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Food groups in dietary prevention of type 2 diabetes

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According to the World Health Organization diabetes will be the seventh leading cause of death worldwide in 2030. Majority of diabetic patients suffer from type 2 diabetes (T2DM), which is mostly avoidable. The most important modifiable risk factors of type 2 diabetes are: overweight and obesity, improper diet, sedentary lifestyle and tobacco smoking. Even in prediabetic state, improving diet and physical activity can slow down or even stop progression to diabetes. In the view of health burden of diabetes it is essential to thoroughly investigate the risk factors and develop more specific preventive strategies. Recently published studies focus on food groups rather than individual products to assess the link between nutrition and risk of type 2 diabetes. Identifying food groups of possible beneficial and deleterious effect on the risk of type 2 diabetes could facilitate the dietary counselling. The aim of the overview is to summarize the possible association between consumption of food groups on the risk of type 2 diabetes on the basis of available literature. Observations from studies and meta-analyses indicate on an inverse association between consumption of fresh vegetables and fruit, whole grains, lean dairy, fish, nuts and the risk of type 2 diabetes. Food groups that seemed to increase the risk of type 2 diabetes are: red and processed meat, refined grains, sugar-sweetened beverages. It is important to note, that no individual nutrients, but diverse dietary pattern, composed of every recommended food group in adequate amounts can contribute to healthy lifestyle and T2DM prevention.
Background. Glycemic Load (GL) is one of the indicators that can be used to assess the nutritional value of the diet. The results of numerous studies have shown that high glycemic index and/or high GL diets were associated with increased risk for type 2 diabetes, cardiovascular disease and cancer. Objectives. The aim of the study was to evaluate dietary GL, intake of food products which are source of carbohydrates and contribution of particular carbohydrates in students’ diets. Material and Methods. The study group consisted of 140 female students from Wroclaw (Poland) aged 21±1.6 years. The dietary assessment was performed using food frequency-questionnaire. The GL of daily food ration (DFR) was considered low for values <80 g, medium for values between 80-120 g and high for values >120 g. Results. The mean GL of the diets was 120.7±42 g. DFR of 12.1% of the students had low GL, 46.6% - medium, and 39.3% - high. Diets in the 4th quartile of GL were characterized by the highest energy value, total carbohydrate, sucrose, starch and fiber content and energy contribution from carbohydrates when compared with lower quartiles. Higher percentage of energy from protein and fats in the diets was related with lower dietary GL. The highest correlation coefficient between GL and weight of the consumed food was observed for sweets (r=0.67), cereal products (r=0.52), juices and sweetened beverages (r=0.50), vegetables (r=0.45) and fruits (r=0.44). In the study, cereal products, fruits, sweets, vegetables and juices and sweetened beverages consumed by the female subjects constituted respectively 26.6%, 12.8%, 11.4%, 9.1% and 8.8% of the total dietary GL. Conclusions. Lower dietary GL in the female students participating in the study can be achieved by limiting the intake of sweets and sweet beverages as well as consuming cereal products with a low GI.
Introduction: Tobacco smoking is still one of the greatest, avoidable, singular causes of death. Although students of medical faculties are expected to have solid knowledge about smoking hazards, a significant number of them still smoke. Aim: The aim of the study was to assess knowledge on tobacco dependence in a sample of students at the Medical University in Wroclaw. Material and methods: Between 2009-2011, non-compulsory lectures on the diagnosis and treatment of tobacco dependence were provided for 3rd to 6th year students of medicine at the Medical University in Wroclaw (170 students). The questionnaire contained 10 questions about smoking-related diseases and medicines used in tobacco dependence treatment. Results: 21% of students smoked cigarettes and 79% were never smokers. 36% of the study group was exposed to passive smoking at the university. Nearly 80% of survey respondents agreed with the statement that cigarette smoking can lead to psychological addiction as strong as drug addiction, but more than 12% of the respondents perceived smoking just as a strong habit. Only 6 out of 10 surveyed students recognised tobacco dependence as an illness classified in an international classification of diseases and health problems (ICD-10). The correct amount of the chemical substances to be found in tobacco smoke was known by 67.1% of all surveyed students. The vast majority of the surveyed students indicated correctly 2 brands of nicotine replacement therapy, but none of them could name even one chemical and corresponding trade name of the pharmaceutical with central effect. Conclusions: The level of knowledge about the diagnosis and treatment of tobacco dependence among the students of the Medical Faculty in Wroclaw Medical University is low, and requires improvement through educational activities at both facultative and compulsory study level. Special attention should be paid to pharmaceutical treatment of the tobacco dependence syndrome.
