Pravilna prehrana iznimno je važna u prevenciji šećerne bolesti i regulaciji glikemije. Šećerna bolest ubraja se u kategoriju bolesti koje se uspješno mogu prevenirati, dobro liječiti te im se može ...spriječiti ili odgoditi razvoj kroničnih komplikacija. Edukacija o pravilnoj prehrani treba biti individualno prilagođena, pri čemu treba obratiti pozornost na dob bolesnika, način života, socioekonomski status, tjelesnu aktivnost i komplikacije vezane uz šećernu bolest. Kod šećerne bolesti promjena životnih navika, što uključuje pravilnu prehranu, redovitu tjelesnu aktivnost i regulaciju tjelesne mase, može uvelike pridonijeti regulaciji glikemije, a u tipu 2 u nekim slučajevima može dovesti i do njene remisije. Smjernice su rezultat suradnje zdravstvenih stručnjaka koji sudjeluju u liječenju i edukaciji osoba koje boluju od šećerne bolesti. Utemeljene su na dokazima, prema metodologiji GRADE (engl. grading of recommendations, assessment, development and evaluation) koja uz snagu dokaza opisuje i razinu preporuke. Temeljni zaključci ovih smjernica odnose se na procjenu nutritivnih potreba te primjenu medicinske nutritivne terapije, individualno prilagođene osobama sa šećernom bolešću kao i onima koji imaju i neke od
vezanih komorbiditeta.
Although the role of vitamin D is well known, the possibility of assessing its intake may be constricted in countries with no vitamin D data in food composition tables, as in the case of Croatia. The ...aim of the presented study was to adjust the VIDEO-FFQ (Vitamin D Estimation Only-Food Frequency Questionnaire), previously validated in Poland, to the Croatian population and to assess the validity and reproducibility of the adjusted Cro-VIDEO-FFQ (Croatian-VIDEO-FFQ). The study involved a group of Croatian women aged 20⁻30 and the Polish questionnaire was adjusted for a population due to similarities of the nutritional habits between countries. 106 individuals were recruited and 63 completed all the stages of the study. Participants conducted a 3-day dietary record and filled out the Cro-VIDEO-FFQ1 (first stage), as well as the same questionnaire (Cro-VIDEO-FFQ2) 6 weeks after (second stage). The following vitamin D intakes were observed in the studied group: 1.9 µg (0.2⁻8.0 µg) for 3-day dietary record, 3.3 µg (1.1⁻10.6 µg) for Cro-VIDEO-FFQ1, 3.6 µg (1.4⁻7.8 µg) for Cro-VIDEO-FFQ2. The Bland-Altman indexes in assessment of validity and reproducibility were 4.8% and 6.3%, respectively, with mean differences of 0.55 µg and 0.12 µg, as well as limits of agreement -0.91⁻2.01 µg and -0.44⁻0.69 µg. The kappa coefficient indicated a fair agreement for validity (0.21) and substantial for reproducibility (0.62), while correlations were significant (
= 0.0027,
= 0.37 for validity;
< 0.0001,
= 0.80 for reproducibility). It was observed that VIDEO-FFQ may be adjusted as a simple tool to assess vitamin D intake in a population with no vitamin D data in food composition tables, while Cro-VIDEO-FFQ may be a valid tool for nutritional assessment in Croatia.
The increase in childhood obesity is one of the biggest public health problems of the 21st century. Among the contributing dietary factors is the high consumption of sugar-sweetened beverages (SSB) ...and sweetened fruit juices (SFJ). On the other hand, regular consumption of milk and dairy products has decreased in many countries over the years, although research has shown an inverse association between dairy consumption and obesity. The aim of this study was to determine the effects of a dietary intervention within a multidisciplinary structured programme on reducing the consumption of SSB and SFJ and simultaneously increasing the consumption of milk and diary products in obese children/adolescents. The study included 100 participants of both sexes who had been diagnosed with obesity and participated in a five-day multidisciplinary structured programme focused on dietary intrevention. Standard anthropometric measurements and a validated questionnaire were used during the study. The mean age of the participants was 12.61±1.90 years, body mass index (BMI) was 98.38±1.26 percentiles; mean consumption of SSB was 1.68 ± 2.89 dL; SFJ was 3.72±5.09 dL and milk and dairy products was 3.10±2.35 dL per day at the start of the intervention. After the five-day programme, patients were reeducated once a month for the first six months, then every two months for up to 24 months. After 24 months, a significant decrease in SSB and SFJ intake (p<0.001) and an increase in milk and dairy products intake (p=0.002) were observed. The percentiles of the BMI also decreased after 24 months (p<0.001). The dietary intervention had a positive effect on the anthropometric values and the change in the dietary habits of the participants, with a focus on the consumption of milk and dairy products.
