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Research into Obesity and Diabetes Prevention and Effectiveness

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (28 February 2021) | Viewed by 110592

Special Issue Editor


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Guest Editor
1. Sydney School of Public Health, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
2. Population Health Research & Evaluation Hub, Sydney Local Health District, Camperdown, NSW 2050, Australia
3. NHMRC Centre of Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH), University of Sydney, Sydney, NSW 2006, Australia
4. Sydney Institute for Women, Children and Their Families, Sydney Local Health District, Camperdown, NSW 2050, Australia
Interests: clinical trials and practices in obesity and diabetes prevention; translational research focused on translating research evidence into practice; research methodologies including epidemiology, statistics, and quantitative research; application of clinical trial design for evaluating complex prevention programs; telehealth and digital health in obesity prevention
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Special Issue Information

Dear Colleagues,

We are organizing a Special Issue on Research into Obesity and Diabetes Prevention and Effectiveness in the International Journal of Environmental Research and Public Health (IJERPH). The venue is a peer-reviewed scientific journal that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health, with an Impact Factor 2.468. For detailed information on the journal, we refer you to the journal website: https://www.mdpi.com/journal/ijerph.

Obesity and diabetes have emerged as significant public health problems globally with no sign of stopping. The adverse health consequences of obesity and diabetes in the life cycle are numerous. People with obesity and diabetes are at increased risk for many serious diseases and health conditions, including all causes of mortality, coronary heart disease, stroke, some cancers, mental illness, low quality of life, and many more. This has created an enormous burden both socially and economically in society. While finding the right treatment is important, prevention is the key to tackling increased prevalence of obesity and diabetes. To date, there have been a number of effective prevention strategies developed based on research evidence. However, there is a lot more work to be done not only for a better understanding of factors contributing to obesity and diabetes in various life stages, but also for searching effective and cost-effective prevention strategies, particularly in the early life stage.  

In addition, advances in communication technologies in recent years have opened new possibilities for innovative public health interventions. There is emerging evidence of the use of mobile devices to improve adherence to health advice, increase access to health information, and promote healthy behavior. However, limited quality research exists in using mobile applications for obesity and diabetes prevention. More importantly, there is lack of understanding of feasibility, acceptability, and effectiveness of such approaches.

We invite investigators to contribute original research articles or review articles that will contribute to the body of evidence of understanding risk factors for obesity and diabetes and demonstrating effective and cost-effective prevention programs for reducing obesity and diabetes at various life stages. Investigators who have conducted research on these topics are invited to submit manuscripts for consideration for this Special Issue in IJERPH.

This Special Issue is open to any subject area related to research into obesity and diabetes prevention and effectiveness. Potential topics include but are not limited to:

  • Epidemiological or clinical studies on obesity and diabetes prevention and their contributing factors;
  • Studies on physical and biological mechanisms of linking important elements to obesity and diabetes prevention;
  • Studies on public health intervention and innovation and its enablers or barriers;
  • Reports on intervention trials, and program evaluations;
  • Recent advances in assessing or monitoring changes in obesity and diabetes;
  • Case study on new clinical evidence of obesity and diabetes prevention.

The listed keywords suggest just a few of the many possibilities.

Prof. Dr. Li Ming Wen
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Obesity
  • Type 2 diabetes
  • Risk factors
  • Prevention
  • Health promotion
  • Intervention and innovation
  • Mobile Health
  • Mobile applications
  • Effectiveness and cost-effectiveness
  • Early years
  • Chronic diseases
  • Population health
  • Quality of life
  • Overweight and obesity
  • Epidemiology
  • Mechanism
  • Case study

Published Papers (12 papers)

