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Nazari J, Yadegari N, Khodam S, Almasi-Hashian A, Amini S. Effect of Consumption of Whole-Wheat Breads on FBS, HbA1c, and Blood Lipids in Patients with Type 2 Diabetes. Prev Nutr Food Sci 2021; 26:269-274. [PMID: 34737987 PMCID: PMC8531422 DOI: 10.3746/pnf.2021.26.3.269] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/07/2021] [Accepted: 08/12/2021] [Indexed: 11/09/2022] Open
Abstract
Whole-wheat can have positive effect on blood parameters, such as blood sugar and fat profiles, in patients with diabetic. The aim of this study was to assess the effect of whole-wheat breads on hemoglobin A1c (HbA1c) and blood lipids in patients with type 2 diabetes (T2D). The study population included men and women with T2D aged 30 years old and over in Arak, Iran. Using random sampling method, 60 patients with T2D were selected and randomly divided into control and intervention groups. After taking blood samples from the patients, the intervention group was administered 180 g of wholegrain wheat for 12 weeks. The participants were asked not to change their diets and amounts of physical activity during the study period. After 12 weeks, blood samples were taken and insulin resistance indexes, blood glucose levels, and lipid profiles were examined. The results indicated that consumption of whole-wheat bread for 12 weeks can significantly reduce body weight, and HbA1c, triglyceride, total cholesterol, and low density lipoprotein cholesterol (LDL-c) levels, and increase high density lipoprotein cholesterol (HDL-c) levels (P<0.05). However, in the control group, changes in body weight, body mass index, HbA1c, total cholesterol, HDL-c, and LDL-c levels did not significantly differ before and after the intervention period (P>0.05). As consumption of whole-wheat bread has positive effects on control of various physical and biochemical indictors in patients with diabetes, its consumption should be included in educational programs at health centers across the country.
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Affiliation(s)
- Javad Nazari
- Department of Pediatrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Nasrin Yadegari
- Department of Nutrition, Deputy of Health, Arak University of Medical Sciences, Arak, Iran
| | - Sousan Khodam
- Department of Nutrition, Deputy of Health, Arak University of Medical Sciences, Arak, Iran
| | - Amir Almasi-Hashian
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - Saeed Amini
- Department of Health Services Management, Khomein University of Medical Sciences, Khomein, Iran
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2
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Barrea L, Vetrani C, Caprio M, El Ghoch M, Frias-Toral E, Mehta RJ, Mendez V, Moriconi E, Paschou SA, Pazderska A, Savastano S, Colao A, Muscogiuri G. Nutritional management of type 2 diabetes in subjects with obesity: an international guideline for clinical practice. Crit Rev Food Sci Nutr 2021; 63:2873-2885. [PMID: 34554038 DOI: 10.1080/10408398.2021.1980766] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Type 2 diabetes mellitus (T2DM) and obesity represent a global public health problem. Current nutritional recommendations focused on weight loss and overall dietary quality. However, there is no consensus on the optimal macronutrient composition of the diet, particularly for the long-term management of T2DM in subjects with obesity. An international panel of experts reviewed and critically appraised the updated literature published on the topic. This review primarily examines the evidence for areas of consensus and uncertainty about nutritional therapy in patients with T2DM and obesity. The aim of this article is to provide nutritional advice to manage these patients in clinical practice.
