Impact of Skills for Change Program on metabolic control, diet and physical activity levels in adults with type 2 diabetes: A cluster randomized trial

Background: Type 2 diabetes mellitus is highly prevalent in the Arab Gulf countries. Despite this, limited culturally-adapted lifestyle intervention studies have been conducted in this region. Methods: In this culturally adapted 12-month cluster randomized trial, 382 patients with type 2 diabetes, aged 20–70 years were recruited from 6 public healthcare centers (3 interventions and 3 controls) in Al Ain, United Arab Emirates. The primary outcome of this study was a change in hemoglobin A1c (HbA1c). The secondary outcomes were Body Mass Index (BMI), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, total cholesterol, dietary intake, and physical activity levels. A diet and physical activity intervention, guided by the social cognitive theory, was delivered individually and in group format to the intervention group. The control group continued receiving only their usual diabetes management care. The data were collected at baseline and 1 year after participation. Results: The mean baseline HbA1c levels of the control and the intervention groups were 7.45 ± 0.11% and 7.81 ± 0.11%, respectively. At the end of the 12-month intervention, there was no significant difference in the changes of mean HbA1c between the intervention and the control groups. On the other hand, BMI and daily caloric intake were significantly decreased in the intervention compared to the control group by 1.18 kg/m2 (95% CI: -1.78 − -0.60) and 246 kcal (95% CI: -419.52 − -77.21), respectively, after controlling for age, gender, education, marital status, duration since diabetes diagnosis, diabetes treatment, treatment clinic, and baseline values. Sitting time during the week-end was significantly lower, difference 52.53 minutes (95% CI: 93.93 − -11.14). Conclusions: This community-based lifestyle intervention for patients with baseline HbA1c <8% did not result in a significant decrease of HbA1c but reduced caloric intake, body weight, and weekend inactivity after controlling for the covariates. Trial registration: This trial was registered on February 11, 2020 with Clinicaltrials.gov (NCT04264793)

Implication de l'activité physique et de l'alimentation dans le syndrome métabolique de l'adolescent

Le syndrome métabolique, défini par le regroupement de plusieurs anomalies métaboliques et associé à un risque cardiovasculaire élevé, est en augmentation dans les pays industrialisés. Les facteurs impliqués dans sa genèse et son développement ainsi que leurs modes d'action sont mal connus, notamment chez l'adolescent. A partir des données issues de deux études transversales, menées sur deux échantillons randomisés (n=4326 et n=1048) d'adolescents en classe de 6e, dans le Bas-Rhin, nous avons tout d'abord montré l'importance du surpoids (22,7 % des adolescents) et du syndrome métabolique (5,8 % des adolescents) dans notre population. Par ailleurs, nous avons montré l'existence d'une interdépendance entre l'activité physique (AP) et l'alimentation, définissant de véritables profils comportementaux. Nous avons mis en évidence l'influence sur es profils du niveau socioéconomique et de l'éducation des parents. Dans un second temps, nous avons montré que l'AP est associée inversement avec l'indice de masse corporelle (IMC) mais également au tour de taille, indépendamment de l'IMC, suggérant un impact spécifique de l'AP sur la localisation abdominale des graisses. Nous avons par ailleurs identifié une relation inverse de l'AP avec la résistance à l'insuline et un état pro-inflammatoire (IL6), qui pourrait participer au risque cardiovasculaire de ces adolescents. Cette relation est indépendante de la masse grasse, de la répartition des graisses et des adipokines (leptine, adiponectine et TNFα récepteur). Une relation inverse de l'AP intense avec la variabilité cardiaque a également été observée. L'étude de la composition en acides gras des phospholipides plasmatiques montre que le rapport des acides gras polyinsaturés/saturés est associé inversement, chez les obèses uniquement, à différentes composantes du syndrome métabolique et à un état pro-inflammatoire. Ce travail nous a permis de montrer que l'AP et l'alimentation pourraient moduler, très précocement, la relation de l'obésité avec le syndrome métabolique et l'état pro-inflammatoire. D'autres travaux sont nécessaires afin de préciser les mécanismes sous-jacents et la façon dont l'AP et l'alimentation interagissent. The metabolic syndrome, which is defined by a clustering of several metabolic abnormalities and which is associated with a high cardiovascular risk, is increasing in industrialized countries. The factors implicated in its origin and development and the mechanisms are not well understood, especially in adolescents. Our data were collected in two cross-sectional studies, conducted in two randomized samples (n=4 327 and n=1 048) in sixth-grade adolescents, in the Department of the Bas-Rhin. First, we showed a high prevalence of overweight (22,7% of the adolescents) and of the metabolic syndrome (5,8% of the adolescents) in our population. Besides, we showed that physical activity (PA) and diet were interdependent which lead to identify PA and diet profiles. We highlighted an influence on these profiles of socioeconomic and educational levels. Then, we showed that PA was associated inversely with body mass index (BMI) but although with waist circumference, independently of BMI, suggesting a specific impact of PA on abdominal fat localization. Moreover, we identified an inverse relation of PA with insulin resistance and a pro-inflammatory state (IL6), that could contribute to cardiovascular risk in adolescents. This relation was independent of fat mass, fat localization and adipokines (leptin, adiponectin and TNFα receptor). An inverse relation of high intensity PA with cardiac variability was observed. Finally, the study of the plasmatic phospholipid fatty acid composition showed that the polyunsaturated/saturated fatty acids ratio was associated inversely with different components of the metabolic syndrome and with a pro-inflammatory state. This work enabled us to show that PA and diet could modulate the relation of obesity with the metabolic syndrome and pro-inflammatory state, early in adolescence. Other works are necessary to precise the mechanisms and how PA and diet are in interaction

