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Purpose: Although vitamin B6 has been suspected to prevent the progression of diabetic retinopathy, evidence of this in patients with type 2 diabetes based on longitudinal studies is sparse. This study investigated the relationship between vitamin B6 intake and the incidence of diabetic retinopathy in Japanese patients with type 2 diabetes. Methods: The study was part of an examination of a nationwide cohort of patients with type 2 diabetes aged 40–70 years with HbA1c ≥ 48 mmol/mol. After excluding nonresponders to a dietary survey using the Food Frequency Questionnaire based on food groups, 978 patients were analyzed. Primary outcome was the 8-year risk of a diabetic retinopathy event, and Cox regression analyses estimated hazard ratios (HRs) for retinopathy according to vitamin B6 intake adjusted for age, gender, body mass index, HbA1c, smoking, energy intake, and other confounders. Results: Mean vitamin B6 intake in quartiles ranged from 1.1 to 1.6 mg/day, and half of the participants had vitamin B6 intake below the recommended daily dietary allowance according to dietary reference intakes in Japanese adults (men 1.4 mg/day; women 1.2 mg/day). After adjusting for confounders, HRs for diabetic retinopathy in the 2nd, 3rd, and 4th quartile groups of vitamin B6 intake compared with the 1st quartile group were 1.17 (95% confidence interval 0.81–1.69, p = 0.403), 0.88 (0.58–1.34, p = 0.550), and 0.50 (0.30–0.85, p = 0.010), respectively. Conclusions: Findings suggested that high vitamin B6 intake was associated with a lower incidence of diabetic retinopathy in Japanese with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Aim: Selecting optimal energy intake during diet therapy for older patients with diabetes mellitus is difficult because of the large differences in physical function and comorbid diseases. In Japan, although requirements for total energy intake are calculated by multiplying a person's standard bodyweight (BW) by the amount of physical activity, evidence supporting the application of this method among older people is limited. Therefore, we aimed to assess optimal energy intake by evaluating the relationship between energy intake and mortality in older patients. Methods: We evaluated data from a 6‐year prospective follow up of 756 older patients with diabetes mellitus, and the association between baseline nutrient intake and mortality. Total energy intake and nutrients were evaluated, and energy intake per actual BW was categorized into quartiles (Q). Cox regression analysis was used for statistical analyses. Energy intake per standard BW or age‐related target BW was statistically analyzed using the same protocol. Results: Analysis of energy intake per actual BW showed that hazard ratios for mortality was significantly higher in Q1 and Q4. Similar associations were found for energy intake per standard or target BW. Subgroup analysis showed that mortality rate was the lowest in Q2 in the young‐old population and in Q3 in the old‐old population. Conclusions: A U‐shaped relationship was observed between energy intake per BW and mortality in older patients with diabetes mellitus, which suggests that the optimal energy intake per actual or target BW should encompass a wide range to prevent malnutrition and excessive nutrition in these patients. Geriatr Gerontol Int 2020; 20: 59–65. [ABSTRACT FROM AUTHOR]

Aim The present study aimed to examine whether nutrient intakes predicted cognitive decline among elderly patients with diabetes mellitus. Methods This study evaluated data from a 6-year prospective follow up of 237 elderly patients (aged ≥65 years) with diabetes mellitus, and the associations of baseline nutrient intakes with cognitive decline. Cognitive decline was defined as a ≥2-point decrease in the Mini-Mental State Examination (MMSE) score. Intakes of food and nutrients were assessed using a validated food frequency questionnaire, and were compared between patients with cognitive decline and intact cognition. Analysis of covariance and logistic regression analysis were used to compare the changes in the MMSE score during the follow up among intake tertile groups for each nutrient. Results Compared with men with intact cognition, the men with cognitive decline had lower baseline intakes of calcium, vitamin A, vitamin B2, pantothenate, soluble fiber, green vegetables and milk. However, no significant associations between cognitive decline and nutrient intakes were observed among women. After adjusting for age, body mass index, glycated hemoglobin levels, history of severe hypoglycemia, previous stroke and baseline MMSE score, we found that cognitive decline was significantly associated with low intakes of carotene, vitamin B2, pantothenate, calcium and green vegetables. Multiple logistic regression analysis showed that intakes of nutrients and green vegetables predicted cognitive decline after adjusting for age, body mass index, glycated hemoglobin levels, baseline MMSE score, and incident stroke during the follow up. Conclusions These findings suggest that sufficient intakes of carotene, vitamin B2, pantothenate, calcium and vegetables could help prevent cognitive decline among elderly men with diabetes mellitus. Geriatr Gerontol Int 2017; 17: 1168-1175. [ABSTRACT FROM AUTHOR]