Abstract
Background and Aims
Malnutrition is a usually observed condition among patients on hemodialysis (HD) and is considered one of studiest indicators of mortality and morbidity. Malnutrition ...inflammation score (MIS) is associated with inflammation, nutritional status, quality of life, and 5-year prospective mortality. Also, phase angle (PhA) measured by bioelectrical impedance analysis (BIA) has been studied as indicator of nutritional status or muscle function in HD patients and lower PhA was associated with a greater risk of malnutrition. The aims of this study are to analyze the prevalence of malnutrition in hemodialysis (HD) patients in Croatia using MIS, and to assess the association of MIS and PhA with body mass composition, sociodemographic characteristics and laboratory parameters related to HD.
Method
166 HD patients aged 68.5 (58.8-76) years, 55 women (33%) and 111 (67%) men with mean HD duration of 4 (2-6) years from 6 HD center were included in this study. For each study participant, data about body composition measured with BIA, laboratory, sociodemographic and clinical parameters were obtained. Also, body mass index (BMI) was calculated, and the Malnutrition Inflammation Score (MIS) used to assess nutritional status.
Results
Using an MIS cut-off point of 5 for malnutrition, 53% of patients were malnourished (MIS≥5). Therefore, those malnourished HD patients were significantly older (p = 0.001), with longer HD duration (p = 0.002), lower residual renal function (p = 0.02), waist circumference (p = 0.001), BMI (p < 0.001), muscle (p = 0.002) and fat mass (p = 0.001) in kg, phase angle PhA (p < 0.001), serum creatinine (p = 0.002), albumin (p = 0.008), phosphate (p = 0.01), and urate (p = 0.008) level but have significantly higher ferritin (p = 0.004), and mean cellular volume level (p = 0.02). Therefore, total MIS score significantly negatively correlated with HD duration (r = −0.247, p < 0.001), waist circumference (r = −0.323, p < 0.001),muscle mass (r = −0.236, p < 0.001), fat mass (r = −0.352, p < 0.001), serum creatinine (r = −0.271, p < 0.001), phosphor (r = −0.245, p < 0.001), urate (r = −0.344, p < 0.001), and TIBC (r = −0.376, p < 0.001), albumin (r = 0.241, p < 0.001), ferritin (r = 0.273, p < 0.001). In contrast, PhA significantly positively correlated with muscle mass (kg) (r = 0.311, p < 0.001), creatinine (r = 0.313, p < 0.001), phosphate (r = 0.208, p = 0.01), urate (r = 0.305, p = 0.01) and Total Iron Binding Capacity (TIBC) (r = 0.245, p < 0.001) while significantly negative correlation with ferritin (r = −0.182, p = 0.03) was found. Also, there was a significant negative correlation between PhA and MIS (r = −0.362, p < 0.001). A multivariate regression analysis showed that age (ß = 0.09, p = 0.005), waist circumference (ß = −0.09, p = 0.004), serum albumin (ß = −0.23, p = 0.04), and urate (ß = −0.01, p = 0.02), were predictive factors for malnutrition.
Conclusion
The prevalence of malnutrition in HD patients in Croatian HD population was high. These results indicate and highlight the urgent need for individualized and structural nutritional screening (using MIS score and PhA) and nutritional support in Croatian HD patients, especially for older HD patients and those with longer HD duration.
