Staff Publications

Staff Publications

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    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

    Publications authored by the staff of the Research Institutes are available from 1995 onwards.

    Full text documents are added when available. The database is updated daily and currently holds about 240,000 items, of which 72,000 in open access.

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    Time Trends in Age at Menarche and Related Non-Communicable Disease Risk during the 20th Century in Mexico
    Petersohn, Inga ; Zarate-Ortiz, Arli G. ; Cepeda-Lopez, Ana C. ; Melse-Boonstra, Alida - \ 2019
    Nutrients 11 (2019)2. - ISSN 2072-6643
    body mass index - diabetes mellitus - height - menarche - non-communicable disease

    Developed countries have shown a time trend towards a younger age at menarche (AAM), which is associated with increased risk of later obesity and non-communicable diseases. This study aimed to assess whether a time trend in AAM is associated with disease risk in Mexican women (n = 30,826), using data from the Mexican National Health Survey (2000). Linear and log binomial regression was used for nutritional and disease outcomes, while Welch⁻ANOVA was used to test for a time trend. AAM (in years) decreased over time (p < 0.001), with a maximal difference of 0.99 years between the 1920s (13.6 years) and 1980s (12.6 years ). AAM was negatively associated with weight (β = -1.01 kg; 95% CI -1.006, -1.004) and body mass index (BMI) (β = -1.01 kg/m²; -1.007, -1.006), and positively with height (β = 0.18 cm; 0.112, 0.231). AAM was associated with diabetes (RR = 0.95; 0.93, 0.98) and hypercholesterolemia (RR = 0.93; 0.90, 0.95), but not with hypertension, breast cancer or arthritis. In Mexico, AAM decreased significantly during the 20th century. AAM was inversely associated with adult weight and BMI, and positively with height. Women with a later AAM had a lower risk of diabetes and hypercholesterolemia.

    Akkermansia muciniphila induces gut microbiota remodelling and controls islet autoimmunity in NOD mice
    Hänninen, Arno ; Toivonen, Raine ; Pöysti, Sakari ; Belzer, Clara ; Plovier, Hubert ; Ouwerkerk, Janneke P. ; Emani, Rohini ; Cani, Patrice D. ; Vos, Willem M. de - \ 2018
    Gut 67 (2018)8. - ISSN 0017-5749 - p. 1445 - 1453.
    autoimmunity - bacterial interactions - diabetes mellitus - gut immunology - probiotics

    Objective Intestinal microbiota is implicated in the pathogenesis of autoimmune type 1 diabetes in humans and in non-obese diabetic (NOD) mice, but evidence on its causality and on the role of individual microbiota members is limited. We investigated if different diabetes incidence in two NOD colonies was due to microbiota differences and aimed to identify individual microbiota members with potential significance. Design We profiled intestinal microbiota between two NOD mouse colonies showing high or low diabetes incidence by 16S ribosomal RNA gene sequencing and colonised the high-incidence colony with the microbiota of the low-incidence colony. Based on unaltered incidence, we identified a few taxa which were not effectively transferred and thereafter, transferred experimentally one of these to test its potential significance. Results Although the high-incidence colony adopted most microbial taxa present in the low-incidence colony, diabetes incidence remained unaltered. Among the few taxa which were not transferred, Akkermansia muciniphila was identified. As A. muciniphila abundancy is inversely correlated to the risk of developing type 1 diabetes-related autoantibodies, we transferred A. muciniphila experimentally to the high-incidence colony. A. muciniphila transfer promoted mucus production and increased expression of antimicrobial peptide Reg3γ, outcompeted Ruminococcus torques from the microbiota, lowered serum endotoxin levels and islet toll-like receptor expression, promoted regulatory immunity and delayed diabetes development. Conclusion Transfer of the whole microbiota may not reduce diabetes incidence despite a major change in gut microbiota, but single symbionts such as A. muciniphila with beneficial metabolic and immune signalling effects may reduce diabetes incidence when administered as a probiotic.

    Novel targets for the development of drugs for Type 2 Diabetes Mellitus
    Sotiriou, Alexandros - \ 2016
    Wageningen University. Promotor(en): Ivonne Rietjens, co-promotor(en): Jacques Vervoort. - Wageningen : Wageningen University - ISBN 9789463430302 - 137
    diabetes mellitus - metabolic disorders - new drugs - drug development - insulin - diabetes mellitus - stofwisselingsstoornissen - nieuwe geneesmiddelen - geneesmiddelenontwikkeling - insuline

    Type 2 Diabetes Mellitus (T2DM) is a modern metabolic disorder. T2DM is related with modern lifestyle and results when the body is unable to produce sufficient insulin or respond properly to insulin, which is the hormone that regulates the levels of glucose in blood. The aim of this project was to define novel targets for the possible development of drugs for T2DM. In the thesis we developed 3 models that can assist the screening of novel drugs for T2DM. .

