Short-term nutritional counseling reduces body mass index, waist circumference, triceps skinfold and triglycerides in women with metabolic syndrome

The Effect of Educational Program Based on Belief, Attitude, Subjective Norm, and Enabling Factors Model on Changing the Metabolic Indices in Elderly Patients with Type II Diabetes

BACKGROUND

Diabetes is the most common disease related to metabolism disorders. Today, diabetes in the elderly is one of the major epidemics of the century. This study aimed to investigate the effect of nutrition and jogging-based Belief, Attitude, Subjective Norm, and Enabling Factors (BASNEF) model in changes in metabolic parameters that performed in elderly patients with type II diabetes in Fasa city.

METHODS

This study was a randomized clinical trial on 108 elderly patients with type II diabetes (54 patients in the experimental group and 54 in control group) referred to the diabetes center in Fasa City, Fars Province, Iran, in 2016. Data were collected using a valid self-reported questionnaire including demographic variables and BASNEF Model (knowledge, attitudes, subjective norms, and enabling factors), checklist for patient's practices nutrition and jogging based on self-reporting patients, assess the level of fasting blood sugar (FBS), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG), and HbAlc patients which was completed by both groups before and 3 months after the intervention. The experimental group received the training in eight sessions; each session lasted for 70 min. Then, the data were entered into the SPSS 22 software (SPSS Inc., IBM, Chicago, IL, USA) and were analyzed using descriptive statistics, Chi-square test, independent t-test, and paired t-test. P <0.05 was considered as statistically significant.

RESULTS

The results showed that the mean scores of the BASNEF components (knowledge, attitudes, subjective norms, and enabling factors) in two experimental and control groups after intervention were a significant difference. After training program, nutritional and jogging performance in the experimental group was better than the control group. Furthermore, FBS (P < 0.001), LDL (P < 0.001), HDL (P < 0.001), TG (P < 0.001), and HbAlc (P < 0.001) improved significantly in the experimental group compared to the control group.

CONCLUSIONS

Plan and implement nutrition and jogging education using the BASNEF model to improve metabolic parameters in diabetic patients are very effective and beneficial. Moreover, in the implementation of these programs, control, monitoring, and follow-up educational are recommended.

High out-of-clinic blood pressure is associated with adiposity indicators in leisure physical activity practitioners in Midwest Brazil

Background

Several diseases, such as obesity, hypertension and type 2 diabetes are frequently associated with metabolic abnormalities, high costs of healthcare and morbi-mortality; thus the aim of this study was to investigate the relationship between out-of-clinic high blood pressure and chronic disease-associated adiposity indicators in practitioners of leisure physical activity.

Methods

A cross-sectional study with 414 subjects of both genders aged 24–65 years. Data were collected by trained interviewers in five public parks. Body Mass Index (BMI), triceps skinfold and waist circumference (WC) were evaluated. Exercise training, smoking status, alcohol consumption and hypertension diagnosis were self-reported. Casual glycemia concentrations were collected and blood pressure was measured out-of-clinic once during the study. Participants with systolic ≥140 mmHg and diastolic ≥90 mmHg blood pressures were classified as high blood pressure. All analyses were adjusted for age and sex.

Results

High-blood pressure was diagnosed in 31.4% (n = 130), but 34 (8.3%) from patients took medication anti-hypertensive and were previously hypertension diagnosed. Participants with high blood pressure had a higher BMI (25.66 vs. 26.87 kg/m²; p = 0.012), WC (90.92 vs. 95.02 cm; p = 0.001), and systolic and diastolic blood pressure (p <  0.0001) when compared to subjects with normal blood pressure. Logistic regression analysis revealed that overweight status assessed by BMI, triceps skinfold and WC increases the high blood pressure probability by approximately 1.61 (95 CI%: 1.06–2.45), 1.02 (95%CI: 1.01–1.05) and 1.61 (95%CI: 1.06–2.45), respectively.

Conclusions

Adiposity indicators are associated with high out-of-clinic blood pressure measured in practitioners of leisure physical activity.

