Publications by authors named "Dorota Szostak-Węgierek"

41 Publications

Validity and efficacy of diets used for preoperative weight reduction among patients qualified for bariatric surgery.

Pol Przegl Chir 2021 Mar;93(2):53-58

Department of Clinical Dietetics, Medical University of Warsaw, Poland.

Introduction: Bariatric surgery is the most effective method of weight reduction among patients suffering from morbid obesity. Reduction of body weight before surgery is an important element. The aim of the study was to present the current knowledge on preoperative weight reduction and diet for this purpose.

Material And Methods: To achieve the aims of the paper, articles available in the PubMed / MEDLINE database published in 2005-2020 were used, as well as the guidelines of societies such as Metabolic and Bariatric Surgery Chapter of the Association of Polish Surgeons, American Association of Clinical Endocrinologists, The Obesity Society and American Society for Metabolic & Bariatric Surgery, International Federation for Surgery of Obesity and Metabolic Disorders-European Chapter and European Association for the Study of Obesity.

Results: Studies show that even a modest reduction in weight in the early preoperative period facilitates surgery and reduces the number of complications. The available data do not support the effect of preoperative weight loss on increased postoperative weight loss. The use of balanced, energy-restricted diet in the preoperative period prepares the patient for changes in the way of nutrition, which improves the nutritional status of patient. Low calorie (LCD) or very low calorie (VLCD) diet can be an effective method of weight loss before surgery, however, this approach does not allow to modify eating habits. The use of a very low calorie ketogenic diet (VLCKD) remains under discussion.

Conclusions: There is a need for large randomized trials to assess short and long term benefits of preoperative weight loss and methods of weight loss among patients qualified for bariatric surgery, also the standardization of nutritional management in the preoperative period.
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http://dx.doi.org/10.5604/01.3001.0014.7953DOI Listing
March 2021

The Influence of Nutrition on Adiponectin-A Narrative Review.

Nutrients 2021 Apr 21;13(5). Epub 2021 Apr 21.

Department of Clinical Dietetics, Faculty of Health Sciences, Medical University of Warsaw, E Ciołka Str. 27, 01-445 Warsaw, Poland.

The adipose tissue is an active endocrine organ which synthesizes and secretes a variety of adipokines, including adiponectin with its anti-inflammatory properties. Its expression is influenced by numerous factors such as age, sex, body weight and adipose tissue content. However, dietary factors, i.e., diet structure and the percentage of individual nutrients and products, are very important modulators. Beneficial dietary habits are the Mediterranean diet, DASH diet, diet based on plant products and diet with reduced energy value. Moreover, the share of individual products and nutrients which increase the concentration of adiponectin is worth noting. This group may include monounsaturated fatty acids, polyunsaturated omega-3 fatty acids, dietary fiber, polyphenols, alcohol and milk products. Conversely, dietary ingredients which have a negative effect on the concentration of adiponectin are typical components of the Western diet: saturated fatty acids, trans fatty acids, monosaccharides and disaccharides, and red meat. Furthermore, a diet characterized by a high glycemic index such as a high-carbohydrate low-fat diet also seems to be unfavorable. Due to the fact that available knowledge should be systematized, this study aimed to summarize the most recent research on the influence of dietary factors on the concentration of adiponectin.
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http://dx.doi.org/10.3390/nu13051394DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8143119PMC
April 2021

Hospital Malnutrition, Nutritional Risk Factors, and Elements of Nutritional Care in Europe: Comparison of Polish Results with All European Countries Participating in the nDay Survey.

Nutrients 2021 Jan 18;13(1). Epub 2021 Jan 18.

Department of Clinical Dietetics, Faculty of Health Sciences, Medical University of Warsaw, E Ciołka Str. 27, 01-445 Warsaw, Poland.

NutritionDay (nDay) is a project established by the Medical University of Vienna and the European Society for Clinical Nutrition and Metabolism (ESPEN) to audit the nutritional status of hospitalized patients and nursing home residents. This study aimed to evaluate nDay data describing the prevalence of hospital malnutrition, nutritional risk factors, and elements of the nutritional care process implemented in hospital wards in 25 European countries and to compare the data derived from Poland with the data collected in all the European countries participating in the study. In total, 10,863 patients (European reference group: 10,863 participants including Poland: 498 participants) were involved in the study. The prevalence of malnutrition was identified on the basis of the ESPEN diagnostic criteria established in 2015, while the prevalence of nutritional risk factors was assessed by analyzing the following parameters: body mass index (BMI), score of Malnutrition Screening Tool (MST), recent weight loss, insufficient food intake, decreased appetite, increased number of drugs intake, reduced mobility, and poor self-reported health status. Malnutrition prevalence was 12.9% in patients from the European reference group and 9.4% in patients from Polish hospital wards ( < 0.05). However, the prevalence of some nutritional risk factors, i.e., recent weight loss, history of decreased food intake, and low actual food intake, were approximately four times more prevalent than diagnosed malnutrition (referring to approximately 40-50% of all participants). In comparison to the European reference group, the significant differences observed in Polish hospital wards concerned mainly dietitian's involvement in the process of treating malnutrition (16% vs. 57.2%; < 0.001); supply of special diets (8% vs. 16.1%; < 0.0001); provision of oral nutritional support (ONS) (3.8% vs. 12.2%; < 0.0001); prescription of enteral/parenteral nutrition therapy to hospitalized patients (8.2% vs. 11.7%; < 0.001); as well as recording patient weight performed at hospital admission (100% vs. 72.9%; < 0.0001), weekly (20% vs. 41.4%; < 0.05), and occasionally (0% vs. 9.2%). These results indicate that the prevalence of malnutrition and malnutrition risk factors in hospitalized patients in Poland was slightly lower than in the European reference group. However, some elements of the nutritional care process in Polish hospitals were found insufficient and demand more attention.
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http://dx.doi.org/10.3390/nu13010263DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7831488PMC
January 2021

The Prevalence of Sarcopenic Obesity in Postmenopausal Women with a History of Breast Cancer Depending on Adopted Methodology - A Case-Control Study.

J Multidiscip Healthc 2020 27;13:1749-1758. Epub 2020 Nov 27.

Department of Clinical Dietetics, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland.

Introduction: Sarcopenic obesity (SO) is characterized as the cooccurrence of sarcopenia and obesity. It is associated with many adverse health consequences, also in oncological patients. The study aimed to assess the prevalence of SO in postmenopausal women with a history of breast cancer depending on adopted methodology.

Materials And Methods: The case-control study enrolled 103 women over the age of 50 with a history of breast cancer, including women who completed oncological treatment and had remained in remission for at least 5 years (group I, n=78) and women in whom the disease recurred (group II, n=25). The control group included women with no history of breast cancer (group III, n=73).

