Objective: To compare glycemic index and load (GI and GL) in the usual diet of PCOS and control women and to investigate whether dietary GI and GL are associated with body composition and anthropometric and metabolic variables across PCOS phenotypes. Design: Cross-sectional study. Setting: University hospital outpatient clinic. Patients: 61 women with PCOS and 44 non-hirsute women with ovulatory cycles. Interventions: Metabolic work-up, biochemical and hormonal assays, assessment of body composition and rest metabolic rate, physical activity (pedometer), and food consumption (food frequency questionnaire). Main outcome measure(s): GI and GL. Results: Mean age was 23.7±6.3 years. The prevalence of obesity was 44.3% in PCOS women and 31.8% in controls. Median GI for the group was 58. PCOS patients with GI>58 had higher BMI, worse metabolic profile, and lower intake of fibers. GI was correlated with BMI in controls and with lipid accumulation product (LAP) in the PCOS group, and was higher in classic PCOS vs. other groups. Conclusions: Dietary GI is increased in PCOS patients, especially in the classic PCOS phenotype. Increased dietary GI is associated with a less favorable anthropometric and metabolic profile in PCOS.

O controle glicêmico intensificado pode prevenir e/ou retardar o aparecimento das complicações crônicas do diabetes melito (DM). O carboidrato da dieta é o principal determinante da glicemia pós-prandial, sendo o índice glicêmico (IG) e a carga glicêmica (CG) úteis para prever a resposta glicêmica aos alimentos. O objetivo deste manuscrito foi revisar criticamente o papel das dietas de baixo IG na prevenção e controle metabólico do DM tipo 2 (DMT2). O risco para desenvolvimento de DMT2 com dietas de alto IG variou de 1,21 a 1,59. A redução de 12 a 32 unidades no IG da dieta diminuiu em 0,39 a 0,50 pontos percentuais a HbA1c. Os efeitos dessas dietas no perfil lipídico e peso corporal no DMT2 permanecem controversos. Em conclusão, as evidências atuais indicam que a incorporação do IG no planejamento dietético de pacientes com DMT2 contribui para a melhora do controle glicêmico. / The tight glycemic control can prevent and/or delay the development of chronic complications of diabetes mellitus (DM). Dietary carbohydrates are the main determinant of postprandial blood glucose and glycemic index (GI) and glycemic load are used to predict blood glucose response to foods. The aim of this paper was to critically review the role of low GI diets in type 2 DM (T2DM) prevention and metabolic control. The risk for development of T2DM with high GI diets ranged from 1.21 to 1.59.The reduction from 12- 32 units in the GI of diets decreased 0.39-0.50% in HbA1c values. However, the effects of these diets on lipid profile and body weight in patients with T2DM remain controversial. In conclusion, the current evidence indicates that the inclusion of GI in the dietary planning for patients with T2DM contributes to the improvement of glycemic control.