Therapeutic effects of soluble dietary fiber consumption on type 2 diabetes mellitus

Soluble dietary fiber (DF) reduces the risk of developing diabetes and may have therapeutic effects in patients with type 2 diabetes mellitus (DM2). The present study aimed to investigate the effect of soluble DF on metabolic control in patients with DM2. A total of 117 patients with DM2 between the ages of 40 and 70 were assessed. Patients were randomly assigned to one of two groups, and administered extra soluble DF (10 or 20 g/day), or to a control group (0 g/day) for one month. Blood glucose, serum insulin and connecting peptide (C-peptide) levels, and the insulin resistance index, as determined using the homeostatic model assessment method, were measured during fasting and up to 2-h postprandially prior to and following one month of treatment. Other measurements included serum levels of glycated albumin (GA), blood lipid profiles, and an analysis of the blood pressure, body weight and waist/hip ratio of all patients. Following intervention, the levels of 2-h blood glucose, fasting insulin and lipoprotein(a), and the insulin resistance index, were significantly improved in all groups. Furthermore, the fasting blood glucose, 2-h insulin, fasting C-peptide, 2-h C-peptide, GA and triglyceride (TG) levels were significantly improved in the soluble DF groups. The 20 g/day soluble DF group exhibited significantly improved fasting blood glucose and low-density lipoprotein levels, as well as a significantly improved insulin resistance index. In addition, 10 and 20 g/day soluble DF significantly improved the waist and hip circumferences and levels of TGs and apolipoprotein A. The results of the present study suggested that increased and regular consumption of soluble DF led to significant improvements in blood glucose levels, insulin resistance and metabolic profiles, without improving the secretory function of the islets of Langerhans, over a short-term intervention period in patients with DM2.

Anthropometric and Quality-of-Life Parameters in Acute Intermittent Porphyria Patients

The porphyrias are a group of rare metabolic disorders. The incidence and prevalence are low because the acute intermittent porphyria (AIP) is rare. Our aim was to assess the use of anthropometric and quality-of-life parameters in porphyric patients in order to identify predictor factors that might help in characterizing AIP patients.Sixteen AIP patients from Murcia (Spain) were recruited from local health centers in 2008 and 2009. A control group of 16 healthy people was established. Body composition was assessed by bioelectrical impedance analysis (BIA) and anthropometric measurements: body weight; height; knee-heel height; waist, hip, upper arm and calf circumferences (CCs); biacromion and biiliac diameters; bicondylar and biepicondylar width; and triceps, subscapular, supraspinale, and calf skinfold thickness. Anthropometric indicators were obtained from anthropometric measurements. A quality-of-life evaluation was carried out using the EuroQol-5D (EQ-5D) questionnaire and Barthel and Katz indexes. Significant differences in means were tested by unpaired Student t test. Group differences in anthropometric measurements were tested with a 2-way analysis of variance (group × condition: age group, overweight, and adiposity degree). Relative frequencies were obtained for noncontinuous variables. Significant differences in prevalence were calculated by means of χ.AIP patients showed statistically significant differences in terms of knee-heel height, biiliac diameter, CC, triceps skinfold thickness, BIA, ponderal index, endomorphy, and ectomorphy. Only 1 quality-of-life indicator, visual analog scale, in the EQ-5D questionnaire showed significant differences between porphyric and control groups.Some anthropometric parameters and the EQ-5D questionnaire could be used to appreciate the presence or follow the evolution of the disease in AIP patients.

Effectiveness of a theory-driven nutritional education program in improving calcium intake among older Mauritian adults

Background. Low calcium intake, a risk factor of osteoporosis and subsequent fractures, has been previously reported among post-menopausal women in Mauritius. Objective. To assess the effectiveness of a theory-based educational intervention in improving the calcium intake, self-efficacy, and knowledge of older Mauritians. Methodology. The study was conducted as a pre- and post-test design which was evaluated through a baseline, immediate postintervention, and 2-month follow-up assessments. Participants were adults (n = 189) aged ≥40 years old from 2 urban community-based centres. The intervention group (IG) (n = 98) participated in 6 weekly interactive lessons based on the health belief model (HBM). The main outcome measures were calcium intake, HB scale scores, knowledge scores, and physical activity level (PAL). Anthropometric measurements were also assessed. Results. The IG significantly increased its baseline calcium intake, knowledge and self-efficacy (P < 0.001) at post-assessments. A significant decrease in waist circumference in the IG was noted (P < 0.05) after intervention. PAL significantly increased by 12.3% at post-test and by 29.6% at follow-up among intervention adults when compared to the CG (P < 0.001). Conclusion. A theory-driven educational intervention is effective in improving the dietary calcium intake, knowledge, self-efficacy, and PAL of older community-based Mauritian adults.

