Amount Of Carbohydrate Intake Research Articles

SAT131 Acceptability And Impact Of Basic Carbohydrate Counting On Glycemic Control In Children And Young People With Type 1 Diabetes

Abstract Disclosure: A. Tandon: None. E. Bhowmik: None. Z. Ali: None. S. Tripathi: None. A. B k: None. V. Bhatia: None. P. Dabadghao: None. S. Sudhanshu: None. Background- Basic carbohydrate counting (BCC) represents a meal-planning approach for people with T1DM, emphasizing on consistency in the timing and amount of carbohydrate intake at each meal. In contrast to advanced carbohydrate counting, it is simpler to learn for people with varied levels of education or numeracy skills. The effect of BCC on glycemic control in children with T1DM using MDI is largely unknown. We aimed to determine whether BCC, compared to routine nutritional education (RNE) of our clinic, would improve glycemic control in these children with typical Indian diets. Methods- This randomized, controlled trial included children, adolescents and young adults with T1DM using MDI. In addition to RNE, the intervention group received BCC education including a personalised diet plan with suggestions for carbohydrate exchanges at each meal based on a 2-week food log prepared by them. The control group received the RNE of our clinic including instructions on healthy food choices, food groups, calorie-free foods, glycemic index, and instructions for special occasions. A retrospective CGM study and HbA1c were performed at baseline and at 12 weeks after the dietary education. The primary outcome was the difference in change in TIR (Time in range; 70-180 mg/dl) from baseline through 12 weeks between the two groups. A questionnaire on acceptability of BCC was administered. Results- Ninety two patients [age 15.7 ± 5.0 years, median (IQR) duration of diabetes 5.9 (5.9) years, baseline HbA1c 8.0 ± 1.5 %] wore the FreeStyle Libre Pro sensor for a median of 14 days. Median (IQR) TIR was 41 (18) %, TBR (Time below range; <70 mg/dl) 14 (13) % and TAR (Time above range; >180 mg/dl) 40.7 ± 20.4 %. Coefficient of variation (% CV) was 49.1±10.3% and 92% had high (>36 %) CV. Multivariate regression showed that older age at onset of diabetes was associated with a higher TIR, TBR and a lower TAR, whereas these glycemic metrics were not influenced by current age, urban vs rural residence, education of mother or socioeconomic status. The use of NPH vs glargine for basal insulin was also associated with higher TBR and %CV but lower TAR. Significant improvement was seen in HbA1c in the BCC group, when compared with their own values during the prior 24 months (baseline [8.2 ± 1.3%], 12 weeks [7.9 ± 1.2%], p = 0.042), but not so in the RNE group (baseline [8.0 ± 1.0%], 12 weeks [8.1 ± 1.0%], p = 0.881). However, no significant differences were observed in the changes in TIR, TBR, TAR, %CV and HbA1c between the two groups after 12 weeks of dietary intervention. Although, acceptability of BCC was high, only half of the participants correctly practiced it at more than 50 percent of their meals. Conclusion- Among our families with T1DM treated with MDI, although BCC had high acceptability, it was not frequently practiced and did not lead to greater improvement in glycemic control as compared to routine nutritional education. Presentation: Saturday, June 17, 2023

Carbohydrate intake - current knowledge on weight management.

Carbohydrates are the main contributor to daily energy intake and, thus, might play an essential role in the development and treatment of obesity. This nonsystematic literature overview summarized current knowledge about the association between carbohydrate intake (quantity and quality) and weight management. There is scientific evidence for the association between the quality of carbohydrates and body weight or metabolic parameters (e.g. fasting glucose). Thus, dietary intake of high-quality carbohydrates should be preferred over food with a low carbohydrate quality. In contrast, heterogeneous data are available for the association between the amount of carbohydrate intake and anthropometric parameters (e.g. body weight, body fat). Regulation of dietary intake and body weight is complex. For instance, gene-diet interactions might play a role in carbohydrate intake and metabolism. There is evidence for the association between intake of high-quality carbohydrates and body weight. However, for the treatment of obesity, a negative energy balance is crucial. The success in weight loss was independent of the quantity and quality of carbohydrate intake. To sum up, recently published literature does not change the current opinion about carbohydrate intake and obesity.

