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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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Mustafa S, Norman K, Kenealy T, Paul R, Murphy R, Lawrenson R, Chepulis L. Management of type 2 diabetes in New Zealand: a scoping review of interventions with measurable clinical outcomes. Public Health 2024; 234:1-15. [PMID: 38908052 DOI: 10.1016/j.puhe.2024.05.017] [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: 12/18/2023] [Revised: 04/28/2024] [Accepted: 05/15/2024] [Indexed: 06/24/2024]
Abstract
OBJECTIVE This review aimed to assess the effectiveness of interventions for type 2 diabetes (T2D) management in New Zealand on clinical outcomes, and explore the factors impacting their feasibility and acceptability. STUDY DESIGN Scoping review. METHODS Three databases (PubMed, Web of Science and Scopus) were searched between January 2000 and July 2023. Reference lists of included studies were hand searched to identify additional articles. RESULTS The search yielded 550 publications, of which 11 were included in the final review. Most interventions (n = 10) focussed on education and seven were delivered by health professionals. Supporting factors for interventions included clinical/peer support (n = 8) and whānau (family) involvement (n = 6). Hindering factors included non-adherence (n = 4) and high drop-out (n = 4). Most studies reported modest improvement in HbA1c and weight at six months, but minimal change in HbA1c, weight, lipids, renal profile, and blood pressure by two years. CONCLUSION Future interventions should involve culturally appropriate approaches to improve engagement and acceptability while addressing lifestyle and medication adherence for T2D management. T2D interventions not widely disseminated via academic channels need to be further identified.
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Affiliation(s)
- S Mustafa
- Medical Research Centre, Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand.
| | - K Norman
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - T Kenealy
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - R Paul
- Medical Research Centre, Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand; Te Whatu Ora Health New Zealand, Hamilton, New Zealand
| | - R Murphy
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - R Lawrenson
- Medical Research Centre, Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand; Te Whatu Ora Health New Zealand, Hamilton, New Zealand
| | - L Chepulis
- Medical Research Centre, Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand
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3
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Al‐Ibraheem AMT, Hameed AAZ, Marsool MDM, Jain H, Prajjwal P, Khazmi I, Nazzal RS, AL‐Najati HMH, Al‐Zuhairi BHYK, Razzaq M, Abd ZB, Marsool ADM, wahedaldin AI, Amir O. Exercise-Induced cytokines, diet, and inflammation and their role in adipose tissue metabolism. Health Sci Rep 2024; 7:e70034. [PMID: 39221051 PMCID: PMC11365580 DOI: 10.1002/hsr2.70034] [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: 11/12/2023] [Revised: 04/23/2024] [Accepted: 08/15/2024] [Indexed: 09/04/2024] Open
Abstract
Background Obesity poses a significant global health challenge, necessitating effective prevention and treatment strategies. Exercise and diet are recognized as pivotal interventions in combating obesity. This study reviews the literature concerning the impact of exercise-induced cytokines, dietary factors, and inflammation on adipose tissue metabolism, shedding light on potential pathways for therapeutic intervention. Methodology A comprehensive review of relevant literature was conducted to elucidate the role of exercise-induced cytokines, including interleukin-6 (IL-6), interleukin-15 (IL-15), brain-derived neurotrophic factor (BDNF), irisin, myostatin, fibroblast growth factor 21 (FGF21), follistatin (FST), and angiopoietin-like 4 (ANGPTL4), in adipose tissue metabolism. Various databases were systematically searched using predefined search terms to identify relevant studies. Articles selected for inclusion underwent thorough analysis to extract pertinent data on the mechanisms underlying the influence of these cytokines on adipose tissue metabolism. Results and Discussion Exercise-induced cytokines exert profound effects on adipose tissue metabolism, influencing energy expenditure (EE), thermogenesis, fat loss, and adipogenesis. For instance, IL-6 activates AMP-activated protein kinase (AMPK), promoting fatty acid oxidation and reducing lipogenesis. IL-15 upregulates peroxisome proliferator-activated receptor delta (PPARδ), stimulating fatty acid catabolism and suppressing lipogenesis. BDNF enhances AMPK-dependent fat oxidation, while irisin induces the browning of white adipose tissue (WAT), augmenting thermogenesis. Moreover, myostatin, FGF21, FST, and ANGPTL4 each play distinct roles in modulating adipose tissue metabolism, impacting factors such as fatty acid oxidation, adipogenesis, and lipid uptake. The elucidation of these pathways offers valuable insights into the complex interplay between exercise, cytokines, and adipose tissue metabolism, thereby informing the development of targeted obesity management strategies. Conclusion Understanding the mechanisms by which exercise-induced cytokines regulate adipose tissue metabolism is critical for devising effective obesity prevention and treatment modalities. Harnessing the therapeutic potential of exercise-induced cytokines, in conjunction with dietary interventions, holds promise for mitigating the global burden of obesity. Further research is warranted to delineate the precise mechanisms underlying the interactions between exercise, cytokines, and adipose tissue metabolism.
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Affiliation(s)
| | | | | | - Hritvik Jain
- All India Institute of Medical SciencesJodhpurIndia
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Mozaffari H, Madani Civi R, Askari M, Lee C, Wong E, Wong C, Conklin AI. The impact of food-based dietary strategies on achieving type 2 diabetes remission: A systematic review. Diabetes Metab Syndr 2024; 18:103096. [PMID: 39163706 DOI: 10.1016/j.dsx.2024.103096] [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: 01/25/2024] [Revised: 07/27/2024] [Accepted: 08/03/2024] [Indexed: 08/22/2024]
Abstract
OBJECTIVE Conventional wisdom once asserted that diabetes was irreversible. However, contemporary research indicates that dietary changes may contribute to achieving diabetes remission in persons with type 2 diabetes (T2D). We aimed to determine the effectiveness of food-based dietary approaches for T2D remission. METHODS We systematically searched Medline, EMBASE, and Web of Science, along with exploring grey literature, to identify longitudinal studies. Data extraction and quality assessment adhered to predetermined criteria, and the results of the included studies were analyzed using a narrative synthesis and graphical display. RESULTS We included 52 original studies-40 % were rated as low-risk of bias. Overall, studies showed the low-carbohydrate Mediterranean diet (LCMD), compared to a low-fat diet, was more effective for achieving T2D remission in newly diagnosed patients who also had a weight loss of up to 6 kg. Compared to both the traditional Mediterranean diet and the American Diabetic Association diet, the LCMD was also more effective at diabetes remission for persons with T2D with any duration of diabetes; however, more substantial weight loss of 8 kg was required. Other diets that appeared effective for T2D remission included low-calorie diets and diets high in plant protein sources. Less weight loss was needed to achieve remission on plant-based diets than a low-calorie diet and low-carbohydrate diet. CONCLUSIONS Diets high in plant protein sources may support T2D remission, particularly among newly diagnosed patients. For patients with a duration of over 2 years, the combination of plant-based diets with greater weight loss should be considered to induce remission.
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Affiliation(s)
- Hadis Mozaffari
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, Canada
| | - Rana Madani Civi
- Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
| | - Mohammadreza Askari
- School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Clover Lee
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, Canada
| | - Emily Wong
- Faculty of Sciences, University of British Columbia, Vancouver, Canada
| | - Cheryl Wong
- Faculty of Arts, University of British Columbia, Vancouver, Canada
| | - Annalijn I Conklin
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, Canada; Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada; Centre for Advancing Health Outcomes (formerly CHÉOS), Providence Healthcare Research Institute, St. Paul's Hospital, Vancouver, Canada.
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5
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Sadler I, Bauer A, Kassam S. Dietary habits and self-reported health outcomes in a cross-sectional survey of health-conscious adults eating a plant-based diet. J Hum Nutr Diet 2024; 37:1061-1074. [PMID: 38798231 DOI: 10.1111/jhn.13321] [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: 11/22/2023] [Accepted: 05/07/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Given the growing popularity of plant-based diets, this study investigated the dietary habits and self-reported health outcomes of health-conscious adults consuming plant-based diets. METHODS A cross-sectional online survey (n = 315) was distributed to members of Plant-Based Health Professionals UK, a community interest company. Dietary intake was assessed through a food frequency questionnaire. Data were summarised descriptively. Dietary habits among respondents following a whole food plant-based (WFPB) and vegan diet were compared using hypothesis tests. RESULTS Respondents reported following a WFPB (61%), vegan (28%) and semi plant-based (11%) diet. Median time on current dietary pattern was 5 years. Daily or more frequent consumption was reported for the following foods: fruits 77%, berries 51%, green vegetables 48%, cruciferous vegetables 45%, other vegetables 64%, beans/legumes 41%, whole grains 62%, nuts and all seeds 63%. Consumption of ultra-processed foods and plant-based meat alternatives was low. About 93% of those on a WFPB or vegan diet supplemented with vitamin B12 and 61% with vitamin D. The median body mass index was 22.4 kg/m2. Fifty per cent of participants reported weight loss after adopting a plant-based diet, with a median loss of 6.4 kg. Thirty-five per cent reported reversing or improving an underlying health condition, and 15% were able to stop or reduce prescribed medication use as a result of dietary changes. CONCLUSIONS This study suggests that a well-planned plant-based diet is achievable and sustainable in a community setting and can be associated with health benefits. How to best encourage such sustainable diets among the broad population requires further research.
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Affiliation(s)
| | - Alexander Bauer
- Statistical Consulting Unit StaBLab, Department of Statistics, LMU Munich, Germany
| | - Shireen Kassam
- King's College London, University of Winchester, Hampshire, UK
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6
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Bassin SR, Ferreira De Carvalho J, Gulati M. A Review of Plant-Based Diets for Obesity Management. Endocr Pract 2024; 30:779-789. [PMID: 38729570 DOI: 10.1016/j.eprac.2024.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/03/2024] [Accepted: 04/29/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE Obesity is the most prevalent chronic disease in the United States with over 70% of the American population suffering from overweight/obesity. Recently, the popularity of plant-based diets (PBDs) has grown, with individuals adopting these diets for ethical, health and environmental reasons. Our aim is to evaluate the effect of a PBD on weight loss among patients who are overweight or obese. METHODS A literature review of PBDs for the treatment of obesity was conducted using PubMed and Scopus. Our search yielded 27 intervention trials (3361 participants) and 6 metanalyses (9168 participants, 61 trials). RESULTS Among the intervention trials evaluated, 75% showed a significant increase in weight loss or decrease in weight in the intervention group, on average -5.0 kg (range -1.8 to -12.1 kg). Other outcomes included energy intake (-420 Kcal/d), systolic blood pressure (-3.78 mmHg), fasting plasma glucose (-2.0 mmol/L), hemoglobin A1c (-0.5%, -3.4 mmol/L), total cholesterol (-0.40 mmol/L), low-density lipoprotein (-0.38 mmol/L), triglyceride levels (+0.13 mmol/L), and fiber intake (+10.8 g/d). The 6 meta-analyses showed weight loss (average -2.9 kg, range -2.02 kg to -4.1 kg), body mass index reduction, and improvements in hemoglobin A1c, low-density lipoprotein, and total cholesterol. CONCLUSION PBDs result in significant weight loss and improve metabolic outcomes. PBDs offer a sustainable approach to long-term weight loss maintenance. Health care providers should encourage open discussions with their patients regarding their dietary habits to assist them in setting feasible lifestyle goals and consider shared medical appointments to support patients in transitioning to PBDs.
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Affiliation(s)
- Sandhya Rao Bassin
- Department of Endocrine, Diabetes, and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, New York.
| | | | - Mahima Gulati
- Department of Medical Sciences, Frank H. Netter MD School of Medicine, Quinnipiac University, Hamden, Connecticut
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7
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Pandey M, AlQassab O, Kanthajan T, Parikh A, Francis AJ, Sreenivasan C, Nwosu M. Effectiveness of High-Fiber, Plant-Based Diets in Reducing Cardiovascular Risk Factors Among Middle-Aged and Older Adults: A Systematic Review. Cureus 2024; 16:e67660. [PMID: 39314563 PMCID: PMC11419598 DOI: 10.7759/cureus.67660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Accepted: 08/24/2024] [Indexed: 09/25/2024] Open
Abstract
Cardiovascular disease (CVD) is a prominent contributor to morbidity and mortality, particularly in the middle-aged and elderly population. Plant-based, high-fiber diets high in fruits, vegetables, whole grains, legumes, and nuts can significantly lower CVD risk factors. This systematic review aims to assess how effectively diet improves cardiovascular health in this demographic. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, we thoroughly searched PubMed, Google Scholar, ScienceDirect, Cochrane Library, and ClinicalTrials.gov, explicitly focusing on papers published in English. The review identified 10 pertinent papers, including three systematic reviews, one randomized-controlled trial (RCT), two observational studies, and four review articles demonstrating significant improvements in blood pressure, cholesterol levels, and glycemic management associated with high-fiber plant-based diets (PBDs). The research specifically emphasized the significance of dietary fiber in decreasing low-density lipoprotein (LDL) cholesterol, enhancing insulin sensitivity, and reducing systemic inflammation. These data support the concept that PBDs high in fiber can effectively lower CVD risk factors. However, limitations such as self-reported dietary intake and variability in adherence were noted. In conclusion, high-fiber PBDs are a viable strategy for managing and preventing CVD in middle-aged and older adults. Future research should focus on long-term adherence, the comparative benefits of different plant-based foods, and developing personalized dietary recommendations to optimize cardiovascular health outcomes in this population.
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Affiliation(s)
- Manorama Pandey
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Osamah AlQassab
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Tatchaya Kanthajan
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Aneri Parikh
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Aida J Francis
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Chithra Sreenivasan
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Marcellina Nwosu
- Clinical Research, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
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Lu Y, Zhang Y, Wang S. From Palm to Plate: Unveiling the Potential of Coconut as a Plant-Based Food Alternative. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2024; 72:15058-15076. [PMID: 38920018 DOI: 10.1021/acs.jafc.3c09838] [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: 06/27/2024]
Abstract
This review investigates coconut as a sustainable and nutrient-rich plant-based alternative to traditional animal-based food sources. We have explored the nutritional profile, culinary versatility, particularly focusing on the use of coconut meat, milk, cream, and oil in diverse dietary contexts when consumed in balance. Comparative analysis with animal-derived products reveals the high content of medium-chain triglycerides (MCTs), essential vitamins, and minerals in coconut, contrasted with its lower protein content. Researchers have underscored the environmental sustainability of coconut, advocating for its role in eco-friendly food production chains. We have also addressed challenges like potential allergies, nutritional balance, sensory attributes, and consumer motivations for coconut-based products, in terms of understanding the market dynamics. In conclusion, this review positions coconut as a promising candidate within sustainable diet frameworks, advocating for further research to augment its nutritional value, sensory characteristics, and product stability, thereby facilitating its integration into health-conscious and eco-centric dietary practices.
