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Amini MR, Askarpour M, Ghalandari H, Gholizadeh M, Pouraram H. Effect of ketogenic diet on blood pressure: A GRADE-Assessed systematic review and meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis 2024; 34:823-837. [PMID: 38310076 DOI: 10.1016/j.numecd.2023.12.004] [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: 07/10/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 02/05/2024]
Abstract
AIMS Cardiovascular diseases (CVDs) are major causes of mortality around the world. High blood pressure (BP) or hypertension is one of the most significant predisposing factors to CVDs. Ketogenic diets (KDs) have been the center of attention for their possible health benefits. The aim of this analysis is to study the impact of KDs on BP through the existing literature. DATA SYNTHESIS We investigated the impact of KDs on systolic and diastolic blood pressures (SBP and DBP) conducted in the format of randomized controlled trials (RCTs). Four online databases (PubMed/Medline, SCOPUS, Cochrane Library, and Google Scholar) were searched from inception up to November 2022. Subgroup analyses were carried out to find the sources of heterogeneities. Twenty-three RCTs with 1664 participants were identified. KDs did not exert any significant impacts on SBP (WMD: -0.87 mmHg, 95% CI: -2.05, 0.31) nor DBP (WMD: -0.11 mmHg, 95% CI -1.14, 0.93). Subgroup analyses did not reveal any further information. Also, non-linear dose-response analysis could not detect any associations between the percentage of calorie intake from fat in the KD format and BP levels. CONCLUSION KDs do not seem to be effective in improving BP. Nonetheless, further investigations are recommended to examine the proportion of fat intake needed to induce favorable clinical impacts.
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Affiliation(s)
- Mohammad Reza Amini
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition & Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Moein Askarpour
- Student Research Committee, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Ghalandari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Gholizadeh
- Department of Clinical Nutrition, Faculty of Nutrition Sciences and Food Industries, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Pouraram
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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de Oliveira MJ, Moreira ES, Lucredi NC, Bonetti CI, de Sá-Nakanishi AB, Comar JF, Bracht A, Bracht L. Effects of a high-fat low-carbohydrate diet under different energy conditions on glucose homeostasis and fatty liver development in rats and on gluconeogenesis in the isolated perfused liver. Can J Physiol Pharmacol 2024; 102:42-54. [PMID: 37523769 DOI: 10.1139/cjpp-2023-0071] [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: 08/02/2023]
Abstract
The beneficial effects of high-fat low-carbohydrate (HFLC) diets on glucose metabolism have been questioned and their effects on liver metabolism are not totally clear. The aim of this work was to investigate the effects of an HFLC diet under different energy conditions on glucose homeostasis, fatty liver development, and hepatic gluconeogenesis using the isolated perfused rat liver. HFLC diet (79% fat, 19% protein, and 2% carbohydrates in Kcal%) was administered to rats for 4 weeks under three conditions: ad libitum (hypercaloric), isocaloric, and hypocaloric (energy reduction of 20%). Fasting blood glucose levels and total fat in the liver were higher in all HFLC diet rats. Oral glucose tolerance was impaired in isocaloric and hypercaloric groups, although insulin sensitivity was not altered. HFLC diet also caused marked liver metabolic alterations: higher gluconeogenesis rate from lactate and a reduced capacity to metabolize alanine, the latter effect being more intense in the hypocaloric condition. Thus, even when HFLC diets are used for weight loss, our data imply that they can potentially cause harmful consequences for the liver.
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Affiliation(s)
- Mateus José de Oliveira
- Laboratory of liver metabolism, Department of Biochemistry, State University of Maringá, Maringá/PR, Brazil
| | - Evelyn Silva Moreira
- Laboratory of liver metabolism, Department of Biochemistry, State University of Maringá, Maringá/PR, Brazil
| | - Naiara Cristina Lucredi
- Laboratory of liver metabolism, Department of Biochemistry, State University of Maringá, Maringá/PR, Brazil
| | - Carla Indianara Bonetti
- Laboratory of liver metabolism, Department of Biochemistry, State University of Maringá, Maringá/PR, Brazil
| | | | - Jurandir Fernando Comar
- Laboratory of liver metabolism, Department of Biochemistry, State University of Maringá, Maringá/PR, Brazil
| | - Adelar Bracht
- Laboratory of liver metabolism, Department of Biochemistry, State University of Maringá, Maringá/PR, Brazil
| | - Lívia Bracht
- Laboratory of liver metabolism, Department of Biochemistry, State University of Maringá, Maringá/PR, Brazil
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Xu J, Ma J, Zeng Y, Si H, Wu Y, Zhang S, Shen B. Transcriptome-wide association study identifies novel genes associated with bone mineral density and lean body mass in children. Endocrine 2023; 79:400-409. [PMID: 36572794 PMCID: PMC9892108 DOI: 10.1007/s12020-022-03225-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 10/05/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To identify novel candidate genes whose expression is associated with bone mineral density (BMD) and body lean mass (LM) in children. METHODS A tissue-specific transcriptome-wide association study (TWAS) was conducted utilizing a large-scale genome-wide association study (GWAS) dataset associated with BMD and LM and involving 10,414 participants. The measurement of BMD and LM phenotypes was made based on total-body dual-energy X-ray absorptiometry (TB-DXA) scans. TWAS was conducted by using FUSION software. Reference panels for muscle skeleton (MS), peripheral blood (NBL) and whole blood (YBL) were used for TWAS analysis. Functional enrichment and protein-protein interaction (PPI) analyses of the genes identified by TWAS were performed by using the online tool Metascape ( http://metascape.org ). RESULTS For BMD, we identified 174 genes with P < 0.05, such as IKZF1 (P = 1.46 × 10-9) and CHKB (P = 8.31 × 10-7). For LM, we identified 208 genes with P < 0.05, such as COPS5 (P = 3.03 × 10-12) and MRPS33 (P = 5.45 × 10-10). Gene ontology (GO) enrichment analysis of the BMD-associated genes revealed 200 GO terms, such as protein catabolic process (Log P = -5.09) and steroid hormone-mediated signaling pathway (Log P = -3.13). GO enrichment analysis of the LM-associated genes detected 287 GO terms, such as the apoptotic signaling pathway (Log P = -8.08) and lipid storage (Log P = -3.55). CONCLUSION This study identified several candidate genes for BMD and LM in children, providing novel clues to the genetic mechanisms underlying the development of childhood BMD and LM.
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Affiliation(s)
- Jiawen Xu
- Orthopedic Research Institute, Department of Orthopedics, Sichuan University West China Hospital, 37# Guoxue Road, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Jun Ma
- Orthopedic Research Institute, Department of Orthopedics, Sichuan University West China Hospital, 37# Guoxue Road, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Yi Zeng
- Orthopedic Research Institute, Department of Orthopedics, Sichuan University West China Hospital, 37# Guoxue Road, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Haibo Si
- Orthopedic Research Institute, Department of Orthopedics, Sichuan University West China Hospital, 37# Guoxue Road, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Yuangang Wu
- Orthopedic Research Institute, Department of Orthopedics, Sichuan University West China Hospital, 37# Guoxue Road, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Shaoyun Zhang
- Orthopedic Research Institute, Department of Orthopedics, Sichuan University West China Hospital, 37# Guoxue Road, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Bin Shen
- Orthopedic Research Institute, Department of Orthopedics, Sichuan University West China Hospital, 37# Guoxue Road, Chengdu, 610041, Sichuan Province, People's Republic of China.
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Sheikhhossein F, Amini MR, Askari M, Pourreza S, Hosseini F, Clark CCT, Djafarian K, Ghanbari M, Shab-Bidar S. The effects of capsinoids supplementation on body composition and anthropometric measures: A systematic review and dose-response meta-analysis of randomized controlled trials. Clin Nutr ESPEN 2022; 52:381-394. [PMID: 36513480 DOI: 10.1016/j.clnesp.2022.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 07/21/2022] [Accepted: 09/19/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND & AIMS The present systematic review and meta-analysis was conducted to investigate the effects of capsinoids on body mass index (BMI), body weight (BW), waist circumference (WC), waist-hip ratio (WHR), fat mass (FM), fat-free mass (FFM), visceral fat area (VFA), and percentage body fat (PBF). METHODS Four databases were searched from inception to November 2020 using relevant keywords. All clinical trials investigating the effects of capsinoids supplementation on body composition and anthropometric measures were retained. RESULTS Overall, 19 effect sizes and 13 trials with a total sample size of 838 participants were included. Capsinoids supplementation had no effect on BW (P = 0.230), BMI (P = 0.182), WC (P = 0.611), FM (P = 0.946), FFM (P = 0.917), WHR (P = 0.599), VFA (P = 0.836), and PBF (P = 0.973). Findings from subgroup analysis revealed a significant reduction in BW in trials conducted on overweight participants, and lasted ≥12 weeks, However, no significant non-linear associations were found between capsinoids supplementation dosage and study duration with both BW (For dosage: Pnon-linearity = 0.527, for duration: Pnon-linearity = 0.410) and BMI (For dosage: Pnon-linearity = 0.308, for duration: Pnon-linearity = 0.578). CONCLUSION Capsinoids supplementation has no significant effect on obesity indicators. However, capsinoids in trials conducted on overweight participants, and lasted ≥12 weeks may have a significant and modest reduction in BW. Well-designed RCTs with larger sample size and longer duration are needed to confirm these results.
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Affiliation(s)
- Fatemeh Sheikhhossein
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mohammad Reza Amini
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Askari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sanaz Pourreza
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Fatemeh Hosseini
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Cain C T Clark
- Centre for Sport, Exercise, and Life Sciences, Coventry University, Coventry, CV15FB, UK
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mahtab Ghanbari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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Li J, Gower B, McLain A, Yarar‐Fisher C. Effects of a low-carbohydrate/high-protein diet on metabolic health in individuals with chronic spinal cord injury: An exploratory analysis of results from a randomized controlled trial. Physiol Rep 2022; 10:e15501. [PMID: 36411989 PMCID: PMC9812250 DOI: 10.14814/phy2.15501] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/07/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023] Open
Abstract
We explored the impact of a low-carbohydrate/high-protein diet (LC/HP, ~30% energy from protein, 40% energy from carbohydrate) on indices of metabolic function and body composition in individuals with chronic spinal cord injury (SCI). Adults with SCI (≥3 years post-injury, C4-L2, AIS A-D) and insulin resistance or pre-diabetes were randomly assigned to an 8-week iso-caloric LC/HP diet group (n = 11) or control group (n = 14). All LC/HP meals were delivered weekly to participants' homes, and participants in the control group consumed their habitual diet. Each participant underwent an oral glucose tolerance test (OGTT) to assess glucose tolerance, insulin, area under the curve (AUC) for glucose and insulin, Matsuda Index, glucose-stimulated insulin secretion (GSIS), disposition index, and hepatic insulin extraction (HIE). Fasting blood lipid and inflammation were assessed, and body composition was estimated using dual-energy x-ray absorptiometry. A linear mixed model was used to evaluate the main effect of diet, time, and their interaction. Compared to the control group, participants in the LC/HP group had reduced total body fat mass (LC/HP: -5.9%, Control: 0.7%), visceral fat mass (LC/HP: -16.2%, Control: 5.2%), total- (LC/HP: -20.1, Control: 3.7 mg/dl), and LDL-cholesterol (LC/HP: -13.9, Control: 3.1 mg/dl) (pdiet*time < 0.05 for all). Regardless of group, AUCinsulin and peak insulin during the OGTT decreased, and HIE increased over time (ptime < 0.05). A trend for diet*time interaction was observed for glucoseOGTT120min (LC/HP: -20.7, Control: 3.0 mg/dl, pdiet*time = 0.09) and peak C-peptide (LC/HP: -2.1, Control: 0.0 ng/ml, pdiet*time = 0.07). HDL-cholesterol, lean body mass, Matsuda Index, fasting glucose, insulin, insulinOGTT120min , AUCglucose , pancreatic beta cell function (GSIS, disposition index), and inflammation (C-reactive protein, IL-6, IL-8, IL-10, TNF-α) did not change over time. In conclusion, our results suggest that individuals with SCI and insulin resistance may adopt an LC/HP diet to improve body composition and lipid profiles. Its impact on glucose metabolism and inflammation remains inconclusive and warrants future investigations.