    In the first model that is presented in this thesis it is shown that resistin downregulation in mouse adipocytes would provide an alternative for PPARγ agonist activity, and assay frequently used in the past to define novel drugs for T2DM. The results revealed a significant correlation between the EC50 for PPARγ activation in a reporter gene cell line and the IC50 for resistin downregulation in adipocytes. The outcomes indicate that PPARγ mediated downregulation of resistin might promote insulin sensitivity and that resistin can be used as a target for searching insulin sensitizing compounds.

    In the second model presented in this thesis, the detection of TLR-4 mediated gene expression was investigated as a possible bioassay to detect candidate antidiabetic drugs able to inhibit resistin mediated TLR-4 activation and subsequent effects. Inhibition of LPS mediated TLR-4 signaling by two known TLR-4 inhibitors could be demonstrated as well as the inhibition of resistin mediated TLR-4 signaling by these two known TRL-4 inhibitors. It was concluded that the TLR-4 reporter gene cell line provides a novel tool for detection of resistin antagonists and might be of use as a new target to screen for a possible new type of antidiabetic drugs.

    A third in vitro model that is presented in this thesis for the search on novel targets for T2DM drugs consists of a model that mimics inflamed adipocytes. Adipocytes (3T3-L1) were co-cultured directly with activated macrophages (RAW264.7) producing an environment for testing compounds under conditions more similar to the in vivo situation in T2DM patients. A comparison of our results to a study on human visceral fat of obese non-diabetic and obese diabetic patients indicated that AUH, NAGK, pCYT2, NNMT, STK39 and CSNK2A2 genes and proteins have the potential of being prognostic biomarkers.

    To further increase the possibility for identification of novel targets for antidiabetic drugs via the possible role of resistin, the mechanism behind resistin mediated effects was investigated. Human adipocytes were exposed to resistin and the effects on gene expression were analysed by RNA sequencing. Based on these observations it was proposed that resistin dependent gene expression is related to modifications in cellular maintenance processes, slowing down metabolic changes resulting in energy conservation. Under these circumstances of metabolic adaptation in the presence of resistin, excess food consumption as in modern societies can result in obesity, inflammation and insulin resistance.

    Altogether, there is a sincere hope that the models presented in this thesis will contribute to the definition of novel therapeutic strategies and enable answering some of the questions about a complex disease such as T2DM that has been studied for so long time.

    The role of energy, nutrients, foods and dietary patterns in the development of gestational diabetes mellitus: a systematic review of observational studies
    Schoenaker, D.A.J.M. ; Mishra, G.D. ; Callaway, L.K. ; Soedamah-Muthu, S.S. - \ 2016
    Diabetes Care 39 (2016). - ISSN 0149-5992 - p. 16 - 23.
    diabetes mellitus - food
    OBJECTIVE Diet may influence the risk of gestational diabetes mellitus (GDM), but inconsistent findings have been reported. The purpose of this study was to synthesize evidence from observational studies on the associations between dietary factors and GDM.
    RESEARCH DESIGN AND METHODS Medline and Embase were searched for articles published until January 2015. We included observational studies of reproductive-aged women that reported on associations of maternal dietary intake before or during pregnancy, including energy, nutrients, foods, and dietary patterns, with GDM. All relevant results were extracted from each article. The number of comparable studies that adjusted for confounders was insufficient to perform a meta-analysis.
    RESULTS The systematic review included 34 articles comprising 21 individual studies (10 prospective cohort, 6 cross-sectional, and 5 case-control). A limited number of prospective cohort studies adjusting for confounders indicated associations with a higher risk of GDM for replacing 1–5% of energy from carbohydrates with fat and for high consumption of cholesterol (≥300 mg/day), heme iron (≥1.1 mg/day), red and processed meat (increment of 1 serving/day), and eggs (≥7 per week). A dietary pattern rich in fruit, vegetables, whole grains, and fish and low in red and processed meat, refined grains, and high-fat dairy was found to be beneficial. The current evidence is based on a limited number of studies that are heterogeneous in design, exposure, and outcome measures.
    CONCLUSIONS The findings support current dietary guidelines to limit consumption of foods containing saturated fat and cholesterol, such as processed meat and eggs, as part of an overall balanced diet. Further large prospective studies are warranted.
    Dietary proteins and aspects of the metabolic syndrome : evidence from observational studies and short-term interventions
    Nielen, M. van - \ 2015
    Wageningen University. Promotor(en): Edith Feskens, co-promotor(en): Marco Mensink. - Wageningen : Wageningen University - ISBN 9789462574793 - 131
    metabool syndroom - diabetes mellitus - stofwisselingsstoornissen - diabetes type 2 - hart- en vaatziekten - sojaeiwit - arginine - eiwitinname - ziekte-incidentie - ontsteking - cohortstudies - metabolic syndrome - diabetes mellitus - metabolic disorders - type 2 diabetes - cardiovascular diseases - soya protein - arginine - protein intake - disease incidence - inflammation - cohort studies

