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Sethi S, Wakeham D, Ketter T, Hooshmand F, Bjornstad J, Richards B, Westman E, Krauss RM, Saslow L. Ketogenic Diet Intervention on Metabolic and Psychiatric Health in Bipolar and Schizophrenia: A Pilot Trial. Psychiatry Res 2024; 335:115866. [PMID: 38547601 DOI: 10.1016/j.psychres.2024.115866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/15/2024] [Accepted: 03/17/2024] [Indexed: 04/14/2024]
Abstract
The ketogenic diet (KD, also known as metabolic therapy) has been successful in the treatment of obesity, type 2 diabetes, and epilepsy. More recently, this treatment has shown promise in the treatment of psychiatric illness. We conducted a 4-month pilot study to investigate the effects of a KD on individuals with schizophrenia or bipolar disorder with existing metabolic abnormalities. Twenty-three participants were enrolled in a single-arm trial. Results showcased improvements in metabolic health, with no participants meeting metabolic syndrome criteria by study conclusion. Adherent individuals experienced significant reduction in weight (12 %), BMI (12 %), waist circumference (13 %), and visceral adipose tissue (36 %). Observed biomarker enhancements in this population include a 27 % decrease in HOMA-IR, and a 25 % drop in triglyceride levels. In psychiatric measurements, participants with schizophrenia showed a 32 % reduction in Brief Psychiatric Rating Scale scores. Overall Clinical Global Impression (CGI) severity improved by an average of 31 %, and the proportion of participants that started with elevated symptomatology improved at least 1-point on CGI (79 %). Psychiatric outcomes across the cohort encompassed increased life satisfaction (17 %) and enhanced sleep quality (19 %). This pilot trial underscores the potential advantages of adjunctive ketogenic dietary treatment in individuals grappling with serious mental illness.
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Affiliation(s)
- Shebani Sethi
- Metabolic Psychiatry, Dept. of Psychiatry and Behavioral Sciences, Stanford Medicine, Stanford, CA, USA.
| | - Diane Wakeham
- Metabolic Psychiatry, Dept. of Psychiatry and Behavioral Sciences, Stanford Medicine, Stanford, CA, USA
| | - Terence Ketter
- Metabolic Psychiatry, Dept. of Psychiatry and Behavioral Sciences, Stanford Medicine, Stanford, CA, USA
| | - Farnaz Hooshmand
- Metabolic Psychiatry, Dept. of Psychiatry and Behavioral Sciences, Stanford Medicine, Stanford, CA, USA
| | - Julia Bjornstad
- Metabolic Psychiatry, Dept. of Psychiatry and Behavioral Sciences, Stanford Medicine, Stanford, CA, USA
| | - Blair Richards
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Eric Westman
- Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Ronald M Krauss
- Department of Pediatrics and Medicine, University of California-San Francisco, San Francisco, CA, USA
| | - Laura Saslow
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA
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Hafez Griauzde D, Saslow L, Patterson K, Ansari T, Liestenfeltz B, Tisack A, Bihn P, Shopinski S, Richardson CR. Mixed methods pilot study of a low-carbohydrate diabetes prevention programme among adults with pre-diabetes in the USA. BMJ Open 2020; 10:e033397. [PMID: 31969366 PMCID: PMC7045213 DOI: 10.1136/bmjopen-2019-033397] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES (1) To estimate weight change from a low-carbohydrate diabetes prevention programme (LC-DPP) and (2) to evaluate the feasibility and acceptability of an LC-DPP. RESEARCH DESIGN Single-arm, mixed methods (ie, integration of quantitative and qualitative data) pilot study. SETTING Primary care clinic within a large academic medical centre in the USA. PARTICIPANTS Adults with pre-diabetes and Body Mass Index of ≥25 kg/m2. INTERVENTION We adapted the Centers for Disease Control and Prevention's National Diabetes Prevention Program (NDPP)-an evidence-based, low-fat dietary intervention-to teach participants to follow a very low-carbohydrate diet (VLCD). Participants attended 23 group-based classes over 1 year. OUTCOME MEASURES Primary outcome measures were (1) weight change and (2) percentage of participants who achieved ≥5% wt loss. Secondary outcome measures included intervention feasibility and acceptability (eg, attendance and qualitative interview feedback). RESULTS Our enrolment target was 22. One person dropped out before a baseline weight was obtained; data from 21 individuals were analysed. Mean weight loss in kilogram was 4.3 (SD 4.8) at 6 months and 4.9 (SD 5.8) at 12 months. Mean per cent body weight changes were 4.5 (SD 5.0) at 6 months and 5.2 (SD 6.0) at 12 months; 8/21 individuals (38%) achieved ≥5% wt loss at 12 months. Mean attendance was 10.3/16 weekly sessions and 3.4/7 biweekly or monthly sessions. Among interviewees (n=14), three factors facilitated VLCD adherence: (1) enjoyment of low-carbohydrate foods, (2) diminished hunger and cravings and (3) health benefits beyond weight loss. Three factors hindered VLCD adherence: (1) enjoyment of high-carbohydrate foods, (2) lack of social support and (3) difficulty preplanning meals. CONCLUSIONS An LC-DPP is feasible, acceptable and may be an effective option to help individuals with pre-diabetes to lose weight. Data from this pilot will be used to plan a fully powered randomised controlled trial of weight loss among NDPP versus LC-DPP participants. TRIAL REGISTRATION NUMBER NCT03258918.