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Affiliation(s)
- Jia Li
- Departments of Physical Medicine and RehabilitationThe University of Alabama at BirminghamBirminghamAlabamaUSA
| | - Barbara Gower
- Department of Nutrition SciencesUAB School of Health ProfessionsBirminghamAlabamaUSA
| | - Amie McLain
- Departments of Physical Medicine and RehabilitationThe University of Alabama at BirminghamBirminghamAlabamaUSA
| | - Ceren Yarar‐Fisher
- Departments of Physical Medicine and RehabilitationThe University of Alabama at BirminghamBirminghamAlabamaUSA
- Departments of Physical Medicine and Rehabilitation and NeuroscienceThe Ohio State UniversityColumbusOhioUSA
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Association between Long-Term Changes in Dietary Percentage of Energy from Fat and Obesity: Evidence from over 20 Years of Longitudinal Data. Nutrients 2022; 14:nu14163373. [PMID: 36014882 PMCID: PMC9414001 DOI: 10.3390/nu14163373] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives: This study assessed the associations between long-term trajectories of percentage of energy from fat (PEF) and obesity among Chinese adults. Methods: Longitudinal data collected by the China Health and Nutrition Survey from 1991 to 2015 were analyzed. A body mass index ≥28.0 was defined as general obesity. Participants’ baseline PEF levels were categorized as lower than the recommendation of the Chinese Dietary Guideline (<20%), meeting the recommendation (20−30%), and higher than the recommendation (>30%). Patterns of PEF trajectories were identified by latent class trajectory analysis for overall participants and participants in different baseline PEF groups, respectively. Cox proportional hazards regression models with shared frailty were used to estimate associations between PEF and obesity. Results: Data on 13,025 participants with 72,191 visits were analyzed. Four patterns of PEF trajectory were identified for overall participants and participants in three different baseline PEF groups, respectively. Among overall participants, compared with “Baseline Low then Increase Pattern” (from 12% to 20%), participants with “Baseline Normal-Low then Increase-to-High Pattern” (from 20% to 32%) had a higher hazard of obesity (hazard ratio (HR) and 95% confident interval (CI) at 1.18 (1.01−1.37)). Compared with the “Stable Pattern” group (stable at around 18% and 22%, respectively), participants with “Sudden-Increase Pattern” (from 18% to 30%) in the baseline group whose PEF levels were lower than the recommendation and those with “Sudden-Increase then Decrease Pattern” (rapidly increased from 25% to 40%, and then decreased) in the baseline group who met the recommendation had higher hazards of obesity (HRs and 95% CIs being 1.65 (1.13−2.41) and 1.59 (1.03−2.46), respectively). Conclusions: Adults with a trajectory that involved a sudden increase to a high-level PEF had a higher risk of general obesity. People should avoid increasing PEF suddenly.
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da Silva Schreiber C, Rafacho A, Silverio R, Betti R, Lerário AC, Lotenberg AMP, Rahmann K, de Oliveira CP, Wajchenberg BL, da Luz PL. The effects of macronutrients composition on hormones and substrates during a meal tolerance test in drugnaive and sitagliptin-treated individuals with type 2 diabetes: a randomized crossover study. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2022; 66:2359-3997000000478. [PMID: 35551683 PMCID: PMC9832851 DOI: 10.20945/2359-3997000000478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 03/07/2022] [Indexed: 11/23/2022]
Abstract
Objective To evaluate the effect of sitagliptin treatment in early type 2 diabetes mellitus (T2DM) and the impact of different macronutrient compositions on hormones and substrates during meal tolerance tests (MTT). Methods Half of the drug-naive patients with T2DM were randomly assigned for treatment with 100 mg of sitagliptin, q.d., or placebo for 4 weeks and then submitted to 3 consecutive MTT intercalated every 48 h. The MTTs differed in terms of macronutrient composition, with 70% of total energy from carbohydrates, proteins, or lipids. After 4 weeks of washout, a crossover treatment design was repeated. Both patients and researchers were blinded, and a repeated-measures ANOVA was employed for statistical analysis. Results Sitagliptin treatment reduced but did not normalize fasting and post-meal glucose values in the three MTTs, with lowered area-under-glucose-curve values varying from 7% to 15%. The sitagliptin treatment also improved the insulinogenic index (+86%) and the insulin/glucose (+25%), glucagon-like peptide-1/glucose (+46%) incremental area under the curves. Patients with early T2DM maintained the lowest glucose excursion after a protein- or lipid-rich meal without any major change in insulin, C-peptide, glucagon, or NEFA levels. Conclusion We conclude that sitagliptin treatment is tolerable and contributes to better control of glucose homeostasis in early T2DM, irrespective of macronutrient composition. The blood glucose excursion during meal ingestion is minimal in protein- or fat-rich meals, which can be a positive ally for the management of T2DM. Clinical trial no: NCT00881543.
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Affiliation(s)
- Cristina da Silva Schreiber
- Instituto do Coração (InCor), Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brasil,
- Present address: CSS is now at Endocrinology and Metabology Section, University Hospital professor Polydoro Ernani de São Thiago, UFSC, Florianópolis, Brazil. R.B. is now at Obesity and Diabetes Center Oswaldo Cruz Hospital Sao Paulo, São Paulo, Brazil. ACL is now at Clinic Hospital of the University of Sao Paulo Medical School, USP, São Paulo, Brazil
| | - Alex Rafacho
- Laboratório de Investigação em Doenças Crônicas (LIDoC), Departamento de Ciências Fisiológicas, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brasil,
| | - Renata Silverio
- Laboratório de Investigação em Doenças Crônicas (LIDoC), Departamento de Ciências Fisiológicas, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brasil
| | - Roberto Betti
- Instituto do Coração (InCor), Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brasil
- Present address: CSS is now at Endocrinology and Metabology Section, University Hospital professor Polydoro Ernani de São Thiago, UFSC, Florianópolis, Brazil. R.B. is now at Obesity and Diabetes Center Oswaldo Cruz Hospital Sao Paulo, São Paulo, Brazil. ACL is now at Clinic Hospital of the University of Sao Paulo Medical School, USP, São Paulo, Brazil
| | - Antonio Carlos Lerário
- Instituto do Coração (InCor), Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brasil
- Present address: CSS is now at Endocrinology and Metabology Section, University Hospital professor Polydoro Ernani de São Thiago, UFSC, Florianópolis, Brazil. R.B. is now at Obesity and Diabetes Center Oswaldo Cruz Hospital Sao Paulo, São Paulo, Brazil. ACL is now at Clinic Hospital of the University of Sao Paulo Medical School, USP, São Paulo, Brazil
| | - Ana Maria Pita Lotenberg
- Laboratório de Lipídios (LIM10), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brasil
| | - Klara Rahmann
- Laboratório de Lipídios (LIM10), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brasil
| | - Carolina Piras de Oliveira
- Instituto do Coração (InCor), Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brasil
| | - Bernardo Léo Wajchenberg
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brasil
- In memmoriam
| | - Protásio Lemos da Luz
- Instituto do Coração (InCor), Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brasil
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Tucker LA. Macronutrient Intake and Insulin Resistance in 5665 Randomly Selected, Non-Diabetic U.S. Adults. Nutrients 2022; 14:nu14050918. [PMID: 35267895 PMCID: PMC8912746 DOI: 10.3390/nu14050918] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/18/2022] [Accepted: 02/19/2022] [Indexed: 12/29/2022] Open
Abstract
The main goal of this investigation was to evaluate the relationships between several macronutrients and insulin resistance in 5665 non-diabetic U.S. adults. A secondary objective was to determine the extent to which the associations were influenced by multiple potential confounding variables. A cross-sectional design and 8 years of data from the 2011–2018 National Health and Nutrition Examination Survey (NHANES) were used to answer the research questions. Ten macronutrients were evaluated: total carbohydrate, starch, simple carbohydrate, dietary fiber, total protein, total fat, saturated, polyunsaturated, monounsaturated, and total unsaturated fat. The homeostatic model assessment (HOMA), based on fasting glucose and fasting insulin levels, was used to index insulin resistance. Age, sex, race, year of assessment, physical activity, cigarette smoking, alcohol use, and waist circumference were used as covariates. The relationships between total carbohydrate intake (F = 6.7, p = 0.0121), simple carbohydrate (F = 4.7, p = 0.0344) and HOMA-IR were linear and direct. The associations between fiber intake (F = 9.1, p = 0.0037), total protein (F = 4.4, p = 0.0393), total fat (F = 5.5, p = 0.0225), monounsaturated fat (F = 5.5, p = 0.0224), and total unsaturated fat (F = 6.5, p = 0.0132) were linear and inversely related to HOMA-IR, with 62 degrees of freedom. Starch, polyunsaturated fat, and saturated fat intakes were not related to HOMA-IR. In conclusion, in this nationally representative sample, several macronutrients were significant predictors of insulin resistance in U.S. adults.
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Affiliation(s)
- Larry A Tucker
- College of Life Sciences, Brigham Young University, Provo, UT 84602, USA
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Zhang S, Wu P, Tian Y, Liu B, Huang L, Liu Z, Lin N, Xu N, Ruan Y, Zhang Z, Wang M, Cui Z, Zhou H, Xie L, Chen H, Sun J. Gut Microbiota Serves a Predictable Outcome of Short-Term Low-Carbohydrate Diet (LCD) Intervention for Patients with Obesity. Microbiol Spectr 2021; 9:e0022321. [PMID: 34523948 PMCID: PMC8557869 DOI: 10.1128/spectrum.00223-21] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/15/2021] [Indexed: 12/25/2022] Open
Abstract
To date, much progress has been made in dietary therapy for obese patients. A low-carbohydrate diet (LCD) has reached a revival in its clinical use during the past decade with undefined mechanisms and debatable efficacy. The gut microbiota has been suggested to promote energy harvesting. Here, we propose that the gut microbiota contributes to the inconsistent outcome under an LCD. To test this hypothesis, patients with obesity or patients who were overweight were randomly assigned to a normal diet (ND) or an LCD group with ad libitum energy intake for 12 weeks. Using matched sampling, the microbiome profile at baseline and end stage was examined. The relative abundance of butyrate-producing bacteria, including Porphyromonadaceae Parabacteroides and Ruminococcaceae Oscillospira, was markedly increased after LCD intervention for 12 weeks. Moreover, within the LCD group, participants with a higher relative abundance of Bacteroidaceae Bacteroides at baseline exhibited a better response to LCD intervention and achieved greater weight loss outcomes. Nevertheless, the adoption of an artificial neural network (ANN)-based prediction model greatly surpasses a general linear model in predicting weight loss outcomes after LCD intervention. Therefore, the gut microbiota served as a positive outcome predictor and has the potential to predict weight loss outcomes after short-term LCD intervention. Gut microbiota may help to guide the clinical application of short-term LCD intervention to develop effective weight loss strategies. (This study has been registered at the China Clinical Trial Registry under approval no. ChiCTR1800015156). IMPORTANCE Obesity and its related complications pose a serious threat to human health. Short-term low-carbohydrate diet (LCD) intervention without calorie restriction has a significant weight loss effect for overweight/obese people. Furthermore, the relative abundance of Bacteroidaceae Bacteroides is a positive outcome predictor of individual weight loss after short-term LCD intervention. Moreover, leveraging on these distinct gut microbial structures at baseline, we have established a prediction model based on the artificial neural network (ANN) algorithm that could be used to estimate weight loss potential before each clinical trial (with Chinese patent number 2021104655623). This will help to guide the clinical application of short-term LCD intervention to improve weight loss strategies.
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Affiliation(s)
- Susu Zhang
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Peili Wu
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ye Tian
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Bingdong Liu
- State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
- The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Liujing Huang
- State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Zhihong Liu
- State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Nie Lin
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Department of Endocrinology and Metabolism, Shantou Central Hospital, Shantou, China
| | - Ningning Xu
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yuting Ruan
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Zhen Zhang
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Ming Wang
- Nephrology Center of Integrated Traditional Chinese and Western Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Zongbing Cui
- State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - HongWei Zhou
- State Key Laboratory of Organ Failure Research, Microbiome Medicine Center, Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Liwei Xie
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
- School of Public Health, Xinxiang Medical University, Xinxiang, China
| | - Hong Chen
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jia Sun
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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Differences in the Concentration of Vitamin D Metabolites in Plasma Due to the Low-Carbohydrate-High-Fat Diet and the Eastern European Diet-A Pilot Study. Nutrients 2021; 13:nu13082774. [PMID: 34444934 PMCID: PMC8400948 DOI: 10.3390/nu13082774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/05/2021] [Accepted: 08/12/2021] [Indexed: 01/27/2023] Open
Abstract
Vitamin D deficiency is a global problem with many health consequences, and it is currently recommended to supplement vitamin D. Change of diet should also be considered to ensure adequate vitamin D in the human body. The aim of this study was to assess the concentration of vitamin D metabolites in two different groups: one group on the low-carbohydrate-high-fat (LCHF) diet and the other group on the Eastern European (EE) diet. In the first stage, 817 participants declaring traditional EE diet or LCHF diet were investigated. Nutrition (self-reported 3-day estimated food record) and basic anthropometric parameters were assessed. After extra screening, 67 participants on the EE diet and 41 on the LCHF diet were qualified for the second stage. Plasma 25-hydroxycholecalciferol (25(OH)D3) and (25(OH)D2) concentration was measured by the validated HPLC—MS/MS method. Plasma 25(OH)D3 concentration was significantly higher in the group on the LCHF diet (34.9 ± 15.9 ng/mL) than in the group on the EE diet (22.6 ± 12.1 ng/mL). No statistical differences were observed in plasma 25(OH)D2 concentration between the study groups (p > 0.05). Women had a higher plasma 25(OH)D2 concentration than men regardless of diet type. The LCHF diet had a positive influence on plasma vitamin D concentration. However, long-term use of the LCHF diet remains contentious due to the high risk of cardiovascular disease. This study confirmed that the type of diet influences the concentration of vitamin D metabolites in the plasma.