    Background Type 2 diabetes (T2D) and cardiovascular diseases (CVD) are important causes of morbidity and mortality worldwide. The metabolic syndrome (MetS) identifies people at elevated risk of T2D and CVD by its mutual risk factors, such as abdominal obesity, atherogenic dyslipidemia, raised blood pressure and impaired glucose tolerance. Improvements in individual aspects of MetS could be risk-reducing for T2D and CVD and could thus be clinically relevant. Besides by using drug therapy, this can be achieved by lifestyle changes, such as weight loss, increasing physical activity and changes in dietary composition. In addition to general dietary recommendations, such as diets rich in fiber, fruits and vegetables and low in refined grains and saturated fatty acids, increasing dietary protein and soy intake seem promising approaches to prevent MetS. Short-term trials report positive effects of dietary protein intake on weight loss and weight maintenance after weight loss. The postprandial and short-term effect of protein and soy consumption on insulin resistance, glucose homeostasis, and other aspects of MetS are not frequently studied in humans in energy balance. Also, the long-term association between dietary protein intake and T2D incidence is uncertain, it even seemed risk-increasing in prior research.

    Objectives We evaluated the impact of dietary protein intake on T2D incidence, aspects of MetS and other cardio-metabolic risk factors, by observational studies (long-term) and interventions (short-term). We studied not only total protein intake, but also specific protein types, more specifically soy protein and arginine-rich protein. We explored the long-term association between total, animal, and plant protein intake and the incidence of T2D. We further investigated the effects of a 4-week strictly controlled weight-maintaining moderate-high-protein diet rich in soy on insulin sensitivity and other cardio-metabolic risk factors. Next, we investigated if inflammatory markers were also changed as a possible pathway through which dietary protein affects cardio-metabolic risk factors. Lastly, we examined whether protein, and more specific arginine-rich protein, added to a high fat meal improved postprandial metabolism and cardiovascular risk factors.

    Methods The association between dietary protein intake and T2D incidence was studied in the EPIC-InterAct case-cohort study (nincident cases= 12,403; nsubcohort=16,154).

    In a randomized crossover trial of 2 4-week periods diets with a moderate-high-protein content, i.e. 22 energy percent (En%) protein, 27En% fat, and 50En% carbohydrate, were studied (n=15). In a diet with protein from mixed sources (HPmix) we partly replaced meat products with soy products (HPsoy) to investigate the effect of soy protein intake on insulin resistance, glucose homeostasis, and other aspects of MetS.

    A high-fat challenge test was used to study postprandial metabolic markers, inflammatory markers and arterial stiffness (n=18). We compared the postprandial response after a high-fat liquid control meal (95g fat) without protein with meals with 30g added protein.

    Results Intake of total protein (per 10 g: HR 1.06 [95% CI 1.02–1.09], Ptrend < 0.001) and animal protein (per 10 g: HR 1.05 [95% CI 1.02–1.08], Ptrend < 0.001) was associated with higher incidence of T2D, after adjustment for main confounders including other dietary factors.

    Partly replacing meat with soy in a moderate-high-protein diet resulted in greater insulin sensitivity (FSIGT: SI:34 ± 29 vs. 22 ± 17 (mU/L)-1min-1, P=0.048; disposition index:4974 ± 2543 vs. 2899 ± 1878, P=0.038). After HPsoy total cholesterol was 4% lower than after HPmix (4.9 ± 0.7 vs. 5.1 ± 0.6 mmol/L, P=0.001) and LDL cholesterol was 9% lower (2.9 ± 0.7 vs. 3.2 ± 0.6 mmol/L, P=0.004). The summary score for inflammation was lower after HPsoy compared with HPmix (ɀ-score: -0.2 ± 0.3 vs. -0.1 ± 0.2, P=0.04), after excluding participants with CRP>6mg/L and extreme outliers. Individual inflammatory markers were not significantly different.

