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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (30 June 2020) | Viewed by 52280

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Dr. Konstantinos Kantartzis

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1. Department of Internal Medicine IV, Division of Endocrinology, Diabetology and Nephrology, University of Tübingen, Tübingen, Germany
2. Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Centre Munich, University of Tübingen, Tübingen, Germany
Interests: prevention and therapy of type 2 diabetes; role of adiposity and body fat distribution; fat accumulation in the liver (fatty liver, NAFLD) in the pathogenesis of diabetes
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Dr. Louise Fritsche

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Department of Internal Medicine IV, Division of Endocrinology, Diabetology and Nephrology, University of Tübingen, Germany and Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Centre Munich at the University of Tübingen, Germany
Interests: gestational diabetes; fetal programing; impact of maternal metabolism on offspring development; insulin sensitivity and secretion during pregnancy; diabetes prevention strategies

Prof. Dr. Triantafyllos Didangelos

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Guest Editor

Diabetes Center, 1st Propaedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Greece
Interests: diabetic neuropathy; new technologies in diabetes; diabetes mellitus type 1; diabetes mellitus type 2; insulin treatment; nutritional supplements in DM
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear colleagues,

Diabetes mellitus is a major global health issue, affecting some 500 million people or about 9% of the adult population worldwide. The obesity epidemic is expected to lead to an enormous increase in diabetes cases in the next decades. Thus, it follows that strategies aimed at the prevention and successful treatment of diabetes are of outermost importance, both for patients and public health. Nutrition holds a central position in such strategies, constituting perhaps the most relevant part of diabetes prevention programs and a continuously integrated part of diabetes therapy. This is because nutrition is involved in the pathophysiology of diabetes by affecting insulin sensitivity and secretion. Some of the mechanisms by which nutrition exerts the latter effects are obvious. Quantitatively, a high calorie intake leads to obesity and the latter, in most cases, leads to insulin resistance. However, nutritional quality most probably plays a critical role in the development of diabetes, but its relevance is less established and the exact mechanisms are largely unknown. For instance, saturated fatty acids are largely believed to exert unfavorable effects, n-3 unsaturated fatty acids are generally associated with positive effects, while the effects of other fatty acids are still under discussion. Likewise, some evidence in the literature suggest that certain amino acids, as well as their respective proteins, may have more or less desired effects on glucose homeostasis than others. Several other issues remain unsolved, such as the ideal carbohydrate intake, the relevance of the combination of nutrients, i.e. certain “diets”, versus individual nutrients, and the possible protective effect of (any kind of) dietary supplements.

We invite clinicians and researchers to submit relevant scientific work, either original articles or review, to this Special Issue of Nutrients “Dietary Intake and Diabetes”.

We look forward to your active participation

Prof. Konstantinos Kantartzis
Dr. Louise Fritsche
Prof. Triantafyllos Didangelos
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

diabetes
fatty acids
dietary proteins and amino acids
very-low calorie diet
Mediterraenean diet
diabetes prevention
gestational diabetes
food supplements
insulin resistance
sweeteners

Published Papers (9 papers)

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Research

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9 pages, 4703 KiB

Open AccessArticle

No Effect of Lifestyle Intervention during Third Trimester on Brain Programming in Fetuses of Mothers with Gestational Diabetes

by Franziska Schleger, Katarzyna Linder, Louise Fritsche, Jan Pauluschke-Fröhlich, Martin Heni, Magdalene Weiss, Hans-Ulrich Häring, Hubert Preissl and Andreas Fritsche

Nutrients 2021, 13(2), 556; https://doi.org/10.3390/nu13020556 - 08 Feb 2021

Cited by 2 | Viewed by 2234

Abstract

Maternal metabolism and intrauterine conditions influence development of health and disease in offspring, leading to metabolic, physiologic, and/or epigenetic adaptation of the fetus. Maternal gestational diabetes (GDM) leads to higher incidence of obesity and type 2 diabetes in offspring. We have previously shown that fetuses of insulin-resistant mothers with GDM have a delayed reaction to auditory stimuli in the postprandial state, indicating a fetal central insulin resistance. We tested whether this effect could be influenced by a lifestyle intervention in mothers with GDM, including diet counselling and regular blood glucose measurements. We measured fetal brain activity over the course of a maternal glucose challenge, at two measurement time points (baseline at an average of 29 weeks of gestation and follow-up after 4 weeks) in mothers with GDM and mothers with normal glucose tolerance (NGT). Data from eight mothers were able to be included. Fetuses of GDM mothers showed longer latencies than those of NGT mothers postprandially at both measurement time points during the third trimester and did not show a difference in response patterns between baseline and after 4 weeks. Maternal postprandial blood glucose and insulin values did not change from baseline to follow-up either. While the overall intervention seems to have been effective, it does not appear to have influenced the fetal postprandial brain responses. This might have been because interventions for GDM take place relatively late in pregnancy. Future research should focus on maternal lifestyle interventions as early as possible during gestation, or even prenatally. Full article

