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Vajdi M, Ardekani AM, Nikniaz Z, Hosseini B, Farhangi MA. Dietary insulin index and load and cardiometabolic risk factors among people with obesity: a cross-sectional study. BMC Endocr Disord 2023; 23:117. [PMID: 37226148 DOI: 10.1186/s12902-023-01377-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 05/19/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND The hypothesis of the effect of the insulinogenic effects of diet on the development of cardiometabolic disorders has been suggested, but limited data are available for adults with obesity. This study aimed to determine the association of dietary insulin index (DII) and dietary insulin load (DIL) with cardiometabolic risk factors among Iranian adults with obesity. METHODS The study was conducted with a total of 347 adults aged 20-50 years in Tabriz, Iran. Usual dietary intake was assessed through a validated 147-item food frequency questionnaire (FFQ). DIL was computed using published food insulin index (FII) data. DII was calculated by dividing DIL by the total energy intake of each participant. Multinational logistic regression analysis was performed to evaluate the association between DII and DIL and cardiometabolic risk factors. RESULTS Mean age of participants was 40.78 ± 9.23 y, and mean body mass index (BMI) was 32.62 ± 4.80 kg/m2. Mean of DII and DIL was 73.15 ± 37.60 and 196,242 ± 100,181. Participants with higher DII had higher BMI, weight, waist circumference (WC), and blood concentrations of triglyceride (TG) and Homeostasis model assessment insulin resistance index (HOMA-IR) (P < 0.05). After taking potential confounders into account, DIL was positively associated with MetS (OR: 2.58; 95% CI: 1.03-6.46), and high blood pressure (OR: 1.61; 95% CI: 1.13-6.56). Moreover, after adjustment for potential confounders, moderate DII was associated with increased odds of MetS (OR: 1.54, 95% CI: 1.36-4.21), high TG (OR, 1.25; 95% CI, 1.17-5.02), and high blood pressure (OR: 1.88; 95% CI: 1.06-7.86). CONCLUSION This population-based study revealed that adults with higher DII and DIL associated with cardiometabolic risk factors and consequently, replacement of high with low DII and DIL may have reduce the risk of cardiometabolic disorders. Further studies with longitudinal design are required to confirm these findings.
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Affiliation(s)
- Mahdi Vajdi
- Department of Community Nutrition, Student Research Committee, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abnoos Mokhtari Ardekani
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Science, & Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Zeinab Nikniaz
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Babak Hosseini
- Department of Surgery, School of Medicine, Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahdieh Abbasalizad Farhangi
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Attar Neyshabouri, Daneshgah Blv, Tabriz, Iran.
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Kohli A, Pandey RM, Siddhu A, Reddy KS. Development of a diet pattern assessment tool for coronary heart disease risk reduction. PUBLIC HEALTH IN PRACTICE 2022; 4:100317. [PMID: 36193539 PMCID: PMC9526230 DOI: 10.1016/j.puhip.2022.100317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/26/2022] [Accepted: 09/09/2022] [Indexed: 11/26/2022] Open
Abstract
Objective Existing diet indices have gaps including neglect of the patterns of intake known to affect the final metabolic impact and use of measurement units prone to reporting error, and have applicability that is limited to specific populations. This study sought to develop a tool for diet-pattern assessment (Prudent Approach to Cardiovascular Epidemic, for Indians – Diet Quality Index (iPACE-DQI)) to reduce diet-related coronary-heart-disease (CHD) risk. Study design The iPACE-DQI was developed on a 0–100 points scale (higher numeric value healthier). A proof-of-concept analysis was done to examine its construct validity and relation with risk-markers. Methods Development of iPACE-DQI was partly guided by ‘prudent diet’ principles, with assessment focus on quality, quantity, and the pattern of intake. In the second part of the study, construct validity was evaluated by association of iPACE-DQI score with nutrients. Further, relationship of the score with risk-markers high-sensitivity C-reactive protein(hs-CRP), body-mass-index(BMI) and body-fat-percent was examined at single-point-in-time (baseline), and predictive ability of score change on hs-CRP change was evaluated in a proof-of-concept 12-weeks pre-post intervention, among free-living Indians (25–44years,n = 55) in an urban setting. Results The iPACE-DQI consists of eight main components. Associations of iPACE-DQI score with mean daily intake of key nutrients were robust and in expected direction [total-dietary-fiber (r = 0.5, p < 0.001), crude-fiber (r = 0.6, p < 0.001), protein (r = 0.5, p < 0.001), total-fat (r = −0.4, p = 0.002), vitamin-C (r = 0.5, p < 0.001), total-carbohydrate (r = 0.3, p = 0.017)]. Trends of hs-CRP, BMI and body-fat-percent across increasing diet-pattern score showed highest degree of abnormality in lowest tertile (≤35). Logistic regression model indicated higher likelihood for hs-CRP reduction (OR: 1.6, 95% CI 0.5–4.9) among those with ≥20% increase in iPACE-DQI score as compared with <20% increase or no-increase over 12-weeks Conclusion The iPACE-DQI is a 100-point scale that assesses diet-pattern with respect to CHD-risk. The proposed tool could be useful for researchers/health practitioners to track diet-pattern change and concomitant CHD-risk reduction.
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Jun S, Lee S, Lee J, Kim J. Diets high in glycemic index and glycemic load are associated with an increased risk of metabolic syndrome among Korean women. Nutr Metab Cardiovasc Dis 2022; 32:1154-1164. [PMID: 35256231 DOI: 10.1016/j.numecd.2022.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS Accurate estimation of the glycemic index (GI) and glycemic load (GL) of diets is essential when assessing health implications of dietary GI and GL. The present study aimed to estimate dietary GI and GL utilizing the updated GI tables with a large number of new, reliable GI values and assess their associations with metabolic syndrome among Korean adults. METHODS AND RESULTS We analyzed data from 3317 men and 6191 women for this cross-sectional study. Dietary intake was assessed with a validated food frequency questionnaire. Metabolic syndrome and its components were defined based on the harmonized criteria with Korean-specific cutoffs for waist circumference. Multivariate logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Compared with women in the lowest quintiles of energy-adjusted dietary GI and GL, women in the highest quintiles had significantly greater risks of metabolic syndrome (GI, OR = 1.56, 95% CI = 1.18-2.06; GL, OR = 1.80, 95% CI = 1.27-2.57), elevated blood pressure, reduced high-density lipoprotein cholesterol (HDL-C, both GI and GL), elevated triglycerides (GI only), elevated waist circumference, and elevated fasting glucose (GL only). Among men, no significant association was noted except for a higher risk of reduced HDL-C (OR = 1.59, 95% CI = 1.01-2.29) in the highest quintile of energy-adjusted dietary GI than in the lowest quintile. CONCLUSION Our findings suggest that dietary GI and GL are positively associated with metabolic syndrome risk among women, but not men, in Korea.
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Affiliation(s)
- Shinyoung Jun
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
| | - Seohyun Lee
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
| | - Jeonghee Lee
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
| | - Jeongseon Kim
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea.
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Ghorbaninejad P, Imani H, Sheikhhossein F, Tijani Jibril A, Mohammadpour S, Shab-Bidar S. Higher dietary insulin load and index are not associated with the risk of metabolic syndrome and obesity in Iranian adults. Int J Clin Pract 2021; 75:e14229. [PMID: 33864715 DOI: 10.1111/ijcp.14229] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/12/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Data about the relation between dietary insulin load (DIL) and dietary insulin index (DII) with metabolic syndrome (MetS) and obesity are scarce. Therefore, the present study aimed to examine the association of the insulinemic potential of the diet with MetS and obesity amongst Iranian adults. METHODS This cross-sectional study was conducted amongst 850 adults aged 20-59 years. Dietary data were collected using a 168-item food frequency questionnaire. DIL was calculated using a standard formula and DII was obtained by dividing DIL by the total energy intake of each participant. The guidelines of the International Diabetes Federation were used to define MetS. General obesity was considered as body mass index ≥ 30 kg/m2 , and abdominal obesity as waist circumference ≥ 94 cm for men and ≥ 80 cm for women. RESULTS Mean DIL and DII values were 101 684 ± 54 802 and 49.4 ± 33.4, respectively. The mean age of participants was 44.9 ± 10.7 years and 36.8%, 28.5% and 48.8% of participants were suffering from MetS, general and abdominal obesity, respectively. In contrast with DIL (P = .73), participants in the last quartile of DII (P = .62) had lower odds of MetS than the first quartile. There were non-significant inverse associations between DIL (P = .91, P = .85) and DII (P = .59, P = .53) with odds of general and abdominal obesity before and after the adjustment of confounders, respectively. CONCLUSIONS We did not observe any significant association of DIL and DII with the risk of MetS and obesity amongst the Iranian population. Further prospective studies are needed to confirm the findings of this study.