    Adding protein to a high-fat meal increased the postprandial insulin response. No differences between arginine-rich and protein low in arginine on postprandial responses were seen. Intact proteins and hydrolysates resulted in similar responses.

    Conclusion High total and animal protein intake was associated with modestly elevated T2D incidence in a large cohort of European adults. In contrast, a moderate-high-protein diet for 4 weeks improved many cardio-metabolic risk factors. Partly replacing meat with soy in this moderate-high-protein diet had clear advantages regarding insulin sensitivity and total and LDL cholesterol, and it improved the overall inflammatory state, although not showing clear benefits at individual inflammation markers. We hypothesized to see an origin of these short-term health effects in postprandial properties of arginine-rich protein. However, arginine-rich protein was not superior to a protein low in arginine added to a high-fat meal, regarding postprandial excursions in glucose, insulin, lipids and inflammatory markers.

    In view of the rapidly increasing prevalence of MetS and T2D, limiting iso-energetic diets high in dietary proteins, particularly from animal sources, should be considered as on the long-term protein intake seems to increase T2D and CVD risk. However, at the short-term partly replacing meat with soy in a moderate high-protein diet could be preventive for several aspects of MetS, such as improvements in insulin sensitivity, total and LDL cholesterol and possibly a reduced inflammatory state.

    Gestational diabetes mellitus in Tanzania : public health perspectives
    Mwanri, A.W. - \ 2015
    Wageningen University. Promotor(en): Edith Feskens, co-promotor(en): J.L. Kinabo; K. Ramaiya. - Wageningen : Wageningen University - ISBN 9789462572645 - 202
    diabetes mellitus - voedselintolerantie - zwangerschap - zwangerschapscomplicaties - obesitas - koolhydraten - diabetes mellitus - food intolerance - pregnancy - pregnancy complications - obesity - carbohydrates

    Gestational diabetes mellitus in Tanzania – public health perspectives


    Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance resulting in hyperglycaemia of variable severity with onset or first recognition during pregnancy. Women with GDM are at increased risk for preeclampsia during pregnancy and for delivery complications. In most cases GDM ends after pregnancy, but it increases the risk for future type 2 diabetes, and cardiovascular diseases, to both the mother and the child. With the current increase in prevalence of overweight/obesity and type 2 diabetes in Tanzania and other Sub Saharan African countries, it is possible that GDM may exist and may be on the rise.

    Methods: A cross-sectional survey was done in 2011 through 2013 where 910 women in Tanzania (609 from urban, 301 from rural areas) were studied during their usual antenatal clinic visits. Weight, height, mid upper arm circumference (MUAC), blood pressure and haemoglobin levels were measured by a trained technician. Blood glucose was measured at fasting and at two hours after 75 g oral glucose tolerance test. Women were classified as having GDM using WHO 1999 criteria. Sociodemographic information was collected through face-to-face interviews using structured questionnaire or retrieved from the antenatal clinic card. Dietary intake data was collected using 24-hour recall interview and foods were categorised into groups based on dietary diversity. The international physical activity questionnaire (IPAQ) was used to assess activities in the past one week. Information on birth outcome was obtained from 466 urban mothers (response rate 77%) through telephone interviews. To estimate the burden of GDM in the region, we additionally conducted a systematic search of published literature on the prevalence and risk factors of GDM in Sub Saharan Africa. Out of the 22 reviewed studies, 15 studies graded as having low or moderate risk of bias were included in a meta-regression analysis. Finally, a review of literature regarding the health system and antenatal care was done and supported by a survey to assess antenatal care services in 24 health facilities that provide maternal and childcare services in Dar es Salaam region.

    Results: The prevalence of GDM was much higher among women residing in the urban (8.4%) compared to those in the rural areas (1.0%), which was much higher compared to 0% reported in the 1990s. Prevalence of GDM was higher for women who had a previous stillbirth, family history of type 2 diabetes and MUAC ≥28 cm, and lower for women with normal haemoglobin concentrations compared to those with anaemia. Likewise, the prevalence of hypertension disorders of pregnancy (HDP) was higher in urban (8.9%) compared to rural areas (5.3%). Risk factors for HDP in urban women were advanced maternal age, high MUAC, gestional age and being HIV positive, and in rural women age and gestational age.

