Gula menyebabkan dislipidemia

Asupan karbohidrat diketahui berhubungan dengan dislipidemia. Dislipidemia akan meningkatkan risiko kardiovaskuler.

Penambahan gula dalam makanan atau minuman juga berhubungan dengan dislipidemia.

Abstrak

JAMA 303(15):1490-1497, 21 April 2010 © 2010 American Medical Association
Caloric Sweetener Consumption and Dyslipidemia Among US Adults. Jean A. Welsh, Andrea Sharma, Jerome L. Abramson, Viola Vaccarino, Cathleen Gillespie, Miriam B. Vos.

Context Dietary carbohydrates have been associated with dyslipidemia, a lipid profile known to increase cardiovasculardisease risk. Added sugars (caloric sweeteners used as ingredients in processed or prepared foods) are an increasing and potentially modifiable component in the US diet. No known studies have examined the association between the consumption of added sugars and lipid measures.

Objective To assess the association between consumption of added sugars and blood lipid levels in US adults.

Design, Setting, and Participants Cross-sectional study among US adults (n = 6113) from the National Health and Nutrition Examination Survey (NHANES) 1999-2006. Respondents were grouped by intake of added sugars using limits specified in dietary recommendations (<> 5%-<10%, src="http://jama.ama-assn.org/math/ge.gif" alt="≥" border="0">25% of total calories). Linear regression was used to estimate adjusted mean lipid levels. Logistic regression was used to determine adjusted odds ratios of dyslipidemia. Interactions between added sugars and sex were evaluated.

Main Outcome Measures Adjusted mean high-density lipoprotein cholesterol (HDL-C), geometric mean triglycerides, and mean low-density lipoprotein cholesterol (LDL-C) levels and adjusted odds ratios of dyslipidemia, including low HDL-C levels (<40 mg/dL for men; <50> (150 mg/dL), high LDL-C levels (130 mg/dL), or high ratio of triglycerides to HDL-C (>3.8). Results were weighted to be representative of the US population.

Results A mean of 15.8% of consumed calories was from added sugars. Among participants consuming less than 5%, 5% to less than 10%, 10% to less than 17.5%, 17.5% to less than 25%, and 25% or greater of total energy as added sugars, adjusted mean HDL-C levels were, respectively, 58.7, 57.5, 53.7, 51.0, and 47.7 mg/dL (P < .001 for linear trend), geometric mean triglyceride levels were 105, 102, 111, 113, and 114 mg/dL (P < .001 for linear trend), and LDL-C levels modified by sex were 116, 115, 118, 121, and 123 mg/dL among women (P = .047 for linear trend). There were no significant trends in LDL-C levels among men. Among higher consumers (10% added sugars) the odds of low HDL-C levels were 50% to more than 300% greatercompared with the reference group (<5%>

Conclusion In this study, there was a statistically significant correlation between dietary added sugars and blood lipid levels among US adults.

Dietary Glycemic Load and Index and Risk of Coronary Heart Disease in a Large Italian Cohort The EPICOR Study

Diet tinggi glycemic load (GL) dan tinggi glycemic index (GI) berhubungan dengan timbulnya penyakit jantung koroner (PJK) pada perempuan, tetapi tidak pada lelaki.

Arch Intern Med 170(7):640-647, 12 April 2010 © 2010 to the American Medical Association
Dietary Glycemic Load and Index and Risk of Coronary Heart Disease in a Large Italian Cohort-The EPICOR Study. Sabina Sieri, Vittorio Krogh, Franco Berrino, et al. 

Background  Dietary glycemic load (GL) and glycemic index (GI) in relation to cardiovascular disease have been investigated in a few prospective studies with inconsistent results, particularly in men. The present EPICOR study investigated the association of GI and GL with coronary heart disease (CHD) in a large and heterogeneous cohort of Italian men and women originally recruited to the European Prospective Investigation into Cancer and Nutrition study.

Methods  We studied 47 749 volunteers (15 171 men and 32 578 women) who completed a dietary questionnaire. Multivariate Cox proportional hazards modeling estimated adjusted relative risks (RRs) of CHD and 95% confidence intervals (CIs).

Results  During a median of 7.9 years of follow-up, 463 CHD cases (158 women and 305 men) were identified. Women in the highest carbohydrate intake quartile had a significantly greater risk of CHD than did those in the lowest quartile (RR, 2.00; 95% CI, 1.16-3.43), with no association found in men (P = .04 for interaction). Increasing carbohydrate intake from high-GI foods was also significantly associated with greater risk of CHD in women (RR, 1.68; 95% CI, 1.02-2.75), whereas increasing the intake of low-GI carbohydrates was not. Women in the highest GL quartile had a significantly greater risk of CHD than did those in the lowest quartile (RR, 2.24; 95% CI, 1.26-3.98), with no significant association in men (P = .03 for interaction).

Conclusion  In this Italian cohort, high dietary GL and carbohydrate intake from high-GI foods increase the overall risk of CHD in women but not men.

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Salam sehat,
Dr. David Fadjar Putra, MS
Spesialis Gizi Klinik
@
www.kliniknutrisi.com
kliniknutrisi.blogspot.com

Effects of treatment in women with gestational diabetes mellitus: systematic review and meta-analysis

Diabetes dalam kehamilan perlu penanganan untuk mengurangi risiko komplikasi perinatal.

BMJ 340:c1395, 1 April 2010 © Horvath et al 2010
Effects of treatment in women with gestational diabetes mellitus: systematic review and meta-analysis. Karl Horvath, Klaus Koch, Klaus Jeitler, et al. 

Objective To summarise the benefits and harms of treatments for women with gestational diabetes mellitus.

Design Systematic review and meta-analysis of randomised controlled trials.

Data sources Embase, Medline, AMED, BIOSIS, CCMed, CDMS, CDSR,CENTRAL, CINAHL, DARE, HTA, NHS EED, Heclinet, SciSearch, severalpublishers' databases, and reference lists of relevant secondary literature up to October 2009.

Review methods Included studies were randomised controlled trials of specific treatment for gestational diabetes compared with usual care or "intensified" compared with "less intensified" specific treatment.

Results Five randomised controlled trials matched the inclusion criteria for specific versus usual treatment. All studies used a two step approach with a 50 g glucose challenge test or screening for risk factors, or both, and a subsequent 75 g or 100 g oral glucose tolerance test. Meta-analyses did not show significant differences for most single end points judged to be of directclinical importance. In women specifically treated for gestational diabetes, shoulder dystocia was significantly less common (odds ratio 0.40, 95% confidence interval 0.21 to 0.75), and one randomised controlled trial reported a significant reduction of pre-eclampsia (2.5 v 5.5%, P=0.02). For the surrogate end point of large for gestational age infants, the odds ratio was 0.48 (0.38 to 0.62). In the 13 randomised controlled trials of different intensities of specific treatments, meta-analysis showed a significant reduction of shoulder dystocia in women with more intensive treatment (0.31, 0.14 to 0.70).

Conclusions Treatment for gestational diabetes, consisting of treatment to lower blood glucose concentration alone or with special obstetric care, seems to lower the risk for some perinatal complications. Decisions regarding treatment should take into account that the evidence of benefit is derived from trials for which women were selected with a two step strategy (glucose challenge test/screening for risk factors and oral glucose tolerance test).

--
Salam sehat,
Dr. David Fadjar Putra, MS
Spesialis Gizi Klinik
@
www.kliniknutrisi.com
kliniknutrisi.blogspot.com