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Njike VY, Kela GCM, Treu JA, Ayettey RG, Kussaga FM, Khan N, Comerford B, Agboola O. Egg Consumption in the Context of Plant-Based Diets and Diet Quality in Adults at Risk for Type 2 Diabetes: A Randomized Single Blind Cross-over Controlled Trial. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2023; 42:130-139. [PMID: 35512755 DOI: 10.1080/07315724.2021.2006824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Lifestyle changes that emphasis on plant-based diets (PBD) are typically recommended for those at risk for type 2 diabetes mellitus (T2DM) to mitigate their cardo-metabolic risk. We examined the impact of the inclusion of eggs compared with their exclusion from PBD on diet quality among adults at risk for T2DM. This was a randomized, controlled, single-blind, crossover trial of 35 adults (mean age 60.7 years; 25 women, 10 men; 34 Caucasians, 1 African-American) at risk for T2DM (i.e., pre- diabetes or metabolic syndrome) assigned to one of two possible sequence permutations of two treatments (PBD with eggs and exclusively PBD), with a 4-week washout period. Participants received dietary counseling from a dietitian to exclude or to include 2 eggs daily in the context of PBD for a 6-week period. Diet quality was assessed using the Healthy Eating Index 2015 (HEI-2015) at baseline and 6 weeks. Compared with the exclusion of eggs, the inclusion of eggs in the context of PBD improved the diet quality score for intake of total protein foods (1.0 ± 1.1 vs. -0.4 ± 1.0; p <.0001); seafood and plant proteins (0.2 ± 1.2 vs. -0.4 ± 1.1; p = 0.0338); and fatty acids (0.8 ± 2.5 vs. -0.7 ± 2.7; p = 0.0260). Overall diet quality score depreciated with the adoption of exclusively PBD without eggs (-3.1 ± 8.3; p = 0.0411), while it was unaffected with the adoption of a PBD with the inclusion of eggs (-0.6 ± 7.9; p = 0.6892). Eggs could be used as an adjuvant to enhance the diet quality among those at risk for T2DM who adopt plant-based dietary patterns.
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Affiliation(s)
- Valentine Y Njike
- Yale-Griffin Prevention Research Center, Griffin Hospital, Derby, CT, USA
| | | | - Judith A Treu
- Yale-Griffin Prevention Research Center, Griffin Hospital, Derby, CT, USA
| | - Rockiy G Ayettey
- Yale-Griffin Prevention Research Center, Griffin Hospital, Derby, CT, USA
| | | | - Nisar Khan
- Yale-Griffin Prevention Research Center, Griffin Hospital, Derby, CT, USA
| | - Beth Comerford
- Yale-Griffin Prevention Research Center, Griffin Hospital, Derby, CT, USA
| | - Olayinka Agboola
- Yale-Griffin Prevention Research Center, Griffin Hospital, Derby, CT, USA
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Cheng J, Liang HW, Klem ML, Costacou T, Burke LE. Healthy Eating Index Diet Quality in Randomized Weight Loss Trials: A Systematic Review. J Acad Nutr Diet 2023; 123:117-143. [PMID: 35963533 PMCID: PMC10624127 DOI: 10.1016/j.jand.2022.08.114] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Weight loss interventions focus on dietary and physical activity changes to induce weight loss. Both through weight loss and independent of it, diet quality is important for reducing chronic disease risk. However, whether and how diet quality changes over the course of a behavioral intervention is unclear. OBJECTIVE To systematically review the evidence from randomized controlled trials on the effect of behavioral interventions on diet quality as defined by the Healthy Eating Index (HEI) among adults with overweight and obesity. METHODS PubMed, Ebscohost CINAHL, Embase, OVID APA PsycInfo, Scopus, and Web of Science were searched through May 2021. Inclusion criteria comprised randomized controlled trial design, a primary or secondary aim of weight loss, a sample of US adults with overweight or obesity, measurement using the HEI-2005, 2010, or 2015, and assessment of the time by treatment effect. Interventions must have included behavioral components and lasted at least 3 months. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. The systematic review protocol was published on Open Science Framework. RESULTS Of 3,707 citations retrieved, 18 studies met inclusion criteria. A wide array of behavioral interventions were assessed, including in-person and mobile health interventions as well as those prescribing intake of specific foods. Risk of bias in the included studies primarily arose from the measurement of the outcome variable. Sample sizes ranged from 34 to 413 participants. Nine studies used multiple dietary recalls, with few using the recommended method of Healthy Eating Index calculation. Changes in diet quality ranged from no improvement to a 20-point improvement. More often, improvement was in the 4- to 7-point range. CONCLUSIONS The evidence for the efficacy of behavioral weight loss interventions for improving diet quality among adults with overweight and obesity is limited. Modest improvements in HEI scores were observed in the reviewed studies.
