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Lang A, Kuss O, Filla T, Kuhnle G, Schlesinger S. The mediating role of obesity on the prospective association between urinary sucrose and diabetes incidence in a sub-cohort of the EPIC-Norfolk. Nutr Diabetes 2023; 13:14. [PMID: 37660118 PMCID: PMC10475125 DOI: 10.1038/s41387-023-00243-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/26/2023] [Accepted: 08/18/2023] [Indexed: 09/04/2023] Open
Abstract
BACKGROUND/OBJECTIVES Findings from epidemiological studies showed controversial findings between dietary sugar intake and the development of diabetes. Most of these studies assessed dietary sugar intake by self-reports which might be prone to bias. Urinary sucrose, an objective biomarker of sucrose intake, might provide better insights into this association. Thus, the aim of this study was to investigate the associations between sucrose intake, measured via self-reports and urinary sucrose, with incident diabetes and to detect the impact of obesity on this association. SUBJECTS/METHODS Data of a sub-group (n = 2996) from the prospective EPIC-Norfolk cohort were investigated. Sucrose intake was assessed by self-reports (validated food frequency questionnaire (FFQ) and 7-day diet diaries (7DD)) and as an objective urinary sucrose biomarker. Cox proportional hazard models were conducted to calculate hazard ratios (HRs) and 95% confidence intervals (CI) for the associations between urinary and dietary sucrose intake and incident diabetes. Mediation analysis was performed to investigate the mediated percentage of body mass index (BMI) and waist circumference (WC) on this association. RESULTS The mean age of the participants was 60.6 ± 9.5 years and 53% were women. After a mean follow-up of 11.2 ± 2.9 years, 97 participants developed diabetes. Findings suggested inverse associations regarding incident diabetes for self-reported sucrose intake per 50 g/d via 7DD [HR: 0.63 (95% CI: 0.43, 0.91)], and a tendency via FFQ [HR: 0.81 (95% CI: 0.46, 1.42)]. Urinary sucrose indicated a positive association with incident diabetes for each increase of 100 µM [HR: 1.14 (95% CI: 0.95, 1.36)]. The proportion mediated of BMI and WC for this association was 16 and 22%. CONCLUSIONS These findings indicate that sucrose measured as objective urinary biomarker points to a positive association with incident diabetes. BMI might partly mediate this association. However, to obtain more precise results, more studies are warranted that consider this objective biomarker.
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Affiliation(s)
- Alexander Lang
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, D-40225, Düsseldorf, Germany.
| | - Oliver Kuss
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, D-40225, Düsseldorf, Germany
- Centre for Health and Society, Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany Institute for Biometrics and Bioinformatics, University Hospital, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
| | - Tim Filla
- Department of Rheumatology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Gunter Kuhnle
- Department of Food & Nutritional Sciences, University of Reading, Reading, RG6 6DZ, United Kingdom
| | - Sabrina Schlesinger
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, D-40225, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
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Vinoy S, Goletzke J, Rakhshandehroo M, Schweitzer L, Flourakis M, Körner A, Alexy U, van Schothorst EM, Ceriello A, Zakrzewski-Fruer JK, Buyken A. Health relevance of lowering postprandial glycaemia in the paediatric population through diet': results from a multistakeholder workshop. Eur J Nutr 2023; 62:1093-1107. [PMID: 36534178 PMCID: PMC10030539 DOI: 10.1007/s00394-022-03047-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 10/20/2022] [Indexed: 12/23/2022]
Abstract
To summarize current knowledge and gaps regarding the role of postprandial glycaemic response in the paediatric population, a workshop was organized in June 2021 by the European branch of the International Life Science Institute (ILSI). This virtual event comprised of talks given by experts followed by in-depth discussions in breakout sessions with workshop participants. The main pre-specified topics addressed by the workshop organizing committee to the invited speakers and the workshop participants were: (1) the role of glycaemic responses for paediatric health, based on mechanistic insights from animal and human data, and long-term evidence from observational and intervention studies in paediatric populations, and (2) changes in metabolism and changes in dietary needs from infancy to adolescence. Each talk as well as the discussions were summarised, including the main identified research gaps. The workshop led to the consensus on the crucial role on health of postprandial glycaemic response in paediatric population. However, a lack of scientific data has been identified regarding detailed glucose and insulin profiles in response to foods commonly consumed by paediatric populations, as well as a lack of long-term evidence including the need for suitable predictors during childhood and adolescence to anticipate health effects during adulthood.
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Affiliation(s)
- Sophie Vinoy
- Mondelēz International, Nutrition Research, Clamart, France
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Goletzke J, Weber KS, Kössler T, Zaharia OP, Bódis K, Müssig K, Szendroedi J, Burkart V, Stutz B, Nöthlings U, Buyken AE, Roden M. Relative validity of a glycemic index extended food-frequency questionnaire. Nutr Metab Cardiovasc Dis 2022; 32:2310-2320. [PMID: 35973887 DOI: 10.1016/j.numecd.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/15/2022] [Accepted: 07/11/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS The dietary glycemic index (GI) and glycemic load (GL) are increasingly recognized as important for the prevention and management of diabetes mellitus. To extend the portfolio of assessment methods for large-scale epidemiological studies, we propose a GI-specific addition to an already established FFQ. METHODS AND RESULTS The German version of the EPIC-FFQ was extended by GI-specific questions for major carbohydrate sources varying notably in GI (breakfast cereals, bread, pasta, rice, potato etc.). We performed relative validation analyses comparing the GI-extended FFQ to three to four 3-day weighted dietary records (3-d WDR) in 100 middle-aged individuals with diabetes mellitus participating in the German Diabetes Study (GDS). Level of agreement between the two methods was assessed by correlation and cross-classification analyses as well as Bland-Altman-Plots, conducted separately for women and men. Spearman correlation analysis for female participants suggested good agreement between the GI-extended FFQ and 3-d WDRs for energy adjusted dietary GL (r = 0.52, p = 0.0004). For both women and men, agreement with the estimations of dietary GI, GL (for men) and carbohydrates from low and higher-GI food sources from the GI-extended FFQ was acceptable (r: 0.28-0.45). Classification of the dietary GI and GL in the opposite quartile was <10% comparing the GI-extended FFQ and 3-d WDR. Bland-Altman plots suggested a tendency for an overestimation of the dietary GI from the GI-extended FFQ in the lower GI-ranges, particularly for men. CONCLUSION Compared to the 3-d WDR, the GI-extended FFQ showed a moderate to good relative validity for parameters of carbohydrate quality.
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Affiliation(s)
- Janina Goletzke
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, 33098 Paderborn, Germany
| | - Katharina S Weber
- Institute of Epidemiology, Kiel University, Kiel, Germany; Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany
| | - Theresa Kössler
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Oana-Patricia Zaharia
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Kálmán Bódis
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Karsten Müssig
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Department of Internal Medicine, Gastroenterology and Diabetology, Niels Stensen Hospitals, Franziskus Hospital Harderberg, Georgsmarienhütte, Germany
| | - Julia Szendroedi
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Clinic for Endocrinology, Diabetology, Metabolic Diseases and Clinical Chemistry at Heidelberg University Hospital, Germany
| | - Volker Burkart
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany
| | - Bianca Stutz
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, 33098 Paderborn, Germany
| | - Ute Nöthlings
- Institute of Nutrition and Food Sciences, Faculty of Agriculture, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Anette E Buyken
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, 33098 Paderborn, Germany.
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Malekipoor R, Johnson SK, Bhattarai RR. Lupin Kernel Fibre: Nutritional Composition, Processing Methods, Physicochemical Properties, Consumer Acceptability and Health Effects of Its Enriched Products. Nutrients 2022; 14:nu14142845. [PMID: 35889802 PMCID: PMC9315693 DOI: 10.3390/nu14142845] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/04/2022] [Accepted: 07/08/2022] [Indexed: 12/25/2022] Open
Abstract
The kernels (dehulled seeds) of lupins (Lupinus spp.) contain far higher dietary fibre levels than other legumes. This fibre is a complex mixture of non-starch polysaccharides making up the thickened cell walls of the kernel. The fibre has properties of both insoluble and soluble fibres. It is a major by-product of the manufacture of lupin protein isolates, which can be dried to produce a purified fibre food ingredient. Such an ingredient possesses a neutral odour and flavour, a smooth texture, and high water-binding and oil-binding properties. These properties allow its incorporation into foods with minimum reduction in their acceptability. The lupin kernel fibre (LKF) has demonstrated beneficial effects in clinical studies on biomarkers for metabolic diseases such as obesity, type 2 diabetes, and cardiovascular disease. It can be described as a “prebiotic fibre” since it improves gut micro-floral balance and the chemical environment within the colon. Thus, LKF is a health-functional ingredient with great opportunity for more widespread use in foods; however, it is evident that more non-thermal methods for the manufacture of lupin kernel fibre should be explored, including their effects on the physicochemical properties of the fibre and the effect on health outcomes in long term clinical trials.
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Affiliation(s)
- Rahil Malekipoor
- School of Molecular and Life Sciences, Faculty of Science and Engineering, Curtin University, Bentley, WA 6102, Australia; (R.M.); (S.K.J.)
| | - Stuart K. Johnson
- School of Molecular and Life Sciences, Faculty of Science and Engineering, Curtin University, Bentley, WA 6102, Australia; (R.M.); (S.K.J.)
- Ingredients by Design Pty Ltd., Lesmurdie, WA 6076, Australia
| | - Rewati R. Bhattarai
- School of Molecular and Life Sciences, Faculty of Science and Engineering, Curtin University, Bentley, WA 6102, Australia; (R.M.); (S.K.J.)
- Correspondence: ; Tel.: +61-8-9266-5182
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Perrar I, Alexy U, Jankovic N. Changes in Total Energy, Nutrients and Food Group Intake among Children and Adolescents during the COVID-19 Pandemic-Results of the DONALD Study. Nutrients 2022; 14:nu14020297. [PMID: 35057478 PMCID: PMC8778042 DOI: 10.3390/nu14020297] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/03/2022] [Accepted: 01/07/2022] [Indexed: 02/01/2023] Open
Abstract
The COVID-19 pandemic may have changed the habitual lifestyles of children and adolescents, in particular, due to the closure of kindergartens and schools. To investigate the impact of the pandemic on nutrients and food intake of children and adolescents in Germany, we analyzed repeated 3-day weighed dietary records from 108 participants (3–18 years; females: n = 45, males: n = 63) of the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study. Polynomial mixed-effects regression models were used to identify prospective changes in dietary intake (total energy (TEI), carbohydrates, fat, protein, free sugar, ultra-processed foods, fruits and vegetables, sugar sweetened beverages and juices) before and during the first months of the COVID-19 pandemic. For the current analysis, we have chosen the first months of the pandemic (March 2020–August 2020), as this was the period with the most restrictions in Germany so far (kindergarten, school and restaurant closures; contact and outdoor activity restrictions). No significant changes in either the selected nutrients or food groups were observed. However, children and adolescents recorded a significantly lower TEI during the pandemic (β = −109.65, p = 0.0062). Results remained significant after the exclusion of participants with under-reported records (β = −95.77, p = 0.0063). While macronutrient intake did not change, descriptive data indicate a non-significant decrease in sugar sweetened beverages and ultra-processed foods intake. We suggest that children and adolescents from high socioeconomic families may have adapted lifestyle changes during the pandemic.
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Affiliation(s)
- Ines Perrar
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Friedrich-Hirzebruch-Allee 7, 53115 Bonn, Germany
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany; (U.A.); (N.J.)
- Correspondence:
| | - Ute Alexy
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany; (U.A.); (N.J.)
| | - Nicole Jankovic
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany; (U.A.); (N.J.)
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Strączek K, Horodnicka-Józwa A, Szmit-Domagalska J, Jackowski T, Safranow K, Petriczko E, Walczak M. Familial dietary intervention in children with excess body weight and its impact on eating habits, anthropometric and biochemical parameters. Front Endocrinol (Lausanne) 2022; 13:1034148. [PMID: 36531483 PMCID: PMC9751449 DOI: 10.3389/fendo.2022.1034148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/04/2022] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Obesity is considered a civilisation disease which increases mortality and impairs quality of life, also among children and adolescents. The prevalence of overweight and obesity is steadily increasing in the developmental age population. Environmental factors are responsible for the main reason of excessive adipose tissue accumulation. Among these, poor eating habits and lack of exercise play the largest role. Familial prevalence of obesity and family dietary patterns also receive significant attention. Many specialists believe that the treatment of obesity should be multidirectional, effective and minimally invasive. Therefore, effective and safe methods are being investigated to effectively reduce body weight and improve eating habits. Dietary education programmes are an alternative to improve the health status of obese and overweight children and adolescents. To be fully effective, these programmes should involve the whole family. AIM OF THE STUDY In the face of constantly increasing prevalence of overweight and obesity in the developmental age population and the lack of effective methods to combat its occurrence, it seems appropriate to try to assess the effectiveness of a one-year-long dietary education of children and adolescents with excess body weight on their eating habits and the eating habits of their mothers, as well as selected anthropometric and biochemical parameters in these children using a simple educational tool, the Healthy Food Pyramid. PATIENTS AND METHODS The study group consisted of 68 children with overweight and obesity, patients of the Department of Paediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age of the Pomeranian Medical University in Szczecin. The study used a proprietary questionnaire to assess dietary habits. Patients participated in six individual educational meetings over a twelve-month period. Eating habits were assessed in children and mothers before and after dietary intervention. Sixty-seven questionnaires before and after the dietary intervention were used for analysis. RESULTS Sixty-eight children completed the study. Those who did not complete the study came from families living in rural areas and their mothers mostly had primary or vocational education. One-year dietary education resulted in significant improvements in body weight, waist and hip circumference, WHtR and selected measured carbohydrate and lipid metabolism parameters with the exception of total cholesterol. The one-year dietary intervention did not have the same effect on the change in dietary habits in children and in their mothers.
