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Lambert DC, Kane J, Newberry C. Lifestyle Therapy for Obesity. Gastrointest Endosc Clin N Am 2024; 34:577-589. [PMID: 39277292 DOI: 10.1016/j.giec.2024.03.003] [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: 09/17/2024]
Abstract
Lifestyle management of obesity includes nutritional therapy, physical activity, and several intermittent fasting therapies. Effective nutrition therapies include optimized low-fat diets, high-quality ketogenic diets, and energy-restricted diets. Adherence to dietary change remains the most substantial barrier to success; therefore, patients engaging in lifestyle changes require intensive support and resources. Physical activity is shown to have benefits to body composition and disease risk beyond the effects on weight loss. Patients should be guided toward a regimen that is appropriate for their capacity for movement. Multiple intermittent fasting strategies have now been shown to cause substantial weight loss and metabolic health improvement.
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Affiliation(s)
- Douglas C Lambert
- Department of General Internal Medicine, Section of Obesity Medicine, Northwell Health, Northwell Center for Weight Management, 865 Northern Boulevard, Suite 102, Great Neck, NY 11021, USA.
| | - Jamie Kane
- Department of General Internal Medicine, Section of Obesity Medicine, Northwell Health, Northwell Center for Weight Management, 865 Northern Boulevard, Suite 102, Great Neck, NY 11021, USA
| | - Carolyn Newberry
- Division of Gastroenterology and Hepatology, Innovative Center for Health and Nutrition in Gastroenterology (ICHANGE), Weill Cornell Medicine, 420 East 70th Street, #442, New York, NY 10021, USA
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2
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Volek JS, Kackley ML, Buga A. Nutritional Considerations During Major Weight Loss Therapy: Focus on Optimal Protein and a Low-Carbohydrate Dietary Pattern. Curr Nutr Rep 2024; 13:422-443. [PMID: 38814519 PMCID: PMC11327213 DOI: 10.1007/s13668-024-00548-6] [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] [Accepted: 05/01/2024] [Indexed: 05/31/2024]
Abstract
PURPOSE OF REVIEW Considering the high prevalence of obesity and related metabolic impairments in the population, the unique role nutrition has in weight loss, reversing metabolic disorders, and maintaining health cannot be overstated. Normal weight and well-being are compatible with varying dietary patterns, but for the last half century there has been a strong emphasis on low-fat, low-saturated fat, high-carbohydrate based approaches. Whereas low-fat dietary patterns can be effective for a subset of individuals, we now have a population where the vast majority of adults have excess adiposity and some degree of metabolic impairment. We are also entering a new era with greater access to bariatric surgery and approval of anti-obesity medications (glucagon-like peptide-1 analogues) that produce substantial weight loss for many people, but there are concerns about disproportionate loss of lean mass and nutritional deficiencies. RECENT FINDINGS No matter the approach used to achieve major weight loss, careful attention to nutritional considerations is necessary. Here, we examine the recent findings regarding the importance of adequate protein to maintain lean mass, the rationale and evidence supporting low-carbohydrate and ketogenic dietary patterns, and the potential benefits of including exercise training in the context of major weight loss. While losing and sustaining weight loss has proven challenging, we are optimistic that application of emerging nutrition science, particularly personalized well-formulated low-carbohydrate dietary patterns that contain adequate protein (1.2 to 2.0 g per kilogram reference weight) and achieve the beneficial metabolic state of euketonemia (circulating ketones 0.5 to 5 mM), is a promising path for many individuals with excess adiposity.
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Affiliation(s)
- Jeff S Volek
- Department of Human Sciences, The Ohio State University, 305 Annie & John Glenn Ave, Columbus, OH, 43210, USA.
| | - Madison L Kackley
- Department of Human Sciences, The Ohio State University, 305 Annie & John Glenn Ave, Columbus, OH, 43210, USA
| | - Alex Buga
- Department of Human Sciences, The Ohio State University, 305 Annie & John Glenn Ave, Columbus, OH, 43210, USA
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Zhang Y, He T, Hu Y, Gao C. Low-Carbohydrate Diet is More Helpful for Weight Loss Than Low-Fat Diet in Adolescents with Overweight and Obesity: A Systematic Review and Meta-Analysis. Diabetes Metab Syndr Obes 2024; 17:2997-3007. [PMID: 39145286 PMCID: PMC11322504 DOI: 10.2147/dmso.s467719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 07/26/2024] [Indexed: 08/16/2024] Open
Abstract
Purpose This manuscript performed a meta-analysis to compare the effects of a low-fat diet (LFD) and a low-carbohydrate diet (LCD) on body weight and lipid levels in adolescents with overweight and obesity. Patients and Methods PubMed and other databases were searched for the full-text literature comparing LFD and LCD up to November 2023 using a subject plus free word strategy, with search terms such as "low-fat diet", "low-carbohydrate diet", "obesity", "weight", "adolescents", "RCT", and so on. Two independent reviewers selected promising candidate trials, collected the data, and assessed the quality of the trials. RevMan 5.3 software was utilized to conduct a meta-analysis of the randomized controlled trials (RCTs) that were included. Results 5 RCTs with 192 participants were included in this meta-analysis. Weight (mean difference -2.81; 95% CI -5.38 to -0.25), Body Mass Index (BMI) (-1.13; 95% CI -2.14 to -0.11) and Triglyceride (TG) (-0.36; 95% CI -0.46 to -0.27) of the LCD were significantly lower than that of the LFD. At the same time, the high-density lipoprotein cholesterol (HDL) levels of the LCD were significantly higher than those of the LFD (0.08; 95% CI 0.04 to 0.12) (P < 0.05). However, there was no significant difference in the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), percent body fat, total cholesterol (TC), and low-density lipoprotein cholesterol (LDL) between the two groups (P>0.05). Conclusion According to this study, LCD is more helpful in improving weight loss, HDL and TG. Thus, LCD may serve as an effective intervention for weight management in adolescents with overweight and obesity, although further research is needed to determine its long-term effects.
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Affiliation(s)
- Yu Zhang
- Graduate School, Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
- Sichuan Clinical Research Center for Nephropathy, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
| | - Tingting He
- Graduate School, Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
- Sichuan Clinical Research Center for Nephropathy, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
| | - Yu Hu
- Graduate School, Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
- Sichuan Clinical Research Center for Nephropathy, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
| | - Chenlin Gao
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
- Sichuan Clinical Research Center for Nephropathy, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
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4
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Adolph TE, Tilg H. Western diets and chronic diseases. Nat Med 2024; 30:2133-2147. [PMID: 39085420 DOI: 10.1038/s41591-024-03165-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 06/28/2024] [Indexed: 08/02/2024]
Abstract
'Westernization', which incorporates industrial, cultural and dietary trends, has paralleled the rise of noncommunicable diseases across the globe. Today, the Western-style diet emerges as a key stimulus for gut microbial vulnerability, chronic inflammation and chronic diseases, affecting mainly the cardiovascular system, systemic metabolism and the gut. Here we review the diet of modern times and evaluate the threat it poses for human health by summarizing recent epidemiological, translational and clinical studies. We discuss the links between diet and disease in the context of obesity and type 2 diabetes, cardiovascular diseases, gut and liver diseases and solid malignancies. We collectively interpret the evidence and its limitations and discuss future challenges and strategies to overcome these. We argue that healthcare professionals and societies must react today to the detrimental effects of the Western diet to bring about sustainable change and improved outcomes in the future.
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Affiliation(s)
- Timon E Adolph
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism, Medical University of Innsbruck, Innsbruck, Austria.
| | - Herbert Tilg
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism, Medical University of Innsbruck, Innsbruck, Austria.
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Varghese A, Gusarov I, Gamallo-Lana B, Dolgonos D, Mankan Y, Shamovsky I, Phan M, Jones R, Gomez-Jenkins M, White E, Wang R, Jones D, Papagiannakopoulos T, Pacold ME, Mar AC, Littman DR, Nudler E. Unraveling cysteine deficiency-associated rapid weight loss. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.07.30.605703. [PMID: 39131293 PMCID: PMC11312522 DOI: 10.1101/2024.07.30.605703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
Forty percent of the US population and 1 in 6 individuals worldwide are obese, and the incidence of this disease is surging globally1,2. Various dietary interventions, including carbohydrate and fat restriction, and more recently amino acid restriction, have been explored to combat this epidemic3-6. We sought to investigate the impact of removing individual amino acids on the weight profiles of mice. Compared to essential amino acid restriction, induction of conditional cysteine restriction resulted in the most dramatic weight loss, amounting to 20% within 3 days and 30% within one week, which was readily reversed. This weight loss occurred despite the presence of substantial cysteine reserves stored in glutathione (GSH) across various tissues7. Further analysis demonstrated that the weight reduction primarily stemmed from an increase in the utilization of fat mass, while locomotion, circadian rhythm and histological appearance of multiple other tissues remained largely unaffected. Cysteine deficiency activated the integrated stress response (ISR) and NRF2-mediated oxidative stress response (OSR), which amplify each other, leading to the induction of GDF15 and FGF21, hormones associated with increased lipolysis, energy homeostasis and food aversion8-10. We additionally observed rapid tissue coenzyme A (CoA) depletion, resulting in energetically inefficient anaerobic glycolysis and TCA cycle, with sustained urinary excretion of pyruvate, orotate, citrate, α-ketoglutarate, nitrogen rich compounds and amino acids. In summary, our investigation highlights that cysteine restriction, by depleting GSH and CoA, exerts a maximal impact on weight loss, metabolism, and stress signaling compared to other amino acid restrictions. These findings may pave the way for innovative strategies for addressing a range of metabolic diseases and the growing obesity crisis.
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Affiliation(s)
- Alan Varghese
- Department of Cell Biology, NYU Grossman School of Medicine, New York, NY 10016, USA
- Department of Biochemistry and Molecular Pharmacology, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Ivan Gusarov
- Department of Biochemistry and Molecular Pharmacology, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Begoña Gamallo-Lana
- Department of Neuroscience and Physiology, Neuroscience Institute, NYU School of Medicine, New York, NY 10016, USA
| | - Daria Dolgonos
- Department of Cell Biology, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Yatin Mankan
- Department of Cell Biology, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Ilya Shamovsky
- Department of Biochemistry and Molecular Pharmacology, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Mydia Phan
- Department of Cell Biology, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Rebecca Jones
- Division of Advanced Research Technologies, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Maria Gomez-Jenkins
- Rutgers Cancer Institute, Rutgers University, New Brunswick, NJ 08901, USA and Department of Molecular Biology and Biochemistry, Rutgers University, Piscataway, NJ 08854, USA
| | - Eileen White
- Rutgers Cancer Institute, Rutgers University, New Brunswick, NJ 08901, USA and Department of Molecular Biology and Biochemistry, Rutgers University, Piscataway, NJ 08854, USA
- Ludwig Princeton Branch, Ludwig Institute for Cancer Research, Princeton University, Princeton, NJ 08544, USA
| | - Rui Wang
- Department of Biology, York University, Toronto, Ontario, M3J 1P3, Canada
| | - Drew Jones
- Division of Advanced Research Technologies, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Thales Papagiannakopoulos
- Department of Pathology, Laura and Isaac Perlmutter Cancer Center, NYU Langone Health, New York, NY 10016, USA
| | - Michael E Pacold
- Department of Radiation Oncology and Laura and Isaac Perlmutter Cancer Center, NYU Langone Health, New York, New York, NY 10016, USA
| | - Adam C Mar
- Department of Neuroscience and Physiology, Neuroscience Institute, NYU School of Medicine, New York, NY 10016, USA
| | - Dan R Littman
- Department of Cell Biology, NYU Grossman School of Medicine, New York, NY 10016, USA
- Howard Hughes Medical Institute, New York, NY 10016, USA
| | - Evgeny Nudler
- Department of Biochemistry and Molecular Pharmacology, NYU Grossman School of Medicine, New York, NY 10016, USA
- Howard Hughes Medical Institute, New York, NY 10016, USA
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Baylie T, Ayelgn T, Tiruneh M, Tesfa KH. Effect of Ketogenic Diet on Obesity and Other Metabolic Disorders: Narrative Review. Diabetes Metab Syndr Obes 2024; 17:1391-1401. [PMID: 38529169 PMCID: PMC10962461 DOI: 10.2147/dmso.s447659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/06/2024] [Indexed: 03/27/2024] Open
Abstract
Obesity is defined as an abnormal or excessive accumulation of fat that increases the burden of different chronic diseases in the population. It has reached epidemic proportions and is a major risk factor for a variety of diseases, including hypertension, cardiovascular disease, type 2 diabetes, dyslipidaemia, atherosclerosis, and some malignancies. Weight gain is a result of excessive energy intake compared to energy expenditure (energy loss from metabolism and physical exercise). A ketogenic diet has a more useful effect on obesity than other diets. A ketogenic diet is a low-carbohydrate, high-fat, moderate-protein diet that induces the production of ketone bodies by mimicking the breakdown of a fasting state. The mechanism behind the ketogenic diet is still unknown, although it obviously helps people with obesity lose weight. Several pathways for the ketogenic diet effect on weight loss have been hypothesized by researchers, including reduced appetite due to effects on appetite control hormones and a possible direct appetite suppressant action of ketone bodies; reduced lipogenesis and increased lipolysis; greater metabolic efficiency; and increased metabolic costs.
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Affiliation(s)
- Temesgen Baylie
- Department of Biomedical Science, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Tiget Ayelgn
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Markeshaw Tiruneh
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kibur Hunie Tesfa
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Hassell Sweatman CZW. Modelling remission from overweight type 2 diabetes reveals how altering advice may counter relapse. Math Biosci 2024; 371:109180. [PMID: 38518862 DOI: 10.1016/j.mbs.2024.109180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 02/22/2024] [Accepted: 03/13/2024] [Indexed: 03/24/2024]
Abstract
The development or remission of diet-induced overweight type 2 diabetes involves many biological changes which occur over very different timescales. Remission, defined by HbA1c<6.5%, or fasting plasma glucose concentration G<126 mg/dl, may be achieved rapidly by following weight loss guidelines. However, remission is often short-term, followed by relapse. Mathematical modelling provides a way of investigating a typical situation, in which patients are advised to lose weight and then maintain fat mass, a slow variable. Remission followed by relapse, in a modelling sense, is equivalent to changing from a remission trajectory with steady state G<126 mg/dl, to a relapse trajectory with steady state G≥126 mg/dl. Modelling predicts that a trajectory which maintains weight will be a relapse trajectory, if the fat mass chosen is too high, the threshold being dependent on the lipid to carbohydrate ratio of the diet. Modelling takes into account the effects of hepatic and pancreatic lipid on hepatic insulin sensitivity and β-cell function, respectively. This study leads to the suggestion that type 2 diabetes remission guidelines be given in terms of model parameters, not variables; that is, the patient should adhere to a given nutrition and exercise plan, rather than achieve a certain subset of variable values. The model predicts that calorie restriction, not weight loss, initiates remission from type 2 diabetes; and that advice of the form 'adhere to the diet and exercise plan' rather than 'achieve a certain weight loss' may help counter relapse.
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Affiliation(s)
- Catherine Z W Hassell Sweatman
- School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, 55 Wellesley Street East, Auckland 1010, New Zealand.
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Livzan MA, Lyalyukova EA, Druk IV, Safronova SS, Khalashte AA, Martirosian KA, Petrosian VY, Galakhov YS. Obesity: current state of the problem, multidisciplinary approach. (based on the consensus of the World Gastroenterological Organization “Obesity 2023” and the European guideline on obesity care in patients with gastrointestinal and liver diseases, 2022). EXPERIMENTAL AND CLINICAL GASTROENTEROLOGY 2024:5-47. [DOI: 10.31146/1682-8658-ecg-218-10-5-47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/17/2024]
Abstract
Obesity is the largest pandemic in the world, and its prevalence continues to increase. The purpose of the presented publication is to raise awareness of doctors about modern methods of diagnosing obesity and approaches to therapy, using an interdisciplinary team approach similar to that used in other chronic diseases, such as diabetes, heart disease and cancer. The article presents data from the World Gastroenterological Organization (2023) and the European Guidelines for the Treatment of Obesity in patients with diseases of the gastrointestinal tract and liver (2022). According to modern approaches, obesity should be considered as a chronic recurrent progressive disease, the treatment of which requires a comprehensive interdisciplinary approach involving psychologists and psychiatrists, nutritionists/nutritionists, therapists, endoscopists and surgeons, including lifestyle changes, a well-defined diet and exercise regimen, drug therapy, endoscopic or surgical methods of treatment. Conclusions. In order to stop the growing wave of obesity and its many complications and costs, doctors, insurance companies and health authorities should make systematic efforts to raise public awareness of both the adverse health risks associated with obesity and the potential reduction of risks through a comprehensive approach to therapy.
