Prevalence of type 2 diabetes mellitus in a representative sample of Greek adults and its association with modifiable risk factors: results from the Hellenic National Nutrition and Health Survey.

OBJECTIVE: Diabetes mellitus is a disease associated with many complications leading to premature death. The aim of this study was to estimate prevalence of type 2 diabetes (T2D), and the proportion of the population unaware of the condition, in association with modifiable risk factors. STUDY DESIGN: Data from the Hellenic National Nutrition and Health Survey were used (n = 3773 adults, 40.8% men) and were obtained by trained personnel. METHODS: Diabetes mellitus disease status was categorized as per the International Classification of Diseases codes (10th version). A subsample from the two main metropolitan areas was used to assess T2D and impaired fasting glucose (IFG) (n = 990; 38.2% men) from plasma analysis. RESULTS: The prevalence of T2D in the population was 5.2% in total, reaching 13.7% in adults aged >60 years (no sex differences). IFG was observed in 27.3% of adults in the two metropolitan areas, and 40% were unaware of having T2D in this subsample. The likelihood of having T2D significantly increased with age and body weight, whereas it decreased with higher educational level and physical activity (P for all <0.001). CONCLUSION: The high T2D prevalence in adults, especially among the older age-groups, suggests a major public health problem in Greece.

Dietary patterns and lifestyle characteristics in adults: results from the Hellenic National Nutrition and Health Survey (HNNHS).

OBJECTIVES: The objective of this study was to identify and describe different dietary patterns in a nationally representative sample of Greek adults and to assess potential associations with lifestyle characteristics. STUDY DESIGN: This was a cross-sectional study. METHODS: Dietary patterns were derived by principal component analysis using individual dietary data (24-h recall) of 3552 participants of the Hellenic National Nutrition and Health Survey (HNNHS). Analysis of variance and chi-squared test were used to determine the lifestyle characteristics of the participants following each pattern. RESULTS: Three dietary patterns were identified explaining 16.5% of variance; a traditional pattern, loading positively on olive oil, non-starchy vegetables, and cheese; a Western pattern, loading positively on refined grains, processed meats, and animal fats; and a prudent pattern, loading positively on fruits, whole grains, and yoghurt and negatively on fast food. A fourth, snack-type pattern, loading positively on sweets, salty snacks, and nuts, was identified in women. Primary crude results revealed an association between dietary patterns and socio-economic status. In multivariate analysis, highest adherence to the prudent pattern was associated with higher protein and unsaturated fat intake and lower energy and saturated fat intake (all P ≤ 0.05); the Western and traditional patterns were associated with higher energy and total and saturated fat intake. The traditional pattern was additionally associated with higher monounsaturated fatty acids intake, whereas the Western pattern, with higher alcohol intake (all P ≤ 0.001). CONCLUSIONS: These findings are valuable for understanding the dietary behaviors of adults in Greece and enabling more focused public health policies for the promotion of healthier food behaviors in the future.

Effectiveness and easiness of adherence to behavioural guidelines for diet and lifestyle changes for cholesterol-lowering: the Increasing Adherence of Consumers to Diet & Lifestyle Changes to Lower (LDL) Cholesterol (ACT) randomised controlled trial.

BACKGROUND: The present study aimed to assess perceived effectiveness and easiness of behavioural diet and lifestyle changes related to dyslipidaemia given by physicians or dieticians as a result of diet and lifestyle modifications being difficult to maintain. METHODS: One-hundred hypercholesterolaemic individuals were enrolled in a parallel, randomised 6-week study. Fifty were advised by dietitians (dietitian group: DG) in six weekly face-to-face behavioural therapy sessions and 50 received standard advice from physicians (physician group: PG). All individuals were followed-up for another 6 weeks under real-life conditions. Questionnaires regarding perceived effectiveness, easiness of adhering, forecasted and actual adherence to specific cholesterol-lowering advice were completed. RESULTS: Scores of perceived effectiveness of advice for sufficient exercise, limiting saturated fat (SFA) intake, eating fish twice a week, consuming plenty of fresh fruit and vegetables, and limiting salt intake different scientifically (all P < 0.05) in PG and DG between study phases. Scores of the individuals' perception of effectiveness at all study phases were higher in the DG compared to PG for sufficient exercise, limiting SFA intake, eating fish twice a week, eating plenty of fruits and vegetables, and limiting salt intake, whereas scores of easiness were significant only for fish consumption (P = 0.008) and using foods with added plant sterols (all P < 0.05). DG and PG significantly differed in forecasted (week 6) versus actual adherence (week 12) to various chances, with DG reporting higher adherence. CONCLUSIONS: Lifestyle and dietary changes related to dyslipidaemia can be achieved with continuous education, monitoring and follow-ups by dieticians, as well as potentially other trained healthcare professionals.

