Dietary intake of eicosapentaenoic and docosahexaenoic acids is linked to gray matter volume and cognitive function in elderly

In the present study, we tested whether elderly with a high dietary intake of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) would have higher cognitive test scores and greater brain volume than those with low dietary intake of these fatty acids. Data were obtained from the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) cohort. The dietary intake of EPA and DHA was determined by a 7-day food protocol in 252 cognitively healthy elderly (122 females) at the age of 70 years. At age 75, participants'' global cognitive function was examined, and their brain volumes were measured by magnetic resonance imaging (MRI). Three different multivariate linear regression models were applied to test our hypothesis: model A (adjusted for gender and age), model B (additionally controlled for lifestyle factors, e.g., education), and model C (further controlled for cardiometabolic factors, e.g., systolic blood pressure). We found that the self-reported 7-day dietary intake of EPA and DHA at the age of 70 years was positively associated with global gray matter volume (P < 0.05, except for model C) and increased global cognitive performance score (P < 0.05). However, no significant associations were observed between the dietary intake of EPA and DHA and global white matter, total brain volume, and regional gray matter, respectively. Further, no effects were observed when examining cognitively impaired (n = 27) elderly as separate analyses. These cross-sectional findings suggest that dietary intake of EPA and DHA may be linked to improved cognitive health in late life but must be confirmed in patient studies.     

Influence of dietary habits,age and gender on plasma fatty acids levels in a population of healthy Tunisian subjects

The fatty acids composition of circulating blood lipids is expected to be altered by many factors (ageing, dietary intake, lifestyle...). In addition to the ageing consequences on their lipid status, elderly subjects represent a population at risk of nutritional imbalance. The main objective of the present study was to investigate the associations between dietary habits and the plasma fatty acids patterns in a healthy Tunisian population with an emphasis on the gender and ageing differences for the ?6-desaturase activity and the EFA proportions. Nutritional habits and plasma fatty acids compositions have been therefore evaluated in 200 healthy volunteers (104 women and 96 men) aged between 40 and 82 years old. The findings revealed that the ?6-desaturase activity was reduced in elderly subjects (by 24% and 10% in women and men respectively). Moreover, DHA (C22:6n−3) and AA (C20:4n−6) were found to increase respectively in high fish and meat consumers. Plasma fatty acids composition could be sensitive to dietary habits according to particular food items and should then help for the establishment of optimal nutritional proportions.     

Back to the future: The Mediterranean diet paradigm

The Mediterranean diet was introduced to the scientific community by the classic Seven Countries study. Since then data on the association between this diet and cardiovascular disease, cancer and other chronic diseases have been accumulating. The Mediterranean diet is characterized by a high intake of olive oil, plant products, fish and seafood; a low intake of dairies, meat and meat products; and a moderate ethanol intake. The Mediterranean diet has been operationalized through various computational scores (e.g. the Mediterranean diet score for adults and the KIDMED index for children) which are all based on the dietary components that capture its essence. Next to evidence generated through both observational studies and intervention trials on the inverse association between Mediterranean diet and several risk factors, inflammatory markers and mortality or incidence of disease, there is increasing evidence that Mediterranean populations are abandoning their traditional eating habits. Publications presenting changes over time in the diet of populations participating in the Seven Countries Study point towards an increase in the intake of processed foods and saturated fat and a decrease in the intake of plant foods and monounsaturated fatty acids. Findings are alarming, particularly in relation to younger generations. Studies among children and adolescents in the Mediterranean region clearly indicate that the largest proportions of these populations poorly adhere to their traditional diet. Mediterraneans have clearly not been the major benefactors in the research on the effects of the Mediterranean lifestyle and younger populations in the regions are already following the wrong path.     

The effect of widowhood on weight change, dietary intake, and eating behavior in the elderly population.

