Victoria Telle Hjellset

Variations in Postprandial Blood Glucose Responses and Satiety after Intake of Three Types of Bread

Background. The magnitude and duration of postprandial blood glucose (PPG) elevations are important risk factors of diabetes and coronary heart diseases. Aim. To study PPG after ingestion of breads with and without pea fibre and rapeseed oil. Methods. After fasting overnight, 10 Pakistani immigrant women participated in three experiments having a crossover design and involving ingestion of various types of bread: regular coarse bread or fibre enriched-bread with two levels of rapeseed oil, all providing 25 g available carbohydrates (CHO). Blood glucose and satiety were determined before the meal and every 15 min over the next 2 hours. Results. Intake of an amount of pea fibre-enriched bread containing 25 g CHO attenuated, the postprandial peak glucose value, the incremental area under the glucose versus time curve during 15 to 75 min, and the glycemic profile, and increased duration of satiety (P < .05), as compared with intake of regular bread with 25 g carbohydrate. Conclusion. Pea fibre-enriched breads can reduce PPG and prolong satiety.

Perceptions of risk factors for diabetes among Norwegian-Pakistani women participating in a culturally adapted intervention

Objective. To explore perceptions of diabetes risk factors among Pakistani immigrant women, as part of their explanatory model of the disease, and the changes in these perceptions after a culturally adapted intervention. Design. Intervention study, carried out in Oslo, Norway, comprising 198 women. Results. At baseline, about 75% of the women perceived sugar to be a risk factor for diabetes, about 30% mentioned physical inactivity and stress and close to 20% mentioned overweight. Twelve per cent could not identify any risk factors. When asked about foods to include in a diet to prevent diabetes, vegetables were mentioned by 45%, while 33% did not know any foods to include. Among those attending ≥60% of the educational sessions, the proportions mentioning little physical activity (p<0.001), overweight (p=0.001) and family history (p=0.007) as risk factors increased. Furthermore, the proportions mentioning legumes (p=0.001), fish (p<0.001), fibre (p=0.035) or vegetables (p=0.015) as important in a diet to prevent diabetes increased, and the proportion not knowing any food to include was reduced to 10% (p=0.004). Except for little physical activity, similar changes in responses were not registered in the control group. Conclusions. There is a need for improved knowledge about diabetes prevention among Pakistani immigrant women, and a culturally adapted intervention may contribute to this.

Barriers to healthy eating among Norwegian-Pakistani women participating in a culturally adapted intervention

Aims: To explore barriers to healthy dietary changes experienced by Pakistani immigrant women participating in a culturally adapted intervention, and whether these barriers were associated with intentions to change dietary behaviours. Methods: Participants were randomly assigned to control and intervention group. The 7-month intervention consisted of six educational group sessions on diet and physical activity, based on knowledge about Pakistani lifestyle and focusing on blood glucose control. Data on barriers for and intentions to healthy dietary changes were collected through an interview with help of a questionnaire. The article is based on data from follow-up assessments in the intervention group, comprising 82 women, aged 28—62 years, without a history of type 2 diabetes. Results: The most important barriers to healthy dietary changes were preferences of children and other family members and perceived expectations during social gatherings. The perceived pressure from other family members was especially strong when the women were trying to change to more vegetables, lentils, and fish and to use less oil in food preparation. The barriers were inversely related to intentions to change. Conclusions: The women encountered various types of barriers when trying to change to healthier food habits, the most prominent being those related to the social dimensions of food consumption, as well as to awareness of the amount of oil used for cooking.

Maintenance of changes in food intake and motivation for healthy eating among Norwegian-Pakistani women participating in a culturally adapted intervention.

OBJECTIVE To investigate maintenance of changes in food intake and motivation for healthy eating at follow-up 2 data collection after a lifestyle intervention among Pakistani immigrant women. DESIGN A culturally adapted lifestyle intervention, aiming at reducing the risk of type 2 diabetes mellitus. Data collection including FFQ and questions on intentions to change dietary behaviour was completed at baseline, right after the 7 ± 1 month intervention (follow-up 1) and 2-3 years after baseline (follow-up 2). SETTING Oslo, Norway. SUBJECTS Pakistani women (n =198), aged 25-60 years, randomized into control and intervention groups. RESULTS From follow-up 1 to follow-up 2 there was a shift from action to maintenance stages for intention to reduce fat intake (P < 0.001), change type of fat (P = 0.001), increase vegetable intake (P < 0.001) and reduce sugar intake (P = 0.003) in the intervention group. The reduction in intakes of soft drinks with sugar, fruit drinks with sugar and red meats, and the increase in intakes of vegetables and fish from baseline to follow-up 1 were maintained (significant change from baseline) at follow-up 2 in the intervention group. The intake of vegetables was higher (P = 0.019) and the intake of fruit drinks with sugar lower (P = 0.023) in the intervention group compared with the control group at follow-up 2. CONCLUSIONS The culturally adapted intervention had the potential of affecting intentions to change food behaviour among Pakistani immigrant women long after completion of the intervention and also of leading to long-term maintenance of beneficial changes in diet.