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Affiliation(s)
- Jessica Cheng
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA
| | - Hai-Wei Liang
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA
| | - Mary Lou Klem
- Health Sciences Library System, University of Pittsburgh, PA
| | - Tina Costacou
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA
| | - Lora E Burke
- Department of Health and Community Systems, School of Nursing, University of Pittsburgh, PA.
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Sanz-González SM, García-Medina JJ, Zanón-Moreno V, López-Gálvez MI, Galarreta-Mira D, Duarte L, Valero-Velló M, Ramírez AI, Arévalo JF, Pinazo-Durán MD. Clinical and Molecular-Genetic Insights into the Role of Oxidative Stress in Diabetic Retinopathy: Antioxidant Strategies and Future Avenues. Antioxidants (Basel) 2020; 9:E1101. [PMID: 33182408 PMCID: PMC7697026 DOI: 10.3390/antiox9111101] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 10/29/2020] [Accepted: 11/03/2020] [Indexed: 12/17/2022] Open
Abstract
Reactive oxygen species (ROS) overproduction and ROS-signaling pathways activation attack the eyes. We evaluated the oxidative stress (OS) and the effects of a daily, core nutritional supplement regimen containing antioxidants and omega 3 fatty acids (A/ω3) in type 2 diabetics (T2DM). A case-control study was carried out in 480 participants [287 T2DM patients with (+)/without (-) diabetic retinopathy (DR) and 193 healthy controls (CG)], randomly assigned to a daily pill of A/ω3. Periodic evaluation through 38 months allowed to outline patient characteristics, DR features, and classic/OS blood parameters. Statistics were performed by the SPSS 24.0 program. Diabetics displayed significantly higher circulating pro-oxidants (p = 0.001) and lower antioxidants (p = 0.0001) than the controls. Significantly higher plasma malondialdehyde/thiobarbituric acid reactive substances (MDA/TBARS; p = 0.006) and lower plasma total antioxidant capacity (TAC; p = 0.042) and vitamin C (0.020) was found in T2DM + DR versus T2DM-DR. The differential expression profile of solute carrier family 23 member 2 (SLC23A2) gene was seen in diabetics versus the CG (p = 0.001), and in T2DM + DR versus T2DM - DR (p < 0.05). The A/ω3 regime significantly reduced the pro-oxidants (p < 0.05) and augmented the antioxidants (p < 0.05). This follow-up study supports that a regular A/ω3 supplementation reduces the oxidative load and may serve as a dietary prophylaxis/adjunctive intervention for patients at risk of diabetic blindness.
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Affiliation(s)
- Silvia M. Sanz-González
- Ophthalmic Research Unit “Santiago Grisolía”, Fundación Investigación Sanitaria y Biomédica (FISABIO), Ave. Gaspar Aguilar 90, 46017 Valencia, Spain; (S.M.S.-G.); (J.J.G.-M.); (V.Z.-M.); (M.V.-V.); (M.D.P.-D.)
- Cellular and Molecular Ophthalmo-Biology Group, University of Valencia, Ave. Blasco Ibañez 15, 46010 Valencia, Spain
- Spanish Net of Ophthalmic Research “OFTARED” RD16/0008/0022, of the Institute of Health Carlos III, 28029 Madrid, Spain; (M.I.L.-G.); (D.G.-M.)
| | - José J. García-Medina
- Ophthalmic Research Unit “Santiago Grisolía”, Fundación Investigación Sanitaria y Biomédica (FISABIO), Ave. Gaspar Aguilar 90, 46017 Valencia, Spain; (S.M.S.-G.); (J.J.G.-M.); (V.Z.-M.); (M.V.-V.); (M.D.P.-D.)
