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Quagliariello V, Berretta M, Bisceglia I, Giacobbe I, Iovine M, Barbato M, Maurea C, Canale ML, Paccone A, Inno A, Scherillo M, Oliva S, Cadeddu Dessalvi C, Mauriello A, Fonderico C, Maratea AC, Gabrielli D, Maurea N. In the Era of Cardiovascular-Kidney-Metabolic Syndrome in Cardio-Oncology: From Pathogenesis to Prevention and Therapy. Cancers (Basel) 2025; 17:1169. [PMID: 40227756 PMCID: PMC11988012 DOI: 10.3390/cancers17071169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2025] [Revised: 03/21/2025] [Accepted: 03/27/2025] [Indexed: 04/15/2025] Open
Abstract
Cardiovascular-kidney-metabolic (CKM) syndrome represents a complex interplay between cardiovascular disease (CVD), chronic kidney disease (CKD), and metabolic disorders, significantly impacting cancer patients. The presence of CKM syndrome in cancer patients not only worsens their prognosis but also increases the risk of major adverse cardiovascular events (MACE), reduces quality of life (QoL), and affects overall survival (OS). Furthermore, several anticancer therapies, including anthracyclines, tyrosine kinase inhibitors, immune checkpoint inhibitors, and hormonal treatments, can exacerbate CKM syndrome by inducing cardiotoxicity, nephrotoxicity, and metabolic dysregulation. This review explores the pathophysiology of CKM syndrome in cancer patients and highlights emerging therapeutic strategies to mitigate its impact. We discuss the role of novel pharmacological interventions, including sodium-glucose cotransporter-2 inhibitors (SGLT2i), proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i), and soluble guanylate cyclase (sGC) activators, as well as dietary and lifestyle interventions. Optimizing the management of CKM syndrome in cancer patients is crucial to improving OS, enhancing QoL, and reducing MACE. By integrating cardiometabolic therapies into oncologic care, we can create a more comprehensive treatment approach that reduces the burden of cardiovascular and renal complications in this vulnerable population. Further research is needed to establish personalized strategies for CKM syndrome prevention and treatment in cancer patients.
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Affiliation(s)
- Vincenzo Quagliariello
- Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy
| | - Massimiliano Berretta
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| | - Irma Bisceglia
- Servizi Cardiologici Integrati, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliera San Camillo Forlanini, 00148 Rome, Italy
| | - Ilaria Giacobbe
- Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy
| | - Martina Iovine
- Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy
| | - Matteo Barbato
- Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy
| | - Carlo Maurea
- ASL NA1, UOC Neurology and Stroke Unit, Ospedale del Mare, 23807 Naples, Italy
| | | | - Andrea Paccone
- Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy
| | - Alessandro Inno
- Medical Oncology, IRCCS Ospedale Sacro Cuore Don Calabria, 37024 Negrar di Valpolicella, Italy
| | - Marino Scherillo
- Cardiologia Interventistica e UTIC, A.O. San Pio, Presidio Ospedaliero Gaetano Rummo, 82100 Benevento, Italy
| | - Stefano Oliva
- Cardio-Oncology Unit, IRCCS Istituto Tumori, “Giovanni Paolo II”, 70124 Bari, Italy
| | | | - Alfredo Mauriello
- Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy
| | - Celeste Fonderico
- Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy
| | - Anna Chiara Maratea
- Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy
| | - Domenico Gabrielli
- U.O.C. Cardiologia, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliera San Camillo Forlanini, 00152 Rome, Italy
| | - Nicola Maurea
- Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy
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Abstract
Evolutionary perspectives have yielded profound insights in health and medical sciences. A fundamental recognition is that modern diet and lifestyle practices are mismatched with the human physiological constitution, shaped over eons in response to environmental selective pressures. This Darwinian angle can help illuminate and resolve issues in nutrition, including the contentious issue of fat consumption. In the present paper, the intake of saturated fat in ancestral and contemporary dietary settings is discussed. It is shown that while saturated fatty acids have been consumed by human ancestors across time and space, they do not feature dominantly in the diets of hunter-gatherers or projected nutritional inputs of genetic accommodation. A higher intake of high-fat dairy and meat products produces a divergent fatty acid profile that can increase the risk of cardiovascular and inflammatory disease and decrease the overall satiating-, antioxidant-, and nutrient capacity of the diet. By prioritizing fiber-rich and micronutrient-dense foods, as well as items with a higher proportion of unsaturated fatty acids, and in particular the long-chain polyunsaturated omega-3 fatty acids, a nutritional profile that is better aligned with that of wild and natural diets is achieved. This would help prevent the burdening diseases of civilization, including heart disease, cancer, and neurodegenerative conditions. Saturated fat is a natural part of a balanced diet; however, caution is warranted in a food environment that differs markedly from the one to which we are adapted.
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Affiliation(s)
- Eirik Garnås
- Institute of Health, Oslo New University College, Ullevålsveien 76, Oslo, 0454, Norway.
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Yılmaz ST, Elma Ö, Malfliet A, Nijs J, Clarys P, Coppieters I, Mertens E, Naert E, Calders P, Devoogdt N, De Groef A, Deliens T. Postprandial glycaemic response and pain sensitivity in breast cancer survivors suffering from chronic pain: a double-blind, randomised controlled cross-over pilot experiment. Support Care Cancer 2025; 33:103. [PMID: 39820733 DOI: 10.1007/s00520-024-09117-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2024] [Accepted: 12/18/2024] [Indexed: 01/19/2025]
Abstract
INTRODUCTION The study's primary goal is to investigate differences in postprandial glycaemic response (PPGR) to beverages with varying glycaemic index (i.e. low and medium) between breast cancer survivors (BCS) with chronic pain and healthy pain-free controls (HC). The secondary goal of the study is to investigate the potential link between PPGR and pain-related outcomes in BCS with chronic pain. METHODS In this study, 15 BCS and 15 HC were included. After 12 h of fasting, subjects were randomised between drinking a beverage made with 50 g of sucrose (medium) or isomaltulose (low) within 250 ml water. Blood glucose levels were monitored at fasting as well as at 15, 30, 45, 60, 90 and 120 min following beverage consumption. Furthermore, each participant was evaluated using several experimental pain measurements, including pressure pain thresholds (PPT), electrical detection threshold, electrical pain threshold, temporal summation and electrical offset analgesia (OA). RESULTS The BCS group had significantly higher PPGR to sucrose (p = .001) than the HC group. Furthermore, when PPGR to sucrose was compared to PPGR to isomaltulose within the groups, the BCS group showed a considerably larger difference (p = .012). Additionally, correlation analyses indicated both positive and negative associations between PPGR after sucrose intake and specific pain measurements (PPT-tibialis (r = .599), OA (rs = - .549), respectively) in BCS, and a positive association between the difference in PPGR between sucrose and isomaltulose and PPT-tibialis (r = .622). CONCLUSION These findings suggest that medium glycaemic index beverage intakes result in significantly higher blood glucose responses (i.e. PPGR) than low-glycaemic index beverage intakes in BCS. Additionally, BCS show an impaired glycaemic response to medium glycaemic index beverage intake and that the impaired glycaemic response might be related to pain sensitivity and endogenous analgesia in BCS. Furthermore, the higher glycaemic response to sucrose and greater difference in the amount of change in PPGR (when isomaltulose was substituted for sucrose) compared to HC highlight the importance of understanding how dietary choices with a lower glycaemic index can alter glycaemic regulation in BCS with chronic pain.
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Affiliation(s)
- Sevilay Tümkaya Yılmaz
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103 - 1090, Brussels, Belgium.
- Pain in Motion International Research Group, www.paininmotion.be, Brussels, Belgium.
| | - Ömer Elma
- Pain in Motion International Research Group, www.paininmotion.be, Brussels, Belgium
- Department of Rehabilitation and Sport Sciences, Faculty of Health and Social Sciences, Physiotherapy Unit, Bournemouth University, Bournemouth, UK
| | - Anneleen Malfliet
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103 - 1090, Brussels, Belgium
- Pain in Motion International Research Group, www.paininmotion.be, Brussels, Belgium
- Research Foundation Flanders (FWO), Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103 - 1090, Brussels, Belgium
- Pain in Motion International Research Group, www.paininmotion.be, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Peter Clarys
- Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Pleinlaan 2 - 1050, Brussels, Belgium
| | - Iris Coppieters
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103 - 1090, Brussels, Belgium
- Pain in Motion International Research Group, www.paininmotion.be, Brussels, Belgium
- Experimental Health Psychology Research Group, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- The Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), Louvain, KU, Belgium
| | - Evelien Mertens
- Department of Health Care, Design and Technology, Nutrition and Dietetics Program, Erasmushogeschool Brussel, Brussels, Belgium
| | - Eline Naert
- Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - Patrick Calders
- Department of Rehabilitation Sciences, UGhent- Ghent University, Ghent, Belgium
| | - Nele Devoogdt
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Louvain, Belgium
- Center for Lymphedema, Department of Vascular Surgery and Department of Physical Medicine and Rehabilitation, UZ Leuven, Louvain, Belgium
| | - An De Groef
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Louvain, Belgium
- Department of Rehabilitation Sciences, MOVANT Research Group, Antwerp University, Antwerp, Belgium
| | - Tom Deliens
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103 - 1090, Brussels, Belgium.
- Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Pleinlaan 2 - 1050, Brussels, Belgium.
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Kripp AM, Feichter A, König D. A low-carbohydrate, high-fat diet leads to unfavorable changes in blood lipid profiles compared to carbohydrate-rich diets with different glycemic indices in recreationally active men. Front Nutr 2024; 11:1473747. [PMID: 39483781 PMCID: PMC11526123 DOI: 10.3389/fnut.2024.1473747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Accepted: 10/07/2024] [Indexed: 11/03/2024] Open
Abstract
Objective In addition to recent discussions of low-carbohydrate, high-fat diets (LCHF) from a performance perspective, there is a paucity of knowledge regarding influence of the combined effect of an exercise and nutritional intervention, which varies in carbohydrate (CHO) intake and glycemic indices, on blood lipid levels in recreationally active men. Methods A total of 65 male runners (VO2 peak = 55 ± 8 mL·min-1·kg-1) completed a 10-week ad libitum nutritional regimen (LOW-GI: ≥ 65% low GI CHO per day, n = 24; HIGH-GI: ≥ 65% high GI CHO per day, n = 20; LCHF: ≤ 50 g CHO daily, n = 21) with a concurrent prescribed endurance training intervention. Fasting total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were determined before and after the intervention. Additionally, 24-h dietary recalls were completed twice weekly. Results Following the intervention, TC was significantly higher in LCHF (196 ± 37 mg·dL-1) compared to both LOW-GI (171 ± 41 mg·dL-1) and HIGH-GI (152 ± 28 mg·dL-1, p < 0.001). Additionally, LDL-C levels increased in LCHF (+17 ± 21 mg·dL-1, p = 0.001), while they decreased in both CHO groups (p < 0.05, respectively). Only the HIGH-GI group demonstrated a significant reduction in HDL-C (-3 ± 9 mg·dL-1, p = 0.006), while a decrease in TG was only significant in LOW-GI (-18 ± 36 mg·dL-1, p = 0.008). Conclusion Although mean blood lipid levels remained within the normal range, the data indicate that a low-carbohydrate, high-fat (LCHF) diet leads to unfavorable changes in individual blood lipid profiles compared to carbohydrate-rich diets. Therefore, it is recommended that the impact of a low-carbohydrate diet on blood lipids be considered when counseling active and healthy individuals.
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Affiliation(s)
- Anna Maria Kripp
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
- Vienna Doctoral School of Pharmaceutical, Nutritional, and Sport Sciences, University of Vienna, Vienna, Austria
- Department of Sport Science, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
| | - Andreas Feichter
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Daniel König
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
- Department of Sport Science, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
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Di Maso M, Augustin LSA, Jenkins DJA, Crispo A, Toffolutti F, Negri E, La Vecchia C, Ferraroni M, Polesel J. Adherence to a Cholesterol-Lowering Diet and the Risk of Pancreatic Cancer: A Case-Control Study. Nutrients 2024; 16:2508. [PMID: 39125388 PMCID: PMC11314520 DOI: 10.3390/nu16152508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/24/2024] [Accepted: 07/29/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Pancreatic cancer risk has been associated with increased serum cholesterol level, which is in turn partially influenced by diet. This study aimed at evaluating the association between pancreatic cancer risk and the adherence to a plant-based cholesterol-lowering diet. METHODS Data were derived from an Italian case-control study including 258 pancreatic cancer patients and 551 controls. The cholesterol-lowering diet score was based on seven components: high intakes of (i) non-cellulosic polysaccharides (a proxy of viscous fibers), (ii) monounsaturated fatty acids, (iii) legumes, and (iv) seeds/corn oils (a proxy of phytosterols); and low intakes of (v) saturated fatty acids, (vi) dietary cholesterol, and (vii) food with a high glycemic index. The score was calculated adding one point for each fulfilled component, thus ranging from zero (no adherence) to seven (complete adherence). The odds ratios (ORs) and 95% confidence intervals (CIs) were estimated through the logistic regression model. RESULTS Scores 5-7 were associated with reduced cancer risk (OR = 0.30; 95% CI: 0.18-0.52) compared to scores 0-2. CONCLUSIONS Adherence to a plant-based cholesterol-lowering diet was associated with a reduced risk of pancreatic cancer.
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Affiliation(s)
- Matteo Di Maso
- Department of Clinical Sciences and Community Health, Department of Excellence 2023–2027, Branch of Medical Statistics, Biometry and Epidemiology “G.A. Maccacaro”, Università degli Studi di Milano, via Celoria 22, 20133 Milan, Italy; (M.D.M.); (M.F.)
| | - Livia S. A. Augustin
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS—“Fondazione G. Pascale”, via M. Semmola 1, 80131 Naples, Italy; (L.S.A.A.); (A.C.)
| | - David J. A. Jenkins
- Departments of Nutritional Science and Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada;
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael’s Hospital, Toronto, ON M5C 2T2, Canada
- Division of Endocrinology and Metabolism, Department of Medicine, St. Michael’s Hospital, Toronto, ON M5C 2T2, Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5C 2T2, Canada
| | - Anna Crispo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS—“Fondazione G. Pascale”, via M. Semmola 1, 80131 Naples, Italy; (L.S.A.A.); (A.C.)
| | - Federica Toffolutti
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, via F. Gallini 2, 33081 Aviano, Italy; (F.T.); (J.P.)
| | - Eva Negri
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, Università di Bologna, via P. Palagi 9, 40138 Bologna, Italy;
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Department of Excellence 2023–2027, Branch of Medical Statistics, Biometry and Epidemiology “G.A. Maccacaro”, Università degli Studi di Milano, via Celoria 22, 20133 Milan, Italy; (M.D.M.); (M.F.)