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11
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Yang Q, Lang X, Li W, Liang Y. The effects of low-fat, high-carbohydrate diets vs. low-carbohydrate, high-fat diets on weight, blood pressure, serum liquids and blood glucose: a systematic review and meta-analysis. Eur J Clin Nutr 2021; 76:16-27. [PMID: 34168293 DOI: 10.1038/s41430-021-00927-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 04/08/2021] [Accepted: 04/15/2021] [Indexed: 01/08/2023]
Abstract
Our aim was to determine the relative effectiveness of two dietary macronutrient patterns (LFHC (low-fat, high-carbohydrate) diets and LCHF (low-carbohydrate, high-fat) diets) on weight loss and cardiovascular risk factors. We searched four databases including MEDLINE, EMBASE, Cochrane Library, and Web of Science to identify the eligible studies on March 13, 2020. Randomized clinical trials (RCT) were included which compared the effect of two diets (LFHC and LCHF) on weight loss, blood pressure, serum liquids, and blood glucose in overweight or obesity adults. Standardized mean difference (SMD) and 95% confidence interval (CI) were used for the pooled results. This paper included eleven studies involving 739 participants. Compared with LFHC diets, LCHF diets had a greater effect on weight loss (SMD = -1.01 kg; 95% CI -1.99 to -0.04, p = 0.04) and HDL-cholesterol changes (SMD = 0.82 mmol/l; 95% CI 0.43 to 1.21, p < 0.0001), but a smaller effect on total cholesterol decrease (SMD = 0.63 mmol/l; 95% CI 0.18-1.08, p = 0.006) and LDL-cholesterol decrease (SMD = 0.59 mmol/l; 95% CI 0.11-1.18, p = 0.05). Between the two groups, changes in lean mass, fat mass, systolic blood pressure, diastolic blood pressure, triglycerides, and glucose were non-significant. To conclude, both diets are effective for weight control and reduction of cardiovascular risk factors. And further studies with long-term follow-up are needed to confirm our results.
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Affiliation(s)
- Qing Yang
- Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100037, China
| | - Xinyue Lang
- Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100037, China.,Medical Research & Biometrics Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, 102300, China
| | - Wei Li
- Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100037, China. .,Medical Research & Biometrics Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, 102300, China.
| | - Yan Liang
- Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100037, China.
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12
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Buga A, Kackley ML, Crabtree CD, Sapper TN, Mccabe L, Fell B, LaFountain RA, Hyde PN, Martini ER, Bowman J, Pan Y, Scandling D, Brownlow ML, O'Connor A, Simonetti OP, Kraemer WJ, Volek JS. The Effects of a 6-Week Controlled, Hypocaloric Ketogenic Diet, With and Without Exogenous Ketone Salts, on Body Composition Responses. Front Nutr 2021; 8:618520. [PMID: 33869263 PMCID: PMC8044842 DOI: 10.3389/fnut.2021.618520] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 02/23/2021] [Indexed: 01/16/2023] Open
Abstract
Background: Ketogenic diets (KDs) that elevate beta-hydroxybutyrate (BHB) promote weight and fat loss. Exogenous ketones, such as ketone salts (KS), also elevate BHB concentrations with the potential to protect against muscle loss during caloric restriction. Whether augmenting ketosis with KS impacts body composition responses to a well-formulated KD remains unknown. Purpose: To explore the effects of energy-matched, hypocaloric KD feeding (<50 g carbohydrates/day; 1.5 g/kg/day protein), with and without the inclusion of KS, on weight loss and body composition responses. Methods: Overweight and obese adults were provided a precisely defined hypocaloric KD (~75% of energy expenditure) for 6 weeks. In a double-blind manner, subjects were randomly assigned to receive ~24 g/day of a racemic BHB-salt (KD + KS; n = 12) or placebo (KD + PL; n = 13). A matched comparison group (n = 12) was separately assigned to an isoenergetic/isonitrogenous low-fat diet (LFD). Body composition parameters were assessed by dual x-ray absorptiometry and magnetic resonance imaging. Results: The KD induced nutritional ketosis (>1.0 mM capillary BHB) throughout the study (p < 0.001), with higher fasting concentrations observed in KD + KS than KD + PL for the first 2 weeks (p < 0.05). There were decreases in body mass, whole body fat and lean mass, mid-thigh muscle cross-sectional area, and both visceral and subcutaneous adipose tissues (p < 0.001), but no group differences between the two KDs or with the LFD. Urine nitrogen excretion was significantly higher in KD + PL than LFD (p < 0.01) and trended higher in KD + PL compared to KD + KS (p = 0.076), whereas the nitrogen excretion during KD + KS was similar to LFD (p > 0.05). Conclusion: Energy-matched hypocaloric ketogenic diets favorably affected body composition but were not further impacted by administration of an exogenous BHB-salt that augmented ketosis. The trend for less nitrogen loss with the BHB-salt, if manifested over a longer period of time, may contribute to preserved lean mass.
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Affiliation(s)
- Alex Buga
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Madison L. Kackley
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | | | - Teryn N. Sapper
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Lauren Mccabe
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Brandon Fell
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Rich A. LaFountain
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Parker N. Hyde
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Emily R. Martini
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Jessica Bowman
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Yue Pan
- Department of Radiology, Davis Heart & Lung Research Institute, The Ohio State University, Columbus, OH, United States
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, OH, United States
- Department of Radiology, Wexner Medical Center, The Ohio State University, Columbus, OH, United States
| | - Debbie Scandling
- Department of Radiology, Davis Heart & Lung Research Institute, The Ohio State University, Columbus, OH, United States
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, OH, United States
- Department of Radiology, Wexner Medical Center, The Ohio State University, Columbus, OH, United States
| | - Milene L. Brownlow
- Research and Development Department, Metagenics, Inc., Aliso Viejo, CA, United States
| | - Annalouise O'Connor
- Research and Development Department, Metagenics, Inc., Aliso Viejo, CA, United States
| | - Orlando P. Simonetti
- Department of Radiology, Davis Heart & Lung Research Institute, The Ohio State University, Columbus, OH, United States
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, OH, United States
- Department of Radiology, Wexner Medical Center, The Ohio State University, Columbus, OH, United States
| | - William J. Kraemer
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Jeff S. Volek
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
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Chawla S, Tessarolo Silva F, Amaral Medeiros S, Mekary RA, Radenkovic D. The Effect of Low-Fat and Low-Carbohydrate Diets on Weight Loss and Lipid Levels: A Systematic Review and Meta-Analysis. Nutrients 2020; 12:E3774. [PMID: 33317019 PMCID: PMC7763365 DOI: 10.3390/nu12123774] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/25/2020] [Accepted: 12/03/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The rise in obesity has emphasised a focus on lifestyle and dietary habits. We aimed to address the debate between low-carbohydrate and low-fat diets and compare their effects on body weight, low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), total cholesterol, and triglycerides in an adult population. METHOD Medline and Web of Science were searched for randomised controlled trials (RCTs) comparing low-fat and low-carbohydrate diets up to September 2019. Three independent reviewers extracted data. Risk of bias was assessed using the Cochrane tool. The meta-analysis was stratified by follow-up time using the random-effects models. RESULTS This meta-analysis of 38 studies assessed a total of 6499 adults. At 6-12 months, pooled analyses of mean differences of low-carbohydrate vs. low-fat diets favoured the low-carbohydrate diet for average weight change (mean difference -1.30 kg; 95% CI -2.02 to -0.57), HDL (0.05 mmol/L; 95% CI 0.03 to 0.08), and triglycerides (TG) (-0.10 mmol/L; -0.16 to -0.04), and favoured the low-fat diet for LDL (0.07 mmol/L; 95% CI 0.02 to 0.12) and total cholesterol (0.10 mmol/L; 95% CI 0.02 to 0.18). Conclusion and Relevance: This meta-analysis suggests that low-carbohydrate diets are effective at improving weight loss, HDL and TG lipid profiles. However, this must be balanced with potential consequences of raised LDL and total cholesterol in the long-term.
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Affiliation(s)
- Shreya Chawla
- Faculty of Life Sciences and Medicine, King’s College London, London WC2R 2LS, UK;
| | - Fernanda Tessarolo Silva
- Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903, BR, Brazil; (F.T.S.); (S.A.M.)
| | - Sofia Amaral Medeiros
- Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903, BR, Brazil; (F.T.S.); (S.A.M.)
| | - Rania A. Mekary
- School of Pharmacy, MCPHS University, Boston, MA 02120, USA;
- Nutrition Department, Harvard TH Chan School of Public Health, Boston, MA 02120, USA
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Mariën I, De Block C, Verrijken A, Van Dessel K, Peiffer F, Verhaegen A, Hubens G, Van Gaal L, Dirinck E. Features of oral glucose tolerance tests in patients after Roux-en-Y gastric bypass with and without hypoglycaemia symptoms in daily life: It's all about speed. Diabetes Obes Metab 2020; 22:2107-2119. [PMID: 32643861 DOI: 10.1111/dom.14130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 06/26/2020] [Accepted: 06/28/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To evaluate the glucose and insulin profiles during an oral glucose tolerance test (OGTT) after Roux-en-Y gastric bypass (RYGB) in symptomatic and asymptomatic patients. RESEARCH DESIGN AND METHODS This retrospective study consisted of two groups that had undergone RYGB. The symptomatic (S) group (n = 27) had an OGTT at presentation, whereas the asymptomatic (A) group (n = 99) had an OGTT 1 year after RYGB. Each group was subdivided into two groups, namely, those with glycaemia <54 mg/dL (S1/A1) and those with glycaemia >54 mg/dL (S2/A2) during OGTT. Most of the patients underwent OGTT preoperatively. RESULTS Preoperatively, the glucose and insulin levels, as well as the speed of increase and decrease, were similar in all groups. Postoperatively, the minimum glucose levels during the OGTT did not differ between the symptomatic and asymptomatic groups (55 ± 19 vs. 54 ± 17 mg/dL) or between the S1 and A1 subgroups (39 ± 7 vs. 43 ± 8 mg/dL). The peak glucose values were higher in the symptomatic versus the asymptomatic group (236 ± 52 vs. 189 ± 43 mg/dL; P <0.05) and in the S1 and S2 versus the A1 and A2 subgroups. The speed of glucose increase and decline was significantly higher in the symptomatic group versus the asymptomatic group, with the speed of glucose decline being the highest in the S1 subgroup. CONCLUSION Assessing hypoglycaemia after a gastric bypass remains challenging. Our study suggests that the main difference in glucose dynamics between symptomatic and asymptomatic patients might be the speed of glucose and insulin increase and decline during OGTT rather than the absolute values obtained.
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Affiliation(s)
- Ilke Mariën
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Antwerp, Belgium
| | - Christophe De Block
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Antwerp, Belgium
- Laboratory of Experimental Medicine and Pediatrics, Antwerp University, Antwerp, Belgium
| | - An Verrijken
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Antwerp, Belgium
- Laboratory of Experimental Medicine and Pediatrics, Antwerp University, Antwerp, Belgium
| | - Kristof Van Dessel
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Antwerp, Belgium
- Laboratory of Experimental Medicine and Pediatrics, Antwerp University, Antwerp, Belgium
| | - Frida Peiffer
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Antwerp, Belgium
| | - Ann Verhaegen
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Antwerp, Belgium
| | - Guy Hubens
- Department of Abdominal Surgery, Antwerp University Hospital, Antwerp, Belgium
| | - Luc Van Gaal
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Antwerp, Belgium
- Laboratory of Experimental Medicine and Pediatrics, Antwerp University, Antwerp, Belgium
| | - Eveline Dirinck
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Antwerp, Belgium
- Laboratory of Experimental Medicine and Pediatrics, Antwerp University, Antwerp, Belgium
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Low-Fat Diet Designed for Weight Loss But Not Weight Maintenance Improves Nitric Oxide-Dependent Arteriolar Vasodilation in Obese Adults. Nutrients 2019; 11:nu11061339. [PMID: 31207908 PMCID: PMC6627594 DOI: 10.3390/nu11061339] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/11/2019] [Accepted: 06/13/2019] [Indexed: 01/26/2023] Open
Abstract
Obesity is associated with microvascular dysfunction. While low-fat diet improves cardiovascular risk, its contributions on microvascular function, independent of weight loss, is unknown. We tested the hypothesis that nitric oxide (NO)-dependent vasodilation in microvessels is improved by low-fat diets designed for weight loss (LFWL) compared to low-fat weight maintenance (LFWM) diet. Obese adults were randomly assigned to either a LFWL diet (n = 11) or LFWM diet (n = 10) for six weeks. Microvessels were obtained from gluteal subcutaneous fat biopsies before and after the intervention for vascular reactivity measurements to acetylcholine (Ach) and flow, with and without L-NAME or indomethacin. Vascular and serum NO and C-reactive protein (CRP) were also measured. LFWL diet increased flow-induced (FID) and ACh-induced dilation (AChID); an effect that was inhibited by L-NAME. Conversely, LFWM diet did not affect FID or AChID. Indomethacin improved FID and AChID in the baseline and this effect was minimized in response to both diets. Serum NO or CRP did not change in response to either diet. In conclusion, LFWL diet improves microvascular reactivity compared to LFWM diet and increased vascular NO contribution to the improved microvascular dilation. These data suggest that weight reduction on low fat diet is critical for microvascular health.
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16
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Effects of carbohydrate-restricted diets on low-density lipoprotein cholesterol levels in overweight and obese adults: a systematic review and meta-analysis. Nutr Rev 2018; 77:161-180. [DOI: 10.1093/nutrit/nuy049] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Dietary Patterns in Secondary Prevention of Heart Failure: A Systematic Review. Nutrients 2018; 10:nu10070828. [PMID: 29949894 PMCID: PMC6073256 DOI: 10.3390/nu10070828] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 06/17/2018] [Accepted: 06/22/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Diet is an important factor in secondary prevention of heart failure (HF) but there is still no consensus as to which dietary model should be adopted by this population. This systematic review aims to clarify the relationship between dietary patterns and secondary prevention in HF. METHODS We searched the Medline, Embase and Cochrane databases for studies with different dietary patterns and outcomes of secondary prevention in HF. No limitation was used in the search. RESULTS 1119 articles were identified, 12 met the inclusion criteria. Studies with Dietary Approaches to Stop Hypertension (DASH), Mediterranean, Hyperproteic and Low-carb diets were found. The DASH pattern showed improvement in cardiac function, functional capacity, blood pressure, oxidative stress and mortality. The Mediterranean diet had a correlation with inflammation, quality of life and cardiac function but just on cross-sectional studies. Regarding the Hyperproteic and Low-carb diets only one study was found with each pattern and both were able to improve functional capacity in patients with HF. CONCLUSIONS DASH pattern may have benefits in the secondary prevention of HF. The Mediterranean diet demonstrated positive correlation with factors of secondary prevention of HF but need more RCTs and cohort studies to confirm these effects. In addition, the Hyperproteic and Low-carb diets, despite the lack of studies, also demonstrated positive effects on the functional capacity in patients with HF.