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Affiliation(s)
- Dina Hafez Griauzde
- Department of Internal Medicine, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Laura Saslow
- University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | | | - Tahoora Ansari
- University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | | | - Aaron Tisack
- Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Patti Bihn
- National Kidney Foundation of Michigan, Ann Arbor, Michigan, USA
| | - Samuel Shopinski
- National Kidney Foundation of Michigan, Ann Arbor, Michigan, USA
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Mason AE, Saslow L, Moran PJ, Kim S, Wali PK, Abousleiman H, Hartman A, Richler R, Schleicher S, Hartogensis W, Epel ES, Hecht F. Correction: Examining the Effects of Mindful Eating Training on Adherence to a Carbohydrate-Restricted Diet in Patients With Type 2 Diabetes (the DELISH Study): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e17226. [PMID: 31929107 PMCID: PMC7006614 DOI: 10.2196/17226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 12/06/2019] [Indexed: 11/23/2022] Open
Affiliation(s)
- Ashley E Mason
- UCSF Osher Center for Integrative MedicineDepartment of MedicineUniversity of California San FranciscoSan Francisco, CAUnited States
- Center for Health and CommunityDepartment of PsychiatryUniversity of California San FranciscoSan Francisco, CAUnited States
| | - Laura Saslow
- School of NursingDepartment of Health Behavior and Biological SciencesUniversity of MichiganAnn Arbor, MIUnited States
| | - Patricia J Moran
- UCSF Osher Center for Integrative MedicineDepartment of MedicineUniversity of California San FranciscoSan Francisco, CAUnited States
| | - Sarah Kim
- Division of Endocrinology, Diabetes and MetabolismDepartment of MedicineSan Francisco General HospitalSan Francisco, CAUnited States
| | - Priyanka K Wali
- UCSF Osher Center for Integrative MedicineDepartment of MedicineUniversity of California San FranciscoSan Francisco, CAUnited States
| | - Hiba Abousleiman
- UCSF Osher Center for Integrative MedicineDepartment of MedicineUniversity of California San FranciscoSan Francisco, CAUnited States
| | - Alison Hartman
- UCSF Osher Center for Integrative MedicineDepartment of MedicineUniversity of California San FranciscoSan Francisco, CAUnited States
| | - Robert Richler
- UCSF Osher Center for Integrative MedicineDepartment of MedicineUniversity of California San FranciscoSan Francisco, CAUnited States
| | | | - Wendy Hartogensis
- UCSF Osher Center for Integrative MedicineDepartment of MedicineUniversity of California San FranciscoSan Francisco, CAUnited States
| | - Elissa S Epel
- UCSF Osher Center for Integrative MedicineDepartment of MedicineUniversity of California San FranciscoSan Francisco, CAUnited States
- Center for Health and CommunityDepartment of PsychiatryUniversity of California San FranciscoSan Francisco, CAUnited States
| | - Frederick Hecht
- UCSF Osher Center for Integrative MedicineDepartment of MedicineUniversity of California San FranciscoSan Francisco, CAUnited States
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Potempa K, Rajataramya B, Barton DL, Singha-Dong N, Stephenson R, Smith EML, Davis M, Dinov I, Hampstead BM, Aikens JE, Saslow L, Furspan P, Sarakshetrin A, Pupjain S. Impact of using a broad-based multi-institutional approach to build capacity for non-communicable disease research in Thailand. Health Res Policy Syst 2019; 17:62. [PMID: 31200726 PMCID: PMC6570856 DOI: 10.1186/s12961-019-0464-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 05/23/2019] [Indexed: 11/10/2022] Open
Abstract
Thailand's transition to high middle-income country status has been accompanied by demographic changes and associated shifts in the nation's public health challenges. These changes have necessitated a significant shift in public health focus from the treatment of infectious diseases to the more expensive and protracted management of non-communicable diseases (NCDs) in older adults.In 2010, in response to this shift in focus, the University of Michigan and colleagues at the Praboromarajchanok Institute for Health Workforce Development in Thailand began work on a broad-based multi-institutional programme for NCD research capacity-building in Thailand.To begin to build a base of intervention research we paired our programme's funded Thai postdoctoral fellows with United States mentors who have strong programmes of intervention research. One direct impact of the programme was the development of research 'hubs' focused upon similar areas of investigative focus such as self-management of cancer