Associations between Conventional and Emerging Indicators of Dietary Carbohydrate Quality and New-Onset Type 2 Diabetes Mellitus in Chinese Adults

ObjectivesOur aim was to investigate the associations between dietary GI, CF and CQI and new-onset T2DM risk among Chinese adult.MethodsDietary glycemic index (GI), carbohydrate to fiber ratio (CF) and carbohydrate quality index (CQI) are conventional and emerging indicators for carbohydrate quality, respectively. Their associations with new-onset type 2 diabetes mellitus (T2DM) risk in Chinese adults remain unclear. We aimed to investigate the associations between dietary GI, CF and CQI and new-onset T2DM risk among Chinese adults. This prospective cohort study included 14,440 adults from the China Health and Nutrition Survey without cardiometabolic diseases at baseline. The associations between dietary GI, CF and CQI and T2DM risk were assessed using Cox proportional hazard regression analysis and dose–response relationships were explored using restricted cubic spline and threshold analyses.ResultsAfter a median follow-up duration of 9 years, a total of 1061 incident T2DM cases were identified. In fully adjusted models, higher dietary GI values were associated with reduced risk of T2DM, especially for Q4 (Q4 vs Q1: HR = 0.51; 95% CI: 0.38, 0.70; P-trend = 0.013), while CF and CQI were not significantly associated with incident T2DM. There were significant effect modifications of the association between dietary GI and T2DM risk by region and amount of carbohydrate intake (both P-interaction < 0.050). RCS analyses demonstrated significant non-linear trends of the associations between dietary GI and CF and T2DM risk (both P-overall < 0.001, P-nonlinear = 0.001), and threshold analyses showed that T2DM risk decreased and reached the bottom when dietary GI was 74.5 (73.4, 75.6) and CF was 27.3 (25.1, 29.6) (both P-log likelihood ratio < 0.001).ConclusionsThere were U-shaped relationships between dietary GI and CF and T2DM risk, indicating both dietary GI and CF should be controlled in a moderate range for T2DM prevention in Chinese adults. Further studies are required to confirm whether these indicators should be incorporated into dietary guidelines and Nutrient Facts panel labeling intended to help reduce T2DM risk in Chinese population.Funding SourcesThis study was funded by Shenzhen Science and Technology Program and the National Natural Science Foundation of China.

Asupan Karbohidrat Harian terhadap Risiko Kejadian Diabetes Melitus Gestasi (GDM) melalui Glyco-Hemoglobin Ibu Hamil

This study aims to identify the relationship between the amount of carbohydrate intake in pregnant women in the third trimester with the incidence of gestational diabetes mellitus (GDM) in the health office area of the City of Bukittinggi. This research method is a cross-sectional study using an experimental approach. The results showed that the daily intake of carbohydrates (grams) of pregnant women in the third trimester had a significant relationship with the incidence of GDM in the working area of the Bukittinggi City Health Office based on 34 pregnant women who had been examined. This can be seen from the higher the daily intake of carbohydrates for pregnant women, the increase in the percentage value of HbA1c. In conclusion, there is a correlation between the consistent daily intake of carbohydrates and the HbA1c weight, which refers to pre-diabetes status and gestational diabetes in the third trimester of pregnant women.&#x0D; &#x0D; Keywords: Carbohydrate Intake; Gestational Diabetes Mellitus; HbA1c

Aralıklı Açlık Diyetleri ve Düşük Karbonhidratlı Diyetlerin Obezite Tedavisindeki Etkisi

