DIETARY PATTERNS IN ROMANIAN PATIENTS WITH TYPE 2 DIABETES MELLITUS
Abstract
Adherence to healthy dietary patterns leads to improvements in metabolic health and prevents the risk of diabetes and obesity. Current guidelines underscore the importance of focusing on individualized dietary patterns in nutritional therapy of diabetics. The objectives of this study were to identify the dietary patterns in Romanian patients with Type 2 Diabetes Mellitus and to investigate the impact of these dietary patterns on associated anthropometric and metabolic parameters. Material and methods: A total of 118 adults were included in this cross-sectional, observational study. Demographic and lifestyle data, information on current pathologies and associated co-morbidities, anthropometric measurements and biological markers were obtained. Dietary intake was assessed via the EPIC food frequency questionnaire. Results: We identified three dietary patterns by principal component analysis, defined as Prudent, Western and Traditional. We found that patients belonging to the Western pattern had higher waist-to-hip ratio, higher glycated hemoglobin A1c and were significantly younger compared to those in the Prudent pattern. Alcohol intake was significantly higher in the Western compared to the Prudent pattern. Conclusions: This study demonstrates that the Western pattern, characterized by high intake of meat and meat products, eggs and soft drinks, has negative metabolic consequences in Romanian adult patients with T2DM, compared to the Prudent pattern. The Traditional pattern was closer to the Prudent one.
References
2. Mota M, Popa SG, Mota E, et al. Prevalence of diabetes mellitus and prediabetes in the adult Romanian population: PREDATORR study. J Diabetes 2016; 8(3): 336-344 / doi: 10.1111/ 1753-0407. 12297.
3. Roman G, Bala C, Creteanu G, et al. Obesity and Health-Related Lifestyle Factors in the General Population in Romania: a Cross Sectional Study. Acta Endocrinologica (Bucharest) 2015; 11(1): 64-72 / doi: 10.4183/ aeb.2015.64.
4. Mihalache L, Graur LI; Popescu DS, Nita O, Graur M. Anthropometric parameters predictive factors for cardio-metabolic diseases. Rev Med Chir Soc Med Nat Iasi 2012; 116(3): 794-798.
5. Mihalache L, Gavril R, Arhire LI, et al. Nutritional biomarkers in patients with obesity-the relation between helicobacter pylori infection and micronutrients. Rev Chim 2016; 67: 2413-2416.
6. Trufa DI, Arhire LI, Grigorescu C, et al. Assessment of preoperative and postoperative prealbumin in thoracic surgery - a two-month experience in a Romanian university hospital / Evaluarea preoperatorie şi postoperatorie a prealbuminei în chirurgia toracică - experiența de 2 luni a unui spital universitar din România. Rev Romana Med Lab. 2015; 23(1): 75-86.
7. Gherasim A, Arhire LI, Niță O, Popa AD, Graur M, Mihalache L. The relationship between lifestyle components and dietary patterns. Proc Nutr Soc 2020; 79(3): 311-323.
8. Mozaffarian D, Appel LJ, Van Horn L. Components of a cardioprotective diet: new insights. Circula-tion 2011; 123(24): 2870-2891 / doi: 10.1161/CIRCULATIONAHA.110.968735.
9. Rodriguez-Monforte M, Flores-Mateo G, Sanchez E. Dietary patterns and CVD: a systematic review and meta-analysis of observational studies. Br J Nutr 2015; 114(9): 1341-1359 / doi: 10.1017/ S0007 114515003177.
10. Godos J, Zappala G, Bernardini S, Giambini I, Bes-Rastrollo M, Martinez-Gonzalez M. Adherence to the Mediterranean diet is inversely associated with metabolic syndrome occurrence: a meta-analysis of observational studies. Int J Food Sci Nutr 2017; 68(2): 138-148 / doi: 10.1080/09637486. 2016. 1221900.
11. Esposito K, Maiorino MI, Bellastella G, Panagiotakos DB, Giugliano D. Mediterranean diet for type 2 diabetes: cardiometabolic benefits.Endocrine 2017; 56(1): 27-32 / doi: 10.1007/s12020-016-1018-2.
12. American Diabetes Association. 5. Lifestyle Management: Standards of Medical Care in Diabetes-2019. Diabetes Care 2019; 42(Suppl 1): S46-S60 / doi: 10.2337/dc19-S005
13. Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; Na-tional Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; Inter-national Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009; 120(16): 1640-1645 / doi: 10.1161/ CIRCULATIO NAHA.109.192644.
14. World Health Organization Waist circumference and waist-hip ratio: report of a WHO expert consul-tation, Geneva, 8-11 December 2008.
15. Gherasim A Arhire LI, Niță O, Străteanu R, Oprescu AC, Graur M, Mihalache L. Can the EPIC food frequency questionnaire be applied to the population in Romania? Rev Med Chir Soc Med Nat Iasi 2015; 119(3): 856-863.
