Assessment of the Dietary Intake Changes in Patients with Head and Neck Cancer Treated with Radical Radiotherapy.

BACKGROUND: Patients during radiotherapy due to head and neck cancers experience a lot of side effects which may have a considerable impact on the patients' ability to meet individual daily energy demands by means of oral diet. METHODS: The study included 104 head and neck cancer patients who qualified for radical radiotherapy. Radical treatment takes 6 weeks and every week the patients were assessed for dietary intake. The subjects were covered with the constant care of a dietician, received FSMP (food for special medical purposes), and, if necessary, enteral nutrition. RESULTS: In the first week of treatment, the patients, from the kitchen diet alone, met 91.5% of the energy demand, while in the last week of treatment, only 40.9%. After introducing the FSMP or enteral nutrition, the patients met 120% of the demand in the first week of therapy and 95% in the last week, respectively. The patients who followed the dietary recommendations were characterized by significantly lower weight loss (3.07 kg) compared to non-adherent patients (5.56 kg). CONCLUSIONS: The used therapy significantly contributed to decreasing nutritional intake in the subsequent weeks of treatment. On the other hand, incorporating FSMP in the diet and enteral nutrition with industrial diets significantly increased the fulfilled energy demand of patients.

Abdominal Obesity in Women with Polycystic Ovary Syndrome and Its Relationship with Diet, Physical Activity and Insulin Resistance: A Pilot Study.

Abdominal obesity is a common feature of women with polycystic ovary syndrome (PCOS), and it is known to exacerbate insulin resistance (IR). Improper dietary and physical activity patterns are crucial environmental factors involved in the development of obesity, and they can significantly influence the central deposition of adipose tissue. Therefore, in this cross-sectional study, we aimed to evaluate the relationship between abdominal adiposity (measured by VAT (visceral adipose tissue), SAT (subcutaneous adipose tissue), VAT/SAT ratio (visceral to subcutaneous fat ratio), and WHR (waist-to-hip ratio)) and the prevalence and odds ratios of IR (measured by the homeostatic model assessment of insulin resistance (HOMA-IR), the homeostatic model assessment-adiponectin (HOMA-AD) and leptin to adiponectin ratio (L/A ratio)) in 56 PCOS women. Furthermore, we investigated the relationship between these abdominal obesity indices and diet and physical activity. An original food frequency questionnaire and Actigraph GT3X-BT were used to assess adherence to the diet recommended in IR and the level of physical activity, respectively. We observed a higher prevalence of IR among women with higher VAT, VAT/SAT, and WHR values compared to women with normal values of those abdominal obesity indices. Moreover, VAT/SAT seemed to be the best predictor of IR measured by HOMA-IR and HOMA-AD. However, VAT appeared to be the best and strongest predictor of IR measured by the L/A ratio. We also observed that higher adherence to the diet recommended in IR and higher levels of vigorous physical activity were associated with lower values of central fat accumulation indices and a greater chance of their normal values. Our findings indicate that central obesity increases the odds of IR and supports the beneficial role of diet and physical activity in the management of abdominal obesity in PCOS women.

Physical Activity, Rather Than Diet, Is Linked to Lower Insulin Resistance in PCOS Women-A Case-Control Study.

Insulin resistance (IR) is a prominent feature of polycystic ovary syndrome (PCOS). The importance of lifestyle interventions in the management of PCOS is strongly highlighted and it is suggested that diet and physical activity may significantly influence insulin sensitivity. Therefore, we evaluated the link between diet and physical activity and various indices of insulin resistance, including adipokines secreted by the adipose tissue in 56 PCOS and 33 healthy control women. The original food frequency questionnaire and Actigraph GT3X-BT were used to assess the adherence to the diet recommended in IR and the level of physical activity, respectively. We observed that higher levels of physical activity were associated with lower HOMA-IR and a greater chance of its normal value in PCOS group. No such relationship was observed for other IR indices and adipokines or for the diet. However, we noted a strong correlation between HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) and HOMA-AD (Homeostatic Model Assessment-Adiponectin) in PCOS women. Additionally, when we used HOMA-AD we observed a higher prevalence of IR among PCOS women. Our study supports the beneficial role of physical activity in the management of insulin resistance in PCOS women. Moreover, our findings indicate that HOMA-AD may be a promising surrogate marker for insulin resistance assessment in women with PCOS.

