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Barrea L, Vetrani C, Verde L, Frias-Toral E, Ceriani F, Cernea S, Docimo A, Graziadio C, Tripathy D, Savastano S, Colao A, Muscogiuri G. Comprehensive Approach to Medical Nutrition Therapy in Patients with Type 2 Diabetes Mellitus: From Diet to Bioactive Compounds. Antioxidants (Basel) 2023; 12:904. [PMID: 37107279 PMCID: PMC10135374 DOI: 10.3390/antiox12040904] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/29/2023] [Accepted: 03/30/2023] [Indexed: 04/29/2023] Open
Abstract
In the pathogenesis of type 2 diabetes mellitus (T2DM), diet plays a key role. Individualized medical nutritional therapy, as part of lifestyle optimization, is one of the cornerstones for the management of T2DM and has been shown to improve metabolic outcomes. This paper discusses major aspects of the nutritional intervention (including macro- and micronutrients, nutraceuticals, and supplements), with key practical advice. Various eating patterns, such as the Mediterranean-style, low-carbohydrate, vegetarian or plant-based diets, as well as healthy eating plans with caloric deficits have been proven to have beneficial effects for patients with T2DM. So far, the evidence does not support a specific macronutrient distribution and meal plans should be individualized. Reducing the overall carbohydrate intake and replacing high glycemic index (GI) foods with low GI foods have been shown as valid options for patients with T2DM to improve glycemic control. Additionally, evidence supports the current recommendation to reduce the intake of free sugars to less than 10% of total energy intake, since their excessive intake promotes weight gain. The quality of fats seems to be rather important and the substitution of saturated and trans fatty acids with foods rich in monounsaturated and polyunsaturated fats lowers cardiovascular risk and improves glucose metabolism. There is no benefit of supplementation with antioxidants, such as carotene, vitamins E and C, or other micronutrients, due to the lack of consistent evidence showing efficacy and long-term safety. Some studies suggest possible beneficial metabolic effects of nutraceuticals in patients with T2DM, but more evidence about their efficacy and safety is still needed.
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Affiliation(s)
- Luigi Barrea
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, Via Porzio, Centro Isola F2, 80143 Napoli, Italy
- Centro Italiano per la Cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Claudia Vetrani
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, Via Porzio, Centro Isola F2, 80143 Napoli, Italy
- Centro Italiano per la Cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Ludovica Verde
- Department of Public Health, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Evelyn Frias-Toral
- School of Medicine, Universidad Católica Santiago de Guayaquil, Av. Pdte. Carlos Julio Arosemena Tola, Guayaquil 090615, Ecuador
| | - Florencia Ceriani
- Nutrition School, Universidad de la Republica (UdelaR), Montevideo 11100, Uruguay
| | - Simona Cernea
- Department M3/Internal Medicine I, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mures, 540146 Târgu Mureş, Romania
- Diabetes, Nutrition and Metabolic Diseases Outpatient Unit, Emergency County Clinical Hospital, 540146 Târgu Mureş, Romania
| | - Annamaria Docimo
- Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Chiara Graziadio
- Centro Italiano per la Cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
- Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Devjit Tripathy
- Division of Diabetes UT Health and ALM VA Hospital, San Antonio, TX 78229, USA
| | - Silvia Savastano
- Centro Italiano per la Cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
- Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Annamaria Colao
- Centro Italiano per la Cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
- Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
- Cattedra Unesco “Educazione Alla Salute e Allo Sviluppo Sostenibile”, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Giovanna Muscogiuri
- Centro Italiano per la Cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
- Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
- Cattedra Unesco “Educazione Alla Salute e Allo Sviluppo Sostenibile”, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
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Chen ZF, Kusuma JD, Shiao SYPK. Validating Healthy Eating Index, Glycemic Index, and Glycemic Load with Modern Diets for E-Health Era. Nutrients 2023; 15:nu15051263. [PMID: 36904261 PMCID: PMC10005628 DOI: 10.3390/nu15051263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/23/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023] Open
Abstract
Predictors of healthy eating parameters, including the Healthy Eating Index (HEI), Glycemic Index (GI), and Glycemic Load (GL), were examined using various modern diets (n = 131) in preparation for personalized nutrition in the e-health era. Using Nutrition Data Systems for Research computerized software and artificial intelligence machine-learning-based predictive validation analyses, we included domains of HEI, caloric source, and various diets as the potentially modifiable factors. HEI predictors included whole fruits and whole grains, and empty calories. Carbohydrates were the common predictor for both GI and GL, with total fruits and Mexican diets being additional predictors for GI. The median amount of carbohydrates to reach an acceptable GL < 20 was predicted as 33.95 g per meal (median: 3.59 meals daily) with a regression coefficient of 37.33 across all daily diets. Diets with greater carbohydrates and more meals needed to reach acceptable GL < 20 included smoothies, convenient diets, and liquids. Mexican diets were the common predictor for GI and carbohydrates per meal to reach acceptable GL < 20; with smoothies (12.04), high-school (5.75), fast-food (4.48), Korean (4.30), Chinese (3.93), and liquid diets (3.71) presenting a higher median number of meals. These findings could be used to manage diets for various populations in the precision-based e-health era.
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Affiliation(s)
- Zhao-Feng Chen
- Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Correspondence: (Z.-F.C.); (S.-Y.P.K.S.); Tel.: +1-(818)-233-6112 (S.-Y.P.K.S.)
| | | | - Shyang-Yun Pamela K. Shiao
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
- Correspondence: (Z.-F.C.); (S.-Y.P.K.S.); Tel.: +1-(818)-233-6112 (S.-Y.P.K.S.)
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Insights into the relations between cell wall integrity and in vitro digestion properties of granular starches in pulse cotyledon cells after dry heat treatment. FOOD SCIENCE AND HUMAN WELLNESS 2023. [DOI: 10.1016/j.fshw.2022.07.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Gluten-Free Diet in Co-Existent Celiac Disease and Type 1 Diabetes Mellitus: Is It Detrimental or Beneficial to Glycemic Control, Vascular Complications, and Quality of Life? Nutrients 2022; 15:nu15010199. [PMID: 36615856 PMCID: PMC9824312 DOI: 10.3390/nu15010199] [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: 12/12/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 01/03/2023] Open
Abstract
Celiac disease (CeD) is associated with type 1 diabetes mellitus (T1DM), and both have the same genetic background. Most patients with T1DM who develop CeD are either asymptomatic or have mild CeD-related gastrointestinal symptoms. Therefore, children affected by T1DM should undergo screening for asymptomatic CeD. The aim of this review is to highlight the influence of a gluten-free diet (GFD) on glycemic control, growth rate, microvascular complications, and quality of life in patients with T1DM and CeD. PubMed, Google Scholar, Web of Science, and Cochrane Central databases were searched. Reports reviewed were those published from 1969 to 2022 that focused on the interplay of T1DM and CeD and examined the effect of diet on glycemic control, growth rate, and quality of life. The most challenging aspect for a child with T1DM and CeD is that most GFD foods have a high glycemic index, while low glycemic index foods are recommended for T1DM. Interestingly, dietary therapy for CeD could improve the elevated HbA1c levels. Avoiding gluten added to a diabetic dietary regimen in T1DM patients might impose practical limitations and lead to important restrictions in the lifestyle of a young patient. Consequently, non-adherence to GFD in patients with T1DM and CeD is common. GFD in patients with T1DM and CeD seems to lower the incidence of micro- and macrovascular complications, but this requires further investigation. It seems that adherence to GFD in young patients with T1DM and CeD leads to regular growth and a stable body mass index without any negative effect on HbA1c or insulin requirements. Furthermore, the lipid profile and quality of life seem to have improved with the introduction of GFD.