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health, Department of Excellence 2023–2027, Branch of Medical Statistics, Biometry and Epidemiology “G.A. Maccacaro”, Università degli Studi di Milano, via Celoria 22, 20133 Milan, Italy; (M.D.M.); (M.F.)
- Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, via F. Sforza 35, 20122 Milan, Italy
| | - Jerry Polesel
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, via F. Gallini 2, 33081 Aviano, Italy; (F.T.); (J.P.)
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Dong Y, Guo Y, Li Q, Zhao Y, Cao J. Soluble dietary fiber from Dendrocalamus brandisii (Munro) Kurz shoot improves liver injury by regulating gut microbial disorder in mice. Food Chem X 2024; 22:101472. [PMID: 38808162 PMCID: PMC11130687 DOI: 10.1016/j.fochx.2024.101472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/10/2024] [Accepted: 05/13/2024] [Indexed: 05/30/2024] Open
Abstract
Bamboo shoot has long been regarded as a nutritious and healthy food. It is low in calorie and rich in high-quality dietary fiber (DF), making them a potential DF resource. However, the protective mechanism of soluble dietary fibers from Dendrocalamus brandisii (Munro) Kurz shoot (DS-SDF) on methionine and choline deficient (MCD) diet-induced non-alcoholic fatty liver disease (NAFLD) is still unclear. This study was aimed to investigate the regulation of DS-SDF on gut microbiota in MCD diet-induced mice and its potential protective effect on liver injury. The NAFLD model was induced by the MCD diet for 8 weeks. Through observation of changes in liver function and gut microorganisms, it was found that DS-SDF supplementation could inhibit liver inflammation, improve liver injury, regulate the diversity of gut microorganisms, increase the abundance of beneficial bacteria and short-chain fatty acid-producing bacteria, and reverse the gut disorders induced by the MCD diet in mice. This study showed that DS-SDF supplementation could treat NAFLD by regulating gut microbiota composition, improving liver function, and inhibiting the inflammatory response. It might broaden the idea of high-value utilization of DS-SDF.
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Affiliation(s)
- Yufan Dong
- Faculty of Food Science and Engineering, Kunming University of Science and Technology, Kunming, China
- Institute of Forestry Industry, Yunnan, Academy of forestry and grassland, Kunming, China
| | - Yuhong Guo
- Institute of Forestry Industry, Yunnan, Academy of forestry and grassland, Kunming, China
| | - Qin Li
- Institute of Forestry Industry, Yunnan, Academy of forestry and grassland, Kunming, China
| | - Yihe Zhao
- Institute of Forestry Industry, Yunnan, Academy of forestry and grassland, Kunming, China
| | - Jianxin Cao
- Faculty of Food Science and Engineering, Kunming University of Science and Technology, Kunming, China
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Castro-Quezada I, Núñez-Ortega PE, Flores-Guillén E, García-Miranda R, Irecta-Nájera CA, Solís-Hernández R, Medina-Gómez C, Ochoa-Díaz-López H. Glycemic Index, Glycemic Load and Dyslipidemia in Adolescents from Chiapas, Mexico. Nutrients 2024; 16:1483. [PMID: 38794721 PMCID: PMC11124452 DOI: 10.3390/nu16101483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/12/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
Cardiovascular disease risk throughout the life course is increased by abnormal blood lipid levels in youth. The dietary glycemic index (GI) and glycemic load (GL) during adolescence might be related to abnormal blood lipids. This study aimed to analyze the association between dietary GI, GL and dyslipidemia in adolescents from two marginalized regions of Chiapas, Mexico. A cross-sectional study was conducted with 213 adolescents. Food intake was assessed using 24 h recalls. The association between dyslipidemia and dietary GI or GL was tested by using logistic regression models. Low HDL-c was the most prevalent risk factor (47.4%), followed by hypertriglyceridemia (25.4%). In this population, overall dietary GI was not associated with dyslipidemia. A high dietary GL was associated with 2.39 higher odds of low HDL-c (95% CI: 1.21-4.74) when compared to low GL. Female adolescents with high dietary GL had 3.20 higher odds of hypertriglyceridemia (95% CI: 1.03-9.88), whereas no association was found for males. No associations were observed between overall dietary GL and total cholesterol or LDL-c. In adolescents from urban and rural communities in Chiapas, a high dietary GL was associated with a detrimental effect on HDL-c. In female adolescents, high GL was associated with hypertriglyceridemia.
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Affiliation(s)
- Itandehui Castro-Quezada
- Health Department, El Colegio de la Frontera Sur, Villahermosa 86280, Mexico; (I.C.-Q.); (R.G.-M.); (C.A.I.-N.)
| | - Pilar Elena Núñez-Ortega
- Health Department, El Colegio de la Frontera Sur, San Cristóbal de las Casas 29290, Mexico; (P.E.N.-O.); (R.S.-H.); (C.M.-G.)
| | - Elena Flores-Guillén
- Faculty of Nutrition and Food Science, University of Science and Arts of Chiapas, Tuxtla Gutiérrez 29039, Mexico;
| | - Rosario García-Miranda
- Health Department, El Colegio de la Frontera Sur, Villahermosa 86280, Mexico; (I.C.-Q.); (R.G.-M.); (C.A.I.-N.)
| | - César Antonio Irecta-Nájera
- Health Department, El Colegio de la Frontera Sur, Villahermosa 86280, Mexico; (I.C.-Q.); (R.G.-M.); (C.A.I.-N.)
| | - Roberto Solís-Hernández
- Health Department, El Colegio de la Frontera Sur, San Cristóbal de las Casas 29290, Mexico; (P.E.N.-O.); (R.S.-H.); (C.M.-G.)
| | - Christian Medina-Gómez
- Health Department, El Colegio de la Frontera Sur, San Cristóbal de las Casas 29290, Mexico; (P.E.N.-O.); (R.S.-H.); (C.M.-G.)
| | - Héctor Ochoa-Díaz-López
- Health Department, El Colegio de la Frontera Sur, San Cristóbal de las Casas 29290, Mexico; (P.E.N.-O.); (R.S.-H.); (C.M.-G.)
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Seckiner S, Bas M, Simsir IY, Ozgur S, Akcay Y, Aslan CG, Kucukerdonmez O, Cetinkalp S. Effects of Dietary Carbohydrate Concentration and Glycemic Index on Blood Glucose Variability and Free Fatty Acids in Individuals with Type 1 Diabetes. Nutrients 2024; 16:1383. [PMID: 38732629 PMCID: PMC11085728 DOI: 10.3390/nu16091383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/08/2024] [Accepted: 04/08/2024] [Indexed: 05/13/2024] Open
Abstract
Monitoring glycemic control status is the cornerstone of diabetes management. This study aimed to reveal whether moderate-carbohydrate (CHO) diets increase the risk of free fatty acid (FFA) levels, and it presents the short-term effects of four different diet models on blood sugar, glycemic variability (GV), and FFA levels. This crossover study included 17 patients with type 1 diabetes mellitus to identify the effects of four diets with different CHO contents and glycemic index (GI) on GV and plasma FFA levels. Diet 1 (D1) contained 40% CHO with a low GI, diet 2 (D2) contained 40% CHO with a high GI, diet 3 (D3) contained 60% CHO with a low GI, and diet 4 (D4) contained 60% CHO with a high GI. Interventions were performed with sensor monitoring in four-day periods and completed in four weeks. No statistical difference was observed among the groups in terms of blood glucose area under the curve (p = 0.78), mean blood glucose levels (p = 0.28), GV (p = 0.59), and time in range (p = 0.567). FFA and total triglyceride levels were higher in the D1 group (p < 0.014 and p = 0.002, respectively). Different diets may increase the risk of cardiovascular diseases by affecting GI, FFA, and blood glucose levels.
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Affiliation(s)
- Selda Seckiner
- Department of Nutrition and Dietetics, Faculty of Health Sciences, İstanbul Beykent University, Istanbul 34520, Turkey
- Institute of Health Sciences, Acibadem Mehmet Ali Aydınlar University, Istanbul 34450, Turkey
| | - Murat Bas
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Acibadem Mehmet Ali Aydınlar University, Istanbul 34450, Turkey;
| | - Ilgin Yildirim Simsir
- Division of Endocrinology and Metabolism Disorders, Department of Internal Medicine, Faculty of Medicine, Ege University, Izmir 35100, Turkey; (I.Y.S.); (S.C.)
| | - Su Ozgur
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Ege University, Izmir 35100, Turkey;
| | - Yasemin Akcay
- Department of Medical Biochemistry, Faculty of Medicine, Ege University, Izmir 35100, Turkey;
| | - Cigdem Gozde Aslan
- Department of Medical Biochemistry, Faculty of Medicine, Biruni University, Istanbul 34010, Turkey;
| | - Ozge Kucukerdonmez
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ege University, Izmir 35100, Turkey;
| | - Sevki Cetinkalp
- Division of Endocrinology and Metabolism Disorders, Department of Internal Medicine, Faculty of Medicine, Ege University, Izmir 35100, Turkey; (I.Y.S.); (S.C.)
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Polesel J, Di Maso M, Esposito G, Vitale S, Palumbo E, Porciello G, Calabrese I, Minopoli A, Grilli B, Cavalcanti E, Serraino D, Celentano E, Jenkins DJA, Augustin LSA. A Plant-Based Cholesterol-Lowering Diet Score Correlates with Serum LDL-Cholesterol Levels. Nutrients 2024; 16:495. [PMID: 38398819 PMCID: PMC10892311 DOI: 10.3390/nu16040495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/05/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND A cholesterol-lowering diet score was previously developed for epidemiological studies; its association with serum lipid profile was not confirmed yet. METHODS The score was developed as an adaptation of the dietary portfolio for cholesterol reduction, assigning one point for adherence to seven dietary indicators and ranging from 0 (null adherence) to 7 (highest adherence). The score was calculated for breast cancer patients enrolled in the DEDiCa study using a 7-day food record; serum lipid profile, including total and low-density lipoprotein cholesterol (LDL-C), was evaluated in serum at baseline. RESULTS Patients with the highest adherence to the cholesterol-lowering diet (i.e., score ≥ 4) reported lower LDL-C level than women with score 0-1 (median: 107 mg/dL and 122 mg/dL, respectively; p < 0.01). The proportion of women with LDL-C above the recommended limit of 116 mg/dL was 60.0% with score 0-1 and 42.6% with score ≥4. Although the score directly correlates with consumption of foods from vegetal sources, it was mildly associated with the healthful plant-based diet index (r-Spearman = 0.51) and the Mediterranean Diet Adherence Screener (r-Spearman = 0.30) Conclusions: These results provide experimental evidence that the cholesterol-lowering diet score is capable of detecting a specific plant-based dietary pattern that affects circulating cholesterol levels.
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Affiliation(s)
- Jerry Polesel
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (J.P.); (D.S.)
| | - Matteo Di Maso
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology “G.A. Maccacaro”, Università degli Studi di Milano, 20133 Milan, Italy; (M.D.M.); (G.E.)
| | - Giovanna Esposito
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology “G.A. Maccacaro”, Università degli Studi di Milano, 20133 Milan, Italy; (M.D.M.); (G.E.)
| | - Sara Vitale
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy (E.P.); (G.P.); (E.C.)
| | - Elvira Palumbo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy (E.P.); (G.P.); (E.C.)
| | - Giuseppe Porciello
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy (E.P.); (G.P.); (E.C.)
| | - Ilaria Calabrese
- Healthcare Direction, “A. Cardarelli” Hospital, 80131 Naples, Italy;
| | - Anita Minopoli
- Laboratory Medicine Unit, Istituto Nazionale Tumori, IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (A.M.); (B.G.); (E.C.)
| | - Bruna Grilli
- Laboratory Medicine Unit, Istituto Nazionale Tumori, IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (A.M.); (B.G.); (E.C.)
| | - Ernesta Cavalcanti
- Laboratory Medicine Unit, Istituto Nazionale Tumori, IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (A.M.); (B.G.); (E.C.)
| | - Diego Serraino
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (J.P.); (D.S.)
| | - Egidio Celentano
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy (E.P.); (G.P.); (E.C.)
| | - David J. A. Jenkins
- Departments of Nutritional Science and Medicine, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada;
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael’s Hospital, Toronto, ON M5C 2T2, Canada
- Division of Endocrinology and Metabolism, Department of Medicine, St. Michael’s Hospital, Toronto, ON M5C 2T2, Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5C 2T2, Canada
| | - Livia S. A. Augustin
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy (E.P.); (G.P.); (E.C.)
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10
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Li A, Han X, Liu L, Zhang G, Du P, Zhang C, Li C, Chen B. Dairy products and constituents: a review of their effects on obesity and related metabolic diseases. Crit Rev Food Sci Nutr 2023; 64:12820-12840. [PMID: 37724572 DOI: 10.1080/10408398.2023.2257782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Obesity has become a global public health problem that seriously affects the quality of life. As an important part of human diet, dairy products contain a large number of nutrients that are essential for maintaining human health, such as proteins, peptides, lipids, vitamins, and minerals. A growing number of epidemiological investigations provide strong evidence on dairy interventions for weight loss in overweight/obese populations. Therefore, this paper outlines the relationship between the consumption of different dairy products and obesity and related metabolic diseases. In addition, we dive into the mechanisms related to the regulation of glucose and lipid metabolism by functional components in dairy products and the interaction with gut microbes. Lastly, the role of dairy products on obesity of children and adolescents is revisited. We conclude that whole dairy products exert more beneficial effect than single milk constituent on alleviating obesity and that dairy matrix has important implications for metabolic health.
