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L P de Oliveira V, de Freitas MM, P de Paula T, Gubert ML, Miller MEP, Schuchmann RA, Souza KLA, Viana LV. DASH diet vs. DASH diet plus physical activity in older patients with type 2 diabetes and high blood pressure: A randomized clinical trial. Nutr Health 2024; 30:389-398. [PMID: 36114615 DOI: 10.1177/02601060221124201] [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] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND AIMS To evaluate the effect of lifestyle modification by adopting a DASH diet, with and without physical activity guidance, on blood pressure, glycemic control, lipid profile, weight, and body composition in older patients with type 2 diabetes mellitus (T2DM) and hypertension. METHODS AND RESULTS For this randomized clinical trial, we recruited patients aged 60 years or older with T2DM and uncontrolled hypertension. One group (DASH) received only DASH dietary guidance, while the other group (DASHPED) received dietary guidance and encouragement to walk with a pedometer. Outcomes of interest were (1) blood pressure, (2) physical activity, (3) weight, body mass index (BMI), and body composition, and (4) biochemical variables. Measurements were taken at baseline and 16 weeks after the intervention. We included 35 patients in the analysis. At the end of the study, the DASHPED group had an mean increase in physical activity of 1721 steps/day. Both groups displayed significantly reduced weight, BMI, and waking diastolic pressures on ambulatory blood pressure monitoring after the intervention. A trend of reduced sleeping diastolic pressure was found in the DASHPED group. Changes in weight, BMI, muscle mass, body fat, waist-hip ratio, glycemic control, lipid profile, and insulin sensitivity did not differ between the groups. CONCLUSION There was no difference in outcomes between the group that only dieted and the group that also performed increased physical activity, despite a significant increase in exercise. This reinforces the importance of dietary changes in immediate blood pressure control.
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Affiliation(s)
- Vanessa L P de Oliveira
- Post-Graduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Mauren M de Freitas
- Post-Graduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Tatiana P de Paula
- Post-Graduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Mayara L Gubert
- Department of internal Medicine, Universidade Federal do Rio Grande do Sul, Brazil
| | - Maria E P Miller
- Department of internal Medicine, Universidade Federal do Rio Grande do Sul, Brazil
| | - Renata A Schuchmann
- Department of internal Medicine, Universidade Federal do Rio Grande do Sul, Brazil
| | - Karen L A Souza
- Department of internal Medicine, Universidade Federal do Rio Grande do Sul, Brazil
| | - Luciana V Viana
- Post-Graduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of internal Medicine, Universidade Federal do Rio Grande do Sul, Brazil
- Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Brazil
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Alharbi M, Stephan BC, Shannon OM, Siervo M. Does dietary nitrate boost the effects of caloric restriction on brain health? Potential physiological mechanisms and implications for future research. Nutr Metab (Lond) 2023; 20:45. [PMID: 37880786 PMCID: PMC10599060 DOI: 10.1186/s12986-023-00766-9] [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: 05/26/2023] [Accepted: 10/07/2023] [Indexed: 10/27/2023] Open
Abstract
Dementia is a highly prevalent and costly disease characterised by deterioration of cognitive and physical capacity due to changes in brain function and structure. Given the absence of effective treatment options for dementia, dietary and other lifestyle approaches have been advocated as potential strategies to reduce the burden of this condition. Maintaining an optimal nutritional status is vital for the preservation of brain function and structure. Several studies have recognised the significant role of nutritional factors to protect and enhance metabolic, cerebrovascular, and neurocognitive functions. Caloric restriction (CR) positively impacts on brain function via a modulation of mitochondrial efficiency, endothelial function, neuro-inflammatory, antioxidant and autophagy responses. Dietary nitrate, which serves as a substrate for the ubiquitous gasotransmitter nitric oxide (NO), has been identified as a promising nutritional intervention that could have an important role in improving vascular and metabolic brain regulation by affecting oxidative metabolism, ROS production, and endothelial and neuronal integrity. Only one study has recently tested the combined effects of both interventions and showed preliminary, positive outcomes cognitive function. This paper explores the potential synergistic effects of a nutritional strategy based on the co-administration of CR and a high-nitrate diet as a potential and more effective (than either intervention alone) strategy to protect brain health and reduce dementia risk.
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Affiliation(s)
- Mushari Alharbi
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, NG7 2UH, UK
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, 22252, Saudi Arabia
| | - Blossom Cm Stephan
- Curtin Dementia Centre of Excellence, EnAble Institute, Curtin University, Kent Street, Bentley, WA, 6102, Australia
| | - Oliver M Shannon
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Mario Siervo
- Curtin Dementia Centre of Excellence, EnAble Institute, Curtin University, Kent Street, Bentley, WA, 6102, Australia.
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Noori S, Mirzababaei A, Abaj F, Ghaffarian-Ensaf R, Mirzaei K. Does the Mediterranean diet reduce the odds of diabetic nephropathy in women? A case–control study. Front Nutr 2022; 9:984622. [PMID: 36118745 PMCID: PMC9481419 DOI: 10.3389/fnut.2022.984622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 08/12/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundIn recent decades, the prevalence of chronic diseases such as diabetes is increasing. One of the major complications of diabetes is diabetic nephropathy (DN), so it is important to find a way that can delay or control the onset of DN. Therefore, in this study, we investigated the relationship between the Mediterranean diet (MED) and the odds of DN.MethodsThis case–control study was performed among 210 women (30–65 years) who were referred to the Kowsar Diabetes Clinic in Semnan, Iran. Biochemical variables and anthropometric measurements were assessed. The food frequency questionnaire (FFQ) was used to calculate dietary intakes. Data from dietary intakes based on the FFQ were used to evaluate the MED score. Logistic regression was used to examine the associations.ResultsOur results showed that in the crude model with higher adherence to the MED (OR: 0.272; 95% CI: 0.154, 0.481; P = 0.001), the odds of DN has reduced by 73%, and in model 1, after controlling for potential confounders, with higher adherence to the MED (OR: 0.239; 95% CI: 0.128, 0.447; P = 0.001), the odds of DN has reduced by 76% compared to low adherence. Also, in model 1, significant associations were observed between high consumption of grains (OR: 0.360; 95% CI: 0.191, 0.676; P = 0.001), legumes (OR: 0.156; 95% CI: 0.083, 0.292; P = 0.001), vegetables (OR: 0.273; 95% CI: 0.149, 0.501; P = 0.001), fruits (OR: 0.179; 95% CI: 0.093, 0.347; P = 0.001), fish (OR: 0.459; 95% CI: 0.254, 0.827; P = 0.01), and reduced odds of DN (P < 0.05).ConclusionWe observed that with higher adherence to the MED, the odds of DN had reduced through mechanisms. However, additional studies are needed to confirm these findings.
