HMG7110 Epidemiology Assignment - Systematic Literature Review, Victoria University, Australia

Topic - Fat Diet in the Prevention of Diabetes

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Introduction

Although the diabetes affect the primary lifestyle and the genes of the individual, there is a major impact of the dietary competition which can affect the development and the other complications as well. The diet fat is considered to be because of the fatty acids which influence the glucose metabolism through the alteration of the cell membrane function and handling the enzyme activities with gene expressions. The focus is on the type 2 diabetes which highlights about the associations which are made in between the different types of the dietary fat and the risks. They are summarized as the control for the feeding activities and the study on the dietary fats on the metabolic mediators. The evidence suggests about the replacement of the saturated fats and the trans fatty acids which are set with the unsaturated fats that has been mainly beneficially effects on the insulin activity. They are mainly to reduce the risks of the type 2 diabetes problem. It is seen that there are polyunsaturated fats with the linoleic acid which comes from the n-6 series for the improvement of the insulin sensitivity. There are larger chains of the n-3 fatty acids which do not tend to appear for the improvement of the sensitivity and the glucose metabolism. Hence, there are practices which include the intake of the rich food and in the vegetable oils, including the non-hydrogenated nuts, and the seeds which can replace the foods rich in the saturated fats as well. It is seen that the dietary composition is also important for the improvement of insulin sensitivity with reducing any risk related to the problems of diabetes. The planning needs to be done for the different chain length and the number of the double bonds that make use of the abundant dietary fatty acids like the linoleic acid, palmitic acid and the stearic acid.

Objectives

Here, the major focus of the paper is to review about the roles for the different types of the dietary plans which are based on the insulin sensitivity and the diabetes risks for the update of the reviews. There are no longer term randomization trials which are found to be on the effect of the dietary fat which also qualifies for the randomized controlled interventions. Here, the relation is to the dietary fat where there are incidence for the epidemiologic studies. The controlled feeding requires to test on the diets which are found to be isocaloric and then they differ in the fat quality as well (Lehtisalo et al., 2016). With this, there are controlled feeding tests which are found to be differing depending upon the small and the short duration patterns to evaluate the endpoints like the sensitivity of insulin. The epidemiologic study highlights on following up the periods which have been used as the objective for the main assessment of the dietary fat quality with the biomarkers of the fatty acids intake. There are other study that have been assessing the dietary fat which is for the using of food records or the questionnaires. The aim is to focus on the larger perspective cohort study where the associations are made for the higher dietary fiber intake with the reduced risks for developing the type 2 diabetes after there are correction for the confounders.

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Methods

The study has been about the Diabetes Prevention study which has been able to describe about the randomization, control and the use of the multi-center lifestyle intervention where the aim of the type 2 diabetes prevention has a higher risk population. The participants who are involved are the middle age men who are from 55 years with the range of 40 to 65 years. Here, the overweight where BMI is more than 25 kg/m2 and then they have impaired glucose tolerance at the baseline (Weickert et al., 2018). The intervention groups have been receiving the frequent individualization of the dietary and the physical activity with reduction of weight counseling and then understanding the interventions, year after year. Wit is seen that there are impaired glucose transactions where the intervention phase is planned for continuing for the time of 6 years where the participants are prematurely holding the discontinuity and then planning about the following of the post interventions plan to follow up with the annual examinations. Here, the planning is about the participants who are working on the control group for the time n-257 where they have been receiving general health advice for the baseline. The intervention is planned for the time of 6 years where the participants are prematurely discontinued based on the analysis that show about the stronger benefits with the lifestyle intervention. Hence, for this, there are study protocols which are approved under the National Public Health Institute. The research also includes the different clinical measurements.

There are baseline and the examinations which comprise of the 2-hour oral glucose tolerance tests with medical history and the examinations at a physical level. They are the measurements with the height and the weight which are considered to be systolic and the diastolic blood pressure (Lehtisalo et al., 2016). There are BMI which is then calculated through the division of the body weight that comes with more height. The average BMI and the waist circumstance is based on the different measurements where the study period is calculated. The 3-day food records are completed and then analyzed at the baselines where there are recording which are facilitated for the nutrients intake and is calculated through the use of the dietary analysis program. The average daily intake of the energy comes from the fat and the energy which is from the baseline that helps in representing the intervention and then following up to the phases. The change in nutrients intake are calculated through the subtraction of the baseline value from the average value.

