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ABSTRACT: The present study sought to assess the impact of an intervention to reduce weight and control risk factors of noncommunicable chronic diseases in overweight or obese adults who are users of primary and secondary healthcare units of the public health system of Pelotas, Brazil. We hypothesized that individuals who received an educational intervention regarding how to lose weight and prevent other noncommunicable chronic disease risk factors through nutrition would lose weight and acquire active habits during leisure time more frequently than individuals under regular care. Two hundred forty-one participants from the Nutrition Outpatient Clinic of the Medical Teaching Hospital of the Federal University of Pelotas, Brazil, aged 20 years or older and classified as overweight or obese were randomly allocated to either the intervention group (IG; n = 120) or control group (CG; n = 121). The IG received individualized nutritional care for 6 months, and the CG received individualized usual care of the health services. Intention-to-treat analyses showed that at 6 months, mean fasting glycemia and daily consumption of sweet foods and sodium were reduced, and the time spent on physical leisure activity was increased in IG. Analysis of adherence to the protocol of the study revealed that individuals from IG had lost more in body weight, waist circumference, and fasting glucose compared to the CG. Leisure time physical activity increased in IG. Individuals adhered equally to the dietetic recommendations, irrespective of the nutrition approach that was used.
Nutrition research (New York, N.Y.) 08/2010; 30(8):541-9. · 1.20 Impact Factor
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ABSTRACT: Coffee consumption has been associated with a lower risk of diabetes, but little is known about the mechanisms responsible for this association, especially related to the time when coffee is consumed.
We examined the long-term effect of coffee, globally and according to the accompanying meal, and of tea, chicory, and caffeine on type 2 diabetes risk.
This was a prospective cohort study including 69,532 French women, aged 41-72 y from the E3N/EPIC (Etude Epidémiologique auprès de Femmes de la Mutuelle Générale de l'Education Nationale/European Prospective Investigation into Cancer and Nutrition) cohort study, without diabetes at baseline. Food and drink intakes per meal were assessed by using a validated diet-history questionnaire in 1993-1995.
During a mean follow-up of 11 y, 1415 new cases of diabetes were identified. In multivariable Cox regression models, the hazard ratio in the highest category of coffee consumption [> or =3 cups (375 mL)/d] was 0.73 (95% CI: 0.61, 0.87; P for trend < 0.001), in comparison with no coffee consumption. This inverse association was restricted to coffee consumed at lunchtime (hazard ratio: 0.66; 95% CI: 0.57, 0.76) when comparing >1.1 cup (125 mL)/meal with no intake. At lunchtime, this inverse association was observed for both regular and decaffeinated coffee and for filtered and black coffee, with no effect of sweetening. Total caffeine intake was also associated with a statistically significantly lower risk of diabetes. Neither tea nor chicory consumption was associated with diabetes risk.
Our data support an inverse association between coffee consumption and diabetes and suggest that the time of drinking coffee plays a distinct role in glucose metabolism.
American Journal of Clinical Nutrition 02/2010; 91(4):1002-12. · 6.67 Impact Factor
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ABSTRACT: We investigated whether lifestyle-induced changes in dietary fat quality are related to improvements on glucose metabolism disturbances in Japanese Brazilians at high risk of type 2 diabetes.
One hundred forty-eight first- and second-generation subjects with impaired glucose tolerance or impaired fasting glycemia who attended a lifestyle intervention program for 12 mo were studied in the city of Bauru, State of São Paulo, Brazil. Dietary fatty acid intakes at baseline and after 12 mo were estimated using three 24-h recalls. The effect of dietary fat intake on glucose metabolism was investigated by multiple logistic regression models.
At baseline, mean +/- standard deviation age and body mass index were 60+/-11 y and 25.5+/-4.2kg/m(2), respectively. After 12 mo, 92 subjects had normal plasma glucose levels and 56 remained in prediabetic conditions. Using logistic regression models adjusted for age, gender, generation, basal intake of explanatory nutrient, energy intake, physical activity, and waist circumference, the odds ratios (95% confidence intervals) for reversion to normoglycemia were 3.14 (1.22-8.10) in the second tertile of total omega-3 fatty acid, 4.26 (1.34-13.57) in the second tertile of eicosapentaenoic acid, and 2.80 (1.10-7.10) in the second tertile of linolenic acid. Similarly, subjects in the highest tertile of omega-3:omega-6 fatty acid ratio showed a higher chance of improving glucose disturbances (2.51, 1.01-6.37).
Our findings support the evidence of an independent protective effect of omega-3 fatty acid and of a higher omega-3:omega-6 fatty acid ratio on the glucose metabolism of high-risk individuals.
Nutrition 08/2009; 26(2):184-91. · 3.03 Impact Factor
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ABSTRACT: The prevalence of type 2 diabetes has been escalating throughout the world and usual food consumption is regarded as one of the most important environmental determinants for chronic diseases. Thus, the role of type and quality of carbohydrates on the etiology of type 2 diabetes is still poorly understood. The present review discusses the available epidemiological evidence regarding the effect of the type and source of carbohydrate of the usual diet and the risk of type 2 diabetes in adults. Although epidemiological investigations support the hypothesis for a potential risk effect of high glycemic index and low fiber content diets for diabetes, the results are controversial and the benefit may be related to the magnesium content of the structure of the grains, suggesting the relevance of taking into account the food sources instead of nutrients on investigations of diet and risk of chronic diseases. The available evidence suggests that eating a diet rich in whole grain cereals and vegetables and low in refined grains, sucrose and fructose contents is beneficial in the prevention of diabetes. Thus, more clinical trials are required to support the associations and establish biologically plausible pathways.
Arquivos Brasileiros de Endocrinologia & Metabologia 07/2006; 50(3):415-26. · 0.88 Impact Factor
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ABSTRACT: This study describes the contribution of changes in trans fatty acid intake in relation to serum lipoproteins. A total of 328 Japanese-Brazilians of the first (Issei) and second (Nisei) generations, aged 40-79 years in 1993, were assessed in two cross-sectional surveys on health and nutritional status in 1993 and 2000. Multiple linear regression models were used with changes (2000/ 1993) in serum lipoproteins as the dependent variable and changes in dietary trans fatty acids (adjusted for total calories) as independent variable. In both genders a significant reduction was observed in total intake of trans fatty acids with lower LDL and increased HDL serum levels during 7-year follow-up. The mean intakes of trans fatty acids (% of total energy) in 1993 and 2000 were: 5.1% and 3.4% for women and 4.7% and 3.3% for men, respectively. Although the association between changes in dietary trans fatty acids and serum lipoprotein was not statistically significant, on average the intake of this trans fat was higher than the WHO recommendation (up to 1% of total energy).
Cadernos de Saúde Pública 03/2006; 22(2):357-64. · 0.89 Impact Factor
