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Volek JS, Kackley ML, Buga A. Nutritional Considerations During Major Weight Loss Therapy: Focus on Optimal Protein and a Low-Carbohydrate Dietary Pattern. Curr Nutr Rep 2024:10.1007/s13668-024-00548-6. [PMID: 38814519 DOI: 10.1007/s13668-024-00548-6] [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: 05/01/2024] [Indexed: 05/31/2024]
Abstract
PURPOSE OF REVIEW Considering the high prevalence of obesity and related metabolic impairments in the population, the unique role nutrition has in weight loss, reversing metabolic disorders, and maintaining health cannot be overstated. Normal weight and well-being are compatible with varying dietary patterns, but for the last half century there has been a strong emphasis on low-fat, low-saturated fat, high-carbohydrate based approaches. Whereas low-fat dietary patterns can be effective for a subset of individuals, we now have a population where the vast majority of adults have excess adiposity and some degree of metabolic impairment. We are also entering a new era with greater access to bariatric surgery and approval of anti-obesity medications (glucagon-like peptide-1 analogues) that produce substantial weight loss for many people, but there are concerns about disproportionate loss of lean mass and nutritional deficiencies. RECENT FINDINGS No matter the approach used to achieve major weight loss, careful attention to nutritional considerations is necessary. Here, we examine the recent findings regarding the importance of adequate protein to maintain lean mass, the rationale and evidence supporting low-carbohydrate and ketogenic dietary patterns, and the potential benefits of including exercise training in the context of major weight loss. While losing and sustaining weight loss has proven challenging, we are optimistic that application of emerging nutrition science, particularly personalized well-formulated low-carbohydrate dietary patterns that contain adequate protein (1.2 to 2.0 g per kilogram reference weight) and achieve the beneficial metabolic state of euketonemia (circulating ketones 0.5 to 5 mM), is a promising path for many individuals with excess adiposity.
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Affiliation(s)
- Jeff S Volek
- Department of Human Sciences, The Ohio State University, 305 Annie & John Glenn Ave, Columbus, OH, 43210, USA.
| | - Madison L Kackley
- Department of Human Sciences, The Ohio State University, 305 Annie & John Glenn Ave, Columbus, OH, 43210, USA
| | - Alex Buga
- Department of Human Sciences, The Ohio State University, 305 Annie & John Glenn Ave, Columbus, OH, 43210, USA
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Simoes EJ, Ramos LR. The Role of Healthy Diet and Lifestyle in Centenarians. Nutrients 2023; 15:4293. [PMID: 37836577 PMCID: PMC10574171 DOI: 10.3390/nu15194293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
Life expectancy at birth (hereafter, life expectancy) and longevity are established indicators of population health [...].
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Affiliation(s)
- Eduardo J. Simoes
- Department of Biomedical Informatics, Biostatistics and Medical Epidemiology, School of Medicine, University of Missouri, Columbia, MO 65212, USA
| | - Luiz R. Ramos
- Department of Preventive Medicine, Federal University of Sao Paulo, São Paulo 04024-002, Brazil;
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Nelson LM, Spencer H, Hijane K, Thinuan P, Nelson CW, Vincent AJ, Gordon CM, Plant TM, Fazeli PK. My 28 Days - a global digital women's health initiative for evaluation and management of secondary amenorrhea: case report and literature review. Front Endocrinol (Lausanne) 2023; 14:1227253. [PMID: 37772077 PMCID: PMC10523024 DOI: 10.3389/fendo.2023.1227253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/18/2023] [Indexed: 09/30/2023] Open
Abstract
There is a need to close the gap between knowledge and action in health care. Effective care requires a convenient and reliable distribution process. As global internet and mobile communication increase capacity, innovative approaches to digital health education platforms and care delivery are feasible. We report the case of a young African woman who developed acute secondary amenorrhea at age 18. Subsequently, she experienced a 10-year delay in the diagnosis of the underlying cause. A global digital medical hub focused on women's health and secondary amenorrhea could reduce the chance of such mismanagement. Such a hub would establish more efficient information integration and exchange processes to better serve patients, family caregivers, health care providers, and investigators. Here, we show proof of concept for a global digital medical hub for women's health. First, we describe the physiological control systems that govern the normal menstrual cycle, and review the pathophysiology and management of secondary amenorrhea. The symptom may lead to broad and profound health implications for the patient and extended family members. In specific situations, there may be significant morbidity related to estradiol deficiency: (1) reduced bone mineral density, 2) cardiovascular disease, and 3) cognitive decline. Using primary ovarian insufficiency (POI) as the paradigm condition, the Mary Elizabeth Conover Foundation has been able to address the specific global educational needs of these women. The Foundation did this by creating a professionally managed Facebook group specifically for these women. POI most commonly presents with secondary amenorrhea. Here we demonstrate the feasibility of conducting a natural history study on secondary amenorrhea with international reach to be coordinated by a global digital medical hub. Such an approach takes full advantage of internet and mobile device communication systems. We refer to this global digital women's health initiative as My 28 Days®.
