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Nkhata SG, Chibwana G. Menus prescribed for diabetes management by Malawian referral hospitals are loaded with calories from carbohydrates and may worsen diabetes condition. Nutr Health 2024; 30:361-369. [PMID: 35934975 DOI: 10.1177/02601060221119248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Management of diabetes demands reduction of carbohydrates and moderation of total calories, fats and protein to promote weight loss while controlling postprandial blood glucose. Hospitals prescribe menus to diabetic patients to achieve these reasons. Whether these menus provide meals that help improve diabetes outcome remains unknown. Aim: Therefore, this study assessed six menus from six different referral hospitals in Malawi. Method: We formulated three separate diets (n = 3) encompassing breakfast, 10 am snack, lunch, 3 pm snack and super that a diabetic person would consume in a day as prescribed by each menu. We developed nutritionally adequate meals based on foods listed on the menu. We calculated, using the Malawi Food Composition Table (MFCT), total available carbohydrates, energy, protein, total fats, SAFA, MUFA and PUFA that each diet provides. We averaged the nutrient content from the three diets. Results: Menus from QECH and ST Joseph Mission Hospital provide significantly higher total carbohydrates (p = 0.001), total energy (p = 0.000) and fats (p = 0.01) but contain similar proteins (p = 0.761). The proportion of energy from carbohydrates for all the menus is very high and ranges from 68-81% while protein and fat proportions are lower and range from 7-16% and 7-20%, respectively. Conclusion: These menus have high propensity to increase postprandial blood glucose and promote weight gain that could be harmful to a diabetic person. All the menus deviate from a somehow recommended energy contribution of approximately 50:25:25 from carbohydrates, fat and protein, respectively.
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Affiliation(s)
- Smith G Nkhata
- Food Processing and Nutrition, Department of Agriculture and Food Systems, Faculty of Life Sciences and Natural Resources, Natural Resources College, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
- Food Technology, Department of Agriculture and Food Systems, Faculty of Life Sciences and Natural Resources, Natural Resources College, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
| | - Gracian Chibwana
- Food Technology, Department of Agriculture and Food Systems, Faculty of Life Sciences and Natural Resources, Natural Resources College, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
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Fujiwara A, Omura Y, Oono F, Sugimoto M, Sasaki S, Takimoto H. A Scoping Review of Epidemiological Studies on Intake of Sugars in Geographically Dispersed Asian Countries: Comparison of Dietary Assessment Methodology. Adv Nutr 2022; 13:1947-1973. [PMID: 35641021 PMCID: PMC9526866 DOI: 10.1093/advances/nmac061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/10/2022] [Accepted: 05/26/2022] [Indexed: 01/28/2023] Open
Abstract
Previous systematic reviews, which focused on sugar intake and its relation with health issues, were mainly conducted in Western countries, not Asian countries characterized by differences in dietary habits and disease prevalence. The scarcity of Asian studies may be attributed to the lack of assessment tools for estimating sugar intake. To provide an overview of the epidemiological studies on sugar intake in Asian countries, with a primary focus on dietary assessment methodology for estimating sugar intake, we conducted a scoping review of the epidemiological studies estimating sugar intake in Asian countries (the United Nations' definition) and Taiwan using PubMed and Web of Science. Study quality was evaluated based on its assessment of sugar intake in the whole diet, dietary assessment methods, and data sources used for estimating sugar content. We identified 143 studies from 136 publications from Eastern (n = 63), Southern (n = 30), South-Eastern (n = 26), and Western (n = 24) Asia. Total sugars were investigated in 95 studies, while 23-30 studies investigated sucrose, fructose, added sugars, and free sugars. The main aim of the selected studies was assessment of diet-disease relations (n = 85) and estimation of dietary intake (n = 40), and 62 studies assessed sugars as the primary exposure/outcome. A total of 120 studies assessed sugar intake in the whole diet, and 62 studies used validated FFQs or multiple-day dietary assessment methods. Only 41 studies used country-specific comprehensive food-composition databases or directly measured sugar content. Only 17 studies reported high-quality data. This review elucidated a sufficient number of epidemiological studies estimating sugar intake across Asian countries; however, most studies reported low-quality data. The results from our review showed that both feasible and validated dietary assessment methods, as well as comprehensive country-specific sugar-composition databases, are essential for producing high-quality studies with accurate sugar intake to examine its association with health outcomes.
