Glycemic control of type 2 diabetic patients after short-term zinc supplementation

This study was carried out to determine whether a short-term zinc supplementation contributes to beneficial changes in glycemic control among type 2 diabetic patients. Seventy-six diabetic subjects and 72 normal adults participated in this study. Subjects were divided into supplemented and control groups. Forty-four diabetic patients and 34 normal subjects were supplemented with 50 mg zinc daily as zinc gluconate for 4 weeks. Zinc status was assessed from fasting plasma levels and urinary excretion. The effects of zinc supplementation on fasting blood glucose, HbA_1c, insulin, and C-peptide were measured at the beginning of the study and after 4 weeks of supplementation. The changes in glycemic control indicators were compared between diabetic groups, classified by baseline HbA_1c levels, and by diabetic duration. At baseline, the incidence of marginal zinc deficiency in the diabetic group, as determined by plasma zinc level, was approximately twice as high as in the normal adult group. The changes of HbA_1c concentration, and fasting blood glucose following supplementation were not statistically significant in diabetic subjects. In normal subjects, a significant decrease of HbA_1c occurred only in the zinc supplemented group. No significant changes were observed for serum insulin and C-peptide in diabetic as well as normal subjects. However, when the changes were compared by baseline HbA_1c level, we found that diabetic subjects with HbA_1c ≥ 7.5% showed significantly improved levels of HbA_1c and fasting glucose after Zn supplementation. While such improvement in fasting blood glucose was significant among diabetics with shorter diabetic duration, significant levels of increase in serum insulin and C-peptide were observed in zinc supplemented subjects with longer diabetic duration. Fasting blood glucose was significantly decreased, whereas serum insulin and C-peptide were increased in diabetics with marginal zinc status. Therefore, we suggest that Zn supplementation for a short-term period may improve glycemic control in diabetic patients with higher HbA_1c levels and marginal zinc status.     

糖尿病病人膳食生糖效应与膳食纤维摄入的关系研究

目的通过对膳食血糖指数(DGI)和膳食血糖负荷(DGL)的评估,研究膳食生糖效应与膳食纤维的关系。方法采用食物称重记账法调查105名2型糖尿病病人的2个3日膳食摄入状况,根据食物血糖指数和膳食碳水化合物摄入量计算DGI和DGL,采用酶-重量法测定食物中总膳食纤维(TDF)、不可溶性膳食纤维(IDF)和可溶性膳食纤维(SDF)含量。结果调查对象的DGI值是62.9±6.8,DGL值是142.4±39.8,TDF、IDF和SDF的摄入量分别是(22.5±6.7)g/d,(16.1±5.5)g/d,(6.4±2.0)g/d。DGI与TDF的相关系数是-0.407(P<0.01)。与DGI最低五分位组的调查对象相比,DGI最高五分位组的调查对象蔬菜类食物摄入量减少了221.9g(P<0.01),TDF、IDF和SDF摄入量分别减少了6.5g、5.0g和1.4g(P值均<0.01),其中由蔬菜提供的膳食纤维减少量最多,谷类摄入量增加了68.0g(P<0.01)。结论DGI与膳食纤维摄入量呈负相关。富含蔬菜和膳食纤维的膳食可降低膳食生糖效应。     

Dietary carbohydrates and glycated proteins in the blood in non diabetic subjects

OBJECTIVES: To evaluate in non diabetic subjects the association of dietary carbohydrates with fructosamine, a measure of total non enzymatic glycated proteins in the blood associated with mortality, particularly from cardiovascular diseases. METHODS: A population sample of 252 subjects (137 men and 115 women, mean age 57) without diabetes and with fasting serum glucose <126 mg/100 mL, participated in the study. Diet and dietary glycemic load were measured with a validated food frequency questionnaire. Fructosamine was measured with a standard colorimetric method. Multiple linear regression was used to analyze the data. RESULTS: Serum fructosamine was positively associated with dietary glycemic load. Moreover, it was positively associated with intake of polyunsaturated fats and alcohol; and negatively with intake of monounsaturated fats, and with physical activity. CONCLUSION: The quality of carbohydrate and fat, as well as physical activity, may explain the variation of non enzymatic glycated serum proteins in non diabetic subjects.     