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Klarod K, Singsanan S, Luangpon N, Kiatkulanusorn S, Boonsiri P, Burtscher M. Effects of qigong Training on Muscle Strengths, Flexibility, Cardiopulmonary Fitness, and Antioxidant/Oxidant Responses in Sedentary Middle-Aged and Elderly Type 2 Diabetes Mellitus Women: A Quasi-Experimental Design, Placebo-Controlled Study. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:288-296. [PMID: 37672606 DOI: 10.1089/jicm.2023.0180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Background: Qigong exercise training has been suggested to elicit beneficial effects on physical functioning, reduction of oxidative stress, and improved antioxidant capacity in women. However, regular exercise training may support the development of antioxidant defense mechanisms and beneficially modulate oxidant/antioxidant responses. Objective: To evaluate the effects of an 8-week qigong exercise training on exercise performance and oxidative stress responses in sedentary middle-aged and elderly women suffering from type 2 diabetic mellitus (T2DM). Method/design: Quasi-experimental design, placebo-controlled study. Setting: The Department of Physical Therapy, Faculty of Allied Health Science, Burapha University, Thailand. Participants: Thirty-six sedentary middle-aged and elderly women with T2DM. Intervention: Participants were allocated to qigong exercise (n = 20) or to the control group (CG, n = 20). Primary outcome measures: Muscle strengths, flexibility, VO2 max predicted, and walking intensity derived from the 6-minute walk test. Secondary outcome measures: Fasting plasma glucose, antioxidant/oxidant stress parameters, and body composition. Results: Leg strength and trunk flexibility were improved after qigong training and changes were significantly different compared with the CG (all p < 0.05). VO2 max predicted, 6-min walking distance, and walking intensity were all increased (p < 0.05), and oxidative stress markers were diminished after qigong training (p < 0.05). The antioxidant/oxidant balance was improved after qigong training (p < 0.05). Conclusion: The presented findings indicate that 8 weeks of qigong training significantly improved leg strength and trunk flexibility in middle-aged and elderly women with T2DM, partly associated with a more favorable antioxidant/oxidant balance. These effects may beneficially impact on health in this specific population. Clinical Trial Number: TCTR20221003001.
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Affiliation(s)
- Kultida Klarod
- Department of Physical Therapy, Faculty of Allied Health Sciences, Burapha University, Chonburi, Thailand
| | - Sanita Singsanan
- Department of Medical Technology, Faculty of Allied Health Sciences, Burapha University, Chonburi, Thailand
| | - Nongnuch Luangpon
- Department of Physical Therapy, Faculty of Allied Health Sciences, Burapha University, Chonburi, Thailand
| | - Sirirat Kiatkulanusorn
- Department of Physical Therapy, Faculty of Allied Health Sciences, Burapha University, Chonburi, Thailand
| | - Patcharee Boonsiri
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Martin Burtscher
- Medical Section, Department of Sport Science, Faculty of Psychology and Sport Science, University of Innsbruck, Innsbruck, Austria
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Galali Y, Zebari SMS, Aj. Jabbar A, Hashm Balaky H, Sadee BA, Hassanzadeh H. The impact of ketogenic diet on some metabolic and non-metabolic diseases: Evidence from human and animal model experiments. Food Sci Nutr 2024; 12:1444-1464. [PMID: 38455178 PMCID: PMC10916642 DOI: 10.1002/fsn3.3873] [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: 08/24/2023] [Revised: 11/10/2023] [Accepted: 11/14/2023] [Indexed: 03/09/2024] Open
Abstract
The ketogenic diet (KD) is recognized as minimum carbohydrate and maximum fat intakes, which leads to ketosis stimulation, a state that is thought to metabolize fat more than carbohydrates for energy supply. KD has gained more interest in recent years and is for many purposes, including weight loss and managing serious diseases like type 2 diabetes. On the other hand, many believe that KD has safety issues and are uncertain about the health drawbacks. Thus, the outcomes of the effect of KD on metabolic and non-metabolic disease remain disputable. The current narrative review aims to evaluate the effect of KD on several diseases concerning the human health. To our best knowledge, the first report aims to investigate the efficacy of KD on multiple human health issues including type 2 diabetes and weight loss, cardiovascular disease, kidney failure and hypertension, non-alcoholic fatty liver, mental problem, oral health, libido, and osteoporosis. The literature searches were performed in Databases, PubMed, Scopus, and web of Science looking for both animal and human model designs. The results heterogeneity seems to be explained by differences in diet composition and duration. Also, the available findings may show that proper control of carbohydrates, a significant reduction in glycemic control and glycated hemoglobin, and weight loss by KD can be an approach to improve diabetes and obesity, hypertension, non-alcoholic fatty liver, PCOS, libido, oral health, and mental problem if isocaloric is considered. However, for some other diseases like cardiovascular disease and osteoporosis, more robust data are needed. Therefore, there is robust data to support the notion that KD can be effective for some metabolic and non-metabolic diseases but not for all of them. So they have to be followed cautiously and under the supervision of health professionals.
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Affiliation(s)
- Yaseen Galali
- Food Technology DepartmentCollege of Agricultural Engineering Sciences, Salahaddin University‐ErbilErbilIraq
| | - Salih M. S. Zebari
- Department of Nutrition and DieteticsCihan University‐ErbilErbilIraq
- Animal Resource DepartmentCollege of Agricultural Engineering Sciences, Salahaddin University‐ErbilErbilIraq
| | - Ahmed Aj. Jabbar
- Department of Medical Laboratory TechnologyErbil Technical Health and Medical College, Erbil Polytechnic UniversityErbilIraq
| | - Holem Hashm Balaky
- General Science Department, Faculty of EducationSoran UniversityErbilIraq
- Mergasor Technical InstituteErbil Polytechnic UniversityErbilIraq
| | - Bashdar Abuzed Sadee
- Food Technology DepartmentCollege of Agricultural Engineering Sciences, Salahaddin University‐ErbilErbilIraq
- Department of Nutrition and DieteticsCihan University‐ErbilErbilIraq
| | - Hamed Hassanzadeh
- Department of Food Science and Technology, Faculty of Para‐veterinaryIlam UniversityIlamIran
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Lu Y, Leng X, Yuan H, Jin C, Wang Q, Song Z. Comparing the impact of personal trainer guidance to exercising with others: Determining the optimal approach. Heliyon 2024; 10:e24625. [PMID: 38298722 PMCID: PMC10828695 DOI: 10.1016/j.heliyon.2024.e24625] [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: 05/14/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 02/02/2024] Open
Abstract
This study aimed to examine the effects of supervised fitness training under the guidance of a personal trainer and those of competitive fitness training with others and reveal the effects of specific differences between them in a detailed manner. The study's participants consisted of 66 healthy male adults (age: 29.2 ± 5.4 years). The participants were divided into three groups: the individual training group (n = 21), which served as the control group; the exercising with a partner group (n = 22); and the group trained by a personal trainer (n = 23). Each participant was subsequently assessed using one repetition maximum bench press, squats, skeletal muscle mass, fat mass, and a questionnaire regarding nutritional plan and injury to compare the effects of training sessions over a period of 12 weeks. Among the three groups, only the group trained by a personal trainer showed an obvious enhancement in fat reduction compared to baseline (-1.61 kg, p = 0.033), which was suggestive of a salient trend that far surpassed those of the individual training group and the exercising with a partner group. Regarding squats, only the group trained by a personal trainer showed a significant change compared to the individual training group (p = 0.003). Regarding the participants' consistent use of a nutritional plan, only the group trained by a personal trainer exhibited a palpable tendency (p < 0.001); furthermore, the effect of preventing injury in the group trained by a personal trainer was more notable than that in the individual training group and the exercising with a partner group. Our results indicate that a fitness personal trainer service is effective in expediting the process of achieving fitness goals in a relatively safe manner, thereby substantiating the diversified values of the fitness personal trainer service.
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Affiliation(s)
- Yunhang Lu
- School of Physical Education and Sports Science, Soochow University, Suzhou 215021, China
- Department of Physical Education, Kyungpook National University, Daegu 41566, Republic of Korea
| | - Xuan Leng
- School of Physical Education and Sports Science, Soochow University, Suzhou 215021, China
| | - Han Yuan
- Department of Physical Education, Kyungpook National University, Daegu 41566, Republic of Korea
| | - Chengji Jin
- School of Physical Education, Liaoning Normal University, Dalian 116000, China
| | - Qing Wang
- College of Foreign Languages, Dalian Minzu University, Dalian 116699, China
| | - Zhengxue Song
- College of Sports Science, Shenyang Normal University, Shenyang 110034, China
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Eyikudamaci G, Ege H, Ensen N, Yelmen N. Role of insulin resistance and leptin in the effect of intermittent feeding with a high-protein ketogenic diet on body composition in rats. Nutrition 2024; 117:112213. [PMID: 37832180 DOI: 10.1016/j.nut.2023.112213] [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: 04/18/2023] [Revised: 08/11/2023] [Accepted: 09/01/2023] [Indexed: 10/15/2023]
Abstract
OBJECTIVES The prevalence of obesity and overweight in children has been increasing rapidly worldwide and threatens society with various chronic diseases that these children are born with. High-protein ketogenic diets and intermittent nutrition are thought to be protective against obesity and metabolic syndrome MetS. However, the exact effects and results, insulin resistance, and the role of leptin in the functioning mechanism of these diets have not been fully elucidated. The aim of this study was to investigate the roles of insulin resistance and leptin hormone on the effects of body composition with a high-protein ketogenic diet and intermittent nutrition combination. METHODS Thirty-two young non-obese rats were randomly divided into four equal groups. Both the standard diet and the high-protein ketogenic diet were given ad libitum and intermittently to the rats for 6 wk. The body weight and fat mass of the rats were measured at the end of the experiment. The fasting glucose, leptin, insulin, high- and low-density lipoprotein, and triacylglycerols were measured with the blood samples. RESULTS The lowest body weight was observed in the intermittent and high-protein ketogenic diet group, followed by the free high-protein ketogenic diet and standard intermittent diet group, respectively. Also, the lowest body fat mass was observed in the intermittent and high-protein ketogenic diet group, followed by the standard intermittent diet group. Although there was no change in leptin, insulin, high- and low-density lipoprotein, and triacylglycerol levels in any group, the lowest blood glucose rate was observed in the intermittent and high-protein ketogenic diet group. CONCLUSION The results of the present study revealed that an intermittent high-protein ketogenic diet is more effective than others in weight loss without disrupting biochemical health parameters, and the applied diets do not prevent growth and development.
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Affiliation(s)
- Gul Eyikudamaci
- Department of Physiology, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Hasan Ege
- Department of Physiology, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Nihal Ensen
- Department of Chest Diseases, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Nermin Yelmen
- Department of Physiology, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey.
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13
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Currenti W, Losavio F, Quiete S, Alanazi AM, Messina G, Polito R, Ciolli F, Zappalà RS, Galvano F, Cincione RI. Comparative Evaluation of a Low-Carbohydrate Diet and a Mediterranean Diet in Overweight/Obese Patients with Type 2 Diabetes Mellitus: A 16-Week Intervention Study. Nutrients 2023; 16:95. [PMID: 38201924 PMCID: PMC10781045 DOI: 10.3390/nu16010095] [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: 10/31/2023] [Revised: 12/22/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION The worldwide prevalence of type 2 diabetes mellitus (T2DM) and obesity has been steadily increasing over the past four decades, with projections indicating a significant rise in the number of affected individuals by 2045. Therapeutic interventions in T2DM aim to control blood glucose levels and reduce the risk of complications. Dietary and lifestyle modifications play a crucial role in the management of T2DM and obesity. While conventional medical nutritional therapy (MNT) often promotes a high-carbohydrate, low-fat Mediterranean diet as an elective treatment, low-carbohydrate diets (LCDs), specifically those restricting carbohydrate intake to less than 130 g/day, have gained popularity due to their multifaceted benefits. Scientific research supports the efficacy of LCDs in improving glycemic control, weight loss, blood pressure, lipid profiles, and overall quality of life. However, sustaining these benefits over the long term remains challenging. This trial aimed to compare the effects of a Mediterranean diet vs. a low-carbohydrate diet (carbohydrate intake < 130 g/day) on overweight/obese patients with T2DM over a 16-week period. The study will evaluate the differential effects of these diets on glycemic regulation, weight reduction, lipid profile, and cardiovascular risk factors. METHODS The study population comprises 100 overweight/obese patients with poorly controlled T2DM. Anthropometric measurements, bioimpedance analysis, and blood chemistry assessments will be conducted at baseline and after the 16-week intervention period. Both dietary interventions were hypocaloric, with a focus on maintaining a 500 kcal/day energy deficit. RESULTS After 16 weeks, both diets had positive effects on various parameters, including weight loss, blood pressure, glucose control, lipid profile, and renal function. However, the low-carbohydrate diet appears to result in a greater reduction in BMI, blood pressure, waist circumference, glucose levels, lipid profiles, cardiovascular risk, renal markers, and overall metabolic parameters compared to the Mediterranean diet at the 16-week follow up. CONCLUSIONS These findings suggest that a low-carbohydrate diet may be more effective than a Mediterranean diet in promoting weight loss and improving various metabolic and cardiovascular risk factors in overweight/obese patients with T2DM. However, it is important to note that further research is needed to understand the clinical implications and long-term sustainability of these findings.
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Affiliation(s)
- Walter Currenti
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy;
| | - Francesca Losavio
- Department of Clinical and Experimental Medicine, University of Foggia, 71100 Foggia, Italy; (F.L.); (G.M.); (R.P.); (F.C.); (R.I.C.)
| | - Stefano Quiete
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy;
| | - Amer M. Alanazi
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia;
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, 71100 Foggia, Italy; (F.L.); (G.M.); (R.P.); (F.C.); (R.I.C.)
| | - Rita Polito
- Department of Clinical and Experimental Medicine, University of Foggia, 71100 Foggia, Italy; (F.L.); (G.M.); (R.P.); (F.C.); (R.I.C.)
| | - Fabiana Ciolli
- Department of Clinical and Experimental Medicine, University of Foggia, 71100 Foggia, Italy; (F.L.); (G.M.); (R.P.); (F.C.); (R.I.C.)
| | - Raffaela Simona Zappalà
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy;
| | - Fabio Galvano
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy;
| | - Raffaele Ivan Cincione
- Department of Clinical and Experimental Medicine, University of Foggia, 71100 Foggia, Italy; (F.L.); (G.M.); (R.P.); (F.C.); (R.I.C.)
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14
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Chase E, Chen V, Martin K, Lane M, Wooliscroft L, Adams C, Rice J, Silbermann E, Hollen C, Fryman A, Purnell JQ, Vong C, Orban A, Horgan A, Khan A, Srikanth P, Yadav V. A low-fat diet improves fatigue in multiple sclerosis: Results from a randomized controlled trial. Mult Scler 2023; 29:1659-1675. [PMID: 37941305 PMCID: PMC10655900 DOI: 10.1177/13524585231208330] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
BACKGROUND Fatigue can be a disabling multiple sclerosis (MS) symptom with no effective treatment options. OBJECTIVE Determine whether a low-fat diet improves fatigue in people with MS (PwMS). METHODS We conducted a 16-week randomized controlled trial (RCT) and allocated PwMS to a low-fat diet (active, total daily fat calories not exceeding 20%) or wait-list (control) group. Subjects underwent 2 weeks of baseline diet data collection (24-hour diet recalls (24HDRs)), followed by randomization. The active group received 2 weeks of nutrition counseling and underwent a 12-week low-fat diet intervention. One set of three 24HDRs at baseline and week 16 were collected. We administered a food frequency questionnaire (FFQ) and Modified Fatigue Impact Scale (MFIS) every 4 weeks. The control group continued their pre-study diet and received diet training during the study completion. RESULTS We recruited 39 PwMS (20-active; 19-control). The active group decreased their daily caloric intake by 11% (95% confidence interval (CI): -18.5%, -3.0%) and the mean MFIS by 4.0 (95% CI: -12.0, 4.0) compared to the control (intent-to-treat). Sensitivity analysis strengthened the association with a mean MFIS difference of -13.9 (95% CI: -20.7, -7.2). CONCLUSIONS We demonstrated a significant reduction in fatigue with a low-fat dietary intervention in PwMS.
