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To clarify the separate influences of digestible carbohydrate and of dietary fibre on blood glucose control and serum lipoproteins, 14 diabetic patients (six Type 1 and eight Type 2) were submitted to three weight-maintaining diets for 10 days each: (1) low carbohydrate/low fibre diet with 42% carbohydrate and 20 g fibre; (2) high carbohydrate/low fibre diet (carbohydrate 53%, fibre 16 g); (3) high carbohydrate/ high fibre diet (carbohydrate 53%, fibre 54 g). In comparison with the low carbohydrate/low fibre diet, the 2-h post-prandial blood glucose and the daily blood glucose profile decreased significantly on the high carbohydrate/high fibre diet, without significant changes during the high carbohydrate/low fibre diet. The diet-induced modifications of blood glucose control were similar in both types of diabetic patients (two-way analysis of variance: F = 5.86, p less than 0.02 for dietary treatment and F = 2.09, NS for type of diabetes). Total and low-density lipoprotein cholesterol were also decreased after the high carbohydrate/high fibre diet in comparison with the low carbohydrate/low fibre diet (p less than 0.001 for both), while they were not significantly modified after the high carbohydrate/low fibre diet. Again the modifications of low density lipoprotein cholesterol induced by diet were similar in both types of diabetic patients (F = 10.02, p less than 0.005 for dietary treatment and F = 0.14 for type of diabetes, NS). High-density lipoprotein cholesterol was lower after the two test diets than after the low carbohydrate/low fibre diet.(ABSTRACT TRUNCATED AT 250 WORDS)

The authors investigated the efficacy of a lifestyle educational program, organized in small group meetings, in improving the outcome of a nonpharmacologic intervention. One hundred and eighty-eight hypertensive patients with stable blood pressure (BP) levels and drug therapy in the previous 6 months were randomly divided into educational care (EC) and usual care (UC) groups. They were followed at 3-month intervals up to 2 years. In addition to the visits in an outpatient clinic, patients in the EC program participated in small group meetings in order to improve their knowledge of the disease and reinforce their motivation for treatment. At baseline, EC and UC groups were similar for age, sex, body mass index (BMI), blood pressure (BP) levels, and pharmacologic treatment. Patients in the EC group had significantly reduced total energy, total and saturated fats, and sodium intake. Physical activity was significantly increased in the EC group as well. At the end of the 1-year follow-up, BMI (P<.001), visceral fat (P<.001), and BP (P<.001) were significantly lower in the EC group compared with the UC group. Pharmacologic treatment during the study was similar for all classes of drugs apart from diuretics whose dose was higher in the UC group at the end of the study. J Clin Hypertens (Greenwich). 2012;14:767-772. Ó2012 Wiley Periodicals, Inc.The association between arterial hypertension and other metabolic diseases has been frequently observed in the literature by several investigators and by ourselves in both clinical studies in the outpatient clinic and in observational studies in large population samples.1-4 Overweight status particularly seems to influence the development of hypertension but impairment in blood lipids and glucose are also involved, as seen in the metabolic syndrome.5 Accordingly, guidelines for optimal treatment of arterial hypertension indicate that nonpharmacologic intervention is the first approach in patients with low global cardiovascular risk and is associated with drug therapy in patients with moderate to high global risk. 6Despite the interest to prevent the vascular complications of hypertension, the goal of normal blood pressure (BP) levels is achieved in only <25% patients with hypertension worldwide. Reasons for this disappointing result vary, including low dosage of antihypertensive drugs, patients not taking prescribed pills, resistant hypertension, and poor compliance to prescribed nonpharmacologic measures. We have described the difficulties found by our patients in continuing a dietary approach to improve BP over a long period of time despite achieving significant improvement in BP and body weight (BW) control, associating lifestyle changes with pharmacologic treatment. The aim of the present study was to evaluate whether an educational program dedicated to nonpharmacologic measures to treat hypertension, including small group meetings with doctors and dieticians in addition to usual controls in the outpatient clinic would be useful in achieving better and long-lasting results i...

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