Body size perceptions among Pakistani women in Norway participating in a controlled trial to prevent deterioration of glucose tolerance

South Asians are prone to diabetes type 2 and cardiovascular diseases, which can be prevented by a diet leading to weight reduction. Body size perceptions may influence compliance to dietary advice. The objective was to study body size perceptions among Pakistani immigrant women in Norway, enrolled in a controlled trial to prevent deterioration of glucose tolerance by focussing on diet and physical activity. Participants (n=198) were 25–62 years of age, 79.8% had BMI > 25 and mean BMI was 29.6. Data were collected by questionnaire interviews with Punjabi/Urdu speaking interviewers, and body weight and height were measured. This article is based on baseline data. Stunkards Figure Rating Scale was used. The scale consists of nine figures, representing women with different body shapes, from very thin (1–2) to very obese (6–9). The women were asked which body size they thought would connote health and wealth. A significantly smaller body size was related to health (mean 2.9) than to wealth (mean 3.3), p<0.01, and both were smaller than their self-rated own body size (mean 5.7), p<0.01. The women perceived that Pakistanis in Norway prefer women to have a smaller body size (mean 3.4) than people in Pakistan (mean 4.5), but larger than Norwegians (mean 2.5). A discrepancy score was calculated between self-rated own body size and perceived body size preference among Pakistanis in Norway. BMI was positively associated, and level of education negatively associated, with the discrepancy score. The women related body size numbers to BMI similarly to what has been described for US women. In conclusion, body size preferences among Pakistani women in this study were within the range of normal weight. However, there was a large discrepancy between own self-rated body size and the perceived ideal for Pakistanis in Norway.

Blood Glucose Measured at Several Time Points and Correlation withIncremental Area under the Curve

Oral glucose tolerance test (OGTT) is used as a standard to diagnose people with diabetes. However, it does not reflect the total glucose load. The aim of this study was to explore correlation between blood glucose values at different times during OGTT and the Incremental Area under the Curve (IAUC), to investigate whether there might be a time point for glucose measurement which would best represent the total glucose load. OGTT were performed in 196 Norwegian-Pakistani women, and glucose was measured fasting and every 15 minute up to 2 hours. The results indicate that fasting values are least correlated with total glucose load, but that values measured at 75, 90 and 60 minutes represent it the best. We suggest that fasting values fail to mirror total glucose load in many cases, and that 2 hour values may be inferior to earlier ones in representing glucose load. High-risk groups, such as Pakistani immigrants, may especially take advantage from improvements in methods to diagnose diabetes.

Short communication: Daily intake of 125 g of cheese for 2 weeks did not alter amount or distribution of serum lipids or desaturase indexes in healthy adults in an exploratory pilot study

Regular cheese contains saturated fat, consumption of which may negatively influence the amount of serum lipids. The American Dietary Guidelines (https://health.gov/dietaryguidelines/2015/guidelines/) recommend consumption of low-fat food. However, we observed a negative association between cheese intake and serum triglycerides and a positive association with high-density lipoprotein cholesterol. Cheese intake was also inversely related to metabolic syndrome and blunted the harmful association of intake of soft drinks with serum lipids. Cheese contains calcium and factors that may inhibit desaturases, thereby partly explaining why cheese might not have negative effects on serum lipids. Thus, opposing forces seem to govern the cheese effect but will any of these prevail? In an exploratory pilot study, 17 healthy subjects participated in a 4-wk crossover trial without washout. During the first 2 wk, 9 subjects were randomly assigned to add 125 g/d of regular cheese to their habitual diet. After 2 wk, cheese intake was discontinued and the subjects were instructed to return to their habitual diet. The other 8 subjects followed their habitual diet during the first 2 wk, and then added 125 g/d of cheese for the next 2 wk. Mean values (mmol/L) before and after 2 wk on habitual (cheese) diet were as follows: serum triglycerides: 0.91 (0.89) and 0.95 (0.91); total cholesterol: 5.25 (5.16) and 5.08 (5.24); low-density lipoprotein cholesterol: 3.18 (3.17) and 3.09 (3.22); and high-density lipoprotein cholesterol: 1.71 (1.64) and 1.61 (1.66). The fatty acid pattern in total serum lipids and desaturase indexes did not change significantly in response to high cheese intake. Thus, an appreciable increase in daily cheese intake for 2 wk may not alter concentrations of serum lipids, estimates of desaturases, or the distribution of serum fatty acids.