The Relationship between Macronutrient Distribution and Type 2 Diabetes in Asian Indians

Asian Indians (AIs) are at increased risk for type 2 diabetes mellitus than other ethnic groups. AIs also have lower body mass index (BMI) values than other populations, so can benefit from strategies other than weight reduction. Macronutrient distributions are associated with improved glycemic control; however, no specific distribution is generally recommended. This study looks at whether a macronutrient distribution of 50:30:20 (percent of total calories from carbohydrates, fats, and protein) is related to diabetes status in AIs. Diet and Hemoglobin A1c (HbA1c) were assessed from convenience sample of AI adults in Maryland. A ratio of actual to needed calories using the 50:30:20 macronutrient distribution was then tested against diabetes status to identify associations. All groups except non-diabetic females, were in negative energy balance. The non-diabetic group consumed larger actual to needed ratios of protein than pre-diabetics and diabetics. However, all groups consumed protein at the lower end of the Acceptable Macronutrient Distribution Range (AMDR), and the quality of all macronutrients consumed was low. Therefore, weight loss may not be the recommendation for diabetes management for AIs. Increasing protein and insoluble fiber consumption, could play a critical role.     

膳食因素与2型糖尿病关系的logistic回归分析

目的：研究日常膳食因素与2型糖尿病患病的关系。方法：采用频数匹配病例对照研究设计,随机选择徐州市2型糖尿病新诊断病例185例,医院对照201例和人群对照197例,通过食物频数法膳食调查收集资料。使用logistic回归分析膳食因素与2型糖尿病的关联。结果：经单因素和多因素非条件logistic回归分析,结果显示膳食因素中高主食摄入（OR＝3．40）,经常性肉类摄入（OR＝2．29）,动物内脏摄入（OR＝2．47）,牛奶摄入（OR＝1．97）和甜食摄入（OR＝2．91）与2型糖尿病有显著性关联。结论：膳食中高能量,高脂肪,高糖摄入可能是当地2型糖尿病的危险因素。倡导健康的生活方法,提倡合理的膳食结构,是2型糖尿病防治的重要措施。     

Dietary Beliefs and Management of Older American Indians With Type 2 Diabetes

ObjectivesThis qualitative study examined dietary-related beliefs and self-management among older American Indians with type 2 diabetes mellitus (T2DM).DesignSemistructured in-person interviews were conducted and digitally recorded.SettingSoutheastern American Indian tribal community.ParticipantsA total of 28 noninstitutionalized older tribal members aged >60 years.Phenomenon of InterestStudy participants’ beliefs and experiences with dietary practices and management related to T2DM.AnalysisTranscribed qualitative interviews were coded using an inductive content analysis approach.ResultsFour themes regarding T2DM dietary beliefs and T2DM dietary management emerged from the analyses: diet changes, portion control, health care professional and family influence, and barriers to healthy eating. Study participants described how their beliefs, practices, and experiences in these 4 areas related to T2DM.Conclusions and ImplicationsAmerican Indian older adults face a variety of challenges to dietary management of T2DM. Future research efforts can focus on assessing how social support can be leveraged to facilitate healthy diets for American Indians with T2DM. Clinicians and diabetes educators and Native communities have an instrumental role in identifying culturally appropriate messages and programs to help persons effectively manage T2DM.     

Osteoporosis and Milk Intake Among Korean Women in California: Relationship with Acculturation to U.S. Lifestyle

The Korean population in the US increased by a third between 2000 and 2010. Korean women in the US report low calcium intake and relatively high rate of fractures. However, little is known about the prevalence of osteoporosis among Korean American women. This paper examined the relationship between prevalence of osteoporosis and milk consumption, and their relationship with acculturation among a representative sample of immigrant California women of Korean descent. Bilingual telephone surveys were conducted from a probability sample (N = 590) in 2007. Lower acculturation significantly related to lower milk consumption for women during the age periods of 12–18 and 19–34 years. Acculturation was related to higher prevalence of osteoporosis among post-menopausal, but not pre-menopausal Korean women in California. Future research should include larger cohorts, objective measures of osteoporosis, other sources of calcium specific to Korean cuisine, and assessment of bone-loading physical activity.     