Nutritional Status, Selected Nutrients Intake, and Metabolic Disorders in Bariatric Surgery Patients.

Bariatric surgery is the most effective treatment for obesity and its complications. However, failure to adhere to dietary recommendations can result in both unsatisfactory weight loss and metabolic disorders. The aim of this study was to evaluate the effects of bariatric surgery on the anthropometric parameters and selected nutrient intake. A total of 12 months postoperatively, percent excess weight loss (%EWL) was significantly higher after laparoscopic Roux-en-Y gastric bypass (LRYGB) than laparoscopic sleeve gastrectomy (LSG) and laparoscopic adjustable gastric banding (LAGB) (93.78% vs. 56.13% and 55.65%, p < 0.001). The same was true for waist-to-hip ratio (WHR) (p = 0.017) and waist-to-height ratio (WHtR) changes (p = 0.022). There was a significant decrease in total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels after RYGB. A significant decrease (p < 0.05) in daily intake was found for energy (4278.4 kcal vs. 1355.17 kcal), sucrose (122.23 g vs. 38.22 g), dietary fiber (30.90 g vs. 14.20 g), eicosapentaenoic fatty acid and docosahexaenoic acid (EPA+DHA) (142.46 mg vs. 52.90 mg) and % energy from fats (42.43% vs. 35.17%), saturated fatty acids (SAFAs) (19.96% vs. 14.11%) and alpha-linolenic fatty acid (ALA) (0.87% vs. 0.69%). Energy intake and energy % from fats positively correlated with body weight (BW), waist circumference (WC), WHR, and WHtR, and negatively with %EWL. The percentage of unsaturated fatty acids positively correlated with WC and WHR. Energy intake correlated positively with serum triglycerides (TGs) and energy % from fats and carbohydrates. Despite significant weight loss, the patient's diet deviated from recommendations and may have contributed to metabolic disorders.

Diet and selected elements of lifestyle in the Polish population before and during the COVID-19 pandemic - a population study.

INTRODUCTION AND OBJECTIVE: The COVID-19 pandemic led to the introduction of sanitary restrictions in many countries which necessitated numerous lifestyle changes, especially in the diet. The study aimed to compare the diet and selected lifestyle elements in the Polish population during the COVID-19 pandemic. MATERIAL AND METHODS: The study group consisted of 964 individuals: 482 before the COVID-19 pandemic (composed using the Propensity Score Matching method) and 482 during the pandemic. The National Health Programme 2017-2020 results were used. RESULTS: During the pandemic increased, e.g. the intake of: total lipids (78.4 g vs. 83 g; p<0.035), saturated fatty acids (SFA) (30.4 g vs. 32.3 g; p=0.01), sucrose (56.5 g vs. 64.6 g; p=0.0001), calcium (602.5 mg vs. 666.6 mg; p=0.004), and folate (261.6 mcg vs. 284.7 mcg; p=0.003). When nutrient densities of pre-Covid-19 and COVID-19 diets were compared, some differences were noted; per 1,000 kcal the amounts decreased of plant protein (13.7 g vs. 13.1 g; p=0.001), carbohydrates (130.8 g vs. 128.0 g; p=0.021), fibre (9.1 g vs. 8.4 g; p=0.000), sodium (1,968.6 mg vs. 1,824.2 mg; p=0.000); while the amounts increased of total lipids (35.9 g vs. 37.0 g; p=0.001), SFA (14.1 g vs. 14.7 g; p=0.003), and sucrose (26.4 g vs. 28.4 g; p=0.001). The COVID-19 pandemic had no effect on alcohol consumption, the number of smokers increased (from 131 to 169), sleep duration during weekdays, and the number of persons with low physical activity (182 vs. 245; p<0.001). CONCLUSIONS: Numerous unfavourable changes occurred in the diet and lifestyle during the COVID-19 pandemic, which may contribute to the exacerbation of health problems in the future. Nutrient density in the diet combined with well-designed consumer education may underlie the development of diet recommendations.

