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2.
Pan Afr Med J ; 33: 260, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692826

RESUMO

Introduction: Dietary management is considered to be one of the cornerstones of diabetes care. Improvement of dietary practice alone can reduce glycosylated hemoglobin (HbA1c) by an absolute 1 to 2% with the greatest impact at the initial stages of diabetes. Methods: Data from Hospital based cross sectional study were used to assess the level of dietary adherence and its determinants among diabetic patients. The morisky 8 item medication adherence scale was used to develop 10 item tool for evaluation of dietary adherence. Multiple logistic regression was conducted to identify factors which affect dietary adherence and variables with P vale < 0.05 were considered statistically significant. Results: More than half of 303 participants (55.7%) were found to be non-adherent to the recommended dietary approach. Gathering with family and friends and eating out were the major reasons for not being compliant with the recommended regimen. Attending diabetic nutrition education (AOR=2.8 95% C 1.97, 5.61) and having the disease for more than 10 years (AOR 2.9 95% CI 1.32, 5.84) were statistically significant with adherence to dietary recommendation. Conclusion: Non-adherence to recommended dietary practice was observed in more than fifty percent of patients; it is therefore a major public health problem. Attending diabetic nutrition education and length of diabetes greater than 10 years were the factors associated with adherence to dietary recommendation. This findings indicate that it is important to design strategies to help patients understand their dietary regimens and improve their adherence.


Assuntos
Diabetes Mellitus/dietoterapia , Cooperação do Paciente/estatística & dados numéricos , Educação de Pacientes como Assunto/métodos , Adulto , Estudos Transversais , Etiópia , Feminino , Hospitais de Ensino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
3.
Nutrients ; 11(9)2019 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-31540227

RESUMO

The Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD) conducted a review of existing systematic reviews and meta-analyses to explain the relationship between different dietary patterns and patient-important cardiometabolic outcomes. To update the clinical practice guidelines for nutrition therapy in the prevention and management of diabetes, we summarize the evidence from these evidence syntheses for the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), Portfolio, Nordic, liquid meal replacement, and vegetarian dietary patterns. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence. We summarized the evidence for disease incidence outcomes and risk factor outcomes using risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs), respectively. The Mediterranean diet showed a cardiovascular disease (CVD) incidence (RR: 0.62; 95%CI, 0.50, 0.78), and non-significant CVD mortality (RR: 0.67; 95%CI, 0.45, 1.00) benefit. The DASH dietary pattern improved cardiometabolic risk factors (P < 0.05) and was associated with the decreased incidence of CVD (RR, 0.80; 95%CI, 0.76, 0.85). Vegetarian dietary patterns were associated with improved cardiometabolic risk factors (P < 0.05) and the reduced incidence (0.72; 95%CI: 0.61, 0.85) and mortality (RR, 0.78; 95%CI, 0.69, 0.88) of coronary heart disease. The Portfolio dietary pattern improved cardiometabolic risk factors and reduced estimated 10-year coronary heart disease (CHD) risk by 13% (-1.34% (95%CI, -2.19 to -0.49)). The Nordic dietary pattern was correlated with decreased CVD (0.93 (95%CI, 0.88, 0.99)) and stroke incidence (0.87 (95%CI, 0.77, 0.97)) and, along with liquid meal replacements, improved cardiometabolic risk factors (P < 0.05). The evidence was assessed as low to moderate certainty for most dietary patterns and outcome pairs. Current evidence suggests that the Mediterranean, DASH, Portfolio, Nordic, liquid meal replacement and vegetarian dietary patterns have cardiometabolic advantages in populations inclusive of diabetes.