Association of meal and snack patterns with micronutrient intakes among Greek children and adolescents: data from the Hellenic National Nutrition and Health Survey.

BACKGROUND: The present study aimed to examine how different meal and snack patterns are associated with micronutrient intakes and diet quality among a nationally representative sample of Greek children and adolescents aged 1-19 years from the cross-sectional Hellenic National Nutrition and Health Survey (n = 598). METHODS: Meal and snack patterns were derived using 24-h dietary recalls. Mean adequacy ratio (MAR) was used as an overall measure of diet quality. Multiple linear regression adjusted for covariates was conducted to examine associations between eating patterns, nutrient intakes and MAR. RESULTS: Four most frequently reported eating schemes were identified including breakfast (B), lunch (L), dinner (D) and two snacks (S) (20.9%); B, L, D and 1S (16.2%); B, L, D and 3S (10.8%); and B, L and D (7.9%). Based on these schemes, the daily consumption of all main meals from the majority of the sample was highlighted. In children and adolescents aged 4-19 years, increasing snack frequency was positively associated with intakes of vitamin D, vitamin K, riboflavin, niacin, pantothenic acid, folate, magnesium, copper and selenium. An inverse association was recorded for vitamin E, vitamin B6 , calcium and iron. Among children aged 1-3 years, only niacin and copper were significantly associated with number of snacks, with the group of 'B-L-D-2S' presenting the highest intake. As for the overall diet quality, among all participants, there was no significant association of MAR with the type of meal and snack pattern, and thus the snack frequency. CONCLUSIONS: Snacking behaviour is a common practice among children and adolescents. Modifying current snack foods with nutrient-rich choices could lead to an improvement of their diet's nutritional quality.

Structured advice provided by a dietitian increases adherence of consumers to diet and lifestyle changes and lowers blood low-density lipoprotein (LDL)-cholesterol: the Increasing Adherence of Consumers to Diet & Lifestyle Changes to Lower (LDL) Cholesterol (ACT) randomised controlled trial.

BACKGROUND: Evidence from healthcare professionals suggest that consumer compliance to healthy diet and lifestyle changes is often poor. The present study investigated the effect of advice provided by a physician or dietitian on consumer adherence to these measures combined with consuming foods with added plant sterols (PS) with the aim of lowering low-density lipoprotein cholesterol (LDL-C). METHODS: One hundred mildly-to-moderately hypercholesterolaemic individuals were enrolled into a parallel, randomised, placebo-controlled study. Dietitians (dietitian group; DG) advised 50 individuals in six weekly face-to-face behavioural therapy sessions, whereas the other 50 received standard advice from physicians (physician group, PG). Both groups consumed foods with added PS (three servings a day) for 6 weeks. Subsequently, all individuals were followed-up for another 6 weeks under real-life conditions. Blood lipids were measured at baseline and weeks 6 and 12 and 3-day diet diaries were taken at weeks 1, 6 and 12. RESULTS: Individuals in the DG significantly improved their dietary habits, physical activity and increased PS intake compared to the PG. After 6 weeks, LDL-C decreased in both groups compared to baseline without any significant differences between groups. At week 12, LDL-C was further significantly improved only in the DG (P = 0.006) compared to week 6. Total cholesterol, LDL-C and triglycerides were significantly lower in the DG compared to the PG at week 12 after adjusting for levels at week 6 (P < 0.001, P < 0.001 and P = 0.009, respectively). CONCLUSIONS: Although structured counselling by dietitians and common standard advice by physicians were equally effective with respect to improving blood cholesterol after 6 weeks, dietitians were more effective in the longer-term (i.e. 6 weeks after the end of the intervention period).

Effect of meal frequency on glucose and insulin levels in women with polycystic ovary syndrome: a randomised trial.

