The persistence of an epidemic of obesity and type 2 diabetes suggests that new nutritional strategies are needed if the epidemic is to be overcome. A promising nutritional approach suggested by this thematic review is metabolic effect of low glycaemic-index diet.The currently available scientific literature shows that low glycaemic-index diets acutely induce a number of favorable effects, such as a rapid weight loss, decrease of fasting glucose and insulin levels, reduction of circulating triglyceride levels and improvement of blood pressure.The long-term effect of the combination of these changes is at present not known.Based on associations between these metabolic parameters and risk of cardiovascular disease, further controlled studies on low-GI diet and metabolic disease are needed. ReviewsObesity is a major global health problem that has been associated with highly occurring disorders such as hypertension, type 2 diabetes, hyperinsulinemia, dyslipidemia, atherosclerosis and certain types of cancer [1,2]. More than one billion adults worldwide are overweight, with ≥ 300 million clinically obese [3]. The epidemic of overweight and obesity, which is rising worldwide, inflicts not only a reduced quality of life and large healthcare-associated costs, but also an increased risk of death [4].Trend analysis in relation to obesity suggests that in most countries the majority of the population is less active than they should be for maintaining good health, while they are simultaneously eating more than they need [5]. Weight gain is considered as a consequence of excessive energy intake as compared with energy expenditure, while successful weigh loss depends upon achieving negative energy balance [2]. In this context, environmental influences, such as an inactive lifestyle and the consumption of energy-dense diets, appear of overriding importance on excessive weight gain in addition to genetic predisposition [6].Weight management in the obese may take into account the energy intake and the dietary macronutrient distribution.A number of nutritional approaches and diets with different proportions of lipids, proteins and carbohydrates are being investigated, which may be energy restricted or prescribed [7,8]. Not only the different macronutrient com-

BackgroundIn patients with chronic hepatitis C (CHC), obesity is involved in the pathogenesis of insulin resistance, fatty liver disease and progression of fibrosis. The objective of this study was to compare a normoglucidic low-calorie diet (NGLCD) with a low-fat diet (LFD) among participants with CHC. Aimed to measure the impact of dietary changes in reduction of insulin resistance, obesity but also in steatosis and fibrosis.MethodsRandomized, controlled trial in three medical centers with assessments at baseline, 6 months and 12 months. Participants were patients over 35 years with chronic hepatitis C (n = 120) with BMI over 25 kg/m2. We evaluated the effects of NGLCD vs. LFD in weight management and metabolic improvement. The primary endpoint was to measure the impact of dietary changes through nutritional intervention in reversibility of insulin resistance, obesity, steatosis, and fibrosis. We performed anthropometric measurements, fasting glucose profile, serum lipids, liver profile, blood count at baseline, 6 and 12 months. Steatosis was evaluated using ultrasonographic criteria. Liver fibrosis was non-invasively assessed.ResultsAfter 6 and 12 months of intervention, both groups had a significant decrease in caloric consumption. At 6 months, weight loss was greater in the NGLCD group (−5.02 ± 3.43 kg vs. −4.1 ± 2.6 kg; p = 0.002) compared to the LFD group. At 1-year, however, weight loss was similar in both groups (−3.9 ± 3.3 kg vs. −3.1 ± 2.6 kg; p = 0.139). At 12 months, fasting plasma glucose, fasting plasma insulin, and HOMA-IR had significant improvements in both groups. With both diets aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT) decreased with significant differences; also there were significant improvements in AST/ALT ratio, Forns fibrosis index. The two diets were associated with reduction of both the prevalence and the severity of steatosis (all p < 0.001). At 12 months, total cholesterol, HDL-cholesterol, triglycerides improved in both groups (all p < 0.05).ConclusionsThe present study establishes the benefits of low-calorie diet and low-fat diet in management of patients with hepatitis C regarding improvement of insulin resistance, steatosis and also fibrosis.Overweight or obese patients with CHC undergoing a lifestyle intervention (specific dietary intervention and physical activity) for 1-year had significant improvements in body weight, lipid and hepatic profile.Trial registrationPNCI2-3343/41008/2007

