The Relationship Between Psychosocial Factors and Adherence to Treatment in Men, Premenopausal and Menopausal Women with Type 2 Diabetes Mellitus.

INTRODUCTION: Type 2 Diabetes Mellitus (T2DM) is a chronic disease that begins in adulthood, and is caused by multiple factors. The onset of menopause involves changes that predispose women to the development of T2DM, which can worsen if the adherence to treatment is inadequate due to psychosocial factors or medications. The present study aims to describe the psychosocial factors that may affect adherence to treatment among men and premenopausal and menopausal women with T2DM. METHODS: This was a cross-sectional study of 96 patients with T2DM, who were divided into three groups: 1) men (n=32); 2) premenopausal women (n=32); and 3) menopausal women (n=32). Somatometric and metabolic control data were obtained. Adherence to treatment and psychosocial factors were evaluated: social support, belief in conventional medicine, disease denial, and depressive symptoms. RESULTS: Adherence to medication had a negative correlation with depressive symptoms in men (p <0.001) and menopausal women (p <0.021). Dietary adherence had a positive correlation with belief in conventional medicine in men (p <0.037) and premenopausal women (p <0.029). CONCLUSION: Medication adherence in men and menopausal women was correlated with fewer depressive symptoms. Adherence to diet in men and premenopausal women was correlated with greater belief in conventional medicine. The results show the diversity of psychosocial factors among the groups that must be addressed in order to improve adherence.

Validation of the Questionnaire "Stage of Change in Behavior of Scholars in Eating Habits and Physical Activity" (CEHAF) / Validación del cuestionario "Etapa de cambio del comportamiento de los escolares en hábitos alimentarios y actividad física" (CEHAF)

Abstract To validate the questionnaire "Stage of Change in Behavior of Scholars in Eating Habits and Physical Activity" (CEHAF). It is based on the Transtheoretical Model, and it intends to be a useful tool for developing strategies against childhood obesity. It measures knowledge, attitudes, and habits towards nutrition and physical activity. Observational, cross-sectional, randomized, and multi-center study in a sample of 1671 Mexican school-age children, from 8 to 12 years old, both genders. The CEHAF questionnaire is self-administered and consists of 35 questions, including 18 multiple choices, on habits and attitudes towards alimentation and physical activity. Reliability analysis through Cronbach's alpha resulted in an alpha coefficient of 0.845. The exploratory factor analysis revealed three theoretically-congruent factors. The final version of the CEHAF questionnaire was conformed of 14 items. The psychometric characteristics of the CEHAF questionnaire indicate that it is a valid and reliable tool for assessing the stage of change in school-age population.

Resumen Validar el cuestionario "Etapa de cambio del comportamiento de escolares en hábitos alimentarios y actividad física" (CEHAF), el cual está basado en el modelo transteórico, y pretende ser una herramienta útil para desarrollar estrategias para combatir la obesidad infantil. Dicha herramienta mide conocimientos, actitudes y hábitos sobre nutrición y actividad física. Estudio observacional, transversal y aleatorizado en una muestra de 1671 estudiantes mexicanos, de 8 a 12 años de edad, ambos sexos. El cuestionario CEHAF es auto-administrado y se conforma por 35 preguntas, incluyendo 18 de opción multiple, sobre hábitos de alimentación y actividad física. Resultados: El análisis de confiabilidad mediante alfa de Cronbach resultó en un coeficiente alfa de 0.845. El análisis factorial exploratorio reveló tres factores teóricamente congruentes. La versión final del cuestionario CEHAF estuvo compuesta de 14 items. Las características psicométricas del cuestionario CEHAF lo vuelven una herramienta válida y confiable para evaluar la etapa de cambio en estudiantes de escuela primaria.

Dietary Advanced Glycation End Products and Cardiometabolic Risk.

PURPOSE OF REVIEW: This report analyzes emerging evidence about the role of dietary advanced glycation end products (AGEs) as a cardiometabolic risk factor. Two important aspects are discussed: First, the modulation of AGE load by dietary AGEs; second, if the evidence of clinical and observational studies is enough to make dietary recommendations towards lowering AGE intake. RECENT FINDINGS: Clinical studies in subjects with diabetes mellitus have shown that high intake of dietary AGEs increases inflammation markers, oxidative stress, and could impair endothelial function. In subjects at risk for cardiometabolic diseases (with overweight, obesity, or prediabetes), dietary AGE restriction decreases some inflammatory molecules and improves insulin sensitivity. However, studies in healthy subjects are limited, and not all of the studies have shown a decrease in circulating AGEs. Therefore, it is still unclear if dietary AGEs represent a health concern for people potentially at risk for cardiometabolic diseases. The evidence shows that dietary AGEs are bioavailable and absorbed, and the rate of excretion depends on dietary intake. The metabolic fate of most dietary AGEs remains unknown. Regardless, most studies have shown that by diminishing AGE intake, circulating levels will also decrease. Thus, dietary AGEs can modulate the AGE load at least in patients with DM, overweight, or obesity. Studies with specific clinical outcomes and large-scale observational studies are needed for a better risk assessment of dietary AGEs and to establish dietary recommendations accordingly.

Effect of an advanced glycation end product-restricted diet and exercise on metabolic parameters in adult overweight men.

