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Astaxanthin improves glucose metabolism and reduces blood pressure in patients with type 2 diabetes mellitus

Background and Objectives: This randomized, placebo-controlled trial was performed for 8 weeks to investigate the potential effects of astaxanthin (AST) supplementation on the adiponectin concentration, lipid peroxidation, glycemic control, insulin sensitivity, and anthropometric indices in participants with type 2 diabetes mellitus. Methods and Study Design: We enrolled 44 participants with type 2 diabetes who met our inclusion criteria. Eight milligrams of AST supplementation or a placebo were randomly administered once daily for 8 weeks to these participants. Results: The 8-week administration of AST supplementation increased the serum adiponectin concentration and reduced visceral body fat mass (p＜0.01), serum triglyceride and very-low-density lipoprotein cholesterol concentrations, and systolic blood pressure (p＜0.05). Furthermore, AST significantly reduced the fructosamine concentration (p＜0.05) and marginally reduced the plasma glucose concentration (p=0.057). Conclusions: We demonstrated that because participants with type 2 diabetes often have hypertriglycemia and uncontrolled glucose metabolism; our findings of dual beneficial effects are clinically valuable. Our results may provide a novel complementary treatment with potential impacts on diabetic complications without adverse effects.

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The effects of green kiwifruit combined with isoflavones on equol production, bone turnover and gut microflora in healthy postmenopausal women

Background and Objectives: Isoflavone (daidzein and genistein) interventions in postmenopausal women have produced inconsistent skeletal benefits, partly due to population heterogeneity in daidzein metabolism to equol by enteric bacteria. This study assessed changes in microflora and bone turnover in response to isoflavone and kiwifruit supplementation in New Zealand postmenopausal women. Methods and Study Design: Healthy women 1-10 years post-menopause were randomly allocated to group A (n=16) or B (n=17) for a 16-week crossover trial. Two consecutive 6-week treatment periods had a 2-week lead-in period at intervention commencement and a 2- week washout period between treatments. Treatments prescribed either (1) daily isoflavone supplementation (50 mg/day aglycone daidzein and genistein) alone, or (2) with two green kiwifruit. At treatment baseline and endpoint (four time points) the serum bone markers C Telopeptide of Type I collagen (CTx), undercarboxylated osteocalcin (unOC), and serum and urinary daidzein and equol, were measured. Changes in gut microflora were monitored in a subgroup of the women. Results: Equol producers made up 30% of this study population (equol producers n=10; non-equol producers n=23) with serum equol rising significantly in equol producers. Serum ucOC decreased by 15.5% (p＜0.05) after the kiwifruit and isoflavone treatment. There were no changes in serum CTx or in the diversity of the gut microflora. Conclusions: 50 mg/day isoflavones did not reduce bone resorption but kiwifruit and isoflavone consumption decreased serum ucOC levels, possibly due to vitamin K1 and/or other bioactive components of green kiwifruit.

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Regular egg consumption at breakfast by Japanese woman university students improves daily nutrient intakes: open-labeled observations

Background and Objectives: Eggs, an important source of high-quality protein, contain a variety of key nutrients and antioxidants. Here we conducted an intervention study to evaluate whether the additional consumption of one egg per day would affect the daily nutritional intakes and blood antioxidant status in Japanese woman university students. Methods and Study Design: For 4 weeks, the 14 subjects were provided a nutritious breakfast including one boiled egg, and they were asked to keep a daily dietary record. Results: The subjects' daily energy intake during the intervention did not differ compared to the baseline, whereas the protein energy ratio and cholesterol intake were significantly increased. The subjects' consumption of confectionery during the intervention was significantly decreased compared to the pre-trial period. The total score of adherence to the food-based Japanese dietary guidelines for a healthy diet during the intervention was higher than that at baseline. The analysis of fasting blood samples showed that the subjects' serum lipids levels were not altered, whereas their malondialdehyde modified low-density lipoprotein (MDA-LDL) levels and the oxidative susceptibility of LDL were significantly reduced after the intervention. More importantly, serum folic acid levels were significantly increased. Conclusions: Our results suggest that regular egg consumption at breakfast can help improve the daily nutritional status and dietary habits and also ameliorate certain indices of antioxidant status in young women.

