Nutritional Approaches for Prevantion and Treatment of Metabolic Syndrome in Adults

Metabolic syndrome, a clustering of components that reflect overnutrition, sedentary lifestyles, and excess adiposity, has become a major health problem worldwide. The increase in its prevalence could be the result of the increase in obesity and insulin resistance. It is suggested that modification of lifestyle including increasing exercise and improving dietary habits is an effective approach for management of the metabolic syndrome. No single diet is recommended for patients with metabolic syndrome. This paper will review the data and make an evidence-based recommendation for the optimal dietary patterns for reducing cardiometabolic risk

Effects of green coffee aqueous extract supplementation on glycemic indices, lipid profile, CRP, and malondialdehyde in patients with type 2 diabetes: a randomized, double-blind, placebo-controlled trial

Background/objectivesStudies have reported the health benefits of green coffee extract (GCE) in experimental models. In the current study, we aimed to determine whether supplementation with GCE improves glycemic indices, inflammation, and oxidative stress in patients with type 2 diabetes (T2D).Methods and study designThis randomized, double-blind, placebo-controlled trial included 44 patients (26 male and 18 female) with T2D and overweight/obesity. After blocked randomization, patients received either capsules containing 400 mg GCE twice per day (n = 22) or a placebo (n = 22) and were followed for 10 weeks. In this study, glycemic indices, lipid profiles, anthropometric examinations, blood pressure, high-sensitivity C-reactive protein (hs-CRP), and malondialdehyde (MDA) were measured twice; at baseline and at the end of the study.ResultsAfter 10 weeks of supplementation, GCE supplementation significantly reduced body weight (p = 0.04) and body mass index (BMI) (p = 0.03) compared to the placebo. The intention-to-treat (ITT) analysis indicated patients in the GCE group had a lower fasting blood glucose (FBG) concentration compared to the placebo group; however, this decreasing was marginally significant (8.48 ± 8.41 vs. 1.70 ± 5.82 mg/dL, p = 0.05). There was no significant difference in insulin levels and HOMA-IR between the groups. At the end of the study, significant changes in systolic blood pressure (SBP) (p = 0.01), triglyceride (TG) level (p = 0.02), high-density lipoprotein (HDL) (p = 0.001), and TG-to-HDL ratio (p = 0.001) were found between the intervention and placebo groups. Our trial indicated GCE supplementation had no effect on diastolic blood pressure (DBP), low-density lipoprotein (LDL), or total cholesterol. During the supplementation period, the hs-CRP level significantly decreased in the GCE group compared to the placebo group (p = 0.02). No significant changes were observed in the MDA level between the two groups at the end of the study (p = 0.54).ConclusionOur findings showed beneficial effects of GCE on SBP, TG, hs-CRP, and HDL levels in patients with T2D and overweight/obesity over a 10-week period of supplementation.Clinical trial registration:https://en.irct.ir/trial/48549, identifier [IRCT20090203001640N18]

Lifestyle interventions and risk of Type 2 diabetes

Diabetes mellitus is one of the most common chronic diseases in nearly all countries. It is difficult to treat and expensive to manage. The development of type 2 diabetes is strongly related to lifestyle factors, thus it might be a preventable disease. Observational studies and intervention trials have shown that physical activity, weight loss and dietary intake including whole grain, dietary fiber and dietary fat are important in delaying and preventing type 2 diabetes. The aim of this review is to gather current information from epidemiologic and clinical trial studies on dietary and lifestyle practices for reducing the risk of type 2 diabetes. The review focuses on the macro and micronutrients, food items and dietary patterns which have been identified as significant in the prevention and management of type 2 diabetes. Also, the role of physical activity and weight loss are presented

Do the other nutrients except calcium and vitamin D prevent the incidence of osteoporosis?

