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Background: Successful management of type 1 diabetes depends on the self-care practices. Sense of coherence has been associated with various measures of lifestyle choices. We aimed to study the associations between sense of coherence and self-care practices in patients with type 1 diabetes. We hypothesized that patients with weak sense of coherence have less prudent food choices and lower physical activity., Methods: Cross-sectional data from 1104 patients (44% men, mean age 45±12 years) from the FinnDiane Study were available. Sense of coherence, dietary intake, and leisure time physical activity were evaluated using self-reported questionnaires. Diet score was calculated based on the degree to which food choices complied with dietary guidelines. Weekly metabolic equivalent hours were calculated by multiplying the activity duration by the activity- and intensity-specific metabolic equivalent., Results: The sense of coherence score correlated positively both with the diet score and the weekly metabolic equivalent hours. Those in the lowest sense of coherence tertile had both the lowest diet scores and the lowest weekly metabolic equivalent hours values. Among women, the sense of coherence score was associated with the diet score when adjusted for age, socioeconomic status, received dietary guidance, and nephropathy status. The sense of coherence score independently predicted the metabolic equivalent hours value in men., Conclusions: A higher sense of coherence score predicted more prudent food choices in women and higher physical activity in men. In the future, the health consequences associated with a weak sense of coherence should be studied prospectively. Also, the possibility to use the sense of coherence questionnaire as a screening instrument to identify patients who could benefit from intensified counseling should be investigated.

Background: Patients with type 1 diabetes are instructed to eat a healthy, balanced diet. Implementation of diet is an under-studied phenomenon. We aimed to describe the nutrient intake of a large sample of adult Finnish patients with type 1 diabetes and assess whether they meet the recommendations., Methods: Cross-sectional data from a total of 817 patients are presented. Data on food intake were collected with a 3-day food record completed twice with a 2-3-month interval. Compliance with dietary guidance was self-reported., Results: Patients frequently reported a diet low in carbohydrates and fibre but high in fat. Only 28% restricted saturated fatty acid to less than 10% of their daily energy intake. One-fourth of the patients reported higher than recommended sucrose intake. Salt recommendations were frequently exceeded. Of the micronutrients, the recommendations for vitamin A, vitamin D, folate, and iron were most frequently unmet. Although self-reported compliance was associated with a higher frequency of meeting the recommendations for some of the macronutrients, the actual frequencies were modest. In general, those compliant were observed to consume more vitamin and mineral-dense food., Conclusion: Dietary intake among patients with type 1 diabetes does not, for many nutrients, meet the recommendations.

Background: Many factors contribute to the need for prandial insulin in Type 1 diabetes. However, patients' success in achieving normal postprandial glucose concentration is understudied. The aim of the present study was to determine how often patients with Type 1 diabetes achieve normal postprandial glucose concentrations and to evaluate factors associated with postprandial hypo- and hyperglycemia., Methods: Data on food intake, physical activity, insulin administration, and blood glucose concentration were collected using a self-administered questionnaire from 331 patients with Type 1 diabetes (43% men; mean age 49 ± 12 years; mean diabetes duration 32 ± 13 years). Of these, 179 provided data on blood glucose concentrations measured 110-150 min postprandially. One such meal per patient was randomized for analyses., Results: Hypoglycemia (< 4.0 mmol/L), normoglycemia (4.0-7.9 mmol/L), and hyperglycemia (≥ 8.0 mmol/L) were observed after 23%, 36%, and 41% of meals, respectively. The three postprandial glycemia groups did not differ with respect to the meal composition or the timing of the postprandial blood glucose measurement. In women, postprandial hyperglycemia was associated with shorter diabetes duration and higher preprandial blood glucose concentration, whereas postprandial hypoglycemia was associated with higher physical activity. No single factor explained the postprandial glycemic state in men., Conclusions: A total of 64% of patients estimated their prandial insulin need inappropriately, suggesting that estimation of the optimal prandial insulin dose is not easy, even after a long duration of diabetes., (© 2010 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Blackwell Publishing Asia Pty Ltd.)

Flavonoids are polyphenolic compounds ubiquitously found in human diets. We have studied the association between urinary excretion of flavonoids and the intake of fruits and vegetables to evaluate the usefulness of flavonoids as a biomarker for fruit and vegetable intake. Levels of 12 dietary relevant flavonoids were determined by LC-MS in urine samples collected prior to an intervention study, when the subjects were on their habitual diet (n = 94), and after they had participated in an intervention study with diets either high or low in fruits, berries, and vegetables (n = 77). Both flavonoid glycosides and aglycones were included in the assay, but only the flavonoid aglycones were detectable. Thus, the flavonols quercetin, kaempferol, isorhamnetin, and tamarixetin, the dihydrochalcone phloretin, and the flavanones naringenin and hesperetin were quantified in the enzymatically hydrolyzed urine samples. The habitual intake of fruits and vegetables, determined by 3-day dietary records before the intervention study, correlated significantly with the total excretion of urinary flavonoids, with a coefficient of correlation of 0.35, P < 0.005 (n = 94). In addition, highly significant differences in the urinary excretion of all flavonoids were observed in the human intervention study between subjects on diets high or low in fruits, berries, and vegetables. Also, at the individual level a significant positive correlation between changes in fruit and vegetable intake and changes in urinary flavonoid excretion was observed. We conclude that urinary flavonoids may be useful as a new biomarker for fruit, berry, and vegetable intakes and may prove useful when the possible health protective effects of flavonoids are studied.

Objectives: The objective of the study was to determine whether an association between diet and platelet function, plasma fibrinogen level and factor VII coagulant activity (VII:C) could be established in young subjects., Design: Data on the habitual diet of the subjects were collected either by a questionnaire on food habits (n = 204) or by a 48-h dietary recall interview (n = 53)., Subjects: The subjects were participants in the project 'Cardiovascular Risk in Young Finns' (age range 15-30 years). A total of 204 subjects having a questionnaire on food habits participated in the platelet function tests and 53 also participated in a 48-h dietary recall interview. Plasma fibrinogen concentration and factor VII: C were measured from 79 subjects., Main Outcome Measures: Platelet function was tested by turbidometric measurement of platelet aggregation using ADP and collagen as aggregation agents., Results: Platelet aggregation with ADP (at up to 4.0 mumol L-1) and collagen (at up to 5.0 micrograms mL-1 platelet-rich plasma PRP) showed that the diet characterized as 'saturated', i.e. containing high-fat milk and saturated fat, was associated with platelets less sensitive to aggregating agents in vitro when compared to the unsaturated type of diet. Collagen- but not ADP-induced aggregation decreased with age of the subjects (P = 0.026-0.057, regression coefficient). An inverse regression coefficient between plasma factor VII:C (101%; range 64-145%) and serum triglycerides (P = 0.006) and the intake of rye (g 1000 kcal-1; P = 0.03) were found., Conclusions: In this study we showed that platelet reactivity and factor VII:C already differ considerably between subjects at a young age, and diet may explain some of this variation.