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Salehi Z, Rahbarinejad P, Ghosn B, Azadbakht L. Association of quality and quantity of macronutrients intake with obesity, new anthropometric indices, lipid accumulation, and blood lipid risk index in Tehranian women. Food Sci Nutr 2024; 12:3237-3250. [PMID: 38726395 PMCID: PMC11077202 DOI: 10.1002/fsn3.3991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 01/07/2024] [Accepted: 01/17/2024] [Indexed: 05/12/2024] Open
Abstract
Background This study examines the association between micronutrient intake, anthropometric indices, lipid accumulation, and blood lipid risk index among Tehranian women. Methods A cross-sectional study was conducted on 556 Tehranian women. Dietary intake was measured using a Food Frequency Questionnaire. Biochemical assessment and anthropometric indices were measured, and demographic information and physical activity were collected. Results Participants with the highest intake of carbohydrates were more prone to obesity. Conversely, those in the top tertile for protein intake had a lower likelihood of obesity and higher levels of lipid accumulation product (LAP). The highest fat consumers had a 63% decreased chance of having a high Castelli's Risk Index 1 (CRI-1). A higher glycemic index (GI) and glycemic load (GL) were linked to an increased probability of a high atherogenic coefficient (AC). Women in the top tertile of GL were significantly more likely to be obese and had lower odds for high LAP. Participants in the top tertile of aromatic amino acids/branched chain amino acids (AAA/BCAA) had significantly lower chances of high CRI-1 and a high atherogenic index of plasma (AIP). Those in the highest tertile of monounsaturated fatty acids/polyunsaturated fatty acids (MUFA/PUFA) had lower odds of obesity and high AIP. Conclusions The amount of carbohydrate (g) and protein intake (%), dietary GL, and the ratio of MUFA to PUFA were associated with obesity. The amount of fat intake (g) and AAA/BCAA indices were associated with CRI-1. LAP decreased with an increase in GL. AC increased with an increase in GI and GL. AAA/BCAA and MUFA/PUFA were associated with AIP.
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Affiliation(s)
- Zahra Salehi
- Department of Community NutritionSchool of Nutritional Sciences and Dietetics, Tehran University of Medical SciencesTehranIran
| | - Pegah Rahbarinejad
- Department of Community NutritionSchool of Nutritional Sciences and Dietetics, Tehran University of Medical SciencesTehranIran
| | - Batoul Ghosn
- Department of Community NutritionSchool of Nutritional Sciences and Dietetics, Tehran University of Medical SciencesTehranIran
| | - Leila Azadbakht
- Department of Community NutritionSchool of Nutritional Sciences and Dietetics, Tehran University of Medical SciencesTehranIran
- Diabetes Research CenterEndocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical SciencesTehranIran
- Department of Community NutritionSchool of Nutrition and Food Science, Isfahan University of Medical SciencesIsfahanIran
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Balali A, Tirani SA, Rouhani P, Shahdadian F, Hajhashemy Z, Mohammadi S, Mokhtari E, Saneei P. Nutrient patterns in relation to metabolic health status and serum levels of brain-derived neurotrophic factor (BDNF) and adropin in adults. Sci Rep 2024; 14:4650. [PMID: 38409315 PMCID: PMC10897437 DOI: 10.1038/s41598-024-54913-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/18/2024] [Indexed: 02/28/2024] Open
Abstract
The present study aimed to investigate the association of nutrient patterns (NPs) with metabolic health status and serum levels of brain-derived neurotrophic factor (BDNF) and adropin in Iranian adults. This cross-sectional survey was performed on 527 adults aged 20-60 years in Isfahan, Iran. To evaluate dietary intake, a validated 168-item semi-quantitative food frequency questionnaire (FFQ) was used. Participants were categorized as metabolically healthy (MH) and metabolically unhealthy (MU) according to their glycemic and lipid profile, insulin resistance (IR), and inflammation status. An overnight fasting blood sample was collected from each participant and serum levels of BDNF and adropin were assessed. A total of 42.50% of participants were recognized as MU. Three NPs were recognized by factor analysis that labeled as "high animal protein" (NP1), "high vegetable" (NP2), and "high carbohydrate" (NP3) patterns. Moderate adherence to NP2 was related to a lower risk of MU (ORT2 vs. T1 = 0.38, 95% CI: 0.18-0.76). Moreover, high adherence of NP2 (T3 vs. T1) was inversely associated with hypertriglyceridemia (OR = 0.27, 95% CI: 0.11-0.65; P-trend < 0.001) and high hs-CRP values (OR = 0.29, 95% CI: 0.09-1.00; P-trend = 0.03). No significant association was observed between adherence of NP1 and NP3 with MU in crude and adjusted models. However, negative associations were found between moderate adherence to NP3 and insulin resistance (IR) (OR = 0.23, 95% CI: 0.06-0.91) as well as high adherence to NP1 and hypertension (OR = 0.23, 95% CI: 0.09-0.61; P-trend < 0.001). NPs were not associated with serum BDNF and adropin values.
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Affiliation(s)
- Arghavan Balali
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahnaz Amani Tirani
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parisa Rouhani
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Farnaz Shahdadian
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Clinical Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Hajhashemy
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sobhan Mohammadi
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elahe Mokhtari
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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Strydom H, Delport E, Muchiri J, White Z. The Application of the Food Insulin Index in the Prevention and Management of Insulin Resistance and Diabetes: A Scoping Review. Nutrients 2024; 16:584. [PMID: 38474713 DOI: 10.3390/nu16050584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/08/2024] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
The food insulin index (FII) is a novel algorithm used to determine insulin responses of carbohydrates, proteins, and fats. This scoping review aimed to provide an overview of all scientifically relevant information presented on the application of the FII in the prevention and management of insulin resistance and diabetes. The Arksey and O'Malley framework and the PRISMA Extension for Scoping Reviews 22-item checklist were used to ensure that all areas were covered in the scoping review. Our search identified 394 articles, of which 25 articles were included. Three main themes emerged from the included articles: 1. the association of FII with the development of metabolic syndrome, insulin resistance, and diabetes, 2. the comparison of FII with carbohydrate counting (CC) for the prediction of postprandial insulin response, and 3. the effect of metabolic status on the FII. Studies indicated that the FII can predict postprandial insulin response more accurately than CC, and that a high DII and DIL diet is associated with the development of metabolic syndrome, insulin resistance, and diabetes. The FII could be a valuable tool to use in the prevention and management of T1DM, insulin resistance, and T2DM, but more research is needed in this field.
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Affiliation(s)
- Hildegard Strydom
- Department of Human Nutrition, University of Pretoria, Pretoria 0084, South Africa
| | - Elizabeth Delport
- GI Foundation of South Africa, Nelspruit, Mbombela 1201, South Africa
| | - Jane Muchiri
- Department of Human Nutrition, University of Pretoria, Pretoria 0084, South Africa
| | - Zelda White
- Department of Human Nutrition, University of Pretoria, Pretoria 0084, South Africa
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Zhang Y, Wang Y, Yang B, Han X, He Y, Wang T, Sun X, Zhao J. Effects of zucchini polysaccharide on pasting, rheology, structural properties and in vitro digestibility of potato starch. Int J Biol Macromol 2023; 253:127077. [PMID: 37769764 DOI: 10.1016/j.ijbiomac.2023.127077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 09/16/2023] [Accepted: 09/23/2023] [Indexed: 10/03/2023]
Abstract
Zucchini polysaccharide (ZP) has a unique molecular structure and a variety of biological activities. This study aimed to evaluate the effects of ZP (1, 2, 3, 4 and 5 %, w/w) on the properties of potato starch (PS), including pasting, rheological, thermodynamic, freeze-thaw stability, micro-structure, and in vitro digestibility of the ZP-PS binary system. The results showed that the appearance of ZP significantly reduced the peak, breakdown, final and setback viscosity and prolonged the pasting temperature of PS, whereas increased the trough viscosity. The tests of rheological showed that ZP had a damaging effect on PS gels. Meanwhile, the results of thermodynamic and Fourier transform infrared exhibited that the presence of ZP significantly retarded the retrogradation of PS, especially at a higher levels. The observation of the microstructure exhibited that ZP significantly altered the microscopic network structure of the PS gels, and ZP reduced the formation of the gel structure. Besides, ZP postponed the retrogradation process of PS gels. Moreover, ZP weakened the freeze-thaw stability of the PS gel. Furthermore, ZP also can decrease the digestibility and estimated glycemic index (eGI) value of PS from 86.04 % and 70.89 to 77.67 % and 65.22, respectively. Simultaneously, the addition of ZP reduced the rapidly digestible starch content (from 25.09 % to 16.59 %) and increased the slowly digestible starch (from 24.99 % to 26.77 %) and resistant starch content (from 49.92 % to 56.64 %). These results have certain guiding significance for the application of ZP in starch functional food.
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Affiliation(s)
- Yu Zhang
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China; China National Engineering Research Center for Fruit and Vegetable Processing, Beijing 100083, China; Key Laboratory of Fruit and Vegetable Processing, Ministry of Agriculture, Beijing 100083, China
| | - Yiming Wang
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China; China National Engineering Research Center for Fruit and Vegetable Processing, Beijing 100083, China; Key Laboratory of Fruit and Vegetable Processing, Ministry of Agriculture, Beijing 100083, China
| | - Bingjie Yang
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China; China National Engineering Research Center for Fruit and Vegetable Processing, Beijing 100083, China; Key Laboratory of Fruit and Vegetable Processing, Ministry of Agriculture, Beijing 100083, China
| | - Xunze Han
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China; China National Engineering Research Center for Fruit and Vegetable Processing, Beijing 100083, China; Key Laboratory of Fruit and Vegetable Processing, Ministry of Agriculture, Beijing 100083, China
| | - Yuting He
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China; China National Engineering Research Center for Fruit and Vegetable Processing, Beijing 100083, China; Key Laboratory of Fruit and Vegetable Processing, Ministry of Agriculture, Beijing 100083, China
| | - Tiange Wang
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China; China National Engineering Research Center for Fruit and Vegetable Processing, Beijing 100083, China; Key Laboratory of Fruit and Vegetable Processing, Ministry of Agriculture, Beijing 100083, China
| | - Xun Sun
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China; China National Engineering Research Center for Fruit and Vegetable Processing, Beijing 100083, China; Key Laboratory of Fruit and Vegetable Processing, Ministry of Agriculture, Beijing 100083, China
| | - Jing Zhao
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China; China National Engineering Research Center for Fruit and Vegetable Processing, Beijing 100083, China; Key Laboratory of Fruit and Vegetable Processing, Ministry of Agriculture, Beijing 100083, China.
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Behbahani HB, Shokuhi M, Clark CCT, Javid AZ, Aghamohammadi V, Bazyar H, Samadani M, Haybar H. Glycemic index, glycemic load, dietary insulin index, and dietary insulin load in relation to cardiometabolic risk factors among participants with atherosclerosis: a cross-sectional study. BMC Nutr 2023; 9:98. [PMID: 37582773 PMCID: PMC10426217 DOI: 10.1186/s40795-023-00755-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 08/08/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND We examined the cross-sectional associations of dietary Glycemic Index (GI), Glycemic Load (GL), Dietary Insulin Index (DII), and Dietary Insulin Load (DIL) with cardiovascular disease (CVD) factors in subjects with atherosclerosis. METHODS The present cross-sectional study was conducted on subjects with atherosclerosis. Regular dietary intake was assessed using a 168-item semi-quantitative food frequency questionnaire (FFQ) and GI, GL, DIL, and DII were also calculated. Odds Ratio (OR) and 95% Confidence Intervals (CIs) were estimated for general and central obesity according to the GI, GL, DII, and DIL. RESULTS According to the continuous score of GL, there was a significant positive association between GL and central obesity for women in all models. Regarding the association between DIL score and biochemical variables, there was a significant positive association between Na and Aspartate transaminase (AST) with DII. Moreover, there was a significant positive association between LDL-c(p = 0.03) and AST (p = 0.04)with DIL score in all 3 models. CONCLUSION In this study, GL was associated with greater odds of central obesity in women, but not in men. Neither dietary DII nor DIL was associated with BMI and central obesity. GI, GL, DII, and DIL were significantly associated with some CVD risk biomarkers in subjects with atherosclerosis.
