Glycaemic threshold for diabetes-specific retinopathy among individuals from Saudi Arabia, Algeria and Portugal.

We studied the glycaemic threshold and prevalence of diabetic retinopathy in screen-detected diabetes in Saudi Arabia, Algeria and Portugal. The prevalence of diabetes-specific retinopathy started to increase at an HbA1c level of 6-6.4% (42-47 mmol/mol) and in individuals with HbA(1c) >7.0% the prevalence was 6.0%.

Stage-matched nutrition guidance: stages of change and fat consumption in Dutch patients at elevated cardiovascular risk.

OBJECTIVE: To assess the effects of stage-matched nutrition counseling on stages of change and fat intake. DESIGN: Controlled clinical trial. SETTING: 9 family practices in a family medicine practice network. PARTICIPANTS: 143 patients at elevated cardiovascular risk, aged 40 to 70 years. INTERVENTION: Intervention patients received stage-matched counseling from their family physician and a dietitian. Control patients received usual care. MAIN OUTCOME MEASURES: Stages of change and fat intake were measured at baseline and after 6 and 12 months. ANALYSIS: Chi-squared tests, t tests, and regression analyses (alpha = .05) were conducted. RESULTS: More patients in the intervention group than in the control group were in the postpreparation stage after 6 months (70% vs 35%; P < .01) but not after 12 months (70% vs 55%; P = .10). Between 0 and 12 months, the reduction in total fat intake (-5.6% kcal vs -2.4% kcal) was largest in the intervention group. CONCLUSIONS AND IMPLICATIONS: Stage-matched nutrition counseling promotes movement through stages of change, resulting in a reduced fat intake. Our results partly support stages of change as a tool for behavior change. Movement across stages of change was not an intermediating factor in the intervention effects. Research should focus on feasible ways to keep patients in the postpreparation stage.

Nutrition guidance in Dutch family practice: behavioral determinants of reduction of fat consumption.

BACKGROUND: Studies have shown that the psychosocial determinants attitude, self-efficacy, subjective norm, and health threat are important in predicting intention to change fat consumption. However, the role of habit in relation to these determinants is still largely unknown. OBJECTIVE: We aimed to assess whether and how habit influences intention in relation to attitude, self-efficacy, subjective norm, and health threat. DESIGN: Cross-sectionally, we studied the self-reported psychosocial determinants and intention of 105 (52 intervention, 53 control) patients who participated in a family practice-based tailored nutrition counseling intervention study for lowering cardiovascular risk. Fat intake 15 mo before the assessment of psychosocial determinants was used as a measure of habit. We used logistic regression analyses to develop a model predicting intention to change fat consumption. RESULTS: Our regression model explained 43% of the variance in intention. Patients who perceived higher subjective norm or more social support had a higher intention. Habit was a significant predictor of intention in interaction with self-efficacy and health threat. Attitude, health threat, age, and group membership (ie, whether patients had been in the intervention group or the control group of the intervention study) were also included in the regression model. CONCLUSIONS: The results suggest that habit in addition to subjective norm and the other more frequently investigated psychosocial determinants are important in predicting intention to change fat consumption. To achieve sustainable health improvement through nutrition education programs, these programs should therefore start focusing more on subjective norm and habit.

Fast and one-step folding of closely and distantly related homologous proteins of a four-helix bundle family.

Bovine acyl-coenzyme A binding protein is a four-helix bundle protein belonging to a group of homologous eukaryote proteins that binds medium and long-chain acyl-coenzyme A esters with a very high affinity. The three-dimensional structure of both the free and the ligated protein together with the folding kinetics have been described in detail for the bovine protein and with four new sequences reported here, a total of 16 closely related sequences ranging from yeasts and plants to human are known. The kinetics of folding and unfolding in different concentrations of guanidine hydrochloride together with equilibrium unfolding have been measured for bovine, rat and yeast acyl-coenzyme A binding protein. The bovine and rat sequences are closely related whereas the yeast is more distantly related to these. In addition to the three natural variants, kinetics of a bovine mutant protein, Tyr31 --> Asn, have been studied. Both the folding and unfolding rates in water of the yeast protein are 15 times faster than those of bovine. The folding rates in water of the two mammalian forms, rat and bovine, are similar, though still significantly different. A faster unfolding rate both for rat and the bovine mutant protein results from a lower stability of the native states of these. These hydrophobic regions, mini cores, have been identified in the three-dimensional structure of the bovine protein and found to be formed primarily by residues that have been conserved throughout the entire eukaryote evolution from yeasts to both plants and mammals as seen in the sample of 16 sequences. The conserved residues are found to stabilize helix-helix interactions and serve specific functional purposes for ligand binding. The fast one-step folding mechanism of ACBP has been shown to be a feature that seems to be maintained throughout evolution despite numerous differences in sequence and even dramatic differences in folding kinetics and protein stability. The protein study raises the question to what extent does the conserved hydrophobic residues provide a scaffold for an efficient one-step folding mechanism.