BACKGROUND/OBJECTIVES: The aim of the study was to compare the effect of two-meal patterns (three vs six meals per day) on glucose and insulin levels in women with polycystic ovary syndrome (PCOS). SUBJECTS/METHODS: In a randomised, crossover, 24-week study, 40 women with PCOS, aged 27±6 years, body mass index 27±6 kg/m(2), followed a weight maintenance diet (% carbohydrates:protein:fat, 40:25:35), consumed either as a three- or a six-meal pattern, with each intervention lasting for 12 weeks. Anthropometric measurements, diet compliance and subjective hunger, satiety and desire to eat were assessed biweekly. All women underwent an oral glucose tolerance test (OGTT) with 75 g glucose for measurement of plasma glucose and insulin at the beginning and end of each intervention. HaemoglobinA1c (HbA1c), blood lipids and hepatic enzymes were measured at the beginning and end of each intervention. RESULTS: Body weight remained stable throughout the study. Six meals decreased significantly fasting insulin (P=0.014) and post-OGTT insulin sensitivity (Matsuda index, P=0.039) vs three meals. After incorporation of individual changes over time, with adjustment for potential confounders, the only variable that remained significant was the Matsuda index, which was then used in multivariate analysis and general linear models. Six meals improved post-OGTT insulin sensitivity independently of age and body weight vs three meals (P=0.012). No significant differences were found between six and three meals for glucose, HbA1c, blood lipids, hepatic enzymes, subjective desire to eat and satiety. CONCLUSIONS: Six meals had a more favourable effect on post-OGTT insulin sensitivity in women with PCOS compared with isocaloric three meals.

Newly derived children-based food index. An index that may detect childhood overweight and obesity.

A food index (FI) based on a priory knowledge was developed to assess the role of diet on overweight (OW) and obesity (OB) in school-aged children. This included «positive¼ and «negative¼ foods based on research evidence and food guidelines, with scores set accordingly. Statistical tests were used to strengthen the sensitivity of the index. The FI was validated using data from the GRECO study. The score ranged from 17 to 53.5 (mean 34.8 ± 5.01) and was inversely associated with body mass index (BMI) (-0.057 ± 0.02; 95% CI -0.098, -0.017) and waist circumference (WC) (-0.08 ± 0.03, 95% CI: -0.137, -0.022). Associations remained significant upon adjusting for age, gender and physical-inactivity (p = 0.02 ad 0.013, respectively). When stratified by gender, the association between FI and WC was not significant for boys (p = 0.08). The association with BMI remained significant for females and males (p = 0.047 and 0.037, respectively). The derived FI seems a valuable tool in detecting OW in children.

Hierarchical analysis of dietary, lifestyle and family environment risk factors for childhood obesity: the GRECO study.

BACKGROUND/OBJECTIVES: To facilitate the development of practical public health advice targeted at childhood obesity (OB) prevention and make the intervention programs more effective, one has to promote the most protective habits and limit or modify the risk factors. The objective of the present study was to recognize the most important dietary and physical activity habits, sedentary behaviors, plus parental influences that are associated with childhood overweight (OW) and OB, in a nationwide, cross-sectional sample of Greek school children. SUBJECTS/METHODS: Data from 4552 children (10-12 years old) and 2225 of their parents were included in the analysis. Direct anthropometric measurements and information on dietary and physical activity habits was obtained from the children, as was information on parental self-reported anthropometric values, perceptions and family environment information. RESULTS: Multiple logistic regression analysis revealed that the most important predictors of childhood OW/OB were breakfast frequency (odds ratio (OR): 0.95; 95% confidence interval (CI): 0.92-0.97), daily number of meals and snacks (OR: 0.92; 95% CI: 0.87-0.97), the frequency of family meals (OR: 0.86; 95% CI: 0.76-0.99), having both a TV and a PC/video game player in the bedroom (OR: 1.41; 95% CI: 1.18-1.69) and study hours on weekdays (OR: 1.07; 95% CI: 1.02-1.13). In the case of parents, mothers' age (OR: 0.91; 95% CI: 0.86-0.97), maternal (OR: 1.13; 95% CI: 1.06-1.21) and paternal (OR: 1.08; 95% CI: 1.02-1.15) body mass index (BMI) and children's BMI misclassification (OR: 6.22; 95% CI: 3.62-10.71) were significant predictors of children's OW/OB. CONCLUSIONS: These findings could guide future investigations or public health initiatives to prevent and confront the childhood OB epidemic more efficiently.