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Research

Jump to: Review

8 pages, 301 KiB  
Article
Modes of Transport to School and Their Associations with Weight Status: A Cross-Sectional Survey of Students in Shanghai, China
by Yuan-Shen Zhu, Zhuo Sun, Dan-Dan Ke, Jia-Qi Yang, Wen-Yun Li, Ze-Qun Deng, Yong-Zhen Li, Min Wu, Li-Ming Wen and Geng-Sheng He
Int. J. Environ. Res. Public Health 2021, 18(9), 4687; https://doi.org/10.3390/ijerph18094687 - 28 Apr 2021
Cited by 2 | Viewed by 2308
Abstract
Background: Over the past two decades, both transport modes as well as overweight/obesity have changed dramatically among students in China, but their relationships are not clear. This study aimed to investigate modes of transport to school and their associations with the weight status [...] Read more.
Background: Over the past two decades, both transport modes as well as overweight/obesity have changed dramatically among students in China, but their relationships are not clear. This study aimed to investigate modes of transport to school and their associations with the weight status of Chinese students. Methods: A cross-sectional study was conducted with non-resident students aged 6 to 17 years from all 16 districts across Shanghai, China in October and November 2019. Information about sociodemographic characteristics and the models of travel to school among students was investigated using an online, self-administered, structured questionnaire (or those assisted by their parents). Weight and height were measured by school health workers, and the Chinese standard age adjusted BMI (weight/height2) was used to classify students’ weight status. Cumulative logistic regression modelling was used to examine the relationships. Results: The main mode of transport to school was an active mode (46.5%, defined as walking, bicycling, or public transport), followed by an inactive mode of transport (30.5%, defined as a car or bicycle as a passenger), and a combination of both modes (23%). About one-third of the students were overweight or obese and 5% were underweight. No statistically significant association between transport modes and weight status was found in this study. Conclusions: In Shanghai, close to one-third of children travel to school by an inactive mode of transport. The findings of this study did not support the notion that an active mode to school could be beneficial for preventing overweight/obesity in students in China. Full article
(This article belongs to the Special Issue Research into Obesity and Diabetes Prevention and Effectiveness)
13 pages, 582 KiB  
Article
Relationships between Maternal Dietary Patterns and Blood Lipid Levels during Pregnancy: A Prospective Cohort Study in Shanghai, China
by Na Wang, Zequn Deng, Liming Wen, Yan Ding and Gengsheng He
Int. J. Environ. Res. Public Health 2021, 18(7), 3701; https://doi.org/10.3390/ijerph18073701 - 1 Apr 2021
Cited by 3 | Viewed by 2288
Abstract
The relationships between maternal dietary patterns and blood lipid profile during pregnancy have not been well understood. We aimed to analyze the dietary patterns of pregnant women and their associations with blood lipid concentrations during pregnancy. A cohort of 1008 Chinese pregnant women [...] Read more.
The relationships between maternal dietary patterns and blood lipid profile during pregnancy have not been well understood. We aimed to analyze the dietary patterns of pregnant women and their associations with blood lipid concentrations during pregnancy. A cohort of 1008 Chinese pregnant women were followed from 10–15 weeks of gestation to delivery. Their dietary patterns were identified using a principal component analysis. The relationships between dietary pattern score and maternal blood lipid concentrations were assessed using both multivariate linear regression models and generalized estimating equation (GEE) models. Five different dietary patterns were identified. GEE showed that a high score for the fish-shrimps pattern was associated with higher concentrations of total cholesterol (TC) (β = 0.11), low-density lipoprotein cholesterol (LDL-C) (β = 0.07), and high-density lipoprotein cholesterol (HDL-C) (β = 0.03), with all p values < 0.001. In contrast, a high tubers-fruit-vegetables pattern score was associated with lower concentrations of TC (β = −0.12), LDL-C (β = −0.07), and HDL-C (β = −0.03), with all p values < 0.001. In addition, dietary protein, carbohydrate, and cholesterol intake significantly contributed to the associations between the fish-shrimps dietary pattern and blood lipid concentrations. Predominant seafood consumption is associated with higher cholesterol concentrations, whereas predominant tuber, fruit, and vegetable consumptions are associated with lower cholesterol concentrations during pregnancy. Full article