Associations Between Discrimination and Cardiovascular Health Among Asian Indians in the United States

Asian Indians (AI) have a high risk of atherosclerotic cardiovascular disease. The study investigated associations between discrimination and (1) cardiovascular risk and (2) self-rated health among AI. Higher discrimination scores were hypothesized to relate to a higher cardiovascular risk score (CRS) and poorer self-rated health. Asian Indians (n = 757) recruited between 2010 and 2013 answered discrimination and self-reported health questions. The CRS (0-8 points) included body-mass index, systolic blood pressure, total cholesterol, and fasting blood glucose levels of AI. Multiple linear regression analyses were conducted to evaluate relationships between discrimination and the CRS and discrimination and self-rated health, adjusting for psychosocial and clinical factors. There were no significant relationships between discrimination and the CRS (p ≥ .05). Discrimination was related to poorer self-reported health, B = ?.41 (SE = .17), p = .02. Findings suggest perhaps there are important levels at which discrimination may harm health.     

Cardiovascular Disease Risk Factors and Diabetes in Asian Indians Residing in Michigan

Asian Indians are the largest Asian subgroup in the state of Michigan; however, data on the prevalence and correlates of cardiovascular disease for this group is limited. The sample consisted of 273 Asian Indians (AI) recruited through health fairs for surveys and blood tests throughout the state of Michigan. The prevalence of self-reported diabetes (20.1%) and elevated/abnormal glycated hemoglobin A1C levels (22.6%) exceeds the percentages of other ethnic groups reported in 2006–2008 Michigan Behavioral Risk Factor Survey. More than half of respondents had elevated body max index. The gender disparity in hypertension prevalence (50% for males vs. 19.3% for females) has not been observed in other similar studies and prevalence of male participants with hypertension also is higher than reported in other studies. In the multivariate analysis after adjusting demographic and access to health care factors, the results showed that the prevalence of metabolic syndrome increases among AI female participants but not among AI males. The data highlight the need for developing culturally-tailored interventions to effectively reduce multiple risk factors in this group.     

2型糖尿病患者体质指数与代谢综合征的关系

[目的]研究2型糖尿病(T2DM)患者体质指数(BMI)与代谢综合征(MS)的相关性,并探讨其可能的机制。[方法]对192例肥胖和94例非肥胖T2DM患者以及59例正常对照组的临床资料进行研究。[结果]肥胖糖尿病组空腹C肽、总胆固醇、甘油三脂、血尿酸高于非肥胖糖尿病组和正常对照组(P<0.01),且高血压病和冠心病的患病率也明显高于非肥胖糖尿病组和正常对照组(P<0.01);而非肥胖糖尿病组的甘油三脂、低密度脂蛋白胆固醇高于正常对照组(P<0.01),高血压病和冠心病的患病率也高于对照组(P<0.05)。[结论]肥胖是影响T2DM患者空腹C肽、血脂、尿酸代谢的重要因素,肥胖加重了T2DM患者的代谢紊乱,两者共同促进了动脉粥样硬化及高血压病和冠心病发生。     

肥胖与2型糖尿病视网膜病变的关系

目的 探讨肥胖与2型糖尿病视网膜病变发生发展的关系。方法72例2型糖尿病人按BMI划分为肥胖与非肥胖两组,肥胖组按腰臀围比划分为A组（内脏型肥胖组）、B组（皮下型肥胖组）,比较其视网膜病变发生率及严重程度。结果 肥胖组视网膜病变发生率较非肥胖组明显升高,肥胖组中增殖型比率较高,A组视网膜病变发生率较B组明显升高、其中增殖型病变亦高。结论 肥胖是加速和加重2型糖尿病人视网膜病变发生的重要因素。     

