Evaluación del consumo de macronutrientes y micronutrientes por individuos prediabéticos / Evaluation of consumption of macronutrients and micronutrients by pre-diabetic individuals

Resumen Introducción La alimentación es una importante estrategia para el control de la glucemia, así como para reducir/eliminar el riesgo del desarrollo de la diabetes. Objetivo Este artículo evaluó el consumo de macronutrientes y micronutrientes de individuos prediabéticos de Santa Cruz do Sul, RS, Brasil. Método El consumo de nutrientes se ha determinado en el programa DietWin® y la prevalencia de adecuación de los macronutrientes fue clasificada según la Sociedad Brasileña de Diabetes y la ingesta inadecuada de micronutrientes por la Dietary Reference Intake. Resultados Los prediabéticos presentaron consumo excesivo de proteínas y grasas totales (28,1% y 31,6%, respectivamente), así como de ácidos grasos saturados y colesterol (91,2% y 35,1%, respectivamente). La ingesta de fibras se presentó insuficiente en 93%. Considerando el consumo de micronutrientes, la vitamina D, el calcio y el selenio se presentaron con una insuficiencia de más del 80%. Conclusión La dieta habitual de individuos prediabéticos demuestra ser excesiva en proteínas y en grasas totales que, relacionado al consumo excesivo de ácidos grasos saturados y colesterol, puede aumentar el riesgo cardiovascular. Esto, junto a la ingestión pobre en fibras e inadecuada en algunos micronutrientes, tales como vitamina D, calcio y selenio pueden afectar el control de la glucemia de estos individuos.

Abstract: Background The diet is an important strategy for glycemic control as well as reducing/eliminating the risk of developing diabetes. Objective This article evaluated the consumption of macronutrients and micronutrients of pre-diabetic individuals from Santa Cruz do Sul, in the state of Rio Grande do Sul (RS), Brazil. Method The nutrients intake was determined in the DietWin® program and the evaluation of the prevalence of adequacy macronutrients was classified according to Guidelines of the Brazilian Society of Diabetes and the evaluation of inadequacy of the micronutrients intake by Dietary Reference Intake were used. Results The pre-diabetic individuals had excessive protein and total fat intake (28.1% and 31.6%, respectively), as well as saturated fatty acids and cholesterol (91.2% and 35.1%, respectively). The fibers intake in this population showed an inadequacy of 93.0%. Considering the micronutrients intakes, vitamin D, calcium and selenium presented an insufficiency greater than 80.0%. Conclusion The usual diet of pre-diabetic individuals showed to be excessive for proteins and total fats, which associated with excessive consumption of saturated fatty acids and cholesterol, can increase cardiovascular risk. This, coupled with inadequate consumption of some micronutrients such as vitamin D, calcium and selenium and low fiber can affect the control of glycemia in these individuals.

Factors associated with the consumption of fi ve daily servings of fruits and vegetables by students / Fatores associados ao consumo de cinco porções de frutas e hortaliças em escolares

ABSTRACT Objective To evaluate and associate the frequency of consumption of five daily servings of fruits and vegetables with socioeconomic and demographic factors of students in the city of Santa Cruz do Sul, Brazil. Methods A cross-sectional study with a sample stratified by clusters of 1,578 students aged 7 to 17 in the city of Santa Cruz do Sul (Rio Grande do Sul state), Brazil. Volunteers were asked whether they consumed five daily servings of fruits and vegetables. This consumption was classified as irregular or regular. Data regarding gender, age, socioeconomic status, domicile area, and information on the nutritional status of students were also collected. The prevalence ratio was calculated with a significance level of p<0.05. Results The consumption of at least five servings of fruits and vegetables per day was reported by 40.6% of students. The irregular consumption of fruits and vegetables was higher among students aged 10-12 (69.7%, p<0.001), boys (60.9%, p<0.001), and urban area residents (61.8%, p<0.001). There were no significant differences between the consumption of fruits and vegetables and the students' socioeconomic status (p=0.094), nor with their nutritional status (p=0.999). Conclusion The students presented an irregular consumption of fruits and vegetables in relation to the recommendations of five servings per day. However, age and domicile area, which were significantly associated with the consumption of fruits and vegetables, were not associated with their socioeconomic and nutritional status.

RESUMO Objetivo Avaliar e associar a frequência do consumo de 5 porções ao dia de frutas e hortaliças com fatores socioeconômicos e demográficos em escolares de Santa Cruz do Sul (Rio Grande do Sul), Brasil. Métodos Este foi um estudo transversal com uma amostra estratificada por conglomerados de 1.578 escolares, com idade entre 7 e 17 anos de Santa Cruz do Sul (Rio Grande do Sul), Brasil. O consumo 5 porções de frutas e hortaliças foi questionado e por conseguinte classificado em consumo irregular ou regular de frutas e hortaliças. Coletou-se também informações referentes ao sexo, a idade, condição socioeconômica, zona de domicílio, bem como informações sobre o estado nutricional dos escolares. A razão de prevalência foi calculada com nível de significância de p<0,05. Resultados O consumo de pelo menos 5 porções de frutas e hortaliças ao dia foi relatado por 40,6% dos escolares. O consumo irregular de frutas e hortaliças, em relação à recomendação, foi mais elevado entre os escolares com idade entre 10 e 12 anos (69,7%, p<0,001), entre os do sexo masculino (60,9%, p=0,077) e os residentes da zona urbana (61,8%, p<0,001). Não houve diferença significativa entre o consumo de frutas e hortaliças e a condição socioeconômica (p=0,094) nem com o estado nutricional (p=0,999). Conclusão Os escolares apresentaram consumo irregular de frutas e hortaliças em relação às recomendações de 5 porções ao dia. Entretanto, a idade e a zona de domicílio, que tiveram associação significativa em relação ao consumo de frutas e hortaliças, não mostraram estar associado a condição socioeconômica e ao estado nutricional.