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Abstract
In the past, different types of diet with a generally low-carbohydrate content (< 50–< 20 g/day) have been promoted, for weight loss and diabetes, and the effectiveness of a very low dietary carbohydrate content has always been a matter of debate. A significant reduction in the amount of carbohydrates in the diet is usually accompanied by an increase in the amount of fat and to a lesser extent, also protein. Accordingly, using the term “low carb–high fat” (LCHF) diet is most appropriate. Low/very low intakes of carbohydrate food sources may impact on overall diet quality and long-term effects of such drastic diet changes remain at present unknown. This narrative review highlights recent metabolic and clinical outcomes of studies as well as practical feasibility of low LCHF diets. A few relevant observations are as follows: (1) any diet type resulting in reduced energy intake will result in weight loss and related favorable metabolic and functional changes; (2) short-term LCHF studies show both favorable and less desirable effects; (3) sustained adherence to a ketogenic LCHF diet appears to be difficult. A non-ketogenic diet supplying 100–150 g carbohydrate/day, under good control, may be more practical. (4) There is lack of data supporting long-term efficacy, safety and health benefits of LCHF diets. Any recommendation should be judged in this light. (5) Lifestyle intervention in people at high risk of developing type 2 diabetes, while maintaining a relative carbohydrate-rich diet, results in long-term prevention of progression to type 2 diabetes and is generally seen as safe.
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Low Wang CC, Hess CN, Hiatt WR, Goldfine AB. Clinical Update: Cardiovascular Disease in Diabetes Mellitus: Atherosclerotic Cardiovascular Disease and Heart Failure in Type 2 Diabetes Mellitus - Mechanisms, Management, and Clinical Considerations. Circulation 2016; 133:2459-502. [PMID: 27297342 PMCID: PMC4910510 DOI: 10.1161/circulationaha.116.022194] [Citation(s) in RCA: 650] [Impact Index Per Article: 81.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cardiovascular disease remains the principal cause of death and disability among patients with diabetes mellitus. Diabetes mellitus exacerbates mechanisms underlying atherosclerosis and heart failure. Unfortunately, these mechanisms are not adequately modulated by therapeutic strategies focusing solely on optimal glycemic control with currently available drugs or approaches. In the setting of multifactorial risk reduction with statins and other lipid-lowering agents, antihypertensive therapies, and antihyperglycemic treatment strategies, cardiovascular complication rates are falling, yet remain higher for patients with diabetes mellitus than for those without. This review considers the mechanisms, history, controversies, new pharmacological agents, and recent evidence for current guidelines for cardiovascular management in the patient with diabetes mellitus to support evidence-based care in the patient with diabetes mellitus and heart disease outside of the acute care setting.
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Affiliation(s)
- Cecilia C Low Wang
- From Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Colorado School of Medicine, Aurora (C.C.L.); CPC Clinical Research, Aurora, CO (C.C.L., C.N.H., W.R.H.); Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora (C.N.H., W.R.H.); Joslin Diabetes Center, and Harvard Medical School, Boston, MA (A.B.G.)
| | - Connie N Hess
- From Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Colorado School of Medicine, Aurora (C.C.L.); CPC Clinical Research, Aurora, CO (C.C.L., C.N.H., W.R.H.); Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora (C.N.H., W.R.H.); Joslin Diabetes Center, and Harvard Medical School, Boston, MA (A.B.G.)
| | - William R Hiatt
- From Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Colorado School of Medicine, Aurora (C.C.L.); CPC Clinical Research, Aurora, CO (C.C.L., C.N.H., W.R.H.); Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora (C.N.H., W.R.H.); Joslin Diabetes Center, and Harvard Medical School, Boston, MA (A.B.G.)
| | - Allison B Goldfine
- From Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Colorado School of Medicine, Aurora (C.C.L.); CPC Clinical Research, Aurora, CO (C.C.L., C.N.H., W.R.H.); Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora (C.N.H., W.R.H.); Joslin Diabetes Center, and Harvard Medical School, Boston, MA (A.B.G.).
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Effect of weight loss induced by energy restriction on measures of arterial compliance: A systematic review and meta-analysis. Atherosclerosis 2016; 247:7-20. [DOI: 10.1016/j.atherosclerosis.2016.01.042] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 01/13/2016] [Accepted: 01/26/2016] [Indexed: 12/16/2022]
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21
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Sackner-Bernstein J, Kanter D, Kaul S. Dietary Intervention for Overweight and Obese Adults: Comparison of Low-Carbohydrate and Low-Fat Diets. A Meta-Analysis. PLoS One 2015; 10:e0139817. [PMID: 26485706 PMCID: PMC4618935 DOI: 10.1371/journal.pone.0139817] [Citation(s) in RCA: 143] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 09/16/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Reduced calorie, low fat diet is currently recommended diet for overweight and obese adults. Prior data suggest that low carbohydrate diets may also be a viable option for those who are overweight and obese. PURPOSE Compare the effects of low carbohydrate versus low fats diet on weight and atherosclerotic cardiovascular disease risk in overweight and obese patients. DATA SOURCES Systematic literature review via PubMed (1966-2014). STUDY SELECTION Randomized controlled trials with ≥8 weeks follow up, comparing low carbohydrate (≤120gm carbohydrates/day) and low fat diet (≤30% energy from fat/day). DATA EXTRACTION Data were extracted and prepared for analysis using double data entry. Prior to identification of candidate publications, the outcomes of change in weight and metabolic factors were selected as defined by Cochrane Collaboration. Assessment of the effects of diets on predicted risk of atherosclerotic cardiovascular disease risk was added during the data collection phase. DATA SYNTHESIS 1797 patients were included from 17 trials with <1 year follow up in 12. Compared with low fat diet, low carbohydrate was associated with significantly greater reduction in weight (Δ = -2.0 kg, 95% CI: -3.1, -0.9) and significantly lower predicted risk of atherosclerotic cardiovascular disease events (p<0.03). Frequentist and Bayesian results were concordant. The probability of greater weight loss associated with low carbohydrate was >99% while the reduction in predicted risk favoring low carbohydrate was >98%. LIMITATIONS Lack of patient-level data and heterogeneity in dropout rates and outcomes reported. CONCLUSIONS This trial-level meta-analysis of randomized controlled trials comparing LoCHO diets with LoFAT diets in strictly adherent populations demonstrates that each diet was associated with significant weight loss and reduction in predicted risk of ASCVD events. However, LoCHO diet was associated with modest but significantly greater improvements in weight loss and predicted ASCVD risk in studies from 8 weeks to 24 months in duration. These results suggest that future evaluations of dietary guidelines should consider low carbohydrate diets as effective and safe intervention for weight management in the overweight and obese, although long-term effects require further investigation.
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Affiliation(s)
| | - David Kanter
- Georgetown University Law Center, Washington, DC, United States of America
| | - Sanjay Kaul
- Cedars-Sinai Medical Center, Los Angeles, CA, United States of America
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de Luis DA, Izaola O, Aller R, de la Fuente B, Bachiller R, Romero E. Effects of a high-protein/low carbohydrate versus a standard hypocaloric diet on adipocytokine levels and insulin resistance in obese patients along 9 months. J Diabetes Complications 2015; 29:950-4. [PMID: 26166555 DOI: 10.1016/j.jdiacomp.2015.06.002] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 05/29/2015] [Accepted: 06/03/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Recent dietary trials and observational studies have focused on the effects of diet on health outcomes such as improvement in levels of surrogate biomarkers. The aim of our study was to examine the changes in weight, adipocytokines levels and insulin resistance after a high-protein/low carbohydrate hypocaloric diet vs. a standard hypocaloric diet during an intervention of 9 months. SUBJECTS AND METHODS 331 obese subjects were randomly allocated to one of two diets for a period of 9 months. Diet HP (n=168) (high-protein hypocaloric diet) consisted in a diet of 1050 cal/day, 33% of carbohydrates, 33% of fats and 34% of proteins. Diet S (n=163) (standard protein hypocaloric diet) consisted in a diet of 1093 cal/day, 53% carbohydrates, 27%fats, and 20% proteins. RESULTS With the diets HP and S, BMI, weight, fat mass, waist circumference, waist-to-hip ratio, systolic blood pressure, total cholesterol, LDL-cholesterol, insulin and HOMA decreased. The decrease at 9 months of (BMI: -2.6±1.3kg/m(2) vs. -2.1±1.2kg/m(2):p<0.05), weight (-8.4±4.2kg vs. -5.0±4.1kg: p<0.05), fat mass (-5.1±4.1kg vs. -3.4±4.2kg: p<0.05), systolic blood pressure (-5.1±7.1mmHg vs. -3.1±2.1mmHg: p<0.05), (insulin levels -4.0±4.8 UI/L vs. -2.2±2.4 UI/L; p<0.05) and HOMA (-0.8±1.0 units vs. -0.3±1.0 units; p<0.05) was higher in diet HP than Diet S. With both diets, leptin levels decreased. CONCLUSION A high-protein/low carbohydrate hypocaloric diet shows a higher weight loss, insulin and HOMA-R decreased after 9 months than a standard hypocaloric diet. The improvement in adipokine levels was similar with both diets.
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Affiliation(s)
- Daniel Antonio de Luis
- Center of Investigation of Endocrinology and Nutrition, Medicine School and Dept Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain.
| | - Olatz Izaola
- Center of Investigation of Endocrinology and Nutrition, Medicine School and Dept Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
| | - Rocio Aller
- Center of Investigation of Endocrinology and Nutrition, Medicine School and Dept Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
| | - Beatriz de la Fuente
- Center of Investigation of Endocrinology and Nutrition, Medicine School and Dept Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
| | - Rosario Bachiller
- Center of Investigation of Endocrinology and Nutrition, Medicine School and Dept Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
| | - Enrique Romero
- Center of Investigation of Endocrinology and Nutrition, Medicine School and Dept Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
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Petersen K, Blanch N, Keogh J, Clifton P. Weight Loss, Dietary Intake and Pulse Wave Velocity. Pulse (Basel) 2015; 3:134-40. [PMID: 26587462 DOI: 10.1159/000435792] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
We have recently conducted a meta-analysis to determine the effect of weight loss achieved by an energy-restricted diet with or without exercise, anti-obesity drugs or bariatric surgery on pulse wave velocity (PWV) measured at all arterial segments. Twenty studies, including 1,259 participants, showed that modest weight loss (8% of the initial body weight) caused a reduction in PWV measured at all arterial segments. However, due to the poor methodological design of the included studies, the results of this meta-analysis can only be regarded as hypothesis generating and highlight the need for further research in this area. In the future, well-designed randomised controlled trials are required to determine the effect of diet-induced weight loss on PWV and the mechanisms involved. In addition, there is observational evidence that dietary components such as fruit, vegetables, dairy foods, sodium, potassium and fatty acids may be associated with PWV, although evidence from well-designed intervention trials is lacking. In the future, the effect of concurrently improving dietary quality and achieving weight loss should be assessed in randomised controlled trials.
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Affiliation(s)
- Kristina Petersen
- Division of Health Sciences, School of Pharmacy and Medical Science, University of South Australia, Adelaide, S.A., Australia
| | - Natalie Blanch
- Division of Health Sciences, School of Pharmacy and Medical Science, University of South Australia, Adelaide, S.A., Australia
| | - Jennifer Keogh
- Division of Health Sciences, School of Pharmacy and Medical Science, University of South Australia, Adelaide, S.A., Australia
| | - Peter Clifton
- Division of Health Sciences, School of Pharmacy and Medical Science, University of South Australia, Adelaide, S.A., Australia
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Cosenso-Martin LN, Giollo-Junior LT, Vilela-Martin JF. DPP-4 Inhibitor Reduces Central Blood Pressure in a Diabetic and Hypertensive Patient: A Case Report. Medicine (Baltimore) 2015; 94:e1068. [PMID: 26166078 PMCID: PMC4504643 DOI: 10.1097/md.0000000000001068] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Hypertension and type 2 diabetes mellitus (DM) are among the main risk factors for the development of cardiovascular disease. Pharmacotherapy for DM should not only improve blood glucose control, but also provide beneficial glucose-independent cardiovascular effects. The central systolic blood pressure (SBP) has become more important than the brachial SBP in the assessment of cardiovascular risk.This case report describes the effect of vildagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, on the central SBP in a 54-year-old woman with hypertension and DM. She was submitted to applanation tonometry (AT) before and after vildagliptin association. AT of the radial artery is a non-invasive method that indirectly assesses arterial stiffness by calculating the central SBP and the augmentation index (AIx).After 3 months of follow-up using vildagliptin, central SBP and AIx were improved. Moreover, she presented better glycemic control.This case suggests an effect of DPP-4 inhibitor on arterial stiffness parameter (central SBP) in a hypertensive and diabetic patient, which shows a glucose-independent beneficial cardiovascular effect of this group of drugs.