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Affiliation(s)
- Kamilla Strączek
- Department of Paediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, Szczecin, Poland
- *Correspondence: Kamilla Strączek,
| | - Anita Horodnicka-Józwa
- Department of Paediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, Szczecin, Poland
| | - Justyna Szmit-Domagalska
- Department of Paediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Jackowski
- Department of Paediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, Szczecin, Poland
| | - Krzysztof Safranow
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland
| | - Elżbieta Petriczko
- Department of Paediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, Szczecin, Poland
| | - Mieczysław Walczak
- Department of Paediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, Szczecin, Poland
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Reconstructing Neanderthal diet: The case for carbohydrates. J Hum Evol 2021; 162:103105. [PMID: 34923240 DOI: 10.1016/j.jhevol.2021.103105] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 12/22/2022]
Abstract
Evidence for plants rarely survives on Paleolithic sites, while animal bones and biomolecular analyses suggest animal produce was important to hominin populations, leading to the perspective that Neanderthals had a very-high-protein diet. But although individual and short-term survival is possible on a relatively low-carbohydrate diet, populations are unlikely to have thrived and reproduced without plants and the carbohydrates they provide. Today, nutritional guidelines recommend that around half the diet should be carbohydrate, while low intake is considered to compromise physical performance and successful reproduction. This is likely to have been the same for Paleolithic populations, highlighting an anomaly in that the basic physiological recommendations do not match the extensive archaeological evidence. Neanderthals had large, energy-expensive brains and led physically active lifestyles, suggesting that for optimal health they would have required high amounts of carbohydrates. To address this anomaly, we begin by outlining the essential role of carbohydrates in the human reproduction cycle and the brain and the effects on physical performance. We then evaluate the evidence for resource availability and the archaeological evidence for Neanderthal diet and investigate three ways that the anomaly between the archaeological evidence and the hypothetical dietary requirements might be explained. First, Neanderthals may have had an as yet unidentified genetic adaptation to an alternative physiological method to spare blood glucose and glycogen reserves for essential purposes. Second, they may have existed on a less-than-optimum diet and survived rather than thrived. Third, the methods used in dietary reconstruction could mask a complex combination of dietary plant and animal proportions. We end by proposing that analyses of Paleolithic diet and subsistence strategies need to be grounded in the minimum recommendations throughout the life course and that this provides a context for interpretation of the archaeological evidence from the behavioral and environmental perspectives.
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Xi Y, Lin Q, Yang Q, Li F, Liu H, Luo J, Ouyang Y, Sun M, Yong C, Xiang C, Zheng W. Association between Free Sugars Intake and Excessive Daytime Sleepiness among Chinese Adolescents. Nutrients 2021; 13:nu13113959. [PMID: 34836214 PMCID: PMC8618473 DOI: 10.3390/nu13113959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/03/2021] [Accepted: 11/03/2021] [Indexed: 12/20/2022] Open
Abstract
This study aimed to investigate the prevalence of excessive daytime sleepiness (EDS) and explore the association between free sugars intake and EDS. In this cross-sectional study, a total of 1517 middle school students (808 boys and 707 girls) aged 12~14 years were recruited. The study was conducted in Changsha city, China. Adolescents completed an online questionnaire, including the Epworth Sleepiness Scale (ESS), sleep characteristics, a 12-item Food Frequency Questionnaire (FFQ), and other self-reported information. The ESS score ≥ ten was defined as EDS. The anthropometric indices, including height, weight, and waist circumference, were measured and recorded by uniformly trained assistants. Statistical analyses included the Chi-square test and binary logistic regression model. The mean ESS score and free sugars consumption were 6.8 ± 3.9 points and 53.1 ± 44.7 g/d, respectively. The prevalence of EDS among adolescents was 22.5%, and more girls than boys had EDS (26.1% vs. 19.4%, p < 0.05). An exceeded free sugars intake was positively associated with EDS, with the adjusted Odds Ratio (OR) with its 95% Confident Interval (95% CI) of 1.366 (1.060~1.761, p < 0.05). EDS and excessive consumption of free sugars are commonly found among Chinese adolescents. Further studies are needed to confirm whether free sugars restriction can be meaningful to improve daytime drowsiness in those with EDS.
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Affiliation(s)
- Yue Xi
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (Y.X.); (Q.L.); (Q.Y.); (H.L.); (J.L.); (Y.O.); (M.S.); (C.Y.); (C.X.)
| | - Qian Lin
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (Y.X.); (Q.L.); (Q.Y.); (H.L.); (J.L.); (Y.O.); (M.S.); (C.Y.); (C.X.)
| | - Qiping Yang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (Y.X.); (Q.L.); (Q.Y.); (H.L.); (J.L.); (Y.O.); (M.S.); (C.Y.); (C.X.)
| | - Fang Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China;
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha 410078, China
| | - Hanmei Liu
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (Y.X.); (Q.L.); (Q.Y.); (H.L.); (J.L.); (Y.O.); (M.S.); (C.Y.); (C.X.)
| | - Jing Luo
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (Y.X.); (Q.L.); (Q.Y.); (H.L.); (J.L.); (Y.O.); (M.S.); (C.Y.); (C.X.)
| | - Yufeng Ouyang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (Y.X.); (Q.L.); (Q.Y.); (H.L.); (J.L.); (Y.O.); (M.S.); (C.Y.); (C.X.)
| | - Minghui Sun
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (Y.X.); (Q.L.); (Q.Y.); (H.L.); (J.L.); (Y.O.); (M.S.); (C.Y.); (C.X.)
| | - Cuiting Yong
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (Y.X.); (Q.L.); (Q.Y.); (H.L.); (J.L.); (Y.O.); (M.S.); (C.Y.); (C.X.)
| | - Caihong Xiang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (Y.X.); (Q.L.); (Q.Y.); (H.L.); (J.L.); (Y.O.); (M.S.); (C.Y.); (C.X.)
| | - Wenya Zheng
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (Y.X.); (Q.L.); (Q.Y.); (H.L.); (J.L.); (Y.O.); (M.S.); (C.Y.); (C.X.)
- Correspondence: ; Tel.: +86-199-7985-1193
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Perrar I, Buyken AE, Penczynski KJ, Remer T, Kuhnle GG, Herder C, Roden M, Della Corte K, Nöthlings U, Alexy U. Relevance of fructose intake in adolescence for fatty liver indices in young adulthood. Eur J Nutr 2021; 60:3029-3041. [PMID: 33464363 PMCID: PMC8354997 DOI: 10.1007/s00394-020-02463-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 12/11/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To examine the association between fructose intake in adolescence and fatty liver indices (hepatic steatosis index (HSI), fatty liver index (FLI)) in young adulthood. METHODS Overall, 246 participants of the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study who had a fasting blood sample in adulthood (18-36 years), at least two 3-day weighed dietary records for calculating fructose intakes and other fructose-containing sugars (total (TS), free (FS), added sugar (AS)) as well as two complete 24-h urine samples for calculating sugar excretion (fructose excretion (FE), fructose + sucrose excretion (FE + SE)) in adolescence (males: 9.5-16.5 years; females: 8.5-15.5 years) were analysed using multivariable linear regression analyses. RESULTS On the level of dietary intake, no prospective associations were observed between adolescent fructose intake and both adult fatty liver indices, whereas higher FS intakes were associated with lower levels of HSI (Ptrend = 0.02) and FLI (Ptrend = 0.03). On the urinary excretion level, however, a higher FE (Ptrend = 0.03) and FE + SE (Ptrend = 0.01) in adolescence were prospectively related to higher adult FLI values. No associations were observed between adolescent sugar excretion and adult HSI. CONCLUSION The present study does not provide unambiguous support for a detrimental impact of adolescent fructose intake on adult liver health. Nonetheless, further examinations estimating exposure by means of urinary excretion as well as dietary intake levels appear warranted.
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Affiliation(s)
- Ines Perrar
- Institute of Nutritional and Food Sciences , Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany
| | - Anette E. Buyken
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, University Paderborn, Warburger Straße 100, 33098 Paderborn, Germany
| | - Katharina J. Penczynski
- Institute of Nutritional and Food Sciences , Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, University Paderborn, Warburger Straße 100, 33098 Paderborn, Germany
- Department Food Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Straße 8-10, 10589 Berlin, Germany
| | - Thomas Remer
- Institute of Nutritional and Food Sciences , Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany
| | - Gunter G. Kuhnle
- Department of Food and Nutritional Sciences, University of Reading, Whiteknights, RG6 6UR UK
| | - Christian Herder
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764 München-Neuherberg, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764 München-Neuherberg, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Karen Della Corte
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, University Paderborn, Warburger Straße 100, 33098 Paderborn, Germany
| | - Ute Nöthlings
- Institute of Nutritional and Food Sciences , Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany
- Institute of Nutritional and Food Sciences, Nutritional Epidemiology, University of Bonn, Endenicher Allee 19 B, 53115 Bonn, Germany
| | - Ute Alexy
- Institute of Nutritional and Food Sciences , Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany
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10
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Zhang X, Gong Y, Della Corte K, Yu D, Xue H, Shan S, Tian G, Liang Y, Zhang J, He F, Yang D, Zhou R, Bao W, Buyken AE, Cheng G. Relevance of dietary glycemic index, glycemic load and fiber intake before and during pregnancy for the risk of gestational diabetes mellitus and maternal glucose homeostasis. Clin Nutr 2021; 40:2791-2799. [PMID: 33933745 DOI: 10.1016/j.clnu.2021.03.041] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 03/16/2021] [Accepted: 03/29/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND & AIMS To date, the prevalence of Gestational diabetes mellitus (GDM) in China was 17.5%. Given the substantial relevance of GDM for medium- and long-term health of both mother and offspring and the paucity of existing data on the link between maternal diet and glucose homeostasis during pregnancy in Asian population, additional studies are needed. To examine the relevance of dietary glycemic index (GI), glycemic load (GL) and fiber intake before and during pregnancy for the development of GDM and glucose homeostasis over the course of pregnancy. METHODS Cox proportional hazards analysis and linear mixed effects regressions were performed on data from 9317 women for whom three food frequency questionnaires (pre-pregnancy, 1st and 2nd trimesters) and biochemical measures during pregnancy were available. Investigated outcome variables included GDM risk, fasting plasma glucose (FPG), glycated hemoglobin (HbA1C), and homeostasis model assessment insulin resistance (HOMA-IR) in the 1st, 2nd and 3rd trimesters. RESULTS Women in the highest tertile of dietary GI (or GL) before pregnancy, in the 1st, or the 2nd trimester respectively had a 12% (15%), 25% (23%) or 29% (25%) higher risk of developing GDM than those in the lowest tertile (all p for trend ≤ 0.02). Women with the highest dietary fiber intake before pregnancy, in the 1st or 2nd trimester had a 11%, 17% or 18% lower GDM risk (all p for trend ≤ 0.03). Moreover, increases in GI or GL and decreases in fiber intake over the course of pregnancy (1st to 3rd trimesters) were independently associated with adverse concurrent developments in FPG, HbA1C and HOMA-IR (p ≤ 0.03). CONCLUSIONS Our study indicates that dietary GI, GL and fiber intake before and during pregnancy affects glucose homeostasis of pregnant Chinese women.
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Affiliation(s)
- Xiao Zhang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Yunhui Gong
- West China Second University Hospital and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, Sichuan University, Chengdu, PR China
| | - Karen Della Corte
- Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, Germany
| | - Dianke Yu
- School of Public Health, Qingdao University, Qingdao, PR China
| | - Hongmei Xue
- College of Public Health, Hebei University, Key Laboratory of Public Health Safety of HeBei University, Baoding, Hebei, China
| | - Shufang Shan
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Guo Tian
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Yi Liang
- Department of Clinical Nutrition, Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, PR China
| | - Jieyi Zhang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Fang He
- West China School of Public Health and Healthy Food Evaluation Research Center, Sichuan University, Chengdu, PR China
| | - Dagang Yang
- Department of Clinical Nutrition, Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, PR China
| | - Rong Zhou
- West China Second University Hospital and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, Sichuan University, Chengdu, PR China
| | - Wei Bao
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52246, USA
| | - Anette E Buyken
- Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, Germany
| | - Guo Cheng
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, PR China.
