Evidence-based nutrition principles and recommendations for prevention of diabetes and related complications as well as of cardiovascular disease are an integral component of medical nutrition therapy. The American Diabetes Association (ADA) recommends that dietary intake of fat is reduced to no more than 30% of total calories (saturated <10%, polyunsaturated ~10%). Dietary intake of cholesterol should be reduced to below 200 mg/day. A low fat/high carbohydrate (55-60%) diet, rich in fiber (25-30 g/day), is advised. It may be prudent to avoid protein intakes >15-20% of total daily energy. American Heart Association (AHA) dietary guidelines advice limiting salt intake (<6 g per day) and engaging in a regular physical activity (30 to 60 min on most if not all days of the week). Energy intake in balance with energy expenditure is essential to prevent weight gain that accompanies aging. Polyunsaturated/saturated (P/S) ratio should be >1.0. Foods containing carbohydrate from whole grains, fruits, vegetables, and low-fat milk should be included in a healthy diet. The total amount of carbohydrate in meals or snacks is more important than the source or type. Carbohydrate and monounsaturated fat together should provide 60-70% of energy intake. In subjects living in Pisa (Central Italy), we have provided first evidence indicating unhealthy lifestyle and dietary behaviors, which could even predispose to the development of diabetes and cardiovascular complications. The distribution of energy sources was incorrect. The proportion of caloric intake derived from total fat and cholesterol did not match general guidelines. Most controls (presumed to be consuming a free diet) ate up to 50% more protein than recommended as RDAs/AIs. Total dietary fiber consumption was above the suggested threshold of 25 g/day only in 27% of all participants. A relevant and unexpected health issue was the evidence of mild to moderate combined-vitamin deficient intakes in otherwise well-nourished healthy adults. Estimated daily intakes of water-soluble vitamin B9 (or total folates) and fat-soluble vitamin D and vitamin E were deficient in comparison with RDAs and AIs (400 µg, 5 to 10 µg, and 15 mg, respectively). Increasing age was associated with increasing body mass and decreasing activity in sport in front of an unchanged intake of total calories. These observations have been recently confirmed through one-year follow-up of type 2 diabetic patients with high cardiovascular risk (according to UKPDS Risk Engine). Medical education partially succeeded in modifying such habits in young people with type 1 diabetes, whereas inveterate habits of aged people with type 2 diabetes seemed hard to change.
Central Italy: unexpected macro- and micro-nutrient deficiencies in regular diet of residents from Pisa province. the potential role of medical education in young people
MATTEUCCI, ELENA;GIAMPIETRO, OTTAVIO
2007-01-01
Abstract
Evidence-based nutrition principles and recommendations for prevention of diabetes and related complications as well as of cardiovascular disease are an integral component of medical nutrition therapy. The American Diabetes Association (ADA) recommends that dietary intake of fat is reduced to no more than 30% of total calories (saturated <10%, polyunsaturated ~10%). Dietary intake of cholesterol should be reduced to below 200 mg/day. A low fat/high carbohydrate (55-60%) diet, rich in fiber (25-30 g/day), is advised. It may be prudent to avoid protein intakes >15-20% of total daily energy. American Heart Association (AHA) dietary guidelines advice limiting salt intake (<6 g per day) and engaging in a regular physical activity (30 to 60 min on most if not all days of the week). Energy intake in balance with energy expenditure is essential to prevent weight gain that accompanies aging. Polyunsaturated/saturated (P/S) ratio should be >1.0. Foods containing carbohydrate from whole grains, fruits, vegetables, and low-fat milk should be included in a healthy diet. The total amount of carbohydrate in meals or snacks is more important than the source or type. Carbohydrate and monounsaturated fat together should provide 60-70% of energy intake. In subjects living in Pisa (Central Italy), we have provided first evidence indicating unhealthy lifestyle and dietary behaviors, which could even predispose to the development of diabetes and cardiovascular complications. The distribution of energy sources was incorrect. The proportion of caloric intake derived from total fat and cholesterol did not match general guidelines. Most controls (presumed to be consuming a free diet) ate up to 50% more protein than recommended as RDAs/AIs. Total dietary fiber consumption was above the suggested threshold of 25 g/day only in 27% of all participants. A relevant and unexpected health issue was the evidence of mild to moderate combined-vitamin deficient intakes in otherwise well-nourished healthy adults. Estimated daily intakes of water-soluble vitamin B9 (or total folates) and fat-soluble vitamin D and vitamin E were deficient in comparison with RDAs and AIs (400 µg, 5 to 10 µg, and 15 mg, respectively). Increasing age was associated with increasing body mass and decreasing activity in sport in front of an unchanged intake of total calories. These observations have been recently confirmed through one-year follow-up of type 2 diabetic patients with high cardiovascular risk (according to UKPDS Risk Engine). Medical education partially succeeded in modifying such habits in young people with type 1 diabetes, whereas inveterate habits of aged people with type 2 diabetes seemed hard to change.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
