, IL
| | - Brooks Hibner
- Biological Sciences Division, University of Chicago, Chicago, IL
| | - Ali Cinar
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL; Biological Sciences Division, University of Chicago, Chicago, IL; Department of Chemical and Biological Engineering, Illinois Institute of Technology, Chicago, IL
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62
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Crowley MJ, Edelman D, Voils CI, Maciejewski ML, Coffman CJ, Jeffreys AS, Turner MJ, Gaillard LA, Hinton TA, Strawbridge E, Zervakis J, Barton AB, Yancy WS. Jump starting shared medical appointments for diabetes with weight management: Rationale and design of a randomized controlled trial. Contemp Clin Trials 2017; 58:1-12. [PMID: 28445783 DOI: 10.1016/j.cct.2017.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 04/03/2017] [Accepted: 04/10/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Rates of glycemic control remain suboptimal nationwide. Medication intensification for diabetes can have undesirable side effects (weight gain, hypoglycemia), which offset the benefits of glycemic control. A Shared Medical Appointment (SMA) intervention for diabetes that emphasizes weight management could improve glycemic outcomes and reduce weight while simultaneously lowering diabetes medication needs, resulting in less hypoglycemia and better quality of life. We describe the rationale and design for a study evaluating a novel SMA intervention for diabetes that primarily emphasizes low-carbohydrate diet-focused weight management. METHODS Jump Starting Shared Medical Appointments for Diabetes with Weight Management (Jump Start) is a randomized, controlled trial that is allocating overweight Veterans (body mass index≥27kg/m2) with type 2 diabetes into two arms: 1) a traditional SMA group focusing on medication management and self-management counseling; or 2) an SMA group that combines low-carbohydrate diet-focused weight management (WM/SMA) with medication management. Hemoglobin A1c reduction at 48weeks is the primary outcome. Secondary outcomes include hypoglycemic events, diabetes medication use, weight, medication adherence, diabetes-related quality of life, and cost-effectiveness. We hypothesize that WM/SMA will be non-inferior to standard SMA for glycemic control, and will reduce hypoglycemia, diabetes medication use, and weight relative to standard SMA, while also improving quality of life and costs. CONCLUSIONS Jump Start targets two common problems that are closely related but infrequently managed together: diabetes and obesity. By focusing on diet and weight loss as the primary means to control diabetes, this intervention may improve several meaningful patient-centered outcomes related to diabetes.
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Affiliation(s)
- Matthew J Crowley
- Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC, United States; Department of Medicine, Division of Endocrinology, Duke University Medical Center, Durham, NC, United States.
| | - David Edelman
- Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC, United States; Department of Medicine, Division of General Internal Medicine, Duke University Medical Center, Durham, NC, United States
| | - Corrine I Voils
- Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC, United States; Department of Medicine, Division of General Internal Medicine, Duke University Medical Center, Durham, NC, United States
| | - Matthew L Maciejewski
- Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC, United States; Department of Medicine, Division of General Internal Medicine, Duke University Medical Center, Durham, NC, United States
| | - Cynthia J Coffman
- Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC, United States; Department of Medicine, Division of General Internal Medicine, Duke University Medical Center, Durham, NC, United States
| | - Amy S Jeffreys
- Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC, United States
| | - Marsha J Turner
- Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC, United States
| | - Leslie A Gaillard
- Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC, United States
| | - Teresa A Hinton
- Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC, United States
| | - Elizabeth Strawbridge
- Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC, United States
| | - Jennifer Zervakis
- Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC, United States
| | - Anna Beth Barton
- Department of Medicine, Division of Endocrinology, Duke University Medical Center, Durham, NC, United States
| | - William S Yancy
- Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC, United States; Department of Medicine, Division of General Internal Medicine, Duke University Medical Center, Durham, NC, United States; Duke Diet and Fitness Center, Durham, NC, United States
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63
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Fortin A, Rabasa-Lhoret R, Roy-Fleming A, Desjardins K, Brazeau AS, Ladouceur M, Gingras V. Practices, perceptions and expectations for carbohydrate counting in patients with type 1 diabetes - Results from an online survey. Diabetes Res Clin Pract 2017; 126:214-221. [PMID: 28273644 DOI: 10.1016/j.diabres.2017.02.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 01/23/2017] [Accepted: 02/14/2017] [Indexed: 01/18/2023]
Abstract
AIMS Characterize adult patients with diabetes on intensive insulin therapy in terms of: (a) practices and perceived difficulties relative to carbohydrate counting (CC) and diabetes treatment, and (b) their perceptions and expectations relative to CC. METHODS Participants completed a 30-question web-based questionnaire. RESULTS Participants with type 1 diabetes (T1D) and using CC as part of their treatment plan (n=180) were included in this analysis. Participants were predominantly women (64%), aged 42±13years old and had diabetes for 22±13years. A large proportion of participants reported being confident in applying CC (78%) and considered precise CC as being important for glycemic control (91%), while only 17% reported finding CC difficult. Despite the low perceived difficulty associated with CC, many specific difficulties were encountered by patients such as the perception that glycemia fluctuates even with appropriate CC and that CC complicates the management of diabetes. A larger proportion of participants with a lower level of education (<university degree) and current or history of depression reported not feeling confident in applying CC. Most respondents believed that new technologies could facilitate CC (57%) and would be interested in such technology (62%). CONCLUSIONS Although a majority of participant reported being confident in applying CC, many difficulties and constraints associated with CC have been identified. These results highlight that patients with a lower level of education and with a history or current depression could benefit from specific CC education strategies. Future studies should examine the efficacy of technology tools to facilitate CC.
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Affiliation(s)
- Andréanne Fortin
- Institut de Recherches Cliniques de Montréal, 110 Pins Avenue West, H2W 1R7 Montreal, Quebec, Canada; Department of Nutrition, University of Montréal, 2375 Chemin de la Côte-Sainte-Catherine, H3T 1A8 Montréal, Quebec, Canada
| | - Rémi Rabasa-Lhoret
- Institut de Recherches Cliniques de Montréal, 110 Pins Avenue West, H2W 1R7 Montreal, Quebec, Canada; Department of Nutrition, University of Montréal, 2375 Chemin de la Côte-Sainte-Catherine, H3T 1A8 Montréal, Quebec, Canada; Montreal Diabetes Research Center (MDRC), 900 Saint-Denis, H2X 0A9 Montreal, Quebec, Canada; Research Center of the University of Montréal Hospital Center (CRCHUM), 900 Saint-Denis, H2X 0A9 Montreal, Quebec, Canada; Division of Experimental Medicine, McGill University, 1110 Pins Avenue, H3A 1A3 Montreal, Quebec, Canada
| | - Amélie Roy-Fleming
- Institut de Recherches Cliniques de Montréal, 110 Pins Avenue West, H2W 1R7 Montreal, Quebec, Canada; Department of Nutrition, University of Montréal, 2375 Chemin de la Côte-Sainte-Catherine, H3T 1A8 Montréal, Quebec, Canada
| | - Katherine Desjardins
- Institut de Recherches Cliniques de Montréal, 110 Pins Avenue West, H2W 1R7 Montreal, Quebec, Canada
| | - Anne-Sophie Brazeau
- Division of Experimental Medicine, McGill University, 1110 Pins Avenue, H3A 1A3 Montreal, Quebec, Canada
| | - Martin Ladouceur
- Research Center of the University of Montréal Hospital Center (CRCHUM), 900 Saint-Denis, H2X 0A9 Montreal, Quebec, Canada
| | - Véronique Gingras
- Institut de Recherches Cliniques de Montréal, 110 Pins Avenue West, H2W 1R7 Montreal, Quebec, Canada; Department of Nutrition, University of Montréal, 2375 Chemin de la Côte-Sainte-Catherine, H3T 1A8 Montréal, Quebec, Canada.
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Mandave P, Khadke S, Karandikar M, Pandit V, Ranjekar P, Kuvalekar A, Mantri N. Antidiabetic, Lipid Normalizing, and Nephroprotective Actions of the Strawberry: A Potent Supplementary Fruit. Int J Mol Sci 2017; 18:E124. [PMID: 28085064 PMCID: PMC5297758 DOI: 10.3390/ijms18010124] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 12/24/2016] [Accepted: 12/28/2016] [Indexed: 12/15/2022] Open
Abstract
The study was designed to assess the effect of different strawberry extracts on glucose levels, lipid profiles, and oxidative stress in nicotinamide-streptozotocin (NIC-STZ) induced diabetic rats. The associated changes were evaluated through biochemical, molecular, and histological assays. Diabetes was induced by intraperitoneal injection of STZ to albino Wistar rats after treatment with nicotinamide. Aqueous, hydroalcoholic, and alcoholic strawberry extracts were administrated orally to diabetic rats. Treatment of strawberry extracts improved lipid profile, liver function, and serum creatinine and led to a significant increase in antioxidant status in diabetic rats. Real-time PCR expression analysis of genes from the liver of animals treated with strawberry extracts exhibited downregulation of several fatty acid synthesis genes, transcription factors, such as Sterol regulatory Element Binding Transcription factor (SREBP) and Nuclear Factor-κβ (NF-κβ), and inflammatory markers, like Interleukin 6 (IL6) and Tumor Necrosis Factor-α (TNF-α). Strawberry extracts also upregulated liver Peroxisome Proliferator Activated Receptor-γ (PPAR-γ). Histological examination confirmed the nephroprotective and β-cell regeneration/protection effects of strawberry extracts. The present study demonstrates several beneficial effects of strawberry extracts along with its probable mechanism of action.
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Affiliation(s)
- Pallavi Mandave
- Interactive Research School for Health Affairs, Bharati Vidyapeeth University, Katraj, Pune, Maharashtra 411043, India.
| | - Suresh Khadke
- Interactive Research School for Health Affairs, Bharati Vidyapeeth University, Katraj, Pune, Maharashtra 411043, India.
| | - Manjiri Karandikar
- Department of Pathology, Bharati Vidyapeeth Medical College, Bharati Vidyapeeth Deemed University, Pune-Satara Road, Pune, Maharashtra 411043, India.
| | - Vijaya Pandit
- Department of Pharmacology, Bharati Vidyapeeth Medical College, Bharati Vidyapeeth Deemed University, Pune-Satara Road, Pune, Maharashtra 411043, India.
| | - Prabhakar Ranjekar
- Interactive Research School for Health Affairs, Bharati Vidyapeeth University, Katraj, Pune, Maharashtra 411043, India.
| | - Aniket Kuvalekar
- Interactive Research School for Health Affairs, Bharati Vidyapeeth University, Katraj, Pune, Maharashtra 411043, India.
| | - Nitin Mantri
- School of Science, RMIT University, Melbourne 3000, Australia.