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11
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Free Sugars Intake among Chinese Adolescents and Its Association with Dental Caries: A Cross-Sectional Study. Nutrients 2021; 13:nu13030765. [PMID: 33652968 PMCID: PMC7996778 DOI: 10.3390/nu13030765] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 02/07/2023] Open
Abstract
This study aims to estimate the free sugars intake, identify the primary food sources of free sugars, and explore the relationship between free sugars intake and dental caries among Chinese adolescents. This cross-sectional study included 1517 middle-school students aged 12–14 years in Changsha city, China. Adolescents completed a 12-item Food Frequency Questionnaire (FFQ) and oral health assessment. The students’ dental caries experience was available as DMFT score (number of decayed, missing, and filled permanent teeth). Statistical analyses included the Mann–Whitney test, Kruskal–Wallis test, Chi-square test, and binary logistic regression model. The average intake of free sugars was 53.1 g/d in adolescents, and 43.2% of the students consumed more than 50 g of free sugars daily. The primary contributor to free sugars was sugar-sweetened beverages (SSBs). Age, boarders, and high family income were risk factors for excessive free sugars intake (p < 0.05), and increased free sugars intake was a risk factor for dental caries (odds ratio, OR = 1.446, 95% confidence interval: 1.138–1.839). Both the free sugars intake and dental caries prevalence in Chinese adolescents were high. Targeted interventions are urgently needed to address the excessive consumption of free sugars and improve Chinese adolescents’ oral health.
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12
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Li M, Cui Z, Meng S, Li T, Kang T, Ye Q, Cao M, Bi Y, Meng H. Associations between Dietary Glycemic Index and Glycemic Load Values and Cardiometabolic Risk Factors in Adults: Findings from the China Health and Nutrition Survey. Nutrients 2020; 13:nu13010116. [PMID: 33396964 PMCID: PMC7823666 DOI: 10.3390/nu13010116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/28/2020] [Accepted: 12/29/2020] [Indexed: 12/14/2022] Open
Abstract
Studies investigating the associations between dietary glycemic index (GI) and glycemic load (GL) values and cardiometabolic risk factors (CMRF) among Chinese populations are strikingly limited. To assess the associations between dietary GI and GL values and CMRF, including dyslipidemia, hyperglycemia, and hyperuricemia in Chinese adults, we extracted data of 7886 apparently healthy adults from the 2009 wave of the China Health and Nutrition Survey. Dietary GI and GL values were calculated using data collected from three consecutive 24 h dietary recalls. Fasting lipid, glucose, and uric acid concentrations were measured and CMRF were defined on the basis of established criteria. There were no significant associations between dietary GI values and CMRF, and analyzing the data by age, sex, body mass index (BMI), and region did not alter these results. Dietary GL values were positively associated with prevalence of hyperuricemia in all participants (Q4 compared with Q1: odds ratio (OR) = 1.46; 95% CI: 1.14, 1.87; p-trend = 0.0030) and prevalence of hypercholesterolemia in participants ≥ 60 years old (Q5 compared with Q1: OR = 1.72; 95% CI: 1.11, 2.68; p-trend < 0.0010). Higher dietary GL but not GI values were associated with increased prevalence of hyperuricemia in apparently healthy Chinese adults and hypercholesterolemia in older Chinese adults. Further studies are required to confirm the public health implication of these findings.
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Affiliation(s)
- Minjuan Li
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518106, China; (M.L.); (Z.C.); (S.M.); (T.L.); (T.K.); (Q.Y.); (M.C.); (Y.B.)
| | - Zhixin Cui
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518106, China; (M.L.); (Z.C.); (S.M.); (T.L.); (T.K.); (Q.Y.); (M.C.); (Y.B.)
| | - Shuangli Meng
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518106, China; (M.L.); (Z.C.); (S.M.); (T.L.); (T.K.); (Q.Y.); (M.C.); (Y.B.)
| | - Ting Li
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518106, China; (M.L.); (Z.C.); (S.M.); (T.L.); (T.K.); (Q.Y.); (M.C.); (Y.B.)
| | - Tong Kang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518106, China; (M.L.); (Z.C.); (S.M.); (T.L.); (T.K.); (Q.Y.); (M.C.); (Y.B.)
| | - Qi Ye
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518106, China; (M.L.); (Z.C.); (S.M.); (T.L.); (T.K.); (Q.Y.); (M.C.); (Y.B.)
| | - Mengting Cao
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518106, China; (M.L.); (Z.C.); (S.M.); (T.L.); (T.K.); (Q.Y.); (M.C.); (Y.B.)
| | - Yuxin Bi
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518106, China; (M.L.); (Z.C.); (S.M.); (T.L.); (T.K.); (Q.Y.); (M.C.); (Y.B.)
| | - Huicui Meng
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518106, China; (M.L.); (Z.C.); (S.M.); (T.L.); (T.K.); (Q.Y.); (M.C.); (Y.B.)
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou 510080, China
- Guangdong Engineering Technology Center of Nutrition Transformation, Guangzhou 510080, China
- Correspondence: ; Tel.: +86-(0)20-8322-6383
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13
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Lang A, Kuss O, Filla T, Schlesinger S. Association between per capita sugar consumption and diabetes prevalence mediated by the body mass index: results of a global mediation analysis. Eur J Nutr 2020; 60:2121-2129. [PMID: 33037438 PMCID: PMC8137616 DOI: 10.1007/s00394-020-02401-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 09/25/2020] [Indexed: 12/13/2022]
Abstract
Purpose The aim of this study was to examine the mediation of body mass index (BMI) on the association between per capita sugar consumption and diabetes prevalence using country-related data. Research design and methods In this ecological study, based on 192 countries, data on per capita sugar consumption were obtained from the Food and Agriculture Organization of the United Nations (FAO), on BMI from the World Health Organization and on diabetes prevalence from the International Diabetes Federation. Data on demography and economic factors were obtained from the Central Intelligence Agency, the United Nations and the FAO. Multiple linear regression analysis was performed to investigate the association between per capita sugar consumption and diabetes prevalence, and mediation analysis to detect the mediated percentage of BMI on this association. Results Each increase of 100 kcal/day per capita sugar consumption was associated with a 1.62% higher diabetes prevalence [adjusted β-estimator (95% CI): 1.62 (0.71, 2.53)]. Mediation analysis using BMI as the mediator demonstrated an adjusted direct association of 0.55 (95% CI: − 0.22, 1.32) and an adjusted indirect association of 1.07 (95% CI: 0.54, 1.68). Accordingly, the BMI explained 66% (95% CI: 34%, 100%) of the association between per capita sugar consumption on diabetes prevalence. Conclusions These findings indicate that the association between dietary sugar intake and the occurrence of diabetes is mediated by BMI to a large proportion. However, it seems that other mechanisms may explain the association between sugar consumption and development of type 2 diabetes. Electronic supplementary material The online version of this article (10.1007/s00394-020-02401-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alexander Lang
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | - Oliver Kuss
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany.,German Center for Diabetes Research (DZD e.V.), München-Neuherberg, Germany
| | - Tim Filla
- Institute for Biometrics and Bioinformatics, University Hospital Düsseldorf, Research at Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Sabrina Schlesinger
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany. .,German Center for Diabetes Research (DZD e.V.), München-Neuherberg, Germany.
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14
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Bergia RE, Biskup I, Giacco R, Costabile G, Gray S, Wright A, Vitale M, Campbell WW, Landberg R, Riccardi G. The MEDGICarb-Study: Design of a multi-center randomized controlled trial to determine the differential health-promoting effects of low- and high-glycemic index Mediterranean-style eating patterns. Contemp Clin Trials Commun 2020; 19:100640. [PMID: 32885091 PMCID: PMC7451809 DOI: 10.1016/j.conctc.2020.100640] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/14/2020] [Accepted: 08/09/2020] [Indexed: 01/08/2023] Open
Abstract
Adults with central adiposity and other features of the metabolic syndrome have a markedly elevated risk of developing type 2 diabetes (T2D) and cardiovascular disease (CVD). A Mediterranean-style healthy eating pattern (MED-HEP) and consumption of foods with a lower glycemic index (GI) are potential dietary approaches to curb the T2D and CVD epidemic. However, experimental evidence of the effectiveness of MED-HEP and of the contribution of GI towards improving indices of glucose homeostasis, especially among non-diabetic people, are lacking. Therefore, we developed the MedGI-Carb trial, a multi-center (Italy, Sweden, and United States) intervention in adults with at least two components of the metabolic syndrome (elevated waist circumference + one other component) that aims to improve markers of glucose homeostasis through dietary modification. All participants were randomized to consume an isocaloric high- or low-GI MED-HEP for 12 weeks. We hypothesized that indexes of insulinemia (primary outcome: postprandial insulin and glucose after standardized breakfast and lunch; secondary outcomes: fasting plasma glucose and insulin, HbA1c, 24-h continuous glucose monitoring) would be improved more with the low-GI versus the high-GI MED-HEP. Additionally, we hypothesized that consumption of a MED-HEP would improve other markers of cardiometabolic health and well-being (fasting blood pressure, fasting lipid profile, sleep quality, satiety, global metabolic alterations in the plasma metabolome, changes in the gut microbiota, subjective health and well-being), with no difference between groups. Collectively, the design of MEDGI-Carb allows several different research questions to be explored. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03410719.
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Affiliation(s)
- Robert E Bergia
- Department of Nutrition Science, Purdue University, 700 West State St, West Lafayette, IN, 47907, USA
| | - Izabela Biskup
- Department of Biology and Biological Engineering, Food Science and Nutrition, Chalmers University of Technology, Gothenburg, Sweden
| | - Rosalba Giacco
- Diabetes, Nutrition and Metabolism Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.,Institute of Food Science, National Research Council, Avellino, Italy
| | - Giuseppina Costabile
- Diabetes, Nutrition and Metabolism Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Savanna Gray
- Department of Nutrition Science, Purdue University, 700 West State St, West Lafayette, IN, 47907, USA
| | - Amy Wright
- Department of Nutrition Science, Purdue University, 700 West State St, West Lafayette, IN, 47907, USA
| | - Marilena Vitale
- Diabetes, Nutrition and Metabolism Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Wayne W Campbell
- Department of Nutrition Science, Purdue University, 700 West State St, West Lafayette, IN, 47907, USA
| | - Rikard Landberg
- Department of Biology and Biological Engineering, Food Science and Nutrition, Chalmers University of Technology, Gothenburg, Sweden
| | - Gabriele Riccardi
- Institute of Food Science, National Research Council, Avellino, Italy
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Pan Y, Liu M, Lian C, Xia Y, Shen D. Spatially-Constrained Fisher Representation for Brain Disease Identification With Incomplete Multi-Modal Neuroimages. IEEE TRANSACTIONS ON MEDICAL IMAGING 2020; 39:2965-2975. [PMID: 32217472 PMCID: PMC7485604 DOI: 10.1109/tmi.2020.2983085] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Multi-modal neuroimages, such as magnetic resonance imaging (MRI) and positron emission tomography (PET), can provide complementary structural and functional information of the brain, thus facilitating automated brain disease identification. Incomplete data problem is unavoidable in multi-modal neuroimage studies due to patient dropouts and/or poor data quality. Conventional methods usually discard data-missing subjects, thus significantly reducing the number of training samples. Even though several deep learning methods have been proposed, they usually rely on pre-defined regions-of-interest in neuroimages, requiring disease-specific expert knowledge. To this end, we propose a spatially-constrained Fisher representation framework for brain disease diagnosis with incomplete multi-modal neuroimages. We first impute missing PET images based on their corresponding MRI scans using a hybrid generative adversarial network. With the complete (after imputation) MRI and PET data, we then develop a spatially-constrained Fisher representation network to extract statistical descriptors of neuroimages for disease diagnosis, assuming that these descriptors follow a Gaussian mixture model with a strong spatial constraint (i.e., images from different subjects have similar anatomical structures). Experimental results on three databases suggest that our method can synthesize reasonable neuroimages and achieve promising results in brain disease identification, compared with several state-of-the-art methods.
