BackgroundIn patients with chronic hepatitis C (CHC), obesity is involved in the pathogenesis of insulin resistance, fatty liver disease and progression of fibrosis. The objective of this study was to compare a normoglucidic low-calorie diet (NGLCD) with a low-fat diet (LFD) among participants with CHC. Aimed to measure the impact of dietary changes in reduction of insulin resistance, obesity but also in steatosis and fibrosis.MethodsRandomized, controlled trial in three medical centers with assessments at baseline, 6 months and 12 months. Participants were patients over 35 years with chronic hepatitis C (n = 120) with BMI over 25 kg/m2. We evaluated the effects of NGLCD vs. LFD in weight management and metabolic improvement. The primary endpoint was to measure the impact of dietary changes through nutritional intervention in reversibility of insulin resistance, obesity, steatosis, and fibrosis. We performed anthropometric measurements, fasting glucose profile, serum lipids, liver profile, blood count at baseline, 6 and 12 months. Steatosis was evaluated using ultrasonographic criteria. Liver fibrosis was non-invasively assessed.ResultsAfter 6 and 12 months of intervention, both groups had a significant decrease in caloric consumption. At 6 months, weight loss was greater in the NGLCD group (−5.02 ± 3.43 kg vs. −4.1 ± 2.6 kg; p = 0.002) compared to the LFD group. At 1-year, however, weight loss was similar in both groups (−3.9 ± 3.3 kg vs. −3.1 ± 2.6 kg; p = 0.139). At 12 months, fasting plasma glucose, fasting plasma insulin, and HOMA-IR had significant improvements in both groups. With both diets aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT) decreased with significant differences; also there were significant improvements in AST/ALT ratio, Forns fibrosis index. The two diets were associated with reduction of both the prevalence and the severity of steatosis (all p < 0.001). At 12 months, total cholesterol, HDL-cholesterol, triglycerides improved in both groups (all p < 0.05).ConclusionsThe present study establishes the benefits of low-calorie diet and low-fat diet in management of patients with hepatitis C regarding improvement of insulin resistance, steatosis and also fibrosis.Overweight or obese patients with CHC undergoing a lifestyle intervention (specific dietary intervention and physical activity) for 1-year had significant improvements in body weight, lipid and hepatic profile.Trial registrationPNCI2-3343/41008/2007
Translation of the Bible or any other text unavoidably involves a determination about its meaning. There have been different views of meaning from ancient times up to the present, and a particularly Enlightenment and Modernist view is that the meaning of a text amounts to whatever the original author of the text intended it to be. This article analyzes the authorial-intent view of meaning in comparison with other models of literary and legal interpretation. Texts are anchors to interpretation but are subject to individualized interpretations. It is texts that are translated, not intentions. The challenge to the translator is to negotiate the meaning of a text and try to choose the most salient and appropriate interpretation as a basis for bringing the text to a new audience through translation.
Background and aims: Epidemiological evidence suggests that people with diabetes have a significantly increased risk of developing various cancers. The aim of the study was to assess the frequency of various cancers in diabetic patients admitted in the National Institute of Diabetes Nutrition and Metabolic Diseases “Prof. N.C. Paulescu” between 01.01.2011 and 01.09.2014.Material and methods: The study analyzed a total of 24.104 admissions, corresponding to a total of 13.960 patients. A total of 520 hospitalizations with a diagnosis of cancer and diabetes were indentified. Finally, 298 patients meeting the inclusion and exclusion criteria were included in the study. For these patients, personal history, clinical and laboratory data were assessed.Results: The prevalence of cancer in hospitalized diabetic patients was 2.13%. The most frequent types of cancer (number of cases) were: breast - 63 patients, colorectal - 45 patients, pancreatic - 37 patients, lung - 31 patients and prostate - 20 patients.Conclusions: Our data showed that the most common form of cancer associated with diabetes was breast cancer (21%), followed by colorectal cancer (15.10%) and pancreatic cancer (12.42%). Further prospective studies are needed in the long term on larger study groups to evaluate the incidence and prevalence of various forms of cancer in the diabetic population.