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Affiliation(s)
- Hossein Bavi Behbahani
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahshad Shokuhi
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, CV1 5FB, UK
| | - Ahmad Zare Javid
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Hadi Bazyar
- Department of Public Health, Sirjan School of Medical Sciences, Sirjan, Iran.
- Student Research Committee, Sirjan School of Medical Sciences, Sirjan, Iran.
| | - Mahsa Samadani
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Habib Haybar
- Cardiovascular Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Herzl E, Schmitt EE, Shearrer G, Keith JF. The Effects of a Western Diet vs. a High-Fiber Unprocessed Diet on Health Outcomes in Mice Offspring. Nutrients 2023; 15:2858. [PMID: 37447184 DOI: 10.3390/nu15132858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
Diet influences critical periods of growth, including gestation and early development. We hypothesized that a maternal/early life diet reflecting unprocessed dietary components would positively affect offspring metabolic and anthropometric parameters. Using 9 C57BL-6 dams, we simulated exposure to a Western diet, a high-fiber unprocessed diet (HFUD), or a control diet. The dams consumed their respective diets (Western [n = 3], HFUD [n = 3], and control [n = 3]) through 3 weeks of pregnancy and 3 weeks of weaning; their offspring consumed the diet of their mother for 4.5 weeks post weaning. Measurements included dual X-ray absorptiometry (DEXA) scans, feed consumption, body weight, blood glucose, and insulin and glycated hemoglobin (HbA1c) in the offspring. Statistical analyses included one-way ANOVA with Tukey's post hoc analysis. The offspring DEXA measures at 5 and 7.5 weeks post parturition revealed higher lean body mass development in the HFUD and control diet offspring compared to the Western diet offspring. An analysis indicated that blood glucose (p = 0.001) and HbA1c concentrations (p = 0.002) were lower among the HFUD offspring compared to the Western and control offspring. The results demonstrate that diet during gestation and early life consistent with traditional diet patterns may influence hyperglycemia and adiposity in offspring.
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Affiliation(s)
- Elizabeth Herzl
- Department of Family & Consumer Sciences, University of Wyoming, Laramie, WY 82071, USA
| | - Emily E Schmitt
- Division of Kinesiology & Health, University of Wyoming, Laramie, WY 82071, USA
- WWAMI Medical Education, University of Wyoming, Laramie, WY 82071, USA
| | - Grace Shearrer
- Department of Family & Consumer Sciences, University of Wyoming, Laramie, WY 82071, USA
- WWAMI Medical Education, University of Wyoming, Laramie, WY 82071, USA
| | - Jill F Keith
- Department of Family & Consumer Sciences, University of Wyoming, Laramie, WY 82071, USA
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Harlan TS, Gow RV, Kornstädt A, Alderson PW, Lustig RH. The Metabolic Matrix: Re-engineering ultraprocessed foods to feed the gut, protect the liver, and support the brain. Front Nutr 2023; 10:1098453. [PMID: 37063330 PMCID: PMC10097968 DOI: 10.3389/fnut.2023.1098453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/03/2023] [Indexed: 04/03/2023] Open
Abstract
Ultraprocessed food is established as a metabolic disruptor acting to increase adiposity, reduce mitochondrial efficiency, drive insulin resistance, alter growth, and contribute to human morbidity and mortality. Consumer packaged goods (CPG) companies are beginning to understand the detrimental impact of the food they market, and have employed substitution strategies to reduce salt, sugar, and fat. However, the harms of ultraprocessed foods are far more complex than any single component, and are not ameliorated by such simple substitutions. Over the past 2 years, the authors have worked with the Kuwaiti Danish Dairy Company (KDD) to conduct a comprehensive scientific evaluation of their entire commercial food and beverage portfolio. Assay of the macronutrients, micronutrients, additives, and toxins contained in each of their products was undertaken to determine the precise nature of each product’s ingredients as well as the health impacts of processing. The authors formed a Scientific Advisory Team (SAT) and developed a tiered “Metabolic Matrix” founded in three science-based principles: (1) protect the liver, (2) feed the gut, and (3) support the brain. The Metabolic Matrix categorizes each product and provides the criteria, metrics, and recommendations for improvement or reformulation. Real-time consultation with the KDD Executive and Operations teams was vital to see these procedures through to fruition. This scientific exercise has enabled KDD to lay the groundwork for improving the health, well-being, and sustainability of their entire product line, while maintaining flavor, economic, and fiscal viability. This process is easily transferrable, and we are sharing this effort and its approaches as a proof-of-concept. The key aim of our work is to not only make ultraprocessed food healthier but to urge other food companies to implement similar analysis and reformulation of their product lines to improve the metabolic health and well-being of consumers worldwide.
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Affiliation(s)
- Timothy S. Harlan
- Division of General Internal Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
- *Correspondence: Timothy S. Harlan,
| | - Rachel V. Gow
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
| | | | - P. Wolfram Alderson
- Human & Environmental Health Department, Kuwaiti Danish Dairy Company, Kuwait City, Kuwait
| | - Robert H. Lustig
- Department of Pediatrics and Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, United States
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Association of low-carbohydrate diet score and carbohydrate quality with visceral adiposity and lipid accumulation product. Br J Nutr 2023; 129:843-853. [PMID: 35570588 DOI: 10.1017/s000711452200143x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The present study examined the association between low-carbohydrate diet (LCD) score, glycemic index (GI), and glycemic load (GL) with visceral fat level (VFL) and lipid accumulation product (LAP). This cross-sectional study was conducted on 270 adults (118 men and 152 women) aged between 18-45 living in Tehran, Iran, between February 2017 and December 2018. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire (FFQ). Body composition were also assessed. We used analyses of covariance and binary logistic regression to explore associations after controlling for age, energy intake (model 1), education, smoking status, physical activity, occupation, marriage and metabolic diseases. There were no significant differences between tertiles of GI, GL and LCD for means of anthropometric measures, LAP and VFL index in men, while women in the highest tertile of GI and GL had significantly higher mean LAP in the crude model (P = 0·02) and model 1(P = 0·04), which disappeared after controlling for other confounders (P = 0·12). Moreover, the OR and CIs for having high LAP and VFL was not associated with dietary GI, GL and LCD in crude and adjusted models. However, chance of high VFL reduced by 65% and 57% among women with high adherence to LCD score (OR = 0·35, 95% CI = 0·16-0·78, P = 0·01) and model 1 (OR = 0·43, 95% CI = 0·18-1, P = 0·05), respectively. However, this significant association disappeared after controlling for other confounders (P = 0·07). Overall, we found carbohydrate quality and LCD score are not associated with LAP and VFL index. However, gender-specific relationship should not be neglect and warrants further investigation.
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Zeng B, Pan H, Li F, Ye Z, Liu Y, Du J. Comparative efficacy of different eating patterns in the management of type 2 diabetes and prediabetes: An arm-based Bayesian network meta-analysis. J Diabetes Investig 2022; 14:263-288. [PMID: 36514864 PMCID: PMC9889690 DOI: 10.1111/jdi.13935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/26/2022] [Accepted: 10/13/2022] [Indexed: 12/15/2022] Open
Abstract
AIMS/INTRODUCTION Diet therapy is a vital approach to manage type 2 diabetes and prediabetes. However, the comparative efficacy of different eating patterns is not clear enough. We aimed to compare the efficacy of various eating patterns for glycemic control, anthropometrics, and serum lipid profiles in the management of type 2 diabetes and prediabetes. MATERIALS AND METHODS We conducted a network meta-analysis using arm-based Bayesian methods and random effect models, and drew the conclusions using the partially contextualized framework. We searched twelve databases and yielded 9,534 related references, where 107 studies were eligible, comprising 8,909 participants. RESULTS Eleven diets were evaluated for 14 outcomes. Caloric restriction was ranked as the best pattern for weight loss (SUCRA 86.8%) and waist circumference (82.2%), low-carbohydrate diets for body mass index (81.6%), and high-density lipoprotein (84.0%), and low-glycemic-index diets for total cholesterol (87.5%) and low-density lipoprotein (86.6%). Other interventions showed some superiorities, but were imprecise due to insufficient participants and needed further investigation. The attrition rates of interventions were similar. Meta-regression suggested that macronutrients, energy intake, and weight may modify outcomes differently. The evidence was of moderate-to-low quality, and 38.2% of the evidence items met the minimal clinically important differences. CONCLUSIONS The selection and development of dietary strategies for diabetic/prediabetic patients should depend on their holistic conditions, i.e., serum lipid profiles, glucometabolic patterns, weight, and blood pressure. It is recommended to identify the most critical and urgent metabolic indicator to control for one specific patient, and then choose the most appropriate eating pattern accordingly.
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Affiliation(s)
| | - Hui‐qing Pan
- School of MedicineTongji UniversityShanghaiChina
| | - Feng‐dan Li
- Nursing DepartmentXiang'an Hospital of Xiamen UniversityXiamenChina
| | - Zhen‐yu Ye
- School of MedicineXiamen UniversityXiamenChina
| | - Yang Liu
- School of MedicineXiamen UniversityXiamenChina
| | - Ji‐wei Du
- Institute of EducationXiamen UniversityXiamenChina,Present address:
The University of Hong Kong‐Shenzhen Hospital Ringgold standard institution ‐ Nursing Department1 Haiyuan 1st RoadShenzhen518040China
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10
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Kim DK, Lee BH. New glucogenesis inhibition model based on complete α-glucosidases from rat intestinal tissues validated with various types of natural and pharmaceutical inhibitors. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2022; 102:4419-4424. [PMID: 35077587 DOI: 10.1002/jsfa.11795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 12/24/2021] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Inhibition of intestinal α-glucosidases from rat intestinal acetone powder (RIAP) has been widely used in research focused on regulating glucogenesis to be applied as a strategy to control obesity and type II diabetes. However, the crude extract has different compositions of α-glucosidases than a complete RIAP suspension due to enzymes anchored on the intestinal tissues after the extraction. Here, the inhibitory effects of different pharmaceutical and food-grade inhibitors on the enzymes in the RIAP suspension were investigated. RESULTS Instead of crude extracts from RIAP, the RIAP suspension without the extraction process was applied to optimize the α-glucosidase inhibitory model by pharmaceutical/natural inhibitors. The results clearly showed that the half-maximal inhibitory concentration ratios of four individual α-glucosidases by various inhibitors were different between the RIAP suspension and the crude extract. In particular, isomaltase from the RIAP suspension required more inhibitors than the crude extraction did, as this enzyme is still anchored to the remaining intestinal tissue from the extraction process. CONCLUSION The crude extract from RIAP contains only a portion of the enzymes, which poses limitations for determining the precise inhibitory properties by various types of enzyme inhibitors. On the contrary, an in vitro assay with RIAP suspension that has all the α-glucosidases is a more suitable method for determining digestibility of glycemic carbohydrates. This new approach can be applied to the development of natural/synthetic α-glucosidase inhibitors to attenuate the postprandial glycemic response more accurately. © 2022 Society of Chemical Industry.
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Affiliation(s)
- Do Kyoung Kim
- Department of Food Science & Biotechnology, Gachon University, Seongnam, Republic of Korea
| | - Byung-Hoo Lee
- Department of Food Science & Biotechnology, Gachon University, Seongnam, Republic of Korea
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Popoola-Akinola OO, Raji TJ, Olawoye B. Lignocellulose, dietary fibre, inulin and their potential application in food. Heliyon 2022; 8:e10459. [PMID: 36090233 PMCID: PMC9449745 DOI: 10.1016/j.heliyon.2022.e10459] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 04/09/2022] [Accepted: 08/22/2022] [Indexed: 11/25/2022] Open
Abstract
In recent years, due to food insecurity, lignocellulose, dietary fibre as well as inulin have received wider attention owing to their abundance and being relatively low-cost indigestible polysaccharides. Since the recognition, acceptance of the consumption and utilization of these polysaccharides, as well as their attraction in science and industry has grown tremendously. There have been further researches carried out to ascertain the fact that people who consume or utilize these polysaccharides have low exposure to some fatal life-threatening illnesses. Rich sources of indigestible polysaccharides such as vegetables, cereals, fruits and nuts are beneficial to good health as consuming them reduce the occurrence of degenerating diseases such as colon cancer, heart disease, diabetes, etc. Despite these increasing facts depicting their advantages in the state of human health, their intake and utilization still fall below the acceptable limit and the knowledge of how they work in the human body are minimal with their explicit actions not easily shown. Hence, this review gives a better understanding of the significance of lignocellulose, dietary fibre and inulin, their functions, classifications, types and applications in the food industry, thereby exposing their various uses as these polycarbohydrates were considered a waste before now.
