The relation of sugar intake to beta cell function in overweight Latino children

BACKGROUND: Few studies have investigated the association between sugar intake and insulin dynamics in children, and none have examined this association in overweight Latino youth. OBJECTIVE: We aimed to examine the relation between dietary components, especially sugar intake, and insulin dynamics in overweight Latino youth. DESIGN: We examined 63 overweight Latino children aged 9-13 y. Dietary intake was determined by 3-d records, and body composition was measured with dual-energy X-ray absorptiometry. Insulin sensitivity (S(I)), acute insulin response (AIR), and disposition index (an index of beta cell function) were measured by using a frequently sampled intravenous-glucose-tolerance test and minimal modeling. Hierarchical regression analysis ascertained the potential independent relation between insulin dynamics and dietary components. RESULTS: The relation between macronutrient intake and any variable related to insulin dynamics was not significant. However, higher total sugar intake, although not related to S(I), was significantly associated with lower AIR (beta = -0.296, P = 0.045) and lower beta cell function (beta = -0.421, P = 0.043), independent of the covariates age, sex, body composition, Tanner stage, and energy intake. Sugar-sweetened beverage intakes trended toward inverse association with lower AIR (beta = -0.219, P = 0.072) and beta cell function (beta = -0.298, P = 0.077). CONCLUSIONS: In overweight Latino children, higher intakes of sugar and sugar-sweetened beverages were associated with lower AIR and disposition index, which suggested that these children already have early signs of poor beta cell function. These results emphasize the need for early nutritional interventions to reduce daily sugar intake in overweight Latino children and potentially reduce their risk for type 2 diabetes.     

Dietary flavan-3-ols intake and metabolic syndrome risk in Korean adults

Flavan-3-ols are a subclass of flavonoids found in a variety of foods including teas. The effects of flavan-3-ols on the risk of metabolic syndrome (MetS) have been investigated, generally focusing on tea catechins or individual flavan-3-ol rich foods, but there is little information on dietary flavan-3-ols intake and risk of MetS in population-based studies. In this cross-sectional study, we examined the association between dietary flavan-3-ols intake and the risk of MetS in Korean adults. Subjects comprised 1,827 men and 2,918 women aged 20-69 years whose data was included in the 2008 Korean National Health and Nutrition Examination Survey. This survey was conducted between January 2008 and December 2008. Total flavan-3-ols intakes were calculated from 24-hour dietary recalls using a flavonoids database. Thirty percent of the male subjects and 24% of the female subjects were reported as having MetS. In the female subjects, flavan3-ols intake was inversely associated with the risk of MetS after adjusting for potential confounders (5th vs. 1st quintile, OR = 0.64, 95% CI = 0.45-0.91, P for trend = 0.384). The main food source of flavan-3-ols was green tea followed by apples and grapes. Among MetS components, flavan3-ols intake was inversely associated with the risk of high blood pressure after adjusting for potential confounders (5th vs. 1st quintile, OR = 0.64, 95% CI = 0.45-0.90, P for trend = 0.005). No significant association between flavan-3-ols intake and risk of MetS was found in the male subjects. After stratified analysis by obesity (BMI ≥ 25 or BMI < 25), however, flavan3-ols intake was inversely related to the risk of hypertension in non-obese men. These results suggest that dietary flavan-3-ols intake may have beneficial effects on MetS risk by reducing the risk of hypertension. The effects of flavan-3-ols intake dependent on obesity need further investigation.     

Dietary magnesium intake is related to metabolic syndrome in older Americans

BACKGROUND: Magnesium (Mg) is an essential cofactor for enzymes involved in glucose and insulin metabolism. Low intakes of dietary magnesium may be linked to greater risk of metabolic syndrome (MS) in older adults. AIM OF THE STUDY: The objective of this study was to examine the cross-sectional relationship between dietary Mg intake, metabolic risk factors and MS in elderly adults. METHODS: This study was conducted in a sample of 535 (179 men and 356 women) community-living adults aged 60 years and in Boston Massachusetts between the years 1981 and 1984. Dietary Mg intake was assessed by a 3-day food record and categorized by quartiles of dietary intake. The MS was defined based on criteria set by the Third Report of the National Cholesterol Education Program except that body mass index was used in place of waist circumference. Logistic regression analysis was used to examine the association between quartile categories of Mg intake, prevalence of MS and components of the MS. Models were adjusted for age, gender, BMI, race, educational attainment, marital status, smoking status, alcohol intake, exercise, energy intake, percentage of calories from saturated fat, use of antihypertensive or lipid medication. RESULTS: Mg intake was inversely associated with the MS; those with the highest intake of Mg had significantly lower risk of having MS compared to the lowest quartile of intake (OR: 0.36, 95% CI 0.19-0.69, P for trend 0.002). Significant inverse relationships were observed between Mg intake and BMI (OR: 0.47, 95% CI: 0.22-1.00, P trend = 0.03), and fasting glucose (OR: 0.41, 95% CI 0.22-0.77, P trend = 0.005). CONCLUSION: Our study demonstrates that Mg intake is inversely associated with prevalence of the MS in older adults. Older adults should be encouraged to eat foods rich in Mg, such as green vegetables, legumes and whole-grains.     