Osteoporosis as a skeletal disorder characterize by compromised bone strength predisposing a person to an increased risk of fracture. All people should be encouraged to take efforts to prevent bone loss and fractures. Nutrition is one of several factors that can be modified to reduce osteoporosis risk. The purpose of this review article is assessment the role of the other nutrients the exception of calcium and vitamin D on bone health and prevention of osteoporosis.The search was undertaken in three databases (PubMed, google scholar and science direct) for publications from 2005 onwards using key words as follows. Initial searches yielded approximately 2467 results. After considering additional exclusion criteria, 33 clinical trial and meta- analysis papers remained.According to investigations, high intake of dietary protein increase bone resorption and calcium excretion and low protein intake can prevent calcium absorption and decrease strength and bone mass. Omega-3 supplementation also can decrease bone resorption and α-linleic acid (for men and women) and arashidonic acid (in men) and isoflavones can significantly diminish the risk of hip fracture. Adequate intake of some nutrients like zinc, vitamin A, boron and manganese in bone formation and copper, fluoride and strontium in bone mineralization have positive effects. However, high intake of vitamin A and fluoride result in hip fracture incretion. Vitamin K (in form of K2) along with calcium and vitamin D induce bone fracture decrease. If intake of phosphate, iron and sodium be more than the recommended values, they may present negative effects on bone mineralization.In conclusion, risk of osteoporosis incidence may be diminished with an adequate and balanced diet containing variety of foods to meet needs and a healthy lifestyle. Nutrition education and training the other preventive factors should be carrying out in childhood to achieve the peak bone mass in youth and aging.

Common Study Designs of Nutrition Clinical Trials: Review of the Basic Elements and the Pros and Cons

Introduction: Nutrition Clinical Trials (NCTs) are pivotal in establishing causal links between nutritional interventions and chronic diseases. This review comprehensively examines prevalent clinical trial designs, emphasizing their strengths and limitations. The goal is to provide insights into the selection and optimization of these designs for dietary intervention studies. Methods: Various study designs in NCTs are explored, including quasi-experimental designs, double-blind randomized placebo-controlled trials for nutrient/functional foods supplementation, community-based lifestyle interventions, pragmatic nutrition interventions, and field trial projects. The characteristics, advantages, and challenges of each design are discussed. Real examples are presented to illustrate how these designs can be tailored and optimized for dietary intervention studies. Results: Parallel randomized clinical trials are acknowledged as the gold standard, despite requiring substantial sample sizes and having inherent limitations. Cross-over NCTs emerge as valuable for assessing temporary treatment effects while mitigating potential confounders and interpatient variability. However, they may not be suitable for acute diseases and progressive disorders, and attrition rates can be higher. Multi-arm randomized designs offer increased study power with a lower sample size but necessitate more intricate design, analysis, and result reporting. Conclusion: In conclusion, each study design in NCTs comes with its set of strengths and limitations. The selection of an appropriate design should consider determinants and common considerations to provide robust evidence for establishing cause-and-effect associations or assessing the safety and efficacy of food products in nutrition research. This comprehensive understanding aids researchers in making informed choices when planning and conducting nutrition clinical trials

Validity and reliability of the Iranian version of the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™) Generic Core Scales in children

<p>Abstract</p> <p>Background</p> <p>This study aimed to investigate the reliability and validity of the Iranian version of the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™ 4.0) Generic Core Scales in children.</p> <p>Methods</p> <p>A standard forward and backward translation procedure was used to translate the US English version of the PedsQL™ 4.0 Generic Core Scales for children into the Iranian language (Persian). The Iranian version of the PedsQL™ 4.0 Generic Core Scales was completed by 503 healthy and 22 chronically ill children aged 8-12 years and their parents. The reliability was evaluated using internal consistency. Known-groups discriminant comparisons were made, and exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted.</p> <p>Results</p> <p>The internal consistency, as measured by Cronbach's alpha coefficients, exceeded the minimum reliability standard of 0.70. All monotrait-multimethod correlations were higher than multitrait-multimethod correlations. The intraclass correlation coefficients (ICC) between the children self-report and parent proxy-reports showed moderate to high agreement. Exploratory factor analysis extracted six factors from the PedsQL™ 4.0 for both self and proxy reports, accounting for 47.9% and 54.8% of total variance, respectively. The results of the confirmatory factor analysis for 6-factor models for both self-report and proxy-report indicated acceptable fit for the proposed models. Regarding health status, as hypothesized from previous studies, healthy children reported significantly higher health-related quality of life than those with chronic illnesses.</p> <p>Conclusions</p> <p>The findings support the initial reliability and validity of the Iranian version of the PedsQL™ 4.0 as a generic instrument to measure health-related quality of life of children in Iran.</p