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Affiliation(s)
- Parivash Ghorbaninejad
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hosein Imani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sheikhhossein
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Aliyu Tijani Jibril
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Saba Mohammadpour
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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Mohan V, Lakshmi Priya N, Gayathri R, Sudha V, Geetha G, Gayathri N, Shilpa B, Shanthi Rani C, Kamala K, Anjana R, Ranjit U, Pradeep S. Prospective associations between a food-based Indian Diet Quality Score and type 2 diabetes risk among South Indian adults (CURES-154). JOURNAL OF DIABETOLOGY 2020. [DOI: 10.4103/jod.jod_35_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
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Misra A, Soares MJ, Mohan V, Anoop S, Abhishek V, Vaidya R, Pradeepa R. Body fat, metabolic syndrome and hyperglycemia in South Asians. J Diabetes Complications 2018; 32:1068-1075. [PMID: 30115487 DOI: 10.1016/j.jdiacomp.2018.08.001] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 07/31/2018] [Accepted: 08/02/2018] [Indexed: 12/26/2022]
Abstract
The prevalence of overweight and obesity is escalating in South Asian countries. South Asians display higher total and abdominal obesity at a lower BMI when compared to Whites. Consequently, metabolic dysfunction leading to metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM) will account for a majority of the health burden of these countries. In this review, we discuss those factors that contribute to MetS and T2DM in South Asians when compared to whites, focusing on adiposity. Abdominal obesity is the single-most important risk factor for MetS and its predisposition to T2DM. Excessive ectopic fat deposition in the liver (non-alcoholic fatty liver disease) has been linked to insulin resistance in Asian Indians, while the effects of ectopic fat accumulation in pancreas and skeletal muscle need more investigation. South Asians also have lower skeletal muscle mass than Whites, and this may contribute to their higher risk T2DM. Lifestyle factors contributing to MetS and T2DM in South Asians include inadequate physical activity and high intakes of refined carbohydrates and saturated fats. These are reflective of the recent but rapid economic transition and urbanization of the South Asian region. There is need to further the research into genetic determinants of dysmetabolism as well as gene x environment interactions. Collectively, MetS and T2DM have multi-factorial antecedents in South Asians and efforts to combat it through low-cost and socio-culturally appropriate lifestyle interventions need to be supported.
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Affiliation(s)
- A Misra
- Centre of Nutrition & Metabolic Research (C-NET), National Diabetes, Obesity and Cholesterol Foundation (N-DOC), SDA, New Delhi, India; Diabetes Foundation (India), SDA, New Delhi, India; Fortis C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chirag Enclave, Nehru Place, New Delhi, India.
| | - Mario J Soares
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Viswanathan Mohan
- Department of Epidemiology & Diabetology, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialties Centre, Chennai, India
| | - Shajith Anoop
- Centre of Nutrition & Metabolic Research (C-NET), National Diabetes, Obesity and Cholesterol Foundation (N-DOC), SDA, New Delhi, India; Diabetes Foundation (India), SDA, New Delhi, India
| | - Vishnu Abhishek
- Department of Epidemiology & Diabetology, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialties Centre, Chennai, India
| | - Ruchi Vaidya
- Genetics of Obesity and Related Traits Program, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rajendra Pradeepa
- Department of Foods Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
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Socioeconomic Status and Glycemic Index Among Punjabis in Kuala Lumpur, Malaysia: Possible Association with Metabolic Syndrome. J Immigr Minor Health 2018; 20:1380-1386. [DOI: 10.1007/s10903-018-0731-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Differential association of dietary carbohydrate intake with metabolic syndrome in the US and Korean adults: data from the 2007-2012 NHANES and KNHANES. Eur J Clin Nutr 2018; 72:848-860. [PMID: 29339830 DOI: 10.1038/s41430-017-0031-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 05/04/2017] [Accepted: 10/03/2017] [Indexed: 01/14/2023]
Abstract
BACKGROUND/OBJECTIVES The risk factors for metabolic syndrome may differ between Western and Asian countries due to their distinct dietary cultures. However, few studies have directly compared macronutrient intake and its association with the risk of metabolic syndrome in the US and Korean adults using national survey data. SUBJECT/METHODS Based on the data from the US and Korean versions of the 2007-2012 National Health and Nutrition Examination Survey (NHANES, KNHANES), a total of 3,324 American and 20,515 Korean adults were included. In both countries, dietary intake was measured using a 24-h dietary recall method and metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. RESULTS The percentages of energy intake from carbohydrate, protein, and fat were 50:16:33 in the US adults and 66:15:19 in the Korean adults. Regarding metabolic abnormalities, Korean adults in the highest quintile of carbohydrate intake showed an increased risk of metabolic syndrome in men and women, with abnormalities of reduced HDL cholesterol and elevated triglyceride levels. In contrast, the US men showed no significant association with metabolic syndrome and its abnormalities, while the US women showed an increased risk of reduced HDL cholesterol and elevated triglycerides. CONCLUSIONS A high carbohydrate intake is associated with metabolic abnormalities. As Korean adults consume more carbohydrate than American adults, stronger associations of dietary carbohydrate with metabolic syndrome were observed. Thus, further studies are necessary to elucidate the underlying mechanisms of different contributors to developing metabolic disease in Western and Asian populations.
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Mohan V, Gayathri R, Jaacks LM, Lakshmipriya N, Anjana RM, Spiegelman D, Jeevan RG, Balasubramaniam KK, Shobana S, Jayanthan M, Gopinath V, Divya S, Kavitha V, Vijayalakshmi P, Bai R MR, Unnikrishnan R, Sudha V, Krishnaswamy K, Salas-Salvadó J, Willett WC. Cashew Nut Consumption Increases HDL Cholesterol and Reduces Systolic Blood Pressure in Asian Indians with Type 2 Diabetes: A 12-Week Randomized Controlled Trial. J Nutr 2018; 148:63-69. [PMID: 29378038 DOI: 10.1093/jn/nxx001] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 10/17/2017] [Indexed: 02/07/2023] Open
Abstract
Background There is increasing evidence that nut consumption decreases the risk of cardiovascular disease. However, there are few data on the health effects of cashew nuts among adults with type 2 diabetes (T2DM). Objective The study aimed to investigate the effects of cashew nut supplementation on glycemia, body weight, blood pressure, and lipid profile in Asian Indians with T2DM. Methods In a parallel-arm, randomized controlled trial, 300 adults with T2DM [mean ± SD age: 51 ± 9.3 y; body mass index (BMI; in kg/m2): 26.0 ± 3.4; 55% male] were randomly assigned to receive advice to follow a standard diabetic diet (control) or similar advice plus 30 g cashew nuts/d (intervention) for 12 wk. The macronutrient composition of the prescribed diabetic diet was 60-65% energy from carbohydrates, 15-25% from fat, and the rest from protein. Differences between groups in changes in anthropometric and biochemical variables were analyzed using linear models with robust variance estimation under an assumed independence working correlation. Results Participants in the intervention group had a greater decrease in systolic blood pressure from baseline to 12 wk than did controls (-4.9 ± 13.7 compared with -1.7 ± 11.6 mm Hg; P = 0.04) and a greater increase in plasma HDL cholesterol compared with controls (+1.7 ± 5.6 compared with +0.1 ± 4.6 mg/dL; P = 0.01). There were no differences between the groups with respect to changes in body weight, BMI, blood lipid, and glycemic variables. Plasma oleic acid concentrations and self-reported dietary intake of nuts, oleic acid, and monounsaturated fatty acids suggested excellent compliance with the nut consumption. Conclusion Cashew nut supplementation in Asian Indians with T2DM reduced systolic blood pressure and increased HDL cholesterol concentrations with no deleterious effects on body weight, glycemia, or other lipid variables. This study was registered at the clinical trial registry of India as CTRI/2017/07/009022.