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Affiliation(s)
- Yingshuang Lu
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300071, China
| | - Yan Zhang
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300071, China
| | - Shuo Wang
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300071, China
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Campbell EK, Campbell TM, Culakova E, Blanchard L, Wixom N, Guido JJ, Fetten J, Huston A, Shayne M, Janelsins MC, Mustian KM, Moore RG, Peppone LJ. A whole food, plant-based randomized controlled trial in metastatic breast cancer: feasibility, nutrient, and patient-reported outcomes. Breast Cancer Res Treat 2024; 206:273-283. [PMID: 38553649 PMCID: PMC11182786 DOI: 10.1007/s10549-024-07284-z] [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: 10/10/2023] [Accepted: 02/07/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE Quality of life (QOL) is among the most important outcomes for women with metastatic breast cancer (MBC), and it predicts survival. QOL is negatively impacted by cognitive impairment, fatigue, and weight gain. We assessed whether a whole food, plant-based (WFPB) diet-promoting weight loss is feasible and might improve QOL. METHODS Women with MBC on stable systemic treatments were randomized 2:1 to 1) WFPB dietary intervention (n = 21) or 2) usual care (n = 11) for 8 weeks. Participants attended weekly education visits and consumed an ad libitum WFPB diet (3 prepared meals/day provided). Patient-reported outcomes and 3-day food records were assessed at baseline and 8 weeks. The effects of WFPB diet on changes in outcomes were assessed by analysis of covariance model controlling for baseline. RESULTS 20 intervention and 10 control participants completed the trial. Intervention participants were highly adherent to the WFPB diet (94.3 % total calories on-plan). Intervention group nutrient intakes changed significantly including dietary fat (35.8 % to 20.4 % percent calories from fat, p < 0.001) and fiber content (12.7 to 30.8 g fiber/1000 kcal, p < 0.001). Perceived cognitive function (FACT-Cog total + 16.1; 95 % confidence interval [CI] = 0.8-31.7; p = 0.040) and emotional well-being (FACT-B emotional well-being subscale + 2.3; CI = 0.5-4.1; p = 0.016) improved in the WFPB versus the control group. Fatigue, measured by the BFI, improved within the WFPB group for fatigue severity (M = 4.7 ± 2.5[SD] to 3.7 ± 2.3, p = 0.047) and fatigue at its worst (5.8 ± 2.8 to 4.4 ± 2.4, p = 0.011). CONCLUSIONS Significant dietary changes in this population are feasible and may improve QOL by improving treatment-related symptoms. Additional study is warranted. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03045289. Registered 7 February 2017.
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Affiliation(s)
- Erin K Campbell
- Department of Public Health Sciences, University of Rochester Medical Center, 265 Crittenden Blvd, Rochester, NY, 14642, USA.
| | - Thomas M Campbell
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Eva Culakova
- Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA
| | - Lisa Blanchard
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Nellie Wixom
- Clinical Research Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Joseph J Guido
- Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA
| | - James Fetten
- Memorial Sloan Kettering Cancer Center, Westchester, NY, USA
| | - Alissa Huston
- Department of Medicine, Hematology/Oncology, University of Rochester Medical Center, Rochester, NY, USA
| | - Michelle Shayne
- Department of Medicine, Hematology/Oncology, University of Rochester Medical Center, Rochester, NY, USA
| | - Michelle C Janelsins
- Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA
| | - Karen M Mustian
- Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA
| | - Richard G Moore
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA
| | - Luke J Peppone
- Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA
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Bayindir Gümüş A, Keser A, Gökgöz M, Güngüneş A. Glycaemic index and glycaemic load of selected packaged vegan foods. NUTR BULL 2024. [PMID: 38940372 DOI: 10.1111/nbu.12692] [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: 07/23/2023] [Revised: 05/22/2024] [Accepted: 06/03/2024] [Indexed: 06/29/2024]
Abstract
While there are data regarding the glycaemic index (GI) and glycaemic load (GL) of many foods in the literature, the values for packaged vegan analogue foods have not been previously published, although processed vegan foods usually contain more carbohydrates than their animal-based counterparts. This study was carried out to determine the GI and GL values of a selection of packaged vegan foods popular in Türkiye. To determine the GI and GL of test foods, 12 healthy volunteer females participated in the study. Participants randomly consumed test and reference foods (glucose and white bread) on each trial day, and capillary blood glucose was measured at baseline, 15, 30, 45, 60, 90 and 120 mins in duplicate. The GIs of vegan schnitzel, vegan chickpea burger, vegan mince pita, vegan chocolate, vegan snack bar and vegan cheese were 26.1 ± 19.61 (low), 27.1 ± 17.21 (low), 65.1 ± 28.60 (moderate), 42.7 ± 22.32 (low), 63.6 ± 45.86 (moderate), 36.4 ± 16.85 (low), respectively, according to the glucose reference, and were 28.2 ± 16.17 (low), 34.7 ± 18.26 (low), 81.2 ± 31.96 (high), 48.8 ± 12.87 (low), 82.0 ± 54.05 (high), 46.7 ± 28.66 (low), respectively, according to the white bread reference. GLs were 3.5 ± 2.66 (low), 8.6 ± 5.46 (low), 26.6 ± 11.67 (high), 6.1 ± 3.19 (low), 14.2 ± 10.28 (moderate), 5.7 ± 2.63 (low), respectively, according to the glucose reference, and were 3.8 ± 2.19 (low), 11.0 ± 5.80 (moderate), 33.1 ± 13.04 (high), 7.0 ± 1.84 (low), 18.4 ± 12.12 (moderate), 7.3 ± 4.47 (low), respectively, according to the white bread reference. The data from this study provide preliminary data for the GIs and GLs of packaged and processed vegan foods and show that the GIs and GLs of meat and cheese vegan analogues, while still low or moderate, tend to be higher than their animal-based counterparts which have lower or no glycaemic responses. Further research on the GIs and GLs of more vegan foods is needed.
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Affiliation(s)
- Aylin Bayindir Gümüş
- First and Emergency Aid Program, Vocational School of Health Services, Kırıkkale University, Kırıkkale, Turkey
| | - Alev Keser
- Department of Nutrition and Dietetics, Ankara University Faculty of Health Sciences, Ankara, Turkey
| | - Murat Gökgöz
- Department of Nutrition and Dietetics, Kırıkkale University Faculty of Health Sciences, Kırıkkale, Turkey
| | - Aşkın Güngüneş
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey
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11
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Del Carmen Fernández-Fígares Jiménez M. Plant foods, healthy plant-based diets, and type 2 diabetes: a review of the evidence. Nutr Rev 2024; 82:929-948. [PMID: 37550262 DOI: 10.1093/nutrit/nuad099] [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: 08/09/2023] Open
Abstract
Type 2 diabetes (T2D) is a metabolic chronic disease in which insulin resistance and insufficient insulin production lead to elevated blood glucose levels. The prevalence of T2D is growing worldwide, mainly due to obesity and the adoption of Western diets. Replacing animal foods with healthy plant foods is associated with a lower risk of T2D in prospective studies. In randomized controlled trials, the consumption of healthy plant foods in place of animal foods led to cardiometabolic improvements in patients with T2D or who were at high risk of the disease. Dietary patterns that limit or exclude animal foods and focus on healthy plant foods (eg, fruits, vegetables, whole grains, nuts, legumes), known as healthy, plant-based diets, are consistently associated with a lower risk of T2D in cohort studies. The aim of this review is to examine the differential effects of plant foods and animal foods on T2D risk and to describe the existing literature about the role of healthy, plant-based diets, particularly healthy vegan diets, in T2D prevention and management. The evidence from cohort studies and randomized controlled trials will be reported, in addition to the potential biological mechanisms that seem to be involved.
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12
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Campbell TM, Campbell EK, Culakova E, Blanchard LM, Wixom N, Guido JJ, Fetten J, Huston A, Shayne M, Janelsins MC, Mustian KM, Moore RG, Peppone LJ. A whole-food, plant-based randomized controlled trial in metastatic breast cancer: weight, cardiometabolic, and hormonal outcomes. Breast Cancer Res Treat 2024; 205:257-266. [PMID: 38446316 PMCID: PMC11101531 DOI: 10.1007/s10549-024-07266-1] [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: 10/11/2023] [Accepted: 01/19/2024] [Indexed: 03/07/2024]
Abstract
PURPOSE Breast cancer treatment is associated with weight gain, and obesity and its related cardiometabolic and hormonal risk factors have been associated with poorer outcomes. Dietary intervention may address these risk factors, but limited research has been done in the setting of metastatic breast cancer requiring systemic therapy. METHODS Women with metastatic breast cancer on stable treatment were randomized 2:1 to an 8-week intervention (n = 21) or control (n = 11). The intervention included weekly assessment visits and an ad libitum whole-food, plant-based (WFPB) diet with provided meals. Cardiometabolic, hormonal, and cancer markers were assessed at baseline, 4 weeks, and 8 weeks. RESULTS Within the intervention group, mean weight decreased by 6.6% (p < 0.01) after 8 weeks. Fasting insulin decreased from 16.8 uIU/L to 11.2 uIU/L (p < 0.01), concurrent with significantly reduced insulin resistance. Total cholesterol decreased from 193.6 mg/dL to 159 mg/dL (p < 0.01), and low-density lipoprotein (LDL) cholesterol decreased from 104.6 mg/dL to 82.2 mg/dL (p < 0.01). Total testosterone was unchanged, but free testosterone trended lower within the intervention group (p = 0.08) as sex hormone binding globulin increased from 74.3 nmol/L to 98.2 nmol/L (p < 0.01). There were no significant differences in cancer progression markers at week 8, although mean CA 15-3, CA 27.29, and CEA were lower in the intervention group (p = 0.53, p = 0.23, and p = 0.54, respectively) compared to control, when adjusted for baseline. CONCLUSION WFPB dietary changes during treatment for metastatic breast cancer are well tolerated and significantly improve weight, cardiometabolic and hormonal parameters. Longer studies are warranted to assess the durability of changes. Trial registration First registered at Clinicaltrials.gov (NCT03045289) on February 7, 2017.
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Affiliation(s)
- Thomas M Campbell
- Department of Family Medicine, University of Rochester Medical Center, 777 South Clinton Ave, Rochester, NY, 14620, USA.
| | - Erin K Campbell
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Eva Culakova
- Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA
| | - Lisa M Blanchard
- Department of Family Medicine, University of Rochester Medical Center, 777 South Clinton Ave, Rochester, NY, 14620, USA
| | - Nellie Wixom
- Clinical Research Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Joseph J Guido
- Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA
| | - James Fetten
- Memorial Sloan Kettering Cancer Center, Westchester, NY, USA
| | - Alissa Huston
- Department of Medicine, Hematology/Oncology, University of Rochester Medical Center, Rochester, NY, USA
| | - Michelle Shayne
- Department of Medicine, Hematology/Oncology, University of Rochester Medical Center, Rochester, NY, USA
| | - Michelle C Janelsins
- Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA
| | - Karen M Mustian
- Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA
| | - Richard G Moore
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA
| | - Luke J Peppone
- Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA
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Şahin Bayram S. A Narrative Review of the Significance of Popular Diets in Diabetes Mellitus Management. Cureus 2024; 16:e61045. [PMID: 38800782 PMCID: PMC11127507 DOI: 10.7759/cureus.61045] [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: 05/25/2024] [Indexed: 05/29/2024] Open
Abstract
Diabetes mellitus is a collection of metabolic disorders marked by elevated levels of glucose in the blood due to irregularities in the generation or functioning of insulin. Medical nutrition therapy and weight loss are crucial elements in the management of diabetes and the prevention of complications. Several diets have become popular over time for the goal of achieving weight loss, but their popularity has declined due to a lack of reliable scientific evidence. This study classifies popular diets into three categories: diets that manage the composition of macronutrients, diets that restrict specific foods or food groups, and diets that manipulate meal timing. The review includes research studies that investigated the effects of popular diets on the prevention, management, and complications of diabetes. It is clear that different popular diets can have positive effects on both preventing and treating diabetes and preventing and treating complications related to diabetes. However, it is not practical to determine which diet is the most effective option for preventing or controlling diabetes. Thus, the main focus should be on common underlying factors that support well-being, such as decreasing the intake of refined grains and added sugar, choosing non-starchy vegetables, and giving priority to whole foods over processed foods whenever possible, until there is stronger evidence supporting the specific benefits of different dietary patterns.
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14
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Albert SL, Massar RE, Kwok L, Correa L, Polito-Moller K, Joshi S, Shah S, McMacken M. Pilot Plant-Based Lifestyle Medicine Program in an Urban Public Healthcare System: Evaluating Demand and Implementation. Am J Lifestyle Med 2024; 18:403-419. [PMID: 38737881 PMCID: PMC11082870 DOI: 10.1177/15598276221113507] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
Lifestyle interventions that optimize nutrition, physical activity, sleep health, social connections, and stress management, and address substance use, can reduce cardiometabolic risk. Despite substantial evidence that healthful plant-based diets are beneficial for long-term cardiometabolic health and longevity, uncertainty lies in how to implement plant-based lifestyle programs in traditional clinical settings, especially in safety-net contexts with finite resources. In this mixed-methods implementation evaluation of the Plant-Based Lifestyle Medicine Program piloted in a large public healthcare system, we surveyed participants and conducted qualitative interviews and focus groups with stakeholders to assess program demand in the eligible population and feasibility of implementation within the safety-net setting. Program demand was high and exceeded capacity. Participants' main motivations for joining the program included gaining more control over life, reducing medication, and losing weight. The program team, approach, and resources were successful facilitators. However, the program faced administrative and payor-related challenges within the safety-net setting, and participants reported barriers to access. Stakeholders found the program to be valuable, despite challenges in program delivery and access. Findings provide guidance for replication. Future research should focus on randomized controlled trials to assess clinical outcomes as a result of program participation.