OBJECTIVES. To assess the effect of recent widowhood on weight, dietary intake, and habits. METHODS. Participants included 58 recently widowed elderly subjects and 58 married subjects who were matched on age, sex, and race. Weight change from baseline and following widowhood, dietary intake, eating behavior, depression, and cognitive and physical functioning were assessed in a clinic interview. RESULTS. Mean weight loss and the prevalence of weight loss were significantly higher among widowed participants. They ate more meals alone, more commercial meals per week, and fewer snacks and homemade meals. They also enjoyed their eating less. A significant difference between cases and controls was evident after adjusting for all the variables. Higher cognitive functioning score, younger age, and better appetite were protective against weight loss. DISCUSSION. Widowed people were found to be at increased risk for weight loss. This may well be due to decreased appetite and enjoyment of their meals.     

Diet quality is associated with circulating C-reactive protein but not irisin levels in humans

Objective

Adherence to a healthy diet has been shown to decrease the incidence of obesity and associated comorbidities. C-reactive protein (CRP) is an established inflammatory marker and irisin was recently identified as a molecule which may play a role in energy regulation and obesity but whether diet alters irisin levels remains unknown. We aimed to investigate the association between circulating irisin, leptin, and CRP levels and dietary quantity and quality using the Alternate Healthy Eating Index (AHEI) and the Alternate Mediterranean Diet Score (aMED).

Materials/Methods

The study evaluated dietary data and biomarker levels of 151 participants between 2009 and 2011 (71 male vs. 80 female, over 35 years old, obese 43.7%). AHEI and aMED scores were calculated based on data derived from self-administered 110-item food-frequency questionnaires estimating usual nutrient intake over the past year. Cross-sectional associations between dietary quantity, quality, body composition by bioelectric impedance, and biomarker levels including irisin, leptin, and CRP after fasting were assessed.

Results

CRP, but not irisin, was negatively correlated with AHEI (r = − 0.34) and aMED (r = − 0.31). Irisin was positively correlated with BMI (r = 0.22), fat mass (r = 0.21), waist circumference (r = 0.24), waist–hip ratio (r = 0.20), leptin (r = 0.32), and CRP (r = 0.25). Participants with the highest AHEI scores tended to have 11.6% lower concentrations of irisin (P for trend = 0.09), but they were not significant after adjustment for potential confounders. Better diet quality was associated with lower CRP concentrations (P for trend = 0.02) in multivariate model. Percentage of energy from carbohydrate was inversely associated with CRP.

Conclusions

Unlike CRP, irisin is not associated with dietary quality or quantity.     

Food consumption patterns in a mediterranean region: does the mediterranean diet still exist?

AIMS: To assess the food consumption patterns in the adult population of a Mediterranean region: the Balearic Islands (BI). METHODS: A cross-sectional nutritional survey was carried out in the BI between 1999 and 2000. A random sample (n = 1,200) of the adult population (16-65 years) was interviewed. Dietary habits were assessed by means of 24-hour recall during 2 non-consecutive days, the first in the warm season and the second in the cold season, and a quantitative food frequency questionnaire. Anthropometric measurements were also obtained. RESULTS: Current food patterns in the BI are characterized by a prominent consumption of dairy products, vegetables, fruit, bread, soft drinks and meat. According to the dietary guidelines for the Spanish population, only appropriate consumption of olive oil and other fats, dairy products, nuts, and soft drinks have been achieved. Intakes of fruit, vegetables, fish, eggs, pulses, cereals and potatoes are below desirable levels. On the other side, intakes of sugary products, sweets and cakes are higher than desirable. Alcohol intake, in the context of the Mediterranean diet, can be considered as acceptable. CONCLUSIONS: The dietary patterns observed among the BI population are in harmony with the actual dietary trends in Spain and other Mediterranean countries. Mediterranean dietary habits still exist, but a progressive departure from the traditional Mediterranean diet is being observed mainly in younger generations. It would be desirable to increase the consumption of fish, vegetables, fruit, cereals and pulses and decrease the intake of food sources containing saturated fat.     