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Effects of maltogenic α-amylase treatment on the proportion of slowly digestible starch and the structural properties of pea starch. FOOD BIOSCI 2022. [DOI: 10.1016/j.fbio.2022.101810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Clinical Analysis of the Renal Protective Effect of GLP-1 on Diabetic Patients Based on Edge Detection. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:6504006. [PMID: 35360475 PMCID: PMC8964200 DOI: 10.1155/2022/6504006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 01/24/2022] [Accepted: 01/31/2022] [Indexed: 11/24/2022]
Abstract
With the rapid development of IoT technology, it is a new trend to combine edge computing with smart medicine in order to better develop modern medicine, avoid the crisis of information “sibling,” and meet the requirements of timeliness and computational performance of the massive data generated by edge devices. However, edge computing is somewhat open and prone to security risks, so the security and privacy protection of edge computing systems for smart healthcare is receiving increasing attention. The two groups were compared before and after treatment for blood glucose, blood lipids, blood pressure, renal function, serum advanced glycosylation end products (AGEs) and cyclic adenosine monophosphate (cAMP), serum oxidative stress indicators, and levels of cAMP/PKA signalling pathway-related proteins in peripheral blood mononuclear cells. The results of this study show that the reduction of AGEs, the improvement of oxidative stress, and the regulation of the cAMP/PKA signalling pathway may be associated with a protective effect against early DKD. By introducing the edge computing system and its architecture for smart healthcare, we describe the security risks encountered by smart healthcare in edge computing, introduce the solutions proposed by some scholars to address the security risks, and finally summarize the security protection framework and discuss the specific solutions for security and privacy protection under this framework, which will provide some help for the credible research of smart healthcare edge computing.
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John D, Sureshkumar S, Raman M. Type‐2 diabetes and identification of major genetic determinants of glycemic index in rice‐ A review. STARCH-STARKE 2022. [DOI: 10.1002/star.202100277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Deepa John
- Department of Biotechnology Faculty of Ocean Science and Technology Kerala University of Fisheries and Ocean Studies Cochin Kerala 682506 India
| | - S Sureshkumar
- Faculty of Ocean Science and Technology Kerala University of Fisheries and Ocean Studies Cochin Kerala 682506 India
| | - Maya Raman
- Department of Food Science and Technology Faculty of Ocean Science and Technology Kerala University of Fisheries and Ocean Studies Cochin Kerala 682506 India
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Xiong W, Devkota L, Zhang B, Muir J, Dhital S. Intact cells: “Nutritional capsules” in plant foods. Compr Rev Food Sci Food Saf 2022; 21:1198-1217. [DOI: 10.1111/1541-4337.12904] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/23/2021] [Accepted: 12/13/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Weiyan Xiong
- Department of Chemical and Biological Engineering Monash University Clayton Campus, VIC 3800 Australia
- School of Food Science and Engineering, Guangdong Province Key Laboratory for Green Processing of Natural Products and Product Safety South China University of Technology Guangzhou Guangdong P. R. China
| | - Lavaraj Devkota
- Department of Chemical and Biological Engineering Monash University Clayton Campus, VIC 3800 Australia
| | - Bin Zhang
- School of Food Science and Engineering, Guangdong Province Key Laboratory for Green Processing of Natural Products and Product Safety South China University of Technology Guangzhou Guangdong P. R. China
| | - Jane Muir
- Department of Gastroenterology Central Clinical School, Monash University Melbourne Victoria Australia
| | - Sushil Dhital
- Department of Chemical and Biological Engineering Monash University Clayton Campus, VIC 3800 Australia
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Trojian T, Colberg S, Harris G, Oh R, Dixit S, Gibson M, Corcoran M, Ramey L, Berg PV. American Medical Society for Sports Medicine Position Statement on the Care of the Athlete and Athletic Person With Diabetes. Clin J Sport Med 2022; 32:8-20. [PMID: 34930869 DOI: 10.1097/jsm.0000000000000906] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/06/2020] [Indexed: 02/02/2023]
Abstract
ABSTRACT The American Medical Society for Sports Medicine (AMSSM) developed this position statement to assist physicians and other health professionals in managing athletes and active people with diabetes. The AMSSM selected the author panel through an application process to identify members with clinical and academic expertise in the care of active patients with diabetes. This article reviews the current knowledge and gaps regarding the benefits and risks of various types of exercise and management issues for athletes and physically active people with diabetes, including nutrition and rehabilitation issues. Resistance exercises seem to be beneficial for patients with type 1 diabetes, and the new medications for patients with type 2 diabetes generally do not need adjustment with exercise. In preparing this statement, the authors conducted an evidence review and received open comment from the AMSSM Board of Directors before finalizing the recommendations.
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Stagi S, Papacciuoli V, Ciofi D, Piccini B, Farello G, Toni S, Ferrari M, Chiarelli F. Retrospective Evaluation on the Use of a New Polysaccharide Complex in Managing Paediatric Type 1 Diabetes with Metabolic Syndrome (MetS). Nutrients 2021; 13:nu13103517. [PMID: 34684518 PMCID: PMC8540288 DOI: 10.3390/nu13103517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/26/2021] [Accepted: 10/01/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Children and adolescents affected by type 1 diabetes have an increased risk of being overweight or obese and of suffering from cardiometabolic symptoms. Aims: To retrospectively evaluate the effects of a new complex of polysaccharide macromolecules, Policaptil Gel Retard® (PGR), on auxological and metabolic parameters, glycaemic variability and control parameters in paediatric patients with type 1 diabetes and metabolic syndrome (MetS). Patients and Methods: Data for 27 paediatric patients with a diagnosis of type 1 diabetes in conjunction with obesity and MetS of at least 5 years’ standing were collected and retrospectively studied. Of these, 16 (median age 12.9, range 9.5–15.8 years) had been adjunctively treated with PGR and 11 (median age 12.6, range 9.4–15.6 years) had not been treated with PGR. Auxological, metabolic and glycaemic control and variability parameters and insulin dosing were compared after 6 months in the two groups. Results: PGR significantly reduced BMI standard deviation score (SDS) (p < 0.005), waist SDS (p < 0.005), HbA1c (p < 0.05) and daily mean insulin dose requirement (p < 0.005). A significant improvement was also observed in the metabolic and glycaemic variability parameters of mean daily blood glucose (BG) levels (p < 0.005), SD of daily BG levels (p < 0.0001), mean coefficient of variation (p < 0.05), LBGI (p < 0.0001), HBGI (p < 0.0001), J-index (p < 0.005), total cholesterol (p < 0.005), HDL-cholesterol (p < 0.005) and LDL-cholesterol (p < 0.005) and triglycerides (p < 0.05). Conclusions: PGR produces a good auxological and metabolic response in obese patients with MetS who are affected by type 1 diabetes. It led to a significant reduction in BMI SDS, waist SDS and an improvement in glucose control and variability as well as in other MetS parameters. The use of polysaccharide compounds, especially if associated with appropriate dietary changes, may help achieve treatment targets in type 1 diabetes and reduce the risk that patients develop metabolic syndrome.
