An intensive 12-month dietary intervention in a community-based setting was effective in improving most modifiable cardiovascular risk factors in all the dietary groups. Only the LCM improved HDL levels and was superior to both the ADA and TM in improving glycaemic control.

There is a growing need to understand how health literacy influences health outcomes in diverse populations. The aim of this study was to examine the relationship between health literacy, health behavior, sociodemographic indicators, and self-assessed health in the adult population in Israel while identifying populations at risk for low health literacy. A cross-sectional national survey was conducted among 600 adults randomly selected from a national database. The Health Literacy Survey-Europe-Q16 (HLS-EU-Q16) research instrument, adapted for use in Israel, was the basis for home interviews in Hebrew, Russian, and Arabic. Three levels of health literacy were distinguished: More than 31% of the sample had inadequate or problematic health literacy, and 69% showed likely sufficient health literacy. Logistic regression analyses showed that after we controlled for other determinants, years of education (β = 1.8) and income (β = 2.2) were significantly associated with health literacy. Multinomial logistic regression analysis showed that health literacy, along with age, was the strongest independent variable associated with self-assessed health. Thus, health literacy, strongly influenced by income and years of education, may play a key role in determining self-assessed health, a proxy health outcome, beyond sociodemographic variables. The study results contribute to understanding the role of health literacy in health disparities and identifying action areas for health promotion.

Children with OSAS are heavy consumers of health care services 1 year before any specific evaluation and treatment for apnea. Early diagnosis and intervention may be cost-effective.

Aim The aim of the study was to compare the effect of different dietary interventions on alanine aminotransferase (ALT) in obese patients with diabetes. Methods A post hoc analysis of an open label, parallel design, quasi-randomised (allocation by alternation), controlled trial, conducted in Israel. Obese patients with diabetes (n=259), treated in the community, were centrally allocated to one of three diets: (1) the 2003 recommended American Diabetes Association diet (ADA): 50-55% carbohydrate, 30% fat and 20% protein, n=85; (2) a low glycaemic index (LGI) diet: 50-55% LGI carbohydrate, 30% fat, 15-20% protein, n = 89; or (3) a modified Mediterranean diet (MMD): 35% LGI carbohydrate, 45% fat that was high in monounsaturated fat, 15-20% protein, n=85. ALT was measured at 6 and 12 months. Results ALT levels decreased in all arms; however, the MMD was associated with the lowest ALT levels at month 6 (n=201: ADA n=64, LGI n=73, MMD n=64) and month 12 of follow-up (n=179). At 12 months mean ALT levels were 19.8±1.4 U/l in the ADA diet arm (n=54), 18.0±1.5 U/l in the LGI diet arm (n=64) and 14.4±1.7 in the MMD arm (n=61, p<0.001). Evidence for an effect of diet on ALT levels persisted when controlling for post-randomisation changes in waist to hip ratio, BMI, homeostasis model assessment (HOMA) or triacylglycerol. Conclusions A Mediterranean diet may have a beneficial effect on liver steatosis in obese patients with diabetes. Results of trials assessing the effect of dietary composition on clinical outcomes should be awaited before a decisive conclusion can be reached. In addition to clinical outcomes, such studies should address the issue of primary prevention of steatosis in high-risk and healthy individuals.

Increased awareness level of obstructive sleep apnea syndrome among primary care physicians, through publications and educational programs, monitored by standardized patients.

No abstract

No abstract

OBJECTIVE -To examine the effect of dairy calcium consumption on weight loss and improvement in cardiovascular disease (CVD) and diabetes indicators among overweight diabetic patients.RESEARCH DESIGN AND METHODS -This was an ancillary study of a 6-month randomized clinical trial assessing the effect of three isocaloric diets in type 2 diabetic patients: 1) mixed glycemic index carbohydrate diet, 2) low-glycemic index diet, and 3) modified Mediterranean diet. Low-fat dairy product consumption varied within and across the groups by personal choice. Dietary intake, weight, CVD risk factors, and diabetes indexes were measured at baseline and at 6 months.RESULTS -A total of 259 diabetic patients were recruited with an average BMI Ͼ31 kg/m 2 and mean age of 55 years. No difference was found at baseline between the intervention groups in CVD risk factors, diabetes indicators, macronutrient intake, and nutrient intake from dairy products. Dairy calcium intake was associated with percentage of weight loss. Among the high tertile of dairy calcium intake, the odds ratio for weight loss of Ͼ8% was 2.4, P ϭ 0.04, compared with the first tertile, after controlling for nondairy calcium intake, diet type, and the change in energy intake from baseline. No association was noted between dairy calcium and other health indexes except for triglyceride levels.CONCLUSIONS -A diet rich in dairy calcium intake enhances weight reduction in type 2 diabetic patients. Such a diet could be tried in diabetic patients, especially those with difficulty adhering to other weight reduction diets. Diabetes Care 30:485-489, 2007R ecent studies suggest that calcium metabolism and perhaps other components of dairy products may contribute to weight reduction in animal and human models (1,2). In addition, an accumulating body of evidence suggests that calcium-rich diets play a direct role in the prevention of obesity (2-5). Zemel et al. (4) analyzed data from National Health and Nutrition Examination Study III and demonstrated that the odds of being in the highest quartile of adiposity are negatively associated with calcium and dairy product intake. These findings have been confirmed in other settings as well (6,7). Other studies (8 -10), however, did not find significant effects of dairy consumption on body weight and body composition.Dairy consumption is an emerging factor that might affect insulin resistance syndrome (IRS). Prevalence of obesity and type 2 diabetes have increased concomitantly with the decrease in milk intake over the past three decades (11-13). In a cross-sectional study conducted by Mennen et al. (14), an inverse association between dairy intake and IRS was observed in men. More recently, analysis of the Coronary Artery Risk Development in Young Adults study by Pereira et al. (15) showed that increased dairy consumption has a strong inverse association with IRS among overweight adults and may reduce the risk of type 2 diabetes. In another longitudinal study (16), low-fat dairy intake was associated with lower incidence of type 2 di...