Long-term interdisciplinary therapy reduces endotoxin level and insulin resistance in obese adolescents

AIM

The purpose of the present study was to assess the dietary fat intake, glucose, insulin, Homeostasis model assessment for insulin resistance HOMA-IR, and endotoxin levels and correlate them with adipokine serum concentrations in obese adolescents who had been admitted to long-term interdisciplinary weight-loss therapy.

DESIGN

The present study was a longitudinal clinical intervention of interdisciplinary therapy. Adolescents (n = 18, aged 15-19 y) with a body mass index > 95th percentile were admitted and evaluated at baseline and again after 1 year of interdisciplinary therapy. We collected blood samples, and IL-6, adiponectin, and endotoxin concentrations were measured by ELISA. Food intake was measured using 3-day diet records. In addition, we assessed glucose and insulin levels as well as the homeostasis model assessment for insulin resistance (HOMA-IR).

RESULTS

The most important finding from the present investigation was that the long-term interdisciplinary lifestyle therapy decreased dietary fat intake and endotoxin levels and improved HOMA-IR. We observed positive correlations between dietary fat intake and endotoxin levels, insulin levels, and the HOMA-IR. In addition, endotoxin levels showed positive correlations with IL-6 levels, insulin levels and the HOMA-IR. Interestingly, we observed a negative correlation between serum adiponectin and both dietary fat intake and endotoxin levels.

CONCLUSIONS

The present results indicate an association between dietary fat intake and endotoxin level, which was highly correlated with a decreased pro-inflammatory state and an improvement in HOMA-IR. In addition, this benefits effect may be associated with an increased adiponectin level, which suggests that the interdisciplinary therapy was effective in improving inflammatory pathways.

Dietary whey protein lessens several risk factors for metabolic diseases: a review

Obesity and type 2 diabetes mellitus (DM) have grown in prevalence around the world, and recently, related diseases have been considered epidemic. Given the high cost of treatment of obesity/DM-associated diseases, strategies such as dietary manipulation have been widely studied; among them, the whey protein diet has reached popularity because it has been suggested as a strategy for the prevention and treatment of obesity and DM in both humans and animals. Among its main actions, the following activities stand out: reduction of serum glucose in healthy individuals, impaired glucose tolerance in DM and obese patients; reduction in body weight; maintenance of muscle mass; increases in the release of anorectic hormones such as cholecystokinin, leptin, and glucagon like-peptide 1 (GLP-1); and a decrease in the orexigenic hormone ghrelin. Furthermore, studies have shown that whey protein can also lead to reductions in blood pressure, inflammation, and oxidative stress.

Gut-central nervous system axis is a target for nutritional therapies

Historically, in the 1950s, the chemist Linus Pauling established a relationship between decreased longevity and obesity. At this time, with the advent of studies involving the mechanisms that modulate appetite control, some researchers observed that the hypothalamus is the "appetite centre" and that peripheral tissues have important roles in the modulation of gut inflammatory processes and levels of hormones that control food intake. Likewise, the advances of physiological and molecular mechanisms for patients with obesity, type 2 diabetes mellitus, inflammatory bowel diseases, bariatric surgery and anorexia-associated diseases has been greatly appreciated by nutritionists. Therefore, this review highlights the relationship between the gut-central nervous system axis and targets for nutritional therapies.

Application of BASNEF educational model for nutritional education among elderly patients with type 2 diabetes: improving the glycemic control

BACKGROUND

The objective of this study was to determine the effects of nutritional educational program on glycemic control of elderly patients with type 2 diabetes.

METHODS

In this parallel randomized controlled educational trial, 100 diabetic elderly patients (≥60 years) were chosen (50 in control and 50 in test group). Nutrition education based on beliefs, attitudes, subjective norms and enabling factors (BASNEF model) was conducted. Dietary intake and glycemic indices as well as the components of the BASNEF model were assessed. The four 70-minute educational sessions were conducted in one month. Three months after training intervention, questionnaire was completed again and blood tests were performed.