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Affiliation(s)
- Viswanathan Mohan
- Departments of Diabetology and Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Rajagopal Gayathri
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Lindsay M Jaacks
- Departments of Global Health and Population, Nutrition, and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Nagarajan Lakshmipriya
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Ranjit Mohan Anjana
- Departments of Diabetology and Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Donna Spiegelman
- Departments of Global Health and Population, Nutrition, and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Departments of Nutrition, and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Raman Ganesh Jeevan
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Kandappa K Balasubramaniam
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Shanmugam Shobana
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Mathialagan Jayanthan
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Viswanathan Gopinath
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Selvakumar Divya
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Vasudevan Kavitha
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Parthasarathy Vijayalakshmi
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Mookambika Ramya Bai R
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Ranjit Unnikrishnan
- Departments of Diabetology and Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Vasudevan Sudha
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Kamala Krishnaswamy
- Departments of Foods, Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Jordi Salas-Salvadó
- Human Nutrition Unit, Hospital Universitari Sant Joan de Reus, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, Reus, Spain, and CIBERobn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain
| | - Walter C Willett
- Departments of Nutrition, and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Departments of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
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Song S, Song WO, Song Y. Dietary carbohydrate and fat intakes are differentially associated with lipid abnormalities in Korean adults. J Clin Lipidol 2017; 11:338-347.e3. [PMID: 28502489 DOI: 10.1016/j.jacl.2017.01.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 12/09/2016] [Accepted: 01/25/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND A high prevalence of metabolic syndrome along with increasing rates of low high-density lipoprotein cholesterol (HDL-C) and elevated triglycerides (TGs) is shown in Korean adults. Little is known about the associations between macronutrient intake and lipid abnormalities in the Asian population, whose major energy source is carbohydrates. OBJECTIVE We examined the associations of dietary carbohydrate and fat intakes with lipid abnormalities in Korean adults. METHODS A total of 14,301 adults (5715 men and 8586 women) aged ≥30 years with no diagnosis and treatment for diabetes, hypertension, or dyslipidemia were selected from the 2008 to 2012 Korea National Health and Nutrition Examination Survey data. From the 24-hour recall data, dietary carbohydrate and fat intakes were estimated. Multivariate logistic regression was used to estimate odds ratios for lipid abnormalities, that is, elevated total cholesterol (TC), low HDL-C, high TC to HDL-C ratio, elevated non-HDL-C, elevated LDL cholesterol (LDL-C), and elevated TG across quintiles of dietary carbohydrate and fat intakes. RESULTS Percentage of energy from carbohydrate was positively associated with elevated TG and low HDL-C but inversely associated with elevated TC and elevated LDL-C in both men and women. Energy-adjusted carbohydrate intake also showed a positive association with low HDL-C. Dietary fat intakes had the opposite associations with lipid abnormalities than results for carbohydrate. CONCLUSION High carbohydrate diet is undesirable with regard to increased TG and reduced HDL-C despite the benefit for LDL-C. Dietary strategies emphasizing appropriate macronutrient intakes by the type of lipid abnormalities are recommended for the prevention of cardiovascular disease in Korean adults.
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Affiliation(s)
- SuJin Song
- Department of Food and Nutrition, Hannam University, Daejeon, Republic of Korea
| | - Won O Song
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA
| | - YoonJu Song
- Major of Food and Nutrition, The Catholic University of Korea, Bucheon-si, Gyeonggi-do, Republic of Korea.
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Jois T, Howard V, Youngs K, Cowley MA, Sleeman MW. Dietary Macronutrient Composition Directs ChREBP Isoform Expression and Glucose Metabolism in Mice. PLoS One 2016; 11:e0168797. [PMID: 27992582 PMCID: PMC5167554 DOI: 10.1371/journal.pone.0168797] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 12/06/2016] [Indexed: 11/18/2022] Open
Abstract
Carbohydrate response element binding protein (ChREBP) is a lipogenic transcription factor that is thought to be involved in the development of hepatic steatosis and insulin resistance. Increased ChREBP expression in liver results in increased hepatic steatosis, and the isoform ChREBPβ in adipose tissue can predict insulin sensitivity in obese humans. As ChREBP is activated by glucose, it was postulated that the composition of diet would regulate ChREBP isoform expression in metabolically relevant tissues. We compared the effects of diets with high complex carbohydrate, high fat, or a normal chow on ChREBP expression and metabolic parameters in C57BL/6 mice. We found that diets high in fat decrease ChREBP expression in adipose tissue, but isocaloric diets high in carbohydrate have no effect. Interestingly, this decrease in adipose ChREBP was associated with increased inflammatory markers. In the same animals a high carbohydrate diet induced a robust increase in hepatic ChREBPβ expression (≈2-fold; p = 0.0002), but little detectable change in the more abundant ChREBPα transcript. This change was accompanied by increased expression of target genes liver pyruvate kinase (p<0.0001), acetyl-CoA carboxylase (p = 0.0191) and stearoyl-CoA desaturase-1 (p = 0.0045). This increase in ChREBP expression was associated with increased hepatic steatosis, despite no changes in body weight or body fat when compared to chow-fed mice. Unexpectedly, mice fed a high carbohydrate diet displayed enhanced sensitivity to exogenous insulin, despite having mild glucose intolerance and increased liver steatosis. In summary, we have shown the composition of diet can selectively regulate ChREBP isoform expression in a tissue specific manner. Furthermore, we have shown a high complex carbohydrate diet selectively increases hepatic ChREBPβ expression, which associates with hepatic steatosis but not insulin resistance. In contrast, a high fat diet reduces adipose ChREBP, which associates with inflammation and insulin resistance.
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Affiliation(s)
- Tara Jois
- Department of Physiology, Monash University, Clayton, Victoria, Australia
| | - Victor Howard
- Department of Physiology, Monash University, Clayton, Victoria, Australia
| | - Kristina Youngs
- Department of Physiology, Monash University, Clayton, Victoria, Australia
| | - Michael A. Cowley
- Department of Physiology, Monash University, Clayton, Victoria, Australia
- Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Mark W. Sleeman
- Department of Physiology, Monash University, Clayton, Victoria, Australia
- Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
- Department of Biochemistry and Molecular Biology, Monash University, Clayton, Victoria, Australia
- * E-mail:
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The effect of dietary changes on distinct components of the metabolic syndrome in a young Sri Lankan population at high risk of CVD. Br J Nutr 2016; 116:719-27. [PMID: 27358019 DOI: 10.1017/s0007114516002476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
South Asian populations are predisposed to early onset of the metabolic syndrome. Lifestyle intervention programmes have demonstrated a reduction in the metabolic syndrome and CVD risk; however, the most effective components of the multi-faceted lifestyle interventions are unknown. We studied 2637 Sri Lankan males (n 1237) and females (n 1380), with a mean BMI of 23·9 (sd 4·2) kg/m2, aged 22·5 (sd 10·0) years, who had participated in a 5-year lifestyle-modification programme to examine the effect of dietary changes on distinct components of the metabolic syndrome. The dietary intervention comprised advice to replace polished starches with unpolished starches, high-fat meat and dairy products with low-fat products and high-sugar beverages and snacks with low-sugar varieties. For the purposes of this analysis, data from the control and intensive lifestyle groups were combined. Anthropometric and biochemical data were recorded, and a FFQ was completed annually. Multiple regression was used to determine the effect of the dietary changes on distinct components of the metabolic syndrome. The ratio unpolished:polished rice was inversely related to change in fasting glucose (β=-0·084, P=0·007) and TAG (β=-0·084, P=0·005) and positively associated with change in HDL-cholesterol (β=0·066, P=0·031) at the 5-year follow-up after controlling for relevant confounders. Red meat intake was positively associated with fasting glucose concentrations (β=0·05, P=0·017), whereas low-fat (β=-0·046, P=0·018) but not high-fat dairy products (β=0·003, P=0·853) was inversely related to glucose tolerance at the follow-up visit. Replacement of polished with unpolished rice may be a particularly effective dietary advice in this and similar populations.