symptoms, self-management of HIV/AIDS and health technology information applications for use in community settings. Within these hubs, interventions with proven efficacy in the United States were used as a foundation for culturally relevant interventions in Thailand. The programme also aimed to develop the research support structures necessary within departments and colleges for grant writing and management, dissemination of new knowledge, and ethical conduct of human subject research.In an effort to capitalise on large national health datasets and big data now available in Thailand, several of the programme's postdoctoral fellows began projects that use data science methods to mine this asset. The investigators involved in these ground-breaking projects form the core of a network of research hubs that will be able to capitalise on the availability of lifespan health data from across Thailand and provide a robust working foundation for expansion of research using data science approaches.Going forward, it is vitally important to leverage this groundwork in order to continue fostering rapid growth in NCD research and training as well as to capitalise upon these early gains to create a sustaining influence for Thailand to lead in NCD research, improve the health of its citizens, and provide ongoing leadership in Southeast Asia.
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Affiliation(s)
- Kathleen Potempa
- School of Nursing, University of Michigan, 400 N. Ingalls, Ann Arbor, MI 48109-5482 United States of America
| | - Benjaporn Rajataramya
- Praboromarajchanok Institute for Health Workforce Development, Ministry of Public Health, Nonthaburi, 110000 Thailand
| | - Debra L. Barton
- School of Nursing, University of Michigan, 400 N. Ingalls, Ann Arbor, MI 48109-5482 United States of America
| | - Naruemol Singha-Dong
- Department of Research, Institute of Nursing, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Rob Stephenson
- School of Nursing, University of Michigan, 400 N. Ingalls, Ann Arbor, MI 48109-5482 United States of America
| | - Ellen M. L. Smith
- School of Nursing, University of Michigan, 400 N. Ingalls, Ann Arbor, MI 48109-5482 United States of America
| | - Matthew Davis
- School of Nursing, University of Michigan, 400 N. Ingalls, Ann Arbor, MI 48109-5482 United States of America
| | - Ivo Dinov
- School of Nursing, University of Michigan, 400 N. Ingalls, Ann Arbor, MI 48109-5482 United States of America
| | - Benjamin M. Hampstead
- Department of Psychiatry-Neuropsychology, University of Michigan, 2101 Commonwealth, Ste C, Ann Arbor, MI 48109-2700 United States of America
| | - James E. Aikens
- Department of Family Medicine, University of Michigan, 1018 Fuller SPC 5708, Ann Arbor, MI 48109 United States of America
| | - Laura Saslow
- School of Nursing, University of Michigan, 400 N. Ingalls, Ann Arbor, MI 48109-5482 United States of America
| | - Philip Furspan
- School of Nursing, University of Michigan, 400 N. Ingalls, Ann Arbor, MI 48109-5482 United States of America
| | - Atiya Sarakshetrin
- Phrachomklao Phetchaburi College of Nursing, 203 Tambon Thongchai, Mueang District, Phetchaburi Province 76000 Thailand
| | - Srijan Pupjain
- Boromrajonani College of Nursing Nakon Lampang, 268 Pakham Road, Huawieng, Muang District, Lampang Province 52000 Thailand
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Evert AB, Dennison M, Gardner CD, Garvey WT, Lau KHK, MacLeod J, Mitri J, Pereira RF, Rawlings K, Robinson S, Saslow L, Uelmen S, Urbanski PB, Yancy WS. Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report. Diabetes Care 2019; 42:731-754. [PMID: 31000505 PMCID: PMC7011201 DOI: 10.2337/dci19-0014] [Citation(s) in RCA: 576] [Impact Index Per Article: 115.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Alison B Evert
- UW Neighborhood Clinics, UW Medicine, University of Washington, Seattle, WA
| | | | - Christopher D Gardner
- Stanford Diabetes Research Center and Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA
| | - W Timothy Garvey
- Diabetes Research Center, Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL
- Birmingham Veterans Affairs Medical Center, Birmingham, AL
| | | | | | - Joanna Mitri
- Section on Clinical, Behavioral and Outcomes Research Lipid Clinic, Adult Diabetes Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA
| | | | | | | | - Laura Saslow
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI
| | | | | | - William S Yancy
- Duke Diet and Fitness Center, Department of Medicine, Duke University Health System, Durham, NC
- Durham Veterans Affairs Medical Center, Durham, NC
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6