Assuntos
Diabetes Mellitus/dietoterapia , Dieta , Terapia Nutricional/métodos , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/prevenção & controle , Complicações do Diabetes/epidemiologia , Complicações do Diabetes/prevenção & controle , Dieta Mediterrânea , Dieta Vegetariana , Abordagens Dietéticas para Conter a Hipertensão , Humanos , MEDLINE , Metanálise como Assunto , Doenças Metabólicas/epidemiologia , Doenças Metabólicas/prevenção & controle , Fatores de Risco , Países Escandinavos e Nórdicos , Revisão Sistemática como Assunto
4.
Medicina (Kaunas) ; 55(8)2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31374951

RESUMO

Background and objectives: Diabetes is largely prevalent in the chronic kidney disease (CKD) population. Both conditions have metabolic and nutritional abnormalities that affect body composition and the presence of diabetes makes the dietary management of CKD patients more difficult. The aim of this study was to assess peculiar nutritional and functional aspects of diabetic patients in an adult/elderly CKD population, and their predictive significance. Materials and methods: This prospective cohort study included 144 out-patients aged >55 years, affected by stage 3b-4 CKD, on tertiary care clinic; 48 (40 males) were type 2 diabetics and 96 (80 males) were nondiabetics. The two groups have similar age, gender, and residual renal function (30 ± 9 vs. 31 ± 11 mL/min×1.73). All patients underwent a comprehensive nutritional and functional assessment and were followed for 31 ± 14 months. Results: Diabetic CKD patients showed higher waist circumference and fat body mass, lower muscle mass, and lower number of steps per day and average daily METs. Meanwhile, resting energy expenditure (REE), as assessed by indirect calorimetry, and dietary energy intake were similar as well as hand-grip and 6 min walking test. Diabetic patients did not show a greater risk for all-cause mortality and renal death with respect to nondiabetics. Middle arm muscle circumference, phase angle, serum cholesterol, and serum albumin were negatively related to the risk of mortality and renal death after adjustment for eGFR. Conclusions: CKD diabetic patients differed from nondiabetics for a greater fat mass, lower muscle mass, and lower physical activity levels. This occurred at the same REE and dietary energy intake. The outcome of diabetic or nondiabetic CKD patients on tertiary care management was similar in terms of risk for mortality or renal death. Given the same residual renal function, low levels of muscle mass, phase angle, serum albumin, and cholesterol were predictive of poor outcome. Overall, a malnutrition phenotype represents a major predictor of poor outcome in diabetic and nondiabetic CKD patients.


Assuntos
Insuficiência Renal Crônica/dietoterapia , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Estudos de Coortes , Complicações do Diabetes/dietoterapia , Complicações do Diabetes/fisiopatologia , Diabetes Mellitus/dietoterapia , Diabetes Mellitus/fisiopatologia , Metabolismo Energético/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Insuficiência Renal Crônica/etiologia , Insuficiência Renal Crônica/fisiopatologia , Estatísticas não Paramétricas , Atenção Terciária à Saúde/métodos
5.
Diabetes Res Clin Pract ; 155: 107819, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31425770

RESUMO

AIMS: We aimed to screen the nutritional status of older adults with diabetes mellitus, seeking to outline the needs of this population group considering their socioeconomic status. METHODS: Cross-sectional study of 246 diabetic people aged 65-94 years in Northeastern Brazil. Semi-structured questionnaires were used to collect sociodemographic, general health and lifestyle data. The Mini Nutritional Assessment was used to screen nutritional status. RESULTS: Participants' mean age was 73 ±â€¯6.4 years, and there was a predominance of women (56.5%). The mean duration of diabetes was 14.1 years (±9.6 years). Patients aged 80 years or older presented a 3.7-fold higher risk of malnutrition (p < 0.001), and those who were uneducated exhibited a 5.8-fold higher risk of malnutrition (p = 0.040). Patients with BMI of 18.6-24.9 km/m2 presented a 2.2-fold higher risk of malnutrition than overweight or obese patients (p < 0.001). Nutritional status was significantly associated with coronary artery disease (p = 0.010) and stroke (p < 0.001). Malnourished patients exhibited a 2.2-fold higher occurrence of infection in the past 6 months (p = 0.017) and 2-fold higher occurrence of foot injuries (p = 0.028) than their well-nourished peers. CONCLUSION: Malnutrition in older diabetic patients exacerbates underlying diseases and contributes to unfavorable prognosis, particularly in the oldest old and in individuals with low levels of education.


