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Wikstrom K.,Finnish National Institute for Health and Welfare | Lindstrom J.,Finnish National Institute for Health and Welfare | Tuomilehto J.,Finnish National Institute for Health and Welfare | Tuomilehto J.,Danube University Krems | And 12 more authors.
Public Health

Objectives: The national development programme for the prevention and care of diabetes was carried out in Finland during 2000-2010. One of the programme goals was to raise awareness of diabetes and its risk factors in the whole population through various activities, e.g. media campaigns and health fares. In addition, a targeted implementation project on the prevention of type 2 diabetes, FIN-D2D, was carried out in selected districts during 2003-2008. The aim of this analysis was to examine the changes in overall awareness of the programme and its association with self-reported lifestyle changes within the adult population during the FIN-D2D project period in the FIN-D2D area compared with the area not participating in the FIN-D2D (the control area). Study design: Health behaviour and health among the Finnish Adult Population -postal Methods: The structured questionnaire mailed to a random population sample included questions on participants' sociodemographic background, medical history, health habits, and recent lifestyle changes. Awareness of the national diabetes programme was also enquired. Data (n=10 831) from the 2004-2008 postal surveys were used for this investigation. Results: In the FIN-D2D area, 25% (347/1384) of men and 48% (797/1674) of women reported being aware of the programme. In the control area, the proportions were 20% (702/3551) and 36% (1514/4222), respectively. The overall awareness increased among both genders and in all areas during the project period, but the level of awareness was consistently higher in the FIN-D2D area. Female gender and higher age were associated with increasing awareness of the programme in both areas. Self-reported lifestyle changes were more common among women, but associated with the level of awareness of the programme more often among men than women. Conclusions: The awareness of diabetes and its risk factors increased among men and women in both implementation and control areas during the FIN-D2D project period. The activities of the implementation project may at least partly explain the differences in lifestyle changes between areas, especially among men. The results suggest that health promotion campaigns increase the population awareness about the prevention of chronic diseases and as a result, especially men may be prompted to make beneficial lifestyle changes. © 2015 The Royal Society for Public Health. Source

Lappi J.,Food and Health Research Center | Selinheimo E.,VTT Technical Research Center of Finland | Schwab U.,Food and Health Research Center | Schwab U.,Kuopio University Hospital | And 6 more authors.
Journal of Cereal Science

Glycemic responses to most of the conventional breads are high, including breads made of wholemeal flour. Baking technology is known to affect these responses. The aim of the present study was to investigate effects of xylanase enzyme treatment and sourdough fermentation in wholemeal wheat bread baking on postprandial glucose and insulin responses and on in vitro protein digestibility. The wheat breads were made of 100% flour from peeled kernels by a straight dough or sourdough fermentation method, and with or without using xylanase during mixing of dough. Standard white wheat bread was used as a reference. All test bread portions contained 50 g available carbohydrate and were served in random order to eleven insulin resistant subjects. Blood samples for measuring glucose and insulin concentrations were drawn over 4 h. The sourdough wholemeal wheat bread resulted in the lowest postprandial glucose and insulin responses among the four tested breads (treatment × time; p = 0.000 and p = 0.022, respectively). There were differences in solubility and depolymerisation of protein and arabinoxylan among the breads but these did not fully explain the in vivo findings. In conclusion, the health effects of wholemeal wheat bread can be further improved by using sourdough process in breadmaking. © 2009 Elsevier Ltd. All rights reserved. Source

Lankinen M.,VTT Technical Research Center of Finland | Lankinen M.,University of Eastern Finland | Schwab U.,University of Eastern Finland | Schwab U.,Kuopio University Hospital | And 14 more authors.
Nutrition, Metabolism and Cardiovascular Diseases

Background and aims: Whole-grain cereals and diets with a low glycemic index may protect against the development of type 2 diabetes and heart disease, but the mechanisms are poorly understood. We studied the effect of carbohydrate modification on serum metabolic profiles, including lipids and branched chain amino acids, and dependencies between these and specific gene expression pathways in adipose tissue. Methods and results: Twenty subjects with metabolic syndrome were selected from the larger FUNGENUT study population, randomized either to a diet high in oat and wheat bread and potato (OWP) or rye bread and pasta (RP). Serum metabolomics analyses were performed using ultra-performance liquid chromatography coupled to electrospray ionization mass spectrometry (UPLC/MS), gas chromatography (GC) and UPLC. In the OWP group multiple proinflammatory lysophosphatidylcholines increased, while in the RP group docosahexaenoic acid (DHA 22:6n-3) increased and isoleucine decreased. mRNA expression of stress reactions- and adipose tissue differentiation-related genes were up-regulated in adipose tissue in the OWP group. In the RP group, however, pathways related to stress reactions and insulin signaling and energy metabolism were down-regulated. The lipid profiles had the strongest association with the changes in the adipose tissue differentiation pathway when using the elastic net regression model of the lipidomic profiles on selected pathways. Conclusion: Our results suggest that the dietary carbohydrate modification alters the serum metabolic profile, especially in lysoPC species, and may, thus, contribute to proinflammatory processes which in turn promote adverse changes in insulin and glucose metabolism. © 2009 Elsevier B.V. All rights reserved. Source

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