Implication of physical activity and diet in the metabolic syndrome in adolescents

Pas de résuméPas de résum

Implication de l'activité physique et de l'alimentation dans le syndrome métabolique de l'adolescent

STRASBOURG-Medecine (674822101) / SudocSudocFranceF

Bioactivity of arid region honey: an in vitro study

Abstract Background Antioxidant and anti-inflammatory properties of honey have been largely recognized by various studies. Almost all of the potential benefits are associated with polyphenol content. Honey varieties from the arid region are reported to be rich in polyphenols, but data related to its bioactivity in vitro is greatly lacking. This study aimed at establishing the antioxidant and anti-inflammatory properties of arid region honey. Four honey varieties from arid region (H1, H2, H3, and H4) and two popular non-arid region honey (H5 and H6) were tested in vitro in this study. Methods The erythrocyte membrane protection effect of honey varieties were measured by hemolysis assay after exposing erythrocytes to a peroxide generator. The subsequent production of MDA (malondialdehyde) content in erythrocytes was measured. Immunomodulatory effect of the honey varieties was tested in prostate cancer cells PC-3 and PBMC (peripheral blood mononuclear cells) by measuring the IL-6 (interleukin 6) and NO (nitric oxide) levels in cell culture supernatant after incubation with the honey varieties. PC-3 cell viability was assessed after incubation with honey varieties for 24 h. Results Arid region honey exhibited superior erythrocyte membrane protection effect with H4 measuring 1.3 ± 0.042mMTE/g and H2 measuring 1.122 ± 0.018mMTE/g. MDA levels were significantly reduced by honey samples, especially H4 (20.819 ± 0.63 nmol/mg protein). We observed a significant decrease in cell population in PC-3 after 24 h in culture on treatment with honey. A moderate increase in NO levels was observed in both cultures after 24 h at the same time levels of IL-6 were remarkably reduced by honey varieties. Conclusion The results demonstrate the antioxidant effect of arid region honey due to its erythrocyte membrane protection effect and subsequent lowering of oxidative damage as evident from lower levels of lipid peroxidation byproduct MDA. Arid region honey varieties were as good as non-arid region types at decreasing cell viability of prostate cancer cells. The moderate increase in NO levels in PC-3 and PBMCs were not significant enough to elicit any pro-inflammatory response. However, IL-6 secretion was remarkably reduced by all honey varieties in a comparable level indicating the potential anti-inflammatory property of arid region honey

Polyphenolic compounds in date fruit seed (Phoenix dactylifera): characterisation and quantification by using UPLC-DAD-ESI-MS

Background Date fruit seeds have been demonstrated to possess high antioxidant activities due to their high content of flavonoids and phenolic compounds. The objective of this work was to identify and quantify the phenolic composition of date seeds. Methods Two UPLC-DAD-ESI-MS analyses were performed on the seed of the Khalas variety as follows: (1) an analysis of simple phenolic compounds [phenolic acids, hydroxycinnamic acids, flavonols, flavones, flavan-3-ols (monomers, dimers and trimers)]; and (2) an analysis of all flavan-3-ols (monomers, and proanthocyanidin oligomers and polymers) after depolymerisation. Results The amount of total phenolic compounds before depolymerisation was found to be 2.194 +/- 0.040 g kg(-1) date seed. The analysis of flavan-3-ol monomers and constitutive units of proanthocyanidins after depolymerisation revealed 50.180 +/- 1.360 g kg(-1) flavan-3-ols with 46.800 +/- 1.012 g kg(-1) epicatechin and 3.380 +/- 0.349 g kg(-1) catechin. Conclusion The results indicate that date seeds are a very rich source of bioactive compounds, thus constituting strong candidates for functional food additives and nutraceuticals