Evaluation of seasonality on total water intake, water loss and water balance in the general population in Greece.

BACKGROUND: Water balance is achieved when water intake from solid and fluid foods and drinking water meets water losses, mainly in sweat, urine and faeces. Seasonality, particularly in Mediterranean countries that have a hot summer, may affect water loss and consequently water balance. Water balance has not been estimated before on a population level and the effect of seasonality has not been evaluated. The present study aimed to compare water balance, intake and loss in summer and winter in a sample of the general population in Greece. METHODS: The Water Balance Questionnaire (WBQ) was used to evaluate water balance, estimating water intake and loss in summer (n = 480) and in winter (n = 412) on a stratified sample of the general population in Athens, Greece. RESULTS: In winter, mean (SD) water balance was -63 (1478) mL/day(-1) , mean (SD)water intake was 2892 (987) mL/day(-1) and mean (quartile range) water loss was 2637 (1810-3922) mL/day(-1) . In summer, mean (SD) water balance was -58 (2150) mL/day(-1) , mean (SD) water intake was 3875 (1373) mL/day(-1) and mean (quartile range) water loss was 3635 (2365-5258) mL/day(-1) . Water balance did not differ between summer and winter (P = 0.96); however, the data distribution was different; in summer, approximately 8% more participants were falling in the low and high water balance categories. Differences in water intake from different sources were identified (P < 0.05). CONCLUSIONS: Water balance in summer and winter was not different. However, water intake and loss were approximately 40% higher in summer than in winter. More people were falling in the low and high water balance categories in summer when comparing the distribution on water balance in winter.

Phytosterols supplementation decreases plasma small and dense LDL levels in metabolic syndrome patients on a westernized type diet.

BACKGROUND AND AIMS: Several studies have observed a hypocholesterolemic effect of plant sterols in hypercholesterolemic patients on a balanced diet. The aim of this study was to examine the effect of phytosterol supplementation on risk factors of coronary artery disease in metabolic syndrome patients on a Westernized type diet. METHODS AND RESULTS: In a randomized placebo-controlled design 108 patients with metabolic syndrome were assigned to consume either 2 plant sterol-enriched yogurt mini drink which provided 4 g phytosterols per day, or a yogurt beverage without phytosterols (control). The duration of the study was 2 months and the patients in both groups followed their habitual westernized type diet and recording it on food diaries. Blood samples were drawn at baseline and after 2 months of intervention. After 2 months supplementation with phytosterols, a significant reduction in total cholesterol, LDL-cholesterol, small and dense LDL (sdLDL) levels, as well as, apoB and triglycerides concentrations were observed in the intervention group (P < 0.05) compared to the control group. In addition, phytosterol supplementation lowered serum total cholesterol by 15.9%, LDL-cholesterol by 20.3% and triglyceride levels by 19.1% (P = 0.02, P < 0.001 and P < 0.001, respectively), although the patients kept their habitual westernized type diet. No differences were observed in HDL cholesterol, apoA1, glucose, C-reactive protein, fibrinogen levels and blood pressure. CONCLUSIONS: Phytosterol supplementation improves risk factors of coronary artery disease even if the diet is a westernized type.

Risk factors of obesity in a cohort of 1001 Cypriot adults: An epidemiological study.

BACKGROUND AND AIMS: To measure the prevalence of overweight and obesity in adults in the Republic of Cyprus, and to evaluate and relate possible obesity risk factors of the adult Cypriot population. METHODS: This is an epidemiological cross-sectional study on a stratified random sample of 1001 (48.5% males-51.5% females) subjects, aged 18-80 years old. Anthropometric, biochemical, and dietary/lifestyle characteristics included in the study. RESULTS: The prevalence of overweight (Ow) and obesity (Ob) was 46.9% and 28.8% for males and 26% and 27% for females, respectively. Overweight and obese subjects were found to have statistically significant higher levels of Body Mass Index (p<0.001), Waist circumference (p<0.001), Total serum cholesterol (p<0.001), Low density lipoprotein (p<0.005), Glucose (p<0.007) and Triglycerides (p<0.001) compared to normal peers. In addition, Ow and Ob participants consumed significantly lower levels of fruits and vegetables (p<0.001), exercised less time/d (p<0.001) and smoke more cigarettes/d (p<0.001), compared to normal subjects, respectively. In multiple regression analysis of factors associated with overweight and obesity, Waist Circumference (beta: 1.132, p<0.001), Glucose (beta: 0.892, p<0.045), alcohol consumption (beta: 0.563, p<0.001), and exercise levels (beta: -0.444, p<0.001), were the most significant ones. CONCLUSION: The prevalence of overweight and obesity is very high in Cypriot adults. The current study also revealed a significant positive relation of Ow and Ob with waist circumference, high blood glucose levels and increased consumption of alcohol and a negative one with decreased levels of exercise.