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Affiliation(s)
- Sahar Noori
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Faezeh Abaj
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Khadijeh Mirzaei
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Reyes-García A, López-Olmedo N, Basto-Abreu A, Shamah-Levy T, Barrientos-Gutierrez T. Adherence to the DASH diet by hypertension status in Mexican men and women: A cross-sectional study. Prev Med Rep 2022; 27:101803. [PMID: 35656216 PMCID: PMC9152786 DOI: 10.1016/j.pmedr.2022.101803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 03/04/2022] [Accepted: 04/18/2022] [Indexed: 11/30/2022] Open
Abstract
Improving dietary patterns is a cornerstone of the non-pharmacological management of hypertension. Evidence about the adherence to healthy dietary patterns at the population level is scarce. We aimed to analyze the adherence to the Dietary Approaches to Stop Hypertension (DASH) diet among Mexican men and women by hypertension status. We used data from the 2012 Mexican National Health and Nutrition Survey (n = 2560). Using self-reported diagnosis of hypertension and blood pressure measurements, we identified participants without, with undiagnosed, and diagnosed hypertension. We calculated DASH scores (total and dietary components) based on a single 24-hour recall and analyzed differences in adherence across hypertension status using sex-specific multivariable Poisson regression models. Overall, regardless of hypertension status, adherence to the DASH score was low, with 35% of men and 38% of women with diagnosed hypertension adhering to recommended guidelines; lower adherence was observed in men (21.8%) and women (27.2%) with undiagnosed hypertension, and with no hypertension (26.8% in men, 26.3% in women). In multivariable models for men, the prevalence of adherence to the total DASH diet was 29% lower in undiagnosed adults versus adults without hypertension (RP 0.71; 95%CI 0.50,0.99). Specifically, adherence to fruits, total dairy, and animal protein was lower in undiagnosed men. Among women, the adherence to the DASH diet was similar across hypertension status in multivariable models. Mexican adults had low adherence to DASH, regardless of hypertension status. Strategies to improve adherence to DASH are needed, focusing in patients with hypertension but also as a preventive measure for the population.
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Affiliation(s)
- Alan Reyes-García
- Center for Population Health Research. National Institute of Public Health. Cuernavaca, Morelos, Mexico
| | - Nancy López-Olmedo
- Center for Population Health Research. National Institute of Public Health. Cuernavaca, Morelos, Mexico
| | - Ana Basto-Abreu
- Center for Population Health Research. National Institute of Public Health. Cuernavaca, Morelos, Mexico
| | - Teresa Shamah-Levy
- Evaluation and Surveys Research Center. National Institute of Public Health. Cuernavaca, Morelos, Mexico
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Wang R, Li M, Strappe P, Zhou Z. Preparation, structural characteristics and physiological property of resistant starch. ADVANCES IN FOOD AND NUTRITION RESEARCH 2021; 95:1-40. [PMID: 33745510 DOI: 10.1016/bs.afnr.2020.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Starch is of the most important carbohydrates in human diets for maintaining normal body's energy metabolisms. However, due to the increased number of chronic diseases worldwide, the further study of the starch property in the dietary formula becomes essential for revealing its association with preventing or intervening the occurrence of such diseases as diabetes, obesity, intestinal diseases and even cardiovascular diseases. Considering that different starches demonstrate different digestion property based on their individual structural characteristics, in particular, the existence of resistant starch (RS) attracts much more interests recently because of its being a major producer of short-chain fatty acids followed by gut microbial fermentation. Furthermore, the understanding of the interaction between RS and microbiota in the gut and its substantial influence on the regulation of diabetes, kidney, disease hypertension and others is still being under investigated. Therefore, this chapter summarized the fine structure of starch, resistant starch structural characteristics, formation and preparation of resistant starches and their corresponding physiological property.
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Affiliation(s)
- Rui Wang
- College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China
| | - Mei Li
- College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China
| | - Padraig Strappe
- School of Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Zhongkai Zhou
- College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China; ARC Functional Grains Centre, Charles Sturt University, Wagga Wagga, NSW, Australia.
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Asbaghi O, Hosseini R, Boozari B, Ghaedi E, Kashkooli S, Moradi S. The Effects of Magnesium Supplementation on Blood Pressure and Obesity Measure Among Type 2 Diabetes Patient: a Systematic Review and Meta-analysis of Randomized Controlled Trials. Biol Trace Elem Res 2021; 199:413-424. [PMID: 32385715 DOI: 10.1007/s12011-020-02157-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 04/15/2020] [Indexed: 12/17/2022]
Abstract
In this study, we aimed to systematically review the literature to evaluate the effects of magnesium (Mg) supplementation on blood pressure (BP) and obesity measure among patients with type 2 diabetes mellitus (T2DM). Major electronic databases of Web of Science, the Cochrane library, PubMed, and Scopus were searched completely from the inception until 15 October 2019 to identify randomized clinical trials (RCTs) pertaining to the topic of interest. All outcomes were pooled using a random-effects model and expressed as weighted mean differences (WMD) with 95% confidential intervals (CI). Heterogeneity, sensitivity analysis, and publication bias were also assessed using standard methods. The pooled analysis of five RCTs showed that Mg supplementation did not affect body weight (WMD: - 0.01 kg, 95% CI: - 0.36 to 0.33), BMI (WMD: - 0.07, 95% CI: - 0.18 to 0.04), and waist circumference (WMD: 0.12, 95% CI: - 1.24 to 1.48) in T2DM patients compared to the control groups of the patients who received placebo. However, pooling seven RCTs together showed significant reduction of systolic blood pressure (WMD: - 5.78 mmHg, 95% CI: - 11.37 to - 0.19) and diastolic blood pressure (WMD: - 2.50 mmHg, 95% CI: - 4.58 to - 0.41) in T2DM patients. Furthermore, subgroup analysis by dose of intervention, intervention duration, and type of intervention suggested that Mg supplementation for > 12 weeks, in doses higher than 300 mg/day or inorganic forms, could significantly decrease both systolic and diastolic BP in T2DM patients. Based on the findings, Mg supplementation has beneficial effects on BP in type 2 diabetes patients independent of body weight status. However, further investigations are needed to provide more reliable evidences.
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Affiliation(s)
- Omid Asbaghi
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Reza Hosseini
- Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behnoosh Boozari
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ehsan Ghaedi
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Kashkooli
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Sajjad Moradi
- Halal Research Centre of IRI, FDA, Tehran, Iran.