2型糖尿病患者的膳食状况及其与血糖控制的相关性研究

目的了解2型糖尿病患者的膳食状况及其与血糖控制的相关性。方法对广州某医院的2型糖尿病患者进行3 d 24 h膳食回顾调查、体格测量和血糖检测,并进行膳食状况与血糖控制情况的关联分析。结果共纳入223例2型糖尿病患者,以50～70岁（占54.7%）、男性（占57.0%）和超重（占47.5%）者为主,吸烟和饮酒率分别为23.8%（53/223）和6.7%（15/223）。轻、中、重体力活动者能量摄入量分别占推荐量的113.2%～149.1%、115.6%～122.9%和85.4%～97.4%。膳食纤维摄入量（8.3 g）和蛋白质供能比（14.0%）低于推荐量下限。维生素E和铁摄入量达到或超过推荐量（占104.4%～195.7%）,维生素A、维生素B1、维生素B2、维生素C、钠和钙摄入量未达推荐量（占21.0%～87.8%）。蔬菜、水果、水产品、蛋类、奶类和大豆及坚果类摄入量未达推荐量,畜禽肉摄入量（100 g）超出推荐量上限。FPG、PPG和HbA1c水平分别为（11.4±4.5）、（17.6±5.6）mmol/L和（9.3±2.1）%。血糖控制不良率为84.3%（188/223）,与蛋白质供能比（r=0.165）、钙（r=0.223）和水产品（r=0.257）的摄入量呈正相关关系（P＜0.05或P＜0.01）,且水产品摄入量＜40 g/d和＞75 g/d的患者血糖控制不良率均高于摄入40～75 g/d的患者,钙摄入≥90% RNI的患者血糖控制不良率低于摄入＜90% RNI的患者（均P＜0.01）。结论调查对象膳食不均衡,水产品、钙和蛋白质的摄入不合理可能与血糖控制不良有关,应加强营养教育和血糖监控,及时调整膳食方案。     

Zinc status of asthmatic, prednisone-treated asthmatic, and non-asthmatic children

To assess interrelationships between asthma, corticosteroid therapy, growth, and zinc status in children, measurements of height, zinc and copper in serum and hair, taste acuity, and dietary intakes of energy, protein, zinc,and copper were analyzed for 29 asthmatic, 11 prednisone-treated asthmatic, and 21 non-asthmatic subjects, 6 to 20 years old. Reduced height attainment was significant only for the prednisone-treated asthmatic group and was not correlated with clinical or dietary indexes of zinc status. Dietary intake data were similar for all three groups; in comparison with the RDAs, daily intakes were adequate for both energy and zinc (80% to 90%), high for protein (185% to 225%), and low for copper (35% to 60%). Results confirmed earlier reports of growth retardation in corticosteroid-treated asthmatics; significant indications that reduced food intake or impaired zinc status played a major part were not evident.     

云南大红山铜矿区成年居民铜、铁、锌血清水平和膳食摄入量

目的 了解云南大红山铜矿成年居民铜、铁、锌的血清水平和膳食摄入量.方法 在大红山矿区随机抽取180名成年居民,采用原子吸收分光光度法检测血清铜、铁、锌水平.从180人中随机抽取60人,采刚化学分析法调查膳食铜、铁、锌摄入量.结果 171人的血清铜、铁、锌水平分别为（0.90±0.18）、（1.25±0.93）、（0.75±0.28）mg/L,血清铜和铁呈显著负相关（r=-0.26,P＜0.001）.血清铜与年龄呈显著正相关（r=0.25,P＜0.001）,女性血清铜水平明显高于男性（P=0.011）.60人的膳食铜、铁、锌摄入量分别为（1.74±1.09）、（16.29±10.73）、（7.56±3.38）mg/d,女性均明显低于男性（P＜0.05）.血清铜、铁、锌水平和膳食摄入量均存在地区差异.结论 云南大红山矿区成年居民血清铜、铁水平均正常,血清锌水平偏低.铜、铁、锌的膳食摄入量均未超过可耐受最高摄人量,且部分人摄入量偏低.     

