The Effects of Mobile-App-Based Low-Carbohydrate Dietary Guidance on Postprandial Hyperglycemia in Adults with Prediabetes.

INTRODUCTION: Postprandial hyperglycemia is independently associated with many adverse complications, while diets with a low glycemic load are beneficial in improving post-meal glucose levels. This study aims to determine if mobile-app-based low-carbohydrate dietary guidance will reduce exposure to postprandial hyperglycemia in adults with prediabetes. METHODS: This single-blind, randomized controlled pilot study included 100 participants (39 men; mean age 53.6 ± 11.9 years) and was performed in the PKU Care CNOOC Hospital, China. The intervention group (n = 57) received low-carbohydrate dietary guidance through a moblie app (CAReNA) for 3 months, while the control group (n = 43) only received health education on a diabetic diet. The primary outcome was change in time of postprandial hyperglycemia between baseline and 3 months. RESULTS: The study revealed that the mean time in postprandial hyperglycemia (> 7.8 mmol/l [140 mg/dl]) monitored by flash glucose monitoring changed from 3.27 h/day at baseline to 2.34 h/day at 3 months in the intervention group and from 3.08 h/day to 2.96 h/day in the control group, with a between-group difference of - 0.81 h/day (P < 0.05). Fasting plasma glucose and glycated hemoglobin (HbA1c) in the intervention group decreased significantly, although no significant difference was seen between the two groups. Compared with the control group, the intervention group had a significant decrease in anthropometric and body composition measurements as well as triglycerides. CONCLUSION: The mobile-app-based low-carbohydrate dietary guidance effectively reduced the time spent in postprandial hyperglycemia in adults with prediabetes. This new type of nutritional management has beneficial effects on people with prediabetes and needs further research. CLINICAL TRIAL REGISTRATION: ChiCTR1900024880.

Elevated concentrations of linoleic acid in erythrocyte membrane phospholipids in patients with inflammatory bowel disease.

Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn disease (CD), is a disorder characterized by diffuse inflammation of the gastrointestinal tract. The immune response and inflammation are mediated by polyunsaturated fatty acids and influenced by dietary fats and lipid metabolism. This study examined the qualitative and quantitative fat intake of IBD patients and healthy controls on plasma phospholipid and erythrocyte membrane phospholipid (EMP) fatty acid content. Measurement of the fatty acid composition of plasma phospholipid and EMP were performed in 29 UC patients, 20 CD patients, and 31 healthy controls. Anthropometric characteristics and data on dietary intake were also collected. We observed significantly lower lipid intake in UC and CD patients vs controls. The UC and CD patients had significantly higher levels of linoleic acid in their EMP than did controls. There were no significant differences in the levels of n-3 polyunsaturated fatty acids, but there were significantly higher levels of the n-6 in the EMP of UC and CD patients compared with controls. The significant differences persisted after the data were adjusted for potential confounders and lipid intake. Higher levels of linoleic acids and n-6 fatty acids, which are involved in production of proinflammatory mediators, were found in IBD patients compared with controls, thereby implicating n-6 fatty acids in the pathophysiology of the disease.

Effects of pre-germinated brown rice on blood glucose and lipid levels in free-living patients with impaired fasting glucose or type 2 diabetes.

White rice (WR) is made by polishing brown rice (BR) and has lost various nutrients; however, most people prefer it to BR, maybe because of the hardness of BR. Pre-germinated brown rice (PGBR) improves the problem of BR. It is made by soaking BR kernels in water to germinate and becomes softer than BR. In this study we compared the effects of WR and PGBR on blood glucose and lipid concentrations in the impaired fasting glucose (IFG) or type 2 diabetes patients. Six men and 5 women with impaired fasting glucose (IFG) or type 2 diabetes were randomly allocated to 6 wk on WR or PGBR diet separated by a 2 wk washout interval in a crossover design. Each subject was instructed to consume 3 packs of cooked WR or PGBR (180 g/pack) daily in each intervention phase. Blood samples were collected 4 times (in study weeks 0, 6, 8 and 14) for biochemical examination. Blood concentrations of fasting blood glucose, fructosamine, serum total cholesterol and triacylglycerol levels were favorably improved on the PGBR diet (p<0.01), but not on the WR diet. The present results suggest that diets including PGBR may be useful to control blood glucose level.

Effect of Vietnamese common diet on postprandial blood glucose level in adult females.