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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Shvabskaia OB, Karamnova NS, Izmailova OV. Healthy Diet: New Rations for Individual Use. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2020. [DOI: 10.20996/1819-6446-2020-12-12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Nutrition is one of the most significant factors influencing the state of health, the development of diseases and the generally the human longevity. The nature of nutrition, which has a protective effect, is the basis of the healthy diet. Among healthy nutritious rations, there are those that have developed naturally, formed from the cultural food heritage and later were made in scientific nutritional recommendations. These are such diets as the Mediterranean type of food, the Scandinavian diet, the Tibetan style of food, etc. At the same time, there are diets specially developed by specialists for specific purposes. All of them correspond to the basic principles of the healthy diet: balance, usefulness and energy balance. This article offers an overview of the use of individual diets that have been developed by nutritionists, such as the intermittent fasting diet, the Paleo diet, and the DASH (Dietary Approaches to Stop Hypertension) diet. The article discusses the differences and advantages of these dietary approaches, presents the results of effectiveness, considers the limitations and features of their use.
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Affiliation(s)
- O. B. Shvabskaia
- National Medical Research Center for Therapy and Preventive Medicine
| | - N. S. Karamnova
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. V. Izmailova
- National Medical Research Center for Therapy and Preventive Medicine
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Aqeel MM, Guo J, Lin L, Gelfand SB, Delp EJ, Bhadra A, Richards EA, Hennessy E, Eicher-Miller HA. Temporal Dietary Patterns Are Associated with Obesity in US Adults. J Nutr 2020; 150:3259-3268. [PMID: 33096568 PMCID: PMC7726125 DOI: 10.1093/jn/nxaa287] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 07/09/2020] [Accepted: 08/31/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The integration of time with dietary patterns throughout a day, or temporal dietary patterns (TDPs), have been linked with dietary quality but relations to health are unknown. OBJECTIVE The association between TDPs and selected health status indicators and obesity, type 2 diabetes (T2D), and metabolic syndrome (MetS) was determined. METHODS The first-day 24-h dietary recall from 1627 nonpregnant US adult participants aged 20-65 y from the NHANES 2003-2006 was used to determine timing, amount of energy intake, and sequence of eating occasions (EOs). Modified dynamic time warping (MDTW) and kernel k-means algorithm clustered participants into 4 groups representing distinct TDPs. Multivariate regression models determined associations between TDPs and health status, controlling for potential confounders, and adjusting for the survey design and multiple comparisons (P <0.05/6). RESULTS A cluster representing a TDP with evenly spaced, energy balanced EOs reaching ≤1200 kcal between 06:00 to 10:00, 12:00 to 15:00, and 18:00 to 22:00, had statistically significant and clinically meaningful lower mean BMI (P <0.0001), waist circumference (WC) (P <0.0001), and 75% lower odds of obesity compared with 3 other clusters representing patterns with much higher peaks of energy: 1000-2400 kcal between 15:00 and 18:00 (OR: 5.3; 95% CI: 2.8, 10.1), 800-2400 kcal between 11:00 and 15:00 (OR: 4.4; 95% CI: 2.5, 7.9), and 1000-2600 kcal between 18:00 and 23:00 (OR: 6.7; 95% CI: 3.9, 11.6). CONCLUSIONS Individuals with a TDP characterized by evenly spaced, energy balanced EOs had significantly lower mean BMI, WC, and odds of obesity compared with the other patterns with higher energy intake peaks at different times throughout the day, providing evidence that incorporating time with other aspects of a dietary pattern may be important to health status.
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Affiliation(s)
- Marah M Aqeel
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Jiaqi Guo
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, USA
| | - Luotao Lin
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Saul B Gelfand
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, USA
| | - Edward J Delp
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, USA
| | - Anindya Bhadra
- Department of Statistics, Purdue University, West Lafayette, IN, USA
| | | | - Erin Hennessy
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
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Bricarello LP, Retondario A, Poltronieri F, Souza ADM, Vasconcelos FDAGD. Abordagem dietética para controle da hipertensão: reflexões sobre adesão e possíveis impactos para a saúde coletiva. CIENCIA & SAUDE COLETIVA 2020; 25:1421-1432. [DOI: 10.1590/1413-81232020254.17492018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 08/02/2018] [Indexed: 01/15/2023] Open
Abstract
Resumo A dieta DASH (Dietary Approach to Stop Hypertension) é considerada um padrão alimentar saudável, sendo preconizada para o controle da hipertensão arterial. O objetivo do artigo foi revisar a literatura sobre a dieta DASH e verificar sua adesão pela população brasileira. Realizou-se revisão integrativa nas bases Medline/PubMed, SciELO e LILACS, nos idiomas inglês e português. A literatura sobre dieta DASH é extensa, entretanto quatro estudos mostrando a adesão pela população brasileira foram encontrados. A dieta DASH representa uma intervenção potencialmente acessível e aplicável que poderia melhorar a saúde da população. Os estudos diferiram entre si nos métodos de avaliação utilizados e a baixa adesão evidencia a necessidade de implementação de ações no âmbito da atenção nutricional ao hipertenso. Estratégias inovadoras serão necessárias para determinar a melhor forma de minimizar as barreiras para disseminação e adesão a esse padrão alimentar saudável. Sugere-se planos alimentares e orientações flexíveis, pouco restritivas, compatíveis, com objetivos claros, direcionados para mudanças graduais, com monitoramento frequente de equipe multiprofissional de saúde.
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Tata CM, Ndinteh D, Nkeh-Chungag BN, Oyedeji OO, Sewani-Rusike CR. Fractionation and bioassay-guided isolation of antihypertensive components of Senecio serratuloides. COGENT MEDICINE 2020. [DOI: 10.1080/2331205x.2020.1716447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Charlotte Mungho Tata
- Department of Human Biology, Faculty of Health Sciences, Walter Sisulu University Mthatha 5117 South Africa
- Department of Chemical Sciences, Faculty of Science, University of Johannesburg Johannesburg South Africa
| | - Derek Ndinteh
- Department of Chemical Sciences, Faculty of Science, University of Johannesburg Johannesburg South Africa
| | | | - Opeopluwa Oyehan Oyedeji
- Department of Chemistry, Faculty of Science and Agriculture, University of Fort Hare PBX1314 Alice Eastern Cape Province 5700 South Africa
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A pilot intervention to reduce postpartum weight retention at primary health care in Brazil. NUTR HOSP 2019; 36:854-861. [PMID: 31232585 DOI: 10.20960/nh.02508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Background: postpartum weight retention (PWR) strongly predicts obesity, the major nutritional concern of this century; however, there is a gap in nutritional care for postpartum women in Brazil. Objective: to evaluate the effect of nutritional counselling provided at primary health care on the reduction of PWR. Method: pilot study carried out in a low-income community in southeastern Brazil, involving postpartum women with PWR, who were provided with individual monthly appointments with a nutritionist over three months of follow-up. Nutritional counselling was based on the Dietary Approach to Stop Hypertension (DASH diet) aiming at healthy and gradual weight loss. Anthropometric evaluation included measurement of weight, height, waist circumference and percentage of body fat. Dietary intake was assessed using a food frequency questionnaire and adherence to diet was evaluated using a DASH score. Results: women who participated in the study (n = 26) showed a reduction in PWR (median -1.80 kg, p = 0.004), body mass index (-0.57 kg/m², p = 0.004), and waist circumference (-2.50 cm, p = 0.024), as well as 91.67% of them presented good adherence to diet. Conclusion: nutritional counselling provided to low-income postpartum women at primary health care contributed to the reduction of PWR, body mass index and waist circumference, as the study participants presented good adherence to a healthy dietary pattern.