Aims/Introduction Though there are many differences in dietary habits and in the metabolic basis between Western and Asian people, the actual dietary intake in Asian patients with diabetes has not been investigated in a nationwide setting, unlike in Western countries. We aimed to clarify dietary intake among Japanese individuals with type 2 diabetes, and identify differences in dietary intake between Japanese and Western diabetic patients. Materials and Methods Nutritional and food intakes were surveyed and analyzed in 1,516 patients with type 2 diabetes aged 40-70 years from outpatient clinics in 59 university and general hospitals using the food frequency questionnaire based on food groups ( FFQg). Results Mean energy intake for all participants was 1737 ± 412 kcal/day, and mean proportions of total protein, fat, and carbohydrate comprising total energy intake were 15.7, 27.6 and 53.6%, respectively. They consumed a 'low-fat energy-restricted diet' compared with Western diabetic patients, and the proportion of fat consumption was within the suggested range that has been traditionally recommended in Western countries. As a protein source, consumption of fish (100 g) and soybean products (71 g) was larger than that of meat (50 g) and eggs (29 g). These results imply that dietary content and food patterns among Japanese patients with type 2 diabetes are quite close to those reported as suitable for prevention of obesity, type 2 diabetes, cardiovascular disease, and total mortality in Europe and America. Conclusions A large difference was shown between dietary intake by Japanese and Western patients. These differences are important to establish ethnic-specific medical nutrition therapy for diabetes. [ABSTRACT FROM AUTHOR]

Antioxidative activity of dietary flavonoids is suggested to be, at least partly, responsible for a wide variety of their biological effects relating to anti-atherosclerosis. However, it is not known whether dietary flavonoids reach to the target site and act as antioxidants. In this study, we tried to evaluate the antioxidative effect of quercetin 3- O -β- d -glucoside (Q3G), a typical flavonoid present in vegetables, in rabbit aorta. New Zealand White rabbits were fed a control diet (control group), 2.0% cholesterol diet (HC group) and 2.0% cholesterol plus 0.1% Q3G (HC + Q3G group) for one month. The amounts of total cholesterol, triacylglycerol and total fatty acids in both the plasma and aorta were significantly lower in the HC + Q3G group as compared with the HC group. Quercetin was detected in the aorta of the HC + Q3G group after enzymatic deconjugation, indicating that quercetin accumulated as conjugated metabolites in the aorta. The contents of TBA-reacting substances (TBARS) and cholesteryl ester hydroperoxides (CEOOH) in the aorta of the HC + Q3G group were significantly lower than those in the HC group. The aorta of HC + Q3G group was more resistant than that of HC group in copper ion-induced lipid peroxidation ex vivo . HC + Q3G group accumulated a higher amount of vitamin E per total cholesterol than HC group in the aorta. These results strongly suggest that quercetin glucosides accumulate in the aorta as their metabolites and attenuate lipid peroxidation occurring in the aorta, along with the attenuation of hyperlipidemia. [ABSTRACT FROM AUTHOR]