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Affiliation(s)
- Luciana Neves Cosenso-Martin
- From the Department of Internal Medicine, Medical School of São José do Rio Preto (FAMERP), Hypertension Clinic of FAMERP and Hospital de Base, Ave Brig Faria Lima 5416, São José do Rio Preto, SP, Brazil
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25
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Yang X, Lai P, Chen XG, Liu ZP, Tang YM, Rao S, Wen CJ, Jiao SR, Lei J. Maternal high-fat diet exposure leads to insulin resistance and impacts myogenic and adipogenicgene expression in offspring rats. EUR J LIPID SCI TECH 2015. [DOI: 10.1002/ejlt.201400421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Xiao Yang
- School of Bioengineering; Xihua University; Chengdu P. R. China
| | - Peng Lai
- School of Bioengineering; Xihua University; Chengdu P. R. China
| | - Xiang-Gui Chen
- School of Bioengineering; Xihua University; Chengdu P. R. China
| | - Zhen-Ping Liu
- School of Bioengineering; Xihua University; Chengdu P. R. China
| | - Yuan-Mou Tang
- School of Bioengineering; Xihua University; Chengdu P. R. China
| | - Su Rao
- School of Bioengineering; Xihua University; Chengdu P. R. China
| | - Chun-Juan Wen
- School of Bioengineering; Xihua University; Chengdu P. R. China
| | - Shi-Rong Jiao
- School of Bioengineering; Xihua University; Chengdu P. R. China
| | - Ji Lei
- School of Bioengineering; Xihua University; Chengdu P. R. China
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26
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Guthrie GE, Bogue RJ. Impact of a Shared Medical Appointment Lifestyle Intervention on Weight and Lipid Parameters in Individuals with Type 2 Diabetes: A Clinical Pilot. J Am Coll Nutr 2015; 34:300-9. [DOI: 10.1080/07315724.2014.933454] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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27
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Deer J, Koska J, Ozias M, Reaven P. Dietary models of insulin resistance. Metabolism 2015; 64:163-71. [PMID: 25441706 DOI: 10.1016/j.metabol.2014.08.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 07/20/2014] [Accepted: 08/29/2014] [Indexed: 12/12/2022]
Abstract
Insulin resistance is a significant factor in the development of type 2 diabetes mellitus, however the connection between the Western diet and the development of insulin resistance has not been fully explained. Dietary macronutrient composition has been examined in a number of articles, and diets enriched in saturated fatty acids, and possibly in fructose, appear to be most consistently associated with the development of insulin resistance. However, mechanistic insights into the metabolic effects of such diets are lacking, and merit further study.
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Affiliation(s)
- James Deer
- Department of Endocrinology, Phoenix VA Health Care System, 650 E Indian School Road Mail Code 111E, Phoenix, AZ 85012-1892.
| | - Juraj Koska
- Department of Endocrinology, Phoenix VA Health Care System, 650 E Indian School Road Mail Code 111E, Phoenix, AZ 85012-1892
| | - Marlies Ozias
- Department of Endocrinology, Phoenix VA Health Care System, 650 E Indian School Road Mail Code 111E, Phoenix, AZ 85012-1892
| | - Peter Reaven
- Department of Endocrinology, Phoenix VA Health Care System, 650 E Indian School Road Mail Code 111E, Phoenix, AZ 85012-1892
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Petersen KS, Blanch N, Keogh JB, Clifton PM. Effect of Weight Loss on Pulse Wave Velocity. Arterioscler Thromb Vasc Biol 2015; 35:243-52. [DOI: 10.1161/atvbaha.114.304798] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Kristina S. Petersen
- From the School of Pharmacy and Medical Science, University of South Australia, Adelaide, Australia
| | - Natalie Blanch
- From the School of Pharmacy and Medical Science, University of South Australia, Adelaide, Australia
| | - Jennifer B. Keogh
- From the School of Pharmacy and Medical Science, University of South Australia, Adelaide, Australia
| | - Peter M. Clifton
- From the School of Pharmacy and Medical Science, University of South Australia, Adelaide, Australia
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Montero D, Roberts CK, Vinet A. Effect of aerobic exercise training on arterial stiffness in obese populations : a systematic review and meta-analysis. Sports Med 2014; 44:833-43. [PMID: 24585152 DOI: 10.1007/s40279-014-0165-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND AND OBJECTIVE Controversy exists as to whether aerobic exercise training decreases arterial stiffness in obese subjects. The aim of this study was to systematically review and quantify the effect of aerobic exercise training on arterial stiffness in obese populations. METHODS MEDLINE, Cochrane, Scopus, and Web of Science were searched up until May 2013 for trials assessing the effect of aerobic training interventions lasting 8 weeks or more on arterial stiffness in obese populations (body mass index ≥30 kg/m(2)). Standardized mean difference (SMD) in arterial stiffness parameters (augmentation index, β-stiffness, distensibility, pulse wave velocity, arterial waveforms) was calculated using a random-effects model. Subgroup and meta-regression analyses were used to study potential moderating factors. RESULTS Eight trials, comprising a total of 235 subjects with an age range of 49-70 years, met the inclusion criteria. Arterial stiffness was not significantly reduced by aerobic training (SMD -0.17; 95 % confidence interval (CI) -0.39, 0.06, P = 0.14). Similarly, post-intervention arterial stiffness was similar between the aerobic-trained and control obese groups (SMD 0.02; 95 % CI -0.28, 0.32, P = 0.88). Neither heterogeneity nor publication bias were detected in these analyses. In subgroup analyses, arterial stiffness was significantly reduced in aerobic-trained subgroups having below median values in post- minus pre-intervention systolic blood pressure (SBP) (P < 0.01), exercise intensity rating score (P < 0.01), and methodological quality score (P < 0.01). Equivalent results were obtained in meta-regression analyses. CONCLUSION Based on current published trials, arterial stiffness is generally not reduced in middle-aged and older obese populations in response to aerobic training. However, in studies using low-intensity aerobic training and yielding a decrease in SBP, arterial stiffness may decrease. Long-term studies are needed to assess the prognostic value of these findings.
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Affiliation(s)
- David Montero
- Avignon University, LAPEC EA4278, 84000, Avignon, France,
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30
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Juhl CB, Bradley U, Holst JJ, Leslie RD, Yderstraede KB, Hunter S. Similar weight-adjusted insulin secretion and insulin sensitivity in short-duration late autoimmune diabetes of adulthood (LADA) and type 2 diabetes: Action LADA 9 [corrected]. Diabet Med 2014; 31:941-5. [PMID: 24628669 DOI: 10.1111/dme.12434] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 12/18/2013] [Accepted: 03/10/2014] [Indexed: 01/09/2023]
Abstract
AIMS To explore insulin sensitivity and insulin secretion in people with latent autoimmune diabetes in adulthood (LADA) compared with that in people with type 2 diabetes. METHODS A total of 12 people with LADA, defined as glutamic acid decarboxylase (GAD) antibody positivity and > 1 year of insulin independency (group A) were age-matched pairwise to people with type 2 diabetes (group B) and to six people with type 2 diabetes of similar age and BMI (group C). β-Cell function (first-phase insulin secretion and assessment of insulin pulsatility), insulin sensitivity (hyperinsulinemic-euglycemic clamp) and metabolic response during a mixed meal were studied. RESULTS Both first-phase insulin secretion and insulin release during the meal were greater (P = 0.05 and P = 0.009, respectively) in type 2 diabetes as compared with LADA; these differences were lost on adjustment for BMI (group C) and could be explained by BMI alone in a multivariate analysis. Neither insulin pulsatility, incretin secretion nor insulin sensitivity differed among the groups. CONCLUSIONS We found no evidence that LADA and type 2 diabetes were distinct disease entities beyond the differences explained by BMI.
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Affiliation(s)
- C B Juhl
- Sydvestjysk Hospital, Esbjerg, Denmark; Odense University Hospital, Odense, Denmark
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31
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Naude CE, Schoonees A, Senekal M, Young T, Garner P, Volmink J. Low carbohydrate versus isoenergetic balanced diets for reducing weight and cardiovascular risk: a systematic review and meta-analysis. PLoS One 2014; 9:e100652. [PMID: 25007189 PMCID: PMC4090010 DOI: 10.1371/journal.pone.0100652] [Citation(s) in RCA: 158] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 05/29/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Some popular weight loss diets restricting carbohydrates (CHO) claim to be more effective, and have additional health benefits in preventing cardiovascular disease compared to balanced weight loss diets. METHODS AND FINDINGS We compared the effects of low CHO and isoenergetic balanced weight loss diets in overweight and obese adults assessed in randomised controlled trials (minimum follow-up of 12 weeks), and summarised the effects on weight, as well as cardiovascular and diabetes risk. Dietary criteria were derived from existing macronutrient recommendations. We searched Medline, EMBASE and CENTRAL (19 March 2014). Analysis was stratified by outcomes at 3-6 months and 1-2 years, and participants with diabetes were analysed separately. We evaluated dietary adherence and used GRADE to assess the quality of evidence. We calculated mean differences (MD) and performed random-effects meta-analysis. Nineteen trials were included (n = 3209); 3 had adequate allocation concealment. In non-diabetic participants, our analysis showed little or no difference in mean weight loss in the two groups at 3-6 months (MD 0.74 kg, 95%CI -1.49 to 0.01 kg; I2 = 53%; n = 1745, 14 trials; moderate quality evidence) and 1-2 years (MD 0.48 kg, 95%CI -1.44 kg to 0.49 kg; I2 = 12%; n = 1025; 7 trials, moderate quality evidence). Furthermore, little or no difference was detected at 3-6 months and 1-2 years for blood pressure, LDL, HDL and total cholesterol, triglycerides and fasting blood glucose (>914 participants). In diabetic participants, findings showed a similar pattern. CONCLUSIONS Trials show weight loss in the short-term irrespective of whether the diet is low CHO or balanced. There is probably little or no difference in weight loss and changes in cardiovascular risk factors up to two years of follow-up when overweight and obese adults, with or without type 2 diabetes, are randomised to low CHO diets and isoenergetic balanced weight loss diets.
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Affiliation(s)
- Celeste E. Naude
- Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Anel Schoonees
- Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Marjanne Senekal
- Division of Human Nutrition, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Taryn Young
- Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Cochrane Centre, South African Medical Research Council, Cape Town, South Africa
| | - Paul Garner
- Effective Health Care Research Consortium, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Jimmy Volmink
- Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Cochrane Centre, South African Medical Research Council, Cape Town, South Africa
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Effect of weight loss on central systolic blood pressure in elderly community-dwelling persons. Hypertens Res 2014; 37:933-8. [PMID: 24965169 DOI: 10.1038/hr.2014.108] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 05/16/2014] [Accepted: 05/19/2014] [Indexed: 11/09/2022]
Abstract
Central blood pressure (BP) has been shown to strongly associate with cardiovascular disease and outcome. Recent studies have demonstrated a relationship between changes in body size by exercise training and peripheral BP; however, the effect on changes in central BP is unknown. The aim of this study was to assess whether changes in body size are independently related to changes in central BP in the elderly. The subjects were 11 men (mean age, 68±6 years) and 84 women (68±7 years) from a rural village. Before and at the end of the 12-week training program, metabolic variables, and first peak radial systolic BP (SBP1) and second peak radial SBP (SBP2) as estimates of central SBP, were obtained. Radial augmentation index (AI) was calculated as follows: ((SBP2-diastolic BP (DBP))/(SBP1-DBP)) × 100 (%) and we used AI corrected at heart rate 75 per min (AI@75). After the 12-week training program, weight loss correlated strongly with reduction in brachial mean arterial pressure (MAP), radial SBP1, SBP2 and AI@75. After adjusting for confounding factors, weight loss was significantly and independently associated with each reduction in brachial MAP (β=0.34, P=0.001), radial SBP1 (β=0.31, P=0.002), SBP2 (β=0.37, P<0.001) and AI@75 (β=0.36, P=0.001). These findings suggest that weight loss by a 12-week training program may be an effective strategy to improve central BP parameters among Japanese elderly persons.
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Llanos AAM, Krok JL, Peng J, Pennell ML, Olivo-Marston S, Vitolins MZ, DeGraffinreid CR, Paskett ED. Favorable effects of low-fat and low-carbohydrate dietary patterns on serum leptin, but not adiponectin, among overweight and obese premenopausal women: a randomized trial. SPRINGERPLUS 2014; 3:175. [PMID: 24790820 PMCID: PMC4000357 DOI: 10.1186/2193-1801-3-175] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 03/27/2014] [Indexed: 12/11/2022]
Abstract
PURPOSE The most effective dietary pattern for breast cancer prevention has been greatly debated in recent years. Studies have examined hypocaloric diets, with particular emphasis on macronutrient composition, yielding inconclusive data. The objective of this study was to examine the effects of calorie-restricted low-fat and low-carbohydrate diets (LFD and LCD, respectively) on circulating adipokines among overweight and obese premenopausal women. METHODS Seventy-nine overweight and obese premenopausal women were randomized to either LFD or LCD, with increased physical activity, for 52 weeks. Serum adiponectin, leptin and the adiponectin-to-leptin ratio (A/L) were measured at baseline, and at weeks 34 and 52 to assess intervention effects. RESULTS While there were no significant changes in serum adiponectin concentrations following the LCD and LFD interventions, leptin concentrations significantly decreased by week 34 of the intervention period (LCD: 35.3%, P = 0.004; LFD: 30.0%, P = 0.01), with no difference by intervention arm. At week 52, these reductions were statistically non-significant, indicating a return to baseline levels by the end of the intervention. While there were non-significant increases in the A/L ratio following the LCD and LFD intervention arms, the overall trend, across groups, was marginally significant (P = 0.05) with increases of 16.2% and 35.1% at weeks 34 and 52, respectively. CONCLUSIONS These findings suggest that caloric-restricted LCD and LFD dietary patterns favorably modify leptin and possibly the A/L ratio, and lend support to the hypothesis that these interventions may be effective for obesity-related breast cancer prevention through their effects on biomarkers involved in metabolic pathways. TRIAL REGISTRATION CLINICAL TRIAL REGISTRATION NUMBER NCT01559194.