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Alizadeh S, Pooyan S, Mirzababaei A, Arghavani H, Hasani H, Mirzaei K. Interaction of MC4R rs17782313 variants and dietary carbohydrate quantity and quality on basal metabolic rate and general and central obesity in overweight/obese women: a cross-sectional study. BMC Endocr Disord 2022; 22:121. [PMID: 35538513 PMCID: PMC9092846 DOI: 10.1186/s12902-022-01023-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 11/28/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Recent studies have shown that dietary carbohydrate quantity and quality as well as genetic variants may contribute to determining the metabolic rate and general and central obesity. This study aimed to examine interactions between melanocortin 4 receptor gene (MC4R) rs17782313 and dietary carbohydrate intake, glycemic index (GI), and glycemic load (GL) on body mass index (BMI), waist circumferences (WC), basal metabolic rate (BMR), and BMR/kg in overweight/obese women. METHODS A total of 282 Iranian women (BMI ≥ 25) aged 18-56 years were enrolled in this cross-sectional study. All participants were assessed for blood parameters, body composition, BMR, and dietary intake. Dietary carbohydrate intake, GI, and GL were determined using a valid, reliable 147-item food frequency questionnaire. MC4R rs17782313 was genotyped by the restriction fragment length polymorphism (PCR-RFLP) method. RESULTS After adjustment for age and energy intake, significant interactions were observed between carbohydrate intake and MC4R rs17782313 in terms of BMI (P Interaction = 0.007), WC (P Interaction = 0.02), and BMR/kg (P Interaction = 0.003) in this way that higher carbohydrate intake, compared with lower intake, was associated with an increase in BMI and WC for individuals with C allele carriers (TC + CC genotypes), while related to an increase in BMR/kg for those carrying the TT genotype. No significant interaction was found between MC4R rs17782313 and GI and GL on BMI, WC, BMR/kg, and BMR. CONCLUSIONS Interactions between the MC4R rs17782313 and carbohydrate intake probably can have an effect on BMI, WC, and BMR/kg in overweight/obese women.
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Affiliation(s)
- Shahab Alizadeh
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sara Pooyan
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box:14155-6117, Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box:14155-6117, Tehran, Iran
| | - Hana Arghavani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box:14155-6117, Tehran, Iran
| | - Hossein Hasani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box:14155-6117, Tehran, Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box:14155-6117, Tehran, Iran.
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Ushula TW, Mamun A, Darssan D, Wang WY, Williams GM, Whiting SJ, Najman JM. Dietary patterns and the risks of metabolic syndrome and insulin resistance among young adults: Evidence from a longitudinal study. Clin Nutr 2022; 41:1523-1531. [DOI: 10.1016/j.clnu.2022.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/20/2022] [Accepted: 05/07/2022] [Indexed: 11/03/2022]
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14
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Liu W, Zhang Y, Xu Z, Pan W, Shen M, Han J, Sun X, Zhang Y, Xie J, Zhang X, Yu L(L. Cross-linked corn bran arabinoxylan improves the pasting, rheological, gelling properties of corn starch and reduces its in vitro digestibility. Food Hydrocoll 2022. [DOI: 10.1016/j.foodhyd.2021.107440] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Ebrahimi Mousavi S, Bagheri A, Benisi-Kohansal S, Azadbakht L, Esmaillzadeh A. Consumption of “Diabetes Risk Reduction Diet” and Odds of Breast Cancer Among Women in a Middle Eastern Country. Front Nutr 2022; 9:744500. [PMID: 35464024 PMCID: PMC9033265 DOI: 10.3389/fnut.2022.744500] [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: 07/20/2021] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background:Given the role of insulin resistance in several cancers, we hypothesized that consumption of a diet that reduces insulin resistance might lower the risk of breast cancer.ObjectiveThe present study was designed to assess the association between consumption of “diabetes risk reduction diet” (DRRD) and odds of breast cancer among a large group of women in a Middle Eastern country.MethodsThis population-based case-control study enrolled 350 newly diagnosed cases of stage I-IV breast cancer and 700 age-matched apparently healthy individuals as controls. We collected dietary data via a validated 106-item Willett-format semi-quantitative dish-based food frequency questionnaire. A DRRD score was included based on 9 dietary factors (cereal fiber, coffee, nuts, whole fruits, ratio of polyunsaturated to saturated, trans fat, sugar-sweetened beverages, red and processed meat, and lower glycemic index). For food and nutrient items with a protective association with diabetes in earlier studies, participants were given the score as the quintile of that food item, but for food groups with unfavorable association with diabetes, we did vice versa. Total DRRD score ranged from 5 to 45.ResultsMean age of cases and controls was 65.28 and 61.04 years. Mean BMI of patients with breast cancer and controls was 25.5 and 21.0. We found that individuals with the greatest adherence to the DRRD were 0.41 times less likely to have breast cancer than those with the lowest adherence (OR: 0.59; 95% CI: 0.38, 0.90, and P-trend = 0.002). Stratified analysis by menopausal status indicated a significant inverse relationship in postmenopausal women (OR: 0.57; 95% CI: 0.36–0.90), but not in premenopausal women (OR: 0.76; 95% CI: 0.19–2.96). Moreover, by BMI status, we found statistically significant inverse association between adherence to the DRRD and odds of breast cancer among normal-weight women (OR: 0.59; 95% CI: 0.36, 0.98) but not in overweight women (OR: 0.66; 95% CI: 0.31, 1.40). Conclusions: Significant inverse associations were found between adherence to DRRD and breast cancer, especially among postmenopausal and normal-weight women.
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Affiliation(s)
- Sara Ebrahimi Mousavi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Bagheri
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanaz Benisi-Kohansal
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
- *Correspondence: Ahmad Esmaillzadeh
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Tucker LA. Macronutrient Intake and Insulin Resistance in 5665 Randomly Selected, Non-Diabetic U.S. Adults. Nutrients 2022; 14:nu14050918. [PMID: 35267895 PMCID: PMC8912746 DOI: 10.3390/nu14050918] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/18/2022] [Accepted: 02/19/2022] [Indexed: 12/29/2022] Open
Abstract
The main goal of this investigation was to evaluate the relationships between several macronutrients and insulin resistance in 5665 non-diabetic U.S. adults. A secondary objective was to determine the extent to which the associations were influenced by multiple potential confounding variables. A cross-sectional design and 8 years of data from the 2011–2018 National Health and Nutrition Examination Survey (NHANES) were used to answer the research questions. Ten macronutrients were evaluated: total carbohydrate, starch, simple carbohydrate, dietary fiber, total protein, total fat, saturated, polyunsaturated, monounsaturated, and total unsaturated fat. The homeostatic model assessment (HOMA), based on fasting glucose and fasting insulin levels, was used to index insulin resistance. Age, sex, race, year of assessment, physical activity, cigarette smoking, alcohol use, and waist circumference were used as covariates. The relationships between total carbohydrate intake (F = 6.7, p = 0.0121), simple carbohydrate (F = 4.7, p = 0.0344) and HOMA-IR were linear and direct. The associations between fiber intake (F = 9.1, p = 0.0037), total protein (F = 4.4, p = 0.0393), total fat (F = 5.5, p = 0.0225), monounsaturated fat (F = 5.5, p = 0.0224), and total unsaturated fat (F = 6.5, p = 0.0132) were linear and inversely related to HOMA-IR, with 62 degrees of freedom. Starch, polyunsaturated fat, and saturated fat intakes were not related to HOMA-IR. In conclusion, in this nationally representative sample, several macronutrients were significant predictors of insulin resistance in U.S. adults.
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Affiliation(s)
- Larry A Tucker
- College of Life Sciences, Brigham Young University, Provo, UT 84602, USA
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Dietary pattern of patients with type 2 diabetes mellitus including date consumption. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01270-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Abstract
Aim
Assess the relationship between date palm fruit consumption and diabetic control among Saudi patients with type 2 diabetes mellitus.
Subjects and methods
Saudi patients with type 2 diabetes (n = 404, aged 55.3 ± 9.7 years) were included in this study. Height, weight and blood pressure were initially measured. Blood glucose levels (fasting and random), glycated hemoglobin HbA1c, total cholesterol, high-density lipoprotein, low-density lipoprotein and triglycerides were retrieved from the patient’s medical records. The amount and frequency of habitual consumption of date fruits were obtained from patients using a validated dietary questionnaire.
Results
The results revealed that high consumption of date fruits was statistically significantly correlated with lower HbA1c and fasting blood glucose (p < 0.01).
Conclusion
This cross-sectional study found an association between high date fruit consumption by patients with type 2 diabetes mellitus and lower HbA1c and fasting blood glucose levels. Further studies are required to verify this interesting finding
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Vasconcelos C, Cabral M, Ramos E, Mendes R. The impact of a community-based food education programme on dietary pattern in patients with type 2 diabetes: Results of a pilot randomised controlled trial in Portugal. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:e318-e327. [PMID: 33761180 DOI: 10.1111/hsc.13356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 01/07/2021] [Accepted: 02/24/2021] [Indexed: 06/12/2023]
Abstract
The purpose of this study was to analyse the effects of a food education programme, with easy-to-implement strategies integrated in a community-based exercise programme, on dietary pattern of patients with type 2 diabetes (T2D). Thirty-three patients (65.4 ± 5.9 years old) were engaged in a 9-month randomised controlled trial: a supervised exercise programme (control group [CON]; n = 15; combined exercise; three sessions per week; 75 min per session) or the same exercise programme plus a concomitant 16-week food education programme (experimental group [EXP]; n = 18; 15-min. group classes and dual-task strategies during exercise). Dietary pattern was assessed using a 3-day food record at baseline and at 9 months. The intake of total fat, polyunsaturated fat, and the daily servings of vegetables significantly increased in EXP compared with the CON group. Retention and adherence to the programme were 54% and 49.5 ± 27.2%, respectively. This food education programme improved dietary pattern of patients with T2D. Special attention should be given to strategies that support participants' attendance.
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Affiliation(s)
- Carlos Vasconcelos
- Department of Sports Sciences, Exercise and Health, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
- School of Education of Viseu, Polytechnic Institute of Viseu, Viseu, Portugal
| | - Maria Cabral
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Elisabete Ramos
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Romeu Mendes
- Department of Sports Sciences, Exercise and Health, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Northern Region Health Administration, Porto, Portugal
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Neuendorf S, Neuendorf J, Yakub M. Origin, Impact, and Solutions for Lifestyle-Related Chronic Diseases in Samoa and American Samoa. Cureus 2021; 13:e17749. [PMID: 34659962 PMCID: PMC8493186 DOI: 10.7759/cureus.17749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2021] [Indexed: 12/12/2022] Open
Abstract
Samoa and American Samoa are two island groups in the South Pacific inundated with the physiological consequences of swift westernization of diet and lifestyle. These polities face the singular theme of lifestyle-related problems seen in other countries. This paper aims to discuss the current demographics in Samoa and American Samoa and examine the origin and impact of lifestyle-related chronic diseases within a subset of its populace. This review will highlight the prominent nutrition transition that these polities have undergone in their development and examine the pathogenesis and pathophysiology of lifestyle-related diseases, primarily type 2 diabetes and obesity, in the context of a prominent cultural shift. Samoa and American Samoa face a litany of public health concerns as a result of the rising prevalence of lifestyle-related chronic diseases and the persistent threat of obesity. Lifestyle medicine is proposed as the optimal treatment solution for the currently devastating disease states and is adapted to the vibrant agricultural resources and healing roots of the Samoan culture.