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Qiu J, Liu Y, Yue Y, Qin Y, Li Z. Dietary tartary buckwheat intake attenuates insulin resistance and improves lipid profiles in patients with type 2 diabetes: a randomized controlled trial. Nutr Res 2016; 36:1392-1401. [DOI: 10.1016/j.nutres.2016.11.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 11/14/2016] [Accepted: 11/15/2016] [Indexed: 11/26/2022]
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Abstract
Medical nutrition therapy (MNT) is a key component of diabetes management. The importance of balancing macronutrients, reducing carbohydrate load, lowering glycemic index, and implementing an overall healthy dietary pattern are emerging as better approaches for MNT in diabetes. Recent research points to improved glycemic control, reduction in body weight, and improvement in many cardiovascular risk factors when these approaches are provided by registered dietitians or health care providers. This review article discusses the current evidence about the role of sensible nutrition in diabetes management. Specific eating plans for weight reduction and for patients with type 1 diabetes are also discussed.
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Affiliation(s)
- Osama Hamdy
- Department of Endocrinology, Joslin Diabetes Center, Harvard Medical School, One Joslin Place, Boston, MA 02481, USA.
| | - Mohd-Yusof Barakatun-Nisak
- Joslin Diabetes Center, Harvard Medical School, Boston, MA 02215, USA; Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia
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67
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Qiu J, Li Z, Qin Y, Yue Y, Liu Y. Protective effect of tartary buckwheat on renal function in type 2 diabetics: a randomized controlled trial. Ther Clin Risk Manag 2016; 12:1721-1727. [PMID: 27920542 PMCID: PMC5125721 DOI: 10.2147/tcrm.s123008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Tartary buckwheat (TB) has been reported to be associated with a decreased risk of type 2 diabetes mellitus (T2DM), and T2DM has had a major impact on the development of diabetic kidney disease (DKD). Thus, the hypothesis that a daily intake of TB will improve DKD risk factors, including urinary albumin to creatinine ratio (UACR), urea nitrogen (UN), serum creatinine, and uric acid was tested. In a parallel, randomized, open-label controlled trial, 104 T2DM patients were randomly assigned to a diet control group (systematic diet plans and intensive nutritional education) or a TB intervention group (daily replacement of a portion of staple foods with TB foods). Blood samples and dietary information were collected at baseline and the end of the 4-week study. The primary outcomes were that TB significantly decreased the rela tive changes in UACR (2.43–2.35, logarithmic transformed mg/g creatinine) and UN (5.12–4.91 mmol/L) in the TB intervention group vs the diet control group at 4 weeks (P<0.05), without obvious effect on blood glucose during the 4-week study. In addition, subgroup analyses based on different DKD stages also showed a significant reduction in UACR and UN for the T2DM patients with normoalbuminuria and microalbuminuria (P<0.05). These results support the hypothesis that TB as a replacement of staple food probably alleviates renal dysfunction in T2DM patients.
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Affiliation(s)
- Ju Qiu
- Institute of Food and Nutrition Development, Ministry of Agriculture
| | - Zaigui Li
- College of Food Science and Nutritional Engineering, China Agricultural University
| | - Yuchang Qin
- Institute of Food and Nutrition Development, Ministry of Agriculture
| | - Yanfen Yue
- Department of Nutrition, Pinggu Hospital of Traditional Chinese Medicine, Pinggu
| | - Yanping Liu
- Department of Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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68
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Li W, Chen S, Zhou G, Li H, Zhong L, Liu S. Potential role of cyanidin 3-glucoside (C3G) in diabetic cardiomyopathy in diabetic rats: An in vivo approach. Saudi J Biol Sci 2016; 25:500-506. [PMID: 29686513 PMCID: PMC5910639 DOI: 10.1016/j.sjbs.2016.11.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 10/29/2016] [Accepted: 11/04/2016] [Indexed: 01/31/2023] Open
Abstract
The present study aimed to evaluate the importance of cyanidin 3-glucoside (C3G) of diabetic cardiomyopathy in diabetic rats. The rats were induced with diabetic using streptozotocin and total triglyceride (TG) and total cholesterol (TC) were determined. The range of myocardial enzymes such as aspartate aminotransferase (AST), creatine kinase (CK) and lactate dehydrogenase (LD) were also estimated, further, the Immuno histochemical analysis and western blot investigation were determined for the actual activity of C3G. Results indicated that the marker enzymes such as CK, LD and AST were significantly (P < 0.05) increased in STZ administered rats (DM group), while the levels of these elevated marker enzymes of cardiac injury significantly (P < 0.05) declined in the DM + C3G group, as compared to the diabetic group of rats. Additionally, a decrease in the level of TNF-alpha and interleukin-6, was noticed in the C3G treated group as compared to diabetic group. Finally, blotting analysis clearly confirmed that theC3G treatment resulted to higher level response of Bcl-2 and lower level response of caspase-3 and BAX. In conclusion, C3G a natural antioxidant may prevent cardiovascular complications by ameliorating oxidative damage, inflammation, metabolic dysfunctions and apoptosis pathways in type 2 diabetes.
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Affiliation(s)
- Weizhen Li
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 20080, China
| | - Songwen Chen
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 20080, China
| | - Genqing Zhou
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 20080, China
| | - Hongli Li
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 20080, China
| | - Lan Zhong
- Division of Gastroenterology, East Hospital of Tongji University School of Medicine, Shanghai 200120, China
| | - Shaowen Liu
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 20080, China
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69
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McArdle PD, Greenfield SM, Avery A, Adams GG, Gill PS. Dietitians' practice in giving carbohydrate advice in the management of type 2 diabetes: a mixed methods study. J Hum Nutr Diet 2016; 30:385-393. [DOI: 10.1111/jhn.12436] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- P. D. McArdle
- Birmingham Community Healthcare NHS Foundation Trust (BCHC); Birmingham UK
| | - S. M. Greenfield
- Primary Care Clinical Sciences; College of Medical & Dental Sciences; University of Birmingham; Birmingham UK
| | - A. Avery
- Faculty of Science; The University of Nottingham; Sutton Bonington UK
| | - G. G. Adams
- Faculty of Science; The University of Nottingham; Sutton Bonington UK
| | - P. S. Gill
- Primary Care Clinical Sciences; College of Medical & Dental Sciences; University of Birmingham; Birmingham UK
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Kobayashi Y, Tatsumi H, Hattori M, Sugiyama H, Wada S, Kuwahata M, Tanaka S, Kanemasa K, Sumida Y, Naito Y, Fukui M, Kido Y. Comparisons of dietary intake in Japanese with non-alcoholic fatty liver disease and type 2 diabetes mellitus. J Clin Biochem Nutr 2016; 59:215-219. [PMID: 27895389 PMCID: PMC5110943 DOI: 10.3164/jcbn.16-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 04/15/2016] [Indexed: 12/13/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a multifactorial disease that involves a complex interaction between genetics, diet, and lifestyle, all of which combine to form the NAFLD phenotype. In Japan, medical nutrition therapy for NAFLD has not yet been established, so NAFLD patients are instructed in the dietary modifications used for type 2 diabetes mellitus (T2DM). Because points of difference may exist in the effects of dietary choices on NAFLD and T2DM, the present study aimed to compare and assess the dietary intake of Japanese individuals with NAFLD and T2DM. This cross-sectional study involved 219 patients (77 NAFLD subjects; 33 males, 44 females; 142 T2DM subjects: 76 males, 66 females) aged 40-79 years. Dietary intake was assessed using a validated self-administered diet history questionnaire. Among the results, the most notable in NAFLD patients relative to T2DM patients were: 1) the low intake of vegetables that can reduce the overall energy density; 2) the high consumption of fruits and confectionery containing simple carbohydrates such as fructose; and 3) BMI may be higher. We demonstrated differences in dietary selection between the two groups. NAFLD patients were more likely to have dietary habits that promote fat accumulation in the body.
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Affiliation(s)
- Yukiko Kobayashi
- Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, Shimogamo, Sakyo-ku, Kyoto 606-8522, Japan
| | - Hina Tatsumi
- Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, Shimogamo, Sakyo-ku, Kyoto 606-8522, Japan
| | - Mikako Hattori
- Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, Shimogamo, Sakyo-ku, Kyoto 606-8522, Japan
| | - Hiroki Sugiyama
- Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, Shimogamo, Sakyo-ku, Kyoto 606-8522, Japan
| | - Sayori Wada
- Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, Shimogamo, Sakyo-ku, Kyoto 606-8522, Japan
| | - Masashi Kuwahata
- Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, Shimogamo, Sakyo-ku, Kyoto 606-8522, Japan
| | - Saiyu Tanaka
- Department of Gastroentroerology and Hepatology, Nara City Hospital, Higashikidera-cho, Nara 630-8305, Japan
| | - Kazuyuki Kanemasa
- Department of Gastroentroerology and Hepatology, Nara City Hospital, Higashikidera-cho, Nara 630-8305, Japan
| | - Yoshio Sumida
- Molecular Gastroentroerology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kajii-cho, Kamigyo, Kyoto 602-8566, Japan
| | - Yuji Naito
- Molecular Gastroentroerology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kajii-cho, Kamigyo, Kyoto 602-8566, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Yasuhiro Kido
- Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, Shimogamo, Sakyo-ku, Kyoto 606-8522, Japan
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71
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Kannan S, Mahadevan S, Seshadri K, Sadacharan D, Velayutham K. Fasting practices in Tamil Nadu and their importance for patients with diabetes. Indian J Endocrinol Metab 2016; 20:858-862. [PMID: 27867892 PMCID: PMC5105573 DOI: 10.4103/2230-8210.192921] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Religious practices and cultural customs related to eating habits have a significant impact on lifestyle and health of the community. The Ramadan fasting in Muslims and its influence on various metabolic parameters such as diabetes have been reasonably studied. However, literature related to Hindu religious customs related to fasting and food patterns during various festivals and its effect on diabetes are scarce. This article is an attempt to describe the Hindu religious customs related to fasting and food practices from the State of Tamil Nadu (South India) and to raise the awareness among physicians about its relationship with diabetes which may help in managing their diabetic patients in a better way.
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Affiliation(s)
- Subramanian Kannan
- Department of Endocrinology, Diabetes and Bariatric Medicine, Narayana Health City, Bengaluru, Karnataka, India
| | - Shriraam Mahadevan
- Department of Endocrinology, Diabetes and Metabolism, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India
| | - Krishna Seshadri
- Department of Endocrinology, Diabetes and Metabolism, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India
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72
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Using Ecological Momentary Assessment to Track Goal Progress Toward the Adoption of a Low Glycemic Index Diet Among Adults With Type 2 Diabetes. TOP CLIN NUTR 2016. [DOI: 10.1097/tin.0000000000000083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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73
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Kam J, Puranik S, Yadav R, Manwaring HR, Pierre S, Srivastava RK, Yadav RS. Dietary Interventions for Type 2 Diabetes: How Millet Comes to Help. FRONTIERS IN PLANT SCIENCE 2016; 7:1454. [PMID: 27729921 PMCID: PMC5037128 DOI: 10.3389/fpls.2016.01454] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 09/12/2016] [Indexed: 05/04/2023]
Abstract
Diabetes has become a highly problematic and increasingly prevalent disease world-wide. It has contributed toward 1.5 million deaths in 2012. Management techniques for diabetes prevention in high-risk as well as in affected individuals, beside medication, are mainly through changes in lifestyle and dietary regulation. Particularly, diet can have a great influence on life quality for those that suffer from, as well as those at risk of, diabetes. As such, considerations on nutritional aspects are required to be made to include in dietary intervention. This review aims to give an overview on the general consensus of current dietary and nutritional recommendation for diabetics. In light of such recommendation, the use of plant breeding, conventional as well as more recently developed molecular marker-based breeding and biofortification, are discussed in designing crops with desired characteristics. While there are various recommendations available, dietary choices are restricted by availability due to geo-, political-, or economical- considerations. This particularly holds true for countries such as India, where 65 million people (up from 50 million in 2010) are currently diabetic and their numbers are rising at an alarming rate. Millets are one of the most abundant crops grown in India as well as in Africa, providing a staple food source for many poorest of the poor communities in these countries. The potentials of millets as a dietary component to combat the increasing prevalence of global diabetes are highlighted in this review.