Association of cognitive dysfunction with hippocampal atrophy in elderly Japanese people with type 2 diabetes

This study aimed to examine the associations of cognitive function with hippocampal and whole brain atrophies, age, education, and diabetes-related parameters in patients with type 2 diabetes.Sixty-one patients over 65 years of age with type 2 diabetes and 53 age- and sex-matched non-diabetic controls were enrolled. Hippocampal and whole brain atrophies were assessed by quantifying hippocampal and brain volumes by brain magnetic resonance imaging. Cognitive function was evaluated by Mini-Mental State Examination (MMSE) and the Revised Hasegawa Dementia Scale (HDS-R).Compared with the non-diabetic group, patients with type 2 diabetes showed significant increases in hippocampal and whole brain atrophies. The MMSE and HDS-R scores in type 2 diabetic patients showed significant negative correlations with age and significant positive correlations with years of education. These scores were also significantly negatively correlated with hippocampal atrophy, but not whole brain atrophy. Hippocampal atrophy in diabetic patients did not, however, correlate with age, years of education, or diabetes-related parameters.We showed hippocampal and whole brain atrophies to be more frequent in elderly patients with type 2 diabetes than in non-diabetic controls. Their cognitive functions were significantly and negatively associated with hippocampal atrophy.     

L’éducation nutritionnelle du patient coronarien en pratique

Background

The Mediterranean diet is one of the food models which showed its ability at the patient at high cardiovascular risk in numerous cohort studies and two major interventional studies: Lyon Heart Study in 1999 and PREDIMED in 2013.

Aim of the study

Propose a practical assistance in the analysis of the dietary habits of the coronary patient with a simplified food frequency questionnaire.

Patients and methods

Hundred coronary patients followed a program of cardiac rehabilitation and benefited from a nutritional education. The analysis of their dietary habits was made with the questionnaire of frequency of consumption of Rennes upon their arrival and 6 months later. We have coded again these data by means of a simplified questionnaire with 15 items and compared the results and their evolution in 6 months.

Results

On studied 200 questionnaires, the score of Rennes was 10.6 ± 4.5 and the simplified score 8.2 ± 3.4 with a coefficient of correlation of Pearson r = 0.94 (0.91–0.95) at risk P < 0.0001. Initial scores were respectively 8.0 ± 4.4 and 6.3 ± 3.4 (r = 0.93) and the scores at 6 months 13.1 ± 2.9 and 10.1 ± 2.2 (r = 0.86). The evolution of the scores of 100 patients were respectively 14.2 ± 11.7% and 12.6 ± 11% (P < 0.26).

Conclusion

The use of a simplified questionnaire allows to analyze the dietary habits of the coronary patient and to estimate their evolution during a therapeutic educational program.     

Low adherence of a clinically healthy Italian population to nutritional recommendations for primary prevention of chronic diseases

Background and aimSeveral data demonstrated that dietary habits significantly affect the health state of the population. During recent years all the major scientific associations have provided nutritional recommendations for primary prevention of chronic diseases but few data are available about prevalence of adherence to these recommendations in an otherwise healthy population. The aims of this study were to evaluate dietary habits, and to assess the adherence of the general population to the recommendations for correct nutritional behaviour.Methods and resultsDietary habits, anthropometric and biochemical parameters were evaluated in a population of 932 (367 M; 565 F) clinically healthy subjects living in Florence, enrolled in an epidemiologic study conducted between 2002 and 2004. By comparing the dietary pattern with the nutritional guidelines, the study population reported a hyperproteic and hyperlipidic nutritional pattern, with a considerably low contribution from polyunsaturated fats (PUFA). A low fibre intake is shown in both genders. In addition, food consumption pattern showed an increased consumption of some foods such as meat, both fresh and processed, and a low intake of some “healthy” foods like fruit and vegetables.ConclusionsWe found several nutritional flaws in the dietary habits of a clinically healthy Italian population. In particular, we reported a high intake of animal protein and total fats with a very low contribution from PUFA.     

Association of cognitive function with serum uric acid level among Chinese nonagenarians and centenarians

This cross-sectional study aimed to assess the association of risk of cognitive impairment with level of serum uric acid (SUA) among very old people, specifically in a cohort of 694 unrelated Chinese aged 90–108 years. Cognitive function was measured using the 30-item Mini-Mental State Examination (MMSE) and SUA level was determined by the uricase–peroxidase method. Cognitive impairment was defined as a score below 18 on the Folstein MMSE. Men had significantly higher cognitive function scores than did women: 17.6 ± 5.6 vs. 14.0 ± 5.2 (P < 0.05). In the total sample, the prevalence of cognitive impairment was 71.6%, with the rates being 50.9% and 81.6% for males and females, respectively (P < 0.000). Men had significantly higher SUA levels than women: 354.1 ± 85.7 vs. 303.8 ± 81.7 mmol/L (P = 0.000). Binary logistic regression analysis indicated an inverse correlation between the risk of cognitive impairment and SUA (OR = 0.996) in men. In conclusion, in male nonagenarians and centenarians, the higher level of SUA is related to the lower risk of cognitive impairment.     

