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Nutrition Journal Feb 2017Intentional weight loss in obese older adults is a risk factor for accelerated muscle mass loss. We investigated whether a high protein diet and/or resistance exercise... (Randomized Controlled Trial)
Randomized Controlled Trial
Effect of a high protein diet and/or resistance exercise on the preservation of fat free mass during weight loss in overweight and obese older adults: a randomized controlled trial.
BACKGROUND
Intentional weight loss in obese older adults is a risk factor for accelerated muscle mass loss. We investigated whether a high protein diet and/or resistance exercise preserves fat free mass (FFM) during weight loss in overweight and obese older adults.
METHODS
We included 100 overweight and obese adults (55-80 year) in a randomized controlled trial (RCT) with a 2 × 2 factorial design and intention-to-treat analysis. During a 10-week weight loss program all subjects followed a hypocaloric diet. Subjects were randomly allocated to either a high protein (1.3 g/kg body weight) or normal protein diet (0.8 g/kg), with or without a resistance exercise program 3 times/week. FFM was assessed by air displacement plethysmography.
RESULTS
At baseline, mean (±SD) BMI was 32 ± 4 kg/m. During intervention, protein intake was 1.13 ± 0.35 g/kg in the high protein groups vs. 0.98 ± 0.29 in the normal protein groups, which reflects a 16.3 ± 5.2 g/d higher protein intake in the high protein groups. Both high protein diet and exercise did not significantly affect change in body weight, FFM and fat mass (FM). No significant protein*exercise interaction effect was observed for FFM. However, within-group analysis showed that high protein in combination with exercise significantly increased FFM (+0.6 ± 1.3 kg, p = 0.011).
CONCLUSION
A high protein diet, though lower than targeted, did not significantly affect changes in FFM during modest weight loss in older overweight and obese adults. There was no significant interaction between the high protein diet and resistance exercise for change in FFM. However, only the group with the combined intervention of high protein diet and resistance exercise significantly increased in FFM.
TRIAL REGISTRATION
Dutch Trial Register, number NTR4556, date 05-01-2014.
Topics: Aged; Aged, 80 and over; Body Composition; Body Mass Index; Caloric Restriction; Diet, High-Protein; Diet, Reducing; Dietary Fats; Dietary Proteins; Female; Hand Strength; Humans; Male; Middle Aged; Obesity; Overweight; Patient Compliance; Resistance Training; Treatment Outcome; Waist Circumference; Weight Loss
PubMed: 28166780
DOI: 10.1186/s12937-017-0229-6 -
International Journal of Molecular... Dec 2018The growing prevalence of metabolic syndrome (MetS) in the U.S. and even worldwide is becoming a serious health problem and economic burden. MetS has become a crucial... (Review)
Review
The growing prevalence of metabolic syndrome (MetS) in the U.S. and even worldwide is becoming a serious health problem and economic burden. MetS has become a crucial risk factor for the development of type 2 diabetes mellitus (T2D) and cardiovascular diseases (CVD). The rising rates of CVD and diabetes, which are the two leading causes of death, simultaneously exist. To prevent the progression of MetS to diabetes and CVD, we have to understand how MetS occurs and how it progresses. Too many causative factors interact with each other, making the investigation and treatment of metabolic syndrome a very complex issue. Recently, a number of studies were conducted to investigate mechanisms and interventions of MetS, from different aspects. In this review, the proposed and demonstrated mechanisms of MetS pathogenesis are discussed and summarized. More importantly, different interventions are discussed, so that health practitioners can have a better understanding of the most recent research progress and have available references for their daily practice.
Topics: Animals; Diet Therapy; Humans; Insulin Resistance; Metabolic Syndrome; Oxidative Stress; Signal Transduction
PubMed: 30602666
DOI: 10.3390/ijms20010128 -
Advances in Nutrition (Bethesda, Md.) Nov 2019Dietary modifications, including caloric restriction, dietary restriction, various intervals of fasting, and even limiting the time when food is consumed can have a... (Review)
Review
Dietary modifications, including caloric restriction, dietary restriction, various intervals of fasting, and even limiting the time when food is consumed can have a pronounced impact on longevity. In addition, dietary modifications are powerful interventions to delay, prevent, or treat many aging-related diseases such as cancer and diabetes. Restricting amino acid and protein intake generally decreases aging-related comorbidities and thereby increases health and longevity. However, chronic dietary interventions are likely not feasible for most people due to low adherence to dietary protocols or resistance to drastic changes to lifestyle, and might even cause detrimental effects, possibly by negatively affecting the immune system and wound healing. The periodic use of low-protein, low-calorie fasting-mimicking diets (FMDs) has the potential to promote health benefits, while minimizing the burden of chronic restriction. Protein restriction and FMDs together have the potential to play an important complementary role in medicine by promoting disease prevention and treatment, and by delaying the aging process at least in part by stimulating stem cell-based regeneration in periods of normal food intake after periodic FMD cycles. The aim of this narrative review is to summarize research on the impact of protein restriction on health and longevity in model organisms and to discuss the implementation of an FMD in mice and in human clinical trials and its effects on biomarkers of healthy aging. Taking into account the importance of sex on aging and diet, we include this information in all discussed studies. Whereas for some model organisms of aging, such as rodents, many studies are available, results are more limited for primates and/or humans.
