Association of body fat distribution with plasma lipids, lipoproteins, apolipoproteins AI and B in postmenopausal women

Associations between the distribution of body fat, measured by the waist/hip circumference ratio (WHR), and plasma lipid fractions were examined in 84 postmenopausal women. WHR was correlated r = 0.39 with body mass index (BMI). After adjustment for BMI and other covariates, WHR was positively and significantly associated with concentrations of triglycerides, apolipoprotein B, low-density lipoprotein cholesterol, and the total cholesterol/high density lipoprotein cholesterol ratio. WHR was negatively and significantly associated with concentrations of high density lipoprotein cholesterol and apolipoprotein AI. These results indicate that in postmenopausal women abdominal fat preponderance is associated with an atherogenic plasma lipid profile, independent of its association with BMI.     

Effect diet therapy on body weight reduction and metabolic control recommended for patients with type 2 diabetes mellitus treated with only diet

The aim of the study to assess the efficacy diet therapy recommended for patients who were recently found to have type 2 diabetes mellitus as well as the influence of the diet on metabolic control of the subjects. The study involved 35 patients of the Dietary Counseling Section of the Central Clinical Hospital of the Ministry of Internal Affairs and Administration in Warsaw. During the course of a 6-month observation, the following parameters were analyzed: body weight, BMI, WHR, indices of metabolic control, such as fasting and post-prandial glycemia, and the level of glycated hemoglobin (HbA1(c)). 6-month dietary intervention brought a decrease in body weight, and improvement in glycemia     

Effects of a high-monounsaturated fat diet on glucose and lipid metabolisms in normal and diabetic mice

The beneficial effects of high-monounsaturated fat (high-MUFA) diets on diabetic patients have been reported, whereas studies concerning the effects on animals have been few. Although experiments on animals should be useful in elucidating underlying mechanisms, it is not clear even whether there are benefits of a high-MUFA diet in animals. This study examined the short-term effects of a high-MUFA diet on normal and genetically diabetic mice. The high-MUFA diet supplied 38% of the total calories as fat (26% from MUFA), while a regular diet was 13% fat (3% from MUFA). Normal C5 7BL/6J and diabetic C57BL/KsJ-db/db mice were fed either the regular or the high-MUFA diet for 1 wk. Serum glucose and lipid levels were then measured. In normal mice, hepatic triglyceride production was also compared between the two dietary groups using the Triton WR1339 method. An oral glucose tolerance test was conducted on the diabetic mice. After 1 wk of feeding to normal mice, the high-MUFA diet was seen to lower serum triglyceride levels and reduce hepatic triglyceride production in comparison with the regular diet; it is suggested that the lowering of triglyceride consists of mechanisms including reduced hepatic triglyceride production. When diabetic mice were fed the high-MUFA diet with a controlled caloric intake, the serum glucose levels lowered without an accompanying deterioration in lipid metabolism and the impaired glucose tolerance was ameliorated. This study demonstrates that a high-MUFA diet can lower serum triglyceride levels in normal mice and improve disorders of glucose metabolism in diabetic mice.     

Mango modulates body fat and plasma glucose and lipids in mice fed a high-fat diet

Consumption of fruits and vegetables has been investigated for their role in the prevention of many chronic conditions. Among the fruits, mango provides numerous bioactive compounds such as carotenoids, vitamin C and phenolic compounds, which have been shown to have antioxidant and anti-inflammatory properties. The present study examined the effects of dietary supplementation of freeze-dried mango pulp, in comparison with the hypolipidaemic drug, fenofibrate, and the hypoglycaemic drug, rosiglitazone, in reducing adiposity and alterations in glucose metabolism and lipid profile in mice fed a high-fat (HF) diet. Male C57BL/6J mice were randomly divided into six treatment groups (eight to nine/group): control (10?% energy from fat); HF (60?% energy from fat); HF+1 or 10?% freeze-dried mango (w/w); HF+fenofibrate (500?mg/kg diet); HF+rosiglitazone (50?mg/kg diet). After 8 weeks of treatment, mice receiving the HF diet had a higher percentage body fat (P?=?0·0205) and epididymal fat mass (P?=?0·0037) compared with the other treatment groups. Both doses of freeze-dried mango, similar to fenofibrate and rosiglitazone, prevented the increase in epididymal fat mass and the percentage of body fat. Freeze-dried mango supplementation at the 1?% dose improved glucose tolerance as shown by approximately 35?% lower blood glucose area under the curve compared with the HF group. Moreover, freeze-dried mango lowered insulin resistance, as indicated by the homeostasis model assessment of insulin resistance, to a similar extent as rosiglitazone and modulated NEFA. The present findings demonstrate that incorporation of freeze-dried mango in the diet of mice improved glucose tolerance and lipid profile and reduced adiposity associated with a HF diet.     