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Affiliation(s)
- Aili Li
- Key Laboratory of Dairy Science, Ministry of Education, College of Food Science, Northeast Agricultural University, Harbin, China
| | - Xueting Han
- Key Laboratory of Dairy Science, Ministry of Education, College of Food Science, Northeast Agricultural University, Harbin, China
| | - Libo Liu
- Key Laboratory of Dairy Science, Ministry of Education, College of Food Science, Northeast Agricultural University, Harbin, China
| | - Guofang Zhang
- Key Laboratory of Dairy Science, Ministry of Education, College of Food Science, Northeast Agricultural University, Harbin, China
| | - Peng Du
- Key Laboratory of Dairy Science, Ministry of Education, College of Food Science, Northeast Agricultural University, Harbin, China
| | - Chao Zhang
- Key Laboratory of Dairy Science, Ministry of Education, College of Food Science, Northeast Agricultural University, Harbin, China
| | - Chun Li
- Key Laboratory of Dairy Science, Ministry of Education, College of Food Science, Northeast Agricultural University, Harbin, China
- Heilongjiang Green Food Research Institute, Harbin, China
| | - Bingcan Chen
- Department of Plant Sciences, North Dakota State University, Fargo, North Dakota, USA
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11
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Dong WH, Gu TM, Zhu BQ, Shen Y, He XY, Bai GN, Shao J. Comparison of anthropometric parameters and laboratory test results before and after the COVID-19 outbreak among Chinese children aged 3–18 years. Front Public Health 2023; 11:1048087. [PMID: 36998284 PMCID: PMC10043305 DOI: 10.3389/fpubh.2023.1048087] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/20/2023] [Indexed: 03/18/2023] Open
Abstract
ObjectiveTo compare the physiological health of Chinese children around the COVID-19 lockdown.MethodsWe extracted data on children's anthropometric and laboratory parameters from May to November in both 2019 and 2020 from the Health Checkup Center, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China. Overall, 2162 children aged 3~18 years without comorbidities in 2019 and 2646 in 2020 were assessed. Mann Whitney U tests were used to compare differences between the above health indicators before and after COVID-19 outbreak. Quantile regression analyses adjusted for age, sex and body mass index (BMI) were also used in analysis. Chi-square tests and Fisher's exact tests were used for comparing differences of categorical variables.ResultsCompared with children examined in 2019 before the outbreak, children in 2020 had a higher median z score of BMI for age (−0.16 vs. −0.31), total cholesterol (TC, 4.34 vs. 4.16 mmol/L), low density lipoprotein cholesterol (LDL-C, 2.48 vs. 2.15 mmol/L), high density lipoprotein cholesterol (HDL-C, 1.45 vs. 1.43 mmol/L) and serum uric acid (290 vs. 282 μmol/L), and a lower hemoglobin (Hb, 134 vs. 133 g/L), triglycerides (TG, 0.70 vs. 0.78 mmol/L) and 25(OH)D (45.8 vs. 52.2 nmol/L), all P < 0.05. No differences were identified for waist height ratio, blood pressure and fasting glucose (both P > 0.05). However, in regression models after adjusting, BMI, TC, LDL-C, blood glucose and sUA were positively correlated with year; while Hb, TG and 25(OH)D were negatively correlated with year (all P < 0.05). Accordingly, children in 2020 had a higher prevalence of overweight/obesity (20.6 vs. 16.7%, P < 0.001), hypercholesterol (16.2%vs. 10.2%, P < 0.001), high LDL-C (10 vs. 2.9%, P < 0.001), hyperuricemia (18.9 vs.15.1%, P = 0.002), vitamin D deficiency (22.6 vs. 8.1%, P < 0.001) and a lower prevalence of high TG (4.3 vs. 2.8%, P = 0.018) compared with children in 2019.ConclusionIn this real-world study, we found that long-term lockdown due to COVID-19 outbreak might cause adverse impact on children's metabolic health, which might increase their future risk of cardiovascular diseases. Thus, parents, health professionals, educationists, and caregivers should pay more attention to children's dietary pattern and lifestyle, especially in this new normal against COVID-19.
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12
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Yang T, Hu Q, Liu Y, Xu R, Wang D, Chang Z, Jin M, Huang J. Biochemical characteristics and potential application of a thermostable starch branching enzyme from Bacillus licheniformis. AMB Express 2023; 13:8. [PMID: 36662316 PMCID: PMC9859979 DOI: 10.1186/s13568-023-01511-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 01/08/2023] [Indexed: 01/21/2023] Open
Abstract
Slowly digestible starch (SDS) has attracted increasing attention for its function of preventing metabolic diseases. Based on transglycosylation, starch branching enzymes (1,4-α-glucan branching enzymes, GBEs, EC 2.4.1.18) can be used to regulate the digestibility of starch. In this study, a GBE gene from Bacillus licheniformis (bl-GBE) was cloned, expressed, purified, and characterized. Sequence analysis and structural modeling showed that bl-GBE belong to the glycoside hydrolase 13 (GH13) family, with which its active site residues were conserved. The bl-GBE was highly active at 80 °C and a pH range of 7.5-9.0, and retained 90% of enzyme activity at 70 °C for 16 h. bl-GBE also showed high substrate specificity (80.88 U/mg) on potato starch. The stability and the changes of the secondary structure of bl-GBE at different temperature were determined by circular dichroism (CD) spectroscopy. The CD data showed a loss of 20% of the enzyme activity at high temperatures (80 °C), due to the decreased content of the α -helix in the secondary structure. Furthermore, potato starch treated with bl-GBE (300 U/g starch) showed remarkable increase in stability, solubility, and significant reduction viscosity. Meanwhile, the slowly digestible starch content of bl-GBE modified potato starch increased by 53.03% compared with native potato starch. Our results demonstrated the potential applications of thermophilic bl-GBE in food industries.
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Affiliation(s)
- Ting Yang
- grid.22069.3f0000 0004 0369 6365School of Life Sciences, East China Normal University, Shanghai, 200241 China
| | - Qianyu Hu
- grid.22069.3f0000 0004 0369 6365School of Life Sciences, East China Normal University, Shanghai, 200241 China
| | - Yu Liu
- grid.22069.3f0000 0004 0369 6365School of Life Sciences, East China Normal University, Shanghai, 200241 China
| | - Rui Xu
- grid.22069.3f0000 0004 0369 6365School of Life Sciences, East China Normal University, Shanghai, 200241 China
| | - Dongrui Wang
- grid.22069.3f0000 0004 0369 6365School of Life Sciences, East China Normal University, Shanghai, 200241 China
| | - Zhongyi Chang
- grid.22069.3f0000 0004 0369 6365School of Life Sciences, East China Normal University, Shanghai, 200241 China
| | - Mingfei Jin
- grid.22069.3f0000 0004 0369 6365School of Life Sciences, East China Normal University, Shanghai, 200241 China
| | - Jing Huang
- grid.22069.3f0000 0004 0369 6365School of Life Sciences, East China Normal University, Shanghai, 200241 China
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13
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Yang D, Lew HL, Mak YY, Ou SJL, Lim JA, Lu Y, Seah CLY, Tan MQH, Huang D, Tai ES, Liu MH. Incorporation of okra (Abelmoschus esculentus (L.) Moench) seed powder into fresh rice noodles with tapioca starch improves postprandial glycemia, insulinemia and satiety in healthy human volunteers. J Funct Foods 2023. [DOI: 10.1016/j.jff.2022.105382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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14
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Perin L, Camboim IG, Lehnen AM. Low glycaemic index and glycaemic load diets in adults with excess weight: Systematic review and meta-analysis of randomised clinical trials. J Hum Nutr Diet 2022; 35:1124-1135. [PMID: 35546475 DOI: 10.1111/jhn.13029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/30/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND To compare the effects of low and high glycaemic index/glycaemic load (GI/GL) diets on body weight in adults with excess weight. METHODS We searched for randomised controlled trials comparing low GI/GL vs. high GI/GL diets from Medline (via PubMed), Embase, Scopus and Web of Science. The variables of interest were anthropometric measurements, fasting glucose and fasting insulin levels and lipid profile, and 10 studies were included in the meta-analysis. RESULTS The sample size ranged from 19 to 203 participants. Low GI/GL is not superior to high GI/GL diets on body weight reduction in adults with excess weight (body mass index [BMI] ≥ 25 kg m-2 ). However, low GI/GL diets show greater body weight reductions in adults with BMI ≥ 30 kg m-2 (-0.93 kg; 95% confidence interval [CI] = -1.73 to -0.12; p = 0.045). Compared with high GI/GL diets, low GI/GL diets may also help reduce fasting glucose (-1.97 mg dl-1 ; 95% CI = -3.76 to 0.19; p = 0.030) and fasting insulin (-0.55 µU ml-1 ; 95% CI = -0.95 to -0.15; p = 0.007). No differences in fat mass, fat-free mass, waist circumference and lipid profile were observed between low GI/GL and high GI/GL diets. The risk of bias for body weight was classified as 'low risk' (25% of the studies) and 'some concerns' for all domains of RoB 2 tool in most studies. CONCLUSIONS When compared with high GI/GL diets, low GI/GL diets appear to more effectively reduce fasting glucose and insulin and promote greater body weight reduction in adults with obesity (BMI ≥ 30 kg m-2 ).
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Affiliation(s)
- Lisiane Perin
- Instituto de Cardiologia do Rio Grande do Sul, Fundação Universitária de Cardiologia, Porto Alegre, Rio Grande Grande do Sul, Brasil
| | - Isadora G Camboim
- Instituto de Cardiologia do Rio Grande do Sul, Fundação Universitária de Cardiologia, Porto Alegre, Rio Grande Grande do Sul, Brasil.,Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande Grande do Sul, Brasil
| | - Alexandre M Lehnen
- Instituto de Cardiologia do Rio Grande do Sul, Fundação Universitária de Cardiologia, Porto Alegre, Rio Grande Grande do Sul, Brasil
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15
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Khodarahmi M, Siri G, Erahimzadeh F, Farhangi MA, Shanehbandi D. Dietary glycemic index and glycemic load mediate the effect of CARTPT rs2239670 gene polymorphism on metabolic syndrome and metabolic risk factors among adults with obesity. BMC Endocr Disord 2022; 22:288. [PMID: 36404325 PMCID: PMC9677654 DOI: 10.1186/s12902-022-01188-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/25/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The importance of genetic and dietary factors in occurrence and progression of chronic diseases such as metabolic syndrome (MetS) has been established. However, complex interrelationships, including direct and indirect effects of these variables are yet to be clarified. So, our aim was to investigate the mediating role of glycemic indices in the relationship between CARTPT rs2239670 polymorphism, socio-demographic and psychological factors and metabolic risk factors and the presence of MetS in adults with obesity. METHODS In a cross-sectional study of 288 apparently healthy adults with obesity aged 20-50 years, dietary glycemic index (GI) and glycemic load (GL) were measured using a validated semi-quantitative food frequency questionnaire (FFQ). Biochemical parameters, blood pressure and anthropometric indicators were assayed by standard methods. Genotyping was carried out by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Structural equation modeling (SEM) was used in the statistical analysis. RESULTS CARTPT rs2239670 had a positive direct effect on MetS (B = 0.037 ± 0.022; P = 0.043) and, on the other hand, this variant was found to be indirectly associated with MetS presence through mediation of GI (B = 0.039 ± 0.017; P = 0.009). CARTPT was a significant predictor of both dietary GI and GL (B = 1.647 ± 0.080 and B = 3.339 ± 0.242, respectively). Additionally, glycemic indicators appeared to mediate the association of age and gender with LDL-C (B = 0.917 ± 0.332; P = 0.006) and HDL (B = 1.047 ± 0.484; P = 0.031), respectively. GI showed a positive relationship with LDL-C (P = 0.024) in men and similar relationships were found between GL and LDL-C (P = 0.050) and cholesterol (P = 0.022) levels in women. CONCLUSION The SEM findings suggest a hypothesis of the mediating effect of glycemic indices in the relationship between genetic susceptibility to obesity and MetS presence. Our findings need to be confirmed with large prospective studies.
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Affiliation(s)
- Mahdieh Khodarahmi
- Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Goli Siri
- Department of Internal Medicine, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnoosh Erahimzadeh
- Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Dariush Shanehbandi
- Molecular Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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The Role of Dietary Glycemic Index and Glycemic Load in Mediating Genetic Susceptibility via MC4R s17782313 Genotypes to Affect Cardiometabolic Risk Factors among Apparently Healthy Obese Individuals. BIOMED RESEARCH INTERNATIONAL 2022; 2022:3044545. [PMID: 36440355 PMCID: PMC9683967 DOI: 10.1155/2022/3044545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 10/11/2022] [Accepted: 10/29/2022] [Indexed: 11/18/2022]
Abstract
Background The association of genetic and dietary factors with occurrence and progression of chronic diseases such as metabolic syndrome (MetS) has long been addressed but there is a lack of evidence for complex interrelationships, including direct and indirect effects of these variables. Hence, this study is aimed at evaluating the mediating role of glycemic indices in the association of melanocortin-4 receptor (MC4R) rs17782313 polymorphism, sociodemographic, and psychological factors with the risk of MetS in obese adults using structural equation modeling. Methods We performed a cross-sectional analysis of data from 287 apparently healthy adults. Dietary glycemic index (GI) and glycemic load (GL) were calculated from a validated 147-item food frequency questionnaire (FFQ). MC4R s17782313 genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Structural equation modeling was used to explore direct and indirect effects of genetic and nongenetic factors on MetS. Results MC4R gene variant was directly associated with the risk of MetS (B = 0.010; P = 0.023). On the other hand, this variant was found to be indirectly and positively associated with LDL-C (B = 6.589; P = 0.042) through mediatory effects of GI and GL. Moreover, GI and GL also mediated indirect positive effects of sex and age on LDL-C (B = 3.970; P ≤ 0.01; B = 0.878; P ≤ 0.01, respectively) and HDL (B = 2.203; P ≤ 0.01; B = 0.129; P ≤ 0.01, respectively). MC4R rs17782313 polymorphism had positive effects on GI (B = 1.577; P ≤ 0.01) and GL (B = 1.235; P ≤ 0.01). Conclusion Our data may state a hypothesis of the mediating effect of quantity and quality of carbohydrates consumed in relationship between genetic susceptibility to obesity and cardiometabolic risk factors. Further analyses should be carried out in high-quality cohort studies in order to confirm the findings.