Assuntos
Diabetes Mellitus/dietoterapia , Estado Nutricional/fisiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Avaliação Nutricional
6.
Nutrients ; 11(7)2019 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-31262013

RESUMO

The Asian food pattern primarily embraces rice and rice-based products, which mainly comprise 90% starch. Among these various food products, Idli is mostly prepared through fermentation. It has high palatability, and the rapid and highly digestible nature of the food product results in a higher post-glucose level in diabetic patients. A heat-treated Idli rice sample was prepared by roasting parboiled rice at the temperature range of 155 to 165 °C for 65 to 75 s. Idli/rice-based Dokala made from heat-treated rice is better when compared to untreated rice in terms of its microbiological profile and physiochemical properties. The proximate composition of heat-treated parboiled rice Idli/Rice Dokala showed slightly higher values than the untreated parboiled rice Idli/Rice Dokala, which reveals that it has marginally higher nutritive value. Determination of the Rapidly Available Glucose (RAG) and Slowly Available Glucose (SAG) values, SEM analysis, resistant starch analysis, microbial assay, and in vivo studies were performed to determine the glycemic index (GI) and glycemic load in normal and diabetic persons. Sensory analysis also proved that heat-treated Idli/Rice Dokala is superior to untreated based on the color, flavor, appearance, taste, and texture.


Assuntos
Glicemia/metabolismo , Diabetes Mellitus/dietoterapia , Dieta para Diabéticos , Manipulação de Alimentos , Microbiologia de Alimentos , Índice Glicêmico , Oryza/microbiologia , Biomarcadores/sangue , Diabetes Mellitus/sangue , Diabetes Mellitus/diagnóstico , Fermentação , Carga Glicêmica , Humanos , Oryza/metabolismo
7.
Adv Food Nutr Res ; 89: 209-238, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31351526

RESUMO

Diabetes mellitus, a chronic metabolic disease, characterized by elevated levels of blood glucose and insufficiency in production and action of insulin is the seventh leading cause of death worldwide. Numerous studies have shown that diabetes mellitus is associated with increased formation of free radicals and decrease in antioxidant potential. In the patients with diabetes mellitus, the levels of antioxidant parameters are found to decrease, hence in many studies phytochemicals which can exert antioxidant and free radical scavenging activities, are suggested to improve the insulin sensitivity. Several phytoactive compounds such as flavonoids, lignans, prophenylphenols, are also found to combat the complications of diabetes. This chapter mainly focuses on the relationship between diabetes mellitus and preventive roles of various phytochemicals on diabetes via their antioxidant properties.


Assuntos
Diabetes Mellitus/dietoterapia , Compostos Fitoquímicos/farmacologia , Suplementos Nutricionais , Humanos , Estresse Oxidativo , Compostos Fitoquímicos/química , Compostos Fitoquímicos/classificação
8.
J Nat Med ; 73(4): 707-716, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31104252

RESUMO

Diabetes is a chronic disease associated with triglyceride metabolism disorder, being an etiological factor in fatty liver disease, hypertension, and cardiovascular diseases. Diet-based therapy including energy balance and herbal supplements is a suitable approach to ameliorate progression of the disease. Leaves of Lippia triphylla (lemon verbena) from the family Verbenaceae are a foodstuff used as a tea drink or cooking seasoning, with confirmed safety during long-term use. We report herein the regulatory effect of L. triphylla extract (LTE) and its major compound acteoside (ACT) on abnormal liver lipid metabolism. Both LTE and ACT administration significantly decreased serum and hepatic lipid content, increased the phosphorylation level of the energy metabolism moderator adenosine 5'-monophosphate-activated protein kinase (AMPK), and reduced two major markers of lipid synthesis, viz. acetyl-CoA carboxylase (ACC) and fatty acid synthase (FAS), with an obvious enhancement in ACC phosphorylation. Furthermore, ACT promoted lipolysis and fatty acid oxidation by increasing messenger RNA (mRNA) expression of adipose triglyceride lipase (ATGL) and carnitine palmitoyltransferase (CPT)-1. These results provide scientific evidence for the development of functional foods containing L. triphylla extract and acteoside for treatment of diabetes-associated lipid metabolism disorder.