: Obesity in children and adolescents results in a number of serious health-related consequences necessitating early treatment. Support from family members and family-focused lifestyle interventions ...can improve effectiveness of the treatment. The aim of the study was to assess the effects of parental characteristics and family-based dietary habits on the adherence and success of a body mass reduction program in children with obesity included in a lifestyle intervention program after 1 year.
: The program included dietetic, psychosocial, and endocrine counseling given to individuals either alone or in groups and was conducted by a multidisciplinary team (consisting of endocrinologists, nurses, psychologists, social counselors, dietitians, and physiotherapists). A total of 113 children aged 10-17 years (mean age 12.9 ± 2.0; 60 girls, 53 boys) were included in the program. After 1 year of participation, the rate of adherence and success were assessed. The effect of the participants' general characteristics, including anthropometric data, as well as parental characteristics (marital status, employment, education, body mass index (BMI), duration of breastfeeding) and the circumstances of meal consumption (eating at home or outside, fast food consumption), was analyzed.
: The most important factors predicting body mass reduction success were baseline BMI (
< 0.0001) and waist-hip ratio (WHR) (
= 0.04), but they did not predict body mass reduction adherence.
: The meal consumption habits and support from family members may be among the determinants of adherence to a body mass reduction program for preadolescents and adolescents with obesity. However, the results of the presented study suggested that baseline BMI and WHR are the most important determinants of the body mass reduction success.
In Poland and Croatia, similarly as for a number of European countries, anemia and osteoporosis are common diet-related diseases in women, while for both the proper nutritional behaviors and ...preventive education are crucial. However, for the proper nutritional education there are some barriers, including those associated with an educator, his own nutritional behaviors and beliefs. The aim of the study was to assess the dietary health risk factors for women in the Polish and Croatian population based on the nutritional behaviors of junior health professionals. The study was conducted in Polish (n = 70) and Croatian (n = 80) female students of the faculties associated with public health at the universities in capital cities. Their diets were assessed based on 3-day dietary records. Nutritional value and consumption of food products, as well as the dietary risk factors for anemia and osteoporosis, were compared. While assessing the risk factors for anemia, in the Polish group, the higher intake of iron and folate, as well as vitamin B12 per 1000 kcal, was observed; and for folate, the higher frequency of inadequate intake was stated for Croatian women. While assessing the risk factors for osteoporosis, in the Polish group, compared with the Croatian, the higher intake of calcium per 1000 kcal was observed, but for vitamin D, there were no differences. Differences of the intake between the Polish and the Croatian group of junior health professionals may result in various dietary health risks for women. Based on the assessment of dietary intake, for anemia, compared to Polish women, a higher risk may be indicated for Croatian women, but for osteoporosis, similar risks may be indicated for Polish and Croatian women. Therefore, for public health, adequate nutritional education of junior health professionals is necessary.
Recent meta-analysis shows that adherence to a Mediterranean diet (MD) can significantly decrease the risk of overall mortality, mortality from cardiovascular diseases, as well as incidence of ...mortality from cancer, and incidence of Parkinson's and Alzheimer's disease. All of these diseases could be linked to oxidative stress (OS) as antioxidative effect of MD is getting more attention nowadays. Although a lot of research has been done in this area and it suggests antioxidative protective role of MD, the presented evidence is still inconclusive. The aim of this paper is to review studies investigating the effect of MD on OS, as well as to identify the areas for further research.
