Alejandra Valencia

Zinc as a Potential Coadjuvant in Therapy for Type 2 Diabetes

Background Type 2 diabetes is highly prevalent in populations having high rates of overweight and obesity. It is a chronic condition responsible for long-term severe dysfunction of several organs, including the kidneys, heart, blood vessels, and eyes. Although there are a number of pharmacologic products in the market to treat insulin resistance and impaired insulin secretion—the most prominent features of this disease—interventions directed at preserving the integrity and function of β-cells in the long term are less available. The use of some nutrients with important cellular protective roles that may lead to a preservation of β-cells has not been fully tested; among these, zinc may be an interesting candidate. Objective To assess the potential of zinc supplementation as coadjuvant to diabetes therapy. Methods This article reviews the available information on the use of zinc as part of diabetes therapy. Results Cellular and animal models provide information on the insulin mimetic action of zinc, as well as its role as a regulator of oxidative stress, inflammation, apoptosis, and insulin secretion. Zinc supplementation studies in humans are limited, although some positive effects have been reported; mainly, a modest but significant reduction in fasting glucose and a trend to decreased glycated hemoglobin (HbA1c). Conclusions Zinc supplementation may have beneficial effects on glycemic control. Nevertheless, among the studies considered, the vast majority lasted for 6 months or less, suggesting the importance of conducting long-duration studies given the characteristics of type 2 diabetes as a chronic disease.

Evolución de la ingesta y del estado nutricional de zinc, hierro y cobre en mujeres sometidas a cirugía bariátrica hasta el segundo año postoperatorio

INTRODUCTION Bariatric surgery allows a significant reduction in weight and improvement of comorbidities associated with obesity in the long term, but it can also adversely affect the nutritional status of some micronutrients. OBJECTIVES To evaluate changes in intake and parameters of nutritional status of zinc, iron and copper in patients undergoing Roux-en-Y gastric bypass (GBP) or sleeve gastrectomy (SG), until the second postoperative year. METHODS We prospectively studied 45 women undergoing GBP or SG (mean age 35.2 ± 8.4 years, mean BMI 39.8 ± 4.0 kg/m²), every 6 months We measured intake and status indications nutritional zinc, iron and copper, and annually evaluated body composition. The contribution of minerals through supplements represented twice the recommended intake for a healthy woman in patients undergoing GT and three times for GBP. RESULTS 20 women underwent GBP and 25 SG. In both groups there was a significant reduction in weight and body fat percentage, which was maintained until the second postoperative year. Women who have had a greater commitment GBP nutritional status of zinc, iron and copper, that patients undergoing SG. CONCLUSIONS Gastric bypass Roux-Y produces a greater commitment of nutritional status of zinc, iron and copper sleeve gastrectomy. It should evaluate whether administration of supplementation fractional improve the absorption of these nutrients.

Communicating about eating behaviors. A qualitative study of Chilean women and their health-care providers

Good communication between health care providers (HCPs) and patients is critical in achieving positive health outcomes. The purpose of this article was to compare the perceptions of Chilean woman and their HCPs with respect to determinants of eating behaviors. Semi-structured interviews were conducted with women (n=15) visiting a public health care center in Chile and with their HCPs (n=8) who were in charge of promoting healthy eating behaviors among women. Data from the interviews indicated similarities and inconsistencies in determinants of eating behaviors between the groups. Both mentioned many important factors that influence womens eating behaviors, including food preferences, dietary knowledge, self-control and self-efficacy, family, food cost, and food availability. HCPs appeared to be less aware of the role that personality traits and past experiences play as potential determinants which women mentioned. In contrast, women were less aware of the influence of anxiety and low self-esteem on eating choices, which HCPs noted as key factors. Although it was encouraging to see agreement between women and their HCPs in some areas, it is important to work on increasing understanding among the groups with respect to the important role psychological factors play in influencing eating behavior. We suggest that HCPs should focus on the importance of womens personality traits and past eating behaviors, as well as work on improving womens self-esteem and helping to decrease their anxiety levels. HCPs should be encouraged to develop good communication with each person in order to help them understand the roles that external and internal factors play in eating behaviors.Abstract Good communication between health care providers (HCPs) and patients is critical in achieving positive health outcomes. The purpose of this article was to compare the perceptions of Chilean woman and their HCPs with respect to determinants of eating behaviors. Semi-structured interviews were conducted with women (n=15) visiting a public health care center in Chile and with their HCPs (n=8) who were in charge of promoting healthy eating behaviors among women. Data from the interviews indicated similarities and inconsistencies in determinants of eating behaviors between the groups. Both mentioned many important factors that influence women’s eating behaviors, including food preferences, dietary knowledge, self-control and self-efficacy, family, food cost, and food availability. HCPs appeared to be less aware of the role that personality traits and past experiences play as potential determinants which women mentioned. In contrast, women were less aware of the influence of anxiety and low self-esteem on eating choices, which HCPs noted as key factors. Although it was encouraging to see agreement between women and their HCPs in some areas, it is important to work on increasing understanding among the groups with respect to the important role psychological factors play in influencing eating behavior. We suggest that HCPs should focus on the importance of women’s personality traits and past eating behaviors, as well as work on improving women’s self-esteem and helping to decrease their anxiety levels. HCPs should be encouraged to develop good communication with each person in order to help them understand the roles that external and internal factors play in eating behaviors.

IMPACTO DE LOS ÁCIDOS GRASOS DE LA DIETA SOBRE EL PERFIL LIPÍDICO, LA SENSIBILIDAD A LA INSULINA Y LA FUNCIONALIDAD DE LAS CÉLULAS b PANCREÁTICAS EN SUJETOS DIABÉTICOS TIPO 2

INTRODUCTION the quality of fats could influence the metabolic control of patients with Type 2 Diabetes Mellitus (DM2). OBJECTIVES to determine the relationship between intake and quality of dietary fatty acids to lipid profile, metabolic control, functionality of pancreatic cells and insulin sensivity in subjects with DM2. METHODS we studied 54 subjects with DM2, anthropometric measurements were performed, body composition and dietary lipid intake, saturated fatty acids (SFA), trans, monounsaturated, polyunsaturated, omega 3, omega 6 and dietary cholesterol. Laboratory parameters related to their metabolic control were determined (fasting blood glucose, glycated hemoglobin, and lipid profile). The insulin secretion and insulin sensitivity was determined with the insulin-modified intravenous glucose tolerance test according to the Bergmans minimal model. RESULTS 28 men and 26 women were studied (BMI of 29.5 ± 3.7 kg/m2; age 55.6 ± 6.8 y.), 48% had LDL-C < 100 mg/dL, 12.9% of men c-HDL > 40 mg/dL and 7.4% of women c-HDL > 50 mg/dL. 32% consumed > 10% of AGS and > 300 mg/day of dietary cholesterol. The SFA intake and percentage of calories from fat (G%) were significantly associated with insulin resistance and fasting plasma glucose concentration. The G% predicted 84% variability on c-VLDL. CONCLUSIONS in patients with DM2 a greater intake of fat and saturated fatty acids it associated with greater fasting glycemia and insulin resistance.