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Affiliation(s)
- Yongsheng Pan
- Y. Pan and Y. Xia are with the National Engineering Laboratory for Integrated Aero-Space-Ground-Ocean Big Data Application Technology, School of Computer Science and Engineering, Northwestern Polytechnical University, Xi’an 710072, China. M. Liu, C. Lian, and D. Shen are with the Department of Radiology and BRIC, University of North Carolina, Chapel Hill, NC 27599, USA. D. Shen is also with the Department of Brain and Cognitive Engineering, Korea University, Seoul 02841, South Korea
| | - Mingxia Liu
- Y. Pan and Y. Xia are with the National Engineering Laboratory for Integrated Aero-Space-Ground-Ocean Big Data Application Technology, School of Computer Science and Engineering, Northwestern Polytechnical University, Xi’an 710072, China. M. Liu, C. Lian, and D. Shen are with the Department of Radiology and BRIC, University of North Carolina, Chapel Hill, NC 27599, USA. D. Shen is also with the Department of Brain and Cognitive Engineering, Korea University, Seoul 02841, South Korea
| | - Chunfeng Lian
- Y. Pan and Y. Xia are with the National Engineering Laboratory for Integrated Aero-Space-Ground-Ocean Big Data Application Technology, School of Computer Science and Engineering, Northwestern Polytechnical University, Xi’an 710072, China. M. Liu, C. Lian, and D. Shen are with the Department of Radiology and BRIC, University of North Carolina, Chapel Hill, NC 27599, USA. D. Shen is also with the Department of Brain and Cognitive Engineering, Korea University, Seoul 02841, South Korea
| | - Yong Xia
- Y. Pan and Y. Xia are with the National Engineering Laboratory for Integrated Aero-Space-Ground-Ocean Big Data Application Technology, School of Computer Science and Engineering, Northwestern Polytechnical University, Xi’an 710072, China. M. Liu, C. Lian, and D. Shen are with the Department of Radiology and BRIC, University of North Carolina, Chapel Hill, NC 27599, USA. D. Shen is also with the Department of Brain and Cognitive Engineering, Korea University, Seoul 02841, South Korea
| | - Dinggang Shen
- Y. Pan and Y. Xia are with the National Engineering Laboratory for Integrated Aero-Space-Ground-Ocean Big Data Application Technology, School of Computer Science and Engineering, Northwestern Polytechnical University, Xi’an 710072, China. M. Liu, C. Lian, and D. Shen are with the Department of Radiology and BRIC, University of North Carolina, Chapel Hill, NC 27599, USA. D. Shen is also with the Department of Brain and Cognitive Engineering, Korea University, Seoul 02841, South Korea
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Yu Z, Fan Y, Wang X, Xia M, Cai Y. In vitro and in vivo digestibility of pea and chickpea powder prepared by cooking and drying treatment. INTERNATIONAL JOURNAL OF FOOD PROPERTIES 2020. [DOI: 10.1080/10942912.2020.1792925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Zhou Yu
- School of Biology, Food and Environment, Hefei University, Hefei, Anhui, China
| | - Yunshan Fan
- Clinical Nutrition Department, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xingwen Wang
- School of Biology, Food and Environment, Hefei University, Hefei, Anhui, China
| | - Ming Xia
- School of Biology, Food and Environment, Hefei University, Hefei, Anhui, China
| | - Yue Cai
- School of Biology, Food and Environment, Hefei University, Hefei, Anhui, China
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18
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Sugar intake among German adolescents: trends from 1990 to 2016 based on biomarker excretion in 24-h urine samples. Br J Nutr 2020; 124:164-172. [PMID: 32102699 DOI: 10.1017/s0007114520000665] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Trend analyses based on dietary records suggest decreases in the intakes of total sugar (TS), added and free sugar since 2005 among children and adolescents in Germany. In terms of age trends, TS intake decreased with increasing age. However, self-reported sugar intake in epidemiological studies is criticised, as it may be prone to bias due to selective underreporting. Furthermore, adolescents are more susceptible to underreporting than children. We thus analysed time and age trends in urinary fructose excretion (FE), sucrose excretion (SE) and the sum of both (FE + SE) as biomarkers for sugar intake among 8·5-16·5-year-old adolescents. Urinary sugar excretion was measured by UPLC-MS/MS in 997 24-h urine samples collected from 239 boys and 253 girls participating in the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study cohort between 1990 and 2016. Time and age trends of log-transformed FE, SE and FE + SE were analysed using polynomial mixed-effects regression models. Between 1990 and 2016, FE as well as FE + SE decreased (linear time trend: P = 0·0272 and P < 0·0001, respectively). A minor increase in excretion during adolescence was confined to FE (linear age trend: P = 0·0017). The present 24-h excretion measurements support a previously reported dietary record-based decline in sugar intake since 2005. However, the previously seen dietary record-based decrease in TS from childhood to late adolescence was not confirmed by our biomarker analysis, suggesting a constant sugar intake for the period of adolescence.
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Perrar I, Schadow AM, Schmitting S, Buyken AE, Alexy U. Time and Age Trends in Free Sugar Intake from Food Groups among Children and Adolescents between 1985 and 2016. Nutrients 2019; 12:nu12010020. [PMID: 31861789 PMCID: PMC7019792 DOI: 10.3390/nu12010020] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 12/30/2022] Open
Abstract
Trend analyses suggest that free sugar (FS) intake—while still exceeding 10%E—has decreased among German children and adolescents since 2005, yet that intakes may shift from sugars naturally occurring in foods to added sugars as children age. Thus, we analysed time and age trends in FS intake (%E) from food groups among 3–18 year-olds (1985–2016) using 10,761 3-day dietary records from 1312 DONALD participants (660 boys, 652 girls) by use of polynomial mixed-effects regression models. Among girls, FS from sugar & sweets decreased from 1985 to 2016 (linear trend p < 0.0001), but not among boys (p > 0.05). In the total sample, FS intake from juices increased until 2000 and decreased since 2005 (linear, quadratic trend p < 0.0001). FS from sugar sweetened beverages (SSB) decreased non-linearly from 1985 to 2016 (girls: linear, quadratic, cubic trend p < 0.0001; boys: linear, quadratic, cubic trend p < 0.02). Younger children consumed more FS from juices than older ones, who had a higher FS intake from SSB. FS intake from sugar & sweets increased until early adolescence and decreased afterwards. Since sugar & sweets represent the main source of FS intake and the source with the least pronounced decline in intake, public health measures should focus on these products.
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Affiliation(s)
- Ines Perrar
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Donald Study Dortmund, Heinstück 11, 44225 Dortmund, Germany; (I.P.); (A.M.S.); (S.S.)
| | - Alena M. Schadow
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Donald Study Dortmund, Heinstück 11, 44225 Dortmund, Germany; (I.P.); (A.M.S.); (S.S.)
| | - Sarah Schmitting
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Donald Study Dortmund, Heinstück 11, 44225 Dortmund, Germany; (I.P.); (A.M.S.); (S.S.)
- Institute of General Practice and Family Medicine, Faculty of Medicine, Ruhr-University Bochum, Universitätsstraße 150, 44801 Bochum, Germany
| | - Anette E. Buyken
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, Warburger Straße 100, 33098 Paderborn, Germany;
| | - Ute Alexy
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Donald Study Dortmund, Heinstück 11, 44225 Dortmund, Germany; (I.P.); (A.M.S.); (S.S.)
- Correspondence: ; Tel.: +49-231-7922-1016
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Alfawaz H, Naeef AF, Wani K, Khattak MNK, Sabico S, Alnaami AM, Al-Daghri NM. Improvements in Glycemic, Micronutrient, and Mineral Indices in Arab Adults with Pre-Diabetes Post-Lifestyle Modification Program. Nutrients 2019; 11:nu11112775. [PMID: 31731609 PMCID: PMC6893589 DOI: 10.3390/nu11112775] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/31/2019] [Accepted: 11/05/2019] [Indexed: 12/28/2022] Open
Abstract
The present study aimed to investigate the changes in dietary patterns of adult Saudis with prediabetes who underwent a six-month lifestyle modification program. A total of 160 Saudis with prediabetes (baseline fasting glucose 5.6–6.9 mmol/L), aged 20–60 years, were enrolled in one of the two arms: A one-time general advice about lifestyle modification (GA group) at orientation or a well-structured and monitored nutrition and lifestyle counseling for six months (guidance group). Fasting blood samples and a dietary recall for daily intakes of macro/micronutrients using a validated computerized food database “ESHA—the Food Processor Nutrition Analysis program” were collected pre- and post-intervention. Compliance to reference daily intake (RDI) was also calculated at both time points. At baseline, overall, severe deficiencies in the majority of micronutrient intakes were observed. Post intervention, clinically significant improvements in the glycemic indices (fasting glucose and insulin resistance) were seen over time in the guidance group. Also, significant improvements in dietary habits and physical activity levels were more apparent in the guidance group than the GA group, particularly in the daily intakes of total carbohydrate (46.9% compliance post vs. 20.3% at baseline); dietary fiber (21.9% vs. 3.1%); and some micronutrients like vitamin B6 (21.3% vs. 6.7%), vitamin B12 (45.3% vs. 28%), vitamin C (21.9% vs. 7.8%), riboflavin (40% vs. 10.7%), niacin (41.3% vs. 14.7%), magnesium (18.8% vs. 4.7%), iron (54.7% vs. 34.4%), and copper (37.3% vs. 13.3%). The study highlights the effects of a six-month lifestyle modification program in improving dietary micronutrient intakes of Saudis with prediabetes. Since micronutrient intake was observed to be low, fortification of these micronutrients in the Saudi diet is recommended.
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Affiliation(s)
- Hanan Alfawaz
- Department of Food Science and Nutrition, College of Food Science and Agriculture King Saud University, Riyadh 12372, Saudi Arabia; (H.A.); (A.F.N.)
- Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (M.N.K.K.); (S.S.); (A.M.A.)
| | - Alsoodeeri Fahadah Naeef
- Department of Food Science and Nutrition, College of Food Science and Agriculture King Saud University, Riyadh 12372, Saudi Arabia; (H.A.); (A.F.N.)
| | - Kaiser Wani
- Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (M.N.K.K.); (S.S.); (A.M.A.)
| | - Malak Nawaz Khan Khattak
- Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (M.N.K.K.); (S.S.); (A.M.A.)
| | - Shaun Sabico
- Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (M.N.K.K.); (S.S.); (A.M.A.)
| | - Abdullah M. Alnaami
- Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (M.N.K.K.); (S.S.); (A.M.A.)
| | - Nasser M. Al-Daghri
- Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (M.N.K.K.); (S.S.); (A.M.A.)
- Correspondence: ; Tel.: +966-14675939; Fax: +966-14675931
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Macit MS, Acar-Tek N. Current Perspectives for Diabetes and Allostatic Load: The Role of Nutrition. CURRENT NUTRITION & FOOD SCIENCE 2019. [DOI: 10.2174/1573401314666180620164859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Allostasis and allostatic load are new concepts explaining the changes in body stemming
from chronic stress. These concepts are explained with the assessment of metabolic, cardiovascular,
inflammatory, and neuroendocrine systems. Type 2 Diabetes Mellitus (DM) is a chronic disease with
the fluctuations in fasting plasma glucose, and also in other various biomarkers and poses a risk
forother chronic diseases. The course and duration of the disease, genetic factors, and environmental
factors, including nutrition, aggravate these complications. Allostatic load is a multi-system assessment.
Individuals’ compliance with the medical nutrition therapy in the short and long-term, changes
in anthropometric and biochemical biomarkers that are used to measure the nutritional status. In the
monitoring of patients with diabetes, it’s important to assess metabolic, cardiovascular, neuroendocrine,
and immune system biomarkers as well as fasting blood glucose. There exist studies in the literature,
investigating the relationship of the allostatic load with socio-economic status, chronic diseases
such as diabetes and cardiovascular diseases, gender, and ethnicity. In these studies, chronic stress, nutritional
status, stress, and allostasis are briefly described. In the present literature review, it was aimed
to evaluate different aspects of the relationships among diabetes, nutrition, allostatic load, and stress.
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Affiliation(s)
- Melahat S. Macit
- Nutrition and Dietetics Department, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey
| | - Nilüfer Acar-Tek
- Nutrition and Dietetics Department, Faculty of Health Sciences, Gazi University, Emniyet Mahallesi, Muammer Yaşar Bostancı Caddesi, No: 16, 06560 Beşevler/Ankara, Turkey
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Hasbullah FY, Mohd Yusof BN, Shariff ZM, Rejali Z, Yong HY, Mitri J. Factors associated with dietary glycemic index and glycemic load in pregnant women and risk for gestational diabetes mellitus. Int J Food Sci Nutr 2019; 71:516-524. [PMID: 31686557 DOI: 10.1080/09637486.2019.1686752] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The risk of gestational diabetes mellitus (GDM) increases during the second trimester of pregnancy. However, the role of dietary glycemic index (GI) and glycemic load (GL) on GDM risk is controversial. We aimed to determine the association of established risk factors of GDM with GI and GL among healthy pregnant women, and whether GI and GL were subsequently related to GDM risk. Dietary GI and GL were assessed in healthy pregnant women from the Seremban Cohort Study using a food frequency questionnaire. After adjusting for energy intake, high GI was significantly associated with lower household income, shorter stature, higher proportion of carbohydrate intake, lower sugar proportion and lower fibre intake. High GL was significantly associated with younger maternal age, higher carbohydrate proportion and lower fibre intake. GI and GL intakes were not significantly associated with GDM risk. However, they were associated with a few established risk factors of GDM.
