非傳染性疾病是目前全球最常見的疾病之一。不健康的食相信是導致非傳染性疾病增加的主要因素之一。因此，我們就食對乳腺癌的形成和膽固醇代謝調控的影響進行了研究。 / 在去除卵巢的祼鼠模型中，我們研究了長期和短期熱量限制對乳腺癌腫瘤增殖的影響。14週齡的小鼠被隨機分為5組：自由攝食組 (AL)；熱量攝入控制在AL80% 的20%CCR組；熱量攝入控制在AL的70% 的30%CCR組；熱量攝入控制在AL的65% 的35%CCR組和短期熱量限制 （SCR）組 (前3.5週熱量攝入控制在AL的65%，之後的13.5週自由攝食)。10週後，熱量限制組的腫瘤體積明顯較AL組小 (P < 0.05)。排除攝食對體重的影響，SCR組的腫瘤重量明顯較AL組小 (P < 0.05)。本實驗結果表明，在此動物模型中，短期熱量限制能有效抑制乳腺癌細胞的增殖。 / 此外，我們還研究了芹菜素在肝細胞中對膽固醇代謝的影響。芹菜素是一種常見的黃酮類化合物。研究發現，在WRL-68細胞中，芹菜素能夠劑量依賴性的抑制3 - 羥基-3 - 甲基 - 戊二酸單酰輔酶還原酶 (HMGCR)和固醇調節元件結合蛋白-2 (SREBP-2) 信使RNA和蛋白的表達及其啟動子的轉錄活性。綜上所述，在肝細胞中，芹菜素能有效抑制HMGCR和SREBP-2的表達，從而達到降低膽固醇的效果。 / 總括而言，本研究表明在去除卵巢的祼鼠模型中，短期熱量限制能有效抑制乳腺癌細胞的生長和芹菜素能有效抑制HMGCR和SREBP-2的表達。 / Non-communicable diseases (NCD) are one of the leading causes of mortality in the developed and under-developing countries. Diet is a major risk factor of NCD. In the present study, effects of diet modification on breast cancer development and cholesterol metabolism were investigated. / In the first part of this study, the effect of chronic and short-term calorie restriction (CR) on breast tumor growth in ovariectomized nude mice was investigated. The calorie-restricted dietary regimen limited the total fat intake only. 14 week-old ovariectomized female nude mice were randomly assigned to ad libitum fed (AL), 20%CCR (17-week 80% of AL), 30%CCR (17-week 70% of AL), 35%CCR (17-week 65% of AL) and short-term CR (3.5-week 65% of AL followed by 13.5-week 100% AL consumption) groups. Starting from 10 weeks after transplant of cells, the tumor volumes in all calorie-restricted groups were significantly smaller (P < 0.05) than that in ad libitum control. At sacrifice, the tumor weight in short-term CR was significantly smaller (P < 0.05) than that in ad-libitum control after normalized with body weight. This indicated that short-term CR could suppress tumor in this model. / In the second part of this study, the effect of apigenin on cholesterol metabolism was investigated. Apigenin is one of the most abundant flavonoids. In the present study, we investigated the effect of apigenin on several cholesterol-related gene expression in hepatic cells. In WRL-68 cells treated with apigenin, promoter transcription activity, mRNA and protein expression of HMGCR and SREBP-2 were significantly decreased in a dose-dependent manner. Taken together, we concluded that apigenin inhibited HMGCR and SREBP-2 gene expressions in hepatic cells, which might elicit the hypocholesterolemic effects. / In conclusion, our study has demonstrated that short-term CR could significantly block the breast tumor growth in a mice model and apigenin could inhibit the expression of HMGCR and SREBP-2 in liver cell lines. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Wong, Tsz Yan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 83-99). / Abstracts also in Chinese. / ACKNOWLEGEMENTS --- p.i / ABSTRACT --- p.ii / 摘要 --- p.iv / list of abbreviations --- p.v / list of figures --- p.vii / list of tables --- p.IX / TABLE of CONTENTS --- p.X / Chapter 1 --- CHAPTER 1 --- p.1 / General Introduction --- p.1 / Chapter 1.1 --- Calorie Restriction and the Prevention of Postmenopausal Breast Cancer --- p.2 / Chapter 1.1.1 --- Breast Cancer --- p.2 / Chapter 1.1.2 --- Epidemiology of Excess Body Weight and Cancer Risk --- p.3 / Chapter 1.1.3 --- Calorie Restriction and Cancer Prevention --- p.7 / Chapter 1.1.4 --- Mechanistic Targets of Calorie Restriction --- p.8 / Chapter 1.1.4.1 --- Effect of Calorie Restriction on Estrogen --- p.8 / Chapter 1.1.4.1 --- Effect of Calorie Restriction on Cell Cycle Regulation --- p.12 / Chapter 1.1.4.1 --- Effect of Calorie Restriction on Apoptosis --- p.14 / Chapter 1.2 --- Effect of Apigenin on Cholesterol Homeostasis --- p.17 / Chapter 1.2.1 --- Cardiovascular Disease and Blood Cholesterol --- p.17 / Chapter 1.2.2 --- Molecular Regulation of Cholesterol Metabolism --- p.21 / Chapter 1.2.2.1 --- HMG-CoA Reductase --- p.21 / Chapter 1.2.2.2 --- CYP7A1 --- p.24 / Chapter 1.2.2.3 --- Apolipoprotein A-1 --- p.26 / Chapter 1.2.2.4 --- Low Density Lipoprotein Receptor --- p.29 / Chapter 1.2.2.5 --- Sterol Regulatory Element Binding Proteins --- p.31 / Chapter 1.2.3 --- Flavonoid and its Association with Cholesterol Metabolism --- p.36 / Chapter 1.2.4 --- Apigenin: A Potential Alternative --- p.39 / Chapter 2 --- CHAPTER 2 --- p.41 / MATERIALS AND METHODS --- p.41 / Chapter 2.1 --- Chemicals and Materials --- p.41 / Chapter 2.1.1 --- Chemicals --- p.41 / Chapter 2.1.2 --- Plasmids --- p.41 / Chapter 2.2 --- Cell Culture --- p.41 / Chapter 2.2.1 --- Maintainance of Cells --- p.41 / Chapter 2.2.2 --- Preparation of Cell Stock --- p.42 / Chapter 2.2.3 --- Cell Recovery from Liquid Nitrogen Stock --- p.42 / Chapter 2.3 --- Measurement of Cell viability --- p.43 / Chapter 2.4 --- Semi-Quantitative and Quantitative RT-PCR Assay --- p.43 / Chapter 2.4.1 --- RNA Isolation and cDNA Synthesis --- p.43 / Chapter 2.4.2 --- Quantitative Real Time PCR Assay --- p.43 / Chapter 2.4.2.1 --- Real Time PCR Using TaqMan Probe --- p.43 / Chapter 2.4.2.2 --- Real Time PCR Using SYBR Green Dye --- p.44 / Chapter 2.4.2.3 --- Statistical Analysis of 2⁻ΔΔ{U+A7F0}{U+1D40} Comparative Gene Expression --- p.44 / Chapter 2.5 --- Western Blot Analysis --- p.46 / Chapter 2.6 --- Measurement of Promoter Activity --- p.46 / Chapter 2.6.1 --- Plasmid Preparation --- p.46 / Chapter 2.6.2 --- Transient Transfection and Dual-Luciferase Assay --- p.47 / Chapter 2.7 --- Animal Experiment Design --- p.47 / Chapter 2.7.1 --- Animal Model and Dietary Regimens --- p.47 / Chapter 2.7.2 --- Tissue Sample Collection --- p.50 / Chapter 2.7.3 --- Plasma Estradiol Determination --- p.50 / Chapter 2.7.4 --- Protein and RNA extraction --- p.50 / Chapter 2.8 --- Statistical Analysis --- p.50 / Chapter 3 --- Chapter 3 --- p.51 / EFFECT OF CHRONIC AND short-term calorie restriction on breast tumor growth in ovariectomized nude mice --- p.51 / Chapter 3.1 --- Introduction --- p.51 / Chapter 3.2 --- Objectives --- p.52 / Chapter 3.3 --- Results --- p.53 / Chapter 3.3.1 --- Food Intakes, Body, Liver and Uterus Wet Weights of the Mice --- p.53 / Chapter 3.3.2 --- Tumor Development --- p.57 / Chapter 3.3.3 --- Plasma Estradiol Level --- p.62 / Chapter 3.3.4 --- Estradiol Responsive Gene expression in Tumors --- p.63 / Chapter 3.3.5 --- Cell Apoptotic and Cell Cycle-Regulated Protein expression in Tumors --- p.65 / Chapter 3.4 --- Discussion --- p.67 / Chapter 4 --- CHAPTER 4 --- p.69 / Apigenin inhibits the expression of hmg-coa reductase and srebp-2 in hepatic cells --- p.69 / Chapter 4.1 --- Introduction --- p.69 / Chapter 4.2 --- Objectives --- p.70 / Chapter 4.3 --- Results --- p.70 / Chapter 4.3.1 --- Effect of Apigenin on Cell Viability --- p.70 / Chapter 4.3.2 --- Effect of Apigenin on HMGCR, CYP7A1, LDLR, ApoA-1, SREBP-1 and SREBP-2 mRNA expressions --- p.72 / Chapter 4.3.3 --- Effect of Apigenin on HMGCR, LDLR, ApoA-1 and SREBP-2 Promoter Transcription Activity --- p.75 / Chapter 4.3.4 --- Effect of Apigenin on HMGCR, SREBP-1 and SREBP-2 Protein Expression --- p.77 / Chapter 4.3.5 --- Role of Estrogen Receptor in Apigenin induced SREBP-2 Inhibition --- p.79 / Chapter 4.4 --- Discussion --- p.80 / Chapter 5 --- CHAPTER 5 --- p.82 / SUMMARY --- p.82 / References --- p.83

O selênio é um elemento essencial à saúde humana, cuja distribuição heterogênea na natureza, favorece o aparecimento tanto da deficiência como da toxicidade. O objetivo deste estudo foi avaliar o estado nutricional relativo ao selênio de indivíduos idosos não institucionalizados antes e após a suplementação com castanha-do-brasil. Foram avaliados 40 indivíduos com idade &#8805; 60 anos, que satisfizeram os critérios de inclusão, ou seja, não eram usuários de suplementos vitamínicos-minerais e não apresentavam qualquer patologia que pudesse vir comprometer o estudo, como câncer, diabetes ou artrite reumatóide. Foram avaliados o consumo alimentar, os dados antropométricos e a concentração de selênio no sangue e unhas desta população antes e depois de uma suplementação de três meses com castanha-do-brasil. A avaliação do consumo alimentar foi feita através de registro alimentar por 3 dias e análise pelo software VirtualNutri. O selênio foi determinado por espectrometria de absorção atômica por geração de hidretos acoplados a cela de quartzo (HGQTAAS). Os resultados indicaram 38% e 0% de inadequação na ingestão de selênio em relação a EAR (Necessidade Média Estimada) antes e depois da suplementação respectivamente. A maioria do grupo apresentou antropometria normal. Verificou-se após a suplementação com castanha-do-brasil que o nível médio da concentração de selênio no plasma e eritrócito foi 49% e 229% maior respectivamente (p&#60;0,05). Nas unhas foi aceita a hipótese de que os valores antes e depois da suplementação foram estatisticamente iguais. / Selenium is an essential element to human health. Its irregular distribution in nature favors the emergence of both deficiency and toxicity, though. The