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Impact of Lifestyle on Cardiometabolic Syndrome and Type 2 Diabetes
Published in Gia Merlo, Kathy Berra, Lifestyle Nursing, 2023
Cindy Lamendola, Jane Nelson Worel
Medical nutrition therapy (MNT) is an important component of diabetes management and a referral to a registered dietitian (RD) who specializes in diabetes specific MNT is recommended (Evert et al., 2019). Reductions in blood glucose with MNT ranged between 50 and 100 mg/dL (Pastors et al., 2002). The DASH diet is rich in vegetables, fruits, and low-fat dairy, along with a reduction of sodium. It has led to reductions in blood pressure of 7–11 mm Hg and is recommended for the prevention and management of hypertension (Arnett et al., 2019; DASH Sodium Collaborative Research Group, 2001). An RD would also be an important resource for those who have comorbid conditions, such as hypertension or chronic kidney disease, and need specific diets including sodium, protein, or potassium restrictions. Nurses and other health care team members are encouraged to provide education and support to persons with cardio metabolic syndrome and diabetes by emphasizing the consumption of non-starchy vegetables and whole foods while limiting highly processed foods, refined grains, and added sugars.
Metabolic Syndrome
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
There are preventive measures for metabolic syndrome, as well as measures to improve the condition. Prevention is a primary goal. Abdominal obesity must be decreased or prevented as a key factor in relation to metabolic syndrome. There must be an improved-quality diet and increased physical activity for weight loss, as well as prevention of hyperglycemia and insulin resistance. Blood pressure must be lowered to less than 140/90 mm Hg ideally. The DASH diet, meaning dietary approaches to stop hypertension, helps assist in this process, along with lifestyle modifications.
Gestational Diabetes
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
A. Dhanya Mackeen, Richard S. Vigh, Kajal Angras
Dietary therapy consists of approximately 30 kcal/kg/day for the average patient and ±5 kcal/kg/day for underweight and overweight women, respectively [25]. Calories should be divided between 3 meals and 2–3 snacks: 33–40% carbohydrate, 20% protein, and 40% unsaturated fat [1]. Since about 30–40% of gestational diabetics fail to achieve glucose control with diet alone, other interventions may be necessary. Dietary counseling has been shown to improve dietary intake in patients at risk for GDM [74], and may result in lower neonatal birth-weight (133 g) and decreased incidence of LGA [75]. While a diet with a low-glycemic index (e.g., decreased consumption of white bread, processed cereals and potatoes) was felt to decrease the need for insulin in women with GDM [76], this recommendation was recently challenged by a larger study which showed no benefit [77]. There are no differences in neonatal and adverse pregnancy outcomes for women on a low glycemic index diet versus a high fiber diet [78]; and a low glycemic index diet compared to healthy eating did not result in differences in birth-weight, fetal percentile, or ponderal index [79]. The DASH diet has demonstrated improved glucose tolerance, lipid profile, diastolic blood pressure, serum insulin level and decreased insulin requirement in small RCTs; however, large trials are needed to further assess its effectiveness [80–82]. An oil-rich diet (45–50 g sunflower oil daily) versus a low-oil diet (20 g daily) did not influence pregnancy outcomes [83].
The effects of the dietary approaches to stop hypertension (DASH) diet on oxidative stress and clinical indices of migraine patients: a randomized controlled trial
Published in Nutritional Neuroscience, 2022
Arman Arab, Fariborz Khorvash, Elham Karimi, Zahra Heidari, Gholamreza Askari
To the best of the authors’ knowledge, the present investigation is original in terms of implementing a DASH diet among migraine patients using a relatively large sample size. Moreover, we used both food records and serum vitamin C levels to comprehensively examine the levels of participants’ adherence to the prescribed diet. However, there were some limitations that should be addressed. Blinding of participants was not possible due to the methodological nature of the study. We recruited only the women; hence, the findings cannot be generalized to all patients. Moreover, in the present study, the DASH diet was provided through a food menu and written recommendations (rather than being fed the diet). Moreover, patients on the DASH diet received a 7-day menu cycle compared to the usual dietary advice recommendations of the control group. This may introduce a bias in which the individuals of the intervention group may feel that received a better cure and consequently followed the recommendations more carefully [45]. In another word, it can be assumed that a higher adherence level of the intervention group to the dietary advice, as proved by serum vitamin C and dietary record, rather than the type of prescribed diet, was the main reason for improved outcomes of migraine patients. It should be noted that the DASH diet in the current study led to an increase in the consumption of dietary fiber, K, Mg, vitamin C, as well as lower amounts of Na. These findings alongside serum vitamin C imply that adherence to the prescribed diet was relatively good; however, all of the DASH diet goals were not achieved.
Short-term effects of modest salt reduction combined with DASH diet on changing salt eating habits in hypertensive patients with type II diabetes
Published in Clinical and Experimental Hypertension, 2022
Dan Chen, Jie Tang, Tao Gong, Lisha Mu, Jing Li, Pingping Yu, Hao Wang, Xiaoqing Bu, Lihong Mu, Ying Mei
The Dietary Approaches to Stop Hypertension (DASH) eating plan was originally developed from a study sponsored by the US National Institutes of Health. The US study investigated the treatment of hypertension without drugs and successfully demonstrated a clinically meaningful hypotensive effect (16). Although this diet was originally developed to prevent or treat hypertension (17), the effects of the DASH diet on patients with metabolic syndrome (18) and other populations (19,20) can be generalized to patients with diabetes. Among patients with diabetes, the DASH diet had beneficial effects on cardiometabolic risks (21). International diabetes (22,23) and cardiovascular health–related (24–26) clinical practice guidelines have also recommended the DASH dietary pattern to reduce the risk of cardiovascular disease.
Early nutritional influences of cardiovascular health
Published in Expert Review of Cardiovascular Therapy, 2021
Diana Drogalis-Kim, Ira Cheifetz, Nathaniel Robbins
With the increase in childhood obesity numbers, hypertension has become an increasing diagnosis in pediatrics. The DASH diet was originally conceived to improve blood pressure. This diet focuses on intake of whole grains, fruits, vegetables, and legumes and nuts. Red or processed meats and sweetened foods and beverages are minimized with low fat dairy consumed in moderation. Programs aimed at adherence to this diet in children have shown small decreases in systolic and diastolic blood pressure and improvements in endothelial function [165–168]. In higher risk populations, such as those with type 1 diabetes, the DASH dietary pattern results in less hyperglycemia and lower blood glucose overall [169]. In patients with hemophilia at high risk for cardiovascular metabolic abnormalities, adherence to a DASH diet showed beneficial effects on blood pressure, lipid profiles, and fasting blood sugar [170]. Similarly, a study of children and adolescents in Tehran showed lower risk of developing metabolic syndrome components, such as elevated fasting glucose, abdominal obesity, and hypertension with greater adherence to the DASH diet [171].