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Affiliation(s)
- Stephanie L. Albert
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA (SLA, REM, LK); Department of Medicine, NYC Health + Hospitals/Bellevue, New York, NY, USA (LC, KP, SJ, SS, MM); Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA (SJ, SS, MM); and Office of Ambulatory Care and Population Health, NYC Health + Hospitals, New York, NY, USA (MM)
| | - Rachel E. Massar
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA (SLA, REM, LK); Department of Medicine, NYC Health + Hospitals/Bellevue, New York, NY, USA (LC, KP, SJ, SS, MM); Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA (SJ, SS, MM); and Office of Ambulatory Care and Population Health, NYC Health + Hospitals, New York, NY, USA (MM)
| | - Lorraine Kwok
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA (SLA, REM, LK); Department of Medicine, NYC Health + Hospitals/Bellevue, New York, NY, USA (LC, KP, SJ, SS, MM); Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA (SJ, SS, MM); and Office of Ambulatory Care and Population Health, NYC Health + Hospitals, New York, NY, USA (MM)
| | - Lilian Correa
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA (SLA, REM, LK); Department of Medicine, NYC Health + Hospitals/Bellevue, New York, NY, USA (LC, KP, SJ, SS, MM); Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA (SJ, SS, MM); and Office of Ambulatory Care and Population Health, NYC Health + Hospitals, New York, NY, USA (MM)
| | - Krisann Polito-Moller
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA (SLA, REM, LK); Department of Medicine, NYC Health + Hospitals/Bellevue, New York, NY, USA (LC, KP, SJ, SS, MM); Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA (SJ, SS, MM); and Office of Ambulatory Care and Population Health, NYC Health + Hospitals, New York, NY, USA (MM)
| | - Shivam Joshi
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA (SLA, REM, LK); Department of Medicine, NYC Health + Hospitals/Bellevue, New York, NY, USA (LC, KP, SJ, SS, MM); Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA (SJ, SS, MM); and Office of Ambulatory Care and Population Health, NYC Health + Hospitals, New York, NY, USA (MM)
| | - Sapana Shah
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA (SLA, REM, LK); Department of Medicine, NYC Health + Hospitals/Bellevue, New York, NY, USA (LC, KP, SJ, SS, MM); Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA (SJ, SS, MM); and Office of Ambulatory Care and Population Health, NYC Health + Hospitals, New York, NY, USA (MM)
| | - Michelle McMacken
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA (SLA, REM, LK); Department of Medicine, NYC Health + Hospitals/Bellevue, New York, NY, USA (LC, KP, SJ, SS, MM); Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA (SJ, SS, MM); and Office of Ambulatory Care and Population Health, NYC Health + Hospitals, New York, NY, USA (MM)
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Wagenaar CA, Toonstra A, Walrabenstein W, van Schaardenburg D, van Nassau F. How the Plants for Joints multidisciplinary lifestyle intervention achieved its effects: a mixed methods process evaluation. BMC Public Health 2024; 24:1034. [PMID: 38615001 PMCID: PMC11016213 DOI: 10.1186/s12889-024-18554-2] [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: 10/02/2023] [Accepted: 04/08/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Plants for Joints (PFJ) is a multidisciplinary intervention centered around a whole-food plant-based diet, physical activity, and sleep and stress management. The PFJ intervention successfully improved disease activity and symptoms in people with rheumatoid arthritis (RA) or osteoarthritis (OA), respectively, and metabolic health. To investigate how these effects were achieved a mixed methods process evaluation was conducted to understand the context, implementation, and mechanism of impact of the PFJ intervention. Also, the relationship between degree of implementation and lifestyle changes was explored. METHODS Quantitative and qualitative data were collected across the evaluation domains context (i.e. reach), implementation (i.e. recruitment and delivery), and mechanism of impact (i.e. responsiveness) of both the participants and coaches (incl. dietitians, sport coaches) according to the UK MRC guidelines for process evaluations. Data was collected from the participants via focus groups and questionnaires after the intervention, and interviews with coaches. Qualitative data were analyzed thematically, and quantitative data were assessed with descriptive statistics and linear regression analyses. Degree of implementation was quantified using a theory-driven implementation index score composed of different process evaluation constructs. RESULTS Of the 155 participants who participated in the PFJ intervention, 106 (68%) took part in the questionnaire and 34 (22%) attended a focus group. Participants felt the intervention was complete, coherent, and would recommend the intervention to others (mean score 9.2 (SD 1.4) out of 10). Participants felt heard and empowered to take control of their lifestyle and health outcomes. Components perceived as most useful were self-monitoring, social support, practical and theoretical information, and (individual) guidance by the multidisciplinary team. Participants perceived the intervention as feasible, and many indicated it effectively improved their health outcomes. In an explorative analysis there was no significant difference in healthy lifestyle changes across implementation index score groups. CONCLUSION This process evaluation offers important insights into why the PFJ intervention works and how the intervention can be optimized for future implementation. Results indicating the intervention's high satisfaction, feasibility, and perceived effectiveness, further support the use of plant-based lifestyle interventions as an additional treatment option for patients with RA, OA, or other chronic diseases. TRIAL REGISTRATION International Clinical Trial Registry Platform numbers: NL7800, NL7801, and NL7802, all registered 17-06-2019.
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Affiliation(s)
- Carlijn A Wagenaar
- Reade Center for Rheumtology and Rehabilitation, Amsterdam, The Netherlands.
- Department of Clinical Immunology and Rheumatology, Amsterdam University Medical Centers, Universiteit van Amsterdam, Amsterdam, The Netherlands.
- Amsterdam Rheumatology and Immunology Center, Amsterdam, The Netherlands.
| | - Alie Toonstra
- Reade Center for Rheumtology and Rehabilitation, Amsterdam, The Netherlands
| | | | - Dirkjan van Schaardenburg
- Reade Center for Rheumtology and Rehabilitation, Amsterdam, The Netherlands
- Department of Clinical Immunology and Rheumatology, Amsterdam University Medical Centers, Universiteit van Amsterdam, Amsterdam, The Netherlands
- Amsterdam Rheumatology and Immunology Center, Amsterdam, The Netherlands
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Goldman DM, Warbeck CB, Karlsen MC. Completely Plant-Based Diets That Meet Energy Requirements for Resistance Training Can Supply Enough Protein and Leucine to Maximize Hypertrophy and Strength in Male Bodybuilders: A Modeling Study. Nutrients 2024; 16:1122. [PMID: 38674813 PMCID: PMC11054926 DOI: 10.3390/nu16081122] [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: 03/03/2024] [Revised: 03/28/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Despite increasing awareness of plant-based diets for health and athletic performance, athletes are cautioned that careful dietary monitoring is necessary. Whether commonly consumed plant-based diets are nutritionally adequate for maximal muscular hypertrophy remains unknown. This modeling study assessed the nutrient composition of completely plant-based diets scaled to the caloric demands of maximal muscle mass and strength development in adult male bodybuilders. To model calorie requirements, anthropometric data from bodybuilders were input into the Tinsley resting metabolic rate prediction equation, and an appropriate physical activity factor and calorie surplus were applied. Dietary data from a large cohort following completely plant-based diets were then scaled to meet these needs. Modeled intakes for nutrients of interest were calculated as 1.8 g/kg/day of protein and 2.75 g/meal of leucine, which surpass mean requirements for maximal increases in muscle mass and strength and muscle protein synthesis, respectively. Daily levels for all micronutrients, except vitamin D, also exceeded requirements. Saturated fat levels were aligned with dietary guidelines, although sodium levels exceeded recommended limits. Consumption of larger portions of commonplace plant-based diets, scaled to meet the energy demands of maximal accrual of muscle mass and strength, satisfied protein and leucine requirements without the need for additional planning.
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Affiliation(s)
- David M. Goldman
- Department of Public Health, University of Helsinki, 00014 Helsinki, Finland
- Department of Research and Development, Metabite Inc., New York, NY 10036, USA
| | - Cassandra B. Warbeck
- Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - Micaela C. Karlsen
- Department of Research, American College of Lifestyle Medicine, Chesterfield, MO 63006, USA;
- Departments of Applied Nutrition and Global Public Health, Adjunct Faculty, University of New England, Biddeford, ME 04005, USA
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17
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Wang X, Yin Z, Yang Y, Fu X, Guo C, Pu K, Zang S. Association of plant-based dietary patterns with depression and anxiety symptoms in Chinese older adults: A nationwide study. J Affect Disord 2024; 350:838-846. [PMID: 38278327 DOI: 10.1016/j.jad.2024.01.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/26/2023] [Accepted: 01/14/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND The associations of plant-based dietary patterns with depression and anxiety symptoms among older adults have not been extensively studied. Therefore, the purpose of this study was to examine these associations in Chinese older adults. METHODS Data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) was employed in the present study. The simplified food frequency questionnaire was used to assess the overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). The Center for Epidemiologic Studies Depression Scale-10 (CES-D-10) was used to evaluate depression symptoms, and the Generalized Anxiety Disorder Scale-7 (GAD-7) was used to assess anxiety symptoms. This study employed logistic regression and linear regression to examine the associations between plant-based dietary patterns and symptoms of depression and anxiety. RESULTS This study included 11,971 older adults, with a mean age of 83.23 ± 11.10 years. The results indicated that PDI and hPDI were negative associated with depression symptoms (adjusted β -0.09, 95 % CI -0.11, -0.07) (adjusted β -0.09, 95 % CI -0.11, -0.07) and anxiety symptoms (adjusted β -0.03, 95 % CI -0.04, -0.02) (adjusted β -0.04, 95 % CI -0.05, -0.02), while uPDI was positive associated with depression symptoms (adjusted β 0.09, 95 % CI 0.07, 0.11) and anxiety symptoms (adjusted β 0.04, 95 % CI 0.03, 0.05). CONCLUSIONS The findings from this study have the potential to promote healthy dietary patterns in older adults, and may have implications for the prevention and management of depression and anxiety in this population.
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Affiliation(s)
- Xue Wang
- Department of Community Nursing, School of Nursing, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Zhihua Yin
- Department of Epidemiology, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Ying Yang
- Library of China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Xiao Fu
- Department of Gastroenterology, Qingdao Huangdao District Central Hospital, No. 9 Huangpujiang Road, Huangdao District, Qingdao, Shandong Province 266555, China
| | - Chaowei Guo
- Department of Community Nursing, School of Nursing, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Keping Pu
- Department of Community Nursing, School of Nursing, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Shuang Zang
- Department of Community Nursing, School of Nursing, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China.
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Ames ML, Karlsen MC, Sundermeir SM, Durrwachter N, Hemmingson TA, Reznar MM, Staffier KL, Weeks B, Gittelsohn J. Lifestyle Medicine Implementation in 8 Health Systems: Protocol for a Multiple Case Study Investigation. JMIR Res Protoc 2024; 13:e51562. [PMID: 38320320 DOI: 10.2196/51562] [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: 08/03/2023] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Lifestyle medicine (LM) is the use of therapeutic lifestyle changes (including a whole-food, plant-predominant eating pattern; regular physical activity; restorative sleep; stress management; avoidance of risky substances; and positive social connection) to prevent and treat chronic illness. Despite growing evidence, LM is still not widely implemented in health care settings. Potential challenges to LM implementation include lack of clinician training, staffing concerns, and misalignment of LM services with fee-for-service reimbursement, but the full range of factors facilitating or obstructing its implementation and long-term success are not yet understood. To learn important lessons for success and failure, it is crucial to understand the experiences of different LM programs. OBJECTIVE This study aims to describe in depth the protocol used to identify barriers and facilitators impacting the implementation of LM in health systems. METHODS The study team comprises team members at the American College of Lifestyle Medicine (ACLM), including staff and researchers with expertise in public health, LM, and qualitative research. We recruited health systems that were members of the ACLM Health Systems Council. From among 15 self-nominating health systems, we selected 7 to represent a diversity of geographic location, type, size, expertise, funding, patients, and LM services. Partway through the study, we recruited 1 additional contrasting health system to serve as a negative case. For each case, we conducted in-depth interviews, document reviews, site visits (limited due to the COVID-19 pandemic), and study team debriefs. Interviews lasted 45-90 minutes and followed a semistructured interview guide, loosely based on the Consolidated Framework for Implementation Research (CFIR) model. We are constructing detailed case narrative reports for each health system that are subsequently used in cross-case analyses to develop a contextually rich and detailed understanding of various predetermined and emergent topics. Cross-case analyses will draw on a variety of methodologies, including in-depth case familiarization, inductive or deductive coding, and thematic analysis, to identify cross-cutting themes. RESULTS The study team has completed data collection for all 8 participating health systems, including 68 interviews and 1 site visit. We are currently drafting descriptive case narratives, which will be disseminated to participating health systems for member checking and shared broadly as applied vignettes. We are also conducting cross-case analyses to identify critical facilitators and barriers, explore clinician training strategies to facilitate LM implementation, and develop an explanatory model connecting practitioner adoption of LM and experiences of burnout. CONCLUSIONS This protocol paper offers real-world insights into research methods and practices to identify barriers and facilitators to the implementation of LM in health systems. Findings can advise LM implementation across various health system contexts. Methodological limitations and lessons learned can guide the execution of other studies with similar methodologies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51562.
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Affiliation(s)
- Meghan L Ames
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Micaela C Karlsen
- American College of Lifestyle Medicine, Chesterfield, MO, United States
| | - Samantha M Sundermeir
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Neve Durrwachter
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | | | - Melissa M Reznar
- School of Health Sciences, Oakland University, Rochester, MI, United States
| | | | - Bruce Weeks
- American College of Lifestyle Medicine, Chesterfield, MO, United States
| | - Joel Gittelsohn
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
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Chwyl C, Metzler AL, Nguyen JT, France M, Karbassi N, Turner-McGrievy G, Wright N, Forman EM. "Mindset Matters": Perseverance, a balanced approach and structured support as facilitators of whole foods plant-based adoption. Appetite 2024; 194:107163. [PMID: 38141878 DOI: 10.1016/j.appet.2023.107163] [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: 09/05/2023] [Revised: 12/09/2023] [Accepted: 12/11/2023] [Indexed: 12/25/2023]
Abstract
Whole foods plant-based diets (WFPBD) show potential for preventing and addressing chronic diseases. However, concerns exist about their acceptability and feasibility. Research on firsthand WFPBD adoption experiences is limited but crucial for promoting dietary change. In a 12-week remotely delivered lifestyle modification program using an ad libitum WFPBD, twenty weight-loss seeking adults (ages 18-75) with overweight or obesity completed self-report surveys and semi-structured interviews via Zoom. The study aimed to explore: (1) experiences with WFPBD adoption; (2) factors that helped or hindered adherence; and (3) perceived salient benefits. Interviews were analyzed inductively through a conventional content analysis, and associations between variables examined with correlational analyses. Participants overall reported WFPBD adoption being a positive, new experience, with an equal number (30%) finding it easy/easier than expected as challenging. Key cited challenges included overwhelm, different eating habits in the household, and meal preparation. Key cited facilitators included adopting an incremental approach to dietary change, persisting after setbacks, and having simple go-to meals. Greater self-compassion and family support, and less sabotage from friends and family corresponded to greater dietary change (rs > 0.45, ps < .05). Participants valued accountability, structure, human support, nutrition psychoeducation and recipes in the program. Three categories emerged regarding perceived benefits of following the WFPBD: physical health benefits, improvements to eating habits, and greater perceived control/agency over health. Results indicate that future interventions should include psychological strategies alongside nutrition education to enhance self-efficacy, address household barriers, and combat feelings of overwhelm through sufficient structure, support, and meal preparation guidance. Messaging around WFPBD may benefit from discussing prevailing positive experiences with adoption, common benefits experienced, and options for an incremental approach given that feasibility and acceptability concerns may deter efforts.
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Affiliation(s)
- Christina Chwyl
- Department of Psychological and Brain Sciences, Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, USA.
| | - Abigail L Metzler
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
| | - Jade T Nguyen
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA.
| | - Madelyn France
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Nikoo Karbassi
- Department of Psychological and Brain Sciences, Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, USA.
| | | | - Nicholas Wright
- Royal New Zealand College of General Practitioners, Gisborne, New Zealand.
| | - Evan M Forman
- Department of Psychological and Brain Sciences, Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, USA.