Obezite, prevalansı giderek artan küresel bir sağlık sorunudur. Fazla kilolu ve obez bireyleri tedavi etmek için yeni diyet stratejileri oluşturulmuştur ve bu diyet stratejileri popüler ve yaygın hale gelmiştir. Bu diyetler arasında “aralıklı açlık diyetleri” ve “düşük karbonhidratlı diyetler (DKD)” bulunmaktadır. Birçok aralıklı açlık diyeti varyasyonu açlık döngülerinin uzunluğu ve sıklığı bakımından farklılık gösterir. Alternatif gün açlık diyetleri (dönüşümlü açlık), zaman kısıtlı beslenme, dini oruç olarak sınıflandırılabilir. Düşük karbonhidratlı diyetlerin ortak bir tanımı bulunmamaktadır. Bazı DKD’lerde enerji alımına bağlı, bazılarında ise enerji alımından bağımsız olarak karbonhidrat alım miktarı kısıtlanmaktadır. Alternatif gün açlık diyetlerinin ve zaman sınırlı beslenmenin vücut ağırlığı kaybında olumlu etkileri olduğu öne sürülmektedir, ancak, açlık süresinin uzaması diyete uyumu azaltabilir. Ramazan orucunda ise genellikle bir aylık süreçte kaybedilen vücut ağırlığı geri kazanılmaktadır. Düşük karbonhidratlı diyetlerin vücut ağırlığı kaybı üzerine olumlu etkileri olsa da düşük yağlı diyetlerin etkileri konusunda çelişkili veriler bulunmaktadır. Her iki beslenme modeli de obezitede vücut ağırlık kontrolü için uygulanabilecek yaklaşımlar olabilir; ancak uzun dönemli etkilerinin ortaya konulması için uzun süreli takip çalışmalarına ihtiyaç duyulmaktadır.

Pengaruh Gaya Hidup Terhadap Status Gizi Pegawai Direktorat Politeknik Kesehatan Kementerian Kesehatan Medan

Gaya hidup sebagai salah satu faktor tidak langsung, memegang peranan penting dalam mempengaruhi status gizi. Tujuan penelitian ini yaitu mengetahui pengaruh gaya hidup terhadap status gizi. Desain penelitian menggunakan cross sectional dengan sampel pegawai Direktorat Kesehatan Politeknik Kesehatan Kementerian Kesehatan Medan sebanyak 70 sampel. Metode penarikan sampel menggunakan total sampling. Faktor-faktor yang diukur adalah pola makan (kecukupan asupan karbohidrat dan lemak, jenis makanan dan frekuensi makan), aktivitas fisik, durasi tidur dan status gizi. Data dianalisis dengan menggunakan uji chi-square dan uji regresi logistik untuk mengidentifikasi faktor yang paling dominan dalam mempengaruhi status gizi responden.Hasil penelitian menunjukkan bahwa ada pengaruh kecukupan asupan karbohidrat (p=0,000), kecukupan asupan lemak (p=0,022), aktivitas fisik (p=0,000) dan durasi tidur (p=0,000) dengan kejadian obesitas. Hasil uji regresi logistik menunjukkan bahwa faktor yang paling dominan dalam mempengaruhi status gizi yaitu jumlah asupan karbohidrat.

GLP-1 analog liraglutide-induced cardiac dysfunction due to energetic starvation in heart failure with non-diabetic dilated cardiomyopathy

BackgroundGlucagon-like peptide-1 (GLP-1) reduces cardiovascular events in diabetic patients; however, its counter-protective effects have also been suggested in patients with heart failure and the clear explanation for its mechanisms have not yet been offered.MethodsThe effects of GLP-1 analog on cardiac function and energy metabolism, especially glycemic and lipid metabolisms were elucidated using non-diabetic J2N-k hamsters which showed spontaneous dilated cardiomyopathy. J2N-k hamsters were treated with PBS (HF group), low-dose (HF-L group) or high-dose liraglutide (HF-H group).ResultsIn failing heart, GLP-1 analog exerted further deteriorated cardiac function (e.g. positive and negative dP/dt; p = 0.01 and p = 0.002, respectively) with overt fibrosis and cardiac enlargement (heart/body weight, 5.7 ± 0.2 in HF group versus 7.6 ± 0.2 in HF-H group; p = 0.02). The protein expression of cardiac muscles indicated the energy starvation status. Indirect calorimetry showed that failing hearts consumed higher energy and carbohydrate than normal hearts; moreover, this tendency was augmented by GLP-1 analog administration. Upon 10% glucose solution loading with GLP-1 analog administration (HF-H-G group) as complementary experiments, the cardiac function and fibrosis significantly ameliorated, whereas carbohydrate utilization augmented further and lipid utilization reduced more. The prognosis of HF-H-G group also significantly improved (p = 0.025).ConclusionsGlucagon-like peptide-1 analog caused the relative but desperate shortage of glycemic energy source for the failing cardiac muscles and it may restrict ATP synthesis, resulting in cardiac function deterioration. Therefore, appropriate energy supply and amount of carbohydrate intake should be carefully considered when administrating incretin-related drugs to patients with heart failure.

