Renata Damião

Dietary intakes associated with metabolic syndrome in a cohort of Japanese ancestry

The present study examined the association between dietary factors and metabolic syndrome in a 7-year follow-up of Japanese-Brazilians. In 1993, a survey estimated the prevalence of diabetes in a Japanese-Brazilian population aged 40-79 years. From 647 subjects studied at baseline, 394 (60.9 %) participated in a second survey (2000); after exclusion of subjects with self-reported diseases, 23.4 % (n 151) were included in the present analysis. Metabolic syndrome diagnosis was based on the National Cholesterol Education Program criteria modified for Asians. Food intake was assessed by a validated food-frequency questionnaire. At baseline, mean ages were 56.1 (sd 9.7) and 54.7 (sd 10.6) years for men and women, respectively. Similar cumulative incidence rates of the metabolic syndrome were found in both sexes (36.9 (95 % CI 26.6, 48.1)% for men and 38.8 (95 % CI 27.1, 51.4) % for women). In 1993, mean values of blood pressure, waist circumference for men and 2 h plasma glucose for both sexes were higher among subjects who developed metabolic syndrome when compared with those who did not. Comparisons of nutrient intakes between subsets of subjects who developed or did not develop metabolic syndrome showed an association of protein intake with the syndrome only in men (96.4 (sd 56.8) v. 74.3 (sd 26.0) g/d; P<0.05). Odds ratios of the metabolic syndrome across tertiles of food groups intake showed that among men the highest tertile of red meat consumption was associated with a 4.7-fold increase in risk of developing the syndrome, after adjustments for confounders. However, the statistical significance of this model disappeared when saturated fatty acids were added. The data raised the possibility of a role of red meat consumption for the occurrence of metabolic syndrome in Japanese-Brazilian men. The present findings may have implications for the prevention of metabolic syndrome in this high-risk population.

Dietary ω-3 fatty acid and ω-3: ω-6 fatty acid ratio predict improvement in glucose disturbances in Japanese Brazilians

OBJECTIVE We investigated whether lifestyle-induced changes in dietary fat quality are related to improvements on glucose metabolism disturbances in Japanese Brazilians at high risk of type 2 diabetes. METHODS One hundred forty-eight first- and second-generation subjects with impaired glucose tolerance or impaired fasting glycemia who attended a lifestyle intervention program for 12 mo were studied in the city of Bauru, State of São Paulo, Brazil. Dietary fatty acid intakes at baseline and after 12 mo were estimated using three 24-h recalls. The effect of dietary fat intake on glucose metabolism was investigated by multiple logistic regression models. RESULTS At baseline, mean +/- standard deviation age and body mass index were 60+/-11 y and 25.5+/-4.2kg/m(2), respectively. After 12 mo, 92 subjects had normal plasma glucose levels and 56 remained in prediabetic conditions. Using logistic regression models adjusted for age, gender, generation, basal intake of explanatory nutrient, energy intake, physical activity, and waist circumference, the odds ratios (95% confidence intervals) for reversion to normoglycemia were 3.14 (1.22-8.10) in the second tertile of total omega-3 fatty acid, 4.26 (1.34-13.57) in the second tertile of eicosapentaenoic acid, and 2.80 (1.10-7.10) in the second tertile of linolenic acid. Similarly, subjects in the highest tertile of omega-3:omega-6 fatty acid ratio showed a higher chance of improving glucose disturbances (2.51, 1.01-6.37). CONCLUSIONS Our findings support the evidence of an independent protective effect of omega-3 fatty acid and of a higher omega-3:omega-6 fatty acid ratio on the glucose metabolism of high-risk individuals.

Fatores associados ao consumo de frutas, verduras e legumes em Nipo-Brasileiros

A identificacao de fatores associados ao consumo de frutas, verduras e legumes constitui-se em ferramenta chave na elaboracao de programas de intervencao mais eficazes, visando o aumento no consumo desses alimentos. O objetivo do presente estudo foi identificar, em analise transversal, fatores associados ao consumo adequado de frutas, verduras e legumes (> 400g/dia) em 581 nipo-brasileiros adultos, de 1a e 2a geracoes, residentes em Bauru, SP, Brasil. O consumo alimentar foi avaliado por meio de tres inqueritos recordatorios de 24 horas. Em modelos de regressao logistica ajustados, verificou-se que o relato de um maior numero de refeicoes diarias estava associado a maior chance [OR (IC 95%)]: [1,31 (1,05; 1,63)] de consumo adequado de frutas, verduras e legumes. Por outro lado, individuos no terceiro tercil de consumo de acidos graxos saturados apresentaram menor chance de consumo adequado destes alimentos [0,35 (0,21; 0,60)]. Verificou-se maior tendencia de consumo adequado de frutas, verduras e legumes entre individuos de maior idade. Os resultados sugerem que programas de intervencao mais intensivos sao necessarios entre individuos jovens e com consumo elevados de acidos graxos saturados. Alem disso, o estimulo ao maior fracionamento da dieta podera favorecer a adesao as metas de consumo de frutas, verduras e legumes.

