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Nursing care to patients with diabetes based on King's Theory.
Araújo, ESS, Silva, LFD, Moreira, TMM, Almeida, PC, Freitas, MC, Guedes, MVC
Revista brasileira de enfermagem. 2018;(3):1092-1098
Abstract
OBJECTIVE To verify the effectiveness of nursing interventions based on the Imogene King's Theory of Goal Attainment, on improving care for people with diabetes and adherence to treatment. METHOD Quasi-experimental, longitudinal, randomized, simple study in a Primary Health Care Unit, in the city of Fortaleza, Ceará state, Brazil. The sample consisted of 60 people with diabetes, divided into intervention and control groups, whose collection occurred from February to August 2013. RESULTS In the intervention group, a significant adherence of the patients to the goals defined in the study was found. In the control, there was improvement in some aspects of the treatment. CONCLUSION With these results, it was possible to conclude the feasibility of using Theory of Goal Attainment in the positive aspects for adherence to diabetes treatment and improvement of quality of life.
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The impact of replacing sugar- by artificially-sweetened beverages on brain and behavioral responses to food viewing - An exploratory study.
Crézé, C, Notter-Bielser, ML, Knebel, JF, Campos, V, Tappy, L, Murray, M, Toepel, U
Appetite. 2018;:160-168
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Abstract
Several studies indicate that the outcome of nutritional and lifestyle interventions can be linked to brain 'signatures' in terms of neural reactivity to food cues. However, 'dieting' is often considered in a rather broad sense, and no study so far investigated modulations in brain responses to food cues occurring over an intervention specifically aiming to reduce sugar intake. We studied neural activity and liking in response to visual food cues in 14 intensive consumers of sugar-sweetened beverages before and after a 3-month replacement period by artificially-sweetened equivalents. Each time, participants were presented with images of solid foods differing in fat content and taste quality while high-density electroencephalography was recorded. Contrary to our hypotheses, there was no significant weight loss over the intervention period and no changes were observed in food liking or in neural activity in regions subserving salience and reward attribution. However, neural activity in response to high-fat, sweet foods was significantly reduced from pre-to post-intervention in prefrontal regions often linked to impulse control. This decrease in activity was associated with weight loss failure, suggesting an impairment in individuals' ability to exert control and adjust their solid food intake over the intervention period. Our findings highlight the need to implement multidisciplinary approaches when aiming to help individuals lose body weight.
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Associations Between Nonnutritive Sweetener Intake and Metabolic Syndrome in Adults.
Hess, EL, Myers, EA, Swithers, SE, Hedrick, VE
Journal of the American College of Nutrition. 2018;(6):487-493
Abstract
OBJECTIVE Individuals looking to improve their health or weight status often use nonnutritive sweeteners (NNS), yet NNS consumption has been associated with increased risk factors for metabolic syndrome (MetS). Most studies examining NNS only assess total intake using diet soda as a proxy for NNS consumption, without distinguishing potential risks associated with individual sweeteners. The objective of this cross-sectional investigation was to identify whether there were associations between NNS consumption (total or individual) and risk factors for MetS in adults (n = 125) from Southwest Virginia. METHODS Participants provided three 24-hour dietary recalls and blood pressure, waist circumference, fasting glucose, triglycerides, and high-density lipoprotein cholesterol were assessed. Linear regression models, adjusted for age, sex, caloric intake, dietary quality, and physical activity, examined associations between total and individual types of NNS with MetS and MetS risk factors. RESULTS Sixty-three participants were classified as NNS consumers and eighteen met the criteria for MetS. While no significant associations between MetS and NNS consumption were found, waist circumference was positively associated with total NNS, saccharin, sucralose, and acesulfame potassium, and both fasting glucose and triglyceride values were positively associated with total NNS and aspartame consumption. CONCLUSION While these cross-sectional data are consistent with previous work implicating NNS in development of MetS, additional research using randomized controlled trials is needed to clarify whether and how NNS in general or specific NNS might contribute to risk factors for MetS. This trial was registered at clinicaltrials.gov (NCT03364452).
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The "sweet" effect: Comparative assessments of dietary sugars on cognitive performance.