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Dietary patterns, dietary biomarkers, and kidney disease in patients with type 2 diabetes: a repeated-measure study in Taiwan

Background and Objectives: Western dietary patterns have been linked with kidney disease. This study investigated the association between Chinese dietary patterns and kidney disease in a Taiwanese population with type 2 diabetes and evaluated dietary fatty acid patterns, a kidney-related dietary biomarker. Methods and Study Design: We recruited 838 patients with type 2 diabetes and used their dietary and renal data obtained from three repeated measures in 2008, 2009 and 2010. Diet was assessed using food-frequency questionnaires, and factor analysis was performed to identify dietary patterns. Albuminuria was defined by having an albumin-to-creatinine ratio ≥30 mg/g and kidney dysfunction by estimated glomerular filtration rate ＜60 mL/min/1.73m^2. Generalized estimating equation models were used to estimate ORs (95% CIs) of kidney disease adjusted for covariates. Erythrocyte fatty acids were only measured in blood samples collected in 2008. Results: Three dietary patterns were identified: high fat-meat, traditional Chinese food-snack, and fish-vegetable. In the adjusted model, the high fat-meat and traditional Chinese food-snack diets were not associated with any kidney outcomes. The fish-vegetable diet was inversely associated with kidney dysfunction (quartile 4 vs 1, OR: 0.75, 0.58-0.97), but not associated with albuminuria. A higher fish-vegetable diet factor score was associated with higher n-3 fatty acid levels. Conclusion: In patients with diabetes, we found greater adherence to a fish-vegetable diet to be associated with better kidney function and greater n-3 fatty acid profiles. The inclusion of repeated dietary assessments and dietary biomarker measurements in future diet-disease research, especially in patient populations, may provide more definitive risk evaluation.

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Dietary glycemic load and metabolic status in newly diagnosed type 2 diabetes in southeastern China

Background and Objectives: Large-scale epidemiological investigations worldwide have shown that dietary glycemic load is associated with metabolic diseases, including diabetes. However, only a few studies have examined the correlations between glycemic load and blood glucose and lipids in Chinese diabetic patients. Therefore, this study aimed to determine these correlations in southeastern China. Methods and Study Design: 201 patients with newly diagnosed type 2 diabetes and 126 participants with normal blood glucose were enrolled at the Sun Yat-sen Memorial Hospital, Guangdong Province. Carbohydrate intake and glycemic load were assessed based on 3-day dietary records. Using glycemic load as the dependent variable, a correlation analysis and multiple regression analyses were used to analyze the correlations between glycemic load and blood glucose and lipids. Results: The mean glycemic load in diabetic patients was significantly higher than that in the control group (p＜0.05). Correlation analysis showed that glycemic load was positively correlated with body mass index and glycated hemoglobin in diabetic patients (p＜0.05) but negatively correlated with high-density lipoprotein cholesterol in all subjects (p＜0.05). Multivariable regression analysis indicated that, among participants in southeastern China, a higher glycemic load increased the odds of having diabetes, a low high-density lipoprotein cholesterol, and higher Charlson weighted index of comorbidities score, as well as being overweight. Conclusions: A high-glycemic load diet may be associated with a risk of diabetes, glycemic control, lipid metabolism, prognosis of diseases, and body composition. It is necessary to control dietary glycemic load for both patients with diabetes and healthy people in southeastern China.

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Prevalence of gestational diabetes mellitus and associated risk factors in pregnant Chinese women: a cross-sectional study in Huangdao, Qingdao, China

Background and Objectives: This study explored the prevalence of gestational diabetes mellitus (GDM) in Chinese pregnant women and identified risk factors for GDM after the implementation of the universal two-child policy. Methods and Study Design: On the basis of income and population, we randomly selected three hospitals through stratified and cluster sampling. From January 1 to July 31, 2016, 4959 women who had been registered within 12 weeks of gestation received a 75-g 2-h oral glucose tolerance test (OGTT) at 24-28 gestational weeks. International Association of Diabetes and Pregnancy Study Group criteria were used for the diagnosis of GDM. Results: The OGTT was positive in 1080 (21.8%; 1080/4959) women, who were then diagnosed as having GDM on the basis of their results. GDM was positively associated with the following factors: advanced maternal age (p＜0.001; adjusted odds ratio [OR]=4.88; 95% confidence interval [CI]=2.38-10.0, pre-pregnancy body mass index overweight (OR=2.44, 95% CI=1.78-3.34)/obesity (OR=10.9, 95% CI=6-19.6; p＜0.001), paternal history of diabetes (p=0.003; OR=2.54, 95% CI=1.38-4.67), and maternal history of diabetes (p＜0.001; OR=3.6, 95% CI=2.16-5.98). Conclusions: Qingdao has an exceptionally high estimated prevalence of GDM. Widely recognized risk factors for GDM were advanced age, pre-pregnancy overweight/obesity, and a family history of diabetes in first-degree relatives. More options to prevent and manage GDM must be explored.

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Differences in brain-derived neurotrophic factor between neonates born to mothers with normal and low ferritin

Background and Objectives: Maternal iron deficiency in late pregnancy, labor, and the postpartum period has an indirect impact to decrease neurotrophin concentration in the fetal hippocampus, namely brain-derived neurotrophic factor (BDNF). It plays an important role in the development of learning, memory, and behavior. The aim of this study was to determine the differences in BDNF between neonates born to mothers with normal and low ferritin. Methods and Study Design: This was an observational study with a cross-sectional design involving 20 term pregnant women with normal ferritin (≥12 ng/mL) and 20 term pregnant women with low ferritin (＜12 ng/mL). Samples were taken from Yarsi hospital, BMC hospital, and Hardi clinic located in Padang, from August 2015 to February 2016. Umbilical cord plasma was examined directly after delivery using an enzyme-linked immunosorbent assay (ELISA) employed at the Biomedical Laboratory of Andalas University. Mean differences were statistically assessed by independent samples t-test. Results: Plasma BDNF concentrations in neonates born to mothers with normal and low ferritin were 3.81±1.37 ng/mL and 2.78±1.19 ng/mL, respectively (p=0.015). Conclusions: Plasma BDNF was lower in neonates born to mothers with low serum ferritin.