The Influence of Obesity on Nutrition and Physical Activity during COVID-19 Pandemic: A Case-Control Study.

Obesity is one of the important risk factors for a severe course of COVID-19. Maintaining a healthy body weight through diet and physical activity is a reasonable approach to preventing a SARS-CoV-2 infection or in alleviating its course. The goal of the study was to determine the influence of obesity on nutrition and physical activity during the COVID-19 pandemic. A total of 964 respondents, including 227 individuals with a body mass index (BMI) ≥30 kg/m2 were evaluated in this study. In the case of 482 respondents, including 105 individuals (21.8%) with BMI ≥ 30 kg/m2, the data were collected during the pandemic period from 1 June to 31 August 2020. The remaining 482 individuals were the "pre-pandemic" group, selected via propensity score matching (PSM) out of the 723 National Health Program study participants whose data was collected in 2017−2019. The evaluated dietary health factors were quantitatively similar in patients with BMI of either <30 kg/m2 or ≥30 kg/m2 and showed no significant changes during the pandemic. The diets of those who suffered from obesity prior to the pandemic showed the evaluated unhealthy nutritional factors to be less pronounced in comparison with those of individuals with BMI < 30 kg/m2. During the pandemic, the BMI ≥ 30 kg/m2 group showed a significant increase in the overall calorie intake (by 319 kcal; p = 0.001) and an increased consumption of total carbohydrates 299.3 ± 83.8 vs. 252.0 ± 101.5; p = 0.000), sucrose (51.7 ± 30.0 vs. 71.6 ± 49.9; p = 0.000), plant protein (26.3 ± 12.1 vs. 29.3 ± 8.3; p = 0.040), total fat (73.1 ± 42.6 vs. 84.9 ± 29.6; p = 0.011) and saturated fatty acids (29.5 ± 16.4 vs. 34.3 ± 13.9; p = 0.014) in comparison with the pre-pandemic period. The energy and nutritional value of the diets of BMI < 30 kg/m2 individuals did not change between the pre-pandemic and pandemic period. Before the pandemic, the level of leisure physical activity of the BMI ≥ 30 kg/m2 group was significantly lower than of those with BMI < 30 kg/m2. Such differences were not observed in the levels of physical activity at work or school. The pandemic did not alter the amount of physical activity either during leisure time or at work/school in individuals with BMI ≥ 30 kg/m2. However, respondents without obesity exercised significantly less during the pandemic than before. In conclusion, the pandemic altered the diets and levels of physical activity in the Polish population, with dietary changes observed in individuals with BMI ≥ 30 kg/m2 and changes in physical activity observed in those with BMI < 30 kg/m2.

The Influence of Diet on Ovulation Disorders in Women-A Narrative Review.

Female infertility is commonly due to ovulation disorders. They are mostly related to polycystic ovary syndrome, which is currently viewed as one of the most common endocrine disorders in women of reproductive age. Ovulation-related female fertility is influenced by multiple factors which may include: age, smoking cigarettes, stress, use of psychoactive substances, and physical activity. Moreover, diet-related factors play an important role in the regulation of ovulation. Dietary components that exert a positive influence on ovulation include: carbohydrate products with low glycemic index, plant protein, monounsaturated and polyunsaturated fatty acids, folic acid, vitamin D, antioxidants, and iron. A diet based on the structure of the Mediterranean diet also seems beneficial. Components that have a negative influence mostly include high glycemic index carbohydrates, large amounts of animal protein, saturated fatty acids, and trans fatty acids, which are typically found in the Western model of nutrition. Due to the paucity of studies that presented a direct link between nutrition and the risk of anovulatory infertility, this study aimed to summarize the most recent research on the influence of dietary factors on ovulation disorders and indicate the possibilities of future research.

GLIM-Defined Malnutrition in Patients with Head and Neck Cancer during the Qualification Visit for Home Enteral Nutrition.

