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Dietary fiber intake and glycemic control: coronary artery calcification in type 1 diabetes (CACTI) study.
Basu, A, Alman, AC, Snell-Bergeon, JK
Nutrition journal. 2019;18(1):23
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The incidence of type 1 diabetes and cardiovascular disease, the major vascular complication of diabetes, have been increasing wordwide. The aim of the study is to identify the associations of dietary fibre with glycaemic control. The study is a cross-sectional longitudinal study which enrolled 1257 individuals in the cross-sectional analysis and a total of 990 participants were included in the longitudinal analysis. The participants had no known history of coronary heart disease. Results indicate an inverse association between total fibre intake and the average blood glucose levels for the last two to three months in both diabetic and nondiabetic participants. Authors conclude that their study provides some evidence on the role dietary fibre intake plays on glycaemic control, which is important in the management of type 1 diabetes in patients at high risk of cardiovascular disease.
Abstract
BACKGROUND Dietary fiber has been recommended for glucose control, and typically low intakes are observed in the general population. The role of fiber in glycemic control in reported literature is inconsistent and few reports are available in populations with type 1 diabetes (T1D). METHODS Using data from the Coronary Artery Calcification in Type 1 Diabetes (CACTI) study [n = 1257; T1D: n = 568; non-diabetic controls: n = 689] collected between March 2000 and April 2002, we examined cross-sectional (baseline) and longitudinal (six-year follow-up in 2006-2008) associations of dietary fiber and HbA1c. Participants completed a validated food frequency questionnaire, and a physical examination and fasting biochemical analyses (12 h fast) at baseline visit and at the year 6 visit. We used a linear regression model stratified by diabetes status, and adjusted for age, sex and total calories, and diabetes duration in the T1D group. We also examined correlations of dietary fiber with HbA1c. RESULTS Baseline dietary fiber intake and serum HbA1c in the T1D group were 16 g [median (IQ): 11-22 g) and 7.9 ± 1.3% mean (SD), respectively, and in the non-diabetic controls were 15 g [median (IQ): 11-21 g) and 5.4 ± 0.4%, respectively. Pearson partial correlation coefficients revealed a significant but weak inverse association of total dietary fiber with HbA1c when adjusted for age, sex, diabetes status and total calories (r = - 0.07, p = 0.01). In the adjusted linear regression model at baseline, total dietary fiber revealed a significant inverse association with HbA1c in the T1D group [β ± SE = - 0.32 ± 0.15, p = 0.034], as well as in the non-diabetic controls [- 0.10 ± 0.04, p = 0.009]. However, these results were attenuated after adjustment for dietary carbohydrates, fats and proteins, or for cholesterol and triglycerides. No such significance was observed at the year 6 follow-up, and with the HbA1c changes over 6 years. CONCLUSION Thus, at observed levels of intake, total dietary fiber reveals modest inverse associations with poor glycemic control. Future studies must further investigate the role of overall dietary quality adjusting for fiber-rich foods in T1D management.
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A Randomized Study of the Effects of Additional Fruit and Nuts Consumption on Hepatic Fat Content, Cardiovascular Risk Factors and Basal Metabolic Rate.
Agebratt, C, Ström, E, Romu, T, Dahlqvist-Leinhard, O, Borga, M, Leandersson, P, Nystrom, FH
PloS one. 2016;11(1):e0147149
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Fruits and vegetables intake has been advocated to improve blood lipids profile and reduce risk of cardiovascular disease, diabetes and cancer. However, a low fat diet rich in fruits and vegetables has showed no effect on cardiovascular disease and cancer in a large randomized American trial. This might be due to the high sugar content in fruits, particularly fructose. The aim of this study was to compare the effects of adding either fruits or nuts to the diet of 30 healthy non-obese individuals on liver fat, metabolic rate and cardiovascular risk markers. Authors concluded that the trial only showed small effects on cardiovascular risk factors. Nevertheless, there was a significant change in lipoprotein (fats that transport fats in the blood) levels between the two groups, which tends to give an advantage to the consumption of nuts over fruits. They deduced that increased intake of fruits doesn’t negatively impact cardiovascular disease risk factors in healthy non-obese individuals. However, further research needs to evaluate the effects on obese and insulin-resistant participants.
