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PubMed2006

ALIFE@Work: a randomised controlled trial of a distance counselling lifestyle programme for weight control among an overweight working population [ISRCTN04265725].

BACKGROUND: The prevalence of overweight is increasing and its consequences will cause a major public health burden in the near future. Cost-effective interventions for weight control among the general population are therefore needed. The ALIFE@Work study is investigating a novel lifestyle intervention, aimed at the working population, with individual counselling through either phone or e-mail. This article describes the design of the study and the participant flow up to and including randomisation. METHODS/DESIGN: ALIFE@Work is a controlled trial, with randomisation to three arms: a control group, a phone based intervention group and an internet based intervention group. The intervention takes six months and is based on a cognitive behavioural approach, addressing physical activity and diet. It consists of 10 lessons with feedback from a personal counsellor, either by phone or e-mail, between each lesson. Lessons contain educational content combined with behaviour change strategies. Assignments in each lesson teach the participant to apply these strategies to every day life. The study population consists of employees from seven Dutch companies. The most important inclusion criteria are having a body mass index (BMI) > or = 25 kg/m2 and being an employed adult. Primary outcomes of the study are body weight and BMI, diet and physical activity. Other outcomes are: perceived health; empowerment; stage of change and self-efficacy concerning weight control, physical activity and eating habits; work performance/productivity; waist circumference, sum of skin folds, blood pressure, total blood cholesterol level and aerobic fitness. A cost-utility- and a cost-effectiveness analysis will be performed as well. Physiological outcomes are measured at baseline and after six and 24 months. Other outcomes are measured by questionnaire at baseline and after six, 12, 18 and 24 months. Statistical analyses for short term (six month) results are performed with multiple linear regression. Analyses for long term (two year) results are performed with multiple longitudinal regression. Analyses for cost-effectiveness and cost-utility are done at one and two years, using bootstrapping techniques. DISCUSSION: ALIFE@Work will make a substantial contribution to the development of cost-effective weight control- and lifestyle interventions that are applicable to and attractive for the large population at risk.

Adult↗

PubMed2003

[Determinants of exercise capacity in hypertensive patients].

An impaired exercise capacity is common in hypertensive patients (pts) and factors affecting exercise capacity are not completely elucidated. The aim of the study was to investigate factors influencing exercise capacity in hypertensive pts Studied group consisted of 41 pts (18 males, 23 females) mean age 54.2 +/- 11.9 with essential hypertension and without coronary artery disease. Each patient underwent an echocardiographic examination followed by treadmill exercise test. Echocardiographic assessment comprised estimation of left ventricular (LV) mass index (LVMI), pattern of LV geometry, ejection fraction (LVEF), fractional shortening (LVFS), peak and integral velocities of early (E, Ei) and late (A, Ai) transmitral flow, deceleration time of E wave (DT), isovolumic relaxation time (IVRT), duration of A wave (A-dur), total ejection isovolume index (TEI), E (ETT) and A (ATT) wave transit time to the LV outflow tract, flow propagation velocity of E wave (EP), peak and integral velocities of systolic (S, Si), diastolic (D, Di) and atrial reversal (AR, ARi) pulmonary venous flow, duration of AR wave (AR-dur), acceleration (SAT) and deceleration (SDT) of systolic pulmonary venous flow, systolic forward fraction of pulmonary venous flow (SFF). Exercise capacity was assessed by exercise time and total workload expressed in MET. Significant correlations were found for MET and: age (r = -0.49, p < 0.001), A (r = -0.62, p < 0.001), E/A ratio (r = 0.55, p < 0.004), Di (r = 0.55), p < 0.004), ARi (r = -0.38, p < 0.01), SFF (r = 0.46, p < 0.002). Exercise time correlated with A (r = -0.61, p < 0.001), E/A ratio (r = 0.41, p < 0.04), Di (r = 0.51, p < 0.009), ARi (r = -0.35, p < 0.02), SFF (r = -0.51, p < 0.008), S/D ratio (r = -0.47, p < 0.01). Other investigated parameters did not correlate with both MET and exercise time. By stepwise multiple linear regression analysis Di and ARi were the only determinants of MET (multiple r = 0.85, p < 0.0001) whereas A and Di turn out to be the only independent predictors of exercise time (multiple r = 0.76, p < 0.0004). In hypertensive pts: 1. diastolic function of LV is a principle determinant of exercise capacity, 2. integral velocity of diastolic and atrial reversal pulmonary venous flow and peak velocity of late transmitral flow are the best predictors of exercise tolerance.