Dietary intake in a randomized-controlled pilot of NOURISH: A parent intervention for overweight children

Objective

NOURISH is a community-based treatment program for parents of overweight and obese children (ages 6-11, BMI ≥ 85th percentile). This study examined the impact of Nourishing Our Understanding of Role modeling to Improve Support and Health on child and parent dietary intake, secondary trial outcomes.

Methods

In Virginia from 2008 to 2009, this randomized controlled pilot was implemented and dietary assessment of parents and children conducted at baseline, post-test, and 6-month follow-up. Parents (85% female, 62% African American, mean BMI = 34.1 ± 9.1) were randomized into intervention (n = 46) or control (n = 50) groups. Children's (mean age = 8.6 ± 1.5) mean Body Mass Index percentile was 98.1 ± 2.6. Parents completed 24-hour dietary records for themselves and their child(ren). Repeated measures analyses assessed treatment effects over time. T-tests evaluated within-group changes from baseline to post-test and to follow-up, using a modified intent-to-treat approach.

Results

Both groups reported significant dietary changes, with few treatment effects found. For parents in NOURISH, significant improvements were found in intakes of total kilocalories/day, grams/day of carbohydrates and sugar, and percent calories from protein (p < 0.05). Among control group children, significant improvements in total kilocalories/day and grams/day of carbohydrates and sugar were found (p < 0.05).

Conclusions

Among parents who self-select into a childhood obesity program, minimal intervention can elicit short-term dietary changes comparable to those of a structured intervention.     

广州市中小学生超重肥胖与代谢综合征关联性

了解广州市儿童青少年代谢综合征(MS)的流行现况,探讨儿童青少年超重和肥胖与MS的关系.方法 采用整群随机抽样的方法在广州市区抽取7所中小学共1 242名10~17岁的中小学生为研究对象,进行身高、体重、腰围、血压的测量和血液中MS组分的检测,比较不同体质量指数(BMI)组儿童青少年MS组分的水平及异常情况,计算MS患病率.结果 超重和肥胖组儿童青少年的腰围(WC)、收缩压(SBP)、舒张压(DBP)和三酰甘油(TG)水平均高于正常体重组,高密度脂蛋白(HDL-C)水平低于正常体重组,差异均有统计学意义(P值均<0.05).肥胖组的WC,SBP,DBP,TG和HDL-C异常检出率均最高,而正常体重组最低(P值均<0.05).广州市10~17岁儿童青少年MS患病率为2.9%,其中正常体重、超重和肥胖儿童青少年MS检出率分别为1.0%,13.7%和32.4%.结论 超重和肥胖儿童青少年MS患病率显著高于正常体重组,且随BMI增加而增加,预防和控制儿童青少年肥胖和代谢综合征的发生势在必行.     

Dietary treatment of the metabolic syndrome

The metabolic syndrome consists of a group of metabolic abnormalities that at least in the early phases are easily treated with a nutritional intervention. Although there has been considerable debate in the past is now evident that the quality and the quantity of the dietary carbohydrate (CHO) content has a central role in the control of the hyperglycemia and the coexistent hyperlipidemia. Also the favorable role of the Monounsaturated Fatty Acids (MUFA) has emerged. Although the effect of some micronutrients is still to be defined and any dietary advice should be tested at the individual level, clear guidelines for the treatment of these subjects have now been defined.     

Dietary soya intake alters plasma antioxidant status and lipid peroxidation in postmenopausal women with the metabolic syndrome