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Affiliation(s)
- Jason Kam
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Gogerddan, AberystwythUK
| | - Swati Puranik
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Gogerddan, AberystwythUK
| | - Rama Yadav
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Gogerddan, AberystwythUK
| | - Hanna R. Manwaring
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Gogerddan, AberystwythUK
| | - Sandra Pierre
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Gogerddan, AberystwythUK
| | - Rakesh K. Srivastava
- International Crops Research Institute for the Semi-Arid Tropics, PatancheruIndia
| | - Rattan S. Yadav
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Gogerddan, AberystwythUK
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74
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Bentzen SMR, Knudsen VK, Christiensen T, Ewers B. Relative validity of a web-based food frequency questionnaire for patients with type 1 and type 2 diabetes in Denmark. Nutr Diabetes 2016; 6:e232. [PMID: 27669176 PMCID: PMC5048016 DOI: 10.1038/nutd.2016.40] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 06/17/2016] [Accepted: 07/14/2016] [Indexed: 12/18/2022] Open
Abstract
Background: Diet has an important role in the management of diabetes. However, little is known about dietary intake in Danish diabetes patients. A food frequency questionnaire (FFQ) focusing on most relevant nutrients in diabetes including carbohydrates, dietary fibres and simple sugars was developed and validated. Objectives: To examine the relative validity of nutrients calculated by a web-based food frequency questionnaire for patients with diabetes. Design: The FFQ was validated against a 4-day pre-coded food diary (FD). Intakes of nutrients were calculated. Means of intake were compared and cross-classifications of individuals according to intake were performed. To assess the agreement between the two methods, Pearson and Spearman's correlation coefficients and weighted kappa coefficients were calculated. Subjects: Ninety patients (64 with type 1 diabetes and 26 with type 2 diabetes) accepted to participate in the study. Twenty-six were excluded from the final study population. Setting: 64 volunteer diabetes patients at the Steno Diabetes Center. Results: Intakes of carbohydrates, simple sugars, dietary fibres and total energy were higher according to the FFQ compared with the FD. However, intakes of nutrients were grossly classified in the same or adjacent quartiles with an average of 82% of the selected nutrients when comparing the two methods. In general, moderate agreement between the two methods was found. Conclusion: The FFQ was validated for assessment of a range of nutrients. Comparing the intakes of selected nutrients (carbohydrates, dietary fibres and simple sugars), patients were classified correctly according to low and high intakes. The FFQ is a reliable dietary assessment tool to use in research and evaluation of patient education for patients with diabetes.
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Affiliation(s)
- S M R Bentzen
- Department of Nutrition and Food Service, Steno Diabetes Center, Gentofte, Denmark
| | - V K Knudsen
- Division of Risk Assessment and Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - T Christiensen
- Division of Risk Assessment and Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - B Ewers
- Department of Nutrition and Food Service, Steno Diabetes Center, Gentofte, Denmark
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75
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Diabetes Nutrition Therapy: Effectiveness, Macronutrients, Eating Patterns and Weight Management. Am J Med Sci 2016; 351:374-9. [PMID: 27079343 DOI: 10.1016/j.amjms.2016.02.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 02/01/2016] [Indexed: 01/30/2023]
Abstract
BACKGROUND Diabetes nutrition therapy provided for individuals with diabetes must be based on research documenting effectiveness. The roles of differing macronutrient percentages, eating patterns and weight loss interventions are controversial. METHODS A review of research related to these topics is summarized. RESULTS Clinical trials as well as systematic reviews and Cochrane reviews report an approximately 1-2% lowering of hemoglobin A1c as well as other beneficial outcomes from nutrition therapy interventions, depending on the type and duration of diabetes and level of glycemic control. There are no ideal percentages of macronutrients or eating patterns or both that apply to all persons with diabetes. Clinical trials demonstrate the effectiveness of modest weight loss and physical activity for the prevention or delay of type 2 diabetes. However, as the disease progresses, weight loss interventions may or may not result in beneficial glycemic and other metabolic outcomes. CONCLUSIONS To be effective, diabetes nutrition therapy must be individualized. Treatment goals, personal preferences (eg, tradition, culture, religion, health beliefs and economics) and the individual׳s ability and willingness to make lifestyle changes all must be considered when educating or counseling individuals with diabetes. A healthy eating pattern emphasizing nutrient-dense foods in appropriate portion sizes, regular physical activity and support are important. A reduced energy intake for persons with prediabetes or type 2 diabetes and matching insulin to planned carbohydrate intake for insulin users is nutrition therapy interventions shown to be effective in achieving glycemic and other metabolic outcomes.
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76
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Bowen ME, Cavanaugh KL, Wolff K, Davis D, Gregory RP, Shintani A, Eden S, Wallston K, Elasy T, Rothman RL. The diabetes nutrition education study randomized controlled trial: A comparative effectiveness study of approaches to nutrition in diabetes self-management education. PATIENT EDUCATION AND COUNSELING 2016; 99:1368-1376. [PMID: 27026388 PMCID: PMC4931976 DOI: 10.1016/j.pec.2016.03.017] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 03/12/2016] [Accepted: 03/18/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To compare the effectiveness of different approaches to nutrition education in diabetes self-management education and support (DSME/S). METHODS We randomized 150 adults with type 2 diabetes to either certified diabetes educator (CDE)-delivered DSME/S with carbohydrate gram counting or the modified plate method versus general health education. The primary outcome was change in HbA1C over 6 months. RESULTS At 6 months, HbA1C improved within the plate method [-0.83% (-1.29, -0.33), P<0.001] and carbohydrate counting [-0.63% (-1.03, -0.18), P=0.04] groups but not the control group [P=0.34]. Change in HbA1C from baseline between the control and intervention groups was not significant at 6 months (carbohydrate counting, P=0.36; modified plate method, P=0.08). In a pre-specified subgroup analysis of patients with a baseline HbA1C 7-10%, change in HbA1C from baseline improved in the carbohydrate counting [-0.86% (-1.47, -0.26), P=0.006] and plate method groups [-0.76% (-1.33, -0.19), P=0.01] compared to controls. CONCLUSION CDE-delivered DSME/S focused on carbohydrate counting or the modified plate method improved glycemic control in patients with an initial HbA1C between 7 and 10%. PRACTICE IMPLICATIONS Both carbohydrate counting and the modified plate method improve glycemic control as part of DSME/S.
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Affiliation(s)
- Michael E Bowen
- Division of General Internal Medicine, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA; Division of Outcomes and Health Services Research, Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kerri L Cavanaugh
- Division of Nephrology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA; Vanderbilt Diabetes Center, Vanderbilt University, School of Medicine, Nashville, TN, USA
| | - Kathleen Wolff
- Vanderbilt Diabetes Center, Vanderbilt University, School of Medicine, Nashville, TN, USA
| | - Dianne Davis
- Vanderbilt Diabetes Center, Vanderbilt University, School of Medicine, Nashville, TN, USA
| | - Rebecca P Gregory
- Vanderbilt Diabetes Center, Vanderbilt University, School of Medicine, Nashville, TN, USA
| | - Ayumi Shintani
- Department of Biostatistics, Vanderbilt University, School of Medicine, Nashville, TN, USA
| | - Svetlana Eden
- Department of Biostatistics, Vanderbilt University, School of Medicine, Nashville, TN, USA
| | - Ken Wallston
- School of Nursing, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Tom Elasy
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University, School of Medicine, Nashville, TN, USA; Vanderbilt Diabetes Center, Vanderbilt University, School of Medicine, Nashville, TN, USA
| | - Russell L Rothman
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University, School of Medicine, Nashville, TN, USA; Vanderbilt Diabetes Center, Vanderbilt University, School of Medicine, Nashville, TN, USA.
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77
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van Wyk H, Daniels M. The Use of Very Low Calorie Diets in the Management of Type 2 Diabetes Mellitus. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2016. [DOI: 10.1080/16070658.2016.1216514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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78
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Sharma A, Amarnath S, Thulasimani M, Ramaswamy S. Artificial sweeteners as a sugar substitute: Are they really safe? Indian J Pharmacol 2016; 48:237-40. [PMID: 27298490 PMCID: PMC4899993 DOI: 10.4103/0253-7613.182888] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Revised: 01/22/2016] [Accepted: 04/29/2016] [Indexed: 01/16/2023] Open
Abstract
Nonnutritive sweeteners (NNS) have become an important part of everyday life and are increasingly used nowadays in a variety of dietary and medicinal products. They provide fewer calories and far more intense sweetness than sugar-containing products and are used by a plethora of population subsets for varying objectives. Six of these agents (aspartame, saccharine, sucralose, neotame, acesulfame-K, and stevia) have previously received a generally recognized as safe status from the United States Food and Drug Administration, and two more (Swingle fruit extract and advantame) have been added in the recent years to this ever growing list. They are claimed to promote weight loss and deemed safe for consumption by diabetics; however, there is inconclusive evidence to support most of their uses and some recent studies even hint that these earlier established benefits regarding NNS use might not be true. There is a lack of properly designed randomized controlled studies to assess their efficacy in different populations, whereas observational studies often remain confounded due to reverse causality and often yield opposite findings. Pregnant and lactating women, children, diabetics, migraine, and epilepsy patients represent the susceptible population to the adverse effects of NNS-containing products and should use these products with utmost caution. The overall use of NNS remains controversial, and consumers should be amply informed about the potential risks of using them, based on current evidence-based dietary guidelines.