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Affiliation(s)
- Adana AM Llanos
- />Division of Cancer Prevention and Control, College of Medicine, The Ohio State University, Columbus, OH USA
- />The Ohio State University Comprehensive Cancer Center, 1590 N. High St., Suite 525, Columbus, OH 43210 USA
| | - Jessica L Krok
- />The Ohio State University Comprehensive Cancer Center, 1590 N. High St., Suite 525, Columbus, OH 43210 USA
| | - Juan Peng
- />Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC USA
| | - Michael L Pennell
- />Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC USA
| | - Susan Olivo-Marston
- />Division of Cancer Prevention and Control, College of Medicine, The Ohio State University, Columbus, OH USA
- />The Ohio State University Comprehensive Cancer Center, 1590 N. High St., Suite 525, Columbus, OH 43210 USA
| | - Mara Z Vitolins
- />Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC USA
| | - Cecilia R DeGraffinreid
- />The Ohio State University Comprehensive Cancer Center, 1590 N. High St., Suite 525, Columbus, OH 43210 USA
| | - Electra D Paskett
- />Division of Cancer Prevention and Control, College of Medicine, The Ohio State University, Columbus, OH USA
- />The Ohio State University Comprehensive Cancer Center, 1590 N. High St., Suite 525, Columbus, OH 43210 USA
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Effects of hypocaloric diet, low-intensity resistance exercise with slow movement, or both on aortic hemodynamics and muscle mass in obese postmenopausal women. Menopause 2014; 20:967-72. [PMID: 23511706 DOI: 10.1097/gme.0b013e3182831ee4] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE This study aims to examine the independent and combined impact of hypocaloric diet and low-intensity resistance exercise training (LIRET) on aortic hemodynamics and appendicular skeletal muscle mass (ASM) in obese postmenopausal women. METHODS Forty-one obese postmenopausal women (mean [SD] age, 54 [1] y) were randomly assigned to LIRET (n = 13), diet (n = 14), or diet + LIRET (n = 14). Body weight, waist circumference, aortic systolic blood pressure, aortic pulse pressure, augmentation index, subendocardial viability ratio (SEVR; myocardial perfusion), and heart rate (HR) were measured before and after 12 weeks. ASM was assessed by dual-energy x-ray absorptiometry. RESULTS Body weight (P < 0.001) and waist circumference (P < 0.01) decreased similarly after diet and diet + LIRET compared with no changes after LIRET. ASM did not change after diet + LIRET, and the decrease observed after diet (P < 0.001) was significant compared with LIRET. Aortic systolic blood pressure decreased similarly after LIRET (P < 0.05), diet (P < 0.01), and diet + LIRET (P < 0.01). Aortic pulse pressure (P < 0.05) decreased similarly after diet and diet + LIRET, but not after LIRET. SEVR (P < 0.01) increased similarly in both diet groups, whereas HR (P < 0.01) decreased only after diet. Changes in SEVR (P < 0.05) and HR (P< 0.01) with diet were different compared with LIRET. The augmentation index did not change in any group. CONCLUSIONS Our findings suggest that diet-induced weight loss may reduce cardiovascular risk by improving SEVR via HR and aortic pulse pressure reductions in obese postmenopausal women. LIRET prevents ASM loss associated with hypocaloric diet but has no additive effects on aortic hemodynamics.
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Ko BJ, Park KH, Mantzoros CS. Diet patterns, adipokines, and metabolism: where are we and what is next? Metabolism 2014; 63:168-77. [PMID: 24360751 DOI: 10.1016/j.metabol.2013.11.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 11/08/2013] [Indexed: 12/13/2022]
Affiliation(s)
- Byung-Joon Ko
- Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA; Department of Family Medicine, College of Medicine, Korea University, Seoul 136-705, South Korea
| | - Kyung Hee Park
- Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA; Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University, Gyeonggi-do, South Korea.
| | - Christos S Mantzoros
- Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA; Section of Endocrinology, Boston VA Healthcare System, Harvard Medical School, Boston, MA 02130, USA
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Ruth MR, Port AM, Shah M, Bourland AC, Istfan NW, Nelson KP, Gokce N, Apovian CM. Consuming a hypocaloric high fat low carbohydrate diet for 12 weeks lowers C-reactive protein, and raises serum adiponectin and high density lipoprotein-cholesterol in obese subjects. Metabolism 2013; 62:1779-87. [PMID: 24075505 PMCID: PMC3845365 DOI: 10.1016/j.metabol.2013.07.006] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Revised: 07/08/2013] [Accepted: 07/16/2013] [Indexed: 01/12/2023]
Abstract
OBJECTIVE High fat, low carbohydrate (HFLC) diets have become popular tools for weight management. We sought to determine the effects of a HFLC diet compared to a low fat high carbohydrate (LFHC) diet on the change in weight loss, cardiovascular risk factors and inflammation in subjects with obesity. METHODS Obese subjects (29.0-44.6 kg/m2) recruited from Boston Medical Center were randomized to a hypocaloric LFHC (n=26) or HFLC (n=29) diet for 12 weeks. RESULTS The age range of subjects was 21-62 years. As a percentage of daily calories, the HFLC group consumed 33.5% protein, 56.0% fat and 9.6% carbohydrate and the LFHC group consumed 22.0% protein, 25.0% fat and 55.7% carbohydrate. The change in percent body weight, lean and fat mass, blood pressure, flow mediated dilation, hip:waist ratio, hemoglobin A1C, fasting insulin and glucose, and glucose and insulin response to a 2h oral glucose tolerance test did not differ (P>0.05) between diets after 12 weeks. The HFLC group had greater mean decreases in serum triglyceride (P=0.07), and hs-CRP (P=0.03), and greater mean increases in HDL cholesterol (P=0.004), and total adiponectin (P=0.045) relative to the LFHC. Secreted adipose tissue adiponectin or TNF-α did not differ after weight loss for either diet. CONCLUSIONS Relative to the LFHC group, the HFLC group had greater improvements in blood lipids and systemic inflammation with similar changes in body weight and composition. This small-scale study suggests that HFLC diets may be more beneficial to cardiovascular health and inflammation in free-living obese adults compared to LFHC diets.
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Affiliation(s)
- Megan R. Ruth
- Department of Medicine, Section of Endocrinology, Diabetes and Nutrition, Boston University, 88 E. Newton St., Suite 4400D, Boston, MA 02118
| | - Ava M. Port
- Department of Medicine, Section of Endocrinology, Diabetes and Nutrition, Boston University, 88 E. Newton St., Suite 4400D, Boston, MA 02118
| | - Mitali Shah
- Department of Medicine, Section of Endocrinology, Diabetes and Nutrition, Boston University, 88 E. Newton St., Suite 4400D, Boston, MA 02118
| | - Ashley C. Bourland
- Department of Medicine, Section of Endocrinology, Diabetes and Nutrition, Boston University, 88 E. Newton St., Suite 4400D, Boston, MA 02118
| | - Nawfal W. Istfan
- Department of Medicine, Section of Endocrinology, Diabetes and Nutrition, Boston University, 88 E. Newton St., Suite 4400D, Boston, MA 02118
| | - Kerrie P. Nelson
- Department of Biostatistics, Boston University School of Public Health, 715 Albany St., CT318, Boston, MA 02118
| | - Noyan Gokce
- Department of Medicine, Cardiology, 88 E. Newton St., D-8, Boston, MA 02118
| | - Caroline M. Apovian
- Department of Medicine, Section of Endocrinology, Diabetes and Nutrition, Boston University, 88 E. Newton St., Suite 4400D, Boston, MA 02118
- Corresponding Author: Caroline M. Apovian, M.D., F.A.C.P., F.A.C.N., Professor of Medicine and Pediatrics, Boston University School of Medicine, Director, Center for Nutrition and Weight Management, Boston Medical Center, 88 East Newton Street, Robinson Bldg, Suite 4400, Boston, MA 02118, Tel: 617-638-8556, Fax: 617-638-8599,
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Wallace IR, McEvoy CT, Hunter SJ, Hamill LL, Ennis CN, Bell PM, Patterson CC, Woodside JV, Young IS, McKinley MC. Dose-response effect of fruit and vegetables on insulin resistance in people at high risk of cardiovascular disease: a randomized controlled trial. Diabetes Care 2013; 36:3888-96. [PMID: 24130354 PMCID: PMC3836143 DOI: 10.2337/dc13-0718] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The purpose of this randomized controlled trial was to investigate the dose-response effect of fruit and vegetable (F&V) intake on insulin resistance (IR) in people who are overweight and at high risk of cardiovascular disease (CVD). RESEARCH DESIGN AND METHODS A total of 105 participants (mean age 56 years) followed a 4-week washout diet (one to two portions of F&Vs per day). Ninety-two participants completed the washout and were randomized to receive one to two, four, or seven portions of F&Vs per day for 12 weeks. IR was assessed at the start and end of this 12-week period by the two-step euglycemic-hyperinsulinemic clamp. Compliance was monitored using a combination of 4-day food diaries and plasma biomarkers of F&V intake. RESULTS A total of 89 participants completed the study. Participants attained self-reported F&V intakes of 1.8, 3.8, and 7.0 portions per day (P < 0.001) per group. There was a significant linear increase in serum lutein status across the groups, indicating good compliance (P < 0.001), and body weight was maintained (P = 0.77). No significant difference was found between groups in terms of a change in measures of whole-body, peripheral, or hepatic IR or adiponectin multimers. CONCLUSIONS Increased consumption of F&Vs, as advocated in public-health advice, has no effect on IR in overweight individuals who are at high risk of CVD when body weight is maintained. Recent evidence from systematic reviews indicates that particular classes or types of F&Vs may have particular antidiabetic properties; hence, it is possible that benefits may only be observed in response to a more specific fruit or vegetable intervention.
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Bielohuby M, Sisley S, Sandoval D, Herbach N, Zengin A, Fischereder M, Menhofer D, Stoehr BJM, Stemmer K, Wanke R, Tschöp MH, Seeley RJ, Bidlingmaier M. Impaired glucose tolerance in rats fed low-carbohydrate, high-fat diets. Am J Physiol Endocrinol Metab 2013; 305:E1059-70. [PMID: 23982154 DOI: 10.1152/ajpendo.00208.2013] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Moderate low-carbohydrate/high-fat (LC-HF) diets are widely used to induce weight loss in overweight subjects, whereas extreme ketogenic LC-HF diets are used to treat neurological disorders like pediatric epilepsy. Usage of LC-HF diets for improvement of glucose metabolism is highly controversial; some studies suggest that LC-HF diets ameliorate glucose tolerance, whereas other investigations could not identify positive effects of these diets or reported impaired insulin sensitivity. Here, we investigate the effects of LC-HF diets on glucose and insulin metabolism in a well-characterized animal model. Male rats were fed isoenergetic or hypocaloric amounts of standard control diet, a high-protein "Atkins-style" LC-HF diet, or a low-protein, ketogenic, LC-HF diet. Both LC-HF diets induced lower fasting glucose and insulin levels associated with lower pancreatic β-cell volumes. However, dynamic challenge tests (oral and intraperitoneal glucose tolerance tests, insulin-tolerance tests, and hyperinsulinemic euglycemic clamps) revealed that LC-HF pair-fed rats exhibited impaired glucose tolerance and impaired hepatic and peripheral tissue insulin sensitivity, the latter potentially being mediated by elevated intramyocellular lipids. Adjusting visceral fat mass in LC-HF groups to that of controls by reducing the intake of LC-HF diets to 80% of the pair-fed groups did not prevent glucose intolerance. Taken together, these data show that lack of dietary carbohydrates leads to glucose intolerance and insulin resistance in rats despite causing a reduction in fasting glucose and insulin concentrations. Our results argue against a beneficial effect of LC-HF diets on glucose and insulin metabolism, at least under physiological conditions. Therefore, use of LC-HF diets for weight loss or other therapeutic purposes should be balanced against potentially harmful metabolic side effects.