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17
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Li J, Gower B, McLain A, Yarar‐Fisher C. Effects of a low-carbohydrate/high-protein diet on metabolic health in individuals with chronic spinal cord injury: An exploratory analysis of results from a randomized controlled trial. Physiol Rep 2022; 10:e15501. [PMID: 36411989 PMCID: PMC9812250 DOI: 10.14814/phy2.15501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/07/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023] Open
Abstract
We explored the impact of a low-carbohydrate/high-protein diet (LC/HP, ~30% energy from protein, 40% energy from carbohydrate) on indices of metabolic function and body composition in individuals with chronic spinal cord injury (SCI). Adults with SCI (≥3 years post-injury, C4-L2, AIS A-D) and insulin resistance or pre-diabetes were randomly assigned to an 8-week iso-caloric LC/HP diet group (n = 11) or control group (n = 14). All LC/HP meals were delivered weekly to participants' homes, and participants in the control group consumed their habitual diet. Each participant underwent an oral glucose tolerance test (OGTT) to assess glucose tolerance, insulin, area under the curve (AUC) for glucose and insulin, Matsuda Index, glucose-stimulated insulin secretion (GSIS), disposition index, and hepatic insulin extraction (HIE). Fasting blood lipid and inflammation were assessed, and body composition was estimated using dual-energy x-ray absorptiometry. A linear mixed model was used to evaluate the main effect of diet, time, and their interaction. Compared to the control group, participants in the LC/HP group had reduced total body fat mass (LC/HP: -5.9%, Control: 0.7%), visceral fat mass (LC/HP: -16.2%, Control: 5.2%), total- (LC/HP: -20.1, Control: 3.7 mg/dl), and LDL-cholesterol (LC/HP: -13.9, Control: 3.1 mg/dl) (pdiet*time < 0.05 for all). Regardless of group, AUCinsulin and peak insulin during the OGTT decreased, and HIE increased over time (ptime < 0.05). A trend for diet*time interaction was observed for glucoseOGTT120min (LC/HP: -20.7, Control: 3.0 mg/dl, pdiet*time = 0.09) and peak C-peptide (LC/HP: -2.1, Control: 0.0 ng/ml, pdiet*time = 0.07). HDL-cholesterol, lean body mass, Matsuda Index, fasting glucose, insulin, insulinOGTT120min , AUCglucose , pancreatic beta cell function (GSIS, disposition index), and inflammation (C-reactive protein, IL-6, IL-8, IL-10, TNF-α) did not change over time. In conclusion, our results suggest that individuals with SCI and insulin resistance may adopt an LC/HP diet to improve body composition and lipid profiles. Its impact on glucose metabolism and inflammation remains inconclusive and warrants future investigations.
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Affiliation(s)
- Jia Li
- Departments of Physical Medicine and RehabilitationThe University of Alabama at BirminghamBirminghamAlabamaUSA
| | - Barbara Gower
- Department of Nutrition SciencesUAB School of Health ProfessionsBirminghamAlabamaUSA
| | - Amie McLain
- Departments of Physical Medicine and RehabilitationThe University of Alabama at BirminghamBirminghamAlabamaUSA
| | - Ceren Yarar‐Fisher
- Departments of Physical Medicine and RehabilitationThe University of Alabama at BirminghamBirminghamAlabamaUSA
- Departments of Physical Medicine and Rehabilitation and NeuroscienceThe Ohio State UniversityColumbusOhioUSA
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18
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Patrakeeva VP, Shtaborov VA. Nutrition and the state of the intestinal microflora in the formation of the metabolic syndrome. OBESITY AND METABOLISM 2022. [DOI: 10.14341/omet12893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The literature review presents the results of modern studies of the relationship between diet and intestinal microbiota in the regulation of metabolic disorders. Metabolic syndrome, which is a symptom complex that combines abdominal obesity, insulin resistance, hyperglycemia, dyslipidemia and arterial hypertension, remains an important problem, being a risk factor for cardiovascular, neurodegenerative, oncological diseases and the development of type 2 diabetes mellitus. Although the pathogenesis of the metabolic syndrome has not yet been fully elucidated, it is known that visceral obesity and its associated complications, such as dyslipidemia and increased levels of pro-inflammatory cytokines, play a central role. The article presents data on the impact of the consumption of certain food products, the inclusion of plant biologically active substances (flavonoids, polyphenols, etc.) in the diet, as well as the use of elimination diets with the exclusion of carbohydrates or fats from the diet, on reducing the risk of cardiovascular accidents, levels of fasting glucose, total cholesterol, LDL, triglycerides, C-reactive protein, leptin, insulin, reduction in body weight and waist circumference, reduction in the level of circulating endotoxins and changes in the activity of immunocompetent cells. Data are presented on the possible influence of the intestinal microbiota in maintaining inflammation and the formation of degenerative changes in the body. The role of changes in the ratio of the levels of pathogenic microflora, bifidobacteria and lactobacilli in the formation of a pathological condition is shown.
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Affiliation(s)
- V. P. Patrakeeva
- N. Laverov Federal Center for Integrated Arctic Research of the Ural Branch of the Russian Academy of Sciences
| | - V. A. Shtaborov
- N. Laverov Federal Center for Integrated Arctic Research of the Ural Branch of the Russian Academy of Sciences
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19
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Handu D, Piemonte T. Dietary Approaches and Health Outcomes: An Evidence Analysis Center Scoping Review. J Acad Nutr Diet 2022; 122:1375-1393.e9. [PMID: 35577747 DOI: 10.1016/j.jand.2021.08.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 11/28/2022]
Abstract
Appropriate diet can prevent, manage, or reverse noncommunicable health conditions such as obesity, cardiovascular disease, and diabetes. Consequently, the public's interest in diet and nutrition has fueled the multi-billion-dollar weight loss industry and elevated its standing on social media and the internet. Although many dietary approaches are popular, their universal effectiveness and risks across overall populations are not clear. The objective of this scoping review was to identify and characterize systematic reviews (SRs) examining diet or fasting (intermittent energy restriction [IER]) interventions among adults who are healthy or may have chronic disease. An in-depth literature search of six databases was conducted for SRs published between January 2010 and February 2020. A total of 22,385 SRs were retrieved, and 1,017 full-text articles were screened for eligibility. Of these, 92 SRs met inclusion criteria. Covered diets were organized into 12 categories: high/restricted carbohydrate (n = 30), Mediterranean, Nordic, and Tibetan (n = 19), restricted or modified fat (n = 17), various vegetarian diets (n = 16), glycemic index (n = 13), high protein (n = 12), IER (n = 11), meal replacements (n = 11), paleolithic (n = 8), Dietary Approaches to Stop Hypretension (DASH; n = 6), Atkins, South Beach, and Zone (n = 5), and eight other brand diets (n = 4). Intermediate outcomes, such as body weight or composition and cardiometabolic, were commonly reported. Abundant evidence was found exploring dietary approaches in the general population. However, heterogeneity of diet definitions, focus on single macronutrients, and infrequent macronutrient subanalyses were observed. Based on this scoping review, the Evidence Analysis Center prioritized the need to collate evidence related to macronutrient modification, specifically restricted carbohydrate diets.
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Affiliation(s)
- Deepa Handu
- Academy of Nutrition and Dietetics Evidence Analysis Center, Chicago, IL.
| | - Tami Piemonte
- Academy of Nutrition and Dietetics Evidence Analysis Center, Chicago, IL
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Di Maso M, Augustin LSA, Jenkins DJA, Carioli G, Turati F, Grisoni B, Crispo A, La Vecchia C, Serraino D, Polesel J. Adherence to a cholesterol-lowering diet and the risk of prostate cancer. Food Funct 2022; 13:5730-5738. [PMID: 35522943 DOI: 10.1039/d1fo03795a] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Evidence suggests a role of serum cholesterol in prostate cancer (PCa) development and of lipid lowering medications in PCa risk reduction. We developed a score for adherence to an established cholesterol-lowering diet and evaluated its association with PCa risk in a multicentric hospital-based case-control study (1294 cases; 1451 matched controls) in Italy (1992-2001). The score was derived from seven dietary indicators which have been reported to lower cholesterol levels: high intake of non-cellulosic polysaccharides (viscous fibres), monounsaturated fatty acids, legumes, seeds/corn oil; low intake of saturated fatty acids, dietary cholesterol, and glycaemic index. Odds ratios (ORs) and corresponding confidence intervals (CIs) were calculated through the unconditional logistic regression model. Although most of the dietary indicators alone were not significantly associated with reduced PCa risk, men who fulfilled 5 to 7 dietary indicators (187 cases and 281 controls) showed a 43% reduction in PCa risk compared to those with 0 to 2 indicators (OR: 0.57; 95% CI: 0.43-0.77). This association was not modified by socio-demographic characteristics or lifestyle factors. In conclusion, adherence to a cholesterol-lowering diet is a favourable factor against the risk of PCa, providing support to dietary guidelines that promote cholesterol reduction through plant-based diets.
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Affiliation(s)
- Matteo Di Maso
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", Università degli Studi di Milano, via A. Vanzetti 5, 20133, Milan (MI), Italy
| | - Livia S A Augustin
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS - "Fondazione G. Pascale", Via M. Semmola 1-80131, Naples (NA), Italy
| | - David J A Jenkins
- Departments of Nutritional Science and Medicine, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.,Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON M5C 2T2, Canada.,Division of Endocrinology and Metabolism, Department of Medicine, St. Michael's Hospital, Toronto, ON M5C 2T2, Canada.,Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON M5C 2T2, Canada
| | - Greta Carioli
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", Università degli Studi di Milano, via A. Vanzetti 5, 20133, Milan (MI), Italy
| | - Federica Turati
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", Università degli Studi di Milano, via A. Vanzetti 5, 20133, Milan (MI), Italy
| | - Benedetta Grisoni
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, via A. Vanzetti 5, 20133, Milan (MI), Italy
| | - Anna Crispo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS - "Fondazione G. Pascale", Via M. Semmola 1-80131, Naples (NA), Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", Università degli Studi di Milano, via A. Vanzetti 5, 20133, Milan (MI), Italy
| | - Diego Serraino
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico (CRO) Aviano, IRCCS, via F. Gallini 2, 33081 Aviano (PN), Italy.
| | - Jerry Polesel
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico (CRO) Aviano, IRCCS, via F. Gallini 2, 33081 Aviano (PN), Italy.
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Jun S, Lee S, Lee J, Kim J. Diets high in glycemic index and glycemic load are associated with an increased risk of metabolic syndrome among Korean women. Nutr Metab Cardiovasc Dis 2022; 32:1154-1164. [PMID: 35256231 DOI: 10.1016/j.numecd.2022.01.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS Accurate estimation of the glycemic index (GI) and glycemic load (GL) of diets is essential when assessing health implications of dietary GI and GL. The present study aimed to estimate dietary GI and GL utilizing the updated GI tables with a large number of new, reliable GI values and assess their associations with metabolic syndrome among Korean adults. METHODS AND RESULTS We analyzed data from 3317 men and 6191 women for this cross-sectional study. Dietary intake was assessed with a validated food frequency questionnaire. Metabolic syndrome and its components were defined based on the harmonized criteria with Korean-specific cutoffs for waist circumference. Multivariate logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Compared with women in the lowest quintiles of energy-adjusted dietary GI and GL, women in the highest quintiles had significantly greater risks of metabolic syndrome (GI, OR = 1.56, 95% CI = 1.18-2.06; GL, OR = 1.80, 95% CI = 1.27-2.57), elevated blood pressure, reduced high-density lipoprotein cholesterol (HDL-C, both GI and GL), elevated triglycerides (GI only), elevated waist circumference, and elevated fasting glucose (GL only). Among men, no significant association was noted except for a higher risk of reduced HDL-C (OR = 1.59, 95% CI = 1.01-2.29) in the highest quintile of energy-adjusted dietary GI than in the lowest quintile. CONCLUSION Our findings suggest that dietary GI and GL are positively associated with metabolic syndrome risk among women, but not men, in Korea.
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Affiliation(s)
- Shinyoung Jun
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
| | - Seohyun Lee
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
| | - Jeonghee Lee
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
| | - Jeongseon Kim
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea.
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22
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Dwivedi AK, Dubey P, Reddy SY, Clegg DJ. Associations of Glycemic Index and Glycemic Load with Cardiovascular Disease: Updated Evidence from Meta-analysis and Cohort Studies. Curr Cardiol Rep 2022; 24:141-161. [PMID: 35119682 DOI: 10.1007/s11886-022-01635-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2021] [Indexed: 02/01/2023]
Abstract
PURPOSE OF REVIEW Diet and lifestyle patterns are considered major contributory factors for cardiovascular disease (CVD) and mortality. In particular, consuming a diet higher in carbohydrates (not inclusive of fruits and vegetables, but more processed carbohydrates) has been associated with metabolic abnormalities that subsequently may increase the risk of CVD and related mortality. Glycemic index (GI) and glycemic load (GL) are values given to foods based on how fast the body converts carbohydrates into glucose also referred to as the glycemic burden of carbohydrates from foods. Conflicting associations of how high GI and GL influence CVDs have been observed even in high-quality meta-analysis studies. We synthesize and report the associations of high GI and GL with various CVDs by sex, obesity, and geographical locations using an updated review of meta-analysis and observational studies. RECENT FINDINGS We identified high GI or high GL is associated with an increased risk of CVD events including diabetes (DM), metabolic syndrome (MS), coronary heart disease (CHD), stroke, and stroke mortality in the general population, and the risk of CVD outcomes appears to be stratified by sex, obesity status, and preexisting CVD. Both high GI and GL are associated with DM and CHD in the general population. However, high GI is strongly associated with DM/MS, while high GL is strongly associated with an increased risk of CHD in females. In addition, high GL is also associated with incident stroke, and appears to be associated with CVD mortality in subjects with preexisting CVD or high BMI and all-cause mortality in non-obese DM subjects. However, high GI appears to be associated with CVD or all-cause mortality only in females without CVD. High GI/GL is an important risk factor for CVD outcomes in the general population. High GI seems to be markedly associated with DM/MS, and it may enhance the risk of CVD or all-cause mortality in both sexes and predominately females. Although both high GI and high GL are risk factors for CHD in females, high GL is associated with CVD outcomes in at-risk populations for CVD. These data suggest that while high GI increases the propensity of CVD risk factors and mortality in healthy individuals, high GL contributes to the risk of severe heart diseases including CVD or all-cause mortality, particularly in at-risk populations. These data indicate dietary interventions designed for focusing carbohydrate quality by lowering both GI and GL are recommended for preventing CVD outcomes across all populations.
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Affiliation(s)
- Alok Kumar Dwivedi
- Division of Biostatistics & Epidemiology, Department of Molecular and Translational Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, 5001 El Paso Drive, TX, 79905, USA.
| | - Pallavi Dubey
- Department of Obstetrics & Gynecology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, 4800 Alberta Avenue, El Paso, TX, 79905, USA
| | - Sireesha Y Reddy
- Department of Obstetrics & Gynecology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, 4800 Alberta Avenue, El Paso, TX, 79905, USA
| | - Deborah J Clegg
- Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, 4800 Alberta Avenue, El Paso, TX, 79905, USA
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23
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Prakash PK, Aswathanarayana Setty JL. Macronutrient Interactions to Facilitate Sustained Carbohydrate Digestibility in Tertiary Food Matrix Systems and Their Potential Applications in Indian Pancake. STARCH-STARKE 2021. [DOI: 10.1002/star.202100117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Pavan Kumar Prakash
- Protein Chemistry and Technology Department CSIR ‐ Central Technological Research Institute Mysuru Karnataka 570020 India
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Effects of substitution dietary guidelines targeted at prevention of IHD on dietary intake and risk factors in middle-aged Danish adults: the Diet and Prevention of Ischemic Heart Disease: a Translational Approach (DIPI) randomised controlled trial. Br J Nutr 2021; 126:1179-1193. [PMID: 33357247 DOI: 10.1017/s0007114520005164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The objective was to investigate the effects of substitution (SUB) dietary guidelines (DG) targeted at the prevention of IHD on dietary intake and IHD risk factors in Danish adults with minimum one self-assessed IHD risk factor. A 6-month single-blinded parallel randomised controlled trial with a follow-up at month 12 included 219 subjects (median age 51 years, 59 % female, 73 % overweight or obese) randomised into an SUB DG, an official (OFF) DG or a control group following their habitual diet (HAB). Participants in the DG intervention groups received bi-weekly reminders of their DG and recipes for dishes and the HAB group received a greeting. Dietary intake and fasting blood, anthropometric and blood pressure measurements were obtained at baseline, month 6 and month 12. Linear regression analyses were applied. At month 6, when compared with the HAB, the SUB had a greater impact on the extent of dietary changes with increased intake of whole grains, dietary fibre and low fibre vegetables compared with the OFF DG, and both DG groups had similar decreased percentage of energy (E%) intake from SFA. The extent of dietary changes was similar at month 12. No overall significant changes from baseline were found in blood pressure, anthropometrics and IHD risk markers. In conclusion, both SUB and OFF DG resulted in cardioprotective dietary changes. However, neither the SUB nor the OFF DG resulted in any overall effects on the selected intermediate risk factors for IHD.
