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      Fiber in Diet Is Associated with Improvement of Glycated Hemoglobin and Lipid Profile in Mexican Patients with Type 2 Diabetes

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          Abstract

          Objective. To assess the association of dietary fiber on current everyday diet and other dietary components with glycated hemoglobin levels (HbA1c), glucose, lipids profile, and body weight body weight, in patients with type 2 diabetes. Methods. A cross-sectional survey of 395 patients with type 2 diabetes was performed. HbA1c, fasting glucose, triglycerides, and lipids profile were measured. Weight, waist circumference, blood pressure, and body composition were measured. Everyday diet with a semiquantitative food frequency questionnaire was evaluated. ANOVA, Kruskal-Wallis, chi-square tests and multivariate logistic regression were used in statistical analysis. Results. Higher fiber intake was associated with a low HbA1c, high HDL-c levels, low weight, and waist circumference. The highest tertile of calories consumption was associated with a higher fasting glucose level and weight. The highest tertile of carbohydrate consumption was associated with a lower weight. The lowest tertile of total fat and saturated fat was associated with the highest tertile of HDL-c levels, and lower saturated fat intake was associated with lower weight ( p < 0.05). Conclusions. A higher content of fiber in the diet reduces HbA1c and triglycerides, while improving HDL-c levels. Increasing fiber consumption while lowering calorie consumption seems to be an appropriate strategy to reduce body weight and promote blood glucose control.

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          Effects of energy-restricted high-protein, low-fat compared with standard-protein, low-fat diets: a meta-analysis of randomized controlled trials.

          It is currently unclear whether altering the carbohydrate-to-protein ratio of low-fat, energy-restricted diets augments weight loss and cardiometabolic risk markers. The objective was to conduct a systematic review and meta-analysis of studies that compared energy-restricted, isocaloric, high-protein, low-fat (HP) diets with standard-protein, low-fat (SP) diets on weight loss, body composition, resting energy expenditure (REE), satiety and appetite, and cardiometabolic risk factors. Systematic searches were conducted by using MEDLINE, EMBASE, PubMed, and the Cochrane Central Register of Controlled Trials to identify weight-loss trials that compared isocalorically prescribed diets matched for fat intake but that differed in protein and carbohydrate intakes in participants aged ≥18 y. Twenty-four trials that included 1063 individuals satisfied the inclusion criteria. Mean (±SD) diet duration was 12.1 ± 9.3 wk. Compared with an SP diet, an HP diet produced more favorable changes in weighted mean differences for reductions in body weight (-0.79 kg; 95% CI: -1.50, -0.08 kg), fat mass (FM; -0.87 kg; 95% CI: -1.26, -0.48 kg), and triglycerides (-0.23 mmol/L; 95% CI: -0.33, -0.12 mmol/L) and mitigation of reductions in fat-free mass (FFM; 0.43 kg; 95% CI: 0.09, 0.78 kg) and REE (595.5 kJ/d; 95% CI: 67.0, 1124.1 kJ/d). Changes in fasting plasma glucose, fasting insulin, blood pressure, and total, LDL, and HDL cholesterol were similar across dietary treatments (P ≥ 0.20). Greater satiety with HP was reported in 3 of 5 studies. Compared with an energy-restricted SP diet, an isocalorically prescribed HP diet provides modest benefits for reductions in body weight, FM, and triglycerides and for mitigating reductions in FFM and REE.
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            Validity and reproducibility of a food frequency questionnaire to assess dietary intake of women living in Mexico City

            Objective. To assess the reproducibility and validity of a 116 item semi-quantitative food frequency questionnaire (FFQ), designed to assess the relation between dietary intake and chronic diseases. Material and methods. To test the reproducibility of the FFQ questionnaire, the FFQ was administered twice to 134 women residing in Mexico City at an interval of approximately one year; to assess the validity we compared results obtained by the FFQs with those obtained by four 4-day 24-hour recalls at three month intervals. Validity and reproducibility were evaluated using regression analysis and Pearson and intraclass correlation coefficients of log-e and calorie-adjusted nutrient scores. Results. Mean values for intake of most nutrients assessed by the two food frequency questionnaires were similar. However, means for the 24-hr recall were significantly lower. Intraclass correlation coefficients for nutrient intakes, assessed by questionnaires, administered one year apart, ranged from 0.38 for cholesterol to 0.54 for crude fiber. Correlation coefficients between energy-adjusted nutrient intakes, measured by diet recalls, and the first FFQ ranged from 0.12 for polyunsaturated fatty acids to 0.67 for saturated fatty acids. Regression coefficients between 24-hr recall and FFQ,s were all significant were significant for all nutrients, except for polyunsaturated fat, folic acid, vitamin E and Zinc. Conclusions. These data indicate that this semi-quantitative FFQ is reproducible and provides a useful estimate by which to categorize individuals by level of past nutrient intake. However, its application outside Mexico City or in different age and gender populations will require additional modifications and validation efforts.
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              Role of intensive glucose control in development of renal end points in type 2 diabetes mellitus: systematic review and meta-analysis intensive glucose control in type 2 diabetes.