Postmenopausal women with the metabolic syndrome are at high risk of oxidative stress. Several studies have suggested possible antioxidant properties of soya, but little evidence is available regarding the effect of soya on oxidative stress in postmenopausal women with the metabolic syndrome. The objective of the present study was to determine the effects of soya consumption on plasma total antioxidant capacity (TAC) and malondialdehyde (MDA) level in postmenopausal women with the metabolic syndrome. A randomised cross-over trial was undertaken on forty-two postmenopausal women with the metabolic syndrome. Participants were randomly assigned to consume a control (Dietary Approaches to Stop Hypertension; DASH) diet, a soya protein diet, or a soya nut diet, each for 8 weeks. Red meat in the DASH diet (one serving per d) was replaced by soya protein in the soya protein period and by soya nuts in the soya nut period. Significant differences between the end values of the control diet, soya protein diet and soya nut diet were seen for MDA (0.70, 0.64 and 0.63 mumol/l; global P < 0.01). The results also showed a significant difference between the end values for TAC (1950, 2030 and 2110 mumol/l, respectively; P < 0.01). The difference from control for TAC was +4.5 % (P < 0.01) in the soya nut period and +5.8 % (P < 0.01) in the soya protein regimen. Both soya nuts and soya protein decreased MDA significantly compared with the control diet (difference from control was - 7.9 % (P < 0.01) in the soya nut period and - 9.4 % (P < 0.01) in the soya protein diet). We conclude that soya consumption reduces plasma MDA and increases plasma TAC levels in postmenopausal women with the metabolic syndrome.     

超重肥胖儿童非酒精性脂肪肝病与代谢综合征相关性研究

【目的】了解超重肥胖儿童非酒精性脂肪肝病(nonalcoholic fatty liver disease,NAFLD)中代谢综合征(metabolic syndrome,MS)的发病情况,探讨NAFLD与MS的相互关系。【方法】对212例超重肥胖儿童进行体格测量、血液生化检测和肝脏超声检查,分析NAFLD与MS的关系。【结果】共检出NAFLD患儿109例,MS 64例。腹型肥胖、高血糖、血脂紊乱、高血压、NAFLD和MS的检出率分别为85.8%、12.7%、57.1%、35.4%、51.4%和30.2%。与无NAFLD的103例相比,两组在体质指数、甘油三酯、稳态模型胰岛素抵抗指数(Homa-IR)和敏感指数(Homa-IAI)以及MS组分数等方面差异有高度统计学意义(P0.001)。腹型肥胖、高血糖、血脂紊乱、高血压发生NAFLD的比值比(OR)分别是非NAFLD组的2.168、2.348、2.145、2.418倍,而MS患者患NAFLD的风险最高(OR=3.109)。109例NAFLD患者中,108例存在1项或多项代谢紊乱,所有代谢紊乱都具有者15例(13.8%)。【结论】超重肥胖儿童NAFLD伴发MS较普遍,NAFLD与MS及其组分密切相关,是儿童MS在肝脏的表现。     

Dietary selenium intake of preschool children

The results of this investigation indicate that the range of selenium intakes of the preschool children who were studied was in the acceptable range of adequate and safe as suggested by the Food and Nutrition Board. The majority of the selenium in the diets of the subjects came from grains. Although the amount of selenium consumed was within normal limits, the concentration in the diet was estimated to be 70% of the expected value for mixed diets, i.e., 0.1 microgram/gm.     

7～17岁超重肥胖儿童青少年代谢综合征流行现况

目的描述7～17岁超重肥胖儿童青少年中代谢综合征(MS)的流行现况。方法采用分层多阶段整群随机抽样方法,对7～17岁儿童青少年2752人进行分析。采用Cook标准进行代谢综合征判定。结果研究人群代谢综合征患病率为3.2%,在体重正常、超重、肥胖的儿童青少年中,MS患病率分别为0.7%、8.0%、23.9%。在控制了其他影响因素后,MS各组分患病率、MS患病率在超重和肥胖儿童青少年中都成倍增加。较多发生的异常为腹型肥胖(超重、肥胖者:41.6%和77.9%)、高血清甘油三酯(超重、肥胖者:36.4%和50.7%)和高血压(超重、肥胖者:19.6%和39.0%)。在体重正常、超重和肥胖者中,至少有1项MS组分的分别为40.3%、65.6%和90.6%;肥胖者中有62.9%至少有2项MS异常;3项以上异常聚集者在肥胖者中为23.9%;有4项以上异常聚集的均为超重和肥胖儿童青少年。结论超重肥胖儿童青少年多存在明显的代谢紊乱。     

代谢综合征的饮食营养干预

代谢综合征(metabolic syndrome)是一种包括葡萄糖代谢异常、肥胖(特别是腹型肥胖)、高血压、血脂代谢紊乱等临床症候群.体力活动不足和不健康的饮食使代谢综合征患病率不断攀升[1],已成为目前国内外共同关注的热点健康问题.据报道美国代谢综合征人群患病率已达25%以上,我国几个城市的代谢综合征患病率为14%～17%,而在高血压、糖尿病和肥胖等特定人群中符合代谢综合征诊断者则高达50%～80%[2].     