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Insights into the latest advances in low glycemic foods, their mechanism of action and health benefits. JOURNAL OF FOOD MEASUREMENT AND CHARACTERIZATION 2021. [DOI: 10.1007/s11694-021-01179-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Chiavaroli L, Lee D, Ahmed A, Cheung A, Khan TA, Blanco S, Mejia, Mirrahimi A, Jenkins DJA, Livesey G, Wolever TMS, Rahelić D, Kahleová H, Salas-Salvadó J, Kendall CWC, Sievenpiper JL. Effect of low glycaemic index or load dietary patterns on glycaemic control and cardiometabolic risk factors in diabetes: systematic review and meta-analysis of randomised controlled trials. BMJ 2021; 374:n1651. [PMID: 34348965 PMCID: PMC8336013 DOI: 10.1136/bmj.n1651] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To inform the update of the European Association for the Study of Diabetes clinical practice guidelines for nutrition therapy. DESIGN Systematic review and meta-analysis of randomised controlled trials. DATA SOURCES Medline, Embase, and the Cochrane Library searched up to 13 May 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised controlled trials of three or more weeks investigating the effect of diets with low glycaemic index (GI)/glycaemic load (GL) in diabetes. OUTCOME AND MEASURES The primary outcome was glycated haemoglobin (HbA1c). Secondary outcomes included other markers of glycaemic control (fasting glucose, fasting insulin); blood lipids (low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), non-HDL-C, apo B, triglycerides); adiposity (body weight, BMI (body mass index), waist circumference), blood pressure (systolic blood pressure (SBP) and diastolic blood pressure (DBP)), and inflammation (C reactive protein (CRP)). DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted data and assessed risk of bias. Data were pooled by random effects models. GRADE (grading of recommendations assessment, development, and evaluation) was used to assess the certainty of evidence. RESULTS 29 trial comparisons were identified in 1617 participants with type 1 and 2 diabetes who were predominantly middle aged, overweight, or obese with moderately controlled type 2 diabetes treated by hyperglycaemia drugs or insulin. Low GI/GL dietary patterns reduced HbA1c in comparison with higher GI/GL control diets (mean difference −0.31% (95% confidence interval −0.42 to −0.19%), P<0.001; substantial heterogeneity, I2=75%, P<0.001). Reductions occurred also in fasting glucose, LDL-C, non-HDL-C, apo B, triglycerides, body weight, BMI, systolic blood pressure (dose-response), and CRP (P<0.05), but not blood insulin, HDL-C, waist circumference, or diastolic blood pressure. A positive dose-response gradient was seen for the difference in GL and HbA1c and for absolute dietary GI and SBP (P<0.05). The certainty of evidence was high for the reduction in HbA1c and moderate for most secondary outcomes, with downgrades due mainly to imprecision. CONCLUSIONS This synthesis suggests that low GI/GL dietary patterns result in small important improvements in established targets of glycaemic control, blood lipids, adiposity, blood pressure, and inflammation beyond concurrent treatment with hyperglycaemia drugs or insulin, predominantly in adults with moderately controlled type 1 and type 2 diabetes. The available evidence provides a good indication of the likely benefit in this population. STUDY REGISTRATION ClinicalTrials.gov NCT04045938.
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Affiliation(s)
- Laura Chiavaroli
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael’s Hospital, Toronto, ON, Canada
| | - Danielle Lee
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael’s Hospital, Toronto, ON, Canada
| | - Amna Ahmed
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael’s Hospital, Toronto, ON, Canada
| | - Annette Cheung
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael’s Hospital, Toronto, ON, Canada
| | - Tauseef A Khan
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael’s Hospital, Toronto, ON, Canada
| | - Sonia Blanco
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael’s Hospital, Toronto, ON, Canada
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Endocrinology and Metabolism, Department of Medicine, St Michael’s Hospital, Toronto, ON, Canada
- Department of Medical Imaging, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, ON, Canada
- Independent Nutrition Logic, Wymondham, UK
- INQUIS Clinical Research, Toronto, ON, Canada
- Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
- School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- Institute for Clinical and Experimental Medicine, Diabetes Centre, Prague, Czech Republic
- Physicians Committee for Responsible Medicine, Washington, DC, USA
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain
- Institut d’Investigació Sanitària Pere Virgili, Hospital Universitari San Joan de Reus, Reus, Spain
- Consorcio CIBER, MP Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- College of Pharmacy and Nutrition, University of Saskatchewan, SK, Canada
| | - Mejia
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael’s Hospital, Toronto, ON, Canada
| | - Arash Mirrahimi
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael’s Hospital, Toronto, ON, Canada
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Medical Imaging, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - David J A Jenkins
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael’s Hospital, Toronto, ON, Canada
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Endocrinology and Metabolism, Department of Medicine, St Michael’s Hospital, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, ON, Canada
| | | | - Thomas M S Wolever
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- INQUIS Clinical Research, Toronto, ON, Canada
| | - Dario Rahelić
- Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
- School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Hana Kahleová
- Institute for Clinical and Experimental Medicine, Diabetes Centre, Prague, Czech Republic
- Physicians Committee for Responsible Medicine, Washington, DC, USA
| | - Jordi Salas-Salvadó
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain
- Institut d’Investigació Sanitària Pere Virgili, Hospital Universitari San Joan de Reus, Reus, Spain
- Consorcio CIBER, MP Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Cyril W C Kendall
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael’s Hospital, Toronto, ON, Canada
- College of Pharmacy and Nutrition, University of Saskatchewan, SK, Canada
| | - John L Sievenpiper
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael’s Hospital, Toronto, ON, Canada
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Endocrinology and Metabolism, Department of Medicine, St Michael’s Hospital, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, ON, Canada
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Adeloye JB, Aluko PA, Oluwajuyitan TD. In vitro α-amylase and α-glucosidase inhibitory activities, antioxidant activity, in vivo glycemic response and nutritional quality of dough meals from Dioscorea alata and Vernonia amygdalina. JOURNAL OF FOOD MEASUREMENT AND CHARACTERIZATION 2021. [DOI: 10.1007/s11694-021-00965-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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28
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Liu Y, Sun P, Shuai P, Qiao Q, Li T. Fat-restricted low-glycemic index diet controls weight and improves blood lipid profile: A pilot study among overweight and obese adults in Southwest China. Medicine (Baltimore) 2021; 100:e26107. [PMID: 34032752 PMCID: PMC8154408 DOI: 10.1097/md.0000000000026107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 03/31/2021] [Indexed: 01/04/2023] Open
Abstract
Evidence from trials demonstrating the benefits and risks of low-glycemic index and fat-restricted diets in weight loss and blood lipid profile changes is unclear. This study aimed to assess the implemented and effects of a fat-restricted low-glycemic index diet on weight control and blood lipid profile changes in in overweight/obese Southwest Chinese individualst.This prospective pilot study enrolled overweight/obese subjects at the People's Hospital of Sichuan Province between February and July 2019. The daily energy intake was reduced by 300 to 500 kcal according to the participant's weight and activity level, with low-glycemic index carbohydrate- and fat-energy ratios < 45% and 25% to 30%, respectively. Participants received guidance for 3 months by telephone follow-up, internet interaction, or WeChat. Changes in weight, body composition, and blood profile were measured.A total of 254 patients were finally analyzed, including 101 males and 153 females. After adjusting for potential confounders, weight (P < .001), body mass index (P < .001), waist circumference (P < .001), waist-hip ratio (P < .001), body fat percentage (P < .001), visceral fat area (P < .001), basal metabolism (P = .002), cholesterol (P < .001), and triglycerides (P < .001) were significantly reduced after the 3-month intervention. The above indexes showed no significant differences between men and women.Regardless of gender, fat-restricted low-glycemic index diet might be helpful for controlling weight and lowering blood cholesterol and triglycerides in overweight/obese individuals in Southwest China.
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Affiliation(s)
- Yuping Liu
- Health Management Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Ping Sun
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Ping Shuai
- Health Management Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Qichuan Qiao
- Health Management Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Tingxin Li
- Health Management Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
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Suara SB, Siassi F, Saaka M, Rahimiforoushani A, Sotoudeh G. Relationship between dietary carbohydrate quality index and metabolic syndrome among type 2 diabetes mellitus subjects: a case-control study from Ghana. BMC Public Health 2021; 21:526. [PMID: 33731080 PMCID: PMC7968214 DOI: 10.1186/s12889-021-10593-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/08/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Dietary carbohydrate quality may play an important role in disease development. We evaluated the association between carbohydrate quality index (CQI) and the odds of metabolic syndrome (MetS) in type 2 diabetes mellitus (T2DM) subjects in Ghana. METHODS In this case-control study, we analyzed data using 124 T2DM subjects. We obtained dietary information using 2-day 24-h dietary recalls. We calculated CQI from dietary fiber, glycemic index, whole grains/total grains ratio, and solid carbohydrates/total carbohydrates ratio. Serum lipid profiles were measured after an overnight fast of 8-12 h. RESULTS Upon adjustments for the effects of covariates, the CQI showed a positive association with high-density lipoprotein cholesterol concentration (beta coefficient (β) = 0.24; standard error (SE) = 0.20; P for trend = 0.01), and an inverse relationship with waist circumference (β = - 17.29; SE = 4.00; P for trend < 0.001), systolic blood pressure (β = - 15.74; SE = 4.69; P for trend < 0.001), diastolic blood pressure (β = - 7.23; SE = 2.97; P for trend = 0.02), and triglyceride concentrations (β = - 0.43; SE = 0.11; P for trend < 0.001). Overall, the CQI had an inverse relationship with the odds of MetS (Odds ratio tertile 3 vs.1 0.05; 95% Confidence interval: 0.01-0.23; p-trend < 0.001). Also, a positive correlation was found between the CQI and fiber, but the CQI showed a negative relationship with dietary glycemic index. CONCLUSIONS The present results suggest an inverse association between the CQI of a diet and the odds of MetS. The CQI approach of dietary recommendation may be a useful strategy for dietary carbohydrate selection for the prevention of MetS.
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Affiliation(s)
- Sufyan Bakuri Suara
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, International Campus, Tehran University of Medical Sciences, Number 21 Dameshgh St. Vali-e Asr Ave., Tehran, 1416753955, Iran
| | - Fereydoun Siassi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost street, Naderi street, Keshavarz Blv, Tehran, Iran.
| | - Mahama Saaka
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, Post Office Box 1350, Tamale, Ghana
| | - Abbas Rahimiforoushani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Gity Sotoudeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost street, Naderi street, Keshavarz Blv, Tehran, Iran.
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Sievenpiper JL. Low-carbohydrate diets and cardiometabolic health: the importance of carbohydrate quality over quantity. Nutr Rev 2021; 78:69-77. [PMID: 32728757 DOI: 10.1093/nutrit/nuz082] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Carbohydrates are increasingly being implicated in the epidemics of obesity, diabetes, and their downstream cardiometabolic diseases. The "carbohydrate-insulin model" has been proposed to explain this role of carbohydrates. It posits that a high intake of carbohydrate induces endocrine deregulation marked by hyperinsulinemia, leading to energy partitioning with increased storage of energy in adipose tissue resulting in adaptive increases in food intake and decreases in energy expenditure. Whether all carbohydrate foods under real-world feeding conditions directly contribute to weight gain and its complications or whether this model can explain these clinical phenomena requires close inspection. The aim of this review is to assess the evidence for the role of carbohydrate quantity vs quality in cardiometabolic health. Although the clinical investigations of the "carbohydrate-insulin model" have shown the requisite decreases in insulin secretion and increases in fat oxidation, there has been a failure to achieve the expected fat loss under low-carbohydrate feeding. Systematic reviews with pairwise and network meta-analyses of the best available evidence have failed to show the superiority of low-carbohydrate diets on long-term clinical weight loss outcomes or that all sources of carbohydrate behave equally. High-carbohydrate diets that emphasize foods containing important nutrients and substances, including high-quality carbohydrate such as whole grains (especially oats and barley), pulses, or fruit; low glycemic index and load; or high fiber (especially viscous fiber sources) decrease intermediate cardiometabolic risk factors in randomized trials and are associated with weight loss and decreased incidence of diabetes, cardiovascular disease, and cardiovascular mortality in prospective cohort studies. The evidence for sugars as a marker of carbohydrate quality appears to be highly dependent on energy control (comparator) and food source (matrix), with sugar-sweetened beverages providing excess energy showing evidence of harm, and with high-quality carbohydrate food sources containing sugars such as fruit, 100% fruit juice, yogurt, and breakfast cereals showing evidence of benefit in energy-matched substitutions for refined starches (low-quality carbohydrate food sources). These data reflect the current shift in dietary guidance that allows for flexibility in the proportion of macronutrients (including carbohydrates) in the diet, with a focus on quality over quantity and dietary patterns over single nutrients.