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Affiliation(s)
- Arun Sharma
- Department of Pharmacology, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India
| | - S. Amarnath
- Department of Pharmacology, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India
| | - M. Thulasimani
- Department of Pharmacology, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India
| | - S. Ramaswamy
- Department of Pharmacology, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India
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Wang X, Jung M, Mossavar-Rahmani Y, Sotres-Alvarez D, Espinoza Giacinto RA, Pirzada A, Reina SA, Casagrande SS, Wang T, Avilés-Santa ML, Kaplan RC, Qi Q. Macronutrient Intake, Diagnosis Status, and Glycemic Control Among US Hispanics/Latinos With Diabetes. J Clin Endocrinol Metab 2016; 101:1856-64. [PMID: 26950682 PMCID: PMC4880152 DOI: 10.1210/jc.2015-3237] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
CONTEXT Diet modification is a mainstay of diabetes management. US Hispanics/Latinos are disproportionately affected by diabetes, but few studies have examined dietary intake among US Hispanics/Latinos with diabetes, and little is known regarding the influence of diabetes awareness on dietary intake. OBJECTIVE We evaluated macronutrient intake and its associations with diabetes awareness and glycemic control among US Hispanics/Latinos with diabetes. PARTICIPANTS This analysis included 3310 diabetic adults aged 18–74 years from the Hispanic Community Health Study/Study of Latinos (2008–2011). MAIN OUTCOME MEASURES Diabetes was defined as diagnosed (based on medical history or antihyperglycemic medication use) or undiagnosed diabetes (based on fasting glucose ≥ 126 mg/dL, glycated hemoglobin [HbA1c] ≥ 6.5%, or 2 h glucose ≥ 200 mg/dL in the absence of a physician diagnosis). Dietary intake was assessed using two 24-hour recalls. RESULTS Among Hispanic/Latino adults with diabetes, 21.2%, 55.7%, and 71.2% met the American Diabetes Association recommendations for fiber (≥14 g per 1000 kcal), saturated fat (<10% of total energy), and cholesterol intake (<300 mg), respectively. Compared with those with undiagnosed diabetes, people with diagnosed diabetes consumed less carbohydrate (50.3 vs 52.4% of total energy; P = .017), total sugar (19.1 vs 21.5% of total energy; P = .002), added sugar (9.8 vs 12.1% of total energy; P < .001), and more total fat (30.7 vs 29.3% of total energy; P = .048) and monounsaturated fat (11.5 vs 10.7% of total energy; P = .021). Association between diabetes awareness and low total and added sugar intake was observed in individuals of Mexican and Puerto Rican background but not in other groups (P for interaction < .05). Among people with diagnosed diabetes, those with HbA1c of 7% or greater consumed more total fat, saturated fat, and cholesterol than those with HbA1c less than 7% (all P < .05). CONCLUSIONS Among US Hispanics/Latinos with diabetes, fiber intake is low, and diabetes awareness is associated with reduced carbohydrate and sugar intake and increased monounsaturated fat intake. Sugar intake may require special attention in certain Hispanic/Latino background groups.
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Affiliation(s)
- Xueyin Wang
- Department of Epidemiology and Population Health (X.W., M.J., Y.M.-R., T.W., R.C.K., Q.Q.), Albert Einstein College of Medicine, Bronx, New York 10461; Department of Epidemiology and Biostatistics (X.W.), School of Public Health, Peking University Health Science Center, Beijing 100191, China; Collaborative Studies Coordinating Center (D.S.-A.), Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599; San Diego State University (R.A.E.G.), San Diego, California 92182; Institute for Minority Health Research (A.P.), University of Illinois at Chicago, Chicago, Illinois 60637; Department of Psychology (S.A.R.), University of Miami, Miami, Florida 33136; National Institute of Diabetes and Digestive and Kidney Diseases (S.S.C.), National Institutes of Health, Bethesda, Maryland 20892; and Division of Cardiovascular Sciences (M.L.A.-S.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20824
| | - Molly Jung
- Department of Epidemiology and Population Health (X.W., M.J., Y.M.-R., T.W., R.C.K., Q.Q.), Albert Einstein College of Medicine, Bronx, New York 10461; Department of Epidemiology and Biostatistics (X.W.), School of Public Health, Peking University Health Science Center, Beijing 100191, China; Collaborative Studies Coordinating Center (D.S.-A.), Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599; San Diego State University (R.A.E.G.), San Diego, California 92182; Institute for Minority Health Research (A.P.), University of Illinois at Chicago, Chicago, Illinois 60637; Department of Psychology (S.A.R.), University of Miami, Miami, Florida 33136; National Institute of Diabetes and Digestive and Kidney Diseases (S.S.C.), National Institutes of Health, Bethesda, Maryland 20892; and Division of Cardiovascular Sciences (M.L.A.-S.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20824
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health (X.W., M.J., Y.M.-R., T.W., R.C.K., Q.Q.), Albert Einstein College of Medicine, Bronx, New York 10461; Department of Epidemiology and Biostatistics (X.W.), School of Public Health, Peking University Health Science Center, Beijing 100191, China; Collaborative Studies Coordinating Center (D.S.-A.), Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599; San Diego State University (R.A.E.G.), San Diego, California 92182; Institute for Minority Health Research (A.P.), University of Illinois at Chicago, Chicago, Illinois 60637; Department of Psychology (S.A.R.), University of Miami, Miami, Florida 33136; National Institute of Diabetes and Digestive and Kidney Diseases (S.S.C.), National Institutes of Health, Bethesda, Maryland 20892; and Division of Cardiovascular Sciences (M.L.A.-S.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20824
| | - Daniela Sotres-Alvarez
- Department of Epidemiology and Population Health (X.W., M.J., Y.M.-R., T.W., R.C.K., Q.Q.), Albert Einstein College of Medicine, Bronx, New York 10461; Department of Epidemiology and Biostatistics (X.W.), School of Public Health, Peking University Health Science Center, Beijing 100191, China; Collaborative Studies Coordinating Center (D.S.-A.), Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599; San Diego State University (R.A.E.G.), San Diego, California 92182; Institute for Minority Health Research (A.P.), University of Illinois at Chicago, Chicago, Illinois 60637; Department of Psychology (S.A.R.), University of Miami, Miami, Florida 33136; National Institute of Diabetes and Digestive and Kidney Diseases (S.S.C.), National Institutes of Health, Bethesda, Maryland 20892; and Division of Cardiovascular Sciences (M.L.A.-S.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20824
| | - Rebeca A Espinoza Giacinto
- Department of Epidemiology and Population Health (X.W., M.J., Y.M.-R., T.W., R.C.K., Q.Q.), Albert Einstein College of Medicine, Bronx, New York 10461; Department of Epidemiology and Biostatistics (X.W.), School of Public Health, Peking University Health Science Center, Beijing 100191, China; Collaborative Studies Coordinating Center (D.S.-A.), Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599; San Diego State University (R.A.E.G.), San Diego, California 92182; Institute for Minority Health Research (A.P.), University of Illinois at Chicago, Chicago, Illinois 60637; Department of Psychology (S.A.R.), University of Miami, Miami, Florida 33136; National Institute of Diabetes and Digestive and Kidney Diseases (S.S.C.), National Institutes of Health, Bethesda, Maryland 20892; and Division of Cardiovascular Sciences (M.L.A.-S.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20824
| | - Amber Pirzada
- Department of Epidemiology and Population Health (X.W., M.J., Y.M.-R., T.W., R.C.K., Q.Q.), Albert Einstein College of Medicine, Bronx, New York 10461; Department of Epidemiology and Biostatistics (X.W.), School of Public Health, Peking University Health Science Center, Beijing 100191, China; Collaborative Studies Coordinating Center (D.S.-A.), Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599; San Diego State University (R.A.E.G.), San Diego, California 92182; Institute for Minority Health Research (A.P.), University of Illinois at Chicago, Chicago, Illinois 60637; Department of Psychology (S.A.R.), University of Miami, Miami, Florida 33136; National Institute of Diabetes and Digestive and Kidney Diseases (S.S.C.), National Institutes of Health, Bethesda, Maryland 20892; and Division of Cardiovascular Sciences (M.L.A.-S.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20824
| | - Samantha A Reina
- Department of Epidemiology and Population Health (X.W., M.J., Y.M.-R., T.W., R.C.K., Q.Q.), Albert Einstein College of Medicine, Bronx, New York 10461; Department of Epidemiology and Biostatistics (X.W.), School of Public Health, Peking University Health Science Center, Beijing 100191, China; Collaborative Studies Coordinating Center (D.S.-A.), Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599; San Diego State University (R.A.E.G.), San Diego, California 92182; Institute for Minority Health Research (A.P.), University of Illinois at Chicago, Chicago, Illinois 60637; Department of Psychology (S.A.R.), University of Miami, Miami, Florida 33136; National Institute of Diabetes and Digestive and Kidney Diseases (S.S.C.), National Institutes of Health, Bethesda, Maryland 20892; and Division of Cardiovascular Sciences (M.L.A.-S.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20824
| | - Sarah S Casagrande
- Department of Epidemiology and Population Health (X.W., M.J., Y.M.-R., T.W., R.C.K., Q.Q.), Albert Einstein College of Medicine, Bronx, New York 10461; Department of Epidemiology and Biostatistics (X.W.), School of Public Health, Peking University Health Science Center, Beijing 100191, China; Collaborative Studies Coordinating Center (D.S.-A.), Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599; San Diego State University (R.A.E.G.), San Diego, California 92182; Institute for Minority Health Research (A.P.), University of Illinois at Chicago, Chicago, Illinois 60637; Department of Psychology (S.A.R.), University of Miami, Miami, Florida 33136; National Institute of Diabetes and Digestive and Kidney Diseases (S.S.C.), National Institutes of Health, Bethesda, Maryland 20892; and Division of Cardiovascular Sciences (M.L.A.-S.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20824
| | - Tao Wang
- Department of Epidemiology and Population Health (X.W., M.J., Y.M.-R., T.W., R.C.K., Q.Q.), Albert Einstein College of Medicine, Bronx, New York 10461; Department of Epidemiology and Biostatistics (X.W.), School of Public Health, Peking University Health Science Center, Beijing 100191, China; Collaborative Studies Coordinating Center (D.S.-A.), Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599; San Diego State University (R.A.E.G.), San Diego, California 92182; Institute for Minority Health Research (A.P.), University of Illinois at Chicago, Chicago, Illinois 60637; Department of Psychology (S.A.R.), University of Miami, Miami, Florida 33136; National Institute of Diabetes and Digestive and Kidney Diseases (S.S.C.), National Institutes of Health, Bethesda, Maryland 20892; and Division of Cardiovascular Sciences (M.L.A.-S.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20824
| | - M Larissa Avilés-Santa
- Department of Epidemiology and Population Health (X.W., M.J., Y.M.-R., T.W., R.C.K., Q.Q.), Albert Einstein College of Medicine, Bronx, New York 10461; Department of Epidemiology and Biostatistics (X.W.), School of Public Health, Peking University Health Science Center, Beijing 100191, China; Collaborative Studies Coordinating Center (D.S.-A.), Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599; San Diego State University (R.A.E.G.), San Diego, California 92182; Institute for Minority Health Research (A.P.), University of Illinois at Chicago, Chicago, Illinois 60637; Department of Psychology (S.A.R.), University of Miami, Miami, Florida 33136; National Institute of Diabetes and Digestive and Kidney Diseases (S.S.C.), National Institutes of Health, Bethesda, Maryland 20892; and Division of Cardiovascular Sciences (M.L.A.-S.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20824
| | - Robert C Kaplan
- Department of Epidemiology and Population Health (X.W., M.J., Y.M.-R., T.W., R.C.K., Q.Q.), Albert Einstein College of Medicine, Bronx, New York 10461; Department of Epidemiology and Biostatistics (X.W.), School of Public Health, Peking University Health Science Center, Beijing 100191, China; Collaborative Studies Coordinating Center (D.S.-A.), Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599; San Diego State University (R.A.E.G.), San Diego, California 92182; Institute for Minority Health Research (A.P.), University of Illinois at Chicago, Chicago, Illinois 60637; Department of Psychology (S.A.R.), University of Miami, Miami, Florida 33136; National Institute of Diabetes and Digestive and Kidney Diseases (S.S.C.), National Institutes of Health, Bethesda, Maryland 20892; and Division of Cardiovascular Sciences (M.L.A.-S.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20824
| | - Qibin Qi
- Department of Epidemiology and Population Health (X.W., M.J., Y.M.-R., T.W., R.C.K., Q.Q.), Albert Einstein College of Medicine, Bronx, New York 10461; Department of Epidemiology and Biostatistics (X.W.), School of Public Health, Peking University Health Science Center, Beijing 100191, China; Collaborative Studies Coordinating Center (D.S.-A.), Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599; San Diego State University (R.A.E.G.), San Diego, California 92182; Institute for Minority Health Research (A.P.), University of Illinois at Chicago, Chicago, Illinois 60637; Department of Psychology (S.A.R.), University of Miami, Miami, Florida 33136; National Institute of Diabetes and Digestive and Kidney Diseases (S.S.C.), National Institutes of Health, Bethesda, Maryland 20892; and Division of Cardiovascular Sciences (M.L.A.-S.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20824
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Moreno-Castilla C, Mauricio D, Hernandez M. Role of Medical Nutrition Therapy in the Management of Gestational Diabetes Mellitus. Curr Diab Rep 2016; 16:22. [PMID: 26879305 DOI: 10.1007/s11892-016-0717-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Medical nutrition therapy (MNT) plays an important role in the management of gestational diabetes mellitus (GDM), and accordingly, it has a significant impact on women and newborns. The primary objective of MNT is to ensure adequate pregnancy weight gain and fetus growth while maintaining euglycemia and avoiding ketones. However, the optimal diet (energy content, macronutrient distribution, its quality and amount, among others) remains an outstanding question. Overall, the nutritional requirements of GDM are similar for all pregnancies, but special attention is paid to carbohydrates. Despite the classical intervention of restricting carbohydrates, the latest evidence, although limited, seems to favor a low-glycemic index diet. There is general agreement in the literature about caloric restrictions in the case of being overweight or obese. Randomized controlled trials are necessary to investigate the optimal MNT for GDM; this knowledge could yield health benefits and cost savings.