Dietary glycemic load, glycemic index, and refined grains intake are associated with reduced beta-cell function in prediabetic Japanese migrants

OBJECTIVE To investigate the association between carbohydrate intakes and beta-cell function (HOMA-beta) in Japanese-Brazilians with impaired glucose tolerance (IGT). METHODS Dietary intakes were assessed by a validated food frequency questionnaire in a cross-sectional survey carried out in 2000. The associations between diet and HOMA-beta were verified in 270 newly diagnosed IGT in multiple linear regression models. RESULTS The mean (SD) age was 58 (11) years and the mean HOMA-beta was 65 (47). The glycemic load was inversely associated with HOMA-beta, beta1 -0.140 (95%CI = -1.044; -0.078), p = 0.023. The inverse association was also observed for refined grains intakes: -0.186 (95%CI = -0.4862; -0.058), p = 0.012. After adjustments for body mass index, the glycemic index was inversely associated with HOMA-beta: -0.1246 (95%CI = -2.2482, -0.0257), p < 0.001. CONCLUSIONS These data suggested that dietary glycemic load, glycemic index, and refined grains intakes are associated with reduced beta-cell function, and the quality of dietary carbohydrates may be relevant for maintaining beta-cell function among individuals with IGT.

União interétnica de nipo-brasileiros associada a hábitos alimentares menos saudáveis e ao pior perfil de risco cardiometabólico

OBJECTIVE: Interethnic marriage between nikkey Brazilians and non-nikkey Brazilians may favor the westernization of diet. Dietary consumption, clinical data and frequencies of metabolic diseases were compared in a Japanese-Brazilian population, with intraethnic or interethnic marriage. METHODS: T test, Mann-Whitney, chi-square and Person coefficient were used. RESULTS: Among 1009 Japanese-Brazilians there were 18.9% of interethnic marriage, being more frequent among nikkey men. These showed higher means of BMI, waist, blood pressure, glycemia and triglyceridemia than women. Overall frequencies of obesity, hypertrigliceridemia and metabolic syndrome were 47.7%, 68.1% and 45.2%, being higher in interethnic than intraethnic marriage. Comparing individuals with interethnic marriages, hypertriglyceridemia was more common among men while low-HDL among women. Energy, fat, groups of alcohol, sweets and oils were higher in interethnic marriage. Individuals with intraethnic marriage consumed more carbohydrate, proteins, fibers, vitamins, minerals, vegetables, fruits/juice, cereals and missoshiru. Comparing individuals with interethnic marriages, nikkey men showed a more westernized dietary pattern than nikkey women. CONCLUSION: Interethnic marriage was associated with less healthy food habits and worse cardiometabolic profile.

Impacto de um programa de intervenção sobre o estilo de vida nos perfis metabólico, antropométrico e dietético em nipo-brasileiros com e sem síndrome metabólica

OBJETIVO: Avaliar as mudancas nos perfis metabolico e nutricional de nipo-brasileiros com e sem sindrome metabolica, apos dois anos de participacao em programa de intervencao. MATERIAIS E METODOS: Trata-se de estudo experimental nao controlado. A pesquisa incluiu tres momentos de avaliacao clinico-laboratorial: basal (2005), apos o primeiro ano de intervencao (2006) e ao final do segundo ano (2007). Na presente analise, utilizaram-se informacoes de 360 individuos examinados nos tres momentos. RESULTADOS: Ambos os grupos apresentaram melhora no perfil metabolico e antropometrico, apos o segundo ano de intervencao. Observaram-se diminuicao na ingestao de gorduras totais, acidos graxos saturados, colesterol e aumento de fibras totais nos homens sem sindrome metabolica. No sexo feminino sem sindrome metabolica, observou-se reducao de gordura total (p = 0,003) e acido graxo monoinsaturado (p = 0,002). CONCLUSAO: Os resultados encontrados mostraram impacto positivo do programa de intervencao nos perfis metabolico e nutricional dos nipo-brasileiros com e sem sindrome metabolica.

Grupos de alimentos para investigação de risco para diabetes tipo 2 e doenças associadas

INTRODUCAO: Os grupos de alimentos convencionalmente empregados em atividades de orientacao nutricional foram estabelecidos de acordo com o seu teor de macronutrientes. Entretanto, nao contemplam as evidencias cientificas recentes da associacao entre consumo alimentar e risco de desenvolvimento de doencas cronicas nao transmissiveis. OBJETIVO: Elaborar uma proposta de agrupamento de alimentos para a investigacao da associacao entre consumo alimentar e risco de desenvolvimento de diabetes tipo 2 e doencas associadas, em Nipo-Brasileiros. METODOS: Analise transversal dos dados da linha de base de um estudo de intervencao no estilo de vida conduzido entre Nipo-Brasileiros de Bauru, SP, entre 2005 e 2007. A avaliacao do consumo alimentar deu-se por meio da analise de tres inqueritos recordatorios de 24 horas em 640 individuos, ambos os sexos, idade entre 30 e 88 anos. RESULTADOS: Foram propostos 18 novos grupos de alimentos considerando-se o teor e qualidade das gorduras e carboidratos, sodio e fibras CONCLUSAO: Os novos grupos de alimentos incorporam evidencias recentes da associacao entre dieta e desenvolvimento de diabetes tipo 2.