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Affiliation(s)
- Stefano Stagi
- Department of Health Sciences, University of Florence, Anna Meyer Children’s University Hospital, 50139 Florence, Italy; (D.C.); (M.F.)
- Correspondence: ; Tel.: +39-055-5662305
| | - Valeria Papacciuoli
- Pediatric Diabetology Unit, Anna Meyer Children’s University Hospital, 50139 Florence, Italy; (V.P.); (B.P.); (S.T.)
| | - Daniele Ciofi
- Department of Health Sciences, University of Florence, Anna Meyer Children’s University Hospital, 50139 Florence, Italy; (D.C.); (M.F.)
| | - Barbara Piccini
- Pediatric Diabetology Unit, Anna Meyer Children’s University Hospital, 50139 Florence, Italy; (V.P.); (B.P.); (S.T.)
| | - Giovanni Farello
- Department of Paediatrics, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Sonia Toni
- Pediatric Diabetology Unit, Anna Meyer Children’s University Hospital, 50139 Florence, Italy; (V.P.); (B.P.); (S.T.)
| | - Marta Ferrari
- Department of Health Sciences, University of Florence, Anna Meyer Children’s University Hospital, 50139 Florence, Italy; (D.C.); (M.F.)
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Siner A, Sevanesan MS, Ambomai T, Abd Wahab Z, Lasem L. Blood glucose response to a calamansi drink in healthy adults: a non-randomised study. BMC Res Notes 2020; 13:404. [PMID: 32859257 PMCID: PMC7455999 DOI: 10.1186/s13104-020-05250-8] [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: 05/22/2020] [Accepted: 08/21/2020] [Indexed: 11/27/2022] Open
Abstract
Objective Glycaemic Index (GI) ranks the body’s response to carbohydrate content in food such that high GI food increases postprandial blood glucose levels. One of the popular drinks at food and beverage outlets is a drink made from calamansi, a citrus that is believed not to induce an increase in blood glucose levels. In this non-randomised single-blind (participants) study, capillary blood from 10 healthy males were sampled following consumption of either glucose or the calamansi drink. The blood glucose measurements were then used to calculate the GI for the drink. Results The GI of the calamansi drink tested was calculated as 37, a value within the range of low GI foods. Trial registration Clinical Trials identifier NCT04462016; Retrospectively registered on July 1, 2020.
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Affiliation(s)
- Angela Siner
- Department of Basic Medical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Sarawak, Malaysia.
| | - Mauna Sree Sevanesan
- Department of Basic Medical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Sarawak, Malaysia
| | - Tati Ambomai
- Department of Basic Medical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Sarawak, Malaysia
| | - Zakiah Abd Wahab
- Department of Basic Medical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Sarawak, Malaysia
| | - Liwan Lasem
- Department of Basic Medical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Sarawak, Malaysia
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Hefni ME, Thomsson A, Witthöft CM. Bread making with sourdough and intact cereal and legume grains - effect on glycaemic index and glycaemic load. Int J Food Sci Nutr 2020; 72:134-142. [PMID: 32466685 DOI: 10.1080/09637486.2020.1769568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The concept of glycaemic index (GI) has led to efforts to develop low-GI foods. Bread contributes around one-quarter of carbohydrate intake in the Swedish diet. In this study, we sought to develop low-GI bread prototypes and examined the effects of bread making on content of total dietary fibre (TDF) and resistant starch (RS). Five bread prototypes were made in a commercial bakery, using sourdough fermentation and intact cereal and legume kernels. Predicted (p-GI) and in vivo GI values were determined, and TDF and RS were quantified. The p-GI value of the five prototypes was between 56 and 68. The confirmed in vivo GI value was 65 and 67 for two of the breads. The TDF content (≥17%) was not affected by bread making, but RS content was increased by three-fold. All breads were categorised as medium-GI, but with low glycaemic load (GL).
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Affiliation(s)
- Mohammed E Hefni
- Department of Chemistry and Biomedical Sciences, Linnaeus University, Kalmar, Sweden.,Department of Food Industries, Faculty of Agriculture, Mansoura University, Mansoura, Egypt
| | - Anette Thomsson
- Department of Chemistry and Biomedical Sciences, Linnaeus University, Kalmar, Sweden
| | - Cornelia M Witthöft
- Department of Chemistry and Biomedical Sciences, Linnaeus University, Kalmar, Sweden
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Li P, Zhang B, Dhital S. Starch digestion in intact pulse cells depends on the processing induced permeability of cell walls. Carbohydr Polym 2019; 225:115204. [DOI: 10.1016/j.carbpol.2019.115204] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/30/2019] [Accepted: 08/14/2019] [Indexed: 01/03/2023]
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14
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Xiong W, Zhang B, Dhital S, Huang Q, Fu X. Structural features and starch digestion properties of intact pulse cotyledon cells modified by heat-moisture treatment. J Funct Foods 2019. [DOI: 10.1016/j.jff.2019.103500] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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15
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Raczkowska E, Łoźna K, Bienkiewicz M, Jurczok K, Bronkowska M. Relation between the Recipe of Yeast Dough Dishes and Their Glycaemic Indices and Loads. Foods 2019; 8:E377. [PMID: 31480598 PMCID: PMC6769818 DOI: 10.3390/foods8090377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 08/25/2019] [Accepted: 08/30/2019] [Indexed: 12/12/2022] Open
Abstract
The aim of the study was to evaluate the glycaemic indices (GI) and glycaemic loads (GL) of four food dishes made from yeast dough (steamed dumplings served with yoghurt, apple pancakes sprinkled with sugar powder, rolls with cheese and waffles with sugar powder), based on their traditional and modified recipes. Modification of the yeast dough recipe consisted of replacing wheat flour (type 500) with whole-wheat flour (type 2000). Energy value and the composition of basic nutrients were assessed for every tested dish. The study was conducted on 50 people with an average age of 21.7 ± 1.1 years, and an average body mass index of 21.2 ± 2.0 kg/m2. The GI of the analysed food products depended on the total carbohydrate content, dietary fibre content, water content, and energy value. Modification of yeast food products by replacing wheat flour (type 500) with whole-wheat flour (type 2000) contributed to the reduction of their GI and GL values, respectively.