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Affiliation(s)
- John L Sievenpiper
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto; and with the Division of Endocrinology & Metabolism; the Department of Medicine; the Li Ka Shing Knowledge Institute; and the Toronto 3D Knowledge Synthesis & Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre; St. Michael's Hospital, Toronto, Ontario, Canada
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Kazemi M, Hadi A, Pierson RA, Lujan ME, Zello GA, Chilibeck PD. Effects of Dietary Glycemic Index and Glycemic Load on Cardiometabolic and Reproductive Profiles in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Adv Nutr 2021; 12:161-178. [PMID: 32805007 PMCID: PMC7850057 DOI: 10.1093/advances/nmaa092] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/09/2020] [Accepted: 07/13/2020] [Indexed: 02/06/2023] Open
Abstract
Women with polycystic ovary syndrome (PCOS) exhibit cardiometabolic (e.g., insulin resistance) and associated reproductive disruptions. Lifestyle modification (e.g., diet) is recommended as the first-line therapy to manage PCOS; however, a favorable dietary regimen remains unclear beyond energy restriction. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to summarize evidence on impacts of dietary glycemic index (GI) or glycemic load (GL) on cardiometabolic and reproductive profiles to update the International Evidence-based Guideline for the Assessment and Management of PCOS. Databases of MEDLINE, Cochrane, Web of Science, and Scopus were searched through 30 October 2019, and confirmed on 25 March 2020, to identify RCTs (≥8 wk) comparing the effects of diets with lower (LGI/LGL) and higher (HGI/HGL) GI/GL on glucoregulatory outcomes, lipid profile, anthropometrics, and androgen status in PCOS. The primary outcome was HOMA-IR. Data were pooled by random-effects models and expressed as weighted mean differences and 95% CIs. The risk of bias was assessed by the Cochrane tool. Ten RCTs (n = 403) were eligible. Eight evaluated LGI and 2 LGL diets. LGI diets decreased HOMA-IR (-0.78; -1.20, -0.37; I2 = 86.6%), fasting insulin (-2.39; -4.78, 0.00 μIU/mL; I2 = 76.8%), total cholesterol (-11.13; -18.23, -4.04 mg/dL; I2 = 0.0%), LDL cholesterol (-6.27; -12.01, -0.53 mg/dL; I2 = 0.0%), triglycerides (-14.85; -28.75, -0.95 mg/dL; I2 = 31.0%), waist circumference (-2.81; -4.40, -1.23 cm; I2 = 53.9%), and total testosterone (-0.21; -0.32, -0.09 nmol/L; I2 = 8.6%) compared with HGI diets (all: P ≤ 0.05) without affecting fasting glucose, HDL cholesterol, weight, or free androgen index (all: P ≥ 0.07). Some results were contradictory and only described narratively for 2 RCTs that evaluated LGL diets, since inclusion in meta-analyses was not possible. LGI diets improved glucoregulatory outcomes (HOMA-IR, insulin), lipid profiles, abdominal adiposity, and androgen status, conceivably supporting their inclusion for dietary management of PCOS. Further RCTs should confirm these observations and address whether LGI diets improve more patient-pressing complications, including ovulatory cyclicity, infertility, and cardiovascular disease risk in this high-risk population. This review was registered at www.crd.york.ac.uk/PROSPERO as CRD42020175300.
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Affiliation(s)
- Maryam Kazemi
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
- Division of Nutrition and Dietetics, College of Pharmacy and Nutrition, University of Saskatchewan, Saskatchewan, Canada
| | - Amir Hadi
- Halal Research Center of IRI, FDA, Tehran, Iran
| | - Roger A Pierson
- Obstetrics and Gynecology, College of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Marla E Lujan
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
| | - Gordon A Zello
- Division of Nutrition and Dietetics, College of Pharmacy and Nutrition, University of Saskatchewan, Saskatchewan, Canada
| | - Philip D Chilibeck
- College of Kinesiology, Physical Activity Complex, University of Saskatchewan, Saskatchewan, Canada
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Yu X, Chu M, Chu C, Du Y, Shi J, Liu X, Liu Y, Zhang H, Zhang Z, Yan N. Wild rice (Zizania spp.): A review of its nutritional constituents, phytochemicals, antioxidant activities, and health-promoting effects. Food Chem 2020; 331:127293. [DOI: 10.1016/j.foodchem.2020.127293] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 05/01/2020] [Accepted: 06/08/2020] [Indexed: 02/08/2023]
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An Assessment of Three Carbohydrate Metrics of Nutritional Quality for Packaged Foods and Beverages in Australia and Southeast Asia. Nutrients 2020; 12:nu12092771. [PMID: 32932799 PMCID: PMC7551443 DOI: 10.3390/nu12092771] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 01/08/2023] Open
Abstract
Carbohydrate quality is an aetiological factor of diet-related disease. Indices of carbohydrate quality featuring various ratios of carbohydrates-to-dietary fibre-to-sugar have been associated with improved product and/or diet quality in westernised countries. Carbohydrate intake is especially high in Asia Pacific. Thus, this study evaluated the ability of such carbohydrate metrics to discriminate the nutritional quality of carbohydrate-rich packaged foods and beverages in Australia, Malaysia, Singapore, Thailand and the Philippines, with an additional focus on beverages. This evaluation was conducted by comparing product nutritional composition and assessing products against three national nutrient profiling models. Results showed that Australia had the highest proportion of products meeting all metrics, compared to the Southeast Asian countries. Beverages had a low adherence to all metrics compared to solid foods. Across the five countries, both processed food and beverages meeting the metrics generally contained higher dietary fibre, protein, and certain vitamins and minerals whilst having lower energy, total sugars, free sugars, trans fat and cholesterol content compared to products not meeting the metrics. The metrics were also aligned with national nutrient profiling models to identify nutritious products. In conclusion, these metrics allowed us to discriminate product nutritional quality in the countries assessed and are applicable to beverages.
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Sieri S, Agnoli C, Grioni S, Weiderpass E, Mattiello A, Sluijs I, Sanchez MJ, Jakobsen MU, Sweeting M, van der Schouw YT, Nilsson LM, Wennberg P, Katzke VA, Kühn T, Overvad K, Tong TYN, Conchi MI, Quirós JR, García-Torrecillas JM, Mokoroa O, Gómez JH, Tjønneland A, Sonestedt E, Trichopoulou A, Karakatsani A, Valanou E, Boer JMA, Verschuren WMM, Boutron-Ruault MC, Fagherazzi G, Madika AL, Bergmann MM, Schulze MB, Ferrari P, Freisling H, Lennon H, Sacerdote C, Masala G, Tumino R, Riboli E, Wareham NJ, Danesh J, Forouhi NG, Butterworth AS, Krogh V. Glycemic index, glycemic load, and risk of coronary heart disease: a pan-European cohort study. Am J Clin Nutr 2020; 112:631-643. [PMID: 32619242 PMCID: PMC7458777 DOI: 10.1093/ajcn/nqaa157] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 05/27/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND High carbohydrate intake raises blood triglycerides, glucose, and insulin; reduces HDLs; and may increase risk of coronary heart disease (CHD). Epidemiological studies indicate that high dietary glycemic index (GI) and glycemic load (GL) are associated with increased CHD risk. OBJECTIVES The aim of this study was to determine whether dietary GI, GL, and available carbohydrates are associated with CHD risk in both sexes. METHODS This large prospective study-the European Prospective Investigation into Cancer and Nutrition-consisted of 338,325 participants who completed a dietary questionnaire. HRs with 95% CIs for a CHD event, in relation to intake of GI, GL, and carbohydrates, were estimated using covariate-adjusted Cox proportional hazard models. RESULTS After 12.8 y (median), 6378 participants had experienced a CHD event. High GL was associated with greater CHD risk [HR 1.16 (95% CI: 1.02, 1.31) highest vs. lowest quintile, p-trend 0.035; HR 1.18 (95% CI: 1.07, 1.29) per 50 g/day of GL intake]. The association between GL and CHD risk was evident in subjects with BMI (in kg/m2) ≥25 [HR: 1.22 (95% CI: 1.11, 1.35) per 50 g/d] but not in those with BMI <25 [HR: 1.09 (95% CI: 0.98, 1.22) per 50 g/d) (P-interaction = 0.022). The GL-CHD association did not differ between men [HR: 1.19 (95% CI: 1.08, 1.30) per 50 g/d] and women [HR: 1.22 (95% CI: 1.07, 1.40) per 50 g/d] (test for interaction not significant). GI was associated with CHD risk only in the continuous model [HR: 1.04 (95% CI: 1.00, 1.08) per 5 units/d]. High available carbohydrate was associated with greater CHD risk [HR: 1.11 (95% CI: 1.03, 1.18) per 50 g/d]. High sugar intake was associated with greater CHD risk [HR: 1.09 (95% CI: 1.02, 1.17) per 50 g/d]. CONCLUSIONS This large pan-European study provides robust additional support for the hypothesis that a diet that induces a high glucose response is associated with greater CHD risk.
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Affiliation(s)
- Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sara Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Amalia Mattiello
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Ivonne Sluijs
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Maria Jose Sanchez
- Andalusian School of Public Health, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Marianne Uhre Jakobsen
- National Food Institute, Division for Diet, Disease Prevention, and Toxicology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Michael Sweeting
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Lena Maria Nilsson
- Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umeå, Sweden
| | - Patrik Wennberg
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Verena A Katzke
- Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Tilman Kühn
- Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Kim Overvad
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Tammy Y N Tong
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | | | | | | | - Olatz Mokoroa
- Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
| | - Jesús-Humberto Gómez
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Anne Tjønneland
- Diet, Genes, and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Emiliy Sonestedt
- Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | | | - Anna Karakatsani
- Hellenic Health Foundation, Athens, Greece
- 2nd Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, “ATTIKON” University Hospital, Haidari, Greece
| | | | - Jolanda M A Boer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | | | - Marie-Christine Boutron-Ruault
- Center for Research in Epidemiology and Population Health, University Paris-South, Faculty of Medicine, University Versailles-St Quentin, National Institute for Health and Medical Research, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Guy Fagherazzi
- Center for Research in Epidemiology and Population Health, University Paris-South, Faculty of Medicine, University Versailles-St Quentin, National Institute for Health and Medical Research, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Anne-Laure Madika
- Center for Research in Epidemiology and Population Health, University Paris-South, Faculty of Medicine, University Versailles-St Quentin, National Institute for Health and Medical Research, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
- Université Lille, CHU Lille, Lille, France
| | - Manuela M Bergmann
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
- DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany
- University of Potsdam, Institute of Nutritional Sciences, Nuthetal, Germany
| | - Pietro Ferrari
- International Agency for Research on Cancer, WHO, Lyon, France
| | - Heinz Freisling
- International Agency for Research on Cancer, WHO, Lyon, France
| | - Hannah Lennon
- International Agency for Research on Cancer, WHO, Lyon, France
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention, Turin, Italy
| | - Giovanna Masala
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, “Civic-M.P.Arezzo” Hospital, ASP Ragusa, Ragusa, Italy
| | - Elio Riboli
- Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom
| | - Nicholas J Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - John Danesh
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Nita G Forouhi
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Adam S Butterworth
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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South Indian Cuisine with Low Glycemic Index Ingredients Reduces Cardiovascular Risk Factors in Subjects with Type 2 Diabetes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176232. [PMID: 32867226 PMCID: PMC7504299 DOI: 10.3390/ijerph17176232] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/07/2020] [Accepted: 08/20/2020] [Indexed: 11/17/2022]
Abstract
Background: Inflammation is considered as a predictor of cardiovascular diseases in type 2 diabetes mellitus. No previous studies have investigated the effect of low glycemic index (LGI) recipes of South Indian cuisine on the risk factors of cardiovascular disease in patients with diabetes. Aim: The aim of this randomized controlled trial was to evaluate the improvement in cardiovascular risk factors and blood glucose control, in patients with type 2 diabetes, after intervention with recipes of Kerala cuisine, from locally available whole grain cereals, low in glycemic index. Method: This was a prospective and randomized controlled study that was conducted over a period of 24 weeks. A total of 80 participants were recruited from the Department of Endocrinology and Diabetes Outpatient in Kerala, South India. All 80 patients had type 2 diabetes, and were aged between 35 and 65 years. Participants were randomly assigned and advised to follow either a LGI diet plan (n = 40) or their usual diet, which served as a control group (n = 40). The advice was reinforced throughout the study period. Anthropometric, biochemical parameters which included glycemic and cardio-metabolic parameters were measured according to standard procedures. T-tests were conducted to compare the differences between intervention and control groups, and the Pearson correlation coefficient was used to evaluate associations between the variables. Results: There were significant differences (p < 0.05) between the intervention and control groups with respect to weight, HbA1c, insulin, triglycerides, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), high sensitivity C-reactive protein (hs-CRP) and apolipoprotein B (ApoB). There was also a positive correlation between weight and blood glucose variables. ApoB was positively correlated with lipid profile and insulin levels. Conclusions: The long-term implementation of LGI diet of Kerala cuisine has been found to promote weight loss, enhance insulin sensitivity and reduce the cardiovascular risk.
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Dinu M, Pagliai G, Angelino D, Rosi A, Dall'Asta M, Bresciani L, Ferraris C, Guglielmetti M, Godos J, Del Bo’ C, Nucci D, Meroni E, Landini L, Martini D, Sofi F. Effects of Popular Diets on Anthropometric and Cardiometabolic Parameters: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials. Adv Nutr 2020; 11:815-833. [PMID: 32059053 PMCID: PMC7360456 DOI: 10.1093/advances/nmaa006] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/19/2019] [Accepted: 01/14/2020] [Indexed: 12/14/2022] Open
Abstract
The prevalence of overweight, obesity, and their related complications is increasing worldwide. The purpose of this umbrella review was to summarize and critically evaluate the effects of different diets on anthropometric parameters and cardiometabolic risk factors. Medline, Embase, Scopus, Cochrane Database of Systematic Reviews, and Web of Science, from inception to April 2019, were used as data sources to select meta-analyses of randomized controlled trials that examined the effects of different diets on anthropometric parameters and cardiometabolic risk factors. Strength and validity of the evidence were assessed through a set of predefined criteria. Eighty articles reporting 495 unique meta-analyses were examined, covering a wide range of popular diets: low-carbohydrate (n = 21 articles), high-protein (n = 8), low-fat (n = 9), paleolithic (n = 2), low-glycemic-index/load (n = 12), intermittent energy restriction (n = 6), Mediterranean (n = 11), Nordic (n = 2), vegetarian (n = 9), Dietary Approaches to Stop Hypertension (DASH) (n = 6), and portfolio dietary pattern (n = 1). Great variability in terms of definition of the intervention and control diets was observed. The methodological quality of most articles (n = 65; 81%), evaluated using the "A MeaSurement Tool to Assess systematic Reviews-2" questionnaire, was low or critically low. The strength of evidence was generally weak. The most consistent evidence was reported for the Mediterranean diet, with suggestive evidence of an improvement in weight, BMI, total cholesterol, glucose, and blood pressure. Suggestive evidence of an improvement in weight and blood pressure was also reported for the DASH diet. Low-carbohydrate, high-protein, low-fat, and low-glycemic-index/load diets showed suggestive and/or weak evidence of a reduction in weight and BMI, but contrasting evidence for lipid, glycemic, and blood pressure parameters, suggesting potential risks of unfavorable effects. Evidence for paleolithic, intermittent energy restriction, Nordic, vegetarian, and portfolio dietary patterns was graded as weak. Among all the diets evaluated, the Mediterranean diet had the strongest and most consistent evidence of a beneficial effect on both anthropometric parameters and cardiometabolic risk factors. This review protocol was registered at www.crd.york.ac.uk/PROSPERO/ as CRD42019126103.
