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      Dietary Patterns in Relation to Metabolic Syndrome among Adults in Poland: A Cross-Sectional Study

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          Abstract

          In several populations the associations between diet and the risk of metabolic syndrome have not been fully examined yet. The aim of the study is to identify the main dietary patterns among Polish adults and the evaluation of the relationships of these patterns with metabolic syndrome and its components. The study was conducted on a group of 7997 participants, aged between 37 and 66 years old. Dietary patterns were identified by factor analysis. Metabolic syndrome was defined according to the International Diabetes Federation. Three dietary patterns were identified and designated as: “Healthy”, “Westernized” and “Traditional-carbohydrate”. In the adjusted model, a higher score in the “Westernized” pattern aligns with a higher risk of abnormal glucose concentration ( p trend = 0.000), but with a lower risk of abnormal High-Density Lipoprotein Cholesterol HDL-cholesterol concentration ( p trend = 0.024). Higher scores in the “Traditional-carbohydrate” pattern were connected with the risk of abdominal obesity ( p trend = 0.001) and increased triglycerides concentration ( p trend = 0.050). Our results suggest that adherence to the “Traditional-carbohydrate” dietary pattern, characterized by higher intakes of refined grains, potatoes, sugar and sweets is associated with a higher risk of abdominal obesity and triglyceridemia. A “Westernized” dietary pattern on the other hand, is related to hyperglycemia. The study results can be used for community-based health promotion and intervention programs to prevent or better manage chronic diseases.

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          Effects of lifestyle modification on metabolic syndrome: a systematic review and meta-analysis

          Background To evaluate the effect of lifestyle modifications on metabolic syndrome (MetS) as assessed by its resolution and improved values for its components. Methods This was a systematic review and meta-analysis. Searches were performed of MEDLINE and the Cochrane Database from January 1966 to October 2011 to identify randomized controlled trials (RCTs) related to the study objective. The included studies were RCTs restricted to the English language, with a follow-up period of 6 months or more, which reported overall resolution of MetS or values of MetS components (fasting blood glucose, waist circumference, high-density lipoprotein (HDL), triglycerides, and systolic and diastolic blood pressure (SBP, DBP)). Two investigators independently assessed study eligibility. The effect sizes were the relative proportion of patients with resolved MetS and mean differences in MetS component values from baseline to 1-year follow-up in a lifestyle-modification intervention (LMI) group versus a control (conventional lifestyle education or no treatment) group. Meta-analyses were conducted using a random-effects model. Results Eleven interventions in eight RCTs were used for the meta-analyses. The relative proportion of patients with resolved MetS in the intervention group was approximately 2.0 (95% CI 1.5 to 2.7) times greater in the intervention group compared with the control group (7 interventions, n = 2.839). LMI (5 interventions, n = 748) significantly reduced mean values for SBP by -6.4 mmHg (95% CI -9.7 to -3.2), DBP by -3.3 mmHg (95% CI -5.2 to -1.4), triglycerides by -12.0 mg/dl (95% CI -22.2 to -1.7), waist circumference by -2.7 cm (95% CI -4.6 to -0.9), and fasting blood glucose by -11.5 mg/dl (95% CI -22.4 to -0.6) (5 interventions), but reductions were not significant for HDL (1.3 mg/dl; 95% CI -0.6 to 3.1). Conclusions The LMI was effective in resolving MetS and reducing the severity of related abnormalities (fasting blood glucose, waist circumference, SBP and DBP, and triglycerides) in subjects with MetS.
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            Associations between red meat intake and biomarkers of inflammation and glucose metabolism in women.