Assuntos
Diabetes Mellitus/dietoterapia , Glucosídeos/farmacologia , Metabolismo dos Lipídeos/efeitos dos fármacos , Lippia/química , Fenóis/farmacologia , Extratos Vegetais/farmacologia , Folhas de Planta/química , Proteínas Quinases Ativadas por AMP/metabolismo , Acetil-CoA Carboxilase/metabolismo , Animais , Carnitina O-Palmitoiltransferase/metabolismo , Ácido Graxo Sintase Tipo I/metabolismo , Lipase/metabolismo , Lipólise/efeitos dos fármacos , Fígado/efeitos dos fármacos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Oxirredução , Fosforilação/efeitos dos fármacos , Triglicerídeos/metabolismo
9.
Indian J Med Res ; 149(1): 41-46, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31115373

RESUMO

Background & objectives: : Amino acids are general nutrients having anti-diabetic property. The present study was undertaken to investigate the mechanism of anti-diabetic effects of amino acids in human visceral adipocyte cells in high glucose environment. Methods: : Experiments were carried out in human visceral adipocytes. Adiponectin (APN) siRNAs were designed using Ambion tools. APN mRNA expression was quantified using real-time polymerase chain reaction, and protein level was studied using ELISA. AMP-activated kinase (AMPK) activity was measured and glucose uptake by 2-deoxyglucose uptake method. Results: : Amino acids (proline and phenylalanine) exposure to adipocytes significantly (P <0.01) increased APN mRNA by 1.5-folds when compared to control whereas proline increased APN secretion by 10.6-folds (P <0.01), phenylalanine by 12.7-folds (P <0.001) and alanine by 6.3-folds (P <0.01). Free amino acid-induced AMPK activity and glucose uptake were decreased with the transient knockdown of APN. Interpretation & conclusions: : Antidiabetic effect of the tested amino acids was exhibited by increased glucose uptake through the AMPK pathway by an APN-dependent mechanism in human visceral adipocytes. This should be tested and confirmed in in vivo system. Newer treatment modalities with amino acids which can enhance glucose uptake and APN secretion can be developed as drug for treating both diabetes and obesity.


Assuntos
Adiponectina/genética , Diabetes Mellitus/dietoterapia , Glucose/metabolismo , Obesidade/dietoterapia , Proteínas Quinases/genética , Adipócitos/efeitos dos fármacos , Adipócitos/metabolismo , Aminoácidos/farmacologia , Células Cultivadas , Diabetes Mellitus/metabolismo , Suplementos Nutricionais , Regulação da Expressão Gênica/efeitos dos fármacos , Humanos , Hipoglicemiantes/farmacologia , Gordura Intra-Abdominal/efeitos dos fármacos , Gordura Intra-Abdominal/metabolismo , Obesidade/metabolismo , Obesidade/patologia , Fenilalanina/farmacologia , Prolina/farmacologia , RNA Mensageiro/genética , RNA Interferente Pequeno/genética , Transdução de Sinais/efeitos dos fármacos
10.
Oxid Med Cell Longev ; 2019: 5484138, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30962863

RESUMO

The prevalence of cardiovascular disease (CVD) is increasing over time. CVD is a comorbidity in diabetes and contributes to premature death. Citrus flavonoids possess several biological activities and have emerged as efficient therapeutics for the treatment of CVD. Citrus flavonoids scavenge free radicals, improve glucose tolerance and insulin sensitivity, modulate lipid metabolism and adipocyte differentiation, suppress inflammation and apoptosis, and improve endothelial dysfunction. The intake of citrus flavonoids has been associated with improved cardiovascular outcomes. Although citrus flavonoids exerted multiple beneficial effects, their mechanisms of action are not completely established. In this review, we summarized recent findings and advances in understanding the mechanisms underlying the protective effects of citrus flavonoids against oxidative stress, inflammation, diabetes, dyslipidemia, endothelial dysfunction, and atherosclerosis. Further studies and clinical trials to assess the efficacy and to explore the underlying mechanism(s) of action of citrus flavonoids are recommended.