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Affiliation(s)
- Aya Fujiwara
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan,Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, Tokyo, Japan
| | - Yuka Omura
- Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Fumi Oono
- Department of Social and Preventive Epidemiology, Division of Health Sciences and Nursing, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Minami Sugimoto
- Institute for Future Initiatives, University of Tokyo, Tokyo, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, Tokyo, Japan
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Chotwanvirat P, Hnoohom N, Rojroongwasinkul N, Kriengsinyos W. Feasibility Study of an Automated Carbohydrate Estimation System Using Thai Food Images in Comparison With Estimation by Dietitians. Front Nutr 2021; 8:732449. [PMID: 34733876 PMCID: PMC8559774 DOI: 10.3389/fnut.2021.732449] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/13/2021] [Indexed: 12/04/2022] Open
Abstract
Carbohydrate counting is essential for well-controlled blood glucose in people with type 1 diabetes, but to perform it precisely is challenging, especially for Thai foods. Consequently, we developed a deep learning-based system for automatic carbohydrate counting using Thai food images taken from smartphones. The newly constructed Thai food image dataset contained 256,178 ingredient objects with measured weight for 175 food categories among 75,232 images. These were used to train object detector and weight estimator algorithms. After training, the system had a Top-1 accuracy of 80.9% and a root mean square error (RMSE) for carbohydrate estimation of <10 g in the test dataset. Another set of 20 images, which contained 48 food items in total, was used to compare the accuracy of carbohydrate estimations between measured weight, system estimation, and eight experienced registered dietitians (RDs). System estimation error was 4%, while estimation errors from nearest, lowest, and highest carbohydrate among RDs were 0.7, 25.5, and 7.6%, respectively. The RMSE for carbohydrate estimations of the system and the lowest RD were 9.4 and 10.2, respectively. The system could perform with an estimation error of <10 g for 13/20 images, which placed it third behind only two of the best performing RDs: RD1 (15/20 images) and RD5 (14/20 images). Hence, the system was satisfactory in terms of accurately estimating carbohydrate content, with results being comparable with those of experienced dietitians.
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Affiliation(s)
- Phawinpon Chotwanvirat
- Doctor of Philosophy Program in Nutrition, Faculty of Medicine, Ramathibodi Hospital, The Institute of Nutrition, Mahidol University, Salaya, Thailand
| | - Narit Hnoohom
- Department of Computer Engineering, Faculty of Engineering, Mahidol University, Salaya, Thailand
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ÖZKARABULUT AH, RASHİDİ M, YILDIRIM G. Tip 2 Diyabetli Hastaların Beslenme Bilgi Düzeylerinin Ölçülmesi. İSTANBUL GELIŞIM ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2021. [DOI: 10.38079/igusabder.910150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Baiocchi CDAF, Rocha de Sá DA. Impact of Metabolic Surgery on Type-2 Diabetes Remission. Curr Diabetes Rev 2021; 17:e121420189129. [PMID: 33319676 DOI: 10.2174/1573399817999201214224920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 09/02/2020] [Accepted: 09/25/2020] [Indexed: 11/22/2022]
Abstract
Diabetes Mellitus is characterized by numerous metabolic disorders, which have in common the serum elevation of glucose, caused for a pancreatic malfunction in insulin secretion and / or its action. It is a non-communicable disease, considered major public health problems and generalized growth worldwide, being a chronic disease, which can generate a high treatment cost. Metabolic surgery is a safe treatment, regulated by the Federal Council of Medicine and useful in treating people with BMI over 30 years of age, who are unable to control pathologies associated with obesity, primarily type 2 diabetes. The general objective of this study is to understand through a literature review the main impacts of metabolic surgery about the remission of DM 2. This present study it is an exploratory and descriptive study carried out through a literature review. Data were collected through research in virtual health databases, at the Virtual Health Library - VHL, Latin American and Caribbean Health Sciences Information System, LILACS, National Library of Medicine - MEDLINE, Scielo, USP database, PUBMED theses and books. Metabolic surgery proof be a good and effective treatment for having and maintaining good weight loss, as well as a significant clinical and metabolic improvement that extends beyond weight loss. Metabolic surgery is a satisfactory way of achieving long-term weight reduction in obese individuals, increasing survival for these patients. Obese patients with DM2 have a long-term remission of DM2 after bariatric / metabolic surgery. Therefore, it concludes that such procedure is effective in the treatment of the disease and other diseases associated with obesity.