Inhibition of Digestive Enzyme and Stimulation of Human Liver Cells (HepG2) Glucose Uptake by Date Seeds Extract

Type 2 diabetes mellitus is increasing worldwide, and the United Arab Emirates is presenting one of the world’s highest prevalence rates. Dietary polyphenols exert an antidiabetic effect by modulating carbohydrates digestion and cellular glucose uptake. Due to their particularly high content in polyphenols, date seeds represent a potential antidiabetic agent. This study aims to determine if date seed polyphenols inhibit the activity of the enzymes (α-amylase and α-glucosidase), responsible for the digestion of carbohydrates and modulating the glucose uptake by human liver cells. In vitro activity of the intestinal α-glucosidase, pancreatic α-amylase, the glucose uptake by HepG2 cells, and the expression of GLUT4 and AMPK analyzed by western blotting (with and without date seeds extract). Our result showed that the maximum enzymes inhibition was obtained with 400 μg/mL and 900 μg/mL DSE for α-amylase and α-glucosidase, respectively. The HepG2 cell viability significantly decreased up to 80% at 4000 μg/mL DSE. The expression of GLUT4 was higher at 100 μg/mL DSE (with insulin and without insulin). However, the expressions of P-AMPK and AMPK were increased by DSE, mainly in a non-insulin-dependent manner. Therefore, DSE, by inhibiting carbohydrate digestion and stimulating glucose uptake by HepG2, can potentially demonstrate the therapeutic potential for diabetes management

Antioxidant Potential of Cookies Formulated with Date Seed Powder

Utilising major waste products from the food industry can have both a great environmental impact and be a means to improve consumer health. Date seed is a food industry byproduct that has been proven to have high nutritional value. The aim of this work was to measure the total polyphenolic content (TPC), flavonoids, and antioxidant activity of the seeds of six date fruit varieties, Fard, Khalas, Khinaizi, Sukkary, Shaham, and Zahidi, and to use those seeds to enhance the antioxidant value of cookies by partially substituting flour with ground date seed. Date seed powder (DSP) was extracted at three levels of sample to solvent ratio (5:1, 10:1 and 15:1 mg/mL). Cookies were prepared using three substitution levels of wheat flour (2.5, 5.0, and 7.5%, w/w) by DSP and two types of flour (white and whole wheat), and were baked at two different temperatures, 180 and 200 &deg;C. The composite cookies were found to contain a significant amount of TPC and flavonoids, and showed increased antioxidant activity compared with the control samples

the [1-13]acetate recovery factor to correct tracer-derived dietary fat oxidation is lower in overweight insulin-resistant subjects

International audienceBackground&aims: An acetate recovery factor (ARF) is utilized to correct tracer-derived fat oxidation when 13C is used. We showed that when 13C labelled fatty acid are given orally, dietary fat oxidation can be accurately corrected by using an averaged dietary ARF (dARF) derived from 56 lean healthy subjects, instead of individual dARF. The extent to which this factor is valid in overweight insulin resistant subjects is unknown. Methods: [1-13C]dARF and [1-13C]fatty acid recoveries were assessed before and after physical activity/ inactivity interventions in overweight insulin-resistant (n ¼ 11) and lean subjects (n ¼ 70) in five studies herein compiled. Results: Overweight dARF was lower compared to lean subjects (45.3 1.5% vs. 50.6 0.6%; P ¼ 0.002). Physical activity intervention did not impact dARF. dARF correlated negatively with %body fat (r2 ¼ 0.10; P ¼ 0.005) and fasting insulin to glucose ratio (r2 ¼ 0.08; P ¼ 0.02). Applying the lean average [1-13C] dARF induced an 11.5% (P ¼ 0.006) average error in fatty acid oxidation rate. Conclusions: Overweight insulin resistant subjects have lower dARF than lean individuals. An average dARF derived from lean subjects cannot be applied in overweight subjects to calculate dietary fat oxidation. We recommend that individual dARF are measured in subjects with metabolic disorder