Micronutrient deficiencies as predisposing factors for hypertension in lacto-vegetarian Indian adults

OBJECTIVE: With the increasing knowledge about the antioxidant potential of many micronutrients such as zinc and vitamin C, their roles in oxidative stress related health disorders have been postulated. This study therefore investigated low micronutrient status as a predisposing factor for hypertension in a traditionally lacto-vegetarian population like Indians. METHODS: Micronutrient profile was assessed in 109 hypertensives with age-gender-socio-economic status matched 115 healthy normotensives (30-58 years of age). Food intakes were estimated through a semi-quantitative food frequency questionnaire. Nutrient intakes were then evaluated by previous estimates of cooked foods from our laboratory. Systolic and diastolic blood pressure (SBP, DBP), age, weight, height, waist and hip circumference, occupation, physical activity, smoking habits were recorded. Fasting blood samples were analyzed for hemoglobin, serum level of glucose, triglycerides, total cholesterol, HDL, ceruloplasmin, plasma level of ascorbic acid, folic acid, retinol, erythrocyte glutathione reductase activity coefficient (EGRAC) and erythrocyte membrane zinc. RESULTS: There were no significant differences between protein, fat intakes of normal and hypertensive individuals, though intakes of men were higher than those of women (p < 0.05). Intakes of omega-6 fatty acids were higher (p = 0.08) and omega-3 fatty acids were lower in hypertensive men than normotensive men (p = 0.04). Gender differences were also significant for micronutrient intakes except vitamin C and beta-carotene. Intakes of potassium, copper, folic acid and vitamin C were significantly lower in hypertensive individuals than in normotenisves. No significant association was found between occupation or activity level and hypertension (p > 0.2) in these subjects. Conditional logistic regression analysis indicated that intakes of vitamin C, folic acid and zinc were associated with 18% (OR = 1.18, 95% CI:1.08, 1.26), 51% (OR = 1.51, 95% CI 0.94, 2.1) higher odds for hypertension, and 3% lower odds for hypertension (OR = 0.97, 95% CI 0.92, 1.01), respectively. Mean plasma vitamin C and folic acid were significantly higher (p < 0.01), and serum ceruloplasmin and erythrocyte membrane zinc were marginally higher (p = 0.07) in normal than hypertensive subjects. In multivariate linear regression analyses, plasma vitamin C, serum ceruloplasmin and erythrocyte membrane zinc were negatively associated with SBP (p = 0.00001) and plasma vitamin C was negatively associated with DBP (p = 0.0001). CONCLUSION: Low dietary intakes of vitamin C, folic acid and zinc emerged as the possible risk factors for hypertension. Further, lower levels of plasma vitamin C, erythrocyte membrane zinc and ceruloplasmin were found to be the putative intermediary biomarkers in pathogenesis of hypertension.     

Dietary fat intake and plasma lipid levels in adolescents.

The relationship between dietary fat intake and fasting plasma lipid levels was assessed in 35 female and 19 male adolescents recruited from two local education authority schools in Norwich, UK. Dietary intakes were assessed using a 7-day weighed dietary record method, coupled with the collection of duplicate diets. Fat and energy intakes calculated using food composition tables were compared with values obtained by direct analysis of duplicate diets. Fasting plasma lipid levels (total, HDL and LDL cholesterol and triglycerides) were measured and compared with total dietary lipids and fatty acid intakes. The average proportion of energy consumed as fat was higher than is currently considered desirable but lower than previous studies have reported for adults. Mean serum total cholesterol values were 4.2 (SEM 0.1) mmol for females and 4.5 (SEM 0.2) mmol for males; this difference was not statistically significant. In male subjects the dietary fatty acid profiles were significantly correlated with several parameters of plasma lipid status which are thought to be risk factors for coronary heart disease, and in particular with the ratio of total:HDL cholesterol.     