Nutritional risk as predictor for healthcare-associated infection among hospitalized elderly patients in the acute care setting.

BACKGROUND: Poor nutritional status is associated with high rates of healthcare-associated infections (HCAIs) among hospitalized elderly patients. Early recognition of patients at risk for HCAIs is important. The Geriatric Nutritional Risk Index (GNRI) is a screening tool able to predict nutrition-related complications. AIM: To examine the use of GNRI as a predictor of HCAIs in the acute care setting. METHODS: A total of 248 consecutive patients aged >65 years, admitted as emergencies to the medical ward of an acute care hospital, were enrolled. On admission, clinical and laboratory assessment, anthropometric measurements, performance status, and GNRI score estimation were performed. HCAIs were recorded during admission. FINDINGS: On admission, 53.8% of the patients were not at risk, 37.2% at low or medium risk and 8.9% at high risk for nutrition-related complications, as stratified by using the GNRI. During hospitalization 23.7% of the patients developed HCAIs. Patients with HCAIs had higher mortality (P < 0.001) and longer hospital stay (P < 0.001). In multivariate analysis, a performance status >1 [hazard ratio (HR): 2.08; 95% confidence interval (CI): 1.07-4.02; P = 0.03] and diabetes (HR: 2.57; 95% CI: 1.37-4.84; P = 0.003) were associated with increased risk for HCAIs, whereas GNRI score (per unit increase) had a protective effect (HR: 0.97; 95% CI: 0.95-0.99; P = 0.01). Well-nourished patients (GNRI >98) were significantly more likely to remain free from HCAIs during hospitalization (P = 0.003). CONCLUSION: GNRI can accurately stratify hospitalized elderly patients according to risk for developing HCAIs.

Adherence to the Mediterranean diet and albuminuria levels in Greek adolescents: data from the Leontio Lyceum ALbuminuria (3L study).

BACKGROUND/OBJECTIVES: Mediterranean diet has favorable effects on the cardiovascular system, whereas albuminuria is associated with atherosclerosis progression. The aim of the study was to assess the relationships of adherence rates to the Mediterranean diet with albumin to creatinine ratio (ACR), in a cohort of Greek adolescents who participated in the Leontio Lyceum ALbuminuria (3L) study. SUBJECTS/METHODS: In a total of 365 adolescents 12-17 years of age included in 3L study, ACR values were determined in a morning-spot urine. RESULTS: The Mediterranean diet Quality Index for children and adolescents (KIDMED) was estimated and accordingly subjects were divided into those with high (≥ 8), average (4-7) and low (≤ 3) score. Adolescents with low (n=153, 42%) compared with those with average (n=187, 51.2%) and high (n=25, 6.8%) KIDMED score were characterized by greater ACR values (22.4 vs 13.4 vs 12.1 mg/g, P<0.05) even after adjustment for confounders. In the total population, KIDMED score was related to body mass index (r=0.122, P=0.02), waist circumference (r=0.118, P=0.02), systolic blood pressure (BP) (r=0.119, P=0.023), whereas it was negatively associated with ACR (r=-0.111, P=0.041). Regarding ACR, it was associated with age (r=-0.11, P=0.044), male sex (r=0.16, P=0.003), body mass index (r=-0.131, P=0.016) and systolic BP (r=-0.144, P=0.008). CONCLUSIONS: Adolescents who adhere to the Mediterranean diet exhibit lower levels of albuminuria, independently of demographic and hemodynamic confounders. The inverse relation of KIDMED index with ACR suggests a close link of accelerated vascular damage reflected by albuminuria with low adherence to this favorable diet of the Mediterranean basin.

A high-protein low-fat diet is more effective in improving blood pressure and triglycerides in calorie-restricted obese individuals with newly diagnosed type 2 diabetes.

