Objective This systematic review aimed to evaluate the association between shift work and eating habits. Methods The protocol was registered in PROSPERO (number 42015024680). PubMed, EMBASE, Scopus, and Web of Science were searched for published reports. Of 2432 identified articles, 33 observational studies met the inclusion criteria. Their methodological approaches were assessed using the Newcastle-Ottawa Scale. Data were extracted using a standardized form. Studies were considered to have a low or a high risk of bias according to a percentage score of quality. Results The majority of the studies presented a quality score of <70% and a high risk of bias for comparability, sample selection and non-respondents. Shift workers show changes in meal patterns, skipping more meals and consuming more food at unconventional times. They also show higher consumption of unhealthy foods, such as saturated fats and soft drinks. Conclusions This review suggests that shift work can affect the quality of workers' diets, but new studies, especially longitudinal studies, which examine the time of exposure to shift work, the duration of the workday and sleep patterns, are necessary to confirm this association.

Obesity is linked to the development of cancer. Previous studies have suggested that there is a relationship between bariatric surgery and reduced cancer risk. Data sources were from Medline, Embase, and Cochrane Library. From 951 references, 13 studies met the inclusion criteria (54,257 participants). In controlled studies, bariatric surgery was associated with a reduction in the risk of cancer. The cancer incidence density rate was 1.06 cases per 1000 person-years within the surgery groups. In the meta-regression, we found an inverse relationship between the presurgical body mass index and cancer incidence after surgery (beta coefficient -0.2, P < 0.05). Bariatric surgery is associated with reduced cancer risk in morbidly obese people. However, considering the heterogeneity among the studies, conclusions should be drawn with care.

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Objective: To evaluate the reproducibility and validity of a previously constructed FFQ to assess the usual diet of patients with type 2 diabetes mellitus (T2DM). Design: Cross-sectional survey using two quantitative FFQ (1-month interval) supported by a food photograph portfolio, a 3 d weighed diet record (WDR) and urinary N output measurement (as a biomarker of protein intake). Setting: Group of Nutrition in Endocrinology, southern Brazil. Subjects: Out-patients with T2DM. Results: From a total of 104 eligible T2DM patients, eighty-eight were included in the evaluation of FFQ reproducibility and seventy-two provided data for the validity study. The intakes estimated from the two FFQ did not differ (P . 0?05) and the correlation coefficients were significant (P , 0?01) for energy and nutrients, ranging from 0?451 (soluble fibre) to 0?936 (PUFA). Regarding the validity evaluation, data from the FFQ were higher than those from the WDR for total (28?3 %), soluble (27?4 %) and insoluble fibres (29?1 %), and SFA (13?5 %), MUFA (11?1 %) and total lipids (9?2 %; all P , 0?05). There were significant correlation coefficients between the FFQ and WDR for most nutrients, when adjusted for energy intake and de-attenuated. Also, the Bland-Altman plots between the FFQ and WDR for energy and macronutrient intakes showed that the FFQ may be used as alternative method to the WDR. The validity coefficient (using the method of triads) for the FFQ protein intake was 0?522 (95 % CI 0?414, 0?597). Conclusions: This quantitative FFQ was valid and precise to assess the usual diet of patients with T2DM, according to its validity and reproducibility.

BackgroundInverse associations between micronutrient intake and cardiovascular outcomes have been previously shown, but did not focus on diabetic patients. ObjectiveTo systematically review the role of micronutrients in the development/presence of cardiovascular outcomes in patients with diabetes. MethodsWe searched Medline, Embase, and Scopus (January/1949-March/2012) for observational studies that evaluated micronutrients and cardiovascular outcomes in patients with diabetes, and then selected and extracted the data (two independent reviewers). ResultsFrom the 15 658 studies identified, five were included, comprising three case-control and two cohorts, with a follow-up of 7-15 years. A meta-analysis was not performed due to the different antioxidant micronutrients (types and measurement methods) and outcomes evaluated. The micronutrients assessed were vitamin C intake in diet and/ or supplementation, chromium and selenium in toenail samples, and α-tocopherol and zinc in serum levels. Intake of > 300 mg of vitamin C through supplementation was associated with increased risk of cardiovascular disease, coronary artery disease (CAD), and stroke (RR 1.69-2.37). High levels of α-tocopherol in serum were associated with 30% lower CAD risk in another study (HR 0.71; 95%CI 0.53-0.94). Among minerals (zinc, selenium, and chromium), an inverse association between zinc and CAD was observed; levels lower than 14.1 μmol/L were associated with an increased risk for CAD (RR 1.70; 95%CI 1.21-2.38). ConclusionThe information available on this issue is scarce. Further prospective studies are needed to elucidate the role of these nutrients in the cardiovascular risk of patients with diabetes.