Effects of aerobic exercise on lipids and lipoproteins in adults with type 2 diabetes: a meta-analysis of randomized-controlled trials

OBJECTIVE: To conduct a meta-analysis of randomized-controlled trials in order to examine the effects of 8 weeks or more of aerobic exercise on lipids and lipoproteins in adults with Type 2 diabetes. METHODS: Studies were included if total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), ratio of TC to HDL-C (TC/HDL-C), triglycerides (TG), or all of the above, were assessed. A secondary outcome was glycosylated haemoglobin (HbA1). RESULTS: Seven studies representing 220 men and women (112 exercise, 108 control) were available for pooling. Using a random-effects model, a statistically significant reduction of about 5% was found for LDL-C, whereas no statistically significant improvements were found for TC, HDL-C, TC/HDL-C or TG. A trend for a statistically significant reduction in HbA1 was also found. CONCLUSIONS: Although our overall results suggest that aerobic exercise lowers LDL-C in adults with Type 2 diabetes, additional randomized-controlled trials are needed on this topic.     

2型糖尿病患者膳食质量与血糖控制的相关性研究

目的 评估2型糖尿病患者膳食质量与血糖控制的关系。方法 2019年采取整群抽样法,对蚌埠市某社区332名2型糖尿病患者进行问卷调查,获得人口社会学、膳食摄入、生化指标等信息。使用中国膳食平衡指数-16评价整体膳食质量,检测糖化血红蛋白评价血糖控制状况。构建受试者工作特征曲线以找到中国膳食平衡指数-16分值截断值,将患者分为膳食质量相对较低和较高组,对两个组别进行统计分析。建立logistic回归模型评价患者膳食质量与血糖控制的关系,以糖化血红蛋白含量≥7％作为因变量,调整月收入、生命质量、并发症、总胆固醇和低密度脂蛋白水平。结果 共有290例2型糖尿病患者被最终纳入分析。中国膳食平衡指数-16膳食质量距得分<26％为分组最佳截断值（受试者工作特征曲线下面积0.58,敏感性为74.0%,特异性为45.0%,P=0.020）。饮食质量较高组患者生命质量自我评分、血浆低密度脂蛋白水平较饮食质量较低组高(Z=-3.821、-2.317,P<0.05),差异有统计学意义。调整混杂因素后,低饮食质量组患者血糖控制不良（OR=1.84,95%CI为1.06~3.20;P=0.03）的概率是高饮食质量组的2倍。结论 社区2型糖尿病患者较低的饮食质量（定义为DBI-16膳食质量距得分>26％）与血糖控制不良有关,通过评价整体饮食质量提供相关饮食建议可能是改善患者血糖控制水平的有效方法。     

Effects of low fat diets differing in degree of fat unsaturation on plasma lipids, lipoproteins, and apolipoproteins in adult men

The effects of two low fat diets with differing ratios of polyunsaturated to saturated fatty acids (P/S) on blood lipids, lipoproteins (LP), and apolipoproteins (Apo) were studied in 23 adult men, 30-60 years old, using a crossover design. Both test diets had 25% fat calories with either a P/S of 0.3 (Diet 1) or a P/S of 1.0 (Diet 2) and equivalent amounts of cholesterol. The study consisted of four periods: a 5-week prestudy on self-selected diet (SS), two 6-week test diet periods followed by a second 5-week post-study period on the SS diet. When compared with the SS diet, Diet 2 lowered the mean plasma total cholesterol (TC) by about 20% (P less than 0.01). Low density lipoprotein (LDL) cholesterol was also decreased by about 18% by Diet 2 (P less than 0.01). The high P/S diet did not cause a change in total cholesterol in the high density lipoprotein (HDL) subclass2 (HDL2) when compared to the SS diet. Levels of triglycerides (TG) were slightly reduced in HDL2 but showed a greater reduction in HDL3 in both diets. Phospholipids (PL) were significantly reduced in HDL2 and in HDL3, but the reduction in HDL3 PL was not statistically significant. Apo A-I levels were not changed by either diet when compared with the SS diet, but Apo A-II levels of HDL2 and HDL3 were significantly decreased by the low fat diets, and there was no P/S effect. No other consistent changes in apoprotein levels occurred. Our data suggest that, in men with normal lipid levels, practical dietary changes involving a moderate increase in P/S from 0.3 to 1.0 in a low fat, low cholesterol diet do influence lipoprotein composition and apoprotein distribution in a short time. The reduction in cholesterol in total lipid composition and in LDL lipids which accompanied the reduction of dietary fat and cholesterol are considered to be beneficial.     