(This article belongs to the Special Issue Research into Obesity and Diabetes Prevention and Effectiveness)
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10 pages, 1137 KiB  
Article
Early Childhood Fat Tissue Changes—Adipocyte Morphometry, Collagen Deposition, and Expression of CD163+ Cells in Subcutaneous and Visceral Adipose Tissue of Male Children
by Robert Mujkić, Darija Šnajder Mujkić, Ivana Ilić, Edi Rođak, Antun Šumanovac, Anđela Grgić, Dalibor Divković and Kristina Selthofer-Relatić
Int. J. Environ. Res. Public Health 2021, 18(7), 3627; https://doi.org/10.3390/ijerph18073627 - 31 Mar 2021
Cited by 5 | Viewed by 2243
Abstract
Childhood obesity is a complex health problem, and not many studies have been done on adipose tissue remodeling in early childhood. The aim of this study was to examine extracellular matrix remodeling in the adipose tissue of healthy male children depending on their [...] Read more.
Childhood obesity is a complex health problem, and not many studies have been done on adipose tissue remodeling in early childhood. The aim of this study was to examine extracellular matrix remodeling in the adipose tissue of healthy male children depending on their weight status. Subcutaneous and visceral adipose tissue was obtained from 45 otherwise healthy male children who underwent elective surgery for hernia repairs or orchidopexy. The children were divided into overweight/obese (n = 17) or normal weight groups (n = 28) depending on their body mass index (BMI) z-score. Serum was obtained for glucose, testosterone, triglyceride, total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) measurements. Sections of adipose tissue were stained with hematoxylin and eosin to determine the adipocytes’ surface area, and Masson’s trichrome stain was used to detect the adipocytes’ collagen content. Immunohistochemistry for CD163+ cells was also performed. The results showed that male children in the overweight group had higher serum triglyceride levels, greater adipocyte surface area and collagen content in their subcutaneous adipose tissue, more crown-like structures in fat tissues, and more CD163+ cells in their visceral adipose tissue than males in the normal weight group. In conclusion, in male children, obesity can lead to the hypertrophy of adipocytes, increased collagen deposition in subcutaneous adipose tissues, and changes in the polarization and accumulation of macrophages. Full article
(This article belongs to the Special Issue Research into Obesity and Diabetes Prevention and Effectiveness)
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12 pages, 625 KiB  
Article
Habitual Physical Activity and Diabetes Control in Young and Older Adults with Type II Diabetes: A Longitudinal Correlational Study
by Chia-Hsun Chang, Ching-Pyng Kuo, Chien-Ning Huang, Shiow-Li Hwang, Wen-Chun Liao and Meng-Chih Lee
Int. J. Environ. Res. Public Health 2021, 18(3), 1330; https://doi.org/10.3390/ijerph18031330 - 2 Feb 2021
Cited by 5 | Viewed by 2814
Abstract
This study aimed to determine whether daily physical activity in young and older adults with T2DM is associated with diabetes control. A prospective correlational study involving 206 young (≤65 years) and older (>65 years) adults was conducted. The International Physical Activity Questionnaire was [...] Read more.
This study aimed to determine whether daily physical activity in young and older adults with T2DM is associated with diabetes control. A prospective correlational study involving 206 young (≤65 years) and older (>65 years) adults was conducted. The International Physical Activity Questionnaire was used to assess their daily physical activity levels. Patients’ mean HbA1c level was 7.8% (±1.4), and 95.9% of patients had unsatisfactory diabetes control. Performing more minutes per week of moderate-intensity daily physical activity was associated with a lower risk of glycemia in both young and older adults. Furthermore, moderate daily physical activity significantly lowered the risk of glycemia. Health personnel must encourage patients to engage in moderate daily physical activities to improve diabetes control. Full article
(This article belongs to the Special Issue Research into Obesity and Diabetes Prevention and Effectiveness)
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10 pages, 762 KiB  
Article
Impact of Non-Tailored One-Way Automated Short Messaging Service (OASMS) on Glycemic Control in Type 2 Diabetes: A Retrospective Feasibility Study
by Ahmad Alamer, Charles Palm, Abdulaziz S. Almulhim, Charisse Te, Merri L. Pendergrass and Maryam T. Fazel