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Affiliation(s)
- Cristina Moreno-Castilla
- Department of Endocrinology & Nutrition, Hospital Universitari Arnau de Vilanova, Rovira Roure, 80, 25198, Lleida, Spain.
| | - Didac Mauricio
- Department of Endocrinology & Nutrition, CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, 08916, Badalona, Spain.
| | - Marta Hernandez
- Department of Endocrinology & Nutrition, Hospital Universitari Arnau de Vilanova, Rovira Roure, 80, 25198, Lleida, Spain.
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81
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Yang J, Ba T, Chen L, Shan C, Zheng M, Wang Y, Ren H, Chen J, Xu J, Han F, Zhang Y, Yang X, Chang B. Effects of metformin and sitagliptin on glycolipid metabolism in type 2 diabetic rats on different diets. Arch Med Sci 2016; 12:233-42. [PMID: 27186166 PMCID: PMC4848356 DOI: 10.5114/aoms.2016.59249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 07/07/2014] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION The aim of the study was to investigate the effects of metformin and sitagliptin on glycolipid metabolism in type 2 diabetes after different diets. MATERIAL AND METHODS Seventy Male Sprague Dawley rats were fed with a high fat diet followed by streptozotocin treatment to induce type 2 diabetes. Then all rats were randomly divided into a control group, a metformin group (200 mg/kg), and a sitagliptin group (10 mg/kg). Each group was further divided into 4 groups receiving one load of high carbohydrate diet (45% glucose, 4.5 ml/kg), high fat diet (20% lipid emulsion, 4.5 ml/kg), high protein diet (20% whey protein, 10 ml/kg) or mixed meal, respectively. The caloric densities were all 33 kJ/kg. Postprandial blood glucose (P2BG), triglyceride (TG), glucagon-like peptide-1 (GLP-1), glucagon and insulin levels were measured. RESULTS In the high carbohydrate group, sitagliptin was more efficient in lowering P2BG compared with metformin (p < 0.05). In the high-fat group, metformin was more powerful in lowering TG (p < 0.05) and P2BG (p < 0.05) levels because of its improvement of insulin sensitivity. In the high protein diet group, metformin did not reduce the P2BG level (p > 0.05), although it did reduce the TG level (p < 0.05). In the mixed diet group, metformin was more efficient in lowering P2BG (p < 0.05) but had a similar effect on TG (p > 0.05) compared with sitagliptin. CONCLUSIONS In the type 2 diabetic model, metformin and sitagliptin have different effects on glycolipid metabolism after different diets. If it is proved in type 2 diabetic patients, then different medicines may be recommended according to different diets in order to improve glycolipid metabolism.
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Affiliation(s)
- Juhong Yang
- Key Laboratory of Hormone and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Disease, Tianjin Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Tu Ba
- Key Laboratory of Hormone and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Disease, Tianjin Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Liming Chen
- Key Laboratory of Hormone and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Disease, Tianjin Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Chunyan Shan
- Key Laboratory of Hormone and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Disease, Tianjin Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Miaoyan Zheng
- Key Laboratory of Hormone and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Disease, Tianjin Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Ying Wang
- Key Laboratory of Hormone and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Disease, Tianjin Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Huizhu Ren
- Key Laboratory of Hormone and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Disease, Tianjin Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Jingli Chen
- Key Laboratory of Hormone and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Disease, Tianjin Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Jie Xu
- Key Laboratory of Hormone and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Disease, Tianjin Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Fei Han
- Key Laboratory of Hormone and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Disease, Tianjin Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Yi Zhang
- Key Laboratory of Hormone and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Disease, Tianjin Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Xiaoyun Yang
- Key Laboratory of Hormone and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Disease, Tianjin Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Baocheng Chang
- Key Laboratory of Hormone and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Disease, Tianjin Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
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Baltzis D, Grammatikopoulou MG, Papanas N, Trakatelli CM, Kintiraki E, Hassapidou MN, Manes C. Obese Patients with Type 2 Diabetes on Conventional Versus Intensive Insulin Therapy: Efficacy of Low-Calorie Dietary Intervention. Adv Ther 2016; 33:447-59. [PMID: 26886777 DOI: 10.1007/s12325-016-0300-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Indexed: 01/13/2023]
Abstract
INTRODUCTION The aim of this prospective study was to assess the results of a standard low-calorie dietary intervention (7.5 MJ/day) on body weight (BW) and the metabolic profile of obese patients with type 2 diabetes mellitus (T2DM) on intensive insulin therapy (IIT: 4 insulin injections/day) versus conventional insulin therapy (CIT: 2/3 insulin injections/day). METHODS A total of 60 patients (n = 60, 23 males and 37 postmenopausal females) were recruited and categorized into two groups according to the scheme of insulin treatment. Thirty were on IIT (13 males and 17 females) and an equal number on CIT (10 males and 20 females). BW, body mass index (BMI), HbA1c, and metabolic parameters were compared at 6 and 12 months after baseline. RESULTS Significant reductions were observed in the BW, BMI, HbA1c (p ≤ 0.001 for all) and cholesterol (p ≤ 0.05) at 6 months post-intervention. At 1 year, median BW reduction was 4.5 kg (3.3, 5.8) for patients on IIT and 4.8 kg (3.6, 7.0) for those on CIT. The 12-month dietary intervention increased prevalence of normoglycemia in the IIT group and reduced the prevalence of obesity prevalence among the CIT participants (all p < 0.001). CIT patients with BW reduction ≥5.0% demonstrated 11-fold greater chances of being normoglycemic (odds ratio 11.3, 95% CI 1.1-110.5). BW reduction ≥7.0% was associated with CIT, being overweight, and having normal HDLc, LDLc, and cholesterol levels. A reduction in BW between 5.0% and 6.9% was associated with IIT, normoglycemia, and obesity. CONCLUSION A 12-month 1800-kcal dietary intervention achieved significant BW and HbA1c reductions irrespectively of insulin regimen. CIT was associated with BW reduction greater than 8.0%, whereas IIT was associated with higher rates of normoglycemia.
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Affiliation(s)
- Dimitrios Baltzis
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, Thessaloniki, Greece.
- Microcirculation Lab and Joslin-Beth Israel Deaconess Foot Center, Harvard Medical School, Boston, MA, USA.
| | - Maria G Grammatikopoulou
- Department of Human Nutrition and Dietetics, Alexander Technological Educational Institute, Thessaloniki, Greece
| | - Nikolaos Papanas
- Diabetes Center, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Evangelia Kintiraki
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Maria N Hassapidou
- Department of Human Nutrition and Dietetics, Alexander Technological Educational Institute, Thessaloniki, Greece
| | - Christos Manes
- Diabetes Center, Papageorgiou General Hospital, Thessaloniki, Greece
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Lifestyle Therapy for Diabetes Mellitus. LIFESTYLE MEDICINE 2016. [DOI: 10.1007/978-3-319-24687-1_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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84
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Dewinter L, Casteels K, Corthouts K, Van de Kerckhove K, Van der Vaerent K, Vanmeerbeeck K, Matthys C. Dietary intake of non-nutritive sweeteners in type 1 diabetes mellitus children. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2015; 33:19-26. [PMID: 26523968 DOI: 10.1080/19440049.2015.1112039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The aims of the current cross-sectional study were (1) to assess the intake of aspartame, cyclamate, acesulfame-k, neohesperidine dihydrochalcone, sucralose, saccharin, steviol glycosides and neotame among children with type 1 diabetes mellitus (T1D); (2) to compare the obtained intakes with the respective acceptable daily intake (ADI) values; and (3) to conduct a scenario analysis to obtain practical guidelines for a safe consumption of non-nutritive sweeteners (NNS) among children with T1D. T1D patients of the Paediatrics Department of the University Hospitals Leuven were invited to complete a food frequency questionnaire designed to assess NNS intake using a tier 2 and tier 3 exposure assessment approach. A scenario analysis was conducted by reducing the P95 consumption of the most contributing food categories in order to reach a total sweetener intake lower than or equal to the ADI. Estimated total intakes higher than ADIs were only found for the P95 consumers only of acesulfame-k, cyclamate and steviol glycosides (tier 2 and tier 3 approach). Scenario analysis created dietary guidelines for each age category for diet soda, bread spreads and dairy drinks. There is little chance for T1D children to exceed the ADI of the different NNS, however diabetes educators and dieticians need to pay attention regarding the use of NNS.