Effect of dietary patterns on oxidative stress in Patiants with metabolic syndrome: Tehran Lipid and Glucose Study

Background: Metabolic syndrome is a prevalent condition with dramatic rising trend worldwide. Single dietary factors, such as omega-3 fatty acids consumption protect body against oxidative damage by reinforcement of dietary total antioxidant capacity but the combination of all dietary components may be more effective when studied as integrated dietary patterns. This present study was designed to assess the association between different dietary patterns and oxidative stress in a population of Tehranian adults suffering from metabolic syndrome. Methods: Dietary data were collected using a validated 147-item semi-quantitative FFQ with a standard serving size. Factor analysis method was used to derive dietary patterns. Blood analysis and anthropometric measurements were also obtained. Oxidative stress was assesses using serum levels of Malondialdehyde (MDA) and total antioxidant capacity (TAC). Results: The regression coefficient for TAC and MDA with different quintiles of dietary patterns, adjusted for potential confounder in model 3 reveal a significant positive association between healthy pattern and serum TAC levels (β=0.244, p=0.008) and also between serum MDA levels and the unhealthy pattern (β=0.387, p=0.0001). On the other hand, a significant negative association found between serum TAC levels (β=-0.289, p=0.001) and the unhealthy pattern, a relationship also noted between serum MDA levels and the healthy dietary pattern (β=-0.273, p=0.002). Conclusions: Our findings suggest that following a healthy pattern filled with fruits and vegetables ameliorates oxidative stress status and on the contrary, attachment to an unhealthy pattern, characterized by higher intakes of fast foods and processed foods, aggravated the oxidative stress levels in Tehranian individuals suffering from metabolic syndrome

Improvement of Consumption of fruits and vegetables aimed at the prevention of obesity in girl students

Background: The intake of fruit and vegetables is considered an important part of a healthy lifestyle. Considering the importance of nutrition education especially Consumption of fruits and vegetables this study was performed to determine effect of health Education Based on Health Belief Model on the improvement of Consumption of fruits and vegetables aimed at the prevention of obesity in girl students in Shahr-e-kord. Methods: Students aged 13-14 years (n 154) were recruited from four high schools in Shahr-e-kord city and randomly allocated to a control group or intervention group. The setting for the interventions was schools. The intervention lasted for 6 weeks. The instruments for data collecting were questionnaire health belief model based and FFQ questionnaire. The HBM questionnaire was completed 3 times (before, immediately and 2 months after education) and FFQ questionnaire was completed 2 times (before and 2 months after education) by students. After pre-test, 6 educational session classes in experimental group were performed. Finally data collected and analyzed by SPSS16 computer software (T test, T-Paired, repeated measure ANOVA). Results: Two groups with no significant difference in terms of demographic variables. Before the intervention was not significant differences between the scores of different structures of this model in two groups (P&gt;0/05), after the intervention was significant differences between experimental and control groups in the levels of knowledge, Perceived susceptibility, perceived severity, perceived benefits, perceived barriers and Consumption of fruits and vegetables (p&lt;0.001). Conclusion: According to the results, intervention has positive impact on the improvement of Consumption of fruits and vegetables among students