Diabetic foods and the diabetic diet: A British Diabetic Association Discussion Paper

The role of special ‘Diabetic’ foods in the diabetic diet is considered and the following conclusions are drawn.

• 1 Most diabetic foods provide slightly, but not substantially, less energy than comparable non-diabetic products.
• 2 Many diabetic foods have a higher fat content than their non-diabetic equivalents. This is contrary to the requirements of the 1984 Food Labelling Regulations.
• 3 Many diabetic products have a relatively high content of protein.
• 4 In percentage terms, the greatest difference between diabetic and non-diabetic foods remains that of carbohydrate content, particularly carbohydrate other than fructose or sorbitol. On a per portion basis (for instance per teaspoon of jam) the difference is relatively small and likely to be of minimal practical significance.
• 5 Diabetic foods cost between 1.5 and 4 times as much as their non-diabetic equivalents.
• 6 Some ordinary reduced-sugar/low-calorie products are preferable to diabetic products in terms of fat and energy content and cost.
• 7 The promotion and widespread availability of diabetic foods tend to delude patients into believing that these products are advantageous, or even necessary. Their existence also undermines current dietary teaching by implying that diabetics cannot eat normal foods.
• 8 Diabetic foods offer no significant physiological or psychological benefits to diabetic patients and can even be counterproductive to good diabetic control. There is no longer a need for special diabetic foods in the modern dietary management of diabetes.

     

骨折与中医食疗

骨折病人食疗的基本原则是整体观念和辨证施食。本文以骨折的三期分治为原则,再根据不同的病因,病程的久暂以及病人的体质等情况分别立法施食,以加快骨折愈合及功能恢复。食疗的组方原则为理气活血,培元益气,化痰祛湿,利水消瘀。     

饮食因素与女性乳腺癌危险性的病例对照研究

[目的]探讨各类饮食因素与女性乳腺癌危险性的关系。[方法]采用以人群为基础的病例对照研究,调查上海市1999年4月至10月间确诊的乳腺癌患者(n=356)和全人群对照(n=925)的一般情况和饮食摄入情况等,采用量化食物摄入频度问卷调查表估价之前5年内的食物摄入情况。[结果]经调整潜在混杂因素后多因素分析发现,以最低摄入量组作参照,新鲜豆类每月平均摄入量在1773g~3748g、>3748g者患乳腺癌的危险性显著下降,OR值(95%CI)分别是0.63(95%CI=0.43~0.93)和0.61(95%CI=0.41~0.91),并有剂量效应关系(P<0.01)。其中毛豆、其他新鲜豆类分别和乳腺癌危险性呈负相关(P<0.01,P=0.04)。将每年摄入量按四分位法分组后,以最低剂量组作参比,随着腌晒类食品和油炸食品摄入量的增加女性患乳腺癌的危险性也增加(趋势检验P=0.02,P=0.01)。[结论]新鲜豆类对女性乳腺癌具有保护作用,而各类腌晒食品和油炸食品特别是油炸鱼/肉、油炸面食以及油煎花生米可增加女性乳腺癌的危险性。     

Fat gram target to achieve high energy intake in cystic fibrosis

Higher fat and energy intakes confer a survival advantage in cystic fibrosis (CF). There is a need to develop effective nutrition programmes that ensure optimal energy intake in CF.

Methodology:

A cross-sectional measurement of clinical characteristics and energy and fat intakes in patients attending the CF outpatients clinic of the John Hunter Hospital, Newcastle was undertaken. Twenty-nine subjects, mean age 12 years (range 4.3–20.2), completed weighed food records to determine the contribution of fat to the percentage of the recommended energy intake obtained and to document use of pancreatic enzyme replacement therapy.

Results:

Diets with a high percentage of energy derived from fat did not guarantee that individuals with CF met their energy requirements. Subjects with total fat intakes of 100 g per day or greater, however, achieved in excess of 110% recommended daily intake (RDI) for energy. Up to 47% of subjects consumed more pancreatic enzyme replacement capsules than shown to give maximum effectiveness.