Assuntos
Doenças Cardiovasculares/tratamento farmacológico , Citrus/metabolismo , Diabetes Mellitus/dietoterapia , Flavonoides/uso terapêutico , Metabolismo dos Lipídeos/fisiologia , Flavonoides/farmacologia , Humanos
11.
J Pak Med Assoc ; 69(4): 595-597, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31000871

RESUMO

Desserts form an important and integral part of South East Asian cuisines and are often associated with festive eating and celebrations. Since most desserts are high in caloric content and contain refined carbohydrates and saturated or trans-fats, their consumption poses obvious challenges in diabetic individuals. Meals should not only meet the biological needs of an individual but should also be palatable, appealing and retain their hedonistic aspects of taste, smell and visual appeal. While remaining within the principles of medical nutrition therapy, desserts can be incorporated into meals with use of whole grains, low fat dairy or yoghurt, fruits, vegetables and pulses as their primary ingredients. Intake of free sugars can be minimized by using non-nutritive sweeteners, soluble fiber, condiments and spices. In this article, we focus on ways to encourage healthy eating among diabetics while still retaining pleasurable foods such as desserts.


Assuntos
Laticínios , Diabetes Mellitus/dietoterapia , Frutas , Adoçantes não Calóricos , Verduras , Chocolate , Fissura , Gorduras na Dieta , Gorduras Insaturadas na Dieta , Açúcares da Dieta , Índice Glicêmico , Humanos , Refeições
12.
Clinics (Sao Paulo) ; 74: e560, 2019 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-30892414

RESUMO

OBJECTIVE: To analyze the changes in the body composition of morbidly obese patients induced by a very low-calorie diet. METHODS: We evaluated 120 patients selected from a university hospital. Body composition was assessed before and after the diet provided during hospitalization, and changes in weight, body mass index, and neck, waist and hip circumferences were analyzed. Bioimpedance was used to obtain body fat and fat-free mass values. The data were categorized by gender, age, body mass index and diabetes diagnosis. RESULTS: The patients consumed the diet for 8 days. They presented a 5% weight loss (without significant difference among groups), which represented an 85% reduction in body fat. All changes in body circumference were statistically significant. There was greater weight loss and a greater reduction of body fat in men, but the elderly showed a significantly higher percentage of weight loss and greater reductions in body fat and fat-free mass. Greater reductions in body fat and fat-free mass were also observed in superobese patients. The changes in the diabetic participants did not differ significantly from those of the non-diabetic participants. CONCLUSIONS: The use of a VLCD before bariatric surgery led to a loss of weight at the expense of body fat over a short period, with no significant differences in the alteration of body composition according to gender, age, body mass index and diabetes status.


Assuntos
Cirurgia Bariátrica , Composição Corporal , Dieta Redutora/métodos , Obesidade Mórbida/dietoterapia , Perda de Peso/fisiologia , Fatores Etários , Índice de Massa Corporal , Diabetes Mellitus/dietoterapia , Diabetes Mellitus/fisiopatologia , Feminino , Quadril/anatomia & histologia , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Pescoço/anatomia & histologia , Obesidade Mórbida/cirurgia , Cuidados Pré-Operatórios/métodos , Estudos Prospectivos , Fatores Sexuais , Circunferência da Cintura
13.
PLoS One ; 14(3): e0214142, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30908526

RESUMO

Instances of non-communicable diseases such as diabetes are on the rise globally leading to greater morbidity and mortality, with the greatest burden in low and middle income countries [LMIC]. A major contributing factor to diabetes is unhealthy dietary behaviour. We conducted 38 semi structured interviews with patients, health professionals, policy-makers and researchers in Kathmandu, Nepal, to better understand the determinants of dietary behaviour amongst patients with diabetes and high blood glucose levels. We created a social ecological model which is specific to socio-cultural context with our findings with the aim of informing culturally appropriate dietary behaviour interventions for improving dietary behaviour. Our findings show that the most influential determinants of dietary behaviour include cultural practices (gender roles relating to cooking), social support (from family and friends), the political and physical environment (political will, healthy food availability) and individuals' motivations and capabilities. Using these most influential determinants, we suggest potentially effective dietary interventions that could be implemented by policy makers. Our findings emphasise the importance of considering socio-cultural context in developing interventions and challenges one-size-fits-all approaches which are often encouraged by global guidelines. We demonstrate how multifaceted and multi layered models of behavioural influence can be used to develop policy and practice with the aim of reducing mortality and morbidity from diabetes.


