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The paper is a review of current research on phytochemicals and how they may alleviate type 2 diabetes by improving insulin activity in the body.

Literature searches were conducted to find a link between common household spices and type 2 diabetes. Only common household spices were researched so that any link found between spices and type 2 diabetes could lead to practical home‐based recommendations for changes in a person's diet.

Cinnamon, garlic, ginger, basil, oregano, nutmeg, tea, bay leaf, allspice, curry, and others were found to play a role in lowering blood glucose, increasing insulin sensitivity, and increasing glucose synthesis in response to food intake. In addition, these spices may improve blood circulation, decrease platelet aggregation, lower blood pressure, and act as blood vessel protectants, ameliorating the cardiovascular disease often associated with type 2 diabetes. To gain these benefits, only average amounts commonly used in foods are necessary, such as amounts usually sprinkled in foods or amounts used in recipes. At high concentrated doses, the advantages to utilizing spices may be inhibited.

The findings that phytochemicals in common household spices can improve insulin activity in the body present a more natural way to possibly treat and prevent type 2 diabetes.

The downstream insulin signaling, such as phosphatidylinositol-3-kinase (PI3K)/protein kinase B (Akt) pathway, is an important step for skeletal glucose disposal through the translocation of glucose transporter (GLUT)-4. In addition, the master of energy regulator adenosine monophosphate-activated kinase (AMPK) is also involved in GLUT-4 translocation, independent from the PI3K/Akt pathway. Fermented cassava tuber or gatot is a traditional food from Indonesia with antihyperglycemic properties. However, the molecular mechanism leading to this effect is unclear. Therefore, this paper aims to evaluate whether the antidiabetic activity of gatot is through PI3K/Akt dependent or AMPK pathway.

Diabetes mellitus was induced in 20 male Wistar rats by intraperitoneal injection of 65 mg/kg body weight streptozotocin and 230 mg/kg body weight nicotinamide. Diabetic rats were randomly allocated into four groups; negative control, positive control (metformin 100 mg/kg body weight), fermented cassava diet replacing 50% of carbohydrate (FC-50) and 100% of carbohydrate (FC-100) in the diet. Serum glucose, insulin and lipid profile were analyzed before and after four weeks of intervention. Genes expression of PI3K subunit alpha, PI3K subunit beta, PI3K regulatory subunit, Akt and AMPK were analyzed using real time polymerase chain reaction (PCR). GLUT-4 protein expression was performed using immunohistochemistry.

There is a significant difference (p = 0.000) in serum glucose, insulin, total cholesterol, triglyceride, high density lipoprotein (HDL)-cholesterol and LDL-cholesterol between groups. Skeletal AMPK gene expression was higher and significantly different between FC-100 (p = 0.006) and healthy control groups. No significant difference was observed in the messenger ribonucleic acid (mRNA) expression of the PI3K/Akt pathway among groups. GLUT-4 expression was highly expressed in a positive control group followed by FC-100.

This paper did not characterize the bioactive component that is responsible for increasing mRNA expression of AMPK. This paper also did not analyze the phosphorylation of PI3K/Akt and AMPK that are important in activating the protein.

To the best of the authors’ knowledge, this is the first study that showed the antidiabetic activity of traditional fermented food is through AMPK-dependent activity.

The purpose of this paper is to provide a comprehensive summary of the effect of different dietary approaches on polycystic ovary syndrome (PCOS).

This review represents the history of PCOS, the symptoms, diagnosis, and treatment. It also includes up‐to‐date research articles on different types of diets that have been shown some promising effects in the treatment of PCOS.

PCOS is nowadays considered the most common endocrine abnormality, with a range of 4‐12 per cent of women affected by the syndrome. It has been proven that diet, in addition to exercise and medication, plays an important role in the treatment of PCOS. The proper dietary approach for women with PCOS should focus on the PCOS symptoms and also improve weight loss, increase fertility, and decrease risks of cardiovascular diseases.

This paper provides accessible and comprehensive information on PCOS (since its discovery in 1935) to researchers, nutritionists, and women with PCOS who are interested in the effect of the diet on PCOS management.

The purpose of this review is to provide a comprehensive summary, for both experts and non‐experts, of new findings on interactions among diet, genes, and exercise in determining the risk for chronic disease.

The present review focuses on the key role of exercise in modulating the ratio of muscle fiber types and the resulting effects on overall health.