Vitamin and micronutrient intake and the risk of community-acquired pneumonia in US women

Background

There are limited data regarding the role of dietary and supplemental vitamin intake and the risk of community-acquired pneumonia.

Methods

We prospectively examined, during a 10-year period, the association between dietary and supplemental vitamin intake and the risk of community-acquired pneumonia among 83,165 women in Nurses’ Health Study II who were between the ages of 27 and 44 years in 1991. We excluded women who had pneumonia before 1991, those who did not provide complete dietary information, or those with a history of cancer, cardiovascular disease, or asthma. Self-administered food frequency questionnaires were used to assess dietary and supplemental vitamin intake. Cases of pneumonia required a diagnosis by a physician and confirmation with a chest radiograph. The independent associations between specific vitamins and pneumonia risk were evaluated.

Results

There were 925 new cases of community-acquired pneumonia during 650,377 person-years of follow up. After adjusting for age, cigarette smoking, body mass index, physical activity, total energy intake, and alcohol consumption, there were no associations between dietary or total intake of any individual vitamin and risk of community-acquired pneumonia. Specifically, women in the highest quintile of vitamin A intake did not have a significantly lower risk of pneumonia than women in the lowest quintile (multivariate relative risk [RR] = 0.88; 95% confidence interval [CI], 0.70-1.09, P for trend = .16). Similarly, vitamin C (RR = 0.94; 95% CI, 0.76-1.16, P for trend = .81) and E (RR = 0.95; 95% CI, 0.76-1.17, P for trend = .74) intake did not alter risk of pneumonia.

Conclusions

Higher vitamin intake from diet and supplements is unlikely to reduce pneumonia risk in well nourished women.     

A Mediterranean lifestyle reduces the risk of cardiovascular disease in the “Seguimiento Universidad de Navarra” (SUN) cohort

Background and aimsA healthy lifestyle is essential to prevent cardiovascular disease (CVD). However, beyond dietary habits, there is a scarcity of studies comprehensively assessing the typical traditional Mediterranean lifestyle with a multi-dimensional index. We assessed the association between the Mediterranean lifestyle (measured with the MEDLIFE index including diet, physical activity, and other lifestyle factors) and the incidence of CVD.Methods and resultsThe “Seguimiento Universidad de Navarra” (SUN) project is a prospective, dynamic and multipurpose cohort of Spanish university graduates. We calculated a MEDLIFE score, composed of 28 items on food consumption, dietary habits, physical activity, rest, social habits, and conviviality, for 18,631 participants by assigning 1 point for each typical Mediterranean lifestyle factor achieved, for a theoretically possible final score ranging from 0 to 28 points. During an average follow-up of 11.5 years, 172 CVD cases (myocardial infarction, stroke or cardiovascular death) were observed. An inverse association between the MEDLIFE score and the risk of primary cardiovascular events was observed, with multivariable-adjusted hazard ratio (HR) = 0.50; (95% confidence interval, 0.31–0.81) for the highest MEDLIFE scores (14–23 points) compared to the lowest scores (0–9 points), p (trend) = 0.004.ConclusionA higher level of adherence to the Mediterranean lifestyle was significantly associated with a lower risk of CVD in a Spanish cohort. Public health strategies should promote the Mediterranean lifestyle to preserve cardiovascular health.     

Circulating irisin,omentin-1, and lipoprotein subparticles in adults at higher cardiovascular risk

Objective

Muscle and fat are now recognized as metabolism-regulating endocrine organs. However, muscle and adipocyte-derived novel cytokines such as irisin and omentin-1 remain understudied in relation to metabolic biomarkers that are associated with cardiovascular risk.