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Affiliation(s)
- Ewa Raczkowska
- Department of Human Nutrition, Faculty of Biotechnology and Food Sciences, Wrocław University of Environmental and Life Sciences, 51-630 Wroclaw, Poland.
| | - Karolina Łoźna
- Department of Human Nutrition, Faculty of Biotechnology and Food Sciences, Wrocław University of Environmental and Life Sciences, 51-630 Wroclaw, Poland
| | - Maciej Bienkiewicz
- Department of Human Nutrition, Faculty of Biotechnology and Food Sciences, Wrocław University of Environmental and Life Sciences, 51-630 Wroclaw, Poland
| | - Karolina Jurczok
- Department of Human Nutrition, Faculty of Biotechnology and Food Sciences, Wrocław University of Environmental and Life Sciences, 51-630 Wroclaw, Poland
| | - Monika Bronkowska
- Department of Human Nutrition, Faculty of Biotechnology and Food Sciences, Wrocław University of Environmental and Life Sciences, 51-630 Wroclaw, Poland
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Samadarsi R, Mishra D, Dutta D. Mangiferin nanoparticles fortified dairy beverage as a low glycemic food product: its quality attributes and antioxidant properties. Int J Food Sci Technol 2019. [DOI: 10.1111/ijfs.14310] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Rohini Samadarsi
- Department of Biotechnology National Institute of Technology Durgapur Mahatma Gandhi Avenue Durgapur 713209 West Bengal India
| | - Divyani Mishra
- Department of Biotechnology National Institute of Technology Durgapur Mahatma Gandhi Avenue Durgapur 713209 West Bengal India
| | - Debjani Dutta
- Department of Biotechnology National Institute of Technology Durgapur Mahatma Gandhi Avenue Durgapur 713209 West Bengal India
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Effect of the flavonoid hesperidin on glucose and fructose transport, sucrase activity and glycaemic response to orange juice in a crossover trial on healthy volunteers. Br J Nutr 2019; 121:782-792. [PMID: 30670104 DOI: 10.1017/s0007114519000084] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Although polyphenols inhibit glucose absorption and transport in vitro, it is uncertain whether this activity is sufficient to attenuate glycaemic response in vivo. We examined this using orange juice, which contains high levels of hesperidin. We first used a combination of in vitro assays to evaluate the potential effect of hesperidin and other orange juice components on intestinal sugar absorption and then tested whether this translated to an effect in healthy volunteers. Hesperidin attenuated transfer of 14C-labelled glucose across differentiated Caco-2/TC7 cell monolayers. The involvement of the sugar transporter GLUT2 was demonstrated by experiments carried out in the absence of Na to exclude the contribution of sodium-glucose linked transporter 1 and further explored by the use of Xenopus laevis oocytes expressing human GLUT2 or GLUT5. Fructose transport was also affected by hesperidin partly by inhibition of GLUT5, while hesperidin, even at high concentration, did not inhibit rat intestinal sucrase activity. We conducted three separate crossover interventions, each on ten healthy volunteers using orange juice with different amounts of added hesperidin and water. The biggest difference in postprandial blood glucose between orange juice and control, containing equivalent amounts of glucose, fructose, sucrose, citric acid and ascorbate, was when the juice was diluted (ΔC max=-0·5 mm, P=0·0146). The effect was less pronounced when the juice was given at regular strength. Our data indicate that hesperidin can modulate postprandial glycaemic response of orange juice by partial inhibition of intestinal GLUT, but this depends on sugar and hesperidin concentrations.
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Xue Y, Zhang XY, Zhou HJ, Ojo O, Wang Q, Wang LL, Jiang Q, Liu T, Wang XH. Associations Between the Knowledge of Different Food Categories and Glycemia in Chinese Adult Patients With Type 2 Diabetes. Clin Nurs Res 2019; 29:313-321. [PMID: 30614264 DOI: 10.1177/1054773818822126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aims to evaluate the levels of knowledge of different food categories and analyze the association between the levels of dietary knowledge and glycemia in Chinese adult patients with type 2 diabetes mellitus (T2DM). A cross-sectional study design was adopted. A total of 334 patients with T2DM were recruited from six hospitals from July to October 2014 in China. The Diabetes Dietary Knowledge Scale was utilized to obtain dietary knowledge. The results showed the item examining knowledge of carbohydrates received the highest score, whereas the item examining knowledge of healthy fats received the lowest score. The item "nuts" (B = -0.49; 95% confidence interval [CI] = [0.38, 0.99]) was associated with the incidence of hyperglycemia. The item "foods when hypoglycemic" (B = 0.42; 95% CI = [1.22, 2.07]) was associated with the incidence of hypoglycemia. There were different knowledge levels of different food categories in patients with T2DM, and these have implications for blood glucose control.
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Affiliation(s)
- Yuan Xue
- The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiao-Yan Zhang
- The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Hui-Juan Zhou
- The First Affiliated Hospital of Soochow University, Suzhou, China
| | | | - Qi Wang
- Medical College of Soochow University, Suzhou, China
| | - Li-Li Wang
- Medical College of Soochow University, Suzhou, China
| | - Qing Jiang
- Medical College of Soochow University, Suzhou, China
| | - Ting Liu
- Medical College of Soochow University, Suzhou, China
| | - Xiao-Hua Wang
- The First Affiliated Hospital of Soochow University, Suzhou, China
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Variation in the rate and extent of starch digestion is not determined by the starch structural features of cooked whole pulses. Food Hydrocoll 2018. [DOI: 10.1016/j.foodhyd.2018.05.022] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Denney JM, Quinn KH. Gestational Diabetes: Underpinning Principles, Surveillance, and Management. Obstet Gynecol Clin North Am 2018; 45:299-314. [PMID: 29747732 DOI: 10.1016/j.ogc.2018.01.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Gestational diabetes mellitus (GDM) is carbohydrate intolerance resulting in hyperglycemia with onset during pregnancy. The article aims to provide clinicians with a working framework to minimize maternal and neonatal morbidity. Landmark historical and recent data are reviewed and presented to provide clinicians with a quick, easy reference for recognition and management of GDM. Data presented tie in insights with underlying pathophysiologic processes leading to GDM. Screening and diagnostic thresholds are discussed along with management upon diagnosis. Good clinical practice regarding screening, diagnosis, and management of GDM effectively reduces risk and improves outcomes of women and fetuses in affected pregnancies.