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Charles JA, Habibullah NK, Bautista S, Davis B, Joshi S, Hull SC. Planting the Seed for Blood Pressure Control: The Role of Plant-Based Nutrition in the Management of Hypertension. Curr Cardiol Rep 2024; 26:121-134. [PMID: 38526748 PMCID: PMC10990999 DOI: 10.1007/s11886-023-02008-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 03/27/2024]
Abstract
PURPOSE OF REVIEW Hypertension results in significant morbidity, mortality, and healthcare expenditures. Fortunately, it is largely preventable and treatable by implementing dietary interventions, though these remain underutilized. Here, we aim to explore the role of healthy dietary patterns in hypertension management and describe approaches for busy clinicians to address nutrition effectively and efficiently with patients. RECENT FINDINGS DASH, Mediterranean, vegetarian, and vegan diets that include minimally processed, plant-based foods as core elements have consistently shown positive effects on hypertension. Recommendations that distill the most healthful components of these diets can significantly impact patient outcomes. Clinicians can harness evidence-based dietary assessment and counseling tools to implement and support behavioral changes, even during brief office visits. Healthful plant-based dietary patterns can often effectively prevent and treat hypertension. Clinicians may help improve patient outcomes by discussing evidence-based nutrition with their patients. Future work to promote infrastructural change that supports incorporating evidence-based nutrition into medical education, clinical care, and society at large can support these efforts.
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Affiliation(s)
- Justin A Charles
- Department of Family Medicine and Public Health, UC San Diego Health, San Diego, CA, USA.
| | | | - Saul Bautista
- Ethos Farm to Health/Ethos Primary Care, Long Valley, NJ, USA
| | - Brenda Davis
- Brenda Davis, Nutrition Consultations, Calgary, AB, Canada
| | - Shivam Joshi
- Department of Veterans Affairs, Orlando, FL, USA
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Sarah C Hull
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
- Program for Biomedical Ethics, Yale School of Medicine, New Haven, CT, USA
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Campbell EK, Taillie L, Blanchard LM, Wixom N, Harrington DK, Peterson DR, Wittlin SD, Campbell TM. Post hoc analysis of food costs associated with Dietary Approaches to Stop Hypertension diet, whole food, plant-based diet, and typical baseline diet of individuals with insulin-treated type 2 diabetes mellitus in a nonrandomized crossover trial with meals provided. Am J Clin Nutr 2024; 119:769-778. [PMID: 38160802 DOI: 10.1016/j.ajcnut.2023.12.023] [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: 09/05/2023] [Revised: 11/28/2023] [Accepted: 12/28/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Americans consume diets that fall short of dietary recommendations, and the cost of healthier diets is often cited as a barrier to dietary change. We conducted a nonrandomized crossover trial with meals provided utilizing 2 diets: Dietary Approaches to Stop Hypertension (DASH) and whole food, plant-based (WFPB), and thus had intake data from baseline and both intervention diets. OBJECTIVES Using actual diet records, describe food costs of baseline diets of individuals with type 2 diabetes (T2DM) as well as therapeutic DASH and WFPB diets. METHODS Three-day food records were collected and analyzed for each 7-d diet phase: baseline, DASH, and WFPB. Nutrient content was analyzed using the Nutrient Data System for Research and cost was determined using Fillet, an application to manage menu pricing. Food costs were calculated for each diet as consumed and adjusted to a standardized 1800 kcal/d. Ingredient-only costs of food away from home (FAFH) were approximated and analyzed. Costs were analyzed using linear mixed-effect models as a function of diet. RESULTS Fifteen subjects enrolled; 12 completed all dietary phases. The baseline, DASH, and WFPB diets, as consumed, cost $15.72/d (95% CI; $13.91, $17.53), $12.74/d ($11.23, $14.25), and $9.78/d ($7.97, $11.59), respectively. When adjusted to an 1800 kcal/d intake, the baseline, DASH, and WFPB diets cost $15.69/d ($13.87, $17.52), $14.92/d ($13.59, $16.26), and $11.96/d ($10.14, $13.78), respectively. When approximated ingredient-only costs of FAFH were analyzed, as consumed baseline [$11.01 ($9.53, $12.49)] and DASH diets [$11.81 ($10.44, $13.18)] had similar costs; WFPB diet [$8.83 ($7.35, $10.31)] cost the least. CONCLUSIONS In this short-term study with meals provided, the food costs of plant-predominant diets offering substantial metabolic health benefits were less than or similar to baseline food costs of adults with insulin-treated T2DM. Longer-term data without meal provision are needed for more generalizable results. This trial was registered at clinicaltrials.gov as NCT04048642.
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Affiliation(s)
- Erin K Campbell
- Department of Public Health Sciences, University of Rochester Medical Center, NY, United States.
| | - Laurie Taillie
- Department of Family Medicine, University of Rochester Medical Center, NY, United States
| | - Lisa M Blanchard
- Department of Family Medicine, University of Rochester Medical Center, NY, United States
| | - Nellie Wixom
- Clinical Research Center, University of Rochester Medical Center, NY, United States
| | - Donald K Harrington
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, NY, United States
| | - Derick R Peterson
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, NY, United States
| | - Steven D Wittlin
- Division of Endocrinology, University of Rochester Medical Center, NY, United States
| | - Thomas M Campbell
- Department of Family Medicine, University of Rochester Medical Center, NY, United States
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22
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Grega ML, Shalz JT, Rosenfeld RM, Bidwell JH, Bonnet JP, Bowman D, Brown ML, Dwivedi ME, Ezinwa NM, Kelly JH, Mechley AR, Miller LA, Misquitta RK, Parkinson MD, Patel D, Patel PM, Studer KR, Karlsen MC. American College of Lifestyle Medicine Expert Consensus Statement: Lifestyle Medicine for Optimal Outcomes in Primary Care. Am J Lifestyle Med 2024; 18:269-293. [PMID: 38559790 PMCID: PMC10979727 DOI: 10.1177/15598276231202970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVE Identify areas of consensus on integrating lifestyle medicine (LM) into primary care to achieve optimal outcomes. METHODS Experts in both LM and primary care followed an a priori protocol for developing consensus statements. Using an iterative, online process, panel members expressed levels of agreement with statements, resulting in classification as consensus, near consensus, or no consensus. RESULTS The panel identified 124 candidate statements addressing: (1) Integration into Primary Care, (2) Delivery Models, (3) Provider Education, (4) Evidence-base for LM, (5) Vital Signs, (6) Treatment, (7) Resource Referral and Reimbursement, (8) Patient, Family, and Community Involvement; Shared Decision-Making, (9) Social Determinants of Health and Health Equity, and (10) Barriers to LM. After three iterations of an online Delphi survey, statement revisions, and removal of duplicative statements, 65 statements met criteria for consensus, 24 for near consensus, and 35 for no consensus. Consensus was reached on key topics that included LM being recognized as an essential component of primary care in patients of all ages, including LM as a foundational element of health professional education. CONCLUSION The practice of LM in primary care can be strengthened by applying these statements to improve quality of care, inform policy, and identify areas for future research.
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Affiliation(s)
- Meagan L. Grega
- St. Luke's University Health Network, Easton, PA, USA; Kellyn Foundation, Tatamy, PA, USA (MLG)
| | - Jennifer T. Shalz
- Lifestyle Medicine Department, St. Luke’s Health System, Boise ID, USA (JTS)
| | - Richard M. Rosenfeld
- Department of Otolaryngology, SUNY Downstate Health Science University, Brooklyn, NY, USA (RMR)
| | - Josie H. Bidwell
- Department of Preventive Medicine, University of Mississippi Medical Center, Jackson, MI, USA (JHB)
| | - Jonathan P. Bonnet
- Palo Alto VA Health Care, Palo Alto, CA, USA; Department of Medicine and Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA (JPB)
| | - David Bowman
- Department of Pediatrics, Howard University College of Medicine, Washington, DC, USA; Lifestyle Med Revolution, LLC, Upper Marlboro, MD, USA (DB)
| | - Melanie L. Brown
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA (MLB)
| | - Mollie E. Dwivedi
- Department of Orthopaedic Surgery, Division of Physical Medicine and Rehabilitation, Washington University Living Well Center, St. Louis, MO, USA (MED)
| | | | - John H. Kelly
- Loma Linda University, Loma Linda, CA, USA; Lifestyle Health Education Inc., Rocky Mount, VA, USA (JHK)
| | - Amy R. Mechley
- University of Cincinnati College of Medicine, Cincinnati, OH, USA (ARM)
| | - Lawrence A. Miller
- Department of Psychiatry & Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA (LAM)
| | - Rajiv K. Misquitta
- Department of Lifestyle Medicine, The Permanente Medical Group, Sacramento, CA, USA (RKM)
| | | | - Dipak Patel
- Community Health Center, Inc., Meriden, CT, USA; Connecticut Lifestyle Medicine, CT, USA (DP)Community Health Center, Inc., Middletown, CT, USA (DP)
| | - Padmaja M. Patel
- Lifestyle Medicine Center, Midland Health, Midland, TX, USA (PMP)
| | - Karen R. Studer
- Preventive Medicine, Loma Linda University Health, Loma Linda, CA, USA (KRS)
| | - Micaela C. Karlsen
- Department of Research, American College of Lifestyle Medicine, Chesterfield, MO, USA; Departments of Applied Nutrition and Global Public Health, University of New England, Biddeford, ME, USA (MCK)
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Reddy KR, Freeman AM. Lifestyle Medicine: An Antidote to Cardiovascular Diseases. Am J Lifestyle Med 2024; 18:216-232. [PMID: 38559785 PMCID: PMC10979734 DOI: 10.1177/15598276221130684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Despite numerous advances in basic understanding of cardiovascular disease pathophysiology, pharmacology, therapeutic procedures, and systems improvement, there hasn't been much decline in heart disease related mortality in the US since 2010. Hypertension and diet induced risk continue to be the leading causes of cardiovascular morbidity. Even with the excessive mortality associated with the COVID-19 pandemic, in 2020, heart disease remained the leading cause of death. Given the degree of disease burden, morbidity, and mortality, there is an urgent need to redirect medical professionals' focus towards prevention through simple and cost effective lifestyle strategies. However, current practice paradigm and financial compensation systems are mainly centered disease management and not health promotion. For example, the financial value placed on 3-10 min smoking cessation counseling (.24RVUs) is 47-fold lower than an elective PCI (11.21 RVUs). The medical community seems to be enamored with the latest and greatest technology, new devices, and surgical procedures. What if the greatest technology of all was simply the way we live every day? Perhaps when this notion is known by enough, we will switch to this lifestyle medicine technology to prevent disease in the first place.
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Affiliation(s)
- Koushik R. Reddy
- Division of Cardiology, Department of Medicine, James A. Haley VA Medical Center and University of South Florida, Tampa, FL, USA (KRR); and Division of Cardiology, Department of Medicine, National Jewish Health, Denver, CO, USA (AMF)
| | - Andrew M. Freeman
- Division of Cardiology, Department of Medicine, James A. Haley VA Medical Center and University of South Florida, Tampa, FL, USA (KRR); and Division of Cardiology, Department of Medicine, National Jewish Health, Denver, CO, USA (AMF)
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24
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Wagenaar CA, Walrabenstein W, van der Leeden M, Turkstra F, Gerritsen M, Twisk JWR, Boers M, van der Esch M, van Middendorp H, Weijs PJM, van Schaardenburg D. Long-term effectiveness of a lifestyle intervention for rheumatoid arthritis and osteoarthritis: 1-year follow-up of the 'Plants for Joints' randomised clinical trial. RMD Open 2024; 10:e004025. [PMID: 38413171 PMCID: PMC10900348 DOI: 10.1136/rmdopen-2023-004025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 02/08/2024] [Indexed: 02/29/2024] Open
Abstract
OBJECTIVES In two randomised controlled trials, the Plants for Joints (PFJ) multidisciplinary lifestyle intervention reduced signs and symptoms of rheumatoid arthritis (RA), or metabolic syndrome-associated hip or knee osteoarthritis (MSOA) compared with usual care. The current study investigated long-term outcomes. METHODS After completion of two 16-week trials in people with (1) RA or (2) MSOA, control groups switched to the active PFJ intervention. At the end of the intervention, all participants were followed up in a 1-year observational extension study. Primary outcomes were 28-joint Disease Activity Score (DAS28) (RA) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (MSOA). Secondary outcomes included body composition, metabolic outcomes, medication changes and intervention adherence. An intention-to-treat analysis with a linear mixed model was used to analyse within-group changes. RESULTS 65 (84%) of 77 RA participants and 49 (77%) of 64 MSOA participants completed the extension study. The effects of the PFJ intervention were replicated in the original control groups and sustained within the RA group a year after intervention completion (mean DAS28 -0.9 points; p<0.001), while in the MSOA group mean WOMAC increased towards but remained well under the starting value (-7.8 points, p<0.001). Improvements in C-reactive protein, waist circumference (RA and MSOA); low-density lipoprotein cholesterol (RA); and weight, haemoglobin A1c, blood pressure (MSOA) were also sustained. Participants had a net decrease of medication, and intervention adherence was largely sustained. CONCLUSIONS A year after the PFJ lifestyle intervention, improvements of disease activity and metabolic outcomes within RA and MSOA groups were largely sustained and related to sustained adherence, with a net decrease of medication. TRIAL REGISTRATION NUMBERS NL7800, NL7801.