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Dietary approaches to stop hypertension, mediterranean dietary pattern, and diabetic nephropathy in women with type 2 diabetes: A case-control study. Clin Nutr ESPEN 2019; 33:164-170. [PMID: 31451255 DOI: 10.1016/j.clnesp.2019.05.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 05/22/2019] [Accepted: 05/28/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS The association between dietary habits and kidney function in patients with type 2 diabetes (T2D) has been poorly investigated. We aimed to test the relationship between adherences to the Dietary Approaches to Stop Hypertension (DASH) diet and the Mediterranean dietary pattern (Med diet) and likelihood of diabetic nephropathy (DN) in women with T2D. METHODS In a case-control study, 105 women with T2D and DN (albumin-creatinine ratio ≥ 30 mg/g, mean age: 55.3 ± 7.0 years; diabetes duration: 7.6 ± 2.2 years), and 105 controls with T2D and without DN (mean age: 55.4 ± 7.1 years; diabetes duration: 7.6 ± 2.1 years) who attended at Kowsar diabetes clinic in Semnan, Iran were matched for age and diabetes duration. Dietary intakes were assessed using a validated 147-item semiquantitative food frequency questionnaire. The DASH and Med diet scores were calculated using the methods developed by Fung and Trichopoulou, respectively. A generalized estimating equation model was used to examine the relationship between dietary scores and odds of DN across tertiles of dietary patterns scores. RESULTS Type 2 diabetic women with moderate and high Med diet scores had 62% and 86% lower odds of DN in comparison with low adherent (ORs: 0.38, 95%CI: 0.20, 0.73; and 0.14, 95%CI: 0.06, 0.33; respectively). A moderate adherence to the DASH diet was not associated with risk of DN, but a significant inverse relationship was found in those with high adherence (OR: 0.71, 95%CI: 0.57, 0.90). CONCLUSIONS Adherence to the DASH and Med diets was inversely and dose-dependently associated with risk of DN. Further observational studies are needed to confirm the present results.
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Ferreira RC, Barbosa LB, Vasconcelos SML. Estudos de avaliação do consumo alimentar segundo método dos escores: uma revisão sistemática. CIENCIA & SAUDE COLETIVA 2019; 24:1777-1792. [DOI: 10.1590/1413-81232018245.12362017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 08/09/2017] [Indexed: 11/21/2022] Open
Abstract
Resumo O presente artigo tem como objetivo revisar de forma sistematizada a literatura relativa a estudos que utilizaram o método dos escores proposto por Fornés e colaboradores, em 2002, para avaliar o consumo alimentar e discutir o método na perspectiva de avaliação do padrão alimentar. Foi realizada busca de artigos nas bases de dados Medline, Lilacs e Scielo. Limitou-se a busca aos idiomas inglês, português e espanhol e aos artigos publicados de 2002 até 2016. Os critérios de inclusão foram: estudos que utilizaram o método dos escores proposto por Fornés et al. para avaliar o consumo alimentar. Foram encontrados 8.300 artigos na busca inicial. Após leitura de títulos, resumos e aplicação de critérios de exclusão, 14 artigos foram selecionados. Os artigos avaliaram o padrão alimentar adotando diferentes grupos e verificaram associações com variáveis antropométricas, socioeconômicas e bioquímicas. Concluiu-se que o método dos escores constitui uma ferramenta capaz de avaliar os padrões alimentares e que permite verificar associações entre variáveis antropométricas, bioquímicas, socioeconômicas e clínica com os componentes da dieta/grupo alimentar investigado aos quais o indivíduo foi exposto.
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Zhu R, Fan Z, Dong Y, Liu M, Wang L, Pan H. Postprandial Glycaemic Responses of Dried Fruit-Containing Meals in Healthy Adults: Results from a Randomised Trial. Nutrients 2018; 10:E694. [PMID: 29848962 PMCID: PMC6024783 DOI: 10.3390/nu10060694] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 05/25/2018] [Accepted: 05/28/2018] [Indexed: 02/06/2023] Open
Abstract
The aim of this study was to explore the glycaemic response (GR) patterns of four dried fruits (DF) and the mixed meals containing dried fruits, rice and almonds. Dried apples (DApp), dried jujubes (DJ), raisins (Ra) and dried apricots (DApr) were tested in eleven healthy subjects in random order. Test meals included the following 3 groups: (1) dried fruits containing 50 g available carbohydrates; (2) mixed meals consisting of DF and rice (DF + R), each contributing 25 g available carbohydrates; (3) Group (2) supplemented with 30 g almonds (DF + R + A). The postprandial GR and other characteristics in 240 min were investigated. The GI values of 4 DFs were 43 for DApp, 55 for DJ, 56 for both Ra and DApr. The DApp displayed the smallest amplitude of glycaemic excursion within 240 min (MAGE0⁻240). Compared with rice, the DApp + R meal elicited a significantly reduced GR and a smaller MAGE0⁻240 (GI 81 vs. 65). With the addition of almonds, the GIs and MAGE0⁻240 decreased significantly in all DF + A + R combinations except DApp + R + A. The ratio of total fructose/glucose contents of test meals were negatively correlated to GIs. Dried fruits and nuts may have the potential to mitigate the postprandial GR when jointly introduced into glycaemic management diets.
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Affiliation(s)
- Ruixin Zhu
- Beijing Advanced Innovation Centre for Food Nutrition and Human Health, China Agricultural University, Beijing 100083, China.
| | - Zhihong Fan
- Beijing Advanced Innovation Centre for Food Nutrition and Human Health, China Agricultural University, Beijing 100083, China.
| | - Yang Dong
- Beijing Advanced Innovation Centre for Food Nutrition and Human Health, China Agricultural University, Beijing 100083, China.
| | - Manman Liu
- Department of Food Science and Engineering, College of Biological Science and Technology, Beijing Forestry University, Beijing 100083, China.
| | - Linlin Wang
- Beijing Advanced Innovation Centre for Food Nutrition and Human Health, China Agricultural University, Beijing 100083, China.
| | - Haikun Pan
- Beijing Advanced Innovation Centre for Food Nutrition and Human Health, China Agricultural University, Beijing 100083, China.