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Affiliation(s)
- Monica Dinu
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Giuditta Pagliai
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Donato Angelino
- Faculty of Bioscience and Technology for Food, Agriculture, and Environment, University of Teramo, Teramo, Italy
| | - Alice Rosi
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Parma, Italy
| | - Margherita Dall'Asta
- Department of Animal Science, Food, and Nutrition, Università Cattolica del Sacro Cuore, Piacenza, Italy
| | - Letizia Bresciani
- Human Nutrition Unit, Department of Veterinary Science, University of Parma, Parma, Italy
| | - Cinzia Ferraris
- Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Monica Guglielmetti
- Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | | | - Cristian Del Bo’
- Department of Food, Environmental, and Nutritional Sciences, Università degli Studi di Milano, Milan, Italy
| | - Daniele Nucci
- Digestive Endoscopy Unit, Veneto Institute of Oncology, Padua, Italy
| | - Erika Meroni
- Department of Food, Environmental, and Nutritional Sciences, Università degli Studi di Milano, Milan, Italy
| | - Linda Landini
- Medical Affairs Janssen, Cologno-Monzese, Milan, Italy
| | - Daniela Martini
- Department of Food, Environmental, and Nutritional Sciences, Università degli Studi di Milano, Milan, Italy
| | - Francesco Sofi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Unit of Clinical Nutrition, University Hospital of Careggi, Florence, Italy
- Don Carlo Gnocchi Foundation Italy, Onlus, Florence, Italy
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Lowering breakfast glycemic index and glycemic load attenuates postprandial glycemic response: A systematically searched meta-analysis of randomized controlled trials. Nutrition 2020; 71:110634. [DOI: 10.1016/j.nut.2019.110634] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/02/2019] [Accepted: 10/19/2019] [Indexed: 11/18/2022]
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Comparison of the Structural Properties and Nutritional Fraction of Corn Starch Treated with Thermophilic GH13 and GH57 α-Glucan Branching Enzymes. Foods 2019; 8:foods8100452. [PMID: 31581739 PMCID: PMC6835866 DOI: 10.3390/foods8100452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 09/27/2019] [Accepted: 09/27/2019] [Indexed: 11/17/2022] Open
Abstract
Two thermophilic 1,4-α-glucan branching enzymes (GBEs), CbGBE from Caldicellulosiruptor bescii and PhGBE from Pyrococcus horikoshii, which belong to the glycoside hydrolase family 13 and 57 respectively, were cloned and expressed in Escherichia coli. Two GBEs were identified to have α-1,6 branching activity against various substrates, but substrate specificity was distinct. Starch was modified by two GBEs and their in vitro digestibility and structural properties were investigated. Short-branched A chains with a degree of polymerization (DP) of 6–12 increased with CbGBE-modified starch, increasing the proportion of slow digestible and resistant starch (RS) fractions. PhGBE-modified starch resulted in an increase in the RS fraction only by a slight increase in part of A chains (DP, 6–9). Compared to the proportion of control not treated with GBE, the proportion of α-1,6 linkages in CbGBE- and PhGBE-modified starch increased by 3.1 and 1.6 times. 13C cross polarization/magic angle sample spinning (CP/MAS) NMR and XRD pattern analysis described that GBE-modified starches reconstructed double helices but not the crystalline structure. Taken together, CbGBE and PhGBE showed distinct branching activities, resulting in different α-1,6 branching ratios and chain length distribution, and double helices amount of starch, ultimately affecting starch digestibility. Therefore, these GBEs can be used to produce customized starches with controlled digestion rates.
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Zafar MI, Mills KE, Zheng J, Regmi A, Hu SQ, Gou L, Chen LL. Low-glycemic index diets as an intervention for diabetes: a systematic review and meta-analysis. Am J Clin Nutr 2019; 110:891-902. [PMID: 31374573 DOI: 10.1093/ajcn/nqz149] [Citation(s) in RCA: 133] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 06/24/2019] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Low-glycemic index (GI) diets are thought to reduce postprandial glycemia, resulting in more stable blood glucose concentrations. OBJECTIVE We hypothesized that low-GI diets would be superior to other diet types in lowering measures of blood glucose control in people with type 1 or type 2 diabetes, or impaired glucose tolerance. METHODS We searched PubMed, the Cochrane Library, EMBASE, and clinical trials registries for published and unpublished studies up until 1 March, 2019. We included 54 randomized controlled trials in adults or children with impaired glucose tolerance, type 1 diabetes, or type 2 diabetes. Continuous data were synthesized using a random effects, inverse variance model, and presented as standardized mean differences with 95% CIs. RESULTS Low-GI diets were effective at reducing glycated hemoglobin (HbA1c), fasting glucose, BMI, total cholesterol, and LDL, but had no effect on fasting insulin, HOMA-IR, HDL, triglycerides, or insulin requirements. The reduction in fasting glucose and HbA1c was inversely correlated with body weight. The greatest reduction in fasting blood glucose was seen in the studies of the longest duration. CONCLUSIONS Low-GI diets may be useful for glycemic control and may reduce body weight in people with prediabetes or diabetes.
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Affiliation(s)
- Mohammad Ishraq Zafar
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Kerry E Mills
- Faculty of Science and Technology, University of Canberra, Canberra, Australia
| | - Juan Zheng
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Anita Regmi
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Sheng Qing Hu
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Luoning Gou
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Lu-Lu Chen
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
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Neuenschwander M, Hoffmann G, Schwingshackl L, Schlesinger S. Impact of different dietary approaches on blood lipid control in patients with type 2 diabetes mellitus: a systematic review and network meta-analysis. Eur J Epidemiol 2019; 34:837-852. [PMID: 31201670 DOI: 10.1007/s10654-019-00534-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 06/08/2019] [Indexed: 12/11/2022]
Abstract
The aim of this study was to assess the effects of different dietary approaches on low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglyceride (TG) levels in patients with type 2 diabetes (T2D) by applying network meta-analysis (NMA). Systematic electronic and hand searches were conducted until January 2018. Randomized controlled trials (RCTs) with an intervention period of ≥ 12 weeks, focussing on adults with T2D, and comparing dietary approaches regarding LDL, HDL or TGs, were included. For each outcome measure, random effects NMA was performed in order to determine the effect of each dietary approach compared to every other dietary intervention. Mean differences (MDs) and 95% confidence intervals (95% CIs) were calculated, and for the ranking, the surface under the cumulative ranking curves (SUCRA) was determined. Additionally, the credibility of evidence was evaluated. 52 RCTs (44 for LDL, 48 for HDL and 52 for TGs) comparing nine dietary approaches (low fat, vegetarian, Mediterranean, high protein, moderate carbohydrate, low carbohydrate, control, low glycaemic index/glycaemic load and Palaeolithic diet) enrolling 5360 T2D patients were included. The vegetarian diet most effectively reduced LDL levels [MD (95% CI): - 0.33 (- 0.55, - 0.12) mmol/L; compared to the control diet]. The Mediterranean diet beneficially raised HDL [MD (95% CI): 0.09 (0.04, 0.15) mmol/L] and decreased TG levels [MD (95% CI): - 0.41 (- 0.72, - 0.10) mmol/L] compared to the control diet. The Mediterranean diet was the most effective dietary approach to manage diabetic dyslipidaemia altogether (SUCRA: 79%). The overall findings are mainly limited by low credibility of evidence.
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Affiliation(s)
- Manuela Neuenschwander
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Georg Hoffmann
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Breisacher Straße 153, 79110, Freiburg, Germany.
| | - Sabrina Schlesinger
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Marchioro L, Geraghty AA, Uhl O, Shokry E, O'Brien EC, Koletzko B, McAuliffe FM. Effect of a low glycaemic index diet during pregnancy on maternal and cord blood metabolomic profiles: results from the ROLO randomized controlled trial. Nutr Metab (Lond) 2019; 16:59. [PMID: 31467584 PMCID: PMC6712779 DOI: 10.1186/s12986-019-0378-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 07/19/2019] [Indexed: 11/10/2022] Open
Abstract
Background Elevated post-prandial blood glucose during pregnancy has been associated with adverse pregnancy and offspring outcomes, such as maternal gestational diabetes and excessive foetal growth. The ROLO Study is a randomized controlled trial (RCT) investigating the effect of a low glycaemic index (GI) diet in pregnancy to prevent foetal macrosomia (birth weight > 4000 g). We described the impact of a low-GI diet on the maternal and feto-placental unit metabolism by studying how the ROLO intervention affected maternal and cord blood metabolomes. Methods Fasting maternal plasma samples pre- and post-intervention of 51 pregnant women and 132 cord blood samples were measured with a targeted metabolomics approach using liquid-chromatography coupled to tandem mass spectrometry. The differences between RCT groups were explored via multivariate models with covariates correction. Significance was set at Bonferroni-corrected level of 0.05. Results A total of 262 metabolites species, sums and ratios were investigated. While no metabolite reached statistical significance after Bonferroni correction, many maternal phospholipids and acylcarnitines were elevated in the intervention group at uncorrected 0.05 alpha level. Most species contained saturated and monounsaturated fatty acid chains with 16 or 18 carbon atoms. In cord blood, no differences were identified between RCT groups. Conclusions A low-GI diet in pregnancy was associated with a trend to modest but consistent changes in maternal lipid and fatty acid metabolism. The intervention seemed not to affect foetal metabolism. Our exploratory findings may be used to direct further investigations about low GI diets before and during pregnancy, to improve patient care for pre-conceptional and pregnant women with lipid dysregulations and potentially modulate the offspring's risk for future metabolic diseases. Trial registration Current Controlled Trials ISRCTN54392969.
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Affiliation(s)
- Linda Marchioro
- Division of Metabolic and Nutritional Medicine, Department of Paediatrics, Dr. von Hauner Children's Hospital, University hospital, LMU Munich, Lindwurmstraße 4, D-80337 Munich, Germany
| | - Aisling A Geraghty
- 2UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Olaf Uhl
- Division of Metabolic and Nutritional Medicine, Department of Paediatrics, Dr. von Hauner Children's Hospital, University hospital, LMU Munich, Lindwurmstraße 4, D-80337 Munich, Germany
| | - Engy Shokry
- Division of Metabolic and Nutritional Medicine, Department of Paediatrics, Dr. von Hauner Children's Hospital, University hospital, LMU Munich, Lindwurmstraße 4, D-80337 Munich, Germany
| | - Eileen C O'Brien
- 2UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Berthold Koletzko
- Division of Metabolic and Nutritional Medicine, Department of Paediatrics, Dr. von Hauner Children's Hospital, University hospital, LMU Munich, Lindwurmstraße 4, D-80337 Munich, Germany
| | - Fionnuala M McAuliffe
- 2UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
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Ojo O, Ojo OO, Wang XH, Adegboye ARA. The Effects of a Low GI Diet on Cardiometabolic and Inflammatory Parameters in Patients with Type 2 and Gestational Diabetes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Nutrients 2019; 11:E1584. [PMID: 31336986 PMCID: PMC6683080 DOI: 10.3390/nu11071584] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 06/24/2019] [Accepted: 07/05/2019] [Indexed: 02/07/2023] Open
Abstract
The prevalence of diabetes is increasing globally, and its effect on patients and the healthcare system can be significant. Gestational diabetes mellitus (GDM) and type 2 diabetes are well established risk factors for cardiovascular disease, and strategies for managing these conditions include dietary interventions, such as the use of a low glycemic index (GI) diet. AIMS This review aimed to evaluate the effects of a low GI diet on the cardio-metabolic and inflammatory parameters in patients with type 2 diabetes and women with GDM and assess whether the effects are different in these conditions. METHODS This review was based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Three databases (EMBASE, Pubmed, and PsycINFO) were searched from inception to 20 February 2019 using search terms that included synonyms and Medical Subject Headings (MeSH) in line with the population, intervention, comparator, outcomes, and studies (PICOS) framework. Studies were evaluated for the quality and risk of bias. RESULTS 10 randomised controlled studies were included in the systematic review, while 9 were selected for the meta-analysis. Two distinct areas were identified: the effect of a low GI diet on lipid profile and the effect of a low GI diet on inflammatory parameters. The results of the meta-analysis showed that there were no significant differences (p > 0.05) between the low GI and higher GI diets with respect to total cholesterol, HDL, and LDL cholesterol in patients with type 2 diabetes. However, there was a significant difference (p = 0.027) with respect to triglyceride which increased by a mean of 0.06 mmol/L (0.01, 0.11) in patients with type 2 diabetes on higher GI diet. With respect to the women with GDM, the findings from the systematic review were not consistent in terms of the effect of a low GI diet on the lipid profile. The results of the meta-analysis did not show significant differences (p > 0.05) between low GI and higher GI diets with respect to adiponectin and C-reactive proteins in patients with type 2 diabetes, but a significant difference (p < 0.001) was observed between the two groups in relation to interleukin-6. CONCLUSION This systematic review and meta-analysis have demonstrated that there were no significant differences (p > 0.05) between the low GI and higher GI diets in relation to total cholesterol-HDL and LDL cholesterol-in patients with type 2 diabetes. However, a significant difference (p < 0.05) was observed between the two groups with respect to triglyceride in patients with type 2 diabetes. The results of the effect of a low GI diet on the lipid profile in patients with GDM were not consistent. With respect to the inflammatory parameters, the low GI diet significantly decreased interleukin-6 in patients with type 2 diabetes compared to the higher GI diet. More studies are needed in this area of research.