BACKGROUND/OBJECTIVES: There is controversy over dietary protein's effects on cardiovascular disease risk factors in diabetic subjects. It is unclear whether observed effects are due to increased protein or reduced carbohydrate content of the consumed diets. The aim of this study was to compare the effects of two diets differing in protein to fat ratios on cardiovascular disease risk factors. SUBJECTS/METHODS: A total of 17 obese (body mass index (BMI) ranging from 31 to 45 kg/m(2)) volunteers with type 2 diabetes (DM2), aged 46+/-3 years, consumed two diets, each for 4 weeks, with 3 weeks of washout period in a random, blind, crossover design. The diets were: (1) a high-protein low-fat diet (HP-LF, with 30% protein, 50% carbohydrates and 20% fat) and (2) a low-protein high-fat diet (LP-HF, with 15% protein, 50% carbohydrates and 35% fat). Their effects on fasting glycemic control, lipid levels and blood pressure, and on postprandial glucose and insulin responses after a standard test meal at the beginning and end of each dietary intervention were analyzed. RESULTS: Both diets were equally effective in promoting weight loss and fat loss and in improving fasting glycemic control, total cholesterol and low-density lipoprotein (LDL) cholesterol, but the HP-LF diet decreased to a greater extent triglyceride (TG) levels (P=0.04) when compared with the LP-HF diet. HP-LF diet improved significantly both systolic and diastolic blood pressure when compared with the LP-HF diet (P<0.001 and P<0.001, respectively). No differences were observed in postprandial glucose and insulin responses. CONCLUSIONS: A protein to fat ratio of 1.5 in diets significantly improves blood pressure and TG concentrations in obese individuals with DM2.

A high protein low fat meal does not influence glucose and insulin responses in obese individuals with or without type 2 diabetes.

BACKGROUND: When substituted for carbohydrate in a meal, dietary protein enhances glycaemic control in subjects with type 2 diabetes (DM2). It is unknown whether the effect is a result of increased protein or reduced carbohydrate. The present study aimed to compare the effects of two meals differing in protein to fat ratios on post-prandial glucose and insulin responses. METHODS: This was a crossover, blind study in which obese subjects with (n = 23) and without (n = 26) DM2 consumed two meals in random order with equal amounts of energy (3.1 MJ, 741 kcal), fibre and carbohydrates and a 1-week washout period. Meals were a high protein, low fat (30% protein, 51% carbohydrates, 19% fat) meal and a low protein, high fat (15% protein, 51% carbohydrates, 34% fat) meal. Subjects were matched for age and body mass index. Plasma glucose and insulin were measured at fasting, 30, 60, 90, 120 min post-prandially. Insulin resistance and insulin sensitivity were assessed. RESULTS: There was no significant meal effect on glucose and insulin responses within groups. Glucose response was higher in diabetic (120 min 11 +/- 0.7 mmol L(-1)) compared to nondiabetic (120 min 5 +/- 0.2; P < 0.001) subjects. Diabetic subjects had significantly higher insulin resistance (P < 0.001) and lower insulin sensitivity (P < 0.001) than nondiabetics. Although peak insulin levels, 60 min post-prandially, did not differ between groups (81 +/- 9 pmol L(-1) for diabetic versus 79 +/- 7 pmol L(-1) for nondiabetic subjects), they were achieved much later, 90 min post-prandially, in diabetic, (99 +/- 8 pmol L(-1)) compared to nondiabetic (63 +/- 7 pmol L(-1), P = 0.002) subjects. CONCLUSIONS: Manipulating protein to fat ratio in meals does not affect post-prandial plasma blood glucose or insulin responses in obese people with and without DM2.

Erythrocyte fatty acid composition and insulin sensitivity in daughters of Type 2 diabetic patients and women with no family history of diabetes.