Int. J. Environ. Res. Public Health 2020, 17(20), 7590; https://doi.org/10.3390/ijerph17207590 - 19 Oct 2020
Cited by 3 | Viewed by 2361
Abstract
Short message service (SMS) is easily accessible and potentially an ideal platform for delivering patient-targeted messages. However, an effective SMS dosing strategy is not well established. Our purpose was to evaluate the impact of diabetes self-care promoting messages via non-tailored one-way automated SMS [...] Read more.
Short message service (SMS) is easily accessible and potentially an ideal platform for delivering patient-targeted messages. However, an effective SMS dosing strategy is not well established. Our purpose was to evaluate the impact of diabetes self-care promoting messages via non-tailored one-way automated SMS (OASMS) on glycemic control in type 2 diabetes (T2DM). The change in hemoglobin A1c (HbA1c) was compared between patients who received the service and those who did not. This retrospective quasi-experimental pre–post feasibility study was conducted at an academic medical center endocrinology clinic. English-speaking adults (≥18 years) with uncontrolled T2DM (HbA1c ≥ 8%) were included. A total of 69 patients (intervention n = 34; control n = 35) met the inclusion criteria. The mean (±SD) baseline HbA1c values were 10.2% (±1.9%) and 9.9% (±1.7%) in the intervention and control arms, respectively. Median follow-up was 3.3 months (IQR = 3–4.2). An ANCOVA model adjusted for baseline HbA1c and age showed an estimated HbA1c reduction difference of −0.97% (95% CI, −1.73 to −0.20%, p = 0.014), favoring the intervention arm. Inverse propensity score weighting confirmed the ANCOVA results. Our study suggests that adding diabetes self-care promoting messages via non-tailored OASMS to usual care improves glycemic control in poorly controlled T2DM. Larger and longer studies are needed to evaluate different features of the non-tailored OASMS strategy. Full article
(This article belongs to the Special Issue Research into Obesity and Diabetes Prevention and Effectiveness)
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16 pages, 365 KiB  
Article
Motivation and Barriers to Maintaining Lifestyle Changes in Patients with Type 2 Diabetes after an Intensive Lifestyle Intervention (The U-TURN Trial): A Longitudinal Qualitative Study
by Sabrina K. Schmidt, Liv Hemmestad, Christopher S. MacDonald, Henning Langberg and Laura S. Valentiner
Int. J. Environ. Res. Public Health 2020, 17(20), 7454; https://doi.org/10.3390/ijerph17207454 - 13 Oct 2020
Cited by 50 | Viewed by 13068
Abstract
The purpose of this study was to explore and identify factors that influence motivation for and barriers to adopting and maintaining lifestyle changes in patients with type 2 diabetes, following participation in an intensive multiple-lifestyle intervention. Participants were recruited from the U-TURN trial, [...] Read more.
The purpose of this study was to explore and identify factors that influence motivation for and barriers to adopting and maintaining lifestyle changes in patients with type 2 diabetes, following participation in an intensive multiple-lifestyle intervention. Participants were recruited from the U-TURN trial, a one-year, intensive lifestyle intervention for type 2 diabetes patients. This study was conducted over time; informants were interviewed twice after the trial ended with a six-month interval between interviews. The qualitative data from these individual interviews were analysed using systematic text condensation with an inductive approach. Five themes emerged: Social support and relatedness, Achievement of results, Support from healthcare professionals, Identification with and acceptance of the new lifestyle and Coping with ongoing challenges. These are all important for maintaining lifestyle changes and diabetes self-management. Changing one’s lifestyle can be a constant, difficult struggle. For sustainable progress after an intensive intervention, the changes must be adopted and endorsed by patients and co-opted into their social setting. Belonging to an exercise group, confidence in managing the lifestyle adjustments and handling of challenges through continual support and professional diabetes treatment are crucial in maintaining and adhering to the new lifestyle. Full article
(This article belongs to the Special Issue Research into Obesity and Diabetes Prevention and Effectiveness)
11 pages, 582 KiB  
Article
The Smartphone-Assisted Intervention Improved Perception of Nutritional Status among Middle School Students
by Yan-Hui Shen, Zheng Liu, Wen-Hao Li, Shuang Zhou, Jin-Hui Xu, Chu Jiang and Hai-Jun Wang
Int. J. Environ. Res. Public Health 2020, 17(16), 5932; https://doi.org/10.3390/ijerph17165932 - 15 Aug 2020