Metabolic syndrome in overweight and obese Japanese children

OBJECTIVE: To determine the prevalence of and sex differences related to the metabolic syndrome among obese and overweight elementary school children. RESEARCH METHODS AND PROCEDURES: Subjects were 471 overweight or obese Japanese children. Children meeting at least three of the following five criteria qualified as having the metabolic syndrome: abdominal obesity, elevated blood pressure, low high-density lipoprotein-cholesterol levels, high triglyceride levels, and high fasting glucose levels. Fasting insulin levels were also examined. RESULTS: Japanese obese children were found to have a significantly lower prevalence (17.7%) of the metabolic syndrome than U.S. obese adolescents (28.7%, p = 0.0014). However, Japanese overweight children had a similar incidence (8.7%) of the metabolic syndrome compared with U.S. overweight adolescents (6.8%). Hyperinsulinemia in girls and abdominal obesity in boys are characteristic features of individual metabolic syndrome factors in Japanese children. DISCUSSION: The prevalence of the metabolic syndrome is not lower in preteen Japanese overweight children than in U.S. overweight adolescents, although it is significantly lower in Japanese obese preteen children than in U.S. obese adolescents. Primary and secondary interventions are needed for overweight preteen children in Japan.     

Social norms in food intake among normal weight and overweight children

This experimental study investigated whether children's food intake is influenced by a peer's intake directly and over time and whether this depends upon weight status. The study consisted of two sessions taking place at Dutch primary schools. During the first (social modeling) session, the participants (N=223) were asked to solve a puzzle with a same-sex normal weight confederate who was instructed to either eat nothing, a small or large amount. In the second session (about two days later), the participants had to solve the puzzle alone while they could freely eat. The study involved a three (no, low, high confederate intake) by two (normal weight, overweight) between-participants design. An interaction effect in the first session suggested that overweight children might be triggered to (over)eat when a peer eats a high amount of snack food, whereas the food intake of normal weight children seemed to depend on whether the confederate did actually eat, regardless of the amount. The guideline set during the first session persisted over time and influenced food intake during the second session, while differences between normal- and overweight children became insignificant. Peers can set an example as to what food intake is appropriate which could affect long-term food intake.     

Dietary fat, insulin sensitivity and the metabolic syndrome

Insulin resistance is the pathogenetic link underlying the different metabolic abnormalities clustering in the metabolic syndrome. It can be induced by different environmental factors, including dietary habits. Consumption of energy-dense/high fat diets is strongly and positively associated with overweight that, in turn, deteriorates insulin sensitivity, particularly when the excess of body fat is located in abdominal region. Nevertheless the link between fat intake and overweight is not limited to the high-energy content of fatty foods; the ability to oxidize dietary fat is impaired in some individuals genetically predisposed to obesity. Insulin sensitivity is also affected by the quality of dietary fat, independently of its effects on body weight. Epidemiological evidence and intervention studies clearly show that in humans saturated fat significantly worsen insulin-resistance, while monounsaturated and polyunsaturated fatty acids improve it through modifications in the composition of cell membranes which reflect at least in part dietary fat composition. A recent multicenter study (KANWU) has shown that shifting from a diet rich in saturated fatty acids to one rich in monounsaturated fat improves insulin sensitivity in healthy people while a moderate alpha-3 fatty acids supplementation does not affect insulin sensitivity. There are also other features of the metabolic syndrome that are influenced by different types of fat, particularly blood pressure and plasma lipid levels. Most studies show that alpha-3 fatty acids reduce blood pressure in hypertensive but not in normotensive subjects while shifting from saturated to monounsaturated fat intake reduces diastolic blood pressure. In relation to lipid abnormalities alpha-3 fatty acids reduce plasma triglyceride levels but in parallel, increase LDL cholesterol. Substitution of unsaturated fat for saturated fat not only reduces LDL cholesterol but contributes also to reduce plasma triglycerides in insulin resistant individuals. In conclusion, there is evidence available in humans indicating that dietary fat quality influences insulin sensitivity and associated metabolic abnormalities. Therefore, prevention of the metabolic syndrome has to be targeted: (1) to correct overweight by reducing the energy density of the habitual diet (i.e., fat intake) and (2) to improve insulin sensitivity and associated metabolic abnormalities through a reduction of dietary saturated fat, partially replaced, when appropriate, by monounsaturated and polyunsaturated fats.     

Dietary lead intake of preschool children.

A nationwide, seven-day food consumption survey of 371 preschool children between the ages of birth and five years indicated that a direct linear relationship existed between age and increased dietary lead intake from foods consumed. Daily dietary lead intake averaged 62 micrograms and ranged from 15 micrograms to 234 micrograms. The various levels of lead intake were attributed to frequency of consumption of food items, quantity of food consumed, and the lead content of particular food items. To account for variation in the quantity of food consumed by the various children, average lead intake per 500 kilocalories consumed and per 500 g of food consumed was calculated. When these standardization procedures were followed, an equalization in the average daily dietary lead intake values was observed among the various aged children.