    We reviewed 22 studies conducted in six out of the 47 Sub saharan African countries. Heterogeneity between the studies was high and it could not be significantly explained by study setting, population, diagnostic criteria, or the year the study was done. Nevertheless, a relatively higher prevalence was observed in studies done after the year 2000, when women at risk were selected and when more current diagnostic criteria were used. The prevalence was up to about 14.0% when women with at least one risk factor were studied. In Dar es Salaam women, despite a high prevalence of anemia and HIV, the prevalence of macrosomia was higher (5.9%) compared to the prevalence of low birth weight (3.6%). Presence of GDM (OR 3.46, 95% CI 1.01-11.85) and birth weight of the previous child (OR 2.42, 95% CI 1.17-4.99) were the main predictors of macrosomia and HDP (OR 3.75, 95% CI 1.11-12.68) was the main predictor of low birth weight. Although glucose testing in urine appeared to be universally done in the urban setting, the sensitivity of this test for detection of GDM is low. Therefore selective blood glucose testing should be implemented and HIV testing and counselling may be used as an entry point.

    Conclusions: The prevalence of GDM and HDP was higher in the urban compared to the rural areas in Tanzania, indicating an increasing in women who are at risk for delivery complications, poor pregnancy outcomes, type 2 diabetes and cardiovascular diseases in later life. The risk factors observed can be used to identify risk groups for screening and as target for prevention interventions. To inform policy makers and for better health care planning, further studies on the costs for blood glucose testing during the usual antenatal clinic visits and on the management of women with GDM are warranted.

    Preventieve aanpak diabetes getest
    Duijzer, G. - \ 2011
    Kennis Online 8 (2011)okt. - p. 7 - 7.
    ziektepreventie - gezondheidsbevordering - diabetes type 2 - diabetes mellitus - voeding en gezondheid - disease prevention - health promotion - type 2 diabetes - diabetes mellitus - nutrition and health
    Bijna de helft van de gevallen van diabetes type 2 is in theorie te voorkomen. Mits mensen gezonder gaan eten en meer gaan bewegen. Wageningen University onderzoekt samen met de GGD Gelre-IJssel een preventieve aanpak van ouderdomssuiker in de reguliere zorg van huisarts, fysiotherapeut en diëtist.
    Moderate alcohol consumption, adiponectin, inflammation and type 2 diabetes risk : prospective cohort studies and randomized crossover trials
    Joosten, M.M. - \ 2011
    Wageningen University. Promotor(en): Renger Witkamp, co-promotor(en): H.F.J. Hendriks. - [S.l. : S.n. - ISBN 9789085858256 - 192
    alcoholinname - diabetes mellitus - risico - genexpressie - vetweefsel - hormonen - alcohol intake - diabetes mellitus - risk - gene expression - adipose tissue - hormones
    Background: Moderate alcohol consumption has been associated with a lower risk of type 2 diabetes in various populations. However, the underlying mechanisms are not entirely clear. The aims of this thesis were 1) to substantiate the evidence of the association between alcohol consumption and type 2 diabetes in observational research and 2) to examine physiological mechanisms in randomized trials with specific attention to adiponectin, inflammation and insulin sensitivity which may mediate the association between alcohol consumption and type 2 diabetes.

    Methods: Two prospective cohort studies, one among 38,031 U.S. men (age: 45-75 y) of the Health Professionals Follow up Study (HPFS) and one among 35,625 Dutch men and women (age: 20-70 y) of the European Prospective Investigation into Cancer and Nutrition (EPIC)-NL cohort. Four randomized, crossover trials of eight to twelve weeks with consumption of 25-30 g alcohol/day in the form of vodka with orange juice, beer, or white wine (twice) compared to orange juice, alcohol free beer, white grape juice or water among 24 young men, 24 premenopausal and 36 and 22 postmenopausal women, respectively.

    Results: A 7.5 g/day increase in alcohol consumption over four years was associated with lower diabetes risk among initial non-drinkers (hazard ratio [HR]: 0.78; 95% confidence interval (CI): 0.60, 1.00) and drinkers initially consuming <15 g/d (HR: 0.89; 95% CI: 0.83, 0.96) but not among men initially drinking ≥15 g/d (HR: 0.99; 95% CI: 0.95, 1.02) (Pinteraction < 0.01) in U.S. men. Among Dutch subjects with ≥3 out of 4 low-risk lifestyle behaviors, moderate alcohol consumption was associated with a lower risk of type 2 diabetes compared with abstention (HR: 0.56; 95% CI: 0.32, 1.00).
    In the randomized crossover trials, alcohol consumption consistently increased circulating adiponectin levels by about 10% compared to abstention (P < 0.05) regardless of beverage type, gender or age. These increases were evident after a minimum of three weeks of alcohol consumption. Moderate alcohol consumption also increased expression of the gene encoding adiponectin in adipose tissue and lowered serum fasting insulin and triglyceride levels (all P < 0.05). An integrated approach of large-scale profiling of proteins and genes revealed that moderate alcohol consumption for four weeks altered gene expression profiles of white blood cells and circulating markers related to inflammation in men (all P < 0.05). However, we did not observe an attenuated inflammatory response after a low-dose in vivo endotoxin bolus, despite increased high-density lipoprotein cholesterol and apolipoprotein levels after four weeks of alcohol consumption compared to abstention. Six minutes of oral white wine exposure without swallowing substantially (-20%; P < 0.05) and temporarily (~20 min) decreased circulating free fatty acid concentrations compared with oral water exposure.