(This article belongs to the Special Issue Dietary Intake and Diabetes)

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14 pages, 338 KiB

Open AccessArticle

Vitamin B12 Supplementation in Diabetic Neuropathy: A 1-Year, Randomized, Double-Blind, Placebo-Controlled Trial

by Triantafyllos Didangelos, Eleni Karlafti, Evangelia Kotzakioulafi, Eleni Margariti, Parthena Giannoulaki, Georgios Batanis, Solomon Tesfaye and Kοnstantinos Kantartzis

Nutrients 2021, 13(2), 395; https://doi.org/10.3390/nu13020395 - 27 Jan 2021

Cited by 52 | Viewed by 15912

Abstract

Aim: To investigate the effect of normalizing vitamin B12 (B12) levels with oral B12 (methylcobalamin) 1000 μg/day for one year in patients with diabetic neuropathy (DN). Patients and methods: In this prospective, double-blind, placebo-controlled trial, 90 patients with type 2 diabetes on metformin for at least four years and both peripheral and autonomic DN were randomized to an active treatment group (n = 44) receiving B12 and a control group (n = 46) receiving a placebo. All patients had B12 levels less than 400 pmol/L. Subjects underwent measurements of sural nerve conduction velocity (SNCV), sural nerve action potential (amplitude) (SNAP), and vibration perception threshold (VPT), and they performed cardiovascular autonomic reflex tests (CARTs: mean circular resultant (MCR), Valsalva test, postural index, and orthostatic hypotension). Sudomotor function was assessed with the SUDOSCAN that measures electrochemical skin conductance in hands and feet (ESCH and ESCF, respectively). We also used the Michigan Neuropathy Screening Instrument Questionnaire and Examination (MNSIQ and MNSIE, respectively) and questionnaires to evaluate quality of life (QoL) and level of pain (pain score). Results: B12 levels increased from 232.0 ± 71.8 at baseline to 776.7 ± 242.3 pmol/L at follow-up, p < 0.0001, in the active group but not in the control group. VPT, MNSIQ, QoL, pain score, SNCV, SNAP, and ESCF significantly improved in the active group (p < 0.001, p = 0.002, p < 0.0001, p < 0.000, p < 0.0001, p < 0.0001, and p = 0.014, respectively), whereas CARTS and MNSIE improved but not significantly. MCR, MNSIQ, SNCV, SNAP, and pain score significantly deteriorated in the control group (p = 0.025, p = 0.017, p = 0.045, p < 0.0001, and p < 0.0001, respectively). Conclusions: The treatment of patients with DN with 1 mg of oral methylcobalamin for twelve months increased plasma B12 levels and improved all neurophysiological parameters, sudomotor function, pain score, and QoL, but it did not improve CARTS and MNSIE. Full article

(This article belongs to the Special Issue Dietary Intake and Diabetes)

15 pages, 342 KiB

Open AccessArticle

Efficacy and Safety of the Combination of Superoxide Dismutase, Alpha Lipoic Acid, Vitamin B12, and Carnitine for 12 Months in Patients with Diabetic Neuropathy

by Triantafyllos Didangelos, Eleni Karlafti, Evangelia Kotzakioulafi, Zisis Kontoninas, Charalampos Margaritidis, Parthena Giannoulaki and Konstantinos Kantartzis

