Makanan sehat mengurangi risiko diabetes dan penyakit jantung

Penelitian ini menilai hubungan pola makan dan risiko diabetes, penyakit jantung koroner (PJK), dan kematian. Analisis prospektif dilakukan terhadap 7.731 pria dan wanita berumur rata² 50 tahun dan difollow up selama 15 tahun.

 

Berdasarkan pola makan dibagi dalam 4 kelompok:

1.      Tidak sehat (roti putih, daging olahan, gorengan dan susu full cream, n=2665)

2.      Manis (roti putih, biscuit, cakes, daging olahan, high-fat dairy products, n=1042)

3.      Mediterranean-like (buah, sayur, nasi, pasta, wine, n=1361)

4.      Sehat  (buah, sayur, whole-meal bread, low-fat dairy, dan sedikit alkohol, n = 2663)

 

Hasil penelitian menunjukkan bahwa pola makan sehat mengurangi risiko PJK (fatal dan non-fatal) dan diabetes dengan rasio Hazard 0,71 dan 0,74.

 

Kesimpulan penelitian ini membuktikan bahwa pola makan yang sehat dapat mengurangi risiko diabetes dan PJK.

 

 

American Journal of Clinical Nutrition 87(5):1414-1421, May 2008© 2008 to the American Society for Nutrition
Dietary patterns and 15-y risks of major coronary events, diabetes, and mortality

Eric J Brunner, Annhild Mosdøl, Daniel R Witte, Pekka Martikainen, Mai Stafford, Martin J Shipley and Michael G Marmot

Background: Few studies have examined the long-term effect of habitual diet on risks of incident diabetes, coronary heart disease, and mortality.

Objective: We analyzed the prospective relation of dietary patterns with incident chronic disease and mortality during 15 y of follow-up in the Whitehall II study.

Design: We conducted a prospective analysis (106 633 person-years at risk) among men and women (n = 7731) with a mean age of 50 y at the time of dietary assessment (127-item food-frequency questionnaire). Coronary death or nonfatal myocardial infarction and incident diabetes were verified by record tracing and oral-glucose-tolerance tests.

Results: Cluster analysis identified 4 dietary patterns at baseline. The patterns were termed unhealthy (white bread, processed meat, fries, and full-cream milk; n = 2665), sweet (white bread, biscuits, cakes, processed meat, and high-fat dairy products; n = 1042), Mediterranean-like (fruit, vegetables, rice, pasta, and wine; n = 1361), and healthy (fruit, vegetables, whole-meal bread, low-fat dairy, and little alcohol; n = 2663). Compared with the unhealthy pattern, the healthy pattern reduced the risk of coronary death or nonfatal myocardial infarction and diabetes; hazard ratios (95% CI) were 0.71 (0.51, 0.98) and 0.74 (0.58, 0.94), respectively, after adjustment for age, sex, ethnicity, dietary energy misreporting, social position, smoking status, and leisure-time physical activity. Dietary pattern was not associated with all-cause mortality. Residual confounding by socioeconomic factors was unlikely to account for the observed dietary effects.

Conclusions: The healthy eating pattern reduced risks of diabetes and major coronary events. Such dietary patterns offer considerable health benefits to individuals and contribute to public health.

Strategi menjaga berat badan

Penelitian berikut membandingkan strategi mempertahankan penurunan berat badan. Para ahli melakukan randomized two-phase trial terhadap >1000 penderita obesitas disertai hipertensi dan dyslipidemia, yang telah mengalami penurunan berat badan minimal 4 kg dalam 6 bulan (fase 1).

Subyek di-randomized untuk fase 2, intervensi untuk mempertahankan penurunan berat badan selama 30 bulan berikut kelompok 1) monthly personal contact, kelompok 2)unlimited access to an interactive technology-based intervention, atau kelompok 3)self-directed control.

 

Hasilnya BB rata2 96,7 kg. Penurunan BB fase 1 rata2 8,5 kg. Setelah randomization kelompok 1 BB naik 4,0 kg ; kelompok 3 BB naik 5,5 kg. Kelompok 2 mengalami kenaikan BB lebih kecil dibanding kelompok 3 tapi perbedaannya tidak bermakna. Setelah 30 bulan juga ada perbedaan bermakna antara kelompok 1 dan kelompok 2. Pada akhir penelitian 71% subyek BB-nya tetap di bawah BB awal.

 

Kesimpulan sebagian besar penderita obesitas yang berhasil menurunkan BB berhasil mempertahankan BB-nya. Kontrol setiap bulan (monthly brief personal contact) merupakan cara terbaik untuk mempertahankan BB.

 

Berikut ini abstract dari penelitian tersebut

 

JAMA 2008;299(10): 1139-1148. Vol. 299 No. 10, March 12, 2008 © 2008 American Medical Association.
Comparison of Strategies for Sustaining Weight Loss. The Weight Loss Maintenance Laura P. Svetkey, MD; Victor J. Stevens, PhD; Phillip J. Brantley, PhD;  Lawrence J. Appel, MD; Jack F. Hollis, PhD; Catherine M. Loria, PhD; William M. Vollmer, PhD; Christina M. Gullion, PhD; Kristine Funk; Patti Smith; Carmen Samuel-Hodge, PhD; Valerie Myers, PhD; Lillian F. Lien, MD; Daniel Laferriere; Betty Kennedy, PhD; Gerald J. Jerome, PhD; Fran Heinith; David W. Harsha, PhD; Pamela Evans; Thomas P. Erlinger, MD; Arline T. Dalcin; Janelle Coughlin, PhD; Jeanne Charleston; Catherine M. Champagne, PhD; Alan Bauck; Jamy D. Ard, MD; Kathleen Aicher; for the Weight Loss Maintenance Collaborative Research Group

 

Context  Behavioral weight loss interventions achieve short-term success, but re-gain is common.