Topics: Aging; Animals; Caloric Restriction; Diabetes Mellitus; Diet, Protein-Restricted; Dietary Proteins; Energy Intake; Fasting; Feeding Behavior; Female; Healthy Aging; Humans; Longevity; Male; Neoplasms
PubMed: 31728501
DOI: 10.1093/advances/nmz079 -
Journal of the American College of... Dec 2017Both sodium reduction and the DASH (Dietary Approaches to Stop Hypertension) diet, a diet rich in fruits, vegetables, and low-fat dairy products, and reduced in... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Both sodium reduction and the DASH (Dietary Approaches to Stop Hypertension) diet, a diet rich in fruits, vegetables, and low-fat dairy products, and reduced in saturated fat and cholesterol, lower blood pressure. The separate and combined effects of these dietary interventions by baseline blood pressure (BP) has not been reported.
OBJECTIVES
The authors compared the effects of low versus high sodium, DASH versus control, and both (low sodium-DASH vs. high sodium-control diets) on systolic blood pressure (SBP) by baseline BP.
METHODS
In the DASH-Sodium (Dietary Patterns, Sodium Intake and Blood Pressure) trial, adults with pre- or stage 1 hypertension and not using antihypertensive medications, were randomized to either DASH or a control diet. On either diet, participants were fed each of 3 sodium levels (50, 100, and 150 mmol/day at 2,100 kcal) in random order over 4 weeks separated by 5-day breaks. Strata of baseline SBP were <130, 130 to 139, 140 to 149, and ≥150 mm Hg.
RESULTS
Of 412 participants, 57% were women, and 57% were black; mean age was 48 years, and mean SBP/diastolic BP was 135/86 mm Hg. In the context of the control diet, reducing sodium (from high to low) was associated with mean SBP differences of -3.20, -8.56, -8.99, and -7.04 mm Hg across the respective baseline SBP strata listed (p for trend = 0.004). In the context of high sodium, consuming the DASH compared with the control diet was associated with mean SBP differences of -4.5, -4.3, -4.7, and -10.6 mm Hg, respectively (p for trend = 0.66). The combined effects of the low sodium-DASH diet versus the high sodium-control diet on SBP were -5.3, -7.5, -9.7, and -20.8 mm Hg, respectively (p for trend <0.001).
CONCLUSIONS
The combination of reduced sodium intake and the DASH diet lowered SBP throughout the range of pre- and stage 1 hypertension, with progressively greater reductions at higher levels of baseline SBP. SBP reductions in adults with the highest levels of SBP (≥150 mm Hg) were striking and reinforce the importance of both sodium reduction and the DASH diet in this high-risk group. Further research is needed to determine the effects of these interventions among adults with SBP ≥160 mm Hg. (Dietary Patterns, Sodium Intake and Blood Pressure [DASH-Sodium]; NCT00000608).
Topics: Adult; Blood Pressure; Diet, Sodium-Restricted; Dietary Approaches To Stop Hypertension; Female; Fruit; Humans; Hypertension; Life Style; Male; Middle Aged; Sodium, Dietary; Treatment Outcome; Vegetables
PubMed: 29141784
DOI: 10.1016/j.jacc.2017.10.011 -
Annals of Medicine 2019Fibromyalgia (FM) is a chronic non-degenerative disease, whose nutritional therapy seems controversial. This systematic review aimed to synthesize the knowledge about...