Optimal energy distribution of carbohydrate intake for Japanese elderly patients with type 2 diabetes: The Japanese Elderly Intervention Trial

In diet therapy for diabetes, optimal energy intake and the energy distribution of macronutrients (protein : fat : carbohydrate [PFC] energy ratio) are important. We aimed to clarify the correlation between the PFC energy ratio and metabolic parameters including glycated hemoglobin A1c (HbA1c) and triglycerides in Japanese elderly patients with type 2 diabetes mellitus aged 65 years or older. Participants were 1173 diabetic patients aged 65 years or older with serum HbA1c level of >/=7.4% enrolled in the Japanese Elderly Diabetes Intervention Trial (J-EDIT). The participants were divided into four groups by the percentage of total energy intake (%E) of carbohydrate (C1: less than 55%E, C2: 55%E or more and less than 60%E, C3: 60%E or more and less than 65%E, and C4: 65%E or more). Relations of %E of carbohydrate to HbA1c and other metabolic parameters, energy intake and nutritional intake were examined. Furthermore, the subjects were divided into four categories by HbA1c levels by quartile method (Q1: less than 7.90%, Q2: 7.90% or more and less than 8.30%, Q3: 8.30% or more and less than 8.80%, Q4: 8.80% or more). Relations of HbA1c to other metabolic parameters, energy intake and nutritional intake were examined. The mean HbA1c levels in the four groups were C1: 8.40%, C2: 8.50%, C3: 8.41% and C4: 8.36% in men, and C1: 8.51%, C2: 8.47%, C3: 8.35% and C4: 8.52% in women, respectively. There were no significant differences and linear trend in HbA1c levels across groups. The mean triglyceride levels were in the range of 122-128 mg/dL in men from C1 to C3, although it was significantly higher in C4 (177 mg/dL). The mean triglyceride levels were in the range of 128-136 mg/dL in women from C1 to C3, although it was significantly higher in Q4 (150 mg/dL). Amounts of protein and fat intakes decreased with an increase of %E of carbohydrate, although amount of carbohydrate intake did not change significantly. As a result, %E of protein and fat, and energy intake decreased in both men and women with an increase in %E of carbohydrate. Among the four quartiles divided by HbA1c levels, there were no significant differences in energy intake and PFC energy ratio. The present study suggests that, within the range studied, the carbohydrate energy ratio has no correlation with HbA1c levels. However, serum triglyceride levels increased and high-density lipoprotein cholesterol levels decreased significantly, with an increase of %E of carbohydrate in men, and the same tendencies were observed in women. Furthermore, in patients with 65%E or more of carbohydrate, serum triglyceride levels exceeded 150 mg/dL, which is the recommended treatment target for diabetic patients. These results suggest that the ideal %E of carbohydrate for Japanese elderly type 2 diabetes is less than 65. The lower limit of %E of carbohydrate could not be determined from the present study.

A prospective randomized trial to evaluate effectiveness of diabetes management through an integrated delivery system (DMIDS) on glycemic and diet control in primary care setting in Taiwan

We evaluated the effectiveness of diabetes education in type 2 diabetes n glycemic and diet control in primary care setting in Taiwan. We randomly assigned 157 adult patients with type 2 diabetes to intervention group receiving intensive nutrition education based on guidelines of ADA (n=74) or control group (n=73). After 12 months follow up, only patients with baseline HbA1c greater or equal to 7%, changes of HbA1c (%) (‐0.6 vs 0.0) were significantly different between two groups. After adjusting for confounders, increasing every 15 grams in carbohydrate intake was related to changes of HbA1c at increments of 0.14% (SE=0.04, p=0.001) and receiving intervention (vs control) was marginally associate with changes of HbA1c at increments of ‐0.52% (SE=0.30, p=0.092). Glycemic and dietary improvements can be achieved through diabetes education addressing nutrition aspects in primary care setting in Taiwan. The improvements of glycemic status may be related to changes in diet such as amount of carbohydrate intake.