Submitted by Jorge Silva (jorgelmsilva@ufrrj.br) on 2017-08-29T18:10:46Z No. of bitstreams: 1 2017 - Renata Oliveira Santos.pdf: 1382777 bytes, checksum: 331bbbcbeb5b7d3a9f1d49008191a5b8 (MD5) / Made available in DSpace on 2017-08-29T18:10:46Z (GMT). No. of bitstreams: 1 2017 - Renata Oliveira Santos.pdf: 1382777 bytes, checksum: 331bbbcbeb5b7d3a9f1d49008191a5b8 (MD5) Previous issue date: 2017-02-14 / CAPES / In the past few years the use of prebiotics in the making of dairy products has been gathering many supports, although the search for low cost raw-material to achieve that it still a big challenge, which highlights the potential to the development in the research for alternatives sources or new processes in order to obtain those ingredients. Besides, the need to reduces the additives in the diet has been mandatory to the consumers who wants a health diet, as a growing tendency in the food industry in the development of products with cleaner labels, which are known as clean label. In this context, the search and/or value of natural ingredients that contributes simultaneously for the improvement in the functional properties, sensory and technological of food products that make them essential. Among the sources of these ingredients, stands out the araruta (Maranta arundinacea L.) as unconventional food plants (PANC?s) from Marantaceas Family, which presents a food potential, nutritional, functional that is neglected. Therefore, the aim of this paper was to evaluate the effect of the adding of araruta flours in the physical Chemical characteristics, rheological and in the growing of probiotic bacteria in the vanilla dairy dessert. In the Chapter I was developed and research in the literature in order to evaluate the sensory aspects and technological of prebiotics flours in the dairy products. In the Chapter II was performed a study of the prebiotic potential in the araruta flour, as well as, the effect of different % of these flours in the reological and technological of the mentioned dessert. It is possible to conclude that the particles size of the flours directed affected the texture of the desserts, once the flours with bigger size contributed to the increase in firmness of the dairy desserts. In addition, regarding the functional aspects, the araruta flour presented high level of resistent starch (29,47%) low IG(41,8), beyond the probiotic potential, which contribute to the increase number on the Lactobacillus Casey counting. Also, it was verified that % flour contribute to the reduction in the syneresis, rheological properties(flow behavior in oscillatory tests), texture (firmness and stickiness) and on the microscopical characteristics in the vanilla dairy dessert. / Nos ?ltimos anos, o uso de prebi?ticos na elabora??o de produtos l?cteos tem sofrido grande incentivo, embora a procura por mat?rias-primas de baixo custo para sua obten??o ainda seja um grande desafio, evidenciando um potencial para desenvolvimento de pesquisas de fontes alternativas ou novos processos de obten??o desses ingredientes. Al?m disso, a necessidade de redu??o de aditivos na dieta tem sido mandat?ria para os consumidores que buscam uma alimenta??o mais saud?vel, assim como, uma tend?ncia crescente da ind?stria de alimentos no desenvolvimento de produtos com r?tulos mais limpos, conhecidos como clean label. Neste contexto, a busca e/ou valoriza??o de ingredientes naturais que contribuam simultaneamente para a melhoria das propriedades funcionais, sensoriais e tecnol?gicas dos produtos aliment?cios se torna fundamental. Dentre as fontes desses ingredientes, destaca-se a araruta (Maranta arundinacea L.) uma planta aliment?cia n?o convencional (PANC) da fam?lia das Marantaceas que apresenta potencial aliment?cio, nutricional, funcional e tecnol?gico negligenciado. Assim, o objetivo geral do presente trabalho foi avaliar o efeito da adi??o de farinha de araruta nas caracter?sticas f?sico-qu?micas, reol?gicas e no crescimento de bact?rias probi?ticas de sobremesa l?ctea sabor baunilha. No Cap?tulo I deste trabalho foi realizada uma revis?o de literatura visando avaliar os aspectos sensoriais e tecnol?gicos do uso de farinhas prebi?ticas em produtos l?cteos. No Cap?tulo II foi realizado o estudo das propriedades f?sicas, funcionais (amido resistente e ?ndice glic?mico) e do potencial prebi?tico da farinha de araruta, bem como, o efeito de diferentes % dessa farinha nas propriedades reol?gicas e tecnol?gicas de uma sobremesa l?ctea sabor baunilha. Pode-se concluir que o tamanho de part?cula das farinhas afetou diretamente a textura das sobremesas, uma vez que, as farinhas com maior tamanho m?dio de part?culas contribu?ram para aumento da firmeza das sobremesas l?cteas. Com rela??o aos aspectos funcionais, a farinha de araruta apresentou elevado teor de amido resistente (29,47%), baixo IG (41,8), al?m de potencial prebi?tico contribuindo para o aumento da contagem de Lactobacillus casei. Foi verificado que % farinha contribui para redu??o da sin?rese, al?m de afetar as propriedades reol?gicas (comportamento de fluxo e ensaios oscilat?rio), na textura (firmeza e adesividade) e nas caracter?sticas microsc?picas da sobremesa l?ctea sabor baunilha.