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Vimaleswaran KS, Bodhini D, Lakshmipriya N, Ramya K, Anjana RM, Sudha V, Lovegrove JA, Kinra S, Mohan V, Radha V. Interaction between FTO gene variants and lifestyle factors on metabolic traits in an Asian Indian population. Nutr Metab (Lond) 2016; 13:39. [PMID: 27274759 PMCID: PMC4891824 DOI: 10.1186/s12986-016-0098-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 05/11/2016] [Indexed: 11/27/2022] Open
Abstract
Background Lifestyle factors such as diet and physical activity have been shown to modify the association between fat mass and obesity–associated (FTO) gene variants and metabolic traits in several populations; however, there are no gene-lifestyle interaction studies, to date, among Asian Indians living in India. In this study, we examined whether dietary factors and physical activity modified the association between two FTO single nucleotide polymorphisms (rs8050136 and rs11076023) (SNPs) and obesity traits and type 2 diabetes (T2D). Methods The study included 734 unrelated T2D and 884 normal glucose-tolerant (NGT) participants randomly selected from the urban component of the Chennai Urban Rural Epidemiology Study (CURES). Dietary intakes were assessed using a validated interviewer administered semi-quantitative food frequency questionnaire (FFQ). Physical activity was based upon the self-report. Interaction analyses were performed by including the interaction terms in the linear/logistic regression model. Results There was a significant interaction between SNP rs8050136 and carbohydrate intake (% energy) (Pinteraction = 0.04), where the ‘A’ allele carriers had 2.46 times increased risk of obesity than those with ‘CC’ genotype (P = 3.0 × 10−5) among individuals in the highest tertile of carbohydrate intake (% energy, 71 %). A significant interaction was also observed between SNP rs11076023 and dietary fibre intake (Pinteraction = 0.0008), where individuals with AA genotype who are in the 3rd tertile of dietary fibre intake had 1.62 cm lower waist circumference than those with ‘T’ allele carriers (P = 0.02). Furthermore, among those who were physically inactive, the ‘A’ allele carriers of the SNP rs8050136 had 1.89 times increased risk of obesity than those with ‘CC’ genotype (P = 4.0 × 10−5). Conclusions This is the first study to provide evidence for a gene-diet and gene-physical activity interaction on obesity and T2D in an Asian Indian population. Our findings suggest that the association between FTO SNPs and obesity might be influenced by carbohydrate and dietary fibre intake and physical inactivity. Further understanding of how FTO gene influences obesity and T2D through dietary and exercise interventions is warranted to advance the development of behavioral intervention and personalised lifestyle strategies, which could reduce the risk of metabolic diseases in this Asian Indian population. Electronic supplementary material The online version of this article (doi:10.1186/s12986-016-0098-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Karani S Vimaleswaran
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research (ICMR), Department of Food and Nutritional Sciences, University of Reading, Reading, UK
| | - Dhanasekaran Bodhini
- Department of Molecular Genetics, Madras Diabetes Research Foundation, Chennai, India
| | - N Lakshmipriya
- Department of Foods, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, India
| | - K Ramya
- Department of Molecular Genetics, Madras Diabetes Research Foundation, Chennai, India
| | - R Mohan Anjana
- Department of Molecular Genetics, Madras Diabetes Research Foundation, Chennai, India ; Department of Foods, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, India ; Dr. Mohan's Diabetes Specialties Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, Chennai, India
| | - Vasudevan Sudha
- Department of Foods, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, India
| | - Julie A Lovegrove
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research (ICMR), Department of Food and Nutritional Sciences, University of Reading, Reading, UK
| | - Sanjay Kinra
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Viswanathan Mohan
- Department of Molecular Genetics, Madras Diabetes Research Foundation, Chennai, India ; Department of Foods, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, India ; Dr. Mohan's Diabetes Specialties Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, Chennai, India
| | - Venkatesan Radha
- Department of Molecular Genetics, Madras Diabetes Research Foundation, Chennai, India
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Pu J, Romanelli R, Zhao B, Azar KMJ, Hastings KG, Nimbal V, Fortmann SP, Palaniappan LP. Dyslipidemia in Special Ethnic Populations. Endocrinol Metab Clin North Am 2016; 45:205-16. [PMID: 26893006 PMCID: PMC7251984 DOI: 10.1016/j.ecl.2015.09.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
This article reviews racial/ethnic differences in dyslipidemia-prevalence of dyslipidemia, its relation to coronary heart disease (CHD) and stroke mortality rates, response to lipid-lowering agents, and lifestyle modification. Asian Indians, Filipinos, and Hispanics are at higher risk for dyslipidemia, which is consistent with the higher CHD mortality rates in these groups. Statins may have greater efficacy for Asians, but the data are mixed. Lifestyle modifications are recommended. Culturally-tailored prevention and intervention should be provided to the minority populations with elevated risk for dyslipidemia and considerably more research is needed to determine the best approaches to helping specific subgroups.
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Affiliation(s)
- Jia Pu
- Palo Alto Medical Foundation Research Institute, Ames Building, 795 El Camino Real, Palo Alto, CA 94301, USA.
| | - Robert Romanelli
- Palo Alto Medical Foundation Research Institute, Ames Building, 795 El Camino Real, Palo Alto, CA 94301, USA
| | - Beinan Zhao
- Palo Alto Medical Foundation Research Institute, Ames Building, 795 El Camino Real, Palo Alto, CA 94301, USA
| | - Kristen M J Azar
- Palo Alto Medical Foundation Research Institute, Ames Building, 795 El Camino Real, Palo Alto, CA 94301, USA
| | - Katherine G Hastings
- Stanford University School of Medicine, 1265 Welch Road, Stanford, CA 94305, USA
| | - Vani Nimbal
- Palo Alto Medical Foundation Research Institute, Ames Building, 795 El Camino Real, Palo Alto, CA 94301, USA
| | - Stephen P Fortmann
- Kaiser Permanente Center for Health Research, 3800 North Interstate Avenue, Portland, OR 97227, USA
| | - Latha P Palaniappan
- Stanford University School of Medicine, 1265 Welch Road, Stanford, CA 94305, USA
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Mohan V, Anjana RM, Gayathri R, Ramya Bai M, Lakshmipriya N, Ruchi V, Balasubramaniyam KK, Jakir MM, Shobana S, Unnikrishnan R, Krishnaswamy K, Henry JK, Sudha V. Glycemic Index of a Novel High-Fiber White Rice Variety Developed in India--A Randomized Control Trial Study. Diabetes Technol Ther 2016; 18:164-70. [PMID: 26741823 DOI: 10.1089/dia.2015.0313] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND White rice, a common Indian staple, has a high glycemic response and is associated with high risk of type 2 diabetes. The aim of this study was to compare the Glycemic Index (GI) of a newly developed high-fiber white rice (HFWR) with that of commercial white rice (WR). MATERIALS AND METHODS HFWR was developed using biochemical screening approaches and classical plant breeding techniques. The GI of HFWR was determined using a validated protocol in 30 healthy participants in the year 2013 and repeated in a subsample of 15 participants in the year 2014; the results were compared with the value for WR. The incremental area under the curve was calculated geometrically by applying the trapezoid rule for both reference food (glucose) and the test foods (HFWR and WR). Proximate principles along with dietary fiber, resistant starch, and amylose content were analyzed using standardized methods. RESULTS The dietary fiber content of HFWR was fivefold higher (8.0 ± 0.1 vs. 1.58 ± 0.17 g%), resistant starch content was 6.5-fold higher (3.9 ± 0.2 vs. 0.6 ± 0.03 g%) (P < 0.001), and amylose content was significantly higher (32.8 ± 1.1 vs. 26.0 ± 0.2 g%) (P < 0.001), compared with WR. HFWR was found to be of medium GI (61.3 ± 2.8), whereas WR was of high GI (79.2 ± 4.8). Overall, HFWR had 23% lower GI compared with WR (P = 0.002). CONCLUSIONS The new HFWR variety can be considered as a potentially healthier alternative to commercial WR in rice-eating populations, on account of its lower GI and high fiber content.