Assuntos
Glicemia/metabolismo , Diabetes Mellitus , Comportamento Alimentar , Comportamentos Relacionados com a Saúde , Modelos Biológicos , População Urbana , Adulto , Diabetes Mellitus/sangue , Diabetes Mellitus/dietoterapia , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nepal/epidemiologia , Fatores Socioeconômicos
14.
Crit Rev Biotechnol ; 39(4): 524-540, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30810398

RESUMO

Diabetes mellitus (DM) increases the risk of cardiovascular diseases and other secondary complications, such as nephropathy, neuropathy, retinopathy, etc. The important risk factors for the pathogenesis of DM are aging, family history, sedentary lifestyle, unhealthy dietary habits, and obesity. Evidence from epidemiological studies also indicates that DM is characterized by specific alterations in the human gut microbiota (GM). GM transplantation in rodents and humans revealed that a specific GM constituent can be the cause and not just the consequence of the DM condition and complications. These findings suggest a potential role of GM in human health, disease prevention, and treatment. Dietary intervention studies using dietary fibers (DFs) suggested that modulation of the GM can suppress the metabolic risk markers in humans. However, a causal role of GM in such studies remains unexplored. Long-term follow-up studies disclosed that the diet rich in insoluble and non-viscous fibers are responsible for DF-mediated antidiabetic activities, while soluble and viscous fibers have little influence on DM despite having a profound impact on glycemia. However, general conclusions cannot be drawn simply based on these findings. Long-term follow-up studies are urgently required in this area to explore the therapeutic potential of different DFs in treating DM and to delineate the exact role of GM involvement. Here we review and discuss the signature of GM during DM, antidiabetic activity of metformin via GM modulation, DFs from different sources and their antidiabetic activity, and the possible role of GM involvement.


Assuntos
Diabetes Mellitus/dietoterapia , Dieta , Fibras na Dieta/uso terapêutico , Microbioma Gastrointestinal/efeitos dos fármacos , Glicemia/efeitos dos fármacos , Diabetes Mellitus/microbiologia , Humanos
15.
Curr Atheroscler Rep ; 21(1): 1, 2019 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-30631963

RESUMO

PURPOSE OF REVIEW: Omega-3 fatty acids (ω-3 FA) are among the most well-recognized health supplements but their cardiovascular benefits have long been controversial owing to inconsistent results from previous cardiovascular outcomes trials (CVOT). In this article, we provide a short review of existing literature followed by recent randomized clinical trial data, with a discussion of the potential clinical implications of these new findings. RECENT FINDINGS: Data from the randomized, controlled trial REDUCE-IT, when viewed within the context of other recently published trials ASCEND and VITAL, add to a growing body of evidence on the use of ω-3 FA therapies in the treatment of atherosclerotic cardiovascular disease (ASCVD). Given the different formulations, dosages, and patient populations studied, CVOTs of ω-3 FA have provided valuable insight into the use of these agents in cardioprotection. Current data suggest that higher dosages of pure eicosapentaenoic acid ω-3 FA formulations provide additional benefit in reduction of ASCVD events.


Assuntos
Cardiotônicos/uso terapêutico , Doenças Cardiovasculares/dietoterapia , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus/dietoterapia , Ácidos Docosa-Hexaenoicos/uso terapêutico , Ácido Eicosapentaenoico/uso terapêutico , Insuficiência Cardíaca/dietoterapia , Infarto do Miocárdio/dietoterapia , Cardiotônicos/administração & dosagem , Cardiotônicos/efeitos adversos , Suplementos Nutricionais/efeitos adversos , Ácidos Docosa-Hexaenoicos/administração & dosagem , Ácidos Docosa-Hexaenoicos/efeitos adversos , Ácido Eicosapentaenoico/administração & dosagem , Ácido Eicosapentaenoico/efeitos adversos , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipertrigliceridemia/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
16.
Crit Rev Food Sci Nutr ; 59(11): 1684-1727, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29494205