BACKGROUND: There is evidence that the impact of environmental factors on insulin sensitivity is modified by the presence of family history of diabetes. AIM: To compare the association between the erythrocyte phospholipid fatty acid composition (a biomarker of dietary fatty acids) and insulin sensitivity in daughters of Type 2 diabetic patients with the corresponding association in women without family history of diabetes. MATERIAL/SUBJECTS AND METHODS: Eighteen offspring of Type 2 diabetic patients [age 30+/-6.5 yr; body mass index (BMI) 22.2+/-2.5 kg/m2; body fat 31.8+/-5.1%] and 18 matched women (age 30.1+/-6.8 yr; BMI 22.2+/-1.8 kg/m2; body fat 32.2+/-6.0%) participated in the study. RESULTS: Insulin Sensitivity Index (ISI)-Matsuda tended to be lower (p=0.06) in the Offspring than the control group. Weight proportions of erythrocyte phospholipid saturated (SFA), polyunsaturated (PUFA), and monounsaturated fatty acids (MUFA) were similar between the two groups. In the offspring, erythrocyte total SFA were negatively correlated with ISI-Matsuda [r=-0.47, p<0.05), ISI(gly)-Belfiore (r=-0.52, p<0.05) and ISI(ffa)-Belfiore (r=-0.53, p<0.05)], whereas total PUFA were positively correlated with insulin sensitivity [ISI-Matsuda, r=0.46, p<0.05; ISI(gly)-Belfiore, r=0.53, p<0.05; ISI(ffa)-Belfiore, r=0.54, p<0.05]. No significant correlations were observed in the control group. CONCLUSIONS: The associations between erythrocyte fatty acid composition and insulin sensitivity are distinct between daughters of Type 2 diabetic patients and women without family history of diabetes.

Effects of red wine on endothelial function: postprandial studies vs clinical trials.

AIMS: There are several epidemiological studies suggesting that moderate daily consumption of red wine may reduce cardiovascular risk. Additionally, results from a great number of in vitro studies indicate that constituents found in red wine are responsible for quite a few beneficial effects on endothelial cells. However, comparison of postprandial studies and clinical trials concerning red wine consumption leads to controversial results about its effect on endothelial function and especially flow-mediated dilatation (FMD). Endothelial function is an early indicator of atherosclerosis and vessel damage and at the same time, it is an independent prognostic factor for cardiovascular risk. Therefore, it is very important to investigate the known acute postprandial effects of red wine consumption, which is highly advised by dieticians and doctors, especially in high-risk populations, such as patients with coronary artery disease (CAD). DATA SYNTHESIS: This is a review of studies investigating acute and short-term effects of red wine on endothelial function, as well as relevant in vitro studies. CONCLUSION: Analysis of all data about the acute effects of red wine constituents on endothelial function, is inconclusive and it is obvious that new studies are necessary in order to elucidate this matter. Undoubtedly, one should be very careful in suggesting red wine consumption in high-risk populations, as its acute postprandial effect is not yet clear.

Dietary supplementation with flaxseed oil lowers blood pressure in dyslipidaemic patients.

OBJECTIVE: Alpha-linolenic acid (ALA) is the natural precursor of the cardioprotective long-chain n-3 fatty acids. Available data indicate a possible beneficial effect of ALA on cardiovascular disease (CVD), but the response of various CVD risk factors to increased ALA intake is not well characterized. The purpose of the present study was to examine the effect of increased ALA intake on blood pressure in man. DESIGN, SETTING, SUBJECTS AND INTERVENTIONS: We used a prospective, two-group, parallel-arm design to examine the effect of a 12-week dietary supplementation with flaxseed oil, rich in ALA (8 g/day), on blood pressure in middle-aged dyslipidaemic men (n=59). The diet of the control group was supplemented with safflower oil, containing the equivalent n-6 fatty acid (11 g/day linoleic acid (LA); n=28). Arterial blood pressure was measured at the beginning and at the end of the dietary intervention period. RESULTS: Supplementation with ALA resulted in significantly lower systolic and diastolic blood pressure levels compared with LA (P=0.016 and P=0.011, respectively, from analysis of variance (ANOVA) for repeated measures). CONCLUSIONS: We observed a hypotensive effect of ALA, which may constitute another mechanism accounting in part for the apparent cardioprotective effect of this n-3 fatty acid.

Nutrition and inflammatory load.

Chronic inflammation has been suggested to play an important role in metabolic diseases, such as atherothrombosis and type 2 diabetes. A lot of research has focused on the immunomodulatory effects of several nutrients, such as fatty acids, antioxidants, carbohydrates, specific amino acids, micronutrients, and alcohol, which play a crucial role in the maintenance of an "optimal" immune response. In addition, specific dietary patterns, such as the Mediterranean diet, are evolving as protective against cardiovascular disease, because of their anti-inflammatory properties. In this article, the existing data concerning the nutrients' pro- and anti-inflammatory properties are presented, as well as dietary patterns that could protect from chronic inflammation and its metabolic and atherothrombotic complications.