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Affiliation(s)
- Viswanathan Mohan
- 1 Department of Diabetology, Madras Diabetes Research Foundation , Chennai, Tamil Nadu, India
| | - Ranjit Mohan Anjana
- 1 Department of Diabetology, Madras Diabetes Research Foundation , Chennai, Tamil Nadu, India
| | - Rajgopal Gayathri
- 2 Department of Foods Nutrition & Dietetics Research, Madras Diabetes Research Foundation , Chennai, Tamil Nadu, India
| | - Mookambika Ramya Bai
- 2 Department of Foods Nutrition & Dietetics Research, Madras Diabetes Research Foundation , Chennai, Tamil Nadu, India
| | - Nagrajan Lakshmipriya
- 2 Department of Foods Nutrition & Dietetics Research, Madras Diabetes Research Foundation , Chennai, Tamil Nadu, India
| | - Vaidya Ruchi
- 2 Department of Foods Nutrition & Dietetics Research, Madras Diabetes Research Foundation , Chennai, Tamil Nadu, India
| | - K K Balasubramaniyam
- 2 Department of Foods Nutrition & Dietetics Research, Madras Diabetes Research Foundation , Chennai, Tamil Nadu, India
| | - M Mohamed Jakir
- 2 Department of Foods Nutrition & Dietetics Research, Madras Diabetes Research Foundation , Chennai, Tamil Nadu, India
| | - Shanmugam Shobana
- 2 Department of Foods Nutrition & Dietetics Research, Madras Diabetes Research Foundation , Chennai, Tamil Nadu, India
| | - Ranjit Unnikrishnan
- 1 Department of Diabetology, Madras Diabetes Research Foundation , Chennai, Tamil Nadu, India
| | - Kamala Krishnaswamy
- 2 Department of Foods Nutrition & Dietetics Research, Madras Diabetes Research Foundation , Chennai, Tamil Nadu, India
| | - Jeya Kumar Henry
- 3 Clinical Nutritional Sciences, Singapore Institute for Clinical Sciences , Brenner Centre for Molecular Medicine, Singapore
| | - Vasudevan Sudha
- 2 Department of Foods Nutrition & Dietetics Research, Madras Diabetes Research Foundation , Chennai, Tamil Nadu, India
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Loftus HL, Astell KJ, Mathai ML, Su XQ. Coleus forskohlii Extract Supplementation in Conjunction with a Hypocaloric Diet Reduces the Risk Factors of Metabolic Syndrome in Overweight and Obese Subjects: A Randomized Controlled Trial. Nutrients 2015; 7:9508-22. [PMID: 26593941 PMCID: PMC4663611 DOI: 10.3390/nu7115483] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 11/06/2015] [Accepted: 11/10/2015] [Indexed: 11/16/2022] Open
Abstract
Limited studies have shown that Coleus forskohlii extract may aid in weight management. This randomized, double blind placebo-controlled clinical study assessed the effects of supplementation with C. forskohlii extract on key markers of obesity and metabolic parameters in overweight and obese individuals. Thirty participants completed the trial and they were randomly assigned to receive either 250 mg of C. forskohlii extract (n = 15) or a placebo twice daily for 12 weeks. All participants were advised to follow a hypocaloric diet throughout the study. Body weight, body mass index (BMI), waist and hip circumference, and waist to hip ratio, were monitored fortnightly. Dietary intake was assessed at the baseline and weeks 4, 8 and 12. Appetite was assessed using visual analogue scales and blood samples were analyzed for plasma lipids, ghrelin, leptin, glucose and insulin at the baseline and end of the intervention. Significant reductions to waist and hip circumference (p = 0.02; p = 0.01, respectively) were recorded in both experimental and placebo groups after the 12 week intervention. Furthermore, high density lipoprotein-cholesterol (HDL-C) was significantly increased (p = 0.01) in both groups. The experimental group showed a favorable improvement in insulin concentration and insulin resistance (p = 0.001; 0.01 respectively) compared to the placebo group. These findings suggest that C. forskohlii extract in conjunction with a hypocaloric diet may be useful in the management of metabolic risk factors.
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Affiliation(s)
- Hayley L Loftus
- Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, P.O. BOX 14428 MCMC, Melbourne 8001, Australia.
| | - Katie J Astell
- Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, P.O. BOX 14428 MCMC, Melbourne 8001, Australia.
| | - Michael L Mathai
- Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, P.O. BOX 14428 MCMC, Melbourne 8001, Australia.
| | - Xiao Q Su
- Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, P.O. BOX 14428 MCMC, Melbourne 8001, Australia.
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17
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Lee J, Jung Y, Park JY, Lee SH, Ryu DH, Hwang GS. LC/MS-based polar metabolite profiling reveals gender differences in serum from patients with myocardial infarction. J Pharm Biomed Anal 2015; 115:475-86. [PMID: 26299524 DOI: 10.1016/j.jpba.2015.08.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Revised: 08/01/2015] [Accepted: 08/09/2015] [Indexed: 12/30/2022]
Abstract
Myocardial infarction (MI), a leading cause of death worldwide, results from prolonged myocardial ischemia with necrosis of myocytes due to a blood supply obstruction to an area of the heart. Many studies have reported gender-related differences in the clinical features of MI, but the reasons for these differences remain unclear. In this study, we applied ultra-performance liquid chromatography/quadrupole time-of-flight mass spectrometry (UPLC/Q-TOF MS) and various statistical methods-such as multivariate, pathway, and correlation analyses-to identify gender-specific metabolic patterns in polar metabolites in serum from healthy individuals and patients with MI. Patients with diagnosed MI (n=68), and age- and body mass index-matched healthy individuals (n=68), were included in this study. The partial least-squares discriminant analysis (PLS-DA) model was generated from metabolic profiling data, and the score plots showed a significant gender-related difference in patients with MI. Many pathways were associated with amino acids and purines; amino acids, acylcarnitines, and purines differed significantly between male and female patients with MI. This approach could be utilized to observe gender-specific metabolic pattern differences between healthy controls and patients with MI.
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Affiliation(s)
- Jueun Lee
- Integrated Metabolomics Research Group, Western Seoul Center, Korea Basic Science Institute (KBSI), Seoul 120-140,Republic of Korea; Department of Chemistry, Sungkyunkwan University (SKKU), Suwon 440-746, Republic of Korea
| | - Youngae Jung
- Integrated Metabolomics Research Group, Western Seoul Center, Korea Basic Science Institute (KBSI), Seoul 120-140,Republic of Korea
| | - Ju Yeon Park
- Integrated Metabolomics Research Group, Western Seoul Center, Korea Basic Science Institute (KBSI), Seoul 120-140,Republic of Korea
| | - Sang-Hak Lee
- Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 120-752, Republic of Korea
| | - Do Hyun Ryu
- Department of Chemistry, Sungkyunkwan University (SKKU), Suwon 440-746, Republic of Korea.
| | - Geum-Sook Hwang
- Integrated Metabolomics Research Group, Western Seoul Center, Korea Basic Science Institute (KBSI), Seoul 120-140,Republic of Korea; Department of Life Science, Ewha Womans University, Seoul 120-750, Republic of Korea.
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18
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Pu J, Romanelli R, Zhao B, Azar KMJ, Hastings KG, Nimbal V, Fortmann SP, Palaniappan LP. Dyslipidemia in special ethnic populations. Cardiol Clin 2015; 33:325-33. [PMID: 25939303 PMCID: PMC4421090 DOI: 10.1016/j.ccl.2015.01.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This article reviews racial/ethnic differences in dyslipidemia-prevalence of dyslipidemia, its relation to coronary heart disease (CHD) and stroke mortality rates, response to lipid-lowering agents, and lifestyle modification. Asian Indians, Filipinos, and Hispanics are at higher risk for dyslipidemia, which is consistent with the higher CHD mortality rates in these groups. Statins may have greater efficacy for Asians, but the data are mixed. Lifestyle modifications are recommended. Culturally-tailored prevention and intervention should be provided to the minority populations with elevated risk for dyslipidemia and considerably more research is needed to determine the best approaches to helping specific subgroups.