Exercise and a diet rich in omega‐3 (n‐3) fatty acids modulate human gene expression and lower the risk for chronic disease. Emerging evidence, synthesized here, shows that a family of gene regulatory proteins, the PPAR (peroxisome proliferator‐activated receptor) transcription factor family, regulates the synthesis of human muscle fibers and thereby affects glucose metabolism and the risk for obesity, diabetes, and heart disease. Dietary fatty acids, in particular n‐3 polyunsaturated fatty acids, act on PPAR family members, and thereby enhance the synthesis of specific muscle fiber types. Human muscle fibers contain a heterogeneous mix of slow‐oxidative, fast‐oxidative, and fast‐glycolytic muscle fibers. At the extremes of the spectrum, low‐oxidative fibers, important for endurance activities, rely on a complete oxidation of sugars as well as fats for energy, and are associated with high insulin sensitivity. In contrast, fast‐glycolytic fibers, important for short, intense exercise, predominantly use a quick, but only partial breakdown of sugars (glycolysis) for energy. Not surprisingly, sprinters have more fast‐glycolytic fibers, while endurance athletes have more slow‐oxidative fibers. The relative ratio of these different fiber types, in part genetically fixed and in part respondent to diet and exercise, determines not only what type of activities an individual performs best, but also affects the risk for chronic disease. Recent research has identified correlations between muscle fiber type and PPAR type as well as between even modest levels of endurance training and a lowering of the risk for insulin resistance, obesity, diabetes, and heart disease.

This review synthesizes recently discovered mechanisms into a framework supporting the conclusion that even moderate levels of endurance exercise, combined with a sufficient intake of n‐3 fatty acids, lower the risk for chronic disease.

This article provides accessible and comprehensive information to researchers, nutritionists, and consumers who are interested in using lifestyle management (such as exercise and diet) to lower the risk for chronic disease.

The purpose of this systematic review and meta-analysis was to investigate the efficacy of propolis on glycemic indices in type 2 diabetic patients.

Web of science (ISI), Embase, Scopus and PubMed were systematically searched to find randomized controlled trials (RCTs) assessing the effects of propolis intake on glycemic controls in type 2 diabetic patients, from inception up to September 1, 2020. A random-effects model was used to pool weighted mean difference (WMD). Meta-regression was performed to detect the potential sources of inter-study heterogeneity.

Seven trials were included in the meta-analysis. Compared to controls, propolis intake significantly improved serum fasting blood sugar (FBS) (WMD = −13.62 mg/dl, 95% CI = [−23.04, −4.20], P = 0.005, I2 = 58.5%) and hemoglobin A1C (HbA1c) (WMD = −0.52%, 95% CI = [−0.86, −0.18], P = 0.002, I2 = 64.0%). In contrast, receiving propolis did not change serum insulin (WMD = −1.46 (uIU/ml), 95% CI = [−2.94, 0.02], P = 0.05, I2 = 75.0%) and homeostatic model assessment for insulin resistance (HOMA-IR) (WMD = −0.98 (%), 95% CI = [−2.00, 0.04], P = 0.06, I2 = 82.3%) compared to controls.

The present meta-analysis demonstrated that propolis intake significantly reduces serum FBS and HbA1c in diabetic patients but does not alter serum insulin and HOMA-IR. Further large-scale RCT’s are needed to approve these effects.

Many foods naturally contain dietary Cr, but lost during processing and cooking. Type 2 diabetes mellitus (T2DM) has been associated with poor glycemic control and low Cr status. The objectives of the current study were to evaluate the dietary Cr intake and its relationship with diabetes risk factors in moderately obese subjects with T2DM.

Thirty‐six subjects (age: 26–65 years) were recruited through local advertisements. Subjects were taking stable doses of oral antidiabetic medication(s) excluding concomitant insulin. Subjects had HbA1c ≥7 per cent, persistent impaired glucose control (2 hour glucose >200 mg dL⁻¹) and at least a one‐year history of T2DM. Demographic characteristics, blood pressure, body mass index (BMI), family and medical history were recorded. Three‐day dietary intakes were collected and evaluated for Cr and nutrient content using Nutritionist V software. Plasma glucose, circulating insulin and lipid profile were analyzed. Homeostatic model assessment insulin resistance (IR), beta cell function (BCF) and derived ratios were calculated. Morning void urinary chromium levels were also measured.

It was observed that mean dietary Cr intake of adults (30 mcg) was below the suggested recommended daily intake (RDI) of 120 mcg day⁻¹. These estimates correspond to approximately 16.4 μg Cr per 1000 Kcals. A significant correlation was observed between dietary Cr and fasting insulin (p<0.05), total‐C (p<0.05), LDL‐C (p<0.01), triglycerides (p<0.05), BCF (p<0.05), TG/HDL‐C ratio (p<0.01), HOMA BCF (p<0.05) and with atherogenic index in plasma (p<0.05).

In this study, the consumption of chromium is less than the RDI. Overall the results suggest that the US diets are inadequate in the essential metal chromium. Further studies are required to explore the relationship of Cr absorption with dietary Cr intake and risk factors in T2DM.