To elucidate the effect of a typical Vietnamese diet including a high content of white rice on postprandial blood glucose levels, the present study was designed. Thirty healthy female subjects with a similar body mass index, 10 each in their twenties, forties and sixties, were recruited. Four meals with a similar protein energy percentage (13-15%) but different energy ratios of fat and carbohydrate (FC ratio) and vegetable contents were provided by cross-over design. Meal A was designed according to the commonly consumed diet in Vietnam. The FC ratio was 14:71 and 84 g of carbohydrate was from rice. Meal B contained carbohydrate in a lower ratio than meal A by fat replacement and its FC ratio was 30:57. Meal C was similar to meal A except lacking vegetables. The energy of meal A, B and C was about 2.1 MJ. Meal D was designed to match the amount of carbohydrate and fat within A and B, respectively. The FC ratio of meal D was 26:61 and the energy was about 2.4 MJ. Fasting blood glucose was measured before consumption of a test meal. Postprandial blood glucose was measured every 30 min for 2 h. Areas under the curve (AUC) were calculated to compare the glycemic response among the four test meals. There was no significant difference in AUC among the four test meals in the subjects in their twenties. In the subjects in their forties, the AUC of meal A tended to be lower than that of meal C (p = 0.07). In the subjects in their sixties, the AUC of meal A was significantly higher than that of meal B (p < 0.001). Glycemic responses showed a significant relationship with age (r = 0.26, p < 0.01); however, there was no association between glycemic responses and BMI (p = 0.20). Dietary fat ratios were inversely associated with glycemic responses (r = -0.28, p < 0.01). In conclusion, the diet with about 70% energy from carbohydrate which is commonly consumed by Vietnamese may increase glycemic response, especially in elderly people and dietary vegetables may be beneficial to prevent such an increase in glycemic response.

Dietary intake, neutrophil fatty acid profile, serum antioxidant vitamins and oxygen radical absorbance capacity in patients with ulcerative colitis.

Nutrition may play an important role in the pathogenesis and treatment of ulcerative colitis. Several studies suggest an association between dietary factors and the onset of ulcerative colitis; however, only few studies have examined the relationship between dietary intake and relapse of ulcerative colitis. The aim of this study was to assess the dietary intake and antioxidative capacity of ulcerative colitis patients and to elucidate the efficacy of dietary therapy for ulcerative colitis. Dietary intake, fatty acid composition of phospholipids in plasma and neutrophils, serum fat-soluble vitamin levels, and oxygen radical absorbance capacity were analyzed in 29 ulcerative colitis patients (7 males and 22 females), who were treated at the Department of Gastroenterology, Okayama University Hospital. Total fat intake, fat energy ratio and linoleic acid intake were significantly lower, while protein and carbohydrate intakes were significantly higher, in the patients than age- and sex-matched controls. In the neutrophil phospholipids of ulcerative colitis patients, significantly higher levels of linoleic aicd and arachidonic acid and a lower level of eicosapentaenoic acid were observed. The concentrations of serum retinol and beta-carotene but not alpha-tocopherol were significantly lower and serum oxygen radical absorbance capacity was also lower than in the controls. Significant correlations between serum oxygen radical absorbance capacity and retinol (r = 0.567, p = 0.0031), alpha-tocopherol (r = 0.560, p = 0.0036) and beta-carotene (r = 0.440, p = 0.0279) concentrations were observed in the ulcerative colitis patients. A diet restricting the intake of linoleic acid and supplemented with eicosapentaenoic acid and antioxidative vitamins may be recommendable for the nutritional management of ulcerative colitis patients.

Purification of liver serine protease which activates microsomal glutathione S-transferase: possible involvement of hepsin.

Rat liver microsomal glutathione S-transferase (MGST1) is known to be activated by trypsin, however, it has not been clarified whether MGST1 is activated by a protease present in liver. In the present study we purified the MGST1 activating protease from liver microsomes and finally identified that the protease is hepsin, a type II transmembrane serine protease. When the protease was incubated with the purified MGST1 or liposomal MGST1 at 4 degrees C, MGST1 activity was increased 3-4.5 fold after 3-6 d. In electrophoretic and immunoblot analyses after the incubation of MGST1 with the protease MGST1 dimer and its degraded fragment were detected. These results suggest that the rat liver microsomal hepsin functions as MGST1 activating/degrading enzyme.