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Affiliation(s)
- Jia Pu
- Palo Alto Medical Foundation Research Institute, Ames Building, 795 El Camino Real, Palo Alto, CA 94301, USA.
| | - Robert Romanelli
- Palo Alto Medical Foundation Research Institute, Ames Building, 795 El Camino Real, Palo Alto, CA 94301, USA
| | - Beinan Zhao
- Palo Alto Medical Foundation Research Institute, Ames Building, 795 El Camino Real, Palo Alto, CA 94301, USA
| | - Kristen M J Azar
- Palo Alto Medical Foundation Research Institute, Ames Building, 795 El Camino Real, Palo Alto, CA 94301, USA
| | - Katherine G Hastings
- Stanford University School of Medicine, 1265 Welch Road, Stanford, CA 94305, USA
| | - Vani Nimbal
- Palo Alto Medical Foundation Research Institute, Ames Building, 795 El Camino Real, Palo Alto, CA 94301, USA
| | - Stephen P Fortmann
- Kaiser Permanente Center for Health Research, 3800 North Interstate Avenue, Portland, OR 97227, USA
| | - Latha P Palaniappan
- Stanford University School of Medicine, 1265 Welch Road, Stanford, CA 94305, USA
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Kim HS. Metabolic syndrome related health inequalities in Korean elderly: Korean National Health and Nutrition Examination Survey (KNHAES). Int J Equity Health 2014; 13:463. [PMID: 25406511 PMCID: PMC4299311 DOI: 10.1186/s12939-014-0097-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 10/11/2014] [Indexed: 11/11/2022] Open
Abstract
While the prevalence of metabolic syndrome is increasing, little is presently known about this syndrome in Korean elderly. This study aimed to group metabolic risk factors and to examine the associations between groups of health living conditions and metabolic syndrome using data from the Korean National Health Examination and Nutritional Assessment (KNHANES). A total of 1,435 subjects aged over 65 years old with both biochemical and dietary data information were obtained from the 4th and 5th KNHANES (2007–2012). Using stratified and multistage probability sample data, five components of metabolic syndrome were adopted to identify health inequalities. Our findings show that groups of health living conditions such as dietary pattern, body image, muscle mass, and fat mass were differentially associated with metabolic syndrome risk factors. Future studies are necessary to examine the underlying mechanisms of individual health living conditions to better understand the role of metabolic risk factors in metabolic syndrome in elderly.
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Affiliation(s)
- Hak-Seon Kim
- Department of Foodservice Management, Kyungsung University, 309 Suyeong-ro Nam-gu, Busan, 608-736, South Korea.
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20
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Dietary glycaemic index and glycaemic load in a rural elderly population (60–74 years of age) and their relationship with cardiovascular risk factors. Eur J Nutr 2014; 54:523-34. [DOI: 10.1007/s00394-014-0733-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 06/30/2014] [Indexed: 10/25/2022]
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21
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Gundgurthi A, Garg MK, Nair V, Pakhetra R, Das S, Sharma S, Dutta MK, Kharb S, Kapoor R. Endocrine complications after busulphan and cyclophosphamide based hematopoietic stem cell transplant: A single tertiary care centre experience. Indian J Endocrinol Metab 2013; 17:855-863. [PMID: 24083167 PMCID: PMC3784869 DOI: 10.4103/2230-8210.117248] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Endocrine complications are common after hematopoietic stem cell transplant (HSCT). Although HSCT is performed at various centers in India, no study is available for endocrine dysfunctions among them. This study was carried out with the objective to evaluate endocrine dysfunction among patients undergone HSCT in the past. MATERIALS AND METHODS We carried out a cross-sectional study in a 50 post-HSCT recipients (39 allogenic, 11 autologous). All relevant data were collected from patient's records. Samples for hormonal estimation were collected and stimulation tests for cortisol and growth hormone were interpreted based on peak values achieved during insulin tolerance test. RESULTS The mean age of patients was 26.3 ± 16.9 years (range 4-74). Adrenal insufficiency (AI) was present in 60%, hypergonadotropic hypogonadism (HH) in 60%, growth hormone deficiency (GHD) in 54%, hypothyroidism in 4%, hyperprolactinemia in 4%, new onset diabetes after transplant in 4%, and impaired fasting glucose in 6%. Multiple endocrine complications were common. GHD was present in 77% of children (n = 22) although height standard deviation score was not statistically different compared to those who didn't have GHD. HH was present in 36% of children. In adults (n = 28), 36% had GHD, all females had HH, and 89% of males had HH. Germ cell dysfunction with compensated Leydig cell dysfunction was the most common pattern of HH in males. Fifteen patients had graft versus host disease (GVHD). GVHD had no bearing on development of endocrine deficiencies. AI was related to duration after and type of transplant, but was unrelated to steroid intake. CONCLUSIONS Endocrine manifestations are common after HSCT; they can occur as early or late complications. All HSCT recipients should have endocrine evaluation as per prevailing guidelines.
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Affiliation(s)
- Abhay Gundgurthi
- Department of Endocrinology, Army Hospital (Research and Referral), Delhi Cantt, New Delhi, India
| | - M. K. Garg
- Department of Endocrinology, Army Hospital (Research and Referral), Delhi Cantt, New Delhi, India
| | - Velu Nair
- Department of Haematology, Army Hospital (Research and Referral), Delhi Cantt, New Delhi, India
| | - Rajeev Pakhetra
- Department of Endocrinology, Army Hospital (Research and Referral), Delhi Cantt, New Delhi, India
| | - Satyanarayan Das
- Department of Haematology, Army Hospital (Research and Referral), Delhi Cantt, New Delhi, India
| | - Sanjeevan Sharma
- Department of Haematology, Army Hospital (Research and Referral), Delhi Cantt, New Delhi, India
| | - Manoj K. Dutta
- Department of Endocrinology, Army Hospital (Research and Referral), Delhi Cantt, New Delhi, India
| | - Sandeep Kharb
- Department of Endocrinology, Army Hospital (Research and Referral), Delhi Cantt, New Delhi, India
| | - Rajan Kapoor
- Department of Haematology, Army Hospital (Research and Referral), Delhi Cantt, New Delhi, India
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Doughman SD, Ryan AS, Krupanidhi S, Sanjeevi CB, Mohan V. High DHA dosage from algae oil improves postprandial hypertriglyceridemia and is safe for type-2 diabetics. Int J Diabetes Dev Ctries 2013. [DOI: 10.1007/s13410-013-0125-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Ayyappa KA, Ghosh S, Mohan V, Radha V. Association of hepatic lipase gene polymorphisms with hypertriglyceridemia and low high-density lipoprotein-cholesterol levels among South Indian subjects without diabetes. Diabetes Technol Ther 2013; 15:503-12. [PMID: 23550552 DOI: 10.1089/dia.2012.0302] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM The aim of this study was to investigate the association of four variants of the hepatic lipase (HL [or LIPC]) gene with various lipid parameters among South Indian subjects with normal glucose tolerance (NGT). SUBJECTS AND METHODS In total, 747 NGT subjects were randomly selected from the Chennai Urban Rural Epidemiological Study (CURES). Serum triglycerides, serum cholesterol, and high-density lipoprotein cholesterol (HDL-C) were measured using a Hitachi-912 autoanalyzer (Roche Diagnostics GmbH, Mannheim, Germany). Genotyping of HL gene variants was done by the polymerase chain reaction-restriction fragment length polymorphism method, and 20% of samples were sequenced to validate the genotypes obtained. Haplotype analysis was also carried out. RESULTS The TT genotype of the rs1800588 C/T (C-480T) polymorphism was significantly associated with hypertriglyceridemia, with an adjusted odds ratio of 2.58 (95% confidence interval 1.38-4.85, P=0.003), whereas those with the CC genotype of the rs6074 A/C (Thr479Thr) had significantly lower HDL-C levels (41.3±9.8 mg/dL) compared with the AA genotype (43.6±10.2 mg/dL, P=0.02). Haplotype analysis showed the TGC haplotype was significantly associated with low HDL-C levels. CONCLUSIONS Among South Indian subjects without diabetes, the rs1800588 C/T (C-480T) and rs6074 C/A (Thr479Thr) variants of the HL gene are associated with hypertriglyceridemia and low HDL-C, respectively. The TGC haplotype was significantly associated with low HDL-C.
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Affiliation(s)
- Kuppuswamy Ashok Ayyappa
- Madras Diabetes Research Foundation-ICMR Advanced Centre for Genomics of Type 2 Diabetes and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, IDF Centre for Education, Gopalapuram, Chennai, India
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Van Rompay MI, McKeown NM, Castaneda-Sceppa C, Ordovás JM, Tucker KL. Carbohydrate nutrition differs by diabetes status and is associated with dyslipidemia in Boston Puerto Rican adults without diabetes. J Nutr 2013; 143:182-8. [PMID: 23269655 PMCID: PMC3542909 DOI: 10.3945/jn.112.168914] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Puerto Rican adults have a greater prevalence of type 2 diabetes (T2D) and lower HDL-cholesterol (HDL-C) than the general U.S. population. Carbohydrate nutrition may play a role in this disparity. Cross-sectional analyses included data from 1219 Puerto Ricans aged 45-75 y enrolled in the Boston Puerto Rican Health Study. Using the Pearson chi-square test and ANCOVA, lifestyle characteristics and dietary intake, as assessed by semiquantitative FFQ, were compared by T2D status based on fasting plasma glucose concentration and medication use. Food source rankings for carbohydrate, dietary glycemic load (GL), and fiber were obtained using the SAS procedure PROC RANK. Geometric mean plasma HDL-C and TG concentrations were compared across quintiles of dietary carbohydrate, glycemic index (GI), GL, and fiber by using ANCOVA and tests for linear trend. In multivariable analyses, individuals with T2D (39.5%) had lower dietary carbohydrate, GL, and total sugar intake from lower intake of sugar, fruit drinks, and soda compared with those without T2D. In individuals without T2D, dietary carbohydrate and GL were inversely associated with HDL-C (P < 0.0001). Associations between dietary fiber and HDL-C were confounded by carbohydrate intake, apparently from concurrent consumption of legumes with white rice, a refined carbohydrate food. No associations were observed between carbohydrate, dietary GI, GL, or fiber and TG. In conclusion, individuals with T2D showed evidence of dietary modification. Among those without diabetes, a high intake of refined carbohydrates was associated with decreased HDL-C. Longitudinal research on carbohydrate nutrition in relation to diabetes risk factors and blood lipids in Puerto Ricans is warranted.