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Affiliation(s)
- Jeffrey M Denney
- Department of Obstetrics and Gynecology, Section on Maternal-Fetal Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
| | - Kristen H Quinn
- Department of Obstetrics and Gynecology, Section on Maternal-Fetal Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
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Onna Lo YM. Glycemic Index and Glycemic Load. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00087-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Huang WQ, Lu Y, Xu M, Huang J, Su YX, Zhang CX. Excessive fruit consumption during the second trimester is associated with increased likelihood of gestational diabetes mellitus: a prospective study. Sci Rep 2017; 7:43620. [PMID: 28272552 PMCID: PMC5341573 DOI: 10.1038/srep43620] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 01/26/2017] [Indexed: 12/18/2022] Open
Abstract
This study aimed to investigate the association between fruit consumption during the second trimester and the occurrence of gestational diabetes mellitus (GDM). A prospective study with 772 female participants was conducted in China from April 2013 to August 2014. Dietary intake was assessed in face-to-face and telephone interviews using a 3-day food record. GDM was ascertained using a standard 75 g 2 hour oral glucose tolerance test. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) after adjustment for various confounders. Of the 772 participants, 169 were diagnosed with GDM during the period under study. Greater total fruit consumption during the second trimester was associated with a higher likelihood of GDM (highest vs. lowest quartile: adjusted OR4.82, 95% CI 2.38 to 9.76). Fruits with a moderate or high glycaemic index (GI) were positively associated with the occurrence of GDM. Fruit subgroups were also categorised by polyphenol content, and tropical-fruit and citrus-fruit consumption was found to be positively related to the occurrence of GDM. These findings suggest that the excessive consumption of fruit, especially fruit with moderate or high GI values, tropical-fruit and citrus-fruit, increases the likelihood of GDM.
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Affiliation(s)
- Wu-Qing Huang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Ying Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.,Guangzhou Center of Disease Control and Prevention, Guangzhou 510440, China
| | - Ming Xu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Jing Huang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yi-Xiang Su
- Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Cai-Xia Zhang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
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Gomes JMG, Fabrini SP, Alfenas RDCG. Low glycemic index diet reduces body fat and attenuates inflammatory and metabolic responses in patients with type 2 diabetes. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2016; 61:137-144. [PMID: 27598983 PMCID: PMC10118866 DOI: 10.1590/2359-3997000000206] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 07/04/2016] [Indexed: 11/22/2022]
Abstract
Objective The aim of this study was to verify the effects of glycemic index (GI) on body composition, and on inflammatory and metabolic markers concentrations in patients with type 2 diabetes. Subjects and methods In this randomized controlled parallel trial, twenty subjects (aged 42.4 ± 5.1 years, BMI 29.2 ± 4.8 kg.m-2) were allocated to low GI (LGI) (n = 10) or high GI (HGI) (n = 10) groups. Body composition, inflammatory and metabolic markers were assessed at baseline and after 30 days of intervention. Food intake was monitored during the study using three-day food records completed on two non-consecutive weekdays and on a weekend day. Results Body fat reduced after the LGI intervention compared with baseline (P = 0.043) and with the HGI group (P = 0.036). Serum fructosamine concentration (P = 0.031) and TNF-α mRNA expression (P = 0.05) increased in the HGI group. Serum non-esterified fatty acids were greater in the HGI than in the LGI group (P = 0.032). IL-6 mRNA expression tended to decrease after the consumption of the LGI diet compared to baseline (P = 0.06). Conclusion The LGI diet reduced body fat and prevented the negative metabolic and inflammatory responses induced by the HGI diet.
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Affiliation(s)
- Júnia Maria Geraldo Gomes
- Instituto Federal de Educação, Ciência e Tecnologia do Sudeste de Minas Gerais, Campus Barbacena, Barbacena, MG, Brasil
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Thompson HJ, Neuhouser ML, Lampe JW, McGinley JN, Neil ES, Schwartz Y, McTiernan A. Effect of low or high glycemic load diets on experimentally induced mammary carcinogenesis in rats. Mol Nutr Food Res 2016; 60:1416-26. [PMID: 26778091 DOI: 10.1002/mnfr.201500864] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 01/08/2016] [Accepted: 01/10/2016] [Indexed: 01/18/2023]
Abstract
SCOPE High glycemic load diets have been associated with increased breast cancer risk in population-based studies, but the evidence is mixed. This investigation determined whether diets differing in glycemic load affected the carcinogenic process using a preclinical model. METHODS AND RESULTS Human diets, formulated to differ 2-fold in glycemic load, were evaluated in the 1-methyl-nitrosourea-induced (37.5 mg/kg) mammary carcinogenesis model. Cancer incidence (23.3 versus 50.0%, p = 0.032), multiplicity, (0.40 versus 1.03, p = 0.030) and burden, (0.62 versus 1.19 g/rat, p = 0.037) were reduced in the low versus high glycemic load diets, respectively. However, the low glycemic protective effect was attenuated when two purified diets that differed in resistant starch and simulated the glycemic effects of the human diets were fed. Protection was associated with alterations in markers of cell growth regulation. CONCLUSION Our findings show that human low or high glycemic load dietary patterns differentially affect the carcinogenic response in a nondiabetic rodent model for breast cancer. However, factors that are associated with these patterns, in addition to dietary carbohydrate availability, appear to account for the differences observed.
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Affiliation(s)
- Henry J Thompson
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, CO, USA
| | | | | | - John N McGinley
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, CO, USA
| | - Elizabeth S Neil
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, CO, USA
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Taylor JR, Emmambux MN, Kruger J. Developments in modulating glycaemic response in starchy cereal foods. STARCH-STARKE 2014. [DOI: 10.1002/star.201400192] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- John R.N. Taylor
- Institute for Food; Nutrition and Well-being and Department of Food Science; University of Pretoria; South Africa
| | - M. Naushad Emmambux
- Institute for Food; Nutrition and Well-being and Department of Food Science; University of Pretoria; South Africa
| | - Johanita Kruger
- Institute for Food; Nutrition and Well-being and Department of Food Science; University of Pretoria; South Africa
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Muhlhausler BS, Vithayathil MA. Impact of maternal obesity on offspring adipose tissue: lessons for the clinic. Expert Rev Endocrinol Metab 2014; 9:615-627. [PMID: 30736199 DOI: 10.1586/17446651.2014.956088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Maternal obesity is a major risk factor for the subsequent development of obesity and Type 2 diabetes in the child. This relationship appears to be driven largely by the exposure of the fetus to an increased nutrient supply during critical periods of development, which results in persistent changes in the structure and function of key systems involved in the regulation of energy balance, appetite and fat deposition. One of the key targets is the fat cell, or adipocyte, in which prenatal overnutrition programs a heightened capacity for fat storage. The increasing prevalence of maternal obesity has led to an urgent need for strategies to break the resulting intergenerational cycle of obesity and metabolic disease. This review will discuss the relationship between maternal obesity and poor metabolic health of the offspring, with a particular focus on the involvement of adipose tissue, recent clinical studies examining potential strategies for intervention and priority areas for further research.