Anthropometric characteristics, dietary patterns and risk of type 2 diabetes mellitus in Vietnam.

OBJECTIVE: To determine the impact of anthropometric characteristics and dietary patterns on Type 2 diabetes mellitus in Vietnam. METHODS: Data from 144 subjects (9m/39f newly diagnosed diabetics; 18m/78f control subjects) were analyzed in this case-control study. Height, weight, waist and hip circumferences and percent body fat were measured. Dietary intakes were assessed by 24-hour recall on three non-consecutive weekdays. Fasting blood samples were collected for the analysis of plasma glucose, fructosamine, protein and lipid concentrations. RESULTS: Although the body mass index (BMI, kg/m(2)) was similar between diabetic and control subjects, diabetic subjects had significantly greater percent body fat (31.1 +/- 5.8% vs. 27.7 +/- 6.2%) and waist-hip ratios (WHR, 0.91 +/- 0.07 vs. 0.86 +/- 0.08). Diabetic subjects had higher intakes of protein (p < 0.01), especially animal protein (p < 0.001), and consumed more meat (p < 0.01) than control subjects. Percent body fat and WHR were positively associated with diabetes (odds ratios [OR] 1.53 [95%CI 1.29-1.79] and 1.09 [95% CI 0.89-1.58], respectively) as were protein intake (OR 1.21 [95% CI 1.12-1.31]) and animal protein intake (OR 1.18 [95% CI 1.10-1.26]). CONCLUSIONS: This study indicates that percent body fat and WHR are risk factors associated with diabetes even when the BMI is normal. Evolving dietary patterns with increasingly more protein and meat consumption may also contribute to the deterioration of glucose metabolism among Vietnamese people.

Determining the prevalence of osteoporosis and related factors using quantitative ultrasound in Vietnamese adult women.

In 2003, the authors conducted a population-based, cross-sectional survey to determine the prevalence of osteoporosis and related factors in Vietnamese adult women by using quantitative ultrasound at the heel bone (calcaneus). A total of 2,232 adult women aged > or =20 years, living in Hanoi City, and free of illnesses affecting bone metabolism were randomly selected to participate in the study. Subjects' bone mass was assessed by speed of sound at the calcaneus, referred to as quantitative ultrasound measurement. The T-score threshold, defined as < or =-1.8, was used to identify subjects with osteoporosis. The crude prevalence of osteoporosis in Hanoi City was 15.4%; after adjustment for age, it was 9.0%. Among premenopausal women, the crude prevalence of osteoporosis was higher in the urban areas compared with the rural areas. By contrast, postmenopausal women in the rural areas had a higher prevalence of osteoporosis. Multiple logistic regression analysis revealed that factors associated with low speed of sound were age, menopause, educational level, lifelong occupation, recreational weight-bearing exercise, number of births, and height. Results suggest that osteoporosis is a noteworthy problem in Vietnam, and intervention strategies should be considered to control it, especially in high-risk populations.

Overweight is associated with allergy in school children of Taiwan and Vietnam but not Japan.

We collected information concerning diagnosed allergy from 2027 school children in Japan, Taiwan and Vietnam. Children were classified according to the age and sex-specific body mass index (BMI) per-age as indicator of weight status. Logistic regression was performed to examine the relationship between percentiles of BMI-per-age and allergy. Compared with children at the lowest percentile group Taiwanese children at > 85th percentile group showed a tendency toward higher risk of allergy (OR = 1.79, 95% CI 0.98 to 3.27; p = 0.060). When children with rhino-conjunctivitis were excluded from the analysis the association reached statistical significance (OR = 2.89, 95% CI 1.08 to 7.75; p = 0.035). Vietnamese children at > 85th percentile group showed a significantly higher risk of allergy (OR = 2.34, 95% CI 1.06 to 5.17; p = 0.035). This association was not observed when children with atopic dermatitis or food allergy were excluded from the analysis, although a tendency toward increased risk of allergy at BMI-per-age > 85th percentile remained. Our study sample of Japanese school children showed no association between being overweight and allergy.

The metabolic syndrome: prevalence and risk factors in the urban population of Ho Chi Minh City.