An audit of diabetes control, dietary management and quality of life in adults with type 1 diabetes mellitus, and a comparison with nondiabetic subjects

OBJECTIVES: The study's objective was to audit current diet and disease management in a community-based sample of people with type 1 diabetes. METHODS: The study involved adults with type 1 diabetes and control subjects. Reported amounts of dietary intake were collected. Indices of diabetes control were determined by standard methods. Quality of life of both groups was assessed with appropriate measures. Results were compared between two groups. RESULTS: Mean HbA(1c) concentration was 8.5% (SD 2.21%) for women with diabetes and 8.6% (SD 1.91%) for men. There was no significant difference between the diabetic and control subjects in self-reported energy intake and macronutrient intake, with the exception that the contribution of saturated fatty acid to energy intake was higher in male controls than in male diabetics. There was no association between dietary intakes and glycemic control in diabetic subjects. Anthropometric measurements, blood pressure and plasma lipids in patients were within normal range and not significantly different from the controls. Plasma fibrinogen concentration was higher in patients. Diabetic subjects did not have a diminished quality of life. CONCLUSIONS: Dietary management in these patients was generally focused on controlling carbohydrate intake. Most had suboptimal diabetes control.     

Current Zinc Intake and Risk of Diabetes and Coronary Artery Disease and Factors Associated with Insulin Resistance in Rural and Urban Populations of North India

Objective: To determine the association between current zinc intake and prevalence of coronary artery disease (CAD) and diabetes as well as factors associated with insulin resistance.

Design, Subjects and Methods: In this cross sectional survey, 3575 subjects, aged 25 to 64 years, including 1769 rural (894 men, 875 women) and 1806 urban (904 men, 902 women) subjects were studied. The survey methods included questionnaires for 7-day food intake record, physical examination, and electrocardiography using World Health Organization criteria.

Results: The prevalence of CAD, diabetes and glucose intolerance was significantly higher among subjects consuming lower intakes of dietary zinc. There was a higher prevalence of hypertension, hypertriglyceridemia and low high-density lipoprotein cholesterol levels which showed significant upward trend with lower zinc intakes. Serum lipoprotein (a) and 2-hour plasma insulin levels also were associated with low zinc intake. Multivariate logistic regression analysis after adjustment for age showed that zinc intake and CAD were inversely associated. Serum zinc (odds ratio:men 0.77, women 0.57), serum triglycerides (men 0.86, women 0.81), blood pressure (0.83 men, women 0.76), diabetes mellitus (men 0.90, women 0.85), central obesity (men 0.88, women 0.87), glucose intolerance (men 0.66, women 0.57) and low high-density lipoprotein cholesterol (men 0.72, women 0.70) were significant risk factors for CAD (explained by tertiles of zinc status) in urban subjects. These associations were not observed in rural subjects.

Conclusion: Lower consumption of dietary zinc and low serum zinc levels were associated with an increased prevalence of CAD and diabetes and several of their associated risk factors including hypertension, hypertriglyceridemia and other factors suggestive of mild insulin resistance in urban subjects.     

Day-to-day consistency in amount and source of carbohydrate intake associated with improved blood glucose control in type 1 diabetes.

OBJECTIVE: To determine if a relationship exists between blood glucose control and variability in nutrient intake from day-to-day in subjects with type 1 diabetes. METHODS: Two three-day diet records and one measurement of glycated hemoglobin (HbA1c) were obtained from 272 subjects with type 1 diabetes treated with a mixture of regular and NPH insulins before breakfast and supper and using a standardized algorithm to adjust insulin dose according to the results of self-monitoring of blood glucose two to four times daily. Day-to-day variation in nutrient intake was expressed as the coefficient of variation (CV = SDx100/mean). RESULTS: Nutrient intakes in the study population (mean +/- SD) were energy 8.35+/-2.43 MJ, fat 81+/-30 g, protein 94+/-28 g, carbohydrate 227+/-68 g, starch 126+/-38 g and dietary fiber 20+/-6 g with diet glycemic index being 84.2+/-7.4. Neither energy, nutrient intakes nor insulin dose was significantly related to HbA1c. Day-to-day variation of carbohydrate (p = 0.0097) and starch (p = 0.0016) intakes and diet glycemic index (p = 0.033) was positively related to HbA1c, and the associations remained significant when adjusted for age, sex, duration of diabetes and BMI. Day-to-day variation in energy, protein or fat intakes was not related to HbA1c. CONCLUSIONS: Consistency in the amount and source of carbohydrate intake from day-to-day is associated with improved blood glucose control in people with type 1 diabetes, a result which supports continued educational efforts to achieve adherence to a diabetes diet plan. This conclusion may not apply to people on intensified insulin therapy who adjust their insulin dose based on their actual carbohydrate intake at each meal.     