Patients with head and neck cancer (HNC) present multiple symptoms that increase the risk of malnutrition. Nutritional care, including enteral nutrition (EN), plays a crucial role in the management of this group of patients. The aim of the study was to determine the Global Leadership Initiative on Malnutrition (GLIM)-based stages of malnutrition and the relationship with selected biochemical parameters during the home enteral nutrition (HEN) qualification visit of patients with HNC. The retrospective analysis involved 224 patients with HNC referred for HEN. The following parameters were evaluated: body mass index (BMI), percent weight loss, and laboratory tests (serum albumin, total serum protein, C-reactive protein (CRP), and total lymphocyte count (TLC)). Malnutrition was defined using GLIM-based criteria. The prevalence of malnutrition based on GLIM criteria was 93.75% (15.18% moderately malnourished, 78.57% severely malnourished). There was a positive correlation between malnutrition based on GLIM criteria, serum albumin, and CRP. In the model assessing the odds of severe malnutrition according to the criteria of GLIM, TLC and CRP had a statistically significant effect on the chance in the probability of qualifying a patient to the severe malnutrition group, but the strength of the results was weak. The prevalence of malnutrition in HNC patients enrolled to HEN is high and most of them are severely malnourished. This suggests that it is important to identify more efficiently patients with risk of malnutrition at an earlier stage. GLIM criteria for malnutrition can be easily applied in this group of patients, but the definition of inflammation criteria should be clarified.

Efficacy of the Nutritional Risk Index, Geriatric Nutritional Risk Index, BMI, and GLIM-Defined Malnutrition in Predicting Survival of Patients with Head and Neck Cancer Patients Qualified for Home Enteral Nutrition.

Malnutrition is a poor prognostic factor in cancer disease. In case of head and neck cancer, there are multiple disease symptoms and side effects of treatment that increase the risk of malnutrition. The aim of the study is to assess the association between nutritional status at the time of qualification for home enteral nutrition (HEN) and overall survival of patients with head and neck cancer (HNC), and assessment usefulness of selected nutritional indices as prognostic factors. The retrospective survival analysis involved 157 patients with HNC referred to HEN between January 2018 and October 2021. The nutritional status assessment was performed at the qualification for HEN visit. We have analyzed results of body mass index (BMI), Nutritional Risk Index (NRI) for patients <65 years, Geriatric Nutritional Risk Index (GNRI) for patients ≥65 years and malnutrition defined by Global Leadership Initiative on Malnutrition (GLIM). The mean patient survival was 44.7 weeks and the median was 23.9 weeks. Patients with low NRI and GNRI score had a higher risk of death (NRI: p = 0.0229; GNRI: p = 0.371). NRI, GNRI, and malnutrition defined by GLIM were superior to BMI as prognostic markers for survival. Results suggest that the use of NRI, GNRI, and GLIM criteria could provide useful prognostic information. The longer survival since the qualifying visit for home enteral nutrition suggests that nutritional management could be initiated earlier.

Validity and efficacy of diets used for preoperative weight reduction among patients qualified for bariatric surgery.

INTRODUCTION: Bariatric surgery is the most effective method of weight reduction among patients suffering from morbid obesity. Reduction of body weight before surgery is an important element. The aim of the study was to present the current knowledge on preoperative weight reduction and diet for this purpose. MATERIAL AND METHODS: To achieve the aims of the paper, articles available in the PubMed / MEDLINE database published in 2005-2020 were used, as well as the guidelines of societies such as Metabolic and Bariatric Surgery Chapter of the Association of Polish Surgeons, American Association of Clinical Endocrinologists, The Obesity Society and American Society for Metabolic & Bariatric Surgery, International Federation for Surgery of Obesity and Metabolic Disorders-European Chapter and European Association for the Study of Obesity. RESULTS: Studies show that even a modest reduction in weight in the early preoperative period facilitates surgery and reduces the number of complications. The available data do not support the effect of preoperative weight loss on increased postoperative weight loss. The use of balanced, energy-restricted diet in the preoperative period prepares the patient for changes in the way of nutrition, which improves the nutritional status of patient. Low calorie (LCD) or very low calorie (VLCD) diet can be an effective method of weight loss before surgery, however, this approach does not allow to modify eating habits. The use of a very low calorie ketogenic diet (VLCKD) remains under discussion. CONCLUSIONS: There is a need for large randomized trials to assess short and long term benefits of preoperative weight loss and methods of weight loss among patients qualified for bariatric surgery, also the standardization of nutritional management in the preoperative period.