RESULTS

Increased intake in the mean daily servings of fruits (0.91± 0.82 vs. 0.17±0.79; p < 0.001), vegetables (0.87±0.86 vs. 0.03±1; p < 0.001) and dairy (0.35±0.52 vs. and 0.12±0.76; p < 0.001) were reported in the intervention group compared to the control group (p < 0.001). The amount of fruits, vegetables and dairy increased in the intervention group at the end of the study (p < 0.001). However, it was not significantly changed in the control group. HbA1c and fasting blood sugar (FBS) levels decreased significantly in the interventional group compared to the control group (p < 0.001). Comparing the amount of FBS and HbA1c at the end of the study with the baseline measurements showed significant reduction in interventional group (p < 0.001). However, there was no significant change in control group in this regard.

CONCLUSIONS

BASNEF-based nutritional educational intervention improved dietary intakes as well as glycemic control, 3 months after intervention.

Long-term nutrition education reduces several risk factors for type 2 diabetes mellitus in Brazilians with impaired glucose tolerance

The aim of this study was to evaluate the effects of a nutrition education program (NEP) on anthropometric, dietetic, and metabolic parameters in high-risk subjects for type 2 diabetes mellitus. Fifty-one participants, both sexes, were randomly assigned to either the control (58.8%) or the intervention (NEP) group. The intervention group received frequent individual and group nutritional counseling from a team of nutritionists. Participants were assessed at baseline (M0) and after 12 months (M1) for anthropometric, dietetic, and metabolic parameters. The hypothesis was that high-risk subjects for type 2 diabetes mellitus participating in NEP would show an improvement in these parameters. At M1, the intervention group showed a significant decline in body weight (-3.4%), body mass index (-5.7%), cholesterol intake (-49.5%), fasting glycemia (-14.0%), fasting insulin (-9.0%), postprandial glycemia (-21.0%), postprandial insulin (-71.0%), total serum cholesterol (-23.0%), and glycated hemoglobin (-24.0%). A decrease in energy intake (5%, P = .06) and low-density lipoprotein cholesterol (25%, P = .07) was observed in the interventional group, although it did not reach statistical significance. In contrast, the control group presented a significantly higher energy intake (19%, P = .04) and a nonsignificant increase in consumption of all macronutrients. The long-term NEP was found to improve anthropometric, dietary, and metabolic parameters in high-risk subjects for type 2 diabetes mellitus.

Is exercise a therapeutic tool for improvement of cardiovascular risk factors in adolescents with type 1 diabetes mellitus? A randomised controlled trial

BACKGROUND

Type 1 diabetes mellitus (T1DM) is associated with a high risk for early atherosclerotic complications especially risk of coronary heart disease.

OBJECTIVE

To evaluate the impact of six months exercise prgram on glycemic control, plasma lipids values, blood pressure, severity and frequency of hypoglycemia, anthropometric measurements and insulin dose in a sample of adolescents with T1DM.

RESEARCH DESIGN AND METHODS

A total of 196 type 1 diabetic patients participated in the study. They were classified into three groups: Group (A) did not join the exercise program(n = 48), group (B) attended the exercise sessions once/week (n = 75), group (C) attended the exercise sessions three times/week (n = 73). Studied parameters were evaluated before and six months after exercise programe.

RESULTS

Exercise improved glycemic control by reducing HbA1c values in exercise groups (P = 0.03, P = 0.01 respectively) and no change in those who were not physically active (P = 0.2). Higher levels of HbA1c were associated with higher levels of cholesterol, LDL-c, and triglycerides (P = 0.000 each). In both groups, B and C, frequent exercise improved dyslipidemia and reduced insulin requirements significantly (P = 0.00 both), as well as a reduction in BMI (P = 0.05, P = 0.00 respectively) and waist circumference(P = 0.02, P = 0.00 respectively). The frequency of hypoglycemic attacks were not statistically different between the control group and both intervention groups (4.7 +/- 3.56 and 4.82 +/- 4.23, P = 0.888 respectively). Reduction of blood pressure was statistically insignificant apart from the diastolic blood presure in group C (P = 0.04).

CONCLUSION

Exercise is an indispensable component in the medical treatment of patients with T1DM as it improves glycemic control and decreases cardiovascular risk factors among them.