Results: In group II sarcopenia occurred significantly more commonly compared to both group I and the control group (for the skeletal muscle index (SMI) ≤29.20%: 13 (52%) in group II vs 16 (20.5%) in group I, p=0.004 and 3 (4.1%) in group III, p<0.001; for SMI ≤26.60%: 10 (40%) in group II vs 9 (11.5%) in group I, p=0.003 and 3 (4.1%) in group III, p<0.001; for SMI ≤33.87%: 17 (68%) in group II vs 21 (26.9%) in group I, p<0.001 and 5 (6.8%) in group III, p<0.001). Depending on the assessment criteria, SO was diagnosed in 0-11.5% of cases in group I, 0-40% of cases in group II and 0-4.1% in the control group. Intergroup differences were not statistically significant, irrespective of the adopted pair of diagnostic criteria. The highest detectability of SO was observed when SMI was combined with each of the diagnostic criteria for obesity used.

Discussion: SO diagnosis based on the percentage of fatty tissue mass in the body of >38% and SMI value were associated with a higher detection rate of SO in each study group, regardless of the adopted cut-off value. Similar results were obtained in each analyzed group when using the remaining diagnostic criteria for obesity and SMI value, regardless of the cut-off value.
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http://dx.doi.org/10.2147/JMDH.S274660DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7708830PMC
November 2020

Milk and Dairy Products and Their Impact on Carbohydrate Metabolism and Fertility-A Potential Role in the Diet of Women with Polycystic Ovary Syndrome.

Nutrients 2020 Nov 13;12(11). Epub 2020 Nov 13.

Department of Clinical Dietetics, Faculty of Health Sciences, Medical University of Warsaw, E Ciołka Str. 27, 01-445 Warsaw, Poland.

Milk and dairy products are considered an important component of healthy and balanced diet and are deemed to exert a positive effect on human health. They appear to play a role in the prevention and treatment of carbohydrate balance disturbances. The products include numerous valuable components with a potential hypoglycemic activity, such as calcium, vitamin D, magnesium and probiotics. Multiple authors suggested that the consumption of dairy products was negatively associated with the risk of type 2 diabetes mellitus, insulin resistance and ovulation disorders. However, there are still numerous ambiguities concerning both the presumed protective role of dairy products in carbohydrate metabolism disorders, and the advantage of consuming low-fat dairy products over high-fat ones, especially in women with the risk of ovulation disorders. Therefore, this literature review aims at the presentation of the current state of knowledge concerning the relationship between dairy product consumption and the risk of insulin resistance, type 2 diabetes mellitus in women, and the potential effect on the course of polycystic ovary syndrome.
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http://dx.doi.org/10.3390/nu12113491DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7696580PMC
November 2020

Dietary Acid Load and Cardiometabolic Risk Factors-A Narrative Review.

Nutrients 2020 Nov 7;12(11). Epub 2020 Nov 7.

Department of Clinical Dietetics, Faculty of Health Sciences, Medical University of Warsaw, E Ciołka Str. 27, 01-445 Warsaw, Poland.

The Western, diet rich in acidogenic foods (e.g., meat, fish and cheese) and low in alkaline foods (e.g., vegetables, fruits and legumes), is deemed to be a cause of endogenous acid production and elevated dietary acid load (DAL), which is a potential cause of metabolic acidosis. Multiple authors have suggested that such a dietary pattern increases the excretion of calcium and magnesium, as well as cortisol secretion. In addition, it is associated with decreased citrate excretion. All of these seem to increase blood pressure and insulin resistance and may contribute to the development of cardiometabolic disorders. However, there are inconsistencies in the results of the studies conducted. Therefore, this narrative literature review aims to present the outcomes of studies performed in recent years that investigated the association between DAL and the following cardiometabolic risk factors: blood pressure, hypertension, carbohydrate metabolism and lipid profile. Study outcomes are divided into (i) statistically significant positive association, (ii) statistically significant inverse association, and (iii) no statistically significant association.
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http://dx.doi.org/10.3390/nu12113419DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7695144PMC
November 2020

Impact of Infant and Maternal Factors on Energy and Macronutrient Composition of Human Milk.

Nutrients 2020 Aug 26;12(9). Epub 2020 Aug 26.

Department of Neonatology, Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Family Hospital, Faculty of Health Science, Medical University of Warsaw, Zwirki i Wigury Str. 63A, 02-091 Warsaw, Poland.

The present study investigates the influence of selected infant and maternal factors on the energy and macronutrient composition of mature human milk (HM). The study enrolled 77 mothers at 4-8 weeks postpartum. Each mother provided 1 sample of HM. Each extracted HM sample was formed by mixing four subsamples of HM, each of which were obtained in one predefined 6-h periods of the day. Among maternal factors, the analysis included: anthropometric data before and after pregnancy; weight gain in pregnancy; body composition, assessed using the Maltron BioScan 920-II to analyze bioimpedance; and dietary intake, assessed with three-day dietary records. Among the neonatal factors, birth weight and length, number of daily feedings and type of delivery were included. The composition of HM, including energy content, protein, fat and carbohydrate concentrations, was analyzed using the Miris human milk analyzer. Pearson's and Spearman's correlation coefficients and multivariable logistic regression models were used to analyze the association between the selected maternal and infant factors and HM milk composition. It was found that total protein content of HM was correlated with pre-pregnancy BMI (Spearman rho = 0.238; = 0.037), current lean body mass (Spearman rho = -0.293, = 0.01) and total water content (Spearman rho = -0.315, = 0.005). Carbohydrates were the only macronutrients whose composition was significantly affected by the infant factors. It was reported that higher carbohydrate content was associated with male sex (OR = 4.52, = 0.049). Our results show that maternal and infant factors, especially maternal pre-pregnancy and current nutritional status and infant sex, interact and affect HM composition, suggesting that macronutrient and energy content in HM may be determined in pregnancy and may have unique compositional profile for every mother-infant dyad.
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http://dx.doi.org/10.3390/nu12092591DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7551856PMC
August 2020

Influence of two different methods of nutrition education on the quality of life in children and adolescents with type 1 diabetes mellitus - a randomized study.

Rocz Panstw Zakl Hig 2020 ;71(2):197-206

Department of Clinical Dietetics, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland.

Background. Nutrition education is one of the most important factors determining the effectiveness of treatment and maintaining an adequate quality of life (QoL) in children and adolescents with type 1 diabetes.

Material and Methods. A randomized single-blind study was conducted between October 2017 and April 2019 at the Children's Clinical Hospital in Warsaw. The study included 170 patients (aged 8-17) with at least 1-year history of type 1 diabetes, treated with insulin pumps. The participants were randomly divided into two groups: a control group (C) - traditional/ informative education methods, and an experimental group (E) - modern/interactive methods. PedsQL Diabetes Module 3.0 questionnaire was used in the assessment of the QoL. Total PedsQL score was the primary outcome. The secondary outcomes included the results obtained in five subscales of the questionnaire. The relationships between selected variables and changes in scores were also verified.

