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| Author(s): |
Daniela Saes Sartorelli
Total Authors: 1
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| Document type: | Doctoral Thesis |
| Press: | São Paulo. |
| Institution: | Universidade de São Paulo (USP). Faculdade de Saúde Pública (FSP/CIR) |
| Defense date: | 2005-04-26 |
| Examining board members: |
Marly Augusto Cardoso;
Bruce Baartholow Duncan;
Laercio Joel Franco;
Paulo Andrade Lotufo;
Carlos Augusto Monteiro
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| Advisor: | Marly Augusto Cardoso |
| Abstract | |
Objective. To investigate the effects of food intake and dietary glycemic index (GI) on fasting plasma levels of glucose and insulin, homeostasis model assessment of insulin resistance (HOMA R) and impaired glucose disturbance - IGD (impaired fasting glucose - IFG, impaired glucose tolerance - IGT and diabetes mellitus type 2). Subjects and methods. 1,054 Japanese-Brazilians living in Bauru, of both genders, 30 to 90 years-old, first- and second-generation, who completed all the information for the cross-sectional survey in 2000, without previous diagnosis of IGD and/or use of oral hipoglycemic medication/insulin. Food consumption was assessed using a validated food frequency questionnaire, with the aid of the software Dietsys 4.0. All dietary factors were log-transformed and adjusted for total energy intake by residual method. The dependent variables were first selected using Pearson correlation with fasting plasma levels of glucose and insulin or HOMA R (continuous independent variables), with p<0.20. The associations between selected nutrients/foods and the continuous independent variables were assessed using multiple linear regression models. Logistic regression models were used to investigate the relationship between dietary factors (tercile) and IGD, while adjusting for confounding factors. Results. After multiple adjustments, intakes of whole dairy products and sweets (g/day) and dietary GI were inversely correlated with fasting glucose levels (mg/dl). Dietary GI was also inversely correlated with HOMA R. The odds ratio (95% confidence interval) for IFG was 1.70 (1.06 - 2.74) in the highest tercile of total dietary fiber (main food sources: white rice and bread, fruits/fruit juices). The second tercile of vegetable intake was associated with a risk reduction of IGT [0.61 (0.38 - 0.98)]. Conclusion. In our study population, the intake of total dietary fiber, largely attributable to high intakes of white rice, white bread, fruits/fruit juices, was positively associated with risk of IGD. On the other hand, a protective effect was observed for higher intake levels of vegetables (AU) | |