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Affiliation(s)
- Lawrence M. Nelson
- Digital Women's Health Initiative, Mary Elizabeth Conover Foundation, Tysons, VA, United States
| | - Hillary Spencer
- Digital Women's Health Initiative, Mary Elizabeth Conover Foundation, Tysons, VA, United States
| | - Karima Hijane
- Digital Women's Health Initiative, Mary Elizabeth Conover Foundation, Tysons, VA, United States
| | - Payom Thinuan
- Faculty of Nursing, Boromarajonani College of Nursing Nakhon, Lampang, Thailand
| | - Chaninan W. Nelson
- Digital Women's Health Initiative, Mary Elizabeth Conover Foundation, Tysons, VA, United States
| | - Amanda J. Vincent
- Monash Centre for Health Research and Implementation (MCHRI), Monash University, Clayton, VIC, Australia
| | - Catherine M. Gordon
- Endocrinology and Metabolism, Baylor College of Medicine, Houston, TX, United States
| | - Tony M. Plant
- Endocrinology and Metabolism, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Pouneh K. Fazeli
- Endocrinology and Metabolism, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
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Diamond DM, Leaverton PE. Historical Review of the Use of Relative Risk Statistics in the Portrayal of the Purported Hazards of High LDL Cholesterol and the Benefits of Lipid-Lowering Therapy. Cureus 2023; 15:e38391. [PMID: 37143855 PMCID: PMC10153768 DOI: 10.7759/cureus.38391] [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] [Accepted: 04/30/2023] [Indexed: 05/06/2023] Open
Abstract
The manner in which clinical trial investigators present their findings to healthcare providers and the public can have a substantial influence on their impact. For example, if a heart attack occurs in 2% of those in the placebo group and in 1% of those in the drug-treated group, the benefit to the treated population is only one percentage point better than no treatment. This finding is unlikely to generate much enthusiasm from the study sponsors and in the reporting of the findings to the public. Instead, trial directors can amplify the magnitude of the appearance of the treatment benefit by using the relative risk (RR) value of a 50% reduction of the risk of a heart attack, since one is 50% of two. By using the RR type of data analysis, clinical trial directors can promote the outcome of their trial in their publication and to the media as highly successful while minimizing or disregarding entirely the absolute risk (AR) reduction of only one percentage point. The practice of expressing the RR without the AR has become routinely deployed in the reporting of findings in many different areas of clinical research. We have provided a historical perspective on how this form of data presentation has become commonplace in the reporting of findings from randomized controlled trials (RCTs) on coronary heart disease (CHD) event monitoring and prevention over the past four decades. We assert that the emphasis on RR coupled with insufficient disclosure of AR in the reporting of RCT outcomes has led healthcare providers and the public to overestimate concerns about high cholesterol and to be misled as to the magnitude of the benefits of cholesterol-lowering therapy. The goal of this review is to prompt the scientific community to address this misleading approach to data presentation.
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Affiliation(s)
| | - Paul E Leaverton
- Epidemiology and Biostatistics, University of South Florida, Tampa, USA
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Wang W, Liu Y, Li Y, Luo B, Lin Z, Chen K, Liu Y. Dietary patterns and cardiometabolic health: Clinical evidence and mechanism. MedComm (Beijing) 2023; 4:e212. [PMID: 36776765 PMCID: PMC9899878 DOI: 10.1002/mco2.212] [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: 11/03/2022] [Revised: 12/31/2022] [Accepted: 01/11/2023] [Indexed: 02/08/2023] Open
Abstract
For centuries, the search for nutritional interventions to underpin cardiovascular treatment and prevention guidelines has contributed to the rapid development of the field of dietary patterns and cardiometabolic disease (CMD). Numerous studies have demonstrated that healthy dietary patterns with emphasis on food-based recommendations are the gold standard for extending lifespan and reducing the risks of CMD and mortality. Healthy dietary patterns include various permutations of energy restriction, macronutrients, and food intake patterns such as calorie restriction, intermittent fasting, Mediterranean diet, plant-based diets, etc. Early implementation of healthy dietary patterns in patients with CMD is encouraged, but an understanding of the mechanisms by which these patterns trigger cardiometabolic benefits remains incomplete. Hence, this review examined several dietary patterns that may improve cardiometabolic health, including restrictive dietary patterns, regional dietary patterns, and diets based on controlled macronutrients and food groups, summarizing cutting-edge evidence and potential mechanisms for CMD prevention and treatment. Particularly, considering individual differences in responses to dietary composition and nutritional changes in organ tissue diversity, we highlighted the critical role of individual gut microbiota in the crosstalk between diet and CMD and recommend a more precise and dynamic nutritional strategy for CMD by developing dietary patterns based on individual gut microbiota profiles.