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Affiliation(s)
- Sable Neuendorf
- Medical Education, California University of Science and Medicine, Colton, USA
| | - Jadon Neuendorf
- Medical Education, California University of Science and Medicine, Colton, USA
| | - Mohsin Yakub
- Medical Education, California University of Science and Medicine, Colton, USA
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20
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Effects of creeping fig seed polysaccharide on pasting, rheological, textural properties and in vitro digestibility of potato starch. Food Hydrocoll 2021. [DOI: 10.1016/j.foodhyd.2021.106810] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Zhang Z, Li J, Hu T, Xu C, Xie N, Chen D. Interventional effect of dietary fiber on blood glucose and pregnancy outcomes in patients with gestational diabetes mellitus. Zhejiang Da Xue Xue Bao Yi Xue Ban 2021; 50:305-312. [PMID: 34402253 DOI: 10.3724/zdxbyxb-2021-0115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To investigate the effect of dietary fiber on blood glucose and pregnancy outcomes in patients with gestational diabetes mellitus (GDM). One hundred and twelve patients with GDM in the second trimester of pregnancy were recruited from Women's Hospital, Zhejiang University School of Medicine. Patients were randomized into two groups with 56 in each group: the control group received basic nutrition support; while the dietary fiber group were given additional dietary fiber ( total dietary fiber per day) before meals in addition to basic nutrition support. Intervention for all cases lasted for 8 weeks. Fasting blood glucose and postprandial blood glucose (2 h BG) were measured every week, and oral glucose tolerance test (OGTT) was performed at 42 d postpartum to evaluate the glycemic outcomes. Perinatal outcomes were recorded. The dietary fiber intervention markedly improved 2 h BG in patients with GDM and significantly elevated the glucose compliance rate from the 3rd to 8th week compared to the control group ( <0.05 or <0.01). OGTT 2 h glucose and the incidence of impaired glucose tolerance in the dietary fiber group were significantly lower than those in the control group, while the glucose compliance rate was significantly higher than that in the control group (all <0.01). Moreover, the rates of adverse perinatal outcomes, such as premature rupture of membranes and neonatal hyperbilirubinemia were declined in the dietary fiber group (<0.05 or <0.01). Dietary fiber intervention can ameliorate hyperglycemia in GDM patients, improve perinatal outcomes and reduce the incidence of postpartum impaired glucose tolerance.
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22
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Paz GM, King JM, Prinyawiwatkul W. High Protein Rice Flour in the Development of Gluten-Free Bread. JOURNAL OF CULINARY SCIENCE & TECHNOLOGY 2021. [DOI: 10.1080/15428052.2020.1768994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Gabriella M. Paz
- School of Nutrition and Food Sciences, Animal and Food Science Laboratory Building, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Joan M. King
- School of Nutrition and Food Sciences, Animal and Food Science Laboratory Building, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Witoon Prinyawiwatkul
- School of Nutrition and Food Sciences, Animal and Food Science Laboratory Building, Louisiana State University, Baton Rouge, Louisiana, USA
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Wang HK, Cheng DC, Yang YM, Wang XH, Chen Y, Zhang L, Xiu L, Xu XM. The Role of High-Content Complex Dietary Fiber in Medical Nutrition Therapy for Gestational Diabetes Mellitus. Front Pharmacol 2021; 12:684898. [PMID: 34276373 PMCID: PMC8281130 DOI: 10.3389/fphar.2021.684898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 06/03/2021] [Indexed: 01/14/2023] Open
Abstract
Objectives: A controlled open clinical study was conducted to evaluate the role of Ricnoat, a high-content complex dietary fiber powder produced by Zhuhai Aimed Biotechnology Co. Ltd., in medical nutrition therapy (MNT) to treat gestational diabetes mellitus (GDM). The study aimed to investigate glycemic control, lipid control, weight control, and pregnancy outcomes (neonatal weight) in patients with GDM, as well as evaluate the clinical safety of Ricnoat. Methods: A total of 120 patients with GDM who were admitted to three hospitals in Shanghai between January 2019 and January 2020 were enrolled. Ricnoat was used for intervention for patients in the experimental group. Using a χ2 test and t-test, respectively, comparisons were conducted between the measurement data and countable data of the demographics and baseline disease characteristics of the experimental group and control group. Results: Fasting blood glucose, 2-h postprandial blood glucose, glycated hemoglobin, total cholesterol, triglycerides, low-density lipoprotein, maternal gestational weight gain, neonatal weight, serum creatinine, glutamate transaminase, and aspartate aminotransferase were lower in the experimental group than in the control group, whereas high-density lipoprotein was higher in the experimental group than in the control group. Ricnoat intervention resulted in satiety higher than the expected 80% and more common occurrence of type 4 (smooth and soft, like salami or a snake) and type 5 (a soft mass with clear edges) stools. Conclusion: Ricnoat intervention had a significant effect on glycemic control, lipid control, weight control, and pregnancy outcomes (neonatal weight) in patients with GDM by enhancing maternal satiety and improving the stool features of pregnant women. It was also found to be safe for application during pregnancy.
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Affiliation(s)
- Hong-Kun Wang
- Department of Obstetrics and Gynecology, Jiao Tong University School of Medicine, Shanghai, China
| | - De-Cui Cheng
- Department of Obstetrics and Gynecology, Jiao Tong University School of Medicine, Shanghai, China
| | - Yue-Min Yang
- Department of Obstetrics and Gynecology, Jiao Tong University School of Medicine, Shanghai, China
| | - Xia-Hong Wang
- Shanghai Jiading Maternal Child Health Hospital, Shanghai, China
| | - Yan Chen
- Shanghai Jiading Maternal Child Health Hospital, Shanghai, China
| | - Lin Zhang
- Shanghai Puto District Maternity and Child Care Hospital, Shanghai, China
| | - Lian Xiu
- Shanghai Puto District Maternity and Child Care Hospital, Shanghai, China
| | - Xian-Ming Xu
- Shanghai General Hospital Shanghai, Shanghai, China
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Basu A, Feng D, Planinic P, Ebersole JL, Lyons TJ, Alexander JM. Dietary Blueberry and Soluble Fiber Supplementation Reduces Risk of Gestational Diabetes in Women with Obesity in a Randomized Controlled Trial. J Nutr 2021; 151:1128-1138. [PMID: 33693835 PMCID: PMC8112774 DOI: 10.1093/jn/nxaa435] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/09/2020] [Accepted: 12/11/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a growing public health concern and maternal obesity and poor dietary intakes could be implicated. Dietary polyphenols and fiber mitigate the risk of diabetes and its complications, but little is known about their efficacy in preventing GDM. OBJECTIVES We examined the effects of whole blueberry and soluble fiber supplementation on primary outcomes of cardiometabolic profiles in women at high risk of developing GDM. METHODS Women (n = 34; mean ± SD age: 27 ± 5 y; BMI: 35.5 ± 4.0 kg/m2; previous history of GDM ∼56%; Hispanic ∼79%) were recruited in early pregnancy (<20 weeks of gestation) and randomly assigned to 1 of the following 2 groups for 18 wk: intervention (280 g whole blueberries and 12 g soluble fiber per day) and standard prenatal care (control). Both groups received nutrition education and maintained 24-h food recalls throughout the study. Data on anthropometrics, blood pressure, and blood samples for biochemical analyses were collected at baseline (<20 weeks), midpoint (24-28 weeks), and end (32-36 weeks) of gestation. Diagnosis of GDM was based on a 2-step glucose challenge test (GCT). Data were analyzed using a mixed-model ANOVA. RESULTS Maternal weight gain was significantly lower in the dietary intervention than in the control group at the end of the trial (mean ± SD: 6.8 ± 3.2 kg compared with 12.0 ± 4.1 kg, P = 0.001). C-reactive protein was also lower in the intervention than in the control group (baseline: 6.1 ± 4.0 compared with 6.8 ± 7.2 mg/L; midpoint: 6.1 ± 3.7 compared with 7.5 ± 7.3 mg/L; end: 5.5 ± 2.2 compared with 9.5 ± 6.6 mg/L, respectively, P = 0.002). Blood glucose based on GCT was lower in the intervention than in the control (100 ± 33 mg/dL compared with 131 ± 40 mg/dL, P < 0.05). Conventional lipids (total, LDL, and HDL cholesterol and triglycerides) did not differ between groups over time. No differences were noted in infant birth weight. CONCLUSIONS Whole blueberry and soluble fiber supplementation may prevent excess gestational weight gain and improve glycemic control and inflammation in women with obesity.This trial was registered at clinicaltrials.gov as NCT03467503.
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Affiliation(s)
- Arpita Basu
- Department of Kinesiology and Nutrition Sciences, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Du Feng
- School of Nursing, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Petar Planinic
- Department of Obstetrics & Gynecology, School of Medicine, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Jeffrey L Ebersole
- School of Dental Medicine, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Timothy J Lyons
- Division of Endocrinology, Medical University of South Carolina, Charleston, SC, USA
| | - James M Alexander
- Department of Obstetrics & Gynecology, School of Medicine, University of Nevada at Las Vegas, Las Vegas, NV, USA
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Yuan F, Deng L, Sun X, Chen Z, Shivappa N, Sheth AK, Cooper GS, Hebert JR, Li L. Dietary inflammatory index and risk of colorectal adenoma: effect measure modification by race, nonsteroidal anti-inflammatory drugs, cigarette smoking and body mass index? Cancer Causes Control 2021; 32:837-847. [PMID: 33928482 DOI: 10.1007/s10552-021-01436-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 04/16/2021] [Indexed: 12/19/2022]
Abstract
PURPOSE To investigate if the association between dietary inflammatory potential and colorectal adenoma (CRA) is modified by race and factors known to modulate inflammation. METHODS We examined effect measure modification of race, nonsteroidal anti-inflammatory drugs (NSAIDs), cigarette smoking and body mass index (BMI) on the diet-CRA association by employing energy-adjusted dietary inflammatory index (E-DII™) to characterize dietary inflammatory potential among 587 cases and 1,313 controls participating in a colonoscopy screening-based cross-sectional study of CRA. Participants completed a food frequency questionnaire from which E-DII score was derived. E-DII score was calculated from 34 food parameters (constituents), utilizing an energy-adjusted global comparative database to compute z scores from which centered proportions were summed to create the score. CRA cases were defined as individuals whose colonoscopy detected at least one pathologically confirmed adenomatous polyp. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS A pro-inflammatory diet was not statistically significantly associated with elevated CRA risk (OR 1.07; 95% CI 0.97-1.19; p value = 0.18) in the multivariate regression model. NSAIDs use (ORnever-users 1.19; 95% CI 1.03-1.38; ORever-users 0.96; 95% CI 0.83-1.12; Pinteraction = 0.04) and race (ORAfrican Americans 1.22; 95% CI 1.03-1.44; OREuropean Americans 0.99; 95% CI 0.86-1.14; Pinteraction = 0.14) appeared to modify the association, whereas cigarette smoking and BMI did not (Pinteraction = 0.40 and 0.78, respectively). CONCLUSION NSAIDs use and race may modify the diet-CRA association. Further investigation in prospective cohort studies is warranted to confirm these findings.
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Affiliation(s)
- Fangcheng Yuan
- Department of Family Medicine, University of Virginia School of Medicine, McKim Hall Rm 3156, Charlottesville, VA, 22908, USA
| | - Lin Deng
- Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Xiangqing Sun
- Department of Family Medicine, University of Virginia School of Medicine, McKim Hall Rm 3156, Charlottesville, VA, 22908, USA
| | - Zhengyi Chen
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Nitin Shivappa
- Department of Epidemiology & Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, USA
| | - Ashutosh K Sheth
- Department of Family Medicine, University of Virginia School of Medicine, McKim Hall Rm 3156, Charlottesville, VA, 22908, USA
| | - Gregory S Cooper
- Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - James R Hebert
- Department of Epidemiology & Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, USA
| | - Li Li
- Department of Family Medicine, University of Virginia School of Medicine, McKim Hall Rm 3156, Charlottesville, VA, 22908, USA.
- Cancer Center, University of Virginia, Charlottesville, VA, USA.