Inledning: Surdeg är idag en trend som fångats av många och de flesta bagerier ochdagligvarubutiker säljer bröd som kallas för surdegsbröd. Ett traditionellt surdegsbröd är ettbröd där surdegen används som enda hävningsmedel i brödet. Syfte: Syftet var att undersöka skillnader i sensoriska egenskaper, utifrån ettkonsumentperspektiv, samt GI-värde mellan surdegsbröd, jästbröd och bröd bakat på bådesurdeg och jäst. Material och metod: Metoderna som användes var två olika konsumenttester för att bestämmaskillnader mellan de tre bröden, och en in vitro-metod för att bestämma GI-värde. Resultat: Resultatet visade att konsumenter känner skillnad mellan surdegsbröd och jästbrödoch mellan surdegsbröd och bröd bakat på både surdeg och jäst men däremot inte mellanjästbröd och bröd bakat på både surdeg och jäst. Den syrliga smaken i surdegsbröd minskar ombrödet bakas på både surdeg och jäst. GI-mätningen genom in vitro-metoden visade att brödetbakat på både surdeg och jäst hade lägst GI medan surdegsbrödet hade högst. Slutsats: Ett bröd bakat på både surdeg och jäst är mer likt ett jästbröd än ett surdegsbröd. In vitro-metoden är inte den mest tillförlitliga för att undersöka skillnader i GI för justsurdegsbröd samtidigt som surdegsbrödets pH-värde kan ha varit för högt för att kunna sänkabrödets GI-värde. Inga slutsatser kunde därför dras från GI-mätningen. / Introduction: Sourdough is today a trend that has been caught by many and most bakeries andgrocery stores sell bread called “Sourdough bread”. Traditional sourdough bread is bread wherethe sourdough is used as only leavening agent. Purpose: The purpose was to examine differences in sensory attributes, from a consumerperspective, and glycemic index between sourdough bread, yeast bread and bread baked withboth sourdough and yeast. Material and Method: The methods used were two different consumer tests to determinedifferences between the three breads, and an in vitro-method for determining the glycemicindex. Result: The results showed that consumers can sense the difference between sourdough breadand yeast bread and between sourdough bread and bread baked with both sourdough and yeastbut not between yeast bread and bread baked with both sourdough and yeast. The sourish tasteof sourdough bread decreases if the bread is baked with both sourdough and yeast. Theglycemic index measurements by the in vitro-method showed that the bread baked with bothsourdough and yeast had the lowest glycemic index value whilst the sourdough bread had thehighest. Conclusion: Bread baked with both sourdough and yeast more resembles yeast bread thansourdough bread. The in vitro-method is not the most reliable for examining differences inglycemic index value for sourdough bread meanwhile the pH-value of the sourdough breadmay have been too high to be able to lower the glycemic value of the bread. No conclusionscould therefore be made from the glycemic index measurements.

This purpose of this thesis was to develop a pilot study to determine if omega-3 fatty acids and vitamin D3 will improve body weight loss and improve risk factors for Metabolic Syndrome within a weight loss program. Risk factors include obesity, hypertension, hyperglycemia, and dyslipidemia. Thirty-five men and women between 18 and 65 years of age with risk factors for Metabolic Syndrome were recruited for this study. All participants followed an energy-restricted, low glycemic-index based diet and exercise program for 16 weeks. Half of these participants received omega-3 fatty acid and vitamin D3 supplements. In those that received these supplements, it was seen that their serum 25-hydroxyvitamin D2/D3 levels and incorporation of docosahexaenoic acid and eicosapentaenoic acid into red blood cell phospholipids improved. The effect of supplementation on changes to body weight and risk factors for Metabolic Syndrome did not reach significance (p<0.05). It was however demonstrated, that an energy-restricted, low glycemic index diet with exercise was effective in inducing weight loss and improving Metabolic Syndrome risk factors with a 50% reduction in participants who had the criteria for diagnosis of Metabolic Syndrome by week 16.

O controle glicêmico intensificado pode prevenir e/ou retardar o aparecimento das complicações crônicas do diabetes melito (DM). O carboidrato da dieta é o principal determinante da glicemia pós-prandial, sendo o índice glicêmico (IG) e a carga glicêmica (CG) úteis para prever a resposta glicêmica aos alimentos. O objetivo deste manuscrito foi revisar criticamente o papel das dietas de baixo IG na prevenção e controle metabólico do DM tipo 2 (DMT2). O risco para desenvolvimento de DMT2 com dietas de alto IG variou de 1,21 a 1,59. A redução de 12 a 32 unidades no IG da dieta diminuiu em 0,39 a 0,50 pontos percentuais a HbA1c. Os efeitos dessas dietas no perfil lipídico e peso corporal no DMT2 permanecem controversos. Em conclusão, as evidências atuais indicam que a incorporação do IG no planejamento dietético de pacientes com DMT2 contribui para a melhora do controle glicêmico. / The tight glycemic control can prevent and/or delay the development of chronic complications of diabetes mellitus (DM). Dietary carbohydrates are the main determinant of postprandial blood glucose and glycemic index (GI) and glycemic load are used to predict blood glucose response to foods. The aim of this paper was to critically review the role of low GI diets in type 2 DM (T2DM) prevention and metabolic control. The risk for development of T2DM with high GI diets ranged from 1.21 to 1.59.The reduction from 12- 32 units in the GI of diets decreased 0.39-0.50% in HbA1c values. However, the effects of these diets on lipid profile and body weight in patients with T2DM remain controversial. In conclusion, the current evidence indicates that the inclusion of GI in the dietary planning for patients with T2DM contributes to the improvement of glycemic control.