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Affiliation(s)
- Louise Dewinter
- a Department of Health and Technology , University College Leuven , Leuven , Belgium
| | - Kristina Casteels
- b Department of Pediatrics , University Hospitals Leuven , Leuven , Belgium.,c Department of Development and Regeneration , KU Leuven , Leuven , Belgium
| | - Karen Corthouts
- d Clinical Nutrition Unit, Department of Endocrinology , University Hospitals Leuven , Leuven , Belgium
| | - Kristel Van de Kerckhove
- d Clinical Nutrition Unit, Department of Endocrinology , University Hospitals Leuven , Leuven , Belgium
| | - Katrien Van der Vaerent
- d Clinical Nutrition Unit, Department of Endocrinology , University Hospitals Leuven , Leuven , Belgium
| | - Kelly Vanmeerbeeck
- a Department of Health and Technology , University College Leuven , Leuven , Belgium
| | - Christophe Matthys
- d Clinical Nutrition Unit, Department of Endocrinology , University Hospitals Leuven , Leuven , Belgium.,e Department of Clinical and Experimental Endocrinology , KU Leuven , Leuven , Belgium
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Chater PI, Wilcox MD, Pearson JP, Brownlee IA. The impact of dietary fibres on the physiological processes governing small intestinal digestive processes. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.bcdf.2015.09.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Monlezun DJ, Kasprowicz E, Tosh KW, Nix J, Urday P, Tice D, Sarris L, Harlan TS. Medical school-based teaching kitchen improves HbA1c, blood pressure, and cholesterol for patients with type 2 diabetes: Results from a novel randomized controlled trial. Diabetes Res Clin Pract 2015; 109:420-6. [PMID: 26002686 DOI: 10.1016/j.diabres.2015.05.007] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 03/18/2015] [Accepted: 05/02/2015] [Indexed: 12/30/2022]
Abstract
AIMS A medical school-based teaching kitchen sought to establish proof-of-principle for its hands-on Mediterranean diet (MD)-based cooking and nutrition curriculum for patients with type 2 diabetes (T2D). METHODS This pilot randomized controlled trial (RCT) allocated 27 patients with T2D between the control and GCCM arms. Mixed effects linear regression with repeated measures was used to investigate differences from baseline to 6 months. The primary and secondary endpoints were HbA1c -0.3% (-27 mmol/mol) and diastolic blood pressure (DBP) -10 mmHg and a 25% improved responses in dietary habits and attitudes and competencies in healthy nutrition. RESULTS Compared to the control group, the GCCM group had superior HbA1c reduction (-0.4% vs. -0.3%, p = 0.575) that was not statistically significant. There were significantly greater reductions in the GCCM vs. control group for DBP (-4 vs. 7 mmHg, p=0.037) and total cholesterol (-14 vs. 17 mg/dL, p = 0.044). There was a greater proportion increase though not significant of GCCM subjects compared to controls who mostly believed they could eat correct portions (18% vs. -11%, p = 0.124), and who used nutrition panels to make food choices (34% vs. 0%, p = 0.745). CONCLUSION This is the first known RCT demonstrating improved biometrics using a novel MD-based hands on cooking and nutrition curriculum for patients with T2D. These results suggest subsequent clinical trials are warranted on the grounds of documented feasibility and clinical efficacy.
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Affiliation(s)
- Dominique J Monlezun
- The Goldring Center for Culinary Medicine, Tulane University, 1430 Tulane Avenue No. 8541, New Orleans, LA 70112, USA; Department of Global Health Systems & Development, Tulane University School of Public Health & Tropical Medicine, 1440 Canal Street, Suite 1900, Box TB-46, New Orleans, LA 70112, USA.
| | - Eric Kasprowicz
- The Goldring Center for Culinary Medicine, Tulane University, 1430 Tulane Avenue No. 8541, New Orleans, LA 70112, USA
| | - Katherine W Tosh
- The Goldring Center for Culinary Medicine, Tulane University, 1430 Tulane Avenue No. 8541, New Orleans, LA 70112, USA
| | - Jenni Nix
- The Goldring Center for Culinary Medicine, Tulane University, 1430 Tulane Avenue No. 8541, New Orleans, LA 70112, USA
| | - Pedro Urday
- The Goldring Center for Culinary Medicine, Tulane University, 1430 Tulane Avenue No. 8541, New Orleans, LA 70112, USA
| | - Daphne Tice
- The Goldring Center for Culinary Medicine, Tulane University, 1430 Tulane Avenue No. 8541, New Orleans, LA 70112, USA
| | - Leah Sarris
- The Goldring Center for Culinary Medicine, Tulane University, 1430 Tulane Avenue No. 8541, New Orleans, LA 70112, USA
| | - Timothy S Harlan
- The Goldring Center for Culinary Medicine, Tulane University, 1430 Tulane Avenue No. 8541, New Orleans, LA 70112, USA
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87
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Zanetti ML, Arrelias CCA, Franco RC, Santos MAD, Rodrigues FFL, Faria HTG. Adherence to nutritional recommendations and sociodemographic variables in patients with diabetes mellitus. Rev Esc Enferm USP 2015; 49:619-25. [DOI: 10.1590/s0080-623420150000400012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVETo determine if there is a relationship between adherence to nutritional recommendations and sociodemographic variables in Brazilian patients with type 2 diabetes mellitus.METHODSCross-sectional observational study using a stratified random sample of 423 individuals. The Food Frequency Questionnaire (FFQ) was used, and the Fisher's exact test was applied with 95% confidence interval (p<0.05).RESULTSOf the 423 subjects, 66.7% were women, mean age of 62.4 years (SD = 11.8), 4.3 years of schooling on average (SD = 3.6) and family income of less than two minimum wages. There was association between the female gender and adherence to diet with adequate cholesterol content (OR: 2.03; CI: 1.23; 3.34), between four and more years of education and adherence to fractionation of meals (OR: 1 92 CI: 1.19; 3.10), and income of less than two minimum wages and adherence to diet with adequate cholesterol content (OR: 1.74; CI: 1.03, 2.95).CONCLUSIONAdherence to nutritional recommendations was associated with the female gender, more than four years of education and family income of less than two minimum wages.
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88
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Association of diet and lifestyle with glycated haemoglobin in type 1 diabetes participants in the EURODIAB prospective complications study. Eur J Clin Nutr 2015; 70:229-36. [PMID: 26173867 DOI: 10.1038/ejcn.2015.110] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 05/27/2015] [Accepted: 06/09/2015] [Indexed: 01/02/2023]
Abstract
BACKGROUND/OBJECTIVES Diet and lifestyle advice for type 1 diabetes (T1DM) patients is based on little evidence and putative effects on glycaemic control. Therefore, we investigated the longitudinal relation between dietary and lifestyle variables and HbA1c levels in patients with type 1 diabetes. SUBJECTS/METHODS A 7-year prospective cohort analysis was performed in 1659 T1DM patients (52% males, mean age 32.5 years) participating in the EURODIAB Prospective Complications Study. Baseline dietary intake was assessed by 3- day records and physical activity, smoking status and alcohol intake by questionnaires. HbA1c during follow-up was centrally assessed by immunoassay. Analysis of variance (ANOVA) and restricted cubic spline regression analyses were performed to assess dose-response associations between diet and lifestyle variables and HbA1c levels, adjusted for age, sex, lifestyle and body composition measures, baseline HbA1c, medication use and severe hypoglycaemic attacks. RESULTS Mean follow-up of our study population was 6.8 (s.d. 0.6) years. Mean HbA1c level was 8.25% (s.d. 1.85) (or 66.6 mmol/mol) at baseline and 8.27% (s.d. 1.44) at follow-up. Physical activity, smoking status and alcohol intake were not associated with HbA1c at follow-up in multivariable ANOVA models. Baseline intake below the median of vegetable protein (<29 g/day) and dietary fibre (<18 g/day) was associated with higher HbA1c levels. Restricted cubic splines showed nonlinear associations with HbA1c levels for vegetable protein (P (nonlinear)=0.008) and total dietary fibre (P (nonlinear)=0.0009). CONCLUSIONS This study suggests that low intake of vegetable protein and dietary fibre are associated with worse glycaemic control in type 1 diabetes.
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89
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Chourdakis M, Kontogiannis V, Malachas K, Pliakas T, Kritis A. Self-care behaviors of adults with type 2 diabetes mellitus in Greece. J Community Health 2015; 39:972-9. [PMID: 24519180 DOI: 10.1007/s10900-014-9841-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to examine self-care behaviors of adults with type 2 diabetes mellitus living in the Metropolitan Area of Thessaloniki in Northern Greece. The Summary of Diabetes Self-Care behaviors measurement was administered to 215 patients, out of which 177 were eligible to participate (87 males). Patients, aged 30 years or more, were recruited through a university hospital day-clinic. Older patients (>65 years), as well as those with "higher educational level" did not distribute their daily carbohydrate intake equally. Nevertheless, they were more likely to adapt to their physician's recommendations regarding medication and to regularly perform suggested blood glucose checking. Exercise patterns were more often found for higher educated, earlier diagnosed males. Younger patients were less likely to follow their healthcare professional's recommendations, regarding diet, medication intake, blood glucose checking, foot care and exercise compared to older patients. These results pose a higher risk for complications and morbidity in younger patients with type 2 diabetes mellitus, who most possibly will require intensive treatment in the future.
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Affiliation(s)
- Michael Chourdakis
- Department of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 54006, Thessaloniki, Greece,
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90
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Lamichhane AP, Crandell JL, Jaacks LM, Couch SC, Lawrence JM, Mayer-Davis EJ. Longitudinal associations of nutritional factors with glycated hemoglobin in youth with type 1 diabetes: the SEARCH Nutrition Ancillary Study. Am J Clin Nutr 2015; 101:1278-85. [PMID: 25948670 PMCID: PMC4441810 DOI: 10.3945/ajcn.114.103747] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 04/02/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Improved glycated hemoglobin (Hb A1c) delays the progression of microvascular and macrovascular complications in individuals with type 1 diabetes (T1D). We previously showed that higher baseline intakes of n-3 (ω-3) fatty acids and leucine are associated with preserved β cell function 2 y later in youth with T1D. OBJECTIVE In the current study, we extend this work to explore the longitudinal associations of nutritional factors with Hb A1c in youth with T1D. DESIGN We included 908 T1D youth with baseline and follow-up Hb A1c measurements. Nutritional factors assessed at baseline were as follows: breastfeeding status and timing of complimentary food introduction; intakes of leucine, carbohydrates, protein, fat, and fiber estimated from a food-frequency questionnaire (FFQ); and plasma biomarkers for vitamins D and E, eicosapentaenoic acid (EPA), and docosahexaenoic acid. We fit linear regression models adjusted for baseline Hb A1c, sociodemographic variables, diabetes-related variables, time between baseline and follow-up visits, saturated fat, physical activity, and for FFQ-derived nutrients, total calories. The vitamin D model was further adjusted for season and body mass index z score. RESULTS The mean ± SD age and diabetes duration at baseline was 10.8 ± 3.9 y and 10.1 ± 5.8 mo, respectively. A total of 9.3% of participants had poor Hb A1c (value ≥9.5%) at baseline, which increased to 18.3% during follow-up (P < 0.0001). Intakes of EPA (β = -0.045, P = 0.046), leucine (β = -0.031, P = 0.0004), and protein (β = -0.003, P = 0.0002) were significantly negatively associated with follow-up Hb A1c after adjustment for confounders. Intake of carbohydrates was significantly positively (β = 0.001, P = 0.003) associated with follow-up Hb A1c after adjustment for confounders. CONCLUSIONS Several nutritional factors may be associated with Hb A1c during early stages of disease progression in youth recently diagnosed with T1D. In addition to the overall role of major macronutrients such as carbohydrates and protein, leucine and n-3 fatty acid intakes, such as of EPA, may be important for long-term glycemic control.