            Greater red meat intake is associated with an increased type 2 diabetes and cardiovascular disease risk. However, the relation of red meat intake to biomarkers of inflammation and glucose metabolism has not been investigated thoroughly. We hypothesized that greater red meat intake would be associated with biomarkers of inflammation and glucose metabolism, which would be partly explained by body mass index (BMI). We analyzed cross-sectional data from diabetes-free female participants in the Nurses' Health Study (n = 3690). Multiple linear regression was conducted to assess the associations of total, unprocessed, and processed red meat intakes (quartile categories) with plasma C-reactive protein (CRP), ferritin, adiponectin, fasting insulin, and hemoglobin A1c (Hb A1c). Greater total, unprocessed, and processed red meat intakes were associated with higher plasma CRP, ferritin, fasting insulin, and Hb A1c and lower adiponectin after adjustment for demographic information (P-trend ≤ 0.03 for all). Adiponectin was not associated with any type of red meat intake when further adjusted for medical and lifestyle factors. After adjustment for BMI, most of these associations with inflammatory and glucose metabolic biomarkers were substantially attenuated and no longer significant. BMI accounted for a statistically significant proportion of associations with CRP, Hb A1c, and fasting insulin (P-contribution ≤ 0.02 for all) but not with ferritin. Substituting a serving of total red meat intake with alternative protein food in a combination of poultry, fish, legumes, and nuts was associated with significantly lower CRP (β ± SE: -0.106 ± 0.043), ferritin (-0.212 ± 0.075), Hb A1c (-0.052 ± 0.015), and fasting insulin (-0.119 ± 0.036) (all P ≤ 0.02 for comparison of extreme quartiles for all). Greater red meat intake is associated with unfavorable plasma concentrations of inflammatory and glucose metabolic biomarkers in diabetes-free women. BMI accounts for a significant proportion of the associations with these biomarkers, except for ferritin. Substituting red meat with another protein food is associated with a healthier biomarker profile of inflammatory and glucose metabolism.
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              Meat consumption, diabetes, and its complications.

              Several prospective studies have reported that risk of type 2 diabetes (T2DM) is elevated in meat consumers, especially when processed meats are consumed. Elevated risks of coronary heart disease (CHD) and stroke in meat consumers have also been reported. In this overview, the evidence regarding meat consumption and the risk of diabetes, both type 1 diabetes (T1DM) and T2DM and their macro- and microvascular complications, is reviewed. For T2DM, we performed a new meta-analysis including publications up to October 2012. For T1DM, only a few studies have reported increased risks for meat consumers or for high intake of saturated fatty acids and nitrates and nitrites. For T2DM, CHD, and stroke, the evidence is strongest. Per 100 g of total meat, the pooled relative risk (RR) for T2DM is 1.15 (95 % CI 1.07-1.24), for (unprocessed) red meat 1.13 (95 % CI 1.03-1.23), and for poultry 1.04 (95 % CI 0.99-1.33); per 50 g of processed meat, the pooled RR is 1.32 (95 % CI 1.19-1.48). Hence, the strongest association regarding T2DM is observed for processed (red) meat. A similar observation has been made for CHD. For stroke, however, a recent meta-analysis shows moderately elevated risks for meat consumers, for processed as well as for fresh meats. For the microvascular complications of diabetes, few prospective data were available, but suggestions for elevated risks can be derived from findings on hyperglycemia and hypertension. The results are discussed in the light of the typical nutrients and other compounds present in meat--that is, saturated and trans fatty acids, dietary cholesterol, protein and amino acids, heme-iron, sodium, nitrites and nitrosamines, and advanced glycation end products. In light of these findings, a diet moderate to low in red meat, unprocessed and lean, and prepared at moderate temperatures is probably the best choice from the public health point of view.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                17 December 2017
                December 2017
                : 9
                : 12
                : 1366
                Affiliations
                [1 ]The Department of the Prevention of Alimentary Tract Diseases, The Institute of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Jan Kochanowski University, ul. IX Wieków Kielc 19, 25-317 Kielce, Poland
                [2 ]The Department of Surgery and Surgical Nursing with the Scientific Research Laboratory, The Institute of Medical Sciences, Faculty of Medicine and Health Sciences, Jan Kochanowski University, ul. IX Wieków Kielc 19, 25-317 Kielce, Poland; dorota.koziel@ 123456wp.pl (D.K.); dorota.rebak@ 123456ujk.edu.pl (D.R.); sgluszek@ 123456wp.pl (S.G.)
                [3 ]The Department of Developmental Age Research, Institute of Public Health, Faculty of Medicine and Health Sciences, Jan Kochanowski University, ul. IX Wieków Kielc 19, 25-317 Kielce, Poland; elaciesla@ 123456poczta.onet.pl
                Author notes
                [* ]Correspondence: edyta.suliga@ 123456ujk.edu.pl ; Tel.: +48-41-349-69-09; Fax: +48-41-349-69-16
                Author information
                https://orcid.org/0000-0003-3063-0380
                https://orcid.org/0000-0001-8114-1814
                https://orcid.org/0000-0001-7752-0459
                Article
                nutrients-09-01366
                10.3390/nu9121366
                5748816
                29258212
                d0760eef-418d-4b43-bfb0-501766e81f00
                © 2017 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 16 October 2017
                : 14 December 2017
                Categories
                Article

                Nutrition & Dietetics
                dietary patterns,adults,metabolic syndrome,international diabetes federation/2009

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