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The fast of Ramadan is a dilemma for diabetic patients due to the complexity of the management of diabetes during this holy month and the multiple risks they face (hypoglycemia, etc.). Objectives: Evaluate the impact of a structured protocol of therapeutic education in a sample of type 2 diabetes, who were authorized by their doctors to fast, on metabolic and anthropometric profiles. Methods: This prospective study was conducted among 54 type 2 diabetic patients (28 men and 26 women) aged 36-65 years, recruited from National Nutrition Institute. Patients were divided into two groups: the first group (n = 26) received an education session one to two weeks before the month of Ramadan; the second group (n = 28) did not have appropriate therapeutic education except therapeutic adjustments. All our diabetic patients benefited from anthropometric measurements, determination of body composition and metabolic assessment (HbA1c, cholesterol, triglycerides, etc.) before and after the month of Ramadan. Results: The fast was completed without complications in 25 diabetic patients educated group and 22 control patients. We found that weight loss was greater among educated diabetic patients (À1.05 kg) than in controls (À0.58 kg), but without statistical significance. Body composition has not undergone significant changes in both diabetic groups. Therapeutic education has led to a decline of 0.27% in HbA1c in the educated group while glycemic control in diabetic patients uneducated remained stable. Furthermore, we observed a better lipid profile in diabetic patients educated than those who did not have education. Conclusion: Our results justify the interest of patient education centered on the month of Ramadan in all type 2 diabetic patients observing the fast of the holy month. This education should be continued during Ramadan in order to fulfill this religious rite safely.

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Background: Salt is directly related to hypertension and cardiovascular disease associated with it. As obesity facilitates the effect of salt, a quantification of obese salt intake is necessary. Methods: Our patients numbering 56 have been recruited in the consultation of the obesity unit. Patients were given a questionnaire about their knowledge concerning salt. Natriuresis of 24 h was quantified. The average amount of sodium consumed per day from foods was determined (SAL), the average amount of sodium consumed per day from table salt added to cooking and seasoning (SAC) and the average total amount of sodium consumed per day (STOQ). Results: The mean age of our patients was 44.31 ± 12.8 years. The average BMI of our patients was 37.12 ± 5.9 kg/m 2. The average systolic blood pressure was 123.8 ± 14 mmHg and mean diastolic blood pressure was 76.45 ± 10.7 mmHg. The average amount of sodium consumed per day from food (SAL) was 1 915 ± 1038 mg. The average amount of sodium consumed per day from cooking salt (SAC) was 2487 ± 1663 mg. The total amount of sodium consumed per day (STOQ) was 4402 ± 1831 mg. This addition is equivalent to 11 ± 4.6 g of salt per day. The total sodium intake exceeded 2000 mg/day in 89.2% of patients. More than half (57%) of spontaneous sodium intake comes from salt added. The average natriuresis in our population is 158 ± 68 mmol/24 h, higher than the norm in 18% of cases. The majority (85%) of our patients have claimed that excess salt is bad to very bad for health. Conclusion: Our study showed the importance of salt consumption in obeses and especially table salt and yet the majority of our patients consider it to be harmful to health. It will be necessary to take into account the sodium intake when prescribing the diet.

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Depression is a multifactorial disease and nutrition is an important environmental factor in its development and progression.Methods: This is a retrospective study of 50 depressed patients recruited from the outpatient department of psychiatry in Tunisia, as well as 50 controls. Both groups were matched for age and sex Results: A pathological waist circumference was found in 84% of cases against 78% of controls p=0.02. Our patients had a significantly higher intake of carbohydrates and sucrose compared to controls p=0.0001, p=0.02, and significantly lower protein intake (p=0.0001), lipids (p=0.0001), SFA (p=0.01), MUFA (p=0.003), EPA (p=0.02), fibers (p=0.05 ), iron (p=0.0001), zinc (p=0.02), vitamin B9 (p=0.0001), vitamin B1 (p=0.02) vitamin C (p=0.02), calcium (P=0.004). In addition, controls consumed significantly more blue fish, hard cheeses and Olive oil than the patients respectively. Plus the depression was severe, according to the PHQ9 score, plus the intakes were significantly lower in: proteins, carbohydrates, alpha linoleic acid Calcium, consumption of butter and cheese spread, and when depression was certain, according to the HAD, intakes of protein, w3, alpha linoleic acid, corn oil and soybean were low. of these deficits, in particular Omega 3, were significantly associated with the severity of depression. Volume 9 • Issue 2 • 1000786 78. Kyrozis A, Psaltopoulou T, Stathopoulos P, Trichopoulos D, Vassilopoulos D, et al. (2009) Dietary lipids and geriatric depression scale score among elders: the EPIC-Greece cohort. J Psychiatr Res 43: 763-769. 79. Logan AC (2005) Omega-3 and depression research: hold the olive oil. Prostaglandins Leukot Essent Fatty Acids 72: 441. 80. Sarris J, Schoendorfer N, Kavanagh DJ (2009) Major depressive disorder and nutritional medicine: a review of monotherapies and adjuvant treatments. Nutr Rev 67: 125-131.

Background and Objectives: Colorectal cancer (CRC) is the most frequent digestive cancer. Its occurrence is associated with many factors including nutrition and lifestyle. CRC is often associated to malnutrition which worsens its prognosis. The objectives of the study were to evaluate the nutritional status of patients with CRC. Patients and Methods: A retrospective study about fifty patients with CRC recruited in the Department of Gastroenterology and Surgery of "La Rabta" Hospital in Tunis as well as fifty random controls. The groups were matched for age and sex. The nutritional status of patients was assessed by anthropometric measurements, laboratory tests (albumin), and three nutritional scores. Dietary intakes were quantified by a frequency questionnaire and 24-h recall. Results: Significant risk factors were obesity (P = 0.02), menopause (P = 0.006) and the high consumption of red meat (P = 0.002), processed meat (P = 0.002), fried foods (P = 0.0001), and sugar (P = 0.0001). The consumption of green tea (P = 0.003), fruit (P = 0.001), and cereals (P = 0.0001) was higher in controls. Malnutrition was common measured by the body mass index, the percentage of weight loss (42%), albumin (60%), and different nutritional scores. The energy and protein intakes of patients were below the recommended requirements in 94% and 92% of patients, respectively. Deficiencies in minerals, vitamins, and trace elements were found. Conclusions: Malnutrition was very common in patients with CRC with multiple vitamin and mineral deficits.

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