Cited by 4 | Viewed by 2120
Abstract
Misperception of nutritional status is common and hinders the progress of childhood obesity prevention. This study aimed to examine the effectiveness of a smartphone-assisted intervention to improve student and parental perception of students’ nutritional status (underweight, normal weight, overweight, obese). We conducted a [...] Read more.
Misperception of nutritional status is common and hinders the progress of childhood obesity prevention. This study aimed to examine the effectiveness of a smartphone-assisted intervention to improve student and parental perception of students’ nutritional status (underweight, normal weight, overweight, obese). We conducted a parallel-group controlled trial with a non-randomized design in three junior middle schools of Beijing, China in 2019. One school was allocated to the intervention group and two schools to the control group. A total of 573 students (aged 13.1 ± 0.4 years) participated in the trial. The 3-month intervention included three components: health education sessions for students and parents, regular monitoring of students’ weight, and the provision of feedback via a smartphone application. Schools in the control group continued their usual practice. Primary outcomes included the student and parental accurate perception of students’ nutritional status. The percentage of students’ accurate perception of their own nutritional status in the intervention group increased from 49.0% to 59.2% from baseline to three months, whereas it decreased from 64.1% to 58.1% in the control group; the adjusted odds ratio (OR) between the two groups was 1.71 (95% confidence interval (CI): 1.13, 2.59). The intervention did not significantly improve parental perception of students’ nutritional status (p > 0.05). The study findings provided a brief approach for improving perception of nutritional status among middle school students. Full article
(This article belongs to the Special Issue Research into Obesity and Diabetes Prevention and Effectiveness)
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13 pages, 4194 KiB  
Article
Developing and Validating an Instrument to Evaluate Theory-Based Behavioral Antecedents of Consuming a High-Fiber Diet
by Paul Branscum
Int. J. Environ. Res. Public Health 2020, 17(12), 4342; https://doi.org/10.3390/ijerph17124342 - 17 Jun 2020
Viewed by 2071
Abstract
Obesity is a major public health concern, with low consumption of fiber-rich foods (e.g., fruits and vegetables) commonly cited as a causal factor. The purpose of this study was to evaluate the validity of a survey measuring the constructs of the Reasoned Action [...] Read more.
Obesity is a major public health concern, with low consumption of fiber-rich foods (e.g., fruits and vegetables) commonly cited as a causal factor. The purpose of this study was to evaluate the validity of a survey measuring the constructs of the Reasoned Action Approach under the context of consuming a high-fiber diet. After an initial draft of the survey was developed, it was evaluated by a panel of six experts to establish face and content validity. Next, data were collected from an adult sample (n = 878), and psychometric data revealed indices of reliability (Cronbach’s alpha) and validity (confirmatory factor analysis). The average age of adults was 51.5 years (±12.8), and a majority were Caucasian (81%), and women (93%). With regards to construct validity, the model structure had adequate fit (e.g., Comparative Fit Index = 0.960). In addition all items loaded significantly on its corresponding scale. For internal consistency reliability, all Cronbach’s alpha scores were > 0.70. Overall the survey appears to be a promising tool for researchers and practitioners. Understanding the theoretical determinants of fiber consumption will help tie theory together with practice. Full article
(This article belongs to the Special Issue Research into Obesity and Diabetes Prevention and Effectiveness)
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13 pages, 395 KiB  
Article
Body Satisfaction, Weight Stigma, Positivity, and Happiness among Spanish Adults with Overweight and Obesity
by Débora Godoy-Izquierdo, Juan González-Hernández, Alejandra Rodríguez-Tadeo, Raquel Lara, Adelaida Ogallar, Estefanía Navarrón, María J. Ramírez, Clara López-Mora and Félix Arbinaga
Int. J. Environ. Res. Public Health 2020, 17(12), 4186; https://doi.org/10.3390/ijerph17124186 - 12 Jun 2020
Cited by 13 | Viewed by 5716
Abstract
Although previous evidence suggests that happiness is lower among individuals with obesity, research on the correlates of subjective well-being (SWB) is warranted to increase our knowledge. We aim to explore excess weight (i.e., measured and self-reported body mass index (BMI)), body image and [...] Read more.