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Affiliation(s)
- Emma Chase
- Department of Neurology, Oregon Health & Science University, Portland, OR
| | - Vicky Chen
- Department of Neurology, Oregon Health & Science University, Portland, OR
- Department of Neurology, Veterans Affairs Portland Health Care System, Portland, OR
| | - Kayla Martin
- Department of Neurology, Oregon Health & Science University, Portland, OR
- Department of Neurology, Veterans Affairs Portland Health Care System, Portland, OR
| | - Michael Lane
- Department of Neurology, Oregon Health & Science University, Portland, OR
- Department of Neurology, Veterans Affairs Portland Health Care System, Portland, OR
| | - Lindsey Wooliscroft
- Department of Neurology, Oregon Health & Science University, Portland, OR
- Department of Neurology, Veterans Affairs Portland Health Care System, Portland, OR
| | - Claire Adams
- Department of Neurology, Oregon Health & Science University, Portland, OR
| | - Jessica Rice
- Department of Neurology, Oregon Health & Science University, Portland, OR
- Department of Neurology, Veterans Affairs Portland Health Care System, Portland, OR
| | - Elizabeth Silbermann
- Department of Neurology, Oregon Health & Science University, Portland, OR
- Department of Neurology, Veterans Affairs Portland Health Care System, Portland, OR
| | - Christopher Hollen
- Department of Neurology, Oregon Health & Science University, Portland, OR
- Department of Neurology, Veterans Affairs Portland Health Care System, Portland, OR
| | - Allison Fryman
- Department of Neurology, Oregon Health & Science University, Portland, OR
- Department of Neurology, Veterans Affairs Portland Health Care System, Portland, OR
| | - Jonathan Q. Purnell
- Department of Medicine, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR
| | - Carly Vong
- Department of Neurology, Oregon Health & Science University, Portland, OR
| | - Anna Orban
- Department of Neurology, Oregon Health & Science University, Portland, OR
| | - Angela Horgan
- Oregon Clinical & Translational Research Institute, Portland, OR
| | - Akram Khan
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Oregon Health & Science University, Portland, OR
| | - Priya Srikanth
- School of Public Health, Oregon Health & Science University-Portland State University Portland, OR
| | - Vijayshree Yadav
- Department of Neurology, Oregon Health & Science University, Portland, OR
- Department of Neurology, Veterans Affairs Portland Health Care System, Portland, OR
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15
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Corkey BE. Reactive oxygen species: role in obesity and mitochondrial energy efficiency. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220210. [PMID: 37482778 PMCID: PMC10363708 DOI: 10.1098/rstb.2022.0210] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 05/29/2023] [Indexed: 07/25/2023] Open
Abstract
Changes correlating with increasing obesity include insulin resistance, hyperlipidaemia, hyperinsulinaemia, highly processed food and environmental toxins including plastics and air pollution. The relationship between the appearance of each of these potential causes and the onset of obesity is unknown. The cause(s) must precede obesity, the consequence, and temporally relate to its rising incidence. Macronutrients such as carbohydrates or fats are unlikely to cause obesity since these have long been constituents of human diets. Furthermore, food consumption and body weight have been well-regulated in most humans and other species until recent times. Thus, attention must focus on changes that have occurred in the last half-century and the relationship between such changes and specific populations that are impacted. The hypothesis presented here is that substances that have entered our bodies recently cause obesity by generating false and misleading information about energy status. We propose that this misinformation is caused by changes in the oxidation-reduction (redox) potential of metabolites that circulate and communicate to organs throughout the body. Examples are provided of food additives that generate reactive oxygen species and impact redox state, thereby, eliciting inappropriate tissue-specific functional changes, including insulin secretion. Reversal requires identification, neutralization, or removal of these compounds. This article is part of a discussion meeting issue 'Causes of obesity: theories, conjectures and evidence (Part I)'.
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Affiliation(s)
- Barbara E. Corkey
- Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA
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16
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Gaspa G, Naciu AM, DI Rosa C, Lattanzi G, Beato I, Micheli V, Turriziani C, Khazrai YM, Cesareo R. Short- and long-term effects of very low- and low-calorie ketogenic diets on metabolism and cardiometabolic risk factors: a narrative review. Minerva Endocrinol (Torino) 2023; 48:318-333. [PMID: 36285748 DOI: 10.23736/s2724-6507.22.03922-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Worldwide obesity and cardiovascular diseases have encouraged the adoption of new and efficient dietary strategies. Among various proposed diets, ketogenic diets, both the very-low-calorie ketogenic diet (VLCKD) and the low-calorie ketogenic diet (LCKD), have been suggested in recent years as an effective nutritional approach for obesity management. The VLCKD and the LCKD are characterized by a low carbohydrate content (<50 g/day), 1-1.5 g of protein/kg of ideal body weight, less than 20-30 g of lipids, and a daily intake of about 800 calories for VLCKD and about 1200-1400 calories for LCKD. The purpose of our narrative review is to offer an overview of the most impactful studies in the scientific literature regarding VLCKD and LCKD to discuss their short- and long-term effects (less than 12 months and more than 12 months respectively) on weight loss, metabolic and cardiovascular aspects. Articles we focused on were cohort studies, case-control studies, cross-sectional studies, randomized controlled trials, and meta-analyses. Results indicate that VLCKD and LCKD could be helpful to ameliorate metabolic and cardiovascular risk factors such as weight loss, glucose, and cholesterol levels, both in the short and long term. Further research in this area may include more randomized controlled trials to gather more data.
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Affiliation(s)
- Gianluigi Gaspa
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University, Rome, Italy -
| | - Anda M Naciu
- Unit of Endocrinology and Diabetes, Department of Medicine, Campus Bio-Medico University, Rome, Italy
| | - Claudia DI Rosa
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University, Rome, Italy
| | - Greta Lattanzi
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University, Rome, Italy
| | - Ivan Beato
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University, Rome, Italy
| | - Vanessa Micheli
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University, Rome, Italy
| | - Clara Turriziani
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University, Rome, Italy
| | - Yeganeh M Khazrai
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University, Rome, Italy
| | - Roberto Cesareo
- Unit of Metabolic Diseases, 'S.M. Goretti' Hospital, Latina, Italy
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17
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Kharmats AY, Popp C, Hu L, Berube L, Curran M, Wang C, Pompeii ML, Li H, Bergman M, St-Jules DE, Segal E, Schoenthaler A, Williams N, Schmidt AM, Barua S, Sevick MA. A randomized clinical trial comparing low-fat with precision nutrition-based diets for weight loss: impact on glycemic variability and HbA1c. Am J Clin Nutr 2023; 118:443-451. [PMID: 37236549 PMCID: PMC10447469 DOI: 10.1016/j.ajcnut.2023.05.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 05/16/2023] [Accepted: 05/23/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Recent studies have demonstrated considerable interindividual variability in postprandial glucose response (PPGR) to the same foods, suggesting the need for more precise methods for predicting and controlling PPGR. In the Personal Nutrition Project, the investigators tested a precision nutrition algorithm for predicting an individual's PPGR. OBJECTIVE This study aimed to compare changes in glycemic variability (GV) and HbA1c in 2 calorie-restricted weight loss diets in adults with prediabetes or moderately controlled type 2 diabetes (T2D), which were tertiary outcomes of the Personal Diet Study. METHODS The Personal Diet Study was a randomized clinical trial to compare a 1-size-fits-all low-fat diet (hereafter, standardized) with a personalized diet (hereafter, personalized). Both groups received behavioral weight loss counseling and were instructed to self-monitor diets using a smartphone application. The personalized arm received personalized feedback through the application to reduce their PPGR. Continuous glucose monitoring (CGM) data were collected at baseline, 3 mo and 6 mo. Changes in mean amplitude of glycemic excursions (MAGEs) and HbA1c at 6 mo were assessed. We performed an intention-to-treat analysis using linear mixed regressions. RESULTS We included 156 participants [66.5% women, 55.7% White, 24.1% Black, mean age 59.1 y (standard deviation (SD) = 10.7 y)] in these analyses (standardized = 75, personalized = 81). MAGE decreased by 0.83 mg/dL per month for standardized (95% CI: 0.21, 1.46 mg/dL; P = 0.009) and 0.79 mg/dL per month for personalized (95% CI: 0.19, 1.39 mg/dL; P = 0.010) diet, with no between-group differences (P = 0.92). Trends were similar for HbA1c values. CONCLUSIONS Personalized diet did not result in an increased reduction in GV or HbA1c in patients with prediabetes and moderately controlled T2D, compared with a standardized diet. Additional subgroup analyses may help to identify patients who are more likely to benefit from this personalized intervention. This trial was registered at clinicaltrials.gov as NCT03336411.
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Affiliation(s)
- Anna Y Kharmats
- Center for Healthful Behavior Change, Institute for Excellence in Health Equity, New York University Langone Health, New York, NY, United States; Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Collin Popp
- Center for Healthful Behavior Change, Institute for Excellence in Health Equity, New York University Langone Health, New York, NY, United States; Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Lu Hu
- Center for Healthful Behavior Change, Institute for Excellence in Health Equity, New York University Langone Health, New York, NY, United States; Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Lauren Berube
- Center for Healthful Behavior Change, Institute for Excellence in Health Equity, New York University Langone Health, New York, NY, United States; Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States.
| | - Margaret Curran
- Center for Healthful Behavior Change, Institute for Excellence in Health Equity, New York University Langone Health, New York, NY, United States; Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Chan Wang
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Mary Lou Pompeii
- Center for Healthful Behavior Change, Institute for Excellence in Health Equity, New York University Langone Health, New York, NY, United States; Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Huilin Li
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Michael Bergman
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States; Division of Endocrinology, Diabetes and Metabolism, New York University Grossman School of Medicine, New York, NY, United States
| | - David E St-Jules
- Department of Nutrition, University of Nevada, Reno, Reno, NV, United States
| | - Eran Segal
- Department of Computer Science and Applied Math, Weizmann Institute of Science, Rehovot, Israel
| | - Antoinette Schoenthaler
- Center for Healthful Behavior Change, Institute for Excellence in Health Equity, New York University Langone Health, New York, NY, United States; Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Natasha Williams
- Center for Healthful Behavior Change, Institute for Excellence in Health Equity, New York University Langone Health, New York, NY, United States; Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Ann Marie Schmidt
- Diabetes Research Program, Department of Medicine, New York University Langone Health, New York, NY, United States
| | - Souptik Barua
- Division of Precision Medicine, Department of Medicine, New York University Langone Health, New York, NY, United States
| | - Mary Ann Sevick
- Center for Healthful Behavior Change, Institute for Excellence in Health Equity, New York University Langone Health, New York, NY, United States; Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States; Division of Endocrinology, Diabetes and Metabolism, New York University Grossman School of Medicine, New York, NY, United States
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18
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Dyńka D, Kowalcze K, Charuta A, Paziewska A. The Ketogenic Diet and Cardiovascular Diseases. Nutrients 2023; 15:3368. [PMID: 37571305 PMCID: PMC10421332 DOI: 10.3390/nu15153368] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
The most common and increasing causes of death worldwide are cardiovascular diseases (CVD). Taking into account the fact that diet is a key factor, it is worth exploring this aspect of CVD prevention and therapy. The aim of this article is to assess the potential of the ketogenic diet in the prevention and treatment of CVD. The article is a comprehensive, meticulous analysis of the literature in this area, taking into account the most recent studies currently available. The ketogenic diet has been shown to have a multifaceted effect on the prevention and treatment of CVD. Among other aspects, it has a beneficial effect on the blood lipid profile, even compared to other diets. It shows strong anti-inflammatory and cardioprotective potential, which is due, among other factors, to the anti-inflammatory properties of the state of ketosis, the elimination of simple sugars, the restriction of total carbohydrates and the supply of omega-3 fatty acids. In addition, ketone bodies provide "rescue fuel" for the diseased heart by affecting its metabolism. They also have a beneficial effect on the function of the vascular endothelium, including improving its function and inhibiting premature ageing. The ketogenic diet has a beneficial effect on blood pressure and other CVD risk factors through, among other aspects, weight loss. The evidence cited is often superior to that for standard diets, making it likely that the ketogenic diet shows advantages over other dietary models in the prevention and treatment of cardiovascular diseases. There is a legitimate need for further research in this area.
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Affiliation(s)
| | | | | | - Agnieszka Paziewska
- Institute of Health Sciences, Faculty of Medical and Health Sciences, Siedlce University of Natural Sciences and Humanities, 08-110 Siedlce, Poland; (D.D.); (K.K.); (A.C.)
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19
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Pepe RB, Lottenberg AM, Fujiwara CTH, Beyruti M, Cintra DE, Machado RM, Rodrigues A, Jensen NSO, Caldas APS, Fernandes AE, Rossoni C, Mattos F, Motarelli JHF, Bressan J, Saldanha J, Beda LMM, Lavrador MSF, Del Bosco M, Cruz P, Correia PE, Maximino P, Pereira S, Faria SL, Piovacari SMF. Position statement on nutrition therapy for overweight and obesity: nutrition department of the Brazilian association for the study of obesity and metabolic syndrome (ABESO-2022). Diabetol Metab Syndr 2023; 15:124. [PMID: 37296485 PMCID: PMC10251611 DOI: 10.1186/s13098-023-01037-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 03/23/2023] [Indexed: 06/12/2023] Open
Abstract
Obesity is a chronic disease resulting from multifactorial causes mainly related to lifestyle (sedentary lifestyle, inadequate eating habits) and to other conditions such as genetic, hereditary, psychological, cultural, and ethnic factors. The weight loss process is slow and complex, and involves lifestyle changes with an emphasis on nutritional therapy, physical activity practice, psychological interventions, and pharmacological or surgical treatment. Because the management of obesity is a long-term process, it is essential that the nutritional treatment contributes to the maintenance of the individual's global health. The main diet-related causes associated with excess weight are the high consumption of ultraprocessed foods, which are high in fats, sugars, and have high energy density; increased portion sizes; and low intake of fruits, vegetables, and grains. In addition, some situations negatively interfere with the weight loss process, such as fad diets that involve the belief in superfoods, the use of teas and phytotherapics, or even the avoidance of certain food groups, as has currently been the case for foods that are sources of carbohydrates. Individuals with obesity are often exposed to fad diets and, on a recurring basis, adhere to proposals with promises of quick solutions, which are not supported by the scientific literature. The adoption of a dietary pattern combining foods such as grains, lean meats, low-fat dairy, fruits, and vegetables, associated with an energy deficit, is the nutritional treatment recommended by the main international guidelines. Moreover, an emphasis on behavioral aspects including motivational interviewing and the encouragement for the individual to develop skills will contribute to achieve and maintain a healthy weight. Therefore, this Position Statement was prepared based on the analysis of the main randomized controlled studies and meta-analyses that tested different nutrition interventions for weight loss. Topics in the frontier of knowledge such as gut microbiota, inflammation, and nutritional genomics, as well as the processes involved in weight regain, were included in this document. This Position Statement was prepared by the Nutrition Department of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), with the collaboration of dietitians from research and clinical fields with an emphasis on strategies for weight loss.