16. Mulligan AA, Luben RN, Bhaniani A, et al. A new tool for converting food frequency questionnaire data into nutrient and food group values: FETA research methods and availability. BMJ Open 2014; 4(3): e004503 / doi: 10.1136/bmjopen-2013-004503.
17. Gimeno SG, Andreoni S, Ferreira SR, Franco LJ, Cardoso MA. Assessing food dietary intakes in Japanese-Brazilians using factor analysis. Cad Saude Publica 2010; 26(11): 2157-2167 / doi: 10.1590/s0102-311x2010001100017.
18. Cheng L, Leung DY, Sit JW, et al. Factors associated with diet barriers in patients with poorly con-trolled type 2 diabetes. Patient Prefer Adherence 2016; 10: 37-44 / doi: 10.2147/ PPA.S94275.
19. Svensson A, Renstrom F, Bluck L, Lissner L, Franks PW, Larsson C. Dietary intake assessment in women with different weight and pregnancy status using a short questionnaire. Public Health Nutr 2014; 17(9): 1939-1948 / doi: 10.1017/S1368980013003042.
20. Fats and fatty acids in human nutrition. Report of an expert consultation 2010. FAO Food Nutr Pap 2010; 91: 1-166.
21. Hu FB, Rimm EB, Stampfer MJ, Ascherio A, Spiegelman D, Willett WC. Prospective study of major dietary patterns and risk of coronary heart disease in men. Am J Clin Nutr 2000; 72(4): 912-921 / doi: 10.1093/ajcn/72.4.912.
22. Hu FB. Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 2002; 13(1): 3-9 / doi: 10.1097/00041433-200202000-00002.
23. Drehmer M, Odegaard AO, Schmidt MI, et al. Brazilian dietary patterns and the dietary approaches to stop hypertension (DASH) diet-relationship with metabolic syndrome and newly diagnosed diabetes in the ELSA-Brasil study. Diabetol Metab Syndr 2017; 9: 13 / doi: 10.1186/s13098-017-0211-7.
24. Niu K, Momma H, Kobayashi Y, et al. The traditional Japanese dietary pattern and longitudinal changes in cardiovascular disease risk factors in apparently healthy Japanese adults. Eur J Nutr 2016; 55(1): 267-279 / doi: 10.1007/s00394-015-0844-y.
25. Marchioni DM, Latorre Mdo R, Eluf-Neto J, Wunsch-Filho V, Fisberg RM. Identification of dietary patterns using factor analysis in an epidemiological study in Sao Paulo. Sao Paulo Med J 2005; 123(3): 124-127 / doi: 10.1590/s1516-31802005000300007.
26. Stanhope KL, Schwarz JM, Keim NL, et al. Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. J Clin Invest 2009; 119(5): 1322-1334 / doi: 10.1172/JCI37385.
27. Jiang R, Manson JE, Stampfer MJ, Liu S, Willett WC, Hu FB. Nut and peanut butter consumption and risk of type 2 diabetes in women. JAMA 2002; 288(20): 2554-2560 / doi: 10.1001/jama.288.20.2 554.
28. Mizoue T, Yamaji T, Tabata S, et al. Dietary patterns and glucose tolerance abnormalities in Japanese men. J Nutr 2006; 136(5): 1352-1358 / doi: 10.1093/jn/136.5.1352
29. Dabbagh-Moghaddam A, Kamali M, Hojjati A, et al. The Relationship between Dietary Patterns with Blood Pressure in Iranian Army Staffs. Adv Biomed Res 2018; 7: 127 / doi: 10.4103/ abr.abr 35_18.
30. Imamura F, Micha R, Khatibzadeh S, et al. Dietary quality among men and women in 187 countries in 1990 and 2010: a systematic assessment. Lancet Glob Health 2015; 3(3): e132-e142 / doi: 10.1016/ s2214-109x(14)70381-x.
31. Wakimoto P, Block G. Dietary intake, dietary patterns, and changes with age: an epidemiological perspective. J Gerontol A Biol Sci Med Sci 2001; 56 (Spec No 2): 65-80 / doi: 10.1093/ gerona/56. Suppl 2.65.
32. Wall CL, Gearry RB, Pearson J, Parnell W, Skidmore PM. Dietary intake in midlife and associations with standard of living, education and nutrition literacy. NZ Med J 2014; 127(1397): 30-40.
33. Martikainen P, Brunner E, Marmot M. Socioeconomic differences in dietary patterns among middle-aged men and women. Soc SciMed 2003; 56(7): 1397-410 / doi: 10.1016/s0277-9536(02)00137-5.
34. Graur M. Ghid pentru alimentația sănătoasă. Iasi: Performantica, 2006.
35. Roman G, Rusu A, Graur M, et al. Dietary Patterns and Their Association with Obesity: A Cross-Sectional Study. Acta Endocrinol (Buchar) 2019; 5(1): 86-95 / doi: 10.4183/ aeb.2019.86.
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