Relationship Between Asthma, Overweight, And Physical Activity Among U.S. High School Students

Asthma is a leading chronic illness among children and adolescents in the United States. This study examined the relationship between asthma and both overweight and physical activity levels. Results are based on data from the Centers for Disease Control and Prevention’s 2003 national Youth Risk Behavior Survey, a cross-sectional survey of health risk behaviors among a representative sample of high school students in the United States. The overall survey response rate was 67% and the results are based on weighted data. SUDAAN was used for all data analysis (prevalence estimates and logistic regression) because it accounts for the complex sampling design of the survey. Significantly more students with current asthma than without were overweight (odds ratio [OR] = 1.4; 95% confidence interval [CI] = 1.1, 1.6) and described themselves as overweight (OR = 1.2; 95% CI = 1.0, 1.4). Significantly more students with current asthma than without used a computer for non-schoolwork 3 or more hours/day (OR = 1.3; 95% CI = 1.1, 1.5). No significant differences were found for participation in sufficient vigorous or moderate physical activity or strengthening exercises among students with and without current asthma. Unlike some other risk factors for developing or exacerbating asthma, overweight and physical activity are generally modifiable. School and community policies and programs can play an important role in asthma management, including promoting the maintenance of an appropriate weight and encouraging continued physical activity.The findings and conclusions in this report are those of the authors and do not necessarily represent the views of Centers for Disease Control and Prevention.     

深圳市社区居民膳食摄入与高血压关系

目的探讨影响深圳市社区居民高血压患病的膳食因素,为高血压的膳食防治提供有针对性的科学依据。方法采用随机抽样的方法,对深圳市梅林街道18岁以上社区居民530人进行膳食调查和血压测量,采用多因素Lo gistic回归分析膳食摄入情况及与高血压的关系。结果高血压人群每日薯类、畜肉类、蛋类、奶类食物摄入量高于正常人群。进入Logistic回归模型的膳食因素中,经调整年龄、体重指数、吸烟、性别等因素后,食用家禽肉类与高血压呈正相关;鱼类与高血压呈负相关,OR值分别为1.800(1.049~3.089)及0.497(0.293~0.844)。结论膳食中既有高血压的危险因素,也有保护因素,合理膳食,减少食用家禽肉类和增加食用鱼肉类是防治高血压的措施之一。     

Anthropometric Characteristics,Dietary Patterns and Risk of Type 2 Diabetes Mellitus in Vietnam

Objective: To determine the impact of anthropometric characteristics and dietary patterns on Type 2 diabetes mellitus in Vietnam.

Methods: Data from 144 subjects (9m/39f newly diagnosed diabetics; 18m/78f control subjects) were analyzed in this case-control study. Height, weight, waist and hip circumferences and percent body fat were measured. Dietary intakes were assessed by 24-hour recall on three non-consecutive weekdays. Fasting blood samples were collected for the analysis of plasma glucose, fructosamine, protein and lipid concentrations.

Results: Although the body mass index (BMI, kg/m²) was similar between diabetic and control subjects, diabetic subjects had significantly greater percent body fat (31.1 ± 5.8% vs. 27.7 ± 6.2%) and waist-hip ratios (WHR, 0.91 ± 0.07 vs. 0.86 ± 0.08). Diabetic subjects had higher intakes of protein (p < 0.01), especially animal protein (p < 0.001), and consumed more meat (p < 0.01) than control subjects. Percent body fat and WHR were positively associated with diabetes (odds ratios [OR] 1.53 [95%CI 1.29–1.79] and 1.09 [95% CI 0.89–1.58], respectively) as were protein intake (OR 1.21 [95% CI 1.12–1.31]) and animal protein intake (OR 1.18 [95% CI 1.10–1.26]).

Conclusions: This study indicates that percent body fat and WHR are risk factors associated with diabetes even when the BMI is normal. Evolving dietary patterns with increasingly more protein and meat consumption may also contribute to the deterioration of glucose metabolism among Vietnamese people.