Nutrition
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Randomized Controlled Trial
Effect of two carbohydrate-modified tube-feeding formulas on metabolic responses in patients with type 2 diabetes.
This study evaluated the glycemic, insulinemic, and glucagon-like peptide-1 (GLP-1) responses of subjects with type 2 diabetes mellitus to consumption of two diabetes-specific tube-feeding formulas (slowly digested carbohydrate formula [SDC] and diabetes-specific formula [DSF]) and one formula intended for individuals without diabetes (standard formula [STND]). ⋯ Both lower-carbohydrate diabetes-specific formulas resulted in a lower postprandial blood glucose response compared with the STND. The formula also rich in slowly digested carbohydrate and monounsaturated and omega-3 fatty acids (SDC) produced significantly lower blood glucose and insulin responses and higher levels of GLP-1 in the presence of significantly lower insulin concentrations. These results support the view that the quantity and quality of carbohydrate and fat may play important roles in the management of patients with type 2 diabetes mellitus and could result in improved beta-cell function over the long term.
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Multicenter Study
Association between dietary fiber and markers of systemic inflammation in the Women's Health Initiative Observational Study.
Systemic inflammation may play an important role in the development of atherosclerosis, type 2 diabetes, and some cancers. Few studies have comprehensively assessed the direct relations between dietary fiber and inflammatory cytokines, especially in minority populations. Using baseline data from 1958 postmenopausal women enrolled in the Women's Health Initiative Observational Study, we examined cross-sectional associations between dietary fiber intake and markers of systemic inflammation (including serum high-sensitivity C-reactive protein [hs-CRP], interleukin-6 [IL-6], and tumor necrosis factor-alpha receptor-2 [TNF-alpha-R2]) in addition to differences in these associations by ethnicity. ⋯ These findings lend support to the hypothesis that a high-fiber diet is associated with lower plasma levels of IL-6 and TNF-alpha-R2. Contrary to previous reports, however, there was no association between fiber and hs-CRP among postmenopausal women. Future studies on the influence of diet on inflammation should include IL-6 and TNF-alpha-R2 and enroll participants from ethnic minorities.
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We investigated the effects of vitamin D treatment on plasma glucose, serum insulin, and insulin sensitivity in vitamin D-deficient individuals without diabetes mellitus. ⋯ In adults without diabetes, correction of vitamin D deficiency is not associated with any effect on blood glucose or insulin concentrations or insulin sensitivity as assessed during an oral glucose tolerance test. These observations do not support an association between glucose/insulin homeostasis and vitamin D, at least in the short term.
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Practice Guideline
AuSPEN clinical practice guideline for home parenteral nutrition patients in Australia and New Zealand.
Evidence based guidelines for home parenteral nutrition (HPN) were commissioned by the Australasian Society of Parenteral and Enteral Nutrition (AuSPEN) and developed by a multidisciplinary group. The guidelines make recommendations in four domains: patient selection, patient training, formulation and monitoring regimens, and preventing and managing complications. ⋯ Overall there is a lack of randomized control trials to provide high-quality evidence-based guidance but graded recommendations can be made. Multidisciplinary teams in centers with HPN management expertise are required for optimal care. This guideline should improve outcomes and quality of life for HPN patients in Australia and New Zealand.
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The objective of this study was to determine whether total serum carotenoids, alpha-tocopherol, selenium, and obesity were independently associated with oxidized low-density lipoproteins (ox-LDLs) in moderately to severely disabled older women living in the community. ⋯ Older women who are overweight or obese or who have low total serum carotenoids are more likely to have higher lipoprotein oxidation. Weight reduction in overweight/obese women and increased intake of carotenoid-rich foods may potentially reduce lipoprotein oxidation.