    Conclusions: Moderate alcohol consumption was associated with a lower risk of type 2 diabetes compared with abstention. The association persisted among subjects already at low risk based on combined favorable lifestyle behaviors. Also, increases in alcohol consumption among initially rare and light drinking men were associated with higher adiponectin levels and lower risk of type 2 diabetes. Increased adiponectin levels, anti-inflammatory effects and decreased insulin and triglyceride levels, may partially explain the inverse association between moderate alcohol consumption and type 2 diabetes.

    De gezondheid van Obelix? : over feestmalen en toverdrankjes
    Feskens, E.J.M. - \ 2009
    Wageningen : Wageningen Universiteit - ISBN 9789085852674 - 32
    stofwisselingsstoornissen - metabolisme - diabetes mellitus - obesitas - overgewicht - gezondheidsbevordering - volksgezondheid - metabolic disorders - metabolism - diabetes mellitus - obesity - overweight - health promotion - public health
    Mediterranean diet and the metabolic syndrome
    Bos, M.B. - \ 2009
    Wageningen University. Promotor(en): Lisette de Groot; Edith Feskens, co-promotor(en): Jeanne de Vries. - [S.l.] : S.n. - ISBN 9789085853756 - 96
    stofwisselingsstoornissen - diabetes mellitus - hart- en vaatziekten - dieet - middellandse-zeegebied - ouderen - maatregel op voedingsgebied - metabolic disorders - diabetes mellitus - cardiovascular diseases - diet - mediterranean region - elderly - nutritional intervention
    Mediterranean diet and the metabolic syndrome