Body Mass Index↗

PubMed1993

A mathematical model for cell killing by heat applied to a C3H mammary carcinoma in vivo.

Jung (1986) has proposed a mathematical model for cell killing by hyperthermia which assumes that heat killing involves two steps: the production (p) of non-lethal lesions at random and a subsequent conversion (c) into lethal lesions. The p & c model has been shown to predict the survival of CHO cells heated in vitro even when complicated biological phenomena such as thermotolerance and step-down heating (SDH) are involved (Jung 1986, 1991). In the present study the objective was to test the p & c model's ability to describe the effect of single heating and SDH in an experimental tumour in vivo. The endpoint was tumour growth delay (GD). The doubling times (DT) for untreated and heated tumours were similar, and the surviving fraction (SF) could therefore be estimated using: SF = -in(2).GD/DT. SF was fitted to the model by non-linear regression. The p & c model adequately described the GD obtained by SDH (39-44.5 degrees C) and single heating above 42.5 degrees C. Multiple linear regression showed that the residuals for single heating and SDH were independent of both heating time and temperature. However, the residuals for single heating (41-44.5 degrees C) were significantly correlated to heating time when analysed separately. The GD obtained by the use of extended single heating times at or below 42.5 degrees C was therefore overestimated by the model. Development of chronic thermotolerance during heating may account for the observed divergence. The Arrhenius plots for both p and c were log-linear with activation energies of 678 and 311 kJ/mol, respectively. Jung (1986) has previously reported similar p and c activation energies above 42.5 degrees C for CHO cells in vitro.

Animals↗

PubMedDate not supplied

Quantifying scatter in Shack-Hartmann images to evaluate nuclear cataract.

PURPOSE: Quantify and localize lenticular forward scatter using Shack-Hartmann wavefront sensing (SHWS) as single-valued metrics and a scatter map, and to examine the relationships between forward scatter and backscatter metrics and visual acuity. METHODS: We obtained SHWS images from 148 patients in the Texas Investigation of Cataract Optics study. Patient age was 22 to 84 years, with Lens Opacities Classification System III (LOCS III) nuclear opalescence (NO) scores ranging from 0.8 to 5.6. Visual acuities were measured at photopic (280 cd/m2) high (VA(PHC)) and low contrast (VA(PLC)) and mesopic (0.75 cd/m2) high (VA(MHC)) and low contrast (VA(MLC)). Scattering was described in a scatter map and by five single-valued metrics characterizing SHWS lenslet point spread functions. The relationships between scatter and visual acuity were tested using linear regression. RESULTS: Visual acuities decreased proportional to both LOCS III NO (R2=up to 39%) and scatter metrics (R2=up to 21%). Stepwise multiple linear regression improved visual acuity prediction by including a backscatter and a forward scatter metric (R2 up to 51.2%). For the subjects over age 60 years (N=46, 68.8+/-6.12 years), the forward scatter metrics explain as much variance in visual acuities (R2=up to 29%) as LOCS III NO (R2=up to 26%). Combined they accounted for up to 48.8% of visual acuity variance. CONCLUSION: Forward light scatter can be quantified using SHWS and the resulting metrics explain significant variance in visual acuity, especially in the aging eye. Together with a backscatter metric they explain approximately 50% of the variance in VA.