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Affiliation(s)
- Luigi Barrea
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, Naples, Italy.,Centro Italiano per la cura e il benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
| | - Claudia Vetrani
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Massimiliano Caprio
- Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele Roma, Rome, Italy.,Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | | | | | - Verna Mendez
- Endocrinology Department, Mexican Institute of Social Security, Los Mochis, Sinaloa, Mexico
| | - Eleonora Moriconi
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Stavroula A Paschou
- Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Agnieszka Pazderska
- St James's Hospital, Dublin, Ireland.,Trinity College Dublin, Dublin, Ireland
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy.,Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", University of Naples "Federico II", Naples, Italy
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy.,Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", University of Naples "Federico II", Naples, Italy
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Zhang JY, Jiang YT, Liu YS, Chang Q, Zhao YH, Wu QJ. The association between glycemic index, glycemic load, and metabolic syndrome: a systematic review and dose-response meta-analysis of observational studies. Eur J Nutr 2019; 59:451-463. [PMID: 31680212 DOI: 10.1007/s00394-019-02124-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 10/21/2019] [Indexed: 01/11/2023]
Abstract
PURPOSE The association of glycemic index (GI) and glycemic load (GL) with metabolic syndrome (MetS) is controversial. Therefore, we conducted this first systematic review and dose-response meta-analysis of observational studies to quantify these associations. METHODS We searched PubMed, EMBASE, Web of Science, and the Cochrane Library for relevant studies up to 1 April 2019. Summary odds ratios (OR) and 95% confidence intervals (CI) were calculated by a random-effects model. This study was registered with PROSPERO (CRD42019131788). RESULTS We included eight high-quality (n = 5) or medium-quality (n = 3) cross-sectional studies in the final meta-analysis, comprising 6058 MetS events and 28,998 participants. The summary ORs of MetS for the highest versus lowest categories were 1.23 (95% CI 1.10-1.38, I2 = 0, tau2 = 0, n = 5) for dietary GI, 1.06 (95% CI 0.89-1.25, I2 = 36.2%, tau2 = 0.0151, n = 6) for dietary GL. The summary OR was 1.12 (95% CI 1.00-1.26, I2 = 0, tau2 = 0, n = 3) per 5 GI units, 0.96 (95% CI 0.83-1.10, I2 = 33.4%, tau2 = 0.0059, n = 2) per 20 GL units. CONCLUSIONS Dietary GI was positively associated with the prevalence of MetS. However, no significant association was found between dietary GL and the prevalence of MetS. Further studies with prospective design are needed to establish potential causal relationship between dietary GI and the MetS.
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Affiliation(s)
- Jia-Yu Zhang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, 110004, Liaoning, People's Republic of China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu-Ting Jiang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, 110004, Liaoning, People's Republic of China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ya-Shu Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, 110004, Liaoning, People's Republic of China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qing Chang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, 110004, Liaoning, People's Republic of China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, 110004, Liaoning, People's Republic of China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, 110004, Liaoning, People's Republic of China. .,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China.
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Joshi SR, Bhansali A, Bajaj S, Banzal SS, Dharmalingam M, Gupta S, Mukhopadhyay S, Shah PR, Sahay R, Sarkar S, Manjrekar PV, Rathod RT, Joshi SS. Results from a dietary survey in an Indian T2DM population: a STARCH study. BMJ Open 2014; 4:e005138. [PMID: 25361834 PMCID: PMC4216859 DOI: 10.1136/bmjopen-2014-005138] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 08/16/2014] [Accepted: 09/10/2014] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To assess the dietary total and complex carbohydrate (CHO) contents in type-2 diabetes mellitus (T2DM) participants in India. SETTING We enrolled 796 participants in this cross-sectional, single-visit, multicentre, two-arm, single-country survey. Participants were enrolled from 10 specialty endocrinology/dialectology centres from five regions of India. PARTICIPANTS A total of 796 participants (Asian) were enrolled in this study (385, T2DM and 409, non-T2DM). Key inclusion criteria-male or female ≥18 years, diagnosed with T2DM ≥12 months (T2DM), and not on any diet plan (non-T2DM). STUDY OUTCOME Primary outcome was to find out the percentage of total energy intake as simple and complex CHO from total CHO. Secondary outcomes were to find the differences in percentage of total energy intake as simple CHO, complex CHO, proteins and fats between T2DM and non-T2DM groups. The percentage of T2DM participants adhering to diet plan and showing glycaemic controls were also examined. RESULTS The mean (SD) of total calorie intake per day (Kcal) was 1547 (610, 95% CI 1486 to 1608) and 2132 (1892, 95% CI 1948 to 2316), respectively, for T2DM and non-T2DM groups. In the T2DM group (n=385), the mean (SD) percentage of total energy intake as total CHO, complex CHO and simple CHO was 64.1±8.3 (95% CI 63.3 to 64.9), 57.0±11.0 (95% CI 55.9 to 58.1) and 7.1±10.8 (95% CI 6.0 to 8.2), respectively. The mean (SD) percentage of complex CHO intake from total CHO was 89.5±15.3 (95% CI 88.0 to 91.1). The mean (SD) total protein/fat intake per day (g) was 57.1 (74.0)/37.2 (18.6) and 57.9 (27.2)/55.3 (98.2) in T2DM and non-T2DM groups, respectively. CONCLUSIONS Our study shows that CHO constitutes 64.1% of total energy from diet in T2DM participants, higher than that recommended in India. However, our findings need to be confirmed in a larger epidemiological survey. TRIAL REGISTRATION NUMBER NCT01450592 & Clinical Trial Registry of India: CTRI/2012/02/002398.