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Affiliation(s)
- Carlijn A Wagenaar
- Reade Center for Rheumtology and Rehabilitation, Amsterdam Rheumatology and Immunology Center, Amsterdam, Netherlands
- Department of Clinical Immunology and Rheumatology, Amsterdam UMC Locatie AMC, Amsterdam, Netherlands
| | | | - Marike van der Leeden
- Reade Center for Rheumtology and Rehabilitation, Amsterdam Rheumatology and Immunology Center, Amsterdam, Netherlands
- Rehabilitation Medicine, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
| | - Franktien Turkstra
- Reade Center for Rheumtology and Rehabilitation, Amsterdam Rheumatology and Immunology Center, Amsterdam, Netherlands
| | - Martijn Gerritsen
- Reade Center for Rheumtology and Rehabilitation, Amsterdam Rheumatology and Immunology Center, Amsterdam, Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Data Science, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
| | - Maarten Boers
- Department of Epidemiology and Data Science, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
| | - Martin van der Esch
- Reade Center for Rheumtology and Rehabilitation, Amsterdam Rheumatology and Immunology Center, Amsterdam, Netherlands
- Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Henriët van Middendorp
- Institute of Psychology, Health, Medical, & Neuropsychology Unit, Leiden University, Leiden, Netherlands
| | - Peter J M Weijs
- Department of Nutrition and Dietetics, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
- Department of Nutrition & Dietetics, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
| | - Dirkjan van Schaardenburg
- Reade Center for Rheumtology and Rehabilitation, Amsterdam Rheumatology and Immunology Center, Amsterdam, Netherlands
- Department of Clinical Immunology and Rheumatology, Amsterdam UMC Locatie AMC, Amsterdam, Netherlands
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Habumugisha T, Engebretsen IMS, Måren IE, Kaiser CWM, Dierkes J. Reducing meat and/or dairy consumption in adults: a systematic review and meta-analysis of effects on protein intake, anthropometric values, and body composition. Nutr Rev 2024; 82:277-301. [PMID: 37236631 PMCID: PMC10859689 DOI: 10.1093/nutrit/nuad055] [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] [Indexed: 05/28/2023] Open
Abstract
CONTEXT Consumers are increasingly encouraged to reduce meat and dairy consumption. However, few meta-analyses of randomized controlled trials (RCTs) on the effect of reducing meat and/or dairy on (absolute) protein intake, anthropometric values, and body composition are available. OBJECTIVE The aim of this systematic review and meta-analysis was to evaluate the effect of reducing meat and/or dairy consumption on (absolute) protein intake, anthropometric values, and body composition in adults aged ≥ 45 years. DATA SOURCES The MEDLINE, Cochrane CENTRAL, Embase, ClinicalTrials.gov, and International Clinical Trials Registry Platform databases were searched up to November 24, 2021. DATA EXTRACTION Randomized controlled trials reporting protein intake, anthropometric values, and body composition were included. DATA ANALYSIS Data were pooled using random-effects models and expressed as the mean difference (MD) with 95%CI. Heterogeneity was assessed and quantified using Cochran's Q and I2 statistics. In total, 19 RCTs with a median duration of 12 weeks (range, 4-24 weeks) and a total enrollment of 1475 participants were included. Participants who consumed meat- and/or dairy-reduced diets had a significantly lower protein intake than those who consumed control diets (9 RCTs; MD, -14 g/d; 95%CI, -20 to -8; I2 = 81%). Reducing meat and/or dairy consumption had no significant effect on body weight (14 RCTs; MD, -1.2 kg; 95%CI, -3 to 0.7; I2 = 12%), body mass index (13 RCTs; MD, -0.3 kg/m2; 95%CI, -1 to 0.4; I2 = 34%), waist circumference (9 RCTs; MD, -0.5 cm; 95%CI, -2.1 to 1.1; I2 = 26%), amount of body fat (8 RCTs; MD, -1.0 kg; 95%CI, -3.0 to 1.0; I2 = 48%), or lean body mass (9 RCTs; MD, -0.4 kg; 95%CI, -1.5 to 0.7; I2 = 0%). CONCLUSION Reduction of meat and/or dairy appears to reduce protein intake. There is no evidence of a significant impact on anthropometric values or body composition. More long-term intervention studies with defined amounts of meat and dairy are needed to investigate the long-term effects on nutrient intakes and health outcomes. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42020207325.
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Affiliation(s)
- Theogene Habumugisha
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Centre for Nutrition, Mohn Nutrition Research Laboratory, Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | | | | | | | - Jutta Dierkes
- Centre for Nutrition, Mohn Nutrition Research Laboratory, Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
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26
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Shah UA, Moshier E, Derkach A, Huang Y, Mailankody S, Tan CR, Maclachlan K, Hultcrantz M, Korde N, Hassoun H, Thibaud S, Sanchez L, Rodriguez C, Richard S, Richter J, Rossi A, Cho HJ, Lesokhin A, Chari A, Usmani SZ, Jagannath S, Parekh S, Gallagher EJ. Prevalence and impact of diabetes on survival of patients with multiple myeloma in different racial groups. Blood Adv 2024; 8:236-247. [PMID: 37772981 PMCID: PMC10918423 DOI: 10.1182/bloodadvances.2023010815] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/04/2023] [Accepted: 08/08/2023] [Indexed: 09/30/2023] Open
Abstract
ABSTRACT Multiple myeloma (MM) is twice as common in Black individuals compared with in White individuals, and diabetes mellitus (DM) disproportionately affects Black patients. Although numerous studies have shown a correlation between DM and MM, this has not been studied in the context of race and in vivo mechanisms. We conducted a retrospective clinical study of 5383 patients with MM of which 15% had DM (White, 12% and Black, 25%). Multivariable Cox models showed reduced overall survival (OS) for patients with DM (hazard ratio, 1.27; 95% confidence interval, 1.11-1.47; P < .001). This appeared to be driven by a marked difference in OS between White patients with and without DM but not in Black patients. In contrast, obesity was associated with better OS in Black patients but not in White patients. To complement this analysis, we assessed MM growth in a genetically engineered immunocompromised nonobese diabetic (Rag1-/-/muscle creatinine kinase promoter expression of a human IGF1R [M] with a lysine [K] to arginine [R] point mutation) mouse model to evaluate the mechanisms linking DM and MM. MM.1S xenografts grew in more Rag1-/-/MKR mice and grew more rapidly in the Rag1-/-/MKR mice compared with in controls. Western blot analysis found that MM1.S xenografts from Rag1-/-/MKR mice had higher phosphorylated S6 ribosomal protein (Ser235/236) levels, indicating greater activation of the mammalian target of rapamycin pathway. Our study is, to our knowledge, the first to evaluate racial differences in DM prevalence and survival in MM, as well as the effect of DM on tumor growth in mouse models. Our results suggest that DM may contribute to the higher incidence of MM in Black patients; and to improve survival in MM, DM management cannot be ignored.
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Affiliation(s)
- Urvi A. Shah
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Erin Moshier
- Department of Population Health Science and Policy, Mount Sinai Health System, New York, NY
| | - Andriy Derkach
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Yuanhui Huang
- Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Sham Mailankody
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Carlyn R. Tan
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Kylee Maclachlan
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Malin Hultcrantz
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Neha Korde
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Hani Hassoun
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Santiago Thibaud
- Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Larysa Sanchez
- Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Cesar Rodriguez
- Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Shambavi Richard
- Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Joshua Richter
- Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Adriana Rossi
- Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Hearn Jay Cho
- Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Alexander Lesokhin
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Ajai Chari
- Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Saad Z. Usmani
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Sundar Jagannath
- Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Samir Parekh
- Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Emily J. Gallagher
- Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY
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Wiśniewska K, Okręglicka KM, Nitsch-Osuch A, Oczkowski M. Plant-Based Diets and Metabolic Syndrome Components: The Questions That Still Need to Be Answered-A Narrative Review. Nutrients 2024; 16:165. [PMID: 38201994 PMCID: PMC10780839 DOI: 10.3390/nu16010165] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/29/2023] [Accepted: 01/02/2024] [Indexed: 01/12/2024] Open
Abstract
Metabolic syndrome (MetS) is defined as the co-occurrence of at least three of the following metabolic disorders: abdominal obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C), high blood glucose, and hypertension. The treatment of MetS involves lifestyle changes, including following an appropriate diet. In addition to weight reduction, it is crucial to search for optimal nutritional patterns that are highly effective in optimizing other MetS markers, such as glucose and lipid metabolism, and reducing blood pressure. To date, the effects of a Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH) diet on MetS have been extensively evaluated. Recent epidemiological studies suggest that plant-based diets (PBDs) may be effective in treating MetS; however, there is still a lack of experimental data. This review aims to analyze the potential benefits of different PBDs on MetS determinants based on the available studies. The findings may help personalize dietary interventions and improve patient care for those with MetS.
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Affiliation(s)
- Klaudia Wiśniewska
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Street, 02-007 Warsaw, Poland; (K.M.O.); (A.N.-O.)
- Doctoral School, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Katarzyna Małgorzata Okręglicka
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Street, 02-007 Warsaw, Poland; (K.M.O.); (A.N.-O.)
| | - Aneta Nitsch-Osuch
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Street, 02-007 Warsaw, Poland; (K.M.O.); (A.N.-O.)
| | - Michał Oczkowski
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159c Nowoursynowska Street, 02-776 Warsaw, Poland;
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Ergas IJ, Mauch LR, Rahbar JA, Kitazono R, Kushi LH, Misquitta R. Health Achieved Through Lifestyle Transformation (HALT): A Kaiser Permanente Diet and Lifestyle Intervention Program for Coronary Artery Disease and Type 2 Diabetes. Am J Lifestyle Med 2024; 18:35-48. [PMID: 39184268 PMCID: PMC11339756 DOI: 10.1177/15598276231164949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2024] Open
Abstract
A whole-food plant-based (WFPB) diet in combination with healthful lifestyle modifications has been shown to be an effective approach to managing and reversing the progression of coronary artery disease and type 2 diabetes mellitus (T2DM). The Health Achieved Through Lifestyle Transformation Program (HALT) is a 20-week real-world healthful diet and lifestyle intervention program implemented at Kaiser Permanente South Sacramento Medical Center (KPSSC), whose goal is to treat, and where possible, reverse CAD and T2DM. Here, our objective is to describe HALT, including enrollment, the intervention, adherence, and data collection activities during a 2-year period from October 15th, 2016, through October 9th, 2018. There were 204 KPSSC members enrolled, of which, 19 (9.3%) had CAD only, 166 (81.4%) had T2DM only, and 19 (9.3%) had both CAD and T2DM. Among the enrolled, 196 (96.1%) completed self-administered questionnaires, and 88.2 to 97.5% completed blood tests, depending on the test. The enrolled were predominantly female (63.2%), ≥50 years old at program entry (83.3%), and white (32.8%) or black (25.5%). HALT has the potential to become a valuable resource for examining the impact of dietary and lifestyle modifications on patients diagnosed with CAD and/or T2DM.
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Affiliation(s)
- Isaac J. Ergas
- Isaac J. Ergas, Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA.
| | - Lisa R. Mauch
- Department of Lifestyle Medicine, Kaiser Permanente Elk Grove Medical Offices, Elk Grove, CA, USA (LM, JR, RM)
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA (IE, LK)
- Department of Behavioral Medicine, Kaiser Permanente South Sacramento Medical Offices, Sacramento, CA, USA (RK)
| | - Joshua A. Rahbar
- Department of Lifestyle Medicine, Kaiser Permanente Elk Grove Medical Offices, Elk Grove, CA, USA (LM, JR, RM)
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA (IE, LK)
- Department of Behavioral Medicine, Kaiser Permanente South Sacramento Medical Offices, Sacramento, CA, USA (RK)
| | - Rachel Kitazono
- Department of Lifestyle Medicine, Kaiser Permanente Elk Grove Medical Offices, Elk Grove, CA, USA (LM, JR, RM)
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA (IE, LK)
- Department of Behavioral Medicine, Kaiser Permanente South Sacramento Medical Offices, Sacramento, CA, USA (RK)
| | - Lawrence H. Kushi
- Department of Lifestyle Medicine, Kaiser Permanente Elk Grove Medical Offices, Elk Grove, CA, USA (LM, JR, RM)
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA (IE, LK)
- Department of Behavioral Medicine, Kaiser Permanente South Sacramento Medical Offices, Sacramento, CA, USA (RK)
| | - Rajiv Misquitta
- Department of Lifestyle Medicine, Kaiser Permanente Elk Grove Medical Offices, Elk Grove, CA, USA (LM, JR, RM)
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA (IE, LK)
- Department of Behavioral Medicine, Kaiser Permanente South Sacramento Medical Offices, Sacramento, CA, USA (RK)
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Neff RA, Ramsing RJ, Kim BF. Commercial weight-loss diets, greenhouse gas emissions and freshwater consumption. J Hum Nutr Diet 2023; 36:2268-2279. [PMID: 37867400 DOI: 10.1111/jhn.13248] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 08/31/2023] [Accepted: 09/20/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Weight-loss attempts are widespread in the United States, with many using commercial weight-loss diet plans for guidance and support. Accordingly, dietary suggestions within these plans influence the nation's food-related environmental footprint. METHODS We modelled United States (US) per capita greenhouse gas emissions (GHGe) and water footprints associated with seven commercial weight-loss diets, the US baseline, and selected other dietary patterns. We characterised consumption in commercial weight-loss diets both via modelling from provided guidelines and based on specific foods in 1-week meal plans. Cradle-to-farmgate GHGe and water footprints were assessed using a previously developed model. GHGe results were compared to the EAT-Lancet 2050 target. Water footprints were compared to the US baseline. RESULTS Weight-loss diets had GHGe footprints on average 4.4 times the EAT-Lancet target recommended for planetary health (range: 2.4-8.5 times). Bovine meat was by far the largest contributor of GHGe in most diets that included it. Three commercial diets had water footprints above the US baseline. Low caloric intake in some diets compensated for the relative increases in GHGe- and water-intensive foods. CONCLUSIONS Dietary patterns suggested by marketing materials and guidelines from commercial weight-loss diets can have high GHGe and water footprints, particularly if caloric limits are exceeded. Commercial diet plan guidance can be altered to support planetary and individual health, including describing what dietary patterns can jointly support environmental sustainability and weight loss.
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Affiliation(s)
- Roni A Neff
- Department of Environmental Health & Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Environmental Health & Engineering Johns Hopkins Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Rebecca J Ramsing
- Department of Environmental Health & Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Environmental Health & Engineering Johns Hopkins Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Brent F Kim
- Department of Environmental Health & Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Environmental Health & Engineering Johns Hopkins Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Campbell EK, Campbell TM, Culakova E, Blanchard LM, Wixom N, Guido J, Fetten J, Huston A, Shayne M, Janelsins M, Mustian K, Moore RG, Peppone LJ. A Whole Food, Plant-Based Randomized Controlled Trial in Metastatic Breast Cancer: Feasibility, Nutrient, and Patient-Reported Outcomes. RESEARCH SQUARE 2023:rs.3.rs-3606685. [PMID: 38045318 PMCID: PMC10690314 DOI: 10.21203/rs.3.rs-3606685/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Purpose Quality of life (QOL) is among the most important outcomes for women with metastatic breast cancer (MBC) and it predicts survival. QOL is negatively impacted by cognitive impairment, fatigue, and weight gain. We assessed whether a whole food, plant-based (WFPB) diet promoting weight loss is feasible and might improve QOL. Methods Women with MBC on stable systemic treatments were randomized 2:1 to 1) WFPB dietary intervention (n = 21) or 2) usual care (n = 11) for 8 weeks. Participants attended weekly education visits and consumed an ad libitum WFPB diet (3 prepared meals/day provided). Patient-reported outcomes and 3-day food records were assessed at baseline and 8 weeks. The effects of WFPB diet on changes in outcomes were assessed by analysis of covariance model controlling for baseline. Results 20 intervention and 10 control participants completed the trial. Intervention participants were highly adherent to the WFPB diet (94.3% total calories on-plan). Intervention group nutrient intakes changed significantly including dietary fat (35.8-20.4% percent calories from fat, p < 0.001) and fiber content (22.1 to 40.8 grams fiber/1000 kcal, p < 0.001). Perceived cognitive function (FACT-Cog total + 16.1; 95% confidence interval [CI] = 0.8-31.7; p = 0.040) and emotional well-being (FACT-B emotional well-being subscale + 2.3; CI = 0.5-4.1; p = 0.016) improved in the WFPB versus the control group. Fatigue, measured by the BFI, improved within the WFPB group for fatigue severity (M = 4.7 ± 2.5[SD] to 3.7 ± 2.3, p = 0.047) and fatigue at its worst (5.8 ± 2.8 to 4.4 ± 2.4, p = 0.011). Conclusions Significant dietary changes in this population are feasible and may improve QOL by improving treatment-related symptoms. Additional study is warranted. Trial registration ClinicalTrials.gov identifier: NCT03045289. Registered 7 February 2017.