Adult↗

PubMed2003

Primer on multiple regression models for diagnostic imaging research.

This article provides an introduction to multiple regression analysis and its application in diagnostic imaging research. We begin by examining why multiple regression models are needed in the evaluation of diagnostic imaging technologies. We then examine the broad categories of available models, notably multiple linear regression models for continuous outcomes and logistic regression models for binary outcomes. The purpose of this article is to elucidate the scientific logic, meaning, and interpretation of multiple regression models by using examples from the diagnostic imaging literature.

Confounding Factors, Epidemiologic↗

PubMed1993

Epidemiology of cardiovascular disease risk factors in Catalonia (Spain).

Cardiovascular disease is one of the most important public health problems in developed countries. We have studied the epidemiology of the following cardiovascular disease risk factors in a random sample (n = 704) of the adult population of Catalonia (Spain): hypercholesterolemia (> or = 6.1) mmol/l or 240 mg/dl), hypertension (SBP > or = 160 and/or DBP > or = 95 mmHg), low HDL-cholesterol concentrations (< 0.9 mmol/l or 35 mg/dl), hypertriglyceridemia (> 2.8 mmol/l or 250 mg/dl), obesity (BMI > 30), smoking and history of diabetes and coronary heart disease. Two percent of participants had hypertriglyceridemia, 3% had a history of coronary heart disease, 4% a history of diabetes, 6% low HDL-cholesterol concentrations, 12% were obese, 20% had hypertension, 24% had hypercholesterolemia and 36% were smokers. 58% of hypertensive individuals had been previously detected, 46% were currently on treatment, and 21% had their blood pressure controlled (SBP < 160 and DBP < 95 mmHg). Correlation and multiple regression analyses were used to investigate the association between cardiovascular risk factors. Multiple linear regression analysis showed independent correlations between risk factors. Prevalence of hypercholesterolemia, obesity and diabetes was higher and prevalence of smoking was lower in hypertensives than normotensives. The odds ratio was 3.68 (95% CI = 2.07-6.54) for hypercholesterolemia, 3.26 (95% CI = 1.52-7.02) for obesity, 3.81 (95% CI = 1.09-7.02) for diabetes and 0.40 (95% CI = 0.22-0.70) for smoking. The adjusted odds ratio was statistically significant for hypercholesterolemia (OR = 2.74, 95% CI = 1.01-3.75). The prevalence of cardiovascular risk factors was similar to that observed in other Mediterranean communities.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed2002

Correlates of bone mineral density in elderly women living in nursing homes for the disabled in Japan.

BACKGROUND AND AIMS: Characteristics of bone aging in the institutionalized elderly are not well known. The aim of this study was to determine the factors correlated with the forearm bone mineral density (BMD) in elderly women with disability. METHODS: Of 175 female residents living in nursing homes for the disabled in Niigata, Japan, 119 agreed to participate and underwent medical examinations in 1999; 107 (age range, 66-100) met our inclusion criteria. We measured forearm BMD by dual-energy X-ray absorptiometry (DXA), and the serum concentrations of 25-hydroxyvitamin D3, 1,25-dihydroxyvitamin D3, intact parathyroid hormone, albumin, total protein, and creatinine. Body weight, score of activities of daily living, and history of femoral neck fractures were also recorded. RESULTS: Forearm BMD decreased with age, and the regression equation was BMD=0.9035exp (-0.0179Age) (R2=0.170, p<0.0001). Multiple linear regression analysis revealed that only age (R2=0.178, p<0.0001), and serum creatinine (R2=0.153, p<0.0001) and albumin (R2=0.051, p=0.005) concentrations were independently associated with log-BMD. Twenty-five of the 107 subjects had a history of femoral neck fracture, and only serum albumin concentration (p=0.031) was shown to be associated with fracture history. CONCLUSIONS: Forearm BMD was associated with age, serum creatinine and albumin, which may be useful parameters for assessing the bone health of elderly women with disability.

