Association between dietary fat intake, liver fat, and insulin sensitivity in sedentary, abdominally obese, older men.

Whether dietary fat influences the interaction between liver fat, visceral adipose tissue (VAT), and metabolic risk is unclear. Thus, we sought to determine the independent associations between 1 and 10 d dietary fat intake, liver fat, and VAT on insulin sensitivity using a cross-sectional design. Liver fat score (LFS) was assessed by computed tomography and VAT by magnetic resonance imaging in 42 abdominally obese older men. Insulin sensitivity was measured by the hyperinsulinemic-euglycemic clamp technique. Diet composition was determined from self-recorded diet records for 1 and 10 d preceding the assessment of LFS. LFS was positively associated with the 10 d average fat and alcohol intake, but not with any 1 d average dietary variables. VAT (r = -0.36) and LFS (r = -0.32) were both negatively correlated with insulin sensitivity (p < 0.05). When LFS and VAT were entered in the same model, only VAT was an independent predictor of insulin sensitivity (p < 0.05). Control for the average 10 d alcohol consumption and fat intake improved the association between insulin sensitivity and LFS (from r = -0.32, p > 0.10 to r = -0.49, p < 0.05), but not VAT. In fact, after control for the 10 d dietary variables, both LFS and VAT were independent predictors of insulin sensitivity (p < 0.05). This was not true for any of the 1 d dietary intake variables. In conclusion, liver fat is associated with dietary fat intake and alcohol consumption over 10 d, but not 1 d. Furthermore, dietary habits may influence the relationship between liver fat and insulin sensitivity.

Is interview a reliable method to verify the compliance with antihypertensive therapy? An international central-European study.

BACKGROUND: Non-compliance with prescribed antihypertensive medication is an important contributor to the failure of antihypertensive therapy. OBJECTIVE: To assess the validity of a short questionnaire in the identification of non-compliant patients. METHODS: In three central-European countries, work-site screening for hypertension was conducted. Blood pressure was measured using an automatic electronic blood pressure measuring device (BpTRU). Respondents were interviewed by trained personnel and a short questionnaire focused on blood pressure awareness and treatment compliance was completed. RESULTS: A total of 2812 persons were screened: 841(29.9%) respondents were hypertensive, and out of these the total number of treated hypertensive subjects was 359 (42.6%). Mean systolic blood pressure and diastolic blood pressure were significantly lower in the compliant group than the non-compliant group (systolic blood pressure, 139.4 and 146.2 mmHg, respectively, P = 0.002; and diastolic blood pressure, 89.2 and 92.3 mmHg, respectively, P < 0.01). The non-compliant group was younger than the compliant group (mean age, 46.7 versus 48.9 years, respectively, P = 0.01). Females, patients on combined therapy and non-smokers were more compliant than males, those on mono-therapy and smokers (P = 0.01, P = 0.004 and P = 0.005, respectively). CONCLUSION: Patients reporting strict compliance with prescribed drug therapy have significantly lower systolic blood pressure and diastolic blood pressure than those who admit even an occasional lapse in taking medication. A properly formulated questionnaire can identify non-compliant patients.