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Affiliation(s)
- Omorogieva Ojo
- Faculty of Education and Health, Department of Adult Nursing and Paramedic Science, University of Greenwich, London SE9 2UG, UK.
| | - Osarhumwese Osaretin Ojo
- South London and Maudsley NHS Foundation Trust, University Hospital, Lewisham High Street, London SE13 6LH, UK
| | - Xiao-Hua Wang
- The School of Nursing, Soochow University, Suzhou 215006, China
| | - Amanda Rodrigues Amorim Adegboye
- Faculty of Education and Health, Department of Psychology, Social Work & Counselling, University of Greenwich, London SE9 2UG, UK
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Gestational Diabetes Mellitus: The Impact of Carbohydrate Quality in Diet. Nutrients 2019; 11:nu11071549. [PMID: 31323991 PMCID: PMC6683084 DOI: 10.3390/nu11071549] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/02/2019] [Accepted: 07/04/2019] [Indexed: 12/29/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is defined as “glucose intolerance that is first diagnosed during pregnancy”. Mothers with GDM and their infants may experience both short and long term complications. Dietary intervention is the first therapeutic strategy. If good glycaemic control is not achieved, insulin therapy is recommended. There is no consensus on which nutritional approach should be used in GDM. In the last few years, there has been growing evidence of the benefits of a low glycaemic index (LGI) diet on diabetes and cardiovascular disease. The effect of a LGI diet on GDM incidence has been investigated as well. Several studies observed a lower incidence of GDM in LGI diet arms, without adverse maternal and fetal outcomes. The main positive effect of the LGI diet was the reduction of 2-h post-prandial glucose (PPG). Several studies have also evaluated the effect of the LGI diet in GDM treatment. Overall, the LGI diet might have beneficial effects on certain outcomes, such as 2-h PPG, fasting plasma glucose and lipid profile in patients with GDM. Indeed, most studies observed a significant reduction in insulin requirement. Overall, according to current evidence, the LGI nutritional approach is safe and it might therefore be considered in clinical care for GDM.
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Tosatti JAG, Bocardi VB, Jansen AK, Bernandes H, Silva FM. Determination of glycemic index of enteral formulas used in clinical practice. Int J Food Sci Nutr 2019; 71:201-210. [PMID: 31244367 DOI: 10.1080/09637486.2019.1634011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Glycemic Index (GI) is a measure of carbohydrate quality and is recognised as a valid and reproducible method of classifying carbohydrate foods according to its effects on postprandial glycaemia. In this randomised crossover trial (RBR-7rjx3k) we determined the GI of nine enteral formulas, following the Food and Agriculture Organisation/World Health Organisation method. Forty healthy participants were included in the study (85% female mean age 27.1 ± 6.7 years). GI of the enteral formulas ranged from 40.5 to 85.2; four formulas had high GI (Nutrienteral 1.5®, Novasource GI Control®, Diamax®, Isosource Soya®), two intermediate GI (Fresubin 1.2 HP Fibre®, Nutrison Energy Multifiber 1.5®) and three low GI (Trophic 1.5®, Glucerna®, Novasource GC HP®). The GI coefficient of variation ranged from 22.9% to 83.6%. The effect of the enteral formulas with low GI in glycemic control of patients with enteral nutrition prescription needs to be test in future studies.
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Affiliation(s)
| | | | - Ann Kristine Jansen
- Nutrition Department, Federal University of Minas Gerais - UFMG, Belo Horizonte, Brazil
| | - Hugo Bernandes
- Risoleta Tolentino Neves Hospital, Belo Horizonte, Brazil
| | - Flávia Moraes Silva
- Nutrition Department and Postgraduation Program of Nutrition Science of Federal University of Healthy Science of Porto Alegre - UFCSPA, Porto Alegre, Brazil
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Cutler DA, Pride SM, Cheung AP. Low intakes of dietary fiber and magnesium are associated with insulin resistance and hyperandrogenism in polycystic ovary syndrome: A cohort study. Food Sci Nutr 2019; 7:1426-1437. [PMID: 31024716 PMCID: PMC6475723 DOI: 10.1002/fsn3.977] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/24/2019] [Accepted: 02/07/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Women with polycystic ovary syndrome (PCOS) often have insulin resistance (IR) which may be worsened by obesity. The roles of dietary intake and activity are unclear. Our objectives were to determine whether (a) high caloric intake or inactivity explains obesity in PCOS, and (b) dietary composition is associated with PCOS phenotypes. METHODS Eighty-seven women with PCOS and 50 women without PCOS participated in this cohort study at a reproductive medicine center. Data collected included 3-day food and physical activity records, anthropometrics, and metabolic and hormonal assays. RESULTS Women with PCOS had increased body mass index (BMI) but similar caloric intake and activity to women without PCOS. There were no differences in protein, carbohydrates, fat, or glycemic load consumption, but women with PCOS consumed less fiber (medians: 19.6 vs. 24.7 g) and less magnesium (medians: 238.9 vs. 273.9 mg). In women with PCOS, those with IR consumed less fiber, less magnesium, and greater glycemic load than those without IR (medians: 18.2 vs. 22.1 g, 208.4 vs. 264.5 mg, 89.6 vs. 83.5). Fiber intake of women with PCOS was negatively correlated with IR, fasting insulin, glucose tolerance, testosterone, and dehydroepiandrosterone sulfate. Magnesium intake was negatively correlated with IR, C-reactive protein, and testosterone, but positively correlated with HDL cholesterol. Fiber intake and BMI accounted for 54.0% of the variance observed in IR. CONCLUSIONS Obesity in women with PCOS could not be explained by overeating or inactivity. Increasing dietary fiber and magnesium intakes may assist in reducing IR and hyperandrogenemia in women with PCOS.
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Affiliation(s)
- Dylan A. Cutler
- Department of Obstetrics and GynaecologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Sheila M. Pride
- Department of Obstetrics and GynaecologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Anthony P. Cheung
- Department of Obstetrics and GynaecologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- Grace Fertility & Reproductive MedicineVancouverBritish ColumbiaCanada
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Zafar MI, Mills KE, Zheng J, Peng MM, Ye X, Chen LL. Low glycaemic index diets as an intervention for obesity: a systematic review and meta-analysis. Obes Rev 2019; 20:290-315. [PMID: 30460737 DOI: 10.1111/obr.12791] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Low glycaemic index (GI) diets may aid in weight loss by reducing postprandial blood glucose excursions, leading to more stable blood glucose concentrations and therefore a reduction in hunger. To test this hypothesis, we conducted a systematic review and meta-analysis of randomized controlled trials comparing low GI diets with other diet types. METHODS We included 101 studies involving 109 study arms and 8,527 participants. We meta-analysed the studies using a random-effects model and conducted subgroup analyses and meta-regression based on control diet, blood glucose control, baseline BMI and dietary GI. RESULTS Low GI diets resulted in small but significant improvements in body weight, BMI, LDL and total cholesterol overall, although no individual control diet was significantly different from low GI diets. Studies in people with normal blood glucose who achieved a difference in GI of 20 points or more resulted in a larger reduction in body weight (SMD = -0.26; 95% CIs [-0.43, -0.09]), and total cholesterol (SMD = -0.24; 95% CIs [-0.42, -0.05]) than studies that only achieved a smaller reduction in GI. CONCLUSIONS Low GI diets, especially diets achieving a substantial decrease in GI, were moderately effective in lowering body weight. However, efforts should be made to increase compliance with low GI diets, in order for them to be effective in people with overweight and obesity.
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Affiliation(s)
- M I Zafar
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - K E Mills
- Faculty of Science and Technology, University of Canberra, Canberra, Australia
| | - J Zheng
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - M M Peng
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - X Ye
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - L L Chen
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Hasni Y, Bachrouch S, Mahjoub M, Maaroufi A, Rouatbi S, Ben Saad H. Biochemical Data and Metabolic Profiles of Male Exclusive Narghile Smokers (ENSs) Compared With Apparently Healthy Nonsmokers (AHNSs). Am J Mens Health 2019; 13:1557988319825754. [PMID: 30819065 PMCID: PMC6440044 DOI: 10.1177/1557988319825754] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 12/19/2018] [Accepted: 12/21/2018] [Indexed: 01/01/2023] Open
Abstract
Studies evaluating the metabolic profiles of ENSs are scarce and presented controversial conclusions. This study aimed to compare the metabolic profiles of ENSs' and AHNSs' groups. Males aged 25-45 years and free from a known history of metabolic and/or cardiovascular diseases were included. According to the smoking status, two groups of ENSs and AHNSs were identified. Body mass index (BMI, kg/m2), waist circumference (WC, cm), systolic and diastolic blood pressures (SBP, DBP, mmHg), fasting blood data in mmol/L (blood glycemia [FBG], triglycerides [TG], total cholesterol [TC], high- and low- density lipoprotein cholesterol [HDL-C, LDL-C]) and obesity status were evaluated. The metabolic syndrome (MetS) was defined according to the 2006 International Diabetes Federation (IDF) recommendations. Data were expressed as mean ± standard deviation ( SD) or percentages. Compared to the AHNSs' group ( n = 29), the ENSs' one ( n = 29) had (a) higher values of BMI (26.5 ± 2.3 vs. 28.2 ± 3.6), WC (95 ± 7 vs. 100 ± 10), and TG (1.22 ± 0.40 vs. 1.87 ± 0.85); and (b) included a lower percentage of males having low HDL-C (82.7% vs. 62.0%), and higher percentages of males having obesity (6.9% vs. 37.9%) or hypertriglyceridemia (10.7% vs. 51.7%). Both the ENSs' and AHNSs' groups: (a) had similar values of FBG (5.38 ± 0.58 vs. 5.60 ± 0.37), TC (4.87 ± 1.16 vs. 4.36 ± 0.74), HDL-C (0.92 ± 0.30 vs. 0.82 ± 0.21), LDL-C (3.09 ± 0.98 vs. 2.92 ± 0.77), SBP (117 ± 9 vs. 115 ± 8), and DBP (76 ± 6 vs. 73 ± 7); and (b) included similar percentages of males having normal weight (17.2% vs. 31.0%); overweight (44.8% vs. 62.1%); android obesity (79.3% vs. 59.6%), hypertension (10.3% vs. 10.3%), hyperglycemia (37.9% vs. 48.2%), and MetS (51.7% vs. 34.5%). There is a need to monitor narghile use among male metabolic patients since it alters some components of the MetS.
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Affiliation(s)
- Yosra Hasni
- Department of Endocrinology, University Hospital Farhat Hached, Sousse, Tunisia
| | - Sabrine Bachrouch
- Department of Endocrinology, University Hospital Farhat Hached, Sousse, Tunisia
| | - Mohamed Mahjoub
- Department of Hospital Hygiene, University Hospital Farhat Hached, Sousse, Tunisia
| | - Amel Maaroufi
- Department of Endocrinology, University Hospital Farhat Hached, Sousse, Tunisia
| | - Sonia Rouatbi
- Laboratory of Physiology and Functional Explorations, Farhat Hached Hospital, Sousse, Tunisia
- Heart Failure (LR12SP09) Research Laboratory, University Hospital Farhat Hached, Sousse, Tunisia
| | - Helmi Ben Saad
- Laboratory of Physiology and Functional Explorations, Farhat Hached Hospital, Sousse, Tunisia
- Heart Failure (LR12SP09) Research Laboratory, University Hospital Farhat Hached, Sousse, Tunisia
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Dietary glycaemic index and cognitive function: prospective associations in adults of the 1946 British birth cohort. Public Health Nutr 2018; 22:1415-1424. [PMID: 30585572 PMCID: PMC6906611 DOI: 10.1017/s136898001800352x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objective Evidence suggests that the rate of glucose release following consumption of carbohydrate-containing foods, defined as the glycaemic index (GI), is inversely associated with cognitive function. To date, most of the evidence stems from either single-meal studies or highly heterogeneous cohort studies. We aimed to study the prospective associations of diet GI at age 53 years with outcomes of verbal memory and letter search tests at age 69 years and rate of decline between 53 and 69 years. Design Longitudinal population-based birth cohort study. Setting MRC National Survey for Health and Development. Participants Cohort members (n 1252). Results Using multivariable linear and logistic regression, adjusted for potential confounders, associations of higher-GI diet with lower verbal memory, lower letter search speed and lower number of hits in a letter search test were attenuated after adjustments for cognitive ability at age 15 years, educational attainment, further training and occupational social class. No association was observed between diet GI at 53 years and letter search accuracy or speed–accuracy trade-off at 69 years, or between diet GI at 53 years and rate of decline between 53 and 69 years in any cognitive measure. Conclusions Diet GI does not appear to predict cognitive function or decline, which was mainly explained by childhood cognitive ability, education and occupational social class. Our findings confirm the need for further research on the association between diet and cognition from a life-course perspective.
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Clifton PM. Diet, exercise and weight loss and dyslipidaemia. Pathology 2018; 51:222-226. [PMID: 30528924 DOI: 10.1016/j.pathol.2018.10.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 10/09/2018] [Accepted: 10/10/2018] [Indexed: 01/06/2023]
Abstract
There is a large amount of controversy relating dietary fat intake and coronary artery disease. It has been strongly suggested that saturated fat is not harmful and that polyunsaturated fat is either not beneficial or even harmful. Given that dietary lipids and fibre can influence serum lipids which are strongly linked to the risk of coronary artery disease I have reviewed recent evidence linking diet and serum lipids to confirm a diet-heart disease link. Over 84 studies have been included in a recent meta-analysis and meta-regression which examined the effects of changes in fat type on lipid levels. An absolute 1% reduction in saturated fat or trans fat intake as a percentage of energy with replacement by n-6 polyunsaturated fat would lead to a reduction in low density lipoprotein (LDL) cholesterol of 0.05 mmol/L. In most Western countries the difference in intake between the highest quintile and the lowest quintile of saturated fat is about 7%, so moving from the highest to the lowest quintile should lower LDL cholesterol by 0.35 mmol/L or about 10%. This change should lower cardiovascular disease rates by at least 10%. Replacing this amount of saturated fat with carbohydrate of average quality would lower LDL cholesterol by 0.21 mmol/L and increase fasting triglyceride by 0.17 mmol/L. This combination of effects would have a neutral effect on cardiovascular disease rates. However, replacement of trans fat appears to reduce disease rates and total mortality. Substituting low glycaemic index carbohydrates for high glycaemic index carbohydrates will lower triglyceride by 15-25% and reduce cardiovascular risk. Large doses of fish oil will lower triglyceride with a mean lowering of 0.45 mmol/L for a 3.5 g/day amount. Large doses of soluble fibre (3.5-7.0 g/day) lower LDL cholesterol by 0.2-0.35 mmol/L with Konjac glucomannan being the most effective per gram. Plant sterols or stanols lower LDL cholesterol by about 10% for a 2 g/day dose, while exercise and weight loss lower cardiovascular risk predominantly by lowering fasting triglyceride. In conclusion, diet lowers LDL cholesterol and triglyceride and dietary changes should be ultimately linked to a reduced risk of heart disease.
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Affiliation(s)
- Peter M Clifton
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.
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SARDÁ FAH, GIUNTINI EB, NAZARE JA, KÖNIG D, BAHIA LR, LAJOLO FM, MENEZES EWD. Effectiveness of carbohydrates as a functional ingredient in glycemic control. FOOD SCIENCE AND TECHNOLOGY 2018. [DOI: 10.1590/fst.42517] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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