RESUMO

The health benefits of fish oil, and its omega-3 long chain polyunsaturated fatty acid content, have attracted much scientific attention in the last four decades. Fish oils that contain higher amounts of eicosapentaenoic acid (EPA; 20:5n-3) than docosahexaenoic acid (DHA; 22:6n-3), in a distinctive ratio of 18/12, are typically the most abundantly available and are commonly studied. Although the two fatty acids have traditionally been considered together, as though they were one entity, different physiological effects of EPA and DHA have recently been reported. New oils containing a higher quantity of DHA compared with EPA, such as fractionated and concentrated fish oil, tuna oil, calamari oil and microalgae oil, are increasingly becoming available on the market, and other oils, including those extracted from genetically modified oilseed crops, soon to come. This systematic review focuses on the effects of high DHA fish oils on various human health conditions, such as the heart and cardiovascular system, the brain and visual function, inflammation and immune function and growth/Body Mass Index. Although inconclusive results were reported in several instances, and inconsistent outcomes observed in others, current data provides substantiated evidence in support of DHA being a beneficial bioactive compound for heart, cardiovascular and brain function, with different, and at times complementary, effects compared with EPA. DHA has also been reported to be effective in slowing the rate of cognitive decline, while its possible effects on depression disorders are still unclear. Interestingly, gender- and age- specific divergent roles for DHA have also been reported. This review provides a comprehensive collection of evidence and a critical summary of the documented physiological effects of high DHA fish oils for human health.


Assuntos
Ácidos Docosa-Hexaenoicos/uso terapêutico , Óleos de Peixe/uso terapêutico , Animais , Asma/dietoterapia , Índice de Massa Corporal , Encéfalo , Sistema Cardiovascular , Bases de Dados Factuais , Diabetes Mellitus/dietoterapia , Ácidos Graxos Ômega-3 , Coração , Humanos , Visão Ocular
17.
Crit Rev Food Sci Nutr ; 59(18): 3019-3031, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29846089

RESUMO

"Diabesity" is the term to illustrate the interdependent relationship between obesity and diabetes. About 80% of the diabetic patients are diagnosed with obesity. Diabesity can be prevented by dietary interventions, especially by incorporating sufficient amount of resistant starch (RS). In the past few decades, RS has inspired the researchers due to its various health benefits. Differing from digestible starch, RS remains undigested in the small intestine, but in the large intestine, it is subjected to fermentation. This review intends to encapsulate the current information related to the dietary RS on diabetes and obesity. RS attenuate hyperglycemic, hyperinsulinemic and hyperlipidemic response in various subjects by restricting gluconeogenesis, bolstering glycogenesis, maintaining glucose and lipid homeostasis and ameliorating pancreatic dysfunction. Various food products were fortified with RS to enhance its dietary intake and were found to exhibit positive impact on human and animal models. This review identified and summarized the research gaps in the available literature.


Assuntos
Diabetes Mellitus , Obesidade , Amido , Animais , Fármacos Antiobesidade , Diabetes Mellitus/dietoterapia , Dieta , Fibras na Dieta/uso terapêutico , Humanos , Hipoglicemiantes , Modelos Animais , Obesidade/dietoterapia , Pesquisa/tendências , Amido/metabolismo , Amido/uso terapêutico
18.
Crit Rev Food Sci Nutr ; 59(7): 1115-1123, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29040025

RESUMO

Pistachio is a nut with high polyunsaturated fatty acids (PUFA), monounsaturated fatty acids (MUFA), polyphenols and carotenoids content, and the synergism between these compounds appears to affect glucose metabolism. In this systematic review we analyzed studies in which the effect of chronic consumption of pistachio on markers of glucose metabolism was evaluated in pre-diabetic and type 2 diabetics. We used the PubMed, Scopus, Cochrane and Lilacs databases. The research terms used were pistachio, pre-diabetes, type 2 diabetes mellitus, insulin resistance, blood glucose, hyperglycemia and glycated hemoglobin (HbA1c). Four articles were selected, of which three tested the intake of 50 to 57 g of pistachio/day and one 20% of the daily caloric intake, for a period of 1 to 4 months. Studies reported a decrease in fasting blood glucose, insulinemia, HOMA-IR, and fructosamine, but no change in HbA1c. Lower concentrations of miR-192 and miR-375 were also found, which correlated positively with HOMA-IR. The synergism between PUFA, MUFA, polyphenols and carotenoids present in pistachios can modulate specific miRNA, increasing insulin sensitivity through the PI3K-AKT signaling pathway. This modulation can be used as a tool to monitor the response to interventions, favoring the prevention and treatment of complications related to diabetes.