Ginieis, R, Franz, EA, Oey, I, Peng, M
Physiology & behavior. 2018;:242-247
Abstract
In recent years there has been increasing interest in studying cognitive effects associated with sugar consumption. Neuro-cognitive research has confirmed that glucose, as a main energy substrate for the brain, can momentarily benefit cognitive performances, particularly for memory functioning. However, there is still limited understanding of relative effects of other common sugars (e.g., fructose and sucrose) on cognitive performance. The present study tested in 49 people the effects of three common dietary sugars against a placebo sweetener (i.e., sucralose), on performance of three well-studied cognitive tasks - simple response time, arithmetic, and Stroop interference, all of which are suggested to rely on the prefrontal lobe. A double-blind, placebo-controlled, cross-over experimental design was used. Results revealed that ingestion of glucose and sucrose led to poorer performances on the assessed tasks as opposed to fructose and the placebo (p<0.05); these effects were particularly pronounced under the fasting condition in comparison to the non-fasting condition (p<0.001). Overall, these results indicate that cognitive effects of sugar are unlikely to be mediated by the perception of sweetness. Rather, the effects are mediated by glucose. Further research should systematically assess effects of dietary sugars on other cognitive domains, such as memory, to give further insights on general cognitive effects of sugar consumption.
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Evolution of complex, discreet nutrient sensing pathways.
Mehat, K, Corpe, CP
Current opinion in clinical nutrition and metabolic care. 2018;(4):289-293
Abstract
PURPOSE OF REVIEW The current review summarizes and discusses current research on differences elicited between sugars and nonnutritive sweeteners via sugar-sensing pathways. RECENT FINDINGS Sugars, sweeteners, and sweetening agents are all perceived as sweet tasting because of their ability to bind to the type 1 taste receptor family of sweet taste receptors in the oral cavity. The ability of a wide variety of chemical ligands to activate the sweet taste receptor highlights the importance of sweet-tasting foods during human evolution. The sweet taste receptor has been located in the gut, and differences between oral and gut sugar-sensing pathways are discussed. SUMMARY Differences in the sweetness transduction cascade, and neuronal signalling may result in incretin hormone release upon activation of the sweet taste receptor from some sweeteners, but not others.
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Process optimization of the extraction condition of β-amylase from brewer's malt and its application in the maltose syrup production.
Niu, C, Zheng, F, Li, Y, Liu, C, Li, Q
Biotechnology and applied biochemistry. 2018;(4):639-647
Abstract
β-Amylase is of important biotechnological aid in maltose syrup production. In this study, the extraction condition of β-amylase from brewer's malt and the optimal dosage of β-amylase in maltose syrup production were optimized using response surface methodology and uniform design method. The optimal extraction condition of β-amylase from brewer's malt was composed of 1:17 (g/v) material/liquid ratio, 44°C extraction temperature, pH 6.4 buffer pH, 2.3 H extraction time, and 1.64 g L-1 NaSO3 dosage with a predicted β-amylase activity of 1,290.99 U g-1 , which was close to the experimental β-amylase activity of 1,230.22 U g-1 . The optimal dosages of β-amylase used in maltose syrup production were 455.67 U g-1 starch and its application in maltose syrup production led to a 68.37% maltose content in maltose syrup, which was 11.2% and 28.9% higher than those using β-amylases from soybean and microbe (P < 0.01). Thus, β-amylase from brewer's malt was beneficial for production of high maltose syrup.
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Rebalancing the Caries Microbiome Dysbiosis: Targeted Treatment and Sugar Alcohols.
Zhan, L
Advances in dental research. 2018;(1):110-116
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Abstract
Dental caries is a disease that results from microbiome dysbiosis with the involvement of multiple cariogenic species, including mutans streptococci (MS), lactobacilli, Scardovia wiggsiae, and several Actinomyces species that have the cariogenic traits of acid production and acid tolerance. Sugar consumption also plays an important role interacting with microbiome dysbiosis, determining the fate of caries development. In addition, the MS transmission that encompasses multiple sources can have long-term impacts on the oral microbiome and caries development in children. Intervention in MS transmission in early childhood may promote effective long-term caries prevention. Anticaries regimens aimed against the above mechanisms will be important for successful caries management. Xylitol and erythritol may serve as good components of anticaries regimens as oral microbiome modifiers, sugar substitutes, and agents to prevent MS transmission in early childhood with both oral and systemic benefits. Further studies are needed to elucidate the mechanism of the anticaries effects of xylitol and erythritol with consideration of their impacts on the microbiome and bacterial virulence, in addition to cariogenic bacteria levels as well as their benefits for overall health. On the other hand, the anticaries agent C16G2, specifically targeting Streptococcus mutans, the most common cariogenic bacterial species, has shown good safety for short-term oral topical use and promising effects in reducing S. mutans in vitro and in vivo with the promotion of oral commensal bacteria. Future study on its anticaries effect will need to include its long-term impact on the oral microbiome and effects on other important cariogenic bacteria.
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Review of 100% Fruit Juice and Chronic Health Conditions: Implications for Sugar-Sweetened Beverage Policy.