Subjects and methods

Thirty-nine subjects with mean (± SD) BMI of 29.2 ± 5.4 kg/m² and either diabetes or two other cardiovascular risk factors were enrolled in a 6-month randomized trial of low-dose ethanol. We examined cross-sectional data at baseline, 3-month, and 6-month visits to assess (1) within-person stability of novel cytokines (irisin, omentin-1, visfatin, resistin, and soluble tumor necrosis factor receptor II) and (2) their associations with metabolic parameters, particularly lipoprotein subparticle profile.

Results

Repeated measures of irisin and omentin-1 were highly correlated, with intra-class correlations of 0.84 (95% CI: 0.74, 0.91; P < 0.001) and 0.81 (0.70, 0.89; P < 0.001), respectively. Irisin was negatively correlated with omentin-1 (7.4% irisin decrease per a 1-SD increment in omentin-1; 95% CI: 0.5%, 13.9%; P = 0.04). In models adjusted for age, sex, and race, irisin was negatively associated with HDL cholesterol (7.3% decrease per a 10 mg/dL increment; 1.0%, 13.3%; P = 0.02) and large HDL particles (15.5% decrease per a 1-SD or 3.5-μmol/L increment; 5.2%, 24.7%; P = 0.005). Omentin-1 was positively associated with mean VLDL size (3.8% increase per a 1-SD increment; 0.06%, 7.8%; P = 0.05). Adjustment for alcohol intervention, BMI, and other cytokines did not materially affect these associations.

Conclusions

Irisin and omentin-1 are stable within-person, inversely associated with each other, and closely related to lipoprotein profile. These molecules may be promising markers for cardiovascular risk.     

Anserine and carnosine supplementation in the elderly: Effects on cognitive functioning and physical capacity

The aim of this study was to investigate the potential beneficial effects of dietary anserine and carnosine (CRC) supplementation on cognitive functioning and physical activity of the elderly. The fifty-six subjects (65+) were allocated to the CRC group or placebo group at a 1:1 ratio. The double-blind procedure was used. Data were collected at the baseline and after 13-weeks of supplementation. In the follow up procedure fifty one subjects took part. Chicken meat extract (CME) containing 40% of CRC components (2:1 ratio of anserine to carnosine) was administered 2.5 g per day which allowed to rich the level of 1 g CRC in dipeptides supplement. The cognitive function, physical capacity, body measurements, blood pressure and heart rate (HR) were assessed. After supplementation Body Mass Index (BMI) decreased significantly (p < 0.05) in the CRC group performance comparing the placebo group. In two of six Senior Fitness Test the scores increased significantly (p < 0.05) in CRC group comparing to the placebo group. The perceived exertion differed significantly (p < 0.05) at the baseline and after follow up at the CRC group. The mean values of the Short Test of Mental Status (STMS) scores showed the significant (p < 0.04) increase only in CRC group, in the subscores of construction/copying, abstraction and recall. Conducted anserine and carnosine supplementation in the elderly brings promising effects on cognitive functioning and physical capacity of participants. However, further studies are needed.     

Increased Serum Level of IGF-1 Correlates With Better Cognitive Status in End-Stage Renal Disease Patients Undergoing Hemodialysis

Prevalence of cognitive function decline in end stage renal disease (ESRD) patients undergoing hemodialysis is higher than in the general population. We analyzed risk factors for cognitive function decline in those patients. This study included 93 ESRD patients undergoing hemodialysis two or three times a week in three centers for hemodialysis in Montenegro. The cognitive status of patients was assessed using the mini mental score examination (MMSE) test. All 93 patients have been divided into three groups according to the results of MMSE. Patients in the first group had severe cognitive impairment and MMSE score below 17 (26.88%), patients in the second group with MMSE score 18–23 had moderate cognitive impairment (40.86%) and third group of patients have MMSE >24 and no cognitive impairment (32.26%). There were no significant differences between groups for gender, smoking habits and level of parathyroid hormone. Level of schooling was significantly different between groups of patients (P < 0.001). Laboratory markers observed in this study with significant differences between groups were: IGF 1, IGFBP 3, erythrocytes and hemoglobin (P < 0.001, P = 0.004, P < 0.001, P = 0.002, respectively). IGF 1 proved to be of great importance for evaluating cognitive status in our study. This marker was statistically different between groups (P < 0.001) and Tukey post hoc analysis showed significant differences between all three groups (first and second group P = 0.045, second and third group P = 0.015, first and third group P < 0.001). Our data suggest that IGF 1 can be considered as novel biomarker for assessment of cognitive functioning in CKD patients, which can be of huge clinical importance.     