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Affiliation(s)
- Renata Bressan Pepe
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP Brazil
| | - Ana Maria Lottenberg
- Laboratório de Lipides (LIM10), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP Brazil
- Nutrition Department of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), Rua Mato Grosso 306 – cj 1711, Sao Paulo, SP 01239-040 Brazil
| | - Clarissa Tamie Hiwatashi Fujiwara
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP Brazil
| | - Mônica Beyruti
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP Brazil
| | - Dennys Esper Cintra
- Centro de Estudos em Lipídios e Nutrigenômica – CELN – University of Campinas, Campinas, SP Brazil
| | - Roberta Marcondes Machado
- Liga Acadêmica de Controle de Diabetes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP Brazil
| | - Alessandra Rodrigues
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP Brazil
| | - Natália Sanchez Oliveira Jensen
- Liga Acadêmica de Controle de Diabetes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP Brazil
| | | | - Ariana Ester Fernandes
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP Brazil
| | - Carina Rossoni
- Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Fernanda Mattos
- Programa de Obesidade e Cirurgia Bariátrica do Hospital Universitário Clementino Fraga Filho da UFRJ, Rio de Janeiro, RJ Brazil
| | - João Henrique Fabiano Motarelli
- Núcleo de Estudos e Extensão em Comportamento Alimentar e Obesidade (NEPOCA) da Universidade de São Paulo - FMRP/USP, Ribeirão Preto, Brazil
| | - Josefina Bressan
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, MG Brazil
| | | | - Lis Mie Masuzawa Beda
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP Brazil
| | - Maria Sílvia Ferrari Lavrador
- Liga Acadêmica de Controle de Diabetes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP Brazil
| | - Mariana Del Bosco
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP Brazil
| | - Patrícia Cruz
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP Brazil
| | | | - Priscila Maximino
- Instituto PENSI - Fundação José Luiz Egydio Setúbal, Instituto Pensi, Fundação José Luiz Egydio Setúbal, Hospital Infantil Sabará, São Paulo, SP Brazil
| | - Silvia Pereira
- Núcleo de Saúde Alimentar da Sociedade Brasileira de Cirurgia Bariátrica e Metabólica, São Paulo, Brazil
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20
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Sun J, Ruan Y, Xu N, Wu P, Lin N, Yuan K, An S, Kang P, Li S, Huang Q, Yingzhang, Li Y, Su J, Ma W, Chen B, Zhang X, Chen X, Liang Y, Lu Z, Deng G, Zhang Z, Wang Y, Wen W, Zhang H, Chen H. The effect of dietary carbohydrate and calorie restriction on weight and metabolic health in overweight/obese individuals: a multi-center randomized controlled trial. BMC Med 2023; 21:192. [PMID: 37226271 PMCID: PMC10210464 DOI: 10.1186/s12916-023-02869-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 04/17/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Both low-carbohydrate (LC) and calorie-restricted (CR) diets have been shown to have metabolic benefits. However, the two regimens have yet to be thoroughly compared. We conducted a 12-week randomized trial to compare the effects of these diets separately and in combination on both weight loss and metabolic risk factors in overweight/obese individuals. METHODS A total of 302 participants were randomized to LC diet (n = 76), CR diet (n = 75), LC + CR diet (n = 76), or normal control (NC) diet (n = 75) using a computer-based random number generator. The primary outcome was the change in body mass index (BMI). The secondary outcomes included body weight, waist circumference, waist-to-hip ratio, body fat, and metabolic risk factors. All participants attended health education sessions during the trial. RESULTS A total of 298 participants were analyzed. BMI change over 12 weeks was - 0.6 (95% CI, - 0.8 to - 0.3) kg/m2 in NC, - 1.3 (95% CI, - 1.5 to - 1.1) kg/m2 in CR, - 2.3 (95% CI, - 2.6 to - 2.1) kg/m2 in LC, and - 2.9 (95% CI, - 3.2 to - 2.6) kg/m2 in LC + CR. LC + CR diet was more effective than LC or CR diet alone at reducing BMI (P = 0.001 and P < 0.001, respectively). Furthermore, compared with the CR diet, the LC + CR diet and LC diet further reduced body weight, waist circumference, and body fat. Serum triglycerides were significantly reduced in the LC + CR diet group compared with the LC or CR diet alone. Plasma glucose, homeostasis model assessment of insulin resistance, and cholesterol concentrations (total, LDL, and HDL) did not change significantly between the groups during the 12-week intervention. CONCLUSIONS The reduction of carbohydrate intake without restricting caloric intake is more potent to achieve weight loss over 12 weeks when compared to a calorie-restricted diet in overweight/obese adults. The combination of restricting carbohydrate and total calorie intake may augment the beneficial effects of reducing BMI, body weight, and metabolic risk factors among overweight/obese individuals. TRIAL REGISTRATION The study was approved by the institutional review board of Zhujiang Hospital of Southern Medical University and registered at the China Clinical Trial Registration Center (registration number: ChiCTR1800015156).
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Affiliation(s)
- Jia Sun
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Avenue, Haizhu Square, Guangzhou, Guangdong, China.
| | - Yuting Ruan
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Avenue, Haizhu Square, Guangzhou, Guangdong, China
| | - Ningning Xu
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Avenue, Haizhu Square, Guangzhou, Guangdong, China
| | - Peili Wu
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Avenue, Haizhu Square, Guangzhou, Guangdong, China
| | - Nie Lin
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Avenue, Haizhu Square, Guangzhou, Guangdong, China
| | - Kun Yuan
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Avenue, Haizhu Square, Guangzhou, Guangdong, China
| | - Shengli An
- Department of Bio-Statistics, Southern Medical University, No.1023 Sha Tai Nan Lu, Baiyun Square, Guangzhou, Guangdong, China
| | - Pei Kang
- Department of Bio-Statistics, Southern Medical University, No.1023 Sha Tai Nan Lu, Baiyun Square, Guangzhou, Guangdong, China
| | - Shu Li
- Department of Endocrinology, Huizhou Municipal Center Hospital, No. 41, Eling North Road, Huizhou, Guangdong, China
| | - Qiya Huang
- Department of Endocrinology, Qing Yuan People's Hospital, Qingyuan, Guangdong, China
| | - Yingzhang
- Department of Endocrinology, The Third Affiliated Hospital of Guangzhou Medical University, No. 63, DuoBao Road, Liwan Square, Guangzhou, Guangdong, China
| | - Yuzhong Li
- Department of Endocrinology, Dongguan Kanghua Hospital, 1000 Dongguan Avenue, Dongguan, Guangdong, China
| | - Jialin Su
- Department of Endocrinology, He Xian Memorial Hospital, No. 2, Qinghe East Road, Panyu District, Guangzhou, Guangdong, China
| | - Wenjun Ma
- Department of Nutrition, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 106, Zhongshan Second Road, Yuexiu District, Guangzhou, Guangdong, China
| | - Bo Chen
- Department of Endocrinology, Guangdong Second Provincial General Hospital, No.466, Xing Gang Middle Road, Haizhu District, Guangzhou, Guangdong, China
| | - Xiuwei Zhang
- Department of Endocrinology, Dongguan People's Hospital, Wandao Road (South), Xinguchong, Wanjiang District, Dongguan, Guangdong, China
| | - Xiaoming Chen
- Department of Endocrinology, Affiliated Hospital of Guangdong Medical University, No. 57, Renmin Avenue South, Xiashan District, Zhanjiang, Guangdong, China
| | - Yongqian Liang
- Department of Endocrinology and Metabolism, Shunde Hospital of Southern Medical University, No. 1, Lunjiao Jiazi Road, Shunde District, Foshan, Guangdong, China
| | - Zeyuan Lu
- Department of Endocrinology, The Eighth Affiliated Hospital of Sun Yat-Sen University, No. 3025, Shennan Road, Shenzhen, Guangdong, China
| | - Guobao Deng
- Department of Endocrinology, Shaoguan First People's Hospital, No. 3, Dongdi South Road, Zhenjiang District, Shaoguan, Guangdong, China
| | - Zhen Zhang
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Avenue, Haizhu Square, Guangzhou, Guangdong, China
| | - Yuqin Wang
- Pansonglou Health Management Center, Guangzhou First People's Hospital, Guangzhou, China
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Dadao Bei, Baiyun Square, Guangzhou, Guangdong, China
| | - Weiheng Wen
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Avenue, Haizhu Square, Guangzhou, Guangdong, China
| | - Huijie Zhang
- Pansonglou Health Management Center, Guangzhou First People's Hospital, Guangzhou, China.
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Dadao Bei, Baiyun Square, Guangzhou, Guangdong, China.
| | - Hong Chen
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Avenue, Haizhu Square, Guangzhou, Guangdong, China.
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21
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Lopaschuk GD, Dyck JRB. Ketones and the cardiovascular system. NATURE CARDIOVASCULAR RESEARCH 2023; 2:425-437. [PMID: 39196044 DOI: 10.1038/s44161-023-00259-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/28/2023] [Indexed: 08/29/2024]
Abstract
Ketone bodies, the main one being β-hydroxybutyrate, have emerged as important regulators of the cardiovascular system. In healthy individuals, as well as in individuals with heart failure or post-myocardial infarction, ketones provide a supplemental energy source for both the heart and the vasculature. In the failing heart, this additional energy may contribute to improved cardiac performance, whereas increasing ketone oxidation in vascular smooth muscle and endothelial cells enhances cell proliferation and prevents blood vessel rarefication. Ketones also have important actions in signaling pathways, posttranslational modification pathways and gene transcription; many of which modify cell proliferation, inflammation, oxidative stress, endothelial function and cardiac remodeling. Attempts to therapeutically increase ketone delivery to the cardiovascular system are numerous and have shown mixed results in terms of effectiveness. Here we review the bioenergetic and signaling effects of ketones on the cardiovascular system, and we discuss how ketones can potentially be used to treat cardiovascular diseases.
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Affiliation(s)
- Gary D Lopaschuk
- Cardiovascular Research Centre, Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.
| | - Jason R B Dyck
- Cardiovascular Research Centre, Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
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22
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Hao L, Bello NT. Sex-Specific Effects on Total Body Fat Gain with 4-Week Daily Dosing of Raspberry Ketone [4-(4-Hydroxyphenyl)-2-butanone] and Ketogenic Diet in Mice. Nutrients 2023; 15:nu15071630. [PMID: 37049471 PMCID: PMC10097242 DOI: 10.3390/nu15071630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
Background: Raspberry ketone (RK: [4-(4-Hydroxyphenyl)-2-butanone]) is a dietary supplement marketed for weight control. RK is structurally unrelated to the ketone bodies elevated with a ketogenic diet (KD). This study aims to determine whether RK oral supplementation with KD improves the weight loss outcomes in high-fat diet (HFD; 45% fat)-fed mice. Methods: Male and female C57BL/6J mice were HFD-fed for 9 weeks and switched to KD (80% fat) or a control diet (CD; 10% fat) or continued with the HFD for 4 weeks. Coincident with the diet switch, each diet group received oral RK (200 mg/kg/day) or a vehicle. Results: In male KD-fed mice, oral RK reduced body weight by ~6% (KD_Veh: −9.2 ± 1% vs. KD_RK: −15.1 ± 1%) and fat composition by ~18% (KD_Veh: −16.0 ± 4% vs. KD_RK: −34.2 ± 5%). HFD and KD feeding induced glucose intolerance in both male and female mice. Oral RK decreased the glucose area under the curve in female mice by ~6% (KD_Veh: 44,877 ± 957 vs. KD_RK: 42,040 ± 675 mg*min/dl). KD also had gut microbiota alterations with higher alpha diversity in males and more beta diversity with RK. These findings suggest sex-specific weight loss effects with RK and KD in mice.
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23
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Bujo S, Toko H, Ito K, Koyama S, Ishizuka M, Umei M, Yanagisawa-Murakami H, Guo J, Zhai B, Zhao C, Kishikawa R, Takeda N, Tsushima K, Ikeda Y, Takimoto E, Morita H, Harada M, Komuro I. Low-carbohydrate diets containing plant-derived fat but not animal-derived fat ameliorate heart failure. Sci Rep 2023; 13:3987. [PMID: 36894670 PMCID: PMC9998649 DOI: 10.1038/s41598-023-30821-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 03/02/2023] [Indexed: 03/11/2023] Open
Abstract
Cardiovascular disease (CVD) is a global health burden in the world. Although low-carbohydrate diets (LCDs) have beneficial effects on CVD risk, their preventive effects remain elusive. We investigated whether LCDs ameliorate heart failure (HF) using a murine model of pressure overload. LCD with plant-derived fat (LCD-P) ameliorated HF progression, whereas LCD with animal-derived fat (LCD-A) aggravated inflammation and cardiac dysfunction. In the hearts of LCD-P-fed mice but not LCD-A, fatty acid oxidation-related genes were highly expressed, and peroxisome proliferator-activated receptor α (PPARα), which regulates lipid metabolism and inflammation, was activated. Loss- and gain-of-function experiments indicated the critical roles of PPARα in preventing HF progression. Stearic acid, which was more abundant in the serum and heart of LCD-P-fed mice, activated PPARα in cultured cardiomyocytes. We highlight the importance of fat sources substituted for reduced carbohydrates in LCDs and suggest that the LCD-P-stearic acid-PPARα pathway as a therapeutic target for HF.
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Affiliation(s)
- Satoshi Bujo
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. .,Department of Advanced Translational Research and Medicine in Management of Pulmonary Hypertension, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Haruhiro Toko
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Kaoru Ito
- Laboratory for Cardiovascular Genomics and Informatics, RIKEN Center for Integrative Medical Sciences, Tsurumi-ku, Yokohama, Kanagawa, 230-0045, Japan
| | - Satoshi Koyama
- Laboratory for Cardiovascular Genomics and Informatics, RIKEN Center for Integrative Medical Sciences, Tsurumi-ku, Yokohama, Kanagawa, 230-0045, Japan
| | - Masato Ishizuka
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Masahiko Umei
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Haruka Yanagisawa-Murakami
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Jiaxi Guo
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Bowen Zhai
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Chunxia Zhao
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Risa Kishikawa
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Norifumi Takeda
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kensuke Tsushima
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yuichi Ikeda
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Department of Advanced Translational Research and Medicine in Management of Pulmonary Hypertension, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Eiki Takimoto
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroyuki Morita
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mutsuo Harada
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Department of Advanced Clinical Science and Therapeutics, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
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24
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Klammer C, Schindler K, Bugl R, Plazek D, Vötter M, Kirchner T, Martino C, Klammer-Martin J, Brix J, Dämon S, Hoppichler F, Kautzky-Willer A, Kruschitz R, Toplak H, Clodi M, Ludvik B. [Nutrition for diabetic patients (Update 2023)]. Wien Klin Wochenschr 2023; 135:62-77. [PMID: 37101026 PMCID: PMC10133079 DOI: 10.1007/s00508-023-02170-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 04/28/2023]
Abstract
All patients with diabetes require individual and personalized nutritional consultation with professionals. The patient's needs should be the primary focus of the dietary therapy, taking their lifestyle and the type of diabetes into consideration. With the recommendations to the patient's diet, there need to be specific metabolic goals to reduce the disease's progression and to avoid long term health effects. Therefore, practical guidelines such as portion size and meal planning tips should be the main focus.According to the latest national and international standards, patients suffering from diabetes should have access to nutrition consulting and nutritional training. During consultation they can be supported on- how to manage their health condition and choosing food and beverage to improve their health.These practical recommendations sum up the latest literature on nutritional aspects of diabetes treatment.
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Affiliation(s)
- Carmen Klammer
- Abteilung für Innere Medizin, Konventhospital der Barmherzigen Brüder Linz, Linz, Österreich
- ICMR - Institute of Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz, Altenberger Straße 69, 4040, Linz, Österreich
| | - Karin Schindler
- Bundesministerium für Soziales, Gesundheit, Pflege und Konsumentenschutz, Wien, Österreich
- Klinische Abteilung für Endokrinologie und Stoffwechsel, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Wien, Österreich
| | - Rita Bugl
- Wiener Gesundheitsverband Klinik Ottakring, Wien, Österreich
| | | | | | - Tanja Kirchner
- Österreichische Gesundheitskasse Mein Peterhof Baden, Baden, Österreich
| | - Claudia Martino
- Österreichische Gesundheitskasse Mein Gesundheitszentrum Floridsdorf, Wien, Österreich
| | | | - Johanna Brix
- Medizinische Abteilung mit Diabetologie, Endokrinologie und Nephrologie, Klinik Landstraße, Wien, Österreich
| | - Sabine Dämon
- Special Institute for Preventive Cardiology and Nutrition, SIPCAN - Initiative für ein gesundes Leben, Elsbethen/Salzburg, Österreich
| | - Friedrich Hoppichler
- Special Institute for Preventive Cardiology and Nutrition, SIPCAN - Initiative für ein gesundes Leben, Elsbethen/Salzburg, Österreich
- Abteilung für Innere Medizin, Krankenhaus der Barmherzigen Brüder Salzburg, Salzburg, Österreich
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Klinische Abteilung für Endokrinologie und Stoffwechsel, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Wien, Österreich
| | - Renate Kruschitz
- Abteilung für Innere Medizin, Krankenhaus der Elisabethinen, Klagenfurt, Österreich
| | - Hermann Toplak
- Klinische Abteilung für Endokrinologie und Diabetologie, Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Graz, Österreich
| | - Martin Clodi
- Abteilung für Innere Medizin, Konventhospital der Barmherzigen Brüder Linz, Linz, Österreich.