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Beretta MV, Bernaud FR, Nascimento C, Steemburgo T, Rodrigues TC. Higher fiber intake is associated with lower blood pressure levels in patients with type 1 diabetes. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2018; 62:47-54. [PMID: 29694634 PMCID: PMC10118680 DOI: 10.20945/2359-3997000000008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 05/17/2017] [Indexed: 11/23/2022]
Abstract
Objective The present investigation sought to evaluate the potential association between dietary fiber intake and blood pressure (BP) in adult patients with type 1 diabetes (T1D). Subjects and methods A cross-sectional study was carried out in 111 outpatients with T1D from Porto Alegre, Brazil. Patients were predominantly male (56%) and white (88%), with a mean age of 40 ± 10 years, diabetes duration of 18 ± 9 years, BMI 24.8 ± 3.85 kg/m2, and HbA1c 9.0 ± 2.0%. After clinical and laboratory evaluation, dietary intake was evaluated by 3-day weighed-diet records, whose reliability was confirmed by 24-h urinary nitrogen output. Patients were stratified into two groups according to adequacy of fiber intake in relation to American Diabetes Association (ADA) recommendations: below recommended daily intake (< 14g fiber/1000 kcal) or at/above recommended intake (≥ 14g/1000 kcal). Results Patients in the higher fiber intake group exhibited significantly lower systolic (SBP) (115.9 ± 12.2 vs 125.1 ± 25.0 mmHg, p = 0.016) and diastolic blood pressure (DBP) (72.9 ± 9.2 vs 78.5 ± 9.3 mmHg, p = 0.009), higher energy intake (2164.0 ± 626.0 vs 1632.8 ± 502.0 kcal, p < 0.001), and lower BMI (24.4 ± 3.5 vs 26.2 ± 4.8, p = 0.044). Linear regression modelling, adjusted for age, energy intake, sodium intake, and BMI, indicated that higher fiber intake was associated with lower SBP and DBP levels. No significant between-group differences were observed with regard to duration of diabetes, glycemic control, insulin dosage, or presence of hypertension, nephropathy, or retinopathy. Conclusion We conclude that fiber consumption meeting or exceeding current ADA recommendations is associated with lower SBP and DBP in patients with T1D.
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Affiliation(s)
- Mileni Vanti Beretta
- Divisão de Endocrinologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil
| | - Fernanda R Bernaud
- Divisão de Endocrinologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil
| | - Ciglea Nascimento
- Divisão de Endocrinologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil
| | - Thais Steemburgo
- Departamento de Nutrição, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Ticiana C Rodrigues
- Divisão de Endocrinologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil
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Blekkenhorst LC, Bondonno NP, Liu AH, Ward NC, Prince RL, Lewis JR, Devine A, Croft KD, Hodgson JM, Bondonno CP. Nitrate, the oral microbiome, and cardiovascular health: a systematic literature review of human and animal studies. Am J Clin Nutr 2018; 107:504-522. [PMID: 29635489 DOI: 10.1093/ajcn/nqx046] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 11/21/2017] [Indexed: 12/25/2022] Open
Abstract
Background Dietary nitrate is an important source of nitric oxide (NO), a molecule critical for cardiovascular health. Nitrate is sequentially reduced to NO through an enterosalivary nitrate-nitrite-NO pathway that involves the oral microbiome. This pathway is considered an important adjunct pathway to the classical l-arginine-NO synthase pathway. Objective The objective of this study was to systematically assess the evidence for dietary nitrate intake and improved cardiovascular health from both human and animal studies. Design A systematic literature search was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines by using key search terms in Medline and EMBASE databases and defined inclusion and exclusion criteria. Results Thirty-seven articles on humans and 14 articles on animals were included from 12,541 screened references. Data on the effects of dietary nitrate on blood pressure, endothelial function, ischemic reperfusion injury, arterial stiffness, platelet function, and cerebral blood flow in both human and animal models were identified. Beneficial effects of nitrate on vascular health have predominantly been observed in healthy human populations, whereas effects in populations at risk of cardiovascular disease are less clear. Few studies have investigated the long-term effects of dietary nitrate on cardiovascular disease clinical endpoints. In animal studies, there is evidence that nitrate improves blood pressure and endothelial function, particularly in animal models with reduced NO bioavailability. Nitrate dose seems to be a critical factor because there is evidence of cross-talk between the 2 pathways of NO production. Conclusions Evidence for a beneficial effect in humans at risk of cardiovascular disease is limited. Furthermore, there is a need to investigate the long-term effects of dietary nitrate on cardiovascular disease clinical endpoints. Further animal studies are required to elucidate the mechanisms behind the observed effects.
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Affiliation(s)
- Lauren C Blekkenhorst
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Nicola P Bondonno
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Alex H Liu
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Natalie C Ward
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia.,School of Biomedical Sciences and Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Richard L Prince
- Medical School, Queen Elizabeth Medical Center Unit, University of Western Australia, Nedlands, Western Australia, Australia
| | - Joshua R Lewis
- Medical School, Queen Elizabeth Medical Center Unit, University of Western Australia, Nedlands, Western Australia, Australia
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Kevin D Croft
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Jonathan M Hodgson
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Catherine P Bondonno
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
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Archundia Herrera MC, Subhan FB, Chan CB. Dietary Patterns and Cardiovascular Disease Risk in People with Type 2 Diabetes. Curr Obes Rep 2017; 6:405-413. [PMID: 29063379 DOI: 10.1007/s13679-017-0284-5] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW The primary objective of this review is to identify dietary patterns with beneficial effects on cardiovascular health of adults with type 2 diabetes. RECENT FINDINGS The prevalence of diabetes is increasing globally. People with diabetes have a greater risk for cardiovascular disease. Mediterranean diet, dietary approaches to stop hypertension diet, vegetarian diet, traditional Korean diet, Japanese diet, and low-glycemic-index diet can reduce cardiovascular disease risk in people with diabetes. Dietary intake is a key modifiable factor in the management of diabetes and plays a significant role in limiting the incidence of cardiovascular diseases.
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Affiliation(s)
- M Carolina Archundia Herrera
- Department of Agriculture, Food and Nutritional Science, Alberta Diabetes Institute, University of Alberta, 6-002 Li Ka Shing Centre for Health Innovation Research, Edmonton, AB, T6G 2E1, Canada
| | - Fatheema B Subhan
- Department of Agriculture, Food and Nutritional Science, Alberta Diabetes Institute, University of Alberta, 6-002 Li Ka Shing Centre for Health Innovation Research, Edmonton, AB, T6G 2E1, Canada
| | - Catherine B Chan
- Department of Agriculture, Food and Nutritional Science, Alberta Diabetes Institute, University of Alberta, 6-002 Li Ka Shing Centre for Health Innovation Research, Edmonton, AB, T6G 2E1, Canada.
- Department of Physiology, Alberta Diabetes Institute, University of Alberta, 6-002 Li Ka Shing Centre for Health Innovation Research, Edmonton, AB, T6G 2E1, Canada.