goal of this research was to evaluate the selenium nutritional status in noninstitutionalized elders before and after the providing of brazil nut supplementation. We studied 40 individuals aged &#8805; 60 years-old who fulfilled the inclusion requirements, i.e., did not make use of vitaminic-mineral supplements and did not suffer from any pathologies able to interfere in the outcome of the study, such as cancer, diabetes or rheumatoid arthritis. We examined their diet, anthropometric data and selenium rates in blood and nails prior and subsequent to a three-month period of brazil nut supplementation. Diet evaluation was performed by taking alimentary notes during 3 days and by analyzing the data with VirtualNutri software. The ratio of selenium was measured using specthrometrics of atomic absorption by generation of hydrates Iinked to a quartz cell (HGQTAAS). Our results indicated 38% and 0% of inadequacy in selenium ingestion in reference to the EAR (Estimated Average Reference) before and after supplementation, respectively. Most of the group presented normal anthropometrical values. It was found that, following the administration of brazil nut, the average selenium rates in plasma and erythrocytes increased 49% and 229% respectively (p&#60;0,05). Concerning the nails, we accepted the hypothesis of statistically equal levels preceding and succeeding treatment.

O selênio é um elemento essencial à saúde humana, cuja distribuição heterogênea na natureza, favorece o aparecimento tanto da deficiência como da toxicidade. O objetivo deste estudo foi avaliar o estado nutricional relativo ao selênio de indivíduos idosos não institucionalizados antes e após a suplementação com castanha-do-brasil. Foram avaliados 40 indivíduos com idade &#8805; 60 anos, que satisfizeram os critérios de inclusão, ou seja, não eram usuários de suplementos vitamínicos-minerais e não apresentavam qualquer patologia que pudesse vir comprometer o estudo, como câncer, diabetes ou artrite reumatóide. Foram avaliados o consumo alimentar, os dados antropométricos e a concentração de selênio no sangue e unhas desta população antes e depois de uma suplementação de três meses com castanha-do-brasil. A avaliação do consumo alimentar foi feita através de registro alimentar por 3 dias e análise pelo software VirtualNutri. O selênio foi determinado por espectrometria de absorção atômica por geração de hidretos acoplados a cela de quartzo (HGQTAAS). Os resultados indicaram 38% e 0% de inadequação na ingestão de selênio em relação a EAR (Necessidade Média Estimada) antes e depois da suplementação respectivamente. A maioria do grupo apresentou antropometria normal. Verificou-se após a suplementação com castanha-do-brasil que o nível médio da concentração de selênio no plasma e eritrócito foi 49% e 229% maior respectivamente (p&#60;0,05). Nas unhas foi aceita a hipótese de que os valores antes e depois da suplementação foram estatisticamente iguais. / Selenium is an essential element to human health. Its irregular distribution in nature favors the emergence of both deficiency and toxicity, though. The goal of this research was to evaluate the selenium nutritional status in noninstitutionalized elders before and after the providing of brazil nut supplementation. We studied 40 individuals aged &#8805; 60 years-old who fulfilled the inclusion requirements, i.e., did not make use of vitaminic-mineral supplements and did not suffer from any pathologies able to interfere in the outcome of the study, such as cancer, diabetes or rheumatoid arthritis. We examined their diet, anthropometric data and selenium rates in blood and nails prior and subsequent to a three-month period of brazil nut supplementation. Diet evaluation was performed by taking alimentary notes during 3 days and by analyzing the data with VirtualNutri software. The ratio of selenium was measured using specthrometrics of atomic absorption by generation of hydrates Iinked to a quartz cell (HGQTAAS). Our results indicated 38% and 0% of inadequacy in selenium ingestion in reference to the EAR (Estimated Average Reference) before and after supplementation, respectively. Most of the group presented normal anthropometrical values. It was found that, following the administration of brazil nut, the average selenium rates in plasma and erythrocytes increased 49% and 229% respectively (p&#60;0,05). Concerning the nails, we accepted the hypothesis of statistically equal levels preceding and succeeding treatment.

Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--University of Stellenbosch, 2006. / Background At least 40 - 80% of all cancer patients develop some degree of clinical malnutrition and cachexia. The complex and multi-factorial nature of cancer cachexia and the inability of conventional nutrition intervention to reverse or attenuate the effects of this syndrome have driven investigators to consider new therapies and approaches to manage the syndrome of cancer cachexia including eicosapentaenoic acid (EPA), an n-3 fatty acid of fish oil origin. Objectives The aim of this study was to review Phase I, Phase II and Phase III (RCT) trials investigating the safety and efficacy of n-3 supplementation in the treatment of cancer cachexia in adult patients with unresectable solid tumours, with special reference to weight loss, body composition, appetite, dietary intake, energy expenditure, functional status, acute phase response and quality of life. Adverse effects associated with EPA supplementation were also reviewed. Methodology and data collection The major databases were systematically searched for studies that met the inclusion criteria using a structured keyword search strategy or various combinations of these keywords. Relevancy of studies was assessed by two independent reviewers according to pre-determined inclusion and exclusion criteria. Quality was assessed by two independent reviewers using the Jadad scale. Data extraction was performed by the principal reviewer and one of the independent reviewers, and investigators of the included studies were contacted where further information was required. Meta-analysis was not appropriate due to heterogeneity of the data. However, where possible, the paired t-test was used for analysis of the data. Descriptive or non-quantitative analysis of the tabulated data provided a summary of the characteristics of the included studies enabling comparisons to be made between interventions and outcomes within the specified population. Results The search resulted in a total of 1408 citations, of which only 16 studies met the inclusion and exclusion criteria. Of these, only 4 studies were of a good quality. Although the reported data was incomplete and variable, the combined analyses suggested that the effect of EPA supplementation on weight, fat mass, dietary intake, energy expenditure, and acute phase response was not significant. Interestingly there appeared to be a significant increase increased or decreased? in lean body mass (p<0.05). There was little or no data to draw any conclusions regarding the effect of supplementation on appetite and quality of life. Conclusion Despite several limitations in this review, the data collected and analysed are suggestive of the beneficial effects of EPA supplementation, but there remains a significant lack of substantial evidence and conclusive statistical analysis to confirm that EPA supplementation is a safe and effective method of intervention in the management of patients with cancer cachexia.

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Thesis (MNutr)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Objective To develop and test a marketable, Continuing Professional Development (CPD) accredited training manual focused on the role of medical nutrition therapy (MNT) for healthcare professionals (HCP) of the multidisciplinary Type 1 and Type 2 Diabetes Mellitus (DM) management team. Methods The study consisted of two components: (a) development of the MNT manual and (b) testing of the MNT manual. The development of the MNT manual consisted of seven steps: (1) needs assessment and problem definition; (2) literature search; (3) draft one of the MNT manual; (4) peer review; (5) draft two of the MNT manual; (6) evaluation by means of a survey; and (7) the final MNT manual. The testing of the MNT manual’s impact on knowledge had a test-retest design which consisted of seven steps: (1) DM knowledge questionnaire development; (2) participant recruitment; (3) questionnaire pilot; (4) initial knowledge testing; (5) self-study of MNT manual; (6) retesting of knowledge; (7) statistical analysis. Results From the literature a total of 132 published documents were selected for inclusion in the MNT manual after grading of the information. The first draft was compiled and sent for peer review and language editing. Recommended changes were made and the second draft was developed and sent to 79 registered dietitians (RDs) who volunteered to complete a survey after reading the MNT manual. The survey indicated that the majority were satisfied with the content, which in turn led to the final MNT manual.The questionnaire was compiled using the content of the MNT manual and creating 10 questions per section of the manual. The pilot was conducted using 10% (n = 7) of the total sample. Minor changes were made. For knowledge testing, participants included RDs between the ages of 23 and 60 years, registered with