Fibromyalgia (FM) is a chronic non-degenerative disease, whose nutritional therapy seems controversial. This systematic review aimed to synthesize the knowledge about the effect of dietary interventions on patient-reported outcomes (PRO) and inflammation in patients with FM. Six electronic databases - PubMed, BioMed Central, Cochrane library, EMBASE, LILACS and ISI - were searched for clinical trials, in which a dietary intervention in patients with FM diagnosed was conducted. Quality of evidence assessment was measured in accordance with GRADE methodology. Seven clinical trials - 3 randomized controlled trials, 1 unrandomized clinical trial and 3 uncontrolled clinical trials were identified. Dietary approaches included gluten-free diet ( = 1), raw vegetarian diet ( = 2), low Fermentable oligo-, di- and monossacharides, alcohols and polyols (FODMAPs) diet ( = 1), hypocaloric diet ( = 2) and monosodium glutamate- and aspartame-free diet interventions ( = 1). The major PRO were pain and functional repercussion, with 5 out of 7 studies reporting an improvement. The progress in secondary outcomes was reported for fatigue (2/5 studies), sleep quality (2/3 studies), depression and anxiety (3/6 studies), quality of life (4/5 studies), gastrointestinal symptoms (1/2 studies) and inflammatory biomarkers (1/1 study). However, according to Cochrane Risk of Bias, these studies had poor statistical quality. Well-designed studies should be performed to investigate the dietary interventions effect on FM. Key messages Fibromyalgia (FM) is a chronic non-degenerative disease, whose nutritional therapy seems controversial but promising. Pain and functional repercussion in FM patients seem to improve with a hypocaloric diet, a raw vegetarian diet or a low FODMAPs diet, as much as quality of life, quality of sleep, anxiety and depression and inflammatory biomarkers. Existing studies in this subject are scarce and low quality, which does not allow conclusions to be drawn.
Topics: Chronic Disease; Diet, Carbohydrate-Restricted; Diet, Gluten-Free; Diet, Reducing; Fibromyalgia; Humans; Quality of Life
PubMed: 30735059
DOI: 10.1080/07853890.2018.1564360 -
Current Nutrition Reports Sep 2018The goal of this paper is to review current literature on nutritional ketosis within the context of weight management and metabolic syndrome, namely, insulin resistance,... (Review)
Review
PURPOSE OF REVIEW
The goal of this paper is to review current literature on nutritional ketosis within the context of weight management and metabolic syndrome, namely, insulin resistance, lipid profile, cardiovascular disease risk, and development of non-alcoholic fatty liver disease. We provide background on the mechanism of ketogenesis and describe nutritional ketosis.
RECENT FINDINGS
Nutritional ketosis has been found to improve metabolic and inflammatory markers, including lipids, HbA1c, high-sensitivity CRP, fasting insulin and glucose levels, and aid in weight management. We discuss these findings and elaborate on potential mechanisms of ketones for promoting weight loss, decreasing hunger, and increasing satiety. Humans have evolved with the capacity for metabolic flexibility and the ability to use ketones for fuel. During states of low dietary carbohydrate intake, insulin levels remain low and ketogenesis takes place. These conditions promote breakdown of excess fat stores, sparing of lean muscle, and improvement in insulin sensitivity.
Topics: Diet, Ketogenic; Humans; Metabolic Syndrome; Obesity; Weight Loss
PubMed: 30128963
DOI: 10.1007/s13668-018-0235-0 -
Revista Medica de Chile Jan 2017The Mediterranean diet is currently considered a healthy dietary pattern. It includes a great variety of foods, which are eaten in moderation and within a positive... (Review)
Review
The Mediterranean diet is currently considered a healthy dietary pattern. It includes a great variety of foods, which are eaten in moderation and within a positive social environment. The generic term "Mediterranean diet" was born after the "Seven Countries Study" led by Ancel Keys around 1960. This dietary pattern is characterized by a high intake of fruits and vegetables, whole grains, legumes, nuts, fish, white meats and olive oil. It also includes moderate consumption of fermented dairy products, low intake of red meat and drinking wine with moderation during meals. Nutritionally, this diet is low in saturated fats and animal protein, high in antioxidants, fiber and monounsaturated fats, and exhibits an adequate omega-6/omega-3 fatty acid balance. The main bioactive compounds, which explain the health benefits of this dietary pattern, are antioxidants, fiber, monounsaturated and omega-3 fatty acids, phytosterols and probiotics. This diet is not exclusively confined to the Mediterranean Basin. Central Chile has a Mediterranean climate and our agriculture and culinary traditions are similar to those found in Mediterranean countries. Therefore, it is fundamental to increase awareness about the richness of our natural produce as well as our culinary culture, which may bring many health benefits and improve the quality of life in our population.