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Katsaridis S, Grammatikopoulou MG, Gkiouras K, Tzimos C, Papageorgiou ST, Markaki AG, Exiara T, Goulis DG, Papamitsou T. Low Reported Adherence to the 2019 American Diabetes Association Nutrition Recommendations among Patients with Type 2 Diabetes Mellitus, Indicating the Need for Improved Nutrition Education and Diet Care. Nutrients 2020; 12:nu12113516. [PMID: 33203138 PMCID: PMC7696891 DOI: 10.3390/nu12113516] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 11/09/2020] [Accepted: 11/13/2020] [Indexed: 11/16/2022] Open
Abstract
Patient adherence to guidelines is important for improved outcomes and prognosis. Nevertheless, many patients with type 2 diabetes mellitus (T2DM) do not comply with the recommendations regarding medication, physical activity, diet or self-care. The present cross-sectional study aimed to assess the level of adherence to the dietary recommendations issued by the American Diabetes Association (ADA) among patients with T2DM in Komotini, Greece. A total of 162 adults with T2DM (64.7 ± 10.6 years old), of which 41.4% were men, were recruited from the Sismanoglio Hospital and participated in the study. The level of adherence to individual recommendations issued by the ADA was assessed using yes/no questions. The overall adherence rate to the guidelines was low (41.2%). According to the multivariable analysis, age and medication therapy were identified as contributors to the compliance rate. No differences were noted in the total compliance rate between patients of different religious denominations (Muslims/Christians). Patients on oral antidiabetic agents (OAA) were more adherent compared with those on insulin therapy. A mere 3.7% of the participants had received nutrition education by a registered dietitian, 9.9% were following an individualized diet plan to improve glycemia, and 3.1% had set specific energy goals to reduce body weight. These findings are indicative of the need for the delivery of improved nutrition education.
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Affiliation(s)
- Savvas Katsaridis
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, Alexander Campus, International Hellenic University, Sindos, GR-57400 Thessaloniki, Greece; (S.K.); (M.G.G.)
| | - Maria G. Grammatikopoulou
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, Alexander Campus, International Hellenic University, Sindos, GR-57400 Thessaloniki, Greece; (S.K.); (M.G.G.)
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital, GR-56429 Thessaloniki, Greece
| | - Konstantinos Gkiouras
- Laboratory of Clinical Pharmacology, Faculty of Health Sciences, Medical School, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece;
| | - Christos Tzimos
- Northern Greece Statistics Directorate, Hellenic Statistical Authority, 218 Delfon Str, GR-54646 Thessaloniki, Greece;
| | - Stefanos T. Papageorgiou
- Faculty of Health Sciences, Medical School, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece;
| | - Anastasia G. Markaki
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hellenic Mediterranean University, PO Box 8556, Trypitos, GR-72300 Sitia, Greece;
| | - Triada Exiara
- Department of Internal Medicine, Sismanoglio General Hospital, 45 Sismanogliou Str, GR-69133 Komotini, Greece;
| | - Dimitrios G. Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital, GR-56429 Thessaloniki, Greece
- Correspondence: (D.G.G.); (T.P.)
| | - Theodora Papamitsou
- Laboratory of Histology and Embryology, Medical School, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece
- Correspondence: (D.G.G.); (T.P.)
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