Here, the major goals have been for the intervention which includes the reduction of the weight which is of 5% and more. Here, this is less than 30% of the energy that includes the fiber intake for the 15g/1000 kcal. The moderate intensity is the physical activity for handling the dietary goals and then determining the intake for the intervention phase. The changes need to be determined from the baseline which is defined for the time of 3 years. The assessment is based on cognition where the baseline is about handling the eligibility of the participants who are working on the invitation letter to participate. The cognitive function is assessed through trained study nurse using the Cognitive Function (Esposito et al., 2017). The neuropsychological tests battery are for the sensitive measures for the cognitive changes with the Alzheimer's disease and the Trail Making Tests that tend to measure the speed and the functions. There are constructional recalls for the recognition with the clock drawing. The drawing is to measure and evaluate the cognitive performance where the focus is on the adjustment which is based on handling the worse performance.

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Weight and the waist change profiles include the separate mean values where the calculations are based on the active intervention and the planning. The weight change categories are determined through the weight loss and the gain at the time of intervention where there are follow up phases. Hence, the categorization is applied for the waist circumference where the change profiles are for the BMI which are set for the defining of the decreased intervention. There are reports about no differences that are based on the cognition and the profiling through control of the groups and then analyzing the performances which are based on the group combinations as well (Zheng et al., 2018).

Flow Diagram for the Study Selection

Characteristics of the Participants

References: ASSOCIATION OF LONG-TERM DIETARY FAT INTAKE, EXERCISE, AND WEIGHT WITH LATER COGNITIVE FUNCTION IN THE FINNISH DIABETES PREVENTION STUDY

The cognition is based on the participation of 364 people who are working on the analysis of the systolic blood pressure which is at the baseline. Apart from this, there are other structures which are found to be at the baseline and then there are lengthy recruitments which are done to handle the cognition and the planning as well. There are lifestyle factors for the baseline which do not tend to differ in between the participants and the non-participants of the cognition study. Hence, the achievement of the lifestyle goals are defined through the participants working on 86% of the goals. There are lifestyle factors that works on the performance of the CERAD TS with lower BMI or the waist circumference. There are greater amount of the moderate to the vigorous activities which are found for handling the changes with association to the physical activity structures.

The weight changing profiles are defined through which there are no differences in the cognition in between the participants and then they tend to follow up with the phase of the CERAD TS performance.

Discussion

Here, the discussion is based on handling the long-term healthy lifestyle with the positive changes that are associated to the cognition and the planning (Alvarez et al., 2015). It includes the different measures of obesity which have been appearing for the lower BMI and then they are associated to the intervention phase where there are decline in the weight prior to the cognitive assessment. There are outcomes which are scarce as well. Here, the DASH diet which is developed through the decreased hypertension leads to the improvement of the cognitive function over the time of 4 months. There are longer term dietary intervention with the investigation of the changes that are made available. The cardiovascular disease prevention includes the trial which needs to suggestion about the benefits after the time of 6 years. Here, the focus is on the cognitive performance and then handling the differences in the diabetes incidences. The lifestyle changes are reported mainly due to the lack of differences and handling the groups which are received with health advice and the monitoring. Here, the results are showing about the total fat and the SFA which is associated to the cognitive function and then it is in line with the previous epidemiological studies as well. The association is based on the spreads which is worked upon through the cognitive function studies. The physical activities are about the intakes and the links which are associated to the lesser cognitive declined and the lower risks of AD.

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Limitation

There are limitations that needs to be addressed with the planning which is based on the baseline cognition that is collection. The high level of the young group of the participants which is relatively group of the function. The cognitive basis is based on the health problems that is unable to the participate. The lifestyles are based on the forms with the lack of the statistical power with major impact with the impact on the analysis with the separate goals. The lifecycle interventions with standard of care that is for the people with IGT. The goals are defined for the cognitive performance with the strategy to support healthy aging.

Conclusion

The analysis is based on the overweight participation with the combination of the weight loss which is during the intervention phase with the weight loss. They are based on the study that includes the intentional weight with the pre-clinical with the pilot study with the lack in the statistical power. The impact is based on the analysis of the condition with the lifestyle that is set for the generalization to the persons with IGT. The findings is based on the association with higher BMI or the waist circumference with the perspective study that is set for handling the prediction of the poor cognition and the other studies for the relationship with cognitive functions.

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