Abstract
BACKGROUND Fruit has since long been advocated as a healthy source of many nutrients, however, the high content of sugars in fruit might be a concern. OBJECTIVES To study effects of an increased fruit intake compared with similar amount of extra calories from nuts in humans. METHODS Thirty healthy non-obese participants were randomized to either supplement the diet with fruits or nuts, each at +7 kcal/kg bodyweight/day for two months. Major endpoints were change of hepatic fat content (HFC, by magnetic resonance imaging, MRI), basal metabolic rate (BMR, with indirect calorimetry) and cardiovascular risk markers. RESULTS Weight gain was numerically similar in both groups although only statistically significant in the group randomized to nuts (fruit: from 22.15 ± 1.61 kg/m(2) to 22.30 ± 1.7 kg/m(2), p = 0.24 nuts: from 22.54 ± 2.26 kg/m(2) to 22.73 ± 2.28 kg/m(2), p = 0.045). On the other hand BMR increased in the nut group only (p = 0.028). Only the nut group reported a net increase of calories (from 2519 ± 721 kcal/day to 2763 ± 595 kcal/day, p = 0.035) according to 3-day food registrations. Despite an almost three-fold reported increased fructose-intake in the fruit group (from 9.1 ± 6.0 gram/day to 25.6 ± 9.6 gram/day, p<0.0001, nuts: from 12.4 ± 5.7 gram/day to 6.5 ± 5.3 gram/day, p = 0.007) there was no change of HFC. The numerical increase in fasting insulin was statistically significant only in the fruit group (from 7.73±3.1 mIE/L to 8.81±2.9 mIE/L, p = 0.018, nuts: from 7.29±2.9 mIE/L to 8.62±3.0 mIE/L, p = 0.14). Levels of vitamin C increased in both groups while α-tocopherol/cholesterol-ratio increased only in the fruit group. CONCLUSIONS Although BMR increased in the nut-group only this was not linked with differences in weight gain between groups which potentially could be explained by the lack of reported net caloric increase in the fruit group. In healthy non-obese individuals an increased fruit intake seems safe from cardiovascular risk perspective, including measurement of HFC by MRI. TRIAL REGISTRATION ClinicalTrials.gov NCT02227511.
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A comparative controlled trial comparing the effects of yoga and walking for overweight and obese adults.
Telles, S, Sharma, SK, Yadav, A, Singh, N, Balkrishna, A
Medical science monitor : international medical journal of experimental and clinical research. 2014;20:894-904
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Walking and yoga are types of exercise that may be useful for weight loss. The aim of this study was to compare the effects of yoga and walking on the biochemistry, body composition, balance and strength in overweight people. 68 Indian adults who were overweight or obese were allocated to either yoga or walking twice a day for 15 days. Both groups were given the same plant-based diet providing 1,650 kcal/day Both groups showed similar and significant decreases in body mass index (BMI), waist and hip circumference, lean mass, body water and total cholesterol over the 15 days. The yoga group increased serum leptin and decreased LDL cholesterol. The walking group decreased serum adiponectin and triglycerides. Since there was no control group, it was not possible to attribute the changes to the yoga or walking, rather than the diet. The authors concluded that both yoga and walking improved anthropometric variables and serum lipid profile in overweight and obese people, and that these interventions may be useful in treating obesity.
Abstract
BACKGROUND Walking and yoga have been independently evaluated for weight control; however, there are very few studies comparing the 2 with randomization. MATERIAL AND METHODS The present study compared the effects of 90 minutes/day for 15 days of supervised yoga or supervised walking on: (i) related biochemistry, (ii) anthropometric variables, (iii) body composition, (iv) postural stability, and (v) bilateral hand grip strength in overweight and obese persons. Sixty-eight participants, of whom 5 were overweight (BMI ≥25 kg/m2) and 63 were obese (BMI ≥30 kg/m2; group mean age ±S.D., 36.4±11.2 years; 35 females), were randomized as 2 groups - (i) a yoga group and (ii) a walking group - given the same diet. RESULTS All differences were pre-post changes within each group. Both groups showed a significant (p<0.05; repeated measures ANOVA, post-hoc analyses) decrease in: BMI, waist circumference, hip circumference, lean mass, body water, and total cholesterol. The yoga group increased serum leptin (p<0.01) and decreased LDL cholesterol (p<0.05). The walking group decreased serum adiponectin (p<0.05) and triglycerides (p<0.05). CONCLUSIONS Both yoga and walking improved anthropometric variables and serum lipid profile in overweight and obese persons. The possible implications are discussed.