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Affiliation(s)
- Maria I. Van Rompay
- Jean Mayer USDA Human Nutrition Research Center on Aging, and,Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA; and
| | - Nicola M. McKeown
- Jean Mayer USDA Human Nutrition Research Center on Aging, and,Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA; and
| | | | - José M. Ordovás
- Jean Mayer USDA Human Nutrition Research Center on Aging, and,Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA; and
| | - Katherine L. Tucker
- Jean Mayer USDA Human Nutrition Research Center on Aging, and,Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA; and,Department of Health Sciences, Northeastern University, Boston, MA,To whom correspondence should be addressed. E-mail:
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Nair M, Prabhakaran D. Why Do South Asians Have High Risk for CAD? Glob Heart 2012; 7:307-14. [PMID: 25689942 DOI: 10.1016/j.gheart.2012.09.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 09/03/2012] [Accepted: 09/06/2012] [Indexed: 11/25/2022] Open
Abstract
South Asians have a higher risk for coronary artery disease (CAD) due to both pathophysiological and life course-related risk factors. We performed a literature search and used qualitative synthesis to present evidence for CAD risk factors among South Asians. A large proportion of the higher risk of South Asians for CAD can be explained by conventional risk factors. However, several conditioning factors such as education, socioeconomic status, and fetal programming, and early life influences may contribute to excess CAD risk in South Asians, suggesting the need for a life course approach. Evidence on unconventional risk factors is provocative but comes from small studies. Large-scale, well-designed epidemiological studies are needed for an in-depth understanding of the CAD risk among South Asians.
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Affiliation(s)
- Manisha Nair
- Centre of Excellence, Centre for Cardiometabolic Risk Reduction in South Asia, Public Health Foundation of India, New Delhi, India
| | - Dorairaj Prabhakaran
- Centre of Excellence, Centre for Cardiometabolic Risk Reduction in South Asia, Public Health Foundation of India, New Delhi, India.
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Lakshmipriya N, Gayathri R, Praseena K, Vijayalakshmi P, Geetha G, Sudha V, Krishnaswamy K, Anjana RM, Henry J, Mohan V. Type of vegetable oils used in cooking and risk of metabolic syndrome among Asian Indians. Int J Food Sci Nutr 2012; 64:131-9. [PMID: 23025245 DOI: 10.3109/09637486.2012.728197] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
There is little data on the type of vegetable oil used and the prevalence of metabolic syndrome (MS) in Asian Indians. Food frequency questionnaire was used to document the type of cooking oil in 1875 adults in Chennai city. MS was assessed by new harmonizing criteria. The prevalence of MS was higher among sunflower oil users (30.7%) than palmolein (23.2%) and traditional oil (17.1%, p < 0.001) users. The higher prevalence of MS in sunflower oil group persisted even when stratified according to body mass index, except in obese groups. The risk of MS was further compounded by quantity of refined cereals consumed. Higher LA%E and linoleic acid/alpha-linolenic acid ratio in sunflower oil probably contributes to increased risk of MS.
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Affiliation(s)
- Nagarajan Lakshmipriya
- Madras Diabetes Research Foundation and Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, International Diabetes Federation (IDF) Centre of Education, Gopalapuram, Chennai, India
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Choi H, Song S, Kim J, Chung J, Yoon J, Paik HY, Song Y. High carbohydrate intake was inversely associated with high-density lipoprotein cholesterol among Korean adults. Nutr Res 2012; 32:100-6. [PMID: 22348458 DOI: 10.1016/j.nutres.2011.12.013] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Revised: 12/20/2011] [Accepted: 12/30/2011] [Indexed: 10/28/2022]
Abstract
The traditional Asian diet, which is characterized as being high in carbohydrate with an abundance of vegetables, may be beneficial for preventing metabolic syndrome abnormalities within the Asian population. However, the prevalence of metabolic syndrome is increasing in Asian countries. This study explored the association between dietary carbohydrates and low high-density lipoprotein cholesterol (HDL-C) prevalence, one of the abnormalities of metabolic syndrome in Korean adults. We used the data from the Fourth Korea National Health and Nutrition Examination Survey and evaluated a total of 9947 Korean adults older 20 years. To measure carbohydrate quality and quantity, total carbohydrate intake (g/d), percentage of energy from carbohydrate, glycemic index, and glycemic load were divided into quintiles. Mean levels of HDL-C significantly decreased across the quintiles for all types of dietary carbohydrate intake except glycemic index after adjusting for potential variables in both men and women. Odds ratios for having low HDL-C in the highest quintile were 1.66 (95% confidence interval, 1.24-2.22) for total carbohydrate, 1.34 (1.02-1.75) for percentage of energy from carbohydrate, and 1.54 (1.17-2.03) for glycemic load in men as compared with the second quintile as a reference. Odds ratio for low HDL-C was 1.38 (1.12-1.71) for percentage of energy from carbohydrate in women. In conclusion, our study indicates that low HDL-C is associated with high carbohydrate intake without regard to energy or fat intake. Further studies would be necessary to optimize carbohydrate intake quantitatively on dyslipidemia for Asian population.
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Affiliation(s)
- Hanui Choi
- Department of Food and Nutrition/Research, Institute of Human Ecology, Seoul National University, Seoul, Korea
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Misra A, Singhal N, Sivakumar B, Bhagat N, Jaiswal A, Khurana L. Nutrition transition in India: secular trends in dietary intake and their relationship to diet-related non-communicable diseases. J Diabetes 2011; 3:278-92. [PMID: 21649865 DOI: 10.1111/j.1753-0407.2011.00139.x] [Citation(s) in RCA: 166] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
India is facing an "epidemic" of diet-related non-communicable diseases (DR-NCDs), along with widely prevalent undernutrition resulting in substantial socioeconomic burden. The aim of this paper is to review secular trends in food groups and nutrient intake, and implications for DR-NCDs in India so as to understand optimal choices for healthy diets for the prevention of DR-NCDs. The literature search was carried out in PubMed (National Library of Medicine, Bethesda, MD, USA) and Google Scholar search engines up to April 2011. A manual search for all other references, national and medical databases was also carried out. Nutrition transition over the past 30 years (1973-2004), has resulted in a 7% decrease in energy derived from carbohydrates and a 6% increase in energy derived from fats. A decreasing intake of coarse cereals, pulses, fruits and vegetables, an increasing intake of meat products and salt, coupled with declining levels of physical activity due to rapid urbanization have resulted in escalating levels of obesity, atherogenic dyslipidemia, subclinical inflammation, metabolic syndrome, type 2 diabetes mellitus, and coronary heart disease in Indians. Studies also suggest that adverse perinatal events due to maternal nutritional deprivation may cause low-birth weight infants, which, coupled with early childhood "catch-up growth", leads to obesity in early childhood, thus predisposing to NCDs later in life. In view of rapidly increasingly imbalanced diets, a multisectoral preventive approach is needed to provide balanced diets to pregnant women, children and adults, and to maintain a normal body weight from childhood onwards, to prevent the escalation of DR-NCDs in India.
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Affiliation(s)
- Anoop Misra
- Fortis-C-DOC Centre of Excellence for Diabetes, Obesity, Metabolic Diseases and Endocrinology, Vasant Kunj, New Delhi 110070, India.