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Affiliation(s)
- Archana P Lamichhane
- From the Department of Nutrition, Gillings School of Global Public Health (APL), the Department of Nutrition, Gillings School of Global Public Health and School of Medicine (EJM-D), and the Departments of Nursing and Biostatistics (JLC), University of North Carolina, Chapel Hill, NC; the Department of Nutritional Sciences, University of Cincinnati Medical Center, Cincinnati, OH (SCC); the Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA (JML), and the Hubert Department of Global Health, Emory University, Atlanta, GA (LMJ).
| | - Jamie L Crandell
- From the Department of Nutrition, Gillings School of Global Public Health (APL), the Department of Nutrition, Gillings School of Global Public Health and School of Medicine (EJM-D), and the Departments of Nursing and Biostatistics (JLC), University of North Carolina, Chapel Hill, NC; the Department of Nutritional Sciences, University of Cincinnati Medical Center, Cincinnati, OH (SCC); the Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA (JML), and the Hubert Department of Global Health, Emory University, Atlanta, GA (LMJ)
| | - Lindsay M Jaacks
- From the Department of Nutrition, Gillings School of Global Public Health (APL), the Department of Nutrition, Gillings School of Global Public Health and School of Medicine (EJM-D), and the Departments of Nursing and Biostatistics (JLC), University of North Carolina, Chapel Hill, NC; the Department of Nutritional Sciences, University of Cincinnati Medical Center, Cincinnati, OH (SCC); the Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA (JML), and the Hubert Department of Global Health, Emory University, Atlanta, GA (LMJ)
| | - Sarah C Couch
- From the Department of Nutrition, Gillings School of Global Public Health (APL), the Department of Nutrition, Gillings School of Global Public Health and School of Medicine (EJM-D), and the Departments of Nursing and Biostatistics (JLC), University of North Carolina, Chapel Hill, NC; the Department of Nutritional Sciences, University of Cincinnati Medical Center, Cincinnati, OH (SCC); the Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA (JML), and the Hubert Department of Global Health, Emory University, Atlanta, GA (LMJ)
| | - Jean M Lawrence
- From the Department of Nutrition, Gillings School of Global Public Health (APL), the Department of Nutrition, Gillings School of Global Public Health and School of Medicine (EJM-D), and the Departments of Nursing and Biostatistics (JLC), University of North Carolina, Chapel Hill, NC; the Department of Nutritional Sciences, University of Cincinnati Medical Center, Cincinnati, OH (SCC); the Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA (JML), and the Hubert Department of Global Health, Emory University, Atlanta, GA (LMJ)
| | - Elizabeth J Mayer-Davis
- From the Department of Nutrition, Gillings School of Global Public Health (APL), the Department of Nutrition, Gillings School of Global Public Health and School of Medicine (EJM-D), and the Departments of Nursing and Biostatistics (JLC), University of North Carolina, Chapel Hill, NC; the Department of Nutritional Sciences, University of Cincinnati Medical Center, Cincinnati, OH (SCC); the Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA (JML), and the Hubert Department of Global Health, Emory University, Atlanta, GA (LMJ)
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91
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Majumdar I, Bethin K, Quattrin T. Weight trajectory of youth with new-onset type 1 diabetes comparing standard and enhanced dietary education. Endocrine 2015; 49:155-62. [PMID: 25358449 DOI: 10.1007/s12020-014-0469-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Accepted: 10/24/2014] [Indexed: 12/01/2022]
Abstract
Youth with type 1 diabetes (T1DM) gain weight after insulin therapy initiation. We aimed to study the effects of Enhanced Dietary Counseling (EDC) compared to Standard of Care Dietary Counseling (SDC) on BMI trajectory in youth with new-onset T1DM. Youth with new-onset T1DM (n = 47; 8.9 + 4.2 years) were randomized 6 weeks post-diagnosis to either SDC per American Diabetes Association guidelines (n = 25) or EDC (n = 22: SDC plus monthly nutritional education and 3-day food records (FRs) at 6 and 24 weeks). Weights and heights were measured at diagnosis, 6 weeks, 3, 6, and 12 months post-diagnosis; pre-diagnosis BMI was obtained from pediatricians' records. BMI Z score was used to track BMI change. Knowledge of recommended daily energy intake (DEI) and daily carbohydrate intake was assessed at follow-up visits. Changes in BMI Z scores were similar in SDC versus EDC subjects from pre-diagnosis to 12 months post-diagnosis. BMI Z score at 12 months exceeded pre-diagnosis level in 58.5 % subjects (54.5 % EDC vs. 63.1 % SDC, p = 0.75). From 6 weeks to 6 months, percentage of subjects correctly recalling recommended DEI increased in EDC along with percentage of subjects meeting recommended daily fruit servings intake from 25 % (6 weeks) to 64 % (6 months), p = 0.047). EDC did not prevent BMI Z score increases in youth with new-onset T1DM, and BMI Z score exceeded pre-diagnosis levels in >50 % 12 months post-diagnosis. A family-based approach and/or additional intervention may be needed to prevent excessive weight gain.
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Affiliation(s)
- Indrajit Majumdar
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, School of Medicine and Biomedical Sciences, University at Buffalo & Women and Children's Hospital of Buffalo, 219 Bryant Street, Buffalo, NY, 14222, USA,
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92
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Franz MJ, Boucher JL, Rutten-Ramos S, VanWormer JJ. Lifestyle weight-loss intervention outcomes in overweight and obese adults with type 2 diabetes: a systematic review and meta-analysis of randomized clinical trials. J Acad Nutr Diet 2015; 115:1447-63. [PMID: 25935570 DOI: 10.1016/j.jand.2015.02.031] [Citation(s) in RCA: 374] [Impact Index Per Article: 41.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 02/24/2015] [Indexed: 12/27/2022]
Abstract
The majority of people with type 2 diabetes are overweight or obese, and weight loss is a recommended treatment strategy. A systematic review and meta-analysis was undertaken to answer the following primary question: In overweight or obese adults with type 2 diabetes, what are the outcomes on hemoglobin A1c (HbA1c) from lifestyle weight-loss interventions resulting in weight losses greater than or less than 5% at 12 months? Secondary questions are: What are the lipid (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides) and blood pressure (systolic and diastolic) outcomes from lifestyle weight-loss interventions resulting in weight losses greater than or less than 5% at 12 months? And, what are the weight and metabolic outcomes from differing amounts of macronutrients in weight-loss interventions? Inclusion criteria included randomized clinical trial implementing weight-loss interventions in overweight or obese adults with type 2 diabetes, minimum 12-month study duration, a 70% completion rate, and an HbA1c value reported at 12 months. Eleven trials (eight compared two weight-loss interventions and three compared a weight-loss intervention group with a usual care/control group) with 6,754 participants met study criteria. At 12 months, 17 study groups (8 categories of weight-loss intervention) reported weight loss <5% of initial weight (-3.2 kg [95% CI: -5.9, -0.6]). A meta-analysis of the weight-loss interventions reported nonsignificant beneficial effects on HbA1c, lipids, or blood pressure. Two study groups reported a weight loss of ≥5%: a Mediterranean-style diet implemented in newly diagnosed adults with type 2 diabetes and an intensive lifestyle intervention implemented in the Look AHEAD (Action for Health in Diabetes) trial. Both included regular physical activity and frequent contact with health professionals and reported significant beneficial effects on HbA1c, lipids, and blood pressure. Five trials (10 study groups) compared weight-loss interventions of differing amounts of macronutrients and reported nonsignificant differences in weight loss, HbA1c, lipids, and blood pressure. The majority of lifestyle weight-loss interventions in overweight or obese adults with type 2 diabetes resulted in weight loss <5% and did not result in beneficial metabolic outcomes. A weight loss of >5% appears necessary for beneficial effects on HbA1c, lipids, and blood pressure. Achieving this level of weight loss requires intense interventions, including energy restriction, regular physical activity, and frequent contact with health professionals. Weight loss for many overweight or obese individuals with type 2 diabetes might not be a realistic primary treatment strategy for improved glycemic control. Nutrition therapy for individuals with type 2 diabetes should encourage a healthful eating pattern, a reduced energy intake, regular physical activity, education, and support as primary treatment strategies.
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93
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Jaacks LM, Liu W, Ji L, Mendez MA, Du S, Crandell J, Rosamond W, Mayer-Davis EJ. Diabetes nutrition therapy and dietary intake among individuals with Type 1 diabetes in China. Diabet Med 2015; 32:399-406. [PMID: 25407093 PMCID: PMC4329062 DOI: 10.1111/dme.12634] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/14/2014] [Indexed: 12/19/2022]
Abstract
AIMS To describe the contribution of diabetes nutrition therapy to disease self-management among individuals with Type 1 diabetes in China and to estimate the association of diabetes nutrition therapy with dietary intake. METHODS The 3C Study was an epidemiological study of the coverage, cost and care of Type 1 diabetes in China. The data reported in the present study are from the 3C Nutrition Ancillary Study, a follow-up study conducted a mean ± sd of 1.6 ± 0.2 years later. Diabetes nutrition therapy was assessed by an interviewer-administered questionnaire. Dietary intake was assessed using three 24-h recalls. The association of diabetes nutrition therapy with dietary intake was estimated using ancova. RESULTS Participants (n = 100; 54% male) had a mean ± sd age of 41.7 ± 16.3 years and a mean ± sd diabetes duration of 11.8 ± 9.7 years. Fewer than half of the participants reported that they had 'ever' met with a dietitian. While 64% of participants were taught carbohydrate counting, only 12% 'ever' use this tool. Participants on insulin pumps and those testing ≥ 1 time/day reported greater dietary flexibility and higher fruit intakes compared with participants on other insulin regimens and testing less frequently. After adjustment for confounding by age and occupation, there were no consistent differences in dietary intake across subgroups of diabetes nutrition therapy. CONCLUSIONS In this sample of individuals with Type 1 diabetes in China there is little dietitian involvement or carbohydrate counting. Increased frequency of nutrition education in conjunction with intensified self-monitoring of blood glucose is needed to improve care.