Objective: To compare glycemic index and load (GI and GL) in the usual diet of PCOS and control women and to investigate whether dietary GI and GL are associated with body composition and anthropometric and metabolic variables across PCOS phenotypes. Design: Cross-sectional study. Setting: University hospital outpatient clinic. Patients: 61 women with PCOS and 44 non-hirsute women with ovulatory cycles. Interventions: Metabolic work-up, biochemical and hormonal assays, assessment of body composition and rest metabolic rate, physical activity (pedometer), and food consumption (food frequency questionnaire). Main outcome measure(s): GI and GL. Results: Mean age was 23.7±6.3 years. The prevalence of obesity was 44.3% in PCOS women and 31.8% in controls. Median GI for the group was 58. PCOS patients with GI>58 had higher BMI, worse metabolic profile, and lower intake of fibers. GI was correlated with BMI in controls and with lipid accumulation product (LAP) in the PCOS group, and was higher in classic PCOS vs. other groups. Conclusions: Dietary GI is increased in PCOS patients, especially in the classic PCOS phenotype. Increased dietary GI is associated with a less favorable anthropometric and metabolic profile in PCOS.

Introdução: A resistência insulínica (RI) decorrente da obesidade está relacionada a distúrbios hormonais que afetam o sistema reprodutor. Leptina e grelina são hormônios que regulam o balanço energético; porém, informações acerca da relação destes hormônios com a infertilidade são escassas. A dieta de baixo índice glicêmico (BIG) parece exercer impacto positivo sobre as alterações metabólicas decorrentes da RI. Objetivo: Verificar o efeito de uma dieta hipocalórica de baixo índice/carga glicêmica sobre parâmetros antropométricos e metabólicos, níveis de grelina e leptina e desfechos reprodutivos em mulheres inférteis com excesso de peso candidatas à fertilização in vitro (FIV). Métodos: Ensaio clínico randomizado. Foram analisadas vinte e seis mulheres inférteis com obesidade Grau I ou II ou pré-obesidade associada à circunferência da cintura aumentada. As pacientes foram alocadas no grupo Dieta Hipocalórica de BIG, ou no grupo Controle (manutenção do hábito alimentar) e acompanhadas por 12 semanas. Parâmetros avaliados: peso corporal, índice de massa corporal (IMC), percentual de gordura (%G), glicose, insulina, HOMA-IR, lipídios séricos, hormônios reprodutivos, grelina acilada, leptina, dose de gonadotrofinas, número e qualidade oocitária e embrionária, taxa de fertilização e de gestação. Resultados: Houve redução de 5,5% do peso corporal e também do IMC (p < 0,001), do %G (p = 0,002), dos níveis de glicose (p = 0,034) e de leptina (p = 0,013) no grupo BIG quando comparado ao grupo controle. Houve um aumento de 18% nos níveis de grelina no grupo BIG quando comparado ao controle, mas esse aumento não foi significativo (p > 0,05). O grupo BIG obteve 85,4% mais oócitos coletados, quando comparado ao grupo controle (7,75 ± 1,44 vs. 4,18 ± 0,87, respectivamente, p = 0.039) no ciclo de FIV. Não houve diferença entre os grupos na dose de gonadotrofinas, na qualidade oocitária e embrionária, e na taxa de fertilização. Três (21,4%) pacientes do grupo BIG apresentaram gestação espontânea durante o acompanhamento, gerando três nascidos vivos. Conclusões: A perda de 5,5% do peso corporal através da dieta hipocalórica BIG foi capaz de melhorar parâmetros antropométricos, metabólicos, reprodutivos e os desfechos de FIV, quando comparado às mulheres que mantiveram o peso corporal. Estes resultados dão sustentação à recomendação clínica de aconselhar mulheres com sobrepeso ou obesas a perderem peso através de uma dieta balanceada, preferencialmente com baixo índice/carga glicêmica, antes de serem submetidas a procedimentos de reprodução assistida. / Introduction: Insulin resistance (IR) resulting from obesity is related to hormonal disorders that affect reproductive system. Leptin and ghrelin are hormones that regulate energy balance; however, the relationship of these hormones with infertility is not clear. The low glycemic index (LGI) diet seems to exert a positive impact on obesity and metabolic changes resulting from IR. Objective: To verify the effect of a hypocaloric diet with low glycemic index/load on anthropometric and metabolic parameters, ghrelin and leptin levels and reproductive outcomes in overweight and obese infertile women candidates to in vitro fertilization (IVF). Methods: Randomized clinical trial. Twenty six infertile women with grade I and II obesity, or pre-obesity with increased waist circumference were analysed. Patients were assigned to hypocaloric LGI diet group or control group (maintenance of usual diet), and followed the protocol for 12 weeks. Parameters evaluated: body weight, body mass índex (BMI), body fat percentage (%BF), glucose, insulin, HOMA-IR, serum lipids, reproductive hormones, leptin, acylated ghrelin, gonadotrophin doses, number and quality of oocytes and embryos, fertilization and pregnancy rates Results: There was a 5.5% weight loss and also a reduction in BMI (p < 0.001), BF% (p = 0.002), glucose (p = 0.034) and leptin levels (p = 0.013) in the LGI group compared to control. There was a 18% increase in ghrelin levels in the LGI group compared to control, but this increase was not significant (p > 0.05). The LGI diet group had 85.4% more oocytes retrieved compared to control group (7.75 ± 1.44 vs. 4.18 ± 0.87, respectively, p = 0.039) in the IVF cycle. The gonadotrophin dose, oocyte and embryo quality, and fertilization rate were similar between groups (p > 0.05). Three (21.4%) patients in the LGI group experienced spontaneous pregnancy during the follow-up, generating three live births. Conclusion: The 5.5% weight loss trough the hypocaloric LGI diet was able to improve antropometric, metabolic, reproductive and IVF outcomes when compared with women that not lose weight. These results support the clinical recommendation to advise overweight and obese women to lose weight through a balanced diet, preferably with low glycemic index/load, prior to be submitted to assisted reproduction technologies.