    Background: The metabolic syndrome refers to a clustering of risk factors including
    abdominal obesity, hyperglycaemia, low HDL-cholesterol, hypertriglyceridaemia,
    and hypertension and it is a risk factor for diabetes mellitus type 2 and cardiovascular
    disease. In this thesis we studied whether a Mediterranean diet favourably affects the
    metabolic syndrome.
    Methods: We assessed the association between a Mediterranean diet and the metabolic
    syndrome in apparently healthy elderly European subjects (SENECA study) and in
    a Dutch study population that was oversampled with subjects with impaired glucose
    tolerance or diabetes mellitus type 2 (CoDAM study). In addition, we conducted a
    controlled-feeding trial to compare the effects of replacing a high saturated fatty acids
    (SFA) diet with a high monounsaturated fatty acids (MUFA) diet or a Mediterranean
    diet on characteristics of the metabolic syndrome: HDL-cholesterol, triglycerides and
    glucose metabolism (glucose concentration and insulin sensitivity).
    Results: In both the SENECA study and the feeding trial we find support for the
    hypothesis that a Mediterranean diet has a beneficial effect on two characteristics of
    the metabolic syndrome, namely HDL-cholesterol and triglyceride concentrations.
    In addition, the findings of the SENECA study suggested that subjects with good
    adherence to a Mediterranean diet had a lower prevalence of the metabolic syndrome
    (prevalence ratio 0.81, 95%CI 0.65; 1.03) and a smaller waist circumference (-1.1 cm,
    95%CI -2.4; 0.3) than subjects with poor adherence. In the CoDAM study, we did not
    find these associations. In none of our studies we found support for the hypothesis
    that a Mediterranean diet has a beneficial effect on glucose concentration, insulin
    sensitivity or blood pressure.
    Conclusion: This thesis finds support for a beneficial effect on two out of five
    characteristics of the metabolic syndrome and also suggests a beneficial effect on a
    third characteristic (abdominal obesity). We therefore conclude that a Mediterranean
    diet may help to prevent the metabolic syndrome and consequently diabetes mellitus
    type 2 and cardiovascular disease.
    Nutritional analysis and intervention in the captive woolly monkey (Lagothric lagotricha)
    Ange-van Heugten, K.D. - \ 2008
    Wageningen University. Promotor(en): Martin Verstegen, co-promotor(en): P. Ferket. - [S.l.] : S.n. - ISBN 9789085049012 - 191
    apen - diervoeding - diergezondheid - dierziekten - diëten - voedingsstoffen - levensverwachting - bloedserum - bloedchemie - diabetes mellitus - hydrocortison - voedselsupplementen - dierentuinen - dieren in gevangenschap - voeding en gezondheid - monkeys - animal nutrition - animal health - animal diseases - diets - nutrients - life expectancy - blood serum - blood chemistry - diabetes mellitus - hydrocortisone - food supplements - zoological gardens - captive animals - nutrition and health
    Woolly monkeys (Lagothrix ssp.) are a threatened species in the wild and are extremely difficult to breed and successfully maintain in captivity. The majority of health complications in woolly monkeys (WM) may be of nutritional origin. The objectives of this thesis were to: 1) determine the current status of the captive WM, 2) isolate potential nutritional causes for primary disorders in captive WM, and 3) investigate the effects that diet nutrients have on WM serum chemistry and cortisol concentrations. Our studies showed that the number of captive WM have decreased by 11% in the past 16 years. The number of institutions holding WM decreased and the birth to death ratio is 0.65 compared to 1.26 for their close relative the spider monkey (SM) (Ateles spp.). Lack of genetic diversity in captive WM also may negatively influence their success. Serum chemistry from 30 WM housed at two zoos were similar to previously reported concentrations for howler (Aloutta sp.) and SM; however, serum glucose was above the baseline range compared to humans and SM. Fasting concentrations of glucose, insulin, fructosamine, glycated hemoglobin, circulating lipids and urinary glucose were within normal ranges in six WM with known hypertension problems compared to other monkeys and humans. Potential stressors, such as unnatural diet, can contribute to the low success of endangered primates via noted health abnormalities. Fecal and salivary cortisol concentrations in WM and SM, at multiple zoological institutions showed that zoos with the highest dietary total carbohydrates, total sugars, glucose and fruit content had the highest cortisol. Supplementation of WM and SM diets with inulin-type fructans numerically decreased fecal cortisol after 4 weeks of supplementation, primarily in SM. The lifespan and reproductive success of captive primates will improve if stressors and negative effects of nutrition on the health status can be reduced and dietary nutrients can be optimized.
    De prevalentie van het metabool syndroom in Nederland: verhoogd risico op hart- en vaatziekten en diabetes mellitus type 2 bij een kwart van de personen jonger van 60 jaar
    Bos, M.B. ; Vries, J.H.M. de; Wolffenbuttel, B.H.R. ; Verhagen, H. ; Hillige, J.L. ; Feskens, E.J.M. - \ 2007
    Nederlands Tijdschrift voor Geneeskunde 151 (2007)43. - ISSN 0028-2162 - p. 2382 - 2388.
    metabolisme - diabetes mellitus - suikerziekte - hart- en vaatziekten - obesitas - overgewicht - risicofactoren - ziekteprevalentie - metabolism - diabetes mellitus - diabetes - cardiovascular diseases - obesity - overweight - risk factors - disease prevalence
    The objective of this research was to estimate the prevalence of the metabolic syndrome in the Netherlands in two populations in the age category 28-59 years and to compare this with the prevalence of hypercholesterolaemia in these populations
    Alcohol consumption and risk of cardiovascular disease and type 2 diabetes : population-based studies and physiological interventions = Alcoholconsumptie en risico op cardiovasculaire ziekten en type 2 diabetes : populatiestudies en fysiologische interventies
    Beulens, J.W.J. - \ 2007
    Wageningen University. Promotor(en): G. Schaafsma; Frans Kok, co-promotor(en): H.F.J. Hendriks. - [S.l.] : S.n. - ISBN 9789085045717 - 226
    alcoholinname - hart- en vaatziekten - diabetes mellitus - alcohol intake - cardiovascular diseases - diabetes mellitus
    Research described in this thesis provides evidence for a causal inverse relation of moderate alcohol consumption with cardiovascular disease and type 2 diabetes. First, it showed that these inverse associations are consistent over different populations such as hypertensive men and older women, both at increased risk of those diseases. Increased cholesterol efflux and adiponectin concentrations after moderate alcohol consumption are a plausible mechanism to explain the associations. Finally, an interaction of alcohol intake with the alcohol dehydrogenase gene for type 2 diabetes indicates that this relation may be causal and due to downstream metabolites instead of ethanol itself.
    Diabetes and diet : food choices
    Niewind, A.C. - \ 1989
    Agricultural University. Promotor(en): J.G.A.J. Hautvast; N.G. Röling. - S.l. : Niewind - 92
    diabetes mellitus - suikerziekte - dieet - diëtetiek - voedselhygiëne - voedingstoestand - consumptiepatronen - diabetes mellitus - diabetes - diet - dietetics - food hygiene - nutritional state - consumption patterns
    This thesis reports on the food choices of diabetic patients. Two studies were undertaken considering the barriers these patients experience with the diabetic diet. Furthermore, the changes in food choices during the first years after the diagnosis of insulin-dependent diabetes as well as patients, food choice motives were investigated. It is concluded that despite thebarriers diabetic patients experience with their diets, they are motivated to change food choices for health-related reasons on a short-term and a more long-term basis. However, the actual changes in food use patients make after being diagnosed as diabetics are only partly in agreement with the principles of the diabetic diet. Many of the changes in food use are not necessary and the barrierssome are even undesirable from a nutritional perspective. It is advised that patients' understanding of the diabetic diet as well as nutrition education programmes for diabetic patients need to be improved.