- ICMR - Institute of Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz, Altenberger Straße 69, 4040, Linz, Österreich.
| | - Bernhard Ludvik
- Medizinische Abteilung mit Diabetologie, Endokrinologie und Nephrologie, Klinik Landstraße, Wien, Österreich
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25
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Lu G, Huang X, Lin C, Zou L, Pan H. A bibliometric and visual analysis of low carbohydrate diet. Front Nutr 2023; 10:1085623. [PMID: 36908904 PMCID: PMC9995895 DOI: 10.3389/fnut.2023.1085623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
Introduction Numerous studies have confirmed the effects of low carbohydrate diet (LChD) on metabolism and chronic diseases. However, there were no bibliometric studies on LChD. This study was conducted through a bibliometric analysis to investigate the current status, hotspots and frontiers trends. Methods We searched all research publications related to LChD from 2002 to 2021 on the Web of Scientific Core Collection (WoSCC). CiteSpace and VOSviewer software was used to analyze countries/regions, institutions, journals, authors, references, and keywords. Results A total of 6938 papers were included, with an increasing trend of annual publication. LChD categories mainly included nutrition, endocrinology, and neurosciences which reflected the interdisciplinary characteristics. USA was with the largest number and the world science center in LChD field. Universities were main research institutions and five of the top 10 institutions were from USA. Eric Heath Kossoff had 101 publications and ranked first. Nutrients was the leading journal. "A randomized trial of a low-carbohydrate diet for obesity" and "Obesity" were considered to be the most co-cited and cited reference respectively. The hotspots of LChD are four aspects, "ketogenic diet", "metabolism disease", "cardiovascular disease" and "cancer". We summarized that "oxidative stress", "gut microbiota", and "inflammation factors" are becoming frontiers trends of LChD research in the future and deserve further study. Discussion Over the past 20 years research on LChD has gained great attention. To better explore LChD field, multilevel mechanism studies will be required in the future.
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Affiliation(s)
- Gang Lu
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xin Huang
- School of Physical Education and Health, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chun Lin
- School of Physical Education and Health, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lijuan Zou
- School of Physical Education and Health, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Huashan Pan
- Science and Technology Division, Guangdong Food and Drug Vocational College, Guangzhou, China
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26
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El Karkafi R, Gebara T, Salem M, Kamel J, El Khoury G, Zalal M, Fakhoury M. Ketogenic Diet and Inflammation: Implications for Mood and Anxiety Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1411:537-554. [PMID: 36949325 DOI: 10.1007/978-981-19-7376-5_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
The ketogenic diet, known as a low-carbohydrate, high-protein, and high-fat diet, drastically restrains the major source of energy for the body, forcing it to burn all excess fat through a process called ketosis-the breaking down of fat into ketone bodies. First suggested as a medical treatment for children suffering from epilepsy, this diet has gained increased popularity as a rapid weight loss strategy. Over the past few years, there have been numerous studies suggesting that the ketogenic diet may provide therapeutic effects for several psychiatric conditions such as mood- and anxiety-related disorders. However, despite significant progress in research, the mechanisms underlying its therapeutic effects remain largely unexplored and are yet to be fully elucidated. This chapter provides an in-depth overview of preclinical and clinical evidence supporting the use of a ketogenic diet in the management of mood and anxiety disorders and discusses its relationship with inflammatory processes and potential mechanisms of actions for its therapeutic effects.
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Affiliation(s)
- Roy El Karkafi
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
| | - Tammy Gebara
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
| | - Michael Salem
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
| | - Jessica Kamel
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
| | - Ghinwa El Khoury
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
| | - Marilynn Zalal
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
| | - Marc Fakhoury
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon.
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27
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Parry‐Strong A, Wright‐McNaughton M, Weatherall M, Hall RM, Coppell KJ, Barthow C, Krebs JD. Very low carbohydrate (ketogenic) diets in type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials. Diabetes Obes Metab 2022; 24:2431-2442. [PMID: 36064937 PMCID: PMC9826205 DOI: 10.1111/dom.14837] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/08/2022] [Accepted: 08/12/2022] [Indexed: 01/11/2023]
Abstract
AIM Very low carbohydrate/ketogenic diets (VLC/KDs) are popular but their role in managing pre-diabetes and type 2 diabetes (T2D) is uncertain. This study uses a systematic review and meta-analysis of randomized controlled trials to estimate the effect of these diets in this population. MATERIALS AND METHODS A systematic review identified randomized controlled trials of at least 6 months duration comparing efficacy and safety of VLC/KDs (≤50 g carbohydrate or ≤10% total energy from carbohydrate per day) with a control diet (carbohydrate above the VLC/KD threshold) in adults with pre-diabetes or T2D. The primary outcome variable was glycated haemoglobin (HbA1c) after 12 months. The meta-analysis method was inverse variance weighting of mean values for continuous variables. RESULTS Key word searches identified 2290 studies; 2221 were not in scope. A full text review of 69 studies identified eight meeting inclusion criteria; in total, it involved 606 participants. Six studies reported HbA1c (%) at 12 months; four as change from baseline with a fixed effects estimate (95% confidence interval): VLC/KD minus control of 0.01% (-0.22 to 0.25), p = .91; and two as change from baseline: -0.65% (-0.99; -0.31) [-7.1 mmol/mol (-10.8; -3.4)], p < .001. Serum triglycerides were lower with VLC/KD versus control: -0.28 mmol/L (-0.44 to -0.11), p < .001. High-density lipoprotein was higher with an estimate of 0.04 mmol/L (0.01 to 0.08), p = .03, in the five studies reporting 12-month summary data. CONCLUSIONS A VLC/KD may cause reductions in HbA1c and triglycerides in those with pre-diabetes or T2D but evidence of an advantage over other strategies is limited. More well-designed studies are required to provide certain evidence.
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Affiliation(s)
- Amber Parry‐Strong
- Department of Medicine, Division of Health SciencesUniversity of Otago Wellington, School of Medicine and Health Sciences BuildingWellingtonNew Zealand
| | - Morag Wright‐McNaughton
- Department of Medicine, Division of Health SciencesUniversity of Otago Wellington, School of Medicine and Health Sciences BuildingWellingtonNew Zealand
| | - Mark Weatherall
- Department of Medicine, Division of Health SciencesUniversity of Otago Wellington, School of Medicine and Health Sciences BuildingWellingtonNew Zealand
| | - Rosemary M. Hall
- Department of Medicine, Division of Health SciencesUniversity of Otago Wellington, School of Medicine and Health Sciences BuildingWellingtonNew Zealand
| | - Kirsten J. Coppell
- Department of Medicine, Dunedin School of MedicineUniversity of OtagoDunedinNew Zealand
| | - Christine Barthow
- Department of Medicine, Division of Health SciencesUniversity of Otago Wellington, School of Medicine and Health Sciences BuildingWellingtonNew Zealand
| | - Jeremy D. Krebs
- Department of Medicine, Division of Health SciencesUniversity of Otago Wellington, School of Medicine and Health Sciences BuildingWellingtonNew Zealand
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Stentz FB, Lawson D, Tucker S, Christman J, Sands C. Decreased cardiovascular risk factors and inflammation with remission of type 2 diabetes in adults with obesity using a high protein diet: Randomized control trial. OBESITY PILLARS (ONLINE) 2022; 4:100047. [PMID: 37990670 PMCID: PMC10661976 DOI: 10.1016/j.obpill.2022.100047] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 11/23/2023]
Abstract
Objective The study objective was to determine the effects a high protein (HP) vs. a high carbohydrate (HC) diet on cardiovascular risk factors (CVR), inflammation, metabolic parameters, oxidative stress, weight loss, lean and fat body mass, and remission of Type 2 Diabetes (T2DM) in subjects with obesity. Research design and methods Twelve women and men with T2D were recruited and randomized to either a HP (30%protein, 30%fat, 40%carbohydrate) (n = 6) or HC (15%protein, 30%fat, 55%carbohydrate) (n = 6) diet feeding study for 6 months in this randomized controlled trial. All meals were purchased at local grocery stores and provided to subjects for 6 months with daily food menus for HP or HC compliance with weekly food pick-up and weight measurements. Oral glucose tolerance and meal tolerance tests with glucose and insulin measurements and DXA scans were done at baseline and after 6 months on the respective diets. Results After 6 months on the HP diet, 100% of the subjects had remission of their T2DM to Normal Glucose Tolerance (NGT), whereas only 16.6% of subjects on the HC diet had remission of their T2DM. The HP diet group exhibited significant improvement in a) cardiovascular risk factors (p = 0.004, b) inflammatory cytokines(p = 0.001), c) insulin sensitivity(p = 0.001), d) oxidative stress(p = 0.001), e) increased %lean body mass(p = 0.001) compared to the HC diet group at 6 months. Conclusions A significant improvement in cardiovascular risk factors, inflammation, metabolic parameters and 100% remission of T2DM to NGT was achieved with a HP diet compared to a HC diet at 6 months. Clinicaltrialsgov identifier NCT01642849.
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Affiliation(s)
- Frankie B. Stentz
- Departments of Medicine, Endocrinology, Diabetes and Metabolism Division, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Damon Lawson
- Departments of Medicine, Endocrinology, Diabetes and Metabolism Division, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Sidney Tucker
- Departments of Medicine, Endocrinology, Diabetes and Metabolism Division, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - John Christman
- Departments of Medicine, Endocrinology, Diabetes and Metabolism Division, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Chris Sands
- Departments of Medicine, Endocrinology, Diabetes and Metabolism Division, The University of Tennessee Health Science Center, Memphis, TN, USA
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Nuwaylati D, Eldakhakhny B, Bima A, Sakr H, Elsamanoudy A. Low-Carbohydrate High-Fat Diet: A SWOC Analysis. Metabolites 2022; 12:1126. [PMID: 36422267 PMCID: PMC9695571 DOI: 10.3390/metabo12111126] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 08/27/2023] Open
Abstract
Insulin resistance (IR) plays a role in the pathogenesis of many diseases, such as type 2 diabetes mellitus, cardiovascular disease, non-alcoholic fatty liver disease, obesity, and neurodegenerative diseases, including Alzheimer's disease. The ketogenic diet (KD) is a low-carbohydrate/high-fat diet that arose in the 1920s as an effective treatment for seizure control. Since then, the KD has been studied as a therapeutic approach for various IR-related disorders with successful results. To date, the use of the KD is still debatable regarding its safety. Some studies have acknowledged its usefulness, while others do not recommend its long-term implementation. In this review, we applied a SWOC (Strengths, Weaknesses, Opportunities, and Challenges) analysis that revealed the positive, constructive strengths of the KD, its potential complications, different conditions that can make used for it, and the challenges faced by both physicians and subjects throughout a KD. This SWOC analysis showed that the KD works on the pathophysiological mechanism of IR-related disorders such as chronic inflammation, oxidative stress and mitochondrial stress. Furthermore, the implementation of the KD as a potential adjuvant therapy for many diseases, including cancer, neurodegenerative disorders, polycystic ovary syndrome, and pain management was proven. On the other hand, the short and long-term possible undesirable KD-related effects, including nutritional deficiencies, growth retardation and nephrolithiasis, should be considered and strictly monitored. Conclusively, this review provides a context for decision-makers, physicians, researchers, and the general population to focus on this dietary intervention in preventing and treating diseases. Moreover, it draws the attention of scientists and physicians towards the opportunities and challenges associated with the KD that requires attention before KD initiation.
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Affiliation(s)
- Dena Nuwaylati
- Clinical Biochemistry Department, Faculty of Medicine, University of Jeddah, Jeddah 21959, Saudi Arabia
| | - Basmah Eldakhakhny
- Clinical Biochemistry Department, Faculty of Medicine, King Abdulaziz University, Jeddah 21465, Saudi Arabia
| | - Abdulhadi Bima
- Clinical Biochemistry Department, Faculty of Medicine, King Abdulaziz University, Jeddah 21465, Saudi Arabia
| | - Hussein Sakr
- Physiology Department, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Oman
- Medical Physiology Department, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Ayman Elsamanoudy
- Clinical Biochemistry Department, Faculty of Medicine, King Abdulaziz University, Jeddah 21465, Saudi Arabia
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
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Hemler EC, Bromage S, Tadesse AW, Zack R, Berhane Y, Canavan CR, Fawzi WW, Willett WC. Associations of percentage energy intake from total, animal and plant protein with overweight/obesity and underweight among adults in Addis Ababa, Ethiopia. Public Health Nutr 2022; 25:3107-3120. [PMID: 35570670 PMCID: PMC9991810 DOI: 10.1017/s1368980022001100] [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: 04/20/2021] [Revised: 04/15/2022] [Accepted: 04/27/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study investigated associations between types and food sources of protein with overweight/obesity and underweight in Ethiopia. DESIGN We conducted a cross-sectional dietary survey using a non-quantitative FFQ. Linear regression models were used to assess associations between percentage energy intake from total, animal and plant protein and BMI. Logistic regression models were used to examine the associations of percentage energy intake from total, animal and plant protein and specific protein food sources with underweight and overweight/obesity. SETTING Addis Ababa, Ethiopia. PARTICIPANTS 1624 Ethiopian adults (992 women and 632 men) aged 18-49 years in selected households sampled using multi-stage random sampling from five sub-cities of Addis Ababa. RESULTS Of the surveyed adults, 31 % were overweight or obese. The majority of energy intake was from carbohydrate with only 3 % from animal protein. In multivariable-adjusted linear models, BMI was not associated with percentage energy from total, plant or animal protein. Total and animal protein intake were both associated with lower odds of overweight/obesity (OR per 1 % energy increment of total protein 0·92; 95 % CI: 0·86, 0·99; P = 0·02; OR per 1 % energy increment of animal protein 0·89; 95 % CI: 0·82, 0·96; P = 0·004) when substituted for carbohydrate and adjusted for socio-demographic covariates. CONCLUSION Increasing proportion of energy intake from total protein or animal protein in place of carbohydrate could be a strategy to address overweight and obesity in Addis Ababa; longitudinal studies are needed to further examine this potential association.
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Affiliation(s)
- Elena C Hemler
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA02120, USA
| | - Sabri Bromage
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Amare Worku Tadesse
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Rachel Zack
- The Greater Boston Food Bank, Boston, MA, USA
| | - Yemane Berhane
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Chelsey R Canavan
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA02120, USA
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA02120, USA
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Walter C Willett
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Pirola L, Ciesielski O, Balcerczyk A. Fat not so bad? The role of ketone bodies and ketogenic diet in the treatment of endothelial dysfunction and hypertension. Biochem Pharmacol 2022; 206:115346. [DOI: 10.1016/j.bcp.2022.115346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/20/2022] [Accepted: 11/08/2022] [Indexed: 11/15/2022]
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Susanto A, Burk J, Hocking S, Markovic T, Gill T. Differences in weight loss outcomes for males and females on a low-carbohydrate diet: A systematic review. Obes Res Clin Pract 2022; 16:447-456. [PMID: 36244957 DOI: 10.1016/j.orcp.2022.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 09/23/2022] [Accepted: 09/27/2022] [Indexed: 12/05/2022]
Abstract
It has been widely demonstrated that there are a broad range of individual responses to all weight management regimens, often masked by reports of the mean. Identifying features of responders and non-responders to weight loss regimens enables a more tailored approach to the provision of weight management advice. Low-carbohydrate diets are currently popular, and anecdote suggests that males are more successful at losing weight using this approach. This is feasible given the physiological and socio-psychological differences between the genders. We analysed the extent and variation in weight change for males and females separately through a systematic search for all low-carbohydrate diet trials published since 1985. Very few studies compared weight loss outcomes by gender and, of those that did, most lacked supporting data. The majority of studies reported no gender difference but when a gender difference was found, males were more frequently reported as losing more weight than females on a low-carbohydrate diet. The lack of gender stratification in weight loss trials is concerning, as there are a range of gender-based factors that affect weight loss outcomes. This study highlights the importance of examining weight change for males and females separately, since as failure to do so may mask any potential differences, which, if detected, could assist with better weight loss outcomes.