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Affiliation(s)
- Beverly S Muhlhausler
- a FOODplus Research Centre, School of Agriculture Food and Wine, University of Adelaide, Adelaide 5064, Australia
- b Sansom Institute for Health Research, School of Pharmacy and Medical Science, University of South Australia, Adelaide 5001, Australia
| | - Mini A Vithayathil
- a FOODplus Research Centre, School of Agriculture Food and Wine, University of Adelaide, Adelaide 5064, Australia
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27
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Kuang H, Sun M, Lv J, Li J, Wu C, Chen N, Bo L, Wei X, Gu X, Liu Z, Mao C, Xu Z. Hippocampal apoptosis involved in learning deficits in the offspring exposed to maternal high sucrose diets. J Nutr Biochem 2014; 25:985-90. [DOI: 10.1016/j.jnutbio.2014.04.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 03/28/2014] [Accepted: 04/26/2014] [Indexed: 01/24/2023]
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Wiley J, Westbrook M, Long J, Greenfield JR, Day RO, Braithwaite J. Diabetes education: the experiences of young adults with type 1 diabetes. Diabetes Ther 2014; 5:299-321. [PMID: 24519150 PMCID: PMC4065294 DOI: 10.1007/s13300-014-0056-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Clinician-led diabetes education is a fundamental component of care to assist people with Type 1 diabetes (T1D) self-manage their disease. Recent initiatives to incorporate a more patient-centered approach to diabetes education have included recommendations to make such education more individualized. Yet there is a dearth of research that identifies patients' perceptions of clinician-led diabetes education. We aimed to describe the experience of diabetes education from the perspective of young adults with T1D. METHODS We designed a self-reported survey for Australian adults, aged 18-35 years, with T1D. Participants (n = 150) were recruited by advertisements through diabetes consumer-organizations. Respondents were asked to rate aspects of clinician-led diabetes education and identify sources of self-education. To expand on the results of the survey we interviewed 33 respondents in focus groups. RESULTS SURVEY The majority of respondents (56.0%) were satisfied with the amount of continuing clinician-led diabetes education; 96.7% sought further self-education; 73.3% sourced more diabetes education themselves than that provided by their clinicians; 80.7% referred to diabetes organization websites for further education; and 30.0% used online chat-rooms and blogs for education. Focus groups: The three key themes that emerged from the interview data were deficiencies related to the pedagogy of diabetes education; knowledge deficiencies arising from the gap between theoretical diabetes education and practical reality; and the need for and problems associated with autonomous and peer-led diabetes education. CONCLUSION Our findings indicate that there are opportunities to improve clinician led-diabetes education to improve patient outcomes by enhancing autonomous health-literacy skills and to incorporate peer-led diabetes education and support with clinician-led education. The results provide evidence for the potential value of patient engagement in quality improvement and health-service redesign.
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Affiliation(s)
- Janice Wiley
- Centre for Clinical Governance Research in Health, Australian Institute of Health Innovation, University of New South Wales, Sydney, Australia,
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Wiley J, Westbrook M, Greenfield JR, Day RO, Braithwaite J. Shared decision-making: the perspectives of young adults with type 1 diabetes mellitus. Patient Prefer Adherence 2014; 8:423-35. [PMID: 24729690 PMCID: PMC3979791 DOI: 10.2147/ppa.s57707] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Shared decision-making (SDM) is at the core of patient-centered care. We examined whether young adults with type 1 diabetes perceived the clinician groups they consulted as practicing SDM. METHODS In a web-based survey, 150 Australians aged 18-35 years and with type 1 diabetes rated seven aspects of SDM in their interactions with endocrinologists, diabetes educators, dieticians, and general practitioners. Additionally, 33 participants in seven focus groups discussed these aspects of SDM. RESULTS Of the 150 respondents, 90% consulted endocrinologists, 60% diabetes educators, 33% dieticians, and 37% general practitioners. The majority of participants rated all professions as oriented toward all aspects of SDM, but there were professional differences. These ranged from 94.4% to 82.2% for "My clinician enquires about how I manage my diabetes"; 93.4% to 82.2% for "My clinician listens to my opinion about my diabetes management"; 89.9% to 74.1% for "My clinician is supportive of my diabetes management"; 93.2% to 66.1% for "My clinician suggests ways in which I can improve my self-management"; 96.6% to 85.7% for "The advice of my clinician can be understood"; 98.9% to 82.2% for "The advice of my clinician can be trusted"; and 86.5% to 67.9% for "The advice of my clinician is consistent with other members of the diabetes team". Diabetes educators received the highest ratings on all aspects of SDM. The mean weighted average of agreement to SDM for all consultations was 84.3%. Focus group participants reported actively seeking clinicians who practiced SDM. A lack of SDM was frequently cited as a reason for discontinuing consultation. The dominant three themes in focus group discussions were whether clinicians acknowledged patients' expertise, encouraged patients' autonomy, and provided advice that patients could utilize to improve self-management. CONCLUSION The majority of clinicians engaged in SDM. Young adults with type 1 diabetes prefer such clinicians. They may fail to take up recommended health services when clinicians do not practice this component of patient-centered care. Such findings have implications for patient safety, improved health outcomes, and enhanced health service delivery.
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Affiliation(s)
- Janice Wiley
- Centre for Clinical Governance Research in Health, Australian Institute of Health Innovation, University of New South Wales
| | - Mary Westbrook
- Centre for Clinical Governance Research in Health, Australian Institute of Health Innovation, University of New South Wales
| | - Jerry R Greenfield
- Diabetes and Obesity Program, Garvan Institute of Medical Research
- Department of Endocrinology, St Vincent’s Hospital, University of New South Wales, Sydney, NSW, Australia
| | - Richard O Day
- Department of Clinical Pharmacology, St Vincent’s Hospital, University of New South Wales, Sydney, NSW, Australia
| | - Jeffrey Braithwaite
- Centre for Clinical Governance Research in Health, Australian Institute of Health Innovation, University of New South Wales
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Hari Kumar KVS, Gupta AK, Kumar A. Clinical profile of patients using normal, high and very high insulin doses in type 2 diabetes. Diabetes Metab Syndr 2014; 8:72-74. [PMID: 24907169 DOI: 10.1016/j.dsx.2014.04.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
AIMS Insulin requirement varies between patients with diabetes due to insulin resistance. The clinical profile of patients based on their insulin requirement has not been studied earlier. We stratified the patients based on total daily insulin requirement (TDIR) and studied their clinical profile and carbohydrate consumption. MATERIALS & METHODS Sixty patients with type 2 diabetes (aged 30-75 years, using stable insulin dose for last 6 months, HbA1c between 6-7.5%, negative screening tests for Acromegaly and Cushing's disease) participated in this clinical observational study. All patients with major illness, surgery or diabetic ketoacidosis were excluded. The patients were divided into 3 groups: Group 1 (TDIR<1 U/kg, n=30), Group 2 (TDIR 1-2 U/kg, n=20) and Group 3 (TDIR>2U/kg, n=10). Data are presented as mean±S.D and comparison between three groups was done using one way ANOVA test. RESULTS The patients (27M: 33F) had mean age 54.3 ± 12.3 years, diabetes duration 10.1±4.7 years and an A1c of 7±0.38%. Patients in group 3 had lower body weight, BMI and highest carbohydrate consumption when compared with the other two groups (P<0.05). Hypoglycemic episodes and complications did not differ between the groups. CONCLUSION Our data showed that the low body weight and high carbohydrate intake are associated with increased insulin requirement. The clinical implications of our study are to check the carbohydrate intake in patients with high insulin requirement.