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Affiliation(s)
| | - Anil Bhansali
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sarita Bajaj
- MLN Medical College, Allahabad, Uttar Pradesh, India
| | | | - Mala Dharmalingam
- Bangalore Endocrinology and Diabetes Research Center Pvt Ltd, Bangalore, Karnataka, India
| | - Shachin Gupta
- Krishna Diabetes Clinic and Educational Research Centre, Bhopal, Madhya Pradesh, India
| | - Satinath Mukhopadhyay
- Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Parag R Shah
- Gujarat Endocrine Centre, Ahmedabad, Gujarat, India
| | - Rakesh Sahay
- Sahay's Endocrine and Diabetes Clinic, Hyderabad, Andhra Pradesh, India
| | - Swapan Sarkar
- Sarkar's Diabetes Nutrition Clinic and Research Center, Agartala, Tripura, India
| | - Pravin V Manjrekar
- Department of Medical Affairs, Bayer Zydus Pharma Private Limited, Thane, Maharashtra, India
| | - Rahul T Rathod
- Department of Medical Affairs, Bayer Zydus Pharma Private Limited, Thane, Maharashtra, India
| | - Shilpa S Joshi
- Mumbai Diet and Health Center, Mumbai, Maharashtra, India
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5
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Clifton PM, Galbraith C, Coles L. Effect of a low dose whey/guar preload on glycemic control in people with type 2 diabetes--a randomised controlled trial. Nutr J 2014; 13:103. [PMID: 25343850 PMCID: PMC4216833 DOI: 10.1186/1475-2891-13-103] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 10/15/2014] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Large preloads of protein and fat have been shown to lower glucose after a carbohydrate-rich meal in people with type 2 diabetes but add a considerable energy burden. Low calorie preloads [<5% of daily energy intake] have been tested in this study in people with prediabetes and with type 2 diabetes. RESEARCH DESIGN AND METHODS This was an unblinded randomised crossover study with two placebo days and two active treatment days. Glucose was measured for 3 hours with fingerprick samples as well as continuous glucose monitoring [CGMS]. Twenty-four subjects with pre-diabetes or moderately controlled type 2 diabetes [fasting glucose < 10 and HbA1c < 8.5%] were recruited. The preload contained 17 g whey protein plus 3 g lactose and 5 g guar, and 1 g flavour material [including sucralose] dissolved in 150 ml cold water or 150 ml cold water with no additives. The breakfast test meal consisted of 2 slices of bread, margarine and jam [3 slices for men] with the test drink 15 minutes beforehand. RESULTS Peak fingerprick glucose was reduced by 2.1 mmol/L at 45 min [p < 0.0001]. Average fingerprick glucose over 3 hours was reduced by 0.8 mmol/L [p = 0.0003]. There was no difference between those with diabetes or prediabetes or those on medication or not on medication. CONCLUSIONS An 80 kcal whey protein/fibre preload can lower average glucose over 3 hours by 0.8 mmol/L. If used long term before at least two carbohydrate-rich meals/day this preload could lower HbA1c by up to 1%. TRIAL REGISTRATION The trial was registered with the Australian New Zealand Clinical Trials Registry number ACTRN12612001251819.
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Affiliation(s)
- Peter M Clifton
- University of South Australia, North Terrace, GPO Box 2471, Adelaide, SA 5001, Australia.
