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      Dietary intake and anthropometric indices in Mexican medical students, stratified by family history of Type 2 Diabetes Translated title: Ingesta dietética e índices antropométricos en estudiantes de medicina mexicanos, estratificados por historia familiar de Diabetes Tipo 2

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          Abstract

          Abstract Introduction Our aim was to evaluate the dietary intake and anthropometric indices in medical students with positive family history of type 2 diabetes (FH-T2D)(+) and without FH-T2D(-). Material and Methods 144 students were analyzed in this cross-sectional, observational study, conducted during the 2017-2018 school year using interviews and 7-day food diary. The participants were characterized anthropometrically. Waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), corrected mid-arm muscle area (MAMA), fat arm index (FAI), and tricipital skinfold (TSF) were calculated. Results We found that 79.2% (95%CI:72.5-85.8) had FH-T2D. BMI was significantly higher in the participants with FH-T2D than without (23.7±3.8 vs. 25.0±3.7, respectively; p<0.05). No significant differences were determined in the indices based on central fat distribution (WHtR and WHR), peripheral distribution (FAI and TSF), or muscle mass (MAMA), when stratified by FH-T2D. Regarding dietary intake, when comparing participants with and without FH-T2D, respectively, we observed low/none legume consumption [30% (95%CI:21.4-38.2) vs. 23% (95%CI:8.2-38.5)], diets high in proteins [38.6% (95%CI:29.7-47.5) vs. 46.7% (95%CI:28.8-64.5)], low in carbohydrates [84.2% (95%CI:77.5-90.9) vs. 83.3% (95%CI:70.0-96.7)], and insufficient energy intake [64% (95%CI:55.2-72.8) vs. 56.7% (95%CI:38.9-74.4)], where the alterations in the dietary pattern were more detrimental for the FH-T2D(+) group. Lastly, the participants with FH-T2D consumed mainly late in the day [60% (95%CI:50.6-68.6) vs. 54% (95%CI:35.5-71.2)]. Conclusions Even though there were minimal significant differences with the consumption by food categories, those students with FH-T2D presented with a poor, little varied and unbalanced dietary pattern with energy consumption mainly at night. These factors, if prolonged, could increase the risk of developing type 2 diabetes.

          Translated abstract

          Resumen Introducción Nuestro objetivo fue evaluar la ingesta dietética y los índices antropométricos en estudiantes de medicina con historia familiar positiva de diabetes tipo 2 (FH-T2D)(+) y sin antecedentes familiares FH-T2D(-). Material y Métodos 144 estudiantes fueron analizados en este estudio transversal y observacional realizado durante el año escolar 2017-2018 mediante entrevistas y un diario de alimentos de 7 días. Los participantes se caracterizaron antropométricamente. Se calculó el ínidce cintura-cadera (WHR) y el índice cintura-altura (WHtR), el área muscular corregida de la mitad del brazo (MAMA), el índice de grasa del brazo (FAI) así como el pliegue cutáneo tricipital (TSF). Resultados El 79,2% (95%CI:72,5-85,8) tenían FH-T2D. El IMC fue significativamente mayor en los participantes con FH-T2D que en aquellos sin FH-T2D (23,7±3,8 vs. 25,0±3,7, respectivamente; p<0,05). No se determinaron diferencias significativas en los índices basados en la distribución de grasa central (WHtR y WHR), la distribución periférica (FAI y TSF) o la masa muscular (MAMA), cuando se estratificó por FH-T2D. Al comparar la ingesta dietética de participantes con y sin FH-T2D, respectivamente, observamos un consumo bajo/ninguno de leguminosas [30% (95%CI:21,4-38,2) frente a 23% (95%CI:8,2-38,5)], dietas altas en proteínas [38,6% (95%CI:29,7-47,5) frente a 46,7% (95%CI:28,8-64,5)], bajas en carbohidratos [84,2% (95%CI:77,5-90,9) frente a 83,3% (95%CI:70,0-96,7)], y la ingesta de energía insuficiente [64% (95%CI:55,2-72,8) frente a 56,7% (95%CI:38,9-74,4)], donde las alteraciones en el patrón de la dieta fueron más perjudiciales para el grupo FH-T2D(+). Los participantes con FH-T2D consumieron al final del día [60% (95%CI:50,6-68,6) frente a 54% (95%CI:35,5-71,2)]. Conclusiones Aunque hubo diferencias mínimas significativas con el consumo por categorías de alimentos, aquellos estudiantes con FH-T2D presentaron un patrón dietético deficiente, poco variado y desequilibrado con un consumo de energía principalmente por la noche. Estos factores, si se prolongan, podrían aumentar el riesgo de desarrollar diabetes tipo 2.