Results. Data obtained from 136 patients were analyzed. In both groups no significant changes regarding total PedsQL were noted 6 months after the intervention. However, a significant reduction occurred as regards the scores of 'Communication' subscale in group C. Analyzing other determinants of the QoL, significant dependencies were observed between: the level of physical activity and a change in 'Diabetes symptoms' subscale, and the level of parents' education and a change in 'Treatment barriers' subscale.

Conclusions. Both methods of nutrition education exerted a comparable influence on the total QoL. However, modern methods were more effective in terms of the improvement in the aspect of communication. Additionally, moderate physical activity and parents' tertiary education constituted valid determinants of various aspects of the QoL in children and adolescents with type 1 diabetes.
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http://dx.doi.org/10.32394/rpzh.2020.0117DOI Listing
April 2021

Resting Energy Expenditure during Breastfeeding: Body Composition Analysis vs. Predictive Equations Based on Anthropometric Parameters.

Nutrients 2020 Apr 30;12(5). Epub 2020 Apr 30.

Department of Clinical Dietetics, Faculty of Health Sciences, Medical University of Warsaw, E Ciolka Str. 27, 01-445 Warsaw, Poland.

Accurate estimation of energy expenditure in a breastfeeding woman is crucial for maintaining the proper nutritional status of the woman and healthy development of the infant. The current literature does not contain data regarding resting energy expenditure (REE) in breastfeeding women. Using mathematical equations is the most common method of REE assessment. However, due to changes in metabolism and body composition during pregnancy and lactation, the mathematical equations used among the general population may not apply. The aim of this study was to evaluate the resting energy expenditure of exclusively breastfeeding women by using body composition analysis - estimated REE (eREE) and to provide the most appropriate predictive equations - predicted REE (pREE) based on anthropometric parameters to estimate it. This was a pilot study with 40 exclusively breastfeeding women. Height and weight were measured and body composition analysis was performed. We predicted REE using fourteen self-selected equations, based on anthropometric parameters and/or age, and/or sex. The median eREE was 1515.0 ± 68.4 kcal (95% Cl, 1477-1582 kcal) and the pREE ranged from 1149.7 kcal (95% Cl, 1088.7-1215.0) by Bernstein et al., to 1576.8 kcal (95% Cl, 1479.9-1683.4), by Müller et al. Significant differences between eREE and all pREE were observed ( < 0.001, except Korth et al. equations). The Müller et al. equation was the most accurate with the smallest individual variation. All predictive equations showed low agreement, and in most cases, the results were underestimated. These findings indicate the need for further studies to propose more suitable methods to determine the energy requirements for breastfeeding women.
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http://dx.doi.org/10.3390/nu12051274DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282268PMC
April 2020

Evaluation of questionnaire as an instrument to measure the level of nutritional and weight gain knowledge in pregnant women in Poland. A pilot study.

PLoS One 2020 15;15(1):e0227682. Epub 2020 Jan 15.

Department of Epidemiology and Biostatistics, Institute of Mother and Child, Warsaw, Poland.

Pregnancy is a period in life in which women are willing to improve their lifestyle. Providing proper information for these women is crucial for their health and the health of their offspring. Clear information about weak points in their nutritional and weight gain knowledge is the first step for proper health care assistance. There are a few previous studies evaluating the nutritional and weight gain knowledge of pregnant women. In the few studies available, different approaches were taken and there was no wider discussion on the content of the questionnaires attempting to measure level of knowledge. The aim of this study, designed in a pilot fashion, was to test the adequacy of the questionnaire as a research instrument in a group of 139 pregnant Polish women. The developed instrument is a 33-item questionnaire comprising four domains: weight gain, importance of nutrients, quality and quantity of food intake. The results of this study indicate that the questionnaire is stable and internal consistency is acceptable (Cronbach's alpha > 0.7) for dimensions with more than four items. For dimensions with less than four items, internal consistency was poor (Cronbach's alpha < 0.7). The cumulative explained variance for domains weight gain, importance of nutrients, quantity and quality of food intake was 54.74%, 42.74%, 54.42% and 48.99% respectively. Results from validity, reliability and factor analysis indicate that the questionnaire is adequate for its purpose.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0227682PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6961901PMC
April 2020

Interactive Nutrition Education Is More Effective in Terms of Improved Levels of Glycated Hemoglobin in Adolescent Patients with Poorly Controlled Type 1 Diabetes - A Randomized Study.

Diabetes Metab Syndr Obes 2019 10;12:2619-2631. Epub 2019 Dec 10.

Department of Clinical Dietetics, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland.

Introduction: Effectively conducted nutrition education is one of the key elements of the therapy of type 1 diabetes. The aim of the study was to compare the effectiveness of two methods of nutrition education.

Material And Methods: A noninvasive interventional randomized single-blind study included 151 patients (13.7±2.2 years old) with poorly controlled type 1 diabetes, treated with the use of insulin pumps. The participants were randomly divided into two groups: a control group (C) in which informative education methods were used (a lecture) and an experimental group (E) in which interactive methods (quiz and multimedia application) were additionally applied. The concentration of glycated hemoglobin (HbA1c) was the primary outcome. The secondary outcomes were: standard deviation score-body mass index (SDS-BMI), standard deviation score-systolic blood pressure (SDS-SBP), standard deviation score-diastolic blood pressure (SDS-DBP), scores of Nutrition Knowledge Survey (NKS) and indices of healthy and unhealthy diet.

Results: A marked reduction in HbA1c concentrations was observed after 3 months in group E [-0.47% (-0.77; -0.17), P<0.01; P=0.038 for the intergroup difference]. The positive effect was no longer present after 6 months. No significant changes regarding HbA1c were noted in group C at any stage of the study. After 6 months, both groups obtained better results in one part of NKS ("Blood glucose response to food"): group C [0.41 (0.15; 0.66), P<0.01], group E [0.80 (0.52; 1.08), P<0.001; P=0.042 for the intergroup difference]. No statistically significant differences between groups were noted as regards the remaining parameters.

Conclusion: Interactive nutrition education is more effective in terms of improved levels of HbA1c in children and adolescents with poorly controlled diabetes. However, an intensification of training frequency is recommended due to the transient effect of education.
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http://dx.doi.org/10.2147/DMSO.S229246DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6911330PMC
December 2019

The prevalence and types of oral- and pharyngeal-stage dysphagia in patients with demyelinating diseases based on subjective assessment by the study subjects.

Mult Scler Relat Disord 2020 Jan 30;37:101484. Epub 2019 Oct 30.

Department of Clinical Dietetics, Medical University of Warsaw, Poland.