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Sokołowska E, Sadowska A, Sawicka D, Kotulska-Bąblińska I, Car H. A head-to-head comparison review of biological and toxicological studies of isomaltulose, d-tagatose, and trehalose on glycemic control. Crit Rev Food Sci Nutr 2021; 62:5679-5704. [PMID: 33715524 DOI: 10.1080/10408398.2021.1895057] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Diabetes mellitus is the most common metabolic disorder contributing to significant morbidity and mortality in humans. Different preventive and therapeutic agents, as well as various pharmacological strategies or non-pharmacological tools, improve the glycemic profile of diabetic patients. Isomaltulose, d-tagatose, and trehalose are naturally occurring, low glycemic sugars that are not synthesized by humans but widely used in food industries. Various studies have shown that these carbohydrates can regulate glucose metabolism and provide support in maintaining glucose homeostasis in patients with diabetes, but also can improve insulin response, subsequently leading to better control of hyperglycemia. In this review, we discussed the anti-hyperglycemic effects of isomaltulose, D-tagatose, and trehalose, comparing their properties with other known sweeteners, and highlighting their importance for the development of the pharmaceutical and food industries.
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Affiliation(s)
- Emilia Sokołowska
- Department of Experimental Pharmacology, Medical University of Bialystok, Bialystok, Poland
| | - Anna Sadowska
- Department of Experimental Pharmacology, Medical University of Bialystok, Bialystok, Poland
| | - Diana Sawicka
- Department of Experimental Pharmacology, Medical University of Bialystok, Bialystok, Poland
| | | | - Halina Car
- Department of Experimental Pharmacology, Medical University of Bialystok, Bialystok, Poland
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Al-Mssallem MQ, Al-Qarni AA, Al-Jamaan M. Dietary carbohydrate intake in patients with type 2 diabetes mellitus and diabetes control: a cross-sectional study. Food Nutr Res 2020; 64:4751. [PMID: 33281534 PMCID: PMC7681780 DOI: 10.29219/fnr.v64.4751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/23/2022] Open
Abstract
Background Food intake has important implications for patients with type 2 diabetes. Objective Similarly, in other crop species, this observational study aimed to assess dietary carbohydrate (CHO) and non-starch polysaccharide (NSP) intake and examine their association with glycemic control among Saudi patients with type 2 diabetes mellitus (T2DM). Design We investigated dietary intake in 404 patients (207 males and 197 females) with T2DM between November 2018 and March 2019. Dietary intake was assessed by face-to-face interviews using a validated dietary questionnaire. Results The results revealed that dietary CHO intake (67% of energy) exceeded the recommended daily intake, and white rice (Basmati rice) was the major contributor to CHO intake. However, the dietary NSP intake was lower than recommended, and it was negatively associated with HbA1c levels. Conclusion This cross-sectional study showed that dietary CHO intake was high among Saudi patients with type 2 diabetes, and that their daily intake of NSPs was correlated with a lower level of HbA1c. Dietary advice should be given for patients with diabetes to reduce their intake of starchy food such as rice.
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Affiliation(s)
- Muneera Q Al-Mssallem
- Department of Food Sciences and Nutrition, Faculty of Agricultural and Food Sciences, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Ali A Al-Qarni
- King Abdullah International Medical Research Centre, Eastern Region, Ministry of National Guard Health Affairs, Al-Ahsa, Saudi Arabia
| | - Mohammed Al-Jamaan
- Primary Health Care, King Abdullah Military Housing, Ministry of National Guard Health Affairs, Eastern Region, Al-Ahsa, Saudi Arabia
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Yang B, Wu M, Zhang X, Xia J, Wang L, Chen QI, Zhong M, Tang X. Multiple dietary fiber for gestational hyperinsulinism: A protocol of systematic review and meta-analysis of randomized clinical trials. Medicine (Baltimore) 2020; 99:e22266. [PMID: 33019401 PMCID: PMC7535687 DOI: 10.1097/md.0000000000022266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Gestational hyperinsulinism is a metabolic disease which is widely concerned at home and abroad. It is a clinical consensus that the embryo implantation ability of patients with hyperinsulinemia is decreased and the abortion rate after implantation is high. The treatment of gestational hyperinsulinism with Multiple dietary fiber diets has been proven. However, due to the lack of evidence, there is no specific method or recommendation, it is necessary to carry out a systematic evaluation of Multiple dietary fiber diet, to provide effective evidence for further research. METHODS AND ANALYSIS The following databases will be searched from their inception to August 2020: Electronic database includes PubMed, Embase, Cochrane Library, Web of Science, Nature, Science online, Chinese Biomedical Database WanFang, VIP medicine information, and CNKI. Primary outcomes: Fasting glucose, fasting insulin, homeostasis model assessment of insulin resistance, glycosylated hemoglobin. Additional outcomes: Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL), triglycerides (TG), total serum cholesterol (TC). Data will be extracted by 2 researchers independently, risk of bias of the meta-analysis will be evaluated based on the Cochrane Handbook for Systematic Reviews (SR) of Interventions. All data analysis will be conducted by data statistics software Review Manager V.5.3. and Stata V.12.0. RESULTS The results of this study will systematically evaluate the effectiveness and safety of Multiple dietary fiber diet interventions in the treatment of gestational hyperinsulinism. CONCLUSION The SR of this study will summarize the current published evidence of Multiple dietary fiber for the treatment of gestational hyperinsulinism, which can further guide the promotion and application of it. ETHICS AND DISSEMINATION This study is a SR, the outcomes are based on the published evidence, so examination and agreement by the ethics committee are not required in this study. We intend to publish the study results in a journal or conference presentations. OPEN SCIENCE FRA NETWORK (OSF) REGISTRATION NUMBER August 19, 2020. osf.io/tbc7z. (https://osf.io/tbc7z).
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Affiliation(s)
- Botong Yang
- Hospital of Chengdu University of Traditional Chinese Medicine
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Mengzhu Wu
- Hospital of Chengdu University of Traditional Chinese Medicine
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xinxia Zhang
- Hospital of Chengdu University of Traditional Chinese Medicine
| | - Jia Xia
- Hospital of Chengdu University of Traditional Chinese Medicine
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Lizhen Wang
- Hospital of Chengdu University of Traditional Chinese Medicine
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - QI Chen
- Hospital of Chengdu University of Traditional Chinese Medicine
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Min Zhong
- Hospital of Chengdu University of Traditional Chinese Medicine
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xiaoming Tang
- Hospital of Chengdu University of Traditional Chinese Medicine
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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Koga F, Kitagami S, Izumi A, Uemura T, Takayama O, Koga T, Mizoguchi T. Relationship between nutrition and reproduction. Reprod Med Biol 2020; 19:254-264. [PMID: 32684824 PMCID: PMC7360971 DOI: 10.1002/rmb2.12332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/16/2020] [Accepted: 05/21/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Recently, the relationship between nutrition and reproduction is being studied. In particular, when older women receive reproductive treatment, egg aging causes greater problems than organic factors. METHODS This study investigated the relationship between nutrition and reproduction with a focus on factors that cause aging, including oxidation, glycation, and chronic inflammation. A large volume of data concerning each nutrient's relationship with reproductive medicine was collected from a number of observational studies. MAIN FINDINGS The results showed that refined carbohydrates should be avoided and care should be taken to achieve proper intake of omega-3 fatty acids. Folic acid and vitamin D were also effective. For men, antioxidant measures are especially effective. The effects of antioxidants are related to insulin resistance, which causes chronic inflammation. CONCLUSION Recent research has shown that rather than meal content, meal intervals are more important for improving insulin resistance. Future research should examine lifestyle-related nutrition factors and their relationships to reproductive treatment.
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Griffith RJ, Alsweiler J, Moore AE, Brown S, Middleton P, Shepherd E, Crowther CA. Interventions to prevent women from developing gestational diabetes mellitus: an overview of Cochrane Reviews. Cochrane Database Syst Rev 2020; 6:CD012394. [PMID: 32526091 PMCID: PMC7388385 DOI: 10.1002/14651858.cd012394.pub3] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The prevalence of gestational diabetes mellitus (GDM) is increasing, with approximately 15% of pregnant women affected worldwide, varying by country, ethnicity and diagnostic thresholds. There are associated short- and long-term health risks for women and their babies. OBJECTIVES We aimed to summarise the evidence from Cochrane systematic reviews on the effects of interventions for preventing GDM. METHODS We searched the Cochrane Database of Systematic Reviews (6 August 2019) with key words 'gestational diabetes' OR 'GDM' to identify reviews pre-specifying GDM as an outcome. We included reviews of interventions in women who were pregnant or planning a pregnancy, irrespective of their GDM risk status. Two overview authors independently assessed eligibility, extracted data and assessed quality of evidence using ROBIS and GRADE tools. We assigned interventions to categories with graphic icons to classify the effectiveness of interventions as: clear evidence of benefit or harm (GRADE moderate- or high-quality evidence with a confidence interval (CI) that did not cross the line of no effect); clear evidence of no effect or equivalence (GRADE moderate- or high-quality evidence with a narrow CI crossing the line of no effect); possible benefit or harm (low-quality evidence with a CI that did not cross the line of no effect or GRADE moderate- or high-quality evidence with a wide CI); or unknown benefit or harm (GRADE low-quality evidence with a wide CI or very low-quality evidence). MAIN RESULTS We included 11 Cochrane Reviews (71 trials, 23,154 women) with data on GDM. Nine additional reviews pre-specified GDM as an outcome, but did not identify GDM data in included trials. Ten of the 11 reviews were judged to be at low risk of bias and one review at unclear risk of bias. Interventions assessed included diet, exercise, a combination of diet and exercise, dietary supplements, pharmaceuticals, and management of other health problems in pregnancy. The quality of evidence ranged from high to very low. Diet Unknown benefit or harm: there was unknown benefit or harm of dietary advice versus standard care, on the risk of GDM: risk ratio (RR) 0.60, 95% CI 0.35 to 1.04; 5 trials; 1279 women; very low-quality evidence. There was unknown benefit or harm of a low glycaemic index diet versus a moderate-high glycaemic index diet on the risk of GDM: RR 0.91, 95% CI 0.63 to 1.31; 4 trials; 912 women; low-quality evidence. Exercise Unknown benefit or harm: there was unknown benefit or harm for exercise interventions versus standard antenatal care on the risk of GDM: RR 1.10, 95% CI 0.66 to 1.84; 3 trials; 826 women; low-quality evidence. Diet and exercise combined Possible benefit: combined diet and exercise interventions during pregnancy versus standard care possibly reduced the risk of GDM: RR 0.85, 95% CI 0.71 to 1.01; 19 trials; 6633 women; moderate-quality evidence. Dietary supplements Clear evidence of no effect: omega-3 fatty acid supplementation versus none in pregnancy had no effect on the risk of GDM: RR 1.02, 95% CI 0.83 to 1.26; 12 trials; 5235 women; high-quality evidence. Possible benefit: myo-inositol supplementation during pregnancy versus control possibly reduced the risk of GDM: RR 0.43, 95% CI 0.29 to 0.64; 3 trials; 502 women; low-quality evidence. Possible benefit: vitamin D supplementation versus placebo or control in pregnancy possibly reduced the risk of GDM: RR 0.51, 95% CI 0.27 to 0.97; 4 trials; 446 women; low-quality evidence. Unknown benefit or harm: there was unknown benefit or harm of probiotic with dietary intervention versus placebo with dietary intervention (RR 0.37, 95% CI 0.15 to 0.89; 1 trial; 114 women; very low-quality evidence), or probiotic with dietary intervention versus control (RR 0.38, 95% CI 0.16 to 0.92; 1 trial; 111 women; very low-quality evidence) on the risk of GDM. There was unknown benefit or harm of vitamin D + calcium supplementation versus placebo (RR 0.33, 95% CI 0.01 to 7.84; 1 trial; 54 women; very low-quality evidence) or vitamin D + calcium + other minerals versus calcium + other minerals (RR 0.42, 95% CI 0.10 to 1.73; 1 trial; 1298 women; very low-quality evidence) on the risk of GDM. Pharmaceutical Possible benefit: metformin versus placebo given to obese pregnant women possibly reduced the risk of GDM: RR 0.85, 95% CI 0.61 to 1.19; 3 trials; 892 women; moderate-quality evidence. Unknown benefit or harm:eight small trials with low- to very low-quality evidence showed unknown benefit or harm for heparin, aspirin, leukocyte immunisation or IgG given to women with a previous stillbirth on the risk of GDM. Management of other health issues Clear evidence of no effect: universal versus risk based screening of pregnant women for thyroid dysfunction had no effect on the risk of GDM: RR 0.93, 95% CI 0.70 to 1.25; 1 trial; 4516 women; moderate-quality evidence. Unknown benefit or harm: there was unknown benefit or harm of using fractional exhaled nitrogen oxide versus a clinical algorithm to adjust asthma therapy on the risk of GDM: RR 0.74, 95% CI 0.31 to 1.77; 1 trial; 210 women; low-quality evidence. There was unknown benefit or harm of pharmacist led multidisciplinary approach to management of maternal asthma versus standard care on the risk of GDM: RR 5.00, 95% CI 0.25 to 99.82; 1 trial; 58 women; low-quality evidence. AUTHORS' CONCLUSIONS No interventions to prevent GDM in 11 systematic reviews were of clear benefit or harm. A combination of exercise and diet, supplementation with myo-inositol, supplementation with vitamin D and metformin were of possible benefit in reducing the risk of GDM, but further high-quality evidence is needed. Omega-3-fatty acid supplementation and universal screening for thyroid dysfunction did not alter the risk of GDM. There was insufficient high-quality evidence to establish the effect on the risk of GDM of diet or exercise alone, probiotics, vitamin D with calcium or other vitamins and minerals, interventions in pregnancy after a previous stillbirth, and different asthma management strategies in pregnancy. There is a lack of trials investigating the effect of interventions prior to or between pregnancies on risk of GDM.
