A diet rich in fibre seems to protect against the metabolic syndrome (MetS), but there is scarce information about the role of fibre intake in patients with the MetS and diabetes. The aim of the present study was to evaluate the effects of soluble fibre from partially hydrolysed guar gum (PHGG) on the MetS and cardiovascular risk factors in patients with type 2 diabetes. In the present randomised controlled clinical trial, forty-four patients with type 2 diabetes (males 38·6 %, age 62 (SD 9) years, diabetes duration 14·2 (SD 9·6) years) and the MetS underwent clinical, laboratory and dietary evaluations at baseline, 4 and 6 weeks. All patients followed their usual diet and the intervention group (n 23) received an additional 10 g/d of PHGG. In the intervention group, waist circumference (WC), glycated Hb (HbA1c), 24 h urinary albumin excretion (UAE) and serum trans-fatty acids (FA) were reduced in comparison with baseline after 4 and 6 weeks: WC 103·5 (SD 9·5) to 102·1 (SD 10) to 102·3 (SD 9·7) cm; HbA1c 6·88 (SD 0·99) to 6·64 (SD 0·94) to 6·57 (SD 0·84) %; 24 h UAE 6·8 (interquartile range 3·0-17·5) to 4·5 (interquartile range 3·0 -10·5) to 6·2 (interquartile range 3·0 -9·5) mg; trans-FA 71 (interquartile range 46-137) to 67 (interquartile range 48 -98) to 57 (interquartile range 30-110) mg/l (P,0·05 for all). The only change in the control group was weight reduction: 77·0 (SD 13·5) to 76·2 (SD 13·3) to 76·1 (SD 13·4) kg (P¼0·005). Other MetS components (blood pressure, TAG, HDL-cholesterol, fasting plasma glucose), total and LDL-cholesterol, C-reactive protein and endothelin-1 did not change in either group. In patients with type 2 diabetes and the MetS, the addition of PHGG to the usual diet improved cardiovascular and metabolic profiles by reducing WC, HbA1c, UAE and trans-FA.

Background/Objectives: Dietary factors have been associated with metabolic syndrome (MS) in healthy individuals and specific ethnic groups. To evaluate possible associations of usual dietary factors with the presence of MS in patients with type 2 diabetes mellitus (DM). Subjects/Methods: In this cross-sectional study, 214 patients with type 2 DM without dietary counseling during previous 6 months were studied. After clinical and laboratory examinations, dietary intake was evaluated by 3-day weighed-diet records, whose reliability was confirmed by 24-h urinary nitrogen output. The presence of MS was defined according to International Diabetes Federation. Results: Patients with MS (n ¼ 174) had a lower intake of total (16.776.2 vs 19.576.5 g day À1 ; P ¼ 0.010) and soluble fibers (5.371.8 vs 6.072.7 g day À1 ; P ¼ 0.011) than patients without MS. In multiple logistic regression models, adjusted for gender and DM duration, variables associated with MS were soluble fibers (OR ¼ 0.86; 95% CI ¼ 0.74-0.98; P ¼ 0.046), soluble fibers from whole-grain foods (OR ¼ 0.43; 95% CI ¼ 0.25-0.76; P ¼ 0.002) and soluble fibers from fruits (OR ¼ 0.76; 95% CI ¼ 0.62-0.95; P ¼ 0.017). Whole-grain and fruits were the foods negatively associated with MS. Conclusions: The intake of soluble fibers, particularly from whole-grain foods and fruits, may have a protective role for the presence of MS in this selected sample of patients with type 2 DM.

RESUMOO papel da dieta na síndrome metabólica (SM) tem sido estudado em relação a cada um de seus componentes: obesidade, níveis pressóricos elevados, dislipidemia e alterações no metabolismo da glicose. Entretanto, poucos estudos avaliaram os efeitos da dieta na presença da SM como uma entidade clínica independente. O objetivo deste manuscrito foi revisar a importância dos fatores dietéticos e as recomendações dietoterápicas na SM. Estudos recentes demonstraram que o consumo de grãos integrais foi associado negativamente com SM. Já alimentos com alto índice glicêmico foram associados positivamente com resistência à insulina e prevalência de SM. O seguimento de uma dieta mediterrânea foi capaz de reduzir o número de componentes da SM. Também a adoção da dieta DASH melhorou o perfil de todos os componentes da SM. Recomenda-se, para pacientes com SM, um valor energético total compatível com a obtenção e/ou manutenção do peso corporal desejável. O conteúdo de gordura, em especial o consumo de gordura saturada, e colesterol deve ser reduzido e o consumo de grãos integrais, frutas e vegetais, aumentado. Provavelmente as fibras alimentares têm um papel importante no manejo dietoterápico da SM. Novos estudos que avaliem o papel da dieta na presença e no desenvolvimento da SM são necessários. The role of diet in metabolic syndrome (MS) has been studied regarding each one of its components: obesity, high blood pressure, dyslipidemia, and abnormal glucose metabolism. However, few studies evaluated the effects of diet in the presence of MS as a unique independent disease. The aim of this manuscript was to review the role of dietary factors and dietary recommendations for MS. Recently some studies demonstrated that intake of whole-grain foods were negatively associated with MS. Foods with high glycemic index were positively associated with insulin resistance and the prevalence of MS. Following a Mediterranean-style diet caused a reduction in the number of MS components. Also, the adoption of the DASH diet improved the profile of all MS components. A total daily energy intake to obtain and/or to maintain a desirable weight is recommended for patients with MS. The fat content, especially from saturated fat, and cholesterol must be reduced and the intake of whole-grain foods, fruits, and vegetables must be increased. Probably, dietary fibers have an important role in the management of MS. New studies to evaluate the role of diet in the presence and development of MS are needed.

The role of each Dietary Approaches to Stop Hypertension (DASH) diet component in blood pressure (BP) of patients with diabetes is still uncertain. The aim of the present study was to evaluate possible associations of the recommended food groups of the DASH diet eating plan with BP values in patients with type 2 diabetes. In the present cross-sectional study, 225 patients with type 2 diabetes (age 61·1 (SD 10·4) years; diabetes duration 13·1 (SD 9·1) years; males 48·4 %; BMI 28·5 (SD 4·3) kg/m 2 ; HbA1c 7·1 (SD 1·3) %; systolic BP 136·7 (SD 20·0) mmHg; diastolic BP 78·4 (SD 11·8) mmHg) without dietary counselling during the previous 6 months had their dietary intake assessed by 3 d weighed-diet records. Patients were divided into two groups according to BP tertiles: LOW BP (first tertile) and HIGH BP (second plus third tertiles). Multivariate logistic regression models demonstrated that the daily intake of 80 g of fruits per 4184 kJ (1000 kcal) (OR 0·781; 95 % CI 0·617, 0·987; P¼0·039) or 50 g of vegetables per 4184 kJ (1000 kcal) (OR 0·781; 95 % CI 0·618, 0·988; P¼ 0·040) reduced the chance of the presence of HIGH mean BP (MBP $92 mmHg) by 22 % each, adjusted for possible confounders. In conclusion, fruit and vegetables were the food groups of the DASH diet associated with reduced BP values in patients with type 2 diabetes, and their consumption might play a protective role against increased BP values.

Heartburn and/or regurgitation affected health-related quality of life of third trimester pregnant women.

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