An in vivo study of the antioxidant potentials of a plant food concentrate

OBJECTIVE: A plant food concentrate (PF) is a source of antioxidants. Its influence on antioxidant status has never been studied. The present longitudinal study investigated the antioxidant and lipidemic responses in 15 moderately hypercholesterolemic (>5.2 mmol/L) male subjects to the supplemental intakes of PF. METHODS: The participants underwent a two-week period where any previous supplemental intakes were withdrawn. This was followed by a two-week baseline period at entry (control). The baseline period was followed by taking PF concentrate (8.5 g twice daily) for two weeks followed by a washout period for two weeks. All subjects completed food frequency questionnaires at pre-supplemental (baseline) and post-PF period. Fasting heparinized and EDTA blood samples were collected at the end of each period. Erythrocyte superoxide dismutase (SOD), whole blood glutathione peroxidase (GPX) and plasma concentrations of zinc and copper, along with plasma levels of lipids, were determined. RESULTS: The PF supplement contributed significantly to the daily intakes of total dietary fiber. The zinc and copper-dependent SOD but not GPX activity were significantly elevated. The total and LDL-cholesterol concentrations in the plasma were significantly decreased while the ratio of HDL/LDL cholesterol was increased post-PF intake. CONCLUSIONS: These results indicate that the antioxidant and cholesterol status of moderately hypercholesterolemic subjects can be potentially improved with the supplemental intake of PF concentrate.     

食物血糖生成指数在糖尿病营养教育中的应用研究

目的 :　通过营养教育 ,观察糖尿病患者对食物血糖生成指数 (glycemic index,GI)知、信、行的变化 ,以及改变膳食 GI对血糖、血脂的影响。方法 :　选择了 72例糖尿病病例作为研究对象 ,随机分为 2组。试验组以食物 GI为主要教育材料 (GI组 ) ;对照组以食物交换份 (food ex-change list,FEL)为主要教育材料 (FEL组 )。采用课堂讲座、个别辅导、电话咨询等方式教育 5个月。观察教育前后研究对象对所授知识的知晓率、膳食行为、血糖和血脂变化等。结果 :　经过连续教育 5个月后 ,GI组对 GI问题知晓率由 0 %提高到 92 .2 %(P<0 .0 1 ) ,FEL组对 FEL问题的知晓率由 6 .5 %提高到 79.4%(P<0 .0 1 ) ;GI组空腹血糖 (FBG)、餐后 2 h血糖 (2 h PBG)、糖化血红蛋白 (Hb A1c)、总胆固醇 (TC)、血脂综合指数 (LCI)均有显著性下降 (P<0 .0 1 ) ,FEL组仅 FBG、2 h PBG有显著性下降 (P<0 .0 1 )。结论 :　糖尿病营养教育是控制血糖、血脂的有效手段 ;GI知识较易被患者理解和掌握 ,通过 GI知识教育达到控制血糖和血脂的效果较为理想 ,便于在医院门诊和社区教育中广泛推广和应用。     