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Affiliation(s)
- Alyssa Susanto
- Boden Group, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, NSW 2006, Australia.
| | - Jessica Burk
- Boden Group, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, NSW 2006, Australia
| | - Samantha Hocking
- Boden Group, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, NSW 2006, Australia; Metabolism & Obesity Service, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Tania Markovic
- Boden Group, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, NSW 2006, Australia; Metabolism & Obesity Service, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Tim Gill
- Boden Group, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, NSW 2006, Australia
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A Health Care Professional Delivered Low Carbohydrate Diet Program Reduces Body Weight, Haemoglobin A1c, Diabetes Medication Use and Cardiovascular Risk Markers-A Single-Arm Intervention Analysis. Nutrients 2022; 14:nu14204406. [PMID: 36297093 PMCID: PMC9609895 DOI: 10.3390/nu14204406] [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: 09/13/2022] [Revised: 10/10/2022] [Accepted: 10/17/2022] [Indexed: 11/17/2022] Open
Abstract
This study examined the effectiveness of a health care professional delivered low-carbohydrate diet program (Diversa Health Program) aiming to improve obesity/type-2-diabetes management for people living in Australia. 511 adults (Age:57.1 ± 13.7 [SD] yrs) who participated between January 2017−August 2021 for ≥30 days with pre-post data collected for ≥1 key outcome variable (body weight and HbA1c) were included in the analysis. Average participation duration was 218 ± 207 days with 5.4 ± 3.9 reported consultation visits. Body weight reduced from 92.3 ± 23.0 to 86.3 ± 21.1 kg (n = 506, p < 0.001). Weight loss was 0.9 ± 2.8 kg (1.3%), 4.5 ± 4.3 kg (5.7%) and 7.9 ± 7.2 kg (7.5%), respectively, for those with a classification of normal weight (n = 67), overweight (n = 122) and obese (n = 307) at commencement. HbA1c reduced from 6.0 ± 1.2 to 5.6 ± 0.7% (n = 212, p < 0.001). For members with a commencing HbA1c of <5.7% (n = 110), 5.7−6.4% (n = 55), and ≥6.5% (n = 48), HbA1c reduced −0.1 ± 0.2%, −0.3 ± 0.3%, and −1.4 ± 1.3%, respectively. For members with a commencing HbA1c ≥6.5%, 90% experienced a HbA1c reduction and 54% achieved a final HbA1c < 6.5%. With inclusion and exclusion of metformin, respectively, 124 and 82 diabetes medications were prescribed to 63 and 42 members that reduced to 82 and 35 medications prescribed to 51 and 26 members at final visit. A health care professional delivered low-carbohydrate diet program can facilitate weight loss and improve glycaemic control with greatest improvements and clinical relevance in individuals with worse baseline parameters.
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He M, Wang J, Liang Q, Li M, Guo H, Wang Y, Deji C, Sui J, Wang YW, Liu Y, Zheng Y, Qian B, Chen H, Ma M, Su S, Geng H, Zhou WX, Guo X, Zhu WZ, Zhang M, Chen Z, Rensen PC, Hui CC, Wang Y, Shi B. Time-restricted eating with or without low-carbohydrate diet reduces visceral fat and improves metabolic syndrome: A randomized trial. Cell Rep Med 2022; 3:100777. [PMID: 36220069 PMCID: PMC9589024 DOI: 10.1016/j.xcrm.2022.100777] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 07/24/2022] [Accepted: 09/20/2022] [Indexed: 11/30/2022]
Abstract
Overconsumption of carbohydrate-rich food combined with adverse eating patterns contributes to the increasing incidence of metabolic syndrome (MetS) in China. Therefore, we conducted a randomized trial to determine the effects of a low-carbohydrate diet (LCD), an 8-h time-restricted eating (TRE) schedule, and their combination on body weight and abdominal fat area (i.e., primary outcomes) and cardiometabolic outcomes in participants with MetS. Compared with baseline, all 3-month treatments significantly reduce body weight and subcutaneous fat area, but only TRE and combination treatment reduce visceral fat area (VFA), fasting blood glucose, uric acid (UA), and dyslipidemia. Furthermore, compared with changes of LCD, TRE and combination treatment further decrease body weight and VFA, while only combination treatment yields more benefits on glycemic control, UA, and dyslipidemia. In conclusion, without change of physical activity, an 8-h TRE with or without LCD can serve as an effective treatment for MetS (ClinicalTrials.gov: NCT04475822).
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Affiliation(s)
- Mingqian He
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Jingya Wang
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Qian Liang
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Meng Li
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Hui Guo
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Yue Wang
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Cuomu Deji
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Jing Sui
- Department of Endocrinology and International Medical Center, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Ya-wen Wang
- Biobank, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China,Department of Laboratory Medicine, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Yufeng Liu
- Biobank, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Yixuan Zheng
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Buyue Qian
- Network and Information Center, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Huaixi Chen
- Network and Information Center, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Mao Ma
- Physical Examination Center, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Shi Su
- Physical Examination Center, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Hui Geng
- Physical Examination Center, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Wen-xu Zhou
- Department of Internal Medicine, The Hospital of Xi’an JiaoTong University, No. 28, West Xianning Road, Xi’an, Shaanxi 710049, P.R. China
| | - Xiaoxiao Guo
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Wen-zhi Zhu
- Med-X institute, Center for Immunological and Metabolic Diseases, the First Affiliated Hospital of Xi’an JiaoTong University, Xi’an JiaoTong University, Xi’an, Shaanxi 710061, P.R. China
| | - Meng Zhang
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Ziyi Chen
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Patrick C.N. Rensen
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China,Department of Medicine, Division of Endocrinology, Leiden University Medical Center, P.O. Box 9600, 2300 Leiden, the Netherlands
| | - Chi-chung Hui
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, and Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Yanan Wang
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China,Med-X institute, Center for Immunological and Metabolic Diseases, the First Affiliated Hospital of Xi’an JiaoTong University, Xi’an JiaoTong University, Xi’an, Shaanxi 710061, P.R. China,Corresponding author
| | - Bingyin Shi
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China,Corresponding author
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Dhillon J, Jacobs AG, Ortiz S, Diaz Rios LK. A Systematic Review of Literature on the Representation of Racial and Ethnic Minority Groups in Clinical Nutrition Interventions. Adv Nutr 2022; 13:1505-1528. [PMID: 35108358 PMCID: PMC9526835 DOI: 10.1093/advances/nmac002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/29/2021] [Accepted: 01/10/2022] [Indexed: 02/04/2023] Open
Abstract
The racial and ethnic disparities in diet-related chronic diseases are major concerns. This systematic review examines the extent to which diet-induced changes in health outcomes, such as cardiometabolic, inflammation, cancer, bone health, and kidney function outcomes, etc., have been reported and discussed by race or ethnicity in randomized trials with 2 or more diet arms that recruited both minority and non-Hispanic White groups. Databases (i.e., PubMed, Cochrane Library, and Web of Science) were searched up to August 2021. Thirty-four studies that discussed effects of defined dietary interventions on health outcomes by racial or ethnic minority group compared with non-Hispanic Whites were included in the systematic review (PROSPERO registration number: CRD42021229256). Acute trials and those with 1 diet arm that accounted for race or ethnicity in their analyses and studies that focused on a single racial or ethnic group were discussed separately. Most studies were conducted in Black compared with White adults testing effects of energy restriction, macronutrient modification, sodium reduction, or variations of the Dietary Approaches to Stop Hypertension (DASH) diet on cardiometabolic outcomes. There was limited focus on other minority groups. Evidence suggests greater blood pressure reduction for Black adults compared with Whites particularly with DASH (or similar) diets. Overall, there was limited consideration for group-specific eating patterns and diet acceptability. Overall risk of bias was low. With emerging precision nutrition initiatives that aim to optimize metabolic responses in population subgroups through tailored approaches, it is imperative to ensure adequate representation of racial and ethnic subgroups for addressing health disparities. Factors that help explain variability in responses such as socioecological context should be included and adequately powered. Given the racial and ethnic disparities in chronic diseases, studying the adoption, maintenance, and effectiveness of dietary interventions on health outcomes among different groups is critical for developing approaches that can mitigate diet-related health disparities.
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Affiliation(s)
- Jaapna Dhillon
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, USA
- Department of Molecular & Cell Biology, School of Natural Sciences, University of California Merced, Merced, CA, USA
| | | | - Sigry Ortiz
- Department of Molecular & Cell Biology, School of Natural Sciences, University of California Merced, Merced, CA, USA
| | - L Karina Diaz Rios
- Division of Agriculture and Natural Resources, University of California Merced, Merced, CA, USA
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Jenkins DJA, Jones PJH, Abdullah MMH, Lamarche B, Faulkner D, Patel D, Sahye-Pudaruth S, Paquette M, Bashyam B, Pichika SC, Kavanagh ME, Patel P, Liang F, Brown R, Zhao T, Phan M, Mathiyalagan G, Tandon S, Vuksan V, Jovanovski E, Sievenpiper JL, Kendall CWC, Leiter LA, Josse RG. Low-carbohydrate vegan diets in diabetes for weight loss and sustainability: a randomized controlled trial. Am J Clin Nutr 2022; 116:1240-1250. [PMID: 36156115 DOI: 10.1093/ajcn/nqac203] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/20/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Low-carbohydrate, high animal fat and protein diets have been promoted for weight loss and diabetes treatment. We therefore tested the effect of a low-carbohydrate vegan diet in diabetes as a potentially healthier and more ecologically sustainable low-carbohydrate option. OBJECTIVES We sought to compare the effectiveness of a low-carbohydrate vegan diet with a moderate-carbohydrate vegetarian diet on weight loss and metabolic measures in diabetes. METHODS One hundred and sixty-four male and female participants with type 2 diabetes were randomly assigned to advice on either a low-carbohydrate vegan diet, high in canola oil and plant proteins, or a vegetarian therapeutic diet, for 3 mo, with both diets recommended at 60% of calorie requirements. Body weight, fasting blood, blood pressure, and 7-d food records, to estimate potential greenhouse gas emissions, were obtained throughout the study with tests of cholesterol absorption undertaken at baseline and end of study on 50 participants. RESULTS Both low-carbohydrate vegan and vegetarian diets similarly but markedly reduced body weight (-5.9 kg; 95% CI: -6.5, -5.28 kg; and -5.23 kg; 95% CI: -5.84, -4.62 kg), glycated hemoglobin (-0.99%; 95% CI: -1.07, -0.9%; and -0.88%; 95% CI: -0.97, -0.8%), systolic blood pressure (-4 mmHg; 95% CI: -7, -2 mmHg; and -6 mmHg; 95% CI: -8, -3 mmHg), and potential greenhouse gas emissions, but only for potential greenhouse gas emissions was there a significant treatment difference of -0.63 kgCO2/d (95% CI: -0.99, -0.27 kgCO2/d) favoring the low-carbohydrate vegan diet. CONCLUSIONS Low-carbohydrate vegan and vegetarian diets reduced body weight, improved glycemic control and blood pressure, but the more plant-based diet had greater potential reduction in greenhouse gas emissions.Trial registration number: clinicaltrials.gov identifier NCT02245399.
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Affiliation(s)
- David J A Jenkins
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada.,Division of Endocrinology and Metabolism, St Michael's Hospital, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St Michael's Hospital, Toronto, Ontario, Canada
| | - Peter J H Jones
- Nutritional Fundamentals for Health Inc., Vaudreuil-Dorion, Quebec, Canada
| | | | - Benoit Lamarche
- Centre santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Quebec City, Quebec, Canada
| | - Dorothea Faulkner
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada
| | - Darshna Patel
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada
| | - Sandhya Sahye-Pudaruth
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada
| | - Melanie Paquette
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada
| | - Balachandran Bashyam
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada
| | - Sathish C Pichika
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada.,Department of Mathematics and Statistics, University of Windsor, Windsor, Ontario, Canada
| | - Meaghan E Kavanagh
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada
| | - Pooja Patel
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada
| | - Fred Liang
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada
| | - Ramon Brown
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada
| | - Tiffany Zhao
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada
| | - Mila Phan
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada
| | - Gajuna Mathiyalagan
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada
| | - Shilpa Tandon
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada
| | - Vladmir Vuksan
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada.,Division of Endocrinology and Metabolism, St Michael's Hospital, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Elena Jovanovski
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada
| | - John L Sievenpiper
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada.,Division of Endocrinology and Metabolism, St Michael's Hospital, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St Michael's Hospital, Toronto, Ontario, Canada
| | - Cyril W C Kendall
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St Michael's Hospital, Toronto, Ontario, Canada.,College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Lawrence A Leiter
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada.,Division of Endocrinology and Metabolism, St Michael's Hospital, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St Michael's Hospital, Toronto, Ontario, Canada
| | - Robert G Josse
- Division of Endocrinology and Metabolism, St Michael's Hospital, Toronto, Ontario, Canada
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Cecchini AL, Biscetti F, Rando MM, Nardella E, Pecorini G, Eraso LH, Dimuzio PJ, Gasbarrini A, Massetti M, Flex A. Dietary Risk Factors and Eating Behaviors in Peripheral Arterial Disease (PAD). Int J Mol Sci 2022; 23:10814. [PMID: 36142725 PMCID: PMC9504787 DOI: 10.3390/ijms231810814] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 11/17/2022] Open
Abstract
Dietary risk factors play a fundamental role in the prevention and progression of atherosclerosis and PAD (Peripheral Arterial Disease). The impact of nutrition, however, defined as the process of taking in food and using it for growth, metabolism and repair, remains undefined with regard to PAD. This article describes the interplay between nutrition and the development/progression of PAD. We reviewed 688 articles, including key articles, narrative and systematic reviews, meta-analyses and clinical studies. We analyzed the interaction between nutrition and PAD predictors, and subsequently created four descriptive tables to summarize the relationship between PAD, dietary risk factors and outcomes. We comprehensively reviewed the role of well-studied diets (Mediterranean, vegetarian/vegan, low-carbohydrate ketogenic and intermittent fasting diet) and prevalent eating behaviors (emotional and binge eating, night eating and sleeping disorders, anorexia, bulimia, skipping meals, home cooking and fast/ultra-processed food consumption) on the traditional risk factors of PAD. Moreover, we analyzed the interplay between PAD and nutritional status, nutrients, dietary patterns and eating habits. Dietary patterns and eating disorders affect the development and progression of PAD, as well as its disabling complications including major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Nutrition and dietary risk factor modification are important targets to reduce the risk of PAD as well as the subsequent development of MACE and MALE.