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Affiliation(s)
- Rebecca J Griffith
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Jane Alsweiler
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Abigail E Moore
- Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Stephen Brown
- School of Interprofessional Health Studies, Auckland University of Technology, Auckland, New Zealand
| | - Philippa Middleton
- Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Emily Shepherd
- Robinson Research Institute, Discipline of Obstetrics and Gynaecology, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
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Mansourian M, Yazdani A, Faghihimani E, Aminorraya A, Amini M, Jafari-Koshki T. Factors associated with progression to pre-diabetes: a recurrent events analysis. Eat Weight Disord 2020; 25:135-141. [PMID: 29931448 DOI: 10.1007/s40519-018-0529-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 06/13/2018] [Indexed: 12/11/2022] Open
Abstract
AIMS Pre-diabetes is a strong risk factor for type 2diabetes (T2D). The aim of this study was to explore factors associated with normal glucose maintenance and pre-diabetes prevention or delay. METHODS Data of 1016 first-degree relatives of T2D patients were retrieved from the Isfahan Diabetes Prevention Study (IDPS). Association of various variables including nutrients, serum tests and physical activity with the risk of pre-diabetes was assessed using recurrent events approach. RESULTS Cumulative incidence of diabetes was 8.17, 9.44, and 4.91% for total sample and individuals with and without pre-diabetes experience in the follow-up. Risk of progression to pre-diabetes was higher in women and older people (p < 0.01). Additionally, BMI and blood pressure had significant association with the risk (p < 0.01) and individuals with higher intake of fat were at higher risk (HR = 2.26; 95% CI 1.66-3.07 for high-intake and HR = 1.52; 95% CI 1.27-1.83 for medium-intake compared to low-intake group). Carbohydrates and protein intake were positively associated with the risk of pre-diabetes with HR = 8.63 per 49 g extra carbohydrates per day and HR = 1.32 per 6 g extra protein per day (p < 0.01). The association was also significant for triglyceride (TG) with 7% risk increase per 1 SD = 1.14 increase in TG level. CONCLUSION Despite frequent studies on lifestyle modification for pre-diabetes prevention, less information is available about the role of nutritional components. We observed direct effects for intake of macronutrients including fat, carbohydrates, and protein in first-degree relatives. Further research is warranted to assess these associations in general populations. LEVEL OF EVIDENCE Level III: Evidence obtained from a single-center cohort study.
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Affiliation(s)
- Marjan Mansourian
- Department of Biostatistics and Epidemiology, Health School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Akram Yazdani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Faghihimani
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Aminorraya
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoud Amini
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tohid Jafari-Koshki
- Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran. .,Road Traffic Injury research Center, Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Attar-Neyshabouri St., Tabriz, Iran.
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RamyaBai M, Wedick NM, Shanmugam S, Arumugam K, Nagarajan L, Vasudevan K, Gunasekaran G, Rajagopal G, Spiegelman D, Malik V, Anjana RM, Hu FB, Unnikrishnan R, Willett W, Malleshi N, Njelekela MA, Gimbi D, Krishnaswamy K, Henry C, Mohan V, Sudha V. Glycemic Index and Microstructure Evaluation of Four Cereal Grain Foods. J Food Sci 2019; 84:3373-3382. [PMID: 31762024 DOI: 10.1111/1750-3841.14945] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 10/01/2019] [Accepted: 10/14/2019] [Indexed: 01/21/2023]
Abstract
To determine the glycemic index (GI) of selected cereals and association with their microstructure. The GI of whole grain pilaf (WGP), instant brown rice (IBR), whole maize ugali (MWU), and refined maize ugali (RMU) was assessed in a randomized trial. Fourteen healthy participants with mean age of 25 years were administered 50 g portions of available carbohydrates from glucose and various test foods after an overnight fast on separate occasions. Capillary blood samples of participants were used to measure blood glucose over 2 hr. The GI was calculated as per standard protocol. The microstructure of test foods, determined by scanning electron microscopy was evaluated to understand the measured GI values. The GI (mean ± standard error) of IBR was the highest (87.8 ± 6.8) followed by RMU (74.7 ± 6.5) and WMU (71.4 ± 5.1). WGP had medium GI (58.9 ± 5.1; P < 0.01 vs. IBR). Microstructure examination of IBR revealed disruption of bran layer and presence of fissures indicating loss of intactness of bran. Stereozoom images for WGP revealed intact bran and germ. For RMU and WMU, the grain was milled leading to loss of integrity. IBR, RMU, and WMU have high GI values, which is likely due to disruption of bran layer, endosperm modification (IBR), and loss of grain matrix (WMU, RMU). WGP has medium GI probably due to fairly intact bran and germ. PRACTICAL APPLICATION: Wholegrain or whole meal flour may not necessarily be low in glycemic index (GI; low GI < 55; medium 55 to 69 and high GI ≥70). "Ugali" a commonly consumed cereal staple food in Tanzania made from either refined or whole meal maize flour was found to be a high GI food. Intact whole grain foods, such as whole grain pilaf (mixed intact whole grains) is a healthier alternative to milled whole grains such as whole meal maize flour. Instant quick cooking brown rice exhibited a high GI, due to the processing method, suggesting that regular brown rice may be a healthier option.
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Affiliation(s)
- Mookambika RamyaBai
- Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
| | - Nicole M Wedick
- Dept. of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Shobana Shanmugam
- Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
| | - Kokila Arumugam
- Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
| | - Lakshmipriya Nagarajan
- Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
| | - Kavitha Vasudevan
- Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
| | - Geetha Gunasekaran
- Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
| | - Gayathri Rajagopal
- Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
| | - Donna Spiegelman
- Dept. of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Dept. of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Vasanti Malik
- Dept. of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
| | - Frank B Hu
- Dept. of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Dept. of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ranjit Unnikrishnan
- Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
| | - Walter Willett
- Dept. of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Dept. of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Nagappa Malleshi
- Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
| | - Marina A Njelekela
- Dept. of Physiology, Muhimbili Univ. of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Dorothy Gimbi
- Dept. of Food Science and Nutrition, Sokoine Univ. of Agriculture, Morogoro, Tanzania
| | - Kamala Krishnaswamy
- Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
| | - Cjk Henry
- Clinical Nutritional Sciences, Singapore Inst. for Clinical Sciences, Brenner Centre for Molecular Medicine, Medical Drive, Singapore
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
| | - Vasudevan Sudha
- Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
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Maino Vieytes CA, Mondul AM, Li Z, Zarins KR, Wolf GT, Rozek LS, Arthur AE. Dietary Fiber, Whole Grains, and Head and Neck Cancer Prognosis: Findings from a Prospective Cohort Study. Nutrients 2019; 11:nu11102304. [PMID: 31569808 PMCID: PMC6835374 DOI: 10.3390/nu11102304] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 09/17/2019] [Accepted: 09/25/2019] [Indexed: 02/06/2023] Open
Abstract
No studies, to date, have examined the relationship between dietary fiber and recurrence or survival after head and neck cancer diagnosis. The aim of this study was to determine whether pretreatment intake of dietary fiber or whole grains predicted recurrence and survival outcomes in newly diagnosed head and neck cancer (HNC) patients. This was a prospective cohort study of 463 participants baring a new head and neck cancer diagnosis who were recruited into the study prior to the initiation of any cancer therapy. Baseline (pre-treatment) dietary and clinical data were measured upon entry into the study cohort. Clinical outcomes were ascertained at annual medical reviews. Cox proportional hazard models were fit to examine the relationships between dietary fiber and whole grain intakes with recurrence and survival. There were 112 recurrence events, 121 deaths, and 77 cancer-related deaths during the study period. Pretreatment dietary fiber intake was inversely associated with risk of all-cause mortality (hazard ratio (HR): 0.37, 95% confidence interval (CI): 0.14–0.95, ptrend = 0.04). No statistically significant associations between whole grains and prognostic outcomes were found. We conclude that higher dietary fiber intake, prior to the initiation of treatment, may prolong survival time, in those with a new HNC diagnosis.
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Affiliation(s)
- Christian A Maino Vieytes
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan, Ann Arbor, MI 48103, USA.
| | - Zonggui Li
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
| | - Katie R Zarins
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI 48103, USA.
| | - Gregory T Wolf
- Department of Otolaryngology, University of Michigan, Ann Arbor, MI 48103, USA.
| | - Laura S Rozek
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI 48103, USA.
- Department of Otolaryngology, University of Michigan, Ann Arbor, MI 48103, USA.
| | - Anna E Arthur
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
- Carle Cancer Center, Carle Foundation Hospital, Urbana, IL 61801, USA.
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Lavie CJ, Laddu D, Arena R, Ortega FB, Alpert MA, Kushner RF. Healthy Weight and Obesity Prevention: JACC Health Promotion Series. J Am Coll Cardiol 2019; 72:1506-1531. [PMID: 30236314 DOI: 10.1016/j.jacc.2018.08.1037] [Citation(s) in RCA: 269] [Impact Index Per Article: 53.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 08/07/2018] [Accepted: 08/08/2018] [Indexed: 12/21/2022]
Abstract
Overweight and obesity have reached epidemic levels in the United States and worldwide, and this has contributed to substantial cardiovascular and other health risks. However, controversy exists concerning the causes of obesity and effective modalities for its prevention and treatment. There is also controversy related to the concept of metabolically healthy obesity phenotype, the "obesity paradox," and on the importance of fitness to protect individuals who are overweight or obese from cardiovascular diseases. In this state-of-the-art review, the authors focus on "healthy weight" with the emphasis on the pathophysiologic effects of weight gain on the cardiovascular system; mechanistic/triggering factors; and the role of preventive actions through personal, education/environment, and societal/authoritative factors, as well as factors to provide guidance for caregivers of health promotion. Additionally, the authors briefly review metabolically healthy obesity, the obesity paradox, and issues beyond lifestyle consideration for weight loss with medications and bariatric surgery.