the Health Professions Council of South Africa. A test-retest design was used. Participants scored a mean of 57.5% on the initial knowledge questionnaire (KQ1), ranging between 33.6% and 79.8%. They lacked knowledge on: management of the hospitalised patient; diabetes and exercise; diabetes and religion; gestational diabetes; supplements commonly used by diabetics; diabetes in prisons; diabetes in children; the function, side-effects and contra-indications of metformin. The mean score on the second knowledge questionnaire (KQ2) increased to 90.5%, with the lowest score 50.4% and the highest 99.2%.There were two questions where participants scored < 50% (mean of n = 79) which related to the type of insulin regime most suitable during Ramadan and risk factors for Type 2 DM in children. Data were also analyzed according to various socio-demographic variables, but only one significant difference was found between groups. Conclusions and implications There is adequate research available to develop a comprehensive guide for HCP on the nutritional management of DM. Such an MNT manual should be marketed for CPD purposes to encourage HCP to improve their DM management skills, as seen by the dramatic improvement in DM management knowledge of the RDs participating in this research. Future studies may include knowledge testing of other HCP, as well as testing to determine if the newly acquired information is put into practice to the benefit of DM patients. / AFRIKAANSE OPSOMMING: Objektiewe Die ontwikkeling en toets van 'n bemarkbare, Voortgesette Professionele Ontwikkeling (VPO) geakkrediteerde handleiding oor die rol van mediese voedings terapie (MVT) vir mediese personeel van die multi-dissiplinêre Tipe 1- en Tipe 2 Diabetes Mellitus (DM) behandelings span. Metodes Die studie het bestaan uit 2 komponente: (a) die ontwikkeling van die MVT handleiding en (b) die toets van die MVT handleiding. Die ontwikkeling van die MVT handleiding het bestaan uit sewe stappe: (1) assesering van benodighede en probleem definisie, (2) literatuursoektog; (3) aanvanklike konsep van die MVT handleiding; (4) eweknie evaluasie; (5) volgende konsep weergawe van die MVT handleiding; (6) evaluering deur ‘n meningsopname; en (7) die finale MVT handleiding. Die toets van die MVT handleiding se impak op die kennis het 'n toets-hertoets ontwerp gehad wat bestaan het uit sewe stappe: (1) DM kennis vraelys ontwikkeling; (2) deelnemer werwing; (3) toets van vraelys; (4) toets van aanvanklike kennis; (5) selfstudie van die MVT handleiding; (6) hertoetsing van kennis; en (7) statistiese analise. Resultate Uit die literatuur is 132 gepubliseerde dokumente gekies vir insluiting in die MVT handleiding na gradering van die kwaliteit van die inligting. Die aanvanklike konsep is ontwikkel, taalversorg en eweknie geevalueer. Aanbevole veranderinge is gemaak en die tweede konsep is ontwikkel en gestuur aan 79 dieetkundiges wat vrywillig die MVT handleiding gelees het en aan ‘n meningsopname deelgeneem het. Uit die meningsopname was dit duidelik dat die meerderheid tevrede was met die inhoud, wat gelei het tot die finale MVT handleiding.Die vraelys is opgestel met 10 vrae per afdeling van die MVT handleiding, en getoets deur 10% (n = 7) van die totale aantal deelnemers, waarna geringe veranderinge gemaak is. Vir kennis toetsing, is dieetkundiges tussen die ouderdomme van 23 en 60 jaar, wat geregistreer is by die Raad vir Gesondheidsberoepe van Suid-Afrika, ingesluit. Deelnemers het 'n gemiddeld behaal van 57.5 % op die aanvanklike kennis vraelys, met kennis wat gewissel het tussen 33.6% en 79.8%. Hulle het aanvanklik gebrekkige kennis gehad oor: die behandeling van die hospitaal pasiënt; diabetes en oefening; diabetes en godsdiens; swangerskaps diabetes; aanvullings gebruik deur diabete; diabetes in gevangenisse; pediatriese diabetes; asook die funksie, newe-effekte en kontra-indikasies van metformien. Die gemiddelde telling op die tweede kennis vraelys het toegeneem tot 90.5%, met ‘n laagste telling van 50.4% en hoogste van 99.2%. Daar was 2 vrae waar deelnemers < 50% (gemiddelde % van n = 79) behaal het. Hierdie vrae het verband gehou met die mees geskikte insulien behandeling tydens Ramadan en risikofaktore vir Tipe 2 DM in kinders. Data is ontleed volgens verskeie sosio-demografiese veranderlikes, maar slegs een beduidende verskil is tussen groepe gevind. Gevolgtrekkings en implikasies Daar is voldoende navorsing beskikbaar om ‘n omvattende handleiding vir mediese personeel oor die rol van voeding in die behandeling van DM te ontwikkel. So 'n MVT handleiding moet bemark word vir VPO doeleindes om mediese personeel aan te moedig om hul DM bestuursvaardighede te verbeter, soos gesien deur die dramatiese verbetering in DM bestuur kennis van die huidige deelnemers. Toekomstige navorsing kan die bepaling van kennis verbetering van ander mediese professies insluit, en of die verbeterde kennis in die praktyk DM pasiënte bevoordeel.