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Affiliation(s)
- Andrea Leonardo Cecchini
- Internal Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Federico Biscetti
- Cardiovascular Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Maria Margherita Rando
- Cardiovascular Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Elisabetta Nardella
- Cardiovascular Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Giovanni Pecorini
- Internal Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Luis H. Eraso
- Division of Vascular and Endovascular Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Paul J. Dimuzio
- Division of Vascular and Endovascular Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Antonio Gasbarrini
- Internal Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Massimo Massetti
- Internal Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Andrea Flex
- Internal Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Cardiovascular Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
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Popp CJ, Hu L, Kharmats AY, Curran M, Berube L, Wang C, Pompeii ML, Illiano P, St-Jules DE, Mottern M, Li H, Williams N, Schoenthaler A, Segal E, Godneva A, Thomas D, Bergman M, Schmidt AM, Sevick MA. Effect of a Personalized Diet to Reduce Postprandial Glycemic Response vs a Low-fat Diet on Weight Loss in Adults With Abnormal Glucose Metabolism and Obesity: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2233760. [PMID: 36169954 PMCID: PMC9520362 DOI: 10.1001/jamanetworkopen.2022.33760] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Interindividual variability in postprandial glycemic response (PPGR) to the same foods may explain why low glycemic index or load and low-carbohydrate diet interventions have mixed weight loss outcomes. A precision nutrition approach that estimates personalized PPGR to specific foods may be more efficacious for weight loss. OBJECTIVE To compare a standardized low-fat vs a personalized diet regarding percentage of weight loss in adults with abnormal glucose metabolism and obesity. DESIGN, SETTING, AND PARTICIPANTS The Personal Diet Study was a single-center, population-based, 6-month randomized clinical trial with measurements at baseline (0 months) and 3 and 6 months conducted from February 12, 2018, to October 28, 2021. A total of 269 adults aged 18 to 80 years with a body mass index (calculated as weight in kilograms divided by height in meters squared) ranging from 27 to 50 and a hemoglobin A1c level ranging from 5.7% to 8.0% were recruited. Individuals were excluded if receiving medications other than metformin or with evidence of kidney disease, assessed as an estimated glomerular filtration rate of less than 60 mL/min/1.73 m2 using the Chronic Kidney Disease Epidemiology Collaboration equation, to avoid recruiting patients with advanced type 2 diabetes. INTERVENTIONS Participants were randomized to either a low-fat diet (<25% of energy intake; standardized group) or a personalized diet that estimates PPGR to foods using a machine learning algorithm (personalized group). Participants in both groups received a total of 14 behavioral counseling sessions and self-monitored dietary intake. In addition, the participants in the personalized group received color-coded meal scores on estimated PPGR delivered via a mobile app. MAIN OUTCOMES AND MEASURES The primary outcome was the percentage of weight loss from baseline to 6 months. Secondary outcomes included changes in body composition (fat mass, fat-free mass, and percentage of body weight), resting energy expenditure, and adaptive thermogenesis. Data were collected at baseline and 3 and 6 months. Analysis was based on intention to treat using linear mixed modeling. RESULTS Of a total of 204 adults randomized, 199 (102 in the personalized group vs 97 in the standardized group) contributed data (mean [SD] age, 58 [11] years; 133 women [66.8%]; mean [SD] body mass index, 33.9 [4.8]). Weight change at 6 months was -4.31% (95% CI, -5.37% to -3.24%) for the standardized group and -3.26% (95% CI, -4.25% to -2.26%) for the personalized group, which was not significantly different (difference between groups, 1.05% [95% CI, -0.40% to 2.50%]; P = .16). There were no between-group differences in body composition and adaptive thermogenesis; however, the change in resting energy expenditure was significantly greater in the standardized group from 0 to 6 months (difference between groups, 92.3 [95% CI, 0.9-183.8] kcal/d; P = .05). CONCLUSIONS AND RELEVANCE A personalized diet targeting a reduction in PPGR did not result in greater weight loss compared with a low-fat diet at 6 months. Future studies should assess methods of increasing dietary self-monitoring adherence and intervention exposure. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03336411.
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Affiliation(s)
- Collin J. Popp
- Institute for Excellence in Health Equity, Center for Healthful Behavior Change, Department of Population Health, NYU Langone Health, New York, New York
| | - Lu Hu
- Institute for Excellence in Health Equity, Center for Healthful Behavior Change, Department of Population Health, NYU Langone Health, New York, New York
| | - Anna Y. Kharmats
- Institute for Excellence in Health Equity, Center for Healthful Behavior Change, Department of Population Health, NYU Langone Health, New York, New York
| | - Margaret Curran
- Institute for Excellence in Health Equity, Center for Healthful Behavior Change, Department of Population Health, NYU Langone Health, New York, New York
| | - Lauren Berube
- Institute for Excellence in Health Equity, Center for Healthful Behavior Change, Department of Population Health, NYU Langone Health, New York, New York
| | - Chan Wang
- Division of Biostatistics, Department of Population Health, NYU Langone Health, New York, New York
| | - Mary Lou Pompeii
- Institute for Excellence in Health Equity, Center for Healthful Behavior Change, Department of Population Health, NYU Langone Health, New York, New York
| | - Paige Illiano
- Institute for Excellence in Health Equity, Center for Healthful Behavior Change, Department of Population Health, NYU Langone Health, New York, New York
| | | | - Meredith Mottern
- Institute for Excellence in Health Equity, Center for Healthful Behavior Change, Department of Population Health, NYU Langone Health, New York, New York
| | - Huilin Li
- Division of Biostatistics, Department of Population Health, NYU Langone Health, New York, New York
| | - Natasha Williams
- Institute for Excellence in Health Equity, Center for Healthful Behavior Change, Department of Population Health, NYU Langone Health, New York, New York
| | - Antoinette Schoenthaler
- Institute for Excellence in Health Equity, Center for Healthful Behavior Change, Department of Population Health, NYU Langone Health, New York, New York
| | - Eran Segal
- Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Rehovot, Israel
| | - Anastasia Godneva
- Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Rehovot, Israel
| | - Diana Thomas
- Department of Mathematical Sciences, United States Military Academy, West Point, New York
| | - Michael Bergman
- Institute for Excellence in Health Equity, Center for Healthful Behavior Change, Department of Population Health, NYU Langone Health, New York, New York
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, NYU Langone Health, New York, New York
| | - Ann Marie Schmidt
- Diabetes Research Program, Department of Medicine, NYU Langone Health, New York, New York
| | - Mary Ann Sevick
- Institute for Excellence in Health Equity, Center for Healthful Behavior Change, Department of Population Health, NYU Langone Health, New York, New York
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, NYU Langone Health, New York, New York
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Lei L, Huang J, Zhang L, Hong Y, Hui S, Yang J. Effects of low-carbohydrate diets versus low-fat diets on metabolic risk factors in overweight and obese adults: A meta-analysis of randomized controlled trials. Front Nutr 2022; 9:935234. [PMID: 36017224 PMCID: PMC9397119 DOI: 10.3389/fnut.2022.935234] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/14/2022] [Indexed: 11/14/2022] Open
Abstract
Background and aims Low-carbohydrate diets (LCD) and low-fat diets (LFD) have shown beneficial effects on the management of obesity. Epidemiological studies were conducted to compare the effects of the two diets. However, the results were not always consistent. This study aimed to conduct a meta-analysis to compare the long-term effects of LCD and LFD on metabolic risk factors and weight loss in overweight and obese adults. Methods We performed a systematic literature search up to 30 March, 2022 in PubMed, EMBASE, and Cochrane Library. The meta-analysis compared the effects of LCD (carbohydrate intake ≤ 40%) with LFD (fat intake < 30%) on metabolic risk factors and weight loss for ≥6 months. Subgroup analyses were performed based on participant characteristics, dietary energy intake, and the proportions of carbohydrates. Results 33 studies involving a total of 3,939 participants were included. Compared with participants on LFD, participants on LCD had a greater reduction in triglycerides (–0.14 mmol/L; 95% CI, –0.18 to –0.10 mmol/L), diastolic blood pressure (–0.87 mmHg; 95% CI, –1.41 to –0.32 mmHg), weight loss (–1.33 kg; 95% CI, –1.79 to –0.87 kg), and a greater increase in high-density lipoprotein cholesterol (0.07 mmol/L; 95% CI, 0.06 to 0.09 mmol/L) in 6–23 months. However, the decrease of total cholesterol (0.14 mmol/L; 95% CI, 0.07 to 0.20 mmol/L) and low-density lipoprotein cholesterol (0.10 mmol/L; 95% CI, 0.06 to 0.14 mmol/L) was more conducive to LFD in 6–23 months. There was no difference in benefits between the two diets after 24 months. Subgroup analyses showed no significant difference in the reduction of total cholesterol, low-density lipoprotein cholesterol, and blood pressure between the two diets in participants with diabetes, hypertension, or hyperlipidemia. Conclusion The results suggest that LCD and LFD may have specific effects on metabolic risk factors and weight loss in overweight and obese adults over 6 months. At 24 months, the effects on weight loss and improvement of metabolic risk factors were at least the same. These indicated that we might choose different diets to manage the overweight and obese subjects. However, the long-term clinical efficacy and effects of various sources of carbohydrates or fat in the two diets need to be studied in the future.
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Affiliation(s)
- Lifu Lei
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.,Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Juan Huang
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.,Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Longlong Zhang
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.,Department of Endocrinology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuqin Hong
- Department of Radiology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Suocheng Hui
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.,Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jian Yang
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.,Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Bracci EL, Milte R, Keogh JB, Murphy KJ. Developing and Piloting a Novel Ranking System to Assess Popular Dietary Patterns and Healthy Eating Principles. Nutrients 2022; 14:nu14163414. [PMID: 36014923 PMCID: PMC9415867 DOI: 10.3390/nu14163414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/07/2022] [Accepted: 08/13/2022] [Indexed: 11/23/2022] Open
Abstract
A multitude of weight loss diets exist. However, no one diet has been proven to be superior, despite their claims. Resultingly, this creates confusion amongst consumers and conflicting nutrition messages. The aim of the ranking system was to evaluate a range of dietary pattern’s nutrition profile and financial costs, as well as their potential long-term sustainability and associated adverse effects. Nutrition profile is typically the focal point of weight loss diets with less attention focused towards other factors that may affect their suitability. Five popular diets (Keto, Paleo, Intermittent Fasting, Optifast, and 8 Weeks to Wow) and two energy restricted healthy eating principles (Australian Guide to Healthy Eating and the Mediterranean Diet) were compared for diet quality, cost, adverse effects, and support for behaviour change. In general, healthy eating principles scored more favourably compared to popular weight loss diets in all categories. Lower carbohydrate diets tended to score lower for diet quality due to restricting multiple food groups, had more associated adverse effects and did not encourage behaviour change compared to the other weight loss diets. Optifast was the only weight loss diet to receive a negative score for cost. There should be considerations when undertaking a change to dietary patterns beyond nutrition profile. Diets indeed vary in terms of diet quality, and in addition can be costly, incur adverse effects, and disregard behaviour change which is important for sustainable weight loss and maintenance. This ranking system could create a reference point for future comparisons of diets.
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Affiliation(s)
- Ella L. Bracci
- Clinical and Health Sciences, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia
- Correspondence:
| | - Rachel Milte
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia
| | - Jennifer B. Keogh
- Clinical and Health Sciences, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia
| | - Karen J. Murphy
- Clinical and Health Sciences, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia
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Seyam MK, Alqahtani M, Sirajudeen MS, Muthusamy H, Kashoo FZ, Salah MM. Effect of circuit training with low-carbohydrate diet on body composition, cardiometabolic indices, and exercise capacity in adults with mild to moderate obesity in Saudi Arabia: A randomized control trial. Medicine (Baltimore) 2022; 101:e30054. [PMID: 35984171 PMCID: PMC9388005 DOI: 10.1097/md.0000000000030054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 03/24/2022] [Accepted: 04/25/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Circuit training that combines aerobic and resisted training is reported to reduce body fat, weight, and improve exercise capacity than performing either type of exercise independently. There is no study evaluating the combined effect of circuit training exercise (CTE) and dietary intervention (low-carbohydrate [LC] diet) among young males with obesity. METHODS A randomized control trial was conducted to explore the effects of a combined program of CTE and a LC diet for adults with mild or moderate obesity. Seventy adults with obesity were allocated randomly into 2 groups. The experimental group (group 1) received circuit training with LC diet intervention, whereas the control (group 2) received only circuit training. The study variables such as exercise capacity, body composition, and cardiometabolic indices were measured at the baseline and the end of 60 days of intervention. RESULTS The participants of group 1 showed significant improvements in body composition (body weight, body mass index, waist circumference, waist hip circumference, and body fat percentage), exercise capacity (maximal oxygen consumption), and cardiometabolic indices (high-density lipoprotein, low-density lipoprotein, triglycerides, and total cholesterol) with a P < .05 for all the variables, when compared with group 2. CONCLUSIONS The combined structured CTE with controlled LC diet intervention in obese adults caused significant reduction in body composition and cardiometabolic indices variables and an increase in exercise capacity.
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Affiliation(s)
- Mohamed K. Seyam
- Department of Physical Therapy & Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Mazen Alqahtani
- Department of Physical Therapy & Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Mohamed Sherif Sirajudeen
- Department of Physical Therapy & Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Hariraja Muthusamy
- Department of Physical Therapy & Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Faizan Z. Kashoo
- Department of Physical Therapy & Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Mukhtar M. Salah
- Mathematics Department, College of Science, Majmaah University, Majmaah, Saudi Arabia
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Khajah MA, Khushaish S, Luqmani YA. Glucose deprivation reduces proliferation and motility, and enhances the anti-proliferative effects of paclitaxel and doxorubicin in breast cell lines in vitro. PLoS One 2022; 17:e0272449. [PMID: 35917304 PMCID: PMC9345370 DOI: 10.1371/journal.pone.0272449] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 07/20/2022] [Indexed: 11/19/2022] Open
Abstract
Background Breast cancer chemotherapy with high dose alkylating agents is severely limited by their collateral toxicity to crucial normal tissues such as immune and gut cells. Taking advantage of the selective dependence of cancer cells on high glucose and combining glucose deprivation with these agents could produce therapeutic synergy. Methods In this study we examined the effect of glucose as well as its deprivation, and antagonism using the non-metabolized analogue 2-deoxy glucose, on the proliferation of several breast cancer cell lines MCF7, MDA-MB-231, YS1.2 and pII and one normal breast cell line, using the MTT assay. Motility was quantitatively assessed using the wound healing assay. Lactate, as the end product of anaerobic glucose metabolism, secreted into culture medium was measured by a biochemical assay. The effect of paclitaxel and doxorubicin on cell proliferation was tested in the absence and presence of low concentrations of glucose using MTT assay. Results In all cell lines, glucose supplementation enhanced while glucose deprivation reduced both their proliferation and motility. Lactate added to the medium could substitute for glucose. The inhibitory effects of paclitaxel and doxorubicin were significantly enhanced when glucose concentration was decreased in the culture medium, requiring 1000-fold lesser concentration to achieve a similar degree of inhibition to that seen in glucose-containing medium. Conclusion Our data show that a synergy was obtained by combining paclitaxel and doxorubicin with glucose reduction to inhibit cancer cell growth, which in vivo, might be achieved by applying a carbohydrate-restricted diet during the limited phase of application of chemotherapy; this could permit a dose reduction of the cytotoxic agents, resulting in greater tolerance and lesser side effects.
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Silverii GA, Cosentino C, Santagiuliana F, Rotella F, Benvenuti F, Mannucci E, Cresci B. Effectiveness of low-carbohydrate diets for long-term weight loss in obese individuals: A meta-analysis of randomized controlled trials. Diabetes Obes Metab 2022; 24:1458-1468. [PMID: 35373905 PMCID: PMC9546386 DOI: 10.1111/dom.14709] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/16/2022] [Accepted: 03/30/2022] [Indexed: 12/13/2022]
Abstract
AIM To assess whether low-carbohydrate (LC) diets are associated with differences in weight loss and well-being in people with obesity, and their cardiovascular and renal safety. MATERIALS AND METHODS A meta-analysis of randomized controlled trials longer than 3 months, retrieved through an extensive search on MedLine and Embase databases, comparing weight loss with LC and control diets in people with body mass index (BMI) greater than 30 kg/m2 , was conducted. RESULTS We retrieved 25 trials. Compared with controls, LC diets were associated with significant reduction of body weight at 3-4 (MD -2.59 [-3.93, -1.25] kg) and 6-8 months (MD -2.64 [-4.32, -0.95]), but no difference at 10-14 and 18-30 months, and significantly greater BMI reduction at 3-4 months (-1.66 [-2.70, -0.61] kg/m2 ), but not at other time points. Because only four trials reported data on renal function and psychological variables, renal safety and impact on well-being could not be assessed. Differences in fasting plasma glucose at any time point were not statistically significant. No significant differences in total or LDL cholesterol or blood pressure were found in the long term, whereas a long-term reduction of triglycerides (23.26 [-45.53, -0.98] mg/dl at 18-30 months), and increase of HDL cholesterol (MD 4.94 [0.30, 9.57] mg/dl at 18-30 months), were observed. CONCLUSION LC diets are associated with greater short-term weight loss than non-carbohydrate-restricted diets and a longer term favourable effect on cardiovascular risk factors. Further evidence on long-term efficacy and renal safety is needed before LC diets can be recommended as the preferred diets in obese people.