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Affiliation(s)
- K V S Hari Kumar
- Department of Endocrinology, Command Hospital, Lucknow 226002, U.P., India.
| | - A K Gupta
- Department of Endocrinology, Command Hospital, Lucknow 226002, U.P., India
| | - Amit Kumar
- Department of Endocrinology, Command Hospital, Lucknow 226002, U.P., India
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Breen C, Ryan M, McNulty B, Gibney MJ, Canavan R, O'Shea D. High saturated-fat and low-fibre intake: a comparative analysis of nutrient intake in individuals with and without type 2 diabetes. Nutr Diabetes 2014; 4:e104. [PMID: 24492470 PMCID: PMC3940826 DOI: 10.1038/nutd.2014.2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Revised: 12/30/2013] [Accepted: 01/05/2014] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE The aim of dietary modification, as a cornerstone of type 2 diabetes (T2DM) management, is to optimise metabolic control and overall health. This study describes food and nutrient intake in a sample of adults with T2DM, and compares this to recommendations, and to intake in age, sex, body mass index (BMI) and social-class matched adults without T2DM. DESIGN A cross-sectional analysis of food and nutrient intake in 124 T2DM individuals (64% male; age 57.4±5.6 years, BMI 32.5±5.8 kg m(-2)) and 124 adults (age 57.4±7.0 years, BMI 31.2±5.0 kg m(-2)) with no diabetes (ND) was undertaken using a 4-day semiweighed food diary. Biochemical and anthropometric variables were also measured. RESULTS While reported energy intake was similar in T2DM vs ND (1954 vs 2004 kcal per day, P=0.99), T2DM subjects consumed more total-fat (38.8% vs 35%, P0.001), monounsaturated-fat (13.3% vs 12.2%; P=0.004), polyunsaturated-fat (6.7% vs 5.9%; P<0.001) and protein (18.6% vs 17.5%, P0.01). Both groups exceeded saturated-fat recommendations (14.0% vs 13.8%). T2DM intakes of carbohydrate (39.5% vs 42.9%), non-milk sugar (10.4% vs 15.0%) and fibre (14.4 vs 18.9 g) were significantly lower (P<0.001). Dietary glycaemic load (GL) was also lower in T2DM (120.8 vs 129.2; P=0.02), despite a similar glycaemic index (59.7 vs 60.1; P=0.48). T2DM individuals reported consuming significantly more wholemeal/brown/wholegrain breads, eggs, oils, vegetables, meat/meat products, savoury snacks and soups/sauces and less white breads, breakfast cereals, cakes/buns, full-fat dairy, chocolate, fruit juices, oily fish and alcohol than ND controls. CONCLUSION Adults with T2DM made different food choices to ND adults. This resulted in a high saturated-fat diet, with a higher total-fat, monounsaturated-fat, polyunsaturated-fat and protein content and a lower GL, carbohydrate, fibre and non-milk sugar content. Dietary education should emphasise and reinforce the importance of higher fibre, fruit, vegetable and wholegrain intake and the substitution of monounsaturated for saturated-fat sources, in energy balanced conditions.
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Affiliation(s)
- C Breen
- Diabetes and Endocrine Units, St Columcille's and St Vincent's University Hospitals, Dublin, UK
| | - M Ryan
- Institute of Food and Health, University College Dublin, Dublin, UK
| | - B McNulty
- Institute of Food and Health, University College Dublin, Dublin, UK
| | - M J Gibney
- Institute of Food and Health, University College Dublin, Dublin, UK
| | - R Canavan
- Diabetes and Endocrine Units, St Columcille's and St Vincent's University Hospitals, Dublin, UK
| | - D O'Shea
- Diabetes and Endocrine Units, St Columcille's and St Vincent's University Hospitals, Dublin, UK
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Hou YC, Chang YL, Kuo SC, Chiang CF, Chiang CY, Lin YF, Weng PC, Hu FC, Wu JH, Lai CH. Serum hyperglycemia might be not related to fat composition of diet and vegetable composition of diet might improve sugar control in taiwanese diabetic subjects. Int J Med Sci 2014; 11:515-21. [PMID: 24688317 PMCID: PMC3970106 DOI: 10.7150/ijms.8158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 03/11/2014] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE This is an Asian study, which was designed to examine the correlations between biochemical data and food composition of diabetic patients in Taiwan. METHODS One hundred and seventy Taiwanese diabetic patients were enrolled. The correlations between biochemical data and diet composition (from 24-hour recall of intake food) of these patients were explored (Spearman correlation, p < 0.05). Diet components were also correlated with each other to show diet characteristics of diabetic patients in Taiwan. Linear regression was also performed for the significantly correlated groups to estimate possible impacts from diet composition to biochemical data. RESULTS Postprandial serum glucose level was negatively correlated with fat percentage of diet, intake amount of polyunsaturated fatty acid and fiber diet composition. Hemoglobin A1c was negatively correlated with fat diet, polyunsaturated fatty acid and vegetable diet. Fat composition, calorie percentage accounted by polyunsaturated fatty acid and monounsaturated fatty acid in diet seemed to be negatively correlated with sugar percentage of diet and positively correlated with vegetable and fiber composition of diet. Linear regression showed that intake amount of polyunsaturated fatty acid, calorie percentage accounted by polyunsaturated fatty acid, fat percentage of diet, vegetable composition of diet would predict lower hemoglobin A1c and postprandial blood sugar. Besides, higher percentage of fat diet composition could predict higher percentage of vegetable diet composition in Taiwanese diabetic patients. CONCLUSION Fat diet might not elevate serum glucose. Vegetable diet and polyunsaturated fatty acid diet composition might be correlated with better sugar control in Taiwanese diabetic patients.