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Affiliation(s)
- L M Jaacks
- Department of Nutrition, University of North Carolina, Chapel Hill, NC, USA
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94
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Iwase H, Tanaka M, Kobayashi Y, Wada S, Kuwahata M, Kido Y, Hamaguchi M, Asano M, Yamazaki M, Hasegawa G, Nakamura N, Fukui M. Lower vegetable protein intake and higher dietary acid load associated with lower carbohydrate intake are risk factors for metabolic syndrome in patients with type 2 diabetes: Post-hoc analysis of a cross-sectional study. J Diabetes Investig 2015. [PMID: 26221526 PMCID: PMC4511307 DOI: 10.1111/jdi.12326] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Aims/Introduction A low-carbohydrate diet based on animal sources is associated with higher all-cause mortality, whereas a vegetable-based low-carbohydrate diet is associated with lower cardiovascular disease mortality. It has been suggested that acid/base imbalance might play an important role in some cardiometabolic abnormalities. The aims of the present study were to evaluate whether carbohydrate intake is associated with quality of dietary protein and acid load, and whether these are related to metabolic syndrome in patients with type 2 diabetes. Materials and Methods The present cross-sectional study involved 149 patients with type 2 diabetes. Dietary intake was assessed using a validated self-administered diet history questionnaire. Dietary acid load was assessed by potential renal acid load and net endogenous acid production. Results Mean daily total energy intake, carbohydrate intake, animal protein intake and vegetable protein intake were 1821.5 kcal, 248.8 g, 36.1 g and 31.1 g, respectively. Carbohydrate energy/total energy was negatively correlated with animal protein energy/total energy, potential renal acid load or net endogenous acid production score, and was positively correlated with vegetable protein energy/total energy. Logistic regression analyses showed that the subgroup of patients with a lower vegetable protein energy/total energy or higher potential renal acid load or net endogenous acid production score was significantly associated with the prevalence of metabolic syndrome. Conclusions The present study showed that carbohydrate intake was associated with the quality of dietary protein and dietary acid load. Furthermore, decreased vegetable protein intake and increased dietary acid load were associated with the prevalence of metabolic syndrome.
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Affiliation(s)
- Hiroya Iwase
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science Kyoto, Japan
| | - Muhei Tanaka
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science Kyoto, Japan
| | - Yukiko Kobayashi
- Graduate School of Life and Environmental Sciences, Kyoto Prefectural University Kyoto, Japan
| | - Sayori Wada
- Graduate School of Life and Environmental Sciences, Kyoto Prefectural University Kyoto, Japan
| | - Masashi Kuwahata
- Graduate School of Life and Environmental Sciences, Kyoto Prefectural University Kyoto, Japan
| | - Yasuhiro Kido
- Graduate School of Life and Environmental Sciences, Kyoto Prefectural University Kyoto, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science Kyoto, Japan
| | - Mai Asano
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science Kyoto, Japan
| | - Masahiro Yamazaki
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science Kyoto, Japan
| | - Goji Hasegawa
- Division of Metabolism, Nephrology and Rheumatology, Japanese Red Cross Kyoto Daini Hospital Kyoto, Japan
| | - Naoto Nakamura
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science Kyoto, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science Kyoto, Japan
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Abstract
Diabetes now affects more than 29 million Americans, and more than 9 million of these people do not know they have diabetes. In adults, type 2 diabetes accounts for about 90% to 95% of all diagnosed cases of diabetes and is the focus of this article. Lifestyle intervention is part of the initial treatment as well as the ongoing management of type 2 diabetes. Lifestyle intervention encompasses a healthful eating plan, physical activity, and often medication to assist in achievement of glucose, lipid, and blood pressure goals. Patient education and self-care practices are also important aspects of disease management.
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Affiliation(s)
- Alison B Evert
- Diabetes Education Programs, Diabetes Care Center, University of Washington Medical Center, 4245 Roosevelt Way Northeast, 3rd Floor, Seattle, WA 98105, USA.
| | - Michael C Riddell
- Muscle Health Research Center, School of Kinesiology and Health Science, Bethune College, York University, 4700 Keele Street, 3rd Floor, Toronto, Ontario M3J1P3, Canada
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Mikami N, Tsujimura J, Sato A, Narasada A, Shigeta M, Kato M, Hata S, Hitomi E. Green Rooibos Extract from Aspalathus linearis, and its Component, Aspalathin, Suppress Elevation of Blood Glucose Levels in Mice and Inhibit α-amylase and α-glucosidase Activities in vitro. FOOD SCIENCE AND TECHNOLOGY RESEARCH 2015. [DOI: 10.3136/fstr.21.231] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Nana Mikami
- Faculty of Nursing and Nutrition, Yamaguchi Prefectural University
- Department of Biomedical Engineering, Sapporo Medical University School of Medicine
| | - Junko Tsujimura
- Faculty of Nursing and Nutrition, Yamaguchi Prefectural University
| | - Ayumi Sato
- Faculty of Nursing and Nutrition, Yamaguchi Prefectural University
| | - Akiko Narasada
- Faculty of Nursing and Nutrition, Yamaguchi Prefectural University
| | - Mayumi Shigeta
- Faculty of Nursing and Nutrition, Yamaguchi Prefectural University
| | - Motoshi Kato
- Faculty of Nursing and Nutrition, Yamaguchi Prefectural University
| | | | - Eri Hitomi
- Faculty of Nursing and Nutrition, Yamaguchi Prefectural University
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97
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Wang ML, Gellar L, Nathanson BH, Pbert L, Ma Y, Ockene I, Rosal MC. Decrease in Glycemic Index Associated with Improved Glycemic Control among Latinos with Type 2 Diabetes. J Acad Nutr Diet 2014; 115:898-906. [PMID: 25547339 DOI: 10.1016/j.jand.2014.10.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 10/03/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Glycemic index and glycemic load are used to facilitate glucose control among adults with type 2 diabetes, with a low glycemic index diet associated with improved glycemic control. OBJECTIVE To examine long-term longitudinal associations between changes in glycemic index and glycemic load with glycemic and metabolic control among Latino adults with diabetes. DESIGN Secondary data from intervention and comparison participants in the Latinos en Control trial (2006 to 2008) were analyzed. PARTICIPANTS/SETTING Data on dietary intake and metabolic characteristics were from low-income, Latino adults (N=238; 87.7% Puerto Rican) with type 2 diabetes. INTERVENTION The Latinos en Control trial was a randomized clinical trial targeting diabetes self-management among Latinos with type 2 diabetes. Participants were randomized to a group-based behavioral intervention or usual care and followed through 12 months. MAIN OUTCOME MEASURES Outcomes included hemoglobin A1c (HbA1c) levels, fasting blood glucose, lipid profiles, anthropometrics, and blood pressure. STATISTICAL ANALYSIS Glycemic index and load were analyzed using data from three 24-hour dietary recalls conducted at baseline, 4 months, and 12 months. Repeated measures regression models were used to examine change in glycemic index and load associated with metabolic characteristics at 12 months. Covariates included sex, age, body mass index, blood pressure, total energy intake, medication use and intensity, physical activity, intervention status (intervention vs usual care), and time. RESULTS Increases in glycemic index from baseline to 12 months were associated with increased logarithm of HbA1c levels (β=0.003; P=0.034) and waist circumference (β=0.12; P=0.026) over time, but not with fasting glucose, blood lipids, or body mass index. There was modest evidence to support small, positive associations between glycemic load and HbA1c levels and waist circumference. CONCLUSIONS Lowering glycemic index is associated with improvements in certain metabolic risk factors among Latinos with diabetes. Targeting glycemic index may be an important component of dietary strategies for diabetes self-management.
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Ogbera AO, Ekpebegh C. Diabetes mellitus in Nigeria: The past, present and future. World J Diabetes 2014; 5:905-11. [PMID: 25512795 PMCID: PMC4265879 DOI: 10.4239/wjd.v5.i6.905] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 08/28/2014] [Accepted: 10/28/2014] [Indexed: 02/05/2023] Open
Abstract
Diabetes mellitus (DM) is a diverse group of metabolic disorders that is often associated with a high disease burden in developing countries such as Nigeria. In the early nineties, not much was known about DM in Nigeria and traditionally, people related DM to "curses" or "hexes" and diagnosis was made based on blood or urinary tests for glucose. Currently, oral hypoglycaemic agents but not insulin are readily accessible and acceptable to persons with DM. The cost of diabetes care is borne in most instances by individuals and often payment is "out of pocket"-this being a sequel of a poorly functional national health insurance scheme. An insulin requiring individual on a minimum wage would spend 29% of his monthly income on insulin. Complementary and alternative medicines are widely used by persons with DM and form an integral component of DM care. Towards reducing the burden of DM in Nigeria, we suggest that there be concerted efforts by healthcare professionals and stakeholders in the health industry to put in place preventative measures, a better functioning health insurance scheme and a structured DM program.
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Bardenheier BH, Cogswell ME, Gregg EW, Williams DE, Zhang Z, Geiss LS. Does knowing one's elevated glycemic status make a difference in macronutrient intake? Diabetes Care 2014; 37:3143-9. [PMID: 25205140 PMCID: PMC4535332 DOI: 10.2337/dc14-1342] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine whether macronutrient intake differs by awareness of glycemic status among people with diabetes and prediabetes. RESEARCH DESIGN AND METHODS We used 24-h dietary recall and other data from 3,725 nonpregnant adults with diabetes or prediabetes aged ≥20 years from the morning fasting sample of the 2005-2010 National Health and Nutrition Examination Survey. Diabetes and prediabetes awareness were self-reported; those unaware of diabetes and prediabetes were defined by fasting plasma glucose (FPG) ≥126 mg/dL or HbA1c ≥6.5% and FPG 100-125 mg/dL or HbA1c of 5.7%-6.4%, respectively. Components of nutrient intake on a given day assessed were total calories, sugar, carbohydrates, fiber, protein, fat, and total cholesterol, stratified by sex and glycemic status awareness. Estimates of nutrient intake were adjusted for age, race/ethnicity, education level, BMI, smoking status, and family history of diabetes. RESULTS Men with diagnosed diabetes consumed less sugar (mean 86.8 vs. 116.8 g) and carbohydrates (mean 235.0 vs. 262.1 g) and more protein (mean 92.3 vs. 89.7 g) than men with undiagnosed diabetes. Similarly, women with diagnosed diabetes consumed less sugar (mean 79.1 vs. 95.7 g) and more protein (mean 67.4 vs. 56.6 g) than women with undiagnosed diabetes. No significant differences in macronutrient intake were found by awareness of prediabetes. All participants, regardless of sex or glycemic status, consumed on average less than the American Diabetes Association recommendations for fiber intake (i.e., 14 g/1,000 kcal) and slightly more saturated fat than recommended (>10% of total kcal). CONCLUSIONS Screening and subsequent knowledge of glycemic status may favorably affect some dietary patterns for people with diabetes.
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Affiliation(s)
- Barbara H Bardenheier
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Mary E Cogswell
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Edward W Gregg
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Desmond E Williams
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Zefeng Zhang
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Linda S Geiss
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
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Romeyke T, Stummer H. Evidence-Based Complementary and Alternative Medicine in Inpatient Care. J Evid Based Complementary Altern Med 2014; 20:87-93. [DOI: 10.1177/2156587214555714] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The aim of this report is to provide the reader an overview of the complex therapy currently used within the German health system. Complex therapies in inpatient care in Germany establish the basis for an integrative and interdisciplinary provision of services. They define minimal criteria for the organization of a hospital, enable the integration of different therapeutic approaches, and therefore, lead to an intensive and holistic treatment by a specially trained team. The German model can be viewed as a pilot program for the introduction of integrative patient-centered care in other hospitals around the world.
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Affiliation(s)
- Tobias Romeyke
- University for Health Sciences, Medical Informatics and Technology, Vienna, Austria
- Waldhausklinik Deuringen, Stadtbergen, Germany
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