              Aggressive glycemic control has been hypothesized to prevent renal disease in patients with type 2 diabetes mellitus. A systematic review was conducted to summarize the benefits of intensive vs conventional glucose control on kidney-related outcomes for adults with type 2 diabetes. Three databases were systematically searched (January 1, 1950, to December 31, 2010) with no language restrictions to identify randomized trials that compared surrogate renal end points (microalbuminuria and macroalbuminuria) and clinical renal end points (doubling of the serum creatinine level, end-stage renal disease [ESRD], and death from renal disease) in patients with type 2 diabetes receiving intensive glucose control vs those receiving conventional glucose control. We evaluated 7 trials involving 28 065 adults who were monitored for 2 to 15 years. Compared with conventional control, intensive glucose control reduced the risk for microalbuminuria (risk ratio, 0.86 [95% CI, 0.76-0.96]) and macroalbuminuria (0.74 [0.65-0.85]), but not doubling of the serum creatinine level (1.06 [0.92-1.22]), ESRD (0.69 [0.46-1.05]), or death from renal disease (0.99 [0.55-1.79]). Meta-regression revealed that larger differences in hemoglobin A1c between intensive and conventional therapy at the study level were associated with greater benefit for both microalbuminuria and macroalbuminuria. The pooled cumulative incidence of doubling of the serum creatinine level, ESRD, and death from renal disease was low (<4%, <1.5%, and <0.5%, respectively) compared with the surrogate renal end points of microalbuminuria (23%) and macroalbuminuria (5%). Intensive glucose control reduces the risk for microalbuminuria and macroalbuminuria, but evidence is lacking that intensive glycemic control reduces the risk for significant clinical renal outcomes, such as doubling of the serum creatinine level, ESRD, or death from renal disease during the years of follow-up of the trials.
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                Author and article information

                Journal
                J Diabetes Res
                J Diabetes Res
                JDR
                Journal of Diabetes Research
                Hindawi Publishing Corporation
                2314-6745
                2314-6753
                2016
                10 April 2016
                : 2016
                : 2980406
                Affiliations
                1Unidad de Investigación en Epidemiología Clínica, Hospital “Carlos MacGregor Sánchez Navarro”, Instituto Mexicano del Seguro Social, Avenida Gabriel Mancera No. 222, Colonia del Valle, Delegación Bénito Juárez, 03100 Ciudad de México, Mexico
                2Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional Autónoma de México, 6 Piso, Edificio B, Circuito Interior, Ciudad Universitaria, Avenida Universidad 3000, Ciudad de México, Mexico
                3Departamento de Investigación, Instituto Nacional de Geriatría, Periférico sur No. 2767, Colonia San Jerónimo Lídice, Delegación Magdalena Contreras, 10200 Ciudad de México, Mexico
                4Unidad de Investigación Médica en Nutrición, Hospital de Pediatría, Centro Medico Nacional “Siglo XXI”, Instituto Mexicano del Seguro Social, Avenida Cuauhtémoc 300, Colonia Doctores, Delegación Cuauhtemoc, 06720 Ciudad de México, Mexico
                5Unidad de Investigación Científica de Endocrinología, Diabetes y Metabolismo, y de Enfermedades Metabólicas, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Avenida Cuauhtémoc 300, Colonia Doctores, Delegación Cuauhtemoc, 06720 Ciudad de México, Mexico
                Author notes
                *Jorge Escobedo-de la Peña: jorgeep@ 123456unam.mx

                Academic Editor: Giovanni Annuzzi

                Article
                10.1155/2016/2980406
                4842057
                27144178
                4de71c6c-6e65-4efb-9425-bed0d327c86d
                Copyright © 2016 Lubia Velázquez-López et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 November 2015
                : 26 February 2016
                : 21 March 2016
                Categories
                Research Article

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