    Diabetes and diet : managing dietary barriers
    Friele, R.D. - \ 1989
    Agricultural University. Promotor(en): J.G.A.J. Hautvast; A.T.J. Nooij. - S.l. : Friele - 108
    diabetes mellitus - suikerziekte - voedselbereiding - kookkunst - diëten - diëtetiek - dieetvoedsel - dieet - voedselhygiëne - voedingstoestand - consumptiepatronen - diabetes mellitus - diabetes - food preparation - cookery - diets - dietetics - dietetic foods - diet - food hygiene - nutritional state - consumption patterns

    This thesis reports on the barriers diabetic patients experience with their diet, and the ways they cope with these barriers. A dietary barrier is a hinderance to a person's well-being, induced by being advised a diet. First inventories were made of possible dietary barriers and ways of coping with them. Secondly the prevalence of these barriers and ways of coping with them were assessed among different diabetic populations. Most prevalent were barriers expressing physical discomfort and restrictions in food-use. Barriers with the highest prevalence were most often dealt with by non-compliance.

    The prevalence of barriers among recently diagnosed diabetics did not differ from prevalences after a follow-up period of one year. It was concluded that dietary barriers are not easily overcome by diabetic patients. Hardly any differences were found in barrier prevalence when comparing insulin- treated and non insulin-treated diabetic patients. Prevalence of barriers among diabetics with conventional insulin therapy was higher when compared to diabetics with continuous subcutaneous insulin infusion and a liberalized diet.

    It is concluded that diets allowing for variability in energy-intake and meal-times will decrease prevalence of dietary barriers among diabetics. Also barrier prevalence could decrease when the diet is not perceived as consisting of forbidden foods. Diets leading to less dietary barriers are not only more pleasurable to live with, such diets also are more likely to be adhered to.

    Inspanning en voeding bij diabetes, hart- en vaatziekten, overgewicht
    Erp-Baart, A.M.J. van; Katan, M.B. ; Kemper, H.C.G. ; Laan, J.A.M. van der; Morris, J.N. ; Nobel, E. de; Saris, W.H.M. ; Weeda, H.W.H. - \ 1985
    Alphen a/d Rijn : Samsom - ISBN 9789060165461 - 115
    bloedstoornissen - hart- en vaatziekten - hart- en vaatstoornissen - suikerziekte - diabetes mellitus - energiebehoeften - moeheid - voeding - obesitas - overgewicht - lichamelijke activiteit - vaatziekten - blood disorders - cardiovascular diseases - cardiovascular disorders - diabetes - diabetes mellitus - energy requirements - fatigue - nutrition - obesity - overweight - physical activity - vascular diseases
    Voeding en diabetes
    Bogaard, P.J.M.A. van den; Dankmeijer, H.F. ; Edema, J.M.P. - \ 1984
    Alphen aan de Rijn : Samsom (Voeding en gezondheid no. 2) - ISBN 9789060162248 - 113
    consumptiepatronen - suikerziekte - diabetes mellitus - voedselhygiëne - voedingstoestand - consumption patterns - diabetes - diabetes mellitus - food hygiene - nutritional state
    Juveniele diabetes in een gezinssituatie
    Gilissen, M. ; Weel, T. van der - \ 1974
    Wageningen : Landbouwhogeschool (Publikatie / Vakgroep humane voeding. Landbouwhogeschool no. 74.06) - 134
    kinderen - suikerziekte - diabetes mellitus - zuigelingen - sociologie - children - diabetes - diabetes mellitus - infants - sociology
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