Assuntos
Diabetes Mellitus Tipo 2/dietoterapia , Carboidratos da Dieta , Glucose/metabolismo , Pistacia/química , Glicemia/metabolismo , Carotenoides/farmacologia , Bases de Dados Factuais , Diabetes Mellitus/dietoterapia , Jejum , Ácidos Graxos Monoinsaturados/farmacologia , Ácidos Graxos Insaturados/farmacologia , Frutose/sangue , Hemoglobina A Glicada , Humanos , Hiperglicemia/dietoterapia , Insulina/sangue , Resistência à Insulina , MicroRNAs , Fosfatidilinositol 3-Quinases , Polifenóis/farmacologia
19.
Curr Pharm Teach Learn ; 10(9): 1272-1279, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30497631

RESUMO

BACKGROUND AND PURPOSE: To determine if a disease state simulation assignment increases empathy, comfort, and knowledge in diabetes nutrition counseling. EDUCATIONAL ACTIVITY AND SETTING: One-hundred forty students completing ambulatory care experiential rotations over two academic years were invited to participate in the study. Students in the intervention group completed an empathy assignment, which involved developing and following a diet plan appropriate for a patient with diabetes followed by a reflection of their experiences. Students completed a pre- and post-intervention survey assessing empathy, comfort with counseling, and knowledge of diabetes nutrition. FINDINGS: Fifty-three students (31 in the intervention, 22 in the non-intervention group) completed the pre- and post-survey and provided informed consent. Empathy scores on the Kiersma Chen Empathy Scale (range 15-105) improved by 6.4 points in students in the intervention group compared to a decline of 1.2 in students in the non-intervention group (p = 0.045). Comfort in counseling on a diabetes diet, measured on a 10-point scale, increased significantly more in students completing the empathy assignment (4.7 vs 3.5; p = 0.044). Knowledge (0-100%) improved by 9.7% and 8.6% in the intervention and non-intervention groups, respectively (p = 0.859). DISCUSSION: Similar to other studies using disease state simulations, the findings of this study show increased confidence in counseling and empathy. Given that the assignment used in this study is more specific to nutrition counseling, its use may be most helpful in settings where pharmacists are responsible for diabetes nutrition counseling. SUMMARY: Implementation of a similar assignment could be considered for experiential rotations with nutrition counseling.


Assuntos
Aconselhamento/educação , Diabetes Mellitus/dietoterapia , Empatia , Simulação de Paciente , Estudantes de Farmácia/psicologia , Adulto , Atitude do Pessoal de Saúde , Aconselhamento/métodos , Educação em Farmácia/métodos , Feminino , Humanos , Masculino , Psicometria/instrumentação , Psicometria/métodos , Psicometria/estatística & dados numéricos , Estudantes de Farmácia/estatística & dados numéricos , Inquéritos e Questionários
20.
J Pak Med Assoc ; 68(12): 1836-1839, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30504952

RESUMO

Ketogenic diet is gaining popularity as a nonpharmacological intervention for weight loss and glycaemic control. There is abundant literature on this topic, which serves to confuse the reader. No scientific recommendations have been formulated to guide evidence-based or rational use of ketogenic diet in obesity and diabetes management. This article is a situational analysis of leading professional guidelines on diabetes care, with regards to their coverage of ketogenic diet. It underscores the need for leading experts to pay attention to this upcoming field of metabolic medicine..


Assuntos
Diabetes Mellitus/dietoterapia , Dieta Cetogênica , Política Nutricional , Obesidade/dietoterapia , Glicemia/fisiologia , Humanos , Perda de Peso/fisiologia
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