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Affiliation(s)
- Farah Yasmin Hasbullah
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Barakatun Nisak Mohd Yusof
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.,Research Centre of Excellence, Nutrition and Non-Communicable Diseases (NNCD), Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Zalilah Mohd Shariff
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Zulida Rejali
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Heng Yaw Yong
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Joanna Mitri
- Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
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Neuenschwander M, Ballon A, Weber KS, Norat T, Aune D, Schwingshackl L, Schlesinger S. Role of diet in type 2 diabetes incidence: umbrella review of meta-analyses of prospective observational studies. BMJ 2019; 366:l2368. [PMID: 31270064 PMCID: PMC6607211 DOI: 10.1136/bmj.l2368] [Citation(s) in RCA: 262] [Impact Index Per Article: 52.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To summarise the evidence of associations between dietary factors and incidence of type 2 diabetes and to evaluate the strength and validity of these associations. DESIGN Umbrella review of systematic reviews with meta-analyses of prospective observational studies. DATA SOURCES PubMed, Web of Science, and Embase, searched up to August 2018. ELIGIBILITY CRITERIA Systematic reviews with meta-analyses reporting summary risk estimates for the associations between incidence of type 2 diabetes and dietary behaviours or diet quality indices, food groups, foods, beverages, alcoholic beverages, macronutrients, and micronutrients. RESULTS 53 publications were included, with 153 adjusted summary hazard ratios on dietary behaviours or diet quality indices (n=12), food groups and foods (n=56), beverages (n=10), alcoholic beverages (n=12), macronutrients (n=32), and micronutrients (n=31), regarding incidence of type 2 diabetes. Methodological quality was high for 75% (n=115) of meta-analyses, moderate for 23% (n=35), and low for 2% (n=3). Quality of evidence was rated high for an inverse association for type 2 diabetes incidence with increased intake of whole grains (for an increment of 30 g/day, adjusted summary hazard ratio 0.87 (95% confidence interval 0.82 to 0.93)) and cereal fibre (for an increment of 10 g/day, 0.75 (0.65 to 0.86)), as well as for moderate intake of total alcohol (for an intake of 12-24 g/day v no consumption, 0.75 (0.67 to 0.83)). Quality of evidence was also high for the association for increased incidence of type 2 diabetes with higher intake of red meat (for an increment of 100 g/day, 1.17 (1.08 to 1.26)), processed meat (for an increment of 50 g/day, 1.37 (1.22 to 1.54)), bacon (per two slices/day, 2.07 (1.40 to 3.05)), and sugar sweetened beverages (for an increase of one serving/day, 1.26 (1.11 to 1.43)). CONCLUSIONS Overall, the association between dietary factors and type 2 diabetes has been extensively studied, but few of the associations were graded as high quality of evidence. Further factors are likely to be important in type 2 diabetes prevention; thus, more well conducted research, with more detailed assessment of diet, is needed. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018088106.
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Affiliation(s)
- Manuela Neuenschwander
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, D-40225 Düsseldorf, Germany
| | - Aurélie Ballon
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, D-40225 Düsseldorf, Germany
| | - Katharina S Weber
- Institute for Clinical Diabetology, German Diabetes Centre, Leibniz Centre for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Centre for Diabetes Research, München-Neuherberg, Germany
| | - Teresa Norat
- Department of Nutrition, Bjørknes University College, Oslo, Norway
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Department of Nutrition, Bjørknes University College, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Faculty of Medicine and Medical Centre-University of Freiburg, Freiburg, Germany
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Sabrina Schlesinger
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, D-40225 Düsseldorf, Germany
- German Centre for Diabetes Research, München-Neuherberg, Germany
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Perrar I, Schmitting S, Della Corte KW, Buyken AE, Alexy U. Age and time trends in sugar intake among children and adolescents: results from the DONALD study. Eur J Nutr 2019; 59:1043-1054. [PMID: 30976903 DOI: 10.1007/s00394-019-01965-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/03/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe age and time trends in added sugar, free sugar and total sugar intake among German 3-18-year-olds. METHODS Overall, 10,761 3-day dietary records kept between 1985 and 2016 by 1312 DONALD participants (660 boys, 652 girls) were analysed (%E) using polynomial mixed-effects regression models. RESULTS TS intake decreased with age (♂: linear, quadratic and cubic trend all p < 0.0098; ♀: linear trend p < 0.0001). While the oldest children had the lowest FS intake (linear, quadratic trend: p < 0.0001), the youngest children had the lowest AS intake (linear, quadratic trend p < 0.0001, cubic trend p = 0.0004). In terms of time trends, TS (♂: cubic trend p = 0.0052; ♀: quadratic trend p = 0.0608, cubic trend p = 0.0014) and FS (quadratic trend p = 0.0163, cubic trend p < 0.0001) intake increased between 1985 and 2005 and decreased thereafter, most notably since 2010. AS intake decreased between 1985 and 1995, increased slightly until 2005 and decreased thereafter, most notably since 2010 (linear, quadratic, cubic trend p < 0.0001). FS intake exceeded 10%E/day throughout the 30-year study period. CONCLUSION Our results do not support the common assumptions that sugar intake is on the rise and generally higher among adolescents than among younger children. Of note, TS, AS and FS intakes have decreased in the last decade among all age groups. Nevertheless, FS intake still exceeds the intake level recommended by the WHO.
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Affiliation(s)
- Ines Perrar
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225, Dortmund, Germany
| | - Sarah Schmitting
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225, Dortmund, Germany
- Institute of General Practice and Family Medicine, Faculty of Medicine, Ruhr-University Bochum, Universitätsstraße 150, 44801, Bochum, Germany
| | - Karen W Della Corte
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, University Paderborn, Warburger Straße 100, 33098, Paderborn, Germany
| | - Anette E Buyken
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, University Paderborn, Warburger Straße 100, 33098, Paderborn, Germany
| | - Ute Alexy
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225, Dortmund, Germany.
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Coughlan MT. Nutritional supplements for diabetes. JOURNAL OF NUTRITION & INTERMEDIARY METABOLISM 2018. [DOI: 10.1016/j.jnim.2018.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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SARDÁ FAH, GIUNTINI EB, NAZARE JA, KÖNIG D, BAHIA LR, LAJOLO FM, MENEZES EWD. Effectiveness of carbohydrates as a functional ingredient in glycemic control. FOOD SCIENCE AND TECHNOLOGY 2018. [DOI: 10.1590/fst.42517] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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WITHDRAWN: Nutritional supplements for diabetes: Preface. JOURNAL OF NUTRITION & INTERMEDIARY METABOLISM 2018. [DOI: 10.1016/j.jnim.2018.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Koch SAJ, Alexy U, Diederichs T, Buyken AE, Roßbach S. The relevance of restrained eating behavior for circadian eating patterns in adolescents. PLoS One 2018; 13:e0197131. [PMID: 29791516 PMCID: PMC5965828 DOI: 10.1371/journal.pone.0197131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 04/26/2018] [Indexed: 01/10/2023] Open
Abstract
Background Restrained Eating, i.e. the tendency to restrict dietary intake to control body-weight, often emerges during adolescence and may result in changes in circadian eating patterns. Objective The objective of the present investigation was to determine the cross-sectional relevance of restrained eating for characteristics of circadian eating pattern in adolescents and whether changes in restrained eating are accompanied by concurrent changes in circadian eating pattern over the course of adolescence. Methods Two questionnaires assessing restrained eating (Score 0–30) with parallel 3-day weighed dietary records from two different time points were available from 209 (♂:101, ♀:108) 11–18 year old adolescents of the DONALD study. Mixed linear regression models were used to analyze whether restrained eating was associated with eating occasion frequency, snack frequency and morning and evening energy intake [in % of daily energy intake, %E]. Linear regression models were used to examine whether changes in restrained eating were associated with changes in the mentioned variables. Results Among girls, greater restrained eating was cross-sectionally associated with higher morning energy intake (p = 0.03). Further, there was a tendency towards lower evening energy intake with higher levels of restrained eating for the whole sample (p = 0.06). No cross-sectional associations were found with eating occasion or snack frequency. Each one-point increase in restrained eating during adolescence was related to a concurrent decrease in eating occasion frequency by 0.04 (95% CI -0.08; -0.01, p = 0.02) and in evening energy intake by 0.36%E (95% CI -0.70; -0.03, p = 0.04). A tendency towards decreasing snack frequency with increasing restrained eating was observed (β = -0.03, 95% CI -0.07; 0.00, p = 0.07). No association was found between changes in restrained eating and concurrent changes in morning energy intake. Conclusion We found indications for cross-sectional and prospective associations between restrained eating and chronobiological aspects of food intake in adolescents. Our results suggest that restrained eating should be considered a relevant determinant of circadian eating patterns.
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Affiliation(s)
- Stefanie A. J. Koch
- DONALD Study, Nutritional Epidemiology, Department of Nutrition and Food Sciences, Faculty of Agriculture, University of Bonn, Bonn, North Rhine-Westphalia, Germany
| | - Ute Alexy
- DONALD Study, Nutritional Epidemiology, Department of Nutrition and Food Sciences, Faculty of Agriculture, University of Bonn, Bonn, North Rhine-Westphalia, Germany
- * E-mail:
| | - Tanja Diederichs
- DONALD Study, Nutritional Epidemiology, Department of Nutrition and Food Sciences, Faculty of Agriculture, University of Bonn, Bonn, North Rhine-Westphalia, Germany
- Public Health Nutrition, Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, University Paderborn, Paderborn, North Rhine-Westphalia, Germany
| | - Anette E. Buyken
- DONALD Study, Nutritional Epidemiology, Department of Nutrition and Food Sciences, Faculty of Agriculture, University of Bonn, Bonn, North Rhine-Westphalia, Germany
- Public Health Nutrition, Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, University Paderborn, Paderborn, North Rhine-Westphalia, Germany
| | - Sarah Roßbach
- DONALD Study, Nutritional Epidemiology, Department of Nutrition and Food Sciences, Faculty of Agriculture, University of Bonn, Bonn, North Rhine-Westphalia, Germany
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Time and age trends in morning and evening protein intakes of German children and adolescents. J Nutr Sci 2018; 7:e9. [PMID: 29599971 PMCID: PMC5869278 DOI: 10.1017/jns.2018.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 12/20/2017] [Accepted: 01/23/2018] [Indexed: 11/16/2022] Open
Abstract
The present study describes time and age trends in morning and evening protein intakes and sources among German children and adolescents from 1985 to 2014. A total of 9757 three-day weighed dietary records of 1246 3- to 18-year-old participants of the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study were analysed using polynomial mixed-effects regression models. Morning protein intake increased over the study period by approximately 1 % of morning energy intake (linear trend P < 0·0001), with the youngest and the oldest children having the highest protein intake (linear, quadratic trend P < 0·0001). Evening protein intake increased over time by approximately 2 % of evening energy intake in girls (linear trend P < 0·0001) and 1 % of evening energy intake in boys (quadratic trend P = 0·0313), with decreasing intake with age (girls: linear trend P < 0·0001; boys: linear trend P = 0·0963). Time trends were largely due to increases in protein from ‘starchy foods’. In conclusion, morning and evening protein intakes increased modestly between 1985 and 2014; these increases were, however, not accompanied by increases in traditional protein sources (i.e. meat or dairy products).
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PREVIEW: Prevention of Diabetes through Lifestyle Intervention and Population Studies in Europe and around the World. Design, Methods, and Baseline Participant Description of an Adult Cohort Enrolled into a Three-Year Randomised Clinical Trial. Nutrients 2017. [PMID: 28632180 PMCID: PMC5490611 DOI: 10.3390/nu9060632] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Type-2 diabetes (T2D) is one of the fastest growing chronic diseases worldwide. The PREVIEW project has been initiated to find the most effective lifestyle (diet and physical activity) for the prevention of T2D, in overweight and obese participants with increased risk for T2D. The study is a three-year multi-centre, 2 × 2 factorial, randomised controlled trial. The impact of a high-protein, low-glycaemic index (GI) vs. moderate protein, moderate-GI diet in combination with moderate or high-intensity physical activity on the incidence of T2D and the related clinical end-points are investigated. The intervention started with a two-month weight reduction using a low-calorie diet, followed by a randomised 34-month weight maintenance phase comprising four treatment arms. Eight intervention centres are participating (Denmark, Finland, United Kingdom, The Netherlands, Spain, Bulgaria, Australia, and New Zealand). Data from blood specimens, urine, faeces, questionnaires, diaries, body composition assessments, and accelerometers are collected at months 0, 2, 6, 12, 18, 24, and 36. In total, 2326 adults were recruited. The mean age was 51.6 (SD 11.6) years, 67% were women. PREVIEW is, to date, the largest multinational trial to address the prevention of T2D in pre-diabetic adults through diet and exercise intervention. Participants will complete the final intervention in March, 2018.
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Diederichs T, Herder C, Roßbach S, Roden M, Wudy SA, Nöthlings U, Alexy U, Buyken AE. Carbohydrates from Sources with a Higher Glycemic Index during Adolescence: Is Evening Rather than Morning Intake Relevant for Risk Markers of Type 2 Diabetes in Young Adulthood? Nutrients 2017; 9:nu9060591. [PMID: 28604592 PMCID: PMC5490570 DOI: 10.3390/nu9060591] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 06/02/2017] [Accepted: 06/07/2017] [Indexed: 12/19/2022] Open
Abstract
Background: This study investigated whether glycemic index (GI) or glycemic load (GL) of morning or evening intake and morning or evening carbohydrate intake from low- or higher-GI food sources (low-GI-CHO, higher-GI-CHO) during adolescence are relevant for risk markers of type 2 diabetes in young adulthood. Methods: Analyses included DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study participants who had provided at least two 3-day weighed dietary records (median: 7 records) during adolescence and one blood sample in young adulthood. Using multivariable linear regression analyses, estimated morning and evening GI, GL, low-GI-CHO (GI < 55) and higher-GI-CHO (GI ≥ 55) were related to insulin sensitivity (N = 252), hepatic steatosis index (HSI), fatty liver index (FLI) (both N = 253), and a pro-inflammatory-score (N = 249). Results: Morning intakes during adolescence were not associated with any of the adult risk markers. A higher evening GI during adolescence was related to an increased HSI in young adulthood (p = 0.003). A higher consumption of higher-GI-CHO in the evening was associated with lower insulin sensitivity (p = 0.046) and an increased HSI (p = 0.006), while a higher evening intake of low-GI-CHO was related to a lower HSI (p = 0.009). Evening intakes were not related to FLI or the pro-inflammatory-score (all p > 0.1). Conclusion: Avoidance of large amounts of carbohydrates from higher-GI sources in the evening should be considered in preventive strategies to reduce the risk of type 2 diabetes in adulthood.