四川农村贫困地区儿童膳食营养状况评价

目的了解四川农村儿童膳食营养状况,为农村儿童营养干预提供依据。方法随机抽取四川省某县3个乡514名3～10岁农村儿童为研究对象,采用24h膳食回顾法和食物频率法进行膳食调查,并以中国居民膳食营养素参考摄入量（DRIs）为标准,评价膳食能量和各营养素摄入状况。结果调查对象膳食以粮谷类、蔬菜水果类为主;能量达到80%RNI者占18.5%,碳水化合物、脂肪和蛋白质的供能比分别为67.2%,20.4%和12.4%;蛋白质达到80%RNI者占11.7%,钙和铁摄入量达到80%AI值者分别为0.9%和36.2%。锌和视黄醇摄入量达到EAR值的儿童分别为12.4%和17.9%,铁和视黄醇均主要来源于植物性食物。结论四川农村儿童膳食结构不合理,能量和各种营养素摄入普遍不足。     

Development of a Diet Quality Index with Special Reference to Micronutrient Adequacy for Adolescent Girls Consuming a Lacto-Vegetarian Diet

Recent dietary guidelines emphasize micronutrient sufficiency by giving importance to consumption of whole grains and a variety of fruits and vegetables. The objective of this study was to identify a measure of micronutrient quality of diets in adolescent girls consuming a lacto-vegetarian diet. Data were collected on the nutritional status of 630 schoolgirls (ages 10 to 16 years) from Pune city, India, in a cross-sectional survey during 2006-2007. Dietary intakes were assessed by 24-hour recall on 3 nonconsecutive days. Nutrient intakes were calculated from the Indian nutritive value databases. Micronutrient adequacy was expressed as a ratio of observed intake to reference intake. An Adolescent Micronutrient Quality Index (AMQI) was formulated using the Indian and the recent US dietary guidelines. Fasting blood samples were analyzed for plasma levels of vitamin C, beta carotene, and zinc. The average energy intake of the majority of the girls was below the Indian recommended dietary intakes, whereas micronutrient intakes were 50% to 70% lower than recommended dietary intakes. The mean AMQI score was 41.5±9.4. The age of subjects as well as mother's education and occupation were significantly associated with the AMQI. The AMQI was correlated with nutrient intakes and the ratio of observed intake to reference intake (P<0.01) after controlling for energy intake and sociodemographic factors. Higher AMQI scores were associated with higher concentrations of plasma vitamin C (r=0.26), beta carotene (r=0.34), and zinc (r=0.12). The AMQI is a useful measure of the dietary adequacy and micronutrient quality of the diets of adolescent girls consuming lacto-vegetarian diets.     

Assessment of carotenoid status and the relation to glycaemic control in type I diabetics: a follow-up study

OBJECTIVE: To assess the carotenoid status in young type I diabetic patients and its relationship to the glycaemic control of the disease. DESIGN: A follow-up study. SETTING: Hospital Universitario Puerta de Hierro, Health Area VI of Madrid (Spain). SUBJECTS: Forty-seven type I diabetic patients, followed for 2.5 years. INTERVENTIONS: Coinciding with physical examination and laboratory tests, serum levels of carotenoids were analysed by HPLC, and dietary intake of carotenoids was evaluated by a semiquantitative food frequency questionnaire and 3-day prospective dietary records. RESULTS: In type I diabetic patients, average intake, serum levels and correlations between diet and serum levels of carotenoids were comparable to those in reference non-diabetic groups. Between-subjects seasonal variations were observed for beta-cryptoxanthin intake and serum levels (higher in winter) and serum lycopene (higher in summer). Significant within-subjects seasonal changes were shown for dietary and serum beta-cryptoxanthin and serum beta-carotene. Serum carotenoids were unrelated to glycaemic control markers. Subjects with clinically acceptable glycaemic control showed lower lycopene intake than those with unacceptable control. Intake of carotenoids did not explain variance in insulin dose, fasting glycaemia, fructosamine or HbA1c. With the exception of lycopene, serum carotenoids were predicted by dietary intake, but in no case by fasting glycaemia, HbA1c or fructosamine. CONCLUSION: In type I diabetic patients, serum carotenoid concentrations and their variance are determined by dietary intake patterns, and are unrelated to the glycaemic control of the disease, as assessed by biochemical markers.     