Activities of Daily Living↗

PubMed2006

The effect of tobacco consumption and body mass index on complications and hospital stay after inguinal hernia surgery.

BACKGROUND: The extent to which lifestyle factors such as tobacco consumption and obesity affect the outcome after inguinal hernia surgery has been poorly studied. This study was undertaken to assess the effect of smoking, smokeless tobacco consumption and obesity on postoperative complications after inguinal hernia surgery. The second aim was to evaluate the effect of tobacco consumption and obesity on the length of hospital stay. METHODS: A cohort of 12,697 Swedish construction workers with prospectively collected exposure data on tobacco consumption and body mass index (BMI) from 1968 onward were linked to the Swedish inpatient register. Information on inguinal hernia procedures was collected from the inpatient register. Any postoperative complication occurring within 30 days was registered. In addition to this, the length of hospitalization was calculated. The risk of postoperative complications due to tobacco exposure and BMI was estimated using a multiple logistic regression model and the length of hospital stay was estimated in a multiple linear regression model. RESULTS: After adjusting for the other covariates in the multivariate analysis, current smokers had a 34% (OR 1.34, 95% CI 1.04, 1.72) increased risk of postoperative complications compared to never smokers. Use of "Swedish oral moist snuff" (snus) and pack-years of tobacco smoking were not found to be significantly associated with an increased risk of postoperative complications. BMI was found to be significantly associated with an increased risk of postoperative complications (P = 0.04). This effect was mediated by the underweighted group (OR 2.94; 95% CI 1.15, 7.51). In a multivariable model, increased BMI was also found to be significantly associated with an increased mean length of hospital stay (P < 0.001). There was no statistically significant association between smoking or using snus, and the mean length of hospitalization after adjusting for the other covariates in the model. CONCLUSION: Smoking increases the risk of postoperative complications even in minor surgery such as inguinal hernia procedures. Obesity increases hospitalization after inguinal hernia surgery. The Swedish version of oral moist tobacco, snus, does not seem to affect the complication rate after hernia surgery at all.

Adolescent↗

PubMed1988

Hemorrhagic complications associated with the use of intravenous tissue plasminogen activator in treatment of acute myocardial infarction.

PURPOSE: Little attention has been paid to the importance of clinical factors associated with bleeding complications caused by the use of thrombolytic agents. The goal of our study was to examine clinical and hematologic factors associated with an increased risk of bleeding in a prospectively observed population that received intravenous tissue plasminogen activator for acute myocardial infarction. PATIENTS AND METHODS: Bleeding complications were evaluated in 386 consecutive patients treated with 150 mg of tissue plasminogen activator over six to eight hours for acute myocardial infarction. All patients also underwent immediate cardiac catheterization. RESULTS: Quantitation of blood loss during the patients' hospital stay included a median drop in hematocrit of 11.4 points, a median nadir hematocrit of 31.2, a 14 percent rate of significant clinically evident bleeding, and a 31 percent rate of transfusion of two or more units of blood. All of these parameters were much more severe in patients treated with coronary artery bypass surgery. Access site hematoma was the most common source of bleeding (45 percent of patients), whereas 8 percent had gastrointestinal bleeding, two patients had retroperitoneal bleeding, and two patients had intracranial bleeding. The median nadir fibrinogen was 1.3 g/liter. Multiple linear regression models were used to investigate the relationship between clinical variables, including multiple hematologic measurements, and measures of the amount of blood loss. The use of coronary artery bypass grafting was the variable most closely associated with hemorrhage. Other invasive procedures (angioplasty and intra-aortic balloon pumping) were also associated with increased bleeding. Among the patient descriptors examined, lighter weight, older age, female sex, and history of hypertension were associated with greater blood loss. Of laboratory coagulation parameters, only nadir fibrinogen levels were significantly associated with more bleeding. CONCLUSION: Careful clinical evaluation may improve assessment of the risk/benefit ratio of thrombolytic therapy.