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Affiliation(s)
- Tanja Diederichs
- IEL-Nutritional Epidemiology, DONALD Study, Rheinische Friedrich-Wilhelms-University Bonn, Heinstueck 11, 44225 Dortmund, Germany.
| | - Christian Herder
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Auf'm Hennekamp 65, 40225 Düsseldorf, Germany.
- German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764 München-Neuherberg, Germany.
| | - Sarah Roßbach
- IEL-Nutritional Epidemiology, DONALD Study, Rheinische Friedrich-Wilhelms-University Bonn, Heinstueck 11, 44225 Dortmund, Germany.
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Auf'm Hennekamp 65, 40225 Düsseldorf, Germany.
- German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764 München-Neuherberg, Germany.
- Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany.
| | - Stefan A Wudy
- Pediatric Endocrinology and Diabetology, Laboratory for Translational Hormone Analytics, Peptide Hormone Research Unit, Center of Child and Adolescent Medicine, Justus Liebig University Giessen, Feulgenstraße 10-12, 35392 Gießen, Germany.
| | - Ute Nöthlings
- IEL-Nutritional Epidemiology, DONALD Study, Rheinische Friedrich-Wilhelms-University Bonn, Heinstueck 11, 44225 Dortmund, Germany.
| | - Ute Alexy
- IEL-Nutritional Epidemiology, DONALD Study, Rheinische Friedrich-Wilhelms-University Bonn, Heinstueck 11, 44225 Dortmund, Germany.
| | - Anette E Buyken
- IEL-Nutritional Epidemiology, DONALD Study, Rheinische Friedrich-Wilhelms-University Bonn, Heinstueck 11, 44225 Dortmund, Germany.
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, University Paderborn, Warburger Straße 100, 33098 Paderborn, Germany.
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Bailey DP, Maylor BD, Orton CJ, Zakrzewski-Fruer JK. Effects of breaking up prolonged sitting following low and high glycaemic index breakfast consumption on glucose and insulin concentrations. Eur J Appl Physiol 2017; 117:1299-1307. [PMID: 28500416 PMCID: PMC5486571 DOI: 10.1007/s00421-017-3610-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 04/08/2017] [Indexed: 11/25/2022]
Abstract
Purpose Breaking up prolonged sitting can attenuate the postprandial rise in glucose and insulin. Whether such effects are dependent of the glycaemic index (GI) of the consumed carbohydrate is unknown. This study examined the acute effects of breaking up prolonged sitting following a low GI and a high GI breakfast on postprandial glucose and insulin concentrations. Procedures Fourteen adult males aged 22.1 ± 1.2 years completed four, 4 h experimental conditions: high GI breakfast followed by uninterrupted sitting (HGI-SIT), low GI breakfast followed by uninterrupted sitting (LGI-SIT), high GI breakfast followed by 2 min activity breaks every 20 min (HGI-ACT), and low GI breakfast followed by 2 min activity breaks every 20 min (LGI-ACT). Positive incremental area under the curve (iAUC) for glucose and insulin (mean [95% CI]) for each 4 h experimental condition was calculated. Statistical analyses were completed using linear mixed models. Results The sitting × breakfast GI interaction was not significant for glucose positive iAUC (P = 0.119). Glucose positive iAUC (mmol/L 4 h−1) was significantly lower in the activity breaks conditions than the uninterrupted sitting conditions (2.07 [2.24, 2.89] vs. 2.56 [1.74, 2.40], respectively, P = 0.004) and significantly lower in the low GI conditions than the high GI conditions (2.13 [1.80, 2.45] vs. 2.51 [2.18, 2.84], respectively, P = 0.022). Insulin concentrations did not differ between conditions (P ≥ 0.203). Conclusions Breaking up prolonged sitting and lowering breakfast GI independently reduced postprandial glucose responses. This indicates that interrupting prolonged sitting and reducing dietary GI are beneficial approaches for reducing cardiometabolic disease risk.
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Affiliation(s)
- Daniel P Bailey
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, United Kingdom.
| | - Benjamin D Maylor
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, United Kingdom
| | - Charlie J Orton
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, United Kingdom
| | - Julia K Zakrzewski-Fruer
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, United Kingdom
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Cheng G, Xue H, Luo J, Jia H, Zhang L, Dai J, Buyken AE. Relevance of the dietary glycemic index, glycemic load and genetic predisposition for the glucose homeostasis of Chinese adults without diabetes. Sci Rep 2017; 7:400. [PMID: 28341844 PMCID: PMC5428428 DOI: 10.1038/s41598-017-00453-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 02/27/2017] [Indexed: 01/19/2023] Open
Abstract
Type 2 diabetes (T2DM) and pre-diabetes have become a major public health problem in China. We examined whether a higher dietary glycemic index (GI) or glycemic load (GL) was associated with a less favorable glucose homeostasis among Chinese adults and whether these associations were modified by their genetic predisposition or whether combined effects exist with their cereal fiber intake. Multivariable regression analyses were performed in 3918 adults aged 23-69 years for whom three 24-hour dietary recalls and information on glucose homeostasis, genetic background and potential confounders was available. Adults in the highest GI (GL) tertile had an approximately 9% (5%) higher fasting plasma glucose, 11% (3%) higher glycated haemoglobin, 12% (7%) higher insulin level, and 28% (22%) higher hepatic insulin resistance compared to those in the lowest tertile (adjusted pfor-trend ≤ 0.04). Moreover, a higher dietary GI or GL was associated with higher odds of pre-diabetes (pfor-trend = 0.03). These associations were more pronounced among persons with a high T2DM genetic risk score (pfor-interaction ≤ 0.06) or a low cereal fiber intake (pfor-interaction ≤ 0.05). In conclusion, our study indicates that the dietary GI or GL is of relevance for glucose homeostasis among Chinese adults, particularly among individuals genetically predisposed to T2DM.
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Affiliation(s)
- Guo Cheng
- West China School of Public Health and State Key Laboratory of Biotherapy and Cancer Center, Sichuan University, Chengdu, P.R. China.
| | - Hongmei Xue
- West China School of Public Health, Sichuan University, Chengdu, P.R. China
| | - Jiao Luo
- West China School of Public Health, Sichuan University, Chengdu, P.R. China
| | - Hong Jia
- Department of Epidemiology and Biostatistics, School of Public Health, Southwest Medical University, Luzhou, China
| | - Lishi Zhang
- West China School of Public Health, Sichuan University, Chengdu, P.R. China
| | - Junbiao Dai
- MOE Key Laboratory of Bioinformatics and Center for Synthetic and Systems Biology, School of Life Sciences, Tsinghua University, Beijing, China
| | - Anette E Buyken
- IEL-Nutritional Epidemiology, University of Bonn, DONALD Study, Dortmund, Germany
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Kessler K, Hornemann S, Petzke KJ, Kemper M, Kramer A, Pfeiffer AFH, Pivovarova O, Rudovich N. The effect of diurnal distribution of carbohydrates and fat on glycaemic control in humans: a randomized controlled trial. Sci Rep 2017; 7:44170. [PMID: 28272464 PMCID: PMC5341154 DOI: 10.1038/srep44170] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 02/02/2017] [Indexed: 12/17/2022] Open
Abstract
Diurnal carbohydrate and fat distribution modulates glycaemic control in rodents. In humans, the optimal timing of both macronutrients and its effects on glycaemic control after prolonged consumption are not studied in detail. In this cross-over trial, 29 non-obese men were randomized to two four-week diets: (1) carbohydrate-rich meals until 13.30 and fat-rich meals between 16.30 and 22.00 (HC/HF) versus (2) inverse sequence of meals (HF/HC). After each trial period two meal tolerance tests were performed, at 09.00 and 15.40, respectively, according to the previous intervention. On the HF/HC diet, whole-day glucose level was increased by 7.9% (p = 0.026) in subjects with impaired fasting glucose and/or impaired glucose tolerance (IFG/IGT, n = 11), and GLP-1 by 10.2% (p = 0.041) in normal glucose-tolerant subjects (NGT, n = 18). Diet effects on fasting GLP-1 (p = 0.009) and PYY (p = 0.034) levels were observed in IFG/IGT, but not in NGT. Afternoon decline of glucose tolerance was more pronounced in IFG/IGT and associated with a stronger decrease of postprandial GLP-1 and PYY levels, but not with changes of cortisol rhythm. In conclusion, the HF/HC diet shows an unfavourable effect on glycaemic control in IFG/IGT, but not in NGT subjects. Consequently, large, carbohydrate-rich dinners should be avoided, primarily by subjects with impaired glucose metabolism.
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Affiliation(s)
- Katharina Kessler
- Dept. of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany.,German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany.,Dept. of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Charité University of Medicine, 12203 Berlin, Germany
| | - Silke Hornemann
- Dept. of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany.,German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany
| | - Klaus J Petzke
- Research Group Physiology of Energy Metabolism, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany
| | - Margrit Kemper
- Dept. of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany.,German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany.,Dept. of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Charité University of Medicine, 12203 Berlin, Germany
| | - Achim Kramer
- Laboratory of Chronobiology, Institute for Medical Immunology, Charité University of Medicine, 10117 Berlin, Germany
| | - Andreas F H Pfeiffer
- Dept. of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany.,German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany.,Dept. of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Charité University of Medicine, 12203 Berlin, Germany
| | - Olga Pivovarova
- Dept. of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany.,German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany.,Dept. of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Charité University of Medicine, 12203 Berlin, Germany
| | - Natalia Rudovich
- Dept. of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany.,German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany.,Dept. of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Charité University of Medicine, 12203 Berlin, Germany.,Division of Endocrinology and Diabetes, Department of Internal Medicine, Spital Bülach, 8180 Bülach, Switzerland
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Kim Y, Keogh JB, Clifton PM. Differential Effects of Red Meat/Refined Grain Diet and Dairy/Chicken/Nuts/Whole Grain Diet on Glucose, Insulin and Triglyceride in a Randomized Crossover Study. Nutrients 2016; 8:nu8110687. [PMID: 27809219 PMCID: PMC5133075 DOI: 10.3390/nu8110687] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 10/19/2016] [Accepted: 10/25/2016] [Indexed: 11/28/2022] Open
Abstract
Epidemiological studies suggest that a diet high in processed meat, with a high glycemic index is associated with an increased risk of type 2 diabetes. It is not clear if this is due to altered insulin sensitivity or an enhanced postprandial glucose. We aimed to compare the acute metabolic response of two different types of meals after ingestion of the matching diet for four weeks. The study was a randomized, crossover acute meal study. Volunteers consumed either a red meat/refined grain meal or a dairy/chicken/nuts/wholegrain meal after four weeks of the matching diet. After a three-week washout period and four weeks of the alternate diet, they consumed the matching meal. The diets differed with respect to both protein and carbohydrate sources. Blood samples were taken for 180 min for the measurement of glucose, insulin, C-peptide and triglyceride. Fifty-one participants (age: 35.1 ± 15.6 years; body mass index: 27.7 ± 6.9 kg/m2, 17 with normal and 34 with impaired glucose tolerance) completed two meal tests. The area under the curve (p < 0.001) and incremental area under the curve (p = 0.001) for insulin was significantly higher after the red meat/refined grain diet than after the dairy/chicken/nuts/whole grain diet. There was an interaction between meal and glucose tolerance group (p < 0.05) in the area under the curve (AUC) and the incremental area under the curve (iAUC) of glucose; the red meat/refined grain diet increased glucose relative to the dairy/chicken/nuts/whole grain diet only in the normal group (+2.5 mmol/L/3 h). The red meat/refined grain diet increased glucose and insulin responses compared with the dairy/chicken/nuts/whole grain diet. This meal pattern would increase pancreatic stress long term and may account for the increased risk of type 2 diabetes with this diet.
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Affiliation(s)
- Yoona Kim
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA 5000, Australia.
| | - Jennifer B Keogh
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA 5000, Australia.
| | - Peter M Clifton
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA 5000, Australia.
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Barton J, Dew K, Dowell A, Sheridan N, Kenealy T, Macdonald L, Docherty B, Tester R, Raphael D, Gray L, Stubbe M. Patient resistance as a resource: candidate obstacles in diabetes consultations. SOCIOLOGY OF HEALTH & ILLNESS 2016; 38:1151-66. [PMID: 27260997 DOI: 10.1111/1467-9566.12447] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
This study uses conversation analysis to explore 'candidate obstacles', a practice observed in sequences of patient resistance to lifestyle advice within health professional consultations. This article presents illustrative analyses of selected data excerpts drawn from audio-visual recordings of 116 tracked consultations between health professionals and 34 patients newly diagnosed with type 2 diabetes mellitus in New Zealand. The analysis shows that in consultations where health promotion activities are central, patient resistance can provide space for patients to identify obstacles to their compliance with lifestyle advice. Identifying candidate obstacles provides opportunities for health professionals to align advice with concerns of patients and potentially improve patient outcomes.