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19
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Vegetarian diet reduces the risk of hypertension independent of abdominal obesity and inflammation: a prospective study. J Hypertens 2017; 34:2164-71. [PMID: 27512965 DOI: 10.1097/hjh.0000000000001068] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES A vegetarian diet may prevent elevation of blood pressures and lower the risk for hypertension through lower degrees of obesity, inflammation, and insulin resistance. This study investigated the association between a vegetarian diet and hypertension incidence in a cohort of Taiwanese adult nonsmokers and examined whether this association was mediated through inflammation, abdominal obesity, or insulin resistance (using fasting glucose as a proxy). METHODS This matched cohort study was from the 1994-2008 MJ Health Screening Database. Each vegetarian was matched with five nonvegetarians by age, sex, and study site. The analysis included 4109 nonsmokers (3423 nonvegetarians and 686 vegetarians), followed for a median of 1.61 years. The outcome includes hypertension incidence, as well as SBP and DBP levels. Regression analysis was performed to assess the association between vegetarian diet and hypertension incidence or future blood pressure levels in the presence/absence of potential mediators. RESULTS Vegetarians had a 34% lower risk for hypertension, adjusting for age and sex (odds ratio: 0.66, 95% confidence interval: 0.50-0.87; SBP: -3.3 mmHg, P < 0.001; DBP: -1.5 mmHg, P < 0.001). The results stay statistically significant after further adjustment for C-reactive protein, waist circumference, and fasting glucose (odds ratio: 0.72, 95% confidence interval: 0.55-0.86; SBP: -2.4 mmHg, P < 0.05; DBP: -1.1 mmHg, P < 0.05). The protective association between vegetarian diet and hypertension appeared to be consistent across age groups. CONCLUSION Taiwanese vegetarians had lower incidence of hypertension than nonvegetarians. Vegetarian diets may protect against hypertension beyond lower abdominal obesity, inflammation, and insulin resistance.
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Abstract
IN BRIEF The DASH (Dietary Approaches to Stop Hypertension) eating plan is an acceptable eating pattern for people who have diabetes. In addition to promoting blood pressure control, this eating pattern has been shown to improve insulin resistance, hyperlipidemia, and even overweight/obesity. This balanced approach promotes consumption of a variety of foods (whole grains, fat-free or low-fat dairy products, fruits, vegetables, poultry, fish, and nuts) and is appropriate for the entire family.
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de Paula TP, Kramer CK, Viana LV, Azevedo MJ. Effects of individual micronutrients on blood pressure in patients with type 2 diabetes: a systematic review and meta-analysis of randomized clinical trials. Sci Rep 2017; 7:40751. [PMID: 28084431 PMCID: PMC5233957 DOI: 10.1038/srep40751] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 12/09/2016] [Indexed: 02/07/2023] Open
Abstract
To investigate the effects of micronutrients on blood pressure (BP) in patients with type 2 diabetes through a systematic review and meta-analysis, randomized clinical trials (RCTs) of the effects of individual micronutrients on BP in patients with type 2 diabetes were searched in the Medline, Embase, Cochrane, and Clinical Trials.gov databases through April 2016. From the 28,164 studies, 11 RCTs (13 interventions, 723 patients, 54% males) with 3 to 52 weeks of follow-up were classified according to the type of micronutrient intervention: sodium (n = 1), vitamin C (n = 2), vitamin D (n = 7), and magnesium (n = 1). The available data enabled us to perform meta-analyses of vitamins C and D. Vitamin C reduced diastolic BP [WMD -2.88 mmHg (95%CI -5.31, -0.46; P = 0.020)] but not systolic BP [WMD -3.93 mmHg (95%CI -14.78, 6.92; P = 0.478)]. Vitamin D caused a reduction of 4.56 mmHg (WMD; 95%CI -7.65, -1.47; P = 0.004) for systolic BP and 2.44 mm Hg (WMD; 95%CI -3.49, -1.39; P < 0.001) for diastolic BP. In conclusion, vitamin D and possibly vitamin C have beneficial effects on BP in patients with type 2 diabetes. These interventions might represent a novel approach to the treatment of hypertension in these patients.
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Affiliation(s)
- Tatiana P. de Paula
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Luciana V. Viana
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Mirela J. Azevedo
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Singh RB, Hristova K, Bjørklund G, Fedacko J, Chirumbolo S, Pella D. Extended consensus on blood pressure variability beyond blood pressure for management of hypertension. ACTA ACUST UNITED AC 2017; 11:6-9. [PMID: 28040405 DOI: 10.1016/j.jash.2016.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 11/10/2016] [Accepted: 11/16/2016] [Indexed: 11/24/2022]
Affiliation(s)
- Ram B Singh
- Halberg Hospital and Research Institute, Moradabad, India
| | - Krasimira Hristova
- Division of Echocardiography Imaging, National Heart Hospital, Sofia, Bulgaria
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway.
| | - Jan Fedacko
- Faculty of Medicine, Pavol Jozef Šafárik University, Kosice, Slovakia
| | - Salvatore Chirumbolo
- Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
| | - Daniel Pella
- Faculty of Medicine, Pavol Jozef Šafárik University, Kosice, Slovakia
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Paula TP, Viana LV, Neto ATZ, Leitão CB, Gross JL, Azevedo MJ. Effects of the DASH Diet and Walking on Blood Pressure in Patients With Type 2 Diabetes and Uncontrolled Hypertension: A Randomized Controlled Trial. J Clin Hypertens (Greenwich) 2015; 17:895-901. [PMID: 26041459 PMCID: PMC8031764 DOI: 10.1111/jch.12597] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 04/13/2015] [Accepted: 04/15/2015] [Indexed: 01/19/2023]
Abstract
Data on the potential beneficial effects of combining diet and exercise on blood pressure (BP) are still scarce. A 4-week randomized controlled clinical trial was undertaken in 40 hypertensive patients with type 2 diabetes with uncontrolled blood pressure (BP) in office and daytime ambulatory BP monitoring (ABPM). Patients were assigned to follow a Dietary Approaches to Stop Hypertension (DASH) diet associated with advice to increase walking using a pedometer (intervention group) or a diet based on the American Diabetes Association recommendations (control group). The lifestyle intervention caused a greater ABPM (mm Hg) reduction in systolic 24-hour, diastolic 24-hour, nighttime systolic, daytime systolic, and daytime diastolic measurements than observed in the control group. In the intervention group there was a decrease in urinary sodium and an increase in urinary potassium, plasma aldosterone, and the number of steps per day (P<.05). The DASH diet and increased walking were associated with clinically significant reductions in ABPM values in hypertensive patients with type 2 diabetes.