初发2型糖尿病肥胖患者体重管理的5年效果及对血糖的影响

目的 了解二甲双胍在初发2型糖尿病患者,特别是肥胖和超重患者体重管理的5年效果及对血糖影响.方法 于我院门诊选取新诊断或病程在1年之内的2型糖尿病患者,无急性并发症,入选患者均符合1999年WHO的糖尿病诊断标准,我们从中筛选人组时使用二甲双胍的患者61例,患者平均年龄（50.8±7.9）岁,男性38例,女性23例,根据体质指数将初发2型糖尿病患者分为肥胖组,超重组和正常组,回顾性分析临床诊疗中二甲双胍管理体重的总体效果,采用重复测量资料的方差分析和多元方差分析,比较各组5年随访期间体重的变化趋势以及对血糖的影响.结果受试者随访2年时BMI下降明显[（26.4±2.7）vs.（25.7±2.6）kg/m2,P＜0.05],与此同时空腹血糖（FBS）和糖化血红蛋白（HbA1 c）都有明显下降,与基线相比差异有统计学意义.随访期间肥胖组和超重组体重明显下降,随访2年时分别下降1.5 kg/m2和0.8 kg/m2,与基线相比有统计学意义,而正常组体重则略有上升（0.7 kg/m2）.基线时肥胖组的FBS和HbA1c相对于正常组低（FBS 7.3±0.8vs.11.8±4.8,P＜0.05;HbA1c 6.8±1.2 vs.8.5±3.1,P＜0.05）,而胰岛素水平则高于正常组（2.20±0.36 vs.1.87±0.29,P＜0.05）.随访2年时肥胖组HbA1c降低的幅度最大,肥胖组、超重组、正常组分别平均降低2.5％,1.4％和1.9％,此时肥胖组与正常组胰岛素水平相近.结论 在初发2型糖尿病肥胖和超重患者中使用二甲双胍进行体重的管理,可以明显减轻体重,进而通过改善高胰岛素水平状态有效的降低血糖,最终达到体重和血糖的双重受益.     

The effect of diet on plasma lipids, lipoproteins, and coronary heart disease

The role that diet plays in the management of plasma lipid levels is discussed in this review. It has long been recognized that saturated fatty acids and cholesterol raise the plasma cholesterol level whereas polyunsaturated fatty acids lower it. Recently, the effects of other dietary constituents in the management of plasma lipid levels have been established. In particular, monounsaturated fatty acids, soluble fiber, and vegetarian diets favorably affect plasma lipid levels. Overweight and obesity adversely affect plasma lipid levels. Omega-3 fatty acids are hypotriglyceridemic, and high carbohydrate diets low in saturated fatty acids are hypocholesterolemic. Further work is required to establish the long-term consequences of alcohol and coffee consumption on the plasma lipid response. A variety of alternative dietary strategies can be employed in conjunction with traditional dietary recommendations (i.e., reduce total fat, especially saturated fatty acids and dietary cholesterol) for the management of plasma lipid levels. The expected plasma total cholesterol (specifically low-density-lipoprotein cholesterol) reduction is approximately 10% to 20% when dietary saturated fatty acids and cholesterol are decreased to less than or equal to 7% of calories and less than or equal to 200 mg of cholesterol per day. Further dietary modifications, such as increasing soluble fiber, may lead to additional reductions of 1% to 10% in plasma total cholesterol.     