Background: Studies show that dysphagia is a common problem in patients with demyelinating diseases. However, there are no published studies on dysphagia in this group of patients, which would include the individual phases or the safety and effectiveness of the swallowing process.

Objective: The main objective of this study was to assess the prevalence of swallowing disorders and to characterize them based on subjective assessment by the study subjects with multiple sclerosis and Devic's syndrome.

Method: The study included 72 patients (47 F, 25 M). Patients at risk of dysphagia were identified using the DYMUS, EAT-10 and SDQ questionnaires. To assess the type of oral- and pharyngeal-stage dysphagia, questions in the questionnaires were classified into groups according to symptoms typical of each stage.

Results: The risk of dysphagia and the need for instrumental examination were identified in 37.5% of the study subjects. Pharyngeal-stage dysphagia (repeated swallowing, increased effort of swallowing, cough, a feeling of food sticking in the throat) was reported to occur at a significantly higher frequency. However, no differences were found between difficulty in swallowing liquids and difficulty in swallowing solid food.

Conclusion: There is a need for further research, which should include a detailed dysphagia-oriented diagnosis, with a view to gaining a detailed insight into the pathophysiology of deglutition in this group of patients.
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http://dx.doi.org/10.1016/j.msard.2019.101484DOI Listing
January 2020

May gender influence the quality of life in children and adolescents with type 1 diabetes?

Patient Prefer Adherence 2019 20;13:1589-1597. Epub 2019 Sep 20.

Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland.

Introduction: Appropriate health-related quality of life (HRQOL) in children and adolescents with type 1 diabetes constitutes one of the most important factors that determine treatment effectiveness. There are numerous studies which tackle the issue of the relationship between HRQOL and various clinical and demographic factors, including gender. Therefore, the aim of the present study was to assess HRQOL and identify factors by which it may be affected, with particular emphasis on gender.

Material And Methods: The study group included 197 girls and boys (13.9±2.33 years old) with a history of type 1 diabetes (>1 year) treated with the use of insulin pumps. PedsQL Diabetes Module 3.0 questionnaire was used in the assessment of HRQOL. Multivariate linear regression with gender as a covariate was used to investigate the relationship between total PedsQL score and selected variables associated with patient characteristics, insulin dosage and the control of glycemia. Moreover, the presence of gender differences was verified in terms of variables which significantly affected HRQOL.

Results: Significantly higher results were observed in boys as regards the total PedsQL score (70.8±11.91 vs 62.4±13.91; <0.001) and individual subscales of the questionnaire (except "Worry"). Regression analysis demonstrated the presence of a significant negative relationship between HRQOL assessment and HbA1c concentrations, WHtR value and the frequency of hypoglycemic episodes. However, it was noted that better HRQOL was observed in boys than in girls, regardless of the quality of the metabolic control of diabetes, regular pattern of adipose tissue distribution and experiencing hyperglycemic episodes.

Conclusion: Female gender was an independent factor which adversely affected HRQOL. Other factors which negatively influenced HRQOL included poor metabolic control of diabetes, central distribution of adipose tissue and frequent episodes of hyperglycemia. It seems necessary to focus also on other factors that may potentially influence HRQOL of patients with type 1 diabetes.
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http://dx.doi.org/10.2147/PPA.S206969DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6759230PMC
September 2019

Current and past adherence to the World Cancer Research Fund/American Institute for Cancer Research recommendations in survivors of breast cancer

Rocz Panstw Zakl Hig 2019 ;70(3):295-305

Medical University of Warsaw, Faculty of Health Science, Department of Clinical Dietetics, Erazma Ciołka 27, 01-445 Warsaw, Poland

Background: Breast cancer is the first in the structure of the incidence of neoplastic diseases in women, with the number of affected individuals becoming higher every year. The risk of breast cancer is influenced not only by genetic factors, but also by the lifestyle. Proper dietary habits, a high level of physical activity and normal body weight not only reduce the risk of developing a primary neoplastic lesion, but also a recurrence. In 2007 the World Cancer Research Fund (WCRF) and American Institute for Cancer Research (AICR) published their recommendations concerning lifestyle in the prophylaxis of neoplasms.

Objective: The aim of the study was to assess whether the adherence to WCRF/AICR recommendations influenced the risk of developing breast cancer in women.

Materials And Methods: A case control study included 108 women aged over 50 with a history of breast cancer. The study group was divided into two subgroups: women who completed oncological treatment and experienced no recurrences for at least 5 years (group I, n=82) and women who had a recurrence (group II, n=26). The control group included women with no history of breast cancer (n=74). The adherence of lifestyle was assessed by assigning points for 8 WCRF/AICR recommendations. The results were compared in the study and control groups, both in all participants and separately in those who declared no changes in dietary habits after being diagnosed with breast cancer.

Results: The adherence of lifestyle to WCRF/AICR recommendations was significantly lower in the group of women with a history of cancer compared to the control group. It was reported both in the study group as a whole (5.5 ± 1.34 vs 6.4 ± 1.48 points) and in those who declared no changes in dietary habits after being diagnosed with breast cancer (5.3 ± 1.24 vs 6.6 ± 1.38 points). The differences in the lifestyles of the participants with breast cancer and those in the control group were associated predominantly with the adherence to recommendations concerning appropriate physical activity, avoiding the consumption of sweetened drinks and limiting the consumption of processed and red meat.

Conclusions: The results of the study confirmed the benefits of complying with WCRF/AICR recommendations in the prevention of breast cancer.
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http://dx.doi.org/10.32394/rpzh.2019.0081DOI Listing
February 2020

Differences in food consumption in regions of Poland that had been previously under Austrian, Prussian and Russian annexations

Rocz Panstw Zakl Hig 2019 ;70(3):287-294

Department of Epidemiology, Prevention of Cardiovascular Diseases and Health Promotion, Institute of Cardiology, Niemodlińska street 33, 04-635 Warsaw, Poland

Background: It seems that one of the factors affecting the way of nutrition in Poland was the dietary habits of countries that in the late 18th century made partitions, ie. Russia, Prussia and Austria. Therefore, nutrition models in the areas of individual partitions have undergone significant changes.

Objective: The aim of the study was to check whether after 85 years after regaining independence there were still differences in the way of feeding indigenous inhabitants of areas previously under Austrian, Prussian and Russian annexation.

Material And Methods: The data collected during the WOBASZ survey carried out in the years 2003-2005 were used for the analysis.

Results: The greatest differences in the way of feeding were found in the area that was previously under the rule of Prussia. The nutrition model was still largely reminiscent of typical German cuisine. There was a large consumption of sausages and spreads, and small vegetables and fruit. Nutrition models in other areas were less characteristic.