Changes in nutritional status and nutritional intake among elderly residents of a community over a 10-year period: the Hisayama Study

The purpose of this study was to investigate the changes in nutritional status and nutrient intake among 387 elderly residents (> or = 60 y.o.) of Hisayama Town. A dietary survey was carried out at baseline in 1988 and repeated at the end of the follow-up period in 1998. During the 10-year follow-up period, mean values of body height and weight, and body mass index significantly decreased in both sexes. Likewise, blood hemoglobin and serum total cholesterol levels significantly decreased, while serum albumin and HDL-cholesterol levels significantly increased. Among dietary factors, mean energy intake significantly decreased due mainly to a decrease in the amount of carbohydrate intake, but no significant changes in the amount of protein and fat intakes were observed. The percentages of the Recommended Dietary Allowance for all nutrients eaten except for iron changed at the levels above 100%. The percentage of energy derived from carbohydrate significantly decreased, while those from protein and fat significantly increased. In conclusion, among community-dwelling healthy elderly people, mean energy intake significantly decreased due to a decrease in the amount of carbohydrate intake, and the fat intake relatively increased, with advancing age, but the blood lipid profile remained unchanged.

Liberalized diet in patients with type 1 diabetes

To document that strict dietary regimen are not necessary in the context of intensified insulin therapy. German multicentre, prospective cohort study; 6 years follow-up. Ambulatory examination using a mobile ambulance. A total of 636 type 1 diabetic patients (age 33 +/- 7 years, diabetes duration 15 +/- 7 years; mean +/- SD), who had participated in a structured, 5-day, in-patient, group treatment and teaching programme for intensification of insulin therapy and liberalization of the diabetes diet 6 years prior to follow-up. Relations between the extent to which patients practise a liberalized diet, the degree of metabolic control (HbA1c, severe hypoglycaemia, body mass index, cholesterol), and the patients' perceived burden through dietary treatment. In the total patient group, HbA1c was 7.9 +/- 1.6%, and the incidence of severe hypoglycaemia was 0.17 cases per patient during the preceding year; 31% patients injected insulin < or = 3 times per day, 58% 4-7 times per day, and 11% used insulin pump therapy. Only 11% patients reported following a meal plan, whereas 89% continually changed timing and amount of carbohydrate intake; only 5% had the same number of meals every day, whereas as many as 20% varied the number of meals per day by four or more; 53% skipped main meals; 85% habitually consumed sugar or sugar containing foods. Patients with a higher degree of diet liberalization injected insulin or used an insulin pump therapy more frequently, and perceived their dietary treatment to be less burdensome. No clinically significant associations were found between the extent of diet liberalization and metabolic control. Under the conditions where type 1 diabetic patients have the opportunity to participate in an intensified insulin treatment and teaching programme, liberalization of the diabetes diet is not associated with adverse effects on glycaemic control, but is associated with less perceived burden through dietary treatment.

Diet liberalization and metabolic control in type I diabetic outpatients treated by continuous subcutaneous insulin infusion.

In 10 type I diabetic outpatients treated by continuous subcutaneous insulin infusion (CSII), dietary habits and metabolic control were investigated. Under conditions of a conventional diabetes diet (including 5-6 meals per day and a strictly planned meal intake) as well as under a "less restricted diabetes diet" (e.g., free choice of number, timing, and amount of carbohydrate intake) near normoglycemia could be achieved. Mean daily blood glucose levels did not change significantly when the patients' nutrition was alternated between both diets. During the "less restricted diabetes diet," the patients opted for a rather high fat intake (51 +/- 5% fat, 34 +/- 5% carbohydrate, and 15 +/- 2% protein). Despite this unintended dietary behavior, serum lipids and body weight remained normal after an observation period of 4-6 mo. It is concluded that during permanent near normoglycemia achieved by CSII a partial liberalization of the diabetes diet does not introduce any short-term or long-term metabolic risk factors for cardiovascular diseases.