The Influence of Nutrition on Adiponectin-A Narrative Review.

The adipose tissue is an active endocrine organ which synthesizes and secretes a variety of adipokines, including adiponectin with its anti-inflammatory properties. Its expression is influenced by numerous factors such as age, sex, body weight and adipose tissue content. However, dietary factors, i.e., diet structure and the percentage of individual nutrients and products, are very important modulators. Beneficial dietary habits are the Mediterranean diet, DASH diet, diet based on plant products and diet with reduced energy value. Moreover, the share of individual products and nutrients which increase the concentration of adiponectin is worth noting. This group may include monounsaturated fatty acids, polyunsaturated omega-3 fatty acids, dietary fiber, polyphenols, alcohol and milk products. Conversely, dietary ingredients which have a negative effect on the concentration of adiponectin are typical components of the Western diet: saturated fatty acids, trans fatty acids, monosaccharides and disaccharides, and red meat. Furthermore, a diet characterized by a high glycemic index such as a high-carbohydrate low-fat diet also seems to be unfavorable. Due to the fact that available knowledge should be systematized, this study aimed to summarize the most recent research on the influence of dietary factors on the concentration of adiponectin.

Hospital Malnutrition, Nutritional Risk Factors, and Elements of Nutritional Care in Europe: Comparison of Polish Results with All European Countries Participating in the nDay Survey.

NutritionDay (nDay) is a project established by the Medical University of Vienna and the European Society for Clinical Nutrition and Metabolism (ESPEN) to audit the nutritional status of hospitalized patients and nursing home residents. This study aimed to evaluate nDay data describing the prevalence of hospital malnutrition, nutritional risk factors, and elements of the nutritional care process implemented in hospital wards in 25 European countries and to compare the data derived from Poland with the data collected in all the European countries participating in the study. In total, 10,863 patients (European reference group: 10,863 participants including Poland: 498 participants) were involved in the study. The prevalence of malnutrition was identified on the basis of the ESPEN diagnostic criteria established in 2015, while the prevalence of nutritional risk factors was assessed by analyzing the following parameters: body mass index (BMI), score of Malnutrition Screening Tool (MST), recent weight loss, insufficient food intake, decreased appetite, increased number of drugs intake, reduced mobility, and poor self-reported health status. Malnutrition prevalence was 12.9% in patients from the European reference group and 9.4% in patients from Polish hospital wards (p < 0.05). However, the prevalence of some nutritional risk factors, i.e., recent weight loss, history of decreased food intake, and low actual food intake, were approximately four times more prevalent than diagnosed malnutrition (referring to approximately 40-50% of all participants). In comparison to the European reference group, the significant differences observed in Polish hospital wards concerned mainly dietitian's involvement in the process of treating malnutrition (16% vs. 57.2%; p < 0.001); supply of special diets (8% vs. 16.1%; p < 0.0001); provision of oral nutritional support (ONS) (3.8% vs. 12.2%; p < 0.0001); prescription of enteral/parenteral nutrition therapy to hospitalized patients (8.2% vs. 11.7%; p < 0.001); as well as recording patient weight performed at hospital admission (100% vs. 72.9%; p < 0.0001), weekly (20% vs. 41.4%; p < 0.05), and occasionally (0% vs. 9.2%). These results indicate that the prevalence of malnutrition and malnutrition risk factors in hospitalized patients in Poland was slightly lower than in the European reference group. However, some elements of the nutritional care process in Polish hospitals were found insufficient and demand more attention.

The Prevalence of Sarcopenic Obesity in Postmenopausal Women with a History of Breast Cancer Depending on Adopted Methodology - A Case-Control Study.