Conclusions: The way of feeding indigenous people living in areas that were once partitions of Poland is still diverse and similar to the cuisine of the occupying country.
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http://dx.doi.org/10.32394/rpzh.2019.0079DOI Listing
February 2020

The Concentration of Omega-3 Fatty Acids in Human Milk Is Related to Their Habitual but Not Current Intake.

Nutrients 2019 Jul 12;11(7). Epub 2019 Jul 12.

Department of Clinical Dietetics, Faculty of Health Sciences, Medical University of Warsaw, E Ciolka Str. 27, 01-445 Warsaw, Poland.

This study determined fatty acid (FA) concentrations in maternal milk and investigated the association between omega-3 fatty acid levels and their maternal current dietary intake (based on three-day dietary records) and habitual dietary intake (based on intake frequency of food products). Tested material comprised 32 samples of human milk, coming from exclusively breastfeeding women during their first month of lactation. Milk fatty acids were analyzed as fatty acid methyl ester (FAME) by gas chromatography using a Hewlett-Packard 6890 gas chromatograph with MS detector 5972A. We did not observe any correlation between current dietary intake of omega-3 FAs and their concentrations in human milk. However, we observed that the habitual intake of fatty fish affected omega-3 FA concentrations in human milk. Kendall's rank correlation coefficients were 0.25 ( = 0.049) for DHA, 0.27 ( = 0.03) for EPA, and 0.28 ( = 0.02) for ALA. Beef consumption was negatively correlated with DHA concentrations in human milk (r = -0.25; = 0.046). These findings suggest that current omega-3 FA intake does not translate directly into their concentration in human milk. On the contrary, their habitual intake seems to markedly influence their milk concentration.
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http://dx.doi.org/10.3390/nu11071585DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683022PMC
July 2019

Maternal Nutritional and Water Homeostasis as a Presage of Fetal Birth Weight.

Adv Exp Med Biol 2019 ;1176:89-99

First Department of Obstetrics and Gynecology, Warsaw Medical University, Warsaw, Poland.

Birth weight is a key determinant of perinatal outcomes which affect physical development and metabolic function. In this study, we evaluated the potential role of maternal body composition and nutritional status in programing fetal birth weight. This was a longitudinal study that included 29 pregnant women and their full-term newborns. Maternal dietary energy and fluid intake and body adipose tissue were assessed. In addition, we measured the serum content of copeptin, aldosterone, and angiotensin II in maternal and umbilical cord blood. The measurements were done across the three trimesters of pregnancy, on average, at 11.6 weeks, 18.3 weeks, and 30.2 weeks. Each newborn's birth weight was determined at the percentile line, using the World Health Organization (WHO) standards based on the gestational age, gender, and weight. We found no appreciable relation of fetal birth weight to the maternal dietary and fluid intakes, and the content of angiotensin II, aldosterone, or copeptin. However, birth weight correlated with increases in body adipose tissue in early pregnancy stages. Further, birth weight correlated positively with copeptin and adversely with angiotensin II in cord blood. We conclude that the present findings may be helpful in the assessment of a critical level of body adipose tissue in women of child-bearing age, above which the potential risk of macrosomia appears. The female population of child-bearing age needs a continual update on the nutritional knowledge to prevent modifiable maternal and fetal perinatal complications.
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http://dx.doi.org/10.1007/5584_2019_389DOI Listing
September 2019

Analysis of the diet quality and dietary habits of children and adolescents with type 1 diabetes.

Diabetes Metab Syndr Obes 2019 17;12:161-170. Epub 2019 Jan 17.

Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland.

Introduction: The dietary habits of patients with type 1 diabetes are key elements of treatment as they facilitate the normalization of glycemia and maintenance of normal body weight (BW), lipid concentration, and the level of blood pressure. Therefore, the aim of this study was to analyze dietary habits and to verify the influence of the quality of diet on insulin dosage and selected clinical variables.

Materials And Methods: The study included 194 subjects (8-18 years old) suffering from type 1 diabetes and treated with the use of insulin pump. A modified KomPAN questionnaire was used to assess dietary habits and the frequency of the consumption of selected products. Two groups of patients were distinguished: G1 (poorer quality of diet) and G2 (better quality of diet). Clinical data were also collected.

Results: Very low scores were noted in the whole study group as regards the index of healthy diet (27.6±11.1, 3.8-61.0). After dividing the participants into groups, it was observed that G1 included more boys (63.8%), and more girls were found in G2 (66.9%). G2 patients chose sweet and salty snacks and fried meals less frequently, and they consumed boiled dishes and avoided sweetening with sugar or honey more frequently. The following characteristics were observed in G1 patients: longer duration of the disease (6.5 vs 5.2 years), higher doses of insulin (0.86 vs 0.76 U/kg of BW/day), and being overweight (31.0% vs 17.6%) and underweight (19.0% vs 8.8%) noted twice more frequently. We did not observe differences concerning the concentration of glycated hemoglobin and lipids in the serum and the values of blood pressure.

Conclusion: The findings revealed unsatisfactory dietary habits in children and adolescents with type 1 diabetes and indicated the necessity to analyze additional factors that might influence the quality of diet of the patients.
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http://dx.doi.org/10.2147/DMSO.S186237DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6342209PMC
January 2019

Maternal Nutrition and Body Composition During Breastfeeding: Association with Human Milk Composition.

Nutrients 2018 Sep 27;10(10). Epub 2018 Sep 27.

Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Family Hospital, Faculty of Health Science, Department of Neonatology, Medical University of Warsaw, Zwirki i Wigury Str. 63A, 02-091 Warsaw, Poland.

The composition of human milk is dynamic and can vary according to many maternal factors, such as diet and nutritional status. This study investigated the association of maternal nutrition and body composition with human milk composition. All measurements and analyses were done at three time points: during the first ( = 40), third ( = 22), and sixth ( = 15) month of lactation. Human milk was analyzed using the Miris human milk analyzer (HMA), body composition was measured with bioelectrical bioimpedance (BIA) using a Maltron BioScan 920-II, and the assessment of women's nutrition was based on a three-day dietary record. The correlation coefficient (Pearson's ) did not show a significant statistical relationship between human milk composition and nutrients in women's diet at three time points. For women in the third month postpartum, we observed moderate to strong significant correlations ( ranged from 0.47 to 0.64) between total protein content in milk and the majority of body composition measures as follows: positive correlations: % fat mass ( = 0.60; = 0.003), fat-free mass expressed in kg ( = 0.63; = 0.001), and muscle mass ( = 0.47; = 0.027); and negative correlation: % total body water ( = -0.60; = 0.003). The variance in milk fat content was related to the body mass index (BMI), with a significant positive correlation in the first month postpartum ( = 0.33; = 0.048). These findings suggest that it is not diet, but rather the maternal body composition that may be associated with the nutritional value of human milk.
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http://dx.doi.org/10.3390/nu10101379DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213543PMC
September 2018

Dietary acid load and cardiometabolic risk in the Polish adult population.

