Wednesday, June 30, 2010

Effect of diet on asthma and allergic sensitisation

Diet berhubungan dengan asma. Konsumsi buah, sayuran dan ikan mencegah asma, sedangkan banyak konsumsi burger meningkatkan asma. Pola diet Mediterrania memberikan efek proteksi terhadap asma pada anak.

 
Thorax 2010;65:516-522

Effect of diet on asthma and allergic sensitisation in the International Study on Allergies and Asthma in Childhood (ISAAC) Phase Two
Gabriele Nagel1, Gudrun Weinmayr1, Andrea Kleiner1, Luis Garcia-Marcos2,David P Strachan3, the ISAAC Phase Two Study Group
Abstract
Background The increasing prevalence of asthma and allergy might be related to diet, particularly in Western countries. A study was undertaken to assess the association between dietary factors, asthma and allergy in a large international study including objective measurements of atopy.
Methods Between 1995 and 2005, cross-sectional studies were performed in 29 centres in 20 countries. Parental questionnaires were used to collect information on allergic diseases and exposure factors and data from 50 004 randomly selected schoolchildren (8–12 years, 29 579 with skin prick testing) were analysed. Random effect models for meta-analysis were applied to calculate combined ORs.
Results Fruit intake was associated with a low prevalence of current wheeze in affluent (ORadj 0.86, 95% CI 0.73 to 1.02) and non-affluent countries (ORadj 0.71, 95% CI 0.57 to 0.88). Consumption of fish in affluent countries (ORadj 0.85, 95% CI 0.74 to 0.97) and of cooked green vegetables in non-affluent countries (ORadj 0.78, 95% CI 0.65 to 0.95) was associated with a lower prevalence of current wheeze. Overall, more frequent consumption of fruit, vegetables and fish was associated with a lower lifetime prevalence of asthma, whereas high burger consumption was associated with higher lifetime asthma prevalence. None of the food items was associated with allergic sensitisation. Except for fruit juice and fruit consumption, no associations were found with atopic wheeze. Food selection according to the 'Mediterranean diet' was associated with a lower prevalence of current wheeze and asthma ever (ptrend=0.03).
Conclusion Diet is associated with wheeze and asthma but not with allergic sensitisation in children. These results provide further evidence that adherence to the 'Mediterranean diet' may provide some protection against wheeze and asthma in childhood.

White Rice, Brown Rice, and Risk of Type 2 Diabetes

Substitusi nasi putih dengan nasi tumbuk akan menurunkan risiko diabetes tipe 2.
Konsumsi karbohidrat sebaiknya berupa biji2an (whole grains) dan menghindari refined grains untuk mencegah diabetes tipe 2.

Abstrak
 
White Rice, Brown Rice, and Risk of Type 2 Diabetes in US Men and Women
Qi Sun, MD, ScD; Donna Spiegelman, ScD; Rob M. van Dam, PhD; Michelle D. Holmes, MD, DrPH; Vasanti S. Malik, MSc;Walter C. Willett, MD, DrPH; Frank B. Hu, MD, PhD

Arch Intern Med. 2010;170(11):961-969.
Background  Because of differences in processing and nutrients, brown rice and white rice may have different effects on risk of type 2 diabetes mellitus. We examined white and brown rice consumption in relation to type 2 diabetes risk prospectively in the Health Professionals Follow-up Study and the Nurses' Health Study I and II.
Methods  We prospectively ascertained and updated diet, lifestyle practices, and disease status among 39 765 men and 157 463 women in these cohorts.
Results  After multivariate adjustment for age and other lifestyle and dietary risk factors, higher intake of white rice (>5 servings per week vs <1 per month) was associated with a higher risk of type 2 diabetes: pooled relative risk (95%confidence interval [CI]), 1.17 (1.02-1.36). In contrast, high brown rice intake (>2 servings per week vs <1 per month) was associated with a lower risk of type 2 diabetes: pooled relative risk, 0.89 (95% CI, 0.81-0.97). We estimated that replacing 50 g/d (uncooked, equivalent to one-third serving per day) intake of white rice with the same amount of brown rice was associated with a 16% (95% CI, 9%-21%) lower risk of type 2 diabetes, whereas the same replacement with whole grains as a group was associated with a 36% (30%-42%) lower diabetes risk.
Conclusions  Substitution of whole grains, including brown rice, for white rice may lower risk of type 2 diabetes. Thesedata support the recommendation that most carbohydrate intake should come from whole grains rather than refined grains to help prevent type 2 diabetes.
 

Monday, June 21, 2010

Effects of fibrates on cardiovascular outcomes: a systematic review and meta-analysis

Fibrat dapat mengurangi risiko kardiovaskuler terutama koroner.
Fibrat juga dapat mengurangi progresi albuminuria.