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Affiliation(s)
- Maximilian Bielohuby
- Endocrine Research Unit, Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität (LMU Munich, Germany
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Daily non-soy legume consumption reverses vascular impairment due to peripheral artery disease. Atherosclerosis 2013; 230:310-4. [DOI: 10.1016/j.atherosclerosis.2013.07.048] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 07/12/2013] [Accepted: 07/23/2013] [Indexed: 02/05/2023]
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Roberts CK, Izadpanah A, Angadi SS, Barnard RJ. Effects of an intensive short-term diet and exercise intervention: comparison between normal-weight and obese children. Am J Physiol Regul Integr Comp Physiol 2013; 305:R552-7. [PMID: 23883675 DOI: 10.1152/ajpregu.00131.2013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Lifestyle intervention programs currently emphasize weight loss secondary to obesity as the primary determinant of phenotypic changes. We examined whether the effects of a short-term lifestyle intervention program differ in normal-weight versus overweight/obese children. Nineteen overweight/obese (O; BMI = 33.6 ± 1.9 kg/m(2)) and 14 normal-weight (N; BMI = 19.9 ± 1.5 kg/m(2)) children participated in a 2-wk program consisting of an ad libitum high-fiber, low-fat diet and daily exercise (2-2.5 h). Fasting serum samples were taken pre- and postintervention for determination of lipids, glucose homeostasis, inflammatory cytokines, and adipokines. Only the O group lost weight (3.9%) but remained overweight/obese (32.3 ± 1.9 kg/m(2)). Both groups exhibited significant intervention-induced decreases (P < 0.05) in serum insulin (N: 52.5% vs. O: 28.1%; between groups, P = 0.38), homeostatic model assessment for insulin resistance (N: 53.1% vs. O: 28.4%, P = 0.43), leptin (N: 69.3% vs. O: 44.1%, P = 0.10), amylin (N: 28.7% vs. O: 26.1%, P = 0.80), resistin (N: 40.0% vs. O: 35.1%, P = 0.99), plasminogen activator-inhibitor-1 (N: 30.8% vs. O: 25.6%, P = 0.59), IL-6 (N: 58.8% vs. O: 48.5%, P = 0.78), IL-8 (N: 46.0% vs. O: 42.2%, P = 0.49), and TNFα (N: 45.8% vs. O: 40.8%, P = 0.99). No associations between indices of weight change and phenotypic changes were noted. A short-term, intensive lifestyle modification program is effective in ameliorating metabolic risk factors in N and O children. These results suggest that obesity per se was not the primary driver of the phenotypes noted and that dietary intake and physical inactivity induce the phenotypic abnormalities. These data may have implications for the weight loss-independent management of cardiometabolic risk in pediatric populations.
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Affiliation(s)
- Christian K Roberts
- Exercise and Metabolic Disease Laboratory, Translational Section, School of Nursing, University of California Los Angeles, Los Angeles, California 90095-6918, USA.
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McEneny J, McPherson P, Spence M, Bradley U, Blair S, McKinley M, Young I, Hunter S. Does a diet high or low in fat influence the oxidation potential of VLDL, LDL and HDL subfractions? Nutr Metab Cardiovasc Dis 2013; 23:612-618. [PMID: 22405535 DOI: 10.1016/j.numecd.2011.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 11/21/2011] [Accepted: 12/09/2011] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND AIMS High-fat diets have become increasingly popular for weight-loss, but their effect on the oxidation potential of lipoprotein subfractions has not been studied. Therefore, this study compared the effects of high-fat vs. low-fat weight reduction diets on this parameter. METHODS AND RESULTS Very-low, low- and high-density lipoprotein (VLDL, LDL & HDL) subfractions were isolated by rapid ultracentrifugation from 24-overweight/obese subjects randomised to a high- or low-fat diet. The lipoprotein subfractions were assessed for oxidation potential by measuring conjugated diene (CD) production and time at half maximum. We found a significant between-group difference in oxidation potential. Specifically, a high-fat diet led to increased CD production in VLDL(A-D) and HDL(2&3), and a prolongation of time at half maximum. Within-group differences found that CDs increased in VLDL(A&D), LDL(I-III) and HDL(2&3) in the high-fat group and fell in VLDL(A-C) and HDL(2&3) and increased in LDL(I&II), in the low-fat group. Furthermore, following both diets all lipoprotein subfractions, except LDL(II) in the low-fat group, were protected against oxidation. CONCLUSION These results demonstrate that at first glance, a high-fat diet may be indicative of having heart-protective properties. However, this may be erroneous, as although the time for oxidation to occur was prolonged, once this occurred these lipoproteins had the potential to produce significantly more oxidised substrate. Conversely, a low-fat diet may be considered anti-atherogenic, as these subfractions were protected against oxidation and mainly contained fewer oxidised substrate. Thus, increased fat intake may, by increasing the oxidation product within lipoprotein subfractions, increase cardiovascular disease.
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MESH Headings
- Adult
- Body Mass Index
- Copper/pharmacology
- Diet, Atherogenic/adverse effects
- Diet, Fat-Restricted/adverse effects
- Diet, High-Fat/adverse effects
- Diet, Reducing/methods
- Fatty Acids, Unsaturated/analysis
- Fatty Acids, Unsaturated/chemistry
- Female
- Humans
- Kinetics
- Lipoproteins, HDL/blood
- Lipoproteins, HDL/chemistry
- Lipoproteins, HDL/drug effects
- Lipoproteins, LDL/analysis
- Lipoproteins, LDL/blood
- Lipoproteins, LDL/chemistry
- Lipoproteins, LDL/drug effects
- Lipoproteins, VLDL/analysis
- Lipoproteins, VLDL/blood
- Lipoproteins, VLDL/chemistry
- Lipoproteins, VLDL/drug effects
- Male
- Obesity/blood
- Obesity/diet therapy
- Overweight/blood
- Overweight/diet therapy
- Oxidants/pharmacology
- Oxidation-Reduction/drug effects
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Affiliation(s)
- J McEneny
- Centre for Public Health, Queen's University Belfast, BT12 6BJ, UK.
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Bays HE, Toth PP, Kris-Etherton PM, Abate N, Aronne LJ, Brown WV, Gonzalez-Campoy JM, Jones SR, Kumar R, La Forge R, Samuel VT. Obesity, adiposity, and dyslipidemia: a consensus statement from the National Lipid Association. J Clin Lipidol 2013; 7:304-83. [PMID: 23890517 DOI: 10.1016/j.jacl.2013.04.001] [Citation(s) in RCA: 295] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 04/02/2013] [Accepted: 04/03/2013] [Indexed: 01/04/2023]
Abstract
The term "fat" may refer to lipids as well as the cells and tissue that store lipid (ie, adipocytes and adipose tissue). "Lipid" is derived from "lipos," which refers to animal fat or vegetable oil. Adiposity refers to body fat and is derived from "adipo," referring to fat. Adipocytes and adipose tissue store the greatest amount of body lipids, including triglycerides and free cholesterol. Adipocytes and adipose tissue are active from an endocrine and immune standpoint. Adipocyte hypertrophy and excessive adipose tissue accumulation can promote pathogenic adipocyte and adipose tissue effects (adiposopathy), resulting in abnormal levels of circulating lipids, with dyslipidemia being a major atherosclerotic coronary heart disease risk factor. It is therefore incumbent upon lipidologists to be among the most knowledgeable in the understanding of the relationship between excessive body fat and dyslipidemia. On September 16, 2012, the National Lipid Association held a Consensus Conference with the goal of better defining the effect of adiposity on lipoproteins, how the pathos of excessive body fat (adiposopathy) contributes to dyslipidemia, and how therapies such as appropriate nutrition, increased physical activity, weight-management drugs, and bariatric surgery might be expected to impact dyslipidemia. It is hoped that the information derived from these proceedings will promote a greater appreciation among clinicians of the impact of excess adiposity and its treatment on dyslipidemia and prompt more research on the effects of interventions for improving dyslipidemia and reducing cardiovascular disease risk in overweight and obese patients.
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Affiliation(s)
- Harold E Bays
- Louisville Metabolic and Atherosclerosis Research Center, 3288 Illinois Avenue, Louisville, KY 40213, USA.
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Figueroa A, Vicil F, Sanchez-Gonzalez MA, Wong A, Ormsbee MJ, Hooshmand S, Daggy B. Effects of diet and/or low-intensity resistance exercise training on arterial stiffness, adiposity, and lean mass in obese postmenopausal women. Am J Hypertens 2013; 26:416-23. [PMID: 23382493 DOI: 10.1093/ajh/hps050] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Obesity and aging are associated with increased arterial stiffness as indicated by an increased pulse-wave velocity (PWV). We evaluated the independent and combined effects on PWV and body composition of a hypocaloric diet and low-intensity resistance exercise training (LIRET) with slow movement. METHODS Forty-one postmenopausal women (mean age, 54±6 years; body mass index (BMI), 33.8±0.5kg/m(2)) were randomly assigned to LIRET (n = 14), diet (n = 13), or diet + LIRET (n = 14) for 12 weeks. The women's PWV, mean arterial pressure (MAP), body composition by dual-en ergy x-ray absorptiometry (DXA), and plasma adipokine and insulin levels were measured before and after the interventions. RESULTS Body weight (P = 0.0001), trunk-fat mass (FM, P = 0.0001), and the serum concentration of leptin (P = 0.02 and P = 0.004) decreased similarly with diet and diet + LIRET, but not with LIRET alone. Leg lean mass (LM) decreased (P = 0.02) with diet, but did not change with diet + LIRET or with LIRET alone. Leg muscle strength increased similarly with LIRET (P = 0.001) and diet + LIRET (P = 0.0001), but did not change with diet alone. Brachial-ankle PWV (baPWV) decreased with diet (P = 0.04) and diet + LIRET (P = 0.01), whereas femoral-ankle PWV (legPWV) decreased only with diet (P = 0.01). Mean arterial pressure (MAP) decreased after LIRET (P = 0.03), diet (P = 0.04), and diet + LIRET (P = 0.004). Carotid-femoral PWV, serum adiponectin concentration, and insulin were not significantly affected by the interventions examined in the study. The reductions in baPWV and legPWV were correlated with one another (r = 0.73, P = 0.0001), and the reductions in legPWV and trunk FM were also correlated with one another (r = 0.36, P = 0.03). CONCLUSIONS A hypocaloric diet decreases baPWV mainly by reducing legPWV, and this reduction is related to the loss of truncal fat. Although LIRET alone does not affect PWV or body composition, LIRET combined with diet improves baPWV and muscle strength while preventing loss of lean body mass in obese postmenopausal women.
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Affiliation(s)
- Arturo Figueroa
- Department of Nutrition, Food and Exercise Sciences, The Florida State University, Tallahassee, FL, USA.
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Griffin TM, Huebner JL, Kraus VB, Yan Z, Guilak F. Induction of osteoarthritis and metabolic inflammation by a very high-fat diet in mice: effects of short-term exercise. ACTA ACUST UNITED AC 2012; 64:443-53. [PMID: 21953366 DOI: 10.1002/art.33332] [Citation(s) in RCA: 171] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To test the hypotheses that obesity due to a very high-fat diet induces knee osteoarthritis (OA), and that short-term wheel-running exercise protects against obesity-induced knee OA by reducing systemic inflammation and metabolic dysregulation. METHODS Male C57BL/6J mice were fed either a control diet (13.5% kcal from fat) or a very high-fat diet (60% kcal from fat) from age 12 weeks to age 24 weeks. From 20 to 24 weeks of age, half of the mice were housed with running wheels. The severity of knee OA was determined by assessing histopathologic features, and serum cytokines were measured using a multiplex bead immunoassay and enzyme-linked immunosorbent assays. Body composition was quantified by dual-energy x-ray absorptiometry, and insulin resistance was assessed by glucose tolerance testing. RESULTS Feeding mice with a very high-fat diet increased knee OA scores and levels of serum leptin, adiponectin, KC (mouse analog of interleukin-8 [IL-8]), monokine induced by interferon-γ (CXCL9), and IL-1 receptor antagonist to an extent in proportion to the gain in body fat (3-fold increase in percent body fat compared to controls). Wheel-running exercise reduced progression of OA in the medial femur of obese mice. In addition, exercise disrupted the clustering of cytokine expression and improved glucose tolerance, without reducing body fat or cytokine levels. CONCLUSION Obesity induced by a very high-fat diet in mice causes OA and systemic inflammation in proportion to body fat. Increased joint loading is not sufficient to explain the increased incidence of knee OA with obesity, as wheel running is protective rather than damaging. Exercise improves glucose tolerance and disrupts the coexpression of proinflammatory cytokines, suggesting that increased aerobic exercise may act independently of weight loss in promoting joint health.
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Ble-Castillo JL, Aparicio-Trapala MA, Juárez-Rojop IE, Torres-Lopez JE, Mendez JD, Aguilar-Mariscal H, Olvera-Hernández V, Palma-Cordova LC, Diaz-Zagoya JC. Differential effects of high-carbohydrate and high-fat diet composition on metabolic control and insulin resistance in normal rats. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:1663-76. [PMID: 22754464 PMCID: PMC3386579 DOI: 10.3390/ijerph9051663] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Revised: 12/28/2011] [Accepted: 01/11/2012] [Indexed: 12/23/2022]
Abstract
The macronutrient component of diets is critical for metabolic control and insulin action. The aim of this study was to compare the effects of high fat diets (HFDs) vs. high carbohydrate diets (HCDs) on metabolic control and insulin resistance in Wistar rats. Thirty animals divided into five groups (n = 6) were fed: (1) Control diet (CD); (2) High-saturated fat diet (HSFD); (3) High-unsaturated fat diet (HUFD); (4) High-digestible starch diet, (HDSD); and (5) High-resistant starch diet (HRSD) during eight weeks. HFDs and HCDs reduced weight gain in comparison with CD, however no statistical significance was reached. Calorie intake was similar in both HFDs and CD, but rats receiving HCDs showed higher calorie consumption than other groups, (p < 0.01). HRSD showed the lowest levels of serum and hepatic lipids. The HUFD induced the lowest fasting glycemia levels and HOMA-IR values. The HDSD group exhibited the highest insulin resistance and hepatic cholesterol content. In conclusion, HUFD exhibited the most beneficial effects on glycemic control meanwhile HRSD induced the highest reduction on lipid content and did not modify insulin sensitivity. In both groups, HFDs and HCDs, the diet constituents were more important factors than caloric intake for metabolic disturbance and insulin resistance.