Conclusion:

Setting a 100 g daily fat target is a realistic way of ensuring high energy intakes in CF. Fat ready reckoners would identify the fat content of food and prescribe specific numbers of pancreatic enzyme replacement capsules to be consumed with each meal or food item.     

Diet and the prevention of cancer

Cancer ranks as the second-leading cause of death in developed countries and diet has long been suspected as playing a prominent role in its etiology. As a result, a substantial amount of research has been devoted to this field of study. Given the epidemiologic and biologic credibility, it is reasonable to attempt to identify specific nutrients, foods, or combination of these that are causally related to the development of cancer. Various study designs have been employed to generate and test specific hypotheses. In this review, we approach the dietary prevention of cancer primarily from an epidemiologic perspective. We examine the growing body of evidence on dietary etiologic factors and explore the practical prospects for prevention of cancer overall. An attempt is also made to explain inconsistencies in the findings and provide ideas for future research efforts in this field.     

Risk Factors for Male Breast Cancer (United States)

Objectives: The etiology of male breast cancer is obscure, although an excess risk has been associated with Klinefelter syndrome, testicular disorders, benign breast disease including gynecomastia, use of exogenous estrogens, radiation, and a family history of male or female breast cancer. We conducted a case-control study to investigate risk factors further for breast cancer in men.Methods: Based on data from the 1986 National (United States) Mortality Followback Survey (NMFS) of almost 20,000 deceased adults (age 25 years or over), we compared information obtained from next-of-kin interviews of 178 men who died of breast cancer with that of 512 male controls who died of other causes. Information was obtained on selected demographic and other factors, including diet, exercise, occupation, height and weight, and use of tobacco and alcohol.Results: Increased risks were found for men who were described by their next-of-kin as very overweight (odds ratio [OR] = 2.3, 95 percent confidence interval [CI] = 1.1-5.0). The risks associated with the three upper quartiles of body mass index (BMI) (wt/ht²) were 1.3, 1.6, and 2.3, respectively, with a significant dose-response relationship (P < 0.01). An excess risk was also associated with limited exercise (OR = 1.3, CI = 0.8-2.0). Consumption of red meat was associated with an increased risk, and consumption of fruits and vegetables with a decreased risk, although the trends were not significant. No association was found for tobacco or alcohol use, but an excess risk was associated with higher levels of socioeconomic status (SES) (OR = 1.8, CI = 1.1-3.0).Conclusions: Our study suggests that obesity increases the risk of male breast cancer, possibly through hormonal mechanisms, while dietary factors, physical activity, and SES indicators also deserve further investigation. Cancer Causes andd Control 1998, 269-275     

Dietary factors and the risk of squamous cell esophageal cancer among black and white men in the United States

Objectives: To investigate dietary factors for squamous cell esophageal cancer and whether these factors may contribute to the five-fold higher incidence of this cancer in the black versus white population of the United States.Methods: Data from a food frequency questionnaire were analyzed for 114 white men and 219 black men with squamous cell esophageal cancer, and 681 white and 557 black male controls from three areas of the United States who participated in a population-based case-control study of esophageal cancer.Results: Protective effects were associated with intake of raw fruits and vegetables (odds ratio for high versus low consumers=0.3 in both white and black men) and use of vitamin supplements (especially vitamin C; odds ratio for high versus low consumers=0.4 in both races), with the frequency of consumption of raw fruits and vegetables and vitamin supplements being greater for white than black controls. In addition, elevated risks were associated with high versus low intake of red meat (OR=2.7 for blacks and 1.5 for whites) and processed meat (OR=1.6 for blacks and 1.7 for whites), with the levels of consumption being greater for black than white controls.Conclusions: In the United States, these dietary factors may contribute in part to the much higher incidence of squamous cell esophageal cancer among black compared to white men.     