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44
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Jayedi A, Zeraattalab-Motlagh S, Jabbarzadeh B, Hosseini Y, Jibril AT, Shahinfar H, Mirrafiei A, Hosseini F, Bidar SS. Dose-dependent effect of carbohydrate restriction for type 2 diabetes management: a systematic review and dose-response meta-analysis of randomized controlled trials. Am J Clin Nutr 2022; 116:40-56. [PMID: 35537861 DOI: 10.1093/ajcn/nqac066] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 03/09/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Carbohydrate restriction is effective for type 2 diabetes management. OBJECTIVES We aimed to evaluate the dose-dependent effect of carbohydrate restriction in patients with type 2 diabetes. METHODS We systematically searched PubMed, Scopus, and Web of Science to May 2021 for randomized controlled trials evaluating the effect of a carbohydrate-restricted diet (≤45% total calories) in patients with type 2 diabetes. The primary outcome was glycated hemoglobin (HbA1c). Secondary outcomes included fasting plasma glucose (FPG); body weight; serum total, LDL, and HDL cholesterol; triglyceride (TG); and systolic blood pressure (SBP). We performed random-effects dose-response meta-analyses to estimate mean differences (MDs) for a 10% decrease in carbohydrate intake. RESULTS Fifty trials with 4291 patients were identified. At 6 months, compared with a carbohydrate intake between 55%-65% and through a maximum reduction down to 10%, each 10% reduction in carbohydrate intake reduced HbA1c (MD, -0.20%; 95% CI, -0.27% to -0.13%), FPG (MD, -0.34 mmol/L; 95% CI, -0.56 to -0.12 mmol/L), and body weight (MD, -1.44 kg; 95% CI, -1.82 to -1.06 kg). There were also reductions in total cholesterol, LDL cholesterol, TG, and SBP. Levels of HbA1c, FPG, body weight, TG, and SBP decreased linearly with the decrease in carbohydrate intake from 65% to 10%. A U-shaped effect was seen for total cholesterol and LDL cholesterol, with the greatest reduction at 40%. At 12 months, a linear reduction was seen for HbA1c and TG. A U-shaped effect was seen for body weight, with the greatest reduction at 35%. CONCLUSIONS Carbohydrate restriction can exert a significant and important reduction on levels of cardiometabolic risk factors in patients with type 2 diabetes. Levels of most cardiometabolic outcomes decreased linearly with the decrease in carbohydrate intake. U-shaped effects were seen for total cholesterol and LDL cholesterol at 6 months and for body weight at 12 months.
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Affiliation(s)
- Ahmad Jayedi
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran.,Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sheida Zeraattalab-Motlagh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahareh Jabbarzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Yasaman Hosseini
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Aliyu Tijen Jibril
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Shahinfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Amin Mirrafiei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Hosseini
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sakineh Shab- Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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45
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Tahreem A, Rakha A, Rabail R, Nazir A, Socol CT, Maerescu CM, Aadil RM. Fad Diets: Facts and Fiction. Front Nutr 2022; 9:960922. [PMID: 35866077 PMCID: PMC9294402 DOI: 10.3389/fnut.2022.960922] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 06/20/2022] [Indexed: 12/11/2022] Open
Abstract
The global prevalence of obesity is alarmingly high and is impacting both developed and underdeveloped countries, beyond the borders of ethnicity, sex, and age. On the other hand, the global interest in dieting has increased, and people are obsessed with certain fad diets, assuming them as a magic bullet for their long-term problems. A fad diet is a popular dietary pattern known to be a quick fix for obesity. These diets are quite appealing due to the proposed claims, but the lack of scientific evidence is a big question mark. Such diets are often marketed with specific claims that defy the basic principles of biochemistry and nutritional adequacy. These diets may have protective effects against obesity and certain chronic diseases like cardiovascular diseases, metabolic syndrome, and certain cancers. Limited evidence exists to support the proposed claims; rather certain studies suggest the negative health consequences of long-term adherence to such dietary patterns. Many fad diets have emerged in the previous few decades. This review article will explore the current evidence related to the health impacts of some most popular diets: Atkins diet, ketogenic diet, Paleolithic diet, Mediterranean diet, vegetarian diet, intermittent fasting and detox diet.
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Affiliation(s)
- Aaiza Tahreem
- National Institute of Food Science and Technology, University of Agriculture, Faisalabad, Pakistan
| | - Allah Rakha
- National Institute of Food Science and Technology, University of Agriculture, Faisalabad, Pakistan
- *Correspondence: Allah Rakha,
| | - Roshina Rabail
- National Institute of Food Science and Technology, University of Agriculture, Faisalabad, Pakistan
| | - Aqsa Nazir
- National Institute of Food Science and Technology, University of Agriculture, Faisalabad, Pakistan
| | | | | | - Rana Muhammad Aadil
- National Institute of Food Science and Technology, University of Agriculture, Faisalabad, Pakistan
- Rana Muhammad Aadil,
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46
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Choi JH, Cho YJ, Kim HJ, Ko SH, Chon S, Kang JH, Kim KK, Kim EM, Kim HJ, Song KH, Nam GE, Kim KI. Effect of Carbohydrate-Restricted Diets and Intermittent Fasting on Obesity, Type 2 Diabetes Mellitus, and Hypertension Management: Consensus Statement of the Korean Society for the Study of Obesity, Korean Diabetes Association, and Korean Society of Hypertension. J Obes Metab Syndr 2022; 31:100-122. [PMID: 35670159 PMCID: PMC9284571 DOI: 10.7570/jomes22009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/15/2022] [Accepted: 05/04/2022] [Indexed: 11/24/2022] Open
Abstract
Carbohydrate-restricted diets and intermittent fasting (IF) have been rapidly gaining interest among the general population and patients with cardiometabolic disease, such as overweight or obesity, diabetes, and hypertension. However, there are limited expert recommendations for these dietary regimens. This study aimed to evaluate the level of scientific evidence on the benefits and harms of carbohydrate-restricted diets and IF to make responsible recommendations. A meta-analysis and systematic literature review of 66 articles on 50 randomized controlled trials (RCTs) of carbohydrate-restricted diets and 10 articles on eight RCTs of IF was performed. Based on the analysis, the following recommendations are suggested. In adults with overweight or obesity, a moderately-low carbohydrate or low carbohydrate diet (mLCD) can be considered as a dietary regimen for weight reduction. In adults with type 2 diabetes mellitus, mLCD can be considered as a dietary regimen for improving glycemic control and reducing body weight. In contrast, a very-low carbohydrate diet (VLCD) and IF are recommended against in patients with diabetes. Furthermore, no recommendations are suggested for VLCD and IF in adults with overweight or obesity, and carbohydrate-restricted diets and IF in patients with hypertension. Here, we describe the results of our analysis and the evidence for these recommendations.
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Affiliation(s)
- Jong Han Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Yoon Jeong Cho
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Hyun-Jin Kim
- Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Seung-Hyun Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Suk Chon
- Department of Endocrinology and Metabolism, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Jee-Hyun Kang
- Department of Family Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - Kyoung-Kon Kim
- Department of Family Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Eun Mi Kim
- Department of Dietetics, Kangbuk Samsung Hospital, Seoul, Korea
| | - Hyun Jung Kim
- Institute for Evidence-based Medicine, Cochrane Korea, Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kee-Ho Song
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Ga Eun Nam
- Department of Family Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kwang Il Kim
- Division of Geriatrics, Department of Internal Medicine, Seoul National University School of Medicine, Seoul, Korea
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Abstract
Obesity remains a serious relevant public health concern throughout the world despite related countermeasures being well understood (i.e. mainly physical activity and an adjusted diet). Among different nutritional approaches, there is a growing interest in ketogenic diets (KD) to manipulate body mass (BM) and to enhance fat mass loss. KD reduce the daily amount of carbohydrate intake drastically. This results in increased fatty acid utilisation, leading to an increase in blood ketone bodies (acetoacetate, 3-β-hydroxybutyrate and acetone) and therefore metabolic ketosis. For many years, nutritional intervention studies have focused on reducing dietary fat with little or conflicting positive results over the long term. Moreover, current nutritional guidelines for athletes propose carbohydrate-based diets to augment muscular adaptations. This review discusses the physiological basis of KD and their effects on BM reduction and body composition improvements in sedentary individuals combined with different types of exercise (resistance training or endurance training) in individuals with obesity and athletes. Ultimately, we discuss the strengths and the weaknesses of these nutritional interventions together with precautionary measures that should be observed in both individuals with obesity and athletic populations. A literature search from 1921 to April 2021 using Medline, Google Scholar, PubMed, Web of Science, Scopus and Sportdiscus Databases was used to identify relevant studies. In summary, based on the current evidence, KD are an efficient method to reduce BM and body fat in both individuals with obesity and athletes. However, these positive impacts are mainly because of the appetite suppressive effects of KD, which can decrease daily energy intake. Therefore, KD do not have any superior benefits to non-KD in BM and body fat loss in individuals with obesity and athletic populations in an isoenergetic situation. In sedentary individuals with obesity, it seems that fat-free mass (FFM) changes appear to be as great, if not greater, than decreases following a low-fat diet. In terms of lean mass, it seems that following a KD can cause FFM loss in resistance-trained individuals. In contrast, the FFM-preserving effects of KD are more efficient in endurance-trained compared with resistance-trained individuals.
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48
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Alternate-Day Ketogenic Diet Feeding Protects against Heart Failure through Preservation of Ketogenesis in the Liver. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:4253651. [PMID: 35707271 PMCID: PMC9192193 DOI: 10.1155/2022/4253651] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/27/2022] [Accepted: 04/25/2022] [Indexed: 12/14/2022]
Abstract
As heart failure develops, the heart utilizes ketone bodies at increased rates, indicating an adaptive stress response. Thus, increasing ketone body availability exerts protective effects against heart failure. However, although it is the widely used approach for increasing ketone body availability, the ketogenic diet shows limited cardioprotective effects against heart failure. This study was aimed at examining the effects of the ketogenic diet on heart failure and the underlying mechanisms. Pressure overload-induced heart failure was established by transverse aortic constriction (TAC) in mice. Continuous ketogenic diet feeding for 8 weeks failed to protect the heart against heart failure. It showed no significant effects on cardiac systolic function and fibrosis but aggravated cardiac diastolic function in TAC mice. Specifically, it induced systemic lipid metabolic disorder and hepatic dysfunction in TAC mice. It decreased the content of 3-hydroxy-3-methylglutaryl-CoA lyase (HMGCL), a key enzyme in ketogenesis, and impaired the capacity of hepatic ketogenesis in TAC mice. It preserved the capacity of hepatic ketogenesis and exerted cardioprotective effects against heart failure, increasing cardiac function and decreasing cardiac fibrosis, in liver-specific HMGCL-overexpressed TAC mice. Importantly, we found that alternate-day ketogenic diet feeding did not impair the capacity of hepatic ketogenesis and exerted potent cardioprotective effects against heart failure. These results suggested that alternate-day but not continuous ketogenic diet protects against heart failure through preservation of ketogenesis in the liver.
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49
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Fernandez CA, Potts K, Bazzano LA. Effect of ideal protein versus low‐fat diet for weight loss: A randomized controlled trial. Obes Sci Pract 2022; 8:299-307. [PMID: 35664249 PMCID: PMC9159558 DOI: 10.1002/osp4.567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 11/20/2022] Open
Abstract
Background Current guidelines call for peer‐reviewed evidence of efficacy and safety for commercial weight loss programs to be recommended as options for those seeking to lose weight. Objectives This study investigated the Ideal Protein (IP) system, a commercial weight loss program, compared to a guideline‐based, low‐calorie/low‐fat (LCLF) dietary behavioral intervention on body weight and CVD risk factors in adults with obesity. Methods In this randomized, assessor‐blinded, parallel‐group trial, 192 participants with body mass index (BMI) ≥30 and ≤49 kg/m2 were assigned to either the IP Phase I diet or LFLC diet interventions. The IP Phase I is focused on lean protein and vegetables with avoidance of fruit and dairy, while the LFLC diet goals include <30% of daily energy from fat, <7% from saturated fat, 55% from carbohydrate, and an energy deficit of 500 kcal/day. The primary endpoint was change in body weight at 3 months. Secondary endpoints included change in waist circumference (WC), hip circumference (HC), total cholesterol (TC), low‐density lipoprotein cholesterol (LDL‐C) and high‐density lipoprotein cholesterol (HDL‐C), triglycerides (TG), fasting glucose (FG), systolic blood pressure (SBP) and diastolic blood pressure (DBP). Results The mean ± SD of change in weight at 3 months was −9.6 ± 12.7 kg in the IP group as compared to −1.6 ± 27.2 kg in the LFLC group. The mean between‐group difference in change at 3 months was −8.1 kg (95% confidence interval [CI] −16.6 to 0.6; p = 0.05). Additional significant between‐group differences included WC, HC, TC, and TG levels, all favoring the IP group. There were no serious adverse events during the intervention period. Conclusions The present findings demonstrate the efficacy and safety of the IP weight loss program as compared to a guideline‐based LCLF dietary behavioral intervention among black and white adults with obesity and CVD risk factors, providing support for the effectiveness of the program.
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Affiliation(s)
- Camilo A. Fernandez
- Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans Louisiana USA
- Center for Sport Tulane University School of Medicine New Orleans Louisiana USA
| | - Kaitlin Potts
- Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans Louisiana USA
| | - Lydia A. Bazzano
- Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans Louisiana USA
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50
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Choi JH, Cho YJ, Kim HJ, Ko SH, Chon S, Kang JH, Kim KK, Kim EM, Kim HJ, Song KH, Nam GE, Kim KI. Effect of carbohydrate-restricted diets and intermittent fasting on obesity, type 2 diabetes mellitus, and hypertension management: consensus statement of the Korean Society for the Study of obesity, Korean Diabetes Association, and Korean Society of Hypertension. Clin Hypertens 2022; 28:26. [PMID: 35642007 PMCID: PMC9158277 DOI: 10.1186/s40885-022-00207-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/25/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Carbohydrate-restricted diets and intermittent fasting (IF) have been rapidly gaining interest among the general population and patients with cardiometabolic disease, such as overweight or obesity, diabetes, and hypertension. However, there are limited expert recommendations for these dietary regimens. This study aimed to evaluate the level of scientific evidence on the benefits and harms of carbohydrate-restricted diets and IF to make responsible recommendations. METHODS A meta-analysis and systematic literature review of 66 articles on 50 randomized controlled clinical trials (RCTs) of carbohydrate-restricted diets and ten articles on eight RCTs of IF was performed. RESULTS Based on the analysis, the following recommendations are suggested. In adults with overweight or obesity, a moderately-low carbohydrate or low carbohydrate diet (mLCD) can be considered as a dietary regimen for weight reduction. In adults with type 2 diabetes, mLCD can be considered as a dietary regimen for improving glycemic control and reducing body weight. In contrast, a very-low carbohydrate diet (VLCD) and IF are recommended against in patients with diabetes. Furthermore, no recommendations are suggested for VLCD and IF in adults with overweight or obesity, and carbohydrate-restricted diets and IF in patients with hypertension. CONCLUSION Here, we describe the results of our analysis and the evidence for these recommendations.
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Affiliation(s)
- Jong Han Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, 05030, South Korea
| | - Yoon Jeong Cho
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, South Korea
| | - Hyun-Jin Kim
- Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Seung-Hyun Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Suk Chon
- Department of Endocrinology and Metabolism, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Jee-Hyun Kang
- Department of Family Medicine, Konyang University College of Medicine, Daejeon, South Korea
| | - Kyoung-Kon Kim
- Department of Family Medicine, Gachon University College of Medicine, Incheon, South Korea
| | - Eun Mi Kim
- Department of Dietetics, Kangbuk Samsung Hospital, Seoul, South Korea
| | - Hyun Jung Kim
- Institute for Evidence-based Medicine, Cochrane Korea, Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Kee-Ho Song
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, 05030, South Korea.
| | - Ga Eun Nam
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, 08308, Republic of Korea.
| | - Kwang Il Kim
- Division of Geriatrics, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, 13620, Republic of Korea.
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