Evidence for optimal dietary intake of calcium for prevention of diabetic complications is sparse although population-based cohort studies showed that calcium intake reduces the risk of type 2 diabetes (T2D). We aimed to investigate the relationship between calcium intake and the incidence of diabetes complications in Japanese patients with T2D aged 40-70 years with HbA1c ≥6.5%. This analysis was conducted as a multicenter prospective study of the incidence of and risk factors for macro- and microvascular complications among 2205 Japanese patients with T2D from outpatient clinics in 59 university and general hospitals in Japan. Analyzed were 1588 responders to a baseline dietary survey assessed by the Food Frequency Questionnaire based on food groups or a dietary record. Primary outcome was the 8-year risk of nephropathy, retinopathy, and cardiovascular disease (CVD). Cox regression analyses estimated hazard ratios (HRs) for dietary intake adjusted for age, gender, BMI, HbA1c, smoking, energy intake, and other confounders. Mean calcium intake in quartiles ranged from 487.5 to 751 mg/day, and more than half of participants had calcium intake below the recommended daily dietary allowance in Japan (men 700 mg/d; women 650 mg/d). After adjusting for confounders, HRs of diabetic nephropathy in the 2nd, 3rd, and 4th quartiles for calcium intake compared with the 1st quartile were 1.20 (95% confidence interval 0.67-2.18, p=0.540), 0.60 (0.28-1.28, p=0.185), and 0.42 (0.18-0.97, p=0.024), respectively. There were no significant associations of calcium intake with retinopathy and CVD in the 2nd to 4th quartiles relative to the 1st quartile (retinopathy: 1.15 (0.81-1.64, p=0.441), 1.14 (0.78-1.68, p=0.491), and 0.93 (0.59-1.46, p=0.809); CVD: 0.86 (0.51-1.44, p=0.558), 0.92 (0.53-1.61, p=0.763), and 0.81 (0.42-1.53, p=0.508). Findings suggested an association of high calcium intake with a lower incidence of diabetes nephropathy in Japanese patients with T2D. Disclosure: C. Horikawa: None. R. Aida: None. S. Tanaka: None. S. Tanaka: None. C. Kamada: None. Y. Yoshimura: None. A. Araki: Speaker's Bureau; Self; Dainippon Sumitomo Parma Co. Ltd., Merck & Co., Inc., Tanabe Mitsubishi Pharma Corporation. T. Moriya: None. S. Katayama: None. Y. Akanuma: None. H. Sone: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kowa Pharmaceutical Europe Co. Ltd., Kyowa Hakko Kirin Co., Ltd., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. Funding: Japan Society for the Promotion of Science; Japan Ministry of Health, Labour and Welfare [ABSTRACT FROM AUTHOR]

Aim: The present study aimed to examine whether nutrient intakes predicted cognitive decline among elderly patients with diabetes mellitus., Methods: This study evaluated data from a 6-year prospective follow up of 237 elderly patients (aged ≥65 years) with diabetes mellitus, and the associations of baseline nutrient intakes with cognitive decline. Cognitive decline was defined as a ≥2-point decrease in the Mini-Mental State Examination (MMSE) score. Intakes of food and nutrients were assessed using a validated food frequency questionnaire, and were compared between patients with cognitive decline and intact cognition. Analysis of covariance and logistic regression analysis were used to compare the changes in the MMSE score during the follow up among intake tertile groups for each nutrient., Results: Compared with men with intact cognition, the men with cognitive decline had lower baseline intakes of calcium, vitamin A, vitamin B 2 , pantothenate, soluble fiber, green vegetables and milk. However, no significant associations between cognitive decline and nutrient intakes were observed among women. After adjusting for age, body mass index, glycated hemoglobin levels, history of severe hypoglycemia, previous stroke and baseline MMSE score, we found that cognitive decline was significantly associated with low intakes of carotene, vitamin B 2 , pantothenate, calcium and green vegetables. Multiple logistic regression analysis showed that intakes of nutrients and green vegetables predicted cognitive decline after adjusting for age, body mass index, glycated hemoglobin levels, baseline MMSE score, and incident stroke during the follow up., Conclusions: These findings suggest that sufficient intakes of carotene, vitamin B 2 , pantothenate, calcium and vegetables could help prevent cognitive decline among elderly men with diabetes mellitus. Geriatr Gerontol Int 2017; 17: 1168-1175., (© 2016 Japan Geriatrics Society.)

An important factor in medical nutritional therapy for elderly patients with diabetes is optimization of energy intake and macronutrient composition, with consideration of the food source and quality of nutrient. In addition, malnutrition and vitamin deficiency should be carefully considered. A dietary pattern that includes a high intake of vegetables, legumes, seaweed, and fish and a low intake of refined grains, sweets, sugar-sweetened beverages, and alcohol is favorable for diabetic patients. Particular attention should be paid to the excessive intake of sweets and fruits. Furthermore, the type and degree of physical function, cognitive function, lifestyle, social factors, medication, and hospitalization vary among elderly individuals. Therefore, individualized medical nutritional therapy that takes into account all these factors is essential.