Nutrients 2020, 12(11), 3254; https://doi.org/10.3390/nu12113254 - 23 Oct 2020

Cited by 34 | Viewed by 6284

Abstract

Aim: To investigate the efficacy of Superoxide Dismutase, Alpha Lipoic Acid, Acetyl L-Carnitine, and Vitamin B12 (B12) in one tablet in Diabetic Neuropathy (DN). Patients–methods: In this prospective, double-blind, placebo-controlled study, 85 patients with Diabetes Mellitus Type 2 (DMT2) were randomly assigned, either to receive the combination of four elements (active group, n = 43), or placebo (n = 42) for 12 months. We used the Michigan Neuropathy Screening Instrument Questionnaire and Examination (MNSIQ and MNSIE), measured the vibration perception threshold (BIO), and Cardiovascular Autonomic Reflex Tests (CARTs). Nerve function was assessed by DPN Check [sural nerve conduction velocity (SNCV) and amplitude (SNAP)]. Pain (PS) and quality of life (QL) questionnaires were administered. Results: At follow-up, BIO, MNSIQ, QL, PAIN, and SNCV, SNAP, and B12 levels had significantly improved inactive group (p < 0.001, p < 0.001, p < 0.001, p < 0.001, p = 0.027, p = 0.031, and p < 0.001 respectively), whereas the inplacebo group MCR (mean circular resultant) and PAIN deteriorated (p < 0.001, p < 0.001). The changes in MNSIQ, QL, SNCV, BIO, and PAIN differed significantly between groups (p < 0.001, p < 0.001, p = 0.031, p < 0.001, and p < 0.001 respectively). Conclusions: The combination of the four elements in one tablet for 12 months in patients with DMT2 improved all indices of peripheral neuropathy, including SNAP and SNCV, pain, and Quality of Life perception, except CARTs and MNSIE. Full article

(This article belongs to the Special Issue Dietary Intake and Diabetes)

16 pages, 632 KiB

Open AccessArticle

Exploring the Diets of Adults with Obesity and Type II Diabetes from Nine Diverse Countries: Dietary Intakes, Patterns, and Quality

by Jade Willey, Marian Wakefield and Heidi J. Silver

Nutrients 2020, 12(7), 2027; https://doi.org/10.3390/nu12072027 - 08 Jul 2020

Cited by 11 | Viewed by 4060

Abstract

Background: Calorie-dense diet is a main driver of the global epidemics of obesity and type 2 diabetes (T2DM). While various dietary strategies and patterns are efficacious in reducing risk and improving glycemic control, dietary intake and diet quality have been inadequately studied among individuals who remain living in their native environments. There is also little published on dietary patterns of diverse ethnic, cultural, or regional populations. Objective: To explore dietary intakes, patterns and overall diet quality in adults with obesity and T2DM from diverse countries. We hypothesized that individuals sharing a common clinical phenotype (age, BMI, years since T2DM diagnosis and inadequate glycemic control) would demonstrate comparable high calorie “western” dietary patterns and low diet quality despite differences in geographic regions and cultures. Design: Diet data were acquired from 611 adults in Argentina, Germany, Poland, Serbia, Slovakia, Slovenia, Spain, Turkey and the USA via three 24-h diet recalls. Contribution of 168 foods to 14 primary food groups was confirmed by Spearman’s rank-order correlations and Principle Component Factor Analysis identified dietary patterns. Diet quality was assessed using the Healthy Eating Index 2015. Results: Eleven dietary patterns were extracted; the most common were a “Mediterranean-like” pattern shared by six countries and a “Calorie Dense” pattern shared by five countries. Also common were “Lacto-Vegetarian, “Pesco-Vegetarian,” and “Vegan” patterns. Only 2.1% of subjects had good diet quality (HEI-2015 score >80). Conclusions: The diet pattern data suggest that influences of more traditional region-specific diets remain. However, overall diet quality was poor and may contribute to inadequate glycemic control, possibly due to excess intake of high calorie/nutrient poor foods, which may be associated with global transitions occurring in the available food supply. Full article

(This article belongs to the Special Issue Dietary Intake and Diabetes)

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15 pages, 1060 KiB

Open AccessArticle

Association between Low Protein Intake and Mortality in Patients with Type 2 Diabetes

by Takuya Yamaoka, Atsushi Araki, Yoshiaki Tamura, Shiro Tanaka, Kazuya Fujihara, Chika Horikawa, Rei Aida, Chiemi Kamada, Yukio Yoshimura, Tatsumi Moriya, Yasuo Ohashi, Yasuo Akanuma, Hideki Ito and Hirohito Sone