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6
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Yang L, Shu L, Jiang J, Qiu H, Zhao G, Zhou Y, Jiang Q, Sun Q, Qin G, Wu H, Yang L, Ruan X, Xu WH. Long-term effect of dietary fibre intake on glycosylated haemoglobin A1c level and glycaemic control status among Chinese patients with type 2 diabetes mellitus. Public Health Nutr 2014; 17:1858-64. [PMID: 23883570 PMCID: PMC10282387 DOI: 10.1017/s1368980013002000] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 06/05/2013] [Accepted: 06/12/2013] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Dietary fibre has been linked to lower levels of glycosylated haemoglobin A1c (HbA1c) among diabetes patients. The present study aimed to evaluate the long-term effect of dietary fibre on HbA1c levels among Chinese patients with type 2 diabetes mellitus. DESIGN Two cross-sectional surveys were conducted in 2006 and 2011, with the second one being a repeat survey on a sub-sample from the initial one. In both surveys, an in-person interview was conducted to collect information on demographic characteristics and lifestyles following a similar protocol. Dietary intake was assessed with a validated FFQ. Anthropometric measures and biochemical assays were performed at the interview. SETTING Communities in Pudong New Area of Shanghai, China. SUBJECTS Chinese patients (n 934) with type 2 diabetes mellitus. RESULTS An inverse association was observed between dietary fibre and glycaemic status indicated by HbA1c level in both surveys, although it was significant only in the first survey. Among 497 patients participating in both surveys, dietary fibre intake at the first survey was inversely associated with uncontrolled glycaemic status at the second survey, with adjusted odds ratios across the tertiles of intake being 1·00, 0·72 (95 % CI 0·43, 1·21) and 0·58 (95 % CI 0·34, 0·99; P trend = 0·048). The change in fibre intake was slightly associated with glycaemic status, with each increase in tertile scores of intake linked to a 0·138 % (β = -0·138; 95 % CI -0·002, 0·278) decrease in HbA1c value and a 19 % (OR = 0·81; 95 % CI 0·65, 1·02) reduced risk of uncontrolled glycaemic status at the second survey. CONCLUSIONS Dietary fibre may have a long-term beneficial effect on HbA1c level among Chinese diabetes patients.
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Affiliation(s)
- Luxi Yang
- Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, People's Republic of China
| | - Le Shu
- Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, People's Republic of China
| | - Junyi Jiang
- Department of Chronic Disease Prevention, Pudong New Area Centers for Disease Control and Prevention, 3039 Zhang Yang Road, Shanghai 200136, People's Republic of China
| | - Hua Qiu
- Department of Chronic Disease Prevention, Pudong New Area Centers for Disease Control and Prevention, 3039 Zhang Yang Road, Shanghai 200136, People's Republic of China
| | - Genming Zhao
- Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, People's Republic of China
| | - Yi Zhou
- Department of Chronic Disease Prevention, Pudong New Area Centers for Disease Control and Prevention, 3039 Zhang Yang Road, Shanghai 200136, People's Republic of China
| | - Qingwu Jiang
- Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, People's Republic of China
| | - Qiao Sun
- Department of Chronic Disease Prevention, Pudong New Area Centers for Disease Control and Prevention, 3039 Zhang Yang Road, Shanghai 200136, People's Republic of China
| | - Guoyou Qin
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, People's Republic of China
| | - Hongyan Wu
- Department of Chronic Disease Prevention, Pudong New Area Centers for Disease Control and Prevention, 3039 Zhang Yang Road, Shanghai 200136, People's Republic of China
| | - Liming Yang
- Department of Chronic Disease Prevention, Pudong New Area Centers for Disease Control and Prevention, 3039 Zhang Yang Road, Shanghai 200136, People's Republic of China
| | - Xiaonan Ruan
- Department of Chronic Disease Prevention, Pudong New Area Centers for Disease Control and Prevention, 3039 Zhang Yang Road, Shanghai 200136, People's Republic of China
| | - Wang Hong Xu
- Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, People's Republic of China
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Cox DJ, Gill Taylor A, Dunning ES, Winston MC, Luk Van IL, McCall A, Singh H, Yancy WS. Impact of behavioral interventions in the management of adults with type 2 diabetes mellitus. Curr Diab Rep 2013; 13:860-8. [PMID: 24072477 DOI: 10.1007/s11892-013-0423-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Research on the role of behavior change as an efficacious intervention for adults with type 2 diabetes is evolving. Searching PubMed and Ovid Medline, we identified and reviewed primarily randomized controlled trials from 2010 to 2013 of adults managing type 2 diabetes without insulin. All studies are evaluated in terms of the rigor of their design and their impact on glycosylated hemoglobin. The most efficacious interventions appear to be low-carbohydrate/glycemic load diets, combined aerobic and resistance training, and self-monitoring of blood glucose, which educates patients about the impact of their food selections and physical activity on their blood glucose.