Bakgrund: Diabetes mellitus typ 2 är en vanlig folksjukdom som innebär en stor börda för patienter. Kostförändringar har visats kunna förbättra patienters situation, men följsamheten av kostråd brister dock ofta och det tillhör sjuksköterskans roll att främja och stödja en effektiv egenvård bland patienter med diabetes. Syfte: Syftet av denna litteraturstudie är att undersöka utifrån patienters perspektiv vad som påverkar till en ökad samt minskad följsamhet av kostråd vid diabetes typ 2. Metod: Litteraturöversikten är baserad på 19 artiklar av både kvantitativa och kvalitativa ansats som valts ut från databaserna PubMed, Cinahl och PsycINFO. De valda artiklarna vetenskaplig kvalitet granskades med checklistor för kvasi-experimentella eller kvalitativa studier. De inkluderade artiklarnas resultat analyserades av båda författarna för att hitta faktorer som påverkar följsamhet av kostråd. Relevant data sorterades i teman beroende på likheter och skillnader. Resultat: Totalt identifierades sex teman som beskriver vad som kan ha betydelse för följsamheten till kostråd: (1) förhållningssätt till förändring, (2) sociala aspekter, (3) mental hälsa, (4) kultur, (5) kunskapsbrist och (6) socioekonomisk situation. Slutsats: Sjukdomsinsikt, self-efficacy och socialt stöd är väsentliga aspekter att beakta när sjuksköterskor vårdar patienter med diabetes, för att främja deras följsamhet till kostråd. Stödjande insatser borde bygga på individens egen förmåga att ändra sin kost genom att inkludera tidig och anpassad information, delaktighet av närstående samt empati gällande personens socioekonomiska, kulturella och psykiska förhållande. / Background: Prevalence of type 2 diabetes mellitus increases worldwide and represents a major disease burden. Effective self-care, including diet changes, has been shown to prevent complications and improve quality of life. However, adherence to diet therapy is often insufficient and it belongs to the nurse’s role to promote and support adequate self-care. Aim: The purpose of this study is to examine, from patients perspectives, what increases and decreases compliance to dietary advice for diabetes type 2. Method: The literature review is based on 19 articles of both quantitative and qualitative approaches, selected from the databases PubMed, CINAHL and PsycINFO. The scientific quality of the selected articles was assessed with checklists for quasi-experimental or qualitative studies. Both authors analyzed the results of the included articles, to identify factors that influence adherence to dietary advice. Relevant data were sorted into themes depending on similarities and differences. Results: Six themes were identified: (1) attitude to change, (2) social relations, (3) mental health, (4) culture, (5) lack of knowledge and (6) socio-economic condition. Conclusion: Disease insight, self-efficacy and social support are essential aspects to consider when nurses care for patients with diabetes, to promote their adherence to dietary advice. Supporting interventions should strengthen the individual's own capability to change their diet, by including early and tailored information, participation of family members and empathy regarding the person's socio-economic, cultural as well as their psychological condition.

Submitted in fulfillment of the requirement for the degree of Doctor of Philosophy in the Faculty of Health Sciences at the University of the Witwatersrand, Johannesburg / Renewed interest in cannabinoid compounds arose since the discovery of the endocannabinoid system in the early 1990’s and its role in mediating the body’s energy balance. The aim of this study was to investigate the effect of an organic Cannabis sativa (hereafter referred to as C. sativa) extract on β-cell secretory function using an in vivo diet-induced obese rat model and an in vitro isolated rat pancreatic islet model and to determine the associated molecular changes within the pancreatic tissue. Materials and methods: Diet-induced obese Wistar rats and rats fed on standard pellets were subcutaneously injected, over a 28 day period, with an organic C. sativa extract or the vehicle (1% Tween 80® in saline). The effect of diet and treatment was evaluated using the intraperitoneal glucose tolerance tests (IPGTTs) and quantitative polymerase chain reaction (qPCR) analysis on rat pancreata. In vitro studies were conducted using isolated rat islets exposed to 11.1 (representative of normoglycemic conditions) and 33.3 mM glucose levels (representative of hyperglycemic conditions) over a 24-(D1; acute) and 96-hour (D4; chronic) period, and treated with C. sativa extract containing an equivalent of 2.5 (T1) and 5 ng/mL (T2) tetrahydrocannabinol (THC). Glucose-stimulated insulin secretion (GSIS), immunohistocytochemistry for apoptosis and proliferation detection and western blotting for detection of cannabinoid receptor type 1 (CB1), CB2 receptors and specific transduction factors were undertaken. Antagonist studies were conducted using AM251 (A1) and AM630 (A2) to block CB1 and CB2, respectively, to determine the role of cannabinoid receptors in insulin secretion. Results: The overall increase in body weight in the experimental groups occurred at a significantly slower rate than the control groups (P < 0.01), irrespective of diet. In the lean group, the area under the curve for glucose (AUCg) was significantly higher compared to the diet-induced obese group (P < 0.001), while C. sativa treatment significantly improved the AUCg in the lean rats (P < 0.05). The cafeteria diet did not induce hyperglycemia and insulin resistance in the obese rats and C. sativa treatment maintained a plasma glycemic profile similar to the obese control rats. The lower AUCg values in the obese group may, in part, be due to the inclusion of milk products (shown to be beneficial in reducing diabetes) in the cafeteria diet. qPCR analysis showed that the cafeteria diet induced down-regulation of the following genes in the obese control group, relative to lean controls: UCP2 (P < 0.01), c-MYC (P < 0.05) and FLIP (P < 0.05), and upregulation of CB1 (P < 0.01), GLUT2 (P < 0.001), UCP2 (P < 0.001) and PKB (P < 0.05), relative to the obese control group, while c-MYC levels were down-regulated (P < 0.05), relative to the lean control group. In the in vitro study, results showed C. sativa treatment decreased chronic insulin secretion in islets cultured under normoglycemic condition for D1 (P < 0.05), but not for D4. In islets cultured under hyperglycemic conditions, C. sativa treatment for the D4 period showed a significant increase in their chronic insulin secretion (HD4T1, P = 0.07; HD4T2, P < 0.001), increase in basal insulin secretion (HD4T1, P < 0.001; HD4T2, P < 0.001), increase in GSIS (HD4T1, P < 0.05; HD4T2, P < 0.001), reduction in glucose-stimulated:basal insulin production (HD4T1, P < 0.05; HD4T2, P < 0.05), reduction in insulin content (HD4T1, P < 0.001), increase in the percentage basal : content ratio (HD4T1, P < 0.001; HD4T2, P < 0.01) and increase in the percentage GSIS : content ratio (HD4T1, P < 0.001; HD4T2, P < 0.05), relative to ND4C islets. In antagonist studies, A2 preconditioning did not affect suppress the stimulatory effect of C. sativa treatment on chronic insulin secretion under normo- and hyperglycemic conditions, relative to the NC and HC islets, respectively. qPCR studies showed that C. sativa exposure induced a 2.2-fold increase in CB1 gene expression, relative to normoglycemic control islets (P < 0.05), while c-MYC and FLIP expression was significantly reduced by 12% (ND4T1, P < 0.05) and 37% (HD4T1, P < 0.05), respectively. C. sativa treatment also induced increased secretion of anti-inflammatory cytokines/chemokines under hyperglycemic conditions. Conclusion: These results suggest that C. sativa protects pancreatic islets against the negative effects of obesity (in vivo studies) and hyperglycemia (in vitro studies). In light of these findings, further investigation into the potential of C. sativa as a complementary therapeutic agent in the treatment of the deleterious effects of hyperglycemia in diabetic patients is warranted. In addition, the significant effect of C. sativa treatment on adipose tissue in experimental rats needs further investigation to determine how the cannabinoids affect the mechanisms of adipogenesis and lipolysis in diet-induced obesity. Keywords: Diet-Induced Obesity, Cannabinoids, C. sativa, THC, β-cell, AM251, AM630.

O estudo avaliou o consumo de magnésio na dieta de praticantes de musculação (n = 15) de acordo com as novas Ingestões Dietéticas de Referência (lDRs). Também foram identificados os alimentos fonte de magnésio na dieta do grupo estudado e em maratonistas da mesma faixa etária, para serem reproduzidos e analisados em seu conteúdo de magnésio total. Desta forma, podem-se comparar os resultados obtidos em laboratório com os encontrados em tabelas de composição de alimentos. Realizando-se ainda a validação de metodologia de determinação de magnésio total. O consumo dietético de Mg (média±desvio padrão) foi 323±115 mgMg/d e 115±26 mgMg/1000kcal na faixa dos 19-30 anos e 345±110 mgMg/d e 110±18 mgMg/1000kcal na faixa dos 31 a 50 anos, sem diferenças significantes entre os grupos estudados. Neste quadro, 5 praticantes de musculação tinham a probabilidade mínima de 70% de estarem com a ingestão usual de Mg adequada, enquanto 6 mostraram a probabilidade mínima de 70% de ingestão usual de Mg inadequada. Deve-se ainda ressaltar um melhor aporte dietético do mineral em questão, enfatizando um maior consumo de alimentos com maior conteúdo de magnésio. As principais fontes alimentares de Mg para o grupo da musculação foram banana, bife, batata cozida, espinafre cozido, feijão, leite semi-desnatado e aveia em flocos. Já para os maratonistas estas foram representadas por banana, farinha de milho, farelo de aveia, feijão, bife, peixe cozido, quiabo, achocolatado em pó, pão integral e mandioca . A curva de calibração de magnésio encontrado foi linear (r = 0,9999), apresentando LO e LQ (Média±desvio padrão) 0,15±0,17 e 0,48±0,55 &#181;gMg/mL. Para determinação de magnésio total os padrões de referência certificado (NIST) e secundário (AIN93G) apresentaram coeficiente de variação (c.v.) 4,4 e 3,2 %, respectivamente. Porém, a concentração obtida no padrão NIST foi significativamente menor (p<0,05) que o valor esperado. Os alimentos analisados tiveram c.v. dentro do limite estabelecido (10%). No padrão AIN93G e no farelo de aveia não foi observada interferência da matriz .O conteúdo de magnésio total encontrado nas marcas de água mineral analisadas variou de 0,5 a 1,2 mgMg/100g. Apesar dos valores estarem acima do encontrado, mesmo assim a