This study aims to examine whether Globularia alypum (Ga) lyophilized aqueous leaves extract treatment improves cardiometabolic syndromes such as hyperglycemia, lipid profiles and oxidative damage resulting from a high-fructose diet induced in hypertriglyceridemic rats.

A total of 24 male Wistar rats weighing 80 ± 5 g were first randomly divided into 2 groups. A total of 12 control rats (C) were fed a standard-diet (St-D) and 12 high fructose (HF) rats were fed a high-fructose diet (HF-D) containing St-D in which cornstarch was substituted by fructose (61.4%). After 15 weeks of feeding, body weight (BW) was about 320 ± 20 g and hypertriglyceridemia was noted in HF vs C group (2.69 ± 0.49 mmol/L) vs (1.25 ± 0.33 mmol/L). Each group of rats was then divided into two equal groups (n = 6) and fed during four weeks either a St-D or HF-D, treated or not with 1% of Ga extract (C-Ga) and (HF-Ga). After 28 days, fasting rats were anesthetized and blood and tissues were removed to measure biochemical parameters.

The results showed no significant differences in BW and insulinemia between all groups. Ga extract supplementation reduced glycemia (−36%), glycosylated hemoglobin (−37%), Homeostasis Model of Assessment-Insulin Resistance index (−34%) and triacylglycerol’s contents in plasma (−33%), very low density lipoproteins–low density lipoproteins (VLDL-LDL) (−48%), liver (−52%) and aorta (−39%); total cholesterol concentrations in aorta was 3.7-fold lower in HF-Ga vs HF group. Ga treatment reduced lipid peroxidation in plasma, VLDL-LDL, red blood cells (RBC), liver, muscle and kidney by improving superoxide dismutase (SOD) activity and glutathione peroxidase (GPx) in RBC and catalase (CAT) activity in kidney (p < 0.05). Moreover, Ga ameliorates glutathione (GSH) production in RBC (+41%) and kidney tissues (+35%).

Ga extract ameliorated cardiometabolic syndrome by its hypotriglyceridemic effect and prevented development of insulin resistance. It reduces lipid peroxidation by enhancing non-enzymatic (GSH) and enzymatic (SOD, GPx and CAT) antioxidant defense systems in high-fructose hypertriglyceridemic rats. Therefore, supplementation of Ga leaves extract as an adjuvant could be used for the treatment of hypertriglyceridemia and the prevention and/or the management of cardio-metabolic adverse effects.

The aim of the present study was to investigate the association of the empirical dietary index for insulin resistance (EDIR) and empirical lifestyle index for insulin resistance (ELIR) with the risk of nonalcoholic fatty liver disease (NAFLD) in Iranian adults.

In this case-control study, 120 cases of NAFLD and 240 controls aged ≥20 years were included. NAFLD was detected by a gastroenterologist using an ultrasonography test. The food frequency questionnaire was used to collect nutritional data and determine the score of EDIR in participants. ELIR was determined based on body mass index, physical activity and dietary pattern. The odds ratios (ORs) of NAFLD were reported across tertiles of EDIR and ELIR using a logistic regression test.

The mean±SD age and BMI of subjects were 41.8 ± 7.5 years and 27.4 ± 2.2 kg/m², respectively. In the age and sex-adjusted model, the odds of NAFLD were increased across tertiles of ELIR (OR = 3.00; 95% CI: 1.63–5.55, P_trend = 0.001). Also, based on the fully adjusted model, the odds of NAFLD were increased according to tertiles of ELIR (OR = 2.66; 95% CI: 1.38–5.10, P_trend = 0.006). However, no significant association was found between the higher score of EDIR and odds of NAFLD based on the age and sex-adjusted model (OR = 1.18; 95% CI: 0.68–2.05, P_trend = 0.52) and the multivariable-adjusted model (OR = 0.91; 95% CI: 0.48–1.70, P_trend = 0.87).

To the best of the authors’ knowledge, this was the first study to examine the role of the insulinemic potential of diet and lifestyle in predicting NAFLD risk. Our findings suggested that a lifestyle with a higher score of ELIR was positively associated with NAFLD risk. However, a diet with a higher score of EDIR was not related to the odds of NAFLD.

A summary of papers given at a recent conference on this topic

We investigate how career disruptions in terms of job loss may impact morbidity for individuals diagnosed with type 2 diabetes (T2D). Combining unique, high-quality longitudinal data from the Swedish National Diabetes Register (NDR) with matched employer–employee data, we focus on individuals diagnosed with T2D, who are established on the labor market and who lose their job in a mass layoff. Using a conditional difference-in-differences evaluation approach, our results give limited support for job loss having an impact on health behavior, diabetes progression, and cardiovascular risk factors.