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Affiliation(s)
- Daniel J Cox
- Behavioral Medicine Center, University of Virginia School of Medicine, 1300 JPA, UVA Hospital West, Barringer IV, Charlottesville, VA, 22908, USA,
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Jiang J, Qiu H, Zhao G, Zhou Y, Zhang Z, Zhang H, Jiang Q, Sun Q, Wu H, Yang L, Ruan X, Xu WH. Dietary fiber intake is associated with HbA1c level among prevalent patients with type 2 diabetes in Pudong New Area of Shanghai, China. PLoS One 2012; 7:e46552. [PMID: 23077514 PMCID: PMC3473058 DOI: 10.1371/journal.pone.0046552] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 09/05/2012] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Dietary factors play an important role in glycemic control in diabetic patients. However, little is known about their effects among Chinese diabetic patients, whose diets are typically abundant in fiber and high in glycemic index (GI) values. METHODOLOGY/PRINCIPAL FINDINGS 934 patients with type 2 diabetes and 918 healthy volunteers from Pudong New Area, Shanghai, China, were interviewed during the period of Oct-Dec, 2006 to elicit demographic characteristics and lifestyle factors. Dietary habits were assessed using a validated food frequency questionnaire. Anthropometric measurements, bio-specimen collection and biochemical assays were conducted at the interview according to a standard protocol. In this population, diabetic patients consumed lower levels of energy and macronutrients but had higher levels of fasting plasma glucose (FPG), glycolated hemoglobin A1c (HbA1c), triglyceride and body mass index than healthy adults. While the average consumption levels of the nutrients among diabetic patients did not vary along duration of the disease, the average levels of FPG and HbA1c increased with increasing duration. Regardless of diabetes duration, HbA1c level was observed lower in patients having a higher fiber or lower GI intake. Compared with those with the lowest tertile intake of fiber, the adjusted odds ratios (ORs) for poor glycemic control reduced from 0.75 (95%CI: 0.54-1.06) to 0.51 (95%CI: 0.34-0.75) with increasing tertile intake (P for trend <0.001). CONCLUSIONS Dietary fiber may play an important role in reducing HbA1c level. Increasing fiber intake may be an effective approach to improve glycemic control among Chinese diabetic patients.
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Affiliation(s)
- Junyi Jiang
- Key Laboratory of Public Health Safety, Department of Epidemiology, School of Public Health, Ministry of Education, Fudan University, Shanghai, People's Republic of China
| | - Hua Qiu
- Pudong New Area Centers for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Genming Zhao
- Key Laboratory of Public Health Safety, Department of Epidemiology, School of Public Health, Ministry of Education, Fudan University, Shanghai, People's Republic of China
| | - Yi Zhou
- Pudong New Area Centers for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Zhijie Zhang
- Key Laboratory of Public Health Safety, Department of Epidemiology, School of Public Health, Ministry of Education, Fudan University, Shanghai, People's Republic of China
| | - Hong Zhang
- Pudong New Area Centers for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Qingwu Jiang
- Key Laboratory of Public Health Safety, Department of Epidemiology, School of Public Health, Ministry of Education, Fudan University, Shanghai, People's Republic of China
| | - Qiao Sun
- Pudong New Area Centers for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Hongyan Wu
- Pudong New Area Centers for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Liming Yang
- Pudong New Area Centers for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Xiaonan Ruan
- Pudong New Area Centers for Disease Control and Prevention, Shanghai, People's Republic of China
- * E-mail: (XR); (WX)
| | - Wang-Hong Xu
- Key Laboratory of Public Health Safety, Department of Epidemiology, School of Public Health, Ministry of Education, Fudan University, Shanghai, People's Republic of China
- * E-mail: (XR); (WX)
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Wu T, Rayner CK, Jones K, Horowitz M. Dietary effects on incretin hormone secretion. VITAMINS AND HORMONES 2011; 84:81-110. [PMID: 21094897 DOI: 10.1016/b978-0-12-381517-0.00003-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The delivery of nutrients from the stomach into the duodenum and their subsequent interaction with the small intestine to stimulate incretin hormone release are central determinants of the glycemic response. The incretin effect has hitherto been attributed to the secretion of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) from enteroendocrine cells in the intestinal epithelium. A number of recent studies have yielded fundamental insights into the influence of individual nutrients on incretin release and the mechanisms involved in the detection of carbohydrates, fats, and proteins by enteroendocrine cells, including the K(ATP) channel, sodium-glucose cotransporter 1 (SGLT1), sweet taste receptors, G-protein-coupled receptors (GPRs), and oligopeptide transporter 1 (PepT1). Dietary modification, including modifying macronutrient composition or the consumption of "preloads" in advance of a meal, represents a novel approach to manipulate the incretin response and thereby regulate glucose homeostasis in patients with type 2 diabetes. This review focuses on the effects of individual nutrients on incretin hormone secretion, our current understanding of the signaling mechanisms that trigger secretion by enteroendocrine cells, and the therapeutic implications of these observations.
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Affiliation(s)
- Tongzhi Wu
- University of Adelaide Discipline of Medicine, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia, Australia
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