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Affiliation(s)
- Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, Louisiana.
| | - Deepika Laddu
- Department of Physical Therapy, College of Applied Health Science, University of Illinois at Chicago, Chicago, Illinois
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Science, University of Illinois at Chicago, Chicago, Illinois
| | - Francisco B Ortega
- PROFITH "PROmoting FITness and Health through Physical Activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Martin A Alpert
- Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia, Missouri
| | - Robert F Kushner
- Northwestern University, Feinberg School of Medicine, Chicago, Illinois
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Effect of diet composition on insulin sensitivity in humans. Clin Nutr ESPEN 2019; 33:29-38. [PMID: 31451269 DOI: 10.1016/j.clnesp.2019.05.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 05/21/2019] [Indexed: 12/27/2022]
Abstract
Diet composition has a marked impact on the risk of developing type 2 diabetes and cardiovascular disease. Prospective studies show that dietary patterns with elevated amount of animal products and low quantity of vegetable food items raise the risk of these diseases. In healthy subjects, animal protein intake intensifies insulin resistance whereas plant-based foods enhance insulin sensitivity. Similar effects have been documented in patients with diabetes. Accordingly, pre-pregnancy intake of meat (processed and unprocessed) has been strongly associated with a higher risk of gestational diabetes whereas greater pre-pregnancy vegetable protein consumption is associated with a lower risk of gestational diabetes. Population groups that modify their traditional dietary habit increasing the amount of animal products while reducing plant-based foods experience a remarkable rise in the frequency of type 2 diabetes. The association of animal protein intake with insulin resistance is independent of body mass index. In obese individuals that consume high animal protein diets, insulin sensitivity does not improve following weight loss. Diets aimed to lose weight that encourage restriction of carbohydrates and elevated consumption of animal protein intensify insulin resistance increasing the risk of developing type 2 diabetes and cardiovascular disease. The effect of dietary components on insulin sensitivity may contribute to explain the striking impact of eating habits on the risk of type 2 diabetes and cardiovascular disease. Insulin resistance predisposes to type 2 diabetes in healthy subjects and deteriorates metabolic control in patients with diabetes. In nondiabetic and diabetic individuals, insulin resistance is a major cardiovascular risk factor.
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Griffith RJ, Alsweiler J, Moore AE, Brown S, Middleton P, Shepherd E, Crowther CA. Interventions to prevent women developing gestational diabetes mellitus: an overview of Cochrane Reviews. Cochrane Database Syst Rev 2019; 2019:CD012394. [PMCID: PMC6515838 DOI: 10.1002/14651858.cd012394.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/30/2023]
Abstract
This is a protocol for a Cochrane Review (Overview). The objectives are as follows: To summarise the evidence from Cochrane systematic reviews regarding the effects of interventions to prevent women developing gestational diabetes mellitus (GDM).
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Affiliation(s)
- Rebecca J Griffith
- University of AucklandDepartment of Paediatrics: Child and Youth HealthAucklandNew Zealand
| | - Jane Alsweiler
- University of AucklandDepartment of Paediatrics: Child and Youth HealthAucklandNew Zealand
| | - Abigail E Moore
- The University of AucklandLiggins Institute85 Park RoadAucklandNew Zealand1023
| | - Stephen Brown
- Auckland University of TechnologySchool of Interprofessional Health Studies90 Akoranga DriveAucklandNew Zealand0627
| | - Philippa Middleton
- Healthy Mothers, Babies and Children, South Australian Health and Medical Research InstituteWomen's and Children's Hospital72 King William RoadAdelaideAustralia5006
| | - Emily Shepherd
- The University of AdelaideRobinson Research Institute, Discipline of Obstetrics and Gynaecology, Adelaide Medical SchoolAdelaideAustralia
| | - Caroline A Crowther
- The University of AucklandLiggins Institute85 Park RoadAucklandNew Zealand1023
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Gheflati A, Adelnia E, Nadjarzadeh A. The clinical effects of purslane (
Portulaca oleracea
) seeds on metabolic profiles in patients with nonalcoholic fatty liver disease: A randomized controlled clinical trial. Phytother Res 2019; 33:1501-1509. [DOI: 10.1002/ptr.6342] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 02/04/2019] [Accepted: 02/13/2019] [Indexed: 01/21/2023]
Affiliation(s)
- Alireza Gheflati
- Nutrition and Food Security Research CenterShahid Sadoughi University of Medical Sciences Yazd Iran
- Department of Nutrition, School of Public HealthShahid Sadoughi University of Medical Sciences Yazd Iran
| | - Elham Adelnia
- Nutrition and Food Security Research CenterShahid Sadoughi University of Medical Sciences Yazd Iran
- Department of Nutrition, School of Public HealthShahid Sadoughi University of Medical Sciences Yazd Iran
| | - Azadeh Nadjarzadeh
- Nutrition and Food Security Research CenterShahid Sadoughi University of Medical Sciences Yazd Iran
- Department of Nutrition, School of Public HealthShahid Sadoughi University of Medical Sciences Yazd Iran
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38
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Ringuette C, Finley J, Prinyawiwatkul W, King JM. Market Surveys to Determine Availability of Reduced Glycemic Load/High Fiber Products. JOURNAL OF CULINARY SCIENCE & TECHNOLOGY 2019. [DOI: 10.1080/15428052.2017.1399951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Christopher Ringuette
- School of Nutrition and Food Sciences, LSU AgCenter, Louisiana State University, Baton Rouge, Louisiana, USA
| | - John Finley
- School of Nutrition and Food Sciences, LSU AgCenter, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Witoon Prinyawiwatkul
- School of Nutrition and Food Sciences, LSU AgCenter, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Joan M. King
- School of Nutrition and Food Sciences, LSU AgCenter, Louisiana State University, Baton Rouge, Louisiana, USA
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Lavie CJ, Laddu D, Arena R, Ortega FB, Alpert MA, Kushner RF. Reprint of: Healthy Weight and Obesity Prevention. J Am Coll Cardiol 2018; 72:3027-3052. [DOI: 10.1016/j.jacc.2018.10.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 08/07/2018] [Accepted: 08/08/2018] [Indexed: 12/23/2022]
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40
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Gertsson J, Uddén Hemmingsson J. Differences in dietary choices in patients who developed postprandial hyperinsulinemic hypoglycemia (dumping syndrome) after Roux-en-Y gastric bypass compared to healthy controls. CLINICAL NUTRITION EXPERIMENTAL 2018. [DOI: 10.1016/j.yclnex.2018.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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41
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Siddiqui S, Zainal H, Harun SN, Sheikh Ghadzi SM. Dietary assessment of pre-diabetic patients by using food frequency questionnaire. A systematic review of study quality, study outcome, study questionnaire and their relative validity and reliability. Clin Nutr ESPEN 2018; 29:213-223. [PMID: 30661689 DOI: 10.1016/j.clnesp.2018.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 10/05/2018] [Indexed: 01/26/2023]
Abstract
BACKGROUND The contribution of dietary factors in the development and progression of pre-diabetes has been increasingly recognized. However, due to high variability in dietary habits measurement of dietary intake remains one of the most challenging tasks in this population. Food frequency questionnaire (FFQ) which investigates usual dietary intake can be used to identify frequent consumption of foods such as dietary fat, fiber, grains that are linked to the risk of pre-diabetes. METHOD This systematic review was conducted to identify and describe FFQs that measure dietary intake of pre-diabetic patients and to examine their relative validity and reliability. The systematic search was done through electronic databases such as PubMed, CINAHL, PsycINFO, ProQuest and Scopus. Methodological quality of included studies and results of study outcome was also summarized in this review. RESULT The search identified 445 papers, of which 18 studies reported 15 FFQs, met inclusion criteria. Most of the FFQs (n = 12) were semi-quantitative while three were frequency measures with portion size estimation of selected food items. Test-retest reliability of FFQ was reported in 7 (38.3%) studies with the correlation coefficient of 0.33-0.92. Relative validity of FFQ was reported in 16 (88.8%) studies with the range of correlation coefficient of 0.08-0.83. Dietary patterns rich in carbohydrate, fat, animal protein and n-3 fatty acids were associated with increased risk of pre-diabetes. CONCLUSION No well-established disease-specific FFQ identified in the literature. Development of a valid, practical and reliable tool is needed for better understanding of the impact of diet in pre-diabetic population.
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Affiliation(s)
- Sania Siddiqui
- Discipline of Clinical Pharmacy, School of Pharmaceutical Science, Universiti Sains Malaysia, Malaysia
| | - Hadzliana Zainal
- Discipline of Clinical Pharmacy, School of Pharmaceutical Science, Universiti Sains Malaysia, Malaysia.
| | - Sabariah Noor Harun
- Discipline of Clinical Pharmacy, School of Pharmaceutical Science, Universiti Sains Malaysia, Malaysia
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Effect of Glycemic Index of a Pre-exercise Meal on Endurance Exercise Performance: A Systematic Review and Meta-analysis. Sports Med 2018; 47:1087-1101. [PMID: 27677914 DOI: 10.1007/s40279-016-0632-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Low glycemic index (GI) pre-exercise meals may enhance endurance performance by maintaining euglycemia and altering fuel utilization. However, evidence for performance benefits is equivocal. OBJECTIVE To evaluate the effect of a low GI (LGI) versus a high GI (HGI) pre-exercise meal on endurance performance using meta-analyses. METHODS Data sources included MEDLINE, SPORTDiscus, AUSPORT, AusportMed, Web of Science, and Scopus. Eligibility criteria were randomized, crossover trials with an endurance exercise (≥60 min) component, e.g., time trial (TT), time to exhaustion (TTE) test, or submaximal bout followed by TT or TTE. Participants were healthy, active individuals aged ≥16 years. Interventions included a LGI (≤55) and HGI (≥70) meal ingested 30-240 min before exercise. Study quality was assessed using an adapted version of the validated Downs and Black tool. Effect size (ES) and 95 % confidence interval were calculated for each study and pooled according to performance test type and whether exogenous carbohydrate (CHO) was given during exercise. Potential effect modifiers including exercise duration, pre-exercise meal timing, glycemic load (GL), and fitness were assessed using meta-regression. RESULTS The search netted 3431 citations with 19 studies eligible for inclusion (totaling 188 participants; 91 % male; VO2max: >50 ml/kg/min). Meals with 0.18-2 g CHO/kg body mass, and a mean GI and glycemic load of 82 (GL: 72) and 35 (GL: 32) for HGI and LGI, respectively, were given between 30 and 210 min before exercise. All test types without CHO ingestion during exercise showed slightly improved performance with LGI, but no significant pooled effects were observed (ES: -0.17 to -0.36; p > 0.05). Studies where exogenous CHO was ingested during exercise showed conflicting results (ES: -0.67 to 0.11; p = 0.04 to 0.94). No significant relationship was observed with any of the effect modifiers (p > 0.05). No consistent metabolic responses (glucose, insulin, lactate, respiratory exchange ratio) during exercise were observed with either meal type. LIMITATIONS There were small numbers of studies within each exercise testing protocol and limited statistical power within studies. Pre-exercise meal timing, GL, meal composition and participant fitness varied across studies, limiting the capacity to assess the influence of these factors on study outcomes. CONCLUSION There was no clear benefit of consuming a LGI pre-exercise meal for endurance performance regardless of carbohydrate ingestion during exercise.
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43
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Naufahu J, Elliott B, Markiv A, Dunning-Foreman P, McGrady M, Howard D, Watt P, Mackenzie RWA. High-Intensity Exercise Decreases IP6K1 Muscle Content and Improves Insulin Sensitivity (SI2*) in Glucose-Intolerant Individuals. J Clin Endocrinol Metab 2018; 103:1479-1490. [PMID: 29300979 DOI: 10.1210/jc.2017-02019] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 12/20/2017] [Indexed: 12/13/2022]
Abstract
CONTEXT Insulin resistance (IR) in skeletal muscle contributes to whole body hyperglycemia and the secondary complications associated with type 2 diabetes. Inositol hexakisphosphate kinase-1 (IP6K1) may inhibit insulin-stimulated glucose transport in this tissue type. OBJECTIVE Muscle and plasma IP6K1 were correlated with two-compartment models of glucose control in insulin-resistant hyperinsulinemic individuals. Muscle IP6K1 was also compared after two different exercise trials. DESIGN Nine prediabetic [hemoglobin A1c; 6.1% (0.2%)] patients were recruited to take part in a resting control, a continuous exercise (90% of lactate threshold), and a high-intensity exercise trial (6 30-second sprints). Muscle biopsies were drawn before and after each 60-minute trial. A labeled ([6,62H2]glucose) intravenous glucose tolerance test was performed immediately after the second muscle sample. RESULTS Fasting muscle IP6K1 content did not correlate with insulin sensitivity (SI2*) (P = 0.961). High-intensity exercise reduced IP6K1 muscle protein and messenger RNA expression (P = 0.001). There was no effect on protein IP6K1 content after continuous exercise. Akt308 phosphorylation of was significantly greater after high-intensity exercise. Intermittent exercise reduced hepatic glucose production after the same trial. The same intervention also increased SI2*, and this effect was significantly greater compared with the effect of continuous exercise improvements. Our in vitro experiment demonstrated that the chemical inhibition of IP6K1 increased insulin signaling in C2C12 myotubes. CONCLUSIONS The in vivo and in vitro approaches used in the current study suggest that a decrease in muscle IP6K1 may be linked to whole body increases in SI2*. In addition, high-intensity exercise reduces hepatic glucose production in insulin-resistant individuals.
