Transculturalization of a Diabetes-Specific Nutrition Algorithm: Asian Application

The prevalence of type 2 diabetes (T2D) in Asia is growing at an alarming rate, posing significant clinical and economic risk to health care stakeholders. Commonly, Asian patients with T2D manifest a distinctive combination of characteristics that include earlier disease onset, distinct pathophysiology, syndrome of complications, and shorter life expectancy. Optimizing treatment outcomes for such patients requires a coordinated inclusive care plan and knowledgeable practitioners. Comprehensive management starts with medical nutrition therapy (MNT) in a broader lifestyle modification program. Implementing diabetes-specific MNT in Asia requires high-quality and transparent clinical practice guidelines (CPGs) that are regionally adapted for cultural, ethnic, and socioeconomic factors. Respected CPGs for nutrition and diabetes therapy are available from prestigious medical societies. For cost efficiency and effectiveness, health care authorities can select these CPGs for Asian implementation following abridgement and cultural adaptation that includes: defining nutrition therapy in meaningful ways, selecting lower cutoff values for healthy body mass indices and waist circumferences (WCs), identifying the dietary composition of MNT based on regional availability and preference, and expanding nutrition therapy for concomitant hypertension, dyslipidemia, overweight/obesity, and chronic kidney disease. An international task force of respected health care professionals has contributed to this process. To date, task force members have selected appropriate evidence-based CPGs and simplified them into an algorithm for diabetes-specific nutrition therapy. Following cultural adaptation, Asian and Asian-Indian versions of this algorithmic tool have emerged. The Asian version is presented in this report

Diabetes-Specific Nutrition Algorithm: A Transcultural Program to Optimize Diabetes and Prediabetes Care

Type 2 diabetes (T2D) and prediabetes have a major global impact through high disease prevalence, significant downstream pathophysiologic effects, and enormous financial liabilities. To mitigate this disease burden, interventions of proven effectiveness must be used. Evidence shows that nutrition therapy improves glycemic control and reduces the risks of diabetes and its complications. Accordingly, diabetes-specific nutrition therapy should be incorporated into comprehensive patient management programs. Evidence-based recommendations for healthy lifestyles that include healthy eating can be found in clinical practice guidelines (CPGs) from professional medical organizations. To enable broad implementation of these guidelines, recommendations must be reconstructed to account for cultural differences in lifestyle, food availability, and genetic factors. To begin, published CPGs and relevant medical literature were reviewed and evidence ratings applied according to established protocols for guidelines. From this information, an algorithm for the nutritional management of people with T2D and prediabetes was created. Subsequently, algorithm nodes were populated with transcultural attributes to guide decisions. The resultant transcultural diabetes-specific nutrition algorithm (tDNA) was simplified and optimized for global implementation and validation according to current standards for CPG development and cultural adaptation. Thus, the tDNA is a tool to facilitate the delivery of nutrition therapy to patients with T2D and prediabetes in a variety of cultures and geographic locations. It is anticipated that this novel approach can reduce the burden of diabetes, improve quality of life, and save lives. The specific Southeast Asian and Asian Indian tDNA versions can be found in companion articles in this issue of Current Diabetes Reports

EDUCAÇÃO PARA O LAZER NO ENSINO FUNDAMENTAL: O USO DE HISTÓRIAS EM QUADRINHOS NAS AULAS DE EDUCAÇÃO FÍSICA

No Brasil, muitos alunos não gostam das aulas de Educação Física devido à repetição de conteúdos, organização curricular insatisfatória, entre outros fatores. Este trabalho objetivou avaliar a eficácia de uma proposta de aulas de Educação Física que contempla conteúdos de práticas corporais e a utilização de histórias em quadrinhos (HQ). Este estudo é qualitativo e foram realizadas pesquisas bibliográficas e de campo. Dez aulas foram ministradas para uma turma de alunos do nono ano de uma escola pública da cidade de Piracicaba / SP / Brasil. Nossos achados apontam que a utilização de HQ como recurso didático é potente na medida em que retrata as experiências vividas pelos alunos, sentidas e mediadas por meio de seus conhecimentos “racionais” e “sensíveis” sobre as práticas corporais.In Brazil, many students dislike Physical Education classes because of content repetition, dissatisfactory curricular organization, among other factors. This work aims at assessing the efficiency of a proposal for Physical Education classes, which includes contents of physical activities and the use of comic books. This is a qualitative study and both bibliographic and field researches were carried out. Ten classes were held to a group of ninth graders from a public school in the city of Piracicaba/SP/Brazil. We found that the use of comic books as a teaching resource is effective: it portrays the experiences that the students, felt and mediated through their “rational” and “sensitive” knowledge about physical activities.