Nasljedna nepodnošljivost fruktoze ili fruktozemija je autosomno recesivno nasljedni poremećaj koji nastaje zbog nedostatne aktiv- nosti enzima fruktoza-1-fosfat aldolaze (aldolaze B). Bolest se ...klinički, u dotad naizgled zdravog dojenčeta, očituje nakon uvođenja namirnica koje sadrže fruktozu, saharozu ili sorbitol. Najčešći simptomi bolesti su povraćanje, bljedilo, drhtavica, somnolencija, a katkad i konvulzije (većinom kao posljedica hipoglikemije, odnosno neuroglikopenije). Može se razviti i akutno zatajenje jetre, a ako se dijete pravilno ne zbrine, takva kriza može završiti smrću. Pošto se fruktoza, saharoza i sorbitol isključe iz prehrane, simptomi bolesti se brzo i spontano povlače. Ako bolest ostane neprepoznata, dugoročno može uzrokovati ponavljajuće bolove u trbuhu, povraćanje, kroničnu bolest jetre, tubulopatiju, rahitis te zaostajanje u rastu i razvoju. Anamnestički podatci o pojavi simptoma nakon uvođenja voća i povrća u dohranu i/ili odbojnost prema slatkoj hrani ključni su za postavljanje sumnje na ovu bolest. Labo- ratorijski nalazi koji podupiru dijagnozu, a česti su u akutnom pogoršanju, su hipoglikemija, hipofosfatemija, hiperuricemija, meta- bolička acidoza i povišene aktivnosti aminotransferaza. Dijagnoza se potvrđuje nalazom bialelnih patogenih mutacija gena ALDOB ili mjerenjem aktivnosti enzima u tkivu jetre ili crijeva, što se danas rjeđe primjenjuje. Pravodobno postavljanje dijagnoze ključno je za dobar ishod. Ako se spriječi unos fruktoze u organizam, prognoza je izvrsna. Cilj ovog rada je predočiti klinička obilježja nasljedne nepodnošljivosti fruktoze prikazom dvoje bolesnika, jednog s akutnim, a drugog sa subakutnim kliničkim tijekom, te tako upozoriti na ovu rijetku, a lječivu nasljednu metaboličku bolest.
Glycemic index in diabetes Rahelić, Dario; Jenkins, Alexandra; Bozikov, Velimir ...
Collegium antropologicum,
12/2011, Volume:
35, Issue:
4
Journal Article
Peer reviewed
Open access
The Glycemic Index (GI) is a rating system that ranks carbohydrate-containing foods according to their postprandial blood glucose response relative to the same quantity of available carbohydrate of a ...standard such as white bread or glucose. The concept of GI was first introduced in the early 80's by Jenkins and coworkers. Since then, numerous trials have been undertaken, many indicating benefits of a low GI diet on glycemic control, as well as lipid profiles, insulin and C-peptide levels, inflammatory and thrombolytic factors, endothelial function and regulation of body weight. As a result, a low-GI diet may prevent or delay the vascular complications of diabetes. However, despite many studies supporting the benefits of the Glycemic Index as part of the treatment of diabetes mellitus, several areas of controversy have been raised in the literature and are addressed here. Clinicians treating diabetic patients should be aware of the potential benefits of low-GI foods in the prevention and treatment of diabetes and its complications.
Cistična fibroza najčešća je nasljedna bolest, koja skraćuje životni vijek, a uzrokuje je defekt u genu za transmembranski regulator provodljivosti cistične fibroze (eng. cystic fibrosis ...transmembrane regulator – CFTR). Poremećena je homeostaza elektrolita, što se očituje simptomima u više organskih sustava. Plućne manifestacije, s kroničnim infekcijama, upalom i, na kraju, respiratornim zatajenjem, ostaju i dalje najvažnija prijetnja životnom vijeku bolesnika. Do prije jednog desetljeća bilo je dostupno samo simptomatsko liječenje. Od 2012. g. dostupno
je liječenje tzv. modulatorima CFTR-proteina i njihovim kombinacijama za osobe s cističnom fibrozom koje nose različite varijante CFTR-gena. Pojavom tih lijekova uvelike se promijenila perspektiva i kvaliteta života ljudi s cističnom fibrozom, ali postavljeni i novi izazovi u vezi s dugoročnim komplikacijama, pitanje eventualnog smanjenja konvencionalnog liječenja, ali i financiranja terapije, koja je mnogim bolesnicima nedostupna. Iznesene su bazične spoznaje o cističnoj fibrozi i funkciji CFTR-proteina, klasifikaciji varijanata CFTR-gena, mogućnostima liječenja CFTR-modulatorima te osnovni ishodi liječenja bolesnika s cističnom fibrozom u Hrvatskoj, gdje se ta terapija primjenjuje od jeseni 2021. godine.
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