INTRODUCTION: Sarcopenic obesity (SO) is characterized as the cooccurrence of sarcopenia and obesity. It is associated with many adverse health consequences, also in oncological patients. The study aimed to assess the prevalence of SO in postmenopausal women with a history of breast cancer depending on adopted methodology. MATERIALS AND METHODS: The case-control study enrolled 103 women over the age of 50 with a history of breast cancer, including women who completed oncological treatment and had remained in remission for at least 5 years (group I, n=78) and women in whom the disease recurred (group II, n=25). The control group included women with no history of breast cancer (group III, n=73). RESULTS: In group II sarcopenia occurred significantly more commonly compared to both group I and the control group (for the skeletal muscle index (SMI) ≤29.20%: 13 (52%) in group II vs 16 (20.5%) in group I, p=0.004 and 3 (4.1%) in group III, p<0.001; for SMI ≤26.60%: 10 (40%) in group II vs 9 (11.5%) in group I, p=0.003 and 3 (4.1%) in group III, p<0.001; for SMI ≤33.87%: 17 (68%) in group II vs 21 (26.9%) in group I, p<0.001 and 5 (6.8%) in group III, p<0.001). Depending on the assessment criteria, SO was diagnosed in 0-11.5% of cases in group I, 0-40% of cases in group II and 0-4.1% in the control group. Intergroup differences were not statistically significant, irrespective of the adopted pair of diagnostic criteria. The highest detectability of SO was observed when SMI was combined with each of the diagnostic criteria for obesity used. DISCUSSION: SO diagnosis based on the percentage of fatty tissue mass in the body of >38% and SMI value were associated with a higher detection rate of SO in each study group, regardless of the adopted cut-off value. Similar results were obtained in each analyzed group when using the remaining diagnostic criteria for obesity and SMI value, regardless of the cut-off value.

Milk and Dairy Products and Their Impact on Carbohydrate Metabolism and Fertility-A Potential Role in the Diet of Women with Polycystic Ovary Syndrome.

Milk and dairy products are considered an important component of healthy and balanced diet and are deemed to exert a positive effect on human health. They appear to play a role in the prevention and treatment of carbohydrate balance disturbances. The products include numerous valuable components with a potential hypoglycemic activity, such as calcium, vitamin D, magnesium and probiotics. Multiple authors suggested that the consumption of dairy products was negatively associated with the risk of type 2 diabetes mellitus, insulin resistance and ovulation disorders. However, there are still numerous ambiguities concerning both the presumed protective role of dairy products in carbohydrate metabolism disorders, and the advantage of consuming low-fat dairy products over high-fat ones, especially in women with the risk of ovulation disorders. Therefore, this literature review aims at the presentation of the current state of knowledge concerning the relationship between dairy product consumption and the risk of insulin resistance, type 2 diabetes mellitus in women, and the potential effect on the course of polycystic ovary syndrome.

Influence of two different methods of nutrition education on the quality of life in children and adolescents with type 1 diabetes mellitus - a randomized study.

Background. Nutrition education is one of the most important factors determining the effectiveness of treatment and maintaining an adequate quality of life (QoL) in children and adolescents with type 1 diabetes.Material and Methods. A randomized single-blind study was conducted between October 2017 and April 2019 at the Children's Clinical Hospital in Warsaw. The study included 170 patients (aged 8-17) with at least 1-year history of type 1 diabetes, treated with insulin pumps. The participants were randomly divided into two groups: a control group (C) - traditional/ informative education methods, and an experimental group (E) - modern/interactive methods. PedsQL Diabetes Module 3.0 questionnaire was used in the assessment of the QoL. Total PedsQL score was the primary outcome. The secondary outcomes included the results obtained in five subscales of the questionnaire. The relationships between selected variables and changes in scores were also verified.Results. Data obtained from 136 patients were analyzed. In both groups no significant changes regarding total PedsQL were noted 6 months after the intervention. However, a significant reduction occurred as regards the scores of 'Communication' subscale in group C. Analyzing other determinants of the QoL, significant dependencies were observed between: the level of physical activity and a change in 'Diabetes symptoms' subscale, and the level of parents' education and a change in 'Treatment barriers' subscale.Conclusions. Both methods of nutrition education exerted a comparable influence on the total QoL. However, modern methods were more effective in terms of the improvement in the aspect of communication. Additionally, moderate physical activity and parents' tertiary education constituted valid determinants of various aspects of the QoL in children and adolescents with type 1 diabetes.

Interactive Nutrition Education Is More Effective in Terms of Improved Levels of Glycated Hemoglobin in Adolescent Patients with Poorly Controlled Type 1 Diabetes - A Randomized Study.