- Cellular and Molecular Ophthalmo-Biology Group, University of Valencia, Ave. Blasco Ibañez 15, 46010 Valencia, Spain
- Spanish Net of Ophthalmic Research “OFTARED” RD16/0008/0022, of the Institute of Health Carlos III, 28029 Madrid, Spain; (M.I.L.-G.); (D.G.-M.)
- Department of Ophthalmology, General University Hospital Morales Meseguer, Ave. Marques de los Velez, s/n 30008 Murcia, Spain
- Department of Ophthalmology and Optometry, University of Murcia, Edificio LAIB Planta 5ª, Carretera Buenavista s/n, 30120 El Palmar Murcia, Spain
| | - Vicente Zanón-Moreno
- Ophthalmic Research Unit “Santiago Grisolía”, Fundación Investigación Sanitaria y Biomédica (FISABIO), Ave. Gaspar Aguilar 90, 46017 Valencia, Spain; (S.M.S.-G.); (J.J.G.-M.); (V.Z.-M.); (M.V.-V.); (M.D.P.-D.)
- Cellular and Molecular Ophthalmo-Biology Group, University of Valencia, Ave. Blasco Ibañez 15, 46010 Valencia, Spain
- Spanish Net of Ophthalmic Research “OFTARED” RD16/0008/0022, of the Institute of Health Carlos III, 28029 Madrid, Spain; (M.I.L.-G.); (D.G.-M.)
- Area of Health, Valencian International University, Calle Pintor Sorolla 21, 46002 Valencia, Spain
| | - María I. López-Gálvez
- Spanish Net of Ophthalmic Research “OFTARED” RD16/0008/0022, of the Institute of Health Carlos III, 28029 Madrid, Spain; (M.I.L.-G.); (D.G.-M.)
- Department of Ophthalmology, The University Clinic Hospital, Ave. Ramón y Cajal 3, 47003 Valladolid, Spain
| | - David Galarreta-Mira
- Spanish Net of Ophthalmic Research “OFTARED” RD16/0008/0022, of the Institute of Health Carlos III, 28029 Madrid, Spain; (M.I.L.-G.); (D.G.-M.)
- Department of Ophthalmology, The University Clinic Hospital, Ave. Ramón y Cajal 3, 47003 Valladolid, Spain
| | - Lilianne Duarte
- Department of Ophthalmology, Complexo Hospitalar “Entre Douro e Vouga”, 4520-211 Santa Maria da Feira, Portugal;
| | - Mar Valero-Velló
- Ophthalmic Research Unit “Santiago Grisolía”, Fundación Investigación Sanitaria y Biomédica (FISABIO), Ave. Gaspar Aguilar 90, 46017 Valencia, Spain; (S.M.S.-G.); (J.J.G.-M.); (V.Z.-M.); (M.V.-V.); (M.D.P.-D.)
| | - Ana I. Ramírez
- Spanish Net of Ophthalmic Research “OFTARED” RD16/0008/0022, of the Institute of Health Carlos III, 28029 Madrid, Spain; (M.I.L.-G.); (D.G.-M.)
- Department of Immunology, Ophthalmology and Otorrinolaringology, Faculty of Optics and Optometry, Universidad Complutense, Calle Arcos de Jalón 118, 28037 Madrid, Spain
- Instituto de Investigaciones Oftalmológicas “Ramón Castroviejo”, Faculty of Medicine, Universidad Complutense, Plaza Ramón y Cajal, s/n 28040 Madrid, Spain
| | - J. Fernando Arévalo
- Wilmer s Eye Institute at the Johns Hopkins Hospital, Baltimore, MD 21287, USA;
| | - María D. Pinazo-Durán
- Ophthalmic Research Unit “Santiago Grisolía”, Fundación Investigación Sanitaria y Biomédica (FISABIO), Ave. Gaspar Aguilar 90, 46017 Valencia, Spain; (S.M.S.-G.); (J.J.G.-M.); (V.Z.-M.); (M.V.-V.); (M.D.P.-D.)
- Cellular and Molecular Ophthalmo-Biology Group, University of Valencia, Ave. Blasco Ibañez 15, 46010 Valencia, Spain
- Spanish Net of Ophthalmic Research “OFTARED” RD16/0008/0022, of the Institute of Health Carlos III, 28029 Madrid, Spain; (M.I.L.-G.); (D.G.-M.)
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