OBJECTIVES: The aim of this study was to review the effect of a low advanced glycation end product (AGEs) diet, exercise, and a combination of both on circulating AGE levels as well as on plasma lipids and anthropometric parameters. METHODS: Forty-three overweight or obese men (body mass index [BMI] >25 kg/m(2)), 30 to 55 y, participated in a 12-wk study and were randomly assigned to one of three groups: low AGE diet, exercise with habitual food intake, or exercise plus low AGE diet. Exercise was for 45 min at 65% to 75% of their maximum heart rate three times a week. We measured somatometric variables (BMI and waist circumference), blood glucose, lipids, and serum AGEs (N(ε)-[Carboxymethyl]Lysine [CML] and methylglyoxal [MG]) at baseline and at 12 wk. RESULTS: Exercise alone was associated with decreased somatometric variables; the low AGE diet had the same effects and decreased serum CML and MG and when combined with exercise reproduced all these effects, but also decreased triacylglycerols and increased high-density lipoprotein. Correlation analysis showed that both changes of CML and MG correlated with changes in dietary AGEs (P < 0.020 and P < 0.038, respectively); change in maximum oxygen consumption correlated inversely with change in weight and triacylglycerols. Regression analyses, including change in dietary AGEs and in dietary calories, showed that change in dietary AGEs was the independent determinant of change in CML (P < 0.020) and MG (P < 0.038). CONCLUSIONS: An AGE-restricted diet reduces serum AGE and indices of body fat. The addition of exercise to the restricted diet has the same effects but also improves lipid profile.

[Contributions of proteomics in the study of diabetes]. / Aportaciones de la proteómica en el estudio de la diabetes.

The incidence of type 2 diabetes mellitus (T2D) is growing rapidly due to aging, urbanization, changes in lifestyle, and increasing prevalence of obesity. In T2D, chronic hyperglycemia leads to macro and micro vascular complications, which currently are serious problem for health systems worldwide. The complexity of T2D and its complications requires study skills of high performance that provide important information in the understanding of the pathophysiology of the disease and biological pathways involved in development of T2D and its complications. In this work we describe the recent contributions of proteomics in the study of T2D and discuss its importance in the identification of therapeutic targets and biomarkers that help to improve the diagnosis of T2D, monitor the disease progression, and the development of new drugs to improve treatment and reduce its complications.

[Aerobic 12-week training reduces cardiovascular risk factors in overweight teenagers]. / El entrenamiento aeróbico de 12 semanas reduce los factores de riesgo cardiovascular en adolescentes con exceso de peso.

BACKGROUND: Obesity and low cardiorespiratory fitness are risk factors for cardiovascular diseases and type 2 diabetes. AIM: To examine changes in cardiorespiratory fitness and cardiovascular risk factors after an exercise program without any dietary change in sedentary overweight teenagers. METHODS: Fifteen obese young males (15.5 ± 0.8 years, 31.5 BMI ± 5.9 kg/m2) participated in this study. Subjects underwent anthropometric and metabolic measurements, peak oxygen consumption (VO2peak), and lipid profile before and after training. Exercise training consisted of treadmill exercise at 70-80% of heart rate maximal (HRmax) during 50 min, 3 days/week for 12 weeks. Before and after training 24-hour recall was recorded and caloric intake was calculated. RESULTS: Participants did not change their dietary habits during the intervention. Aerobic training diminished the abdominal circumference (p < 0.05), body fat percentage (p < 0.01), and increased VO2peak (p < 0.001). No significant change in body weight, lipid profile, or blood glucose was observed after training. CONCLUSION: Our study shows that 12 weeks of aerobic training improved cardiorespiratory fitness and decreased body fat percentage in overweight male teenagers.

Knowledge, attitudes, and behavior concerning nutrition and physical activity in Mexican children.

OBJECTIVE: To identify the stages of behavior change and the knowledge, attitudes, and habits concerning nutrition and physical activity in Mexican children. METHODS: A survey was applied to 48 children from 10 years old to obtain data. Stages of behavior change were classified according to the transtheoretical model. RESULTS: For food habits, 31% were in precontemplation, 17% in contemplation, 10% in preparation, 40% in action, and 2% in maintenance. For physical activity, 12% were in precontemplation, 15% in contemplation, 29% in preparation, 42% in action, and 2% in maintenance. CONCLUSIONS: It is important to consider the stages of behavior change to plan strategies of educational models.

[Acute responses on lipid profile by practicing cycling]. / Acondicionamiento físico y respuesta aguda en la concentración de lípidos séricos. La práctica de ciclismo fijo.

BACKGROUND: it has been demonstrated an association between the increase in physical activity and improvements in the lipid profile. OBJECTIVE: to evaluate changes in the serum lipids caused by spinning practice. METHODS: nine men and twelve women were studied, they underwent to an initial evaluation that included a treadmill effort test, in order to establish the physical fitness level. With the purpose of determine the lipids change, a blood sample was obtained before and after a typical spinning session. The design was prospective, experimental, longitudinal and comparative study. Student's t-test and regression model were used to determine the changes in the lipids concentrations, and its relation with the physical fitness level. A p value < or = 0.05 was required for statistical significance. RESULTS: lipids increase concentrations were observed (p < 0.05), except at triglycerides in men, in which it had a decrease. It was statistically significant relation between the physical fitness level and the percentage of high-density lipoproteins variation (r = 0.44, p = 0.046). CONCLUSIONS: the percentage of high-density lipoproteins variation was greater when the values of VO(2)max were higher. At greater level of medical fitness greater positive answer in this lipoproteins. In the case of the rest serum lipids, it was not observed relation between the level of medical fitness and the percentage of variation due to the execution of the spinning session.