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Breast milk and infant iodine status during the first 12 weeks of lactation in Tianjin City, China

Background and Objectives: The present study investigated the iodine status of breast milk and breast-fed infants during the first 12 weeks postpartum in Tianjin, China. Methods and Study Design: A total of 175 pregnant women were recruited before delivery. Their breastmilk and 24-h urine samples were collected at 4, 8, and 12 weeks postpartum; spot urine samples were simultaneously collected from their infants. The iodine content of the samples was measured. Results: The mean breast milk iodine concentrations (BMICs) at 4, 8, and 12 weeks were 221.7±103.5 μg/L, 175.2±76.2 μg/L, and 148.1±66.2 μg/L, respectively. Significant differences existed between the mean BMICs of the three sampling times (F=12.449, p＜0.001). The BMIC showed a decreasing trend during the first 12 weeks postpartum. The median urinary iodine concentrations (UICs) of the mothers were 152, 112, and 109 μg/L at the different sampling times. The BMIC and UIC were not correlated in the mothers. The median UICs in the infants were 251, 183, and 164 μg/L. The infant UICs were statistically different at the three sampling times (p=0.001). Moreover, the infant UICs correlated with the BMICs (Rs=0.205, p=0.010) but not with the maternal UICs (Rs=0.131, p=0.067). Conclusion: The BMIC in and infant iodine intake from breast milk decreased in the first 12 weeks. Breastfed infants could receive adequate iodine from breast milk in Tianjin City.

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Childhood overweight and obesity amongst primary school children in Hai Phong City, Vietnam

Background and Objectives: Childhood obesity is a rising health concern in Vietnam, however, research in this area is not extensive. The aim of this study was to determine the prevalence of childhood overweight and obesity, and to study associations between weight status and selected lifestyle factors, such as diet and physical activity levels, among children aged 6-10 years in Hai Phong City, Vietnam. Methods and Study Design: Two hundred and seventy-six children from an urban and a rural primary school participated in this cross-sectional study. Data on weight, height and waist circumference were used to calculate BMI, and waist-height ratio to determine the proportion of children who were overweight, obese and had high central adiposity. Information on diet, physical activity and socioeconomic status of families was collected using questionnaires. Results: Prevalences of overweight, obesity and high abdominal adiposity were 11.2%, 10.1% and 19.9%, respectively. Children who completed ≥60 minutes of physical activity daily were 50% and 80% less likely to be overweight and have high abdominal adiposity, respectively. Computer usage increased the odds of overweight and high abdominal adiposity by 4.5 and 3.9 times, respectively. Mothers with higher education and income levels increased the risk of their children being overweight (p＜0.05). Conclusions: Physical inactivity and high maternal education and income levels increased the risk of childhood overweight and obesity in this cohort. Future interventions should target parents and their children by providing both with educational modules centred on healthy eating habits, parental feeding practices and strategies for increasing physical activity.

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Dietary patterns and obesity in preschool children in Australia: a cross-sectional study

Background and Objectives: Dietary patterns have been linked to the risk of obesity in adults but little is known about such a link in young children. To examine the association between dietary patterns, nutrient intake and obesity in a representative population of preschool children in Australia. Methods and Study Design: Dietary intake was assessed using a 3-day weighed food diary. Dietary patterns were identified by factor analysis. Children were classified as overweight or obesity if their BMI z-score was between the 85th-95th percentiles or was above the 95th percentile, respectively. Results: Three dietary patterns were identified. The 'Traditional' pattern was characterised by grains, fruit, vegetables, and red meat. The 'Processed' pattern was characterised by processed meats, snack foods and confectionary. The 'Health conscious' pattern was characterised by eggs, fish, polyunsaturated margarines and low fat dairy products. The ＂Traditional' pattern was positively associated with protein and zinc intake while the 'Processed' pattern was inversely associated. Both patterns were inversely associated with calcium intake. No associations were found between the 'Health conscious' pattern and macronutrients and key micronutrients intakes. The 'Traditional' pattern was positively associated with obesity but the association became non-significant after adjustment for energy and protein intake. No association was observed between the other two dietary patterns and weight status. Conclusions: In this cross-sectional study, dietary patterns were not associated with obesity. Longitudinal follow up will help to better understand the relationship between dietary patterns in early childhood and the risk of obesity later in life.