The purpose of this study was to determine the prevalence of metabolic syndrome (MeS) and its risk factors in urban population of Ho Chi Minh City. A cross-sectional study was conducted in urban areas of Ho Chi Minh City with 611 participants. The demographic, socio-economic details, anthropometric indexes and blood pressure were recorded. A fasting blood sample was collected for the analyses of glucose, total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). MeS was defined by presence of three or more of the following components: abdominal obesity, hypertriglyceridemia, low HDL-cholesterolemia, high blood pressure and high fasting plasma glucose. The crude prevalence of MeS was 18.5% (95% CI: 15.5-21.9). After age, sex standardization, this prevalence was 12.0% (95% CI: 10.9-13.2). The prevalence increased with age and sedentary work. Subjects with MeS had significantly higher body fat percentage than that of normal subjects. Metabolic syndrome showed a positive association with age, body fat percentage and sedentary occupation. This first study on MeS showed that 12% adults in urban areas of Ho Chi Minh City had metabolic syndrome. It suggests that MeS is becoming a noteworthy health problem in Vietnam and to the early detection and appropriate intervention as well as healthy lifestyle education programs need to be established.

Nutritional factors, parasite infection and allergy in rural and suburban Vietnamese school children.

Urban areas often have more allergy than rural areas. Dietary patterns and parasite infection have been suggested as possible related factors. This study evaluated the prevalence of allergy in school children in one rural and suburban area of Vietnam where parasite infection is common. A total of 195 children aged 9 to 13 years old completed a self-administered allergy questionnaire and provided blood and stool samples for analysis. Nutritional status, dietary intake and parasite infection were determined in all participants. Allergy was more common in girls (10.7% vs. 7.6%), suburban children (11.8% vs. 6.9%), children with weight-for-age (16.7% vs. 6.0%) and height-for-age (14.8% vs. 4.9%) in the 10th to 75th percentile compared to <3rd percentile, and in children without trichuriasis compared to light trichuriasis (12.5% vs. 9.3%), although none of these comparisons were statistically significant. Logistic regression adjusted for sex, age and area of residence revealed no association between allergy and nutritional status, food intake or parasite infection. Intake of riboflavin, however, was negatively associated with allergy (OR=0.00, 95% CI:0.00-0.65, p=0.038). In conclusion, we were unable to detect any association between allergy and nutritional status, diet, or parasite infection. However, in a population with high undernutrition and parasite infection, the prevalence of allergy was low and the extremely low intake of riboflavin was associated with a higher risk of allergy.

Relationship between smoking habits and serum oxygen radical absorbance capacity and dietary intake in Japanese adults.

1. The present study was undertaken to investigate the effect of smoking habits on dietary intake, serum oxygen radical absorbance capacity (ORAC) and lifestyle in Japanese adults. 2. Lifestyle factors were recorded by questionnaire and dietary intake was measured by a single 24 h food recall. Blood was collected under fasting conditions for analysis. 3. Smokers had lower intakes of vitamin C, fruits and dark green and yellow vegetables (DGYV), higher consumption of alcohol, lower physical activity and lower ORAC values than non-smokers. Body mass index (BMI), serum total cholesterol (TC) and triacylglycerol (TG) increased, whereas high-density lipoprotein-cholesterol (HDL-C) decreased with an increase in the amount smoked, but there were no significant differences between smokers and non-smokers. 4. It is considered that high cancer and cardiovascular risks among smokers are also reinforced by undesirable lifestyle factors other than smoking.

Oolong tea increases energy metabolism in Japanese females.

Oolong tea is a traditional Chinese tea that has long been believed to be beneficial to health such as decreasing body fat. We were interested in this assertion and tried to evaluate the effect of oolong tea on energy expenditure (EE) in comparison with green tea. The subjects were eleven healthy Japanese females (age 20+/-1 y; body mass index (BMI) 21.2+/-2.5 kg/m2) who each consumed of three treatments in a crossover design: 1) water, 2) oolong tea, 3) green tea. Resting energy expenditure (REE) and EE after the consumption of the test beverage for 120 min were measured using an indirect calorimeter. The cumulative increases of EE for 120 min were significantly increased 10% and 4% after the consumption of oolong tea and green tea, respectively. EE at 60 and 90 min were significantly higher after the consumption of oolong tea than that of water (P<0.05). In comparison with green tea, oolong tea contained approximately half the caffeine and epigallocatechin galate, while polymerized polyphenols were double. These results suggest that oolong tea increases EE by its polymerized polyphenols.