Energy Metabolism in Relation to Diet and Physical Activity: A South Asian Perspective

Perception of diet, dietary practices and sources of dietary information among people with type 2 diabetes followed up at a tertiary care outpatient clinic: a qualitative study

BACKGROUND

Dietary practices and beliefs among people living with diabetes in low-middle-income South-Asian countries are unique. Understanding them is paramount in supporting them to improve their clinical outcomes. This study aimed to understand the perception of diet, dietary practices, and sources of dietary information among Sri Lankan adults with type 2 diabetes.

METHODS

Focus group discussions (FGD) were conducted with the participation of adults with type 2 diabetes attending a Medical Clinic at a tertiary care hospital in Sri Lanka. Eligible participants were recruited between June to October 2022 through convenience sampling. FGDs were facilitated by two researchers using a semi-structured discussion guide developed for this study. Abridged transcripts were formulated using the notes and audio recordings. Data were analysed using Braun and Clarke's six-step method for thematic analysis.

RESULTS

Among 38 participants included in five FGDs, the mean age was 59.9 (range: 39-76) years, 27 (71.1%) were females, and mean duration since the diagnosis of diabetes was 9.4 (range: 0-25) years. Five main themes were identified. (1) Diet in diabetes and composition of the meal; participants were aware of the importance of diet in diabetes and understood a healthy meal including the plate concept. (2) Individual components in the diet; many participants used 'sugar' to refer to 'starch' in the food. Participants considered rice superior to wheat flour-based products in diabetes. Finger millet products were believed to lower blood glucose. We observed beliefs on the glycaemic effects of specific varieties of yams, legumes and fruits. Some participants completely avoided sweets and starchy vegetables. (3) Utilisation of food labels; only a few participants referred to food labels. (4) Factors affecting the practice; external factors such as the recent economic crisis, family members' influence, and availability affected their food choices. (5) Sources of information; some felt that ready access to information was limited.

CONCLUSIONS

We identified several misconceptions and undue dietary restrictions, minimal utilisation of food labels and information sources, and the impact of several external factors including economic restrictions. Understanding these dynamic patient and social factors would enable culturally acceptable dietary interventions by health professionals to improve patient outcomes.

Endocrine, genetic, and microbiome nexus of obesity and potential role of postbiotics: a narrative review

Obesity is a public health crisis, presenting a huge burden on health care and the economic system in both developed and developing countries. According to the WHO's latest report on obesity, 39% of adults of age 18 and above are obese, with an increase of 18% compared to the last few decades. Metabolic energy imbalance due to contemporary lifestyle, changes in gut microbiota, hormonal imbalance, inherent genetics, and epigenetics is a major contributory factor to this crisis. Multiple studies have shown that probiotics and their metabolites (postbiotics) supplementation have an effect on obesity-related effects in vitro, in vivo, and in human clinical investigations. Postbiotics such as the SCFAs suppress obesity by regulating metabolic hormones such as GLP-1, and PPY thus reducing feed intake and suppressing appetite. Furthermore, muramyl di-peptides, bacteriocins, and LPS have been tested against obesity and yielded promising results in both human and mice studies. These insights provide an overview of targetable pharmacological sites and explore new opportunities for the safer use of postbiotics against obesity in the future.

Eating Habits and Disease Risk Factors

Diet plays an inevitable role in human health and disease prevention [...]

Characterizing Retail Food Environments in Peri-Urban Pakistan during the COVID-19 Pandemic

(1) Background: To date, there are limited data in low- and middle-income countries (LMICs) that collect, monitor, and evaluate food environments in standardized ways. The development of a pilot survey tool, tailored to LMICs and focused on retail food environments, is necessary for improving public health nutrition. (2) Methods: A novel survey tool was developed and piloted in a sample of village retail food environments (n = 224) in Matiari, Pakistan between October 2020 to April 2021. Villages were randomly selected, and food outlets were surveyed within a 500-m radius from each village center. Descriptive statistics (counts and percentages) were used to describe the characteristics of food outlets and the availability of food. To test whether there was a difference in characteristics or in the mean of number of healthy, unhealthy, and total food items available by village size, a χ2 test or one-way ANOVA was conducted, respectively. (3) Results: In total, 1484 food outlets were surveyed for food accessibility, availability, and promotion across small (n = 54), medium (n = 112), and large villages (n = 58). In small and medium-sized villages, mobile food vendors were the predominant food outlet type (47.8% and 45.1%, respectively), whereas in large villages, corner stores (36%) were more prominent. The mean number of total food items (p < 0.006) and unhealthy food items (p < 0.001) available in food outlets differed by village size. The proportion of food outlets with available fruits, meat and poultry, water, and sugar-sweetened beverages also differed by village size (p < 0.001). (4) Conclusions: This study informs the global evidence gap in the current understanding of food environments in various ethnically diverse and dynamic LMICs, and the developed methodology will be useful to other LMICs for measuring and monitoring the food environment, especially among vulnerable population groups. This work complements current national and provincial survey efforts in Pakistan.

Assessment of Energy Expenditure of Police Officers Trained in Polish Police Schools and Police Training Centers

Knowledge of the energy expenditure related to the training of policemen allows for assessment of the intensity of the work performed and is an indispensable element of planning and implementing nutrition. This study on energy expenditure comprised a total of 280 persons, students of two Polish police schools and two police training centers. The energy expenditure of policemen was determined based on measurements of the heart rate using Polar RC3 GPS heart rate monitors. The energy expenditure of policemen associated with the training process in the police schools and training centers ranged from 1793 to 3043 kcal/8 h and amounted to 2314 ± 945 kcal/8 h during training on average. The values of energy expenditure related to a typical training day in Polish institutions conducting police training are diverse and depend on the specificity and nature of the training. According to the criteria for assessing the burden of work, the work performed by police officers can be classified as hard work and very hard work.

Adipose Stromal/Stem Cell-Derived Extracellular Vesicles: Potential Next-Generation Anti-Obesity Agents

Over the last decade, several compounds have been identified for the treatment of obesity. However, due to the complexity of the disease, many pharmacological interventions have raised concerns about their efficacy and safety. Therefore, it is important to discover new factors involved in the induction/progression of obesity. Adipose stromal/stem cells (ASCs), which are mostly isolated from subcutaneous adipose tissue, are the primary cells contributing to the expansion of fat mass. Like other cells, ASCs release nanoparticles known as extracellular vesicles (EVs), which are being actively studied for their potential applications in a variety of diseases. Here, we focused on the importance of the contribution of ASC-derived EVs in the regulation of metabolic processes. In addition, we outlined the advantages/disadvantages of the use of EVs as potential next-generation anti-obesity agents.