Although previous evidence suggests that happiness is lower among individuals with obesity, research on the correlates of subjective well-being (SWB) is warranted to increase our knowledge. We aim to explore excess weight (i.e., measured and self-reported body mass index (BMI)), body image and satisfaction, self-stigma, positivity, and happiness among Spanish adults with overweight or obesity. We further aim to investigate the predictors of SWB in this sample. A convenience sample of 100 individuals with excess weight completed self-reports on the study variables and were weighed and their height measured. On average, the participants reported body perceptions revealing minor excessive weight, moderate body satisfaction, low-to-moderate weight-related stigma, and elevated positivity and happiness. BMI and gender/sex independently affected these variables, but there were no significant interaction effects. Furthermore, individuals with overweight or obesity with higher body satisfaction and elevated positivity were more likely to report being happy, independent of their age, gender/sex, weight, and weight-related stigma. Mediation effects were found for body satisfaction and positivity in the relationship between weight and happiness. Moreover, positive orientation suppressed the pervasive influence of stigma on SWB. Our findings confirm the key role of body image dimensions and weight-related stigma for happiness and add support to the relevance of positivity for overall well-being of individuals with excess weight. These results may inform obesity management actions focused on inclusive aesthetic models, combating social stigmatization and enhancing positivity for a flourishing and fulfilling life. Full article
(This article belongs to the Special Issue Research into Obesity and Diabetes Prevention and Effectiveness)
13 pages, 704 KiB  
Article
Type 2 Diabetes Mellitus in Class II and III Obesity: Prevalence, Associated Factors, and Correlation between Glycemic Parameters and Body Mass Index
by Erika Aparecida Silveira, Lorena Pereira de Souza Rosa, Annelisa Silva e Alves de Carvalho Santos, Camila Kellen de Souza Cardoso and Matias Noll
Int. J. Environ. Res. Public Health 2020, 17(11), 3930; https://doi.org/10.3390/ijerph17113930 - 2 Jun 2020
Cited by 18 | Viewed by 4344
Abstract
Despite the worldwide growth of class II and III obesity, the factors associated with type 2 diabetes mellitus (T2DM) in these obese individuals are not widely understood. Moreover, no study has investigated these associations in South America. Our study aimed to investigate the [...] Read more.
Despite the worldwide growth of class II and III obesity, the factors associated with type 2 diabetes mellitus (T2DM) in these obese individuals are not widely understood. Moreover, no study has investigated these associations in South America. Our study aimed to investigate the prevalence of T2DM and its associated factors, with an emphasis on biochemical parameters and eating habits, in class II and III obese individuals. We also aimed to analyze the correlation between glycemic parameters and body mass index (BMI). Baseline data from a randomized clinical trial (DieTBra Trial) of 150 class II and III obese individuals (BMI > 35 kg/m2) was used. An accelerometer, Food Frequency Questionnaire, and bioimpedance analysis were used to assess physical activity levels, eating habits, and body composition, respectively. Blood was collected after 12 h of fasting. Hierarchical multivariate Poisson regression was performed, and prevalence ratios (PRs) were calculated. Correlations between glycemic parameters (fasting blood glucose, glycosylated hemoglobin, homeostasis model assessment of insulin resistance (HOMA-IR), and insulin) and BMI were also analyzed. The prevalence of T2DM was 40.0% (95% CI, 32.1–48.3), high fasting blood glucose level was 19.33% (95% CI, 13.3–26.6), and high glycosylated hemoglobin was 32.67% (95% CI, 25.2–40.8). Age ≥ 50 years (PR = 3.17, 95% CI, 1.26–7.98) was significantly associated with T2DM; there was a positive linear trend between age and T2DM (p = 0.011). Multivariate analysis showed an association with educational level (PR = 1.49, 1.07–2.09, p = 0.018), nonconsumption of whole grains daily (PR = 1.67, 1.00–2.80, p = 0.049), and high HOMA-IR (PR = 1.54, 1.08–2.18, p = 0.016). We found a high prevalence of T2DM and no significant correlations between BMI and glycemic parameters. Full article
(This article belongs to the Special Issue Research into Obesity and Diabetes Prevention and Effectiveness)
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Review