Adv Clin Exp Med 2018 Oct;27(10):1347-1354

Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, National Institute of Cardiology, Warszawa, Poland.

Background: The potential influence of disorders of acid/base homeostasis on cardiovascular risk factors has been suggested.

Objectives: The aim of the study was to estimate the relationship between dietary acid load and the prevalence of cardiovascular disease and the prevalence and intensity of cardiovascular risk factors (i.e., hypertension, diabetes, overweight and obesity, dyslipidemia) in the Polish adult population.

Material And Methods: Data was derived from a cross-sectional survey of a random sample of 6,170 Polish residents aged 20+ (Multi-Center National Population Health Examination Survey, WOBASZ II study), including anthropometric and laboratory measurements, and estimates of nutrient intakes by 24-h recall. Dietary acid/ base load was assessed as potential renal acid load (PRAL) and net endogenous acid production (NEAP).

Results: The median PRAL and NEAP values for the whole study population were: PRAL -3.85 mEq/day and NEAP 39.79 mEq/day. The prevalence of overweight and obesity, both in males and females, tended to decrease across tertiles of PRAL and to increase across tertiles of NEAP. In females, the values of several metabolic characteristics differed across tertiles of NEAP. After adjustment for age and waist circumference, these relationships did not persist, but the prevalence of diabetes was found to increase across tertiles of PRAL (p for trend <0.05) in females.

Conclusions: The dietary acid load in the Polish adult population was relatively low. There was no independent relationship between dietary acid load and cardiovascular disease and its risk factors in the population under study, except for the positive association between the PRAL value and diabetes prevalence in females.
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http://dx.doi.org/10.17219/acem/69733DOI Listing
October 2018

Dietary practices and nutritional status in survivors of breast cancer

Rocz Panstw Zakl Hig 2018;69(2):175-182

Medical University of Warsaw, Faculty of Health Science, Department of Clinical Dietetics, Warsaw, Poland

Background: Wrong dietary practices and excessive body mass may not only influence the risk of primary breast cancer but also the risk of its recurrence.

Objective: Evaluation of dietary practices and identification of nutritional factors which may influence the risk of tumor recurrence in women with prior breast cancer.

Materials And Methods: The case-control study involved 108 women aged 50 years and older with history of breast cancer who were divided into two categories: women after completed cancer treatment with no recurrence for minimum 5 years (group I, n=82) and women with diagnosed breast cancer recurrence (group II, n=26). A control group (n=74) constituted of subjects with no breast cancer diagnosis. In every subject anthropometric measurements were taken and dietary practices were evaluated by means of an original questionnaire.

Results: Average BMI and hip circumference values were higher in the group II than in the group I. In both study groups the percentage of high WHR values was significantly higher than in the control group. Women with history of cancer consumed significantly fewer vegetable and fruit and more refined cereals, dairy products, meat and cold cuts than women in the control group. Group I responders more often declared implementation and maintenance of changes in their diet after diagnosis of cancer than women from group II. Subjects with cancer history consumed more alcohol and more often used supplements than females in the control group.

Conclusion: Avoiding overweight and obesity along with following the principles of a healthy diet seems to reduce the risk of both breast cancer incidence and its recurrence.
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August 2018

Metabolic syndrome and its components in Polish women of childbearing age: a nationwide study.

BMC Public Health 2017 07 13;18(1):15. Epub 2017 Jul 13.

Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, Institute of Cardiology, Warsaw, Poland.

Background: Abnormal body mass and related metabolic disorders may affect female reproductive health. The purpose of the study was to determine the prevalence of underweight, overweight, obesity, lipid and glucose metabolism disorders, hypertension, and metabolic syndrome, among Polish women of childbearing age.

Methods: One thousand five hundred eighty-eight non-pregnant Polish women of childbearing age (20-49 years) who participated in the Multi-Centre National Population Health Examination Survey (WOBASZ II study) in 2013-2014, were assigned to 3 age groups: 20-29 years (n = 403), 30-39 years (n = 600) and 40-49 years (n = 585). Measurements of weight, height, waist circumference, blood pressure, blood lipids, and blood glucose were taken. For statistical analysis, the Kruskal-Wallis, Chi-Square, and Cohran-Armitage tests were used.

Results: Of the participants, 4.3% were determined to be underweight, 25.2% were overweight, 15% were obese, and 53.1% had abdominal obesity. With age, the prevalence of both excessive body mass and abdominal obesity tended to increase, and that of underweight to decrease. Frequency of hypercholesterolemia and hypertriglyceridemia found in the whole group were 50% and 12.6% respectively, and also tended to rise with age. Low serum HDL-cholesterol (high density lipoprotein cholesterol) levels were found in 15.1% of the participants. Prevalence of impaired fasting glucose in the whole group was 8.2% and tended to increase with age. Diabetes was found in 1.2% of the participants and its prevalence also tended to rise with age, at the borderline of significance. Frequency of arterial hypertension and metabolic syndrome in the whole group was 15.7% and 14.1% respectively and both tended to increase with age.

Conclusions: Overweight and obesity, especially of abdominal type, and the related metabolic abnormalities are common in Polish women of childbearing age. Their prevalence tends to increase with age. Underweight is relatively common in the youngest age group.
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http://dx.doi.org/10.1186/s12889-017-4564-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508652PMC
July 2017

Are dietary habits of the Polish population consistent with the recommendations for prevention of cardiovascular disease? - WOBASZ II project.

Kardiol Pol 2016 18;74(9):969-77. Epub 2016 Jan 18.

Zakład Epidemiologii, Prewencji Chorób Układu Krążenia i Promocji Zdrowia, Instytut Kardiologii w Warszawie.

Background: Diet is a modifiable risk factor for cardiovascular disease (CVD).

Aim: To assess diet quality in the adult Polish population, taking into consideration consumption of various nutrients as well as the total diet quality.

Methods: Within the frame of the National Multicentre Health Survey (WOBASZ II), a random sample of the whole Polish population aged 20 years and above was screened during the years 2013-2014. Dietary habits were assessed in 5690 subjects (2554 men and 3136 women). Nutrient intakes were compared to the Dietary Reference Intakes. Total diet quality was measured using the Healthy Diet Indicator (HDI) score, based on the World Health Organisation recommendations for CVD prevention, that includes 7 nutrients (saturated and polyunsaturated fatty acids, cholesterol, protein, dietary fibre, fruits and vegetables, free sugars) and ranges from 0 (the least healthy diet) to 7 (the healthiest diet).

