Browsing by Subject "energiaravintoaineet"

Introduction: The research on the effect of plant-based diets is needed in order to promote sustainability and to recommend diets containing more plant-based and less animal protein, at population level. Objective: The aim of this thesis was to study how replacing animal protein sources with plant-based protein affects the intake of energy, protein, total fat and saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids and n-3 and n-6 fatty acids, carbohydrates and the dietary fiber. Study compliance was assessed on the basis of protein intake (17 E%). Materials and methods: A 12-week clinical intervention study was carried out at the Department of Food and Environmental sciences in the University of Helsinki in spring 2017. This thesis includes data from 132 participants. The participants were randomized in three different groups which differed in their protein sources (animal versus plant-based protein): Group 1: 70 % of animal and 30 % of plant-based protein; Group 2: 50 % animal and 50 % plant-based protein; Group 3: 30 % animal and 70 % plant-based protein. Participants kept food diary for 4 days, both before the intervention and on the 12th week of the intervention. The differences between the intake of the energy-yielding nutrients were compared between the groups with variance analysis and Bonferroni test, and within the groups with t-test. The compliance was determined based on the intake of protein on 12th week of the intervention. Results: Compared to the baseline, the intake of the protein decreased in group 3 and did not reach 17 E%. In groups 2 and 3 the intake of saturated fatty acids decreased (p<0,001) and the intake of polyunsaturated fatty acids (p<0,001), n-6 (p<0,001) and n-3 fatty acids (G2: p<0,001; G3: p=0,016) increased. The intake of dietary fiber increased in groups 2 and 3 (p<0,001). During the intervention the intake of protein in group 3 (14,3 E%) was lower compared to group 1 (17,6 E%) and group 2 (16,3 E%). Compared to group 1, the intake of n-3 -fatty acids in groups 2 (p=0,004) and 3 (p=0,024) was higher and the differences were statistically significant. There were statistically significant differences in the intake of saturated, polyunsaturated and n-6-fatty acids and dietary fiber between the groups and the differences were statistically significant. The intake of saturated fatty acids was highest in group 1 and lowest in group 3. The intake on polyunsaturated and n-6-fatty acids and dietary fiber was highest in group 3 and lowest in group 1. Conclusions: When animal protein sources were replaced with plant-based protein sources, the intake of dietary fiber and unsaturated fatty acids increased, while the intake of saturated fatty acids and protein decreased. When animal protein sources were replaced with plant-based protein sources, the quality of the diet changed to correspond better to the Finnish nutrition recommendations.

Introduction: The incidence of gestational diabetes (GDM) is rising in the Western world along with the increment in young women’s overweight and obesity rates. GDM poses short- and long-term threats to the health of both mother and child, which in turn might add to the economical burden and cause human suffering. Lifestyle counseling and nutritional management are key to managing adverse outcomes in both the woman with GDM and her unborn child. Objective: The aim of this thesis is to study whether the intake of energy, energy nutrients, and fiber change after the diagnosis of GDM. The changes in intakes of energy, energy nutrients, and fiber are compared between women with GDM and women with normal glucose tolerance. In addition, the changes in energy nutrients and fiber in different food sources are studied and compared between groups. Materials and methods: The study was conducted based on data from the control group in The Finnish gestational diabetes prevention study (RADIEL). RADIEL is a prospective, randomized, controlled intervention that was carried out in 2008–2014, and in which women at high risk of GDM pregnant in the first half of pregnancy or planning pregnancy were enrolled. The control group received usual care at antenatal clinics. The data was collected before the initiation of this thesis. Study participants with 3-day food record data from both the first and the third trimester of pregnancy were eligible for this study (n=111). GDM was diagnosed by a 75 g oral glucose tolerance test in 22 of the participants in 22–28 weeks of gestation. Of the participants, 89 remained healthy by their glucose metabolism. The differences between women with GDM and women with normal glucose tolerance were tested using a t-test for normally distributed variables, and Mann-Whitney U test, χ2 test or Fisher’s exact test for non-normally distributed variables. Analysis of covariance was used to test the differences in change in intake of energy, energy nutrients, and fiber between the first and third trimester. GDM, previous GDM, age, body mass index (BMI), education in years, and the intake of the nutrient at baseline (first trimester) were used as covariates. Results: The women with GDM had significantly lower prepregnancy BMI (p=0.025) and a history of GDM (p=0.011) was more common among them compared to women with normal glucose tolerance. Moreover, at baseline, their fasting insulin (p=0.033) and HOMA-IR (p=0.041) were lower and their HbA1c (p=0.038) higher than that of the women with normal glucose tolerance. The intake of energy, and energy nutrients and fiber in relation to energy did not differ between groups (p>0.05). However, as compaired to women with normal glucose tolerance, women with GDM reduced their intake of carbohydrates (adj. p=0.002) and sucrose (adj. p=0.002), and increased their intake of fat (adj. p=0.037) and fiber (adj. p=0.002) in relation to energy from the first trimester to the third. In food sources, the only difference between groups regarded the change of fiber (p=0.049) in relation to the total intake of fiber; this was seen in the food source of bread and flour, in which the proportion of fiber increased in women with GDM. Conclusions: The dietary intake changes significantly differently between women with GDM and women with normal glucose tolerance in regards of carbohydrate, fat, sucrose, and fiber. In women with GDM, the changes in beforementioned nutrients are in line with the Current Care Guidelines of GDM, with the exception of fiber that still changes towards the guidelines. The proportion of fiber changes differently between groups in the food source of bread and flour. Nutrition management of GDM should focus more on the importance of fiber and the composition of fatty acids in the diet, but it should also focus on increasing the proportion of protein to optimize the intake of carbohydrates and fat. The fact that women with GDM in this study had a relatively low energy intake from carbohydrates and a high energy intake from fat, raises the possible need to study how this affects the blood glucose and body composition of the child.