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18 pages, 1914 KiB  
Review
Low-Carbohydrate Diets in the Management of Obesity and Type 2 Diabetes: A Review from Clinicians Using the Approach in Practice
by Tara Kelly, David Unwin and Francis Finucane
Int. J. Environ. Res. Public Health 2020, 17(7), 2557; https://doi.org/10.3390/ijerph17072557 - 8 Apr 2020
Cited by 57 | Viewed by 60686
Abstract
Low-carbohydrate diets are increasingly used to help patients with obesity and type 2 diabetes. We sought to provide an overview of the evidence for this treatment approach, considering the epidemiology and pathophysiology of obesity and diabetes in terms of carbohydrate excess. We describe [...] Read more.
Low-carbohydrate diets are increasingly used to help patients with obesity and type 2 diabetes. We sought to provide an overview of the evidence for this treatment approach, considering the epidemiology and pathophysiology of obesity and diabetes in terms of carbohydrate excess. We describe the mechanistic basis for the clinical benefits associated with nutritional ketosis and identify areas of practice where the evidence base could be improved. We summarize the key principles which inform our approach to treating patients with low-carbohydrate diets. The scientific controversy relating to these diets is real but is consistent with the known challenges of any dietary interventions and also the limitations of nutritional epidemiology. Secondly, notwithstanding any controversy, international guidelines now recognize the validity and endorse the use of these diets as a therapeutic nutritional approach, in appropriate patients. Thirdly, we have found that early de-prescription of diabetes medications is essential, in particular insulin, sulphonylureas, and sodium-glucose cotransporter (SGLT2) inhibitors. Fourthly, we encourage patients to eat ad libitum to satiety, rather than calorie counting per se. Furthermore, we monitor cardiovascular risk factors frequently, as with all patients with obesity or diabetes, but we do not necessarily consider an increase in low-density lipoprotein (LDL)-cholesterol as an absolute indication to stop these diets, as this is usually related to large LDL particles, which are not associated with increased cardiovascular risk. In the absence of large randomized controlled trials with cardiovascular and other hard endpoints, adopting a low-carbohydrate diet is a legitimate and potentially effective treatment option for patients with diabetes or obesity. Full article
(This article belongs to the Special Issue Research into Obesity and Diabetes Prevention and Effectiveness)
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12 pages, 500 KiB  
Review
Effects of Nigella Sativa on Type-2 Diabetes Mellitus: A Systematic Review
by Amiza Hamdan, Ruszymah Haji Idrus and Mohd Helmy Mokhtar
Int. J. Environ. Res. Public Health 2019, 16(24), 4911; https://doi.org/10.3390/ijerph16244911 - 5 Dec 2019
Cited by 54 | Viewed by 9179
Abstract
Diabetes mellitus is one of the most prevalent metabolic disorders that affect people of all genders, ages, and races. Medicinal herbs have gained wide attention from researchers and have been considered to be a beneficial adjuvant agent to oral antidiabetic drugs because of [...] Read more.
Diabetes mellitus is one of the most prevalent metabolic disorders that affect people of all genders, ages, and races. Medicinal herbs have gained wide attention from researchers and have been considered to be a beneficial adjuvant agent to oral antidiabetic drugs because of their integrated effects. Concerning the various beneficial effects of Nigella sativa, this systematic review aims to provide comprehensive information on the effects of Nigella sativa on glucose and insulin profile status in humans. A computerized database search performed through Scopus and Medline via Ebscohost with the following set of keywords: Nigella Sativa OR black seed oil OR thymoquinone OR black cumin AND diabetes mellitus OR hyperglycemia OR blood glucose OR hemoglobin A1C had returned 875 relevant articles. A total of seven articles were retrieved for further assessment and underwent data extraction to be included in this review. Nigella sativa was shown to significantly improve laboratory parameters of hyperglycemia and diabetes control after treatment with a significant fall in fasting blood glucose, blood glucose level 2 h postprandial, glycated hemoglobin, and insulin resistance, and a rise in serum insulin. In conclusion, these findings suggested that Nigella sativa could be used as an adjuvant for oral antidiabetic drugs in diabetes control. Full article
(This article belongs to the Special Issue Research into Obesity and Diabetes Prevention and Effectiveness)
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