Lactobacillus plantarum HAC01 Supplementation Improves Glycemic Control in Prediabetic Subjects: A Randomized,Double-Blind,Placebo-Controlled Trial

A recent animal study demonstrated that administration of Lactobacillus plantarum HAC01 isolated from Korean kimchi improved glycemic control in type 2 diabetic mice. In the present study, we evaluated Lactobacillus plantarum HAC01’s effects on metabolic parameters of prediabetic human subjects. Forty subjects with isolated impaired glucose tolerance were randomly assigned to receive a daily placebo (n = 20) or a dose of Lactobacillus plantarum HAC01 (n = 20) over eight weeks. The primary endpoint was a change in 2 h postprandial glucose (2h-PPG) levels and the secondary endpoints were assessment of other glucose metabolism parameters, including HbA1c, gut microbiota composition, and fecal short-chain fatty acids (SCFAs). The group with a diet supplemented with Lactobacillus plantarum HAC01 saw a significant reduction in 2h-PPG and HbA1c levels compared to the placebo group. Fasting plasma glucose, insulin, HOMA-IR, QUICKI, microbiota composition, and fecal SCFAs, however, were not significantly altered. No serious adverse effects were reported. This is the first clinical trial to show a beneficial effect of single-strain probiotic supplementation administered over eight weeks on HbA1c levels in prediabetic subjects.     

Food habits are related to glycemic control among people with type 2 diabetes mellitus

OBJECTIVE: To investigate the food habits of people with type 2 diabetes and to identify those habits related to glycemic control. DESIGN: The purposive sampling plan targeted people (40 to 65 years old) living in two urban communities in the Southeastern United States with type 2 diabetes for >1 year (60% women, 50% African Americans and low-income individuals). In-depth interviews were used to identify food habits. Glycated hemoglobin (HbA(1c)) was measured to assess glycemic control. SUBJECTS: The final sample contained 89 participants (62% women, 48% African American, and 43% below 200% of the poverty level). STATISTICAL ANALYSES PERFORMED: Analysis of variance, principal component/factor analysis, cluster analysis, and multiple regression were used to relate food habits to glycemic control. RESULTS: A four-factor solution derived from 15 food habits explained 51.5% of the total variance in HbA(1c) values. High factor scores for three factors (Basic Eating Practices, Meal Planning, and Carbohydrate/Vegetable Strategies) and low factor scores for a fourth factor (Challenges of Dining Out) were related to lower HbA(1c) values. Based on similar patterns across the 15 food habits, participants were clustered into four groupings. The clusters differing on HbA(1c) (mean+/-standard deviation) were Healthful Eating Lifestyle (6.25+/-0.25), Disciplined Eating Approach (7.31+/-0.35), Limited Dietary Focus (8.28+/-0.33), and Poor Dietary Management (9.05+/-0.24). These groupings reflected different food habit factor profiles. CONCLUSIONS: Knowledge of the specific food habits of people with diabetes can offer a way to structure a meaningful dialog with clients about dietary self-management and guide the collaborative development of relevant dietary goals.     

Nutritional Evaluation of "Advantaged" Elderly Persons Residing in a Life Care Retirement Center

The nutritional status of a defined group of 49 older men and women living in a non-profit life care retirement center was assessed by means of analysis of dietary intake from food records, anthropometry and biochemical indices. The individuals ranged in age from 70 through 91 years, were generally healthy, had attended college, engaged in professional careers and were of upper socioeconomic status. The mean energy and nutrient intakes were calculated from food composition tables and compared to the 1980 Recommended Dietary Allowances. Dietary, anthropometric and biochemical characteristics of these "advantaged" elderly persons were compared with the nutritional status of free living persons of low and middle socioeconomic status as reported in the literature. The "advantaged" elderly individuals generally had higher nutrient and energy intakes, less subcutaneous fat, lower serum cholesterol and higher serum ascorbic acid values. The apparently better nutrition status of the "advantaged" subjects could be attributed to their good health and appetities, regular physical activity, positive outlook on life, high degree of social interaction and educational attainment, and an income level high enough to permit them to reside in a center which provided total medical care, individual apartments and dining, social and sport facilities.