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Affiliation(s)
- Yi-Cheng Hou
- 1. Department of Nutrition, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Ya-Lin Chang
- 1. Department of Nutrition, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Shi-Ching Kuo
- 1. Department of Nutrition, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Chih-Fan Chiang
- 1. Department of Nutrition, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Cheng-Yang Chiang
- 1. Department of Nutrition, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Yu-Fang Lin
- 1. Department of Nutrition, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Pei-Chen Weng
- 1. Department of Nutrition, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Fang-Ching Hu
- 1. Department of Nutrition, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Jing-Hui Wu
- 1. Department of Nutrition, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Chien-Han Lai
- 2. Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
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Scaramuzza AE, Mantegazza C, Bosetti A, Zuccotti GV. Type 1 diabetes and celiac disease: The effects of gluten free diet on metabolic control. World J Diabetes 2013; 4:130-134. [PMID: 23961323 PMCID: PMC3746085 DOI: 10.4239/wjd.v4.i4.130] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 05/23/2013] [Accepted: 07/19/2013] [Indexed: 02/05/2023] Open
Abstract
Type 1 diabetes mellitus is associated with celiac disease, with a prevalence that varies between 0.6% and 16.4%, according to different studies. After a diagnosis of celiac disease is confirmed by small bowel biopsy, patients are advised to commence a gluten-free diet (GFD). This dietary restriction may be particularly difficult for the child with diabetes, but in Europe (and in Italy) many food stores have targeted this section of the market with better labeling of products and more availability of specific GFD products. Treatment with a GFD in symptomatic patients has been shown to improve the symptoms, signs and complications of celiac disease. However, the effects of a GFD on diabetic control are less well established. Initial reports of improved hypoglycemic control were based on children who were diagnosed with celiac disease associated with malabsorption, but there have subsequently been reports of improvement in patients with type 1 diabetes with subclinical celiac disease. There are other studies reporting no effect, improved control and an improvement of hypoglycemic episodes. Moreover, in this review we wish to focus on low glycemic index foods, often suggested in people with type 1 diabetes, since they might reduce postprandial glycemic excursion and enhance long-term glycemic control. In contrast, GFD may be rich in high glycemic index foods that can increase the risk of obesity, insulin resistance and cardiovascular disease, worsening the metabolic control of the child with diabetes. Hence, it is important to evaluate the impact of a GFD on metabolic control, growth and nutritional status in children with type 1 diabetes.
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Postprandial lipid responses to standard carbohydrates used to determine glycaemic index values. Br J Nutr 2013; 110:1782-8. [PMID: 23656707 DOI: 10.1017/s000711451300130x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Prior studies assessing the metabolic effects of different types of carbohydrates have focused on their glycaemic response. However, the response of postprandial cardiometabolic risk indicators has not been considered in these studies. The present study assessed postprandial lipid responses to two forms of carbohydrates used as reference foods for glycaemic index determinations, white bread (50 g available carbohydrate) and glucose (50 g), under controlled conditions and with intra-individual replicate determinations. A total of twenty adults (20–70 years) underwent two cycles of challenges with each pair of reference foods (four challenges/person), administered in a random order on separate days under standard conditions. Serum lipids (total cholesterol, LDL-cholesterol, HDL-cholesterol, TAG and NEFA), glucose and insulin were monitored for 5 h post-ingestion. Oral glucose resulted in greater glycaemic and insulinaemic responses than white bread for the first 90 min and a greater subsequent decline after 120 min (P =0·0001). The initial decline in serum NEFA concentrations was greater after the oral glucose than after the white bread challenge, as was the rebound after 150 min (P = 0·001). Nevertheless, the type of carbohydrate had no significant effect on postprandial total cholesterol, LDL-cholesterol and HDL-cholesterol concentrations. Following an initial modest rise in TAG concentrations in response to both challenges, the values dropped below the fasting values for oral glucose but not for the white bread challenge. These data suggest that the type of carbohydrate used to determine the glycaemic index, bread or glucose, has little or modest effects on postprandial plasma cholesterol concentrations. Differences in TAG and NEFA concentrations over the 5 h time period were modest, and their clinical relevance is unclear.
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Louie JCY, Brand-Miller JC, Moses RG. Carbohydrates, glycemic index, and pregnancy outcomes in gestational diabetes. Curr Diab Rep 2013; 13:6-11. [PMID: 23065366 DOI: 10.1007/s11892-012-0332-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This review critically evaluates the current evidence regarding the effect of the dietary glycemic index (GI) on pregnancy outcomes in gestational diabetes mellitus (GDM). Current evidence, although limited, consistently supports the advantages of, and has demonstrated no disadvantages of, a low-GI diet. We conclude that pregnant women with GDM are likely to benefit from following a low-GI meal pattern, with no significant side effects, and consideration of the GI should be given when formulating a diet for GDM. However, until larger scale intervention trials are completed, an exclusive low-GI diet should not replace the current recommended diets for GDM from relevant government and health agencies. Further studies that intervene at an earlier stage of pregnancy are required.
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Affiliation(s)
- Jimmy Chun Yu Louie
- School of Health Sciences, Faculty of Health and Behavioral Sciences, The University of Wollongong, Wollongong, NSW, 2522, Australia.
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Muhlhausler BS, Gugusheff JR, Ong ZY, Vithayathil MA. Nutritional approaches to breaking the intergenerational cycle of obesity. Can J Physiol Pharmacol 2013; 91:421-8. [PMID: 23745987 DOI: 10.1139/cjpp-2012-0353] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The link between poor maternal nutrition and an increased burden of disease in subsequent generations has been widely demonstrated in both human and animal studies. Historically, the nutritional challenges experienced by pregnant and lactating women were largely those of insufficient calories and severe micronutrient deficiencies. More recently, however, Western societies have been confronted with a new nutritional challenge; that of maternal obesity and excessive maternal intake of calories, fat, and sugar. Exposure of the developing fetus and infant to this obesogenic environment results in an increased risk of obesity and metabolic disease later in life. Furthermore, increased caloric, fat, and sugar intake can occur in conjunction with micronutrient deficiency, which may further exacerbate these programming effects. In light of the current epidemic of obesity and metabolic disease, attention has now turned to identifying nutritional interventions for breaking this intergenerational obesity cycle. In this review, we discuss the approaches that have been explored to date and highlight the need for further research.
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Affiliation(s)
- Beverly S Muhlhausler
- FOODplus Research Centre, School of Agriculture Food and Wine, Waite Main Building, The University of Adelaide, SA 5064, Australia.
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Urita Y, Noda T, Watanabe D, Iwashita S, Hamada K, Sugimoto M. Effects of a soybean nutrition bar on the postprandial blood glucose and lipid levels in patients with diabetes mellitus. Int J Food Sci Nutr 2012; 63:921-9. [DOI: 10.3109/09637486.2012.694847] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Khan SK. The Glycemic Index/Load. Integr Med (Encinitas) 2012. [DOI: 10.1016/b978-1-4377-1793-8.00069-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hypolipidemic effect of Smallanthus sonchifolius (yacon) roots on diabetic rats: Biochemical approach. Chem Biol Interact 2011; 194:31-9. [DOI: 10.1016/j.cbi.2011.08.009] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 08/16/2011] [Accepted: 08/19/2011] [Indexed: 12/19/2022]
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