Topics: Chile; Diet Therapy; Diet, Mediterranean; Food; Humans; Quality of Life
PubMed: 28393974
DOI: 10.4067/S0034-98872017000100012 -
BMJ (Clinical Research Ed.) Jun 2018Common ground on dietary approaches for the prevention, management, and potential remission of type 2 diabetes can be found, argue (Review)
Review
Common ground on dietary approaches for the prevention, management, and potential remission of type 2 diabetes can be found, argue
Topics: Diabetes Mellitus, Type 2; Diet, Carbohydrate-Restricted; Humans; Practice Guidelines as Topic; Remission Induction
PubMed: 29898883
DOI: 10.1136/bmj.k2234 -
Nutrients Mar 2021Despite being a focal issue to patients, the effect of diet on adult inflammatory bowel disease (IBD) remains underexplored with limited guidance. While promising... (Review)
Review
Despite being a focal issue to patients, the effect of diet on adult inflammatory bowel disease (IBD) remains underexplored with limited guidance. While promising clinical trials are currently underway, there is a need for further evidence-based recommendations. As such, we summarize the current evidence on various diets used in the treatment of IBD and also explore the potential applications of dietary data from related immune-mediated inflammatory diseases (IMIDs), such as rheumatoid arthritis and psoriasis, to provide additional information to inform IBD providers. To date, there have been multiple diets investigated as adjunctive therapy in IBD, but many associated studies are small, non-randomized, and not controlled. Mediterranean, vegetarian/vegan, and reduced-calorie/fasting diets have been studied and have shown some positive results in other IMIDs, which may suggest potential applicability to those with IBD, but larger, well-designed clinical trials are needed for further guidance. Gluten-free and low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP)diets do not appear to have an impact on IBD disease activity, but low FODMAP may potentially be helpful for those with concurrent functional gastrointestinal symptoms. Specific carbohydrate diets have been mainly assessed in children but show some potential in small adult studies.
Topics: Arthritis, Rheumatoid; Caloric Restriction; Diet; Diet, Carbohydrate-Restricted; Diet, Gluten-Free; Diet, High-Protein Low-Carbohydrate; Diet, Mediterranean; Diet, Paleolithic; Diet, Vegan; Diet, Vegetarian; Fasting; Humans; Inflammatory Bowel Diseases; Psoriasis
PubMed: 33801883
DOI: 10.3390/nu13030890 -
Effect of green-Mediterranean diet on intrahepatic fat: the DIRECT PLUS randomised controlled trial.Gut Nov 2021To examine the effectiveness of green-Mediterranean (MED) diet, further restricted in red/processed meat, and enriched with green plants and polyphenols on non-alcoholic... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To examine the effectiveness of green-Mediterranean (MED) diet, further restricted in red/processed meat, and enriched with green plants and polyphenols on non-alcoholic fatty liver disease (NAFLD), reflected by intrahepatic fat (IHF) loss.
DESIGN
For the DIRECT-PLUS 18-month randomized clinical trial, we assigned 294 participants with abdominal obesity/dyslipidaemia into healthy dietary guidelines (HDG), MED and green-MED weight-loss diet groups, all accompanied by physical activity. Both isocaloric MED groups consumed 28 g/day walnuts (+440 mg/day polyphenols provided). The green-MED group further consumed green tea (3-4 cups/day) and Mankai (a aquatic plant strain; 100 g/day frozen cubes) green shake (+1240 mg/day total polyphenols provided). IHF% 18-month changes were quantified continuously by proton magnetic resonance spectroscopy (MRS).
RESULTS
Participants (age=51 years; 88% men; body mass index=31.3 kg/m; median IHF%=6.6%; mean=10.2%; 62% with NAFLD) had 89.8% 18-month retention-rate, and 78% had eligible follow-up MRS. Overall, NAFLD prevalence declined to: 54.8% (HDG), 47.9% (MED) and 31.5% (green-MED), p=0.012 between groups. Despite similar moderate weight-loss in both MED groups, green-MED group achieved almost double IHF% loss (-38.9% proportionally), as compared with MED (-19.6% proportionally; p=0.035 weight loss adjusted) and HDG (-12.2% proportionally; p<0.001). After 18 months, both MED groups had significantly higher total plasma polyphenol levels versus HDG, with higher detection of and 2-5-dihydroxybenzoic-acid in green-MED. Greater IHF% loss was independently associated with increased Mankai and walnuts intake, decreased red/processed meat consumption, improved serum folate and adipokines/lipids biomarkers, changes in microbiome composition (beta-diversity) and specific bacteria (p<0.05 for all).
CONCLUSION
The new suggested strategy of green-Mediterranean diet, amplified with green plant-based proteins/polyphenols as Mankai, green tea, and walnuts, and restricted in red/processed meat can double IHF loss than other healthy nutritional strategies and reduce NAFLD in half.
TRIAL REGISTRATION NUMBER
NCT03020186.
Topics: Araceae; Diet, Mediterranean; Diet, Reducing; Female; Humans; Male; Middle Aged; Non-alcoholic Fatty Liver Disease; Polyphenols; Tea
PubMed: 33461965
DOI: 10.1136/gutjnl-2020-323106