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Affiliation(s)
- Tatiana P Paula
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Luciana V Viana
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Alessandra T Z Neto
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Cristiane B Leitão
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Jorge L Gross
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Mirela J Azevedo
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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ANTONIO JP, SILVA FM, CAMEY SA, AZEVEDO MJD, ALMEIDA JCD. Development of a Healthy Eating Index for patients with type 2 diabetes. REV NUTR 2015. [DOI: 10.1590/1415-52732015000500006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objective:This study sought to develop a dietary index for assessment of diet quality aiming for compliance with dietary recommendations for diabetes: The Diabetes Healthy Eating Index.Methods:Cross-sectional study with 201 outpatients with type 2 diabetes (61.4±9.7 years of age; 72.1% were overweight; 12.1±7.7 years of diagnosis; 7.3±1.3% mean HbA1c). Clinical and laboratory evaluations were performed together with 3-day weight diet records. The dietary index developed included 10 components: "diet variety", "fresh fruits", "vegetables", "carbohydrates and fiber sources", "meats and eggs", "dairy products and saturated fatty acids", "oils and fats", "total lipids", "cholesterol", and "transunsaturated fatty acids". The performance of each component was evaluated using the Item Response Theory, and diet quality was scored from 0-100%.Results:Overall, diet quality in this sample was 39.8±14.3% (95%CI=37.8-41.8%), and only 55 patients had a total diet quality score >50%. Good compliance was observed in only four index components: "total lipids", "variety", "fiber sources", and "dairy and saturated fatty acids". The components that differentiated patients with poor dietary quality from those with good dietary quality were "vegetables", "diet variety", "dairy and saturated fatty acids" and "total lipids". The greatest determinants of dietary quality were the components "diet variety", "vegetables", and "total lipids".Conclusion:This dietary index proposed assesses diet quality in compliance with the specific nutritional recommendations for diabetes. In clinical practice, this novel index may be a useful tool for the assessment and management of diet of patients with type 2 diabetes.
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Hieda K, Sunagawa Y, Katanasaka Y, Hasegawa K, Morimoto T. Pharmacological effect of functional foods with a hypotensive action. Nihon Yakurigaku Zasshi 2015; 146:33-9. [PMID: 26165340 DOI: 10.1254/fpj.146.33] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Golzarand M, Bahadoran Z, Mirmiran P, Zadeh-Vakili A, Azizi F. Consumption of nitrate-containing vegetables is inversely associated with hypertension in adults: a prospective investigation from the Tehran Lipid and Glucose Study. J Nephrol 2015; 29:377-384. [PMID: 26335410 DOI: 10.1007/s40620-015-0229-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 08/19/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND There is growing evidence of the potential properties of nitrate-rich foods against development of hypertension (HTN) and vascular disease. In this study, we investigated the association of nitrate-containing vegetables (NCVs) with risk of HTN after 3 years of follow-up. METHODS This prospective study was conducted on 1546 non-hypertensive subjects, aged 20-70 years. Blood pressure was measured at baseline and after 3 years and HTN was defined by the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure criteria. Dietary intake was collected using a validated semi-quantitative food frequency questionnaire (FFQ). NCVs and high-, medium- and low-NCV subcategories were defined, and the odds of HTN after 3 years according to tertiles of NCV and NCV-category intake were estimated by logistic regression and adjusted for potential variables. RESULTS Mean age of participants was 38.0 ± 12.0 years at baseline and 57.0 % were women. Mean dietary intake of energy-adjusted NCV was 298.0 ± 177.3 g/day. After adjustment for total energy intake, fiber, sodium, potassium and processed meat, a significant inverse association was observed between NCV and the risk of HTN in the highest tertile category (odds ratio 0.63, 95 % confidence interval: 0.41-0.98, p for trend = 0.05). There was no significant association of 3 year risk of HTN across tertiles of low nitrate-, medium nitrate- and high-nitrate vegetables. CONCLUSION Higher dietary nitrate intake from vegetables sources may have a protective effect against development of HTN.
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Affiliation(s)
- Mahdieh Golzarand
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.,Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Zahra Bahadoran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.,Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran. .,, No. 24, Parvaneh St, Yemen St, Chamran Exp, PO Box 19395-4763, Tehran, Islamic Republic of Iran.
| | - Azita Zadeh-Vakili
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.,Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
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Hieda K, Sunagawa Y, Katanasaka Y, Hasegawa K, Morimoto T. Antihypertensive effects of foods. World J Hypertens 2015; 5:53-62. [DOI: 10.5494/wjh.v5.i2.53] [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: 12/17/2014] [Revised: 02/04/2015] [Accepted: 04/07/2015] [Indexed: 02/06/2023] Open
Abstract
Hypertension is one of the major risk factors for arteriosclerosis, which leads to cardiovascular disease and stroke. Several clinical trials revealed that control of the blood pressure is useful to reduce the morbidity and mortality associated with these diseases. However, the protective efficacy against these complications still remains at less than 50% even if the high blood pressure is treated by current medical drugs. Healthy diets are expected to not only prevent but also treat lifestyle-related diseases. Improvement of the dietary life, including low-salt diets, appropriate alcohol consumption, and calorie restriction, is important for the prevention of hypertension. In addition, green tea, which has been drunk on a daily basis in Japan and China since ancient times, possesses an antihypertensive effect, and it was revealed that its components with this effect are catechins. Many studies have been performed on the antihypertensive effects of foods. Therefore, functional foods and their ingredients, reported to possess antihypertensive effects in animal experiments and human clinical trials, are summarized in this review. Blood pressure might be controlled by improvement of the daily eating habits based on evidence regarding these functional foods, and a healthy longevity can be expected.
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Sarmento RA, Antonio JP, Riboldi BP, Montenegro KR, Friedman R, de Azevedo MJ, de Almeida JC. Reproducibility and validity of a quantitative FFQ designed for patients with type 2 diabetes mellitus from southern Brazil. Public Health Nutr 2014; 17:2237-45. [PMID: 24107661 PMCID: PMC10282628 DOI: 10.1017/s1368980013002644] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 08/11/2013] [Accepted: 08/25/2013] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To evaluate the reproducibility and validity of a previously constructed FFQ to assess the usual diet of patients with type 2 diabetes mellitus (T2DM). DESIGN Cross-sectional survey using two quantitative FFQ (1-month interval) supported by a food photograph portfolio, a 3 d weighed diet record (WDR) and urinary N output measurement (as a biomarker of protein intake). SETTING Group of Nutrition in Endocrinology, southern Brazil. SUBJECTS Out-patients with T2DM. RESULTS From a total of 104 eligible T2DM patients, eighty-eight were included in the evaluation of FFQ reproducibility and seventy-two provided data for the validity study. The intakes estimated from the two FFQ did not differ (P > 0·05) and the correlation coefficients were significant (P < 0·01) for energy and nutrients, ranging from 0·451 (soluble fibre) to 0·936 (PUFA). Regarding the validity evaluation, data from the FFQ were higher than those from the WDR for total (28·3%), soluble (27·4%) and insoluble fibres (29·1%), and SFA (13·5%), MUFA (11·1 %) and total lipids (9·2%; all P < 0·05). There were significant correlation coefficients between the FFQ and WDR for most nutrients, when adjusted for energy intake and de-attenuated. Also, the Bland-Altman plots between the FFQ and WDR for energy and macronutrient intakes showed that the FFQ may be used as alternative method to the WDR. The validity coefficient (using the method of triads) for the FFQ protein intake was 0·522 (95% CI 0·414, 0·597). CONCLUSIONS This quantitative FFQ was valid and precise to assess the usual diet of patients with T2DM, according to its validity and reproducibility.