Auerbach, BJ, Dibey, S, Vallila-Buchman, P, Kratz, M, Krieger, J
Advances in nutrition (Bethesda, Md.). 2018;(2):78-85
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Abstract
Whether or not drinking 100% fruit juice causes poor health is controversial. Although 100% fruit juice may contain as much sugar as regular soda, it provides needed nutrients to Americans' diets. We systematically reviewed the current evidence of the association of 100% fruit juice consumption and chronic health conditions in children and adults. We focused on data from systematic reviews and meta-analyses about cardiometabolic health outcomes, liver disease, and caries. Aside from increased risk of tooth decay in children and small amounts of weight gain in young children and adults, there is no conclusive evidence that consumption of 100% fruit juice has adverse health effects. Guidelines from groups like the American Academy of Pediatrics and Dietary Guidelines for Americans recommending that 100% fruit juice may be consumed in moderation are consistent with the available evidence and should be used to inform food policies.
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Weight-based carbohydrate treatment of hypoglycaemia in people with Type 1 diabetes using insulin pump therapy: a randomized crossover clinical trial.
McTavish, L, Corley, B, Weatherall, M, Wiltshire, E, Krebs, JD
Diabetic medicine : a journal of the British Diabetic Association. 2018;(3):339-346
Abstract
AIM: To test whether weight-based treatment is more effective than usual care in people with Type 1 diabetes receiving continuous subcutaneous insulin infusion therapy with regard to both hypoglycaemia and avoiding excessive rebound hyperglycaemia. METHODS Children and adults on continuous subcutaneous insulin infusion were enrolled into a study with a crossover design. Each episode of hypoglycaemia (defined as capillary glucose <4.0 mmol/l) was randomly assigned one of two treatment protocols using glucose tablets: either 0.3 g/kg body weight or usual treatment with 15 g (adults) or 10 g (children) for capillary glucose levels 3-3.9 mmol/l or twice these doses for capillary glucose levels <3 mmol/l. All participants received each treatment in random order for up to 10 hypoglycaemic episodes. Glucose levels were re-tested 10 min after treatment, with a repeat dose if still <4 mmol/l. RESULTS Of the 37 participants enrolled, 35 (aged 6-68 years) completed the study. Twenty-four participants completed all treatment episodes, while 10 participants had <10 hypoglycaemic episodes and two withdrew without data. The mean glucose difference between weight-based and usual treatment after 10 min was 0.33 mmol/l (95% CI 0.005 to 0.66; P=0.047) in adults and 0.45 (95% CI 0.18 to 0.72; P=0.001) in children. The odds ratios for resolution of hypoglycaemia at 10 min with a single treatment using weight-based compared with usual treatment were 3.12 (95% CI 1.38 to 7.02; P=0.0070) in adults and 2.61 (95% CI 1.19 to 5.74; P=0.017) in children. CONCLUSIONS Weight-based treatment using 0.3 g/kg glucose was more effective for symptomatic hypoglycaemia in children and adults with Type 1 diabetes who were using continuous subcutaneous insulin infusion than treatment based on current international recommendations.
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Effects of Consuming a Low Dose of Alcohol with Mixers Containing Carbohydrate or Artificial Sweetener on Simulated Driving Performance.
Brickley, B, Desbrow, B, McCartney, D, Irwin, C
Nutrients. 2018;(4)
Abstract
The Australian National Drug and Alcohol Research Centre (NDARC) devised gender-based drinking recommendations to ensure blood or equivalized breath alcohol concentrations (BrAC) remain <0.050%. However, these may be inappropriate for individuals consuming alcohol without carbohydrate (CHO), which results in higher BrACs. This study investigated the effects of ingesting alcohol with and without CHO on BrACs and simulated driving performance. Thirty-two participants (16 males; age: 23 ± 6 years) completed two randomized single-blinded trials. Participants performed a baseline drive (Drive 1), then an experimental drive (Drive 2), following alcohol consumption (males: 20 g; females: 10 g). Alcoholic beverages contained either 25 g sucrose or aspartame (AS). Driving performance was assessed using lateral control (standard deviation of lane position [SDLP] and number of lane departures) and risk-taking (number of overtaking maneuvers and maximum overtaking speed). BrAC and subjective ratings (e.g., intoxication) were also assessed. BrAC was significantly lower as Drive 2 commenced with CHO compared to AS (0.022 ± 0.008% vs. 0.030 ± 0.011%). Two males provided BrACs >0.050% with AS. Neither beverage influenced changes to simulated driving performance. Ingesting alcohol in quantities advised by the NDARC results in no detectable simulated driving impairment. However, the likelihood of exceeding the legal drink-driving BrAC is increased when alcohol is consumed with artificially-sweetened mixers.