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          The Impact of Dietary Fiber on Gut Microbiota in Host Health and Disease

          Food is a primordial need for our survival and well-being. However, diet is not only essential to maintain human growth, reproduction, and health, but it also modulates and supports the symbiotic microbial communities that colonize the digestive tract-the gut microbiota. Type, quality, and origin of our food shape our gut microbes and affect their composition and function, impacting host-microbe interactions. In this review, we will focus on dietary fibers, which interact directly with gut microbes and lead to the production of key metabolites such as short-chain fatty acids, and discuss how dietary fiber impacts gut microbial ecology, host physiology, and health. Hippocrates' notion "Let food be thy medicine and medicine be thy food" remains highly relevant millennia later, but requires consideration of how diet can be used for modulation of gut microbial ecology to promote health.
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            Economic Costs of Diabetes in the U.S. in 2017

            (2018)
            OBJECTIVE This study updates previous estimates of the economic burden of diagnosed diabetes and quantifies the increased health resource use and lost productivity associated with diabetes in 2017. RESEARCH DESIGN AND METHODS We use a prevalence-based approach that combines the demographics of the U.S. population in 2017 with diabetes prevalence, epidemiological data, health care cost, and economic data into a Cost of Diabetes Model. Health resource use and associated medical costs are analyzed by age, sex, race/ethnicity, insurance coverage, medical condition, and health service category. Data sources include national surveys, Medicare standard analytical files, and one of the largest claims databases for the commercially insured population in the U.S. RESULTS The total estimated cost of diagnosed diabetes in 2017 is $327 billion, including $237 billion in direct medical costs and $90 billion in reduced productivity. For the cost categories analyzed, care for people with diagnosed diabetes accounts for 1 in 4 health care dollars in the U.S., and more than half of that expenditure is directly attributable to diabetes. People with diagnosed diabetes incur average medical expenditures of ∼$16,750 per year, of which ∼$9,600 is attributed to diabetes. People with diagnosed diabetes, on average, have medical expenditures ∼2.3 times higher than what expenditures would be in the absence of diabetes. Indirect costs include increased absenteeism ($3.3 billion) and reduced productivity while at work ($26.9 billion) for the employed population, reduced productivity for those not in the labor force ($2.3 billion), inability to work because of disease-related disability ($37.5 billion), and lost productivity due to 277,000 premature deaths attributed to diabetes ($19.9 billion). CONCLUSIONS After adjusting for inflation, economic costs of diabetes increased by 26% from 2012 to 2017 due to the increased prevalence of diabetes and the increased cost per person with diabetes. The growth in diabetes prevalence and medical costs is primarily among the population aged 65 years and older, contributing to a growing economic cost to the Medicare program. The estimates in this article highlight the substantial financial burden that diabetes imposes on society, in addition to intangible costs from pain and suffering, resources from care provided by nonpaid caregivers, and costs associated with undiagnosed diabetes.
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              Sleep patterns and predictors of disturbed sleep in a large population of college students.

              To characterize sleep patterns and predictors of poor sleep quality in a large population of college students. This study extends the 2006 National Sleep Foundation examination of sleep in early adolescence by examining sleep in older adolescents. One thousand one hundred twenty-five students aged 17 to 24 years from an urban Midwestern university completed a cross-sectional online survey about sleep habits that included the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale, the Horne-Ostberg Morningness-Eveningness Scale, the Profile of Mood States, the Subjective Units of Distress Scale, and questions about academic performance, physical health, and psychoactive drug use. Students reported disturbed sleep; over 60% were categorized as poor-quality sleepers by the PSQI, bedtimes and risetimes were delayed during weekends, and students reported frequently taking prescription, over the counter, and recreational psychoactive drugs to alter sleep/wakefulness. Students classified as poor-quality sleepers reported significantly more problems with physical and psychological health than did good-quality sleepers. Students overwhelmingly stated that emotional and academic stress negatively impacted sleep. Multiple regression analyses revealed that tension and stress accounted for 24% of the variance in the PSQI score, whereas exercise, alcohol and caffeine consumption, and consistency of sleep schedule were not significant predictors of sleep quality. These results demonstrate that insufficient sleep and irregular sleep-wake patterns, which have been extensively documented in younger adolescents, are also present at alarming levels in the college student population. Given the close relationships between sleep quality and physical and mental health, intervention programs for sleep disturbance in this population should be considered. Copyright 2010 Society for Adolescent Medicine. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                renhyd
                Revista Española de Nutrición Humana y Dietética
                Rev Esp Nutr Hum Diet
                Academia Española de Nutrición y Dietética (Pamplona, Navarra, Spain )
                2173-1292
                2174-5145
                December 2020
                : 24
                : 4
                : 374-388
                Affiliations
                [3] Atlixco orgnameInstituto Mexicano del Seguro Social orgdiv1Centro de investigación Biomédica de Oriente orgdiv2Laboratorio de Fisiopatología en Enfermedades Crónicas Mexico
                [2] Puebla orgnameBenemérita Universidad Autónoma de Puebla orgdiv1Facultad de Medicina Mexico
                [1] Puebla orgnameBenemérita Universidad Autónoma de Puebla orgdiv1Facultad de Nutrición Clínica Mexico
                Article
                S2174-51452020000400009 S2174-5145(20)02400400009
                10.14306/renhyd.24.4.1090
                87aec730-8443-4542-baa4-063e0a737d56

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 30 June 2020
                : 09 September 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 48, Pages: 15
                Product

                SciELO Spain

                Categories
                Investigations

                América Latina,Índice de Masa Corporal,Pesos y Medidas Corporales,Antropometría,Dieta,Estado Nutricional,Anamnesis,Adulto Joven,Diabetes Mellitus Tipo 2,Mexico,Latin America,Body Mass Index,Body Weights and Measures,Anthropometry,Diet,Nutritional Status,Medical History Taking,Young Adult,Diabetes Mellitus, Type 2,México

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