Objective  To compare 2 weight loss maintenance interventions with a self-directed control group.

Design, Setting, and Participants  Two-phase trial in which 1032 overweight or obese adults (38% African American, 63% women) with hypertension, dyslipidemia, or both who had lost at least 4 kg during a 6-month weight loss program (phase 1) were randomized to a weight-loss maintenance intervention (phase 2). Enrollment at 4 academic centers occurred August 2003-July 2004 and randomization, February-December 2004. Data collection was completed in June 2007.

Interventions  After the phase 1 weight-loss program, participants were randomized to one of the following groups for 30 months: monthly personal contact, unlimited access to an interactive technology–based intervention, or self-directed control.

Main Outcome  Changes in weight from randomization.

Results  Mean entry weight was 96.7 kg. During the initial 6-month program, mean weight loss was 8.5 kg. After randomization, weight regain occurred. Participants in the personal-contact group regained less weight (4.0 kg) than those in the self-directed group (5.5 kg; mean difference at 30 months, –1.5 kg; 95% confidence interval [CI], –2.4 to –0.6 kg; P = .001). At 30 months, weight regain did not differ between the interactive technology–based (5.2 kg) and self-directed groups (5.5 kg; mean difference –0.3 kg; 95% CI, –1.2 to 0.6 kg; P = .51); however, weight regain was lower in the interactive technology–based than in the self-directed group at 18 months (mean difference, –1.1 kg; 95% CI, –1.9 to –0.4 kg; P = .003) and at 24 months (mean difference, –0.9 kg; 95% CI, –1.7 to –0.02 kg; P = .04). At 30 months, the difference between the personal-contact and interactive technology–based group was –1.2 kg (95% CI –2.1 to –0.3; P = .008). Effects did not differ significantly by sex, race, age, and body mass index subgroups. Overall, 71% of study participants remained below entry weight.

Conclusions  The majority of individuals who successfully completed an initial behavioral weight loss program maintained a weight below their initial level. Monthly brief personal contact provided modest benefit in sustaining weight loss, whereas an interactive techonology–based intervention provided early but transient benefit.

Pola makan dan Timbulnya Sindroma Metabolik

Penelitian tentang hubungan antara sindroma metabolic dan asupan makanan dilakukan atas >9.500 partisipan berusia 45-64 tahun dan diikuti selama 9 tahun. Selama penelitian insiden sindroma metabolik sebesar 3.782

 

Hasil penelitian menunjukkan bahwa pola Western diet berhubungan dengan timbulnya sindroma metabolic, terutama asupan daging, gorengan, dan diet soda. Sebaliknya susu (dairy product) justru memberikan proteksi.

 

Kesimpulan Western diet, terutama daging, gorengan dan diet soda menyebabkan timbulnya sindroma metabolic, namun dairy product dapat mencegah sindroma metabolik.

 

Circulation. 2008;117:754-761. February 12, 2008 © 2008 American Heart Association, Inc.
Dietary Intake and the Development of the Metabolic Syndrome. The Atherosclerosis Risk in Communities Study. Pamela L. Lutsey, MPH; Lyn M. Steffen, PhD, MPH, RD; June Stevens, PhD, MS, RD  

 

Background— The role of diet in the origin of metabolic syndrome (MetSyn) is not well understood; thus, we sought to evaluate the relationship between incident MetSyn and dietary intake using prospective data from 9514 participants (age, 45 to 64 years) enrolled in the Atherosclerosis Risk in Communities (ARIC) study.

 

Methods and Results— Dietary intake was assessed at baseline via a 66-item food frequency questionnaire. We used principal-components analysis to derive "Western" and "prudent" dietary patterns from 32 food groups and evaluated 10 food groups used in previous studies of the ARIC cohort. MetSyn was defined by American Heart Association guidelines. Proportional-hazards regression was used. Over 9 years of follow-up, 3782 incident cases of MetSyn were identified. After adjustment for demographic factors, smoking, physical activity, and energy intake, consumption of a Western dietary pattern (P_trend=0.03) was adversely associated with incident MetSyn. After further adjustment for intake of meat, dairy, fruits and vegetables, refined grains, and whole grains, analysis of individual food groups revealed that meat (P_trend<0.001), fried foods (P_trend=0.02), and diet soda (P_trend=< 0.001) also were adversely associated with incident MetSyn, whereas dairy consumption (P_trend=0.006) was beneficial. No associations were observed between incident MetSyn and a prudent dietary pattern or intakes of whole grains, refined grains, fruits and vegetables, nuts, coffee, or sweetened beverages.

 

Conclusions— These prospective findings suggest that consumption of a Western dietary pattern, meat, and fried foods promotes the incidence of MetSyn, whereas dairy consumption provides some protection. The diet soda association was not hypothesized and deserves further study.