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Campbell TM, Campbell EK, Culakova E, Blanchard L, Wixom N, Guido J, Fetten J, Huston A, Shayne M, Janelsins MC, Mustian KM, Moore RG, Peppone LJ. A Whole-Food, Plant-Based Randomized Controlled Trial in Metastatic Breast Cancer: Weight, Cardiometabolic, and Hormonal Outcome. RESEARCH SQUARE 2023:rs.3.rs-3425125. [PMID: 37986940 PMCID: PMC10659540 DOI: 10.21203/rs.3.rs-3425125/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Purpose Breast cancer treatment is associated with weight gain, and obesity and its related cardiometabolic and hormonal risk factors have been associated with poorer outcomes. Dietary intervention may address these risk factors, but limited research has been done in the setting of metastatic breast cancer requiring systemic therapy. Methods Women with metastatic breast cancer on stable treatment were randomized 2:1 to an 8-week intervention (n = 21) or control (n = 11). The intervention included weekly assessment visits and an ad libitum whole food, plant-based (WFPB) diet with provided meals. Cardiometabolic, hormonal, and cancer markers were assessed at baseline, 4 weeks, and 8 weeks. Results Within the intervention group, mean weight decreased by 6.6% (p < 0.01) after 8 weeks. Fasting insulin decreased from 16.8 uIU/L to 11.2 uIU/L (p < 0.01), concurrent with significantly reduced insulin resistance. Total cholesterol decreased from 193.6 mg/dL to 159 mg/dL (p < 0.01) and low-density lipoprotein (LDL) cholesterol decreased from 104.6 mg/dL to 82.2 mg/dL (p < 0.01). Total testosterone was unchanged, but free testosterone trended lower within the intervention group (p = 0.08) as sex hormone binding globulin increased from 74.3 nmol/L to 98.2 nmol/L (p < 0.01). There were no significant differences in cancer progression markers at week 8, although mean CA 15 - 3, CA 27.29, and CEA were lower in the intervention group (p = 0.53, p = 0.23, and p = 0.54, respectively) compared to control, when adjusted for baseline. Conclusion WFPB dietary changes during treatment for metastatic breast cancer are well tolerated and significantly improve weight and cardiometabolic and hormonal parameters. Longer studies are warranted to assess the durability of changes. Trial registration First registered at Clinicaltrials.gov (NCT03045289) on February 7, 2017.
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Affiliation(s)
| | | | - Eva Culakova
- University of Rochester School of Medicine and Dentistry
| | - Lisa Blanchard
- University of Rochester School of Medicine and Dentistry
| | - Nellie Wixom
- University of Rochester School of Medicine and Dentistry
| | - Joseph Guido
- University of Rochester School of Medicine and Dentistry
| | | | - Alissa Huston
- University of Rochester School of Medicine and Dentistry
| | | | | | | | | | - Luke J Peppone
- University of Rochester School of Medicine and Dentistry
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Melgar B, Diaz-Arocutipa C, Huerta-Rengifo C, Piscoya A, Barboza JJ, Hernandez AV. Vegetarian diets on anthropometric, metabolic and blood pressure outcomes in people with overweight and obesity: a systematic review and meta-analysis of randomized controlled trials. Int J Obes (Lond) 2023; 47:903-910. [PMID: 37528197 DOI: 10.1038/s41366-023-01357-7] [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] [Received: 12/31/2022] [Revised: 07/01/2023] [Accepted: 07/18/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND It is unknown whether vegetarian diets (VDs) may improve outcomes in people with overweight and obesity. OBJECTIVE To systematically assess the effects of VDs vs. omnivore diets on anthropometric, metabolic, and blood pressure outcomes in people with overweight and obesity. METHODS We searched for randomized controlled trials (RCTs) in EMBASE, PubMed, Web of Science, and Scopus until February 2, 2022. Primary outcomes were anthropometric risk factors (weight, body mass index [BMI], waist circumference [WC], hip circumference [HC], and body fat percentage). Secondary outcomes were metabolic risk factors (fasting serum glucose, HbA1c, insulin levels) and blood pressure (systolic blood pressure [SBP], diastolic blood pressure [DBP]). Random-effects meta-analyses were performed and effects were expressed as mean difference (MD) and their 95% confidence intervals (CI). The quality of evidence was assessed using GRADE methods. RESULTS Nine RCTs (n = 1628) were included. VDs decreased weight (MD -3.60 kg, 95%CI -4.75 to -2.46) and glucose (MD -10.64 mg/dL, 95%CI -15.77 to -5.51), but did not decrease WC (MD -3.00 cm, 95%CI -6.20 to 0.20), BMI (MD -0.87 kg/m2, 95%CI -1.80 to 0.06), or HC (MD: -0.86 cm, 95%CI -3.46 to 1.74). VDs did not decrease HbA1c (MD -0.40%, 95%CI -0.89 to 0.10), insulin (MD -3.83 mU/L, 95%CI -8.06 to 0.40), SBP (MD -0.25 mmHg, 95%CI -2.58 to 2.07), or DBP (MD -1.57 mmHg, 95%CI -3.93 to 0.78). Subgroup analyses by type of VD (four RCTs evaluated lacto-ovo-vegetarian diets and five RCTs vegan diets) showed similar results to the main analyses. QoE was very low for most of the outcomes. CONCLUSIONS In comparison to an omnivorous diet, VDs may reduce weight and glucose, but not blood pressure or other metabolic or anthropometric outcomes. However, the QoE was mostly very low. Larger RCTs are still needed to evaluate the effects of VD on anthropometric, metabolic factors, and blood pressure in people with overweight and obesity.
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Affiliation(s)
- Beatriz Melgar
- Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru.
| | - Carlos Diaz-Arocutipa
- Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
| | - Claudia Huerta-Rengifo
- Tau Relaped Group, Trujillo, Peru
- Facultad de Medicina, Universidad Privada Antenor Orrego, Trujillo, Peru
| | - Alejandro Piscoya
- Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
- Hospital Guillermo Kaelin de la Fuente, Lima, Peru
| | - Joshuan J Barboza
- Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
- Tau Relaped Group, Trujillo, Peru
| | - Adrian V Hernandez
- Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
- Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group, University of Connecticut School of Pharmacy, Storrs, CT, USA
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Charles JA, Wood NI, Neary S, Moreno JO, Scierka L, Brink B, Zhao X, Gielissen KA. "Zoom"ing to the Kitchen: A Novel Approach to Virtual Nutrition Education for Medical Trainees. Nutrients 2023; 15:4166. [PMID: 37836450 PMCID: PMC10574391 DOI: 10.3390/nu15194166] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/06/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
While nutritional interventions are first-line therapy for many chronic diseases, most medical trainees receive minimal nutrition education, leaving them unprepared to address nutritional issues with patients. An interactive, single-session, virtual nutrition curriculum was taught online to 80 physician assistant (PA) students. Topics included plant-based nutrition, dietary history-taking and counseling, and culinary medicine. Students were surveyed before, immediately after, and four weeks after the curriculum to assess changes to nutrition-related knowledge, attitudes, confidence, and personal dietary behaviors. Seventy-three PA students (91%) completed the pre-survey, 76 (95%) completed the post-survey, and 42 (52.5%) completed the delayed post-survey. Knowledge scores increased immediately post-intervention (48.9% to 78.9%; p < 0.001) and persisted four weeks later (78.9% to 75.8%; p = 0.54). Post-intervention, students felt more confident in dietary history-taking (55% vs. 95%; p = 0.001) and nutrition counseling (53% vs. 84%; p = 0.003) and agreed that dietary changes alone could reverse type 2 diabetes (74% vs. 97%; p = 0.027) and coronary artery disease (66% vs. 92%; p = 0.039). Curricula using virtual teaching kitchens may be a scalable approach to nutrition education for medical trainees.
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Affiliation(s)
- Justin A. Charles
- Department of Family Medicine and Public Health, UC San Diego Health, San Diego, CA 92093, USA
| | - Nathan I. Wood
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA; (N.I.W.); (J.O.M.); (L.S.)
| | - Stephanie Neary
- Physician Assistant Online Program, Yale University School of Medicine, New Haven, CT 06520, USA;
| | - Jorge O. Moreno
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA; (N.I.W.); (J.O.M.); (L.S.)
| | - Lindsey Scierka
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA; (N.I.W.); (J.O.M.); (L.S.)
| | - Benjamin Brink
- Department of Internal Medicine, Brown University-Rhode Island Hospital, Providence, RI 02912, USA
| | - Xiwen Zhao
- Yale Center for Analytical Sciences, Yale University School of Public Health, New Haven, CT 06511, USA;
| | - Katherine A. Gielissen
- Division of General Internal Medicine, Emory University School of Medicine, Atlanta, GA 30303, USA;
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Tan Y, Xu Y, Zhang Z, Ran Z, Liu X, Jia Y, Chen Y. The Prognostic Value and Treatment Strategies of Nutritional Status in Heart Failure Patients. Curr Probl Cardiol 2023; 48:101742. [PMID: 37087080 DOI: 10.1016/j.cpcardiol.2023.101742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 04/10/2023] [Accepted: 04/14/2023] [Indexed: 04/24/2023]
Abstract
Heart failure is a complex clinical syndrome caused by a variety of reasons leading to abnormal changes in the structure and/or function of the heart, with ventricular systolic and/or diastolic dysfunction, which is a serious manifestation or late stage of various heart diseases. The overall prognosis of patients is poor, and risk assessment of patients with HF is currently a hot topic of research due to the large heterogeneity of etiology, phenotype, and genetic background of HF patients. Besides, the nutritional level and status of HF patients are affected by various aspects. Patients with malnutrition, high saturated fatty acids and cholesterol, low minerals, and other conditions tend to have a poor prognosis. So targeted improvement of the nutritional status of HF patients is important to improve the prognosis and the quality of survival of patients. We use heart failure, nutrition, and diet therapy as the keyword method to summarize the prognostic value of indicators of nutritional status in HF patients, the effects of nutritional status on HF patients with different etiology, and potential treatment strategies for HF patients with different etiology. This review is valuable for understanding the prognostic value of nutritional levels in patients with HF and guiding clinical therapeutic approaches.
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Affiliation(s)
- Yinxi Tan
- West China School of Public Health and West China fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuanwei Xu
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zixuan Zhang
- West China School of Public Health and West China fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zechao Ran
- West China School of Clinical Medicine and West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xinyue Liu
- West China School of Public Health and West China fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yunqi Jia
- West China School of Public Health and West China fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yucheng Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Campbell TM, Campbell EK, Attia J, Ventura K, Mathews T, Chhabra KH, Blanchard LM, Wixom N, Faniyan TS, Peterson DR, Harrington DK, Wittlin SD. The acute effects of a DASH diet and whole food, plant-based diet on insulin requirements and related cardiometabolic markers in individuals with insulin-treated type 2 diabetes. Diabetes Res Clin Pract 2023; 202:110814. [PMID: 37419391 PMCID: PMC10528443 DOI: 10.1016/j.diabres.2023.110814] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/28/2023] [Accepted: 06/30/2023] [Indexed: 07/09/2023]
Abstract
AIMS There is limited research regarding insulin dosing changes following adoption of plant-based diets. We conducted a nonrandomized crossover trial utilizing two plant-based diets (Dietary Approaches to Stop Hypertension, or DASH, and Whole Food, Plant-Based, or WFPB) to assess acute changes in insulin requirements and associated markers among individuals with insulin-treated type 2 diabetes. METHODS Participants (n = 15) enrolled in a 4-week trial with sequential, one-week phases: Baseline, DASH 1, WFPB, and DASH 2. Each diet was ad libitum and meals were provided. RESULTS Compared to baseline, daily insulin usage was 24%, 39%, and 30% lower after DASH 1, WFPB, and DASH 2 weeks respectively (all p < 0.01). Insulin resistance (HOMA-IR) was 49% lower (p < 0.01) and the insulin sensitivity index was 38% higher (p < 0.01) at the end of the WFPB week before regressing toward baseline during DASH 2. Total, LDL, and HDL cholesterol, leptin, urinary glucose, and hsCRP decreased to a nadir at the end of the WFPB week before increasing during DASH 2. CONCLUSIONS Adopting a DASH or WFPB diet can result in significant, rapid changes in insulin requirements, insulin sensitivity, and related markers among individuals with insulin-treated type 2 diabetes, with larger dietary changes producing larger benefits.
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Affiliation(s)
- Thomas M Campbell
- Department of Family Medicine, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, USA.
| | - Erin K Campbell
- Department of Public Health Sciences, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, USA
| | - Jonven Attia
- Division of Endocrinology, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, USA
| | - Kenilia Ventura
- Division of Endocrinology, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, USA
| | - Tony Mathews
- Division of Endocrinology, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, USA
| | - Kavaljit H Chhabra
- Division of Endocrinology, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, USA
| | - Lisa M Blanchard
- Department of Family Medicine, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, USA
| | - Nellie Wixom
- Clinical Research Center, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, USA
| | - Tumininu S Faniyan
- Division of Endocrinology, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, USA
| | - Derick R Peterson
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, USA
| | - Donald K Harrington
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, USA
| | - Steven D Wittlin
- Division of Endocrinology, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, USA
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Kokkinopoulou A, Pagkalos I, Rodopaios NE, Koulouri AA, Vasara E, Papadopoulou SK, Skepastianos P, Hassapidou M, Kafatos AG. Does Religious Fasting Have a Protective Role against Metabolic Syndrome in Individuals Aged >50 Years? Nutrients 2023; 15:3215. [PMID: 37513633 PMCID: PMC10385780 DOI: 10.3390/nu15143215] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/16/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
OBJECTIVE The Christian Orthodox Church (COC) fasting is a periodic vegetarian-type diet lasting 180-200 days annually in which seafood and snails are allowed on all fasting days. Our aim was to investigate the effects of COC fasting on metabolic syndrome (MetS) in adults >50 years. METHODS One hundred seventy-six individuals participated in the study (mean age 59.7 ± 6.0 years). Eighty-nine had been following the COC fasting regime since their childhood and eighty-seven were non-fasters. Anthropometric measurements, blood samples, and nutrient intake data were collected at a scheduled appointment, during a non-fasting period. RESULTS Fasters had significantly higher hip circumference (102 ± 8.5 vs. 98.8 ± 7.5 cm, p = 0.009), low-density lipoprotein (LDL) cholesterol (136 ± 73 vs. 115 ± 51 mg/dL, p = 0.033), and folic acid levels (6.0 ± 4.0 vs. 3.0 ± 1.2 ng/mL, p = 0.018), as well as lower systolic blood pressure (SBP) (131 ± 13 vs. 136 ± 14 mmHg, p = 0.045), diastolic blood pressure (DBP) (80 ± 8 vs. 83 ± 7 mmHg, p = 0.007), glucose (87 ± 16 vs. 93 ± 25 mg/dL, p = 0.039), and triglycerides (143 ± 94 vs. 175 ± 84 mg/dL, p = 0.040). Fasters had significantly less intake of calories (1493.65 ± 363.74 vs. 1614.65 ± 426.28 kcal, p = 0.044) and fat (81.17 ± 25.47 vs. 90.74 ± 24.75 g, p = 0.012), whereas they also consumed significantly less vitamin A-retinol, vitamin B2, vitamin B12, vitamin E, folic acid, pantothenic acid, calcium, phosphorus, zinc, and significantly more vitamin C (p < 0.005 for all comparisons). BP was significantly higher in non-fasters (44.8 vs. 22.5%, p = 0.002), whereas MetS was more frequently present in non-fasters vs. fasters, with a marginal level of significance (35.6 vs. 22.5%, p = 0.055). CONCLUSIONS COC fasting may affect beneficially MetS prevalence in individuals >50 years, although future research is needed before reaching definite conclusions.