Avaliação da ingestão de Vitamina D e Cálcio em indivíduos pré-diabéticos e sua relação com a estabilidade genômica / The ingestion of Vitamins D and Calcium in pre-diabetic people and its relationship with genomic stability

Avaliar a ingestão de vitamina D e cálcio em indivíduos pré-diabéticos e verificar sua relação com a estabilidade genômica. Estudo transversal, com 51 indivíduos pré-diabéticos. A ingestão de vitamina D e cálcio foi determinada no programa DietWin® e a avaliação da prevalência de inadequação dos nutrientes foi classificada de acordo com as recomendações das Dietary Reference Intakes (DRIs). O ensaio de citoma de micronúcleos com bloqueio de citocinese (CBMN) e o ensaio cometa foram utilizados para avaliar a estabilidade genômica. A prevalência de inadequação de vitamina D e cálcio foi de 94,1% e 86,3%, respectivamente. O consumo de vitamina D associou-se à ingestão de cálcio (r=0,66 e p<0,01) e ambos os micronutrientes se associaram com glicose de jejum (p<0,05). Em relação ao ensaio CBMN, o consumo de cálcio associou-se negativamente com a frequência de brotos nucleares (r=-0,30 e p=0,04). Dentre os pré-diabéticos avaliados existe alta prevalência de inadequação de vitamina D e cálcio. Além disso, ambos os nutrientes pouco influenciaram na instabilidade genômica, pois apenas o consumo insuficiente de cálcio mostrou estar relacionado com danos no DNA, aumentando a formação de brotos nucleares.

The ingestion of vitamins D and calcium in pre-diabetic people and its relationship with genomic stability are analyzed by a transversal study with 51 pre-diabetic people. The ingestion of vitamins D and calcium was determined in the DietWin® program and the evaluation of the prevalence of nutrient inadequacy was classified according to recommendations by Dietary Reference Intakes (DRIs). Assay on micronucleus cytome with cytokinesis blockage (CBMN) and comet assay evaluated genomic stability. Inadequacy prevalence of vitamins D and calcium was 94.1% and 86.3%, respectively. The intake of vitamin D is associated with the ingestion of calcium (r=0.66; p<0.01) and the two micronutrients are associated with fasting glucose (p<0.05). In the case of CBMN, intake of calcium was associated negatively with the frequency of nuclear buds (r=-0.30; p=0.04). There is high inadequacy prevalence for vitamins D and calcium among pre-diabetic people. The two nutrients only slightly affect genomic instability since only the insufficient intake of calcium proved to be related with DNA damage, increasing the formation of nuclear buds.

Vitamin C intake reduces the cytotoxicity associated with hyperglycemia in prediabetes and type 2 diabetes.

Hyperglycemia leads to the formation of free radicals and advanced glycation end-products (AGEs). Antioxidants can reduce the level of protein glycation and DNA damage. In this study, we compared the levels of vitamin C intake, which is among the most abundant antioxidants obtained from diet, with the levels of fasting plasma glucose (FPG), glycated hemoglobin (A1C), DNA damage, and cytotoxicity in prediabetic subjects and type 2 diabetic subjects. Our results indicated that there was no significant correlation between FPG or A1C and DNA damage parameters (micronuclei, nucleoplasmic bridges, and nuclear buds). FPG and A1C correlated with necrosis (r = 0.294; P = 0.013 and r = 0.401; P = 0.001, resp.). Vitamin C intake correlated negatively with necrosis and apoptosis (r = -0.246; P = 0.040, and r = -0.276; P = 0.021, resp.). The lack of a correlation between the FPG and A1C and DNA damage could be explained, at least in part, by the elimination of cells with DNA damage by either necrosis or apoptosis (cytotoxicity). Vitamin C appeared to improve cell survival by reducing cytotoxicity. Therefore, the present results indicate the need for clinical studies to evaluate the effect of low-dose vitamin C supplementation in type 2 diabetes.

DNA damage and cytotoxicity in adult subjects with prediabetes.

Prediabetes (intermediate hyperglycemia) is a high-risk state for diabetes that is defined by higher than normal glycemic levels that are below the level required for a diagnosis of diabetes. Prediabetes is characterized by oxidative stress, yet the associated DNA damage and cytotoxicity remain unknown to date. Therefore, we evaluated the relationship between glycemic alterations, DNA damage and cytotoxicity in the lymphocytes of individuals with pre-diabetes. Fasting plasma glucose (FPG) and glycated hemoglobin (A1C) levels were quantified and used as inclusion criteria. Anthropometric parameters were also evaluated. The cytokinesis-block micronucleus cytome assay (CBMN Cyt) was used to evaluate DNA damage and cytotoxicity. FPG correlated with A1C (r=0.562, p=0.002). Because A1C is the best predictor of diabetes complications, the association between A1C and the evaluated variables was assessed. The waist-hip ratio correlated with A1C (p<0.01). Regarding DNA damage, the frequency of nucleoplasmic bridges correlated with A1C (p<0.05). Both apoptosis and necrosis correlated with A1C (p<0.05). The overall frequency of DNA damage and cytotoxicity also correlated with A1C (p<0.01). Additional studies evaluating cell cycle and cell death patterns in prediabetes are necessary.