 
The Lancet, Volume 375, Issue 9729, Pages 1875 - 1884, 29 May 2010

Effects of fibrates on cardiovascular outcomes: a systematic review and meta-analysis
Min Jun MSc a, Celine Foote MBBS a, Jicheng Lv MD a b, Prof Bruce Neal MBChB a, Anushka Patel MD a, Stephen J Nicholls MBBS c,Prof Diederick E Grobbee MD d, Prof Alan Cass MBBS a, Prof John Chalmers MBBS a, Dr Vlado Perkovic MBBS a
Summary
Background
Several clinical trials have reported inconsistent findings for the effect of fibrates on cardiovascular risk. We undertook a systematic review and meta-analysis to investigate the effects of fibrates on major clinical outcomes.
Methods
We systematically searched Medline, Embase, and the Cochrane Library for trials published between 1950 and March, 2010. We included prospective randomised controlled trials assessing the effects of fibrates on cardiovascular outcomes compared with placebo. Summary estimates of relative risk (RR) reductions were calculated with a random effects model. Outcomes analysed were major cardiovascular events, coronary events, stroke, heart failure, coronary revascularisation, all-cause mortality, cardiovascular death, non-vascular death, sudden death, new onset albuminuria, and drug-related adverse events.
Findings
We identified 18 trials providing data for 45 058 participants, including 2870 major cardiovascular events, 4552 coronary events, and 3880 deaths. Fibrate therapy produced a 10% RR reduction (95% CI 0—18) for major cardiovascular events (p=0·048) and a 13% RR reduction (7—19) for coronary events (p<0·0001), but had no benefit on stroke (−3%, −16 to 9; p=0·69). We noted no effect of fibrate therapy on the risk of all-cause mortality (0%, −8 to 7; p=0·92), cardiovascular mortality (3%, −7 to 12; p=0·59), sudden death (11%, −6 to 26; p=0·19), or non-vascular mortality (−10%, −21 to 0·5; p=0·063). Fibrates reduced the risk of albuminuria progression by 14% (2—25; p=0·028). Serious drug-related adverse events were not significantly increased by fibrates (17 413 participants, 225 events; RR 1·21, 0·91—1·61; p=0·19), although increases in serum creatinine concentrations were common (1·99, 1·46—2·70; p<0·0001).
Interpretation
Fibrates can reduce the risk of major cardiovascular events predominantly by prevention of coronary events, and might have a role in individuals at high risk of cardiovascular events and in those with combined dyslipidaemia.

Thursday, June 03, 2010

Konsumsi kacang memperbaiki profil lipid

Konsumsi kacang2an 67 g per hari dapat memperbaiki profil lipid (menurunkan kolesterol total, LDL dan trigliserid)
 

Nut Consumption and Blood Lipid Levels
A Pooled Analysis of 25 Intervention Trials
Joan Sabaté, MD, DrPH; Keiji Oda, MA, MPH; Emilio Ros, MD, PhD

Arch Intern Med. 2010;170(9):821-827.
Background  Epidemiological studies have consistently associated nut consumption with reduced risk for coronary heart disease. Subsequently, many dietary intervention trials investigated the effects of nut consumption on blood lipid levels. The objectives of this study were to estimate the effects of nut consumption on blood lipid levels and to examine whether different factors modify the effects.

Methods  We pooled individual primary data from 25 nut consumption trials conducted in 7 countries among 583 men and women with normolipidemia and hypercholesterolemia who were not taking lipid-lowering medications. In a pooled analysis, we used mixed linear models to assess the effects of nut consumption and the potential interactions.
Results  With a mean daily consumption of 67 g of nuts, the following estimated mean reductions were achieved: total cholesterol concentration (10.9 mg/dL [5.1% change]), low-density lipoprotein cholesterol concentration (LDL-C) (10.2 mg/dL [7.4% change]), ratio of LDL-C to high-density lipoprotein cholesterol concentration (HDL-C) (0.22 [8.3% change]), and ratio of total cholesterol concentration to HDL-C (0.24 [5.6% change]) (P < .001 for all) (to convert all cholesterol concentrations to millimoles per liter, multiply by 0.0259). Triglyceride levels were reduced by 20.6 mg/dL (10.2%) in subjects with blood triglyceride levels of at least 150 mg/dL (P < .05) but not in those with lower levels (to convert triglyceride level to millimoles per liter, multiply by 0.0113). The effects of nut consumption were dose related, and different types of nuts had similar effects on blood lipid levels. The effects of nut consumption were significantly modified by LDL-C, body mass index, and diet type: the lipid-lowering effects of nut consumption were greatest among subjects with high baseline LDL-C and with low body mass index and among those consuming Western diets.
Conclusion  Nut consumption improves blood lipid levels in a dose-related manner, particularly among subjects with higher LDL-C or with lower BMI.