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Affiliation(s)
- Wenting Wang
- National Clinical Research Centre for Chinese Medicine Cardiology Xiyuan Hospital China Academy of Chinese Medical Sciences Beijing China
| | - Yanfei Liu
- National Clinical Research Centre for Chinese Medicine Cardiology Xiyuan Hospital China Academy of Chinese Medical Sciences Beijing China
| | - Yiwen Li
- National Clinical Research Centre for Chinese Medicine Cardiology Xiyuan Hospital China Academy of Chinese Medical Sciences Beijing China
| | - Binyu Luo
- National Clinical Research Centre for Chinese Medicine Cardiology Xiyuan Hospital China Academy of Chinese Medical Sciences Beijing China
| | - Zhixiu Lin
- Faculty of Medicine The Chinese University of Hong Kong Hong Kong
| | - Keji Chen
- National Clinical Research Centre for Chinese Medicine Cardiology Xiyuan Hospital China Academy of Chinese Medical Sciences Beijing China
| | - Yue Liu
- National Clinical Research Centre for Chinese Medicine Cardiology Xiyuan Hospital China Academy of Chinese Medical Sciences Beijing China
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Heart Failure in Menopause: Treatment and New Approaches. Int J Mol Sci 2022; 23:ijms232315140. [PMID: 36499467 PMCID: PMC9735523 DOI: 10.3390/ijms232315140] [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: 10/25/2022] [Revised: 11/15/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022] Open
Abstract
Aging is an important risk factor for the development of heart failure (HF) and half of patients with HF have preserved ejection fraction (HFpEF) which is more common in elderly women. In general, sex differences that lead to discrepancies in risk factors and to the development of cardiovascular disease (CVD) have been attributed to the reduced level of circulating estrogen during menopause. Estrogen receptors adaptively modulate fibrotic, apoptotic, inflammatory processes and calcium homeostasis, factors that are directly involved in the HFpEF. Therefore, during menopause, estrogen depletion reduces the cardioprotection. Preclinical menopause models demonstrated that several signaling pathways and organ systems are closely involved in the development of HFpEF, including dysregulation of the renin-angiotensin system (RAS), chronic inflammatory process and alteration in the sympathetic nervous system. Thus, this review explores thealterations observed in the condition of HFpEF induced by menopause and the therapeutic targets with potential to interfere with the disease progress.
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Diamond DM, Bikman BT, Mason P. Statin therapy is not warranted for a person with high LDL-cholesterol on a low-carbohydrate diet. Curr Opin Endocrinol Diabetes Obes 2022; 29:497-511. [PMID: 35938780 DOI: 10.1097/med.0000000000000764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Although there is an extensive literature on the efficacy of the low carbohydrate diet (LCD) for weight loss and in the management of type 2 diabetes, concerns have been raised that the LCD may increase cardiovascular disease (CVD) risk by increasing the level of low-density lipoprotein cholesterol (LDL-C). We have assessed the value of LDL-C as a CVD risk factor, as well as effects of the LCD on other CVD risk factors. We have also reviewed findings that provide guidance as to whether statin therapy would be beneficial for individuals with high LDL-C on an LCD. RECENT FINDINGS Multiple longitudinal trials have demonstrated the safety and effectiveness of the LCD, while also providing evidence of improvements in the most reliable CVD risk factors. Recent findings have also confirmed how ineffective LDL-C is in predicting CVD risk. SUMMARY Extensive research has demonstrated the efficacy of the LCD to improve the most robust CVD risk factors, such as hyperglycemia, hypertension, and atherogenic dyslipidemia. Our review of the literature indicates that statin therapy for both primary and secondary prevention of CVD is not warranted for individuals on an LCD with elevated LDL-C who have achieved a low triglyceride/HDL ratio.