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Affiliation(s)
- Anna Kokkinopoulou
- Department of Preventive Medicine and Nutrition Unit, School of Medicine, University of Crete, 71003 Crete, Greece
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece
| | - Ioannis Pagkalos
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece
| | - Nikolaos E Rodopaios
- Department of Preventive Medicine and Nutrition Unit, School of Medicine, University of Crete, 71003 Crete, Greece
| | | | - Eleni Vasara
- Laboratory of Animal Physiology, Department of Zoology, School of Biology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Sousana K Papadopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece
| | - Petros Skepastianos
- Department of Medical Laboratory Studies, International Hellenic University, 57400 Thessaloniki, Greece
| | - Maria Hassapidou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece
| | - Anthony G Kafatos
- Department of Preventive Medicine and Nutrition Unit, School of Medicine, University of Crete, 71003 Crete, Greece
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Clemente-Suárez VJ, Beltrán-Velasco AI, Redondo-Flórez L, Martín-Rodríguez A, Tornero-Aguilera JF. Global Impacts of Western Diet and Its Effects on Metabolism and Health: A Narrative Review. Nutrients 2023; 15:2749. [PMID: 37375654 PMCID: PMC10302286 DOI: 10.3390/nu15122749] [Citation(s) in RCA: 89] [Impact Index Per Article: 89.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
The Western diet is a modern dietary pattern characterized by high intakes of pre-packaged foods, refined grains, red meat, processed meat, high-sugar drinks, candy, sweets, fried foods, conventionally raised animal products, high-fat dairy products, and high-fructose products. The present review aims to describe the effect of the Western pattern diet on the metabolism, inflammation, and antioxidant status; the impact on gut microbiota and mitochondrial fitness; the effect of on cardiovascular health, mental health, and cancer; and the sanitary cost of the Western diet. To achieve this goal, a consensus critical review was conducted using primary sources, such as scientific articles, and secondary sources, including bibliographic indexes, databases, and web pages. Scopus, Embase, Science Direct, Sports Discuss, ResearchGate, and the Web of Science were used to complete the assignment. MeSH-compliant keywords such "Western diet", "inflammation", "metabolic health", "metabolic fitness", "heart disease", "cancer", "oxidative stress", "mental health", and "metabolism" were used. The following exclusion criteria were applied: (i) studies with inappropriate or irrelevant topics, not germane to the review's primary focus; (ii) Ph.D. dissertations, proceedings of conferences, and unpublished studies. This information will allow for a better comprehension of this nutritional behavior and its effect on an individual's metabolism and health, as well as the impact on national sanitary systems. Finally, practical applications derived from this information are made.
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Affiliation(s)
- Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (J.F.T.-A.)
| | | | - Laura Redondo-Flórez
- Department of Health Sciences, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, C/Tajo s/n, 28670 Villaviciosa de Odón, Spain;
| | - Alexandra Martín-Rodríguez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (J.F.T.-A.)
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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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Asoudeh F, Mousavi SM, Keshteli AH, Hasani-Ranjbar S, Larijani B, Esmaillzadeh A, Adibi P. The association of plant-based dietary pattern with general and abdominal obesity: a large cross-sectional study. J Diabetes Metab Disord 2023; 22:469-477. [PMID: 37255813 PMCID: PMC10225380 DOI: 10.1007/s40200-022-01166-1] [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: 04/01/2022] [Revised: 10/31/2022] [Accepted: 11/30/2022] [Indexed: 06/01/2023]
Abstract
Purpose Only a few studies have studied the association between plant-based dietary index (PDI) and the prevalence of obesity. The purpose of this study was to investigate the association between PDI and the prevalence of general and abdominal obesity in a large sample of Iranian adults. Methods The current cross-sectional study was performed from 2010 to 2012 in Isfahan, Iran. This study comprised 6,724 adults between the ages of 18 and 55. We analyzed data from 6,724 participants who were classified as having general obesity and 5,203 individuals who were classified as having abdominal obesity. Dietary intake was assessed using a validated food frequency questionnaire. We determined the PDI by assigning plant foods positive scores and animal foods negative values using the method of Satija et al. General obesity was defined as having a body mass index (BMI) greater than 30 kg/m2, whereas abdominal obesity was classified as having a waist circumference (WC) greater than 88 cm for women and 102 cm for men. Data was examined using Chi-squared test and the analysis of variance (ANOVA and ANCOVA). Multivariable binary logistic regression analyses were performed to evaluate the association between PDI and risk of general as well as abdominal obesity. Results The mean age of the study participants was 36.8 ± 8.08 years, and 57% of them were female. General obesity prevalence was 9.6%, while abdominal obesity was 26.8%. In all the unadjusted and multivariable adjusted models of the total population, there was no significant association between highest vs. lowest adherence to the PDI and general obesity or abdominal obesity. No significant association was found when men and women were analyzed separately as well. Conclusion In the present study, no association was observed between PDI and general and abdominal obesity in the Iranian adult population.
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Affiliation(s)
- Farzaneh Asoudeh
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Mousavi
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Shirin Hasani-Ranjbar
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peyman Adibi
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Koch CA, Kjeldsen EW, Frikke-Schmidt R. Vegetarian or vegan diets and blood lipids: a meta-analysis of randomized trials. Eur Heart J 2023:7177660. [PMID: 37226630 PMCID: PMC10361023 DOI: 10.1093/eurheartj/ehad211] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 02/23/2023] [Accepted: 03/24/2023] [Indexed: 05/26/2023] Open
Abstract
AIMS Due to growing environmental focus, plant-based diets are increasing steadily in popularity. Uncovering the effect on well-established risk factors for cardiovascular diseases, the leading cause of death worldwide, is thus highly relevant. Therefore, a systematic review and meta-analysis were conducted to estimate the effect of vegetarian and vegan diets on blood levels of total cholesterol, low-density lipoprotein cholesterol, triglycerides, and apolipoprotein B. METHODS AND RESULTS Studies published between 1980 and October 2022 were searched for using PubMed, Embase, and references of previous reviews. Included studies were randomized controlled trials that quantified the effect of vegetarian or vegan diets vs. an omnivorous diet on blood lipids and lipoprotein levels in adults over 18 years. Estimates were calculated using a random-effects model. Thirty trials were included in the study. Compared with the omnivorous group, the plant-based diets reduced total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B levels with mean differences of -0.34 mmol/L (95% confidence interval, -0.44, -0.23; P = 1 × 10-9), -0.30 mmol/L (-0.40, -0.19; P = 4 × 10-8), and -12.92 mg/dL (-22.63, -3.20; P = 0.01), respectively. The effect sizes were similar across age, continent, duration of study, health status, intervention diet, intervention program, and study design. No significant difference was observed for triglyceride levels. CONCLUSION Vegetarian and vegan diets were associated with reduced concentrations of total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B-effects that were consistent across various study and participant characteristics. Plant-based diets have the potential to lessen the atherosclerotic burden from atherogenic lipoproteins and thereby reduce the risk of cardiovascular disease.
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Affiliation(s)
- Caroline A Koch
- Department of Clinical Biochemistry, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Emilie W Kjeldsen
- Department of Clinical Biochemistry, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Ruth Frikke-Schmidt
- Department of Clinical Biochemistry, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
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Chew HSJ, Heng FKX, Tien SA, Thian JY, Chou HS, Loong SSE, Ang WHD, Chew NWS, Lo KHK. Effects of Plant-Based Diets on Anthropometric and Cardiometabolic Markers in Adults: An Umbrella Review. Nutrients 2023; 15:2331. [PMID: 37242214 PMCID: PMC10222061 DOI: 10.3390/nu15102331] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/05/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
We conducted an umbrella review to consolidate the evidence of adopting plant-based diets on anthropometric and cardiometabolic outcomes. Six electronic databases (CINAHL, EMBASE, PubMed, Scopus, the Cochrane Library, and Web of Science) were searched for systematic reviews with meta-analysis (SRMAs) published from each journal's inception until 1 October 2022. Effect sizes from SRMAs and primary studies were pooled separately using random effects models. Overlapping primary studies were removed for primary studies' analyses. Seven SRMAs representing 51 primary studies were included, suggesting significant benefits of plant-based diets on weight (-2.09 kg, 95% CI: -3.56, -0.62 kg, p = 0.01, I2 = 95.6%), body mass index (-0.95 kg/m2, 95% CI: -1.26, -0.63 kg/m2, p = 0.002; I2 = 45.1%), waist circumference (-2.20 cm, 95% CI: -0.08, 0.00 cm, p = 0.04; I2 = 88.4%), fasting blood glucose (-0.11 mmol/L, 95% CI: -0.13, -0.09 mmol/L, p < 0.001, I2 = 18.2%), and low-density lipoprotein cholesterol (-0.31 mmol/L, 95% CI: -0.41, -0.20 mmol/L, p < 0.001, I2 = 65.6%). Changes in high-density lipoprotein cholesterol, triglycerides, and blood pressure were not statistically significant. Generally, plant-based diets were recommended to improve anthropometry, lipid profile, and glucose metabolism. However, findings should be interpreted with caution, because most of the reviews were rated to be of low credibility of evidence and were largely based on Western eating habits and traditions, which may limit the generalizability of findings.
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Affiliation(s)
- Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Felicia Kai Xin Heng
- Department of Nursing, Ng Teng Fong General Hospital, Singapore 609606, Singapore
| | - Si Ai Tien
- Department of Nursing, Khoo Teck Puat Hospital, Singapore 768828, Singapore
| | - Jie Yun Thian
- Department of Nursing, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Hui Shan Chou
- Department of Nursing, Singapore General Hospital, Singapore 169608, Singapore
| | - Shaun Seh Ern Loong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Wei How Darryl Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Nicholas W. S. Chew
- Department of Cardiology, National University Heart Centre, Singapore 119074, Singapore
| | - Ka-Hei Kenneth Lo
- Department of Food Science and Nutrition, The Hong Kong Polytechnic University, Hong Kong
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Friedman SM, Scheuer K, Beha BG, Dewhirst M, Barnett TD. Whole-food plant-based Jumpstart for a Deaf and Hard of Hearing cohort. Front Nutr 2023; 10:1125075. [PMID: 37090777 PMCID: PMC10113654 DOI: 10.3389/fnut.2023.1125075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/14/2023] [Indexed: 04/08/2023] Open
Abstract
Deaf and Hard of Hearing (DHH) patients are at high risk of developing chronic illness, and when they do, are at higher risk of poor outcomes than in a hearing community. Rochester Lifestyle Medicine Institute adapted its online, Zoom-based, medically-facilitated 15 Day Whole-Food Plant-Based (WFPB) Jumpstart program, to give DHH participants knowledge, skills, and support to make dietary changes to improve their health. Adaptations included having a medical provider present who is fluent in American Sign Language (ASL), is board-certified in Lifestyle Medicine, and has a Master of Science in Deaf Education; spotlighting participants when asking a question during the Q&A session; using ASL interpreters; utilizing closed captioning/automatic transcription during all Zoom meetings; and employing a Success Specialist to provide outreach via text and email throughout the program. Participants had significant positive changes in their eating pattern. They reported improvements in biometric measures as well as in how they were feeling. They all reported that they planned to continue to eat a more WFPB diet than they did prior to Jumpstart. All either agreed or strongly agreed that they learned important information, were confident that they knew the best eating pattern for health, and gained the skills they needed to make changes. Although this was a small pilot program, it suggests that this model can be used to provide education and support for behavior change that will lead to improved health in a DHH community.
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Affiliation(s)
- Susan M. Friedman
- Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
- Rochester Lifestyle Medicine Institute, Rochester, NY, United States
- *Correspondence: Susan M. Friedman,
| | - Kim Scheuer
- Rochester Lifestyle Medicine Institute, Rochester, NY, United States
- Plant-Based Telehealth, Austin, TX, United States
| | - Beth Garver Beha
- Rochester Lifestyle Medicine Institute, Rochester, NY, United States
| | - Maria Dewhirst
- Rochester Lifestyle Medicine Institute, Rochester, NY, United States
| | - Ted D. Barnett
- Rochester Lifestyle Medicine Institute, Rochester, NY, United States
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Hargreaves SM, Rosenfeld DL, Moreira AVB, Zandonadi RP. Plant-based and vegetarian diets: an overview and definition of these dietary patterns. Eur J Nutr 2023; 62:1109-1121. [PMID: 36681744 DOI: 10.1007/s00394-023-03086-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 01/06/2023] [Indexed: 01/23/2023]
Abstract
PURPOSE This paper aims to present an overview of the definitions of "plant-based and "vegetarian diets" adopted by different organizations worldwide, proposing new standard definitions and discussing the notion of vegetarianism as a restrictive dietary pattern. METHODS An extensive literature review on the different definitions of vegetarian and plant-based diets was conducted. Definitions of different international vegetarian and vegan organizations were also taken into account. Objective definitions for vegetarian and plant-based diets, as well as for their subcategories, were proposed. Other aspects related to how vegetarian diets are viewed and defined were also discussed. RESULTS We proposed that a vegetarian diet should be defined as "a dietary pattern that excludes meat, meat-derived foods, and, to different extents, other animal products". This definition would include, among others, ovolactovegetarian and vegan diets. The proposed definition for a plant-based diet was "a dietary pattern in which foods of animal origin are totally or mostly excluded". Other types of diets, such as flexitarian and pescetarian diets, could be considered plant-based. A vegetarian diet should not be considered restrictive. Instead, terms such as alternative or non-conventional could be used to define it and to distinguish it from the conventional diet adopted by most of the Western population. CONCLUSION This paper was able to elaborate objective definitions of vegetarian and plant-based diets. Standardizing nomenclatures may reduce misinterpretation and confusion in this field of study.
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Affiliation(s)
- Shila Minari Hargreaves
- Department of Nutrition, Faculty of Health Sciences, University of Brasilia (UnB), Campus Darcy Ribeiro, Asa Norte, Brasilia, DF, 70910-900, Brazil
| | - Daniel L Rosenfeld
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Los Angeles, CA, 90095, USA
| | | | - Renata Puppin Zandonadi
- Department of Nutrition, Faculty of Health Sciences, University of Brasilia (UnB), Campus Darcy Ribeiro, Asa Norte, Brasilia, DF, 70910-900, Brazil.