água não contribui com o consumo dietético de magnésio acima de 7% da EAR, considerando a ingestão de 2 litro/d de água. Dentre os alimentos submetidos à cocção, o quiabo, o espinafre, a mandioca e o feijão tiveram diferenças significativas (p<0,05) entre as formas cruas e processadas. As marcas de farinha de milho, farelo de aveia, pão integral e achocolatado em pó analisadas estão diferentes dos valores esperados, provavelmente devido à diferente origem dos alimentos encontrados nas tabelas de composição utilizadas. / The study evaluated the magnesium comsuption in body building\'s diet (n = 15) according to the new Dietary Reference Intakes (IDRs). Magnesium\'s food sources also were identified of the studied group and in marathon runners\' diet of the same age, so they could be reproduced and analyzed in its total magnesium content. This way, the obtained results in laboratory could becompared with the ones found in food composition tables, also conducting the validity of total magnesium\'s determination methodology . The magnesium dietary consumption (average±standard deviation) was 323±115 mgMg/d and 115±26 mgMg/1000kcal in the the 19-30 year-old group and 345±110 mgMg/d and 110±18 mgMg/1000kcal in the 31 to 50 year-old group, without significant differences among the studied groups. In this scenario, 5 body building athletes had the minimum probability of 70% of adequate magnesium\'s usual ingestion, while 6 showed at least 70% of minimum probability of inadequate magnesium\'s usual ingestion. Should be done a better dietary contribution of the mineral in question, emphasizing a larger food consumption with higher magnesium content. The main boby builders\' Mg food sources were banana, steak, cooked potato, cooked spinach, bean, semi-skimmed milk and oat flakes. Also, for the marathon runners these were represented by banana, com flour, oat bran, bean, steak, cooked fish, okra, chocolate powder, whole-meal bread and cassava. The calibration curve found for magnesium was linear (r = 0,9999), presenting DL and QL O, 15±0, 17 and 0,48±0,55 mgMg/mL In total magnesium determination the certified reference material (NIST) and secundary reference material (AIN93G) presented a variation coefficient (c.v.) of 4,4 and 3,2%, respectively. Even so, the obtained concentration in the NIST reference material was significantly smaller (p <0,05) than the expected value. The analyzed foods had c.v. below the established limit (10%). In the AIN93G reference material and in the oat bran no matrix\'s interference were observed . The total magnesium content found in the analyzed brands of mineral water ranged from 0,5 to 1,2 mgMg/100g. In spite the values above the expected ones, the water doesn\'t contribute with the dietary consumption of magnesium above 7% of EAR, considering the ingestion of 2 liter/d of water. Among the foods submitted to cooking process, okra, spinach, cassava and bean had significant differences (p <0,05) among raw and processed forms. The corn flour, oat bran, whole-meal bread and chocolate powder\'s brands analyzed are different from the expected values, probably due to the different origin of the foods found in the used composition tables.

Thesis (MTech (Consumer Science: Food and Nutrition))--Cape Peninsula University of Technology, 2016. / Objective: To determine the association between the dietary fat knowledge and consumption of foods rich in fat among first-year students in self-catering residence at a university of technology, Cape Town, South Africa. Design: The two concepts – the dietary fat knowledge (represented by dietary fat food knowledge and dietary fat nutrition knowledge) and the consumption of foods rich in fat – were assessed separately. Two norm-referenced, valid and reliable knowledge tests and an intake screening questionnaire were used for the assessments (as subsidiary objectives), before the associations between the concepts were determined (main objective). The dietary fat food and nutrition knowledge as assessed was categorised in the range poor or below average, average and good or above average, and the consumption of foods rich in fat as high, quite high, the typical Western diet, approaching low or desirable. The Pearson‟s chi-square test was applied to these categorical findings to determine if associations (five percent significance) existed between the concepts. Results: The stratified sample included 225 first-year students. Nearly half (48.4%) of them achieved an average fat food knowledge score, while the majority (80.9%) achieved a poor fat nutrition knowledge score. More than half (52.5%) either followed a typical Western diet, a diet quite high in fat or high in fat. While no significant (p > 0.05) association was found between the students‟ dietary fat food knowledge and consumption of foods rich in fat, significant results were found in the association between the students‟ dietary fat nutrition knowledge and consumption of foods rich in fat (p < 0.05) and between their fat food knowledge and fat nutrition knowledge (p < 0.001). Conclusions: An inverse association was found between the students‟ dietary fat nutrition knowledge and fat consumption, a positive association between their dietary fat food knowledge and dietary fat nutrition knowledge, and no association between their dietary fat food knowledge and fat consumption.