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Affiliation(s)
- Jorge L. Ble-Castillo
- Centro de Investigación, DACS, Universidad Juarez Autónoma de Tabasco (UJAT), Villahermosa, Tabasco 86150, Mexico; (I.E.J.-R.); (J.E.T.-L.); (H.A.-M.); (V.O.-H.); (L.C.P.-C.); (J.C.D.-Z.)
- Author to whom correspondence should be addressed; ; Tel.: +52-993-358-1500 (ext. 6318); Fax: +52-993-351-1132
| | | | - Isela E. Juárez-Rojop
- Centro de Investigación, DACS, Universidad Juarez Autónoma de Tabasco (UJAT), Villahermosa, Tabasco 86150, Mexico; (I.E.J.-R.); (J.E.T.-L.); (H.A.-M.); (V.O.-H.); (L.C.P.-C.); (J.C.D.-Z.)
| | - Jorge E. Torres-Lopez
- Centro de Investigación, DACS, Universidad Juarez Autónoma de Tabasco (UJAT), Villahermosa, Tabasco 86150, Mexico; (I.E.J.-R.); (J.E.T.-L.); (H.A.-M.); (V.O.-H.); (L.C.P.-C.); (J.C.D.-Z.)
| | - Jose D. Mendez
- Unidad de Investigación Médica en Enfermedades Metabólicas, Hospital de Especialidades, CMN, Siglo XXI, IMSS, Mexico D.F. 06703, Mexico;
| | - Hidemi Aguilar-Mariscal
- Centro de Investigación, DACS, Universidad Juarez Autónoma de Tabasco (UJAT), Villahermosa, Tabasco 86150, Mexico; (I.E.J.-R.); (J.E.T.-L.); (H.A.-M.); (V.O.-H.); (L.C.P.-C.); (J.C.D.-Z.)
| | - Viridiana Olvera-Hernández
- Centro de Investigación, DACS, Universidad Juarez Autónoma de Tabasco (UJAT), Villahermosa, Tabasco 86150, Mexico; (I.E.J.-R.); (J.E.T.-L.); (H.A.-M.); (V.O.-H.); (L.C.P.-C.); (J.C.D.-Z.)
| | - Leydi C. Palma-Cordova
- Centro de Investigación, DACS, Universidad Juarez Autónoma de Tabasco (UJAT), Villahermosa, Tabasco 86150, Mexico; (I.E.J.-R.); (J.E.T.-L.); (H.A.-M.); (V.O.-H.); (L.C.P.-C.); (J.C.D.-Z.)
| | - Juan C. Diaz-Zagoya
- Centro de Investigación, DACS, Universidad Juarez Autónoma de Tabasco (UJAT), Villahermosa, Tabasco 86150, Mexico; (I.E.J.-R.); (J.E.T.-L.); (H.A.-M.); (V.O.-H.); (L.C.P.-C.); (J.C.D.-Z.)
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de Souza RJ, Bray GA, Carey VJ, Hall KD, LeBoff MS, Loria CM, Laranjo NM, Sacks FM, Smith SR. Effects of 4 weight-loss diets differing in fat, protein, and carbohydrate on fat mass, lean mass, visceral adipose tissue, and hepatic fat: results from the POUNDS LOST trial. Am J Clin Nutr 2012; 95:614-25. [PMID: 22258266 PMCID: PMC3278241 DOI: 10.3945/ajcn.111.026328] [Citation(s) in RCA: 121] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Weight loss reduces body fat and lean mass, but whether these changes are influenced by macronutrient composition of the diet is unclear. OBJECTIVE We determined whether energy-reduced diets that emphasize fat, protein, or carbohydrate differentially reduce total, visceral, or hepatic fat or preserve lean mass. DESIGN In a subset of participants in a randomized trial of 4 weight-loss diets, body fat and lean mass (n = 424; by using dual-energy X-ray absorptiometry) and abdominal and hepatic fat (n = 165; by using computed tomography) were measured after 6 mo and 2 y. Changes from baseline were compared between assigned amounts of protein (25% compared with 15%) and fat (40% compared with 20%) and across 4 carbohydrate amounts (35% through 65%). RESULTS At 6 mo, participants lost a mean (±SEM) of 4.2 ± 0.3 kg (12.4%) fat and 2.1 ± 0.3 kg (3.5%) lean mass (both P < 0.0001 compared with baseline values), with no differences between 25% and 15% protein (P ≥ 0.10), 40% and 20% fat (P ≥ 0.34), or 65% and 35% carbohydrate (P ≥ 0.27). Participants lost 2.3 ± 0.2 kg (13.8%) abdominal fat: 1.5 ± 0.2 kg (13.6%) subcutaneous fat and 0.9 ± 0.1 kg (16.1%) visceral fat (all P < 0.0001 compared with baseline values), with no differences between the diets (P ≥ 0.29). Women lost more visceral fat than did men relative to total-body fat loss. Participants regained ~40% of these losses by 2 y, with no differences between diets (P ≥ 0.23). Weight loss reduced hepatic fat, but there were no differences between groups (P ≥ 0.28). Dietary goals were not fully met; self-reported contrasts were closer to 2% protein, 8% fat, and 14% carbohydrate at 6 mo and 1%, 7%, and 10%, respectively, at 2 y. CONCLUSION Participants lost more fat than lean mass after consumption of all diets, with no differences in changes in body composition, abdominal fat, or hepatic fat between assigned macronutrient amounts. This trial was registered at clinicaltrials.gov as NCT00072995.
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Affiliation(s)
- Russell J de Souza
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
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Hambly C, Duncan JS, Archer ZA, Moar KM, Mercer JG, Speakman JR. Repletion of TNFα or leptin in calorically restricted mice suppresses post-restriction hyperphagia. Dis Model Mech 2012; 5:83-94. [PMID: 21954068 PMCID: PMC3255546 DOI: 10.1242/dmm.007781] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Accepted: 08/02/2011] [Indexed: 11/30/2022] Open
Abstract
The causes of post-restriction hyperphagia (PRH) represent a target for drug-based therapies to prevent obesity. However, the factors causing PRH are poorly understood. We show that, in mice, the extent of PRH was independent of the time under restriction, but depended on its severity, suggesting that PRH was driven by signals from altered body composition. Signals related to fat mass were important drivers. Circulating levels of leptin and TNFα were significantly depleted following caloric restriction (CR). We experimentally repleted their levels to match those of controls, and found that in both treatment groups the level of PRH was significantly blunted. These data establish a role for TNFα and leptin in the non-pathological regulation of energy homeostasis. Signals from adipose tissue, including but not limited to leptin and TNFα, regulate PRH and might be targets for therapies that support people engaged in CR to reduce obesity.
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Affiliation(s)
- Catherine Hambly
- Aberdeen Centre for Energy Regulation and Obesity (ACERO), Rowett Institute of Nutrition and Health, University of Aberdeen, Bucksburn, Aberdeen AB21 9SB, Scotland, UK
- ACERO, Institute of Biological and Environmental Science, University of Aberdeen, Aberdeen, AB24 2TZ, Scotland, UK
| | - Jacqueline S. Duncan
- Aberdeen Centre for Energy Regulation and Obesity (ACERO), Rowett Institute of Nutrition and Health, University of Aberdeen, Bucksburn, Aberdeen AB21 9SB, Scotland, UK
| | - Zoë A. Archer
- Aberdeen Centre for Energy Regulation and Obesity (ACERO), Rowett Institute of Nutrition and Health, University of Aberdeen, Bucksburn, Aberdeen AB21 9SB, Scotland, UK
| | - Kim M. Moar
- Aberdeen Centre for Energy Regulation and Obesity (ACERO), Rowett Institute of Nutrition and Health, University of Aberdeen, Bucksburn, Aberdeen AB21 9SB, Scotland, UK
| | - Julian G. Mercer
- Aberdeen Centre for Energy Regulation and Obesity (ACERO), Rowett Institute of Nutrition and Health, University of Aberdeen, Bucksburn, Aberdeen AB21 9SB, Scotland, UK
| | - John R. Speakman
- Aberdeen Centre for Energy Regulation and Obesity (ACERO), Rowett Institute of Nutrition and Health, University of Aberdeen, Bucksburn, Aberdeen AB21 9SB, Scotland, UK
- ACERO, Institute of Biological and Environmental Science, University of Aberdeen, Aberdeen, AB24 2TZ, Scotland, UK
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A review of the evidence for the effects of total dietary fat, saturated, monounsaturated and n-6 polyunsaturated fatty acids on vascular function, endothelial progenitor cells and microparticles. Br J Nutr 2011; 107:303-24. [DOI: 10.1017/s0007114511004764] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Vascular dysfunction is recognised as an integrative marker of CVD. While dietary strategies aimed at reducing CVD risk include reductions in the intake of SFA, there are currently no clear guidelines on what should replace SFA. The purpose of this review was to assess the evidence for the effects of total dietary fat and individual fatty acids (SFA, MUFA and n-6 PUFA) on vascular function, cellular microparticles and endothelial progenitor cells. Medline was systematically searched from 1966 until November 2010. A total of fifty-nine peer-reviewed publications (covering fifty-six studies), which included five epidemiological, eighteen dietary intervention and thirty-three test meal studies, were identified. The findings from the epidemiological studies were inconclusive. The limited data available from dietary intervention studies suggested a beneficial effect of low-fat diets on vascular reactivity, which was strongest when the comparator diet was high in SFA, with a modest improvement in measures of vascular reactivity when high-fat, MUFA-rich diets were compared with SFA-rich diets. There was consistent evidence from the test meal studies that high-fat meals have a detrimental effect on postprandial vascular function. However, the evidence for the comparative effects of test meals rich in MUFA or n-6 PUFA with SFA on postprandial vascular function was limited and inconclusive. The lack of studies with comparable within-study dietary fatty acid targets, a variety of different study designs and different methods for determining vascular function all confound any clear conclusions on the impact of dietary fat and individual fatty acids on vascular function.
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Haufe S, Utz W, Engeli S, Kast P, Böhnke J, Pofahl M, Traber J, Haas V, Hermsdorf M, Mähler A, Busjahn A, Wiesner S, Otto C, Mehling H, Luft FC, Boschmann M, Schulz-Menger J, Jordan J. Left ventricular mass and function with reduced-fat or reduced-carbohydrate hypocaloric diets in overweight and obese subjects. Hypertension 2011; 59:70-5. [PMID: 22068866 DOI: 10.1161/hypertensionaha.111.178616] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
In animals, carbohydrate and fat composition during dietary interventions influenced cardiac metabolism, structure, and function. Because reduced-carbohydrate and reduced-fat hypocaloric diets are commonly used in the treatment of obesity, we investigated whether these interventions differentially affect left ventricular mass, cardiac function, and blood pressure. We randomized 170 overweight and obese subjects (body mass index, 32.9±4.4; range, 26.5-45.4 kg/m(2)) to 6-month hypocaloric diets with either reduced carbohydrate intake or reduced fat intake. We obtained cardiac MRI and ambulatory blood pressure recordings over 24 hours before and after 6 months. Ninety subjects completing the intervention period had a full cardiac MRI data set. Subjects lost 7.3±4.0 kg (7.9±3.8%) with reduced-carbohydrate diet and 6.2±4.2 kg (6.7±4.4%) with reduced-fat diet (P<0.001 within each group; P=not significant between interventions). Caloric restriction led to similar significant decreases in left ventricular mass with low-carbohydrate diets (5.4±5.4 g) or low-fat diets (5.2±4.8 g; P<0.001 within each group; P=not significant between interventions). Systolic and diastolic left ventricular function did not change with either diet. The 24-hour systolic blood pressure decreased similarly with both interventions. Body weight change (β=0.33; P=0.02) and percentage of ingested n-3 polyunsaturated fatty acids (β=-0.27; P=0.03) predicted changes in left ventricular mass. In conclusion, weight loss induced by reduced-fat diets or reduced-carbohydrate diets similarly improved left ventricular mass in overweight and obese subjects over a 6-month period. However, n-3 polyunsaturated fatty acid ingestion may have an independent beneficial effect on left ventricular mass.
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Affiliation(s)
- Sven Haufe
- Franz Volhard Clinical Research Center at the Experimental and Clinical Research Center, Charité University Medical Faculty and Max-Delbrück Center for Molecular Medicine, Berlin, Germany
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Frigolet ME, Ramos Barragán VE, Tamez González M. Low-carbohydrate diets: a matter of love or hate. ANNALS OF NUTRITION AND METABOLISM 2011; 58:320-34. [PMID: 21985780 DOI: 10.1159/000331994] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Accepted: 08/18/2011] [Indexed: 12/14/2022]
Abstract
Low-carbohydrate diets (LChD) have become very popular among the general population. These diets have been used to lose body weight and to ameliorate various abnormalities like diabetes, nonalcoholic fatty liver disease, polycystic ovary syndrome, narcolepsy, epilepsy, and others. Reports suggest that body weight reduction and glycemic control could be attained while following LChD. However, these advantages are more notably found in short periods of time consuming an LChD. Indeed, the safety and efficacy of the latter diets in the long term have not been sufficiently explored. In contrast to what has been proposed, other mentioned pathologies are not improved or are even worsened by carbohydrate restriction. Therefore, the aim of this review is to define the concept of LChD and to explain their clinical effects in the short and long term, their influence on metabolism, and the opinion of nutrition or health authorities. Finally, evincing the research gaps of LChD that are here exposed will later allow us to reach a consensus with regard to their utilization.
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