Purpose. Assessing cardiovascular risk in patients with acromegaly using traditional cardiovascular risk factors is inadequate. Endothelial dysfunction seems to be a much better indicator for assessing cardiovascular risk in acromegaly. The study aims to compare from this point of view two groups of patients, with hypertension and with acromegaly. Methods. The first group consists of 54 patients with acromegaly and the second group of 64 hypertensive patients. Endothelial dysfunction was evaluated by the FMD method. The relationship between endothelial dysfunction, specific humoral markers of acromegaly and traditional cardiovascular risk factors was analysed in both groups. Results. Although the presence of cardiovascular risk factors was statistically significantly higher in the group of hypertensives (the most important were age, blood pressure, glycemia, hypertriglyceridemia and SCORE), the presence of endothelial dysfunction was higher in the acromegaly group (61.10% vs. 32.10%, p=0.02). The best correlation with endothelial dysfunction in acromegaly group was the level of GH (28.9±28 vs. 11.7±10.3, p=0.003). Conclusions. The presence of endothelial dysfunction in patients with acromegaly is highly dependent on the level of GH and traditional cardiovascular risk factors are less important. In these patients the cardiovascular risk should not be evaluated in the same way as in normal population.

Background and Aims-To evaluate the impact of nutritional intervention on vitamins and minerals from intake food and anthropometric parameters at overweight and obese patients.Material and methods-To a sample of 40 overweight and obese patients we evaluated the nutritional content of food intake (kilocalories, macro and micronutrients). We also measured anthropometric parameters like weight, body mass index, body fat, percent of body fat, abdominal circumference and arterial tension.Results-After the nutritional intervention, overweight and obese patients had significantly lower level of intake carbohydrates (P=.018), lipids (P=.002), B1 vitamin (P<.001), B3 vitamin (P=.02) and E vitamin (P=.016). There is a significantly increased level of proteins (P<.001). Regarding the minerals, we found that the intake levels of following‗s decreased: sodium (P<.001), magnesium (P=.006), zinc (P=.035), copper (P=.002), manganese (P<.001). Phosphorus is the only mineral of which the intake level increased significantly (P<.001). All the anthropometric parameters decreased significantly: weight (P<.001), body mass index (P<.001), body fat (P<.001), percent of body fat (P<.001), abdominal circumference (P<0.001), systolic arterial tension (P<.001), diastolic arterial tension (P=.002).Conclusions-All the patients had imbalanced intake of vitamins and minerals both before and after intervention. There is a significant improved on anthropometric measures after nutritional intervention. We need to promote healthy lifestyle changes to prevent the risks associated with obesity.Keywords: overweight; obese; intake food; vitamins; minerals; anthropometric measures. . Obesity is a major risk factor for type 2 diabetes, cardiovascular diseases (mainly stroke and heart disease), cancer (endometrial, breast, colon), pulmonary diseases, osteoporosis, periodontal diseases. It has numerous consequences on lipid, glucose and protein metabolism with hiperglicemia and insulin resistance, hiperlipidemia and hiperuricemia. Obesity apears as a consequence of imbalance between energy intake (by food) and consumed energy (mainly by phisical activities). Sedentary life and unhealthy meals, riched in energy-dense foods ( high-fat, high sugar, high-salt, micronutrient poor ) are the main problem of the contemporany world.Except the vitamin D, that is synthesized in the human body, in the cutaneous tissue, in response to sunlight exposure [2], all the other vitamins are provided by food intake. There are two types of vitamins-one's that are soluble in fat, like vitamins A, D, E. and K and other's that are soluble in water-like vitamins B1, B2, B3, B5, B6, B12, folic acid. Excess of fat-soluble vitamins can not be eliminated so this vitamins will be stored in human body if the intake level is high and it can lead to simptoms and diseases. The water soluble vitamins are eliminated through kidney or liver and the risk of intoxication is lower and the simptoms occurs rarely.Minerals represent only 4-5 % of body weight but they are very important by p...

Background and Aims: The aim of this study was to document the eating habits of normal weight and obese patients in order to implement a new and healthier lifestyle. Material and Methods: We evaluated the intake of energy and that of vitamins and minerals in a sample of 199 normal weight and obese subjects. We also performed anthropometric's measurements, paraclinic’s and laboratory’s tests. Results: The mean intake of vitamins and minerals is significantly different for B1 and B3 vitamins and for iron, phosphorus, copper and selenium. Vitamins like B1, B2, B3, B6, B12, C and A vitamin and minerals like, zinc, manganese, phosphorus and selenium are over consumed in both groups. Regarding the sodium’s intake, only 37.04% of normal weight patients fulfill the recommendations of less than 2 g/day. The prevalence of a high fat diet is about 59.29% in normal weight people and 60.69% among obese ones. Only 25% of normal weight patients had normal abdominal circumference and 58.47% of obese subjects had normal HDL-cholesterol levels. Conclusions: Regardless the body mass index (BMI) status, neither normal weight subjects nor the obese ones' had an adequate micronutrient intake. Also, there is a high prevalence of high sodium’s intake and a high fat diet among the normal weight patients.