Age Factors↗

PubMed2004

High circulating vascular endothelial growth factor (VEGF) is related to a better systolic function in diabetic hypertensive patients.

BACKGROUND: VEGF seems to have a protective role on cardiac microcirculation, but no data are available on its action on cardiac function and morphology in diabetic patients. We sought to test the hypothesis that circulating VEGF levels could influence the cardiac performance in type 2 diabetic hypertensive patients. METHODS: We studied 30 patients with type 2 diabetes and hypertension, without severe cardiac, retinal, renal and peripheral vascular damage. Ten non-diabetic hypertensive patients represented the control group. VEGF plasma levels (ELISA) and echocardiographic parameters were evaluated. RESULTS: Diabetic patients had VEGF plasma levels higher than hypertensive non-diabetic subjects [median 82 (IQR 12-190) vs 50.5 (IQR 28-77) pg/mL, p=0.05]. Simple linear regression analysis showed that VEGF levels are related to relative wall thickness (RWT) and both endocardial and midwall systolic parameters in the diabetic patients. Multiple linear regression analysis showed that RWT and ejection fraction (EF) were the only independent correlates of VEGF (r2=0.274, p=0.03, p=0.05; respectively). CONCLUSIONS: Our data showed that high VEGF plasma levels are associated to a better systolic function in diabetic hypertensive patients with cardiac remodeling. VEGF may play a role in the improvement of cardiac performance in diabetes.

Blood Pressure↗

PubMed1991

Prediction of gas chromatographic relative retention times of anabolic steroids.

The prediction of gas chromatographic relative retention times (RRTs) of anabolic steroids, used in the doping control of athletes, was performed by a quantitative structure-retention relationship (QSRR) and multiple linear regression analysis study. A nine-variable model was generated with a multiple correlation coefficient R = 0.991 and relative standard error of less than 3%. Preliminary results indicated that the application of the model, especially in the prediction of RRTs of metabolites of the anabolic steroids, will be helpful.

Anabolic Agents↗

PubMed2003

INTERMAP: background, aims, design, methods, and descriptive statistics (nondietary).

Blood pressure (BP) above optimal (< or =120/< or =80 mmHg) is established as a major cardiovascular disease (CVD) risk factor. Prevalence of adverse BP is high in most adult populations; until recently research has been sparse on reasons for this. Since the 1980s, epidemiologic studies confirmed that salt, alcohol intake, and body mass relate directly to BP; dietary potassium, inversely. Several other nutrients also probably influence BP. The DASH feeding trials demonstrated that with the multiple modifications in the DASH combination diet, SBP/DBP (SBP: systolic blood pressure, DBP: diastolic blood pressure) was sizably reduced, independent of calorie balance, alcohol intake, and BP reduction with decreased dietary salt. A key challenge for research is to elucidate specific nutrients accounting for this effect. The general aim of the study was to clarify influences of multiple nutrients on SBP/DBP of individuals over and above effects of Na, K, alcohol, and body mass. Specific aims were, in a cross-sectional epidemiologic study of 4680 men and women aged 40-59 years from 17 diverse population samples in China, Japan, UK, and USA, test 10 prior hypotheses on relations of macronutrients to SBP/DBP and on role of dietary factors in inverse associations of education with BP; test four related subgroup hypotheses; explore associations with SBP/DBP of multiple other nutrients, urinary metabolites, and foods. For these purposes, for all 4680 participants, with standardized high-quality methods, assess individual intake of 76 nutrients from four 24-h dietary recalls/person; measure in two timed 24-h urine collections/person 24-h excretion of Na, K, Ca, Mg, creatinine, amino acids; microalbuminuria; multiple nutrients and metabolites by nuclear magnetic resonance and high-pressure liquid chromatography. Based on eight SBP/DBP measurements/person, and data on multiple possible confounders, utilize mainly multiple linear regression and quantile analyses to test prior hypotheses and explore relations of multiple dietary and urinary variables to SBP/DBP of individuals. The 4680 INTERMAP participants are equally divided across four age/gender strata: diverse in ethnicity, education, occupation, physical activity; use of cigarettes, alcohol; diagnosed high BP, CVD, diabetes; CVD family history; women vary in parity, use of contraceptive medication and hormone replacement therapy.