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Mason AE, Saslow L, Moran PJ, Kim S, Wali PK, Abousleiman H, Hartman A, Richler R, Schleicher S, Hartogensis W, Epel ES, Hecht F. Examining the Effects of Mindful Eating Training on Adherence to a Carbohydrate-Restricted Diet in Patients With Type 2 Diabetes (the DELISH Study): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e11002. [PMID: 30545813 PMCID: PMC6401674 DOI: 10.2196/11002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/30/2018] [Accepted: 09/19/2018] [Indexed: 01/03/2023] Open
Abstract
Background Diet patterns have a profound influence on glycemic control for individuals with type 2 diabetes mellitus (T2DM), and craving-related eating is an important obstacle to dietary adherence. A growing body of research suggests that carbohydrate-restricted (CR) diets can improve glycemic control and reduce medication dependence in T2DM. However, limited data speak to the effects of long-term adherence to CR diets. Mindful eating training has been shown to reduce craving-related eating in overweight populations but has yet to be examined as a behavioral support for dietary adherence in T2DM. This trial examines behavioral mechanisms, particularly craving-related eating, through which mindful eating training might improve adherence to CR dietary recommendations in T2DM. This will clarify the importance of focusing on craving-related eating in the optimization of dietary adherence interventions. Objective The aim of this trial is to determine whether providing training in mindful eating increases adherence to a CR dietary recommendation in T2DM. Methods We are randomizing 60 participants to receive a CR diet with or without mindful eating training (12-week group intervention) and are following participants for 12 weeks after intervention completion. We hypothesize that participants who receive mindful eating training (relative to those who do not) will demonstrate greater adherence to the CR diet. Results Our primary outcome is change in craving-related eating, as assessed using an ecological momentary assessment mobile phone–based platform. Secondary behavioral pathway outcomes include changes in stress-related eating, impulsivity, glycemic control, weight change, dietary adherence, and resumption of dietary adherence after dietary nonadherence. Conclusions This theory-driven trial will shed light on the impact of mindfulness training on mechanisms that may impact dietary adherence in T2DM. Trial Registration ClinicalTrials.gov NCT03207711; https://clinicaltrials.gov/ct2/show/NCT03207711 (Archived by WebCite at http://www.webcitation.org/73pXscwaU)
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Affiliation(s)
- Ashley E Mason
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States.,Center for Health and Community, Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
| | - Laura Saslow
- School of Nursing, Department of Health Behavior and Biological Sciences, University of Michigan, Ann Arbor, MI, United States
| | - Patricia J Moran
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Sarah Kim
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, San Francisco General Hospital, San Francisco, CA, United States
| | - Priyanka K Wali
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Hiba Abousleiman
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Alison Hartman
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Robert Richler
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | | | - Wendy Hartogensis
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Elissa S Epel
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States.,Center for Health and Community, Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
| | - Frederick Hecht
- UCSF Osher Center for Integrative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
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Saslow L, Mason AE, Kim S, Goldman V, Ploutz-Snyder R, Bayandorian H, Daubenmier J, Hecht FM, Moskowitz JT. Authors' Reply: Comment on "An Online Intervention Comparing a Very Low-Carbohydrate Ketogenic Diet and Lifestyle Recommendations Versus a Plate Method Diet in Overweight Individuals With Type 2 Diabetes: A Randomized Controlled Trial". J Med Internet Res 2018; 20:e181. [PMID: 29716886 PMCID: PMC5954229 DOI: 10.2196/jmir.8776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 08/18/2017] [Indexed: 12/25/2022] Open
Affiliation(s)
- Laura Saslow
- School of Nursing, Department of Health Behavior and Biological Sciences, University of Michigan, Ann Arbor, MI, United States
| | - Ashley E Mason