INTRODUCTION: Effectively conducted nutrition education is one of the key elements of the therapy of type 1 diabetes. The aim of the study was to compare the effectiveness of two methods of nutrition education. MATERIAL AND METHODS: A noninvasive interventional randomized single-blind study included 151 patients (13.7±2.2 years old) with poorly controlled type 1 diabetes, treated with the use of insulin pumps. The participants were randomly divided into two groups: a control group (C) in which informative education methods were used (a lecture) and an experimental group (E) in which interactive methods (quiz and multimedia application) were additionally applied. The concentration of glycated hemoglobin (HbA1c) was the primary outcome. The secondary outcomes were: standard deviation score-body mass index (SDS-BMI), standard deviation score-systolic blood pressure (SDS-SBP), standard deviation score-diastolic blood pressure (SDS-DBP), scores of Nutrition Knowledge Survey (NKS) and indices of healthy and unhealthy diet. RESULTS: A marked reduction in HbA1c concentrations was observed after 3 months in group E [-0.47% (-0.77; -0.17), P<0.01; P=0.038 for the intergroup difference]. The positive effect was no longer present after 6 months. No significant changes regarding HbA1c were noted in group C at any stage of the study. After 6 months, both groups obtained better results in one part of NKS ("Blood glucose response to food"): group C [0.41 (0.15; 0.66), P<0.01], group E [0.80 (0.52; 1.08), P<0.001; P=0.042 for the intergroup difference]. No statistically significant differences between groups were noted as regards the remaining parameters. CONCLUSION: Interactive nutrition education is more effective in terms of improved levels of HbA1c in children and adolescents with poorly controlled diabetes. However, an intensification of training frequency is recommended due to the transient effect of education.

Current and past adherence to the World Cancer Research Fund/American Institute for Cancer Research recommendations in survivors of breast cancer

Background: Breast cancer is the first in the structure of the incidence of neoplastic diseases in women, with the number of affected individuals becoming higher every year. The risk of breast cancer is influenced not only by genetic factors, but also by the lifestyle. Proper dietary habits, a high level of physical activity and normal body weight not only reduce the risk of developing a primary neoplastic lesion, but also a recurrence. In 2007 the World Cancer Research Fund (WCRF) and American Institute for Cancer Research (AICR) published their recommendations concerning lifestyle in the prophylaxis of neoplasms. Objective: The aim of the study was to assess whether the adherence to WCRF/AICR recommendations influenced the risk of developing breast cancer in women. Materials and methods: A case control study included 108 women aged over 50 with a history of breast cancer. The study group was divided into two subgroups: women who completed oncological treatment and experienced no recurrences for at least 5 years (group I, n=82) and women who had a recurrence (group II, n=26). The control group included women with no history of breast cancer (n=74). The adherence of lifestyle was assessed by assigning points for 8 WCRF/AICR recommendations. The results were compared in the study and control groups, both in all participants and separately in those who declared no changes in dietary habits after being diagnosed with breast cancer. Results: The adherence of lifestyle to WCRF/AICR recommendations was significantly lower in the group of women with a history of cancer compared to the control group. It was reported both in the study group as a whole (5.5 ± 1.34 vs 6.4 ± 1.48 points) and in those who declared no changes in dietary habits after being diagnosed with breast cancer (5.3 ± 1.24 vs 6.6 ± 1.38 points). The differences in the lifestyles of the participants with breast cancer and those in the control group were associated predominantly with the adherence to recommendations concerning appropriate physical activity, avoiding the consumption of sweetened drinks and limiting the consumption of processed and red meat. Conclusions: The results of the study confirmed the benefits of complying with WCRF/AICR recommendations in the prevention of breast cancer.