Nutrients 2020, 12(6), 1629; https://doi.org/10.3390/nu12061629 - 01 Jun 2020

Cited by 13 | Viewed by 3631

Abstract

The aim of this study was to investigate the association between protein intake and mortality risk in patients with type 2 diabetes. We analyzed a pooled data of 2494 diabetic patients from two prospective longitudinal studies. Nutritional intake was assessed using a Food Frequency Questionnaire at baseline. Protein intake per body weight (kg) per day was categorized into quartile groups. Adjusted hazard ratios (HRs) and 95% confidence interval (CI) were calculated using Cox regression analysis. During the six-year follow-up, there were 152 incidents of all-cause mortality. The HR for mortality in the lowest quartile of protein intake per body weight compared with the highest quartile was 2.26 (95% CI: 1.34–3.82, p = 0.002) after adjustment for covariates. Subgroup analyses revealed significant associations between low protein intake and mortality in patients aged over 75 years or under 65 years. After further adjustment of the total energy intake, a significant association between protein intake and mortality remained in patients aged ≥ 75 years, whereas the association was attenuated in those aged < 65 years. Our results suggest that adequate protein intake is necessary in older diabetic patients over 75 years, whereas with diabetes, whereas whole optimal total energy intake is required in younger patients with type 2 diabetes. Full article

(This article belongs to the Special Issue Dietary Intake and Diabetes)

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14 pages, 664 KiB

Open AccessArticle

Apple Preload Halved the Postprandial Glycaemic Response of Rice Meal in Healthy Subjects

by Jiacan Lu, Wenqi Zhao, Linlin Wang, Zhihong Fan, Ruixin Zhu, Yixue Wu and Ying Zhou

Nutrients 2019, 11(12), 2912; https://doi.org/10.3390/nu11122912 - 02 Dec 2019

Cited by 14 | Viewed by 4017

Abstract

This study aimed to investigate the possible glycemic effect of apple preload on acute postprandial glycemic responses (GRs) of a following rice meal, comparing with its co-ingestion counterpart and an apple sugar solution preload, based on equal carbohydrates intake. In a randomized crossover trial, 18 healthy female subjects consumed (1) rice, (2) co-ingestion of apple and rice (A+R), (3) apple preload and rice (PA+R), and (4) rice with sugar solution preload (same sugar profile as in apple) (PSS+R). Acute postprandial GR tests and subjective satiety tests were carried out for each test food. Compared with rice reference, the PA+R achieved a 50% reduction of the iAUC_0-120, a 51.4% reduction of the average peak value, and a 52.6% reduction of glycemic excursion in 240 min, while the PSS+R showed 29.7% and 31.6% reduction of peak value and glycemic excursion, respectively. No significant differences were found between R and PA+R in any of the satiety characteristics. Compared with rice control, apple preload of 15 g available carbohydrates remarkably lowered the acute postprandial GR without negative effect on satiety. The sugar component may partly contribute to the glycemic suppressing effect of the apple preload. Full article

(This article belongs to the Special Issue Dietary Intake and Diabetes)

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14 pages, 575 KiB

Open AccessReview

Whether or Not the Effects of Curcuma longa Supplementation Are Associated with Physical Exercises in T1DM and T2DM: A Systematic Review

by Ailton Santos Sena-Júnior, Felipe José Aidar, Ana Mara de Oliveira e Silva, Charles dos Santos Estevam, Carla Roberta de Oliveira Carvalho, Fábio Bessa Lima, Jymmys Lopes dos Santos and Anderson Carlos Marçal

Nutrients 2021, 13(1), 124; https://doi.org/10.3390/nu13010124 - 31 Dec 2020

Cited by 3 | Viewed by 4093

Abstract

Diabetes mellitus is one of the most prevalent chronic diseases in the world; one of its main characteristics is chronic hyperglycemia. Pharmacotherapy and other alternatives such as regular exercise are among the therapeutic methods used to control this pathology and participate in glycemic control, as well as the ingestion of plant extracts with antioxidant effects. Among the different plants used for this purpose, curcumin has potential to be used to attenuate the hyperglycemic condition triggered by diabetes mellitus (DM). Some prior studies suggest that this plant has antioxidant and hypoglycemic potential. This review aims to evaluate the antioxidant and hypoglycemic potential of curcumin supplementation in Type 1 DM (T1DM) and Type 2 DM (T2DM). The search considered articles published between 2010 and 2019 in English and Portuguese, and a theoretical survey of relevant information was conducted in the main databases of scientific publications, including the Virtual Health Library and its indexed databases, PubMed, LILACS (Latin American and Caribbean Literature on Health Sciences—Health Information for Latin America and the Caribbean—BIREME/PAHO/WHO), and Scientific Electronic Library Online (SciELO). The associated use of turmeric and physical exercise has demonstrated antioxidant, anti-inflammatory, and hypoglycemic effects, suggesting that these could be used as potential therapeutic methods to improve the quality of life and survival of diabetic patients. Full article