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Affiliation(s)
- Josh Barton
- School of Social and Cultural Studies, Victoria University of Wellington
| | - Kevin Dew
- School of Social and Cultural Studies, Victoria University of Wellington
| | - Anthony Dowell
- Department of Primary Health Care and General Practice, University of Otago
| | | | - Timothy Kenealy
- Faculty of Medical and Health Sciences, The University of Auckland
| | - Lindsay Macdonald
- Department of Primary Health Care and General Practice, University of Otago
| | - Barbara Docherty
- Faculty of Medical and Health Sciences, The University of Auckland
| | - Rachel Tester
- Department of Primary Health Care and General Practice, University of Otago
| | - Debbie Raphael
- Faculty of Medical and Health Sciences, The University of Auckland
| | - Lesley Gray
- Department of Primary Health Care and General Practice, University of Otago
| | - Maria Stubbe
- Department of Primary Health Care and General Practice, University of Otago
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The Effectiveness of Different Diet Strategies to Reduce Type 2 Diabetes Risk in Youth. Nutrients 2016; 8:nu8080486. [PMID: 27517953 PMCID: PMC4997399 DOI: 10.3390/nu8080486] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 07/20/2016] [Accepted: 08/04/2016] [Indexed: 01/05/2023] Open
Abstract
Type 2 diabetes in children and adolescents has become a prominent clinical issue in recent decades. Increasing numbers of young people have risk factors for type 2 diabetes, particularly obesity, indicating the need for effective type 2 diabetes prevention strategies. The aim of this review was to identify specific dietary strategies that optimize improvements in risk factors for type 2 diabetes in youth and hence reduce the risk of type 2 diabetes development. Our review of the current literature indicates that dietary interventions lead to weight loss when intervention adherence is high. However, in addition to weight loss, a diet that is reduced in carbohydrates may optimize improvements in other type 2 diabetes risk factors, including insulin resistance and hyperglycemia. While further research is needed to confirm this finding, reduced carbohydrate diets may include a very low-carbohydrate diet, a very low-energy diet, a lower-glycemic-index diet, and/or an intermittent fasting diet. This array of dietary strategies provides a suite of intervention options for clinicians to recommend to young people at risk of type 2 diabetes. However, these findings are in contrast to current guidelines for the prevention of type 2 diabetes in adults which recommends a low-fat, high-carbohydrate diet.
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38
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Tanemura Y, Yamanaka-Okumura H, Sakuma M, Nii Y, Taketani Y, Takeda E. Effects of the intake of Undaria pinnatifida (Wakame) and its sporophylls (Mekabu) on postprandial glucose and insulin metabolism. THE JOURNAL OF MEDICAL INVESTIGATION 2016; 61:291-7. [PMID: 25264047 DOI: 10.2152/jmi.61.291] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Long-term suppression of postprandial glucose concentration is an important dietary strategy for the prevention and treatment of type 2 diabetes. Because previous reports have suggested that seaweed may exert anti-diabetic effects in animals, the effects of Wakame or Mekabu intake with 200 g white rice, 50 g boiled soybeans, 60 g potatoes, and 40 g broccoli on postprandial glucose, insulin and free fatty acid levels were investigated in healthy subjects. Plasma glucose levels at 30 min and glucose area under the curve (AUC) at 0-30 min after the Mekabu meal were significantly lower than that after the control meal. Plasma glucose and glucose AUC were not different between the Wakame and control meals. Postprandial serum insulin and its AUC and free fatty acid concentration were not different among the three meals. In addition, fullness, satisfaction, and wellness scores were not different among the three meals. Thus, consumption of 70 g Mekabu with a white rice-based breakfast reduces postprandial glucose concentration.
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Affiliation(s)
- Yoko Tanemura
- Department of Clinical Nutrition, Institute of Health Biosciences, the University of Tokushima Graduate School
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Villarino CBJ, Jayasena V, Coorey R, Chakrabarti-Bell S, Johnson SK. Nutritional, Health, and Technological Functionality of Lupin Flour Addition to Bread and Other Baked Products: Benefits and Challenges. Crit Rev Food Sci Nutr 2015; 56:835-57. [DOI: 10.1080/10408398.2013.814044] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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40
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Sabin MA, Magnussen CG, Juonala M, Shield JPH, Kähönen M, Lehtimäki T, Rönnemaa T, Koskinen J, Loo BM, Knip M, Hutri-Kähönen N, Viikari JSA, Dwyer T, Raitakari OT. Insulin and BMI as predictors of adult type 2 diabetes mellitus. Pediatrics 2015; 135:e144-51. [PMID: 25535261 DOI: 10.1542/peds.2014-1534] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Fasting insulin concentrations are increasingly being used as a surrogate for insulin resistance and risk for type 2 diabetes (T2DM), although associations with adult outcomes are unclear. Our objective was to determine whether fasting insulin concentrations in childhood associate with later T2DM. METHODS Fasting insulin values were available from 2478 participants in the longitudinal Cardiovascular Risk in Young Finns Study at baseline age 3 to 18 years, along with data on adult T2DM (N = 84, mean age = 39.6 years). RESULTS Among 3- to 6-year-olds, a 1-SD increase in fasting insulin was associated with a relative risk (RR) of 2.04 (95% confidence interval [CI], 1.54-2.70) for later T2DM, which remained significant after we adjusted for BMI and parental history of T2DM. For those aged 9 to 18 years, a 1-SD increase in insulin was associated with an RR of 1.32 (95% CI, 1.06-1.65) for T2DM, but this became nonsignificant after we adjusted for BMI and parental history of T2DM. In the latter age group, a 1-SD increase in BMI was associated with an RR of 1.45 (95% CI, 1.21-1.73) for T2DM, with adjustment for insulin and parental history of T2DM not improving this association. BMI in younger children was not associated with later T2DM. In life course analyses, those with T2DM had higher fasting insulin levels in early childhood and later adulthood but not in peripubertal years. CONCLUSIONS Elevated fasting insulin concentrations in early childhood, but not adolescence, are independently associated with an elevated risk of T2DM in adulthood.
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Affiliation(s)
- Matthew A Sabin
- Murdoch Childrens Research Institute, Royal Children's Hospital and University of Melbourne, Melbourne, Australia;
| | - Costan G Magnussen
- Research Centre of Applied and Preventive Cardiovascular Medicine, and Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia
| | - Markus Juonala
- Research Centre of Applied and Preventive Cardiovascular Medicine, and Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Julian P H Shield
- National Institute for Health Research, Bristol Biomedical Research Unit in Nutrition, University of Bristol and Royal Hospital for Children, Bristol, United Kingdom
| | - Mika Kähönen
- Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Finlab Laboratories, University of Tampere School of Medicine, Tampere, Finland
| | - Tapani Rönnemaa
- Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Juha Koskinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, and
| | - Britt-Marie Loo
- National Institute for Health and Welfare, Department of Chronic Disease Prevention, Population Studies Unit, Turku, Finland; and
| | - Mikael Knip
- Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland
| | - Nina Hutri-Kähönen
- Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Jorma S A Viikari
- Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Terence Dwyer
- Murdoch Childrens Research Institute, Royal Children's Hospital and University of Melbourne, Melbourne, Australia
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, and Departments of Clinical Physiology and Nuclear Medicine, and
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Licata R, Coorey R, Zhao Y, Chu J, Johnson S. Maximizing slowly digested starch in an expanded sorghum-maize extruded food using response surface methodology. STARCH-STARKE 2014. [DOI: 10.1002/star.201400191] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Rebecca Licata
- School of Public Health; Faculty of Health Sciences; Curtin University; Bentley Western Australia Australia
| | - Ranil Coorey
- School of Public Health; Faculty of Health Sciences; Curtin University; Bentley Western Australia Australia
| | - Yun Zhao
- School of Public Health; Faculty of Health Sciences; Curtin University; Bentley Western Australia Australia
| | - Jiayue Chu
- School of Public Health; Faculty of Health Sciences; Curtin University; Bentley Western Australia Australia
| | - Stuart Johnson
- School of Public Health; Faculty of Health Sciences; Curtin University; Bentley Western Australia Australia
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Garnett SP, Gow M, Ho M, Baur LA, Noakes M, Woodhead HJ, Broderick CR, Chisholm K, Briody J, De S, Steinbeck K, Srinivasan S, Ambler GR, Cowell CT. Improved insulin sensitivity and body composition, irrespective of macronutrient intake, after a 12 month intervention in adolescents with pre-diabetes; RESIST a randomised control trial. BMC Pediatr 2014; 14:289. [PMID: 25422027 PMCID: PMC4252020 DOI: 10.1186/s12887-014-0289-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 11/06/2014] [Indexed: 01/01/2023] Open
Abstract
Background A higher protein to carbohydrate ratio in the diet may potentiate weight loss, improve body composition and cardiometabolic risk, including glucose homeostasis in adults. The aim of this randomised control trial was to determine the efficacy of two structured lifestyle interventions, differing in dietary macronutrient content, on insulin sensitivity and body composition in adolescents. We hypothesised that a moderate-carbohydrate (40-45% of energy), increased-protein (25-30%) diet would be more effective than a high-carbohydrate diet (55-60%), moderate-protein (15%) diet in improving outcomes in obese, insulin resistant adolescents. Methods Obese 10–17 year olds with either pre-diabetes and/or clinical features of insulin resistance were recruited at two hospitals in Sydney, Australia. At baseline adolescents were prescribed metformin and randomised to one of two energy restricted diets. The intervention included regular contact with the dietician and a supervised physical activity program. Outcomes included insulin sensitivity index measured by an oral glucose tolerance test and body composition measured by dual-energy x-ray absorptiometry at 12 months. Results Of the 111 adolescents recruited, 85 (77%) completed the intervention. BMI expressed as a percentage of the 95th percentile decreased by 6.8% [95% CI: −8.8 to −4.9], ISI increased by 0.2 [95% CI: 0.06 to 0.39] and percent body fat decreased by 2.4% [95% CI: −3.4 to −1.3]. There were no significant differences in outcomes between diet groups at any time. Conclusion When treated with metformin and an exercise program, a structured, reduced energy diet, which is either high-carbohydrate or moderate-carbohydrate with increased-protein, can achieve clinically significant improvements in obese adolescents at risk of type 2 diabetes. Trial registration Australian New Zealand Clinical Trail Registry ACTRN12608000416392. Registered 25 August 2008.
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Affiliation(s)
- Sarah P Garnett
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia. .,Kids Research Institute, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia. .,The Children's Hospital at Westmead Clinical School, University of Sydney, Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia.
| | - Megan Gow
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia. .,The Children's Hospital at Westmead Clinical School, University of Sydney, Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia.
| | - Mandy Ho
- The Children's Hospital at Westmead Clinical School, University of Sydney, Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia.
| | - Louise A Baur
- Kids Research Institute, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia. .,The Children's Hospital at Westmead Clinical School, University of Sydney, Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia.
| | - Manny Noakes
- CSIRO Food and Nutritional Sciences, PO Box 10041, Adelaide, BC South Australia, 5000, Australia.
| | - Helen J Woodhead
- Department of Paediatrics, Campbelltown Hospital, PO Box 149, Campbelltown, NSW, 2560, Australia. .,Department of Diabetes and Endocrinology, Sydney Children's Hospital Network, Randwick, Sydney, NSW, 2031, Australia.
| | - Carolyn R Broderick
- The Children's Hospital Institute of Sports Medicine, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia. .,The School of Medical Sciences, UNSW Medicine, The University of New South Wales, Sydney, NSW, 2052, Australia.
| | - Kerryn Chisholm
- Nutrition and Dietetics and Weight Management Services, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia.
| | - Julie Briody
- Department of Nuclear Medicine, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia.
| | - Sukanya De
- Kids Research Institute, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia.
| | - Katherine Steinbeck
- Academic Department of Adolescent Medicine, Sydney Medical School, University of Sydney, Sydney, NSW, 2066, Australia.
| | - Shubha Srinivasan
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia.
| | - Geoffrey R Ambler
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia. .,The Children's Hospital at Westmead Clinical School, University of Sydney, Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia.
| | - Chris T Cowell
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia. .,Kids Research Institute, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia. .,The Children's Hospital at Westmead Clinical School, University of Sydney, Locked Bag 4001, Westmead, Sydney, NSW, 2145, Australia.