Effect of a high-carbohydrate vs a high–cis-monounsaturated fat diet on lipid and lipoproteins in individuals with and without type 2 diabetes

It is not known whether the extent of the improvement in lipids and lipoproteins on a high–cis-monounsaturated (high-mono) diet compared with a high-carbohydrate (high-carb) diet is different in patients with type 2 diabetes mellitus (T2DM) and nondiabetic subjects. The aim of this study is to compare the effect of a high-mono and a high-carb diet on lipids and lipoproteins in patients with T2DM and nondiabetic subjects.

Ten healthy nondiabetic men, 8 men with T2DM on dietary therapy alone, and 10 men with T2DM requiring insulin therapy were fed an isoenergic high-carb diet (60% energy as carbohydrate and 25% as fat) and a high-mono diet (50% energy as fat and 35% as carbohydrate) for 2 to 4 weeks in a randomized, crossover fashion. Dietary fiber, simple carbohydrates, and cholesterol were held constant across diets. The lipid and lipoprotein responses to these diets were compared in nondiabetic and T2DM subjects by repeated measures analysis of variance model. Patients with T2DM had 2.2 to 2.3 times greater reductions in plasma triacylglycerol, very low-density lipoprotein (VLDL) cholesterol, and total cholesterol/high-density lipoprotein cholesterol ratio (TC/HDLC) on the high-mono diet compared with the high-carb diet than the nondiabetic subjects (P = .02-.04). The reductions in triacylglycerol and VLDL cholesterol were 2.7 times greater (P = .009-.02) in T2DM subjects with high plasma triacylglycerol concentrations (>2.26 mmol/L) but only 1.4 to 2.0 times greater (P = .16-.52) in T2DM patients with low triacylglycerol concentrations (<2.26 mmol/L) compared with nondiabetic subjects who all had low triacylglycerol concentrations (<2.26 mmol/L). Patients with T2DM experienced greater decreases in plasma triacylglycerol, VLDL cholesterol, and TC/HDLC on a high-mono diet compared with a high-carb diet than nondiabetic subjects. The extents of the improvements were likely related to plasma triacylglycerol concentrations in patients with T2DM.     

Changes in nutrient intake and dietary quality among participants with type 2 diabetes following a low-fat vegan diet or a conventional diabetes diet for 22 weeks

BACKGROUND: Although vegan diets improve diabetes management, little is known about the nutrient profiles or diet quality of individuals with type 2 diabetes who adopt a vegan diet. OBJECTIVE: To assess the changes in nutrient intake and dietary quality among participants following a low-fat vegan diet or the 2003 American Diabetes Association dietary recommendations. DESIGN: A 22-week randomized, controlled clinical trial examining changes in nutrient intake and diet quality. SUBJECTS/SETTING: Participants with type 2 diabetes (n=99) in a free-living setting. RESEARCH DESIGN AND METHODS: Participants were randomly assigned to a low-fat vegan diet or a 2003 American Diabetes Association recommended diet. MAIN OUTCOME MEASURES: Nutrient intake and Alternate Healthy Eating Index (AHEI) scores were collected at baseline and 22 weeks. STATISTICAL ANALYSES PERFORMED: Between-group t tests were calculated for changes between groups and paired comparison t tests were calculated for changes within-group. Pearson's correlation assessed relationship of AHEI score to hemoglobin A1c and body weight changes. RESULTS: Both groups reported significant decreases in energy, protein, fat, cholesterol, vitamin D, selenium, and sodium intakes. The vegan group also significantly reduced reported intakes of vitamin B-12 and calcium, and significantly increased carbohydrate, fiber, total vitamin A activity, beta carotene, vitamins K and C, folate, magnesium, and potassium. The American Diabetes Association recommended diet group also reported significant decreases in carbohydrate and iron, but reported no significant increases. The vegan group significantly improved its AHEI score (P<0.0001), while the American Diabetes Association recommended diet group did not (P=0.7218). The difference in AHEI score at 22 weeks between groups was significant (P<0.0001). With both groups combined, AHEI score was negatively correlated with both changes in hemoglobin A1c value (r=-0.24, P=0.016) and weight (r=-0.27, P=0.007). CONCLUSIONS: Vegan diets increase intakes of carbohydrate, fiber, and several micronutrients, in contrast with the American Diabetes Association recommended diet. The vegan group improved its AHEI score whereas the American Diabetes Association recommended diet group's AHEI score remained unchanged.     