O controle glicêmico intensificado pode prevenir e/ou retardar o aparecimento das complicações crônicas do diabetes melito (DM). O carboidrato da dieta é o principal determinante da glicemia pós-prandial, sendo o índice glicêmico (IG) e a carga glicêmica (CG) úteis para prever a resposta glicêmica aos alimentos. O objetivo deste manuscrito foi revisar criticamente o papel das dietas de baixo IG na prevenção e controle metabólico do DM tipo 2 (DMT2). O risco para desenvolvimento de DMT2 com dietas de alto IG variou de 1,21 a 1,59. A redução de 12 a 32 unidades no IG da dieta diminuiu em 0,39 a 0,50 pontos percentuais a HbA1c. Os efeitos dessas dietas no perfil lipídico e peso corporal no DMT2 permanecem controversos. Em conclusão, as evidências atuais indicam que a incorporação do IG no planejamento dietético de pacientes com DMT2 contribui para a melhora do controle glicêmico. / The tight glycemic control can prevent and/or delay the development of chronic complications of diabetes mellitus (DM). Dietary carbohydrates are the main determinant of postprandial blood glucose and glycemic index (GI) and glycemic load are used to predict blood glucose response to foods. The aim of this paper was to critically review the role of low GI diets in type 2 DM (T2DM) prevention and metabolic control. The risk for development of T2DM with high GI diets ranged from 1.21 to 1.59.The reduction from 12- 32 units in the GI of diets decreased 0.39-0.50% in HbA1c values. However, the effects of these diets on lipid profile and body weight in patients with T2DM remain controversial. In conclusion, the current evidence indicates that the inclusion of GI in the dietary planning for patients with T2DM contributes to the improvement of glycemic control.

Objective: To compare glycemic index and load (GI and GL) in the usual diet of PCOS and control women and to investigate whether dietary GI and GL are associated with body composition and anthropometric and metabolic variables across PCOS phenotypes. Design: Cross-sectional study. Setting: University hospital outpatient clinic. Patients: 61 women with PCOS and 44 non-hirsute women with ovulatory cycles. Interventions: Metabolic work-up, biochemical and hormonal assays, assessment of body composition and rest metabolic rate, physical activity (pedometer), and food consumption (food frequency questionnaire). Main outcome measure(s): GI and GL. Results: Mean age was 23.7±6.3 years. The prevalence of obesity was 44.3% in PCOS women and 31.8% in controls. Median GI for the group was 58. PCOS patients with GI>58 had higher BMI, worse metabolic profile, and lower intake of fibers. GI was correlated with BMI in controls and with lipid accumulation product (LAP) in the PCOS group, and was higher in classic PCOS vs. other groups. Conclusions: Dietary GI is increased in PCOS patients, especially in the classic PCOS phenotype. Increased dietary GI is associated with a less favorable anthropometric and metabolic profile in PCOS.