Blood Pressure↗

PubMed2002

Estimation of second order rate constants using chemometric methods with kinetic constraints.

Several methods are described for determining rate constants for second order reactions of the form U + V --> W using chemometrics and hard modelling to analyse UV absorption spectroscopic data, where all species absorb with comparable concentrations and extinctions. An interesting feature of this type of reaction is that the number of steps in the reaction is less than the number of absorbing species, resulting in a rank-deficient response matrix. This can cause problems when using some of the methods described in the literature. The approaches discussed in the paper depend, in part, on what knowledge is available about the system, including the spectra of the reactants and product, the initial concentrations and the exact kinetics. Sometimes some of this information may not be available or may be hard to estimate. Five groups of methods are discussed, namely use of multiple linear regression to obtain concentration profiles and fit kinetics information, rank augmentation using multiple batch runs, difference spectra based approaches, mixed spectral approaches which treat the reaction as two independent pseudospecies, and principal components regression. Two datasets are simulated, one where the spectra are quite different and the other where the spectrum of one reactant and the product share a high degree of overlap. Three sources of error are considered, namely sampling error, instrumental noise and errors in initial concentrations. The relative merits of each method are discussed.

Journal Article↗

PubMedDate not supplied

Age and height as predictors of peak expiratory flow rate in Indian girls.

Peak expiratory flow rate (PEF) was measured on 175 healthy Indian girls in the age range 8-18 years with the help of Wright's Peak Flow Meter. PEF was recorded in the post absorptive phase at least 1 h after breakfast. The subjects rested for 0.5 h before the test procedure and tests were carried out between 1000-11000 hrs to avoid diurnal changes. The highest of three recordings was noted as the subject's PEF. PEF, age, height and body weight were correlated with each other and an intercorrelation matrix between these variables has been designed. It was observed, after performing multivariate regression analysis, that age and height are significant predictors of PEF. A multiple linear regression equation and a nomogram have been constructed for predicting PEF from age and height in young healthy Indian girls.

Adolescent↗

PubMed2003

Neuropeptide Y, left ventricular mass and function in patients with end stage renal disease.

OBJECTIVE: Neuropeptide Y (NPY) is released during sympathetic stimulation and mediates the central effects of the adipostatic hormone leptin. The plasma concentration of NPY and leptin is increased in patients with end stage renal disease (ESRD), but it is unknown whether these substances are related to biochemical markers of sympathetic activity and to alterations in left ventricular (LV) mass and function in these patients. DESIGN: We investigated the relationship between NPY, norepinephrine (NE), leptin and echocardiographic measurements in a cross-sectional study in 198 patients with ESRD. RESULTS: NPY was directly related to plasma NE and heart rate but it was largely independent of arterial pressure and of retention of metabolic waste products. NPY was significantly higher in patients with LV hypertrophy and in those with LV systolic dysfunction than in those without these alterations. Of note, NPY emerged as an independent correlate of LV mass index and of LV ejection fraction (LVEF) (both P <or= 0.002) in multiple linear regression analyses including a series of cardiovascular risk factors. Furthermore in a multiple logistic regression model patients in the top NPY tertile had a risk for LV concentric hypertrophy that was 18.10 (95% confidence interval: 5.87-55.83) times higher than in those in the first tertile (P < 0.001). Leptin was unrelated to NPY as well as to LV mass and to systolic function. CONCLUSIONS: Elevated NPY is independently associated with LV concentric hypertrophy and systolic dysfunction in ESRD. It remains to be seen whether these links contribute to the high cardiovascular mortality in these patients.