Results: The studied group was characterised by a high prevalence of overweight and obesity (69% in men vs. 59% in women), hypercholesterolaemia (56% vs. 55%, respectively), hypertension (50% vs. 42%), and diabetes (12% vs. 10%). At the same time, a significant percentage of Poles had improper dietary habits. A low fat and low cholesterol diet was reported by only 8% and a low calorie diet by 1% of the respondents. Adding salt to already seasoned dishes was reported by 27% of men and 18% of women, and 56% and 30% of them, respectively, consumed meat products with visible fat. The diet of most adult Polish citizens was found to be not balanced. Vitamins A, C, E, B1, B2, B6, and B12, protein, dietary cholesterol and fruits/vegetables were consumed in recommended doses only by 44-80% of the respondents. The recommended intake of fat, saturated and polyunsaturated fatty acids, which significantly affect lipid levels, was found in 18-37% of the respondents. Dietary intakes of folate and minerals important for the prevention of hypertension were insufficient. The desired level of folate intake was found only in 13-26% of the respondents, and that of magnesium, calcium and potassium in 5-36% of them. The average HDI value was about 3.2 (out of the maximum of 7). A healthy diet (5-7 points) was noted in 15% of adult Poles. Most subjects (60%) were characterised by a low quality diet (0-3 points). Nevertheless, about 55% of respondents believed that their diet was appropriate.

Conclusions: The quality of dietary habits of the majority of the adult Polish population falls far short of the recommendations relevant for CVD prevention.
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http://dx.doi.org/10.5603/KP.a2016.0003DOI Listing
June 2017

Flavonoids intake among Polish and Spanish students.

Rocz Panstw Zakl Hig 2015 ;66(4):319-25

Medical University of Warsaw, Faculty of Health Science, Department of Human Nutrition, Warsaw, Poland.

Background: Flavonoids are a group of bioactive compounds that are extensively found in foodstuffs of plant origin. Their regular consumption plays an important role in the prevention of degenerative diseases, particularly cardiovascular disease, and cancer.

Objective: The purpose of the study was to estimate dietary flavonoid intake among Polish and Spanish students and to establish the main dietary sources of flavonoids.

Material And Methods: This study included 91 Polish and 60 Spanish students. Dietary data were collected using a food frequency questionnaire. The dietary USDA Database for the flavonoid content of selected foods was used to calculate daily and weekly flavonoid intakes by the subjects.

Results: The average flavonoid consumption in the Polish students was 801 mg/day, and in Spanish students 297 mg/day. Food categories such as beverages, vegetables and fruits were found to be significant sources of flavonoids, of which tea, oranges, orange juice, dried parsley and oregano were the main contributors among Polish students and oranges, tea, chick-peas, orange juice and dried parsley were the main sources of flavonoids among Spanish students.

Conclusions: Flavonoid consumption in Polish students was more than two times higher than in Spanish students. Compared to other population studies consumption of flavonoids in both students groups was adequate.
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May 2016

Metabolic disorders in women at procreative age living in Warsaw.

Rocz Panstw Zakl Hig 2015 ;66(3):245-51

Institute of Cardiology, Cardiovascular Disease Prevention and Health Promotion, Department of Epidemiology, Warsaw, Poland.

Background: Abnormal body mass and related metabolic disorders may affect female reproductive health.

Objectives: To determine the prevalence of under- and overweight, and also related metabolic disorders, among women at procreative age in Warsaw.

Material And Methods: 164 non-pregnant women at procreative age (20-49 years) living in Warsaw, who in 2011-2012 participated in the WAW-KARD cross-sectional study of the Warsaw population, assigned to 3 age groups: 20-29 years (n=17), 30-39 years (n=78) and 40-49 years (n=69).

Results: Under- and overweight, obesity and abdominal obesity was found in respectively 1.2%, 25%, 12.2% and 37.2% of the participants. Prevalence of excessive body mass tended to increase with age. Hypercholesterolemia was shown in 42.7% of the whole group and was particularly widespread in the oldest females (56.5%). Prevalence of low serum HDL-cholesterol levels (found in 13.4% of the whole group) tended to increase with age, on the borderline of statistical significance. The mean fasting glucose level was 5.0±0.4 mmol/l and tended to increase with age. Impaired fasting glucose concerned 7.7% and 10.6% of females in age groups of 30-39 and 40-49 years respectively, and diabetes 4.4% of females 40-49 years old. Prevalence of arterial hypertension and metabolic syndrome (MS) in the whole group was 10.4% and 7.3% respectively; prevalence of MS tended to increase with age, on the borderline of statistical significance.

Conclusions: Overweight and obesity, especially of abdominal type, are prevalent in women at procreative age in Warsaw. Disturbances of lipid and glucose metabolism, as well as arterial hypertension and MS, are also frequent. Prevalence of many of them tended to increase with age. Some of the women exhibited diabetes.
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February 2016

Relationship between 28-year food consumption trends and the 10-year global risk of death due to cardiovascular diseases in the adult Warsaw population.

Kardiol Pol 2015 ;73(8):650-5

Department of Epidemiology, Cardiovascular Disease Prevention, and Health Promotion, National Institute of Cardiology, Warsaw, Poland.

Background: Diet plays an important role in the aetiology of cardiovascular (CV) disease. SCORE risk charts are popular and simple tools for the assessment of the global risk of CV death.

Aim: To evaluate food consumption trends in the adult Warsaw population in 1984-2012 and to establish their relationship to the 10-year global risk of death due to CV diseases.

Methods: Nutrient intake and CV risk factors were assessed in independent representative samples of the Warsaw population in the Pol-MONICA projects (in 1984, 1988, 1993, and 2001) and the WAW-KARD project (in 2012). Overall, these surveys included 3404 men and 3446 women aged 35-64 years. The global CV risk was calculated using the SCORE risk chart for high-risk European regions. On the basis of the collected data, trends of dietary intakes and the SCORE risk values in the years 1984-2012 were estimated by linear and nonlinear regressions and correlations.

Results: Over the period of 28 years (1984-2012), a significant decrease in the SCORE risk (by 20% in men and by 35% in women) was seen, accompanied by significant changes in the dietary habits of the Warsaw population. Declining trends (an exponential model) were noted for total energy, total fat, cholesterol, and added animal fat intake. Intake of saturated fatty acids decreased until 2001 and increased thereafter (a second degree polynomial regression model). These changes in the dietary habits of the Warsaw population correlated with the SCORE risk values. Significant correlations were noted for total energy, total fat, and dietary cholesterol intake in both sexes, and animal fat and saturated fatty acid intake in men, with the correlation coefficients ranging from 0.85 to 0.98.

Conclusions: A significant reduction in the SCORE risk was seen in the Warsaw population in 1984-2012, which was associated with positive dietary changes. However, an unexpected decrease and reversal of the favourable trends in the structure of fat consumption occurred in the last decade.
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http://dx.doi.org/10.5603/KP.a2015.0070DOI Listing
February 2017

Health outcomes of vitamin D. Part II. Role in prevention of diseases.