Background and Aims-To evaluate the impact of nutritional intervention on vitamins and minerals from intake food and anthropometric parameters at overweight and obese patients.Material and methods-To a sample of 40 overweight and obese patients we evaluated the nutritional content of food intake (kilocalories, macro and micronutrients). We also measured anthropometric parameters like weight, body mass index, body fat, percent of body fat, abdominal circumference and arterial tension.Results-After the nutritional intervention, overweight and obese patients had significantly lower level of intake carbohydrates (P=.018), lipids (P=.002), B1 vitamin (P<.001), B3 vitamin (P=.02) and E vitamin (P=.016). There is a significantly increased level of proteins (P<.001). Regarding the minerals, we found that the intake levels of following‗s decreased: sodium (P<.001), magnesium (P=.006), zinc (P=.035), copper (P=.002), manganese (P<.001). Phosphorus is the only mineral of which the intake level increased significantly (P<.001). All the anthropometric parameters decreased significantly: weight (P<.001), body mass index (P<.001), body fat (P<.001), percent of body fat (P<.001), abdominal circumference (P<0.001), systolic arterial tension (P<.001), diastolic arterial tension (P=.002).Conclusions-All the patients had imbalanced intake of vitamins and minerals both before and after intervention. There is a significant improved on anthropometric measures after nutritional intervention. We need to promote healthy lifestyle changes to prevent the risks associated with obesity.Keywords: overweight; obese; intake food; vitamins; minerals; anthropometric measures. . Obesity is a major risk factor for type 2 diabetes, cardiovascular diseases (mainly stroke and heart disease), cancer (endometrial, breast, colon), pulmonary diseases, osteoporosis, periodontal diseases. It has numerous consequences on lipid, glucose and protein metabolism with hiperglicemia and insulin resistance, hiperlipidemia and hiperuricemia. Obesity apears as a consequence of imbalance between energy intake (by food) and consumed energy (mainly by phisical activities). Sedentary life and unhealthy meals, riched in energy-dense foods ( high-fat, high sugar, high-salt, micronutrient poor ) are the main problem of the contemporany world.Except the vitamin D, that is synthesized in the human body, in the cutaneous tissue, in response to sunlight exposure [2], all the other vitamins are provided by food intake. There are two types of vitamins-one's that are soluble in fat, like vitamins A, D, E. and K and other's that are soluble in water-like vitamins B1, B2, B3, B5, B6, B12, folic acid. Excess of fat-soluble vitamins can not be eliminated so this vitamins will be stored in human body if the intake level is high and it can lead to simptoms and diseases. The water soluble vitamins are eliminated through kidney or liver and the risk of intoxication is lower and the simptoms occurs rarely.Minerals represent only 4-5 % of body weight but they are very important by p...
Background and Aims: The aim of the study was to assess nutritional status in patients with chronic hepatitis C and metabolic syndrome by different methods and to evaluate predictors of malnutrition. Material and Methods: This cross-sectional study was held in three centers from Bucharest and included 171 patients with chronic hepatitis C, divided into two groups according to the presence of metabolic syndrome (MetS). Anthropometric and biochemical parameters (including fasting plasma glucose, glycosylated hemoglobin, lipid profile, liver profile, complete blood count, and cytokines) were recorded. Nutritional status was assessed using Body Mass Index (BMI), Mini-nutritional assessment (MNA), Instant Nutritional Assessment (INA) and Nutritional Risk Index (NRI). We also recorded a malnutrition combined score. We considered patients to be malnourished according to the combined score if any score indicate malnutrition. Hepatic fibrosis was assessed using Forns index. Results: The average age was 53.14±8.3 years and 52% (n=89) were women. Using the combined score, malnutrition was present in 18 patients (10.5%). Multivariate logistic regression analysis showed that diabetes, hepatic fibrosis and IL-6 were independent risk factors for malnutrition (all p <0.05). Conclusions: Prevalence of malnutrition was high in patients with chronic hepatitis C (10.5%). In these patients diabetes, hepatic fibrosis and IL-6 were independent predictors for malnutrition.
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