癌症放疗患者营养状况分析及评价

目的分析接受放疗的肿瘤患者营养状况、营养素摄入及膳食结构。方法采用膳食回顾法和称量法相结合的方法,对120例患者进行了营养素摄入量及膳食结构调查;通过体格测量及血液中血红蛋白(HB)、血清白蛋白(Alb)和总淋巴细胞(totallymphocytecount,TLC)等生化指标分析了解患者营养状况。结果放疗患者热能摄入不足,平均为5862kJ(1400kcal),占参考摄入量(dietaryrecommendedintakes,DRIs)的76%;蛋白质和碳水化合物来源不足,脂肪摄入过高,占DRIs的123%;Ca、Fe、Zn、维生素A和维生素B1摄入不足。膳食结构中存在谷类、水产品和豆制品摄入较少的问题。贫血患病率为40%左右,消瘦[体质指数(bodymassindex,BMI)<18.5]比例为23%。结论癌症放疗患者肥胖与消瘦并存,蛋白质储备及碳水化合物摄入不足,脂肪摄入过高,膳食结构需要调整。     

Evolution of atherogenic diets in South Asian and Italian women after migration to a higher risk region

BACKGROUND: To identify differences in the evolution of the diets of South Asian and Italian migrants, a cross-sectional, multiethnic study was undertaken in Glasgow, Scotland. METHODS: Five groups of women aged 20-42 years comprising general population (n = 35), South Asian migrants (n = 35) British-born controls (n = 37), Italian migrants (n = 30) and British-born (n = 38) participated in an interviewer administered structured questionnaire on issues relating to health, diet and food selection. Anthropometric measurements were made and subjects completed a 7-day weighed diet inventory. RESULTS: Compared with the general population, dietary differences were greatest amongst first generation migrant groups. There were major differences between the two migrant groups. South Asian migrants tended to display a more atherogenic profile (fat 42.4% energy, saturated fat 15.0% energy, vitamin C 5.1 mg per 1000 kJ) than the general population (fat 39.1% energy, saturated fat 13.5% energy, vitamin C 6.8 mg per 1000 kJ), and Italian migrants (fat 35.7% energy, saturated fat 12.1% energy, vitamin C 10.9 mg per 1000 kJ). However, South Asian groups had higher intakes of polyunsaturated fatty acids which may be cardioprotective. CONCLUSIONS: South Asian migrants to Scotland appear to develop adverse dietary elements in the first generation, which are modified in subsequent generations, whereas Italians' diets remain cardioprotective in the migrant generation but deteriorate in subsequent generations.     

Aproteic diet decreases hypothalamic catecholamine turnover in adult male rats

Previous reports indicate that malnutrition reduces reproductive functions. We have demonstrated that protein deprivation in the diet also causes reproductive dysfunction by reducing hypothalamic GnRH secretion. Noradrenaline and nitric oxide are modulators of GnRH secretion. Noradrenaline stimulates GnRH secretion and nitric oxide inhibits catecholamine release. This work studies the hypothalamic catecholaminergic and nitrergic neuron activity in Wistar adult male rats fed on an aproteic diet (AP) during 21 days; this treatment was started when rats were 70 days old. Our first experiment studied catecholamine turnover rate after inhibition of tyrosine hydroxylase activity by injecting (i.p.) 400 mg/kg alpha-methyl-p-tyrosine. Our second experiment studied in vitro hypothalamic nitric oxide synthase (NOS) activity in animals under the same diet. AP diet significantly decreased both noradrenaline (P<0.05) and dopamine (P<0.05) hypothalamic turnover rate. Noradrenaline turnover in cerebral cortex was not altered by the aproteic diet. However, hypothalamic NOS activity was not affected in animals fed on an AP diet. These results indicate that the lack of protein in the diet reduces catecholaminergic neuron activity in adult male rats by a NO-independent mechanism, thus suggesting that a decrease in noradrenergic activity may be involved in the reduction of GnRH secretion induced by an AP diet.