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Affiliation(s)
- David M Diamond
- Department of Psychology, University of South Florida, Tampa, Florida
| | - Benjamin T Bikman
- Department of Cell Biology and Physiology, Brigham Young University, Provo, Utah, USA
| | - Paul Mason
- Concord Orthosports, Concord, New South Wales, Australia
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Bays HE, Golden A, Tondt J. Thirty Obesity Myths, Misunderstandings, and/or Oversimplifications: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022. OBESITY PILLARS (ONLINE) 2022; 3:100034. [PMID: 37990730 PMCID: PMC10661978 DOI: 10.1016/j.obpill.2022.100034] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 08/03/2022] [Indexed: 11/23/2023]
Abstract
Background This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) is intended to provide clinicians an overview of 30 common obesity myths, misunderstandings, and/or oversimplifications. Methods The scientific support for this CPS is based upon published citations, clinical perspectives of OMA authors, and peer review by the Obesity Medicine Association leadership. Results This CPS discusses 30 common obesity myths, misunderstandings, and/or oversimplifications, utilizing referenced scientific publications such as the integrative use of other published OMA CPSs to help explain the applicable physiology/pathophysiology. Conclusions This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) on 30 common obesity myths, misunderstandings, and/or oversimplifications is one of a series of OMA CPSs designed to assist clinicians in the care of patients with the disease of obesity. Knowledge of the underlying science may assist the obesity medicine clinician improve the care of patients with obesity.
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Affiliation(s)
- Harold Edward Bays
- Louisville Metabolic and Atherosclerosis Research Center, University of Louisville School of Medicine, 3288, Illinois Avenue, Louisville, KY, 40213, USA
| | - Angela Golden
- NP Obesity Treatment Clinic, Flagstaff, AZ, 86001, USA
| | - Justin Tondt
- Department of Family and Community Medicine, Penn State Health, Penn State College of Medicine, 700 HMC Crescent Rd Hershey, PA, 17033, USA
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Gopalam R, Manasa V, Vaishnav SR, Daga P, Tumaney AW. Profiling of Lipids, Nutraceuticals, and Bioactive Compounds Extracted from an Oilseed Rich in PUFA. PLANT FOODS FOR HUMAN NUTRITION (DORDRECHT, NETHERLANDS) 2022; 77:98-104. [PMID: 35088213 DOI: 10.1007/s11130-021-00945-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 06/14/2023]
Abstract
Polyunsaturated fatty acid (PUFA) rich vegetable oils are nutritionally and economically important agriculture based commodities. The lipid profile, nutraceutical content, and antioxidant activity of Indian chia seed oil (CSO) were analysed and compared with PUFA rich vegetable oils. The total oil content was 28% (w/w) with α-linolenic acid (ALA; 65%) as the predominant fatty acid and a n-3/n-6 ratio of 3.5. The tocopherol content was 144 mg/kg of oil, with γ + β being the most abundant. The squalene content was 178.47 mg/100 g of oil, and the total phenolic content was 0.014 mg GAE/g of oil. The identity of major polyphenols in the methanolic extract of CSO were established by LC-HRMS. FTIR spectra of CSO exhibited characteristic features that were identical to other PUFA rich oils. Results demonstrate that the Indian CSO is an excellent source of essential fatty acids and key nutraceuticals.
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Affiliation(s)
- Rahul Gopalam
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201 002, India
- Department of Lipid Science, Council of Scientific and Industrial Research, Central Food Technological Research Institute, Mysore, 570 020, India
| | - Vallamkondu Manasa
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201 002, India
- Department of Lipid Science, Council of Scientific and Industrial Research, Central Food Technological Research Institute, Mysore, 570 020, India
| | - Salony R Vaishnav
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201 002, India
- Department of Lipid Science, Council of Scientific and Industrial Research, Central Food Technological Research Institute, Mysore, 570 020, India
| | - Palak Daga
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201 002, India
- Department of Lipid Science, Council of Scientific and Industrial Research, Central Food Technological Research Institute, Mysore, 570 020, India
| | - Ajay W Tumaney
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201 002, India.
- Department of Lipid Science, Council of Scientific and Industrial Research, Central Food Technological Research Institute, Mysore, 570 020, India.
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