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Shobana S, Kokila A, Lakshmipriya N, Subhashini S, Ramya Bai M, Mohan V, Malleshi NG, Anjana RM, Henry CJK, Sudha V. Glycaemic index of three Indian rice varieties. Int J Food Sci Nutr 2011; 63:178-83. [PMID: 21916534 DOI: 10.3109/09637486.2011.615300] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Three commonly consumed Indian rice varieties (Sona Masuri, Ponni and Surti Kolam) were tested for their glycaemic index (GI). Healthy volunteers were recruited and after an overnight fast were given a 50 g available carbohydrate portion of glucose (reference food) or different varieties of cooked rice (test foods) on separate occasions. The fasting as well as postprandial capillary blood glucose response was determined over 2 h, and the incremental area under the curve (IAUC) was calculated. The GI was calculated as the IAUC of the test food/IAUC of the reference food (glucose) × 100. The differences between the GI values for Sona Masuri (72.0 ± 4.5), Ponni (70.2 ± 3.6) and Surti Kolam (77.0 ± 4.0) rice varieties were non-significant (p = 0.606) and are all classified as high GI varieties of rice. There is an urgent need to study the GI of other commonly consumed rice varieties and to develop rice of a lower GI value.
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Affiliation(s)
- S Shobana
- Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialties Centre, WHO Collaborating Centre for Non-Communicable Diseases, International Diabetes Federation (IDF) Centre of Education, Gopalapuram, Chennai, India
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Misra A, Sharma R, Gulati S, Joshi SR, Sharma V, Ibrahim A, Joshi S, Laxmaiah A, Kurpad A, Raj RK, Mohan V, Chandalia H, Krishnaswamy K, Boindala S, Gopalan S, Bhattiprolu SK, Modi S, Vikram NK, Makkar BM, Mathur M, Dey S, Vasudevan S, Gupta SP, Puri S, Joshi P, Khanna K, Mathur P, Krishnaswamy S, Madan J, Karmarkar M, Seth V, Passi SJ, Chadha D, Bhardwaj S. Consensus dietary guidelines for healthy living and prevention of obesity, the metabolic syndrome, diabetes, and related disorders in Asian Indians. Diabetes Technol Ther 2011; 13:683-94. [PMID: 21488798 DOI: 10.1089/dia.2010.0198] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
India is undergoing rapid nutritional transition, resulting in excess consumption of calories, saturated fats, trans fatty acids, simple sugars, salt and low intake of fiber. Such dietary transition and a sedentary lifestyle have led to an increase in obesity and diet-related non-communicable diseases (type 2 diabetes mellitus [T2DM], cardiovascular disease [CVD], etc.) predominantly in urban, but also in rural areas. In comparison with the previous guidelines, these consensus dietary guidelines include reduction in the intake of carbohydrates, preferential intake of complex carbohydrates and low glycemic index foods, higher intake of fiber, lower intake of saturated fats, optimal ratio of essential fatty acids, reduction in trans fatty acids, slightly higher protein intake, lower intake of salt, and restricted intake of sugar. While these guidelines are applicable to Asian Indians in any geographical setting, they are particularly applicable to those residing in urban and in semi-urban areas. Proper application of these guidelines will help curb the rising "epidemics" of obesity, the metabolic syndrome, hypertension, T2DM, and CVD in Asian Indians.
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Affiliation(s)
- Anoop Misra
- Fortis-CDOC Center of Excellence for Diabetes, Obesity Metabolic Diseases and Endocrinology, Fortis Flt. Lt. Rajan Dhall Hospital, Vasant Kunj, New Delhi 110070, India.
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Dietary profile of urban adult population in South India in the context of chronic disease epidemiology (CURES-68). Public Health Nutr 2010; 14:591-8. [PMID: 20701818 DOI: 10.1017/s136898001000203x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Few dietary surveys have been done with reference to chronic diseases, such as diabetes, in India, which is considered to be the diabetes capital of the world. We report on the dietary intake of urban adults living in Chennai, South India. DESIGN A population-based cross-sectional study. SETTING A representative population of urban Chennai in southern India. SUBJECTS The study population comprised 2042 individuals aged≥20 years selected from the Chennai Urban Rural Epidemiological Study (CURES). Dietary intake was measured using a validated and previously published interviewer-administered semi-quantitative meal-based FFQ. RESULTS The mean daily energy intake was 10,393 (sd 2347) kJ (male: 10953 (sd 2364) kJ v. female: 9832 (sd 233) kJ). Carbohydrates were the major source of energy (64%), followed by fat (24%) and protein (12%). Refined cereals contributed to the bulk of the energy (45.8%), followed by visible fats and oils (12.4%) and pulses and legumes (7.8%). However, energy supply from sugar and sweetened beverages was within the recommended levels. Intake of micronutrient-rich foods, such as fruit and vegetable consumption (265 g/d), and fish and seafoods (20 g/d), was far below the FAO/WHO recommendation. Dairy and meat products intake was within the national recommended intake. CONCLUSIONS The diet of this urban South Indian population consists mainly of refined cereals with low intake of fish, fruit and vegetables, and all of these could possibly contribute to the risk of non-communicable diseases such as diabetes in this population.
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Du D, Shi YH, Le GW. The effect of diet with different glycemic index on the redox status of duodenums in mice and its underlying mechanism. Eur Food Res Technol 2010. [DOI: 10.1007/s00217-010-1240-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Glycaemic index of Indian flatbreads (rotis) prepared using whole wheat flour and ‘atta mix’-added whole wheat flour. Br J Nutr 2010; 103:1642-7. [DOI: 10.1017/s0007114509993680] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
To compare the glycaemic index (GI) of newly developed ‘atta mix’ roti with whole wheat flour roti. Eighteen healthy non-diabetic subjects consumed 50 g available carbohydrate portions of a reference food (glucose) and two test foods (whole wheat flour roti and atta mix roti) in random order after an overnight fast. The reference food was tested on three separate occasions, while the test foods were each tested once. Capillary blood samples were measured from finger-prick samples in fasted subjects ( − 5 and 0 min) and at 15, 30, 45, 60, 90 and 120 min from the start of each food. No significant difference was observed between roti prepared from whole wheat flour and atta mix in terms of appearance, texture, flavour, taste or acceptability. For each test food, the incremental area under the curve and GI values were determined. The GI of atta mix roti (27·3 (sem2·2)) was considerably lower than the whole wheat flour roti (45·1 (sem3·5),P < 0·001). Development of foods with lower dietary glycaemic load such as the atta mix roti could help in the prevention and control of diabetes in South Asian populations, which habitually consume very high glycaemic load diets.
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Dietary carbohydrates, glycaemic load, food groups and newly detected type 2 diabetes among urban Asian Indian population in Chennai, India (Chennai Urban Rural Epidemiology Study 59). Br J Nutr 2009; 102:1498-506. [DOI: 10.1017/s0007114509990468] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The aim of the study was to examine the association of dietary carbohydrates and glycaemic load with the risk of type 2 diabetes among an urban adult Asian Indian population. Adult subjects aged >20 years (n 1843) were randomly selected from the Chennai Urban Rural Epidemiology Study, in Chennai city in southern India. Dietary carbohydrates, glycaemic load and food groups were assessed using FFQ. Oral glucose tolerance tests were performed using 75 g glucose in all subjects. Diagnosis of diabetes was based on WHO Consulting Group criteria. OR for newly detected diabetes were calculated for carbohydrates, glycaemic load and specific food groups comparing subjects in the highest with those in the lowest quartiles, after adjustment for potential confounders such as age, sex, BMI, family history of diabetes, physical activity, current smoking, alcohol consumption and relevant dietary factors. We identified 156 (8·5 %) newly diagnosed cases of type 2 diabetes. Refined grain intake was positively associated with the risk of type 2 diabetes (OR 5·31 (95 % CI 2·98, 9·45); P < 0·001). In the multivariate model, after adjustment for potential confounders, total carbohydrate (OR 4·98 (95 % CI 2·69, 9·19), P < 0·001), glycaemic load (OR 4·25 (95 % CI 2·33, 7·77); P < 0·001) and glycaemic index (OR 2·51 (95 % CI 1·42, 4·43); P = 0·006) were associated with type 2 diabetes. Dietary fibre intake was inversely associated with diabetes (OR 0·31 (95 % CI 0·15, 0·62); P < 0·001). In urban south Indians, total dietary carbohydrate and glycaemic load are associated with increased, and dietary fibre with decreased, risk of type 2 diabetes.
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