Dietary practices and nutritional status in survivors of breast cancer

Background: Wrong dietary practices and excessive body mass may not only influence the risk of primary breast cancer but also the risk of its recurrence. Objective: Evaluation of dietary practices and identification of nutritional factors which may influence the risk of tumor recurrence in women with prior breast cancer. Materials and methods: The case-control study involved 108 women aged 50 years and older with history of breast cancer who were divided into two categories: women after completed cancer treatment with no recurrence for minimum 5 years (group I, n=82) and women with diagnosed breast cancer recurrence (group II, n=26). A control group (n=74) constituted of subjects with no breast cancer diagnosis. In every subject anthropometric measurements were taken and dietary practices were evaluated by means of an original questionnaire. Results: Average BMI and hip circumference values were higher in the group II than in the group I. In both study groups the percentage of high WHR values was significantly higher than in the control group. Women with history of cancer consumed significantly fewer vegetable and fruit and more refined cereals, dairy products, meat and cold cuts than women in the control group. Group I responders more often declared implementation and maintenance of changes in their diet after diagnosis of cancer than women from group II. Subjects with cancer history consumed more alcohol and more often used supplements than females in the control group. Conclusion: Avoiding overweight and obesity along with following the principles of a healthy diet seems to reduce the risk of both breast cancer incidence and its recurrence.

Flavonoids intake among Polish and Spanish students.

BACKGROUND: Flavonoids are a group of bioactive compounds that are extensively found in foodstuffs of plant origin. Their regular consumption plays an important role in the prevention of degenerative diseases, particularly cardiovascular disease, and cancer. OBJECTIVE: The purpose of the study was to estimate dietary flavonoid intake among Polish and Spanish students and to establish the main dietary sources of flavonoids. MATERIAL AND METHODS: This study included 91 Polish and 60 Spanish students. Dietary data were collected using a food frequency questionnaire. The dietary USDA Database for the flavonoid content of selected foods was used to calculate daily and weekly flavonoid intakes by the subjects. RESULTS: The average flavonoid consumption in the Polish students was 801 mg/day, and in Spanish students 297 mg/day. Food categories such as beverages, vegetables and fruits were found to be significant sources of flavonoids, of which tea, oranges, orange juice, dried parsley and oregano were the main contributors among Polish students and oranges, tea, chick-peas, orange juice and dried parsley were the main sources of flavonoids among Spanish students. CONCLUSIONS: Flavonoid consumption in Polish students was more than two times higher than in Spanish students. Compared to other population studies consumption of flavonoids in both students groups was adequate.

Health outcomes of vitamin D. Part II. Role in prevention of diseases.

UNLABELLED: Apart from the classic role of vitamin D, its hormonal active form, calcitriol is also characterized by pleiotropic effects on various organs and tissues. For the last several years, many researchers have shown an association between deficiency of vitamin D and the risk of type 2 diabetes mellitus (T2DM). Recent investigations suggested the need of vitamin D supplementation in T2DM prevention. It was shown that vitamin D deficiency decreases insulin secretion. It was also observed that proper vitamin D supplementation may improve the ability of the cells of the islets of Langerhans to synthesize many proteins de novo and to convert proinsulin to insulin. Apart from regulating bone metabolism and also calcium and phosphate homeostasis, 1,25(OH)2D3 exerts antiproliferative and pro-differentiating effects on a wide variety of cell types. It also induces apoptosis of cancer cells and slows their proliferation. In a number of major studies the relationship between low vitamin D levels and increased risk of various cancers was observed. It concerns colorectal, lung, prostate, breast and ovarian cancer. It was observed that in patients with low serum vitamin D concentrations such disorders as ischemic heart disease, heart attack, stroke, cardiac arrhythmia, and hypertension were more frequent and mortality was significantly higher. These results led the researchers to consider vitamin D deficiency as a potential risk factor for cardiovascular diseases. The possible mechanism in the pathogenesis of cardiovascular diseases that may be related to low levels of vitamin D, is its adverse effect on the renin-angiotensin-aldosterone system (RAAS). Calcitriol is also an important determinant of muscle cell proliferation and differentiation, as well as inhibition of apoptosis. Vitamin D is synthesized in the skin. However, there are only a few food products that are rich in vitamin D3, e.g.: fish oils, fish and fortified-products, such as dairy products and margarines. Individuals who are vulnerable to vitamin D deficiency should be supplemented. KEY WORDS: vitamin D, diabetes mellitus, deficiency of vitamin D, cancer, cardiovascular diseases, muscle physiology.