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Xu Y, Mo G, Yao Y, Li C. The effects of vegetarian diets on glycemia and lipid parameters in adult patients with overweight and obesity: a systematic review and meta-analysis. Eur J Clin Nutr 2023:10.1038/s41430-023-01283-x. [PMID: 36964271 DOI: 10.1038/s41430-023-01283-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 03/26/2023]
Abstract
Several randomized controlled trials have reported the effects of vegetarian diets on blood lipids and glucose homeostasis in adults, but not in overweight or obese individuals. Thus, the purpose of this study was to evaluate the effects of vegetarian diets on blood lipids and glucose homeostasis in overweight or obese adults by systematic review and meta-analysis. We searched Medline, Embase, and the Cochrane Library through October 2021. We chose to include overweight or obese patients in the studies of the vegetarian diet for metabolic control. Seven trials with a total of 783 overweight or obese adult were included in the meta-analysis. The analysis of the data revealed that the vegetarian diets significantly reduced low-density lipoprotein cholesterol (LDL-C) (WMD, -0.31; 95% CI, -0.46 to -0.16), total cholesterol (TC) (WMD, -0.37; 95% CI, -0.52 to -0.22), and HbA1c (WMD (%), -0.33; 95% CI, -0.55 to -0.11). The vegetarian diets had an elevated effect on blood triglycerides (WMD, 0.29; 95% CI, 0.11-0.47). However, there were no significant effects of vegetarian diets on high-density lipoprotein cholesterol (HDLC), Fasting plasma glucose(FPG), and HOMA-IR in these individuals. The results of this study suggest that vegetarian diets effectively reduce LDL-C, TC, and HbA1c levels, thus functioning as a promising therapeutic strategy for improving the metabolic dysfunction in overweight or obese individuals. However, further large-scale clinical trials are required to confirm the validity of these findings.
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Affiliation(s)
- Yang Xu
- The First College for Clinical Medicine, Guangxi Medical University, Guangxi, China
| | - Guli Mo
- The First College for Clinical Medicine, Guangxi Medical University, Guangxi, China
| | - Yu Yao
- The First College for Clinical Medicine, Guangxi Medical University, Guangxi, China
| | - Chuan Li
- Department of Pediatrics, The Second Affiliated Hospital of Guangxi Medical University, Guangxi, China.
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Komarnytsky S, Wagner C, Gutierrez J, Shaw OM. Berries in Microbiome-Mediated Gastrointestinal, Metabolic, and Immune Health. Curr Nutr Rep 2023; 12:151-166. [PMID: 36738429 DOI: 10.1007/s13668-023-00449-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE OF REVIEW Current research has shown that berry-derived polymeric substrates that resist human digestion (dietary fibers and polyphenols) are extensively metabolized in the gastrointestinal tract dominated by microbiota. This review assesses current epidemiological, experimental, and clinical evidence of how berry (strawberry, blueberry, raspberry, blackberry, cranberry, black currant, and grapes) phytochemicals interact with the microbiome and shape health or metabolic risk factor outcomes. RECENT FINDINGS There is a growing evidence that the compositional differences among complex carbohydrate fractions and classes of polyphenols define reversible shifts in microbial populations and human metabolome to promote gastrointestinal health. Interventions to prevent gastrointestinal inflammation and improve metabolic outcomes may be achieved with selection of berries that provide distinct polysaccharide substrates for selective multiplication of beneficial microbiota or oligomeric decoys for binding and elimination of the pathogens, as well as phenolic substrates that hold potential to modulate gastrointestinal mucins, reduce luminal oxygen, and release small phenolic metabolites signatures capable of ameliorating inflammatory and metabolic perturbations. These mechanisms may explain many of the differences in microbiota and host gastrointestinal responses associated with increased consumption of berries, and highlight potential opportunities to intentionally shift gut microbiome profiles or to modulate risk factors associated with better nutrition and health outcomes.
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Affiliation(s)
- Slavko Komarnytsky
- Plants for Human Health Institute, North Carolina State University, 600 Laureate Way, Kannapolis, NC, 28081, USA.
- Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, 400 Dan Allen Drive, Raleigh, NC, 27695, USA.
| | - Charles Wagner
- Plants for Human Health Institute, North Carolina State University, 600 Laureate Way, Kannapolis, NC, 28081, USA
| | - Janelle Gutierrez
- Plants for Human Health Institute, North Carolina State University, 600 Laureate Way, Kannapolis, NC, 28081, USA
| | - Odette M Shaw
- Plant & Food Research, Private Bag 11600, Palmerston North, 4442, New Zealand
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Jaworsky K, DeVillez P, Basu A. The Role of Phytochemicals and Plant-Based Diets in Gestational Diabetes: Evidence from Clinical Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4188. [PMID: 36901197 PMCID: PMC10001985 DOI: 10.3390/ijerph20054188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
Gestational diabetes mellitus (GDM) is defined as glucose intolerance identified during pregnancy. The increased risk of pregnancy complications and the adverse health effects for the mother and baby associated with GDM require urgent and effective ways to control the condition. The primary goal of this semi-quantitative review was to examine the effects of phytochemicals and plant-based diets on GDM in clinical studies involving women undergoing pregnancy and to summarize the findings for application in clinical practice and disease management. The articles included in this review show that intervention strategies, including fruits, vegetables, whole grains, nuts and seeds, and tea, may be beneficial in the management of GDM and lower blood glucose and improve adverse pregnancy outcomes in these women. The randomized controlled trials reviewed collectively show improved glycemic control markers, blood lipid values, and body weight and composition when supplemented with phytochemical-rich supplements and foods compared to those in the control groups. The findings support the clinical observations of lower GDM risks in women consuming plant-derived diets rich in phytochemicals. Nutrition interventions involving plant-based foods and diets are thus a practical way to reduce hyperglycemia both in patients diagnosed with GDM and those at high risk for the development of GDM.
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Affiliation(s)
- Kataryna Jaworsky
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA
- Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89154, USA
| | - Pamela DeVillez
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA
| | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA
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Jafri SH, Ngamdu KS, Price D, Baloch ZQ, Cohn J, Wilcox M, Freeman AM, Ornish D, Wu WC. Intensive Cardiac Rehabilitation Attenuates the Gender Gap in Cardiac Rehabilitation Participation. Curr Probl Cardiol 2023; 48:101668. [PMID: 36828042 DOI: 10.1016/j.cpcardiol.2023.101668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023]
Abstract
INTRODUCTION Traditional cardiac rehabilitation programs historically have had considerable gender gaps in cardiac rehabilitation (CR) outcomes. Intensive-Cardiac-Rehabilitation (ICR) has non-exercise components such as stress management, peer support and diet modification, in addition to exercise, which may reduce barriers to CR completion. However, there is a paucity of data in ICR outcomes based on gender. METHODS We conducted a nationwide retrospective cohort study of 15,613 patients enrolled in 46 Ornish-ICR programs across the US from January 2016 - December 2020 and compared ICR physical and psychological outcomes in women versus men. Primary endpoints were depression scores (CESD), health status (SF-36 physical and mental composite-scores) and exercise minutes per week. RESULTS Of 15,613 ICR participants who participated in the program, 6788 (44%) were women. ICR completion rates were 64.7% overall and nearly equal between men and women (63.3% women vs 65.9% men). There were a few small differences in outcomes after ICR completion: women had slightly more improvement in depression scores (women: -6.10 ± 8.79, 49.6% reduction vs. men: -4.92 ± 7.80, 46.4% reduction; P<0.01) and SF-36 physical (women: 5.95±6.86 vs men: 5.28±6.71, P<0.01) and SF-36 mental (women: 5.76±8.11 vs men: 4.60±7.33, P<0.01) composite scores than men. There was no significant difference in exercise-minutes per week between the two groups. CONCLUSIONS ICR attenuates the gender gap in cardiac rehabilitation completion. Further, of the completers, women achieved slightly higher depression and quality-of-life improvements compared to men. As such, ICR can be a good option to reduce gender-based differences in CR participation.
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Affiliation(s)
- S Hammad Jafri
- Advanced Heart Failure and Transplant Cardiology, Indiana University, Indianapolis, IN; Providence Veterans Affairs Medical Center, Providence, RI; Alpert Medical School, Brown University, Providence, RI.
| | - Kyari Sumayin Ngamdu
- Providence Veterans Affairs Medical Center, Providence, RI; Alpert Medical School, Brown University, Providence, RI
| | - Dana Price
- Providence Veterans Affairs Medical Center, Providence, RI; Alpert Medical School, Brown University, Providence, RI
| | | | - Joel Cohn
- Michigan State University, Lansing, MI
| | | | - Andrew M Freeman
- Division of Cardiology, Department of Medicine, National Jewish Health, Denver, CO
| | - Dean Ornish
- Preventive Medicine Research Institute and University of California, San Francisco, CA
| | - Wen-Chih Wu
- Providence Veterans Affairs Medical Center, Providence, RI; Alpert Medical School, Brown University, Providence, RI.
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48
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The Effect of a Vegan Diet on the Cardiovascular System. J Cardiovasc Dev Dis 2023; 10:jcdd10030094. [PMID: 36975858 PMCID: PMC10052889 DOI: 10.3390/jcdd10030094] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 02/25/2023] Open
Abstract
The vegan diet, often known as a plant-rich diet, consists primarily of plant-based meals. This dietary approach may be beneficial to one’s health and the environment and is valuable to the immune system. Plants provide vitamins, minerals, phytochemicals, and antioxidants, components that promote cell survival and immune function, allowing its defensive mechanisms to work effectively. The term “vegan diet” comprises a range of eating patterns that prioritize nutrient-rich foods such as fruits and vegetables, legumes, whole grains, nuts, and seeds. In comparison to omnivorous diets, which are often lower in such products, the vegan diet has been favorably connected with changes in cardiovascular disease (CVD) risk markers such as reduced body mass index (BMI) values, total serum cholesterol, serum glucose, inflammation, and blood pressure. Reduced intake of low-density lipoprotein (LDL), saturated fat, processed meat, and greater consumption of fiber and phytonutrients may improve cardiovascular health. However, vegans have much smaller amounts of nutrients such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), selenium, zinc, iodine, and vitamin B12, compared to non-vegans, which may lead to detrimental cardiovascular effects. This review aims to present the effect of plant-based diets (PBDs), specifically vegan diets, on the cardiovascular system.
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49
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Salehin S, Rasmussen P, Mai S, Mushtaq M, Agarwal M, Hasan SM, Salehin S, Raja M, Gilani S, Khalife WI. Plant Based Diet and Its Effect on Cardiovascular Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3337. [PMID: 36834032 PMCID: PMC9963093 DOI: 10.3390/ijerph20043337] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/13/2023] [Accepted: 01/28/2023] [Indexed: 06/12/2023]
Abstract
Cardiovascular disease remains the leading cause of death globally and here in the United States. Diet has a major impact on the pathogenesis of atherosclerosis and subsequent cardiovascular morbidity and mortality. An unhealthy diet is the most significant potential behavioral and modifiable risk factor for ischemic heart disease. Despite these established facts, dietary interventions are far less frequent than pharmaceutical and procedural interventions in the management of cardiovascular disease. The beneficial effects of a plant-based diet on cardiovascular morbidity and mortality have been demonstrated in a number of recent clinical studies. The significant findings of each study are discussed in this review article, highlighting the role of a healthy plant-based diet in improving cardiovascular outcomes. From a clinician's standpoint, the knowledge and understanding of the facts and data points from these recent clinical studies would ensure more effective patient counseling on the substantial benefits of dietary interventions.
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Affiliation(s)
- Salman Salehin
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Peter Rasmussen
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Steven Mai
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Muhammad Mushtaq
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Mayank Agarwal
- Department of Cardiology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Syed Mustajab Hasan
- Department of Cardiology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Shahran Salehin
- School of Medicine, Holy Family Red Crescent Medical College Hospital, Dhaka 1000, Bangladesh
| | - Muhammad Raja
- Department of Cardiology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Syed Gilani
- Department of Cardiology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Wissam I. Khalife
- Department of Cardiology, University of Texas Medical Branch, Galveston, TX 77555, USA
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50
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Slonecki TJ, Rutter WB, Olukolu BA, Yencho GC, Jackson DM, Wadl PA. Genetic diversity, population structure, and selection of breeder germplasm subsets from the USDA sweetpotato ( Ipomoea batatas) collection. FRONTIERS IN PLANT SCIENCE 2023; 13:1022555. [PMID: 36816486 PMCID: PMC9932972 DOI: 10.3389/fpls.2022.1022555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/28/2022] [Indexed: 06/18/2023]
Abstract
Sweetpotato (Ipomoea batatas) is the sixth most important food crop and plays a critical role in maintaining food security worldwide. Support for sweetpotato improvement research in breeding and genetics programs, and maintenance of sweetpotato germplasm collections is essential for preserving food security for future generations. Germplasm collections seek to preserve phenotypic and genotypic diversity through accession characterization. However, due to its genetic complexity, high heterogeneity, polyploid genome, phenotypic plasticity, and high flower production variability, sweetpotato genetic characterization is challenging. Here, we characterize the genetic diversity and population structure of 604 accessions from the sweetpotato germplasm collection maintained by the United States Department of Agriculture (USDA), Agricultural Research Service (ARS), Plant Genetic Resources Conservation Unit (PGRCU) in Griffin, Georgia, United States. Using the genotyping-by-sequencing platform (GBSpoly) and bioinformatic pipelines (ngsComposer and GBSapp), a total of 102,870 polymorphic SNPs with hexaploid dosage calls were identified from the 604 accessions. Discriminant analysis of principal components (DAPC) and Bayesian clustering identified six unique genetic groupings across seven broad geographic regions. Genetic diversity analyses using the hexaploid data set revealed ample genetic diversity among the analyzed collection in concordance with previous analyses. Following population structure and diversity analyses, breeder germplasm subsets of 24, 48, 96, and 384 accessions were established using K-means clustering with manual selection to maintain phenotypic and genotypic diversity. The genetic characterization of the PGRCU sweetpotato germplasm collection and breeder germplasm subsets developed in this study provide the foundation for future association studies and serve as precursors toward phenotyping studies aimed at linking genotype with phenotype.
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Affiliation(s)
- Tyler J. Slonecki
- United States Vegetable Laboratory, Agricultural Research Service, United States Department of Agriculture, Charleston, SC, United States
| | - William B. Rutter
- United States Vegetable Laboratory, Agricultural Research Service, United States Department of Agriculture, Charleston, SC, United States
| | - Bode A. Olukolu
- Department of Entomology and Plant Pathology, University of Tennessee, Knoxville, TN, United States
| | - G. Craig Yencho
- Department of Horticultural Science, North Carolina State University, Raleigh, NC, United States
| | - D. Michael Jackson
- United States Vegetable Laboratory, Agricultural Research Service, United States Department of Agriculture, Charleston, SC, United States
| | - Phillip A. Wadl
- United States Vegetable Laboratory, Agricultural Research Service, United States Department of Agriculture, Charleston, SC, United States
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