Mediterranean diet and leukocyte telomere length in a multi-ethnic elderly population

Leukocyte telomere length (LTL) is considered as the marker of biological aging and may be related to environmental factors. The current study aimed to examine the relation between Mediterranean-type diet and LTL. We used a cross-sectional study of 1743 multi-ethnic community residents of New York aged 65 years or older. Mediterranean-type diet (MeDi) was calculated from dietary information collected using a food frequency questionnaire. LTL was measured from leukocyte DNA using a real-time PCR method to measure T/S ratio, the ratio of telomere (T) to single-copy gene (S) sequence. Regression analysis showed that the MeDi score was not associated with LTL in the overall study population (β = 12.5; p = 0.32) after adjusting for age, sex, education, ethnicity, caloric intake, smoking, and physical and leisure activities. However, we found a significant association between MeDi and LTL among non-Hispanic whites (β = 48.3; p = 0.05), and the results held after excluding dementia subjects (β = 49.6; p = 0.05). We further found that, in the whole population, vegetable and cereal consumption above the sex-specific population median was associated with longer LTL (β = 89.1, p = 0.04) and shorter LTL (β = −93.5; p = 0.03), respectively. Among non-Hispanic whites, intake of meat or dairy below sex-specific population medians was associated with longer LTL (β = 154.7, p = 0.05; β = 240.5, p < 0.001, respectively). We found that higher adherence to a MeDi was associated with longer LTL among whites but not among African Americans and Hispanics. Additionally, a diet high in vegetables but low in cereal, meat, and dairy might be associated with longer LTL among healthy elderly.

Electronic supplementary material

The online version of this article (doi:10.1007/s11357-015-9758-0) contains supplementary material, which is available to authorized users.     

Dietary Fiber Intake is Associated with Cognitive Function in Older Adults: Data from the National Health and Nutrition Examination Survey

BackgroundAging is a global health challenge that is associated with a decline in cognitive function. In the United States, most older adults (≥50 years) do not meet the recommended daily fiber intake, although preliminary evidence suggests that dietary fiber consumption could elicit clinical benefits on cognitive function. We investigated the associations between dietary fiber intake and cognitive function in older adults.MethodsWe analyzed data from the US National Health and Nutrition Examination Survey (NHANES) between 2011 and 2014, with a study cohort of 1070 older adults (≥60 years). Cognitive function was assessed using the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word Learning Test (WLT), Word Recall Test (WRT) and their Intrusion Word Count Tests (WLT-IC and WRT-IC), the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST). Multiple linear regression and cubic spline analyses were employed to examine the association between dietary fiber intake and cognitive performance on a test-by-test basis, after covariates adjustment (ie, age, sex, race, socioeconomic status, educational level, medical history, body mass index, alcohol, and energy intake).ResultsParticipants had a mean age of 69.2 years and were primarily non-Hispanic white of middle-high socioeconomic status with a college degree at minimum. The mean dietary fiber intake was 17.3 g/d. The analysis showed that dietary fiber intake was positively associated with DSST (P = .031). No associations with CERAD WLT (P = .41), WRT (P = .68), WLT-IC (P = .07), and WRT-IC (P = .28), and AFT (P = .40) scores were observed. A plateau in DSST score was revealed at a dietary fiber intake of 34 g/d.ConclusionsHigher dietary fiber intake is associated with improved specific components of cognitive function in older adults aged 60 years and older. Public health interventions that target a recommended dietary fiber intake may provide a promising strategy to combat cognitive decline in high-risk groups of older adults.     

Food habits, energy and nutrient intake in adolescents with Type 1 diabetes mellitus.