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McEvoy CT, Cardwell CR, Woodside JV, Young IS, Hunter SJ, McKinley MC. A posteriori dietary patterns are related to risk of type 2 diabetes: findings from a systematic review and meta-analysis. J Acad Nutr Diet 2014; 114:1759-75.e4. [PMID: 25001435 DOI: 10.1016/j.jand.2014.05.001] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 05/01/2014] [Indexed: 11/18/2022]
Abstract
Our review and meta-analysis examined the association between a posteriori-derived dietary patterns (DPs) and risk of type 2 diabetes mellitus. MEDLINE and EMBASE were searched for articles published up to July 2012 and data were extracted by two independent reviewers. Overall, 19 cross-sectional, 12 prospective cohort, and two nested case-control studies were eligible for inclusion. Results from cross-sectional studies reported an inconsistent association between DPs and measures of insulin resistance and/or glucose abnormalities, or prevalence of type 2 diabetes. A meta-analysis was carried out on nine prospective cohort studies that had examined DPs derived by principle component/factor analysis and incidence of type 2 diabetes risk (totaling 309,430 participants and 16,644 incident cases). Multivariate-adjusted odds ratios were combined using a random-effects meta-analysis. Two broad DPs (Healthy/Prudent and Unhealthy/Western) were identified based on food factor loadings published in original studies. Pooled results indicated a 15% lower type 2 diabetes risk for those in the highest category of Healthy/Prudent pattern compared with those in the lowest category (95% CI 0.80 to 0.91; P<0.0001). Compared with the lowest category of Unhealthy/Western DP, those in the highest category had a 41% increased risk of type 2 diabetes (95% CI 1.32 to 1.52; P<0.0001). These results provide evidence that DPs are consistently associated with risk of type 2 diabetes even when other lifestyle factors are controlled for. Thus, greater adherence to a DP characterized by high intakes of fruit, vegetables, and complex carbohydrate and low intakes of refined carbohydrate, processed meat, and fried food may be one strategy that could have a positive influence on the global public health burden of type 2 diabetes.
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Lau E, Soong YY, Zhou W, Henry J. Can bread processing conditions alter glycaemic response? Food Chem 2014; 173:250-6. [PMID: 25466020 DOI: 10.1016/j.foodchem.2014.10.040] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 09/12/2014] [Accepted: 10/07/2014] [Indexed: 01/29/2023]
Abstract
Bread is a staple food that is traditionally made from wheat flour. This study aimed to compare the starch digestibility of western baked bread and oriental steamed bread. Four types of bread were prepared: western baked bread (WBB) and oriental steamed bread (OSB), modified baked bread (MBB) made with the OSB recipe and WBB processing, and modified steamed bread (MSB) made with the WBB recipe and OSB processing. MBB showed the highest starch digestibility in vitro, followed by WBB, OSB and MSB. A similar trend was observed for glycaemic response in vivo. MBB, WBB, OSB and MSB had a glycaemic index of 75±4, 71±5, 68±5 and 65±4, respectively. Processing differences had a more pronounced effect on starch digestibility in bread, and steamed bread was healthier in terms of glycaemic response. The manipulation of processing conditions could be an innovative route to alter the glycaemic response of carbohydrate-rich foods.
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Affiliation(s)
- Evelyn Lau
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, 14 Medical Drive, #07-02, Singapore 117599, Singapore
| | - Yean Yean Soong
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, 14 Medical Drive, #07-02, Singapore 117599, Singapore
| | - Weibiao Zhou
- Food Science and Technology Programme, Department of Chemistry, National University of Singapore, S14 Level 5, Science Drive 2, Singapore 117543, Singapore
| | - Jeyakumar Henry
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, 14 Medical Drive, #07-02, Singapore 117599, Singapore; Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, 14 Medical Drive, #14-01, Singapore 117599, Singapore.
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Goletzke J, Buyken AE, Joslowski G, Bolzenius K, Remer T, Carstensen M, Egert S, Nöthlings U, Rathmann W, Roden M, Herder C. Increased intake of carbohydrates from sources with a higher glycemic index and lower consumption of whole grains during puberty are prospectively associated with higher IL-6 concentrations in younger adulthood among healthy individuals. J Nutr 2014; 144:1586-93. [PMID: 25080538 DOI: 10.3945/jn.114.193391] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Chronic low-grade inflammation represents a likely intermediary in the relation between carbohydrate nutrition and both type 2 diabetes and cardiovascular disease. This study assessed the prospective association between carbohydrate quantity and quality [dietary glycemic index (GI), glycemic load (GL), and added sugar, fiber, and whole-grain intake] during puberty, a potentially critical period for later disease, and low-grade inflammation in younger adulthood. The analysis was based on 205 participants (113 girls and 92 boys) from the DONALD (Dortmund Nutritional and Anthropometric Longitudinally Designed) study with at least 2 3-d weighed dietary records during puberty (girls: 9-14 y, boys: 10-15 y) and blood samples in younger adulthood (18-36 y). Multivariable linear regression models were used to analyze the associations between carbohydrate nutrition and circulating concentrations of pro- and anti-inflammatory immune mediators [high-sensitivity C-reactive protein (hs-CRP), interleukin (IL) 6, IL-18, and adiponectin]. A higher intake of carbohydrates during puberty (P-trend = 0.005), particularly from higher-GI food sources (P-trend = 0.01), was prospectively related to higher concentrations of IL-6 in younger adulthood, independently of baseline BMI and early life, socioeconomic, and other nutritional factors. Furthermore, a higher dietary GL (P-trend = 0.002) and a lower intake of whole grains (P-trend = 0.01) were independently associated with higher IL-6 concentrations in adults. Dietary GI and added sugar and fiber intakes were not independently associated with IL-6 (P-trend ≥ 0.09). Carbohydrate nutrition during puberty was not independently related to hs-CRP, IL-18, and adiponectin concentrations (all P-trend > 0.1). During puberty, a higher intake of carbohydrates from higher-GI food sources and lower whole-grain consumption prospectively predict greater IL-6 concentrations in young adulthood. These data support the hypothesis that diet during puberty influences later inflammation and metabolic dysfunction.
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Affiliation(s)
- Janina Goletzke
- Department of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Dortmund, Germany
| | - Anette E Buyken
- Department of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Dortmund, Germany
| | - Gesa Joslowski
- Department of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Dortmund, Germany
| | - Katja Bolzenius
- Department of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Dortmund, Germany
| | - Thomas Remer
- Department of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Dortmund, Germany
| | - Maren Carstensen
- Institute for Clinical Diabetology and German Center for Diabetes Research (DZD) partner site, Düsseldorf, Germany
| | | | - Ute Nöthlings
- Nutritional Epidemiology, Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany; and
| | - Wolfgang Rathmann
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
| | - Michael Roden
- Institute for Clinical Diabetology and German Center for Diabetes Research (DZD) partner site, Düsseldorf, Germany Division of Endocrinology and Diabetology, University Hospital Düsseldorf, Heinrich-Heine University, Düsseldorf, Germany
| | - Christian Herder
- Institute for Clinical Diabetology and German Center for Diabetes Research (DZD) partner site, Düsseldorf, Germany
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Abstract
The increasing global prevalence of type 2 diabetes mellitus (T2DM) is a major public health concern. Accumulating data provides strong evidence of the shared contribution of genetic and environmental factors to T2DM risk. Genome-wide association studies have hugely improved our understanding of the genetic basis of T2DM. However, it is obvious that genetics only partly account for an individuals' predisposition to T2DM. The dietary environment has changed remarkably over the last century. Examination of individual macronutrients and more recently of foods and dietary patterns is becoming increasingly important in terms of developing public health strategies. Nutrigenetics offers the potential to improve diet-related disease prevention and therapy, but is not without its own challenges. In this review we present evidence on the dietary environment and genetics as risk factors for T2DM and bridging the 2 disciplines we highlight some key gene-nutrient interactions.
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Affiliation(s)
- Janas M Harrington
- Centre for Diet and Health Research, Department of Epidemiology and Public Health, University College Cork, Western Gateway Building, Cork, Ireland
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Buyken AE, Goletzke J, Joslowski G, Felbick A, Cheng G, Herder C, Brand-Miller JC. Association between carbohydrate quality and inflammatory markers: systematic review of observational and interventional studies. Am J Clin Nutr 2014; 99:813-33. [PMID: 24552752 DOI: 10.3945/ajcn.113.074252] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Chronic low-grade inflammation is a likely intermediary between quality of carbohydrate and chronic disease risk. OBJECTIVE We conducted a systematic literature search to evaluate the relevance of carbohydrate quality on inflammatory markers in observational and intervention studies. DESIGN MEDLINE, EMBASE, and the Cochrane Library were searched for studies on associations between glycemic index (GI), glycemic load (GL), dietary fiber or fiber supplements or whole grain intake, and high-sensitivity C-reactive protein (hsCRP) or interleukin 6 (IL-6). Included studies had to be conducted on adults (healthy, overweight, with type 2 diabetes or metabolic syndrome features, but without inflammatory disease) with ≥20 participants and a 3-wk duration. RESULTS In total, 22 of the 60 studies that met our inclusion criteria examined GI/GL: 5 of 9 observational studies reported lower concentrations of hsCRP or IL-6 among persons with a lower dietary GI/GL; 3 of 13 intervention studies showed significant antiinflammatory effects of a low-GI/GL diet, and 4 further studies suggested beneficial effects (trends or effects in a subgroup). For fiber intake, 13 of 16 observational studies reported an inverse relation with hsCRP or IL-6, but only 1 of 11 intervention studies showed a significant antiinflammatory effect of fiber intake, and a further trial reported a beneficial trend. For whole-grain intake, 6 of 7 observational studies observed an inverse association with inflammatory markers, but only 1 of 7 intervention studies reported significant antiinflammatory effects, 1 further study was suggestive (in a subgroup) of such, and another study found an adverse effect (trend only). CONCLUSIONS Evidence from intervention studies for antiinflammatory benefits is less consistent for higher-fiber or whole-grain diets than for low-GI/GL diets. Benefits of higher fiber and whole-grain intakes suggested by observational studies may reflect confounding.
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Affiliation(s)
- Anette E Buyken
- From IEL-Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Dortmund, Germany (AEB, JG, GJ, and AF); Sichuan University, Chengdu, PR China (GC); the Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany (CH); and the Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders and Department of Molecular Bioscience, University of Sydney, Sydney, Australia (JCB-M)
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Joslowski G, Halim J, Goletzke J, Gow M, Ho M, Louie JCY, Buyken AE, Cowell CT, Garnett SP. Dietary glycemic load, insulin load, and weight loss in obese, insulin resistant adolescents: RESIST study. Clin Nutr 2014; 34:89-94. [PMID: 24534012 DOI: 10.1016/j.clnu.2014.01.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 01/10/2014] [Accepted: 01/20/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS The optimal dietary approach for weight loss and improving insulin sensitivity in adolescents is unknown. This study aimed to explore the association between the estimated insulin demand of the diet, as measured by glycemic and insulin load, weight loss, percentage body fat and insulin sensitivity index (ISI) in obese adolescents with clinical features of insulin resistance and/or prediabetes after a 3 month lifestyle and metformin intervention. METHODS Secondary data analysis of 91 adolescents (median age 12.7 years (range 10.1-17.4) participating in a randomized controlled trial, known as RESIST; ACTRN12608000416392. Weight change between baseline and 3 months was measured by BMI expressed as percentage of the 95th centile (BMI %95). Body composition was measured by dual energy X-ray absorptiometry and ISI was determined by an oral glucose tolerance test. RESULTS Higher dietary glycemic load and insulin load were associated with less weight loss (BMI %95), adjusted for sex and pubertal stage, β = 0.0466, P = 0.007 and β = 0.0124, P = 0.040, respectively. Inclusion of total energy intake in the model explained observed associations between dietary glycemic load and insulin load and change in BMI %95. Neither dietary glycemic load nor insulin load were associated with changes in percentage body fat or ISI. Dietary glycemic index and macronutrient content (% of total energy) were not associated to changes in BMI %95, percentage body fat or ISI. CONCLUSION Reduced energy diet contributes to weight loss in obese, insulin resistant adolescents. Diets with a lower insulin demand were associated with a lower energy intake and may hence assist with weight loss.
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Affiliation(s)
- Gesa Joslowski
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia; IEL-Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Germany.
| | - Jocelyn Halim
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia
| | - Janina Goletzke
- IEL-Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Germany
| | - Megan Gow
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia; The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia
| | - Mandy Ho
- The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia
| | - Jimmy C-Y Louie
- Faculty of Science, Medicine and Health, The University of Wollongong, Australia
| | - Anette E Buyken
- IEL-Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Germany
| | - Chris T Cowell
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia; The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia; Kids Research Institute at the Children's Hospital at Westmead, Sydney, Australia
| | - Sarah P Garnett
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia; The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia; Kids Research Institute at the Children's Hospital at Westmead, Sydney, Australia
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Licata R, Chu J, Wang S, Coorey R, James A, Zhao Y, Johnson S. Determination of formulation and processing factors affecting slowly digestible starch, protein digestibility and antioxidant capacity of extruded sorghum-maize composite flour. Int J Food Sci Technol 2013. [DOI: 10.1111/ijfs.12444] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Rebecca Licata
- School of Public Health; Curtin Health Innovation Research Institute; Curtin University; Bentley WA 6102 Australia
| | - Jiayue Chu
- School of Public Health; Curtin Health Innovation Research Institute; Curtin University; Bentley WA 6102 Australia
| | - Shilong Wang
- School of Public Health; Curtin Health Innovation Research Institute; Curtin University; Bentley WA 6102 Australia
| | - Ranil Coorey
- School of Public Health; Curtin Health Innovation Research Institute; Curtin University; Bentley WA 6102 Australia
| | - Anthony James
- School of Public Health; Curtin Health Innovation Research Institute; Curtin University; Bentley WA 6102 Australia
| | - Yun Zhao
- School of Public Health; Curtin Health Innovation Research Institute; Curtin University; Bentley WA 6102 Australia
| | - Stuart Johnson
- School of Public Health; Curtin Health Innovation Research Institute; Curtin University; Bentley WA 6102 Australia
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