Rocz Panstw Zakl Hig 2014 ;65(4):273-9

Unlabelled: Apart from the classic role of vitamin D, its hormonal active form, calcitriol is also characterized by pleiotropic effects on various organs and tissues. For the last several years, many researchers have shown an association between deficiency of vitamin D and the risk of type 2 diabetes mellitus (T2DM). Recent investigations suggested the need of vitamin D supplementation in T2DM prevention. It was shown that vitamin D deficiency decreases insulin secretion. It was also observed that proper vitamin D supplementation may improve the ability of the cells of the islets of Langerhans to synthesize many proteins de novo and to convert proinsulin to insulin. Apart from regulating bone metabolism and also calcium and phosphate homeostasis, 1,25(OH)2D3 exerts antiproliferative and pro-differentiating effects on a wide variety of cell types. It also induces apoptosis of cancer cells and slows their proliferation. In a number of major studies the relationship between low vitamin D levels and increased risk of various cancers was observed. It concerns colorectal, lung, prostate, breast and ovarian cancer. It was observed that in patients with low serum vitamin D concentrations such disorders as ischemic heart disease, heart attack, stroke, cardiac arrhythmia, and hypertension were more frequent and mortality was significantly higher. These results led the researchers to consider vitamin D deficiency as a potential risk factor for cardiovascular diseases. The possible mechanism in the pathogenesis of cardiovascular diseases that may be related to low levels of vitamin D, is its adverse effect on the renin-angiotensin-aldosterone system (RAAS). Calcitriol is also an important determinant of muscle cell proliferation and differentiation, as well as inhibition of apoptosis. Vitamin D is synthesized in the skin. However, there are only a few food products that are rich in vitamin D3, e.g.: fish oils, fish and fortified-products, such as dairy products and margarines. Individuals who are vulnerable to vitamin D deficiency should be supplemented.

Key Words: vitamin D, diabetes mellitus, deficiency of vitamin D, cancer, cardiovascular diseases, muscle physiology.
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June 2015

Flavonoids--food sources and health benefits.

Rocz Panstw Zakl Hig 2014 ;65(2):79-85

Flavonoids are a group of bioactive compounds that are extensively found in foodstuffs of plant origin. Their regular consumption is associated with reduced risk of a number of chronic diseases, including cancer, cardiovascular disease (CVD) and neurodegenerative disorders. Flavonoids are classified into subgroups based on their chemical structure: flavanones, flavones, flavonols, flavan-3-ols, anthocyanins and isoflavones. Their actions at the molecular level include antioxidant effects, as well the ability to modulate several key enzymatic pathways. The growing body of scientific evidence indicates that flavonoids play a beneficial role in disease prevention, however further clinical and epidemiological trials are greatly needed. Among dietary sources of flavonoids there are fruits, vegetables, nuts, seeds and spices. Consumption of these substances with diet appears to be safe. It seems that a diet rich in flavonoids is beneficial and its promotion is thus justifiable.
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October 2014

Health outcomes of vitamin D. Part I. characteristics and classic role.

Rocz Panstw Zakl Hig 2014 ;65(3):179-84

Chair of Dietetics, Department of Nutritional Physiology, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences, Warsaw, Poland.

Vitamin D is a compound responsible for maintaining mineral homeostasis. It protects against calcium and phosphate deficiency through the effects on the intestine, kidney, parathyroid gland and bone. All mechanisms that help maintain mineral homeostasis of the body are regulated by the vitamin D hormonal form - calcitriol. Synthesis of vitamin D starts in the skin as a non-enzymatic process, which begins during exposure to sunlight, when the absorption of ultraviolet B (UVB) radiation results in convertion of 7-dehydrocholesterol, a metabolite of cholesterol that is stored in the skin, to precholecalciferol (previtamin-D₃) that is immediately converted into cholecalciferol (vitamin D₃). After the skin synthesis cholecalciferol is transported to the liver where it undergoes hydroxylation, what results in formation of calcidiol (25(OH)D₃). The second metabolic process takes place in the kidney, where calcidiol undergoes hydroxylation at the C-1 position to the hormonal, the most active metabolite - 1,25-dihydroxyvitamin D (calcitriol). Vitamin D deficiency may result in bone diseases, such as rickets in children and osteomalacia and osteoporosis in adults. Symptoms of osteomalacia affect mainly the skeletal system and are similar to that observed in rickets. It concerns thoracic kyphosis, pelvis deformities and also the varus knee. Osteoporosis is another condition that is related to abnormalities of mineral homeostasis. It is characterized by the progressive loss of bone mass, impaired bone microarchitecture, and consequently increased fragility and susceptibility to fracture. For the last several years other, non-classic actions of vitamin D₃ have been discussed. It was engendered by the discovery of vitamin D3 receptor (VDR) in the most of body tissues and cells. Hence, there are many hypotheses which suggest the inverse relationship between vitamin D status and various diseases, such as cancer, autoimmune diseases, diabetes mellitus and others.
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January 2015

Intrauterine nutrition: long-term consequences for vascular health.

Int J Womens Health 2014 11;6:647-56. Epub 2014 Jul 11.

Department of Human Nutrition, Medical University of Warsaw, Warsaw, Poland.

There is a growing body of evidence that improper intrauterine nutrition may negatively influence vascular health in later life. Maternal malnutrition may result in intrauterine growth retardation and, in turn, metabolic disorders such as insulin resistance, diabetes, hypertension, and dyslipidemia, and also enhanced risk of atherosclerosis and cardiovascular death in the offspring. Energy and/or protein restriction is the most critical determinant for fetal programming. However, it has also been proposed that intrauterine n-3 fatty acid deficiency may be linked to later higher blood pressure levels and reduced insulin sensitivity. Moreover, it has been shown that inadequate supply of micronutrients such as folate, vitamin B12, vitamin A, iron, magnesium, zinc, and calcium may contribute to impaired vascular health in the progeny. In addition, hypertensive disorders of pregnancy that are linked to impaired placental blood flow and suboptimal fetal nutrition may also contribute to intrauterine growth retardation and aggravated cardiovascular risk in the offspring. On the other hand, maternal overnutrition, which often contributes to obesity and/or diabetes, may result in macrosomia and enhanced cardiometabolic risk in the offspring. Progeny of obese and/or diabetic mothers are relatively more prone to develop obesity, insulin resistance, diabetes, and hypertension. It was demonstrated that they may have permanently enhanced appetites. Their atheromatous lesions are usually more pronounced. It seems that, particularly, a maternal high-fat/junk food diet may be detrimental for vascular health in the offspring. Fetal exposure to excessive levels of saturated fatty and/or n-6 fatty acids, sucrose, fructose and salt, as well as a maternal high glycemic index diet, may also contribute to later enhanced cardiometabolic risk.
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http://dx.doi.org/10.2147/IJWH.S48751DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4103922PMC
July 2014