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Affiliation(s)
- Roberta Aguiar Sarmento
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2350, Prédio 12, 4° andar, 90035-003 Porto Alegre, Rio Grande do Sul, Brazil
| | - Juliana Peçanha Antonio
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2350, Prédio 12, 4° andar, 90035-003 Porto Alegre, Rio Grande do Sul, Brazil
| | - Bárbara Pelicioli Riboldi
- Nutrition College, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Karina Romeu Montenegro
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2350, Prédio 12, 4° andar, 90035-003 Porto Alegre, Rio Grande do Sul, Brazil
- Nutrition College, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Rogério Friedman
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2350, Prédio 12, 4° andar, 90035-003 Porto Alegre, Rio Grande do Sul, Brazil
- Department of Internal Medicine, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Mirela Jobim de Azevedo
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2350, Prédio 12, 4° andar, 90035-003 Porto Alegre, Rio Grande do Sul, Brazil
- Department of Internal Medicine, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Jussara Carnevale de Almeida
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2350, Prédio 12, 4° andar, 90035-003 Porto Alegre, Rio Grande do Sul, Brazil
- Nutrition College, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Department of Internal Medicine, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Bernaud FSR, Rodrigues TC. [Dietary fiber--adequate intake and effects on metabolism health]. ACTA ACUST UNITED AC 2014; 57:397-405. [PMID: 24030179 DOI: 10.1590/s0004-27302013000600001] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 04/14/2013] [Indexed: 01/04/2023]
Abstract
The positive effects of dietary fiber are related, in part, to the fact that a portion of the fermentation of components takes place in the large intestine, which has an impact on the speed of digestion, pH of the colon, and production of by-products with important physiological functions. Individuals with high fiber intake seem to have lower risk of developing coronary artery disease, hypertension, obesity, diabetes, and colon cancer. The increase in fiber intake reduces serum cholesterol, improves blood glucose in patients with diabetes, reduces body weight, and is associated with lower serum ultrasensitive C-reactive protein. Increased fiber intake and intake of more fiber than the currently recommended level (14 g/1,000 kcal) may provide greater health benefits, including reducing low-grade inflammation.
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Jung SJ, Park SH, Choi EK, Cha YS, Cho BH, Kim YG, Kim MG, Song WO, Park TS, Ko JK, So BO, Chae SW. Beneficial effects of Korean traditional diets in hypertensive and type 2 diabetic patients. J Med Food 2014; 17:161-71. [PMID: 24456367 DOI: 10.1089/jmf.2013.3042] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The prevalence of metabolic syndrome, hypertension, and diabetes has been increasing rapidly in Korea. The rate of increase has paralleled the replacement of Korean traditional diets (KTD), which emphasize vegetables and fermented foods, with western style dietary patterns that are rich in animal foods and saturated fat. We aimed to investigate the efficacy of the KTD in controlling fasting plasma glucose, blood pressure, and cardiovascular disease risk factors in hypertensive and type 2 diabetic (T2D) patients. Forty-one patients (61.8±1.5 years) who were taking medications prescribed for respective diseases were recruited from the Chonbuk National University Hospital for participation in a 12-week, parallel, controlled clinical trial. The control group (n=20) was advised to "eat as usual," whereas the experimental KTD diet group (n=21) was fed the KTD three times a day for 12 weeks. At the end of the trial, both groups had lower body mass index, % body fat, and waist-hip ratio compared to the baseline values (P<.05). Compared to the control group, the KTD group had a greater mean change (P<.05) from the baseline for glycated hemoglobin (HbA₁c) (-0.72% vs. -0.25%) and heart rate (-7.1 vs. +1.6). Regular consumption of the KTD for 12 weeks by hypertensive and T2D patients resulted in favorable changes in cardiovascular risk factors.
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Affiliation(s)
- Su-Jin Jung
- 1 Clinical Trial Center for Functional Foods, Chonbuk National University Hospital , Jeonju, Republic of Korea
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Sarmento RA, Riboldi BP, da Costa Rodrigues T, de Azevedo MJ, de Almeida JC. Development of a quantitative food frequency questionnaire for Brazilian patients with type 2 diabetes. BMC Public Health 2013; 13:740. [PMID: 23938026 PMCID: PMC3751547 DOI: 10.1186/1471-2458-13-740] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 08/07/2013] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND To investigate the association between dietary components and development of chronic diabetic complications, the dietary evaluation should include a long period, months or years. The present manuscript aims to develop a quantitative food frequency questionnaire (FFQ) and a portfolio with food photos to assess the usual intake pattern of Brazilian patients with type 2 diabetes to be used in future studies. METHODS Dietary data using 3-day weighed diet records (WDR) from 188 outpatients with type 2 diabetes were used to construct the list of usually consumed foods. Foods were initially clustered into eight groups: "cereals, tubers, roots, and derivatives"; "vegetables and legumes"; "fruits"; "beans"; "meat and eggs"; "milk and dairy products"; "oils and fats", and "sugars and sweets". The frequency of food intake and the relative contribution of each food item to the total energy and nutrient intakes were calculated. Portion sizes were determined according to the 25th, 50th, 75th, and 95th percentiles of intake for each food item. RESULTS A total of 62 food items were selected based on the 3-day WDR and another 27 foods or how they are prepared and nine beverages were included after the expert examination. Also, a portfolio with food photos of each included food item and portion sizes was made to assist the patients in identifying the consumed portion. CONCLUSIONS We developed a practical quantitative FFQ and portfolio with photos of 98 food items covering those most commonly consumed in the past 12 months, to assess the usual diet pattern of patients with type 2 diabetes in Southern Brazil.
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Affiliation(s)
- Roberta Aguiar Sarmento
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Brazil
| | - Bárbara Pelicioli Riboldi
- Nutrition Graduate Program, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Ticiana da Costa Rodrigues
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Brazil
- Department of Internal Medicine, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Mirela Jobim de Azevedo
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Brazil
- Department of Internal Medicine, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Jussara Carnevale de Almeida
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Brazil
- Nutrition Graduate Program, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Department of Internal Medicine, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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