Purpose: The aim of the study was to assess the content of specific fatty acids in the diet and adipose tissue in a selected group of inhabitants of Lower Silesia in Poland. Methods: The study group consisted of 95 inhabitants of Wroclaw and surrounding villages (22 men and 23 women from the urban area, 23 men and 27 women from the rural area). Fatty acid content in subcutaneous fat samples was assessed by gas-chromatography. Dietary assessment was carried out using food frequency questionnaire. Dietary intake was analyzed using computer programme The Food Processor SQL 10.5.2 produced by ESHA Research USA, with a Polish database. Results: Mean daily energy and fatty acids intake was significantly higher among rural than urban inhabitants. Intake of alpha-linolenic acid (ALA), mainly from rapeseed oil, in urban inhabitants was 1.5 g/day in men and 1.6 g/day in women, and in rural inhabitants 2.6 g/day and 2.1 g/day, respectively. Dietary n-6 to n-3 ratio was higher among urban compared to rural inhabitants (6.7 vs. 5.5 among men and 6.4 vs. 5.5 among women, respectively). Content of ALA in adipose tissue was higher in rural women than in urban men (1.08% vs. 0.92% of total fat). Content of eicosapentaenoic acid (EPA) in adipose tissue in rural men (0.04% of total fat) and women (0.05% of total fat) was higher than in urban men (0.01% of total fat). The positive correlation (r=0.43) between the level of EPA in adipose tissue and percentage of energy from dietary EPA was observed among rural men. Overall, positive correlations were found between saturated (SFA) and polyunsaturated (PUFA) n-3 level in adipose tissue and percentage of energy from these fatty acids in a diet (r=0.20 and r=0.22, respectively). Conclusions: Mean daily n-3 fatty acid intake in urban inhabitants was lower than the recommended daily consumption in Poland. The positive correlation between fatty acids level in adipose tissue and dietary fatty acid intake was observed only for EPA among rural men, and in the all-study population for SFA and PUFA n-3. A high n-6 to n-3 ratio in the study group was observed.
Introduction. A decreased serum high density lipoprotein-cholesterol (HDL-C) is a strong predictor of cardiovascular risk. However, total HDL is a very dynamic, changeable fraction, and does not perform the function of atherosclerosis markers. In the presented study, the pattern of serum lipids, including HDL-C subclasses (HDL2- and HDL3-cholesterol), in a middleaged Polish Lower Silesia population was defined. Materials and method. A group of 746 males and 1,298 females, aged 35–70, were investigated. All subjects were participants in the PURE study. Mean serum lipid levels were determined for groups selected on the basis of gender, age, cigarette smoking, drinking alcohol and place of residence (urban/rural area). The data were analyzed using STATISTICA 6.0 PL. Results. In multiple linear regression models, age was the most important independent and consistent predictor of total cholesterol (TC) and LDL cholesterol (LDL-C). The prevalence of low HDL-C (threshold 40 mg/dL in males, 50 mg/dL in females) was 16.5% for males and 22.6% for females. This gender-conditioned difference in the prevalence of low HDL-C was greater in rural (20.0% vs. 30.9%, respectively, in males and females) in comparison to urban (14.4% vs. 17.1%) areas. The lipid pattern was significantly worse in rural than in urban females. Female rural inhabitants showed higher triglycerides (TG) and lower HDL cholesterol (total and contained in subclasses HDL2 and HDL3). Simultaneously, a higher BMI, higher percent of smokers and drinkers and lower age of smoking female rural inhabitants in comparison to urban females were estimated. In the total population, cigarette smoking or drinking alcohol were associated with significant increases in TC, LDL-C and TG, also with decreased HDL-C (smoking) or HDL2-C (drinking). Two-way analysis of variance showed the existence of interaction between these risk factors in their influence on HDL-C and HDL3-C. Conclusion. In the middle-aged population of the Lower Silesian region in Poland the place of residence (urban/rural area) had a significant impact on the lipid pattern. This pattern is more atherogenic in rural women than in urban women.
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