- University of California, San Francisco, San Francisco, CA, United States
| | - Sarah Kim
- University of California, San Francisco, San Francisco, CA, United States
| | - Veronica Goldman
- University of California, San Francisco, San Francisco, CA, United States
| | | | | | - Jennifer Daubenmier
- Institute of Holistic Health, Department of Health Education, San Francisco State University, San Francisco, CA, United States
| | - Frederick M Hecht
- University of California, San Francisco, San Francisco, CA, United States
| | - Judith T Moskowitz
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Cucuzzella MT, Tondt J, Dockter NE, Saslow L, Wood TR. A low-carbohydrate survey: Evidence for sustainable metabolic syndrome reversal. J insul resist 2017. [DOI: 10.4102/jir.v2i1.30] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background: Metabolic syndrome has become a significant problem, with the American Diabetes Association estimating the cost of diabetes and pre-diabetes in the United States alone to be $322 billion per year. Numerous clinical trials have demonstrated the efficacy of low-carbohydrate diets in reversing metabolic syndrome and its associated disorders.Aim: This study was designed to examine how voluntary adherents to a low-carbohydrate diet rate its effectiveness and sustainability using an online survey.Setting and methods: The 57-question survey was administered online and shared internationally via social media and ‘low-carb’ communities. Where appropriate, chi-squared tests and paired t-tests were used to analyse the responses.Results: There were 1580 respondents. The majority of respondents had consumed less than 100 g of carbohydrates per day for over a year, typically for reasons of weight loss or disease management. There was a reported decrease in waist circumference and weight with a simultaneous decrease in hunger and increase in energy level. Of those who provided laboratory values, the majority saw improvements in their HbA1c, blood glucose measurements, and lipid panel results. There was a reduction in usage of various medications, and 25% reported medication cost savings, with average monthly savings of $288 for those respondents. In particular, the usage of pain relievers and anti-inflammatories dropped with a simultaneous decreased rating of pain and increase in mobility.Conclusion: We conclude that low-carbohydrate diets are a sustainable method of metabolic syndrome reversal in a community setting.
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Feinman RD, Pogozelski WK, Astrup A, Bernstein RK, Fine EJ, Westman EC, Accurso A, Frassetto L, Gower BA, McFarlane SI, Nielsen JV, Krarup T, Saslow L, Roth KS, Vernon MC, Volek JS, Wilshire GB, Dahlqvist A, Sundberg R, Childers A, Morrison K, Manninen AH, Dashti HM, Wood RJ, Wortman J, Worm N. Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutrition 2014; 31:1-13. [PMID: 25287761 DOI: 10.1016/j.nut.2014.06.011] [Citation(s) in RCA: 479] [Impact Index Per Article: 47.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 06/28/2014] [Accepted: 06/28/2014] [Indexed: 12/16/2022]
Abstract
The inability of current recommendations to control the epidemic of diabetes, the specific failure of the prevailing low-fat diets to improve obesity, cardiovascular risk, or general health and the persistent reports of some serious side effects of commonly prescribed diabetic medications, in combination with the continued success of low-carbohydrate diets in the treatment of diabetes and metabolic syndrome without significant side effects, point to the need for a reappraisal of dietary guidelines. The benefits of carbohydrate restriction in diabetes are immediate and well documented. Concerns about the efficacy and safety are long term and conjectural rather than data driven. Dietary carbohydrate restriction reliably reduces high blood glucose, does not require weight loss (although is still best for weight loss), and leads to the reduction or elimination of medication. It has never shown side effects comparable with those seen in many drugs. Here we present 12 points of evidence supporting the use of low-carbohydrate diets as the first approach to treating type 2 diabetes and as the most effective adjunct to pharmacology in type 1. They represent the best-documented, least controversial results. The insistence on long-term randomized controlled trials as the only kind of data that will be accepted is without precedent in science. The seriousness of diabetes requires that we evaluate all of the evidence that is available. The 12 points are sufficiently compelling that we feel that the burden of proof rests with those who are opposed.