BackgroundTo investigate the association between dietary components and development of chronic diabetic complications, the dietary evaluation should include a long period, months or years. The present manuscript aims to develop a quantitative food frequency questionnaire (FFQ) and a portfolio with food photos to assess the usual intake pattern of Brazilian patients with type 2 diabetes to be used in future studies.MethodsDietary data using 3-day weighed diet records (WDR) from 188 outpatients with type 2 diabetes were used to construct the list of usually consumed foods. Foods were initially clustered into eight groups: “cereals, tubers, roots, and derivatives”; “vegetables and legumes”; “fruits”; “beans”; “meat and eggs”; “milk and dairy products”; “oils and fats”, and “sugars and sweets”. The frequency of food intake and the relative contribution of each food item to the total energy and nutrient intakes were calculated. Portion sizes were determined according to the 25th, 50th, 75th, and 95th percentiles of intake for each food item.ResultsA total of 62 food items were selected based on the 3-day WDR and another 27 foods or how they are prepared and nine beverages were included after the expert examination. Also, a portfolio with food photos of each included food item and portion sizes was made to assist the patients in identifying the consumed portion.ConclusionsWe developed a practical quantitative FFQ and portfolio with photos of 98 food items covering those most commonly consumed in the past 12 months, to assess the usual diet pattern of patients with type 2 diabetes in Southern Brazil.

Background Despite the association between cardiovascular diseases and periodontitis, there are scarce data on the impact of oral health in the dietary intake of patients with coronary artery disease (CAD). The aim of this study was to assess the association between dietary intake with periodontitis and present teeth in individuals with stable CAD. Methods This cross‐sectional study included 115 patients with stable CAD (76 males, aged 61.0 ± 8.3 years) who were under cardiovascular care in an outpatient clinic for at least 3 months. Dietary intake was recorded applying a food frequency questionnaire previously validated. Periodontal examinations were performed by two calibrated examiners in six sites per tooth from all present teeth. Blood samples were collected to determine serum levels of lipids. Multivariable logistic and linear regression models were fitted to evaluate the association between dietary outcomes and oral health variables. Results Individuals with periodontitis had significantly higher percentage of total energy intake from fried foods, sweets, and beans, and also had lower consumption of fruits than those without periodontitis. Presence of periodontitis was associated with lower percentage of individuals who reached the nutritional recommendation of monounsaturated fatty acids and higher blood concentration of triglycerides. Having a greater number of present teeth (≥20 teeth) was associated with higher intake of fibers and total calories. Conclusion In patients with stable CAD, the presence of periodontitis and tooth loss were associated with a poor dietary intake of nutrients and healthy foods, which are important for cardiovascular prevention.

BackgroundThis study aimed to evaluate the concordance between two dietary indexes, the Healthy Eating Index (HEI) and the Diabetes Healthy Eating Index (DHEI), in evaluating diet quality and its possible association with therapeutic targets in patients with type 2 diabetes.MethodsCross-sectional study of outpatients with type 2 diabetes mellitus treated at a university hospital. Dietary information was obtained from a quantitative food frequency questionnaire (previously validated for use in patients with type 2 diabetes) and converted into daily intakes. Diet quality was assessed using two dietary indexes: HEI (12 components, nine food groups and three moderation components) and DHEI (10 components, six food groups, three nutrient groups, and one for variety of diet). In both indexes, the sum of the scores for each component yields an overall score converted on a scale from 0 to 100%; diet quality is subsequently ranked as low (<51%), needing improvement (51–80%), or high (>80%). Patients underwent clinical and laboratory assessment. Those with fasting blood glucose values 70–130 mg/dL, A1c < 7%, total cholesterol <200 mg/dL, LDL-cholesterol <100 mg/dL, and triglycerides <150 mg/dL were considered to meet therapeutic targets. All analyses were conducted in PASW Statistics 18.0, and p < 0.05 deemed significant.ResultsWe analyzed 148 patients with type 2 diabetes (73% white, mean age 63.2 ± 9.4 years, median diabetes duration 10 [IQR 5–19] years, mean A1c% 8.4 ± 2.0%, and mean BMI 30.5 ± 4.2 kg/m2). Mean energy intake was 2114 ± 649 kcal/day. DHEI scores were 17.0 (95%CI -6.8 to 41.0) points lower than HEI scores (55.9 ± 14.2% vs. 72.9 ± 10.7%, respectively; P < 0.001), suggesting there is no agreement (Bland-Altman method), and the Pearson correlation coefficient was 0.55 (P < 0.001). More patients were classified as having a low-quality diet by the DHEI than by the HEI (38.5% vs. 1.4%; P < 0.001). A higher proportion of patients (35.7%) with out-of-target total cholesterol levels had a low-quality diet evaluated by the DHEI (P = 0.03). We did not find associations between overall score of HEI and therapeutic targets.ConclusionsIn its intended population of patients with type 2 diabetes, the DHEI seems to be a more rigorous tool to evaluate association between diet quality and changes in metabolic parameters.Electronic supplementary materialThe online version of this article (10.1186/s12937-017-0296-8) contains supplementary material, which is available to authorized users.