Adult↗

PubMed1992

Case-mix groups for VA hospital-based home care.

The purpose of this study is to group hospital-based home care (HBHC) patients homogeneously by their characteristics with respect to cost of care to develop alternative case mix methods for management and reimbursement (allocation) purposes. Six Veterans Affairs (VA) HBHC programs in Fiscal Year (FY) 1986 that maximized patient, program, and regional variation were selected, all of which agreed to participate. All HBHC patients active in each program on October 1, 1987, in addition to all new admissions through September 30, 1988 (FY88), comprised the sample of 874 unique patients. Statistical methods include the use of classification and regression trees (CART software: Statistical Software; Lafayette, CA), analysis of variance, and multiple linear regression techniques. The resulting algorithm is a three-factor model that explains 20% of the cost variance (R2 = 20%, with a cross validation R2 of 12%). Similar classifications such as the RUG-II, which is utilized for VA nursing home and intermediate care, the VA outpatient resource allocation model, and the RUG-HHC, utilized in some states for reimbursing home health care in the private sector, explained less of the cost variance and, therefore, are less adequate for VA home care resource allocation.

Aftercare↗

PubMed2005

Whole-genome association analysis to identify markers associated with recombination rates using single-nucleotide polymorphisms and microsatellites.

Recombination during meiosis is one of the most important biological processes, and the level of recombination rates for a given individual is under genetic control. In this study, we conducted genome-wide association studies to identify chromosomal regions associated with recombination rates. We analyzed genotype data collected on the pedigrees in the Collaborative Study on the Genetics on Alcoholism data provided by Genetic Analysis Workshop 14. A total of 315 microsatellites and 10,081 single-nucleotide polymorphisms from Affymetrix on 22 autosomal chromosomes were used in our association analysis. Genome-wide gender-specific recombination counts for family founders were inferred first and association analysis was performed using multiple linear regressions. We used the positive false discovery rate (pFDR) to account for multiple comparisons in the two genome-wide scans. Eight regions showed some evidence of association with recombination counts based on the single-nucleotide polymorphism analysis after adjusting for multiple comparisons. However, no region was found to be significant using microsatellites.

Female↗

PubMed2000

Dietary patterns in a high-risk population for glucose intolerance. Japanese-Brazilian Diabetes Study Group.

We evaluated dietary habits as risk factor for glucose intolerance in a high risk population of Japanese-Brazilians enrolled in a study on the prevalence of diabetes (DM). Based on oral glucose tolerance test and WHO criteria, 331 had normal tolerance (NGT), 88 impaired tolerance (IGT) and 83 had type 2 DM (51 self-reported, 32 newly diagnosed diabetics). Clinical, laboratory and dietary data, assessed by food frequency questionnaire (FFQ), were compared between the NGT group and another composed of IGT and newly diagnosed DM (disturbed glucose tolerance or DGT group). Associations of total energy intake and nutrient intakes with glucose intolerance were analyzed by logistic regression. Also, subjects with NGT and DGT entered into separate models of multiple linear regression including BMI as the dependent variable, and total energy intake or each nutrient as independent variables. DGT group showed higher waist-to-hip ratio, blood pressure, plasma glucose and insulin levels and worse lipid profile. Total energy intake, macronutrients, fibers, alcohol and saturated fat intakes did not differ between groups; DGT was not associated with any nutrient intake in multivariate analyses. BMI of the subjects with DGT but not with NGT was associated with protein and cholesterol intakes in linear regression analysis. Our findings did not support an association between nutritional factors and glucose intolerance even in subjects who are unaware of their DGT, using FFQ to reflect current habits. However, we suggest that protein and cholesterol intakes may be markers of increased BMI. Despite assuming that obesity and insulin resistance precedes DM, FFQ may not be useful in the assessment of unfavorable dietary patterns among subjects at risk for glucose intolerance, such as Japanese-Brazilians with elevated BMI.

Adult↗