AIMS: The aims were to describe the food habits of adolescents with Type 1 diabetes (Type 1 DM) and to compare them with healthy control subjects; to describe the distribution of energy-providing nutrients in patients and compare it with current recommendations and previous reports; and finally, to investigate associations between dietary intake and glycaemic control. METHODS: One hundred and seventy-four adolescents with Type 1 DM and 160 age- and sex-matched healthy control subjects completed a validated food frequency questionnaire, and 38 randomly chosen patients completed a prospective 4-day food record. RESULTS: Patients ate more regularly, and more often ate fruit and fruit juice, potatoes and root vegetables, meat, fish, egg, offal and sugar-free sweets than control subjects. Control subjects more often ate ordinary sweets and snacks. Patients chose coarse rye bread and dairy products with less fat to a greater extent than control subjects. Patients were heavier than control subjects. The intake of saturated fat was higher in patients compared with recommendations and, for boys with diabetes, the intake of protein was higher than recommended. Patients with poorer glycaemic control ate vegetables, fruit and fish less often than patients with better control. CONCLUSIONS: The food habits of adolescents with Type 1 DM were healthier than those of control subjects. The intake of energy-providing nutrients was in line with current recommendations and showed improvements compared with previous reports, with the exception of fibre intake. The association between dietary intake and glycaemic control needs further investigation in prospective studies.     

Changes in dietary habits and their association with metabolic markers after a non-intensive, community-based lifestyle intervention to prevent type 2 diabetes, in Greece. The DEPLAN study

Aims

The aim of the present study was to evaluate the impact on dietary and activity habits of a non-intensive, community based lifestyle intervention for type 2 diabetes prevention, in high-risk Greek individuals.

Methods

A total of 191 high-risk persons were invited to participate in a one-year lifestyle intervention program, consisting of six bi-monthly sessions with a dietician. The dietary aims of the intervention were: reduction of saturated fat, sugars and refined cereals intake and at least five servings of fruits and vegetables, daily. Demographic, dietary, anthropometric, medical and biochemical indices were recorded at baseline and at the end of the intervention.

Results

The intervention was completed by 126 participants. At study end, participants reported decreased whole fat dairies and processed meats consumption (p = 0.018 and 0.016, respectively), sugars (p = 0.006) and refined cereals (p = 0.045). Participants who improved their diet, decreased body weight (p = 0.040), plasma triglycerides (p = 0.020) and 2-h post-load plasma glucose (p = 0.05) compared to those who had worsened their dietary habits. Total time spent daily on physical activity, remained unchanged throughout the intervention.

Conclusions

The implementation of a group-based, non-intensive dietary counseling proved to be practical and feasible in “real-world” community settings and was accompanied by favorable dietary changes and health benefits.     

Subclinical albuminuria is linked to gray matter atrophy in type 2 diabetes mellitus

Objective

Microalbuminuria (MA), a marker of renal microvascular disease, is associated with brain atrophy and neurovascular changes in older adults with type 2 diabetes mellitus (DM). We evaluated the relationship between urine albumin-to-creatinine ratio (UACR) and regional brain volumes to determine whether subclinical albuminuria may indicate early structural brain changes in type 2 DM.

Materials/Methods

We studied UACR and brain volumes in 85 type 2 DM patients (64.8 ± 8.3 years) and 40 age-matched controls using 3D magnetization prepared rapid acquisition with gradient echo (MP-RAGE) MRI (magnetic resonance imaging) at 3 Tesla. The relationship between UACR and brain volumes was analyzed using the least square models.

Results

In DM patients, UACR ≥ 5 mg/g, UACR ≥ 10 mg/g and clinically significant MA (UACR ≥ 17 mg/g [males] and 25 mg/g [females]) were associated with lower gray matter (GM) volume in the frontal lobe (r²_adj = 0.2–0.4, P = 0.01–0.05) and UACR ≥ 5 mg/g was also related to global GM atrophy (r²_adj = 0.1, P = 0.04), independent of DM duration, glucose levels, HbA_1c and hypertension. For UACR ≥ 5 mg/g, a lower global GM volume was related to worse executive function (P = 0.04) in the DM group. No associations were found for UACR (< 5 mg/g) and controls.

Conclusions

Subclinical albuminuria (UACR ≥ 5 mg/g) is associated with lower GM volume that has clinical impact on cognitive function in older diabetic patients, and these relationships are independent of DM control and hypertension. Therefore, UACR levels may serve as an additional marker of DM-related brain structural changes.