Long-term effect of a low-fat, high-carbohydrate diet on plasma lipids of patients affected by familial endogenous hypertriglyceridemia

We evaluated the effect of a low-fat, high carbohydrate (LFHC) diet on plasma lipids in 10 patients affected by familial endogenous hypertriglyceridemia. All the patients studied underwent a base-line period of 4 wk, a 12-wk intervention period, and an 8-wk switch-back period. During the control periods patients consumed approximately 45% of energy as fat and approximately 40% as carbohydrate. During the intervention period they consumed an isocaloric diet containing approximately 25% of energy as fat and approximately 60% as carbohydrate. Total plasma triglyceride and cholesterol levels decreased significantly after 45 and 90 d of treatment (p less than 0.01). The reduction of plasma cholesterol was associated mostly with the decrease in VLDL cholesterol (p less than 0.01) while LDL cholesterol increased at days 45 and 90 of the LFHC diet (p less than 0.01). Finally, we observed a significant increase in HDL cholesterol both at days 45 and 90 of the LFHC diet (p less than 0.01). The LFHC diet we used may be an useful tool in the management of hypertriglyceridemia.     

Effects of a high-protein and low-fat diet vs a low-protein and high-fat diet on blood glucose, serum lipoproteins, and cholesterol metabolism in noninsulin-dependent diabetics

Six middle-aged patients with noninsulin-dependent diabetes and six normoglycemic control subjects were fed protein-rich and fat-poor (diet A) or protein-poor and fat-rich food (diet B). The patients were hyperglycemic, VLDL triglycerides levels were higher, and HDL cholesterol levels lower than corresponding findings in control subjects. Bile acid formation and biliary lipid composition did not differ between the two groups, but net steroid balance in the patients was elevated by a factor of approximately 2. A switch from diet A to diet B in control subjects was associated with an increase in HDL cholesterol and decreases in bile acid synthesis and net steroid balance. Lipoprotein pattern in the patients remained unchanged, and effects on total bile acid production and steroid balance were less consistent. It is suggested that the response in the patients reflected diabetes-associated abnormalities in lipid metabolism.     

The effect of case management on glycemic control in patients with type 2 diabetes

Diabetes is a chronic yet controllable disease. It is not like a broken arm; it cannot be seen and will never heal completely. Although people can live long, full lives with diabetes, the disease will affect their and their family's lifestyles. However, diabetics can take comfort in knowing that diabetes is one disease over which they, given the appropriate tools, can exercise enormous control.[1] Case management (CM) of diabetic care that ensures appropriate therapy, based on the American Diabetes Association's (ADA) Clinical Practice Recommendations, effectively optimizes diabetic health and slows the progression of complications. [2] Fewer complications mean fewer resources are used and the overall cost of long-term care is decreased.     

Increased homocysteinemia is associated with beneficial effects on body weight after long-term high-protein, low-fat diet in rats

ObjectiveDiets rich in protein are often used for weight loss in obese patients, but their long-term effects are not fully understood. Homocysteine (Hcy) is considered to be a risk factor for cardiovascular diseases, and its levels are influenced by diet, particularly the protein and fat content. We studied the effect of diets with varying fat/protein content on body weight and composition, food intake, Hcy, B vitamins, leptin, and several pro-inflammatory cytokines.MethodsFor 2 mo, Long-Evans rats were fed either a low protein/high fat (LP), a standard control (C), or a high protein/low fat (HP) diet containing 5, 15, or 40% protein, respectively, and normal carbohydrate content (55% of total energy).ResultsThe HP rats ingested 12 to 15% fewer calories (P < 0.001), gained less weight (P < 0.04), and were less fatty (P < 0.01) than the other groups. Plasma Hcy was increased in HP rats compared to C (+23%) and LP (+29%) rats (P < 0.03). It was positively correlated with protein intake (r = 0.386; P < 0.01). No obvious signs of inflammation were observed in any of the groups. Hcy increase was related directly to decrease in plasma folate (r = ?0.372; P < 0.02).ConclusionThese data confirm the beneficial effects of HP diets on body weight but bring attention to the control of folate allowance to limit the adverse effects of elevated Hcy. Ingestion of folate-rich foods or even folate supplementation should be considered when using these HP diets over the long term for weight loss.     

Relating sociodemographic factors and glycemic control among inpatients with type 2 diabetes

Journal of Public Health - Diabetes is a major public health concern and is significantly linked to mental illness and adverse health outcomes. The overarching goal of this study was to...