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Affiliation(s)
- Jane Naufahu
- Faculty of Science and Technology, Department of Life Sciences, University of Westminster, London, United Kingdom
| | - Bradley Elliott
- Faculty of Science and Technology, Department of Life Sciences, University of Westminster, London, United Kingdom
| | - Anatoliy Markiv
- Biosciences Education, King's College London, London, United Kingdom
| | - Petra Dunning-Foreman
- Faculty of Science and Technology, Department of Life Sciences, University of Westminster, London, United Kingdom
| | - Maggie McGrady
- Faculty of Science and Technology, Department of Life Sciences, University of Westminster, London, United Kingdom
| | - David Howard
- Department of Oncology, Charing Cross Hospital, Imperial NHS Trust Hospitals, London, United Kingdom
| | - Peter Watt
- Centre for Sport and Exercise Science and Medicine (SESAME), University of Brighton, Eastbourne, United Kingdom
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44
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Saglam D, Saka M, Sayaca N. The effect of consumption of low glycemic index, high fat content bread on anthropometric measurement and cardiometabolic risk factors in women with type 2 diabetes mellitus. Int J Diabetes Dev Ctries 2018. [DOI: 10.1007/s13410-018-0624-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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45
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Fuseini AM, Rahimi MH, Mollahosseini M, Yekaninejad MS, Maghbooli Z, Mirzaei K. The Association Between Dietary Glycemic Index and Glycemic Load and a Body Shape and Fat Distribution Among Apparently Healthy Iranian Adults. J Am Coll Nutr 2018. [DOI: 10.1080/07315724.2017.1416312] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Abdul-Mutala Fuseini
- Department of Community Nutrition, Tehran University of Medical Sciences–International Campus, Tehran, Iran
| | | | - Mehdi Mollahosseini
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Zhila Maghbooli
- Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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den Biggelaar LJCJ, Eussen SJPM, Sep SJS, Mari A, Ferrannini E, van Greevenbroek MM, van der Kallen CJ, Schalkwijk CG, Arts ICW, Stehouwer CDA, Dagnelie PC. Prospective associations of dietary carbohydrate, fat, and protein intake with β-cell function in the CODAM study. Eur J Nutr 2018. [PMID: 29525890 PMCID: PMC6437317 DOI: 10.1007/s00394-018-1644-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE Type 2 diabetes mellitus (T2DM) is characterized by both impaired pancreatic β-cell function (BCF) and insulin resistance. In the etiology of T2DM, BCF basically determines whether a person with a certain degree of insulin resistance develops T2DM, as β-cells are able to compensatorily increase insulin secretion. The effects of dietary intake on BCF are largely unknown. Our study aim was to investigate whether dietary macronutrient intake predicts BCF. METHODS Prospective data (median follow-up 7 years) of 303 individuals recruited from the CODAM study population (aged 40-70 years, 39% women) were analyzed. BCF was measured by C-peptide deconvolution and physiological modeling of data from a 5-point, 75-g, 2-h oral glucose tolerance test. Macronutrient intake was estimated by a 178-item Food Frequency Questionnaire. RESULTS Associations adjusted for relevant covariates of baseline macronutrient intake with model-derived parameters describing BCF (glucose sensitivity, rate sensitivity or potentiation) or C-peptidogenic index were detected for trans fat [standardized regression coefficient (95%-CI) glucose sensitivity - 0.14 (- 0.26, - 0.01)] per g, cholesterol [potentiation 0.20 (0.02, 0.37)] per 100 mg, dietary fiber [glucose sensitivity 0.21 (0.08, 0.33)] per 10 g, MUFA glucose sensitivity 0.16 (0.02, 0.31) per 10 g, and polysaccharide [potentiation - 0.24 (- 0.43, - 0.05), C-peptidogenic index - 0.16 (- 0.29 - 0.03); odds ratio lowest versus highest tertile (95%-CI) rate sensitivity 1.51 (1.06, 2.15)) per 50 g. CONCLUSIONS In this population at high risk for developing T2DM, polysaccharide and trans fat intake were associated with worse BCF, whereas increased intake of MUFA, dietary cholesterol, and fiber were associated with better BCF.
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Affiliation(s)
- Louise J C J den Biggelaar
- Department of Epidemiology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Simone J P M Eussen
- Department of Epidemiology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. .,School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, The Netherlands. .,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands. .,Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands.
| | - Simone J S Sep
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Centre of Expertise in Rehabilitation and Audiology, Adelante, Hoensbroek, The Netherlands.,Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Andrea Mari
- CNR Institute of Clinical Physiology, Pisa, Italy.,Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Ele Ferrannini
- CNR Institute of Neuroscience, Padova, Italy.,Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marleen M van Greevenbroek
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Carla J van der Kallen
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Casper G Schalkwijk
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Ilja C W Arts
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, The Netherlands.,Maastricht Centre for Systems Biology (MaCSBio), Maastricht University, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Pieter C Dagnelie
- Department of Epidemiology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, The Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
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Tucker LA. Fiber Intake and Insulin Resistance in 6374 Adults: The Role of Abdominal Obesity. Nutrients 2018; 10:E237. [PMID: 29461482 PMCID: PMC5852813 DOI: 10.3390/nu10020237] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 02/14/2018] [Accepted: 02/16/2018] [Indexed: 01/02/2023] Open
Abstract
A cross-sectional design was used to evaluate the relationship between fiber intake and insulin resistance, indexed using HOMA (homeostatic model assessment), in a National Health and Nutrition Examination Study (NHANES) sample of 6374 U.S. adults. Another purpose was to test the influence of covariates on the association. A third aim was to compare HOMA levels between two groups based on the recommended intake of 14 grams of fiber per 1000 kilocalories (kcal). Fiber intake was measured using a 24-hour recall. With demographic variables controlled, results showed that HOMA differed across High, Moderate, and Low fiber categories (F = 5.4, p = 0.0072). Adjusting for the demographic variables, the possible misreporting of energy intake, smoking, and physical activity strengthened the relationship (F = 8.0, p = 0.0009), which remained significant after adjusting for body fat (F = 7.0, p = 0.0019) and body mass index (BMI) (F = 4.9, p = 0.0108), with the other covariates. However, the fiber-HOMA relationship was eliminated after adjusting for waist circumference (F = 2.3, p = 0.1050). Dividing participants based on the recommended 14-gram standard resulted in meaningful HOMA differences (F = 16.4, p = 0.0002), and the association was not eliminated after controlling for waist circumference. Apparently, adults with high fiber consumption have less insulin resistance than their counterparts. However, much of the association is due to differences in waist circumference, unless the recommended intake of fiber is attained.
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Affiliation(s)
- Larry A Tucker
- Department of Exercise Sciences, Brigham Young University, Provo 84602, UT, USA.
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de Carvalho CM, de Paula TP, Viana LV, Machado VM, de Almeida JC, Azevedo MJ. Plasma glucose and insulin responses after consumption of breakfasts with different sources of soluble fiber in type 2 diabetes patients: a randomized crossover clinical trial. Am J Clin Nutr 2017; 106:1238-1245. [PMID: 28855225 DOI: 10.3945/ajcn.117.157263] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 08/04/2017] [Indexed: 11/14/2022] Open
Abstract
Background: The amount and quality of carbohydrates are important determinants of plasma glucose after meals. Regarding fiber content, it is unclear whether the intake of soluble fibers from foods or supplements has an equally beneficial effect on lowering postprandial glucose.Objective: The aim of our study was to compare the acute effect of soluble fiber intake from foods or supplements after a common meal on postprandial plasma glucose and plasma insulin in patients with type 2 diabetes (T2D).Design: A randomized crossover clinical trial was conducted in patients with T2D. Patients consumed isocaloric breakfasts (mean ± SD: 369.8 ± 9.4 kcal) with high amounts of fiber from diet food sources (total fiber: 9.7 g; soluble fiber: 5.4 g), high amounts of soluble fiber from guar gum supplement (total fiber: 9.1 g; soluble fiber: 5.4 g), and normal amounts of fiber (total fiber: 2.4 g; soluble fiber: 0.8 g). Primary outcomes were postprandial plasma glucose and insulin (0-180 min). Data were analyzed by repeated measures ANOVA and post hoc Bonferroni test.Results: A total of 19 patients [aged 65.8 ± 7.3 y; median (IQR), 10 (5-9) y of T2D duration; glycated hemoglobin 7.0% ± 0.8%; body mass index (in kg/m2) 28.2 ± 2.9] completed 57 meal tests. After breakfast, the incremental area under the curve (iAUC) for plasma glucose [mg/dL · min; mean (95% CI)] did not differ between high fiber from diet (HFD) [7861 (6257, 9465)] and high fiber from supplement (HFS) [7847 (5605, 10,090)] (P = 1.00) and both were lower than usual fiber (UF) [9527 (7549, 11,504)] (P = 0.014 and P = 0.037, respectively). iAUCs [μIU/mL · min; mean (95% CI)] did not differ (P = 0.877): HFD [3781 (2513, 5050)], HFS [4006 (2711, 5302), and UF [4315 (3027, 5603)].Conclusions: Higher fiber intake was associated with lower postprandial glucose at breakfast, and the intake of soluble fiber from food and supplement had a similar effect in patients with T2D. This trial was registered at clinicaltrials.gov as NCT02204384.
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Affiliation(s)
| | | | - Luciana V Viana
- Endocrine Division, Hospital de Clínicas de Porto Alegre, and
| | | | - Jussara C de Almeida
- Endocrine Division, Hospital de Clínicas de Porto Alegre, and.,Department of Nutrition, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Koloverou E, Panagiotakos DB, Georgousopoulou EN, Grekas A, Christou A, Chatzigeorgiou M, Chrysohoou C, Tousoulis D, Stefanadis C, Pitsavos C. Dietary Patterns and 10-year (2002-2012) Incidence of Type 2 Diabetes: Results from the ATTICA Cohort Study. Rev Diabet Stud 2017; 13:246-256. [PMID: 28394951 DOI: 10.1900/rds.2016.13.246] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
AIM To identify dietary patterns among apparently healthy individuals and to determine their long-term effect on diabetes incidence. METHODS During 2001-2002, a random sample of 3,042 men and women (18-89 years old), living in greater Athens, was randomly selected to participate in the study. During 2011-2012, the 10-year follow-up was performed in 2,583 participants (15% drop-out rate). After excluding participants with diabetes at baseline and those for whom no information on diabetes status was available at follow-up, the working sample consisted of 1,485 participants. Dietary habits were assessed by means of a validated semi-quantitative, food frequency questionnaire. Factor analysis was performed to extract dietary patterns from 18 food groups. RESULTS Diabetes diagnosis at follow-up was made in 191 participants, yielding an incidence rate of 12.9%. Six factors (i.e. dietary patterns) were identified that explained 54% of the variation in consumption. After adjusting for major confounders, and stratification by age-group, logistic regression revealed that the most healthful pattern consisted of the consumption of fruits, vegetables, legumes, bread, rusk, and pasta which reduced the 10-year diabetes risk by 40%, among participants aged 45-55 years. The association reached marginal statistical significance (95% CI: 0.34, 1.07), while no significant association was observed for the other age-groups. When the analysis was additionally adjusted for carbohydrate percentage, statistical significance was lost completely, suggesting a possibly mediating effect of this macronutrient. CONCLUSIONS The results confirm the potentially protective effect of a plant-based dietary pattern in the primary prevention of diabetes, in particular among middle-aged people. Carbohydrate content may be a specific factor in this relationship; other micronutrients found in plant-based food groups may also play a role.
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Affiliation(s)
- Efi Koloverou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Ekavi N Georgousopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Athanasios Grekas
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Aimilia Christou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Michail Chatzigeorgiou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | | | | | | | - Christos Pitsavos
- First Cardiology Clinic, School of Medicine, University of Athens, Greece
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