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Affiliation(s)
- Richard D Feinman
- Department of Cell Biology, State University of New York Downstate Medical Center, Brooklyn, New York, USA.
| | - Wendy K Pogozelski
- Department of Chemistry, State University of New York Geneseo, Geneseo, NY, USA
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, Copenhagen University, Denmark
| | | | - Eugene J Fine
- Department of Radiology (Nuclear Medicine), Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Anthony Accurso
- Department of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Lynda Frassetto
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Barbara A Gower
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Samy I McFarlane
- Departments of Medicine and Endocrinology, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | | | - Thure Krarup
- Department of Endocrinology I, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Laura Saslow
- University of California San Francisco, San Francisco, CA, USA
| | - Karl S Roth
- Department of Pediatrics, Creighton University, Omaha, NE, USA
| | | | - Jeff S Volek
- Department of Human Sciences (Kinesiology Program) Ohio State University, Columbus, OH, USA
| | | | | | | | | | | | | | - Hussain M Dashti
- Faculty of medicine, Department of Surgery, Kuwait university, Kuwait
| | | | - Jay Wortman
- First Nations Division, Vancouver, BC, Canada
| | - Nicolai Worm
- German University for Prevention and Health Care Management, Saarbrücken, Germany
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10
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McCoy SK, Wellman JD, Cosley B, Saslow L, Epel E. Is the Belief in Meritocracy Palliative for Members of Low Status Groups? Evidence for a Benefit for Self-Esteem and Physical Health via Perceived Control. Eur J Soc Psychol 2013; 43:307-318. [PMID: 24039310 DOI: 10.1002/ejsp.1959] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Consensually held ideologies may serve as the cultural "glue" that justifies hierarchical status differences in society (e.g. Augustinos, 1998). Yet to be effective these beliefs need to be embraced by low-status groups. Why would members of low-status groups endorse beliefs that justify their relative disadvantage? We propose that members of low-status groups in the United States may benefit from some system-justifying beliefs (such as the belief in meritocracy) to the extent that these beliefs emphasize the perception of control over future outcomes. In 2 studies, among women, lower-SES women, and women of color, we found a positive relationship between the belief in meritocracy and well-being (self-esteem and physical health) that was mediated by perceived control. Members of low-status groups may benefit from some system-justifying beliefs to the extent that these beliefs, like the belief in meritocracy, emphasize the perception of control over future outcomes.
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11
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Groesz LM, McCoy S, Carl J, Saslow L, Stewart J, Adler N, Laraia B, Epel E. What is eating you? Stress and the drive to eat. Appetite 2011; 58:717-21. [PMID: 22166677 DOI: 10.1016/j.appet.2011.11.028] [Citation(s) in RCA: 230] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Revised: 11/08/2011] [Accepted: 11/29/2011] [Indexed: 01/15/2023]
Abstract
Non-human animal studies demonstrate relationships between stress and selective intake of palatable food. In humans, exposure to laboratory stressors and self-reported stress are associated with greater food intake. Large studies have yet to examine chronic stress exposure and eating behavior. The current study assessed the relationship between stress (perceived and chronic), drive to eat, and reported food frequency intake (nutritious food vs. palatable non-nutritious food) in women ranging from normal weight to obese (N=457). Greater reported stress, both exposure and perception, was associated with indices of greater drive to eat-including feelings of disinhibited eating, binge eating, hunger, and more ineffective attempts to control eating (rigid restraint; r's from .11 to .36, p's<.05). These data suggest that stress exposure may lead to a stronger drive to eat and may be one factor promoting excessive weight gain. Relationships between stress and eating behavior are of importance to public health given the concurrent increase in reported stress and obesity rates.
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Affiliation(s)
- Lisa M Groesz
- UCSF, Department of Psychiatry, 3333 California St, San Francisco, CA 94118, USA.
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Saslow L. Nothing short of amazing. The nurses of Hackensack Medical Center. Revolution 1996; 6:24-5. [PMID: 9043396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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