(This article belongs to the Special Issue Dietary Intake and Diabetes)

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18 pages, 1826 KiB

Open AccessReview

The Effects of Legume Consumption on Markers of Glycaemic Control in Individuals with and without Diabetes Mellitus: A Systematic Literature Review of Randomised Controlled Trials

by Dale Bielefeld, Sara Grafenauer and Anna Rangan

Nutrients 2020, 12(7), 2123; https://doi.org/10.3390/nu12072123 - 17 Jul 2020

Cited by 31 | Viewed by 7445

Abstract

Legumes are a rich source of dietary fibre, plant protein, and low-Glycaemic Index (GI) carbohydrate. Evidence suggests a positive effect on glycaemic control following a single meal; however, the effects of habitual consumption are less clear. This review aimed to investigate whether medium-to-long-term legume consumption had an effect on markers of glycaemic control in individuals with diabetes mellitus, without diabetes mellitus, or with prediabetes. As per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, the online databases MEDLINE, Embase, CENTRAL, and CINAHL were searched from inception through to 31 March 2020. Randomised controlled trials (RCTs) ≥6 weeks in duration, reporting ≥1 of the following: fasting blood glucose (FBG), fasting blood insulin (FBI), glycosylated haemoglobin (HbA1c), homeostatic model assessment-insulin resistance (HOMA-IR), or 2-h postprandial glucose (2-h PPG), were deemed eligible. The overall quality of evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) assessment. A total of 18 RCTs were included, of which, 5 focused on individuals with diabetes mellitus, 12 on individuals without diabetes mellitus, and one on individuals with prediabetes. Only studies of those with type 2 diabetes mellitus (n = 5) reported significant effects for legume interventions, three of which consistently reported reductions in FBG, two reported reductions in HbA1c, one reported a reduction in FBI, and another a reduction in 2-h PPG (p < 0.05); however, the overall quality of evidence was very low. The findings of this review support the dietary inclusion of legumes; however, the need for further high-quality RCTs to be conducted is also highlighted, particularly among individuals with prediabetes, gestational diabetes mellitus and type 1 diabetes mellitus. Full article

(This article belongs to the Special Issue Dietary Intake and Diabetes)

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17 pages, 2151 KiB

Open AccessReview

Impact of Crocus sativus L. on Metabolic Profile in Patients with Diabetes Mellitus or Metabolic Syndrome: A Systematic Review

by Parthena Giannoulaki, Evangelia Kotzakioulafi, Michail Chourdakis, Apostolos Hatzitolios and Triantafyllos Didangelos

Nutrients 2020, 12(5), 1424; https://doi.org/10.3390/nu12051424 - 14 May 2020

Cited by 20 | Viewed by 3541

Abstract

Background: Experimental studies demonstrated a positive effect of administration of Crocus sativus L. (saffron) and its bioactive ingredients on metabolic profile through their antioxidant capacity. Purpose: To determine if the use of saffron in humans is beneficial to patients with diabetes mellitus (DM) or metabolic syndrome (MS). Methods: This systematic review includes 14 randomized control trials that investigated the impact of saffron administration and its bioactive ingredient crocin on the metabolic profile of patients with DM, MS, prediabetes, and coronary artery disease. We documented the following clinical outcomes: fasting blood glucose (FBG), glycated haemoglobin (HbA1c), total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, systolic, and diastolic blood pressure. Results: Eight studies examined the efficacy of saffron in patients with DM, four with the metabolic syndrome, one with prediabetes and one with coronary artery disease. A favorable effect on FBG was observed. The results regarding blood lipids and blood pressure were inconclusive in the current review. Conclusions: According to the available limited evidence, saffron may have a favorable effect on FBG. Many of the studies in the reviewed literature are of poor quality, and more research is needed in this direction to confirm and establish the above findings. Full article

(This article belongs to the Special Issue Dietary Intake and Diabetes)

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